Topical Area: Medical Nutrition/Case Study Vignettes
(P16-010-20) Content Validation of Defining Characteristics of Nineteen Prevalent Nutrition Diagnoses in Adult Hospitalized Patients
Objectives: To validate the content of 19 prevalent nutrition diagnoses (NDs), 17 from the Nutrition Care Process Terminology (NCPT) and two other NDs, identified by Clinical Registered Dietitian Nutritionists (CRDN) in an acute-care hospital and identify critical defining characteristics (signs and/or symptoms).
Methods: Using a descriptive research design with survey methodology, a ND Validation Instrument was completed by seven CRDNs with knowledge of NDs. Each ND included a label, a definition, and a mean number of 14 defining characteristics (range 1-33). CRDNs were asked to read labels, definitions and think about adult hospitalized patients and use a 4-point Likert scale (very, quite, very little, and not at all characteristic) to rate the 264 defining characteristics. Diagnostic content validity (DCV) scores using weighted means were calculated. Critical defining characteristics were identified with a DCV score of ≥ 0.80.
Results: The CRDNs had 13.29+5.09 years of clinical experience and 12.57+5.26 years using NDs at the study site. Seventy-one percent of the CRDNs held a graduate degree. The DCV scores of 264 critical characteristics ranged from 0.32 to 1.00. Twenty-four percent (n=64) of the characteristics were validated with a mean of 3.36 critical characteristics per diagnosis (range: 1-10). Eighty-nine percent (n=57) of the critical characteristics were in three of the five NCPT assessment categories: (Food/Nutrition-Related History; Anthropometric measurements and Nutrition-focused physical findings.
Conclusions: Content validation of 19 NDs resulted in the identification of 24% (N=64) of characteristics as valid with 89% (N=57) clustered in three of the five NCPT assessment categories. The low content validity of 76% (N=200) of the characteristics suggests that the criteria are not representative or consistent with the definitions of the NDs. Identification of a minimum number of critical characteristics and assessment categories for each diagnosis will make it easier for CRDNs to learn the signs/symptoms and to recognize them when present in patients, to make an accurate diagnosis. Further validation studies with larger samples and various patient populations, nationally and internationally, are needed to refine critical characteristics and assessment categories.
Funding Sources: None
Nancy A. Hakel-Smith
Manager, Clinical Nutrition Services Bryan Health Lincoln, Nebraska