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Montoro-Pérez N, Oliver-Roig A, Montejano-Lozoya R, Richart-Martínez M. Psychometric properties of parental stress scales used in paediatric health care settings: A systematic review 1. J Clin Nurs 2024; 33:911-931. [PMID: 37926938 DOI: 10.1111/jocn.16920] [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: 02/15/2023] [Revised: 08/28/2023] [Accepted: 10/18/2023] [Indexed: 11/07/2023]
Abstract
AIM To identify scales that assess parental stress in the paediatric clinical population and to analyse their psychometric properties. METHODS Four electronic databases (PubMed, Web of Science, PsycINFO, and Scopus) and metasearch engines (Google Scholar and Open Grey) were searched with no time period limitations. Methodological quality was assessed using the COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN) and quality of evidence using the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) approach modified by COSMIN. Finally, recommendations were made for the instruments with the highest quality of evidence. RESULTS A total of 38 studies reporting on 11 different instruments for assessing parental stress in the paediatric clinical setting were included. Six instruments were 'A' rated (recommended) in the final phase in line with COSMIN guidelines. The Paediatric Inventory for Parents was the instrument that evaluated the highest number of psychometric properties and obtained the highest methodological quality, global assessment, and quality of evidence for the different psychometric properties. CONCLUSIONS This systematic review provides an overview of the measurement properties of the parental stress instruments used in the paediatric clinical setting. The Paediatric Inventory for Parents stands out as being one of the most robust instruments for measuring stress in parents with a hospitalised or sick child. Evidence needs to be generated for all the parental stress scales used in the clinical setting. IMPACT Given that the psychometric properties of the existing parental stress scales used in paediatric health care settings have not been systematically assessed, the present review utilised comprehensive methods according to COSMIN. NO PATIENT OR PUBLIC CONTRIBUTION REPORTING METHOD: PRISMA statement and COSMIN reporting guidelines for studies on measurement properties of patient-reported outcome measures.
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Affiliation(s)
- Néstor Montoro-Pérez
- Department of Nursing, Faculty of Health Sciences, Person-centred Care and Health Outcomes Innovation Group, University of Alicante, San Vicente del Raspeig, Spain
- GREIACC Research Group, La Fe Health Research Institute, Valencia, Spain
| | - Antonio Oliver-Roig
- Department of Nursing, Faculty of Health Sciences, Person-centred Care and Health Outcomes Innovation Group, University of Alicante, San Vicente del Raspeig, Spain
| | | | - Miguel Richart-Martínez
- Department of Nursing, Faculty of Health Sciences, Person-centred Care and Health Outcomes Innovation Group, University of Alicante, San Vicente del Raspeig, Spain
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Garcia D, Fortney CA, Gerhardt CA, Baughcum AE, Slaughter JL, Rodriguez EM. Inclusion of Spanish-Speaking Families in NICU Symptom Research Using a Community Advisory Board. Adv Neonatal Care 2023; 23:212-219. [PMID: 36912673 DOI: 10.1097/anc.0000000000001061] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/14/2023]
Abstract
BACKGROUND Admission rates of Hispanic/Latinx families to the neonatal intensive care unit (NICU) are rising, yet knowledge regarding their experiences is limited. Non-English-speaking families are often excluded from research because study measures are not available in their language. The inclusion of these families in NICU research is crucial to understand the impact of cultural and language barriers in infant and family care, and the translation of study measures into Spanish could better ensure that these families' perspectives are included. However, previous research has utilized the standard translation-backtranslation method with which problems have been noted. PURPOSE This article describes the planning, preparation, and action phases that were completed with the use of a community advisory board (CAB) to prepare and transcreate research study materials from English to Spanish for pilot testing. METHODS Community members of interest were invited to form the CAB, and 2 meetings were held to review study materials in the English and Spanish versions. Prior to the second meeting, a professional translation company translated study materials from English to Spanish. RESULTS Feedback from the CAB ensured consistent content and reading levels, and culturally appropriate language usage. The CAB also provided suggestions to the research protocol and advised sensitive methods of recruitment and measure administration. IMPLICATIONS FOR PRACTICE AND RESEARCH More accurate and culturally appropriate transcreation of study measures can reduce barriers to research participation and facilitate better communication with non-English-speaking families in health equity research to better inform evidence-based interventions and clinical practices across diverse groups.
