Advances in neonatal care : official journal of the National Association of Neonatal Nurses最新文献

{"title":"Effect of Adhesive Dwell Time on Skin Injury in Neonates: A Randomized Controlled Trial.","authors":"Kardelen Köroğlu, Berna Eren Fidanci","doi":"10.1097/ANC.0000000000001444","DOIUrl":"10.1097/ANC.0000000000001444","url":null,"abstract":"<p><strong>Background: </strong>Neonatal skin is immature and highly susceptible to injury, particularly in neonatal intensive care units (NICUs) where medical adhesives are frequently used. Medical adhesive-related skin injury is a common clinical concern, yet evidence regarding optimal adhesive dwell time remains limited.</p><p><strong>Purpose: </strong>This study aimed to evaluate the effect of adhesive dwell time on neonatal skin integrity and its association with skin injury outcomes.</p><p><strong>Methods: </strong>A randomized controlled trial was conducted between August and December 2023 in a tertiary NICU. Sixty term neonates (37-40 weeks) were randomized to either a 2-hour adhesive dwell time group (n = 30) or a 4-hour routine care group (n = 30). Skin condition and risk were assessed using the Neonatal Skin Condition Score and the Neonatal Skin Risk Assessment Scale (NSRAS).</p><p><strong>Results: </strong>The experimental group demonstrated significantly lower Neonatal Skin Condition Scores on Day 1 ( P = .010) and Day 3 ( P < .001), indicating improved skin condition. No significant between-group differences were observed in NSRAS scores ( P > .05), although scores decreased over time in both groups. Birth weight and gestational age were negatively correlated with NSRAS scores in the experimental group ( P < .05).</p><p><strong>Implications for practice and research: </strong>Shorter adhesive dwell time appears to improve neonatal skin condition and may represent a simple and effective strategy to reduce localized skin injury in NICU settings. However, its effect on broader skin risk profiles remains limited. Further research is needed to evaluate long-term outcomes and the interaction between adhesive duration and material type across different neonatal populations.</p>","PeriodicalId":520547,"journal":{"name":"Advances in neonatal care : official journal of the National Association of Neonatal Nurses","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2026-10-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149171766","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Neonatal Cardiac Tamponade Related to Peripherally Inserted Central Catheter: A Rare Case Report.","authors":"Nasrin Khalesi, Fatemeh Zamaniashtiani, Firoozeh Hafizi, Carole Kenner, Saleheh Tajalli","doi":"10.1097/ANC.0000000000001417","DOIUrl":"https://doi.org/10.1097/ANC.0000000000001417","url":null,"abstract":"<p><strong>Background: </strong>Peripherally inserted central catheters (PICCs) are commonly used in neonatal intensive care units (NICUs) to provide prolonged intravenous access for preterm and critically ill infants. They are generally preferred over surgically placed central venous catheters because of easier insertion and, in some settings, lower infection rates. However, rare but life-threatening complications may occur. Cardiac tamponade, resulting from catheter malposition or delayed migration with perforation of the superior vena cava (SVC) or cardiac wall, is one such complication. This case highlights the need for vigilant monitoring even when initial catheter placement is confirmed as correct.</p><p><strong>Clinical findings: </strong>A male infant born at 32 weeks' gestation with intrauterine growth restriction (IUGR) required mechanical ventilation and surfactant therapy. A PICC was inserted through the right radial vein, and radiographic assessment confirmed appropriate positioning in the SVC. The infant initially improved. On day 10 of NICU admission, he developed sudden respiratory distress, hypotonia, bradycardia, and cardiovascular collapse.</p><p><strong>Diagnosis: </strong>Echocardiography demonstrated severe pericardial effusion and cardiac tamponade due to SVC perforation by the PICC tip.</p><p><strong>Intervention and outcome: </strong>The catheter was immediately removed, and emergency pericardiocentesis was performed. Despite aggressive resuscitation, the infant died on day 11 of life.</p><p><strong>Practice recommendations: </strong>Delayed perforation can occur days after apparently correct placement. Preventive strategies should include risk-stratified catheter positioning, preference for lower SVC tip placement, routine echocardiographic surveillance especially after the first week and enhanced staff training for early recognition of warning signs. Continuous quality improvement and readiness for emergency intervention are essential to improve neonatal outcomes.