新生儿进食结局评估：工具开发与评分者间信度。
Neonatal Eating Outcome Assessment: tool development and inter-rater reliability.
机构信息
Program in Occupational Therapy, Washington University School of Medicine, St. Louis, MO, USA.
Department of Pediatrics, Washington University School of Medicine, St. Louis, MO, USA.
出版信息
Acta Paediatr. 2018 Mar;107(3):414-424. doi: 10.1111/apa.14128. Epub 2017 Dec 8.
AIM
To define the process of tool development and revision for the Neonatal Eating Outcome (NEO) Assessment and to report preliminary inter-rater reliability.
METHODS
Tool development consisted of a review of the literature and observations of feeding performance among 178 preterm infants born ≤32 weeks gestation. 11 neonatal therapy feeding experts provided structured feedback to establish content validity and define the scoring matrix. The tool was then used to evaluate feeding in 50 preterm infants born ≤32 weeks of gestation and 50 full-term infants. Multiple revisions occurred at each stage of development. Finally, six neonatal occupational therapists participated in reliability testing by independently scoring five videos of oral feeding of preterm infants using version 4 of the tool.
RESULTS
The intraclass correlation for the 'prefeeding' score was 0.71 (0.37-0.96), and the intraclass correlation for the 'total' score was 0.83 (0.56-0.98).
CONCLUSION
The 'total' score had good to excellent reliability. Fleiss' Kappa scores for all 18 scorable items ranged from slight agreement to moderate agreement. Items with the lowest Kappa scores were revised, and additional feedback from therapists engaged in reliability testing was incorporated, resulting in final version 5.
目的
定义新生儿摄食结局（NEO）评估工具的开发和修订过程，并报告初步的评分者间信度。
方法
工具的开发包括对文献的回顾和对 178 名胎龄≤32 周的早产儿喂养表现的观察。11 名新生儿治疗喂养专家提供了结构化反馈，以建立内容效度并定义评分矩阵。然后，该工具用于评估 50 名胎龄≤32 周的早产儿和 50 名足月儿的喂养情况。在开发的每个阶段都进行了多次修订。最后，6 名新生儿职业治疗师通过对使用工具版本 4 对 5 名早产儿口腔喂养的视频进行独立评分，参与了可靠性测试。
结果
“预喂食”评分的组内相关系数为 0.71（0.37-0.96），“总分”的组内相关系数为 0.83（0.56-0.98）。
结论
“总分”具有良好到极好的可靠性。18 个可评分项目的 Fleiss Kappa 评分范围从轻微一致到中度一致。Kappa 评分最低的项目进行了修订，并纳入了参与可靠性测试的治疗师的额外反馈，最终形成了版本 5。
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