Validity and Reliability of the Comfort Behavior Scale in Children Undergoing Wound Dressing Replacement in Vietnam

Original Research

Abstract

Background: This study translated and culturally adapted the Comfort Behavior Scale (Comfort-B) into Vietnamese using a standard protocol guided by the World Health Organization.

Methods: The Comfort-B was translated into Vietnamese and then English back-translated by independent translators. These versions were reviewed and assessed by a Vietnamese expert’s panel and an English expert’s panel. Thirty-four nurses of the Nhi Dong 1 Hospital were invited to use the Vietnamese Comfort-B to assess pain while watching five videos recorded before, during and after wound dressing replacement. The eight characteristics of the Vietnamese Comfort-B were assessed by 34 nurses. Fifteen nurses agreed to do the second assessment two weeks from the first assessment. The content validity index was used to assess the relevance and clarity of all items and the whole scale. Agreements between raters were explored using Kappa statistics. Intraclass correlation coefficients (ICC) were used to assess intra-rater and inter-rater reliability. Multi-level linear regression was used to assess changes in the Vietnamese Comfort-B before, during and after wound dressing replacement between two assessments.

Results: The Vietnamese Comfort-B was accredited by the Vietnamese expert’s panel. The English-back translated version was approved by the English expert’s panel. The nurses agreed that the Vietnamese Comfort-B can be used in clinical practice and research. Kappas of all items were ≥0.96 indicating excellent agreement between raters. Alpha coefficients of two assessments were ≥0.97 indicating excellent internal consistency. All ICCs ≥ 0.79 indicated good intra-rater and inter-rater reliability.

Conclusions: The study suggested that the Vietnamese Comfort-B can be used for future studies assessing children’s pain in the local hospital context.

Graphical abstract

Validation of predictive equations against DXA for estimation of body fat composition in Vietnamese children

Original Research

Abstract

Background: Childhood overweight and obesity are becoming more pronounced in Vietnam, so an assessment tool of high efficiency in the community is warranted. This study sought to validate skinfold thickness (SFT) equations for estimation of body fatness by Goran and Slaughter against DXA to aid in assessing obesity.

Method: A cross-sectional study was conducted on 144 healthy children (ages 6-17) who were conveniently sampled from schools within an urban district. Their anthropometric measurements (height, weight, and SFT) and DXA whole-body results were taken to record body fat percentage (BF%). Bland-Altman analysis and correlation between bias and body fat were employed to understand the agreement between results from each equation and DXA whole body.

Result: BF% was 32.2 ± 7.6% (mean ± SD). 52.8% of the children were overweight or obese. Bland-Altman plots showed that all four SFT equations had wide limits of agreement (LOAs) and largely underestimated the reference BF% by up to 8.90%. Goran equation predicted better when BF% decreased, whereas Slaughter equations produced less bias when there was more body fat.

Conclusion: The prevalence rate of overweight and obesity has become alarming. Besides, Goran and Slaughter equations cannot be used as alternatives for DXA scanning to measure body fat due to their underestimation.

Graphical abstract

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