{
  "abstract": "The survival of infants and children with complex medical conditions continues to increase, underscoring the need to quantify technology dependence more effectively. Existing measures emphasize mortality risk and fail to capture the burden of ongoing technological support. To address this gap, the Technology Dependence Index (TDI) was developed and initially validated as a standardized measure capturing the technology‐dependence component of neonatal and pediatric caregiving complexity. Technology dependence is defined as the complexity and intensity of the skilled, health‐related caregiving an infant or child needs to sustain physiological functioning, beyond the presence of any single device. Pooled data from six studies yielded 818 TDI observations across 265 infants. Inter‐rater reliability was moderate (κ = 0.61), with intraclass correlations from 0.90 to 0.99 and at least 90% agreement for 10 of 12 domains, noting the medication domain had the lowest inter‐rater reliability (45%–48%). Principal components analysis supported a multidimensional internal structure, with the 12 domains loading onto three retained factors. Researchers and clinicians can use the TDI retrospectively through chart review, prospectively in real time, or via parent report, making it adaptable to both research and clinical settings.",
  "abstract_shown": true,
  "affiliations": [
    "Center for Healthcare Improvement Henry Ford Health Detroit Michigan USA",
    "College of Nursing Michigan State University East Lansing Michigan USA",
    "Department of Pediatrics, College of Human Medicine Michigan State University East Lansing Michigan USA",
    "School of Nursing The University of North Carolina at Wilmington Wilmington North Carolina USA",
    "College of Nursing The Ohio State University Columbus Ohio USA",
    "Center for Biobehavioral Health Nationwide Children's Hospital Research Institute Columbus Ohio USA",
    "Division of Nursing Science and Family Centered Health, School of Nursing Duke University Durham North Carolina USA",
    "Department of Pediatrics, School of Medicine Duke University Durham North Carolina USA"
  ],
  "article_type": "research article",
  "arxiv": null,
  "author_total": 6,
  "authors": [
    {
      "affs": [
        0,
        1,
        2
      ],
      "name": "Ashlee J. Vance",
      "orcid": "0000-0003-0284-3995"
    },
    {
      "affs": [
        3
      ],
      "name": "Matthew Peterson",
      "orcid": "0000-0003-1403-6365"
    },
    {
      "affs": [
        3
      ],
      "name": "Hayley H. Estrem",
      "orcid": "0000-0003-2599-8893"
    },
    {
      "affs": [
        4,
        5
      ],
      "name": "Christine A. Fortney",
      "orcid": "0000-0003-0300-1968"
    },
    {
      "affs": [
        6,
        7
      ],
      "name": "Sharron L. Docherty",
      "orcid": "0000-0003-2465-9179"
    },
    {
      "affs": [
        6,
        7
      ],
      "name": "Debra H. Brandon",
      "orcid": "0000-0001-6375-6719"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/3tcv0n559htqm.bib",
  "cited_by": 0,
  "doi": "10.1002/nur.70121",
  "fulltext_url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC13729730/",
  "id": "3tcv0n559htqm",
  "issns": [
    "0160-6891",
    "1098-240X"
  ],
  "landing_url": "https://doi.org/10.1002/nur.70121",
  "language": "en",
  "licence": "CC-BY-4.0",
  "licence_label": "CC BY 4.0",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "heading",
      "Research Article"
    ],
    [
      "openalex",
      "2735|Infant Development and Preterm Care"
    ]
  ],
  "openalex": "W7203534124",
  "pdf_url": "https://onlinelibrary.wiley.com/doi/pdfdirect/10.1002/nur.70121",
  "pmcid": "PMC13729730",
  "pmid": "42603123",
  "published": "2026-08-15",
  "publisher": null,
  "ris": "https://research.draconitic.com/paper/3tcv0n559htqm.ris",
  "sources": [
    {
      "first_seen": "2026-11-07T12:22:28Z",
      "native_id": "PMC13729730",
      "source": "pmc",
      "url": "https://doi.org/10.1002/nur.70121"
    }
  ],
  "subjects": [
    {
      "field": "medicine",
      "origin": "openalex:2735|Infant Development and Preterm Care",
      "subfield": "reproductive-child"
    }
  ],
  "title": "The Technology Dependence Index (TDI): Development and Validation in Neonatal and Pediatric Populations",
  "title_text": "The Technology Dependence Index (TDI): Development and Validation in Neonatal and Pediatric Populations",
  "type": "peer-reviewed",
  "updated_at": "2026-11-07T12:22:28Z",
  "url": "https://research.draconitic.com/paper/3tcv0n559htqm",
  "venue": "Research in Nursing & Health",
  "versions": []
}