Abstract: Background: The effectiveness of clinical practice and the improvement of care quality are evaluated based on the satisfaction and experience of parents whose infants have been admitted to the neonatal intensive care unit (NICU). Currently, there is a lack of a professional assessment tool in China for evaluating parental satisfaction in the NICU. Objective: To translate the Empowerment of Parents in The Intensive Care-Neonatology (EMPATHIC-N) into Chinese to make it a family-centered parent satisfaction assessment tool appropriate for NICUs in China. Design: Cross-sectional study. Methods: The original version of the EMPATHIC-N scale was translated into Chinese using ten steps of scale translation and cultural adaptation summarized by Wild. The sample size was estimated to facilitate sampling methods. The parents were included for infants admitted to the NICU at Children's Hospital of Fudan University between March 2021 and June 2022，with a gestational age＜37 weeks，the birth weight＜1,500 g, and the length of stay ＞72 hours. Infants who passed away during their hospitalization were excluded. A nurse who has received training explained the purpose of the study to the parents and guided them to complete the questionnaire. Each family received one copy. The parent, either the mother or the father, filled out the questionnaire on the spot, and the data were checked by the nurse. The internal consistency reliability and Spearman-Brown split-half reliability of the Chinese version of the EMPATHIC-N scale were tested using Cronbach's α coefficients and split-half reliability coefficients. The construct validity of the Chinese version of the EMPATHIC-N scale was evaluated through exploratory factor analysis and confirmatory factor analysis. Main outcome measuresReliability and validity of EMPATHIC-N scale in Chinese. Results: A total of 330 questionnaires were distributed and all were effectively collected. The Chinese version of the EMPATHIC-N scale comprises 57 items. During exploratory factor analysis, principal component analysis resulted in the extraction of five factors including information provision, care and treatment, parental involvement, unit environment, and professional attitude. These factors exhibited characteristic root values exceeding 1, contributing to a cumulative variance explanation rate of 87.4%. The factor loadings for each item ranged from 0.706 to 0.953. The validation factor analysis model's fitting results revealed a chi-square degree of freedom ratio of χ2/df=6.635, with an RMSEA of 0.131, a SRMR of 0.053, a CFI of 0.807, and load factor numbers ranging from 0.792 to 0.999. The evaluation of convergent validity revealed that the average variance extracted (AVE) of the scale ranged from 0.757 to 0.964, while the composite reliability value was between 0.974 and 0.996. The discriminant validity evaluation revealed that the square root of the AVE of the five factors in the scale ranged from 0.870 to 0.982. Furthermore, the square root of each factor's AVE was greater than the absolute value of its correlation coefficient with other factors. Internal consistency test showed that the coefficients for Cronbach's alpha of the five factors and the total scale α are 0.976, 0.996, 0.975, 0.995, 0.973, and 0.982, respectively. The Spearman-Brown split-half reliability results revealed that the split-half correlation coefficients for the five factors and the total scale were 0.988, 0.998, 0.980, 0.994, 0.984, and 0.771, respectively. Conclusion: The Chinese version of the EMPATHIC-N scale exhibits satisfactory reliability, convergent validity, and discriminant validity, however, the model fitting effect is not satisfactory. It is imperative to validate the evaluation tool for parental satisfaction in the full-time accompanying NICU setting.

Key words: EMPATHIC-N scale, Satisfaction, Reliability, Validity, Parent, Neonatal Intensive Care Units