{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,27]],"date-time":"2026-02-27T02:51:27Z","timestamp":1772160687851,"version":"3.50.1"},"reference-count":40,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2025,5,13]],"date-time":"2025-05-13T00:00:00Z","timestamp":1747094400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J Human Nutrition Diet"],"published-print":{"date-parts":[[2025,6]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Hyperphosphataemia is a common complication of paediatric chronic kidney disease (CKD), despite the use of phosphate binders and the numerous strategies employed to reduce dietary phosphate (P) intake. This article describes the development of two self\u2010administered semi\u2010structured Phosphate Understanding and Knowledge Assessment (PUKA) questionnaires. The purpose of these is to assess challenges with adherence and measure declarative nutrition and procedural knowledge of phosphate in children and young people (CYP) with CKD and their caregivers. The aim is to create questionnaires that will be used for future studies investigating the relationship between knowledge and blood P\u2010levels.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Questions were generated from a literature review, clinical experience and feedback from a survey sent to UK paediatric kidney dietitians. The content, format and style of the questions were adapted and validated via expert consensus (including a psychologist, play therapist, paediatric kidney dietitians and nephrologists from the international Paediatric Renal Nutrition Taskforce, and our Young Persons\u2019 Advisory Group), two caregivers and two CYP. A draft questionnaire was piloted with five caregivers and CYP with CKD to ensure face and content validity. To allow utilisation in a planned multi\u2010centre trial, it was translated into five languages (Dutch, French, German, Italian and Turkish). The final English version questionnaires were used in a sample of CYP with CKD stages 4\u20135 and on dialysis (CKD4\u20105D), and caregivers, from three UK paediatric kidney centres.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>From an initial pool of 80 questions, 37 were included in the final PUKA questionnaire. Thirteen were knowledge\u2010based, and a knowledge score was developed. An adult and a child\u2010friendly format were designed. Pilot testing confirmed face validity to ensure the questions were understandable. Forty\u2010four CYP with CKD4\u20105D and 33 caregivers completed the final English PUKA questionnaires, with over 80% rating it easy to complete. The median time required to complete it was 11:06\u2009min (IQR: 7:22\u201316:31).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>The PUKA questionnaires are a valid and reliable tool for measuring P\u2010related knowledge and experiences of managing phosphate in CYP with CKD and their caregivers.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/jhn.70067","type":"journal-article","created":{"date-parts":[[2025,5,14]],"date-time":"2025-05-14T02:29:18Z","timestamp":1747189758000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Development of a Questionnaire to Assess Phosphate Knowledge in Children With Chronic Kidney Disease and Their Caregivers"],"prefix":"10.1111","volume":"38","author":[{"ORCID":"https:\/\/orcid.org\/0009-0009-3681-6312","authenticated-orcid":false,"given":"Louise","family":"McAlister","sequence":"first","affiliation":[{"name":"Great Ormond Street Hospital for Children NHS Foundation Trust London UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Vanessa","family":"Shaw","sequence":"additional","affiliation":[{"name":"UCL Great Ormond Street Institute of Child Health University College London London UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Pearl","family":"Pugh","sequence":"additional","affiliation":[{"name":"Nottingham Children's Hospital Nottingham University Hospitals NHS Trust Nottingham UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Triona","family":"Joyce","sequence":"additional","affiliation":[{"name":"Department of Nutrition and