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

Abstract

BackgroundIn 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.MethodsA 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.ResultsBack-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.ConclusionsThe 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 materialThe online version of this article (10.1186/s13052-017-0439-8) contains supplementary material, which is available to authorized users.

Parent Satisfaction With Care and Treatment Relates to Missed Nursing Care in Neonatal Intensive Care Units

“…Parents of NICU infants in our sample were highly satisfied. This finding is consistent with NICU parent satisfaction reported across other samples globally in the NICU (24,28) and pediatric intensive care unit (PICU) (25). For example, in a Dutch sample from which the EMPATHIC-N was derived, values ranged from 5.22 to 5.57 in a cohort of 59 parents used for confirmatory analysis (24).…”

“…In this study we measured parent satisfaction within 24 h up to expected discharge. This timing was consistent with that of previous studies, which surveyed NICU parents prior to discharge (25,30), or on the day of discharge and up to 3 days after discharge (28). In other parent satisfaction studies, Latour et al surveyed parents 2-3 weeks after discharge of a child from the PICU (23, 31) and 3-4 weeks after discharge of infants from the NICU (24).…”

“…In that sample, the highest scores were given for Professional Attitude and the lowest scores for Information (24). Mean scores for individual items of the Italian EMPATHIC-N in an Italian sample ranged from 4.3 to 5.9 (28). In a Brazilian sample of parents, the most frequently reported satisfaction rating was between 4 and 5 for items of the EMPATHIC-N (29).…”

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

“…There is also a 57-item EMPATHIC-N, which was developed in the Netherlands to measure NICU parent satisfaction ( 20 ). The EMPATHIC-N has been translated into Portuguese ( 28 ), Greek ( 29 ), and Italian ( 30 ). The EMPATHIC ( 26 ), the EMPATHIC-30 ( 27 ), and the EMPATHIC-N ( 20 ) all contain five domains of satisfaction: information, care and treatment, organization, parental participation, and professional attitude.…”

“…The Cronbach alphas for the total score for the EMPATHIC-30 was 0.93 from the Netherlands ( 27 ) and 0.95 from Spain ( 31 ) and 0.87 for the EMPATHIC-N from Greece ( 29 ). The EMPATHIC-N exhibited domain-level Cronbach alphas above 0.70 in samples from the Netherlands ( n = 441), Italy ( n = 162), Greece ( n = 256), and Brazil ( n = 40) ( 20 , 28 – 30 ).…”