目的开发综合营养认知、食欲及机体功能等评价进行营养风险筛查的量表，并进行信效度验证。 方法 在文献回顾、患者访谈及项目组讨论的基础上确定量表维度、形成条目池，经过德尔斐专家咨询形成原始量表。选取首都医科大学附属北京世纪坛医院104例肿瘤患者进行调查，检验量表的信效度。 结果 最终形成的肿瘤患者营养认知-食欲-功能（nutrition belief-appetite-function， BAF）评估量表包括营养认知、食欲和功能指标3个维度，共13个条目。项目分析时发现各条目和总分的相关系数均＞0.3，各条目的决断值均达到预设标准，故不考虑删除条目。本量表的分半信度为0.750，各维度的分半信度为0.590～0.847；量表的Cronbachs α系数为0.806，各维度的Cronbachs α系数为0.631～0.866，营养认知和功能维度的系数未达到理想状态；量表的重测信度为0.784，各维度的重测信度为0.588～0.721。量表效度分析方面，各维度与总量表间得分的相关系数为0.539～0.890，均有显著性；结构性因子分析提取2个公因子，累计方差贡献率为56.36%，删除2个条目后得到营养认知和食欲及功能相关的两个维度；量表总分及各维度得分均与NRS 2002的显著正相关。 结论 编制的肿瘤患者BAF评估量表具有较好的信效度，可有效评估肿瘤患者的营养风险。
Abstract
ObjectiveTo develop a nutritional risk screening scale of cancer patients containing assessments of nutrition belief, appetite, and physical function, and to test its reliability and validity. MethodsThe evaluation dimensions were determined on the basis of literature review, patients interview, and research group discussion, and then the items pool was formed. The initial scale was developed by Delphi expert advisory. A total of 104 cancer patients in Beijing Shijitan Hospital were selected as subjects. The reliability and validity of the scale were tested. ResultsThe final nutrition belief-appetite-function (BAF) scale included the following 3 dimensions: nutritional belief, appetite, and physical functions, and 13 items. In the item analysis, the correlation coefficients with the total points of the scale and the Critical ratio (CR) of every item met the preset standards, without deleting any items. The split-half reliability of the BAF scale was 0.750, from 0.590 to 0.847 of each dimension. The Cronbachs α coefficient of the BAF scale was 0.806, from 0.631 to 0.866 of each dimension. The retest reliability coefficient was 0.784, from 0.588 to 0.721 of each dimension. The correlation coefficients of each dimension with the total points of the scale were from 0.539 to 0.890, and all were significant. Exploratory factor analysis (EFA) extracted 2 factors, whose cumulative contribution of variance accounted for 56.36%, and 2 items were deleted. The total points of the scale and the points of each dimension were all positively correlated with Nutritional risk screening 2002 (NRS 2002). ConclusionThe BAF scale has good reliability and validity. The scale can be used as a screening tool for evaluating the nutritional risk of cancer patients.
关键词
肿瘤 /
营养认知 /
食欲 /
功能 /
量表 /
信度 /
效度
Key words
Cancer /
Nutrition belief /
Appetite /
Function；Scale /
Reliability /
Validity
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参考文献
1.解红文, 贾静, 孙英,等. 胃肠肿瘤手术患者营养风险评估及临床结果的调查分析［J］. 中华现代护理杂志, 2011,17(21):2572-2573.
2.许静涌,唐普贤,陈伟,等. 老年肿瘤患者营养风险、营养不良及营养治疗情况调查［J/CD］. 肿瘤代谢与营养电子杂志, 2018,5(2):159-164.
3.ZHANG X, TANG T, PANG L, et al. Malnutrition and overall survival in older adults with cancer: a systematic review and meta-analysis［J］. J Geriatr Oncol, 2019,10(6):874-883.
4.DE PINHO N B, MARTUCCI R B, RODRIGUES V D, et al. High prevalence of malnutrition and nutrition impact symptoms in older patients with cancer: Results of a Brazilian multicenter study［J］. Cancer, 2020,126(1):156-164.
5.ZHANG F, JIN Y, QIANG W. The effects of dietary advice on malnutrition in Cancer patients: a systematic review and meta-analysis［J］. Support Care Cancer, 2020,28(4):1579-1585.
6.MUELLER C, COMPHER C, ELLEN D M, et al. A.S.P.E.N. clinical guidelines:nutrition screening, assessment, and intervention in adults［J］. J Parenter Enteral Nutr, 2011,35(1):16-24.
7.张春宏,熊祥玲. 某区养老院老年人营养知识调查［J］. 中国老年学杂志, 2015,35(4):1102-1103.
