Article(id=1322924425355604879, tenantId=1146029695717560320, journalId=1220038315760373764, issueId=1322924415817757501, articleNumber=null, orderNo=null, doi=10.12102/j.issn.1009-6493.2026.17.018, pmid=null, cstr=null, oa=null, hot=null, price=null, onlineType=0, articleFormat=0, articleType=null, articleTypeStr=null, receivedDate=1768147200000, receivedDateStr=2026-01-12, revisedDate=1783872000000, revisedDateStr=2026-07-13, acceptedDate=null, acceptedDateStr=null, onlineDate=1793339361751, onlineDateStr=2026-10-30, pubDate=1788969600000, pubDateStr=2026-09-10, doiRegisterDate=null, doiRegisterDateStr=null, onlineIssueDate=1793339361751, onlineIssueDateStr=2026-10-30, onlineJustAcceptDate=null, onlineJustAcceptDateStr=null, onlineFirstDate=null, onlineFirstDateStr=null, sourceXml=null, magXml=null, createTime=1793339361751, creator=13701087609, updateTime=1793339361751, updator=13701087609, issue=Issue{id=1322924415817757501, tenantId=1146029695717560320, journalId=1220038315760373764, year='2026', volume='40', issue='17', pageStart='2961', pageEnd='3152', issueExtLink='null', onlineDate='null', pubDate='1788969600000', pubDateStr='2026-09-10', beforeIssueId=null, nextIssueId=null, price=null, status=1, issueComplete=1, articleOrder=1, issueType=-1, specialIssue=null, createTime=1793339359478, creator='13701087609', updateTime=1793343089343, updator='13701087609', preIssue=null, nextIssue=null, articleTotal=null, ext={EN=IssueExt(id=1322940060072542250, tenantId=1146029695717560320, journalId=1220038315760373764, issueId=1322924415817757501, language=EN, specialIssueTitle=, coverIllustrator=null, specialIssueEditor=, specialIssueAbout=), CN=IssueExt(id=1322940060072542251, tenantId=1146029695717560320, journalId=1220038315760373764, issueId=1322924415817757501, language=CN, specialIssueTitle=, coverIllustrator=null, specialIssueEditor=, specialIssueAbout=)}, issueFiles=null, downloadFileDto=null}, startPage=3080, endPage=3085, ext={EN=ArticleExt(id=1322924425573708688, articleId=1322924425355604879, tenantId=1146029695717560320, journalId=1220038315760373764, language=EN, title=Chinesization and reliability and validity testing of the Pregnancy Eating Attitudes Questionnaire, columnId=1220689492655129450, journalTitle=Chinese Nursing Research, columnName=Scale Study, runingTitle=null, highlight=null, articleAbstract=
Objective

To translate the Pregnancy Eating Attitudes Questionnaire(PEA-Q) into Chinese and test its reliability and validity.

Methods

Following Brislin's translation model,the English version of PEA-Q was forward-translated,back-translated,cross-culturally adapted,and pilot-tested to develop the Chinese version of PEA-Q.From June to October 2025,1 032 pregnant women were recruited from one tertiary hospital and three community health centers in Changzhou.Classical test theory and item analysis were used to evaluate reliability,validity,measurement invariance,and item performance.

Results

The Chinese version of PEA-Q consisted of 11 items across three dimensions:permissive eating attitude,self-regulated eating attitude,and mildly restrained eating attitude.The scale-level content validity index was 1.000,and the item-level content validity index was 1.000.Exploratory factor analysis extracted three common factors,with a cumulative variance contribution rate of 78.075%.Confirmatory factor analysis indicated a good fit for the three-factor model.The overall Cronbach's α coefficient was 0.895.The questionnaire demonstrated measurement invariance across different gestational weeks and age groups.Item discrimination ranged from 1.59 to 2.80,and item difficulty ranged from -2.02 to 2.17.

Conclusion

The Chinese version of PEA-Q shows good reliability,validity,and cross-group measurement invariance.Its items exhibit strong measurement performance. It is a reliable tool for assessing eating attitudes during pregnancy.

