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Ruiz-González C, Martín-Casas P, Latour JM, Úbeda-Tikkanen A, López-de-Uralde-Villanueva I, Sánchez-Aparicio García S, Cuadrado-Obregón N. Spanish adaptation and validation of the empowerment of parents in the intensive care-neonatology (EMPATHIC-N) questionnaire. An Pediatr (Barc) 2023; 99:82-93. [PMID: 37419707 DOI: 10.1016/j.anpede.2023.04.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2023] [Accepted: 04/26/2023] [Indexed: 07/09/2023] Open
Abstract
INTRODUCTION Parental satisfaction is rarely measured in the neonatal intensive care unit due to a lack of specific assessment tools. The Empowerment of Parents in The Intensive Care-Neonatology (EMPATHIC-N) questionnaire is an instrument to assess satisfaction in relation to family-centred care that has been validated in several countries, but not Spain. OBJECTIVES To perform the translation and cultural adaptation of the EMPATHIC-N to Spanish followed by its validation for the purpose of assessing satisfaction in parents with children admitted to the neonatal intensive care unit. MATERIAL AND METHODS The questionnaire first underwent forward and backward translation and transcultural adaptation by a panel of experts through a standardized process based on the Delphi method, followed by a pilot study in 8 parents and then a cross-sectional study in the neonatal intensive care unit of a tertiary care hospital to assess the reliability and converging validity of the Spanish version. RESULTS The study proved the comprehensibility, validity, feasibility, applicability and usefulness of the Spanish version of the EMPATHIC-N in the field of paediatric health after being evaluated by 19 professionals and 60 parents. The content validity was found to be excellent (0.93). The reliability and convergent validity of the Spanish version of the EMPHATIC-N was analysed in a sample of 65 completed questionnaires. The Cronbach α for each domain was greater than 0.7, indicating a high internal consistency. We assessed validity by analysing the correlation of the 5 domains with the with the 4 general satisfaction items. The validity was found to be adequate (rs, 0.4-0.76; P < .01). CONCLUSIONS The Spanish version of the EMPATHIC-N questionnaire is a comprehensible, useful, valid and reliable instrument to measure satisfaction in the parents of children admitted to neonatal care units.
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Affiliation(s)
| | - Patricia Martín-Casas
- Departamento de Radiología, Rehabilitación y Fisioterapia, Facultad de Enfermería, Fisioterapia y Podología, Universidad Complutense de Madrid, IdISSC, Madrid, Spain.
| | - Jos M Latour
- Escuela de Enfermería y Obstetricia, Facultad de Salud, Universidad de Plymouth, Plymouth, UK
| | - Ana Úbeda-Tikkanen
- Servicio de Rehabilitación, Hospital de Rehabilitación Infantil y Spaulding de Boston, Boston, MA, USA
| | - Ibai López-de-Uralde-Villanueva
- Departamento de Radiología, Rehabilitación y Fisioterapia, Facultad de Enfermería, Fisioterapia y Podología, Universidad Complutense de Madrid, IdISSC, Madrid, Spain
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Weis J, Beck SA, Jensen A, Brødsgaard A, Latour JM, Greisen G. Psychometric testing of a Danish version of the empowerment of parents in the intensive care - Neonatology questionnaire has confirmed validity. Acta Paediatr 2023; 112:708-718. [PMID: 36607258 DOI: 10.1111/apa.16661] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/01/2022] [Revised: 01/03/2023] [Accepted: 01/05/2023] [Indexed: 01/07/2023]
Abstract
AIM Investigating parent satisfaction with care is important to guide quality development. In this study, we translated and validated a Danish version of the empowerment of parents in the intensive care - neonatology (EMPATHIC-N) questionnaire to determine validity in Danish contexts. METHOD A psychometric study design was applied. Translation was performed according to recommended international standards. Confirmatory factor analyses including standardised factor loadings, Cronbach's α reliability estimates, congruent validity and non-differential validity testing were applied. The study was performed from June 2017 to November 2019 at a 33-bed level IV neonatal intensive care unit. RESULTS Participants were 311 parents (response rate = 42,8%). Confirmative factor analyses disclosed a moderate model fit of the instrument with Comparative Fit Index (CFI) values of 0.83-0.92. Cronbach's α showed good reliability (0.82-0.93). Congruent validity showed good positive correlations (0.48-0.71) between the instrument domains and four overall satisfaction indicators. In search of improved model fit, a version including 27 items was tested. This version showed a better model fit with CFI values of 0.92-0.99 and satisfactory Cronbach's α values. CONCLUSIONS Model fit for the Danish full EMPATIC-N was moderate. The shorter version showed better psychometric properties.
