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Cross Cultural Adaptation and Validation of Psychometric Properties of the Instrument Nutrition in Patient Care Survey (Nips) in Brazil

ABSTRACT

Introduction

Inadequate nutritional habits are considered a leading risk factor for the development of chronic noncommunicable diseases (CNCD). The physician plays an important role in modifying and improving the nutritional behavior of his patients and consequently safeguarding their health. In this context, it is necessary to measure, through reliable instruments, the attitude of students and physicians toward nutrition in patient care, to subsidize educational interventions that will impact clinical practice.

Objective

To translate, culturally adapt and validate the Nutrition in Patient Care Survey (NIPS), which assesses attitudes in nutritional care in clinical practice, to be used in the Portuguese-speaking population in Brazil.

Methodology

The original English version of NIPS was initially translated into Portuguese and submitted to a cross-cultural adaptation of vocabulary and linguistic construction. This version was then retranslated into English. The questionnaire was then applied to pre-test in 30 medical students, in order to eliminate doubts about comprehension of the questions. The final version of the adapted instrument was applied to 400 medical students. The reliability and validity of the survey was ascertained using exploratory factor analysis, conducted through principal component extraction and Varimax rotation methods.

Result

Four hundred students answered all NIPS questions and were included in the analysis. Following factorial analysis, the final structure of the scale was defined, which now has 37 items, in Likert form ranging from 1 (totally disagree) to 5 (totally agree), divided into ten factors, which differs from the original scale with five factors. The internal consistency (Cronbach’s alpha) for the ten factors studied was greater than 0.60 in most cases and the general alpha was greater than 0.50. In the construct validity analysis, the majority of the correlation coefficients were significant (p values < 0.005). With this structure, the proposed scale presented an internal consistency understood as favorable, explaining 58.93% of students’ attitudes regarding nutritional care in patient care.

Conclusion

The version in Portuguese of the NIPS instrument, after an adaptation process, proved to be useful and adequate for gathering information regarding the attitude of medical students related to nutritional care of patients.

Questionnaire; Nutritional Sciences; Attitudes; Practice; Medical education

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