Psychometric properties of the oral feeding assessment in premature infants scale

Sergio Alonso-Fernández, Carlos Rodrigo Gonzalo de Liria, Teresa Lluch-Canut, Laura Poch-Pla, Josep Perapoch-López, Maria-Eulàlia Juvé-Udina, Maria-Antonia Martínez-Momblan, Bárbara Hurtado-Pardos, Juan-Francisco Roldán-Merino, Sergio Alonso-Fernández, Carlos Rodrigo Gonzalo de Liria, Teresa Lluch-Canut, Laura Poch-Pla, Josep Perapoch-López, Maria-Eulàlia Juvé-Udina, Maria-Antonia Martínez-Momblan, Bárbara Hurtado-Pardos, Juan-Francisco Roldán-Merino

Abstract

Professionals that work in neonatal units need to identify the strengths and weaknesses of the premature infant who is in the transition process from feeding through a gastric tube to oral feeding. The main aim of this study was to validate the Oral FEeding Assessment in premaTure INfants (OFEATINg) instrument. A psychometric validity and reliability study was conducted in Neonatal Intensive Care Units of two public, metropolitan, university hospitals. The study population were premature infants at a postconceptional age of 31-35 weeks. The study included evaluation of the reliability, convergent, discriminant and construct validity, sensitivity and specificity of the OFEATINg instrument. A total of 621 feedings of 56 preterm infants were evaluated. Confirmatory factor analysis identified 3 factors and 13 indicators with a good fit to the model. Cronbach's alpha coefficient was 0.78. The instrument showed high indices of inter-rater reliability (Pearson 0.9 and intraclass correlation coefficient 0.95). The OFEATINg scale is a valid and reliable instrument for evaluating the readiness for oral feeding of preterm infants. It may enable clinicians to evaluate the physiological and behavioral abilities involved in the oral feeding process and help them make decisions related to the transition to full oral feeding.Clinical trial registration: This study was prospectively registered at the two Institutional review boards.

Conflict of interest statement

The authors declare no competing interests.

© 2022. The Author(s).

Figures

Figure 1
Figure 1
Psychometric testing process.
Figure 2
Figure 2
Model specification with 3 factors and 13 indicators.
Figure 3
Figure 3
ROC curve obtained from the sum of the instrument scores at each feeding versus the feeding tolerance.