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Affiliation(s)
- Janne Weis
- Department of Intensive Care of Newborns and Small Children, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark
| | - Sanne Allermann Beck
- Department of Intensive Care of Newborns and Small Children, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark
| | - Andreas Jensen
- Department of Paediatrics and Adolescent Medicine, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark
| | - Anne Brødsgaard
- Research Unit for Nursing and Health, Faculty of Health, University of Aarhus, Aarhus, Denmark.,Department of Paediatrics and Adolescent Medicine & Gynaecology and Obstetrics, Copenhagen University Hospital, Amager and Hvidovre, Copenhagen, Denmark
| | - Jos M Latour
- School of Nursing and Midwifery, Faculty of Health, University of Plymouth, Plymouth, UK
| | - Gorm Greisen
- Department of Intensive Care of Newborns and Small Children, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark.,Institute of Clinical Medicine, Copenhagen University, Copenhagen, Denmark
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Alle YF, Akenaw B, Seid S, Bayable SD. Parental satisfaction and its associated factors towards neonatal intensive care unit service: a cross-sectional study. BMC Health Serv Res 2022; 22:1266. [PMID: 36261864 PMCID: PMC9583552 DOI: 10.1186/s12913-022-08645-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2022] [Revised: 09/24/2022] [Accepted: 10/07/2022] [Indexed: 11/18/2022] Open
Abstract
Background Parental satisfaction is a well-established outcome indicator and tool for assessing a healthcare system’s quality, as well as input for developing strategies for providing acceptable patient care. This study aimed to assess parental satisfaction with neonatal intensive care unit service and its associated factors. Method A cross-sectional study design was conducted on parents whose neonates were admitted to the neonatal intensive care unit at Debre Tabor Comprehensive Specialized Hospital, in North Central Ethiopia. Data were collected by adopting an EMPATHIC-N instrument during the day of neonatal discharge, after translating the English version of the instrument to the local language (Amharic). Both Bivariable and multivariable logistic analyses were done to identify factors associated with parental satisfaction with neonatal intensive care unit service. P < 0.05 with 95% CI was considered statistically significant. Results The data analysis was done on 385 parents with a response rate of 95.06%. The overall average satisfaction of parents with neonatal intensive care unit service was 47.8% [95% CI= (43.1–52.5)]. The average parental satisfaction of neonatal intensive care unit service in the information dimension was 50.40%; in the care and treatment dimension was 36.9%, in the parental participation dimension was 50.1%, in the organization dimension was 59.0% and the professional attitude dimension was 48.6%. Gender of parents, residency, parental hospital stay, birth weight, and gestational age were factors associated with parental satisfaction. Conclusion There was a low level of parental satisfaction with neonatal intensive care unit service. Among the dimensions of EMPATHIC-N, the lowest parental satisfaction score was in the care and treatment while the highest parental satisfaction score was in the organization dimension.
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Affiliation(s)
- Yewlsew Fentie Alle
- Departement of Anesthesia, College of Medicine and Health Sciences, Debre Tabor University, Debre Tabor, 272, Ethiopia.
| | - Bantigegn Akenaw
- Departement of Anesthesia, College of Medicine and Health Sciences, Debre Tabor University, Debre Tabor, 272, Ethiopia
| | - Shimelis Seid
- Departement of Anesthesia, College of Medicine and Health Sciences, Debre Tabor University, Debre Tabor, 272, Ethiopia
| | - Samuel Debas Bayable
- Departement of Anesthesia, College of Medicine and Health Sciences, Debre Markos University, Debre Markos, Ethiopia
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Loureiro F, Antunes V. Instruments to evaluate hospitalised children parents' satisfaction with nursing care: a scoping review. BMJ Paediatr Open 2022; 6:e001568. [PMID: 36053623 PMCID: PMC9438009 DOI: 10.1136/bmjpo-2022-001568] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/05/2022] [Accepted: 08/11/2022] [Indexed: 11/05/2022] Open
Abstract
AIM To identify instruments that allow the evaluation of parent's satisfaction regarding nursing care during their child hospitalisation. METHODS A review was performed using Preferred Reporting Items for Scoping Reviews. The study was prospectively registered in Open Science Framework. Research was carried out on EBSCOhost, PubMed, SciELO, Web of Science and ScienceDirect platforms as well as grey literature. Additionally, the references of selected articles were also examined. RESULTS A sample of 65 articles allowed the identifications of 38 distinctive instruments to evaluate parents' satisfaction in different hospital settings. Most studies were applied in paediatric wards (n=28), followed by neonatal intensive care units (n=21), paediatric intensive care units (n=9) and emergency departments (n=7). Sample size ranged from 13 to 3354 and 3 studies used mixed methods, 20 were methodological studies of instruments construction or validation and 43 were quantitative studies. 21 different instruments previously existent were found. In 3 studies, adapted instruments were used and, in 14 studies, structured instruments were purposively designed for the study. Instruments had between 1 and 13 domains and total number of items ranged between 13 and 92. Most studies assessed overall satisfaction (n=53) and instrument reliability (n=49) and/or validity (n=37). CONCLUSION Most instruments consider nursing care as a domain of satisfaction. Only two instruments focused specifically on nursing care. In most of the studies, there was a concern to evaluate instruments psychometric properties. This review clearly shows that there is still a gap in the literature on the range of aspects that influence satisfaction and a lack of consensus on ideal conditions for instrument use and application.
