IJLTEMAS International Journal of Latest Technology in Engineering, Management & Applied Science (IJLTEMAS) IJLTEMAS 2278-2540 IJLTEMAS 304 10.51583/IJLTEMAS.2026.150800110 Education Examining the Influence of Nurse-Led Discharge Education on Parental Readiness and Anxiety: A Path Analysis in the NICU Setting Jon-Jon T. Martinez Dr. Taif University, Al Mutamarat Rd, Al Mathnah, At Taif, 26521, Saudi Arabia Saudi Arabia Marie Ancheta Anne University of Perpetual Help System – DALTA, Alabang–Zapote Rd, Las Piñas, 1740 Metro Manila, Philippines Philippines 15 8 1531 1546 04 09 2026 09 09 2026 19 09 2026 nurse-led discharge education parental readiness parental anxiety NICU discharge path analysis Abstract

This study examined the influence of nurse-led discharge education on parental readiness and anxiety among parents of neonates admitted to the Neonatal Intensive Care Unit. Specifically, it determined the respondents’ demographic profile, perceived level of nurse-led discharge education, level of parental readiness, level of parental anxiety prior to discharge, relationships among the major variables, differences in readiness and anxiety when grouped according to demographic profile, and the mediating role of parental readiness in the relationship between nurse-led discharge education and parental anxiety. The study employed a quantitative, non-experimental, cross-sectional, predictive-correlational design using mediation/path analysis. A total of 133 parents participated in the study through purposive sampling. Data were gathered using the researcher-made Parent Discharge Preparation Questionnaire (NICU) and analyzed using descriptive statistics, Pearson correlation, t-test, ANOVA, and mediation/path analysis. Findings revealed that nurse-led discharge education was perceived as very high, parental readiness was high, and parental anxiety prior to discharge was low. Nurse-led discharge education was significantly and positively related to parental readiness and significantly and negatively related to parental anxiety. Parental readiness was also significantly and negatively related to parental anxiety. Significant differences in parental readiness and anxiety were found according to previous NICU experience and length of infant’s NICU stay. Mediation/path analysis showed that parental readiness significantly mediated the relationship between nurse-led discharge education and parental anxiety, indicating that discharge education may reduce anxiety by strengthening parents’ readiness for home caregiving. Based on the findings, the NICU Parent Discharge Readiness and Anxiety Reduction Program was proposed to strengthen structured, continuous, skills-based, and emotionally supportive discharge education for parents.

 References American Academy of Pediatrics Committee on Fetus and Newborn. (2008). Hospital discharge of the high-risk neonate. Pediatrics, 122(5), 1119–1126. https://doi.org/10.1542/peds.2008-2174 Boateng, G. O., Neilands, T. B., Frongillo, E. A., Melgar-Quiñonez, H. R., & Young, S. L. (2018). Best practices for developing and validating scales for health, social, and behavioral research: A primer. Frontiers in Public Health, 6, 149. https://doi.org/10.3389/fpubh.2018.00149 Cronbach, L. J. (1951). Coefficient alpha and the internal structure of tests. Psychometrika, 16(3), 297–334. https://doi.org/10.1007/BF02310555 DeVellis, R. F., & Thorpe, C. T. (2021). Scale development: Theory and applications (5th ed.). SAGE Publications. Franck, L. S., Kriz, R. M., Bisgaard, R., Gay, C. L., Sossaman, S., Sossaman, J., Cormier, D. M., Joe, P., Sasinski, J. K., Kim, J. H., Lin, C., & Sun, Y. (2023). Parent readiness for their preterm infant’s neonatal intensive care unit discharge. The Journal of Perinatal & Neonatal Nursing, 37(1), 68–76. https://doi.org/10.1097/JPN.0000000000000612 Fritz, M. S., & MacKinnon, D. P. (2007). Required sample size to detect the mediated effect. Psychological Science, 18(3), 233–239. https://doi.org/10.1111/j.1467-9280.2007.01882.x Griffin, T., & Abraham, M. (2006). Transition to home