Article(id=1322168484897862180, tenantId=1146029695717560320, journalId=1220038315760373764, issueId=1322168329855418548, articleNumber=null, orderNo=null, doi=10.12102/j.issn.1009-6493.2026.07.013, pmid=null, cstr=null, oa=null, hot=null, price=null, onlineType=0, articleFormat=0, articleType=null, articleTypeStr=null, receivedDate=1752681600000, receivedDateStr=2025-07-17, revisedDate=1772899200000, revisedDateStr=2026-03-08, acceptedDate=null, acceptedDateStr=null, onlineDate=1793159131501, onlineDateStr=2026-10-28, pubDate=1775750400000, pubDateStr=2026-04-10, doiRegisterDate=null, doiRegisterDateStr=null, onlineIssueDate=1793159131501, onlineIssueDateStr=2026-10-28, onlineJustAcceptDate=null, onlineJustAcceptDateStr=null, onlineFirstDate=null, onlineFirstDateStr=null, sourceXml=null, magXml=null, createTime=1793159131501, creator=13701087609, updateTime=1793159131501, updator=13701087609, issue=Issue{id=1322168329855418548, tenantId=1146029695717560320, journalId=1220038315760373764, year='2026', volume='40', issue='7', pageStart='1057', pageEnd='1240', issueExtLink='null', onlineDate='null', pubDate='1775750400000', pubDateStr='2026-04-10', beforeIssueId=null, nextIssueId=null, price=null, status=1, issueComplete=1, articleOrder=1, issueType=-1, specialIssue=null, createTime=1793159094536, creator='13701087609', updateTime=1793159094536, updator='13701087609', preIssue=null, nextIssue=null, articleTotal=null, ext=null, issueFiles=null, downloadFileDto=null}, startPage=1157, endPage=1163, ext={EN=ArticleExt(id=1322168485191463461, articleId=1322168484897862180, tenantId=1146029695717560320, journalId=1220038315760373764, language=EN, title=Sinicization of the Preference for Intuition and Deliberation in Eating Decision-making Scale and its reliability and validity test, columnId=1220689492655129450, journalTitle=Chinese Nursing Research, columnName=Scale Study, runingTitle=null, highlight=null, articleAbstract=
Objective

To translate the Preference for Intuition and Deliberation in Eating Decision-making Scale(E-PID) into Chinese based on network analysis,and to test its reliability and validity.

Methods

Based on the Brislin translation model,the Preference for Intuition and Deliberation in Eating Decision-making Scale was translated,culturally adapted and pre-investigated to form the Chinese version of the Preference for Intuition and Deliberation in Eating Decision-making Scale.From July to December 2024,1 463 patients with cardiovascular diseases from a tertiary grade A hospital were selected as the study subjects.The reliability and validity were tested.

Results

The Chinese version of Preference for Intuition and Deliberation in Eating Decision-making Scale included 2 dimensions and 7 items.Exploratory factor analysis extracted 2 common factors.The cumulative contribution rate of variance was 67.99%.The item-level content validity index(I-CVI) ranged from 0.83 to 1.00.The average scale-level content validity index(S-CVI/Ave) was 0.97.The score of preference for intuition dimension showed a positive correlation with the total score of the Intuitive Eating Scale-2(P<0.001).The score of preference for deliberation dimension showed a positive correlation with the total score of the Brief Self-Control Scale(P<0.001).The Cronbach's alpha(McDonald's omega) coefficients for the Chinese version of Preference for Intuition and Deliberation in Eating Decision-making Scale and each dimension were 0.71(0.81),0.83(0.87),and 0.75(0.73),respectively.The test-retest reliability for the Chinese version of Preference for Intuition and Deliberation in Eating Decision-making Scale and each dimension were 0.94,0.90,0.94.EGA Bootstrap analysis showed that the dimensional structure of the scale was completely stable.The consistency indexes of the network structure were all 1.00.Confirmatory factor analysis results showed a good model fit.

Conclusions

The Chinese version of the Preference for Intuition and Deliberation in Eating Decision-making Scale has a stable network structure,streamlined items,good reliability and validity,and could be used to evaluate the dietary decision-making preferences among cardiovascular disease patients in China.

