Validation of ‘the staff attitudes to nutritional
nursing care geriatric scale (SANN-G scale)’
in Italian
Loris Bonetti
1
RN, MSCNURS, Annamaria Bagnasco
2
RN, MSCNURS, PhD,
Giuseppe Aleo
3
MA & Loredana Sasso
4
RN, MSCNURS
1 PhD Student, 2 Researcher, 3 Lecturer in Scientific English, 4 Associate Professor of Nursing, Department of Health
Sciences, University of Genoa, Genoa, Italy
BONETTI L., BAGNASCO A., ALEO G. & SASSO L. (2013) Validation of ‘the staff attitudes to
nutritional nursing care geriatric scale (SANN-G scale)’ in Italian. International Nursing Review
Aim: To validate in Italian ‘The Staff Attitudes to Nutritional Nursing Care Geriatric scale’ (SANN-G scale), a
tool created in Sweden to measure nurses’ attitudes towards nutritional care in older people.
Background: Malnutrition in institutionalized older people is a serious problem having negative impact on
patient outcomes. It is reported in the literature that nurses have negative attitudes towards nutritional care.
Methods: Forward and back-translation were carried out to build the Italian version of the tool. Content and
face validity were then examined by pilot study. Test-retest reliability with Spearman’s rho (rs) correlation,
intraclass correlation (ICC) and internal consistency reliability with Cronbach’s a were assessed. Differences
between test-rest were assessed by t-test.
Results: Linguistic and semantic adaptation of the tool into Italian was successful. Thirty-three nurses skilled
in caring for older patients did pilot testing and 46 test-retesting. SANN-G GITA-scale achieved good content
and face validity, good internal consistency reliability (Cronbach’s a= 0.85) and acceptable stability [rs = 0.75,
P = 0.001; ICC = 0.76, 95% confidence interval (CI) 0.63–0.86; P = 0.001]. The t-test showed no significant
difference between test and retest results, confirming stability of the tool (t(64) =-0.98; P = 0.33).
Discussion: The process of adaptation of the scale from Swedish to Italian language was successful. Thus, the
SANN-GITA scale can be useful to assess attitudes of nursing staff to nutritional care in the Italian context.
Conclusions: This tool will allow the identification of areas where Italian nurses have negative attitudes and
where to implement strategies to improve overall nutritional care.
Keywords: Attitudes, Malnutrition, Nursing, Nursing Staff, Nutritional Care, Older People, Reliability, Validity
Introduction
Malnutrition in institutionalized older people is a serious issue
because it increases mortality rate, length of hospital stay, infec-
tion susceptibility, risk of developing pressure wounds and time
required for them to heal. All these aspects produce consider-
able harm to patients and increase health care costs (Chapman
Correspondence address: Dr Annamaria Bagnasco, Department of Health Sciences,
University of Genoa,Via Pastore 1, 16132 Genoa, Italy; Tel: 3472721175;
Fax: 010 353 8552; E-mail: annamaria.bagnasco@unige.it.
Conflict of interest statement: the authors declare that they have no con-
flict of interest.
Funding: the study was funded by the Italian National Board of Nursing
(Federazione Nazionale dei Collegi IPASVI)
Research Methods
© 2013 International Council of Nurses 1