, authors=Wen LYU1, 2, Xian WU2, Jiayi WENG1, Siyuan SUN1, Zhuo WANG1, authorsList=Wen LYU, Xian WU, Jiayi WENG, Siyuan SUN, Zhuo WANG, authorCompany=null, correspAuthors=Zhuo WANG, authorNote=null, correspAuthorsNote=null, 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=1322924426769085329, articleId=1322924425355604879, tenantId=1146029695717560320, journalId=1220038315760373764, language=CN, title=孕期饮食态度问卷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

汉化孕期饮食态度问卷(Pregnancy Eating Attitude Questionnaire,PEA-Q),并检验其信效度。

方法

根据Brislin模型对英文版PEA-Q进行正译、回译、跨文化调试及预调查,形成中文版PEA-Q。于2025年6月—10月选取常州市1所三级甲等医院就诊及3个社区建卡的1 032名孕妇进行调查,并结合经典测量法与项目分析评价其信效度、测量不变性和条目性能。

结果

中文版PEA-Q包括放任型饮食观、自主调控型饮食观和轻负型饮食观3个维度,共11个条目。中文版PEA-Q量表水平内容效度为1.000,条目水平内容效度为1.000。探索性因子分析提取3个公因子,累计方差贡献率为78.075%;验证性因子分析显示3因子模型拟合良好。问卷总Cronbach′s α系数为0.895。问卷在不同孕周和不同年龄段孕妇群体等值性检验中具有测量不变性。条目区分度为1.59~2.80,难度系数为-2.02~2.17。

结论

中文版孕期饮食态度问卷具有良好的信效度和跨群体测量不变性,各条目测量性能较高,是评价孕期饮食态度的可靠工具。

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吕雯,主管护师,硕士研究生在读

, correspAuthorsNote=
王濯,E-mail:
WANG Zhuo, E-mail:
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Factor loading of the Chinese version of PEA-Q

, figureFileSmall=null, figureFileBig=null, tableContent=
条目放任型饮食观自主调控型饮食观轻负型饮食观
我不确定孕期增加多少体重是合适的0.844
怀孕期间,我可以想吃什么就吃什么0.831
怀孕就像一张“通行证”,让我可以想吃多少就吃多少0.836
怀孕就像一张“通行证”,让我可以吃任何类型食物0.841
“一人吃,两人补”意味着我每天需要摄入更多食物0.855
怀孕期间,我每天需要吃得更多0.864
怀孕不意味着我需要吃更多0.842
怀孕后,我会吃更多零食和/或正餐0.869
因为怀孕,我每顿饭需要吃得更多0.833
只要我感觉良好,我不担心怀孕期间体重会增加多少0.849
怀孕期间,我不担心我会吃得太多0.884
), ArticleFig(id=1322924433664521152, tenantId=1146029695717560320, journalId=1220038315760373764, articleId=1322924425355604879, language=CN, label=表1, caption=

中文版孕期饮食态度问卷旋转后因子载荷矩阵

, figureFileSmall=null, figureFileBig=null, tableContent=
条目放任型饮食观自主调控型饮食观轻负型饮食观
我不确定孕期增加多少体重是合适的0.844
怀孕期间,我可以想吃什么就吃什么0.831
怀孕就像一张“通行证”,让我可以想吃多少就吃多少0.836
怀孕就像一张“通行证”,让我可以吃任何类型食物0.841
“一人吃,两人补”意味着我每天需要摄入更多食物0.855
怀孕期间,我每天需要吃得更多0.864
怀孕不意味着我需要吃更多0.842
怀孕后,我会吃更多零食和/或正餐0.869
因为怀孕,我每顿饭需要吃得更多0.833
只要我感觉良好,我不担心怀孕期间体重会增加多少0.849
怀孕期间,我不担心我会吃得太多0.884
), ArticleFig(id=1322924433744212929, tenantId=1146029695717560320, journalId=1220038315760373764, articleId=1322924425355604879, language=EN, label=Table 2, caption=

