Initial Development of the Nurse Perception of Infant Condition (NPIC) Scale.

Background: More than 350,000 U.S. infants are admitted to the neonatal intensive care unit (NICU) annually and likely experience discomfort. Although nurse perceptions of infant symptoms, suffering, and quality of life (QOL) are valuable, the availability of standardized assessment tools to measure these concepts are limited.

Purpose: To provide preliminary evidence of the internal structure, reliability, and validity of the Nurse Perception of Infant Condition (NPIC) scale.

Methods: Infants were enrolled from a Level IV NICU in the U.S. Midwest. Nurses reported on their perceptions of the infant symptom experience and their expectations for infant survival. Weekly behavioral observations of infants were obtained before and after standard delivery of care to obtain a comfort score.

Results: 237 nurses who cared for 73 infants completed 569 surveys over 28 months. All NPIC items were significantly correlated with each other ( P < .001). Factor analysis revealed strong evidence of a 2-factor structure (survival and suffering subscales). Both subscales demonstrated good to excellent internal consistency. Together the 2 factors explained 82% of the variability in the scale responses. Limited validity evidence was found.

Implications for practice and research: Evidence was found to support the internal structure and reliability of the NPIC scale. However, further item development and refinement is needed to increase the utility NPIC scale in clinical and research settings. The development of improved assessments of the infant NICU experience is warranted. Nurse perceptions of infant suffering or poor QOL may have implications for their expectations for infant survival and possibly care delivery.