Knowledge, Attitudes and Self-reported practices Questionnaire on Pureed Diet Preparation (KAP DYS Puree) among Food Handlers in Malaysian Hospitals for Dysphagia Management: Development, Validity, and Reliability Testing
Main Article Content
Abstract
Introduction: This methodological research study aimed to measure content validity and reliability of a newly developed questionnaire of knowledge, attitudes, and self-reported practices towards pureed diet preparation (KAP DYS Puree) among hospital food handlers for dysphagia management. Methods: The study was conducted through face validation, content validation, content reliability and construct validation. A cross-sectional design with convenience sampling was carried out involving 4 panels for face validation, 10 raters for content validity and 161 food handlers participated for Exploratory Factor Analysis (EFA), while 30 food handlers were involved for test-retest reliability. The questionnaire which consisted of 40 items distributed into 3 domains and was assessed and analyzed using modified kappa (k*) for reliability. Results: Content Validity Index revealed the following I-CVI values: knowledge = 0.915, attitudes = 0.922 and self-reported practices = 0.900 and modified kappa values (k*) knowledge = 0.983, attitudes = 0.9214 and self-reported practices = 0.899. The EFA was employed for two dimensions which were self-reported practices and attitudes based on principal axis of factoring with varimax rotation. The factor analysis yielded two factors with a total of 10 items in the attitudes domain and two factors with a total of 9 items in the self-reported practices domain that had satisfactory factor loading (> 0.3). The Kaiser-Meyer-Olkin (KMO) values for attitudes = 0.816 and self-reported practices = 0.776. Bartlett’s test of sphericity was significant at p < 0.0001 for attitudes and self-reported practices indicating the suitability of this data for factor analysis. Interclass Correlation Index (ICC) values for attitudes = 0.739 and self-reported practices = 0.789. Conclusion: This instrument can be used as a need assessment tool in the development of a comprehensive training module for pureed diet preparations in dysphagia management.
Downloads
Article Details
References
Cichero JAY, Lam P, Steele CM, Hanson B, Chen J, Dantas RO, et al. Development of international terminology and definitions for texture-modified foods and thickened fluids used in dysphagia management: The IDDSI framework. Dysphagia 2017;32(2):293-314. doi: 10.1007/s00455-016-9758-y.
Razalli NH, Cheah CF, Mohammad NMA, Abdul Manaf Z. Plate waste study among hospitalised patients receiving texture-modified diet. Nutr Res Pract. 2021;15(5):655. doi:10.4162/nrp.2021.15.5.6552):293–314.
Aung PP, Foung CS, Azman KB, Ain N, Zulkifeli B;. F, Esmaeili MA, et al. Quantifying hospital services by carbon footprint: A systematic literature review of patient care alternatives. Resources, Conservation and Recycling. 2012 International Conference on Nutrition and Food Sciences IPCBEE [Internet]. 2012;39. doi:10.1016/j.resconrec.2019.104560
Alshqaqeeq F, Amin Esmaeili M, Overcash M, Twomey J. Quantifying hospital services by carbon footprint: A systematic literature review of patient care alternatives. Resour Conserv Recycl [Internet]. 2020;154(104560):104560. doi:10.1016/j.resconrec.2019.104560
Calleja-Fernández A, Pintor-de-la-Maza B, Vidal-Casariego A, Cano-Rodríguez I, Ballesteros-Pomar MD. Objective evaluation tool for texture-modified food (OET-TMF): Development of the tool and validation. Dysphagia [Internet]. 2016;31(3):360–6. doi:10.1007/s00455-015-9684-4
Haron H, Kamal NF, Yahya HM, Shahar S. Knowledge, attitude and practice (KAP) of Malay elderly on Salt Intake and its relationship with blood pressure. Front Public Health [Internet]. 2020;8:559071. doi:10.3389/fpubh.2020.559071
Polit DF, Beck CT, Owen SV. Is the CVI an acceptable indicator of content validity? Appraisal and recommendations. Res Nurs Health [Internet]. 2007;30(4):459–67. hdoi:10.1002/nur.20199
Teffo LA, Tabit FT. An assessment of the food safety knowledge and attitudes of food handlers in hospitals. BMC Public Health [Internet]. 2020;20(1):311 doi:10.1186/s12889-020-8430-5
Akabanda F, Hlortsi EH, Owusu-Kwarteng J. Food safety knowledge, attitudes and practices of institutional food-handlers in Ghana. BMC Public Health [Internet]. 2017;17(1):40 doi:10.1186/s12889-016-3986-9
Mohd Azman AS, Mohd Amirol K, Lee PC, Rosli N, Zulkifli NAN, Nawawi K, et al. Assessment of knowledge, attitude and practice among house officers in UKM medical centre on needle stick injuries. Sains Malays [Internet]. 2020;49(11):2763–72. https://core.ac.uk/download/pdf/362875118.pdf
Yhi C, Saat NZM, Farah N. Knowledge, attitude and practice (KAP) on daily steps among university employees. Malaysian Journal of Public Health Medicine. 2018;77–91.
