Department of Midwifery and Women's Health, Division of Health Sciences and Nursing, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-0033, Japan.
The Global Nursing Research Center, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-0033, Japan.
BMC Pediatr. 2022 Oct 25;22(1):614. doi: 10.1186/s12887-022-03691-7.
Severe infant eczema on the face should be treated early because it may lead to allergic diseases in the future. However, caregivers find it difficult to assess. A visual tool for caregivers is needed to easily determine infants' facial skin condition severity based on the tool's scores. We developed an infant facial skin assessment tool (IFSAT) and evaluated its reliability and validity.
The IFSAT draft was developed based on results of a previous literature review and qualitative sketch. Panels including medical professionals and a caregiver checked the draft's content and face validity, and the IFSAT was finalized. To test the IFSAT's reliability and validity, caregivers and one-month-old infants were recruited. Two scoring methods were additionally created based on the relation between the items and cure period. The relationships between scores and cure period, and the ability to predict whether the infant needed medical treatment were examined by each scoring method. For the predictive validity, scores for infants requiring medical treatment and those for infants who did not were also compared. For the intra-examiner reliability analysis, two pediatricians rated the scores separately twice using photographs. Inter-rater reliabilities were analyzed among pediatricians, nurses, and caregivers.
Altogether, 113 infant-caregiver pairs participated in the testing phase. Of the two scoring methods created (versions 1 and 2), pediatricians' and caregivers' scores using versions 1 and 2 were related to the cure period. These scores predict whether the infant needed medical treatment. We then selected version 2 based on the medical professionals' opinions. The scores of caregivers of infants requiring medical treatment were higher than those of caregivers of infants not requiring treatment (p < 0.001). The intraclass correlation coefficient (ICC) of intra-examiner reliability was 0.87. The ICC of inter-rater reliabilities between pediatricians' and caregivers' scores and between nurses' and caregivers' scores were 0.66, and 0.66, respectively.
The proposed IFSAT may be used to assess whether infants need medical treatment and whether to extend the cure period. The tool's reliability and validity were confirmed.
严重的婴儿面部湿疹应及早治疗，因为它可能导致未来的过敏疾病。然而，护理人员发现难以评估。需要一种供护理人员使用的视觉工具，以便根据工具的分数轻松确定婴儿面部皮肤状况的严重程度。我们开发了一种婴儿面部皮肤评估工具（IFSAT），并评估了其可靠性和有效性。
IFSAT 草案是根据之前文献回顾和定性草图的结果制定的。包括医疗专业人员和护理人员在内的小组检查了草案的内容和表面有效性，并最终确定了 IFSAT。为了测试 IFSAT 的可靠性和有效性，招募了护理人员和一个月大的婴儿。还根据项目与治愈期之间的关系创建了两种评分方法。通过每种评分方法检查了得分与治愈期之间的关系，以及预测婴儿是否需要治疗的能力。对于预测有效性，还比较了需要治疗的婴儿和不需要治疗的婴儿的得分。对于内部检查者可靠性分析，两名儿科医生分别使用照片两次单独评分。在儿科医生、护士和护理人员之间分析了评分者之间的可靠性。
共有 113 对婴儿-护理人员参与了测试阶段。在创建的两种评分方法（版本 1 和 2）中，儿科医生和护理人员使用版本 1 和 2 的评分与治愈期相关。这些分数预测婴儿是否需要治疗。然后，我们根据医疗专业人员的意见选择了版本 2。需要治疗的婴儿的护理人员的评分高于不需要治疗的婴儿的评分（p<0.001）。内部检查者可靠性的组内相关系数（ICC）为 0.87。儿科医生和护理人员评分之间以及护士和护理人员评分之间的评分者之间的 ICC 分别为 0.66 和 0.66。
提出的 IFSAT 可用于评估婴儿是否需要治疗以及是否延长治愈期。该工具的可靠性和有效性得到了证实。
