Validation of a simple stool diary used by caregivers to document diarrhea among young children in a low-income country

Benedikte Grenov; Hanifa Namusoke; Nicolette Nabukeera-Barungi; Betty Lanyero; Christian Ritz; Amalie Carlsson; Cecilie Kragh Vinther; Kim F. Michaelsen; Tove Holm-Larsen

doi:10.1097/MPG.0000000000001462

Validation of a simple stool diary used by caregivers to document diarrhea among young children in a low-income country

Benedikte Grenov, Hanifa Namusoke, Nicolette Nabukeera-Barungi, Betty Lanyero, Christian Ritz, Amalie Carlsson, Cecilie Kragh Vinther, Kim F. Michaelsen, Tove Holm-Larsen

Lifecourse Nutrition & Health

3 Citations (Scopus)

Abstract

Objectives: The aim of the study was the development and validation of a simple stool diary for caretakers collecting data on stool frequency and consistency among young children in a low-income country. Methods: Focus group studies evaluated how diarrhea was understood by caregivers (content validity). The sensitivity, reliability, and correlations between dehydration and diary scores (construct validity) were tested in a clinical trial. Results: Caregivers recognized and understood the concept and severity of diarrhea. Stool frequency and liquid consistency decreased in children admitted with diarrhea (P < 0.0001 for both), confirming good sensitivity of the diary. High reliability was obtained after a few days of training. The caregiver intracorrelation coefficients were 0.66 (0.55-0.77) and 0.75 (0.66-0.84) after 2 and 7 days of training, respectively, and subjective staff evaluation of caregiver scores showed that ≤6% of caregivers had low scoring abilities after 3 days. The degree of dehydration (4-point score) was correlated with both increasing stool frequency and liquid stool consistency (+0.2 points [0.07-0.3], P = 0.0018 for 6 or more diarrheal stools, compared to 3 or more diarrheal stools per day, and +0.5 points (0.3-0.6), P < 0.0001 for diarrheal episodes with 3 or more watery stools/day compared with episodes with 3 or more "watery + abnormally loose + loose" stools per day). Conclusions: The diary showed high validity, good reliability, and high sensitivity. After 3 days of training, caregivers with mainly no or limited education could report stool consistency with good reliability. Stool consistency, which correlated strongly with dehydration, may be considered an important marker of diarrhea severity in future research.

Original language	English
Journal	Journal of Pediatric Gastroenterology and Nutrition
Volume	65
Issue number	2
Pages (from-to)	156-164
Number of pages	9
ISSN	0277-2116
DOIs	https://doi.org/10.1097/MPG.0000000000001462
Publication status	Published - 1 Aug 2017

Keywords

Faculty of Science
Diarrhea
Malnutrition
Stool frequency
Stool consistancy

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

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10.1097/MPG.0000000000001462

Cite this

Grenov, B., Namusoke, H., Nabukeera-Barungi, N., Lanyero, B., Ritz, C., Carlsson, A., Vinther, C. K., Michaelsen, K. F., & Holm-Larsen, T. (2017). Validation of a simple stool diary used by caregivers to document diarrhea among young children in a low-income country. Journal of Pediatric Gastroenterology and Nutrition, 65(2), 156-164. https://doi.org/10.1097/MPG.0000000000001462

Validation of a simple stool diary used by caregivers to document diarrhea among young children in a low-income country. / Grenov, Benedikte; Namusoke, Hanifa; Nabukeera-Barungi, Nicolette et al.

In: Journal of Pediatric Gastroenterology and Nutrition, Vol. 65, No. 2, 01.08.2017, p. 156-164.

Research output: Contribution to journal › Journal article › Research › peer-review

Grenov, B, Namusoke, H, Nabukeera-Barungi, N, Lanyero, B, Ritz, C, Carlsson, A, Vinther, CK, Michaelsen, KF & Holm-Larsen, T 2017, 'Validation of a simple stool diary used by caregivers to document diarrhea among young children in a low-income country', Journal of Pediatric Gastroenterology and Nutrition, vol. 65, no. 2, pp. 156-164. https://doi.org/10.1097/MPG.0000000000001462

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author = "Benedikte Grenov and Hanifa Namusoke and Nicolette Nabukeera-Barungi and Betty Lanyero and Christian Ritz and Amalie Carlsson and Vinther, {Cecilie Kragh} and Michaelsen, {Kim F.} and Tove Holm-Larsen",

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AU - Grenov, Benedikte

AU - Namusoke, Hanifa

AU - Nabukeera-Barungi, Nicolette

AU - Lanyero, Betty

AU - Ritz, Christian

AU - Carlsson, Amalie

AU - Vinther, Cecilie Kragh

AU - Michaelsen, Kim F.