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Affiliation(s)
- Dana Garcia
- The Abigail Wexner Research Institute at Nationwide Children's Hospital, Columbus, Ohio (Ms Garcia and Drs Fortney, Gerhardt, Baughcum, and Slaughter); The Ohio State University, Columbus, Ohio (Drs Fortney, Gerhardt, and Baughcum); and The University of Texas at Austin, Austin (Dr Rodriguez)
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Reiter A, De Meulemeester J, Kenya-Mugisha N, Tagoola A, Kabajaasi O, Wiens MO, Duby J. Parental participation in the care of hospitalized neonates in low- and middle-income countries: A systematic review and meta-analysis. Front Pediatr 2022; 10:987228. [PMID: 36090576 PMCID: PMC9453204 DOI: 10.3389/fped.2022.987228] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/05/2022] [Accepted: 07/28/2022] [Indexed: 11/22/2022] Open
Abstract
INTRODUCTION To determine the effect of parental participation in hospital care on neonatal and parental outcomes in low- and middle-income countries (LMICs) and to identify the range of parental duties in the care of hospitalized neonates in LMICs. METHODS We searched CINAHL, CENTRAL, LILACs, MEDLINE, EMBASE and Web of Science from inception to February 2022. Randomized and non-randomized studies from LMICs were eligible if parents performed one or more roles traditionally undertaken by healthcare staff. The primary outcome was hospital length-of-stay. Secondary outcomes included mortality, readmission, breastfeeding, growth, development and parental well-being. Data was extracted in duplicate by two independent reviewers using a piloted extraction form. RESULTS Eighteen studies (eight randomized and ten non-randomized) were included from seven middle-income countries. The types of parental participation included hygiene and infection prevention, feeding, monitoring and documentation, respiratory care, developmental care, medication administration and decision making. Meta-analyses showed that parental participation was not associated with hospital length-of-stay (MD -2.35, 95% CI -6.78-2.07). However, parental involvement was associated with decreased mortality (OR 0.46, 95% CI 0.22-0.95), increased breastfeeding (OR 2.97 95% CI 1.65-5.35) and decreased hospital readmission (OR 0.36, 95% CI 0.16-0.81). Narrative synthesis demonstrated additional benefits for growth, short-term neurodevelopment and parental well-being. Ten of the eighteen studies had a high risk of bias. CONCLUSION Parental participation in neonatal hospital care is associated with improvement in several key neonatal outcomes in middle-income countries. The lack of data from low-income countries suggests that there remains barriers to parental participation in resource-poor settings. SYSTEMATIC REVIEW REGISTRATION [https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=187562], identifier [CRD42020187562].
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Affiliation(s)
- Anna Reiter
- Faculty of Medicine and Health Sciences, McGill University, Montreal, QC, Canada
| | | | | | | | | | - Matthew O Wiens
- Walimu, Kampala, Uganda.,Center for International Child Health, BC Children's Hospital, Vancouver, BC, Canada.,Department of Anesthesiology, Pharmacology & Therapeutics, Faculty of Medicine, University of British Columbia (UBC), Vancouver, BC, Canada
| | - Jessica Duby
- Department of Pediatrics, McGill University, Montreal, QC, Canada
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Reliability and Validity of the Arabic Version of the Parental Stressor Scale and Nurse Parental Support Tool: Opening Up Research on Parental Needs in Neonatal Intensive Care Units in Egypt. Adv Neonatal Care 2021; 21:E101-E109. [PMID: 33278101 DOI: 10.1097/anc.0000000000000826] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND The admission of a newborn infant to a neonatal intensive care unit (NICU) due to preterm birth or high-risk conditions, such as perinatal injury, sepsis, hypoxia, congenital malformation, or brain injury, is a stressful experience for mothers. There is currently a lack of research on maternal perceived stress and support in Egyptian NICUs and no validated Arabic tool to investigate this further. PURPOSE To determine the reliability and validity of the Arabic language versions of the Parental Stressor Scale: NICU (PSS:NICU) and the Nurse Parental Support Tool (NPST). METHODS Egyptian mothers completed the PSS:NICU and the NPST at the time of their infants' discharge from the NICU. Reliability was assessed with Cronbach α and Spearman-Brown coefficient. The multifactorial structure of the PSS:NICU Arabic version was tested. Associations with sociodemographic and clinical variables were explored with bivariate correlations and t tests. RESULTS Sixty-eight mothers of preterm (PT) infants and 52 mothers of ill full-term (IFT) infants completed the study. Mothers of PT and IFT infants did not differ for sociodemographic variables. High internal consistency (α range between .93 and .96) emerged for both tools. Spearman-Brown coefficients ranged between 0.86 and 0.94. The multidimensional structure of the PSS:NICU was confirmed and 3 core dimensions explained up to 71.48% of the variance. Perceived nursing support did not diminish the effects of stress in mothers of infants admitted to the NICU, regardless of PT or IFT infants' status. A longer NICU stay was associated with greater stress in mothers of PT infants. The presence of comorbidities was significantly associated with stress of mothers of IFT infants. IMPLICATIONS FOR RESEARCH Future research is needed to develop evidence-based support for mothers whose infants are admitted to a NICU in Egypt. The availability of validated and reliable PSS:NICU and NPST scales in Arabic will facilitate cross-country and cross-cultural research on maternal stress in the NICU. IMPLICATIONS FOR PRACTICE Neonatal care nurses in Egypt will be able to increase their understanding of the stressors experienced by mothers of infants admitted to the NICU. This will in turn enable the introduction of neonatal care policies aimed at reducing specific stressors and provide improved maternal support.
