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

Mari Viviers, Alta Kritzinger and Bart Vinck UGent (2016) SOUTH AFRICAN JOURNAL OF COMMUNICATION DISORDERS. 63(1).
abstract
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.
Please use this url to cite or link to this publication:
author
organization
year
type
journalArticle (original)
publication status
published
subject
keyword
MOTOR-ASSESSMENT SCALE, PRETERM INFANTS, TERM INFANTS, DISORDERS, CHILDREN, TOOL, VALIDATION, DYSPHAGIA, PATTERNS, CARE
journal title
SOUTH AFRICAN JOURNAL OF COMMUNICATION DISORDERS
S. Afr. J. Commun. Disord.
volume
63
issue
1
article number
a148
pages
11 pages
ISSN
0379-8046
2225-4765
DOI
10.4102/sajcd.v63i1.148
language
English
UGent publication?
no
classification
A2
id
8518715
handle
http://hdl.handle.net/1854/LU-8518715
date created
2017-04-26 09:52:17
date last changed
2017-06-12 14:43:58
@article{8518715,
  abstract     = {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.},
  articleno    = {a148},
  author       = {Viviers, Mari and Kritzinger, Alta and Vinck, Bart},
  issn         = {0379-8046},
  journal      = {SOUTH AFRICAN JOURNAL OF COMMUNICATION DISORDERS},
  keyword      = {MOTOR-ASSESSMENT SCALE,PRETERM INFANTS,TERM INFANTS,DISORDERS,CHILDREN,TOOL,VALIDATION,DYSPHAGIA,PATTERNS,CARE},
  language     = {eng},
  number       = {1},
  pages        = {11},
  title        = {Development of a clinical feeding assessment scale for very young infants in South Africa},
  url          = {http://dx.doi.org/10.4102/sajcd.v63i1.148},
  volume       = {63},
  year         = {2016},
}

Chicago
Viviers, Mari, Alta Kritzinger, and Bart Vinck. 2016. “Development of a Clinical Feeding Assessment Scale for Very Young Infants in South Africa.” South African Journal of Communication Disorders 63 (1).
APA
Viviers, M., Kritzinger, A., & Vinck, B. (2016). Development of a clinical feeding assessment scale for very young infants in South Africa. SOUTH AFRICAN JOURNAL OF COMMUNICATION DISORDERS, 63(1).
Vancouver
1.
Viviers M, Kritzinger A, Vinck B. Development of a clinical feeding assessment scale for very young infants in South Africa. SOUTH AFRICAN JOURNAL OF COMMUNICATION DISORDERS. 2016;63(1).
MLA
Viviers, Mari, Alta Kritzinger, and Bart Vinck. “Development of a Clinical Feeding Assessment Scale for Very Young Infants in South Africa.” SOUTH AFRICAN JOURNAL OF COMMUNICATION DISORDERS 63.1 (2016): n. pag. Print.