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A Feeding Adequacy Scale for Children With Bronchiolitis: Prospective Multicenter Study
Agnes Sebastian1,2, Cornelia M Borkhoff3,4,2, Gita Wahi5
1Temerty Faculty of Medicine.
Insights
The Feeding Adequacy Scale (FAS) is a feasible, reliable, and valid tool for assessing feeding in infants with bronchiolitis. It accurately measures feeding adequacy and responsiveness to clinical changes during hospitalization.
Area of Science:
- Pediatrics
- Clinical Assessment
- Health Outcomes Research
Background:
- Bronchiolitis is a common respiratory infection in infants, often leading to hospitalization and feeding difficulties.
- Assessing feeding adequacy is crucial for managing hospitalized infants and predicting discharge readiness.
Purpose of the Study:
- To evaluate the measurement properties of the Feeding Adequacy Scale (FAS).
- To determine the feasibility, reliability, validity, and responsiveness of the FAS in young children hospitalized with bronchiolitis.
Main Methods:
- A multicenter cohort study involving 228 infants hospitalized with bronchiolitis.
- Caregivers and nurses completed the FAS, a 10-cm visual analog scale, to assess feeding.
- Measurement properties including feasibility, test-retest reliability, interrater reliability, construct validity, and responsiveness were analyzed.
Main Results:
- The FAS was feasible for both caregivers and nurses, with no floor or ceiling effects.
- Moderate to good reliability was observed for test-retest (caregivers: ICC 0.73; nurses: ICC 0.75) and interrater assessments (ICC 0.55).
- The FAS demonstrated good construct validity and responsiveness, correlating with length of stay and readiness for discharge, and showing significant improvement from admission to discharge.
Conclusions:
- The Feeding Adequacy Scale (FAS) is a feasible, reliable, valid, and responsive measure for assessing feeding adequacy in infants hospitalized with bronchiolitis.
- Caregiver and nurse completion of the FAS provides valuable insights into infant feeding status during hospitalization and recovery.
Objectives:
To determine the measurement properties of the Feeding Adequacy Scale (FAS) in young children hospitalized with bronchiolitis.
Methods:
Multicenter cohort study of infants hospitalized with bronchiolitis at children's and community hospitals in Ontario, Canada. Caregivers and nurses completed the FAS, a 10-cm visual analog scale anchored by "not feeding at all" (score 0) and "feeding as when healthy" (score 10). The main outcome measures were feasibility, reliability, validity, and responsiveness of the FAS.
Results:
A total of 228 children were included with an average (SD) age of 6.3 (5.4) months. Completing the FAS was feasible for caregivers and nurses, with no floor or ceiling effects. Test-retest reliability was moderate for caregivers (intraclass correlation coefficient [ICC] 2,1 0.73; 95% confidence interval [CI] 0.63-0.80) and good for nurses (ICC 2,1 0.75; 95% CI 0.62-0.83). Interrater reliability between 1 caregiver and 1 nurse was moderate (ICC 1,1 0.55; 95% CI 0.45-0.64). For construct validity, the FAS was negatively associated with length of hospital stay and positively associated with both caregiver and nurse readiness for discharge scores (P values <.0001). The FAS demonstrated clinical improvement from the first FAS score at admission to the last FAS score at discharge, with significant differences between scores for both caregivers and nurses (P values for paired t test <.0001).
Conclusions:
These results provide evidence of the feasibility, reliability, validity, and responsiveness of caregiver-completed and nurse-completed FAS as a measure of feeding adequacy in children hospitalized with bronchiolitis.
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