Preparation And Preliminary Application Of Diet Self-Management Assessment Scale For Non-Dialysis Patients With Chronic Kidney Disease

Research objectives(1)To compile the diet self-management assessment scale for non-dialysis patients with chronic kidney disease,and to test its reliability and validity.(2)The formal scale was used to investigate the status quo of diet self-management in non-dialysis patients with chronic kidney disease and to explore the influencing factors,so as to provide evidence for the subsequent formulation of intervention measures.Research methods(1)Semi-structured interviews were conducted on non-dialysis patients with chronic kidney disease and medical care,combined with literature review and multiple discussions by the subject group,and the initial item pool of the scale was formed by referring to existing self-management assessment tools.(2)Delphi expert letter consultation method: 17 experts from Jiangsu and Anhui were selected to conduct two rounds of letter consultation on the scale.The dimensions and items of the scale were supplemented and modified based on the expert opinions,and the initial evaluation scale was formed on this basis.(3)Reliability and validity test of the initial assessment scale: convenient sampling method was used to conduct a questionnaire survey on 243 patients from three universities in Zhenjiang and Suqian.Items were further selected by critical ratio method,correlation coefficient method and homogeneity test,and exploratory factor analysis method was used to determine the scale dimensions.Cronbach’s a coefficient and split half reliability were used to evaluate the reliability of the scale.The structural validity of the scale was tested by correlation analysis,and the Person correlation coefficients between each item and each dimension,and between each dimension and the total table were discussed.The content validity of each item was evaluated by experts and the final scale was formed.(4)Investigation application: Convenience sampling method was adopted to investigate patients in Jiangsu and Anhui,and analyze the current situation and influencing factors of diet self-management of non-dialysis patients with chronic kidney disease.Research results(1)Six themes were identified in the qualitative interview: patients paid less attention to diet and lacked knowledge reserve;Lack of interaction and effective communication channels between doctors and patients;The combination of multiple chronic diseases leads to the conflict and confusion of patients’ dietary information;Lack of eating skills;Inadequate family support,lack of self-efficacy,and weak awareness of dietary compliance;Not enough attention.Form a pool of 28 entries.(2)After two rounds of expert letter consultation,an initial scale containing 19 items was formed.(3)Project analysis results: 5 items did not meet the target and were deleted;Three common factors were extracted by exploratory factor analysis combined with lithotripsy map,and the cumulative variance contribution rate was 68.745%.The scale included 14 items in 3 dimensions including cognition of diet self-management,compliance of diet self-management and efficacy of diet self-management.The content validity index of the diet self-management assessment scale for non-dialysis patients with chronic kidney disease was 0.871,and the contents of each item of the scale were 0.815 ～ 1.000.Cronbach’s a coefficient of the total volume table was 0.899,and the broken half reliability was 0.813.The coefficients of each dimension were0.878,0.886 and 0.868,and the broken half reliability were 0.921,0.875 and 0.861.After two weeks,the retest reliability of the scale was 0.837,and the retest reliability of each dimension was 0.881,0.828,0.904,0.869.(4)The total score of diet self-management of non-dialysis patients with chronic kidney disease was(48.77±7.96),the score of diet self-management cognition dimension was(3.33±0.61),the score of diet self-management compliance dimension was(3.67±0.91),and the score of diet self-management efficacy dimension was(2.33±0.61).Age,educational level,monthly income,complicity of chronic diseases and social support were the factors that affected the self-management assessment of diet.Research conclusion(1)All indexes of the diet self-management Assessment scale for non-dialysis patients with chronic kidney disease prepared in this study meet the requirements of the scale,and can be used as an effective tool for diet self-management assessment for non-dialysis patients.(2)Further application of the scale found that the diet self-management assessment level of non-dialysis patients was low,and intervention programs could be constructed to evaluate and meet the real needs of patients according to influencing factors such as age,educational level,monthly income,whether chronic diseases were combined with social support,so as to further improve the diet management level of these patients.