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Affiliation(s)
- Fernanda Loureiro
- Nursing, Egas Moniz Cooperativa de Ensino Superior CRL, Caparica, Portugal
- Nursing, Centro de Investigação Interdisciplinar Egas Moniz, Caparica, Portugal
| | - Vanessa Antunes
- Nursing, Egas Moniz Cooperativa de Ensino Superior CRL, Caparica, Portugal
- Nursing, Centro de Investigação Interdisciplinar Egas Moniz, Caparica, Portugal
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Lessa AD, Cabral FC, Tonial CT, Costa CAD, Andrades GRH, Crestani F, Einloft PR, Bruno F, Sganzerla D, Matte MCC, Fiori HH, Latour JM, Garcia PCR. Brazilian Translation, Cross-Cultural Adaptation, Validity, and Reliability of the EMpowerment of PArents in THe Intensive Care 30 (EMPATHIC-30) Questionnaire to Measure Parental Satisfaction in PICUs. Pediatr Crit Care Med 2021; 22:e339-e348. [PMID: 33044413 DOI: 10.1097/pcc.0000000000002594] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVES To conduct the Brazilian translation, cross-cultural adaptation, validation, and reliability testing of the EMpowerment of PArents in THe Intensive Care (EMPATHIC-30). DESIGN Prospective study. SETTING PICU of a tertiary-care teaching hospital. PATIENTS Parents (n = 141) completed the translated EMPATHIC-30 questionnaire 72 hours after their child's PICU discharge. INTERVENTIONS None. MEASUREMENTS AND MAIN RESULTS The translation and cultural adaptation were performed in accordance with the principles of good practice for the translation and cultural adaptation process for patient-reported outcomes measures. Sentences were adapted according to the Brazilian syntax. Total content validity coefficient was above the established average (> 0.8). Reliability was evaluated with the coefficients McDonald omega and Cronbach alpha. The lowest Cronbach alpha found was 0.47 (CI 95%, 0.35-0.59) in the organization domain, where the lowest response rate was also concentrated. The values of the other domains were as follows: 0.64 (95% CI, 0.55-0.73) for information, 0.77 (95% CI, 0.71-0.83) for care and treatment, 0.72 (95% CI, 0.66-0.78) for parent participation, and 0.72 (95% CI, 0.65-0.79) for professional attitudes. The total internal consistency independent of the domain was 0.90 (CI 95%, 0.88-0.92). With regard to McDonald Omega, values were identified: 0.68 (95% CI, 0.49-0.88) for information, 0.73 (95% CI, 0.61-0.85) for care and treatment, 0.85 (95% CI, 0.47-0.80) for parent participation, 0.85 (95% CI, 0.76-0.93), and 0.72 (95% CI, 0.58-0.86) for professional attitudes. CONCLUSIONS EMPATHIC-30 has been translated and culturally adapted for the Brazilian population. Validation demonstrated an above-average total content validity coefficient, confirming the instrument content validity. A sufficient reliability was observed in both analyzed coefficients. The results support the use of the Brazilian version of EMPATHIC-30 for the evaluation of parents' satisfaction of children admitted to the PICU.
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Affiliation(s)
- Alessandra D Lessa
- Department of Pediatrics, School of Medicine and Pediatric Intensive Care of Hospital São Lucas, Pontifícia Universidade Católica do Rio Grande do Sul (PUCRS), Porto Alegre, Brazil
| | - Felipe C Cabral
- Department of Pediatrics, School of Medicine and Pediatric Intensive Care of Hospital São Lucas, Pontifícia Universidade Católica do Rio Grande do Sul (PUCRS), Porto Alegre, Brazil
- Digital Health Coordinator, Hospital Moinhos de Vento, Porto Alegre, Brazil
| | - Cristian T Tonial
- Department of Pediatrics, School of Medicine and Pediatric Intensive Care of Hospital São Lucas, Pontifícia Universidade Católica do Rio Grande do Sul (PUCRS), Porto Alegre, Brazil
| | - Caroline A D Costa
- School of Health and Life Sciences, Pontifícia Universidade Católica do Rio Grande do Sul (PUCRS), Porto Alegre, Brazil
| | - Gabriela R H Andrades
- Post-graduate Program in Pediatrics and Child Health, School of Medicine and Pediatric Intensive Care of Hospital São Lucas, Pontifícia Universidade Católica do Rio Grande do Sul (PUCRS), Porto Alegre, Brazil
| | - Francielly Crestani
- Post-graduate Program in Pediatrics and Child Health, School of Medicine and Pediatric Intensive Care of Hospital São Lucas, Pontifícia Universidade Católica do Rio Grande do Sul (PUCRS), Porto Alegre, Brazil