Model fitting indicators for each equivalent model

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项目分类χ2值νCFITLIRMSEA△CFI△TLI△RMSEA
年龄形态等值101.693820.9940.9910.019
单位等值108.440900.9940.9930.0170.0000.002-0.002
尺度等值126.6121010.9920.9910.0190.0000.003-0.004
孕周形态等值135.2881230.9960.9950.012
单位等值149.3241390.9970.9960.0100.0010.001-0.002
尺度等值205.5671610.9850.9850.013-0.008-0.0050.004
), ArticleFig(id=1322924433811321794, tenantId=1146029695717560320, journalId=1220038315760373764, articleId=1322924425355604879, language=CN, label=表2, caption=

各等值模型拟合指标

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项目分类χ2值νCFITLIRMSEA△CFI△TLI△RMSEA
年龄形态等值101.693820.9940.9910.019
单位等值108.440900.9940.9930.0170.0000.002-0.002
尺度等值126.6121010.9920.9910.0190.0000.003-0.004
孕周形态等值135.2881230.9960.9950.012
单位等值149.3241390.9970.9960.0100.0010.001-0.002
尺度等值205.5671610.9850.9850.013-0.008-0.0050.004
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孕期饮食态度问卷的汉化及信效度检验
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吕雯 1, 2 , 吴贤 2 , 翁佳怡 1 , 孙思远 1 , 王濯 1, *, *
护理研究 | 量表研究 2026,40(17): 3080-3085
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护理研究 |量表研究 2026 , 40 (17) : 3080 -3085
孕期饮食态度问卷的汉化及信效度检验
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吕雯1, 2, 吴贤2, 翁佳怡1, 孙思远1, 王濯1, *, *
作者信息
  • 1常州大学医学与健康工程学院,江苏 213164
  • 2常州市妇幼保健院
通讯作者:
王濯,E-mail:
WANG Zhuo, E-mail:
作者简介:

吕雯,主管护师,硕士研究生在读

Chinesization and reliability and validity testing of the Pregnancy Eating Attitudes Questionnaire
Wen LYU1, 2, Xian WU2, Jiayi WENG1, Siyuan SUN1, Zhuo WANG1
Affiliations
  • 1School of Medicine and Health Engineering, Changzhou University, Jiangsu 213164 China
  • 2Changzhou Maternal and Child Health Hospital
出版时间: 2026-09-10 doi: 10.12102/j.issn.1009-6493.2026.17.018
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目的

汉化孕期饮食态度问卷(Pregnancy Eating Attitude Questionnaire,PEA-Q),并检验其信效度。

方法

根据Brislin模型对英文版PEA-Q进行正译、回译、跨文化调试及预调查,形成中文版PEA-Q。于2025年6月—10月选取常州市1所三级甲等医院就诊及3个社区建卡的1 032名孕妇进行调查,并结合经典测量法与项目分析评价其信效度、测量不变性和条目性能。

结果

中文版PEA-Q包括放任型饮食观、自主调控型饮食观和轻负型饮食观3个维度,共11个条目。中文版PEA-Q量表水平内容效度为1.000,条目水平内容效度为1.000。探索性因子分析提取3个公因子,累计方差贡献率为78.075%;验证性因子分析显示3因子模型拟合良好。问卷总Cronbach′s α系数为0.895。问卷在不同孕周和不同年龄段孕妇群体等值性检验中具有测量不变性。条目区分度为1.59~2.80,难度系数为-2.02~2.17。

结论

中文版孕期饮食态度问卷具有良好的信效度和跨群体测量不变性,各条目测量性能较高,是评价孕期饮食态度的可靠工具。

孕妇  /  饮食态度  /  评估工具  /  测量不变性  /  饮食管理
Objective

To translate the Pregnancy Eating Attitudes Questionnaire(PEA-Q) into Chinese and test its reliability and validity.

Methods

Following Brislin's translation model,the English version of PEA-Q was forward-translated,back-translated,cross-culturally adapted,and pilot-tested to develop the Chinese version of PEA-Q.From June to October 2025,1 032 pregnant women were recruited from one tertiary hospital and three community health centers in Changzhou.Classical test theory and item analysis were used to evaluate reliability,validity,measurement invariance,and item performance.