8.黄英,刘艳瑰,杨彩霞. 烧伤患者营养相关生化检查及营养知识、态度、行为调查分析［J］. 广东医学, 2020,41(7):688-691.
9.刘兵兵,杜红珍,李增宁,等.恶性肿瘤患者食欲素A水平变化及其与营养相关性研究［J］.中华肿瘤防治杂志,2016,23(2):101-104.
10.杜红珍,魏雨佳,张玲玲,等. 肿瘤患者食欲的评价及药物干预［J/CD］. 肿瘤代谢与营养电子杂志, 2017,4(1):120-124.
11.屈清荣,石佩玉,杨程舒, 等.胃癌患者主要家庭照顾者营养知识认知水平及需求调查分析［J］.中国实用护理杂志,2018,34(22):1730-1734.
12.毕研霞,洪忠新,张立红,等. 肿瘤化疗患者存在营养风险的相关因素研究［J］. 中国全科医学, 2018,21(6):694-697.
13.郑智慧,姜小鹰,陈艳清. AIDS临床护理服务质量标准指标体系的初步构建［J］. 中华护理杂志, 2013,48(1):66-70.
14.刘晨星,张文光,李瑶,等. 脑卒中病人出院准备度评估量表的编制［J］. 护理研究, 2020,34(15):2671-2675.
15.王蕾蕾,陈秋霞,张片红,等. 营养教育对病人营养风险筛查和营养支持效果的影响［J］. 肠外与肠内营养, 2014,21(5):270-272.
16.OH S Y, KOH S J, BAEK J Y, et al. Validity and reliability of korean version of simplified nutritional appetite questionnaire in patients with advanced cancer: a multicenter, longitudinal study［J］. Cancer Res Treat, 2019,51(4):1612-1619.
17.LELLI D, TOLONE S, PULIGNANO G, et al. Nutritional status is associated with physical function and disability in older adults with chronic heart failure［J］. Eur J Intern Med, 2020,74:73-78.
18.KONDRUP J, RASMUSSEN HH, HAMBERG O, et al. Nutritional risk screening (NRS 2002): a new method based on an analysis of controlled clinical trials［J］. Clin Nutr, 2003,22(3):321-336.
19.孙海嵩. 住院病人的营养误区［J］. 实用全科医学, 2003,1(2):152.
20.郭志学, 冯新,宋新梅,等．保定市第二医院住院肿瘤病人营养风险及营养支持状况分析［J］．饮食保健,2019,6(21):60-61
21.WILSON M-MG, THOMAS D R, RUBENSTEIN L Z, et al. Appetite assessment: simple appetite questionnaire predicts weight loss in community-dwelling adults and nursing home residents［J］. Am J Clin Nutr, 2005,82(5):1074-1081.
22.MUDGE A M, ROSS L J, YOUNG A M, et al. Helping understand nutritional gaps in the elderly (HUNGER): a prospective study of patient factors associated with inadequate nutritional intake in older medical inpatients［J］. Clin Nutr, 2011,30(3):320-325.
23.LANDI F, LIPEROTI R, LATTANZIO F, et al. Effects of anorexia on mortality among older adults receiving home care: an observation study［J］. J Nutr Health Aging, 2012,16(1):79-83.
24.ROLLAND Y, PERRIN A, GARDETTE V, et al. Screening older people at risk of malnutrition or malnourished using the Simplified Nutritional Appetite Questionnaire (SNAQ): a comparison with the Mini-Nutritional Assessment (MNA) tool［J］. J Am Med Dir Assoc, 2012,13(1):31-34.
25.NAKATSU N, SAWA R, MISU S, et al. Reliability and validity of the Japanese version of the simplified nutritional appetite questionnaire in community-dwelling older adults［J］. Geriatr Gerontol Int, 2015,15(12):1264-1269.
26.KONDRUP J, ALLISON S P, ELIA M, et al. ESPEN guidelines for nutrition screening 2002［J］. Clin Nutr, 2003,22(4):415-421.
27.WELENDORF C, NICOLETTI C F, PINHEL M A D S, et al. Obesity, weight loss, and influence on telomere length: New insights for personalized nutrition［J］. Nutrition, 2019,66:115-121.
28.吴明隆. 问卷统计分析实务——SPSS操作与应用［M］. 重庆: 重庆大学出版社,2010.
29.顾仁萍,杨媛媛. 军人心理求助障碍量表的汉化及信度效度检验［J］. 第二军医大学学报, 2020,41(3):339-341.
30.李祯,王洁,陶沙,等. 癌症健康素养量表汉化及信效度评价［J］. 中国健康教育, 2020,36(5):402-407,410.
基金
国家重点研发计划项目(2017YFC1309203)
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