Content validation of a standardized language diagnosis by certified specialists in gerontological nutrition

Validation of the nutrition standardized language assures the language is accurate for use in practice, policy, and research, but few validation studies have been reported. The purpose of this descriptive study was to validate content of all components of the nutrition diagnostic term involuntary weight loss using experts providing care for older adults in health care settings. A Nutrition Diagnosis Validation Instrument was developed that contained the definition, etiologies, and signs and symptoms of the diagnosis plus items added from literature review. Questions on clarity and completeness of the language were included. The Nutrition Diagnosis Validation Instrument used a Likert-type scale for deriving a Diagnostic Content Validity (DCV) score for all items in the definition, etiology, and signs and symptoms components to define major, minor, and nonrelevant characteristics and a mean total DCV score for the term. In 2008, all Board Certified Specialists in Gerontological Nutrition (CSGs) were recruited by mail. CSGs (n=110, 73% response) reported 15±10 (mean±standard deviation) practice years in gerontological nutrition. The total DCV component scores were 0.80±0.17 (definition), 0.63±0.08 (etiology), and 0.69±0.12 (signs and symptoms). The mean total DCV score of the diagnostic term was 0.69±0.11. Cognitive decline, poor oral health, and impaired skin integrity were identified as missing language. In conclusion, the majority of the definition, etiologies, and signs and symptoms of the term were content-validated, including seven items derived from literature review. The validated items, including recommendations for added language, need to be retested using the same process.