Development and validation of a questionnaire for the management of nutrition and immune-related adverse events in patients with liver cancer who received immunotherapy
10.3760/cma.j.cn311367-20240509-00188
- VernacularTitle:肝癌免疫治疗患者营养及免疫相关不良事件管理知信行问卷编制及信效度检验
- Author:
Wen WEN
1
;
Yingshuang CHEN
;
Chunling LIU
;
Liling TONG
;
Hua ZHANG
Author Information
1. 中南大学湘雅医学院附属海口医院肝胆外科，海口 570208
- Publication Type:Journal Article
- Keywords:
Liver neoplasms;
Immunotherapy;
Nutrition;
Immune-related adverse events;
Health knowledge, attitudes, practice
- From:
Chinese Journal of Digestion
2024;44(10):693-701
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To develop and verify the validity of a questionnaire on nutrition and immune-related adverse events in patients with liver cancer and received immune therapy. To provide a survey and evaluation tool for targeted health education, improving compliance and quality of life.Methods:Based on the knowledge attitude practice (KAP) theory, the preliminary draft of questionnaire was determined by literature search and 30 patients with liver cancer who received immunotherapy at Haikou People′s Hospital were selected for pre survey. The expert consultation was conducted by associate chief physicians from the department of hepatobiliary surgery and the department of oncology, the nutritionists and specialist nurses from the department of gastroenterology. According to the consultation results, the questionnaire was modified into the test version. It was estimated that the minimum sample size required for structural validity evaluation was 322 cases. Patients with liver cancer who received immunotherapy at Haikou People′s Hospital were recruited by convenience sampling, and the test version questionnaire were filled in. According to random number table method, the patients were divided into 2 groups. Exploratory and confirmatory factors analysis of the questionnaire were conducted respectively. The reliability of the questionnaire was evaluated by Cronbach′s α coefficient, split half reliability and retest reliability. Results:The completion time of the pre-survey questionnairein was (9.57±7.57) min. A total of 407 test questionnaires were distributed, and 400 were recovered, and the recovery rate of test questionnaire was 98.28%.The final questionnaire consisted of 27 items in 3 dimensions (knowledge, attitude, and practice), including 9 items of knowledge dimension, 10 items of attitude dimension and 8 items of practice dimension. Three factors were extracted in exploratory factors analysis with a cumulative variance contribution rate of 65.265%. In validation factor analysis, the chi-square freedom ratio was 3.956, the root mean square error of approximation was 0.086, the root mean square residual was 0.076, the comparative fit index was 0.871, and the incremental fit index was 0.872. The main indicators of the questionnaire fit were all with in the acceptable range. The total Cronbach′s α coefficient, split-half reliability and test-retest reliability of this questionnaire were 0.935, 0.834, 0.933, respectively. Conclusions:The questionnaire has good reliability and validity, and can be used as a preliminary assessment tool to understand the current status of knowledge, attitude, and practice of nutritional and immune-related adverse events in patients with liver cancer who received immunotherapy.
