Validation of the Persian-Translated NutritionDay Questionnaire

Document Type : Original Article

Authors

1 Department of Nutrition, Isfahan Cardiovascular Research Center, Isfahan University of Medical Sciences, Isfahan, Iran.

2 Department of Nutrition, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.

3 Department of Community Medicine and Public Health, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.

4 Transplant Research Center, Clinical Research Institute, Mashhad University of Medical Sciences, Mashhad, Iran.

Abstract

Introduction: Hospital malnutrition is a widespread health problem. Most studies on hospital malnutrition used different validated screening tools to determine malnutrition and the nutritional status of patients. Therefore, it is not possible to compare the prevalence of malnutrition among wards and hospitals. The nutritionDay project is a one-day, cross-sectional audit run in healthcare institutions. The nutritionDay hospital questionnaires are available in more than 30 languages and it includes 4 sheets focused on hospital structure, ward structure/processes, patient’s clinical condition, patient’s nutritional status, and 30-day outcome. For the first time, we analyzed to prove the validity and reliability of the Persian translation of the nutritionDay questionnaires.
Method: At first, two separate people did the questionnaire's translation into Persian and re-translation into English. Then, the translation was sent to 15 experts to assess content validity. The validity of the questionnaire was evaluated by checking relevance, clarity, simplicity, and importance score. Questions with a content validity ratio (CVR)>0.49 were accepted. The average technique was used to calculate the content validity index (CVI). Also, Cronbach’s alpha coefficient and test-retest couldn’t be calculated for reliability assessment due to the variety of variables and the nature of the nutrition questionnaire.
Result : Overall, the CVR of all questions was above 0.49. Also, the CVI-Relevancy, CVI-Clarity, CVI-simplicity, and Importance scores of the final tool were 0.98, 0.99, 0.99, and 4.69 respectively.
Conclusion : This Persian translated nutritionDay questionnaire demonstrates strong content and face validity. Furthermore, it can be an appropriate tool for evaluating patients' clinical conditions and nutritional status.