</p>","PeriodicalId":520547,"journal":{"name":"Advances in neonatal care : official journal of the National Association of Neonatal Nurses","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2026-10-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149225695","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Matriarchal Influence on Black Women's Decisions to Provide Mother's Own Milk for Preterm Infants: An Integrative Review.","authors":"Stephanie DeVane-Johnson, Paula Meier, Tricia J Johnson, Beverly Rossman, Aloka L Patel","doi":"10.1097/ANC.0000000000001427","DOIUrl":"https://doi.org/10.1097/ANC.0000000000001427","url":null,"abstract":"<p><strong>Background: </strong>Black preterm infants cared for in the neonatal intensive care unit (NICU) are less likely to receive mothers' own milk (MOM) at NICU discharge than non-Black preterm infants. This disparity increases the risk of health and neurodevelopmental problems and their associated costs throughout the lifespan. One modifiable barrier to receipt of MOM at NICU discharge may lie within the role of Black maternal matriarchs; however, this role is not well characterized.</p><p><strong>Purpose: </strong>To describe and synthesize evidence related to the Black matriarch's influence on a mother's decision to provide MOM for a preterm infant hospitalized in a NICU.</p><p><strong>Data sources: </strong>We searched the Cochrane Database of Systematic Reviews, CENTRAL, PubMed, CINAHL, and Web of Science databases and reviewed reference lists of included articles.</p><p><strong>Study selection: </strong>A total of 139 articles were retrieved (n = 99 after deduplication), of which 2 met a priori criteria for inclusion.</p><p><strong>Data extraction: </strong>We conducted an integrative review, using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) checklist.</p><p><strong>Results: </strong>One key theme emerged: the Black matriarch serves as a barrier to continued MOM provision among mothers of preterm infants in the NICU, despite mothers perceiving the Black matriarch as supportive or helpful.</p><p><strong>Implications for practice and research: </strong>Matriarchal influence over Black women's decision to provide MOM to their preterm infant hospitalized in the NICU likely serves as a barrier to continued MOM provision. Research priorities include developing culturally sensitive instruments to measure Black matriarchal support for MOM provision and conducting intergenerational studies.</p>","PeriodicalId":520547,"journal":{"name":"Advances in neonatal care : official journal of the National Association of Neonatal Nurses","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2026-10-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149225658","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Examining the Association Between Shift Length, Fatigue, and Perceived Safety in NNP Practice.","authors":"Jacqueline Hoffman, Meredith Farmer, Jordan Pelkmans, Tracey R Bell","doi":"10.1097/ANC.0000000000001433","DOIUrl":"https://doi.org/10.1097/ANC.0000000000001433","url":null,"abstract":"<p><strong>Background: </strong>Neonatal nurse practitioners (NNPs) often work extended shifts to support continuity of care in neonatal intensive care units (NICUs). Prolonged shift length has been associated with fatigue and safety risks in other healthcare populations; however, evidence specific to NNP practice remains limited.</p><p><strong>Purpose: </strong>The purpose was to examine associations between shift length, self-reported fatigue, and safety-related outcomes among NNPs, and to evaluate how these outcomes vary by demographic and practice characteristics.</p><p><strong>Methods: </strong>This cross-sectional survey examined shift characteristics, self-reported fatigue, and safety-related outcomes among board-certified NNPs. Using a national certification mailing list, 6717 NNPs were invited; 623 initiated the survey, with analytic sample size varying by item. Quantitative data were analyzed using descriptive statistics, chi-square tests, and logistic regression.</p><p><strong>Results: </strong>More than half of respondents (n = 190, 51%) preferred 24-hour shifts despite reporting fatigue-related concerns. Most respondents (n = 435, 85%) reported that unit census and acuity influence fatigue. Nearly half (49%) reported feeling unsafe to drive home at least once after working an extended shift (>16 hours). Years of experience, rather than age, were associated with fewer reported safety concerns. Safety perceptions varied by NICU level, with less experienced NNPs reporting greater impairment.</p><p><strong>Implications for practice and research: </strong>Fatigue-related safety concerns varied by NICU level and clinical experience, while most respondents continued to prefer 24-hour shifts despite these concerns. These findings highlight the tension between workforce sustainability, provider preference, and safety within neonatal practice.