Development and Preliminary Validation of a Questionnaire on Parental Perception of The Ketogenic Diet

Abstract

Background: Epilepsy is a prevalent neurological disorder in children, often requiring specialized management strategies. The ketogenic diet (KD), a high-fat, low-carbohydrate therapy, has shown efficacy in reducing seizure frequency in drug-resistant epilepsy. However, adherence is challenging due to dietary restrictions, complexity, and side effects. Understanding parental perceptions is crucial to addressing barriers and improving adherence. This study aimed to develop and preliminarily validate a questionnaire assessing parental perceptions of the KD.

Methodology: Two questionnaires (pre- and post-intervention) were designed to evaluate ten domains, including parental understanding, effectiveness, dietary management, concerns, support, and financial impact. Content validity was assessed using the Content Validity Index (CVI) with expert evaluation based on Lawshe’s method. Six experts, including dietitians and neurologists, reviewed item relevance and clarity. Internal consistency was analyzed using Cronbach’s alpha.

Results: Content validity scores ranged from 0.83 to 1.0 (I-CVI) and 0.94 to 1.0 (S-CVI), indicating excellent validity. Some discrepancies in four domains were resolved through expert consensus. Internal consistency was confirmed with satisfactory Cronbach’s alpha values.

Conclusion: The developed questionnaire demonstrated strong validity and reliability, making it a valuable tool for identifying adherence barriers. Further psychometric testing is required for comprehensive validation.