A short form of the neonatal intensive care unit family needs inventory

Alves, Elisabete; Severo, Milton; Amorim, Mariana; Grande, Catarina; Silva, Susana

doi:10.1016/j.jped.2015.04.010

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ORIGINAL ARTICLES • J. Pediatr. (Rio J.) 92 (1) • Jan-Feb 2016 • https://doi.org/10.1016/j.jped.2015.04.010 copy

A short form of the neonatal intensive care unit family needs inventory^☆ ☆ Please cite this article as: Alves E, Severo M, Amorim M, Grande C, Silva S. A short form of the neonatal intensive care unit family needs inventory. J Pediatr (Rio J). 2016;92:73-80. ^☆☆ ☆☆ Study conducted at Instituto de Saúde Pública, Universidade do Porto (ISPUP), Porto, Portugal.

Authorship SCIMAGO INSTITUTIONS RANKINGS

ABSTRACT

OBJECTIVE:

The identification of parental needs in Neonatal Intensive Care Units is essential to design and implement family-centered care. This article aims to validate the Neonatal Intensive Care Units Family Needs Inventory for the Portuguese population, and to propose a Short Form.

METHODS:

A linguistic adaptation of the Neonatal Intensive Care Units Family Needs Inventory, a self-report scale with 56-items, was performed. The instrument was administered to 211 parents of infants hospitalized in all level III Neonatal Intensive Care Units in the North of Portugal, 15-22 days after admission (July of 2013-June of 2014). The number of items needed to achieve reliability close to 0.8 was calculated using by the Spearman-Brown formula. The global goodness of fit of the scale was evaluated using the comparative fit index. Construct validity was assessed through association of each dimension score with socio-demographic and obstetric characteristics.

RESULTS:

Exploratory factor analysis revealed two dimensions, one focused on parents' needs and another on the infant's needs. To compose the Short Form Inventory, items with ceiling effect were eliminated and 22 items were submitted to confirmatory analysis, which supported the existence of two dimensions (CFI = 0.925). The Short Form showed a high degree of reliability (alpha ≥ 0.76). Less educated and older parents more frequently attributed a significantly higher importance to parent-centered needs, while parents of multiples revealed a tendency to value infant-centered needs.

CONCLUSIONS:

The Short Form of the Neonatal Intensive Care Units Family Needs Inventory is a brief, simple, and valid instrument with a high degree of reliability. Further studies are needed to explore associations with practices of family-centered care.

Keywords:
Neonatal intensive care units; Needs assessment; Parents; Validation studies as topic

	Total n (%)	Parents-centered needs Mean (SD)	p	Infant-centered needs Mean (SD)	p
Overall		3.5 (2.6)		8.6 (2.7)

Sex
Female	120 (56.9)	3.7 (2.6)		8.8 (2.7)
Male	91 (43.1)	3.3 (2.4)	0.239	8.3 (2.7)	0.230

Age (years)
<35	148 (70.1)	3.3 (2.3)		8.5 (2.6)
≥35	63 (29.9)	4.1 (3.0)	0.037	8.8 (2.9)	0.516

Education (years)
<9	78 (37.0)	4.3 (2.5)		8.7 (2.9)
≥9	133 (63.0)	3.1 (2.5)	<0.001	8.5 (2.6)	0.600

Household monthly income (€)
≤1000	72 (34.6)	3.9 (2.6)		8.4 (3.0)
>1000	136 (65.4)	3.4 (2.6)	0.149	8.7 (2.6)	0.518

Gravidity
0	117 (55.5)	3.7 (2.6)		8.8 (2.6)
≥1	94 (44.5)	3.4 (2.5)	0.446	8.2 (2.9)	0.111

Pregnancy complications ^a
Yes	90 (42.7)	3.4 (2.7)		8.3 (2.6)
No	121 (57.4)	3.6 (2.5)	0.530	8.8 (2.9)	0.256

Multiple pregnancy
Yes	50 (23.7)	4.0 (2.6)		9.4 (2.8)
No	161 (76.3)	3.4 (2.5)	0.117	8.3 (2.7)	0.024