</p>","PeriodicalId":520547,"journal":{"name":"Advances in neonatal care : official journal of the National Association of Neonatal Nurses","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2026-10-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149225704","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association of Red Blood Transfusion With Necrotizing Enterocolitis in Very Low Birth-Weight Neonates: A 7-Year Retrospective Cohort Study in Saudi Arabia.","authors":"Heidi Al-Wassia, Maha Bamehrez, Mazen Kurdi, Ahdab Rubihan, Mohamed Abellatif","doi":"10.1097/ANC.0000000000001418","DOIUrl":"https://doi.org/10.1097/ANC.0000000000001418","url":null,"abstract":"<p><strong>Background: </strong>Necrotizing enterocolitis (NEC) is a multifactorial disorder of the gastrointestinal tract of very low birth-weight (VLBW) infants. Blood transfusions are suspected to be associated with NEC in this population.</p><p><strong>Purpose: </strong>To examine the association between packed red blood cells (PRBCs) transfusion and NEC in VLBW neonates (less than 1500 gm) or less than 32 weeks.</p><p><strong>Methods: </strong>A retrospective cohort study of all VLBW neonates admitted to the neonatal intensive care unit (NICU) at King Abdulaziz University Hospital (KAUH) from January 1, 2014, to December 31, 2020.</p><p><strong>Results: </strong>Of 3018 newborns admitted to the NICU, 441 were VLBW neonates born at less than 32 weeks of gestational age (mean: 29 weeks ± 2.3; male: 220, 49.9%). The sample was divided into 2 groups: those who developed NEC 49 (11.1%) and those who did not develop NEC 392 (88.9%). Infants who developed NEC had significantly lower birth weight, gestational age (GA), and initial hematocrit (P < 0.05). Although blood transfusions were more often noted in those who developed NEC 7.4% versus 32.1% (P < 0.01), only sepsis showed significant associations with NEC, OR 8.2 (3.893-17.259) after adjusting for other studied risk factors.</p><p><strong>Implication for practice and research: </strong>PRBC transfusion was not associated with an increased risk of NEC in VLBW neonates. Sepsis was the only variable found to be significantly associated with NEC. Future prospective cohort studies to assess the role of anemia, the timing of PRBC transfusion, and the number of transfusions on incidence of NEC are needed.</p>","PeriodicalId":520547,"journal":{"name":"Advances in neonatal care : official journal of the National Association of Neonatal Nurses","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2026-10-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149225685","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Global Trends and Research Hotspots in Human Milk Research for Preterm Infants A Bibliometric Analysis.","authors":"Meltem Özkaya","doi":"10.1097/ANC.0000000000001412","DOIUrl":"https://doi.org/10.1097/ANC.0000000000001412","url":null,"abstract":"<p><strong>Background: </strong>Human milk plays a critical role in improving survival and health outcomes in preterm infants, making it a key focus of clinical and scientific research.</p><p><strong>Purpose: </strong>This study aimed to examine trends in scientific output, thematic development, and international collaboration networks in research on human milk in preterm infants using bibliometric analysis.</p><p><strong>Methods: </strong>A bibliometric analysis was conducted using data retrieved from the Web of Science Core Collection and PubMed databases between February and March 2026. Data were analyzed using the Bibliometrix package and Biblioshiny interface in RStudio. Analyses included annual scientific output, citation analysis, logistic growth modeling, Bradford's and Lotka's laws, keyword trends, conceptual structure, and collaboration networks.</p><p><strong>Results: </strong>The analyzed studies were published between 1977 and 2026, showing an annual growth rate of 4.34%. A marked increase in publications was observed after 2011, with a peak in 2021. Bradford's Law identified Breastfeeding Medicine, Journal of Human Lactation, and Advances in Neonatal Care as the most productive journals. Meier P. was the most prolific author, with productivity consistent with Lotka's law. The United States had the highest scientific output, while low- and middle-income countries showed limited contribution. Keyword and conceptual analyses revealed a shift from general neonatal nutrition to more specialized topics such as human milk and lactation management in preterm infants.</p><p><strong>Implications for practice and research: </strong>These findings indicate that research on human milk in preterm infants is evolving toward a mature and clinically focused field, highlighting the need for high-quality, collaborative, and context-specific studies.