Results

The Chinese version of PEA-Q consisted of 11 items across three dimensions:permissive eating attitude,self-regulated eating attitude,and mildly restrained eating attitude.The scale-level content validity index was 1.000,and the item-level content validity index was 1.000.Exploratory factor analysis extracted three common factors,with a cumulative variance contribution rate of 78.075%.Confirmatory factor analysis indicated a good fit for the three-factor model.The overall Cronbach's α coefficient was 0.895.The questionnaire demonstrated measurement invariance across different gestational weeks and age groups.Item discrimination ranged from 1.59 to 2.80,and item difficulty ranged from -2.02 to 2.17.

Conclusion

The Chinese version of PEA-Q shows good reliability,validity,and cross-group measurement invariance.Its items exhibit strong measurement performance. It is a reliable tool for assessing eating attitudes during pregnancy.

pregnant women  /  eating attitude  /  assessment tool  /  measurement invariance  /  dietary management
吕雯, 吴贤, 翁佳怡, 孙思远, 王濯. 孕期饮食态度问卷的汉化及信效度检验. 护理研究, 2026 , 40 (17) : 3080 -3085 . DOI: 10.12102/j.issn.1009-6493.2026.17.018
Wen LYU, Xian WU, Jiayi WENG, Siyuan SUN, Zhuo WANG. Chinesization and reliability and validity testing of the Pregnancy Eating Attitudes Questionnaire[J]. Chinese Nursing Research, 2026 , 40 (17) : 3080 -3085 . DOI: 10.12102/j.issn.1009-6493.2026.17.018
孕期饮食行为对母体健康和胎儿生长发育具有重要意义。流行病学调查显示,40%~70%的孕妇未能达到孕期膳食指南推荐的合理饮食模式,不健康饮食行为已经成为影响母婴健康的重要公共问题之一[1]。孕期饮食态度(pregnancy eating attitude)是指孕妇对饮食行为所持有的相对稳定的认知评价、情感反应及行为倾向的综合体现[2],是孕期饮食行为的重要影响因素。研究显示,22%的孕妇存在饮食失调态度,其中78%伴随暴饮暴食倾向或对体重增加过度担忧[3]。不良的饮食态度往往通过影响饮食行为增加孕期营养失衡的风险[4],并与妊娠期糖尿病、妊娠期高血压、巨大儿等母婴不良健康结局密切相关[5-7]。因此,准确评估孕期饮食态度特征,有助于早期识别不同类型的饮食态度,为制定个体化营养管理方案与行为干预提供依据。然而,现有饮食态度测量工具主要针对一般成人或特定疾病人群开发,尚缺乏专门针对孕期女性的标准化评估工具。Jouppi等[8]于2024年编制了孕期饮食态度问卷(Pregnancy Eating Attitude Questionnaire,PEA-Q),具有良好的信效度。本研究基于经典测量理论与项目反应理论,采用传统测量方法及等级反应模型(GRM)检验PEA-Q的信效度和条目性能,并为确保问卷在不同亚组中测量的可靠性与可比性,进一步评价其在不同孕周与年龄群体中的测量不变性,以期为我国孕妇饮食态度评估提供科学测量工具。