Dietetics Guy's &amp; St Thomas\u2019 NHS Foundation Trust Westminster Bridge Road London UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Evelien","family":"Snauwaert","sequence":"additional","affiliation":[{"name":"Department of Pediatric Nephrology Ghent University Hospital Ghent Belgium"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Fionna","family":"Bathgate","sequence":"additional","affiliation":[{"name":"Great Ormond Street Hospital for Children NHS Foundation Trust London UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Charlotte","family":"Holt","sequence":"additional","affiliation":[{"name":"Great Ormond Street Hospital for Children NHS Foundation Trust London UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0116-9006","authenticated-orcid":false,"given":"Caroline","family":"Anderson","sequence":"additional","affiliation":[{"name":"University Hospital Southampton NHS Foundation Trust Southampton UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"An","family":"Desloovere","sequence":"additional","affiliation":[{"name":"University Hospital Ghent Ghent Belgium"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jos\u00e9","family":"Renken\u2010Terhaerdt","sequence":"additional","affiliation":[{"name":"Wilhelmina Children's Hospital University Medical Center Utrecht Utrecht The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Maria Rosa","family":"Grassi","sequence":"additional","affiliation":[{"name":"University of Milan Milan Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sevcan","family":"Bakkalo\u011flu","sequence":"additional","affiliation":[{"name":"Gazi University Ankara Turkey"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gulsah","family":"Sahin","sequence":"additional","affiliation":[{"name":"At\u0131l\u0131m University Ankara Turkey"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michiel","family":"Oosterveld","sequence":"additional","affiliation":[{"name":"Emma Children's Hospital Amsterdam University Medical Center Amsterdam The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rukshana","family":"Shroff","sequence":"additional","affiliation":[{"name":"Great Ormond Street Hospital for Children NHS Foundation Trust London UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5935-7328","authenticated-orcid":false,"given":"Kelly","family":"Lambert","sequence":"additional","affiliation":[{"name":"University of Wollongong Wollongong Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2025,5,13]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00467-019-04370-z"},{"issue":"1","key":"e_1_2_11_3_1","first-page":"1","article-title":"Kidney Disease: Improving Global Outcomes\u2014Clinical Practice Guideline Update for the Diagnosis, Evaluation, Prevention, and Treatment of Chronic Kidney Disease\u2010Mineral and Bone Disorder (CKD\u2010MBD)","volume":"7","author":"KDIGO","year":"2017","journal-title":"Kidney International"},{"key":"e_1_2_11_4_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12882-017-0734-z"},{"key":"e_1_2_11_5_1","doi-asserted-by":"publisher","DOI":"10.1007\/s40620-014-0062-3"},{"key":"e_1_2_11_6_1","doi-asserted-by":"publisher","DOI":"10.1111\/jorc.12069"},{"key":"e_1_2_11_7_1","doi-asserted-by":"publisher","DOI":"10.1186\/1471-2369-9-2"},{"key":"e_1_2_11_8_1","doi-asserted-by":"publisher","DOI":"10.1038\/ki.2010.316"},{"key":"e_1_2_11_9_1","doi-asserted-by":"publisher","DOI":"10.1007\/s004670000465"},{"key":"e_1_2_11_10_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.jrn.2007.05.009"},{"key":"e_1_2_11_11_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.jrn.2011.11.003"},{"key":"e_1_2_11_12_1","doi-asserted-by":"publisher","DOI":"10.1111\/bjhp.12116"},{"key":"e_1_2_11_13_1","doi-asserted-by":"publisher","DOI":"10.1111\/jan.14700"},{"key":"e_1_2_11_14_1","doi-asserted-by":"publisher","DOI":"10.11124\/JBISRIR-2017-003360"},{"key":"e_1_2_11_15_1","doi-asserted-by":"publisher","DOI":"10.1093\/ndt\/gfq161"},{"key":"e_1_2_11_16_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00467-005-1884-y"},{"key":"e_1_2_11_17_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