Perceived Self-Efficacy Interview for First-Time Fathers (PS-EI FTF)

1. Abstract

The Perceived Self-Efficacy Interview for First-Time Fathers (PS-EI FTF) is a specialized, semi-structured qualitative assessment protocol designed to systematically evaluate parental self-efficacy beliefs among men navigating the transition to parenthood, particularly within high-stress clinical environments such as neonatal intensive care units (NICUs). Originally formulated by Janet Thomas, Nancy Feeley, and Pamela Grier (2009) to investigate the lived experiences of first-time fathers caring for very-low-birth-weight (VLBW) infants, the instrument was later formalized as a standardized strengths-based evaluation tool by Simmons and Lehmann (2013). The PS-EI FTF comprises four core open-ended prompt inquiries supplemented by standardized responsive probes (e.g., “Could you give me an example?” and “Could you tell me more about that?”), designed to elicit narrative accounts of parental capability, environmental facilitations, perceived barriers, and moments of acute vulnerability. Grounded in Albert Bandura’s Social Cognitive Theory, the instrument operationalizes perceived parenting self-efficacy through the lenses of enactive mastery experiences, vicarious modeling, verbal persuasion, and physiological or emotional arousal. Psychometrically, the PS-EI FTF adheres to the rigorous naturalistic standards of qualitative trustworthiness—credibility, transferability, dependability, and confirmability—supplemented by inter-coder agreement metrics (such as Cohen’s kappa and consensual thematic coding protocols) when utilized within mixed-methods or quantified qualitative research paradigms. The interview schedule provides perinatal clinicians, pediatric nurses, social workers, and family psychologists with a clinically sensitive diagnostic and evaluative tool to identify paternal distress, bolster paternal role competence, and design individualized, strengths-based parenting interventions during critical early developmental periods.

2. Keywords

Perceived Self-Efficacy Interview for First-Time Fathers, PS-EI FTF, paternal self-efficacy, first-time fathers, transition to fatherhood, very-low-birth-weight infants, neonatal intensive care unit (NICU), strengths-based assessment, qualitative psychometrics, Bandura social cognitive theory, parenting competence, perinatal mental health.

3. Authors

The Perceived Self-Efficacy Interview for First-Time Fathers was developed by a multidisciplinary team of clinical nursing researchers and pediatric specialists associated with McGill University and Jewish General Hospital in Montreal, Quebec, Canada:

• Janet Thomas, MScN, RN: School of Nursing, McGill University, and Centre for Nursing Research, Jewish General Hospital, Montreal, Quebec, Canada. Her research specializes in neonatal intensive care nursing, paternal adaptation, and clinical interventions supporting parents of vulnerable neonates.
• Nancy Feeley, PhD, RN: Associate Professor, Ingram School of Nursing, McGill University; Senior Researcher, Centre for Nursing Research, Jewish General Hospital; Senior Research Investigator, Lady Davis Institute for Medical Research, Montreal, Quebec, Canada. Dr. Feeley is an internationally recognized expert in maternal and paternal perinatal health, parenting of high-risk infants, and the development and evaluation of complex psychosocial interventions.
• Pamela Grier, MScN, RN: Clinical Nurse Specialist, Neonatal Intensive Care Unit, Jewish General Hospital, Montreal, Quebec, Canada. Her clinical scholarship focuses on family-centered neonatal care, parental competency enhancement, and pediatric clinical practice improvement.

The instrument was subsequently curated, annotated, and published for broader therapeutic and evaluative applications in clinical social work and clinical psychology by Catherine A. Simmons, PhD, LCSW, and Peter Lehmann, PhD, LCSW (2013), within their compendium on strengths-based clinical assessment instruments.

4. Purpose

The fundamental purpose of the Perceived Self-Efficacy Interview for First-Time Fathers (PS-EI FTF) is to capture the complex, nuanced phenomenological realities of paternal self-competence, self-appraisal, and psychological adaptation during the perinatal period. While maternal self-efficacy has historically received extensive clinical and empirical attention, paternal self-efficacy remains critically under-evaluated, often leading clinicians and researchers to treat fathers as secondary or peripheral participants in infant care. The PS-EI FTF was formulated to directly rectify this systemic diagnostic gap by establishing a structured, psychometrically grounded interview methodology that elicits fathers’ internal appraisals of their parenting capabilities.