| | - Paulo R Einloft
- Department of Pediatrics, School of Medicine and Pediatric Intensive Care of Hospital São Lucas, Pontifícia Universidade Católica do Rio Grande do Sul (PUCRS), Porto Alegre, Brazil
| | - Francisco Bruno
- Department of Pediatrics, School of Medicine and Pediatric Intensive Care of Hospital São Lucas, Pontifícia Universidade Católica do Rio Grande do Sul (PUCRS), Porto Alegre, Brazil
| | - Daniel Sganzerla
- Digital Health Coordinator, Hospital Moinhos de Vento, Porto Alegre, Brazil
| | - Maria C C Matte
- Digital Health Coordinator, Hospital Moinhos de Vento, Porto Alegre, Brazil
| | - Humberto H Fiori
- Department of Pediatrics, Post-graduate Program in Pediatrics and Child Health, School of Medicine and Neonatal Intensive Care of Hospital São Lucas, Pontifícia Universidade Católica do Rio Grande do Sul (PUCRS), Porto Alegre, Brazil
| | - Jos M Latour
- School of Nursing and Midwifery, Faculty of Health, University of Plymouth, Plymouth, United Kingdom
| | - Pedro Celiny R Garcia
- Department of Pediatrics, Post-graduate Program in Pediatrics and Child Health, School of Medicine and Pediatric Intensive Care of Hospital São Lucas, Pontifícia Universidade Católica do Rio Grande do Sul (PUCRS), Porto Alegre, Brazil
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Gulo B, Miglierina L, Tognon F, Panunzi S, Tsegaye A, Asnake T, Manenti F, Dall'Oglio I. Parents' Experience and Satisfaction in Neonatal Intensive Care Units in Ethiopia: A Multicenter Cross-Sectional Study Using an Adapted Version of EMPATHIC-N. Front Pediatr 2021; 9:738863. [PMID: 34692612 PMCID: PMC8531748 DOI: 10.3389/fped.2021.738863] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/09/2021] [Accepted: 09/13/2021] [Indexed: 12/27/2022] Open
Abstract
Background: In neonatal intensive care units (NICU) setting, parents' experience and satisfaction permit to evaluate clinical practice and improve the care of infants and parents. Little is known about this topic in low resource settings. The aim of this study was to (1) translate, adapt and validate the EMpowerment of PArents in THe Intensive Care-Neonatology (EMPHATIC-N) questionnaire in two languages in Ethiopia (2) explore parents' satisfaction with the care received in the NICUs in three hospitals; and, (3) explore socio-demographic characteristics and level of the NICU influence on the EMPATHIC-N domains. Methods: This was a cross-sectional multicenter study. Participants were recruited from three different NICUs in Ethiopia upon discharge. We reduced the original EMPATHIC-N instrument to 38 items, culturally adapted and validated it in two local languages. Confirmatory Factor Analysis (CFA) was applied to verify the factor structure of the questionnaire, investigating the relationship between items and the five latent domains. Single item scores and the aggregate scores of the domains were investigated across NICUs and in the sample overall. Differences in the distribution of the domain scores were tested according to socio-demographic participants' characteristics. The scores of four general questions about overall experience and satisfaction were investigated in relation to the participant's characteristics and NICU levels. Qualitative data were collected using four open-ended questions and a synthesis of results was provided. Results: Almost all the parents answered to the questionnaire (92%, n = 386). Questionnaire items on satisfaction on average scored more than four. The highest mean scores were obtained for Parental participation (median: 5.17; iqr: 4.67-5.62), while they were lower for Organization/Hospital environment (median: 4.67; iqr:4.33-5.17). Different levels of parent satisfaction were observed across the NICU levels showing a statistically higher satisfaction in level II NICU compared to the other levels. Education, place of residence and length of stay were associated with parental satisfaction and experience. Conclusion: This study validated two Ethiopian versions of the EMPATHIC-N questionnaire to assess parents' experience and satisfaction during their child's stay in the NICU. The differences found across the three levels of NICU suggest the need to further investigate the determinants of satisfaction.
