Development and validation of Neonatal Satisfaction Survey--NSS-13
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Updated: Apr 27, 2026

Assessment and Evaluation of the High Risk Neonate: The NICU Network Neurobehavioral Scale
Published on: August 25, 2014
Inger H Hagen1,2, Tove B Vadset1,2, Johan Barstad3
1Aalesund University College, Aalesund, Norway.
Insights
A new survey, the Neonatal Satisfaction Survey (NSS-13), was developed and validated to assess parental satisfaction with neonatal units. This tool helps evaluate and improve the quality of care provided in these specialized wards.
Area of Science:
- Neonatal care research
- Patient satisfaction measurement
- Survey development and validation
Background:
- Parental satisfaction is crucial for evaluating neonatal unit quality.
- Existing tools may not comprehensively capture parental experiences in neonatal settings.
- A validated instrument is needed to assess satisfaction across various aspects of neonatal care.
Purpose of the Study:
- To develop and validate a survey instrument for assessing parental satisfaction with neonatal wards.
- To investigate parental satisfaction in infants born from ≥24 weeks gestation up to 3 months post-term.
- To provide a comprehensive tool for quality improvement initiatives in neonatal care.
Main Methods:
- Literature review and focus groups with healthcare professionals and parents.
- Development of the Neonatal Satisfaction Survey (NSS-13).
- Validation of the survey in a parent population (N=105) with analysis of internal consistency.
Main Results:
- The Neonatal Satisfaction Survey (NSS-13) comprises 13 subcategories covering staff, admission, nurses, anxiety, siblings, information, timeout, doctors, facilities, nutrition, discharge preparation, trust, and visitors.
- The survey includes 69 items, with each subcategory containing 2-11 items.
- All subcategories demonstrated acceptable internal consistency.
Conclusions:
- The Neonatal Satisfaction Survey (NSS-13) is a suitable instrument for measuring parental satisfaction in neonatal units.
- The survey can be utilized in its entirety or by individual subcategories.
- Findings underscore the importance of parental satisfaction in driving quality improvements within neonatal wards.
Aims:
The purpose of this study was to develop and validate a survey to investigate parents' satisfaction with neonatal wards in a population of parents of children with a gestation age of ≥24 weeks to 3 months after full-term birth.
Method:
We explored the literature and conducted three focus groups: two with expert health personnel and one with parents. We tested the survey in a parent population (N = 105) and report the different stages in the validation process along with the full survey, the Neonatal Satisfaction Survey - 13 categories (NSS-13).
Results:
We found 13 subcategories in the Neonatal Satisfaction Survey. The subcategories measure parents' satisfaction with neonatal units based on staff, admission, nurses, anxiety, siblings (parents' perceptions of caring for the siblings of the newborn), information, timeout, doctors, facilities, nutrition, preparation for discharge, trust and visitors. Each subcategory showed acceptable internal consistency. The full version of the Neonatal Satisfaction Survey presents 69 items, and each subcategory contains two to eleven items.
Conclusion:
The Neonatal Satisfaction Survey seems suitable to measure parents' satisfaction with neonatal units and can be used in full, but it can also measure subcategories. Parents' satisfaction with neonatal units can be used to improve the quality in such wards. We consider this study as the first in a series to validate the NSS-13. The full survey with subcategories is presented in this paper.
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