Covert Assessment of Concurrent and Construct Validity of a Chart to Characterize Fecal Output and Diarrhea in Patients Receiving Enteral Nutrition

作者：Kevin Whelan, Patricia A. Judd, Victor R. Preedy, Moira A. Taylor · 发表于：Journal of Parenteral and Enteral Nutrition · 年份：2008 · DOI：10.1177/0148607108314769 · 被引用次数：42 · 研究领域：Clinical Nutrition and Gastroenterology、Dysphagia Assessment and Management、Nutrition and Health in Aging

BACKGROUND: An accurate and convenient method for characterizing fecal output and a consistent threshold for classifying diarrhea in patients receiving enteral nutrition are required. The aim of this study is to covertly assess the construct and concurrent validity of a chart for characterizing fecal output and classifying diarrhea in patients receiving enteral nutrition. METHODS: The chart was used to monitor fecal output in patients receiving enteral nutrition for a total of 280 patient days. Nurses characterized 291 fecal samples, of which 84 underwent measurement of fecal water using lyophilization and 60 underwent Clostridium difficile enterotoxin analysis using enzyme-linked immunosorbent assay. Construct and concurrent validity was assessed covertly to measure the true performance of the chart in a real-life clinical and research context. RESULTS: Use of the chart demonstrated higher fecal frequency (P <or= .04), heavier stools (P <or= .167), more unformed stools (P <or= .001), higher daily fecal scores (P <or= .001), and higher incidence of diarrhea (P <or= .002) on days when patients had severe hypoalbuminemia, were receiving antibiotics, or had a recent positive C difficile assay, demonstrating construct validity. The water content of samples assigned to hard and formed (62.0%), soft and formed (72.1%), loose and unformed (79.3%), and liquid (87.9%) categories was significantly different (P < .001), demonstrating concurrent validity. CONCLUSIONS: Under covert assess...