Communication in Neonatal Intensive Care: Translation and Validation of the “Parents’ Experiences of Communication in Neonatal Care” Questionnaire for the Portuguese Population

Abstract

Introduction: Communication is a fundamental aspect in healthcare, more so in fragile environments such as Neonatology. To optimize communication strategies with parents, it is essential to assess its quality. The aim of this study was to validate, for the Portuguese population, an instrument for assessing the quality of communication between healthcare professionals and parents in neonatal care units.
Methods: The Parents’ Experiences of Communication in Neonatal Care questionnaire was developed in the United Kingdom to evaluate communication with parents specifically. The 28-question instrument was adapted and translated to European Portuguese following a three-step protocol: translation, review, and back-translation. Subsequently, the validation process was conducted in three stages: (1) face validity through cognitive interviews; (2) content validity through external panel evaluation; and (3) performance assessment through a four-month pilot study in a tertiary neonatal intensive care unit.
Results: Cultural adaptation resulted in the removal of two questions. The remaining questions were translated to Portuguese. Cognitive interviews were conducted with a convenience sample of ten parents, leading to important revisions in two questions. Five external professionals evaluated the item’s relevance in a 4-point Likert scale. Four questions presented an item content validity index value below the threshold of 0.78. Two questions were adjusted and two were eliminated at this stage. The questionnaire was delivered to 31 parents, with a total of 60 questionnaires completed. Five questions were reviewed due to a non-response rate greater than 5%, and one for exceeding 95% uniform responses. No question had a dropout rate greater than 5%, nor did any have a rate of non-informative answers exceeding 5%. A significant correlation (Kendall’s Tau > 0.7) was found between three sets of questions.
Conclusion: The European Portuguese version of Parents’ Experiences of Communication in Neonatal Care survey contains 24 questions. This is the first comprehensive and valid instrument at national level to objectively measure satisfaction with communication of parents of children admitted to the neonatal intensive care units. Its use will enable monitoring of interventions aimed at improving communication, which is crucial for enhancing family-centered care.