</p>","PeriodicalId":520547,"journal":{"name":"Advances in neonatal care : official journal of the National Association of Neonatal Nurses","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2026-10-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149225694","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Optimizing Enteral Nutrition During and After Therapeutic Hypothermia: An Evidence-Based Practice Initiative.","authors":"Lauren Yates, Sarah Gregory, Lakshmi Katakam, Jamie Johnson, Desi Newberry","doi":"10.1097/ANC.0000000000001428","DOIUrl":"https://doi.org/10.1097/ANC.0000000000001428","url":null,"abstract":"<p><strong>Background: </strong>Feeding practices during therapeutic hypothermia (TH) vary widely across neonatal intensive care units, and many centers delay enteral nutrition because of concerns about gastrointestinal intolerance and necrotizing enterocolitis. Current evidence suggests that early, clinically guided enteral feeding may be safe and beneficial for neonates with hypoxic-ischemic encephalopathy. An evidence-based feeding guideline was implemented to promote enteral nutrition during and after TH.</p><p><strong>Purpose: </strong>To evaluate whether initiating minimal enteral feeding in clinically stable neonates undergoing TH reduced time to full enteral feeds and parenteral nutrition days compared with delayed feeding practices.</p><p><strong>Methods: </strong>A preintervention and postintervention design was used to evaluate the impact of a standardized, stability-based feeding guideline. Retrospective data from neonates treated with TH between January 2023 and May 2025 established baseline outcomes (n = 26). The evidence-based practice change was implemented from June to December 2025, during which 8 neonates met inclusion criteria. Neonates who died were excluded.</p><p><strong>Results: </strong>The median time to full enteral feeds decreased by 18% (from 8.5 to 7 days). Parenteral nutrition days remained unchanged (median 6 days), potentially reflecting the conservative feeding advancement incorporated into the guideline. No feeding-related complications occurred among neonates who received enteral feeds during TH.</p><p><strong>Implications for practice and research: </strong>Our findings provide evidence for the feasibility and safety of minimal enteral feeding in clinically stable neonates undergoing TH. Earlier feeding may shorten time to full enteral nutrition and reduce reliance on parenteral nutrition without increasing feeding-related complications. Larger studies are needed to further evaluate optimal feeding strategies during TH.</p>","PeriodicalId":520547,"journal":{"name":"Advances in neonatal care : official journal of the National Association of Neonatal Nurses","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2026-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149198633","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Hope, Help, and Healing: Implementation of a NICU Registered Nurse Navigator Role to Enhance Family-Centered Care.","authors":"Christine Tucker","doi":"10.1097/ANC.0000000000001431","DOIUrl":"https://doi.org/10.1097/ANC.0000000000001431","url":null,"abstract":"<p><strong>Background: </strong>Families of infants admitted to the neonatal intensive care unit (NICU) experience emotional distress, inconsistent communication, and difficulty navigating complex, high-acuity care. Although advances in neonatal medicine have improved survival, increasing care complexity highlights the need for structured approaches that strengthen family-centered support and interdisciplinary communication.</p><p><strong>Purpose: </strong>To describe implementation of a NICU Registered Nurse (RN) Navigator role designed to enhance family support, communication, care coordination, and transitions from the NICU to home.</p><p><strong>Methods: </strong>This quality improvement initiative was conducted in a tertiary-level NICU. A Registered Nurse Navigator served as a consistent point of contact for families of infants requiring prolonged or complex hospitalization by providing education, facilitating communication, supporting discharge planning, and coordinating outpatient resources. Evaluation included qualitative family feedback and staff observations regarding communication, care coordination, and discharge preparedness.</p><p><strong>Results: </strong>Families reported feeling more informed and supported during hospitalization and transition planning. Staff observed improved interdisciplinary communication, enhanced service coordination, and more efficient resolution of family concerns. Findings are limited to descriptive observations.</p><p><strong>Implications for practice and research: </strong>A NICU RN Navigator role may address communication and coordination gaps in high-acuity neonatal settings. Further systematic evaluation with measurable outcomes is needed before broader adoption.