, authors=Huixia HUANG1, Guiping HU2, Ping LIN3, Xueqin GAO3, Qingfang YE1, Xuejia HUANG4, Menglei WANG1, Guojie LIU3, authorsList=Huixia HUANG, Guiping HU, Ping LIN, Xueqin GAO, Qingfang YE, Xuejia HUANG, Menglei WANG, Guojie LIU, authorCompany=null, correspAuthors=Guojie LIU, authorNote=null, correspAuthorsNote=
LIU Guojie, E-mail:
, copyrightStatement=null, copyrightOwner=null, extLink=null, articleAbsUrl=null, sourceXml=null, magXml=null, pdfUrl=null, pdf=null, pdfFileSize=null, pdfExtLink=null, richHtmlUrl=null, mobilePdfUrl=null, reviewReport=null, pdfFirstPage=null, abstractGraph=null, abstractGraphContent=null, abstractVideo=null, citation=null, cebUrl=null, magXmlContent=null, mapNumber=null, fund=null), CN=ArticleExt(id=1322168486290371114, articleId=1322168484897862180, tenantId=1146029695717560320, journalId=1220038315760373764, language=CN, title=饮食行为决策偏好量表的汉化及信效度检验, columnId=1220689492902593405, journalTitle=护理研究, columnName=量表研究, runingTitle=null, highlight=null, articleAbstract=
目的

基于网络分析对饮食行为决策偏好量表(E-PID)进行汉化并检验其信效度。

方法

依据Brislin翻译模型,对饮食行为决策偏好量表进行翻译、文化调适及预调查,形成中文版饮食行为决策偏好量表。于2024年7月—12月,选取某三级甲等医院1 463例心血管疾病病人为研究对象,进行信效度检验。

结果

最终形成的中文版饮食行为决策偏好量表包括直觉偏好与审慎偏好2个维度,共7个条目。探索性因子分析提取出2个公因子,累计方差贡献率为67.99%。量表条目水平的内容效度指数为0.83~1.00,量表水平的内容效度指数为0.97。直觉偏好维度得分与直觉饮食量表-2(IES-2)总分呈正相关(P<0.001);审慎偏好维度得分与简版自我控制量表(BSCS)总分呈正相关(P<0.001)。中文版饮食行为决策偏好总量表和各维度的Cronbach's α(McDonald's ω)系数分别为0.71(0.81)、0.83(0.87)和0.75(0.73);重测信度分别为0.94,0.90和0.94。EGA Bootstrap分析显示量表维度结构完全稳定,网络结构一致性指标均为1.00。验证性因子分析显示模型拟合指标较好。

结论

中文版饮食行为决策偏好量表网络结构稳定、条目精简,具有良好的信效度,可用于评价我国心血管疾病病人饮食行为决策偏好。

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黄辉霞,护师,硕士研究生在读

, correspAuthorsNote=
刘国杰,E-mall:
LIU Guojie, E-mail:
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and enhancing the American Heart Association's construct of cardiovascular health:a presidential advisory from the American Heart Association, refAbstract=null), Reference(id=1322530344612516499, tenantId=1146029695717560320, journalId=1220038315760373764, articleId=1322168484897862180, doi=null, pmid=null, pmcid=null, year=2023, volume=15, issue=3, pageStart=957, pageEnd=982, url=null, language=null, rfNumber=27, rfOrder=26, authorNames=SPROESSER G, AULBACH M, GÜLTZOW T, journalName=Applied Psychology Health and Well-Being, refType=null, unstructuredReference=SPROESSER G,AULBACH M,GÜLTZOW T,et al.Do nutrition knowledge,food preferences,and habit strength moderate the association between preference for intuition and deliberation in eating decision-making and dietary intake?[J].Applied Psychology Health and Well-Being,2023,15(3):957-982., articleTitle=Do nutrition knowledge,food preferences,and habit strength moderate the association between preference for intuition and deliberation in 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General information of patients with cardiovascular diseases(n=1 463)

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项目分类例数百分比(%)项目分类例数百分比(%)
性别男88860.7高血压有80955.3
女57539.3无65444.7
学历小学及以下32522.2糖尿病有38926.6
初中76852.5无1 07473.4
高中24116.5吸烟是43129.5
本科及以上1298.8否1 03270.5
居住地城市60741.5饮酒是1339.1
非城市85658.5否1 33090.9
首诊患病是74150.6体质指数偏低362.5
否72249.4正常52736.0
行经皮冠状动脉介入治疗是84858.0超重64043.7
否61542.0肥胖26017.8
), ArticleFig(id=1322530338333643380, tenantId=1146029695717560320, journalId=1220038315760373764, articleId=1322168484897862180, language=CN, label=表1, caption=

心血管疾病病人的一般资料(n=1 463)

