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Validation of a Novel Dietary Knowledge and Needs Questionnaire: The Postoperative Colorectal Cancer TCM Diet
Lanxia Pan1, Ankang Liu2, Jie Zhang3
1School of Nursing, Henan University of Chinese Medicine, Zhengzhou, Henan, People's Republic of China.
Background:
Postoperative colorectal cancer (CRC) patients may benefit from both conventional nutritional support and culturally specific Traditional Chinese Medicine (TCM) dietary guidance, yet no validated instrument specifically assesses their TCM dietary knowledge and educational needs. This study aimed to develop and preliminarily validate the Postoperative Colorectal Cancer TCM Diet Questionnaire (PCRC-TDQ) for assessing postoperative CRC patients' TCM dietary knowledge and educational needs.
Methods:
An initial 40-item pool was generated through literature review, multidisciplinary discussion, qualitative interviews, two rounds of Delphi expert consultation with 20 experts, and pilot testing, resulting in a 30-item preliminary questionnaire. The questionnaire was administered to 252 postoperative CRC patients, and 250 valid questionnaires were included in the psychometric analysis. Item analysis, content-validity assessment, exploratory factor analysis (EFA), and reliability testing were conducted.
Results:
Three items (K6, N7, and N9) were removed after exploratory factor analysis (EFA), resulting in the final 27-item PCRC-TDQ comprising 19 knowledge items and eight needs items. The PCRC-TDQ contained two conceptual domains (TCM dietary knowledge and dietary needs), with four underlying factors identified within these domains, explaining 51.43% of the total variance. Item-level content validity indices ranged from 0.88 to 1.00, and the scale-level content validity index/average was 0.990. Cronbach's alpha was 0.899 for the total instrument, 0.913 for the knowledge domain, and 0.849 for the needs domain.
Conclusion:
The 27-item PCRC-TDQ demonstrated satisfactory preliminary content validity, structural validity, internal consistency, and test-retest reliability in the study sample. It may serve as a preliminary assessment tool during initial postoperative dietary consultations to identify TCM dietary knowledge gaps and educational needs. Independent structural validation, including confirmatory factor analysis in separate cohorts, and multicenter validation are required before routine clinical implementation.