Cultural Adaption, Validation and Factor Analysis of the Persian Version of the Non-Nutritive Sucking Scoring System

Amirsalar Tozihi; Leila Ghelichi; Arash Bordbar; Maryam Tarameshlu

doi:10.18502/jimc.v7i1.14217

Amirsalar Tozihi Department of Speech and Language Pathology, Rehabilitation Research Center, School of Rehabilitation Sciences, Iran University of Medical Sciences, Tehran, Iran
Leila Ghelichi Department of Speech and Language Pathology, Rehabilitation Research Center, School of Rehabilitation Sciences, Iran University of Medical Sciences, Tehran, Iran
Arash Bordbar Shahid Akbarabadi Clinical Research Development Unit (ShACRDU), Iran University of Medical Sciences, Tehran, Iran
Maryam Tarameshlu Department of Speech and Language Pathology, Rehabilitation Research Center, School of Rehabilitation Sciences, Iran University of Medical Sciences, Tehran, Iran

DOI: https://doi.org/10.18502/jimc.v7i1.14217

Keywords: Cross-Sectional Studies, Factor Analysis, Infant,Newborn, Persian people, Premature, Psychometrics, Reproducibility of results, Statistical

Abstract

Background: Valid and reliable tools are required to measure non-nutritive sucking and oral feeding readiness of preterm infants. The aim of this study was to translate the Non-Nutritive Sucking scoring system (NNS) into Persian language and to evaluate its measurement properties.

Methods: A cross-sectional study was conducted to translate and cross-culturally adapt the NNS to Persian language (P-NNS) following steps described in guidelines. Eighty-eight preterm infants participated in this study. Psychometric properties of floor/ceiling effects, internal consistency reliability, inter-rater reliability, Standard Error of Measurement (SEM), Smallest Detectable Change (SDC) and construct validity were tested. Factor analysis was performed to determine the P-NNS structure.

Results: There were no floor or ceiling effects that indicate the content and responsiveness of P-NNS. Internal consistency was high (Cronbach’s α 0.905). Item–total correlations exceeded acceptable standard of 0.3 for the all the items (0.3–0.9). The inter-rater reliability was excellent (k=0.91, SE=0.04; p<0.001). SEM and SDC were 8.04 and 22.28, respectively. Construct validity was supported by a significant correlation between the P-NNS total score and the Persian version of the Early Feeding Skills (EFS) total score (r=0.94, p<0.001). Explanatory factor analysis revealed 2 components for p-NNS.

Conclusion: The P-NNS was cross-culturally adapted to Persian and demonstrated to be a reliable and valid instrument to measure non-nutritive sucking and oral feeding readiness of preterm infants.