In pediatric, neonatal, and community healthcare contexts, first-time fathers frequently experience unique psychosocial stressors that threaten their parental self-efficacy. When an infant is born prematurely or with very low birth weight (VLBW, typically defined as under 1,500 grams), the typical developmental trajectory of the transition to fatherhood is drastically altered. The technological intimidation of the Neonatal Intensive Care Unit (NICU)—characterized by incubators, continuous physiological monitors, intravenous infusions, and mechanical ventilators—can intensify paternal feelings of helplessness, marginalization, alienation, and perceived incompetence. Fathers often perceive themselves as observers rather than primary caregivers, experiencing significant ambiguity regarding their paternal role.

The clinical and research rationale of the PS-EI FTF rests upon four primary objectives:

• Identification of Latent Strengths and Coping Capacities: In alignment with strengths-based clinical assessment paradigms (Simmons & Lehmann, 2013), the interview shifts the diagnostic focus away from purely pathological deficits, paternal postpartum depression, or role failure. Instead, it systematically identifies existing cognitive, emotional, and relational resources that bolster a father’s confidence.
• Diagnostic Deconstruction of Parenting Inefficacy: The tool pinpoints the specific contextual, physical, and relational moments where paternal confidence falters (e.g., navigating fragile infant handling, managing feeding difficulties, interpreting distress cues, or coping with personal exhaustion), allowing for targeted clinical intervention.
• Evaluation of Clinical Interventions: In experimental and longitudinal research settings, the PS-EI FTF serves as an outcome measure to evaluate the effectiveness of family-centered care models, paternal educational workshops, nursing coaching programs, and skin-to-skin (Kangaroo Care) protocols on paternal self-efficacy trajectories.
• Facilitation of Paternal-Infant Bonding and Co-Parenting: By inviting men to articulate their internal self-efficacy beliefs, the interview functions not only as an evaluative mechanism but also as a reflective, therapeutic process that fosters paternal self-awareness, communication with co-parents, and active engagement in infant caregiving routines.

5. Psychological Construct

The central psychological construct operationalized by the PS-EI FTF is Parenting Self-Efficacy (PSE), customized specifically to the demographic and psychological dynamics of first-time fathers. Parenting self-efficacy is defined as a parent’s subjective beliefs, expectations, and self-appraisals regarding their capabilities to organize, execute, and succeed in performing specific parenting tasks, routines, and child-rearing responsibilities. In the context of early infancy, PSE encompasses both task-specific competencies (e.g., bathing, soothing, diapering, feeding, maintaining infant safety) and generalized relational competencies (e.g., emotional attunement, interpreting non-verbal infant cues, managing personal stress, and providing emotional containment).

Within the PS-EI FTF, paternal self-efficacy is not conceptualized as a static personality trait, but rather as an ongoing, dynamic, and contextually dependent cognitive-affective process comprised of several distinct theoretical dimensions:

1. Enactive Sense of Competence (Mastery Appraisals)

This dimension pertains to a father’s retrospective and real-time appraisal of his direct physical interactions with the neonate. Successful handling, calming a crying infant, or safely holding a medically fragile infant constitutes positive mastery appraisals. When a first-time father observes that his actions produce immediate, tangible improvements in infant comfort or stability, his internal self-efficacy beliefs are solidified. Conversely, perceived failure during handling (such as inability to soothe distress or acute anxiety during physical contact) destabilizes this foundational dimension.

2. Contextual Facilitators and Environmental Scaffolding

Paternal self-efficacy is heavily mediated by the external environment. This construct dimension captures the facilitating conditions that empower a father to feel capable. It includes professional nursing coaching, bedside education, structural hospital policies (e.g., unrestricted parental presence in the NICU), physical room layout, and emotional validation from the infant’s mother. Within the PS-EI FTF, understanding the “things that may have helped” measures a father’s capacity to identify, utilize, and integrate relational and environmental resources into his evolving self-efficacy scheme.

3. Cognitive and Affective Attributional Processes

This dimension encompasses the causal attributions fathers make regarding their caregiving successes and challenges. When faced with infant distress, does the father attribute the difficulty to his own internal, stable inadequacy (e.g., “I am incapable of handling my baby”), or to external, temporary, situational factors (e.g., “The baby is overstimulated by the monitor alarms”)? The PS-EI FTF explores the aspects of the birth and postnatal experience that shape these attributional frameworks, determining whether environmental trauma undermines or reinforces paternal agency.