from the newborn intensive care unit: Applying the principles of family-centered care to the discharge process. Journal of Perinatal & Neonatal Nursing, 20(3), 243–249. https://doi.org/10.1097/00005237-200607000-00012 Hayes, A. F. (2022). Introduction to mediation, moderation, and conditional process analysis: A regression-based approach (3rd ed.). The Guilford Press. Hua, W., Yuwen, W., Simoni, J. M., Yan, J., & Jiang, L. (2020). Parental readiness for hospital discharge as a mediator between quality of discharge teaching and parental self-efficacy in parents of preterm infants. Journal of Clinical Nursing, 29(19–20), 3754–3763. https://doi.org/10.1111/jocn.15405 Institute for Patient- and Family-Centered Care. (n.d.). Patient- and family-centered care. https://www.ipfcc.org/about/pfcc.html Kline, R. B. (2023). Principles and practice of structural equation modeling (5th ed.). The Guilford Press. Likert, R. (1932). A technique for the measurement of attitudes. Archives of Psychology, 22(140), 1–55. Lin, K., Zhang, S., Zhang, Z., Zheng, W., Chen, Z., Lin, Z., Zhang, H., & Lin, N. (2025). Implementing intelligent nursing interventions to enhance self-efficacy and hospital readiness in parents of preterm infants: A randomised controlled trial protocol. BMJ Open, 15, e101498. https://doi.org/10.1136/bmjopen-2025-101498 Lynn, M. R. (1986). Determination and quantification of content validity. Nursing Research, 35(6), 382–385. Malouf, R., Harrison, S., Burton, H. A. L., Gale, C., Stein, A., Franck, L. S., & Alderdice, F. (2022). Prevalence of anxiety and post-traumatic stress among the parents of babies admitted to neonatal units: A systematic review and meta-analysis. eClinicalMedicine, 43, 101233. https://doi.org/10.1016/j.eclinm.2021.101233 National Commission for the Protection of Human Subjects of Biomedical and Behavioral Research. (1979). The Belmont report: Ethical principles and guidelines for the protection of human subjects of research. U.S. Department of Health and Human Services. Polit, D. F., & Beck, C. T. (2021). Nursing research: Generating and assessing evidence for nursing practice (11th ed.). Wolters Kluwer. Preacher, K. J., & Hayes, A. F. (2008). Asymptotic and resampling strategies for assessing and comparing indirect effects in multiple mediator models. Behavior Research Methods, 40(3), 879–891. https://doi.org/10.3758/BRM.40.3.879 Segers, E., Ockhuijsen, H., Baarendse, P., van Eerden, I., & van den Hoogen, A. (2019). The impact of family centred care interventions in a neonatal or paediatric intensive care unit on parents’ satisfaction and length of stay: A systematic review. Intensive and Critical Care Nursing, 50, 63–70. https://doi.org/10.1016/j.iccn.2018.08.008 Shetty, A. P., Halemani, K., Issac, A., Thimmappa, L., Dhiraaj, S., K, R., Mishra, P., & Upadhyaya, V. D. (2024). Prevalence of anxiety, depression, and stress among parents of neonates admitted to neonatal intensive care unit: A systematic review and meta-analysis. Clinical and Experimental Pediatrics, 67(2), 104–115. https://doi.org/10.3345/cep.2023.00521 Siva, N., Phagdol, T., Nayak, B. S., Mathias, E. G., Lewis, L. E. S., Velayudhan, B., Shankar, R. N., & D’Souza, P. (2024). Stress and stressors experienced by the parents of high-risk neonates admitted in neonatal intensive care unit: Systematic review and meta-analysis evidence available from India. Stress and Health, 40(2). https://doi.org/10.1002/smi.3301 Tavakol, M., & Dennick, R. (2011). Making sense of Cronbach’s alpha. International Journal of Medical Education, 2, 53–55. https://doi.org/10.5116/ijme.4dfb.8dfd World Medical Association. (2013). World Medical Association Declaration of Helsinki: Ethical principles for medical research involving human subjects. JAMA, 310(20), 2191–2194. https://doi.org/10.1001/jama.2013.281053 Yeomans, E., Butler, A. E., Hunt, R. W., & Copnell, B. (2026). Interventions to enhance family centred care in the neonatal intensive care unit: A scoping review. Intensive and Critical Care Nursing, 93, 104313. https://doi.org/10.1016/j.iccn.2025.104313