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项目分类例数百分比(%)项目分类例数百分比(%)
性别男88860.7高血压有80955.3
女57539.3无65444.7
学历小学及以下32522.2糖尿病有38926.6
初中76852.5无1 07473.4
高中24116.5吸烟是43129.5
本科及以上1298.8否1 03270.5
居住地城市60741.5饮酒是1339.1
非城市85658.5否1 33090.9
首诊患病是74150.6体质指数偏低362.5
否72249.4正常52736.0
行经皮冠状动脉介入治疗是84858.0超重64043.7
否61542.0肥胖26017.8
), ArticleFig(id=1322530340011364981, tenantId=1146029695717560320, journalId=1220038315760373764, articleId=1322168484897862180, language=EN, label=Table 2, caption=

Factor loadings of the Chinese version of the Preference for Intuition and Deliberation in Eating Decision-making Scale

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条目直觉偏好审慎偏好
条目1:我选吃的就是凭感觉0.853
条目2:大多数时候,吃什么完全听从本能就行了0.877
条目3:我吃东西很随心,爱怎么吃就怎么吃0.888
条目4:我通常会想一想再决定吃什么0.802
条目5:我对自己的饮食行为计划和目标比别人想得更多、更全面0.731
条目6:我更喜欢规划好我的饮食,而不是随便凑合0.762
条目7:我会反思自己的饮食习惯0.806
), ArticleFig(id=1322530340145582710, tenantId=1146029695717560320, journalId=1220038315760373764, articleId=1322168484897862180, language=CN, label=表2, caption=

中文版饮食行为决策偏好量表的因子载荷

, figureFileSmall=null, figureFileBig=null, tableContent=
条目直觉偏好审慎偏好
条目1:我选吃的就是凭感觉0.853
条目2:大多数时候,吃什么完全听从本能就行了0.877
条目3:我吃东西很随心,爱怎么吃就怎么吃0.888
条目4:我通常会想一想再决定吃什么0.802
条目5:我对自己的饮食行为计划和目标比别人想得更多、更全面0.731
条目6:我更喜欢规划好我的饮食,而不是随便凑合0.762
条目7:我会反思自己的饮食习惯0.806
), ArticleFig(id=1322530340233663095, tenantId=1146029695717560320, journalId=1220038315760373764, articleId=1322168484897862180, language=EN, label=Table 3, caption=

Model fit of the EGA and EGA(revise) structure of the Chinese version of the Preference for Intuition and Deliberation in Eating Decision-making Scale

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量表结构RMSEA[90%CI]SRMRCFITFIAICBIC
探索性图分析0.057[0.039,0.075]0.0320.9780.96411 016.97711 086.457
探索性图分析(修订)0.030[0.000,0.054]0.0230.9950.99010 994.99611 078.372
), ArticleFig(id=1322530340330132088, tenantId=1146029695717560320, journalId=1220038315760373764, articleId=1322168484897862180, language=CN, label=表3, caption=

中文版饮食行为决策偏好量表探索性图分析网络结构、探索性图分析(修订)结构拟合度对比

, figureFileSmall=null, figureFileBig=null, tableContent=
量表结构RMSEA[90%CI]SRMRCFITFIAICBIC
探索性图分析0.057[0.039,0.075]0.0320.9780.96411 016.97711 086.457
探索性图分析(修订)0.030[0.000,0.054]0.0230.9950.99010 994.99611 078.372
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饮食行为决策偏好量表的汉化及信效度检验
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黄辉霞 1 , 胡桂萍 2 , 林平 3 , 高学琴 3 , 叶青芳 1 , 黄雪嘉 4 , 王梦雷 1 , 刘国杰 3, *, *
护理研究 | 量表研究 2026,40(7): 1157-1163
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护理研究 |量表研究 2026 , 40 (7) : 1157 -1163
饮食行为决策偏好量表的汉化及信效度检验
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黄辉霞1, 胡桂萍2, 林平3, 高学琴3, 叶青芳1, 黄雪嘉4, 王梦雷1, 刘国杰3, *, *
作者信息
  • 1哈尔滨医科大学护理学院,黑龙江 150086
  • 2四川工业科技学院
  • 3哈尔滨医科大学附属第二医院
  • 4福建医科大学附属第二医院
通讯作者:
刘国杰,E-mall:
LIU Guojie, E-mail:
作者简介:

黄辉霞,护师,硕士研究生在读

Sinicization of the Preference for Intuition and Deliberation in Eating Decision-making Scale and its reliability and validity test
Huixia HUANG1, Guiping HU2, Ping LIN3, Xueqin GAO3, Qingfang YE1, Xuejia HUANG4, Menglei WANG1, Guojie LIU3
Affiliations
  • 1College of Nursing, Harbin Medical University, Heilongjiang 150086 China
  • 2Sichuan Institute of Industrial Technology
  • 3The 2nd Affiliated Hospital of Harbin Medical University
  • 4The 2nd Affiliated Hospital of Fujian Medical University
  • Corresponding Author:
    LIU Guojie, E-mail:
出版时间: 2026-04-10 doi: 10.12102/j.issn.1009-6493.2026.07.013
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目的

