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Updated: May 5, 2026
Assessment and Evaluation of the High Risk Neonate: The NICU Network Neurobehavioral Scale
Published on: August 25, 2014
Validation of the Finnegan neonatal abstinence syndrome tool-short form
Denise Maguire1, Genieveve J Cline, Lisa Parnell
1College of Nursing, University of South Florida, Tampa (Dr Maguire and Mr Tai); All Children's Hospital, St Petersburg, Florida (Mr Cline); and Maternal Child Health, Western Baptist Hospital, Padukah, Kentucky (Mr Parnell).
Purpose:
The purpose of this study was to reduce the number of items in the Modified Finnegan Neonatal Abstinence Syndrome Tool (M-FNAST) to the minimum possible while retaining or improving its validity in a short version.
Subjects:
All infants with a diagnosis of neonatal abstinence syndrome (171) who were admitted to a large neonatal intensive care unit in southwest Florida between September 2010 and October 2012 comprised the sample.
Design:
This was a psychometric evaluation of 33 856 M-FNAST assessments that were downloaded from the electronic medical record.
Methods:
Principal axis factoring extraction with varimax rotation was performed on the M-FNAST data. Principal components extraction was used before principal factors extraction to estimate the number of factors with the scree test and factorability of the correlation matrices with Bartlett's chi-square test, and Kaiser-Meyer-Olkin Measure of Sampling Adequacy.
Results:
The M-FNAST scores ranged from 0 to 29, with a mean of 3.5 (SD = 2.5). Less than 1% (21) of infants had scores of 17 or more. Nearly all (97.7%) scores fell between 0 and 9. Most subjects were full-term gestation, but 11 were preterm between 28 and 37 weeks' gestational age. The 2-factor solution explained 23.74% of the total variance and consists of 2 factors, mild/early and moderate/advanced signs. The 2-factor solution was significantly correlated with the total score on the MFNAST (r = 0.917; P < .001). Among infants who scored 8 or greater, the total score on the 2-factor solution short form FNAST was significantly correlated with the total score on the M-FNAST (r = 0.629; P < .001).
