Evaluating content validity of the Distress Thermometer, for Parents of preterm infants.

Abstract

Background: Unexpected preterm delivery is a traumatic event, which is associated with parental fear and known to cause significant stress. Parental stress hampers the bonding process between infant and parents and early detection is necessary to minimise disruption of this process. The Distress Thermometer for Parents (DT-P) is a valid measurement instrument that measures parental stress for parents with a chronically ill child. Validating the DT-P for parents of preterm infants could help healthcare professionals’ recognise symptoms of distress in parents at an early stage and alert them to parents’ need for expert help. Aim: To evaluate content validity of the DT-P in the context of preterm infants, according to their parents Method: This content validity study has a cross-sectional design and was conducted by using an online survey. Conform COSMIN criteria, parents rated 42 items of the DT-P on relevance, completeness, and comprehensibility with a four-point ordinal scale. Subsequently, Content Validity Index (CVI) was calculated as Scale-Content Validity Index /Average (S-CVI/Ave) and Item-Content Validity Index (I-CVI). Results: The S-CVI/Ave on relevance was 0.57. Parents judged the DT-P as irrelevant. Four domains were assessed as important so revision is advised. Comprehensiveness (S-CVI/Ave 0.89) was acceptable and comprehensibility (S-CVI/Ave 0.95) was desirable. Conclusion: Content validity of the DT-P of preterm infants assessed by parents can be considered insufficient. Although most items were not regarded as relevant it may be interesting to explore the four domains of the relevant items. Implication of key findings: For clinical practice, this study marks the first step in determining whether validation is possible for this new target group. As the COSMIN criteria indicate, survey research alone is not sufficient. Additional research with in-depth qualitative research is recommended to enrich the collected data.