Psychometric validation of Emotional Reaction Instrument‐English to measure American children’s emotional responses to hospitalisation

Aims and objectives. The aim of this study was to test the initial psychometric properties of the Emotional Reactions Instrument‐English with hospitalised American children, ages 7–12 years, in the USA. Background. Children’s negative emotional responses have been a subject of concern for paediatric clinicians and researchers, especially because negative emotional responses following or during hospitalisation are associated with adverse patient outcomes. Existing self‐report paediatric instruments have a number of limitations including lack of clinical feasibility and psychometric evidence. Design. A survey and psychometric approach was used to test initial reliability and validity of the Emotional Reactions Instrument‐English. Methods. Two hundred hospitalised American children, 7–12 years of age, who were admitted to a Children’s Hospital in the USA were recruited for this study. The children were administered the Emotional Reactions Instrument‐English, the Facial Affective Scale, and a demographic form. Results. Internal consistency was supported by a Cronbach’s alpha of 0·83 for the total scale. Alpha coefficients for subscales ranged from 0·59–0·82. Construct validity was tested with exploratory factor analysis. Through principal component analysis, four factors were identified that explained 64% of the variance. Concurrent validity was supported by most items in the Emotional Reactions Instrument‐English being significantly correlated with the Facial Affective Scale (r = 0·18–0·59). The instrument can be administered to hospitalised children in 5–10 minutes. Conclusions. The results of this exploratory study provide initial support for the psychometric adequacy of the Emotional Reactions Instrument‐English with hospitalised American children ages 7–12 years. Further testing of the Emotional Reactions Instrument‐English is required to validate the subscales and evaluate the instrument’s use with children of different ages, race and ethnicity. Relevance to clinical practice. This study introduces a new, clinically feasible instrument to measure children’s diverse emotional responses to hospitalisation.