[Measurement properties of items for the assessment of pediatric incontinence-associated dermatitis in hospital].

Measurement properties of items for the assessment of pediatric incontinence-associated dermatitis in hospital Abstract:

Background

Paediatric incontinence-associated dermatitis (PIAD) is a common skin problem in children. There is no standardised instrument for assessing PIAD in German-speaking countries. Aim: Psychometric testing of the items aIADchild for assessing PIAD in German in hospitals.

Methods

Mono-centre observational study of hospitalised children with PIAD (≥ 32 weeks of gestation to 3 years of age). Simultaneous assessment of PIAD during care by nurses and researcher, followed by independent assessment of the items (agreement, interrater reliability) and cognitive interviews with nurses (content validity, practicability).

Results

62 double assessments by nurses and researcher were recorded for 22 children (0-2.6 years). Agreement was good across all items (PO = 85.8%; SD = 0.14), but positive agreement low (PA = 48.6%; SD = 32.30) and kappa (k) fair (0.37; SD = 0.18). Agreement was good for 40 of 51 characteristics and positive agreement for 9 of 51 characteristics. It was difficult to differentiate diagnostically between papules, pustules and vesicles, the extent of erythema and exudation, and the depth of skin damage.

Conclusions

Compared to other studies, reliability was low. The extent to which the wording of the items, the context or clinical competence were decisive is unclear. An improvement in positive agreement through a reduction or clarification of the characteristics should be investigated.