{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,9]],"date-time":"2026-10-09T19:54:24Z","timestamp":1791575664770,"version":"4.3.4"},"reference-count":55,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2026,10,9]],"date-time":"2026-10-09T00:00:00Z","timestamp":1791504000000},"content-version":"vor","delay-in-days":8,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T00:00:00Z","timestamp":1790812800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Nursing Open"],"published-print":{"date-parts":[[2026,10]]},"abstract":"ABSTRACT<\/jats:title>\n \n Aim<\/jats:title>\n This study aimed to develop and validate a culturally tailored scale (CKD\u2010MKAP) for assessing malnutrition\u2010related perceived knowledge, attitude and practice (KAP) among patients with chronic kidney disease (CKD) in China.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n The initial item pool was developed through a comprehensive literature review, semi\u2010structured interviews and the Delphi method. Content validity was evaluated by an experts panel. Construct validity was initially explored using exploratory factor analysis (EFA) and subsequently verified via confirmatory factor analysis (CFA).<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n During the development phase, a 27\u2010item scale was established following content validity assessment and a pilot study. Subsequent item analysis of the \u2018Perceived Knowledge (K)\u2019 domain led to the deletion of item K1. EFA (\n n<\/jats:italic>\n \u2009=\u2009152) for the \u2018Attitude (A)\u2019 and \u2018Practice (P)\u2019 domains yielded factor loadings exceeding 0.50, explaining 69.87% and 61.84% of the total variance, respectively. CFA (\n n<\/jats:italic>\n \u2009=\u2009151) demonstrated that the final 6\u2010item model for the \u2018K\u2019 domain exhibited a good model fit: RMSEA (90% CI)\u2009=\u20090.070 (0.000\u20130.124), CFI\u2009=\u20090.978, TLI\u2009=\u20090.963 and SRMR\u2009=\u20090.061. Similarly, the 9\u2010item \u2018A\u2019 domain and the 10\u2010item \u2018P\u2019 domain exhibited excellent fit indices. The three domains demonstrated satisfactory to excellent internal consistency, with Cronbach's alpha coefficients of 0.740 for Perceived Knowledge, 0.970 for Attitude and 0.958 for Practice.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusion<\/jats:title>\n The CKD\u2010MKAP is a valid and reliable instrument that can be effectively utilized by clinical nurses to evaluate the malnutrition\u2010related KAP among CKD patients in mainland China.<\/jats:p>\n <\/jats:sec>\n \n Implications for the Profession and\/or Patient Care<\/jats:title>\n The CKD\u2010MKAP scale offers healthcare professionals a valid, culturally tailored and time\u2010efficient tool to assess malnutrition\u2010related cognition and behaviours in CKD patients. Identifying specific deficits in perceived knowledge, attitudes or practices allows for personalized nutritional interventions, optimizing patient care and self\u2010management.<\/jats:p>\n <\/jats:sec>\n \n Impact<\/jats:title>\n This study addresses a critical gap in CKD management in China by introducing a multidimensional nutritional KAP assessment tool. The application of this scale can facilitate the early identification of malnutrition risks, improve the precision of patient education and ultimately contribute to slowing CKD progression and reducing the disease burden associated with malnutrition.<\/jats:p>\n <\/jats:sec>\n \n Reporting Method<\/jats:title>\n The methodology and findings of this multiphase quantitative study are reported in accordance with standard psychometric validation procedures.<\/jats:p>\n <\/jats:sec>\n \n Patient or Public Contribution<\/jats:title>\n Patients' lived experiences, shared during qualitative interviews, were used to generate the initial item pool and ensure the scale reflected patient perspectives and cultural nuances.<\/jats:p>\n <\/jats:sec>","DOI":"10.1002\/nop2.70925","type":"journal-article","created":{"date-parts":[[2026,10,9]],"date-time":"2026-10-09T19:39:36Z","timestamp":1791574776000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Development and Validation of\n CKD<\/scp>\n \u2010\n MKAP<\/scp>\n : A Malnutrition Perceived Knowledge, Attitude, and Practice (\n KAP<\/scp>\n ) Scale for Patients With Chronic Kidney Diseases (\n CKD<\/scp>\n ) in China"],"prefix":"10.1002","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4807-2949","authenticated-orcid":false,"given":"Shengrui","family":"Zhu","sequence":"first","affiliation":[{"name":"School of Medicine Xizang Minzu University Xianyang People's Republic of China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6940-0841","authenticated-orcid":false,"given":"Hafzan","family":"Yusoff","sequence":"additional","affiliation":[{"name":"Nutrition and Dietetics Programme, School of Health Sciences, Health Campus Universiti Sains Malaysia Kubang Kerian Malaysia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kueh Yee","family":"Cheng","sequence":"additional","affiliation":[{"name":"Biostatistics and Research Methodology Unit, School of Medical Sciences, Health Campus Universiti Sains Malaysia Kubang Kerian Malaysia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dariah Mohd","family":"Yusoff","sequence":"additional","affiliation":[{"name":"Nursing Programme, School of Health Sciences, Health Campus Universiti Sains Malaysia Kubang Kerian Malaysia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-8681-224X","authenticated-orcid":false,"given":"Xiujuan","family":"Feng","sequence":"additional","affiliation":[{"name":"Nutrition and Dietetics Programme, School of Health Sciences, Health Campus Universiti Sains Malaysia Kubang Kerian Malaysia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0004-1619-6279","authenticated-orcid":false,"given":"Wen\u2010Kai","family":"Zheng","sequence":"additional","affiliation":[{"name":"School of Basic Medicine Inner Mongolia Medical University Hohhot People's Republic of China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hongfang","family":"Chen","sequence":"additional","affiliation":[{"name":"Human Resources Office Xi'an Provincial Hospital of Traditional Chinese Medicine Xi'an People's Republic of China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,10,9]]},"reference":[{"key":"e_1_2_14_2_1","first-page":"3408","article-title":"Knowledge, Attitudes, and Practice With Respect to Antibiotic Use Among Pharmacy Students: A Cross\u2010Sectional Study","volume":"26","author":"Al\u2010Qerem W.","year":"2022","journal-title":"European Review for Medical and Pharmacological Sciences"},{"issue":"40","key":"e_1_2_14_3_1","doi-asserted-by":"crossref","DOI":"10.1097\/MD.0000000000030757","article-title":"Factors Associated With the Prevalence of Malnutrition Among Adult Hemodialytic Patients: A Two\u2010Center Study in the Jeddah Region, Saudi Arabia","volume":"101","author":"Azzeh F. 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