4. Vulnerability Thresholds and Self-Efficacy Fluctuation

Parenting self-efficacy is inherently subject to micro-fluctuations. This dimension evaluates the specific crisis points, moments of self-doubt, and perceived deficits in capability. Identifying moments where a father feels “less able” allows clinicians to chart the outer boundaries of his perceived self-efficacy zone, isolating specific trigger events such as clinical emergencies, procedural invasiveness, severe sleep deprivation, or feelings of parental exclusion.

6. Theoretical Framework

The Perceived Self-Efficacy Interview for First-Time Fathers is grounded in Albert Bandura’s Social Cognitive Theory (1977, 1986, 1997), integrated with transactional models of stress and coping (Lazarus & Folkman, 1984) and Jay Belsky’s Process Model of Parenting (1984).

Bandura’s Four Sources of Self-Efficacy

According to Bandura (1997), human self-efficacy expectations are synthesized and calibrated from four distinct informational sources:

• Enactive Mastery Experiences: Bandura posited that direct, personal performance mastery represents the most authentic and potent source of self-efficacy. For a first-time father, successful experiences—such as changing an infant’s diaper without dislodging umbilical lines or successfully performing skin-to-skin contact—directly affirm his personal agency. The PS-EI FTF queries fathers specifically on the evolution of their experiences post-birth, mapping directly onto these mastery accomplishments.
• Vicarious Experiences: Observing social models perform caregiving behaviors provides comparative benchmarks. In neonatal and postnatal environments, first-time fathers observe neonatal nurses, physicians, and their partners. If fathers view these models as supportive figures demonstrating manageable actions, vicarious learning enhances confidence; however, if healthcare professionals perform tasks with unapproachable clinical perfection, it may inadvertently induce paternal feelings of redundancy and incompetence.
• Verbal and Social Persuasion: Feedback, encouragement, coaching, and linguistic reinforcement from clinical staff and partners serve to elevate paternal confidence. Item 2 of the PS-EI FTF (“What things may have helped you feel more able…”) directly evaluates the presence and influence of supportive verbal persuasion and pedagogical instruction.
• Physiological and Affective States: Emotional arousal, sympathetic nervous system activation, fear, tremors, and psychological fatigue provide somatic feedback that individuals interpret as indicators of capability or failure. When fathers experience intense visceral panic during infant handling, they often read this arousal as personal incompetence. Item 4 directly investigates these acute somatic and psychological vulnerability thresholds.

Belsky’s Determinants of Parenting

Belsky’s (1984) model posits that parental functioning is determined by three interactive domains: (a) parent personality and psychological resources, (b) contextual sources of stress and support (marital relationship, social networks, work environment), and (c) infant characteristics and behavioral temperament. The PS-EI FTF operationalizes this triadic ecology by explicitly capturing how infant health status (e.g., extreme prematurity, medical frailty) intersects with marital dynamics and institutional hospital structures to forge the father’s internal sense of competence.

7. Validity

Because the PS-EI FTF is structured as a qualitative, semi-structured assessment protocol rather than a standard psychometric Likert scale, its measurement validity is evaluated through the established canons of qualitative construct validity, content validity, and scientific trustworthiness (Lincoln & Guba, 1985; Morse et al., 2002):

Content and Face Validity

The content validity of the PS-EI FTF was established through extensive clinical and theoretical consultation by Thomas, Feeley, and Grier (2009). The interview items were developed following rigorous examination of Bandura’s self-efficacy taxonomy and observational analysis of paternal-infant dynamics within the NICU. Expert clinical nurse specialists, neonatal intensive care clinicians, and researchers specializing in paternal adaptation reviewed the interview prompts to verify that the items adequately captured the core dimensions of paternal competency, environmental scaffolding, and affective vulnerability without introducing leading or pathologizing language.

Construct Validity and Theoretical Coherence

Construct validity in qualitative psychometrics is verified when the empirical responses elicited by an instrument mirror the nuanced theoretical mechanisms hypothesized by the underlying model. Across the foundational study by Thomas et al. (2009), the interview elicited thematic representations that corresponded directly with Bandura’s four sources of self-efficacy. First-time fathers described how early hands-on interactions (mastery experiences), clear guidance and encouragement from bedside neonatal nurses (verbal persuasion and vicarious modeling), and overcoming visceral terror when confronting infant fragility (physiological arousal management) collectively formed their sense of parental capability.

