71 Development and validation of the COCINL scale assessing family resilience in the NICU among parents of preterm infants
Bibliographic record
Abstract
Abstract Background Given the negative impact of parental distress on preterm infants and their families, examining the role of family resilience in the neonatal intensive care unit (NICU) is a promising avenue for promoting parental mental health while remaining consistent with family-centered care. A tool to assess NICU family resilience is essential to guide care and research, yet none specifically adapted for the neonatal context exists to date according to a recent systematic review. Objectives Therefore, the aim of this study was to develop and validate a new scale, the COCINL scale, designed to measure family resilience in the context of neonatal care among French-speaking parents of preterm infants. Design/Methods This methodological design study was carried out in four successive phases: (I) compilation of an item pool (II) mixed-method evaluation of content validity (clarity, relevance, representativeness) involving 12 experts, (III) pre-testing and electronic administration of the COCINL scale, along with a measure of psychological distress (Kessler-6) and an open-ended self-report question on family resilience to parents of preterm infants (n=88) and (IV) psychometric testing of the COCINL scale (internal consistency, construct validity, exploratory sensitivity and specificity). Parents of preterm infants and experts were recruited by convenience sampling from two urban, level III NICUs. Results From a pool of 112 items, 55 items were favorably evaluated after content validation (S-CVI>0.95). Based on preliminary interitem correlations and internal consistency results, the COCINL scale was shortened to 42 items and divided in four subscales. High internal consistency is also shown in subscales (0.796 to 0.908) and total scale (0.937) Cronbach’s alphas. The COCINL scale displays adequate construct validity, as determined by the Pearson correlation obtained between scores of family resilience and psychological distress (r=-0.236, p=0.027). Strong in between correlations of the four subscales and with the COCINL total score (0.732 to 0.851), further indicated good construct validity. Exploratory sensitivity and specificity analysis revealed the COCINL scale compares to participants' self-reported perception of family resilience (AUC 0.754). Conclusion The COCINL scale has shown strong evidence of validity and internal consistency. Thus, the scale can be recommended for research use as a measure of family resilience in the neonatal context. Still, additional evidence of its validity and reliability should be compiled before clinical use is considered. The COCINL scale could potentially support the development, evaluation and implementation of nursing interventions consistent with the family-centered care approach being promoted in NICUs across Canada and worldwide.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.011 | 0.021 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.001 |
| Bibliometrics | 0.002 | 0.001 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.002 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".