Interobserver reliability of the “POFRAS” instrument for the initiation of oral feeding in hospitalized premature infants. Popayan-Colombia

Abstract

BACKGROUND: Currently, speech therapists in Colombia do not have standardized tests that allow them to clearly establish the right time to start oral feeding of the newborn; For this reason, the international test POFRAS (Preterm Oral Feeding Readiness Assessment Scale), could be of great help in this evaluation process if it is validated in this country. OBJECTIVE: To establish the interobserver reliability of the POFRAS instrument, in the evaluation of the initiation of oral feeding in premature infants, in the NICU of Hospital San José. MATERIALS AND METHODS: Quantitative descriptive concordance study, in which 2 speech therapists participated from the San José de Popayán Hospital participated, evaluating twenty premature infants, selected by non-probabilistic sampling, with prior establishment of ethical aspects. RESULTS: An agreement proportion of 74% was obtained, indicating a good coincidence between the two evaluators in the rating of the items in premature infants. To determine concordance, weighted Kappa was used in each item; it was found in the evaluation of behavioral organization, the general tone with value k=0, 76, state of consciousness k=0, 53 and global posture k=0, 51, with an excellent and good concordance. In oral reflexes, sucking reflex was k=0, 74, rooting reflex k=0, 59, bite k=0, 55 and gag k=0, 57; here the concordance was good. In non-nutritive sucking and in signs of stress, the kappa values showed good agreement. In oral posture, a concordance with values regular was observed. The Kappa Coefficient of the instrument was k=0, 52 classified as "good" concordance. CONCLUSION: The POFRAS test has a "good" reliability to establish the initiation of oral feeding in the neonatal population.