PEA-Q由Jouppi团队于2024年在焦点小组讨论和文献回顾基础上编制而成,用于评估孕妇孕期饮食态度。该问卷共11个条目,包括放任型饮食观(4个条目)、自主调控型饮食观(5个条目)、轻负型饮食观(2个条目)3个维度。问卷采用Likert 5级评分法,“非常不同意”计1分,“非常同意”计5分,其中条目9采取反向计分,计分方式取各维度总分的平均值。评估人员可根据各维度得分情况,判断孕妇饮食态度现状和类型。原问卷各维度Cronbach′s α系数分别为0.82,0.81,0.83,内部一致性良好。
在征得原作者授权后,根据Brislin翻译模型[9]对英文版PEA-Q问卷进行汉化。1)正译:由2名母语为中文并熟练掌握英语的1名护理硕士研究生以及1名英语教师分别将PEA-Q问卷翻译成为中文版本,形成正译稿A1、A2,经课题组分析、比较、整合后形成PEA-Q中文稿1。2)回译:由2名未接触过原问卷内容的双语专家,1名为大学护理学教师,另1名为英国留学经历的医学硕士对PEA-Q问卷中文稿1分别进行回译,经课题组分析、比较、整合后形成PEA-Q回译稿。3)原作者咨询:将回译稿经邮件返回原作者,根据原作者意见进行修改与完善,形成PEA-Q中文稿2。4)文化调适:邀请8名相关领域专家,包括临床护理专家4人,产科主任医师2人,妇科主任医师1人,营养科副主任医师1人。其中博士研究生1人,硕士研究生3人,本科4人,工作年限12~31(24.38±7.09)年,对中文稿2进行文化调适。最终形成PEA-Q问卷中文稿3。5)预调查:于2025年5月—6月从常州市某三级甲等妇幼保健院采用便利抽样法选取门诊就诊及住院孕妇100人对中文版PEA-Q进行预调查,结果显示问卷Cronbach′s α系数为0.87,受试者填写时间2~3 min。同时询问受试者对问卷理解程度,有无填写困难或语义模糊条目,并针对反馈进行修改,最终形成中文版PEA-Q问卷。
于2025年6月—10月选取常州市某三级甲等妇幼专科医院就诊孕妇以及3个社区建卡孕妇作为调查对象。纳入标准:1)年龄≥18岁;2)确诊宫内妊娠且知晓自身已怀孕;3)知情同意参加本研究。排除标准:1)患有精神疾病或认知功能障碍者;2)已确诊为进食障碍患者;3)正在参与其他研究。根据因子分析样本量要求[10],样本量应为条目数的5~10倍,本问卷共11个条目,故样本量需55~110人。测量不变性检验要求每个亚组样本量≥200人为宜,以保证模型拟合稳定和可靠[11],本研究以孕早、中、晚期以及是否≥35岁划分亚组,考虑到20%无效问卷,故样本量至少需要750人。本研究已通过常州市妇幼保健院伦理委员会审查(审批号:2025-K004-01),所有调查对象均已签署知情同意且自愿参与。
采用自行设计的一般资料调查表,包括孕妇年龄、文化程度、职业状况、居住地、家庭人均月收入、医疗保险类型等人口学资料;孕妇的孕前体质指数(BMI)、孕周、既往孕产史、本次受孕方式等产科资料。
该量表是基于我国孕期女性饮食行为测量概念模型开发,用于测量我国孕期女性饮食行为的量表,由黄艳平等[12]编制。量表包含6个维度,共31个条目,采用Likert 5级评分法。“完全不同意”计1分,“完全同意”计5分,得分越高表示饮食行为越不合理。该量表Cronbach′s α系数为0.91,分半信度为0.81,重测信度为0.88。
采用汉化形成的最终中文版PEA-Q。
由经过培训的研究人员进行问卷调查。在调查过程中,研究人员向孕妇说明研究目的,填写方式,征得知情同意后发放问卷,填写完成后当场收回并检查其完整性。本研究共发放问卷1 150份,剔除填写时间不足60 s的问卷,所有条目同一选项的问卷,以及信息不足、前后矛盾的问卷,最终收回有效问卷1 032份,有效回收率为89.7%。