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Affiliation(s)
- Berhanu Gulo
- Doctors With Africa CUAMM, Addis Ababa, Ethiopia
| | | | - Francesca Tognon
- Doctors With Africa CUAMM, Padua, Italy.,Department of Women's and Children's Health, University of Padua, Padua, Italy
| | - Silvia Panunzi
- Unit of Epidemiology and Medical Statistics, Department of Diagnostics and Public Health, University of Verona, Verona, Italy
| | | | - Tina Asnake
- Federal Ministry of Health, Addis Ababa, Ethiopia
| | | | - Immacolata Dall'Oglio
- Professional Development, Continuous Education and Research Service, Bambino Gesù Children's Hospital IRCCS, Rome, Italy
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Lake ET, Smith JG, Staiger DO, Hatfield LA, Cramer E, Kalisch BJ, Rogowski JA. Parent Satisfaction With Care and Treatment Relates to Missed Nursing Care in Neonatal Intensive Care Units. Front Pediatr 2020; 8:74. [PMID: 32257979 PMCID: PMC7093579 DOI: 10.3389/fped.2020.00074] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/20/2019] [Accepted: 02/14/2020] [Indexed: 11/13/2022] Open
Abstract
Background: The satisfaction of parents of infants in neonatal intensive care is important to parent-infant bonding and parents' ability to care for their baby, including after discharge. Given the principal caregiver role of nurses in this setting, parent satisfaction is influenced by high quality nursing care. Nursing care that is required but missed, such as counseling and support, might influence parent satisfaction. How missed nursing care relates to parent satisfaction is unknown. Objective: To describe the satisfaction of parents of infants in neonatal intensive care and to determine how satisfaction relates to missed nursing care in a sample of USA nursing units. Methods: The design was cross-sectional and correlational. Thirty neonatal intensive care units that participate in the National Database of Nursing Quality Indicators were recruited. To maximize sample variation in missed care, the highest and lowest quartile hospitals on missed nursing care, measured by nurse survey, were eligible. Ten parents of infants who were to be discharged were recruited from each site to complete a survey. Parent satisfaction was measured by the EMPATHIC-38 instrument, comprising five subscales: information, care and treatment, organization, parental participation, and professional attitude, and a total satisfaction score. Multivariate regression models were estimated. Results: Parent satisfaction was high (5.70 out of 6.00). The prevalence of missed care was 25 and 51% for low and high missed care units, respectively, and 40% for all units. On average, nurses missed 1.06 care activities; in the low and high missed care units the averages were 0.46 and 1.32. Over 10% of nurses missed activities that involved the parent, e.g., teaching, helping breastfeeding mothers, and preparing families for discharge. One standard deviation decrease in missed care activities at the unit level was associated with a 0.08-point increase in parent satisfaction with care and treatment (p = 0.01). Conclusion: Parents in USA neonatal intensive care units are highly satisfied. Neonatal intensive care nurses routinely miss care. Parent satisfaction with care and treatment is related to missed nursing care. Nursing care that is missed relates primarily to the care of the baby by the parents, which could have long term health and developmental consequences.
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Affiliation(s)
- Eileen T. Lake
- Center for Health Outcomes and Policy Research, School of Nursing, University of Pennsylvania, Philadelphia, PA, United States
| | - Jessica G. Smith
- College of Nursing and Health Innovation, University of Texas at Arlington, Arlington, TX, United States
| | | | - Linda A. Hatfield
- School of Nursing, University of Pennsylvania, Philadelphia, PA, United States
| | - Emily Cramer
- School of Nursing, University of Kansas, Kansas City, KS, United States
| | | | - Jeannette A. Rogowski
- Department of Health Policy and Administration, The Pennsylvania State University, University Park, PA, United States
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Tiryaki Ö, Zengin H, Çınar N, Umaroǧlu MM, Latour JM. Turkish Adaptation and Validation of the EMpowerment of PArents in THe Intensive Care (EMPATHIC-30) Questionnaire to Measure Parent Satisfaction in Neonatal Intensive Care Units. Front Pediatr 2020; 8:421. [PMID: 32850537 PMCID: PMC7403180 DOI: 10.3389/fped.2020.00421] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/11/2020] [Accepted: 06/18/2020] [Indexed: 11/16/2022] Open
Abstract
Aim: The aim of this study was to translate and validate the shortened version of the "EMpowerment of PArents in THe Intensive Care" (EMPATHIC-30) questionnaire into Turkish to measure parent satisfaction in the Neonatal Intensive Care Units (NICU). Method: The study used a cross-sectional design. The data of the study were collected from parents with infants staying in the NICU of a training and research hospital in Sakarya, Turkey, between July 2018-2019 after obtaining ethical approval. Totally, 238 parents (234 mothers, four fathers) agreed to participate in the study and completed the questionnaire. Of these, 35 mothers were recruited 1 month later for the test-retest reliability analysis. The questionnaire was translated using back and forward translation. Reliability and validity test were performed to measure the psychometric properties of the Turkish EMPATHIC-30. Results: The mean age of the parents was 28.27 (SD 5.93), and 48.3% of them were primary school graduates. The infants: 55.9% were male, the mean gestational age was 36.89 (SD 3.25) weeks, and mean length of hospital stay was 9.36 (SD 10.17) days. The mean scores of each item with a six-point scale of the EMPATHIC-30 questionnaire ranged between 4.01 and 4.87. The Cronbach's alpha of the total questionnaire was 0.95. Cronbach's alpha of the five domains (Information, Care and Treatment, Organization, Parent Participation, and Professional Attitude) ranged between 0.80 and 0.92. Pearson correlation coefficient between the domains and total questionnaire was r = 0.988. The Intraclass correlation coefficient was ICC = 0.998 in the test-retest evaluation. Confirmatory factor analysis was performed for construct validity and was moderate; Comparative Fit Index = 0.792, Tucker-Lewis Index = 0.770, Standardized Root Mean Square Residual = 0.0811, and Root Mean Square Error of Approximation = 0.107. Conclusion: The Turkish version of EMPHATIC-30 has adequate psychometric properties. The EMPATHIC-30-Turkish questionnaire is an easy and appropriate instrument which can be used to measure satisfaction of Turkish parents with infants staying in the NICU.