Extremely premature delivery ^b
Yes	45 (21.3)	3.5 (2.8)		8.4 (3.0)
No	166 (78.7)	3.6 (2.5)	0.943	8.6 (2.7)	0.692

Extremely low birth weight delivery ^c
Yes	63 (29.9)	3.3 (2.5)		8.4 (2.6)
No	148 (70.1)	3.6 (2.6)	0.375	8.6 (2.8)	0.547

	Very important	Two factor EFA
	n (%)	std.z1	std.z2
Item
1	191 (91.4)	0.673	-0.173
2	147 (72.1)	0.365	0.196
3	157 (75.5)	0.652	-0.173
4	178 (84.8)	0.658	0.137
5	200 (95.7)	0.773	-0.099
6	186 (91.6)	0.723	-0.022
7	139 (66.2)	0.644	-0.065
8	96 (45.7)	0.389	0.402
9	96 (49.5)	0.319	0.460
10	189 (90.0)	0.848	-0.094
11	181 (86.6)	0.754	-0.116
12	104 (50.0)	0.454	0.288
13	167 (80.7)	0.450	0.255
14	197 (94.7)	0.994	0.651
15	63 (31.3)	0.440	0.358
16	131 (63.6)	0.636	-0.039
17	152 (73.8)	0.493	0.094
18	139 (67.5)	0.701	0.006
19	101 (49.3)	0.262	0.328
20	186 (89.0)	0.902	-0.424
21	56 (27.3)	0.404	0.455
22	22 (11.7)	-0.112	0.941
23	120 (57.7)	0.643	0.081
24	35 (17.7)	-0.009	0.884
25	142 (68.3)	0.614	0.265
26	114 (54.6)	0.546	0.315
27	101 (45.6)	0.557	0.407
28	96 (45.9)	0.482	0.422
29	100 (48.1)	0.312	0.272
30	90 (43.3)	0.221	0.694
31	106 (56.1)	0.274	0.290
32	110 (53.1)	0.411	0.407
33	98 (47.3)	0.317	0.528
34	169 (82.0)	0.595	0.272
35	196 (94.2)	0.824	0.021
36	173 (83.6)	0.650	0.104
37	158 (79.0)	0.612	0.266
38	191 (91.8)	0.893	0.000
39	201 (96.6)	1.008	-0.023
40	192 (92.3)	0.948	-0.348
41	92 (44.4)	0.028	0.835
42	160 (78.8)	0.747	0.094
43	59 (52.2)	0.621	0.358
44	93 (46.0)	0.494	0.445
45	71 (60.2)	0.619	0.341
46	131 (64.5)	0.637	0.208
47	91 (46.4)	0.415	0.507
48	174 (84.1)	0.698	0.268
49	183 (89.7)	0.632	0.153
50	157 (76.6)	0.569	0.081
51	44 (22.1)	0.306	0.467
52	195 (96.1)	0.806	-0.037
53	195 (95.6)	0.967	0.015
54	167 (81.9)	0.460	0.092
55	176 (87.6)	0.651	-0.038
56	195 (95.1)	0.784	0.095

Item number Short Version	Item number NICU Family Needs Inventory	Previous subscale	Short-Form dimension
1	3	Proximity	Infant-centered needs
2	4	Information	Infant-centered needs
3	8	Comfort	Parents-centered needs
4	11	Information	Infant-centered needs
5	13	Information	Infant-centered needs
6	15	Support	Parents-centered needs
7	16	Information	Infant-centered needs
8	19	Support	Parents-centered needs
9	20	Information	Infant-centered needs
10	21	Comfort	Parents-centered needs
11	22	Support	Parents-centered needs
12	24	Comfort	Parents-centered needs
13	25	Comfort	Infant-centered needs
14	27	Support	Infant-centered needs
15	29	Proximity	Infant-centered needs
16	31	Support	Parents-centered needs
17	32	Comfort	Infant-centered needs
18	33	Information	Parents-centered needs
19	36	Information	Infant-centered needs
20	47	Support	Parents-centered needs
21	50	Assurance	Infant-centered needs
22	51	Support	Parents-centered needs