</p>","PeriodicalId":520547,"journal":{"name":"Advances in neonatal care : official journal of the National Association of Neonatal Nurses","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2026-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149140205","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Caring for Preterm Infants on Home Oxygen: A Descriptive Qualitative Study of Caregivers' Experiences in Belgium.","authors":"Gwenn Fauconnier, Brenda van Delft, Linde Peeters, Lieve Peremans, Filip Cools","doi":"10.1097/ANC.0000000000001437","DOIUrl":"https://doi.org/10.1097/ANC.0000000000001437","url":null,"abstract":"<p><strong>Background: </strong>In the Flemish part of Belgium, preterm births and NICU admissions for acute lung diseases have increased. Nearly half of extremely preterm infants develop bronchopulmonary dysplasia (BPD), requiring prolonged oxygen therapy. Oxygen dependency often delays hospital discharge, leading to more infants going home with oxygen. Caregivers, especially mothers, face significant stress and emotional challenges during this transition, worsened by social isolation due to infection fears.</p><p><strong>Purpose: </strong>To gain a clearer understanding of caregivers' experiences caring for oxygen-dependent infants at home after discharge.</p><p><strong>Method: </strong>Caregivers of infants discharged home on oxygen from the University Hospital Brussels (UZB) between January 2019 and December 2023 participated in semistructured, nurse-administered interviews.</p><p><strong>Results: </strong>Thirteen caregivers participated. Caregivers adapted to complex care routines, use of medical equipment, and shared caring responsibilities. Fear of infections led to parental preventive behaviors that reduced social contacts and increased feelings of isolation, particularly during high-risk viral seasons. Changed family dynamics included disrupted sleep and altered household roles. Despite difficulties, many caregivers stated their shared caregiving strengthened family bonds. Emotional and financial challenges such as income loss and expenses were frequently voiced.</p><p><strong>Implications for practice and research: </strong>These findings highlight the need for comprehensive ongoing support from healthcare providers (in hospital and at home) to address the medical and psychosocial needs to reduce parental stress and social isolation and that assist families adapt to life at home caring for their infant on oxygen.</p>","PeriodicalId":520547,"journal":{"name":"Advances in neonatal care : official journal of the National Association of Neonatal Nurses","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2026-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149169399","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Competency Scale for Developmentally Supportive Parenting of High-Risk Infants (CS-DSPHI): Development and Psychometric Testing.","authors":"Won-Oak Oh, Yoo-Jin Heo","doi":"10.1097/ANC.0000000000001436","DOIUrl":"https://doi.org/10.1097/ANC.0000000000001436","url":null,"abstract":"<p><strong>Background: </strong>Developmentally supportive parenting (DSP) is the parental competency that optimizes developmental outcomes in high-risk infants, spanning developmental knowledge, emotional responsiveness, cognitive stimulation, and the psychological capacity to sustain these behaviors. Existing measures assess caregiving confidence or require trained observers; none captures DSP competency by self-report.</p><p><strong>Purpose: </strong>This study aimed to develop a self-report scale measuring DSP competency among parents of high-risk infants and to evaluate its psychometric properties.</p><p><strong>Methods: </strong>A total of 440 parents of high-risk infants participated in the study between February 2 and 28, 2024. The study was conducted in 2 phases. In Phase 1, the instrument was developed through a review of the relevant literature and interviews with parents; thereafter, the preliminary items were evaluated for content validity. Phase 2 included psychometric testing, item analysis, and construct validity analysis. Concurrent validity, internal consistency, and test-retest reliabilities were also examined.</p><p><strong>Results: </strong>The final scale was confirmed using exploratory and confirmatory factor analyses, yielding a 4-factor scale with 28 items. The 4 factors were parental knowledge of child health and development; parental emotional support; cognitive development promotion and behavioral guidance; and parental mindfulness and self-care. Concurrent validity was demonstrated, and instrument reliability was deemed acceptable.</p><p><strong>Implications for practice and research: </strong>The CS-DSPHI is a valid and reliable instrument for assessing DSP competency in parents of high-risk infants. Healthcare providers can use these scores to identify specific areas requiring educational support and guidance. Further validation across diverse parent populations and infant risk levels is warranted.</p>","PeriodicalId":520547,"journal":{"name":"Advances in neonatal care : official journal of the National Association of Neonatal Nurses","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2026-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149169414","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}