References

    1. Griffith TT, et al. Oral feeding success: A concept analysis. Adv. Neonatal Care. 2019;19:21–31. doi: 10.1097/ANC.0000000000000540.
    1. American Academy of Pediatrics Committee on Fetus and Newborn. Hospital discharge of the high-risk neonate. Pediatrics122, 1119–1126 (2008).
    1. Briere C-E, McGrath J, Cong X, Cusson R. State of the Science: A contemporary review of feeding readiness in the preterm infant. J. Perinat. Neonatal. Nurs. 2014;28:51–58. doi: 10.1097/JPN.0000000000000011.
    1. Goldfield EC, Perez J, Engstler K. Neonatal feeding behavior as a complex dynamical system. Semin. Speech Lang. 2017;38:77–86. doi: 10.1055/s-0037-1599105.
    1. Als H. Toward a synactive theory of development: Promise for the assessment and support of infant individuality. Infant. Ment. Heal. J. 1982;3:229–243. doi: 10.1002/1097-0355(198224)3:4<229::AID-IMHJ2280030405>;2-H.
    1. Matthews MK. Developing an instrument to assess infant breastfeeding behaviour in the early neonatal period. Midwifery. 1988;4:154–165. doi: 10.1016/S0266-6138(88)80071-8.
    1. Shrago L, Bocar D. The infant’s contribution to breastfeeding. J. Obs. Gynecol. Neonatal Nurs. 1990;19:209–215. doi: 10.1111/j.1552-6909.1990.tb01638.x.
    1. Mulford C. The mother-baby assessment (MBA): An ‘Apgar score’ for breastfeeding. J. Hum. Lact. 1992;8:79–82. doi: 10.1177/089033449200800216.
    1. Jensen D, Wallace S, Kelsay P. LATCH: A breastfeeding charting system and documentation tool. J. Obs. Gynecol Neonatal Nurs. 1994;23:27–32. doi: 10.1111/j.1552-6909.1994.tb01847.x.
    1. Nyqvist KH, Rubertsson C, Ewald U, Sjödén P-O. Development of the preterm infant breastfeeding behavior scale (PIBBS): A study of nurse-mother agreement. J. Hum. Lact. 1996;12:207–219. doi: 10.1177/089033449601200318.
    1. Fujinaga, C. I. Prontidão do prematuro para início da alimentação oral: proposta de um instrumento de avaliação [thesis]. (Universidade de São Paulo, 2002). 10.11606/D.22.2002.tde-20032005-105010.
    1. McGrath, J. M. Pilot-testing of the Preterm Infant Nipple Feeding Readiness Scale (PINFRS). in Proceedings of the Communicating Nursing Research Conference and WIN Assembly, ”Responding to Societal Imperatives Through Discovery and Innovation“ vol. 36 289 (Communicating Nursing Research, 2003).
    1. Thoyre SM, Shaker CS, Pridham KF. The early feeding skills assessment for preterm infants. Neonatal. Netw. 2005;24:7–16. doi: 10.1891/0730-0832.24.3.7.
    1. Zarem C, et al. Psychometrics of the neonatal oral motor assessment scale. Dev. Med. Child Neurol. 2013;55:1115–1120. doi: 10.1111/dmcn.12202.
    1. Streiner, D. L., Norman, G. R. & Cairney, J. Health measurement scales: a practical guide to their development and use. (Oxford University Press, 2015).
    1. Howe TH, Lin KC, Fu CP, Su CT, Hsieh CL. A review of psychometric properties of feeding assessment tools used in neonates. J Obs. Gynecol Neonatal Nurs. 2008;37:338–349. doi: 10.1111/j.1552-6909.2008.00240.x.
    1. Thoyre SM, Pados BF, Shaker CS, Fuller K, Park J. Psychometric properties of the early feeding skills assessment tool. Adv. Neonatal Care. 2018;18:E13–E23. doi: 10.1097/ANC.0000000000000537.
    1. Horner S, et al. Setting the stage for successful oral feeding: The impact of implementing the SOFFI feeding program with medically fragile NICU infants. J. Perinat. Neonatal. Nurs. 2014;28:59–68. doi: 10.1097/JPN.0000000000000003.
    1. Ross ES, Philbin MK. Supporting oral feeding in fragile infants: an evidence-based method for quality bottle-feedings of preterm, ill, and fragile infants. J. Perinat. Neonatal Nurs. 2011;25:349–357. doi: 10.1097/JPN.0b013e318234ac7a.
    1. Philbin MK, Ross ES. The SOFFI Reference Guide: text, algorithms, and appendices: A manualized method for quality bottle-feedings. J. Perinat. Neonatal Nurs. 2011;25:360–380. doi: 10.1097/JPN.0b013e31823529da.
    1. Ludwig SM, Waitzman KA. Changing feeding documentation to reflect infant-driven feeding practice. Newborn Infant. Nurs. Rev. 2007;7:155–160. doi: 10.1053/j.nainr.2007.06.007.
    1. Settle M, Francis K. Does the infant-driven feeding method positively impact preterm infant feeding outcomes? Adv. Neonatal Care. 2019;19:51–55. doi: 10.1097/ANC.0000000000000577.
    1. Gianni ML, et al. Usefulness of the Infant Driven Scale in the early identification of preterm infants at risk for delayed oral feeding independency. Early Hum. Dev. 2017;115:18–22. doi: 10.1016/j.earlhumdev.2017.08.008.
    1. Argimón Pallás, J. M. & Jiménez Villa, J. Métodos de investigación clínica y epidemiológica. (Elsevier, 2013).
    1. Jaju, A. & Crask, M. The perfect design: optimization between reliability, validity, redundancy in scale items and response rates. in Issues in Scaling: Proceedings of the AMA (Winter) Educators’ Conference (eds. Menon, A. & Sharma, A.) 127–131 (American Marketing Association, 1999).
    1. Fleiss, J. L. Statistical methods for rates and proportions. (Wiley, 1981).
    1. Harrington, D. Confirmatory factor analysis. (Oxford University Press, 2008).
    1. Bartlett MS. Tests of significance in factor analysis. Br. J. Psychol. 1950;3:77–85.
    1. Guttman L. Image theory for the structure of quantitative variates. Psychometrika. 1953;18:277–296. doi: 10.1007/BF02289264.
    1. Browne MW, Cudeck R. Alternative ways of assessing model fit. Sociol. Methods Res. 1992;21:230–258. doi: 10.1177/0049124192021002005.
    1. Bollen, K. A. & Long, J. S. Testing Structural Equation Models. (Sage, 1993).
    1. Fayers, P. M. & Machin, D. Quality of Life - The assessment analysis and reporting of patient-reported outcomes. (Wiley, 2016).
    1. Fujinaga, C. et al. Clinical validation of the Preterm Oral Feeding Readiness Assessment Scale. Rev. Lat. Am. Enfermagem21, 140–145 (2013).
    1. Howe T-H, Sheu C-F, Hsieh Y-W, Hsieh C-L. Psychometric characteristics of the Neonatal Oral-Motor Assessment Scale in healthy preterm infants. Dev. Med. Child Neurol. 2007;49:915–919. doi: 10.1111/j.1469-8749.2007.00915.x.
    1. Case-Smith J. An efficacy study of occupational therapy with high-risk neonates. Am. J. Occup. Ther. 1988;42:499–506. doi: 10.5014/ajot.42.8.499.
    1. Fleiss JL. The equivalence of weighted kappa and the intraclass correlation coefficient as measures of reliability. Educ. Psychol. Meas. 1973;33:613–619. doi: 10.1177/001316447303300309.
    1. Palmer MM. Identification and management of the transitional suck pattern in premature infants. J. Perinat. Neonatal. Nurs. 1993;7:66–75. doi: 10.1097/00005237-199306000-00009.

Source: PubMed

Sponsorzy i współpracownicy

Warunki medyczne

Interwencje lekowe

3
Subskrybuj