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      Content Validation through Expert Judgement of an Instrument on the Nutritional Knowledge, Beliefs, and Habits of Pregnant Women

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          Abstract

          The aim of this study was to conduct content validation through expert judgement of an instrument which explores the nutritional knowledge, beliefs, and habits during pregnancy. This is a psychometric study in which 14 experts participated in the evaluation of each of the questionnaire items, which were divided into two blocks according to the characteristics of sufficiency, clarity, coherence, and relevance. Fleiss’ κ statistic was used to measure strength of agreement. A pre-test with 102 participants was conducted to measure the degree of understandability of the instrument. The strength of agreement obtained for each of the dimensions was almost perfect. For each pair of experts, strength of agreement ranged between substantial and almost perfect. Sufficiency was the characteristic of the questionnaire that obtained the highest values in the two blocks, and was also the most statistically significant ( p < 0.001). Coherence was the most statistically significant characteristic in the first block ( p = 0.030). Clarity was the most statistically significant characteristic in the second block ( p = 0.037). The wording of five of the twenty original items was corrected. The new version of the instrument attained a high degree of understandability. The results suggest that the instrument is valid and may therefore be applied.

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          Validity and reliability of measurement instruments used in research.

          Issues related to the validity and reliability of measurement instruments used in research are reviewed. Key indicators of the quality of a measuring instrument are the reliability and validity of the measures. The process of developing and validating an instrument is in large part focused on reducing error in the measurement process. Reliability estimates evaluate the stability of measures, internal consistency of measurement instruments, and interrater reliability of instrument scores. Validity is the extent to which the interpretations of the results of a test are warranted, which depends on the particular use the test is intended to serve. The responsiveness of the measure to change is of interest in many of the applications in health care where improvement in outcomes as a result of treatment is a primary goal of research. Several issues may affect the accuracy of data collected, such as those related to self-report and secondary data sources. Self-report of patients or subjects is required for many of the measurements conducted in health care, but self-reports of behavior are particularly subject to problems with social desirability biases. Data that were originally gathered for a different purpose are often used to answer a research question, which can affect the applicability to the study at hand. In health care and social science research, many of the variables of interest and outcomes that are important are abstract concepts known as theoretical constructs. Using tests or instruments that are valid and reliable to measure such constructs is a crucial component of research quality.
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            Nutrition in adolescents: physiology, metabolism, and nutritional needs.

            Adolescence is the period of development that begins at puberty and ends in early adulthood. Most commonly, adolescence is divided into three developmental periods: early adolescence (10-14 years of age), late adolescence (15-19 years of age), and young adulthood (20-24 years of age). Adolescence is marked by physical and sexual maturation, social and economic independence, development of identity, acquisition of skills needed to carry out adult relationships and roles, and the capacity for abstract reasoning. Adolescence is characterized by a rapid pace of growth that is second only to that of infancy. Nutrition and the adolescent transition are closely intertwined, since eating patterns and behaviors are influenced by many factors, including peer influences, parental modeling, food availability, food preferences, cost, convenience, personal and cultural beliefs, mass media, and body image. Here, we describe the physiology, metabolism, and nutritional requirements for adolescents and pregnant adolescents, as well as nutrition-related behavior and current trends in adolescent nutrition. We conclude with thoughts on the implications for nutrition interventions and priority areas that would require further investigation.
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              Nutrition in early life and the programming of adult disease: a review.

              Foetal development and infancy are life stages that are characterised by rapid growth, development and maturation of organs and systems. Variation in the quality or quantity of nutrients consumed by mothers during pregnancy, or infants during the first year of life, can exert permanent and powerful effects upon developing tissues. These effects are termed 'programming' and represent an important risk factor for noncommunicable diseases of adulthood, including the metabolic syndrome and coronary heart disease. This narrative review provides an overview of the evidence-base showing that indicators of nutritional deficit in pregnancy are associated with a greater risk of type-2 diabetes and cardiovascular mortality. There is also a limited evidence-base that suggests some relationship between breastfeeding and the timing and type of foods used in weaning, and disease in later life. Many of the associations reported between indicators of early growth and adult disease appear to interact with specific genotypes. This supports the idea that programming is one of several cumulative influences upon health and disease acting across the lifespan. Experimental studies have provided important clues to the mechanisms that link nutritional challenges in early life to disease in adulthood. It is suggested that nutritional programming is a product of the altered expression of genes that regulate the cell cycle, resulting in effective remodelling of tissue structure and functionality. The observation that traits programmed by nutritional exposures in foetal life can be transmitted to further generations adds weight the argument that heritable epigenetic modifications play a critical role in nutritional programming. © 2014 The British Dietetic Association Ltd.
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                Author and article information

                Journal
                Nutrients
                Nutrients
                nutrients
                Nutrients
                MDPI
                2072-6643
                18 April 2020
                April 2020
                : 12
                : 4
                : 1136
                Affiliations
                [1 ]Department of Nursing, Faculty of Health Sciences, Melilla Campus, University of Granada, Calle Santander s/n, 52001 Melilla, Spain; elisabetfdez@ 123456ugr.es (E.F.-G.); ademartin@ 123456ugr.es (A.M.-S.); maso@ 123456ugr.es (M.A.S.-O.); silnado@ 123456ugr.es (S.N.-P.)
                [2 ]Department of Inorganic Chemistry, HUM-613 Research Group, Faculty of Health Sciences, Melilla Campus, University of Granada, Calle Santander s/n, 52001 Melilla, Spain; cenrique@ 123456ugr.es
                Author notes
                [* ]Correspondence: triluva@ 123456ugr.es ; Tel.: +34-686-951-942
                Author information
                https://orcid.org/0000-0003-2421-783X
                https://orcid.org/0000-0002-3852-9861
                https://orcid.org/0000-0002-4911-5672
                https://orcid.org/0000-0003-1873-1795
                https://orcid.org/0000-0002-9713-2864
                Article
                nutrients-12-01136
                10.3390/nu12041136
                7230573
                32325669
                e630b5ce-0526-4f1c-a2f5-e99450f8381b
                © 2020 by the authors.

                Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license ( http://creativecommons.org/licenses/by/4.0/).

                History
                : 20 March 2020
                : 15 April 2020
                Categories
                Article

                Nutrition & Dietetics
                content validity,expert judgement,fleiss’ κ,pregnant women,eating habits
                Nutrition & Dietetics
                content validity, expert judgement, fleiss’ κ, pregnant women, eating habits

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