Tool to classify stool consistency: content validity and use by persons of diverse cultures

Developing and testing the quality of a research instrument, including its ability to be used by culturally diverse persons, is an important methodological objective. The present study determined the content validity and feasibility of culturally diverse persons to use an instrument to classify stool consistency that has been employed in research on fecal incontinence. Five multidisciplinary clinicians experienced in assessing stool consistency determined the tool to possess content validity. Twenty-four foreign nationals of diverse cultures who spoke English as a second language (ESL) classified the consistency of nine stools using word only or word plus diagram descriptions. The agreement of the ratings of the participants were compared with the those of an experienced investigator. There was no significant difference between the ratings of participants using either type of description. There was good agreement between the classifications of the participants and those of the investigator. The findings of this study contribute to the quality of our instrument and support its use by culturally diverse persons.