1)项目分析:通过决断值法、题总相关法和逐项删除法进行;2)效度:通过内容效度、结构效度、聚合效度、区分效标关联效度评价问卷的效度;3)测量不变性检验:通过多组验证性因子分析,依次检验形态等值、单位等值、尺度等值,评估问卷在不同亚组中是否具有等效性;4)信度:采用克朗巴赫α系数(Cronbach′s α系数)与组合信度(Composite Reliability,CR)评估问卷内部一致性[13]。
IRT分析能独立于特定样本,量化每个条目在不同潜在特质水平上的鉴别能力与反应阈值,并通过区分度(a)和难度(b)描述[14]。单维性是项目分析的基础,采用主成分分析法,当维度第一特征根与第二特征根比值>3时则提示满足单维性要求[15]。鉴于本问卷为Likert 5级评分法,采用等级响应模型GRM进行分析,GRM为各条目估计一个区分度参数(a)以及4个难度阈值参数(b1~b4)[16]。通常认为,区分度a在0.3~3.0为宜;难度b在-3~3为宜[17];难度参数b1~b4代表受试者在相邻反应类别之间转换时所需的潜在特质水平,需确保其逻辑顺序合理且分布适当,且理论上满足b1<b2<b3<b4的单调性;通过项目特征曲线(ICC)、项目信息曲线(IIC)、总信息曲线(TIC)评价条目反应模式、测量性能和测量范围[18-19]。
双人核对后录入数据,采用SPSS 29.0、AMOS 26.0、R 4.4软件进行数据分析。符合正态分布的定量资料采用均数±标准差(x±s)表示,定性资料采用频数、百分比(%)表示。以P<0.05为差异有统计学意义。
课题组结合专家意见,在讨论后对问卷内容进行如下修改:1)专家认为“进食”一词更侧重于具体的、机械地“吃”的行为动作,而“饮食”是更为全面、科学的术语,故将问卷的题目“孕期进食态度问卷”修改为“孕期饮食态度问卷”。2)专家认为基于有准则的适宜范围,更能准确评估受访者对“孕期体重增加”概念的认知程度,将条目3“我不确定孕期体重应该增加多少”修改为“我不确定孕期增加多少体重是合适的”。3)经原作者审核后,提出条目1中表述方式为西方谚语,为确保问卷在中国文化语境中的有效性,建议调整为概念对等的中文表达,故将“为两人吃”修改为“一人食,两人补”。
本研究共对1 032名孕妇进行有效调查。文化程度:初中及以下12人,高中185人,专科及以上528人;居住地:城市757人,农村275人;职业:在职752人,无业280人;家庭人均月收入:<3 000元57人,3 000~5 000元271人,>5 000元704人;子女数量:无531人,1个406人,≥2个95人;孕BMI:<18.5 kg/m2消瘦96人,18.5~24.0 kg/m2正常620人,24.0~28.0 kg/m2超重229人,≥28.0 kg/m2肥胖87人;年龄:<35岁847人,≥35岁185人;孕周:<孕14周199人,孕14~28周375人,孕>28周458人。
采用决断值法,各条目临界比值比为31.628~39.347,均>3且P<0.05。采用题总相关法,计算条目得分与维度总分相关系数,结果显示相关系数为0.683~0.821,均>0.4且P<0.05[20]。采用逐项删除法,逐一剔除单独条目后其Cronbach's α系数,删除后问卷Cronbach's α系数均下降,保留所有条目。
邀请8名相关领域专家对条目内容与孕期饮食态度相关性进行评价,由“不相关”到“非常相关”分别赋1~4分,结果显示条目水平内容效度指数(I-CVI)为1.000,量表平均内容效度指数(S-CVI/Ave)为1.000,量表全体一致性指数(S-CVI/UA)为1.000,均>0.78[21],表明问卷内容效度良好。
1)探索性因子分析:随机抽取332份问卷用于探索性因子分析。结果显示KMO值为0.885,Bartlett′s球形检验显示χ2为2 373.691,且P<0.01,表明问卷可进行探索性因子分析[22]。采用主成分分析法和最大方差法,结合碎石图提取3个特征值>1公因子,累计方差贡献率为78.075%,分别命名为放任型饮食观、自主调控型饮食观、轻负型饮食观。各条目对应维度因子载荷均>0.5,可保留所有条目[20],各条目因子载荷分析见表1。2)验证性因子分析:将剩余700份问卷用于验证性因子分析,采用极大似然法对模型进行拟合验证,拟合结果为:近似误差均方根RMSEA=0.029,比较拟合指数(CFI)=0.992,Tucker-Lewis指数(TLI)=0.989,表明模型拟合良好[23]。
