Development of an instrument to measure mothers' perceptions of professional labor support
Bowers, Beverly Bryce
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The purpose of this methodological study was to estimate the psychometric properties ofthe Perceived Professional Labor Support Tool (PPLST), a 51-item instrument designed to measure mothers' perceptions of professional labor support (PLS) provided by the registered nurse during labor. The PPLST was based upon a new conceptual model of PLS called the "5 Cs": caring, communication, comfort, competency, and concern. The sample (n = 256) consisted of mothers with non-complicated pregnancies who delivered healthy term infants by either vaginal delivery (91.1 %) or cesarean section ( 8.1 %), at five different birth centers. Mothers were: (a) less than 48 hours postpartum, (b) age 18-42 years (M = 26.1), (c) gravida (M = 2.3), (d) para (M = 1.9). Ethnic representation included: African American (9.9%), Caucasian (78.3%), Hispanic (6. 7%), Native American (1.6%), Asian (1.6%), and other (2%). Psychometric properties of the initial 51-item PPLST that were estimated included: content validity (CVI =1.0), internal consistency (a= .91), test-retest stability!= .93, Q = .00, and concurrent validity with 6 questions representing the 5 Cs conceptual model of PLS, L ==.44 , 12 = .01 . Item reduction using a combination ofCronbach's alpha and principal components analysis (PCA) with varimax rotation resulted in a 30-item scale, the PPLST30, that was internally consistent, a =.94. Six subscales emerged: caring, nurse 's informal communication, nurse's technical communication, monitoringcompetence, professional comfort, and choices- concern. There were significant differences in PPLST30 scores based upon delivery type and ethnicity. Cesarean delivered mothers had lower perceptions ofPLS than those who delivered vaginally. Hispanics and other combined non-Caucasian ethnic groups had lower perceptions of PLS than Caucasians. PLS may not meet multi-cultural needs. The most supportive nursing actions were: (a) being friendly, kind, and respectful; (b) pain management; and (c) monitoring the fetus and mother. Traditional comfort measures (e.g. back rub, hand holding) were considered as least supportive. Findings supported the initial validity and reliability ofthe PPLST30 as a measure ofPLS as well as the "5Cs" conceptual model. The PPLST30, which needs further replication with other samples, could be useful in future outcome studies.