基于网络分析对饮食行为决策偏好量表(E-PID)进行汉化并检验其信效度。

方法

依据Brislin翻译模型,对饮食行为决策偏好量表进行翻译、文化调适及预调查,形成中文版饮食行为决策偏好量表。于2024年7月—12月,选取某三级甲等医院1 463例心血管疾病病人为研究对象,进行信效度检验。

结果

最终形成的中文版饮食行为决策偏好量表包括直觉偏好与审慎偏好2个维度,共7个条目。探索性因子分析提取出2个公因子,累计方差贡献率为67.99%。量表条目水平的内容效度指数为0.83~1.00,量表水平的内容效度指数为0.97。直觉偏好维度得分与直觉饮食量表-2(IES-2)总分呈正相关(P<0.001);审慎偏好维度得分与简版自我控制量表(BSCS)总分呈正相关(P<0.001)。中文版饮食行为决策偏好总量表和各维度的Cronbach's α(McDonald's ω)系数分别为0.71(0.81)、0.83(0.87)和0.75(0.73);重测信度分别为0.94,0.90和0.94。EGA Bootstrap分析显示量表维度结构完全稳定,网络结构一致性指标均为1.00。验证性因子分析显示模型拟合指标较好。

结论

中文版饮食行为决策偏好量表网络结构稳定、条目精简,具有良好的信效度,可用于评价我国心血管疾病病人饮食行为决策偏好。

饮食行为  /  决策偏好  /  量表  /  结构验证  /  网络分析  /  信度  /  效度
Objective

To translate the Preference for Intuition and Deliberation in Eating Decision-making Scale(E-PID) into Chinese based on network analysis,and to test its reliability and validity.

Methods

Based on the Brislin translation model,the Preference for Intuition and Deliberation in Eating Decision-making Scale was translated,culturally adapted and pre-investigated to form the Chinese version of the Preference for Intuition and Deliberation in Eating Decision-making Scale.From July to December 2024,1 463 patients with cardiovascular diseases from a tertiary grade A hospital were selected as the study subjects.The reliability and validity were tested.

Results

The Chinese version of Preference for Intuition and Deliberation in Eating Decision-making Scale included 2 dimensions and 7 items.Exploratory factor analysis extracted 2 common factors.The cumulative contribution rate of variance was 67.99%.The item-level content validity index(I-CVI) ranged from 0.83 to 1.00.The average scale-level content validity index(S-CVI/Ave) was 0.97.The score of preference for intuition dimension showed a positive correlation with the total score of the Intuitive Eating Scale-2(P<0.001).The score of preference for deliberation dimension showed a positive correlation with the total score of the Brief Self-Control Scale(P<0.001).The Cronbach's alpha(McDonald's omega) coefficients for the Chinese version of Preference for Intuition and Deliberation in Eating Decision-making Scale and each dimension were 0.71(0.81),0.83(0.87),and 0.75(0.73),respectively.The test-retest reliability for the Chinese version of Preference for Intuition and Deliberation in Eating Decision-making Scale and each dimension were 0.94,0.90,0.94.EGA Bootstrap analysis showed that the dimensional structure of the scale was completely stable.The consistency indexes of the network structure were all 1.00.Confirmatory factor analysis results showed a good model fit.

Conclusions

The Chinese version of the Preference for Intuition and Deliberation in Eating Decision-making Scale has a stable network structure,streamlined items,good reliability and validity,and could be used to evaluate the dietary decision-making preferences among cardiovascular disease patients in China.

