Development and Validation of a Scale to Assess Health-Related Quality of Life in Tube-Fed Patients

IF 2.5 3区医学 Q3 NUTRITION & DIETETICS

Journal of Human Nutrition and Dietetics Pub Date : 2025-06-16 DOI:10.1111/jhn.70077

Hongji Zeng, Xi Zeng, Nanxi Zeng, Weijia Zhao, Jing Zeng, Siyu Wang, Yi Li

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引用次数: 0

Abstract

Objectives

This study aimed to develop and validate a questionnaire to assess health-related QOL in tube-fed patients, Zeng's Tube-feeding Index (ZTI).

Methods

Expert consultations, patient interviews, and literature reviews were used to design the draft items. Four rounds of expert and patient review were conducted to refine the items. A preliminary survey was conducted for the dimension division. In 2024, a formal study involving 419 tube-fed patients was conducted to validate the ZTI. The primary diagnoses were haemorrhagic stroke (83, 19.81%), ischaemic stroke (156, 37.23%), traumatic brain injury (70, 16.71%), neurodegenerative diseases (58, 13.84%), head and neck cancer (11, 2.26%), sarcopenia (16, 3.81%), and others (25, 5.97%), respectively. The Cronbach's α coefficient was used to measure internal consistency. Spearman's correlation was used to measure test-retest reliability. The Dysphagia Handicap Index and subjective QOL scores were used to measure the construct validity. Ten independent experts were included to evaluate content validity. Factor analyses were used for structural validity.

Results

The ZTI has four dimensions, with a total of 23 items, using a Likert 4-point scale. The Cronbach's α coefficients were > 0.8 for dimensions and = 0.889 for the scale. The Spearman correlation coefficients were > 0.7 for items or dimensions, and = 0.802 for the scale (p < 0.001). The ZTI showed significant correlations with the Dysphagia Handicap Index and subjective QOL scores in both the total scores and each dimension (|r| > 0.7, p < 0.001). The content validity indices were ≥ 0.8 for items, dimensions, and the scale. The Exploratory Factor Analysis identified four factors that collectively explained > 80% of the variance and built a four-dimensional model. The model showed a good fit through the Confirmatory Factor Analysis.

Conclusions

The ZTI is a validated tool for assessing tube-feeding-related QOL.

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管饲患者健康相关生活质量评估量表的开发与验证

目的设计并验证一种评估管饲患者健康相关生活质量的问卷——曾氏管饲指数（Zeng's管饲指数，ZTI）。方法采用专家咨询、患者访谈、文献回顾等方法设计草案项目。进行了四轮专家和患者审查以完善项目。对维度划分进行了初步调查。2024年，一项涉及419名管饲患者的正式研究进行了验证ZTI。主要诊断为出血性脑卒中（83例，19.81%）、缺血性脑卒中（156例，37.23%）、外伤性脑损伤（70例，16.71%）、神经退行性疾病（58例，13.84%）、头颈癌（11例，2.26%）、肌肉减少症（16例，3.81%）、其他（25例，5.97%）。采用Cronbach’s α系数衡量内部一致性。Spearman相关被用来测量重测信度。使用吞咽障碍指数和主观生活质量评分来衡量构念效度。10位独立专家参与评估内容效度。结构效度采用因子分析。结果ZTI量表有4个维度，共23个项目，采用李克特4点量表。量表的Cronbach’s α系数为>； 0.8，量表的Cronbach’s α系数为= 0.889。项目或维度的Spearman相关系数为>； 0.7，量表的Spearman相关系数为= 0.802 （p < 0.001）。ZTI与吞咽障碍指数和主观生活质量评分在总分和各维度上均有显著相关性（| > 0.7, p < 0.001）。项目、维度、量表的内容效度指标均≥0.8。探索性因子分析确定了四个因素，这些因素共同解释了80%的方差，并建立了一个四维模型。经验证性因子分析，模型拟合良好。结论ZTI是评价管饲相关生活质量的有效工具。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of Human Nutrition and Dietetics 医学-营养学

CiteScore

5.30

自引率

15.20%

发文量

133

审稿时长

6-12 weeks

期刊介绍： Journal of Human Nutrition and Dietetics is an international peer-reviewed journal publishing papers in applied nutrition and dietetics. Papers are therefore welcomed on: - Clinical nutrition and the practice of therapeutic dietetics - Clinical and professional guidelines - Public health nutrition and nutritional epidemiology - Dietary surveys and dietary assessment methodology - Health promotion and intervention studies and their effectiveness - Obesity, weight control and body composition - Research on psychological determinants of healthy and unhealthy eating behaviour. Focus can for example be on attitudes, brain correlates of food reward processing, social influences, impulsivity, cognitive control, cognitive processes, dieting, psychological treatments. - Appetite, Food intake and nutritional status - Nutrigenomics and molecular nutrition - The journal does not publish animal research The journal is published in an online-only format. No printed issue of this title will be produced but authors will still be able to order offprints of their own articles.