The psychometric properties of an instrument measuring intrapartum nurses' beliefs related to birth practice




Adams, Ellise

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Purpose: Birth in America has become medicalized without a significant improvement in maternal or newborn outcomes. Most of these births occur in the hospital setting with an intrapartum nurse in attendance. Intrapartum nurses provide a central role in birth and make important decisions about the care of laboring women. These decisions are driven by a set of beliefs. Knowledge of the connection between beliefs and the practice of intrapartum nurses may provide much need information to address the negative issues related to the medicalization of birth. Therefore, the purpose of this research was to develop a valid and reliable instrument to measure birth beliefs of the intrapartum nurse related to birth practice.

Procedure: The Theory of Planned Behavior guided development of the Intrapartum Nurses Beliefs Related to Birth Practice scale, providing a basis for the connection between beliefs and practice. Domain identification, item generation, and instrumentation of the scale occurred through a review of the literature, through focus groups and through concept analysis and was modeled after the Labor Support Questionnaire, Part 1. The original 42 item scale was submitted to rigorous testing of concept validity through expert content review; convergent validity with an instrument measuring similar concepts; internal consistency through item analysis and construct validity through factor analysis.

Data Sources: The sample for this study consisted of 313 intrapartum nurses currently working on intrapartum nursing units in America. The nurses were recruited from four large databases and through snowballing. Data were retrieved using an online platform.

Interpretation: Findings include reduction of the original instrument to a 36 item instrument following content validity testing; a moderate, positive correlation with a similar instrument; Cronbach's alpha of .797 and two factors identifying belief systems.

Conclusions: With further revision this instrument may provide an accurate measure of the birth beliefs of the intrapartum nurse. Once beliefs and practices of the intrapartum nurse have been identified, birth outcomes can be correlated to the practice of the intrapartum nursing. This practice can then be refined to assist in reversing the negative trend of medicalized birth practices in America.



Health and environmental sciences, Intrapartum nursing, Medicalized birth, Normal birth, Psychometric properties