dietary behavior  /  decision-making preference  /  scale  /  structural validation  /  network analysis  /  reliability  /  validity
黄辉霞, 胡桂萍, 林平, 高学琴, 叶青芳, 黄雪嘉, 王梦雷, 刘国杰. 饮食行为决策偏好量表的汉化及信效度检验. 护理研究, 2026 , 40 (7) : 1157 -1163 . DOI: 10.12102/j.issn.1009-6493.2026.07.013
Huixia HUANG, Guiping HU, Ping LIN, Xueqin GAO, Qingfang YE, Xuejia HUANG, Menglei WANG, Guojie LIU. Sinicization of the Preference for Intuition and Deliberation in Eating Decision-making Scale and its reliability and validity test[J]. Chinese Nursing Research, 2026 , 40 (7) : 1157 -1163 . DOI: 10.12102/j.issn.1009-6493.2026.07.013
《中国心血管健康与疾病报告2023年概要》[1]指出,心血管疾病的发病率和死亡率持续上升,截至2023年已成为我国居民的首位死因。研究表明,饮食对心血管疾病的发生和发展具有明确影响,是其中最重要的可干预因素之一,其行为决策偏好直接影响个体的食物选择和对饮食干预的依从性[2-3]。饮食决策偏好由快速直觉反应和慢速审慎思考双因子认知系统共同调控[4-5],例如面对高热、高脂食物时的“想吃”冲动与“要健康”之间的权衡。现有研究主要聚焦直觉偏好的评估,尚未检索到对审慎偏好或两者协同的系统测量[6],限制了对饮食行为决策过程的全面理解与干预设计。2021年,德国学者König等[7]开发了饮食行为决策偏好量表(Preference for Intuition and Deliberation in Eating Decision-Making Scale,E-PID),用于评估个体在饮食决策中对直觉与审慎的偏好,并在德国健康成年人中验证了该量表包含7个条目的双因子结构,信效度良好,但尚未检索到在我国应用的研究。在量表结构探索中,传统因子分析依赖预设因子数量且对模型假设敏感,可能忽略条目间复杂关系[8]。网络分析则无须事先假定因子结构,能够数据驱动揭示条目之间的直接关联和潜在维度,且具备直观可视化和结构稳定性评估优势[9]。因此,本研究结合网络分析对饮食行为决策偏好量表进行汉化并评估其结构特征与信效度,旨在为心血管疾病病人的饮食行为决策偏好评估提供可靠工具。
饮食行为决策偏好量表由König等[7]在Betsch直觉审慎偏好量表的基础上开发改编而成,专用于评估个体在饮食行为决策中是采用直觉式还是审慎式决策风格倾向。量表在德国健康成年人中显示出良好信度(其Cronbach's α系数为0.79~0.82),西班牙语版[10]亦在成年女性样本中验证了其信效度(McDonald's ω系数为0.77~0.82)。量表包含直觉偏好(3个条目)和审慎偏好(4个条目)2个维度,共7个条目,各条目均采用Likert 5级评分,“完全不同意”计1分,“完全同意”计5分,均采用正向计分,维度得分为各条目得分均分,得分越高表示该偏好越强。
2024年6月获得原作者授权后,遵循Brislin翻译模型进行汉化。1)正译:由营养学、心理学和临床医学领域3名博士研究生独立正向翻译,由1名具有留学经验的护理学硕士研究生整合为初译本T1;2)回译:由3名不熟悉原量表的护理/英语硕士研究生独立回译,再由1名有留学经历的护理硕士研究生整合为BT1;3)原作者审核:将BT1提交原作者审阅,结合反馈对存在歧义的条目进行修订,形成中文版T2。
在形成中文版T2后,由1名具有医学博士研究生学位且精通双语的专家对量表进行文化调适,修订量表部分表述以确保语义等效,形成中文版T3。随后邀请6名具有临床、管理与教育经验的护理专家(均具硕士研究生及以上学历,工作年限≥10年)对中文版T3进行函询,围绕内容适宜性、语义准确性及医学表达规范性提出建议,并据此修订,最终形成中文版饮食行为决策偏好量表初稿。
采用便利抽样法,选取20例心血管疾病病人进行量表初稿的预调查。病人完成填写后,研究团队对其进行访谈,收集关于条目理解、表达清晰度及文化适应性的反馈意见。根据访谈结果对量表条目进行修订,最终形成包含7个条目的中文版饮食行为决策偏好量表。
