Development and Validation of a Tool to Assess Healthcare Professionals' Views on Parental Presence During Neonatal Resuscitation

Nurs Rep. 2025 Sep 26;15(10):352. doi: 10.3390/nursrep15100352.

Abstract

Background/Objectives: Childbirth is a natural and joyfully anticipated life event for parents and relatives. Yet, in some cases, it can be a medical emergency requiring immediate intervention, i.e., neonatal resuscitation. The majority of newborns breathe spontaneously; a small number, though, may receive basic life support (assisted transition), and an even smaller but clinically significant number require advanced life support (resuscitation). Within the context of family-centered care, the presence of parents during resuscitation has emerged as a factor with potential implications for emotional adjustment, communication with healthcare providers, and early parent-infant bonding. However, the presence of family members during neonatal resuscitation remains a subject of ongoing debate among healthcare professionals (HCPs). Despite increasing recognition of its potential benefits, HCPs' views on parental presence during such critical procedures have not been extensively investigated in Greece. This study aims at developing and validating a tool to assess healthcare professionals' views on parental presence during neonatal resuscitation. Methods: A preliminary questionnaire was developed based on the principles of family-centered care and adapted to the Greek population. The first phase included expert assessment of validity, clarity, and relevance using a modified Delphi method. Item Content Validity Index (I-CVI) and Scale CVI (S-CVI) were calculated. Pilot testing was conducted to assess test-retest reliability. Reliability was assessed using the Intraclass Correlation Coefficient (ICC) and Bland-Altman analyses. The study followed the principles of the Declaration of Helsinki, ensuring anonymity, informed consent, and confidentiality. Results: The questionnaire includes 37-50 items allocated in four sections. It demonstrated excellent content validity (CVI = 1.00) and good test-retest reliability (ICC = 0.86). Qualitative feedback indicated that the tool is user-friendly and comprehensive. Interestingly, participants expressed genuine concerns regarding the implementation of parental presence in neonatal resuscitation. Conclusions: The questionnaire development process led to a comprehensive tool, ready for large-scale testing in order to further establish its validity and internal consistency.

Keywords: development; family presence; questionnaire; resuscitation; validation.