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Affiliation(s)
- Öznur Tiryaki
- Institute of Health Sciences, Sakarya University, Sakarya, Turkey
| | - Hamide Zengin
- Department of Pediatric Nursing, Faculty of Health Sciences, Bilecik Şeyh Edebali University, Bilecik, Turkey
| | - Nursan Çınar
- Department of Pediatric Nursing, Faculty of Health Sciences, Sakarya University, Sakarya, Turkey
| | - Mümtaz Mutlu Umaroǧlu
- Faculty of Medicine Basic Medical Sciences, Biostatistics, Sakarya University, Sakarya, Turkey
| | - Jos M Latour
- Faculty of Health: Medicine, Dentistry and Human Sciences, School of Nursing and Midwifery, University of Plymouth, Plymouth, United Kingdom
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Lake ET, Smith JG, Staiger DO, Schoenauer KM, Rogowski JA. Measuring Parent Satisfaction With Care in Neonatal Intensive Care Units: The EMPATHIC-NICU-USA Questionnaire. Front Pediatr 2020; 8:541573. [PMID: 33123503 PMCID: PMC7573183 DOI: 10.3389/fped.2020.541573] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/09/2020] [Accepted: 08/19/2020] [Indexed: 11/29/2022] Open
Abstract
Background: Neonatal intensive care unit (NICU) patient satisfaction is measured as parent satisfaction. Parents are critical to the family-centered care model and can evaluate care. Several EMpowerment of PArents in THe Intensive Care (EMPATHIC) instruments were developed in the Netherlands to measure parent satisfaction with neonatal and pediatric intensive care. EMPATHIC instruments comprise five domains and a total score: information, care and treatment, organization, parental participation, and professional attitude. To our knowledge, the EMPATHIC has not been adapted for USA use. Objectives: (1) To select a relevant EMPATHIC instrument for our study. (2) To expand the content reflecting the role of nurses and the cultural heterogeneity of USA NICU infants. (3) To adapt the selected EMPATHIC instrument to USA English. (4) To establish psychometric properties of the linguistically adapted instrument. (5) To evaluate instrument performance with additional items. Methods: The EMPATHIC-30 was selected based on shortest length, high overlap with neonatal EMPATHIC-N, and availability of a validated Spanish-language version. Six items from the EMPATHIC-N were added, two of which were split into separate items, resulting in the EMPATHIC-38. A neonatal nurse practitioner adapted wording to USA English. Cognitive debriefing was performed with eight NICU parents to evaluate adapted wording. Parent survey data from a study about missed nursing care and NICU parent satisfaction were utilized. Internal consistency of the five domains and overall score was measured by Cronbach's alpha. Spearman's rank correlations were computed for domains and overall score with four validity measures. Differential validity was determined using 13 parent demographic subgroups. Results: Data were from 282 parents. Parent race was predominantly White (61%) or Black (22%). One fifth were Hispanic. The adapted wording was satisfactory. Four of the five EMPATHIC-30 and EMPATHIC-38 domains had Cronbach alphas at or above 0.70, indicating acceptable reliability. Correlations between the domain, total scores, and validity indicators ranged from 0.30 to 0.57, indicating positive, moderate associations. Results were replicated in demographic subgroups. Reliability and validity of the three domains with additional items were better than or equivalent to values for the original. Conclusion: The linguistically adapted EMPATHIC-30-NICU-USA and the expanded EMPATHIC-38-NICU-USA exhibit satisfactory psychometric properties and are suitable for use in USA NICUs.
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Affiliation(s)
- Eileen T Lake
- Center for Health Outcomes and Policy Research, School of Nursing, University of Pennsylvania, Philadelphia, PA, United States
| | - Jessica G Smith
- College of Nursing and Health Innovation, University of Texas at Arlington, Arlington, TX, United States
| | - Douglas O Staiger
- Department of Economics, Dartmouth College, Hanover, NH, United States
| | - Kathryn M Schoenauer
- Center for Health Outcomes and Policy Research, School of Nursing, University of Pennsylvania, Philadelphia, PA, United States
| | - Jeannette A Rogowski
- Department of Health Policy and Administration, The Pennsylvania State University, University Park, PA, United States
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Caffarelli C, Santamaria F, Mastrorilli C, Santoro A, Iovane B, Petraroli M, Gaeta V, Di Pinto R, Borrelli M, Bernasconi S, Corsello G. Report on advances for pediatricians in 2018: allergy, cardiology, critical care, endocrinology, hereditary metabolic diseases, gastroenterology, infectious diseases, neonatology, nutrition, respiratory tract disorders and surgery. Ital J Pediatr 2019; 45:126. [PMID: 31619283 PMCID: PMC6796402 DOI: 10.1186/s13052-019-0727-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/11/2019] [Accepted: 09/30/2019] [Indexed: 12/11/2022] Open
Abstract
This review reported notable advances in pediatrics that have been published in 2018. We have highlighted progresses in allergy, cardiology, critical care, endocrinology, hereditary metabolic diseases, gastroenterology, infectious diseases, neonatology, nutrition, respiratory tract disorders and surgery. Many studies have informed on epidemiologic observations. Promising outcomes in prevention, diagnosis and treatment have been reported. We think that advances realized in 2018 can now be utilized to ameliorate patient care.