采用便利抽样法,于2024年7月—12月,选取某三级甲等医院心内科的心血管疾病病人作为调查对象。纳入标准:1)年龄18~80岁;2)无智力或语言障碍,能够完成问卷评估。排除标准:1)正在进行饮食相关治疗;2)患有精神疾病。按照因子分析的要求,样本量应为量表条目数的5~10倍[11]。本研究已通过哈尔滨医科大学附属第二医院医学伦理委员会临床研究项目伦理审查(伦理审查批件号:YJSKY2024-406)。所有调查对象均知情同意,自愿参加本研究。
包括病人性别、年龄、体质指数、居住地、学历、职业状态、吸烟、饮酒情况等。
使用中文版饮食行为决策偏好量表作为调查工具,该量表包括2个维度,共7个条目,各条目采用Likert 5级评分法。
采用吴敏娟等[12]引进并汉化的中文版IES-2检验中文版饮食行为决策偏好量表的效标关联效度。该量表在心血管疾病病人中显示良好信度,其Cronbach's α系数为0.95。中文版IES-2包含无条件允许进食(6个条目)、生理需求进食(8个条目)、饥饿饱腹依赖(6个条目)和身体-食物一致性(3个条目)4个维度,共23个条目。各条目采用Likert 5级评分法,“完全不同意”至“完全同意”依次计1~5分,得分越高表明直觉饮食倾向越强。
采用中文版BSCS[13]评估个体的自我控制能力。BSCS包含自律(3个条目)及冲动控制(4个条目)2个维度,共7个条目。各条目采用Likert 5级评分法,“完全不同意”至“完全同意”依次计1~5分,得分越高表示个体自我控制能力越强。
由统一培训的调查员现场发放问卷,发放前向调查对象简要介绍研究目的、意义及填写方法,强调本研究为匿名、自愿参与,在征得同意后进行调查。问卷填写完成后当场回收。本研究共发放1 480份问卷,回收有效问卷1 463份,问卷有效回收率为98.9%,量表填写时间均短于10 min。
采用临界比值法和相关系数法进行项目分析。1)临界比值法:将中文版饮食行为决策偏好量表得分按照从高到低排序,前27%为高分组,后27%为低分组,对两组进行独立样本t检验,若决断值(t值)<3.000或P>0.05说明区分度差,予以删除[14];2)相关系数法:计算各条目得分与量表总分的相关系数(r值),删除相关系数<0.40或P>0.05的条目[15]。
邀请参与德尔菲函询的6名专家对量表的内容效度进行Likert 4级评分,“不相关”“弱相关”“比较相关”“强相关”依次计1、2、3、4分。内容效度评估指标包括各条目水平的内容效度指数(item-level content validity index,I-CVI)及量表水平的内容效度指数(scale-level content validity index,S-CVI)。I-CVI≥0.78、S-CVI≥0.80表示量表内容效度较理想[16]。
采用探索性因子分析(EFA)确定量表的结构效度。进行探索性因子分析时要求KMO值>0.7且Bartlett's球形检验结果P<0.01,以主成分分析法提取特征值>1的公因子并采用最大方差法进行旋转,公因子累计方差解释率应>40%,最后根据特征值、累计方差贡献率和碎石图分析保留因子[15]。
将IES-2和BSCS分别作为中文版饮食行为决策偏好量表直觉偏好和审慎偏好维度的效标。依据Cohen[17]效应量判断标准:相关系数>0.5为强相关,0.3~0.5为中度相关,<0.3为弱相关。
通过Cronbach's α系数、McDonald's ω系数和重测信度检验中文版饮食行为决策偏好量表的信度。总量表和各维度的Cronbach's α(McDonald's ω)系数>0.70为信度良好,重测信度>0.70表示具有较好的时间稳定性[18]。
采用高斯图域模型(Gaussian graphical model,GGM)对中文版饮食行为决策偏好量表进行网络估计,构建条目间的稀疏网络,网络结构中的节点代表量表条目,边表示条目间的偏相关关系[19]。采用Fruchterman-Reingold布局算法生成网络图,通过不同颜色直观展示变量在网络中形成的聚类结构。
采用探索性图分析(exploratory graph analysis,EGA)通过偏相关聚类识别量表网络维度结构[20]。根据EGA Bootstrap算法评估维度结构稳定性,评价指标包括维度数量一致性、条目复制指数和各维度结构一致性,各指标均>0.75表示网络维度结构稳定[21]。
使用条目复制指数评估所有条目聚类到各自维度的稳定性,若复制指数<0.75,则认为条目归类不稳定,考虑删除或修订。
