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| Construction of Toddler Anal Function Assessment Scale for children aged 1 to 3 years based on Delphi method |
| SUN Yanting, FU Yi, LIANG Hongtao, PAN Yibin, WANG Chen, LU Jingen
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| Longhua Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai 200032, China |
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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.
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Received: 19 January 2026
Revised: 23 June 2026
Published: 27 July 2026
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