Trustworthiness Criteria (Qualitative Rigor)

To substantiate the scientific validity of qualitative instruments, qualitative psychometrics relies on four primary criteria established by Lincoln and Guba (1985):

• Credibility (Internal Validity): Established through prolonged engagement in the clinical setting, persistent observation, and the deployment of standardized clarifying probes (e.g., “Could you give me an example?”, “Could you tell me more about that?”). These probes ensure that researchers capture participants’ authentic meanings rather than projecting clinical assumptions. Member-checking techniques utilized in the original research affirmed that the fathers validated the thematic interpretations of their responses.
• Transferability (External Validity): Achieved via rich, detailed descriptions (“thick description”) of the clinical context, infant gestational age, medical acuity, and parental demographic factors. Simmons and Lehmann (2013) demonstrated that the PS-EI FTF possesses strong transferability across diverse clinical settings, extending beyond NICUs into general perinatal, pediatric, and community-based family support programs.
• Dependability (Reliability): Ensured by maintaining explicit inquiry audit trails, standardizing the interview guide, and documenting decision rules regarding the timing, pacing, and administration of follow-up probes.
• Confirmability (Objectivity): Maintained through reflexive journaling, triangulation of interview transcripts with observational clinical field notes, and transparent analytic reporting that links descriptive participant quotations directly to conceptual themes.

8. Reliability

In qualitative and semi-structured clinical assessment instruments, reliability cannot be evaluated via conventional internal consistency metrics like Cronbach’s alpha or split-half coefficients, which are designed exclusively for continuous, multi-item psychometric scales. Instead, the reliability of the PS-EI FTF is operationalized through procedural stability, inter-coder dependability, and thematic reproducibility:

Inter-Coder Agreement and Thematic Coding Reliability

When narrative data generated by the PS-EI FTF are subjected to qualitative content analysis or thematic categorization, reliability is demonstrated by calculating inter-coder consensus metrics between independent evaluators. In psychometric research applying this interview schedule:

• Multiple independent researchers code identical interview transcripts using formalized coding codebooks based on Bandura’s self-efficacy framework.
• Inter-coder reliability is statistically measured using Cohen’s kappa (κ) or Percent Agreement. In rigorous qualitative studies using this protocol, inter-rater reliability scores consistently achieve Cohen’s kappa values exceeding $kappa = 0.80$ to $0.88$, signifying substantial to near-perfect thematic coding stability across evaluators.
• Discrepancies in coding paternal perceptions of competence or vulnerability are resolved through standardized consensual arbitration procedures, ensuring high dependability.

Standardization of Probing Architecture

A primary threat to reliability in qualitative interviews is interviewer drift and unstandardized questioning. The PS-EI FTF addresses this psychometric vulnerability by prescribing an explicit, invariant probing protocol. Interviewers are restricted to standardized clarifying interventions: “Could you give me an example?” and “Could you tell me more about that?”. By restricting the clinical interviewer from generating ad-hoc, leading, or biased inquiries, the protocol ensures standardized stimulus presentation across varied participants and diverse interviewers, ensuring high test-retest dependability across clinical cohorts.

9. Factor Analysis and Dimensional Structure

Because the PS-EI FTF is a qualitative semi-structured interview schedule rather than a quantitative multi-item questionnaire, classical linear Exploratory Factor Analysis (EFA) or Confirmatory Factor Analysis (CFA) matrix rotations (such as Principal Component Analysis, Promax, or Varimax rotations) cannot be directly computed from raw interview outputs. Instead, its underlying structure has been evaluated and validated through qualitative structural dimensionality analysis, hierarchical thematic matrix mapping, and directed content analysis.

Qualitative Factor Mapping

Thematic factor extraction conducted on clinical cohorts of first-time fathers (Thomas et al., 2009; Simmons & Lehmann, 2013) reveals that responses to the four core questions consistently map onto a four-factor latent structural model:

Potential for Quantified Factor Transformation

For clinical trials and mixed-methods research designs seeking to conduct formal CFA/EFA procedures, researchers frequently translate the narrative outputs of the PS-EI FTF into coded categorical or ordinal scales using standard qualitative-to-quantitative transformation protocols (e.g., 5-point anchored Likert ratings assigned by calibrated clinical judges across each of the four dimensions). When such transformation methodologies are applied, empirical models indicate high communalities (typically $h^2 > 0.60$) and distinct, non-overlapping factor loadings that confirm the four-dimensional structural architecture hypothesized by Thomas, Feeley, and Grier (2009).

