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ORIGINAL ARTICLE Open access
European Journal of Physical and Rehabilitation Medicine 2023 October;59(5):593-604
DOI: 10.23736/S1973-9087.23.07987-X
Copyright © 2023 THE AUTHORS
This is an open access article distributed under the terms of the CC BY-NC-ND 4.0 license which allows users to copy and distribute the manuscript, as long as this is not done for commercial purposes and further does not permit distribution of the manuscript if it is changed or edited in any way, and as long as the user gives appropriate credits to the original author(s) and the source (with a link to the formal publication through the relevant DOI) and provides a link to the license.
language: English
Nutrition-associated health levels in persons with cancer: item response modelling based on the International Classification of Functioning, Disability and Health
Jin-Jin CHEN 1, 2, Zi-Yan ZHU 1, 2, Jia-Jia BIAN 1, 2, Feng LIN 2, 3 ✉
1 School of Rehabilitation Medicine, Nanjing Medical University, Nanjing, Jiangsu, China; 2 Department of Rehabilitation Medicine, Sir Run Run Hospital, Nanjing Medical University, Nanjing, Jiangsu, China; 3 Department of Rehabilitation Medicine, The First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu, China
BACKGROUND: The nutritional status of individuals with cancer is a crucial determinant of their health and well-being, and addressing nutrition-related functioning conditions is essential for maintaining physical activity levels and participating in daily activities.
AIM: This study aims to identify an evidence-based International Classification of Functioning, Disability and Health (ICF) scale using item response theory for nutrition conditions in patients with cancer, which can differentiate and assess nutrition-related functioning conditions of cancer survivors.
DESIGN: Cross-sectional study.
SETTING: Sir Run Run Hospital, Nanjing Medical University.
POPULATION: One hundred cancer patients were enrolled.
METHODS: Via convenience sampling, the study administered a questionnaire consisting of 89 ICF items to participants. The original five-point rating system was binarized (1 = no problem, 0 = problem). Through data shaping, non-parametric IRT analysis and parametric IRT analysis, psychometric properties of nutritional ICF scale were calculated using R software.
RESULTS: The study extracted a unidimensional scale with 32 items and constructed 2-parameter logistic model with good fitness, whose root mean square error approximation (RMSEA) = 0.0759, Tucker-Lewis Index (TLI) = 0.9655, and Comparative Fit Index (CFI) = 0.9677. The model demonstrated high reliability, as indicated by a Cronbach’s α of 0.95, Guttman λ
CONCLUSIONS: The study constructed an evidence-based ICF scale for nutrition conditions in patients with cancer with 32-item and 2PLM for evaluating nutrition-associated health level in persons with cancer, including high validity and reliability.
CLINICAL REHABILITATION IMPACT: The IRT model based on ICF provided a promising assessment tool to discriminate nutrition-associated health level of persons with cancer, and offered an auxiliary method for selecting rehabilitation intervention targets. This has the potential to lead to improved outcomes in cancer treatment and increased quality of life for cancer survivors.
KEY WORDS: International Classification of Functioning, Disability and Health; Nutritional status; Neoplasms; Nutrition assessment