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A global perspective on parental stress in the neonatal intensive care unit: a meta-analytic study. J Perinatol 2020; 40:1739-1752. [PMID: 32901116 DOI: 10.1038/s41372-020-00798-6] [Citation(s) in RCA: 69] [Impact Index Per Article: 17.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/23/2020] [Revised: 08/15/2020] [Accepted: 08/20/2020] [Indexed: 12/12/2022]
Abstract
OBJECTIVES The Parental Stressor Scale: Neonatal Intensive Care Unit (PSS:NICU) is a well-validated tool to assess different sources of stress in parents during the NICU hospitalization of their infant. The present meta-analytic study assessed the relative impact of different NICU-related sources of parental stress in a pool of studies conducted in a wide set of different countries. Also, differences in stress levels by parent gender and country, as well as the impact of infants' neonatal characteristics and clinical conditions were explored. METHODS Records were searched on PubMed, Scopus, and Web of Science (January 1993-December 2019). A purposive open search string was adopted: ["PSS:NICU"] OR ["PSS-NICU"] OR ["Parental Stressor Scale"]. A multiple random-effect meta-analysis was conducted on data from 53 studies extracted by independent coders. RESULTS Parental role alteration emerged as the greatest source of stress for both mothers and fathers. Mothers reported higher stress levels compared to fathers. A significant difference emerged only for the subscale related to sights and sounds physical stimuli. No significant effects of infants' neonatal characteristics (gestational age, birth weight) and clinical conditions (comorbidities) emerged. A marginal positive effect of NICU length of stay emerged on the global level of parents' stress. CONCLUSIONS The current meta-analysis underlines that parental stress related to NICU admission is a worldwide healthcare issue. Immediate and tailored support to parents after the birth of their at-risk infant should be prioritized to reduce parental stress and to promote mothers and fathers' emotional well-being and new-born neurodevelopmental outcomes.
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Tandberg BS, Flacking R, Markestad T, Grundt H, Moen A. Parent psychological wellbeing in a single-family room versus an open bay neonatal intensive care unit. PLoS One 2019; 14:e0224488. [PMID: 31689307 PMCID: PMC6830777 DOI: 10.1371/journal.pone.0224488] [Citation(s) in RCA: 35] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2019] [Accepted: 10/15/2019] [Indexed: 01/30/2023] Open
Abstract
Background Studies of parents’ psychological well-being in single-family rooms in neonatal intensive care units have shown conflicting results. Aims To compare emotional distress in the form of depression, anxiety, stress and attachment scores among parents of very preterm infants cared for in a single-family rooms unit vs an open bay unit. Study design Prospective survey design. Subject Parents (132) of 77 infants born at 28 0/7–32 0/7 weeks of gestation in the two units. Outcome measures Duration of parental presence was recorded. Scores for depression (The Edinburgh Postnatal Depression Scale), anxiety (The State–Trait–Anxiety Inventory, Short Form Y), stress (The Parent Stressor Scale: neonatal intensive care unit questionnaire and The Parenting Stress Index—short form) and attachment (Maternal Postnatal Attachment Scale) measured 14 days after delivery, at discharge, expected term date and four months post-term. Results Parents were present 21 hours/day in the single-family room unit vs 7 hours/day in the Open bay unit. Ninety-three percent of the fathers in the single-family rooms unit were present more than 12 hours per day during the first week. Mothers in the single-family rooms had a significantly lower depression score -1.9 (95% CI: -3.6, -0.1) points from birth to four months corrected age compared to mothers in the Open bay unit, and 14% vs 52% scored above a cut-off point considered being at high risk for depression (p<0.005). Both mothers and fathers in the single-family rooms reported significantly lower stress levels during hospitalization. There were no differences between the groups for anxiety, stress or attachment scores after discharge. Conclusion The lower depression scores by the mothers and lower parental stress scores during hospitalization for both parents supports that single-family rooms care contribute to parents’ psychological wellbeing.