验证性因子分析结果显示,问卷各条目标准化因子载荷为0.677~0.867,均≥0.50;3个维度组合信度为0.813~0.937,均≥0.60;平均方差变异(average variance extracted,AVE)为0.574~0.685,均≥0.50[23],表明问卷聚敛效度良好。维度的AVE平方根为0.758~0.827,均大于维度之间相关系数[23],说明问卷有良好的区分效度。
中文版PEA-Q各维度得分与孕期饮食行为量表总分均为负相关,相关系数分别为-0.432~-0.470(P<0.05),问卷具有良好的效标关联度[21]。
以孕周划分为孕早期、孕中期、孕晚期3个胎龄组;以是否≥35岁,划分为普通和高龄产妇2个年龄组。测量不变性通过嵌套模型来实现,依次检验不同水平的测量等值性。结果显示,在各参数不受限制,不同群体之间因子结构一致,模型拟合良好,形态等值性成立。在此基础上,依次限制项目因子载荷和项目截距,结果显示各嵌套模型拟合度与基准模型差异均在理想范围之内(△CFI<0.01、△TLI<0.01、△RMSEA<0.015),单位等值性和尺度等值性成立,表明中文版PEA-Q具有跨孕周和跨年龄的测量不变性[24],见表2。
中文版PEA-Q的总Cronbach′s α系数为0.895,各维度Cronbach′s α系数为0.813~0.926;各维度组合信度为0.813~0.937;均>0.7[20]。表明问卷具有良好的内部一致性和稳定性。
1)单维性:本问卷为多维结构,故分别检验各维度单维性。结果显示,各维度第一特征根与第二特征根比值在5.29~6.29之间,均>3,符合单维性要求。2)项目参数:条目区分度参数为1.59~2.80,难度参数为-2.02~2.17,均在理想范围内。3)项目特征曲线(ICC):各条目ICC为光滑、陡峭S型曲线,从左至右依次排列,峰值出现有序。4)项目信息曲线(IIC):各条目项目信息曲线峰值在所对应的潜在特质水平。5)总信息曲线(TIC):问卷在θ为1~2表现出较高的测量精度,提供最多信息量。
既往研究表明,孕期饮食态度与其饮食行为的选择以及妊娠期体重管理密切相关[25]。一项纳入92项研究的系统评价结果显示,孕妇饮食变化的调整,很大程度源于对其自身状况的评估与孕期需求的认知评价与态度取向,强调了饮食态度在孕期管理中具有重要的作用[26]。Savard等[27]研究结果同样证实,饮食态度越积极的妊娠期女性,其健康饮食意向和行为水平越高;相反,不良的饮食态度可能诱发不适应性饮食行为[28]。然而,现有相关研究多依赖于进食态度测试(EAT)、进食障碍诊断量表(EDE)等普适性评估工具,主要基于非孕期人群或病理性进食构建,对孕期特有的生理变化与社会心理情境饮食态度覆盖不足。因此,有必要引入或开发专为孕期女性设计的饮食态度标准化评估工具。中文版PEA-Q能够科学评估不同类型孕期饮食态度,且结构简明、表述清晰,条目较少,具有良好的可行性和临床适用性。通过对中文版PEA-Q各维度的分析,可帮助医护人员在常规产检及孕期随访中,早期识别存在不良饮食态度和潜在饮食风险的孕妇,为开展分层化营养宣教和个体化饮食干预提供依据。本研究按不同孕周分组,主动调整型饮食观在孕中期得分高于孕早期。这提示孕中晚期可能是饮食观念与决策更易发生变化的关键干预窗口期。而放任型饮食观与轻负型饮食观得分波动较小,则提示可作为产检随访中持续筛查与风险分层指标。基于此,中文版PEA-Q亦可作为过程性评价指标,为动态调整宣教重点与后续结合饮食行为、孕期体重增长等结局开展纵向研究提供量化依据[8]。同时,其能应用于不同妊娠阶段和年龄段的女性,为开展不同人群间比较研究提供了可靠的测量工具,具有良好的应用前景。