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Affiliation(s)
- Carlo Caffarelli
- Clinica Pediatrica, Department of Medicine and Surgery, Azienda Ospedaliera-Universitaria, University of Parma, Via Gramsci 14, Parma, Italy.
| | - Francesca Santamaria
- Department of Translational Medical Sciences, Federico II University, Naples, Italy
| | - Carla Mastrorilli
- UO Pediatria e Pronto Soccorso, Azienda Ospedaliero-Universitaria Consorziale Policlinico Pediatric Hospital Giovanni XXIII, Bari, Italy
| | - Angelica Santoro
- Clinica Pediatrica, Department of Medicine and Surgery, Azienda Ospedaliera-Universitaria, University of Parma, Via Gramsci 14, Parma, Italy
| | - Brunella Iovane
- UOC Pediatria Generale e d'Urgenza, Department of Medicine and Surgery, Azienda Ospedaliera-Universitaria, University of Parma, Parma, Italy
| | - Maddalena Petraroli
- Clinica Pediatrica, Department of Medicine and Surgery, Azienda Ospedaliera-Universitaria, University of Parma, Via Gramsci 14, Parma, Italy
| | - Valeria Gaeta
- Department of Translational Medical Sciences, Federico II University, Naples, Italy
| | - Rosita Di Pinto
- Department of Translational Medical Sciences, Federico II University, Naples, Italy
| | - Melissa Borrelli
- Department of Translational Medical Sciences, Federico II University, Naples, Italy
| | - Sergio Bernasconi
- Pediatrics Honorary Member University Faculty, G D'Annunzio University of Chieti-Pescara, Chieti, Italy
| | - Giovanni Corsello
- Department of Sciences for Health Promotion and Mother and Child Care "G. D'Alessandro", University of Palermo, Palermo, Italy
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Papamichael E, Ioannou M, A Talias M. EMPATHIC-N in a Greek-Cypriot sample: confirming its factorial structure. BMC Health Serv Res 2018; 18:968. [PMID: 30547797 PMCID: PMC6295023 DOI: 10.1186/s12913-018-3793-3] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2018] [Accepted: 12/04/2018] [Indexed: 12/03/2022] Open
Abstract
Background Family-centered care has been receiving increased attention during the last decades and health professionals recognize family satisfaction with care as an important health indicator. The Empowerment of Parents in The Intensive Care-Neonatology (EMPATHIC-N) is a newly developed, yet empirically reliable and valid measure for the assessment of parental satisfaction with the care provided by Neonatal Intensive Care Units (NICU). The present study aims to present the Greek version of the EMPATHIC-N and to confirm its factorial structure. Methods The EMPATHIC-N was translated in Greek using a forward-backward translation and was piloted before use. A sample of 256 families receiving intensive care at the NICU of Archbishop Makarios III Public Hospital in Cyprus which is the only NICU in Cyprus, participated in the validation study of the EMPATHIC-N. Confirmatory factor analyses were performed using SPSS and AMOS 24.0. Results The Greek version of the EMPATHIC-N had good psychometric characteristics (Cronbach’s alpha = .87). The CFAs for the separate subscales of professionalism, organization, information, parental involvement and intervention for the EMPATHIC-N showed that all five subscales represented five distinct components of parental satisfaction with care. The CFA of the general instrument supported that a second-order model with a higher-order factor reflecting the organizational structure (professionalism, intervention and organization loaded on this factor) fitted the data best [χ2 (259) = 405.332, p < .001, ΤLI = .887, CFI = .903, RMSEA = .065 (90% CI .058, .073), SRMR = .0597]. Conclusions EMPATHIC-N is a valid and reliable measure for the assessment of parental satisfaction with neonatal care in a Greek-Cypriot context. The organizational dimension of the NICUs is an important component with specific research and clinical implications for the enhancement of parental satisfaction with care. Electronic supplementary material The online version of this article (10.1186/s12913-018-3793-3) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Elena Papamichael
- Neonatal Intensive Care Unit, Arch. Makarios III Hospital, 6 Koritsas street, 1474, Strovolos, Nicosia, Cyprus. .,Health Management Unit, Open University of Cyprus, Nicosia, Cyprus.