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Affiliation(s)
- Bente Silnes Tandberg
- Department of Paediatric and Adolescent Medicine, Drammen Hospital, Vestre Viken Hospital Trust, Drammen, Norway
- Lovisenberg Diaconal University College, Oslo, Norway
- Department of Clinical Science, Faculty of Medicine and Dentistry, University of Bergen, Bergen, Norway
- * E-mail:
| | - Renée Flacking
- School of Education, Health and Social Studies, Dalarna University, Falun, Sweden
| | - Trond Markestad
- Department of Clinical Science, Faculty of Medicine and Dentistry, University of Bergen, Bergen, Norway
| | - Hege Grundt
- Department of Paediatrics, Haukeland University Hospital, Bergen, Norway
| | - Atle Moen
- Department of Paediatric and Adolescent Medicine, Drammen Hospital, Vestre Viken Hospital Trust, Drammen, Norway
- Department of Neonatology, Oslo University Hospital, Oslo, Norway
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Domínguez-Martínez V, Cortés-Escárcega I. Adaptación cultural y validación de Parental Stressor Scale: Neonatal Intensive Care Unit en padres mexicanos. ENFERMERÍA UNIVERSITARIA 2019. [DOI: 10.22201/eneo.23958421e.2019.4.641] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
Introducción: La hospitalización de un recién nacido prematuro en la Unidad de Cuidados Intensivos Neonatales (UCIN), constituye un suceso estresante para los padres, como consecuencia de factores ambientales y psicosociales de la UCIN. Así, la identificación del grado de estrés de los padres a través de instrumentos adaptados y validados a su contexto, establecerá protocolos para disminuirlo durante la hospitalización de su hijo.
Objetivo: Adaptar culturalmente y validar la Escala de Estrés Parental: Unidad de Cuidados Intensivos Neonatales (PSS: NICU) para su aplicación en un grupo de madres y padres mexicanos.
Métodos: Estudio descriptivo y transversal, con una muestra intencional de 130 padres de recién nacidos prematuros hospitalizados en la Unidad de Cuidados Intensivos Neonatales. El estrés parental se midió utilizando la PSS: NICU, que fue adaptada y validada para su aplicación en padres mexicanos. La información se procesó con el paquete estadístico SPSS v.24.
Resultados: El instrumento adaptado al contexto cultural en población mexicana presentó una consistencia interna de .945, probando así su confiabilidad para su aplicación en padres mexicanos. El estrés parental total promedio fue de 2.48 + .986, considerado poco estresante.
Conclusiones: La adaptación cultural y validación de la PSS: NICU en población mexicana, resultó una herramienta válida y confiable para su aplicación en padres mexicanos. El factor más asociado con el incremento del nivel de estrés fue la alteración del rol parental, por lo que es importante establecer intervenciones dirigidas a mejorar la participación de los padres que apunten hacia el bienestar emocional de los mismos.
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Månsson C, Sivberg B, Selander B, Lundqvist P. The impact of an individualised neonatal parent support programme on parental stress: a quasi‐experimental study. Scand J Caring Sci 2019; 33:677-687. [DOI: 10.1111/scs.12663] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2018] [Accepted: 01/08/2019] [Indexed: 01/30/2023]
Affiliation(s)
- Catrin Månsson
- Department of Health Sciences Faculty of Medicine Lund University Lund Sweden
- Department of Neonatology Skåne University Hospital Lund Sweden
| | - Bengt Sivberg
- Department of Health Sciences Faculty of Medicine Lund University Lund Sweden
| | - Bo Selander
- Department of Pediatrics Central Hospital Kristianstad Sweden
| | - Pia Lundqvist
- Department of Health Sciences Faculty of Medicine Lund University Lund Sweden
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Barkin JL, Stausmire JM, Te MN, Pazik-Huckaby A, Serati M, Buoli M, Harding RS, Bruss CA, Stausmire KL. Evaluation of Maternal Functioning in Mothers of Infants Admitted to the Neonatal Intensive Care Unit. J Womens Health (Larchmt) 2019; 28:941-950. [PMID: 30681387 DOI: 10.1089/jwh.2018.7168] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Objective: Factors associated with maternal functioning in biological mothers whose infants were admitted to a Neonatal Intensive Care Unit (NICU) were identified as measured by a modified version of the Barkin Index of Maternal Functioning. Materials and Methods: This multivariable regression analysis explored sociodemographic and clinical data from 146 mother-infant dyads admitted to a Level III NICU between February 2015 and May 2016. Eligible dyads included: (1) adult biological mothers with singleton infants discharged home alive after NICU admission meeting criteria and (2) infants discharged home alive from the NICU with adult, biological mothers after a minimum 6-day admission. Results: Lower scores on the Edinburgh Postnatal Depression Scale (p < 0.0001), and an infant admission diagnosis of hypoglycemia (p = 0.0295) were significantly associated with higher levels of maternal functioning. Conclusions: The significant association between maternal functioning and depressive symptom score is corroborated by the literature. Results relative to a diagnosis of infant hypoglycemia and higher levels of maternal functioning are intriguing, considering current literature linking increased postpartum depression to gestational diabetes. The severity of other possible admission diagnoses may provide a partial explanation. We believe this is the first study suggesting a potential role between infant admission diagnosis and the level of maternal functioning.