	Total n (%)	Parents-centered needs Mean (SD)	p	Infant-centered needs Mean (SD)	p
Overall		3.5 (2.6)		8.6 (2.7)
Sex
Female	120 (56.9)	3.7 (2.6)		8.8 (2.7)
Male	91 (43.1)	3.3 (2.4)	0.239	8.3 (2.7)	0.230
Age (years)
< 35	148 (70.1)	3.3 (2.3)		8.5 (2.6)
≥ 35	63 (29.9)	4.1 (3.0)	0.037	8.8 (2.9)	0.516
Education (years)
< 9	78 (37.0)	4.3 (2.5)		8.7 (2.9)
≥ 9	133 (63.0)	3.1 (2.5)	< 0.001	8.5 (2.6)	0.600
Household monthly income (€)
≤ 1,000	72 (34.6)	3.9 (2.6)		8.4 (3.0)
> 1000	136 (65.4)	3.4 (2.6)	0.149	8.7 (2.6)	0.518
Gravidity
0	117 (55.5)	3.7 (2.6)		8.8 (2.6)
≥ 1	94 (44.5)	3.4 (2.5)	0.446	8.2 (2.9)	0.111
Pregnancy complications ^a
Yes	90 (42.7)	3.4 (2.7)		8.3 (2.6)
No	121 (57.4)	3.6 (2.5)	0.530	8.8 (2.9)	0.256
Multiple pregnancy
Yes	50 (23.7)	4.0 (2.6)		9.4 (2.8)
No	161 (76.3)	3.4 (2.5)	0.117	8.3 (2.7)	0.024
Extremely premature delivery ^b
Yes	45 (21.3)	3.5 (2.8)		8.4 (3.0)
No	166 (78.7)	3.6 (2.5)	0.943	8.6 (2.7)	0.692
Extremely low birth weight delivery ^c
Yes	63 (29.9)	3.3 (2.5)		8.4 (2.6)
No	148 (70.1)	3.6 (2.6)	0.375	8.6 (2.8)	0.547

	Total n (%)	Parents-centered needs Mean (SD)	p	Infant-centered needs Mean (SD)	p
Overall		3.5 (2.6)		8.6 (2.7)
Sex
Female	120 (56.9)	3.7 (2.6)		8.8 (2.7)
Male	91 (43.1)	3.3 (2.4)	0.239	8.3 (2.7)	0.230
Age (years)
< 35	148 (70.1)	3.3 (2.3)		8.5 (2.6)
≥ 35	63 (29.9)	4.1 (3.0)	0.037	8.8 (2.9)	0.516
Education (years)
≤ 9	78 (37.0)	4.3 (2.5)		8.7 (2.9)
> 9	133 (63.0)	3.1 (2.5)	< 0.001	8.5 (2.6)	0.600
Household monthly income (€)
≤ 1,000	72 (34.6)	3.9 (2.6)		8.4 (3.0)
> 1000	136 (65.4)	3.4 (2.6)	0.149	8.7 (2.6)	0.518
Gravidity
0	117 (55.5)	3.7 (2.6)		8.8 (2.6)
≥ 1	94 (44.5)	3.4 (2.5)	0.446	8.2 (2.9)	0.111
Pregnancy complications ^a
Yes	90 (42.7)	3.4 (2.7)		8.3 (2.9)
No	121 (57.4)	3.6 (2.5)	0.530	8.8 (2.6)	0.256
Multiple pregnancy
Yes	50 (23.7)	4.0 (2.6)		9.4 (2.8)
No	161 (76.3)	3.4 (2.5)	0.117	8.3 (2.7)	0.024
Extremely premature delivery ^b
Yes	45 (21.3)	3.5 (2.8)		8.4 (3.0)
No	166 (78.7)	3.6 (2.5)	0.943	8.6 (2.7)	0.692
Extremely low birth weight delivery ^c
Yes	63 (29.9)	3.3 (2.5)		8.4 (2.6)
No	148 (70.1)	3.6 (2.6)	0.375	8.6 (2.8)	0.547

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[1] Corresponding author. E-mail:elisabete.alves@ispup.up.pt (E. Alves).