Maternal Role Adaptation Scale in Neonatal Intensive Care Units (MRAS: NICU): Development, Validation and Psychometric Tests

BACKGROUND: Maternal role adaptation involves conceptualization and establishment of a responsible maternal role, which is characterized by a new identity and formation of mothering behaviors. Becoming a mother in intensive care unit is very different from becoming a mother with a term infant at home. The aim of the study was to develop a valid and reliable tool for assessment of maternal role adaptation of mothers with preterm neonates admitted to neonatal intensive care units.

METHODS: This was an exploratory study which was conducted in 2 phase of qualitative and quantitative. A 90-item scale was developed after semi-structured interviews with 25 mothers and review of literature. After merging the similar items, it reduced to 45-item scale. Validity was determined through assessment of face, content and constructs validities, and reliability was confirmed through internal consistency and test-retest.

RESULTS: Face validity led to elimination of 2 items, and further 8 items were eliminated through content validity index with cut-off point 0.79 and content validity ratio with cut-off point 0.42. Thus, the number of items reduced to 35-item. In exploratory factor analysis, 6 factors were identified that explained 54% of the variance. Construct validity led to elimination of 3 other items, and the final scale was developed with 32 items. Cronbach’s alpha and intra-class correlation coefficient were 0.77 and 0.81 respectively.

CONCLUSION: The 32-item “Maternal role adaptation scale in mothers with preterm neonates admitted to neonatal intensive care units” (MRAS: NICU) is a valid and reliable tool.