EMpowerment of PArents in THe Intensive Care Questionnaire: Translation and Validation in Italian PICUs

Instruments to evaluate hospitalised children parents' satisfaction with nursing care: a scoping review

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.

"Greek KOOS-Child: a valid, disease specific, diagnostically accurate and responsive PROM in children with knee-related pathology"

PURPOSE

The Knee Injury Osteoarthritis Outcome Score (KOOS)-Child questionnaire is one of the frequently child-friendly measures used in pediatric studies. The aim of this study was to transculturally adapt the Greek version of KOOS-Child and evaluate its clinimetric properties in children with knee disorders.

METHODS

Children visiting the Outpatients Orthopaedic Clinic of a Greek Paediatric General Hospital were considered eligible if they were aged 8-14 years, had a knee soft tissue injury and associated physical limitations. The transcultural adaptation was based on a multistage backward translation approach. Participants completed the KOOS-Child at their first visit to the orthopedic specialist (baseline), 2 weeks and 3 months after baseline. Content validity of the KOOS-Child was evaluated using general QoL measures (KIDSCREEN and Kid-KINDL) and construct validity was explored by correlating relevant items. Responsiveness was evaluated according to the children's response on the given orthopeadic treatment.

RESULTS

Sample consisted of 59 children (30 males), aged: 11 ± 1.8 years. The KOOS-Child showed high internal consistency (Cronbach's a: 0.80-0.96). Adequate convergent validity with > 75% relevant a priori hypotheses was confirmed. Construct validity was moderate to strong (Pearson's r correlations between related KOOS and Kid-KINDL subdimensions: 0.54-0.62). KOOS and KIDSCREEN subdimensions correlations were fair (Pearson's r correlations: 0.32-0.65). KOOS-Child's diagnostic accuracy was high. Factor analysis extracted height factors accounting for 76.15% of the total variance, confirmed by the scree plot. Responsiveness was moderate to high with Cohen's d from 0.6 to 1.4.

CONCLUSION

The Greek version of the KOOS-Child demonstrated excellent internal consistency, good construct validity, diagnostic accuracy and interpretability as well as good responsiveness. The measure could be used across Greek children with orthopaedic knee problems. Generalisability of findings is limited due to the relatively limited cohort.

LEVEL OF EVIDENCE

II.

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

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.

Five Years of Journal Clubs With Pediatric Nurses and Allied Health Professionals: A Retrospective Study and Satisfaction Survey

PURPOSE

Journal Clubs (JCs) for nurses and allied health professionals have been held in an Italian pediatric hospital since April 2008. This study aimed to: examine what type of articles have been used during JCs across 5years; investigate the potential implications for clinical and organizational practice; assess the participants' satisfaction about JCs and their contribution to professional development.

DESIGN AND METHODS

Using a retrospective design, all articles proposed in the JCs were examined. Specific criteria were used to evaluate the implications for practice within the hospital, which were classified as direct or indirect. Using a cross-sectional design, 63 JCs participants were asked to express their opinion and satisfaction about the JC sessions attended.

RESULTS

Overall, 132 articles were analyzed: most of them focused on pediatric care (64.4%) and nursing (96.2%). Almost half of the articles (n=60, 45.6%) were appraised as having brought implications for clinical practice, both direct (58.3%) and indirect (41.7%). Forty-one participants (12 attendees; 29 active participants) completed a questionnaire about their opinion about JCs. Most of participants (80.5%) reported that the topics selected for the JCs were interesting and relevant to their everyday practice.

CONCLUSIONS

Multidisciplinary JCs were considered useful for clinical practice, improvement of the quality of care, and professional development. However, lack of pragmatism and the difficulty to bridge the gap between research and practice were reported as weaknesses.

PRACTICE IMPLICATIONS

JCs can represent a quality improvement strategy for promoting research utilization among health professionals and thereby improving the quality of care.

Neonatal intensive care parent satisfaction: a multicenter study translating and validating the Italian EMPATHIC-N questionnaire

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.

Empowering Parents of Australian Infants and Children in Hospital: Translation, Cultural Adaptation, and Validation of the EMpowerment of PArents in The Intensive Care-30-AUS Questionnaire

OBJECTIVES

To translate, culturally adapt, and psychometrically test the EMpowerment of PArents in The Intensive Care-30 questionnaire in Australian pediatric critical care, neonatal, and pediatric ward settings.

DESIGN

Cross-sectional, descriptive, multicenter study conducted in two phases; 1) translation and cultural adaptation and 2) validation of the EMpowerment of PArents in The Intensive Care-30 questionnaire.

SETTINGS

Two Western Australian sites, the PICU and two pediatric wards of a children's hospital and the neonatal unit of a women's and newborn hospital.

PARTICIPANTS

Parents whose baby or child was admitted to the participating wards or units with a length of hospital stay greater than 24 hours.

INTERVENTION

None.

MEASUREMENTS AND MAIN RESULTS

Phase 1: A structured 10-step translation process adhered to international principles of good practice for translation and cultural adaptation of patient-reported outcomes. Thirty parents participated in cognitive debriefing. Phase 2: A total of 328 parents responded to the EMpowerment of PArents in The Intensive Care-30-AUS questionnaire. Reliability was sufficient (Cronbach α at domain level 0.70 -0.82, for each clinical area 0.56-0.86). Congruent validity was adequate between the domains and three general satisfaction items (rs 0.38-0.69). Nondifferential validity showed no significant effect size between three patient or parent demographic characteristics and the domains (Cohen's d < 0.36). Between the different clinical areas, significant differences in responses were found in all domains.

CONCLUSIONS

The translated and culturally adapted EMpowerment of PArents in The Intensive Care-30-AUS is a reliable and valid questionnaire to measure parent-reported outcomes in pediatric critical care, pediatric ward, and neonatal hospital settings. Using this questionnaire can provide a framework for a standardized quality improvement approach and identification of best practices across specialties, hospital services and for benchmarking similar health services worldwide.