| | - Myria Ioannou
- Psychology Department, University of Cyprus, Nicosia, Cyprus
| | - Michael A Talias
- Health Management Unit, Open University of Cyprus, Nicosia, Cyprus
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12
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Dall'Oglio I, Fiori M, Tiozzo E, Mascolo R, Portanova A, Gawronski O, Ragni A, Amadio P, Cocchieri A, Fida R, Alvaro R, Rocco G, Latour JM. Neonatal intensive care parent satisfaction: a multicenter study translating and validating the Italian EMPATHIC-N questionnaire. Ital J Pediatr 2018; 44:5. [PMID: 29304879 PMCID: PMC5756347 DOI: 10.1186/s13052-017-0439-8] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/18/2017] [Accepted: 12/11/2017] [Indexed: 11/18/2022] Open
Abstract
Background In Neonatal Intensive Care Units (NICUs), parent satisfaction and their experiences are fundamental to assess clinical practice and improve the quality of care delivered to infants and parents. Recently, a specific instrument, the EMpowerment of PArents in THe Intensive Care-Neonatology (EMPATHIC-N), has been developed in the Netherlands. This instrument investigated different domains of care in NICUs from a family-centered care perspective. In Italy, no rigorous instruments are available to evaluate parent satisfaction and experiences in NICU with family-centered care. The aim of this study was to translate and validate the EMPATHIC-N instrument into Italian language measuring parent satisfaction. Methods A psychometric study was conducted in nine Italian NICUs. The hospitals were allocated across Italy: four in the North, four in Central region, one in the South. Parents whose infants were discharged from the Units were enrolled. Parents whose infants died were excluded. Results Back-forward translation was conducted. Twelve parents reviewed the instrument to assess the cultural adaptation; none of the items fell below the cut-off of 80% agreement. A total of 186 parents of infants who were discharged from nine NICUs were invited to participate and 162 parents responded and returned the questionnaire (87%). The mean scores of the individual items varied between 4.3 and 5.9. Confirmatory factor analysis was performed and all factor loadings were statistically significant with the exception of item ‘Our cultural background was taken into account’. The items related to overall satisfaction showed a higher trend with mean values of 5.8 and 5.9. The Cronbach’s alpha’s (at domain level 0.73-0.92) and corrected item-total scale correlations revealed high reliability estimates. Conclusions The Italian EMPATHIC-N showed to be a valid and reliable instrument measuring parent satisfaction in NICUs from a family-centered care perspective. Indeed, it had good psychometric properties, validity, and reliability. Furthermore, this instrument is fundamental for further research and internationally benchmarking. Electronic supplementary material The online version of this article (10.1186/s13052-017-0439-8) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Immacolata Dall'Oglio
- Professional Development, Continuing Education and Nursing Research Service, Bambino Gesù Children's Hospital, IRCCS, IRCCS P.za Sant'Onofrio 4, 00165, Rome, Italy. .,Department of Biomedicine and Prevention, Tor Vergata, University of Rome, Rome, Italy.
| | - Martina Fiori
- Professional Development, Continuing Education and Nursing Research Service, Bambino Gesù Children's Hospital, IRCCS, IRCCS P.za Sant'Onofrio 4, 00165, Rome, Italy.,Plymouth University, Faculty of Health and Human Sciences, School of Nursing and Midwifery, Plymouth, UK
| | - Emanuela Tiozzo
- Professional Development, Continuing Education and Nursing Research Service, Bambino Gesù Children's Hospital, IRCCS, IRCCS P.za Sant'Onofrio 4, 00165, Rome, Italy
| | - Rachele Mascolo
- Professional Development, Continuing Education and Nursing Research Service, Bambino Gesù Children's Hospital, IRCCS, IRCCS P.za Sant'Onofrio 4, 00165, Rome, Italy
| | - Anna Portanova
- Department of Medical and Surgical Neonatology, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
| | - Orsola Gawronski
- Professional Development, Continuing Education and Nursing Research Service, Bambino Gesù Children's Hospital, IRCCS, IRCCS P.za Sant'Onofrio 4, 00165, Rome, Italy.,Department of Biomedicine and Prevention, Tor Vergata, University of Rome, Rome, Italy
| | - Angela Ragni
- Department of Medical and Surgical Neonatology, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
| | - Patrizia Amadio
- Department of Medical and Surgical Neonatology, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
| | | | - Roberta Fida
- Norwich Business School, University of East Anglia, Norwich, UK
| | - Rosaria Alvaro
- Department of Biomedicine and Prevention, Tor Vergata, University of Rome, Rome, Italy
| | - Gennaro Rocco
- Centre of Excellence for Nursing Scholarship, IPASVI Rome Nursing College, Rome, Italy
| | - Jos M Latour
- Plymouth University, Faculty of Health and Human Sciences, School of Nursing and Midwifery, Plymouth, UK
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