Translation and validation of Neonatal Feeding Assessment Scale (NFAS) in Persian

Document Type : Original Article

Authors

1 Department of Speech therapy, Faculty of Paramedical Sciences and Rehabilitation, Mashhad University of Medical Sciences, Mashhad, Iran

2 Department of Pediatrics, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran

Abstract

Background: Feeding difficulties and dysphagia can lead to malnutrition, dehydration, pneumonia, prolonged hospitalization, and even death in neonates. Accordingly, it should be recognized as soon as possible to provide necessary medical care, nursing, and rehabilitation. This study aimed to translate the Neonatal Feeding Assessment Scale (NFAS) into Persian and determine its psychometric properties in Iranian neonates.
Methods: After receiving permission from developers, the main version of NFAS was translated into Persian. Face validity of NFAS was assessed by 10 qualified speech and language pathologists in the field of pediatric swallowing. In order to define the internal consistency of the items, 52 infants were evaluated using the Persian version of NFAS, and the correlation between the items was determined using Kuder-Richardson 20. The test-retest and inter-rater reliabilities were also calculated by Cohen's Kappa coefficient in 30 and 40 infants, respectively. The convergent reliability between NFAS and Early Feeding Skills (EFS) was calculated by point-biserial correlation in 30 infants.
Results: According to experts, all translated items were transparent and understandable. The internal consistency score was obtained at 0.76. Moreover, Cohen's Kappa coefficients were calculated at 0.96 and 0.87 for test-retest and inter-rated reliabilities, respectively. Point biserial correlation between Persian NFAS and EFS was estimated at 0.63.
Conclusion: Persian version of NFAS is a valid and reliable tool to assess feeding problems and oro-pharyngeal dysphagia in infants and make clinical decisions.
 
 

