Measuring Parent Satisfaction With Care in Neonatal Intensive Care Units: The EMPATHIC-NICU-USA Questionnaire

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.

Validation of the Chinese Empowerment of Parents in the Intensive Care (EMPATHIC-30) Questionnaire Among Parents in Neonatal Intensive Care Units: A Prospective Cross-Sectional Study

“…The reliability estimates were very good for most domains, and the validity outcomes showed a weak correlation with other satisfaction scales. We chose this questionnaire because the EMPATHIC-30 questionnaire has been validated and used in several other countries and in NICU settings ( 26 – 29 ). Having a Chinese version of the EMPATHIC-30 for NICU settings allows us to benchmark parents' satisfaction data with national and international colleagues.…”

Parental satisfaction and its associated factors towards neonatal intensive care unit service: a cross-sectional study

“…Parental and patient satisfaction has become a well-established outcome indicator and tool for assessing a healthcare system's quality, as well as input for developing strategies and providing accessible, sustainable, economical, as well as acceptable patient care [7,9,10]. Parental satisfaction reflects the balance between their expectations of ideal care and their perception of real and available care [3,11,12]. It is also one of the objectives and missions of every health care center that gives NICU care service [10,11].…”

Parents' Experience and Satisfaction in Neonatal Intensive Care Units in Ethiopia: A Multicenter Cross-Sectional Study Using an Adapted Version of EMPATHIC-N

“…The EMpowerment of PArents in THe Intensive Care-Neonatology (EMPATHIC-N) questionnaire was developed in the Netherlands to measure NICU parent satisfaction and experience (3) and has been translated and culturally adapted in several countries (2,(8)(9)(10). A similar questionnaire related to the pediatric intensive care unit was culturally translated in South Africa (11).…”

“…): "It was nice/great/perfect/wonderful/good/not bad" "No problem" Neg(10): "I can't say that it was good" "Not good. But I will come here If any problem because I have no choice" Feeling 205 Pos (205): "I'm happy/glad" "Leave with happiness"…”