Adaptation and validation of the Bristol scale stool form translated into the Spanish language among health professionals and patients

Rev Esp Enferm Dig. 2009 May;101(5):312-6. doi: 10.4321/s1130-01082009000500002.


Background: stool type represents an important semiologic part of medical interviews. The Bristol Scale Stool Form is a clinical tool to evaluate stool consistency and form. The aim of this study was to translate and adapt the Bristol Scale Stool Form into Spanish. Differences in validation results between health professionals and patients surveyed were also evaluated.

Methods: the study population included 79 physicians, 79 nurses, and 78 patients. Subjects were invited to match a randomly selected text defining one of the seven stool types in the scale with one of seven drawings described originally. A random selection of samples was offered for re-test reliability.

Results: the overall Kappa index was 0.708. Thirty-two subjects repeated the test for a test-retest assessment in a mean interval of 7.76 days, and the percentage concordance between definition and image was 84.4% with a Kappa index of 0.816. There were no differences in the validation study between physicians, nurses, and patients.

Conclusions: this study has shown that the Spanish version of the Bristol Scale Stool Form is reliable for use as a tool to evaluate stool consistency and form.

Publication types

  • Validation Study

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Classification
  • Feces*
  • Female
  • Gastrointestinal Diseases / diagnosis
  • Humans
  • Language
  • Male
  • Middle Aged
  • Nurses / psychology
  • Observation
  • Observer Variation
  • Patients / psychology*
  • Personnel, Hospital / psychology*
  • Physicians / psychology
  • Reproducibility of Results
  • Spain
  • Young Adult