Krejcie RV, Morgan DW. Determining sample size for research activities. Educ Psychol Meas [Internet]. 1970;30(3):607–10. doi:10.1177/001316447003000308
Landis JR, Koch GG. The measurement of observer agreement for categorical data. Biometrics [Internet]. 1977;33(1):159. doi:10.2307/2529310
Issa ZM, Muda WAMW. Determination of the primary school cooks’ knowledge, attitude and practice in preparing healthy school meal using Rasch analysis. In: Pacific Rim Objective Measurement Symposium (PROMS) 2015 Conference Proceedings. Singapore: Springer Singapore; 2016. p. 239–49.
Koo HC, Poh BK, Ruzita AT. Assessment of knowledge, attitudes and self-reported practices towards whole grains among chil-dren aged 10 and 11 years in Kuala Lumpur Int J Food Sci Nutr Diet. 2015;4(1):171–7. doi: 10.19070/2326-3350-1500032
Fleiss JL, Levin B, Paik MC. The measurement of interrater agreement. Statistical methods for rates and pro-portions. 1981;2:22–3.
Yaghmaei F. Content validity and its estimation. Journal of Medical Education Spring. 2003;3(1): e105015 doi: 10.22037/jme.v3i1.870
Gerensea H, Yohannse A, Baymot B, Atsbha H, Nguse K, Gebru L. Knowledge, attitude and practice (KAP) towards iodized salt utilization in HaweltiKebelle. Edorium Journal of Nutrition and Dietetics Edorium J Nutr Diet Edo-rium J Pathol. 2015;222:1–81. doi: 10.5348/N09-2016-3-OA-1
Bolarinwa O. Principles and methods of validity and reliability testing of questionnaires used in social and health science researches. Niger Postgrad Med J [Internet]. 2015;22(4):195. doi:10.4103/1117-1936.173959
Abdul Basir SM, Abdul Manaf Z, Ahmad M, Abdul Kadir NB, Ismail WNK, Mat Ludin AF, et al. Reliability and validity of the Malay Mindful Eating Questionnaire (MEQ-M) among overweight and obese adults. Int J Environ Res Public Health [Internet]. 2021;18(3):1021. doi:10.3390/ijerph18031021
Watkins MW. Exploratory factor analysis: A guide to best practice. J Black Psychol [Internet]. 2018;44(3):219–46. doi:10.1177/0095798418771807
Ursachi G, Horodnic IA, Zait A. How Reliable Are Measurement Scales? External Factors with Indirect Influence on Reliability Estimators. External Factors with Indirect Influence on Reliability Estimators Procedia Economics and Finance [Internet]. 2015;220(15):679–86. doi:10.1016/S2212-5671(15)00123-
Cc H, Ys C, Ym C, Mt MN. Development and validation of knowledge, attitude and practice on healthy lifestyle questionnaire (KAP-HLQ) for Malaysian adolescents. J Nutr Health Sci [Internet]. 2015;2(4). doi:10.15744/2393-9060.2.407
Koo TK, Li MY. A guideline of selecting and reporting intraclass correlation coefficients for reliability research. J Chiropr Med [Internet]. 2016;15(2):155–63. doi:10.1016/j.jcm.2016.02.012
Moitra P, Verma P, Madan J. Development and validation of a questionnaire measuring knowledge, attitudes, and practices (KAP) to healthy eating and activity patterns in school children (HEAPS). Nutr Health [Internet]. 2021;27(2):199–209. doi:10.1177/0260106020982356