采用验证性因子分析(CFA)拟合模型,构建基于原始量表的双因子模型及基于探索性图分析结果的结构模型,并结合修正指数(MI>10)引入显著残差协方差形成修正模型[22]。通过近似误差均方根(root mean square error of approximation,RMSEA)、相对拟合指数(comparative fit index,CFI)、赤池信息准则(Akaike information criterion,AIC)和贝叶斯信息准则(Bayesian information criterion,BIC)等指标评估模型拟合效果,其中RMSEA<0.08为良好拟合,CFI>0.90为可接受拟合[23],AIC和BIC值越小表示拟合越优[24]。
使用SPSS 27.0和R 4.4.1软件进行统计分析。将所有样本随机分为数据集A(n=704)和数据集B(n=759),数据集A用于探索性因子分析和探索性图分析,数据集B用于验证性因子分析,比较不同结构模型的拟合效果。各变量正态性通过偏度<|2|与峰度<|7|判断[25]。符合正态分布的定量资料以均数±标准差(x±s)表示,定性资料以频数、百分比(%)描述。
根据翻译、跨文化调适、德尔菲函询及预调查结果,修订部分条目内容,具体如下:条目3“我是一个非常凭直觉决定饮食的人”修改为“我吃东西很随心,爱怎么吃就怎么吃”,以提升表述的通俗性与可理解性;条目5“我比其他人更常考虑我的饮食计划和目标”修改为“我对自己的饮食行为计划和目标比别人想得更多、更全面”,避免“更常考虑”引发频率误解,更准确地体现原量表中对思考深度和广度的强调。
本研究纳入的1 463例心血管疾病病人年龄18~80(61.04±9.21)岁,其他一般资料见表1。
1)临界比值法:结果显示,各条目决断值为20.63~62.48,均P<0.001,表明条目具备良好的区分能力。2)相关系数法:结果显示,所有条目得分与量表总分的相关系数为0.71~0.89,均P<0.001,说明各条目与量表均呈正相关,相关性良好。中文版饮食行为决策偏好量表的7个条目都予以保留。
结果显示,中文版饮食行为决策偏好量表的I-CVI为0.83~1.00,S-CVI为0.97,量表有良好的内容效度。
结果显示,中文版饮食行为决策偏好量表的KMO值为0.76,Bartlett's球形检验显示,χ2值为1 761.63,P<0.001,表明该量表适合进行探索性因子分析。采用主成分分析法及最大方差法提取2个特征值>1的公因子,累计方差贡献率为67.99%;碎石图第3个因子的曲线趋于平稳,提示应有2个公因子。旋转结果显示,量表各条目载荷值为0.731~0.888,无双载荷现象。将因子分别命名为直觉偏好和审慎偏好。中文版饮食行为决策偏好量表包括直觉偏好、审慎偏好2个维度,共7个条目,详见表2。
结果显示,直觉偏好维度与IES-2总分的相关系数为0.55(P<0.001);审慎偏好维度与BSCS总分的相关系数为0.66(P<0.001)。
中文版饮食行为决策偏好量表总量表、直觉偏好维度及审慎偏好维度的Cronbach's α(McDonald's ω)系数分别为0.71(0.81)、0.83(0.87)、0.75(0.73);6周后总量表及各维度的重测信度分别为0.94,0.90,0.94。
探索性图分析模型探索出中文版饮食行为决策偏好量表2个维度的网络结构与原始量表结构一致。详见图1。图中节点代表7个条目,相邻节点连线的粗细反映了关联的强弱;红色节点表示直觉偏好维度,蓝色节点表示审慎偏好维度;绿色连线越粗,表示正相关关系越强[20]。
通过Bootstrap检测探索性图分析网络结构一致性评价指标结果显示:1)2个维度的频率为1.00;2)所有条目复制表现稳定,条目归类到各自专属维度的频率均为1.00,详见图2。以上结果表明中文版饮食行为决策偏好量表的探索性图分析结构稳定,各条目均予保留。
探索性图分析模型拟合良好,各评估指标均在可接受范围,AIC和BIC指标均支持修正模型优于探索性图分析模型,表明基于网络分析的量表结构稳定、拟合度好,详见表3。
本研究对心血管疾病病人的饮食行为决策偏好进行了调查,采用高斯图域模型对中文版饮食行为决策偏好量表进行网络结构估计,使用探索性图分析模型探索其潜在维度,并通过Bootstrap抽样法计算其结构的稳定性指标,以此筛选条目并评估结构的稳健性。结果显示,探索性图分析所识别的网络结构与原量表一致[7],网络中条目聚群划分与理论维度高度契合,这表明中文版饮食行为决策偏好量表在心血管疾病人群中呈现出稳定的网络结构。与传统的探索性因子分析相比,探索性图分析通过将每个条目视为节点,条目间的条件独立关系以边的形式可视化,能够清晰揭示条目之间的直接关系网络,识别网络中具有较高中心性的关键条目[9]。这不仅有助于理解中文版饮食行为决策偏好量表在文化调试过程中的潜在结构调整,也为后续干预中优先关注的核心行为特征提供了依据。此外,中文版饮食行为决策偏好量表稳定性指标均为1.00,表明条目归类到各自专属维度的频率均为1.00,网络结构在多次重采样中均保持一致,进一步验证了网络结构的稳定性。
