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Development and psychometric evaluation of the parent-administered metered-dose inhaler skills scale for children
Esra Nur Kocaaslan Mutlu1, İsmail Çetintaş1, Esra Cumur Başkır2
1Trakya University, Department of Nursing, Child Health and Diseases Nursing Edirne, 22030, Türkiye.
Insights
A new scale, the Parent-Administered Metered-Dose Inhaler Skills Scale for Children with Asthma (PAMDIS), has been developed and validated. This tool helps assess parental inhaler technique in children aged 4-9 years, improving asthma care.
Area of Science:
- Pediatric Allergy and Immunology
- Respiratory Medicine
- Healthcare Quality Improvement
Background:
- Effective asthma management in children relies on correct inhaler technique.
- Parental administration skills are crucial for delivering medication effectively.
- A standardized tool for assessing these skills was lacking in pediatric asthma care.
Purpose of the Study:
- To develop and validate the Parent-Administered Metered-Dose Inhaler Skills Scale for Children with Asthma (PAMDIS).
- To provide a reliable and valid measure for evaluating parental skills in administering metered-dose inhalers (MDIs) to children.
- To address the need for a standardized assessment tool in pediatric asthma management.
Main Methods:
- The study involved 182 parents of children aged 4-9 years with asthma.
- Item generation followed current asthma guidelines and literature.
- Content validity was assessed by expert review; construct validity by factor analyses.
- Reliability was determined through internal consistency and item-total correlations.
Main Results:
- Exploratory factor analysis identified a 14-item, three-factor structure explaining 60.78% of variance.
- Confirmatory factor analysis supported the three-factor model with good fit indices.
- The PAMDIS demonstrated high internal consistency (Cronbach's α = 0.915) and strong item-total correlations.
Conclusions:
- The PAMDIS is a valid and reliable scale for assessing parental MDI administration skills in young children with asthma.
- Pediatric nurses can utilize PAMDIS to identify technique errors, personalize education, and improve asthma outcomes.
- The scale offers a standardized method to evaluate and support parental competence in inhaler use.
Aim:
This study aimed to develop the Parent-Administered Metered-Dose Inhaler Skills Scale for Children with Asthma (PAMDIS) and evaluate its validity and reliability. The scale aims to address this gap in pediatric asthma care by providing a standardized tool for evaluating parental inhaler application skills.
Study Design:
The study was conducted with 182 parents of children aged 4-9 years diagnosed with asthma who attended a pediatric allergy and immunology outpatient clinic. Item generation was based on current asthma management guidelines and relevant literature. Content validity was confirmed by expert review, while construct validity was examined using exploratory and confirmatory factor analyses. Reliability was evaluated through internal consistency and item-total correlations.
Results:
After item reduction, exploratory factor analysis revealed a 14-item, three-factor structure explaining 60.78% of the total variance, with factor loadings ranging from 0.47 to 0.98. Confirmatory factor analysis supported the three-factor model, with good to acceptable fit indices (χ2/df = 1.37, CFI = 0.99, TLI = 0.99, RMSEA = 0.045, SRMR = 0.078). The overall scale demonstrated high internal consistency (Cronbach's α = 0.915), and item-total correlation coefficients were ranged from 0.543 to 0.823.
Conclusion:
PAMDIS is a valid and reliable tool for assessing parental MDI administration skills in children aged 4-9 years.
Practice Implications:
Pediatric nurses can use PAMDIS to detect parental inhaler technique errors, tailor individualized education, and enhance asthma management outcomes. The scale fills a practical gap by offering a standardized method to evaluate and support parents' competence in inhaler administration.
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