AU - Holm-Larsen, Tove

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N2 - Objectives: The aim of the study was the development and validation of a simple stool diary for caretakers collecting data on stool frequency and consistency among young children in a low-income country. Methods: Focus group studies evaluated how diarrhea was understood by caregivers (content validity). The sensitivity, reliability, and correlations between dehydration and diary scores (construct validity) were tested in a clinical trial. Results: Caregivers recognized and understood the concept and severity of diarrhea. Stool frequency and liquid consistency decreased in children admitted with diarrhea (P < 0.0001 for both), confirming good sensitivity of the diary. High reliability was obtained after a few days of training. The caregiver intracorrelation coefficients were 0.66 (0.55-0.77) and 0.75 (0.66-0.84) after 2 and 7 days of training, respectively, and subjective staff evaluation of caregiver scores showed that ≤6% of caregivers had low scoring abilities after 3 days. The degree of dehydration (4-point score) was correlated with both increasing stool frequency and liquid stool consistency (+0.2 points [0.07-0.3], P = 0.0018 for 6 or more diarrheal stools, compared to 3 or more diarrheal stools per day, and +0.5 points (0.3-0.6), P < 0.0001 for diarrheal episodes with 3 or more watery stools/day compared with episodes with 3 or more "watery + abnormally loose + loose" stools per day). Conclusions: The diary showed high validity, good reliability, and high sensitivity. After 3 days of training, caregivers with mainly no or limited education could report stool consistency with good reliability. Stool consistency, which correlated strongly with dehydration, may be considered an important marker of diarrhea severity in future research.

AB - Objectives: The aim of the study was the development and validation of a simple stool diary for caretakers collecting data on stool frequency and consistency among young children in a low-income country. Methods: Focus group studies evaluated how diarrhea was understood by caregivers (content validity). The sensitivity, reliability, and correlations between dehydration and diary scores (construct validity) were tested in a clinical trial. Results: Caregivers recognized and understood the concept and severity of diarrhea. Stool frequency and liquid consistency decreased in children admitted with diarrhea (P < 0.0001 for both), confirming good sensitivity of the diary. High reliability was obtained after a few days of training. The caregiver intracorrelation coefficients were 0.66 (0.55-0.77) and 0.75 (0.66-0.84) after 2 and 7 days of training, respectively, and subjective staff evaluation of caregiver scores showed that ≤6% of caregivers had low scoring abilities after 3 days. The degree of dehydration (4-point score) was correlated with both increasing stool frequency and liquid stool consistency (+0.2 points [0.07-0.3], P = 0.0018 for 6 or more diarrheal stools, compared to 3 or more diarrheal stools per day, and +0.5 points (0.3-0.6), P < 0.0001 for diarrheal episodes with 3 or more watery stools/day compared with episodes with 3 or more "watery + abnormally loose + loose" stools per day). Conclusions: The diary showed high validity, good reliability, and high sensitivity. After 3 days of training, caregivers with mainly no or limited education could report stool consistency with good reliability. Stool consistency, which correlated strongly with dehydration, may be considered an important marker of diarrhea severity in future research.

KW - Faculty of Science

KW - Diarrhea

KW - Malnutrition

KW - Stool frequency

KW - Stool consistancy

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DO - 10.1097/MPG.0000000000001462

M3 - Journal article

C2 - 27861203

SN - 0277-2116

VL - 65

SP - 156

EP - 164

JO - Journal of Pediatric Gastroenterology and Nutrition

JF - Journal of Pediatric Gastroenterology and Nutrition

IS - 2

ER -

Validation of a simple stool diary used by caregivers to document diarrhea among young children in a low-income country

Abstract

Keywords

UN SDGs

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