The Fathers' Support Scale: Neonatal Intensive Care Unit (FSS:NICU): Development and initial content validation

BackgroundFathers whose infants are cared for in the neonatal intensive care unit have unique support needs. No tool has been developed to evaluate systematically the support needs of fathers.PurposeTo establish the content validity and initial reliability of the Fathers' Support Scale: Neonatal Intensive Care Unit (FSS:NICU).MethodsItems for the FSS:NICU were derived from themes from qualitative interviews. For phase 1, the FSS:NICU was reviewed by 10 neonatologists from across Canada and by 19 fathers whose infants had been admitted to the NICU. Using a binary scale, each item on the FSS:NICU was evaluated for relevance and clarity. Percentage agreement between raters was calculated. For phase 2, item reliability and test-retest reliability of the FSS:NICU was evaluated on 116 fathers on NICU patients. Of those, 72 fathers were seen on two occasions one week apart. The Beck Depression Inventory Short Form was also administered at the first assessment. Internal consistency was analyzed using Cronbach's alpha. Test re-test reliability was assessed using Pearson's r. Correlations between Beck Depression Inventory and FSS:NICU sections scores were evaluated with Pearson's r.FindingsIn phase 1, percentage agreement between neonatologists was 60–100% resulting in 13 changes in question thematic structure, 7 changes in question wording, and the addition of 9 questions to the scale. Agreement between the fathers ranged from 32 to 100%. Two questions were re-worded, and 6 were dropped: the scale finally comprised 33 questions. In phase 2, internal consistency (Cronbach's alpha) was 0.82 (N = 116). Test-retest reliability (N = 72) for the full scale score was 0.81.Implications.This study established the initial content validity and reliability of the FSS:NICU for determining support needs of fathers whose infants were admitted to the NICU. The FSS:NICU is a relevant tool validated by fathers which can be used to improve support for and communication between fathers and the NICU staff.