Content validation of the defining characteristics of the diagnostic label failure to thrive in the elderly population

Failure to thrive (FTT) was a concept derived from the pediatric literature that was used with increasing frequency in the elderly population. It was a multidimensional syndrome that lacked a clear definition or set of defining characteristics for the elderly population. The research question addressed in this study was, “What were the defining characteristics for the diagnostic label ‘failure to thrive’ in the elderly population?” The purposes of this study were to develop an instrument for establishing the defining characteristics of the diagnostic label, failure to thrive, in the elderly population entitled: “Defining Characteristics for Failure to Thrive” (DCFTT) (Phase I); to establish the content validity of the defining characteristics of the diagnostic label FTT in the elderly population; and to compare those characteristics with the characteristics presented by the North American Nursing Diagnoses Association (NANDA) for the nursing diagnosis, “adult failure to thrive” (Phase II). Phase II of the study incorporated the use of the Delphi technique to establish content validity of the defining characteristics of the diagnostic label FTT in the elderly population. A 46-item instrument was prepared based on the literature using a Likert-type scale, with a section for comments, based on the Diagnostic Content Validation (DCV) model (Fehring, 1987).; A stratified random sampling method was used to obtain a sample of geriatric nurse practitioners in Phase I (n = 15) and Phase II ( n = 150) as “experts.” Nurse experts were asked to rate each defining characteristic on a scale of 1 to 5, with 1 being “not at all characteristic,” and 5 being “very characteristic.” Weighted ratios for each defining characteristic were calculated to obtain a total DCV score according to Fehring's Model.; Thirty-nine items on the round three DCFTT instrument were supported as being content valid. Nine items were rated as “major,” and 30 items were rated as “minor” defining characteristics of the diagnosis failure to thrive in the elderly. Major defining characteristics centered around a decline in nutritional status. All 12 of NANDA's defining characteristics for the diagnosis, “adult failure to thrive” were supported.