Botucatu Medical School, São Paulo State University (UNESP), São Paulo, Brazil.
Department of Surgery and Orthopedics - Division of Pediatric Surgery, Botucatu Medical School, São Paulo State University (UNESP), São Paulo, Brazil.
BMC Pediatr. 2021 Feb 4;21(1):64. doi: 10.1186/s12887-021-02527-0.
For newborns and infants wearing diapers the difficulties in characterizing the appearance of the stool are significant, since the changes in consistency, quantity, and color of the stool are higher than in other age groups. The Amsterdam Infant Stool Scale (AISS) was created and validated in 2009, providing a specific tool for the evaluation of the stool of children up to 120 days old. However, to be used in clinical practice and scientific investigations in Brazil, it is mandatory to perform the translation and cross-cultural adaptation process for Brazilian Portuguese language. Thus, we aim to perform the translation and cross-cultural adaptation of AISS into Brazilian Portuguese and to evaluate the psychometric properties of the translated version.
The process of translation and cross-cultural adaptation was performed according to the internationally accepted methodology, including: translation, summary of translations, backtranslation, preparation of the pre-final version, application of the pre-test and determination of the final version. The evaluation of the psychometric properties was performed through the application of Brazilian Portuguese AISS, by five examiners (including child health field specialists and a literate adult lay on the subject), analyzing 238 stool photographs of children under 120 days old. The intra and inter-examiner agreement values were determined using kappa statistic. The validity of the criterion was investigated through correlation analysis (Kendall's coefficient) between the classifications determined by the non-specialist examiner and the expert examiners.
In all 30 tests performed between different examiners, there was an agreement considered as at least moderate (kappa values above 0.40). The intra-examiner reliability was considered as substantial (kappa> 0.6). There was a statistically significant correlation (p < 0.05) between the classifications determined by the examiners considered as specialists and the examiner considered as non-specialist.
The Brazilian Portuguese AISS version proved to be valid and reliable to be used by healthcare professionals and the general public in the evaluation of stool from children up to 120 days old.
对于戴尿布的新生儿和婴儿来说，粪便外观的特征存在困难，因为粪便的稠度、数量和颜色变化比其他年龄段更高。阿姆斯特丹婴儿粪便量表（AISS）于 2009 年创建并经过验证，为评估 120 天以下儿童的粪便提供了特定工具。然而，要在巴西的临床实践和科学研究中使用，必须进行巴西葡萄牙语的翻译和跨文化适应性处理。因此，我们旨在将 AISS 翻译成巴西葡萄牙语，并评估翻译版本的心理测量特性。
翻译和跨文化适应性处理过程按照国际认可的方法进行，包括：翻译、翻译摘要、回译、准备预终版、预测试应用和确定终版。通过应用巴西葡萄牙语 AISS 对 238 张 120 天以下儿童粪便照片进行分析，对心理测量特性进行评估。由五名检查者（包括儿童保健领域专家和一名对该主题有文化的成年非专业人员）进行评估，使用 Kappa 统计来确定内部和外部检查者之间的一致性值。通过对非专业检查者和专家检查者确定的分类之间的相关性分析（肯德尔系数）来研究标准效度。
在所有 30 次不同检查者之间进行的测试中，都认为有至少中度的一致性（Kappa 值高于 0.40）。内部检查者的可靠性被认为是实质性的（Kappa>0.6）。专家检查者和非专家检查者确定的分类之间存在统计学上显著的相关性（p<0.05）。
巴西葡萄牙语 AISS 版本被证明是有效和可靠的，可以由医疗保健专业人员和公众在评估 120 天以下儿童的粪便时使用。
