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Am J Perinatol 2015; 32(06): 583-590
DOI: 10.1055/s-0035-1544946
Original Article
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Development and Validation of the Proxy-Reported Pulmonary Outcomes Scale for Premature Infants

Wayne A. Price
1   Department of Pediatrics, School of Medicine, The University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
,
Sofia R. Aliaga
1   Department of Pediatrics, School of Medicine, The University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
,
Sara E. Massie
2   Center for Public Health Quality, Raleigh, North Carolina
,
Darren A. DeWalt
3   Learning and Diffusion Group, Centers for Medicare and Medicaid Services, Baltimore, Maryland
,
Matthew M. Laughon
1   Department of Pediatrics, School of Medicine, The University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
,
William F. Malcolm
4   Department of Pediatrics, Duke University, Durham, North Carolina
,
Krisa Van Meurs
5   Department of Pediatrics, Stanford University School of Medicine and Lucile Salter Packard Children's Hospital, Palo Alto, California
,
Jonathan M. Klein
6   Stead Family Department of Pediatrics, Roy J. and Lucille A. Carver College of Medicine, University of Iowa, Iowa City, Iowa
,
George El-Ferzli
7   Department of Pediatrics, University of Alabama at Birmingham, Birmingham, Alabama
,
Brooke E. Magnus
8   Department of Psychology, The University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
,
Sue Tolleson-Rinehart
1   Department of Pediatrics, School of Medicine, The University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
9   North Carolina Translational and Clinical Sciences Institute, The University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
› Author Affiliations
Further Information

Publication History

17 October 2014

19 December 2014

Publication Date:
25 February 2015 (online)

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Abstract

Objective Test the feasibility of using a bedside nurse–reported tool (Proxy-Reported Pulmonary Outcome Scale, PRPOS) for evaluating the severity of bronchopulmonary dysplasia (BPD) by assessing functional, disease-related measures.

Study Design Bedside nurses tested the 26-item instrument by observing preterm infants (23–30 weeks at birth) at 36 to 374/7 weeks postmenstrual age before, during, and after a care time. We analyzed item reliability, validity, and model fit to determine the six items to include in the final measurement tool.

Result We completed assessments on 188 preterm infants. The frequency of an abnormal PRPOS item score increased with increasing National Institute of Child Health and Development (NICHD) BPD category. The six-candidate items produced an internally consistent scale. Addition of the NICHD BPD classification increased reliability moderately; addition of feeding items decreased reliability. The PRPOS score correlated with postmenstrual age at discharge. Infants discharged on oxygen or diuretics had higher median PRPOS scores than did infants who were not prescribed those therapies.

Conclusion The PRPOS is an internally consistent, proxy-reported measure of respiratory function in premature infants, based on observable, functional performance measures. Initial testing demonstrates known-groups validity and ongoing testing can assess predictive validity.

Keywords

bronchopulmonary dysplasia - infant - premature - outcome assessment - lung disease - neonatal
 

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