Date of Award


Degree Type


Degree Name

Master of Science in Nutrition and Food Science


Nutrition and Food Sciences

First Advisor

Geoffrey Greene


Background: Currently, there is no known patient reported outcome (PRO) instrument being used in clinical practice for the home parenteral nutrition (HPN) population. To address this gap, the Home Parenteral Nutrition-Patient Reported Outcome Questionnaire (HPN-PROQ) was developed for use during medical appointments or homecare visits. The purpose of this research is to provide evidence that the items and scales of the HPN-PROQ possess content validity, a crucial step in the process of questionnaire development.

Subjects: Qualitative sample included 32 HPN patients and quantitative sample included 13 expert home care clinicians (physicians, dietitian, pharmacists, registered nurses and patient advocates.)

Methods: In Phase I, cognitive interviews (CI) were conducted to evaluate HPN patients’ understanding of the instructions, items, and response scales on a draft HPN-PROQ. The draft HPN-PROQ was revised based on results of CIs. In Phase II, a revised draft was sent to expert clinicians to complete the Content Validity Index (CVI). Any item achieving a I-CVI kappa score ≤ 0.783 was removed. The Scale-CVI-Average (S-CVI/AVG) was calculated following a second round of CVI by a reduced expert panel.

Results: The final HPN-PROQ contains thirty-four items with an I-CVI score ≥ 0.783. The overall S-CVI/AVG score of the HPN-PROQ was 0.961.

Conclusion: This study provides evidence that the HPN-PROQ has acceptable content-validity and after future validation procedures, may be appropriate as a new tool for fostering dialogue between HPN patients and their clinicians.