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Validation of the Finnegan Neonatal Abstinence Syndrome ToolShort Form

Maguire, Denise PhD, RN, CNL; Cline, Genieveve J. DNP, ARNP, NNP-BC; Parnell, Lisa MSN, RN; Tai, Chun-Yi PhD, RN

Section Editor(s): Dowling, Donna

Advances in Neonatal Care:
doi: 10.1097/ANC.0000000000000033
Original Research

PURPOSE: The purpose of this study was to reduce the number of items in the Modified Finnegan Neonatal Abstinence Syndrome Tool (M-FNAST) to the minimum possible while retaining or improving its validity in a short version.

SUBJECTS: All infants with a diagnosis of neonatal abstinence syndrome (171) who were admitted to a large neonatal intensive care unit in southwest Florida between September 2010 and October 2012 comprised the sample.

DESIGN: This was a psychometric evaluation of 33 856 M-FNAST assessments that were downloaded from the electronic medical record.

METHODS: Principal axis factoring extraction with varimax rotation was performed on the M-FNAST data. Principal components extraction was used before principal factors extraction to estimate the number of factors with the scree test and factorability of the correlation matrices with Bartlett's chi-square test, and Kaiser-Meyer-Olkin Measure of Sampling Adequacy.

RESULTS: The M-FNAST scores ranged from 0 to 29, with a mean of 3.5 (SD = 2.5). Less than 1% (21) of infants had scores of 17 or more. Nearly all (97.7%) scores fell between 0 and 9. Most subjects were full-term gestation, but 11 were preterm between 28 and 37 weeks' gestational age. The 2-factor solution explained 23.74% of the total variance and consists of 2 factors, mild/early and moderate/advanced signs. The 2-factor solution was significantly correlated with the total score on the MFNAST (r = 0.917; P < .001). Among infants who scored 8 or greater, the total score on the 2-factor solution short form FNAST was significantly correlated with the total score on the M-FNAST (r = 0.629; P < .001).

Author Information

College of Nursing, University of South Florida, Tampa (Dr Maguire and Mr Tai); All Children's Hospital, St Petersburg, Florida (Mr Cline); and Maternal Child Health, Western Baptist Hospital, Padukah, Kentucky (Mr Parnell).

Correspondence: Denise Maguire, PhD, RN, CNL, College of Nursing, University of South Florida, 12901 Bruce B. Downs Blvd, MDC 22, Tampa, FL 33612 (

This study was conducted at All Children's Hospital, St Petersburg, Florida.

The authors declare no conflict of interest.

© 2013 by The National Association of Neonatal Nurses