.jrn.2009.10.011"},{"key":"e_1_2_11_18_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jada.2003.10.016"},{"key":"e_1_2_11_19_1","doi-asserted-by":"publisher","DOI":"10.1097\/00005650-198206000-00003"},{"key":"e_1_2_11_20_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.jrn.2008.11.001"},{"key":"e_1_2_11_21_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.jrn.2003.09.008"},{"key":"e_1_2_11_22_1","doi-asserted-by":"publisher","DOI":"10.3390\/nu16132034"},{"key":"e_1_2_11_23_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12882-019-1334-x"},{"key":"e_1_2_11_24_1","doi-asserted-by":"publisher","DOI":"10.1590\/S0101-28002010000200003"},{"key":"e_1_2_11_25_1","doi-asserted-by":"publisher","DOI":"10.1017\/S1368980017001471"},{"key":"e_1_2_11_26_1","doi-asserted-by":"publisher","DOI":"10.1111\/nure.12115"},{"key":"e_1_2_11_27_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.jrn.2024.02.004"},{"key":"e_1_2_11_28_1","doi-asserted-by":"publisher","DOI":"10.1111\/jorc.12260"},{"key":"e_1_2_11_29_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1755-6686.2008.00034.x"},{"key":"e_1_2_11_30_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0041362"},{"key":"e_1_2_11_31_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.xkme.2022.100437"},{"key":"e_1_2_11_32_1","unstructured":"Paediatric Renal Nutrition Taskforce. Guides for Patients and Families \u2010 Managing Phosphate Intake [Available from:https:\/\/www.vitaflo-via.com\/]."},{"key":"e_1_2_11_33_1","doi-asserted-by":"publisher","DOI":"10.4103\/ija.IJA_334_19"},{"key":"e_1_2_11_34_1","first-page":"12","article-title":"Formatting a Paper\u2010Based Survey Questionnaire: Best Practices","volume":"10","author":"Fanning E.","year":"2005","journal-title":"Practical Assessment, Research and Evaluation"},{"key":"e_1_2_11_35_1","doi-asserted-by":"publisher","DOI":"10.4103\/sja.SJA_203_17"},{"key":"e_1_2_11_36_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.324.7347.1183"},{"key":"e_1_2_11_37_1","doi-asserted-by":"publisher","DOI":"10.4103\/sja.sja_163_21"},{"key":"e_1_2_11_38_1","unstructured":"R. Gunning ed. \u201cReadabilityFormulas.com. \u201d accessed November 12 2024 https:\/\/www.readabilityformulas.com\/readability-scoring-system.php."},{"key":"e_1_2_11_39_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11165-014-9438-6"},{"key":"e_1_2_11_40_1","doi-asserted-by":"publisher","DOI":"10.1093\/pubmed\/fdi031"},{"key":"e_1_2_11_41_1","unstructured":"\u201cLanguage England and Wales: Census 2021. [Internet] \u201d Office for National Statistics 2022 accessed November 10 2024 https:\/\/www.ons.gov.uk\/peoplepopulationandcommunity\/culturalidentity\/language\/bulletins\/languageenglandandwales\/census2021."}],"container-title":["Journal of Human Nutrition and Dietetics"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/jhn.70067","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,9,4]],"date-time":"2025-09-04T12:33:11Z","timestamp":1756989191000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/jhn.70067"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,5,13]]},"references-count":40,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2025,6]]}},"alternative-id":["10.1111\/jhn.70067"],"URL":"https:\/\/doi.org\/10.1111\/jhn.70067","archive":["Portico"],"relation":{"has-review":[{"id-type":"doi","id":"10.1111\/JHN.70067\/v1\/review1","asserted-by":"object"},{"id-type":"doi","id":"10.1111\/JHN.70067\/v2\/review1","asserted-by":"object"},{"id-type":"doi","id":"10.1111\/JHN.70067\/v1\/decision1","asserted-by":"object"},{"id-type":"doi","id":"10.1111\/JHN.70067\/v2\/response1","asserted-by":"object"},{"id-type":"doi","id":"10.1111\/JHN.70067\/v2\/decision1","asserted-by":"object"}]},"ISSN":["0952-3871","1365-277X"],"issn-type":[{"value":"0952-3871","type":"print"},{"value":"1365-277X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,5,13]]},"assertion":[{"value":"2024-11-28","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-05-03","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-05-13","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e70067"}}