Development and testing of a self-report measure of preparing to parent in the context of a fetal anomaly diagnosis. Issue 3 (March 2021)

• Record Type: Journal Article
• Authors: McKechnie, Anne Chevalier; Erickson, Kari; Ambrose, Matthew B.; Chen, Sophie; Miller, Sarah J.; Mathiason, Michelle A.; Johnson, Kathy A.; Leuthner, Steven R.
• Is Part Of: Patient education and counseling. Volume 104:Issue 3(2021)
• Page Start: 666
• Page End: 670
• Publication Date: 2021-03
• Subjects: Assessment -- Exploratory factor analysis -- Infant care -- Instrument development -- Maternal-fetal care -- Measurement -- Parents -- Pregnancy -- Prenatal diagnosis -- Prenatal care; Patient education -- Periodicals; Health counseling -- Periodicals; Health education -- Periodicals; Counseling -- Periodicals; Patient Education -- Periodicals; Éducation des patients -- Périodiques; Counseling -- Périodiques; Éducation sanitaire -- Périodiques; 615.5071
• DOI: 10.1016/j.pec.2020.08.017
• Languages: English
• ISSNs: 0738-3991

Abstract

Highlights: A measure of parental preparation for medically at-risk infants has been lacking. PreP-ARE can inform timely and sensitive counseling of expectant parents. Responses to PreP-ARE could cue supplemental mental health assessments. Abstract: Objective: To generate a self-report instrument to capture clinically relevant variations in expectant parents' caregiving development, specified by how they are preparing to parent an infant with a major congenital anomaly. Methods: Recent literature structured domains to guide item generation. Evaluations by experts and expectant parents led to a refined instrument for field testing. Psychometric testing included exploratory factor analysis, internal consistency, and test-retest reliability. Results: Samples included expert evaluators (n = 9), and expectant parent evaluators (n = 20) and expectant mother field testers (n = 67) with fetal anomaly diagnoses. Preparing to Parent-Act, Relate, Engage (PreP-ARE) resulted from a three factor solution that explained 71.8 % of the total variance, with global Cronbach's α = 0.72, and sub-scales 0.81, 0.65, 0.72 respectively. Cohen's weighted kappa indicated all items were acceptably reliable, with 14 of 19 items showing moderate ( ≥ 0.41) or good ( ≥ 0.61) reliability. Convergent validity was found between the maternal antenatal attachment and Act scales ( r = 0.39, p = 0.001). Conclusion: This empirically-based instrument was demonstrated to be valid and reliable, and has potential for studying this transitional time. Practice Implications: PreP-ARE could be used to understand patient responses to the diagnosis, level of engagement, readiness to make decisions, and ability to form collaborative partnerships to manage healthcare.