Development and Validation of a Knowledge, Attitude, and Practice Questionnaire and Its Utility Study Toward Nutritional Habits Among Nondialytic chronic kidney disease Patients: A Prospective Study.

OBJECTIVE

Knowledge, attitude, and practices (KAPs) related to dietary habits play a critical role in managing disease progression in chronic kidney disease (CKD) patients, yet these aspects remain understudied. This study focused on developing, validating, and assessing the utility of a tailored KAP questionnaire specifically designed for CKD patients.

METHODS

This prospective study was conducted from November 2022 to November 2023 among CKD stage 3 to nondialytic stage 5 patients attending a nephrology outpatient department. A multiple-choice KAP questionnaire, developed with input from 10 nephrologists, included 33 knowledge items (diet 23, disease 10), 33 attitude items on a Likert scale, and 11 practice items on dietary intake. Validity was assessed in a pilot group of 30 CKD patients. A total of 199 patients aged 18-60 years were enrolled and randomized into three diet groups: normal protein intake (0.8-1.0 g/kg/day), low protein intake (0.6 g/kg/day), and very low protein intake with ketoanalogues supplementation (0.3 g/kg/day). Baseline demographic, socioeconomic, dietary data, and KAP scores were recorded, followed by dietary counseling. KAP scores were reassessed at 6 months and compared to baseline.

RESULTS

Among 199 enrolled CKD patients (60% male, 74.7% literate), postcounselling KAP scores showed significant improvements: knowledge increased from 29.5 ± 21.3 to 53.3 ± 19.8, attitude from 108.8 ± 16.2 to 133.9 ± 20.2, and practice from 17.0 ± 3.2 to 20.1 ± 2.8 (P < .05). In addition, all KAP components and estimated glomerular filtration rate significantly improved across different CKD stages following the 6-month dietary intervention.

CONCLUSION

The validated KAP questionnaire revealed significant improvements in knowledge, attitude, and practice over 6 months following dietary counseling. These findings underscore the necessity of integrating dietary counseling into the management of CKD at all stages.