Development and validation of a documenting tool for an Instrumental Feeding Assessment; Fibreoptic Endoscopic Evaluation of Swallowing (FEES)

Abstract

Background: Fibreoptic Endoscopic Evaluation of Swallowing (FEES) is an emerging assessment in speech therapy practice in Sri Lanka. However, the absence of an appropriate documentation system has been a major issue due to a lack of consensus on the format of reporting the findings of FEES among different clinical settings and missing essential areas of assessment. The study focused on developing and validating a documentation system for FEES, which can assess people who have no prior clinical examination history.Methods: For this validation study (action research), the modified Delphi method with 2 rounds was conducted with 7 speech therapists who are involved in conducting FEES in government hospitals and in the private sector. Two independent rounds through online questionnaires were conducted to finalize and validate the developed tool. The first round focused on finalizing the developed tool and round two considered content face validation of the finalized tool. Results: The record sheet for FEES was finalized with the accepted components and suggestions from both Delphi panels. The Delphi panels agreed with the content with an excellent content validity index score for face validation of the tool. The finalized tool consisted of 3 subsystems: pre-FEES, FEES findings and post FEES. Conclusion: A comprehensive record sheet was developed during the study to address the lack of a proper documentation system for FEES in clinical settings in Sri Lanka. The tool was designed in a clinician-friendly manner where a clinician can evaluate an outpatient who has not gone through a bedside evaluation. The content and face validity reflected user-friendliness and reliability of included items.