本研究探索性因子分析与探索性图分析均提取出2个潜在因子,与原量表结构一致,条目维度归属未见偏移,验证了其跨文化结构稳定性。基于此构建并修订的结构模型在验证性因子分析中表现出更优拟合指标,进一步支持其结构效度。内容效度方面,6名专家函询结果显示,量表的I-CVI为0.83~1.00,S-CVI为0.97,显示,中文版饮食行为决策偏好量表具备良好的内容效度[16]。效标效度分析结果显示,量表2个维度与IES-2、BSCS的相关系数均>0.5(P<0.001),显示强相关,支持良好的效标关联效度。探索性图分析所示网络社区划分与传统因子结构高度一致,为结构效度提供了新的证据。综上所述,中文版饮食行为决策偏好量表在本研究样本中展现出可靠的结构效度、内容效度与校标效度。
本研究结果显示,中文版饮食行为决策偏好量表2个维度的Cronbach's α系数和McDonald's ω系数均≥0.70,表明条目在测量同一潜在维度方面具有较高一致性,且与原量表[7]及西班牙语版[10]结果相近,显示量表在不同文化背景下具备稳定的测量性能。6周后量表重测信度均>0.90,反映出良好的时间稳定性。项目分析结果表明各条目对所属因子具有良好代表性,此外,条目复制指数均为1.00,也显示各条目均在对应网络社区中,未出现偏倚的情况。这表明中文版饮食行为决策偏好量表不仅在传统信度指标下表现良好,也在网络框架下展现出合理的条目分布,进一步加强了中文版饮食行为决策偏好量表的测量稳定性和信度可靠性。然而,在验证性因子分析中结果提示可能存在内容重叠或文化适配偏差,建议未来结合质性研究进一步优化条目表述。
在心血管健康行为要素中,饮食被视为核心可干预领域[26]。有效的饮食干预不仅依赖科学的营养指导,更有赖于对个体饮食决策方式的深入理解。研究表明,决策偏好显著影响个体的食物选择与干预依从性,特别是在心血管疾病病人中尤为突出[27]。因此,在饮食干预前评估病人的决策偏好已成为推动个体化干预策略制定的关键一步。然而,当前国内尚缺乏系统、有效的工具评估饮食决策中“直觉”与“审慎”偏好,这在一定程度上限制了干预人群的筛查与精准策略的制定。中文版饮食行为决策偏好量表作为一项聚焦双系统决策偏好的量表,弥补了现有研究中仅关注直觉偏好的不足。本研究严格遵循Brislin翻译模型对饮食行为决策偏好量表进行汉化,翻译人员均具有医学背景和留学经验,确保了语义与内容的等效性。同时,由多学科专家组成的跨文化调试团队对条目表述进行了优化,使其更贴近我国文化语境。在预调查的基础上进一步修订条目语言,提高了可读性与理解度。最终形成的中文版饮食行为决策偏好量表包含2个维度,共7个条目,具有良好的语言适配性与文化适应性。量表验证结果显示,中文版饮食行为决策偏好量表在心血管疾病病人中具有良好的信效度,网络分析进一步支持其双因子结构,条目间关系清晰、维度区分稳定。相比传统因子分析,网络分析揭示了更细致的条目关联关系与结构稳健性,丰富了量表的心理测量学依据。中文版饮食行为决策偏好量表结构简明、易于应用,可作为快速识别病人饮食决策偏好的工具,助力临床制定个体化饮食干预方案,并为后续干预效果追踪提供支持。
本研究严格遵循量表汉化流程,对饮食行为决策偏好量表进行了本土化调试和信效度检验,创新性引入网络分析,从偏相关网络识别潜在维度。结果显示,中文版饮食行为决策偏好量表包含直觉偏好和审慎偏好2个维度,共7个条目,结构稳定且条目精简,适用于评估心血管疾病病人的饮食决策偏好。然而,本研究样本存在地域局限和选择偏倚,尽管修正模型拟合优于探索性图分析模型,表明两因子结构稳定、合理,但未能完全解释汉化样本数据,条目间可能因文化语言差异存在交叉负载,建议未来开展质性访谈深入探讨。

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doi: 10.12102/j.issn.1009-6493.2026.07.013
  • 接收时间:2025-07-17
  • 首发时间:2026-10-28
  • 出版时间:2026-04-10
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  • 收稿日期:2025-07-17
  • 修回日期:2026-03-08
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    1哈尔滨医科大学护理学院,黑龙江 150086
    2四川工业科技学院
    3哈尔滨医科大学附属第二医院
    4福建医科大学附属第二医院

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