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Development of a clinical feeding assessment scale for very young infants in South Africa

BACKGROUND: There is a need for validated neonatal feeding assessment instruments in South Africa. A locally developed instrument may contribute to standardised evaluation procedures of high-risk neonates and address needs in resource constrained developing settings. OBJECTIVE: The aim of the study...

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Autores principales: Viviers, Mari, Kritzinger, Alta, Vinck, Bart
Formato: Online Artículo Texto
Lenguaje:English
Publicado: AOSIS 2016
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5843192/
https://www.ncbi.nlm.nih.gov/pubmed/27796101
http://dx.doi.org/10.4102/sajcd.v63i1.148
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author Viviers, Mari
Kritzinger, Alta
Vinck, Bart
author_facet Viviers, Mari
Kritzinger, Alta
Vinck, Bart
author_sort Viviers, Mari
collection PubMed
description BACKGROUND: There is a need for validated neonatal feeding assessment instruments in South Africa. A locally developed instrument may contribute to standardised evaluation procedures of high-risk neonates and address needs in resource constrained developing settings. OBJECTIVE: The aim of the study was to develop and validate the content of a clinical feeding assessment scale to diagnose oropharyngeal dysphagia (OPD) in neonates. METHOD: The Neonatal Feeding Assessment Scale (NFAS) was developed using the Delphi method. Five international and South African speech-language therapists (SLTs) formed the expert panel, participating in two rounds of electronic questionnaires to develop and validate the content of the NFAS. RESULTS: All participants agreed on the need for the development of a valid clinical feeding assessment instrument to use with the neonatal population. The initial NFAS consisted of 240 items across 8 sections, and after the Delphi process was implemented, the final format was reduced to 211 items across 6 sections. The final format of the NFAS is scored using a binary scoring system guiding the clinician to diagnose the presence or absence of OPD. All members agreed on the format, the scoring system and the feeding constructs addressed in the revised final format of the NFAS. CONCLUSION: The Delphi method and the diverse clinical and research experience of participants could be integrated to develop the NFAS which may be used in clinical practice in South Africa or similar developing contexts. Because of demographically different work settings marked by developed versus developing contexts, participants did not have the same expectations of a clinical dysphagia assessment. The international participants contributed to evidence-based content development. Local participants considered the contextual challenges of South African SLTs entering the field with basic competencies in neonatal dysphagia management, thereby justifying a comprehensive clinical instrument. The NFAS is aimed at clinicians working in Neonatal Intensive Care Units where they manage large caseloads of high-risk neonates. Further validation of the NFAS is recommended to determine its criterion validity in comparison with a widely accepted standard such as the modified barium swallow study.
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spelling pubmed-58431922018-03-14 Development of a clinical feeding assessment scale for very young infants in South Africa Viviers, Mari Kritzinger, Alta Vinck, Bart S Afr J Commun Disord Original Research BACKGROUND: There is a need for validated neonatal feeding assessment instruments in South Africa. A locally developed instrument may contribute to standardised evaluation procedures of high-risk neonates and address needs in resource constrained developing settings. OBJECTIVE: The aim of the study was to develop and validate the content of a clinical feeding assessment scale to diagnose oropharyngeal dysphagia (OPD) in neonates. METHOD: The Neonatal Feeding Assessment Scale (NFAS) was developed using the Delphi method. Five international and South African speech-language therapists (SLTs) formed the expert panel, participating in two rounds of electronic questionnaires to develop and validate the content of the NFAS. RESULTS: All participants agreed on the need for the development of a valid clinical feeding assessment instrument to use with the neonatal population. The initial NFAS consisted of 240 items across 8 sections, and after the Delphi process was implemented, the final format was reduced to 211 items across 6 sections. The final format of the NFAS is scored using a binary scoring system guiding the clinician to diagnose the presence or absence of OPD. All members agreed on the format, the scoring system and the feeding constructs addressed in the revised final format of the NFAS. CONCLUSION: The Delphi method and the diverse clinical and research experience of participants could be integrated to develop the NFAS which may be used in clinical practice in South Africa or similar developing contexts. Because of demographically different work settings marked by developed versus developing contexts, participants did not have the same expectations of a clinical dysphagia assessment. The international participants contributed to evidence-based content development. Local participants considered the contextual challenges of South African SLTs entering the field with basic competencies in neonatal dysphagia management, thereby justifying a comprehensive clinical instrument. The NFAS is aimed at clinicians working in Neonatal Intensive Care Units where they manage large caseloads of high-risk neonates. Further validation of the NFAS is recommended to determine its criterion validity in comparison with a widely accepted standard such as the modified barium swallow study. AOSIS 2016-10-26 /pmc/articles/PMC5843192/ /pubmed/27796101 http://dx.doi.org/10.4102/sajcd.v63i1.148 Text en © 2016. The Authors http://creativecommons.org/licenses/by/2.0/ Licensee: AOSIS. This work is licensed under the Creative Commons Attribution License.
spellingShingle Original Research
Viviers, Mari
Kritzinger, Alta
Vinck, Bart
Development of a clinical feeding assessment scale for very young infants in South Africa
title Development of a clinical feeding assessment scale for very young infants in South Africa
title_full Development of a clinical feeding assessment scale for very young infants in South Africa
title_fullStr Development of a clinical feeding assessment scale for very young infants in South Africa
title_full_unstemmed Development of a clinical feeding assessment scale for very young infants in South Africa
title_short Development of a clinical feeding assessment scale for very young infants in South Africa
title_sort development of a clinical feeding assessment scale for very young infants in south africa
topic Original Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5843192/
https://www.ncbi.nlm.nih.gov/pubmed/27796101
http://dx.doi.org/10.4102/sajcd.v63i1.148
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