Development and validation of the Proxy-Reported Pulmonary Outcomes Scale for premature infants

Area of Science:

• Neonatology
• Pediatric Pulmonology
• Clinical Assessment Tools

Background:

• Bronchopulmonary dysplasia (BPD) is a significant complication in preterm infants.
• Accurate assessment of BPD severity is crucial for appropriate management and outcomes.
• Existing assessment tools may not fully capture functional respiratory status from a bedside perspective.

Purpose of the Study:

• To evaluate the feasibility of the Proxy-Reported Pulmonary Outcome Scale (PRPOS) as a bedside nurse-reported tool.
• To assess the PRPOS's ability to measure the severity of bronchopulmonary dysplasia (BPD) using functional, disease-related indicators.
• To identify the most reliable items for a final PRPOS measurement tool.

Main Methods:

• A 26-item instrument, the PRPOS, was tested by bedside nurses on preterm infants (born 23-30 weeks gestation).
• Assessments were conducted at 36 to 37(4/7) weeks postmenstrual age, before, during, and after care times.
• Item reliability, validity, and model fit were analyzed to select six final items.

Main Results:

• Assessments were completed on 188 preterm infants.
• PRPOS item scores increased with higher National Institute of Child Health and Development (NICHD) BPD categories.
• The final six-item scale demonstrated internal consistency and known-groups validity.
• PRPOS scores correlated with postmenstrual age at discharge and were higher in infants discharged on oxygen or diuretics.

Conclusions:

• The PRPOS is an internally consistent, proxy-reported measure of respiratory function in premature infants.
• It utilizes observable, functional performance measures for assessing BPD.
• Initial testing supports its known-groups validity, with ongoing research to assess predictive validity.