本研究从问卷整体信效度和条目性能两方面对中文版PEA-Q进行了心理测量学评价。项目参数结果显示,各条目区分度为1.59~2.80,提示条目能够有效区分孕妇在饮食态度上的差异水平;难度参数为-2.02~2.17,且阈值呈递增分布,提示条目能够有效反映孕妇饮食态度的差异。进一步结合ICC分析可见,各条目曲线形态良好,反应类别概率随潜在特质水平呈单调变化,各类别峰值顺序清晰,阈值区间未出现倒置或重叠现象,表明量表选项层级设置合理、结构清晰。问卷对中等态度特质水平孕妇测量精度最高,符合一般态度特质在人群中分布特征,同时,也提示条目在极高或极低态度特质区间测量精度相对有限[17]。结合对部分孕妇的回访,可能与条目内容直接反映孕妇对体重和饮食关注程度,更有利于捕捉到中高水平态度特质有关。在信度方面,中文版PEA-Q总体及各维度内部一致性处于较高水平,提示问卷条目之间具有较好的同质性,能够稳定反应孕期女性饮食态度特征。在效度方面,专家一致认为问卷内容能够较为准确覆盖孕期饮食态度相关构念。探索性与验证性因子分析支持原问卷三因子结构,表明中文版PEA-Q在我国孕妇人群中具有良好的结构稳定性,并与以往研究中孕妇在妊娠期会存在不同类型饮食态度预期一致[29]。测量不变性分析则证明中文版PEA-Q在不同妊娠阶段和年龄亚组中具有一致的测量含义,这为开展跨群体研究及纵向比较提供了方法学保障。
本研究严格遵循量表引进与调适流程。在翻译与跨文化调试阶段,邀请8名具有丰富经验的专家参与评议,专家来源涵盖产科、护理学以及营养学相关领域。重点从语义、概念内涵以及测量对等性层面修订条目,使其表述更贴近我国孕期女性语言习惯与认知特点,并获得原作者认可。在信效度检验阶段,不仅采用经典测量理论对问卷整体信效度和结构稳定性进行评价,还进一步引入测量不变性分析与项目反应理论,证实其跨群体稳定性与良好的条目测量性能,增强了问卷在不同应用场景中的适用性与可靠性。通过严谨的调试流程与多方法心理测量学检验,充分体现了中文版PEA-Q汉化过程的科学与严谨,为准确评估我国孕期女性饮食态度提供了可靠工具。
本研究在严格遵循Brislin模型基础上,将经典测量方法与项目分析相结合,对PEA-Q进行汉化与信效度检验。结果表明,中文版PEA-Q测量结果可靠,具有良好的信效度和条目检测性能,并且适用于不同妊娠阶段和年龄层孕妇,是评估孕期女性饮食态度有效、可靠的工具。本研究存在以下局限,样本仅来自1所三级甲等妇幼专科医院以及3所社区医院,样本代表性有限。未来可扩大调查范围和研究人群,进一步验证问卷适用性,以提升其推广和应用价值。

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2026年第40卷第17期
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doi: 10.12102/j.issn.1009-6493.2026.17.018
  • 接收时间:2026-01-12
  • 首发时间:2026-10-30
  • 出版时间:2026-09-10
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  • 收稿日期:2026-01-12
  • 修回日期:2026-07-13
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    1常州大学医学与健康工程学院,江苏 213164
    2常州市妇幼保健院

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2种不同金属材料的力学参数
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属
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鹅膏菌科Amanitaceae 2 11 5.26 鹅膏菌属 Amanita 10 4.78
小菇科 Mycenaceae 2 12 5.74 丝盖伞属 Inocybe 5 2.39
多孔菌科 Polyporaceae 8 14 6.70 蜡蘑属 Laccaria 5 2.39
红菇科 Russulaceae 3 23 11.00 小皮伞属 Marasmius 6 2.87
小菇属 Mycena 11 5.26
光柄菇属 Pluteus 5 2.39
红菇属 Russula 17 8.13
栓菌属 Trametes 5 2.39
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