Watkins Rochelle E, Payne Janet M, Reibel Tracy, Jones Heather M, Wilkins Amanda, Mutch Raewyn, Bower Carol
Telethon Kids Institute, The University of Western Australia, Perth, Australia.
Child and Adolescent Health Service, Department of Health Western Australia, Perth, Australia.
BMC Pregnancy Childbirth. 2015 Dec 30;15:353. doi: 10.1186/s12884-015-0779-6.
Prenatal alcohol exposure is an important modifiable cause of adverse fetal outcomes during and following pregnancy. Midwives are key providers of antenatal care, and it is important to understand the factors which influence their ability to provide appropriate advice and support to women about alcohol use in pregnancy. The main aim of this study was to develop a psychometrically valid scale to evaluate midwives' beliefs about assessing alcohol use during pregnancy.
A self-administered questionnaire was developed to evaluate midwives' beliefs about assessing alcohol use during pregnancy, including beliefs about positive and negative consequences of asking about alcohol use, and beliefs about capacity to assess alcohol use. The questionnaire was sent to 245 midwives working for a state-wide country health service in Western Australia. Exploratory factor analysis was used to identify the latent constructs assessed by the 36 belief items and provide initial construct validation of the Asking About Alcohol (AAA) Scale.
Of the 166 (67.8 %) midwives who responded to the survey, 160 (96.4 %) completed one or more of the belief items and were included in this analysis. Factor analysis identified six subscales which assessed beliefs about discomfort, capacity, effectiveness, role, trust and knowledge. Midwives held the most positive beliefs about their capacity to ask and the effectiveness of asking about alcohol use, and the least positive beliefs about women's knowledge about alcohol use and discomfort associated with asking about alcohol use in pregnancy. Midwives' beliefs about their role and the effectiveness of asking were most strongly associated with the intention to ask all pregnant women about alcohol use during pregnancy (r = -0.59, p < 0.001 and r = -0.52, p < 0.001).
Our analysis has identified key constructs underlying midwives' beliefs about the assessment of alcohol use during pregnancy. The AAA Scale provides a basis for improved clarity and consistency in the conceptualisation and measurement of midwives' beliefs which can be used to enhance our understanding of factors influencing midwives' ability to deliver interventions to prevent alcohol use during pregnancy. The constructs identified in this exploratory analysis require confirmatory analysis to support their validity and generalizability.
孕期酒精暴露是孕期及产后不良胎儿结局的一个重要可改变病因。助产士是产前护理的关键提供者，了解影响她们就孕期饮酒向女性提供适当建议和支持能力的因素很重要。本研究的主要目的是开发一种心理测量学上有效的量表，以评估助产士对孕期饮酒评估的信念。
编制了一份自填式问卷，以评估助产士对孕期饮酒评估的信念，包括对询问饮酒的正面和负面后果的信念，以及对评估饮酒能力的信念。该问卷被发送给在西澳大利亚州一家全州范围的乡村卫生服务机构工作的245名助产士。探索性因素分析用于识别由36个信念项目评估的潜在结构，并对询问酒精使用量表（AAA量表）进行初步的结构验证。
在回复调查的166名（67.8%）助产士中，160名（96.4%）完成了一个或多个信念项目并被纳入本分析。因素分析确定了六个子量表，分别评估关于不适感、能力、有效性、角色、信任和知识的信念。助产士对自己询问的能力和询问饮酒的有效性持有最积极的信念，而对女性关于饮酒的知识以及与孕期询问饮酒相关的不适感持有最不积极的信念。助产士对自己角色的信念以及询问的有效性与在孕期询问所有孕妇饮酒情况的意愿最密切相关（r = -0.59，p < 0.001和r = -0.52，p < 0.001）。
我们的分析确定了助产士对孕期饮酒评估信念背后的关键结构。AAA量表为提高助产士信念概念化和测量的清晰度及一致性提供了基础，可用于增进我们对影响助产士实施预防孕期饮酒干预能力的因素的理解。在这项探索性分析中确定的结构需要进行验证性分析以支持其有效性和普遍性。
