Riordan J M, Koehn M
School of Nursing, Wichita State University, KS 67260-0041, USA.
J Obstet Gynecol Neonatal Nurs. 1997 Mar-Apr;26(2):181-7. doi: 10.1111/j.1552-6909.1997.tb02131.x.
This study examined validity and reliability of three clinical instruments that assess feedings at the breast.
A descriptive correlational design testing the validity and interrater and test-retest reliability of instruments.
Hospital rooms and the participants' homes.
Eleven breastfeeding women and their neonates were videotaped in 23 breastfeeding observations.
The Infant Breastfeeding Assessment Tool (IBFAT), the Mother Baby Assessment Tool (MBA), and the LATCH assessment tool were scored by three nurse raters using videotapes of breastfeedings. Instruments were completed twice by each rater with a 6-month period between administration.
To test validity, test-retest, and interrater reliability, Spearman correlation coefficients among raters' breastfeeding assessment scores, among scores of each instrument, and between test and retest scores of raters. Percent of agreement among raters for each of the items in the three tools.
Reliability coefficients for all three assessment tools are below acceptable levels for clinical decisions. Spearman rank coefficients of pairwise interrater correlations were .57, .27, and .69 for the IBFAT: .66, .64, and .33 for the MBA; and .11, .46, and .48 for the LATCH assessment tool. Spearman rank coefficients among instrument scores were .69, .78, and .68. Test-retest correlations were .88, .78, and .64. Percent of agreement among raters for each of the items in the three tools was highly variable, ranging from 37.0 to 97.2.
The IBFAT, MBA, and LATCH as tools to measure breastfeeding effectiveness are not sufficiently reliable at this stage in their development; thus, these tools cannot be valid for clinical use. These tools need to be revised and retested before use in clinical practice to identify breastfeeding mother-infant pairs who need intervention.
本研究检验了三种评估母乳喂养情况的临床工具的有效性和可靠性。
一项描述性相关性设计，测试工具的有效性、评分者间信度和重测信度。
医院病房和参与者家中。
对11名母乳喂养的女性及其新生儿进行了23次母乳喂养观察并录像。
三名护士评分者根据母乳喂养录像对婴儿母乳喂养评估工具（IBFAT）、母婴评估工具（MBA）和LATCH评估工具进行评分。每位评分者对工具进行两次评分，两次评分间隔6个月。
为检验有效性、重测信度和评分者间信度，计算评分者母乳喂养评估分数之间、各工具分数之间以及评分者测试与重测分数之间的Spearman相关系数。三名评分者对三种工具中各项目的一致率。
所有三种评估工具的信度系数均低于临床决策可接受水平。IBFAT评分者间两两相关的Spearman等级系数分别为0.57、0.27和0.69；MBA为0.66、0.64和0.33；LATCH评估工具为0.11、0.46和0.48。工具分数之间的Spearman等级系数分别为0.69、0.78和0.68。重测相关性分别为0.88、0.78和0.64。三名评分者对三种工具中各项目的一致率差异很大，范围从37.0%到97.2%。
在现阶段的发展中，IBFAT、MBA和LATCH作为衡量母乳喂养效果的工具可靠性不足；因此，这些工具在临床应用中无效。在临床实践中使用之前，这些工具需要修订并重新测试，以识别需要干预的母乳喂养母婴对。
