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.