Development and validation of knowledge, attitude and practices questionnaire on food waste among hospital staffs: addressing the strategies and challenges in reducing food waste

Abstract

Hospital staff play a crucial role in minimising food waste, ensuring sustainable operations and quality patient care in the foodservice industry. This study aimed to develop and assess the content and face validity of a questionnaire of knowledge, attitude, and practices regarding food waste among nursing staff (KAP-HPWQ-N) and foodservice officers (KAP-HPWQ-FS) in hospitals. In Phase 1, strategies were identified to address food waste, including the development of tools and staff training by conducted a scoping review. The review revealed the need for tools development and staff training as strategies to be explored more. Phase 2 focused group discussions explored food waste reduction in Malaysian hospitals from the perspective of staff with foodservice management and dietetic backgrounds. Food waste in hospitals is a result of insufficient staff training, poor meal preparation, negative attitudes, limited menu options, and ineffective management practices. Strategic planning and utilising tools can improve operational efficiency. Phase 3 involved the development of two questionnaires aimed at assessing the knowledge, attitudes, and practices of hospital staff in ward and kitchen operations regarding food waste issues. A total of two sets of questionnaires; (KAP-HPWQ-N) for nurses and (KAP-HPWQ-FS) for foodservice officers consisted 20 items on knowledge, 20 items on attitude, and 20 items on practices were reviewed by eight expert panels with excellent content validity scores on knowledge (S-CVI=0.98, S-CVI/UA=0.89), attitude (S-CVI=0.96, S-CVI/UA=0.80) and practice (S-CVI=0.98, S-CVI/UA=0.90) for foodservice officers while for nurses on knowledge (S-CVI=0.98, S-CVI/UA=0.89), attitude (S-CVI=0.97, SCVI/ UA=0.90) and practice (S-CVI=0.97, S-CVI/UA=0.85) respectively following removal of two items knowledge questions from each part of the questionnaire. Next, 10 nurses, 5 catering officers, and 5 dietitians evaluated the face validity of the questionnaire based on clarity and understandability. The questionnaire set for foodservice officers had good face validity scores on knowledge (S-FVI=1.00, SFVI/ UA=1.00), attitude (S-FVI=1.00, S-FVI/UA=1.00), and practice (S-FVI=1.00, SFVI/ UA=1.00). As for the nurses' questionnaire set, only the knowledge part required revision based on the feedback given. Good final scores were then obtained on knowledge following revision of 4 items (S-FVI=1.00, S-FVI/UA=1.00), attitude (SFVI= 1.00, S-FVI/UA=1.00), and practice (S-FVI=1.00, S-FVI/UA=1.00) respectively. This study developed and validated a 58-item both KAP-HPWQ for hospital staff to measure knowledge, attitudes, and practices regarding food waste, aiding in formulating effective strategies to mitigate waste in healthcare facilities. In conclusion, these tools highlight gaps in hospital food waste knowledge, attitude and practices, enabling targeted staff training to develop more effective waste reduction strategies.