新生儿摄食结局评估的评定者间信度和同时效度。
Interrater Reliability and Concurrent Validity of the Neonatal Eating Outcome Assessment.
机构信息
Roberta Pineda, PhD, OTR/L, is Assistant Professor, Program in Occupational Therapy and Department of Pediatrics, Washington University School of Medicine, St. Louis, MO;
Lara Liszka, OTD/S, is Doctor of Occupational Therapy Student, Program in Occupational Therapy, Washington University School of Medicine, St. Louis, MO.
出版信息
Am J Occup Ther. 2020 Mar/Apr;74(2):7402205050p1-7402205050p11. doi: 10.5014/ajot.2020.039578.
IMPORTANCE
Few neonatal feeding assessments are currently available, and the Neonatal Eating Outcome Assessment is the only one that identifies feeding impairment while considering the developmental changes that occur from preterm birth to term-equivalent age.
OBJECTIVE
To determine the interrater reliability and concurrent validity of the Neonatal Eating Outcome Assessment.
DESIGN
Prospective, observational study.
SETTING
Level 4 neonatal intensive care unit.
PARTICIPANTS
A convenience sample of 7 neonatal therapists participated in reliability testing. For concurrent validity, a prospective cohort of 52 preterm infants born ≤32 wk gestation had feeding assessed at term-equivalent age.
OUTCOMES AND MEASURES
Intraclass correlations (ICCs) and Fleiss's κ statistics were used to define reliability across therapists, who independently scored five videos of preterm infants orally feeding using the Neonatal Eating Outcome Assessment. Concurrent validity was determined by evaluating relationships between the Neonatal Oral Motor Assessment Scale (NOMAS) and the Neonatal Eating Outcome Assessment using an independent-samples t test and χ² analysis.
RESULTS
The ICC for the Neonatal Eating Outcome Assessment total score was 0.90 (confidence interval [CI] [0.70, 0.99]). Fleiss's κ scores for the 19 scorable items on the Neonatal Eating Outcome Assessment had predominately moderate, fair, and slight agreement, with 3 items having poor agreement. Dysfunctional NOMAS scores were related to lower Neonatal Eating Outcome Assessment scores (t[49.4] = 3.72, mean difference = 12.2, 95% CI [5.60, 18.75], p = .001).
CONCLUSIONS AND RELEVANCE
The Neonatal Eating Outcome Assessment has excellent reliability. Concurrent validity was established.
WHAT THIS ARTICLE ADDS
This article reports that the final version of the Neonatal Eating Outcome Assessment (Version 5.7) has excellent interrater and concurrent validity and is an important tool to assess the occupation of infant feeding in clinical practice.
重要性
目前可用的新生儿喂养评估方法很少，而新生儿进食结果评估是唯一一种在考虑从早产儿到足月龄期间发生的发育变化的同时识别喂养障碍的方法。
目的
确定新生儿进食结果评估的评分者间信度和同时效度。
设计
前瞻性观察性研究。
设置
4 级新生儿重症监护病房。
参与者
7 位新生儿治疗师参与了可靠性测试的便利性样本。为了评估同时效度，前瞻性队列研究了 52 名胎龄≤32 周的早产儿，在足月龄时进行喂养评估。
结果和措施
使用组内相关系数（ICC）和 Fleiss 的κ统计量来定义治疗师之间的可靠性，治疗师们独立地使用新生儿进食结果评估对 5 个早产儿经口喂养的视频进行评分。通过独立样本 t 检验和 χ²分析评估新生儿口腔运动评估量表（NOMAS）和新生儿进食结果评估之间的关系，来确定同时效度。
结果
新生儿进食结果评估总分的 ICC 为 0.90（置信区间[CI] [0.70, 0.99]）。新生儿进食结果评估 19 个可评分项目的 Fleiss 的κ评分主要为中度、公平和轻度一致，有 3 个项目的一致性较差。功能障碍性 NOMAS 评分与较低的新生儿进食结果评估评分相关（t[49.4]=3.72，平均差异=12.2，95%CI [5.60, 18.75]，p=.001）。
结论和相关性
新生儿进食结果评估具有极好的可靠性。同时效度得到了验证。
这篇文章的重要性
本文报道了新生儿进食结果评估（第 5.7 版）具有极好的评分者间信度和同时效度，是评估临床实践中婴儿喂养职业的重要工具。
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