Keywords


  1. Schenker S. Undernutrition in the UK. Nutrition Bulletin. 2003 Mar;28(1):87-120.
  2. Sauer AC, Goates S, Malone A, Mogensen KM, Gewirtz G, Sulz I, et al. Prevalence of malnutrition risk and the impact of nutrition risk on hospital outcomes: results from nutritionDay in the US. Journal of parenteral and enteral nutrition. 2019 Sep;43(7):918-26.
  3. Motedayen M, Dousti M, Sayehmiri F, Pourmahmoudi AA. An investigation of the prevalence and causes of malnutrition in Iran: a review article and meta-analysis. Clinical nutrition research. 2019 Apr 3;8(2):101-18.
  4. Schindler K, Pichard C, Sulz I, Volkert D, Streicher M, Singer P, et al. nutritionDay: 10 years of growth. Clinical nutrition. 2017 Oct 1;36(5):1207-14.
  5. Nematy M, Salami H, Norouzy A, Siadat Z, Shahsavan N, Tavallaie S, et al. Indices of malnutrition in patients admitted to general medical and chest medicine wards of an Iranian teaching hospital on admission and discharge. Mediterranean Journal of Nutrition and Metabolism. 2012 Jul 20;6(1):53-7.
  6. Nitichai N, Angkatavanich J, Somlaw N, Voravud N, Lertbutsayanukul C. Validation of the Scored Patient-Generated Subjective Global Assessment (PG-SGA) in Thai setting and association with nutritional parameters in cancer patients. Asian Pacific journal of cancer prevention: APJCP. 2019;20(4):1249.
  7. Shahbazi S, Hajimohammadebrahim-Ketabforoush M, Shariatpanahi MV, Shahbazi E, Shariatpanahi ZV. The validity of the global leadership initiative on malnutrition criteria for diagnosing malnutrition in critically ill patients with COVID-19: A prospective cohort study. Clinical nutrition ESPEN. 2021 Jun 1;43:377-82.
  8. Martínez-de la Iglesia J, Romero-Saldaña M. Is the Spanish short version of Mini Nutritional Assessment (MNA-SF) valid for nutritional screening of the elderly?. Nutricion hospitalaria. 2019 Apr 1;36(2):290-5.
  9. Nishioka S, Omagari K, Nishioka E, Mori N, Taketani Y, Kayashita J. Concurrent and predictive validity of the Mini Nutritional Assessment Short‐Form and the Geriatric Nutritional Risk Index in older stroke rehabilitation patients. Journal of Human Nutrition and Dietetics. 2020 Feb;33(1):12-22.
  10. Bolayir B, Arik G, Yeşil Y, Kuyumcu ME, Varan HD, Kara Ö, et al. Validation of nutritional risk screening‐2002 in a hospitalized adult population. Nutrition in Clinical Practice. 2019 Apr;34(2):297-303.
  11. Pérez Doménech M, Soriano del Castillo JM, Merino Torres JF. Development, validation and implementation of a program to detect malnutrition with NRS-2002 screening tool in patients from the oncology and hematology service.
  12. nutritionday  [Available from: https://www.nutritionday.org/en/hospitals-intensive-care-units-.nursing-homes/hospitals/questionaires/index.html.
  13. Kimberlin CL, Winterstein AG. Validity and reliability of measurement instruments used in research. American journal of health-system pharmacy. 2008 Dec 1;65(23):2276-84.
  14. Halek M, Holle D, Bartholomeyczik S. Development and evaluation of the content validity, practicability and feasibility of the Innovative dementia-oriented Assessment system for challenging behaviour in residents with dementia. BMC health services research. 2017 Dec;17:1-26.
  15. Armstrong TS, Cohen MZ, Eriksen L, Cleeland C. Content validity of self-report measurement instruments: an illustration from the development of the Brain Tumor Module of the MD Anderson Symptom Inventory. InOncology Nursing Forum-Oncology Nursing Society 2005 May 10 (Vol. 32, No. 3, pp. 669-681). [Pittsburgh, PA, etc.] Oncology Nursing Society.
  16. Zamanzadeh V, Ghahramanian A, Rassouli M, Abbaszadeh A, Alavi-Majd H, Nikanfar AR. Design and implementation content validity study: development of an instrument for measuring patient-centered communication. Journal of caring sciences. 2015 Jun;4(2):165.
  17. Drost EA. Validity and reliability in social science research. Education Research and perspectives. 2011 Jan 1;38(1):105-23.
  18. Mohammadbeigi A, Mohammadsalehi N, Aligol M. Validity and reliability of the instruments and types of measurments in health applied researches. Journal of rafsanjan university of medical sciences. 2015 Mar 10;13(12):1153-70.
  19. DeVon HA, Block ME, Moyle‐Wright P, Ernst DM, Hayden SJ, Lazzara DJ, et al. A psychometric toolbox for testing validity and reliability. Journal of Nursing scholarship. 2007 Jun;39(2):155-64.
  20. Gliem JA, Gliem RR. Calculating, interpreting, and reporting Cronbach’s alpha reliability coefficient for Likert-type scales. InMidwest research-to-practice conference in adult, continuing, and community education 2003 Oct 8 (Vol. 1, pp. 82-87).
  21. Helms JE, Henze KT, Sass TL, Mifsud VA. Treating Cronbach’s alpha reliability coefficients as data in counseling research. The counseling psychologist. 2006 Sep;34(5):630-60.
  22. Cronbach LJ, Meehl PE. Construct validity in psychological tests. Psychological bulletin. 1955 Jul;52(4):281.
  23. GHASEMI V. CRONBACH COEFFICIENT ALPHA AND SOME OF ITS SPECIALTIES WITH EMPHASIS ON APPLICATIONS IN SOCIAL RESEARCH.2005.
  24. DeVellis RF, Thorpe CT. Scale development: Theory and applications. Sage publications; 2021 Sep 16.
  25. Wells CS, Wollack JA. An instructor’s guide to understanding test reliability. Testing & Evaluation Services University of Wisconsin. 2003 Nov.
  26. Cronbach LJ, Shavelson RJ. My current thoughts on coefficient alpha and successor procedures. Educational and psychological measurement. 2004 Jun;64(3):391-418.
  27. Guttman L. A basis for analyzing test-retest reliability. Psychometrika. 1945 Dec;10(4):255-82.
  28. Webb NM, Shavelson RJ, Haertel EH. 4 reliability coefficients and generalizability theory. Handbook of statistics. 2006 Jan 1;26:81-124.
  29. Najafi F, Kheiri B. Investigating the impact of country of origin on customer behavior: investigation of the moderating roles of product involvement and product familiarity on product evaluation and customer behavioral intentions. Jounal of Marketing Management. 2012;7(17):37-60.
  30. Gilbert GE, Prion S. Making sense of methods and measurement: Lawshe's content validity index. Clinical simulation in nursing. 2016 Dec 1;12(12):530-1.