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

Parent Satisfaction With Neonatal Care: A Secondary Analysis

BACKGROUND

Understanding parent satisfaction with care is an integral part of ensuring care delivery is family-focused and responsive to family needs, preferences, and values.

PURPOSE

The purposes of the study were to describe parental satisfaction with neonatal care, assess differences between satisfaction scores and identify areas for care improvement.

METHODS

A secondary analysis of data collected from an online survey of the neonatal intensive care unit (NICU) parent experiences during the early months of the COVID-19 Pandemic in the United States was used. Parent satisfaction with NICU care was measured using the EMpowerment of PArents in THe Intensive Care (EMPATHIC) scale. Descriptive statistics described individual items, domain scores, and total score. Independent t-tests with Bonferroni correction compared this study to previously published results.

RESULTS

159 mothers and 5 fathers responded to the EMPATHIC scale. The overall mean and all domain scores were significantly different from a pre-pandemic sample where scores were consistently higher. Parents indicated their desire for more cultural competence, emotional support, acknowledgement, and space to discuss their experience, guidance for discharge, better medication information and quicker response to an infant's condition.

IMPLICATIONS FOR PRACTICE AND RESEARCH

Our study identified statistically significant differences between our sample and a pre-pandemic sample and found the absolute mean difference in 3 domain scores to be > 1, suggesting clinical significance. We were able to offer more clarity about what factors were contributing to higher or lower satisfaction scores.

Application of the intelligent interactive system to promote the full course care of very low birth weight infants

Aim

To explore the effects of full course care with an intelligent interactive system on the growth, neurodevelopment and follow up adherence of very low birth weight infants (VLBW), as well as parental satisfaction.

Methods

The preterm infants admitted between January 2022 and December 2022 were designated as the experimental group, while those admitted from January 2021 to December 2021 constituted the control group. The experimental group received a full course of care through an intelligent interactive system, whereas the control group received inpatient and follow-up care from primary and clinic nurses, respectively. We compared the two groups' parental satisfaction at discharge, infants' anthropometric assessments, follow-up adherence, and infant's neurodevelopment.

Results

From January 1, 2021, to December 31, 2022, 171 VLBWI and their parents were enrolled at a tertiary hospital, with 89 infants in the experimental group and 82 in the control group. Parental satisfaction in the experimental group was significantly higher than in the control group (P < 0.05). At the corrected ages of 1, 3, and 6 months, the height and weight of the preterm infants in the experimental group were also superior to those of the control group (P < 0.05). Additionally, the follow-up adherence rate of the experimental group exceeded that of the control group at the corrected ages of 3 and 6 months (P < 0.05). Furthermore, at the corrected age of 6 months, the scores for fine motor skills, adaptability, and social interaction of infants in the experimental group were higher than those in the control group (P < 0.05).

Conclusion

An intelligent interactive system can facilitate comprehensive management of VLBWI by integrating inpatient care and follow-up. This approach has significant clinical value as it promotes the physical and cognitive development of infants while enhancing parent satisfaction and adherence.

EMpowerment of PArents in THe Intensive Care: A multicentre validation study in Japan

BACKGROUND

The importance of assessing family satisfaction in paediatric intensive care units (PICUs) is becoming increasingly recognised. The survey, EMpowerment of Parents in THe Intensive Care "EMPATHIC-30", was designed to assess family satisfaction and has been translated and implemented in several countries but not yet in Japan.

OBJECTIVES

The objective of this study was to translate, culturally adapt, and validate the EMPATHIC-30 questionnaire in Japanese and to identify potential factors for family-centred care satisfaction.

METHODS

We translated and adapted for patient-reported outcome measures via a 10-step process outlined by the Principles of Good Practice. Four paediatric PICUs in Japan participated in the validation study, and the parental enrolment criterion was a child with a PICU stay of >24 h. Reliability was measured by Cronbach's α, and congruent validity was tested with overall satisfaction-with-care scales by correlation analysis. Multivariate linear regression modelling was conducted to identify factors related to each domain of the Japanese EMPATHIC-30.

RESULTS

A total of 163 parents (mean age: 31.9 ± 5.4 years; 81% were mothers) participated. The five domains of the Japanese EMPATHIC-30 showed high reliability (α = 0.87 to 0.97) and congruent validity, demonstrating high correlations with overall satisfaction in nurses (r = 0.75) and doctors (r = 0.76). Multivariate modelling found that elective admission, mechanical ventilation, and parents who had experience of a family member in an adult intensive care unit had higher satisfaction scores in all five domains (p < 0.05). Moreover, Buddhists assigned higher satisfaction scores in the Care and Treatment domain (p = 0.03).

CONCLUSIONS

The Japanese EMPATHIC-30 questionnaire has demonstrated adequate reliability and validity measures. We also identified that elective admission, mechanical ventilation, and having previous adult intensive care unit experience of a family member were factors in assigning higher scores for all satisfaction domains. PICU clinicians need to be cognisant of ethical, cultural, and religious factors relating to the critically ill child and their family.