Nagano Ayano, Maeda Keisuke, Matsumoto Tomohiro, Murotani Kenta, Wakabayashi Hidetaka, Koyama Tamami, Nagai Takako, Mori Naoharu
Department of Nursing, Nishinomiya Kyoritsu Neurosurgical Hospital, Nishinomiya, Hyogo, Japan.
Palliative and Supportive Medicine, Graduate School of Medicine, Aichi Medical University, Nagakute, Aichi, Japan.
Eur Geriatr Med. 2024 Oct;15(5):1437-1445. doi: 10.1007/s41999-024-01016-8. Epub 2024 Jul 15.
Feeding assistance should be safe and improve the assisted individual's ability to feed, yet objective tools for evaluating these skills are lacking. This study focuses on developing a tool for assessing feeding assistance skills.
A group consisting of 25 experts employed the Delphi method to achieve a consensus on the essential items necessary for assessing feeding assistance skills. Subsequently, a draft score using a three-point scale was developed. To test the reliability of the draft scores, a group of 20 patients and 20 nurses was matched to record a meal assistance scene, which were independently evaluated by three raters. We computed the AC statistic to assess both intra- and inter-rater reliability, and further examined correlations between the Feeding Assistance Skill Score (FASS) scores and outcome items to verify validity.
Initially, an 18-item draft score was generated using the Delphi method. Subsequently, seven items were omitted from the intra- or inter-rater reliability analysis. Furthermore, after discussion, researchers removed one item that assessed food cognition, because the agreement score between the two items was 91%. Finally, the 10-item FASS was developed, showing a correlation with dietary intake upon validation.
We successfully developed a scoring system for peer evaluation of feeding assistance skills. Future studies should aim to validate the FASS. The implementation of the FASS aims to assess the effectiveness of feeding assistance training and care quality, potentially improving safety and satisfaction for those receiving feeding assistance.
喂食辅助应安全且能提高被辅助者的进食能力，但缺乏评估这些技能的客观工具。本研究着重于开发一种评估喂食辅助技能的工具。
由25名专家组成的小组采用德尔菲法就评估喂食辅助技能所需的基本项目达成共识。随后，制定了一个采用三点量表的初步评分。为测试初步评分的可靠性，选取20名患者和20名护士组成一组记录一次进餐辅助场景，由三名评估者独立进行评估。我们计算了AC统计量以评估评估者内部和评估者之间的可靠性，并进一步检查喂食辅助技能评分（FASS）分数与结果项目之间的相关性以验证有效性。
最初，采用德尔菲法生成了一个包含18个项目的初步评分。随后，在评估者内部或评估者之间的可靠性分析中剔除了7个项目。此外，经过讨论，研究人员删除了一个评估食物认知的项目，因为这两个项目之间的一致率为91%。最终，开发出了包含10个项目的FASS，验证时显示其与饮食摄入量相关。
我们成功开发了一种用于同行评估喂食辅助技能的评分系统。未来的研究应致力于验证FASS。FASS的实施旨在评估喂食辅助培训的有效性和护理质量，有可能提高接受喂食辅助者的安全性和满意度。
