The Validity of the Modified Tal Score and Wang Respiratory Score Instruments in Assessing the Severity of Respiratory System Disorders in Children

ABSTRACT

Nurses need to have a high awareness of children’s respiratory status changes to prevent worse conditions such as respiratory failure. For this reason, nurses require a tool or instrument that can facilitate a comprehensive assessment of the severity of respiratory system disorders in children. The aim of this study was to identify the validity and reliability of the Modified Tal Score and Wang Respiratory Score instruments and their sensitivity and specificity for assessing the severity of respiratory system disorders in children. A descriptive-analytic research design and a cross-sectional approach were used in this research. A total of 48 children aged 0–2 years who were hospitalized in a top referral hospital in Jakarta with acute respiratory infections were assessed for the severity of respiratory system impairment using the Modified Tal Score and the Wang Respiratory Score instruments. The modified Tal Score had a strong correlation with SpO₂ (r = −0.699; p = 0.0001; α = 0.05), as did the Wang Respiratory Score (r = −0.501; p = 0.0001; α = 0.05). The Cronbach’s Alpha value for the Modified Tal Score instrument was 0.768, while that for the Wang Respiratory Score instrument was 0.68. Analysis using ROC curves gave an AUC value of 0.897 (95% CI 0.794; 1, p = 0.0001) for the Modified Tal Score instrument for predicting the severity of respiratory system disorders in children versus 0.815 (95% CI 0.681; 0.95, p = 0.0001) for the Wang Respiratory Score instrument. These results showed that the Modified Tal Score instrument has higher validity and reliability, as well as better sensitivity and specificity, than the Wang Respiratory Score instrument for assessing the severity of respiratory system disorders in children. A further study for instruments’ improvement by classifying the children’s respiratory rate according to their age, as well as adding an item related to the use of supplementary oxygen, is needed.

KEYWORDS:

• Modified Tal score
• pediatric
• respiratory tract infections
• Wang respiratory score

Acknowledgments

The authors would like to express gratitude to the Directorate of Research and Community Services at Universitas Indonesia for the Hibah Publikasi Internasional Terindeks untuk Tugas Akhir mahasiswa Universitas Indonesia (PITTA) grant 2018. We would also like to thank the participating hospital, nurse associates, primary nurses, head nurses, supervisors, and directors for their assistance in this study.

Disclosure statement

The authors report no conflicts of interest.

Additional information

Funding

This work was supported by the Directorate of Research and Community Engagement Universitas Indonesia (1837/UN2.R3.1/HKP.05.00/2018).