Global Journal of Medical Research, J: Dentistry and Otolaryngology, Volume 23 Issue 1

covering ONS pre-use assessment, scope of application, formulation selection, risk assessment, efficacy evaluation, and health education. c) Delphi expert correspondence i. Develop an expert letter questionnaire The Expert Letter Questionnaire consists of 4 parts. The first part is the preface, including the background, purpose, significance and filling requirements of the questionnaire; the second part is the basic information of the expert, mainly including the expert's age, education, work field, working years, professional title and position, etc.; the third part For the "Oncology Nurses ONS Knowledge, Attitude and Action Questionnaire Item Evaluation Form", experts are required to use the Likert 5-point scoring method to evaluate the importance of each item, "1-5 points" respectively indicate "not important", "not very important", and "generally important" "More important" and "Very important", and set up "Item Modification Opinion Column" and "Add Item Column" for experts to fill in their opinions and suggestions; the fourth part is the self-assessment form for the degree of authority of experts, including the expert's familiarity with the content and Judgment is based on two aspects. ii. Selection of correspondence experts Expert selection criteria: high academic level in the field of ONS; engaged in oncology related work for ≥ 10 years; bachelor degree or above; intermediate or above professional title; actively participate in and support this research. A total of 15 experts were invited to participate in the letter inquiries, aged 36-51 (44.07±4.59) years old; education: 9 undergraduates (60%), 6 masters (40%); working years 10-31 (19.93±6.44) Year; Professional Title: 1 Intermediate Professional Title (6.67%), 14 Senior Professional Title (93.33%); Position: 5 Clinical Nursing (33.33%); 9 Nursing Management (60%); 1 Nursing Education (6.67%). d) Item revisions Questionnaires are distributed and returned by means of electronic communication. A total of 2 rounds of expert correspondence were conducted in this study, and the effective recovery rates of the questionnaires in both rounds were 100%, indicating that the experts were highly motivated and attached great importance to this research; the authoritative coefficients of the experts in the 2 rounds of correspondence were 0.893 and 0.921, both >0.7 , indicating that the degree of authority of experts is high, and the results of letter inquiry are reliable; the Kendall coordination coefficients of the two rounds of expert letter inquiry are 0.135 and 0.149 respectively (P<0.001). After the two rounds of correspondence, the average value of each item was 4.06 to 5.00, and the coefficient of variation was 0 to 0.18, indicating that the experts had basically reached an agreement and no further correspondence was required. Taking the item importance evaluation average score < 3.5 and the coefficient of variation > 0.25 as the criteria for item deletion [9], the research team revised the items based on expert opinions. After the first round of inquiries, the research team made the following changes: delete “A4: I think oncology nurses should have the relevant knowledge and skills of ONS”; delete “P12: I will provide patients with different types and flavors of ONS preparations” , to guide patients to choose appropriate ONS preparations”; merge “A6: I think oncology nurses play an important role in improving the efficacy of ONS in patients” and “A7: I think oncology nurses should pay attention to the treatment and care of ONS in cancer patients” as "A17: I think oncology nurses should pay attention to the treatment and care of ONS in cancer patients and play an important role"; will "A11: I think oncology nurses should accurately identify the adverse reactions after ONS, such as gastrointestinal intolerance symptoms, elevated blood sugar, etc.""A12: I think oncology nurses should be proficient in the preventive measures and correct treatment methods for adverse reactions after ONS" merged into "A18: I think oncology nurses should accurately identify adverse reactions after ONS, and take appropriate measures.""K13: When the NRS-2002 score is greater than how many points need to formulate a nutrition plan"; replace "P2: For patients with abnormal screening, I will use appropriate evaluation tools to conduct a comprehensive evaluation of the patients, Objective and quantitative assessment of nutritional intake, nutritional impact symptoms, muscle mass, physical condition, and degree of systemic inflammation" is revised to "For patients with abnormal screening, I will use appropriate assessment tools to conduct a comprehensive nutritional status assessment of the patient Evaluation"; Amend "P13: I will add different kinds of condiments (such as juice, vegetable juice, honey, milk and salt, etc.) to the ONS agent according to the patient's dietary habits and preferences" to "I will Underlying diseases, dietary habits and preferences, adding different kinds of condiments (such as juice, vegetable juice, honey, milk, and salt, etc.) to ONS agents”. "P23: When the patient's dietary intake reaches the recommended daily dietary intake and maintains good nutritional status, I will instruct the patient to discontinue ONS reasonably" to "When the patient's dietary intake reaches the recommended daily dietary intake and maintains good nutritional status" I will instruct patients to gradually stop ONS when their nutritional status is not sufficient, and instruct them to use ONS in a timely manner when dietary intake is insufficient.” After the second round of inquiries, the experts did not put forward new opinions, and the final initial questionnaire included 48 items, including 13 10 Year Global Journal of Medical Research Volume XXIII Issue I Version I ( D ) 2023 J © 2023 Global Journals Development of Knowledge-Attitude-Practice Questionnaire on Oral Nutrition Supplement among Nurses in Oncology Department and its Reliability and Validity Test