Tool to classify stool consistency: Content validity and use by persons of diverse cultures

Dhamani, Khairunnisa; Savik, Kay; Kirk, Karen S.

doi:10.1046/j.1442-2018.2003.00145.x

Cited by 11 publications

(2 citation statements)

References 16 publications

(29 reference statements)

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“…For the secondary outcome of consistency of incontinent feces, subjects used a 4-level classification ( hard and formed, soft but formed, loose and unformed , and liquid ) shown to have good face and content validity, criterion validity (≥ 80% agreement with experts for 75% of stools tested) and reliability (inter-rater reliability weighted kappa = 0.84 [ p < .001]; Bliss et al, 1999; Bliss et al, 2001; Bliss, Dhamani, Savik, & Kirk, 2003). These ratings were then averaged over each day.…”

Section: Methodsmentioning

confidence: 99%

Dietary Fiber Supplementation for Fecal Incontinence: A Randomized Clinical Trial

Bliss

Savik

Jung

et al. 2014

Research in Nursing & Health

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Dietary fiber supplements are used to manage fecal incontinence (FI), but little is known about the fiber type to recommend or the level of effectiveness of such supplements, which appear related to the fermentability of the fiber. The aim of this single-blind, randomized controlled trial was to compare the effects of three dietary fiber supplements (carboxymethylcellulose [CMC], gum arabic [GA], or psyllium) with differing levels of fermentability to a placebo in community-living individuals incontinent of loose/liquid feces. The primary outcome was FI frequency; secondary outcomes included FI amount and consistency, supplement intolerance, and quality of life (QoL). Possible mechanisms underlying supplement effects were also examined. After a 14-day baseline, 189 subjects consumed a placebo or 16g total fiber/day of one of the fiber supplements for 32 days. FI frequency significantly decreased after psyllium supplementation versus placebo, in both intent-to-treat and per-protocol mixed model analyses. CMC increased FI frequency. In intent-to-treat analysis, the number of FI episodes/week after supplementation was estimated to be 5.5 for Placebo, 2.5 for Psyllium, 4.3 for GA, and 6.2 for CMC. Only psyllium consumption resulted in a gel in feces. Supplement intolerance was low. QoL scores did not differ among groups. Patients with FI may experience a reduction in FI frequency after psyllium supplementation, and decreased FI frequency has been shown to be an important personal goal of treatment for patients with FI. Formation of a gel in feces appears to be a mechanism by which residual psyllium improved FI.

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Section: Methodsmentioning

confidence: 99%

Dietary Fiber Supplementation for Fecal Incontinence: A Randomized Clinical Trial

Bliss

Savik

Jung

et al. 2014

Research in Nursing & Health

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“…The tool has four categories with depictions and descriptions and can be applied at the bedside, but with fewer categories; it has a good reliability when used by healthcare professionals, nursing students and volunteers 8. Further reliability and validity testing has been performed,8 9 though this instrument has not been as widely used in research. There are no studies that validate the Bristol Stool Chart or the Bliss Stool Classification System in the ICU setting for either clinical or research purposes.…”

Section: Introductionmentioning

confidence: 99%

Diarrhoea: interventions, consequences and epidemiology in the intensive care unit (DICE-ICU): a protocol for a prospective multicentre cohort study

et al. 2019

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IntroductionDiarrhoea is a frequent concern in the intensive care unit (ICU) and is associated with prolonged mechanical ventilation, increased length of ICU stay, skin breakdown and renal dysfunction. However, its prevalence, aetiology and prognosis in the critically ill have been poorly studied. The primary objectives of this study are to determine the incidence, risk factors and consequences of diarrhoea in critically ill adults. The secondary objectives are to estimate the incidence ofClostridium difficile-associated diarrhoea (CDAD) in ICU patients and to validate the Bristol Stool Chart and Bliss Stool Classification System characterising bowel movements in the ICU. Our primary outcome is the incidence of diarrhoea . Our secondary outcomes include: CDAD, ICU and hospital mortality and ICU and hospital length of stay.Methods and analysisThis international prospective cohort study will enrol patients over 10 weeks in 12 ICUs in Canada, the USA, Poland and Saudi Arabia. We will include all patients 18 years of age and older who are admitted to the ICU for at least 24 hours and follow them daily until ICU discharge. Our primary outcome is the incidence of diarrhoea based on the WHO definition, during the ICU stay. Our secondary outcomes include: CDAD, ICU and hospital mortality and ICU and hospital length of stay. We will use logistic regression to identify factors associated with diarrhoea (as defined using WHO criteria) and the kappa statistic to measure agreement on diarrhoea rates between the WHO definition and the Bristol Stool Chart and Bliss Stool Classification System.Ethics and disseminationThe protocol has been approved by the research ethics board of all participating centres. The diarrhoea interventions, consequences and epidemiology in the intensive care unit (DICE-ICU) study will generate evidence about diarrhoea and its frequency, predisposing factors and consequences, to inform critical care practice and future research.Lay summaryDiarrhoea is a frequent clinical problem for hospitalised patients including those who are critically ill in the ICU. Diarrhoea can cause complications such as skin damage, dehydration and kidney problems. It is not clear how common diarrhoea is in the ICU, the factors that cause it or the best way for clinicians to assess it. The DICE-ICU study is an international prospective observational study to examine the frequency, risk factors and outcomes of diarrhoea during critical illness.

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Diarrhea during critical illness: a multicenter cohort study

et al. 2022

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Tool to classify stool consistency: Content validity and use by persons of diverse cultures

Cited by 11 publications

References 16 publications

Dietary Fiber Supplementation for Fecal Incontinence: A Randomized Clinical Trial

Dietary Fiber Supplementation for Fecal Incontinence: A Randomized Clinical Trial

Diarrhoea: interventions, consequences and epidemiology in the intensive care unit (DICE-ICU): a protocol for a prospective multicentre cohort study

Diarrhea during critical illness: a multicenter cohort study

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