Development and validation of the infant nursing assessment scale: Results from exploratory factor analysis and Rasch modeling

Purpose: The primary challenge in infant care is developing a comprehensive, rapid, and reliable assessment tool that is minimally dependent on subjective evaluations and applicable in various inpatient settings. This study aims to develop and assess the structural validity of the Infant Nursing Assessment Scale (INA), enabling a comprehensive evaluation of hospitalized newborns and infants. Design and methods: A development and validation study based on cross-sectional design was undertaken. The study included the conceptualization and validation of the INA scale through qualitative expert interviews, followed by a pilot study and psychometric evaluation using exploratory factor analysis and Rasch analysis. The INA scale comprises three subscales: Functionality, Breastfeeding, and Parental-infant relationship dynamics, encompassing 22 items. Results: The study included 319 valid measurements, with significant score decreases from admission to discharge in most items, indicating the scale's sensitivity to clinical status changes. Factor analysis revealed strong structural validity while the Rasch analysis revealed optimal Infit and Outfit Mean-Square values for most items. Items Sensorium and Mother's substance use did not show significant changes and were considered for removal. The scale's internal consistency was acceptable, with Cronbach's Alpha values ranging from 0.59 to 0.74 across subscales. Conclusions: The INA scale is a reliable instrument for assessing the comprehensive needs of hospitalized infants, supporting targeted nursing interventions and enhancing the quality of pediatric care. The study confirms the INA scale's validity and reliability, highlighting its potential for broader application in various in-hospital clinical settings.