Abstract：Objective To construct the item framework and weight coefficients of Toddler Anal Function Assessment Scale for children aged 1 to 3 years, so as to provide a tool for evaluating anal function in this age group. Methods The items of the anal function assessment scale for infants and toddlers were developed through theoretical deduction, literature review, and interviews. After three rounds of screening and discussion within the research working group, a preliminary assessment framework comprising 4 dimensions and 12 items was established. Two rounds of Delphi expert consultation were conducted with experts specializing in pediatrics, traditional Chinese medicine proctology, and perianal imaging for infants and toddlers. The quality of the expert consultation was evaluated using the response rate, authority coefficient, and degree of agreement among experts. Items were screened based on importance scores, full-score ratio, accuracy scores, and coefficient of variation. The weights of the indicators were determined using the analytic hierarchy process. Results A total of 18 experts participated in the consultation, including 9 males and 9 females. The mean age of the experts was (51.17±9.36) years and the mean years of practice was (26.56±9.95) years. Eleven held a master's degree or higher, and 17 held senior or above professional titles. The response and return rates for two rounds of Delphi consultation were 100%. The authority coefficients were 0.810 and 0.825, respectively. Kendall's coefficients were 0.096 and 0.131 (both P<0.05); and the coefficients of variation ranged from 0.14 to 0.28 and 0.12 to 0.32, respectively. The scale includes 4 dimensions and 10 items. The dimensions are the assessment of fecal control capability, impact on daily life, defecation status, and interventions and perianal appearance, with weight coefficients of 0.520 7, 0.222 4, 0.144 3, and 0.112 6, respectively. Among the items, those with higher weights are soiling, fecal control capability, control over solid stool, control over watery or loose stool, and activity restriction, with weights of 0.101 2, 0.064 7, 0.058 8, 0.046 4, and 0.035 4, respectively. Conclusion The constructed scale for assessing anal function in toddlers, comprising 4 dimensions and 10 items, can be applied to clinical evaluation or efficacy assessment of anal function in toddlers aged 1 to 3 years.
孙琰婷, 傅颐, 梁宏涛, 潘一滨, 王琛, 陆金根. 应用德尔菲法构建1~3岁幼儿肛门功能评估量表[J]. 预防医学, 2026, 38(7): 690-694.
SUN Yanting, FU Yi, LIANG Hongtao, PAN Yibin, WANG Chen, LU Jingen. Construction of Toddler Anal Function Assessment Scale for children aged 1 to 3 years based on Delphi method. Preventive Medicine, 2026, 38(7): 690-694.
[1] 吴印爱.中华直肠肛门重建外科手术学[M].郑州:河南科学技术出版社,2019. [2] Steele S R,Hull T L,Hyman N,et al.The ASCRS Textbook of Colon and Rectal Surgery[M].Cham:Springer International Publishing,2016. [3] Cox D J,Ritterband L M,Quillian W,et al.Assessment of behavioral mechanisms maintaining encopresis:virginia encopresis-constipation apperception test[J].J Pediatr Psychol,2003,28(6):375-382. [4] Jorge J M N,Wexner S D.Etiology and management of fecal incontinence[J].Dis Colon Rectum,1993,36(1):77-97. [5] Vaizey C J,Carapeti E,Cahill J A,et al.Prospective comparison of faecal incontinence grading systems[J].Gut,1999,44(1):77-80. [6] Pescatori M,Anastasio G,Bottini C,et al.New grading and scoring for anal incontinence.Evaluation of 335 patients[J].Dis Colon Rectum,1992,35(5):482-487. [7] 王睿,李碧香,赵斯君.先天性肛门直肠畸形患儿的临床特征及手术后肛门功能相关因素分析[J].临床小儿外科杂志,2022,21(6):535-539. [8] 胡濛,孙琰婷,付滢锌,等.肛门功能主观评估工具的研究进展和临床应用现状分析[J].新医学,2026,57(6):649-661. [9] 王晶亚.中医药国际标准实施效果评价指标体系构建研究[J].中国中医基础医学杂志,2023,29(1):99-103. [10] 王媛媛.医学量表的编制与评价——理论、方法与实例操作[M].北京:北京大学医学出版社,2020. [11] 张颖,季聪华,李秋爽,等.中医临床实践指南制修订中德尔菲法的统计分析方法[J].中华中医药杂志,2018,33(1):249-251. [12] 覃花杏.基于德尔菲法构建先天性巨结肠患儿术后污粪风险评估调查表[J].中国医药导报,2022,19(29):55-59. [13] Saaty R W.The analytic hierarchy process:what it is and how it is used[J].Math Model,1987,9(3/4/5):161-176. [14] 张婷,刘珊珊,汪清雅,等.重庆市疾控机构耐药肺结核治疗管理评价指标体系构建[J].预防医学,2021,33(6):592-594. [15] Holschneider A,Hutson J,Peña A,et al.Preliminary report on the international conference for the development of standards for the treatment of anorectal malformations[J].J Pediatr Surg,2005,40(10):1521-1526. [16] Rintala R J,Lindahl H.Is normal bowel function possible after repair of intermediate and high anorectal malformations?[J].J Pediatr Surg,1995,30(3):491-494.
