Psychometric Evaluation of the Family-Centered Care Scale in Neonatal Intensive Care Units in Iran

BACKGROUND: Family-centered care (FCC) is a core approach in neonatal intensive care units (NICUs), yet culturally adapted measurement tools remain limited. PURPOSE: This study evaluated the validity and reliability of the Family-Centered Care Scale for Neonatal Intensive Care Units (FCCS-NICU) in Iranian NICUs. METHODS: A methodological study was conducted in 2025 across 11 NICUs in Shiraz, Iran. The adaptation process involved translation, back-translation, and pilot testing with 40 mothers. The final version of the scale was administered to 500 mothers. Content validity was examined using the Content Validity Index. Construct validity was assessed through Exploratory Factor Analysis (EFA) and Confirmatory Factor Analysis (CFA). Reliability was evaluated using Cronbach alpha, item-total correlations, and test-retest reliability with intraclass correlation coefficients. RESULTS: EFA revealed a four-factor structure-dignity and respect, information sharing, participation in care, and family collaboration-explaining 68.34% of the total variance. CFA confirmed this structure, with all path coefficients statistically significant (P < 0.05). Internal consistency was excellent (Cronbach alpha = 0.865-0.933 for subscales; 0.941 overall). Test-retest reliability showed high stability (99.6%), and item-total correlations ranged from 0.215 to 0.802, indicating strong reliability. The consistency between EFA and CFA further supported the robustness of the factor structure. IMPLICATION FOR PRACTICE AND RESEARCH: The validated FCC-NICU scale provides healthcare professionals with a reliable and practical tool to measure FCC in Iranian NICUs. Its application can guide strategies to enhance family involvement, strengthen collaboration between families and providers, and improve overall satisfaction with neonatal care.