Hildegard Strydom, Jane Muchiri, Elizabeth Delport, Zelda White
{"title":"依从性计分表监测糖尿病患者对个性化营养教育的依从性的可靠性和有效性。","authors":"Hildegard Strydom, Jane Muchiri, Elizabeth Delport, Zelda White","doi":"10.1016/j.clnesp.2025.07.1128","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Dietary management of diabetes relies on the patient's ability to adhere to the nutrition guidelines presented to them by a health care professional. Traditional analysis of dietary intake to monitor adherence can be tedious, and there is a need for a short, easy-to-use tool to measure dietary adherence from food records. This study aimed to determine the reliability and validity of an Adherence Score Sheet (ASS) developed to quantify dietary adherence to personalised nutrition education.</p><p><strong>Methodology: </strong>67 three-day food records of patients with diabetes who received nutrition education were scored using the ASS Adherence scores were given for adhering to glycemic index (GI), glycemic load (GL), protein and fat guidelines, and a total adherence score. Intraclass correlation (ICC) and Bland-Altman plots were used to demonstrate the amount of agreement between ASS from two independent raters (inter-rater reliability) and ASS score from Rater 1 [test method] vs ASS obtained from dietary analysis (DA) program [reference method] for the assessment of concurrent validity.</p><p><strong>Results: </strong>ICC values for the total adherence score showed good agreement (ICC = 0.74) between raters, with subcategories agreement being fair to excellent (ICC ranging from 0.56 to 0.81). The Bland-Altman plots for all 5 categories (GI, GL, protein, fat, and total score) indicated acceptable agreement between Rater 1 and Rater 2. ICC values for all categories indicated excellent validity between Rater 1 and the DA scores. The Bland-Altman plots for validity indicated overall acceptable agreement between Rater 1 and DA for all 5 categories.</p><p><strong>Conclusion: </strong>Our findings reveal that the ASS is a reliable and valid tool to determine and quantify adherence to personalised nutrition education among patients with diabetes.</p>","PeriodicalId":10352,"journal":{"name":"Clinical nutrition ESPEN","volume":" ","pages":"442-448"},"PeriodicalIF":2.6000,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Reliability and validity of an adherence score sheet to monitor adherence of patients with diabetes to personalised nutrition education.\",\"authors\":\"Hildegard Strydom, Jane Muchiri, Elizabeth Delport, Zelda White\",\"doi\":\"10.1016/j.clnesp.2025.07.1128\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>Dietary management of diabetes relies on the patient's ability to adhere to the nutrition guidelines presented to them by a health care professional. Traditional analysis of dietary intake to monitor adherence can be tedious, and there is a need for a short, easy-to-use tool to measure dietary adherence from food records. This study aimed to determine the reliability and validity of an Adherence Score Sheet (ASS) developed to quantify dietary adherence to personalised nutrition education.</p><p><strong>Methodology: </strong>67 three-day food records of patients with diabetes who received nutrition education were scored using the ASS Adherence scores were given for adhering to glycemic index (GI), glycemic load (GL), protein and fat guidelines, and a total adherence score. Intraclass correlation (ICC) and Bland-Altman plots were used to demonstrate the amount of agreement between ASS from two independent raters (inter-rater reliability) and ASS score from Rater 1 [test method] vs ASS obtained from dietary analysis (DA) program [reference method] for the assessment of concurrent validity.</p><p><strong>Results: </strong>ICC values for the total adherence score showed good agreement (ICC = 0.74) between raters, with subcategories agreement being fair to excellent (ICC ranging from 0.56 to 0.81). The Bland-Altman plots for all 5 categories (GI, GL, protein, fat, and total score) indicated acceptable agreement between Rater 1 and Rater 2. ICC values for all categories indicated excellent validity between Rater 1 and the DA scores. The Bland-Altman plots for validity indicated overall acceptable agreement between Rater 1 and DA for all 5 categories.</p><p><strong>Conclusion: </strong>Our findings reveal that the ASS is a reliable and valid tool to determine and quantify adherence to personalised nutrition education among patients with diabetes.</p>\",\"PeriodicalId\":10352,\"journal\":{\"name\":\"Clinical nutrition ESPEN\",\"volume\":\" \",\"pages\":\"442-448\"},\"PeriodicalIF\":2.6000,\"publicationDate\":\"2025-10-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Clinical nutrition ESPEN\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.1016/j.clnesp.2025.07.1128\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2025/8/5 0:00:00\",\"PubModel\":\"Epub\",\"JCR\":\"Q3\",\"JCRName\":\"NUTRITION & DIETETICS\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Clinical nutrition ESPEN","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.1016/j.clnesp.2025.07.1128","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2025/8/5 0:00:00","PubModel":"Epub","JCR":"Q3","JCRName":"NUTRITION & DIETETICS","Score":null,"Total":0}
Reliability and validity of an adherence score sheet to monitor adherence of patients with diabetes to personalised nutrition education.
Background: Dietary management of diabetes relies on the patient's ability to adhere to the nutrition guidelines presented to them by a health care professional. Traditional analysis of dietary intake to monitor adherence can be tedious, and there is a need for a short, easy-to-use tool to measure dietary adherence from food records. This study aimed to determine the reliability and validity of an Adherence Score Sheet (ASS) developed to quantify dietary adherence to personalised nutrition education.
Methodology: 67 three-day food records of patients with diabetes who received nutrition education were scored using the ASS Adherence scores were given for adhering to glycemic index (GI), glycemic load (GL), protein and fat guidelines, and a total adherence score. Intraclass correlation (ICC) and Bland-Altman plots were used to demonstrate the amount of agreement between ASS from two independent raters (inter-rater reliability) and ASS score from Rater 1 [test method] vs ASS obtained from dietary analysis (DA) program [reference method] for the assessment of concurrent validity.
Results: ICC values for the total adherence score showed good agreement (ICC = 0.74) between raters, with subcategories agreement being fair to excellent (ICC ranging from 0.56 to 0.81). The Bland-Altman plots for all 5 categories (GI, GL, protein, fat, and total score) indicated acceptable agreement between Rater 1 and Rater 2. ICC values for all categories indicated excellent validity between Rater 1 and the DA scores. The Bland-Altman plots for validity indicated overall acceptable agreement between Rater 1 and DA for all 5 categories.
Conclusion: Our findings reveal that the ASS is a reliable and valid tool to determine and quantify adherence to personalised nutrition education among patients with diabetes.
期刊介绍：
Clinical Nutrition ESPEN is an electronic-only journal and is an official publication of the European Society for Clinical Nutrition and Metabolism (ESPEN). Nutrition and nutritional care have gained wide clinical and scientific interest during the past decades. The increasing knowledge of metabolic disturbances and nutritional assessment in chronic and acute diseases has stimulated rapid advances in design, development and clinical application of nutritional support. The aims of ESPEN are to encourage the rapid diffusion of knowledge and its application in the field of clinical nutrition and metabolism. Published bimonthly, Clinical Nutrition ESPEN focuses on publishing articles on the relationship between nutrition and disease in the setting of basic science and clinical practice. Clinical Nutrition ESPEN is available to all members of ESPEN and to all subscribers of Clinical Nutrition.
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