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Background <p>Dietary decision-making plays a crucial role in the management of patients with inflammatory bowel disease (IBD). However, it is complex and involves multiple challenges. Decision-making competence may assist healthcare professionals (HCPs) in evaluating patients’ competence to make healthy dietary decisions and to design targeted dietary support programs. Assessment of healthy dietary decision-making competence is essential for guiding IBD patients in daily dietary management. Currently, no valid instrument is available to measure this construct. This study aimed to develop an instrument to evaluate healthy dietary decision-making competence in patients with IBD.</p> Methods <p>The development and test of the healthy dietary decision-making competence scale (HDMCS) proceeded according to two phases: (i) instrument development: identifying preliminary items through literature reviews, interviews with 24 patients, an expert panel with 24 experts and cognitive interviews with 8 patients. (ii) scale verification: surveying 354 patients with IBD from five tertiary general hospitals in Nanjing and Shenzhen city, China. Item analysis, exploratory factor analysis, confirmatory factor analysis, and reliability rest were performed to evaluate the reliability and validity of this scale.</p> Results <p>The exploratory factor analysis and confirmatory factor analysis yield a four-factor scale (χ<sup>2</sup>/df = 1.972, RMSEA = 0.068, GFI = 0.848, IFI = 0.929 and CFI = 0.928). The four factors were ‘dietary management perception’, ‘resource utilization competence’, ‘decisional balance competence’ and ‘post-decision reflection competence’. The reliability was demonstrated to be acceptable, with the Cronbach’s alpha coefficient of 0.941, and the 4 factors were from 0.818 to 0.912. Test–retest reliability (by ICC) of the total scale was 0.874.</p> Conclusions <p>The HDMCS demonstrated satisfactory reliability and validity to warrant further development as a measure of dietary decision-competence of patients with IBD. By evaluating dietary decision-making competence across multiple domains, HCPs could gain a comprehensive understanding of patients’ beliefs, preferences, and values related to dietary decisions, thereby tailoring interventions accordingly.</p>

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Development and validation of healthy dietary decision-making competence scale for inflammatory bowel disease: an instrument design study

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2025年12月15日

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  • Yiting Li,
  • Yongqi Liang,
  • Murong Wang,
  • Tingting Yin,
  • Tianxu Chen,
  • Ling Ji,
  • Ping Zhang,
  • Qiong Li,
  • Wenjing Tu,
  • Guihua Xu

摘要

Background

Dietary decision-making plays a crucial role in the management of patients with inflammatory bowel disease (IBD). However, it is complex and involves multiple challenges. Decision-making competence may assist healthcare professionals (HCPs) in evaluating patients’ competence to make healthy dietary decisions and to design targeted dietary support programs. Assessment of healthy dietary decision-making competence is essential for guiding IBD patients in daily dietary management. Currently, no valid instrument is available to measure this construct. This study aimed to develop an instrument to evaluate healthy dietary decision-making competence in patients with IBD.

Methods

The development and test of the healthy dietary decision-making competence scale (HDMCS) proceeded according to two phases: (i) instrument development: identifying preliminary items through literature reviews, interviews with 24 patients, an expert panel with 24 experts and cognitive interviews with 8 patients. (ii) scale verification: surveying 354 patients with IBD from five tertiary general hospitals in Nanjing and Shenzhen city, China. Item analysis, exploratory factor analysis, confirmatory factor analysis, and reliability rest were performed to evaluate the reliability and validity of this scale.

Results

The exploratory factor analysis and confirmatory factor analysis yield a four-factor scale (χ2/df = 1.972, RMSEA = 0.068, GFI = 0.848, IFI = 0.929 and CFI = 0.928). The four factors were ‘dietary management perception’, ‘resource utilization competence’, ‘decisional balance competence’ and ‘post-decision reflection competence’. The reliability was demonstrated to be acceptable, with the Cronbach’s alpha coefficient of 0.941, and the 4 factors were from 0.818 to 0.912. Test–retest reliability (by ICC) of the total scale was 0.874.

Conclusions

The HDMCS demonstrated satisfactory reliability and validity to warrant further development as a measure of dietary decision-competence of patients with IBD. By evaluating dietary decision-making competence across multiple domains, HCPs could gain a comprehensive understanding of patients’ beliefs, preferences, and values related to dietary decisions, thereby tailoring interventions accordingly.