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Affiliation(s)
- Jennifer L Barkin
- 1Department of Community Medicine, Mercer University School of Medicine, Macon, Georgia
| | - Julie M Stausmire
- 2Regional Academic Affairs, Mercy Health St. Vincent Medical Center, Toledo, Ohio
| | - Minda N Te
- 3Pediatrics/Neonatal Intensive Care Unit, Mercy Children's Hospital, Toledo, Ohio
| | - Alicia Pazik-Huckaby
- 4Obstetrics & Gynecology Residency Program, Mercy Health St. Vincent Medical Center, Toledo, Ohio
| | - Marta Serati
- 5Fondazione IRCCS Ca'Granda-Ospedale Maggiore Policlinico, Milan, Italy
| | | | - Roberta S Harding
- 7Neonatal Intensive Care Unit, Mercy Children's Hospital, Toledo, Ohio
| | - Cynthia A Bruss
- 7Neonatal Intensive Care Unit, Mercy Children's Hospital, Toledo, Ohio
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Svavarsdottir EK, Looman W, Tryggvadottir GB, Garwick A. Psychometric testing of the Iceland Health Care Practitioner Illness Beliefs Questionnaire among school nurses. Scand J Caring Sci 2017; 32:261-269. [PMID: 28851060 DOI: 10.1111/scs.12457] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2016] [Accepted: 02/14/2017] [Indexed: 11/27/2022]
Abstract
BACKGROUND Beliefs have been found to have an effect on how people deal with illness. Therefore, knowing healthcare practitioners' beliefs about specific high frequency illnesses are vital when caring for vulnerable populations such as school-age children with chronic illnesses or disorders. AIM To psychometrically test the Iceland Health Care Practitioner Illness Beliefs Questionnaire for healthcare professionals who are working with families of school-age children with asthma and attention deficit/hyperactivity disorder. DESIGN The Iceland Health Care Practitioner Illness Beliefs Questionnaire is a 7-item Likert-type instrument with four additional open-ended questions that was developed from the Iceland Family Illness Belief Questionnaire. The questionnaire is designed to measure a provider's beliefs about their understanding of the meaning of the illness situation for families. The questionnaire was administered to 162 school nurses in Iceland and the state of Minnesota. METHOD Two condition-specific versions of the Iceland Health Care Practitioner Illness Beliefs Questionnaire were developed in this study: one to measure beliefs about families of children with asthma and one to measure beliefs about families of children with attention deficit hyperactivity disorder. Higher scores on the questionnaire indicate that healthcare professionals are more confident in their illness beliefs. After initial development, the questionnaire was translated into English. Participants completed the questionnaire using an online survey platform and parallel study procedures in both countries. RESULTS Based on exploratory factor analysis using principal component analysis, the Iceland Health Care Practitioner Illness Beliefs Questionnaire was found to have a one-factor solution with good construct validity (Cronbach's α = 0.91). Confirmatory factor analysis supported the one-factor solution (Cronbach's α = 0.91). CONCLUSION This instrument is a promising tool for measuring illness beliefs among healthcare practitioners in clinical and research settings.
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Affiliation(s)
| | - Wendy Looman
- University of Minnesota Twin Cities, Minneapolis, MN, USA
| | | | - Ann Garwick
- University of Minnesota Twin Cities, Minneapolis, MN, USA
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