Reliability and Validity of an Assessment Algorithm to Predict the Coping Skills of 3- to 6-Year-old Children Undergoing Blood Sampling

Background: We developed an assessment algorithm to predict the coping skills of children aged 3 to 6 years who undergo blood sampling. The objective of this study was to determine the reliability and validity of this algorithm. Methods: Subjects were 41 children aged 3 to 6 years who were to undergo blood sampling in two hospitals, and their parents. To use the assessment algorithm, we used a questionnaire to obtain the following information from the parent before the child’s blood sampling: the child’s age, whether they had previously undergone blood sampling, and the parent’s prediction regarding the child’s coping behavior. The coping behavior of the children undergoing blood sampling was directly observed and scored by one researcher. In the examination of reliability, two different researchers independently estimated the coping skills of the child using the assessment algorithm based on the parent’s questionnaire, and the estimates were compared. We analyzed the predictive validity of the coping skills estimated by the assessment algorithm and the child’s actual coping behavior during blood sampling. We evaluated the sensitivity according to the number of children for whom the coping skills estimated by the assessment algorithm exceeded those exhibited in actual coping behavior. Results: The coping skills of the children estimated by the two researchers using the assessment algorithm were concordant (kappa = 1.000, p = 0.000). Spearman’s correlation coefficient between the coping skills estimated for the children using the assessment algorithm and their actual coping behavior was very high (r = -0.74, p = 0.000). Because the assessment algorithm we developed estimated a higher level of coping skill than was exhibited in actual coping behavior for five children, its sensitivity was higher than that of any other classification algorithm. Conclusion: Our analysis showed high reliability and validity of the assessment algorithm.