Keywords

References

  1. Rudolph CD, Link DT. Feeding disorders in infants and children. Pediat Clin. 2002;49(1):97-12.
  2. Dodrill P, Gosa MM. Pediatric dysphagia: physiology, assessment, and management. Ann Nutr Metab. 2015;66(Suppl 5):24-31.
  3. Mandysová P, Ehler E, Škvrňáková J, Černý M, Bártová I, Pellant A. Development of the Brief Bedside Dysphagia screening Test–Revised: a cross-sectional Czech study. Acta Med. 2015;58(2):49-55.
  4. Lefton-Greif MA. Pediatric dysphagia. Phys Med Rehabil Clin. 2008;19(4):837-51.
  5. Stark AR. Hospital discharge of the high-risk neonate. Pediatrics. 2008;122(5):1119-26.
  6. Jadcherla S. Dysphagia in the high-risk infant: potential factors and mechanisms. Am J Clin Nutr. 2016;103(2):622S-8S.
  7. Mousavi SZ, Shahbodaghi MR, Kadivar M, Khosravi N, Mirzazade M. The study of oral feeding disorders incidence in infants in NICU of Tehran University of medical sciences hospitals. J Mod Rehabil. 2015;9(4):1-7.
  8. Arvedson JC, Lefton-Greif MA. Instrumental assessment of pediatric dysphagia. Seminars in speech and language. Thieme Medical Publishers. 2017;38(2):135-46.
  9. Karsch E, Irving SY, Aylward BS, Mahle WT. The prevalence and effects of aspiration among neonates at the time of discharge. Cardiol Young. 2017;27(7):1241-7.
  10. Mahesh M. Fluoroscopy: patient radiation exposure issues. Radiographics. 2001;21(4):1033-45.
  11. Martin-Harris B, Logemann JA, McMahon S, Schleicher M, Sandidge J. Clinical utility of the modified barium swallow. Dysphagia. 2000;15:136-41.
  12. Plaat BE, van der Laan BF, Wedman J, Halmos GB, Dikkers FG. Distal chip versus fiberoptic laryngoscopy using endoscopic sheaths: diagnostic accuracy and image quality. Eur Arch Otorhinolaryngol. 2014;271:2227-32.
  13. Cootney RW. Ultrasound imaging: principles and applications in rodent research. ILAR J. 2001;42(3):233-47.
  14. Arvedson JC, Brodsky L, Lefton-Greif MA. Pediatric swallowing and feeding: Assessment and management. Plural Publishing. 2019.
  15. Palmer MM, Crawley K, Blanco IA. Neonatal Oral-Motor Assessment scale: a reliability study. J Perinatol. 1993;13(1):28-35.
  16. Reilly S, Skuse D, Mathisen B, Wolke D. The objective rating of oral-motor functions during feeding. Dysphagia. 1995;10:177-91.
  17. Arvedson JC. Assessment of pediatric dysphagia and feeding disorders: clinical and instrumental approaches. Dev Disabil Res Rev. 2008;14(2):118-27.
  18. Thoyre S, Shaker C, Pridham K. The early feeding skills assessment for preterm infants. Neonatal Netw. 2005;24(3):7-16.
  19. Thoyre SM, Pados BF, Shaker CS, Fuller K, Park J. Psychometric properties of the early feeding skills assessment tool. Adv Neonatal Care. 2018;18(5):E13-E23.
  20. Viviers M, Kritzinger A, Vinck B. Development of a clinical feeding assessment scale for very young infants in South Africa. S Afr J Commun Disord. 2016;63(1):1-11.
  21. Viviers M, Kritzinger A, Vinck B, Graham M. Preliminary psychometric performance of the neonatal feeding assessment scale. S Afr J Commun Disord. 2017;64(1):1-8.
  22. Ohrbach R, Bjorner J, Jezewski M, John M, Lobbezoo F. Guidelines for establishing cultural equivalency of instruments. New York: University at Buffalo. 2009.
  23. Polit DF, Beck CT, Owen SV. Is the CVI an acceptable indicator of content validity? Appraisal and recommendations. Res Nurs Health. 2007;30(4):459-67.
  24. Arafat SY. Validation study can be a separate study design. Int J Med Sci Public Health. 2016;5(11):2421-2.
  25. Bujang MA, Omar ED, Baharum NA. A review on sample size determination for Cronbach’s alpha test: a simple guide for researchers. Malays J Med Sci. 2018;25(6):85-99.
  26. Landis JR, Koch GG. The measurement of observer agreement for categorical data. Biometrics. 1977;
    33(1):159-74.
  27. Mallery P. SPSS for Windows step by step. Canadà: La Sierra University. 2003.
  28. Dawson B, Trapp R. Research questions about relationships among variables. Basic and Clinical Biostatistics 4th edn Lange Medical Books/McGraw-Hill. 2004:190-220.
  29. Wherry RJ. Multiple bi-serial and multiple point bi-serial Psychometrika. 1947;12(3):189-95.
  30. Dancey CP, Reidy J. Statistics without maths for psychology: Pearson education; 2007.
  31. Swift MC, Scholten I. Not feeding, not coming home: parental experiences of infant feeding difficulties and family relationships in a neonatal unit. J Clin Nurs. 2010;19(1‐2):249-58.
  32. Viviers M. Reliability and validity of the neonatal feeding assessment scale (nfas) for the early identification of dysphagia in moderate to late preterm neonates. Dysphagia. 2022;35(1):134-5.
  33. Pados BF, Park J, Estrem H, Awotwi A. Assessment tools for evaluation of oral feeding in infants less than six months old. Adv Neona Care. 2016;16(2):143–150.
  34. Matthews MK. Developing an instrument to assess infant breastfeeding behaviour in the early neonatal period. Midwifery. 1988;4(4):154-65.
  35. Altuntas N, Turkyilmaz C, Yildiz H, Kulali F, Hirfanoglu I, Onal E, et al. Validity and reliability of the infant breastfeeding assessment tool, the mother baby assessment tool, and the LATCH scoring system. Breastfeed Med. 2014;9(4):191-5.
  36. Mulford C. The mother-baby assessment (MBA): An" Apgar Score" for breastfeeding. J Hum Lact. 1992;8(2):79-82.
  37. Kearney MH, Cronenwett LR, Barrett JA. Breast-feeding problems in the first week postpartum. Nurs Res. 1990;39(2):90-5.
  38. Johnson TS, Mulder PJ, Strube K. Mother-infant breastfeeding progress tool: A guide for education and support of the breastfeeding dyad. J Obstet Gynecol Neonatal Nurs. 2007;36(4):319-27.
  39. Ingram J, Johnson D, Copeland M, Churchill C, Taylor H. The development of a new breast feeding assessment tool and the relationship with breast feeding self-efficacy. Midwifery. 2015;31(1):132-7.
  40. Nyqvist KH, Rubertsson C, Ewald U, Sjödén P. Development of the Preterm Infant Breastfeeding Behavior Scale (PIBBS): a study of nurse-mother agreement. J Hum Lact. 1996;12(3):207-19.
  41. Adams D, Hewell S. Maternal and professional assessment of breastfeeding. J Hum Lact. 1997;13(4):279-83.
  42. Jensen D, Wallace S, Kelsay P. LATCH: a breastfeeding charting system and documentation tool. J Obstet Gynecol Neonatal Nurs. 1994;23(1):27-32.    
Iranian Journal of Neonatology
Volume 14, Issue 4
October 2023
Pages 40-47

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