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Updated: May 2, 2026
Assessment and Evaluation of the High Risk Neonate: The NICU Network Neurobehavioral Scale
Published on: August 25, 2014
Validation and psychometric properties of the neonatal intensive care unit parental beliefs scale
Bernadette Mazurek Melnyk1, Krista L Oswalt, Kimberly Sidora-Arcoleo
1Bernadette Mazurek Melnyk, PhD, RN, CPNP/PMHNP, FAAN, is Associate Vice President for Health Promotion, University Chief Wellness Officer, and Dean and Professor, College of Nursing, The Ohio State University, Columbus. Krista L. Oswalt, PhD, is Research Assistant Professor, Arizona State University, Tempe. Kimberly Sidora-Arcoleo, PhD, MPH, is Associate Dean for Research & Transdisciplinary Scholarship and Director, Center for Women, Children and Youth, The Ohio State University, Columbus.
Insights
The Neonatal Intensive Care Unit Parental Beliefs Scale (NICU PBS) reliably measures parental beliefs in preterm infants
Area of Science:
- Neonatal care
- Parental psychology
- Psychometrics
Background:
- Parental perceptions and confidence significantly impact preterm infant outcomes.
- Understanding parental beliefs is crucial for supporting infants in intensive care.
Purpose of the Study:
- To evaluate the psychometric properties of the Neonatal Intensive Care Unit Parental Beliefs Scale (NICU PBS).
- To assess the scale's reliability and validity in mothers and fathers of preterm infants in intensive care.
Main Methods:
- Administered the NICU PBS to 245 mothers and 143 fathers of preterm infants during intensive care.
- Collected data at NICU admission and prior to discharge.
- Utilized confirmatory factor analysis to validate the NICU PBS factor structure.
Main Results:
- A three-factor structure (Parental Role Confidence, Parent-Baby Interaction, Knowledge of the NICU) was confirmed.
- The NICU PBS demonstrated high reliability (Cronbach's alpha .75–.91) and test-retest stability (.84–.92).
- Demographic and psychological factors (e.g., maternal age, stress, education, income) were associated with NICU PBS scores.
Conclusions:
- The NICU PBS is a reliable instrument for assessing parental beliefs in mothers and fathers of hospitalized preterm infants.
- The scale shows potential for predicting parental stress, depression, and anxiety.
Background:
Parental perception of their infants and confidence/beliefs about their parenting are among the most salient factors influencing outcomes of preterm infants.
Objectives:
The purpose of this study was to assess the psychometric properties of scores on the Neonatal Intensive Care Unit Parental Beliefs Scale (NICU PBS) in a sample of mothers and fathers of preterm infants receiving intensive care. The NICU PBS is a rating instrument designed to assess parental beliefs about their premature infant and their role during hospitalization.
Methods:
The sample consisted of 245 mothers and 143 fathers. As part of the Creating Opportunities for Parent Empowerment trial, participants completed the NICU PBS 4-8 days after NICU admission and again approximately 4 days before discharge. Validation data were obtained at various times throughout the study. Confirmatory factor analysis was used to evaluate the NICU PBS factor structure.
Results:
A three-factor solution was accepted (Parental Role Confidence, Parent-Baby Interaction, and Knowledge of the NICU). Reliability of scores on the total scale and subscales was high; Cronbach's alpha ranged from .75 to .91. Test-retest correlations ranged from .84 to .92. Younger maternal age; birth of another child; return to work within the past 12 months; and lower stress, depression, and anxiety were all significantly associated with higher scores on all subscales and the total score. Lower education, lower household income, receipt of Medicaid, and non-White race were associated with higher scores on the parent role confidence subscale and total. Lower household income and receipt of Medicaid were associated with higher Parent-Baby Interaction scores.
Discussion:
The NICU PBS can be used reliably with mothers and fathers of premature infants who are hospitalized in the NICU, and it may be a useful scale in predicting parental stress, depression, and anxiety.
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