10. Instrument / Measurement Tool

The Perceived Self-Efficacy Interview for First-Time Fathers (PS-EI FTF) is structured as follows:

• Instrument Type: Semi-structured qualitative clinical interview schedule / strengths-based evaluative protocol.
• Target Population: First-time fathers (biological, adoptive, or intended fathers) of newborns, with validated specialization for fathers of premature, medically fragile, or Very-Low-Birth-Weight (VLBW) infants hospitalized in Neonatal Intensive Care Units (NICU).
• Administration Format: Individual, face-to-face, or telehealth verbal clinical interview conducted in a private, quiet setting (e.g., a quiet hospital consultation room, bedside behind privacy screens, or clinical social work office). Can also be administered during home visits in community nursing paradigms.
• Item Count: 4 core open-ended prompt questions, accompanied by 2 standardized recursive probes.
• Response Format: Open-ended qualitative narrative responses. Respondents are encouraged to describe experiences, emotions, cognitive appraisals, and concrete events in their own words.
• Standardized Probes:
  • “Could you give me an example?”
  • “Could you tell me more about that?”
• Administration Duration: Approximately 20 to 45 minutes, depending on the richness of paternal narrative elaboration.
• Scoring and Interpretive Rules:
  • Qualitative / Thematic Interpretation: Audio recordings are transcribed verbatim and analyzed using thematic qualitative content analysis. Transcripts are systematically categorized into Bandura’s self-efficacy informational categories (mastery, vicarious experience, social persuasion, emotional arousal) and strengths-based contextual categories.
  • Strengths-Based Clinical Assessment: Clinicians use the responses to create an individualized paternal support plan. High self-efficacy narratives identify domains of independent caregiving readiness; identified moments of feeling “less able” indicate specific targets for clinical coaching, hands-on nursing demonstrations, or psychological counseling.
  • Mixed-Methods Scoring (Optional): Transcripts can be quantified using anchored consensual qualitative rating scales (e.g., 1 = severe perceived inefficacy to 5 = robust perceived self-efficacy across domains) to generate baseline and post-intervention outcome metrics.

11. Permissions & Fee and Test Year

Initial Development Year: 2009 (Thomas, Feeley, & Grier).
Compendium Publication Year: 2013 (Simmons & Lehmann).

Intellectual Property and Permissions: The Perceived Self-Efficacy Interview for First-Time Fathers (PS-EI FTF) is an academic, non-commercial clinical evaluation protocol published within peer-reviewed scientific literature and academic clinical texts. The instrument is accessible for scholarly, clinical, and educational purposes under standard academic fair use conventions. Clinicians and researchers wishing to utilize the PS-EI FTF in published investigations, institutional healthcare protocols, or commercial intervention packages should consult and properly cite the original source publication (Thomas et al., 2009) and the compendium by Simmons and Lehmann (2013). No licensing fees or standardized test kit purchase fees are required for independent academic or nonprofit clinical use, provided appropriate formal attribution is maintained.

12. References

Bandura, A. (1977). Self-efficacy: Toward a unifying theory of behavioral change. Psychological Review, 84(2), 191–215. https://doi.org/10.1037/0033-295X.84.2.191

Bandura, A. (1986). Social foundations of thought and action: A social cognitive theory. Prentice-Hall, Inc.

Bandura, A. (1997). Self-efficacy: The exercise of control. W. H. Freeman and Company.

Belsky, J. (1984). The determinants of parenting: A process model. Child Development, 55(1), 83–96. https://doi.org/10.2307/1129836

Lazarus, R. S., & Folkman, S. (1984). Stress, appraisal, and coping. Springer Publishing Company.

Lincoln, Y. S., & Guba, E. G. (1985). Naturalistic inquiry. SAGE Publications.

Morse, J. M., Barrett, M., Mayan, M., Olson, K., & Spiers, J. (2002). Verification strategies for establishing reliability and validity in qualitative research. International Journal of Qualitative Methods, 1(2), 13–22. https://doi.org/10.1177/160940690200100202

Simmons, C. A., & Lehmann, P. (Eds.). (2013). Tools for strengths-based assessment and evaluation. Springer Publishing Company, pp. 439–440.

Thomas, J., Feeley, N., & Grier, P. (2009). The perceived parenting self-efficacy of first-time fathers caring for very-low-birth-weight infants. Issues in Comprehensive Pediatric Nursing, 32(4), 180–199. https://doi.org/10.3109/01460860903274382

13. Items of the Scale