Questionnaire on the Care Needs of Primary Caregivers of Premature Infants at Home: A Tool Development and Validation Study Based on the KANO Model

Background Systematically assessing the nursing needs of primary caregivers of premature infants in the home environment can provide targeted support for primary caregivers of premature infants. The aim of this study is to develop and validate a questionnaire on the care needs of primary caregivers of premature infants at home Methods The initial questionnaire was formed through a literature review, semistructured interviews, and Delphi expert consultation. On the basis of the KANO model questionnaire design principles, each need item was phrased as paired positive and negative questions and pretested. A cross-sectional survey was subsequently conducted among primary caregivers of premature infants discharged within the past 6 months. The sample was randomly split into two parts for item analysis, validity, and reliability evaluation. Results A preliminary questionnaire containing 49 items was constructed and transformed into a format with paired positive and negative questions according to the KANO model. After exploratory factor analysis (EFA), the final questionnaire retained 27 items covering three dimensions: existence needs, relatedness needs, and growth needs. Confirmatory factor analysis (CFA) showed good fit for both the positive and negative questionnaires: positive questionnaire: χ²/df = 2.857, RMR = 0.012, SRMR = 0.049, RMSEA = 0.077, IFI = 0.914, TLI = 0.906, CFI = 0.914; negative questionnaire: χ²/df = 2.785, RMR = 0.016, SRMR = 0.045, RMSEA = 0.075, IFI = 0.930, TLI = 0.923, CFI = 0.930. The questionnaire demonstrated good convergent and discriminant validity. The item-level content validity index (I-CVI) ranged from 0.71-1.00, and the scale-level average content validity index (S-CVI/Ave) was 0.93. The internal consistency reliability (Cronbach's α) was 0.932 for the positive questionnaire and 0.940 for the negative questionnaire. Conclusion The caregiver care needs questionnaire for premature infants at home, which was developed on the basis of the KANO model in this study, has good reliability and validity. It is suitable for assessing the care needs of this population and shows good potential for clinical application.