伊朗女性分娩方式决策问卷的编制及心理测量学特性
Development and Psychometric Properties of the Decision Making on the Type of Delivery Questionnaire in Iranian Women.
作者信息
Latifnejad Roudsari Robab, Zakerihamidi Maryam, Merghati Khoei Effat, Kazemnejad Anoshirvan
机构信息
Evidence-Based Care Research Centre, Department of Midwifery, School of Nursing and Midwifery, Mashhad University of Medical Sciences, Mashhad, Iran.
Department of Midwifery, School of Medicine, Tonekabon Branch, Islamic Azad University, Tonekabon, Iran.
出版信息
Int J Community Based Nurs Midwifery. 2017 Jul;5(3):292-302.
BACKGROUND
A tool which can help to decide on the determinants in selecting the delivery type is an effective step towards the goals of the World Health. This study aimed to develop and evaluate the psychometric properties of a scale based on Iranian culture to make decision on the type of delivery.
METHODS
This is a methodological study using a questionnaire proposed by Schneider. The following steps were used to design the project. In the first step, perceptions and experiences of 45 pregnant women, postpartum women, midwives, gynecologists and non-pregnant women were determined based on interviews and observations using focused ethnography. In the second stage, the terms in the questionnaire based on qualitative study was assessed. Then, in the third stage, psychometric testing of the decision making on the type of delivery scale (DMTDS) based on the cultural concepts of decision making towards the type of delivery and its influencing factors based on focused ethnography using face validity, content validity, construct validity, internal consistency and reliability was done on400 pregnant and postpartum women.
RESULTS
The initially developed scale consisted of 60 items on a 5-point Likert scale, which reduced to 43 items following measurement of the face and content validity. The results of the exploratory factor analysis elicited 36 items and a seven-factor structure including motivational beliefs on vaginal delivery, social beliefs towards childbirth, motivational beliefs on cesarean delivery, personal beliefs, sources of information, catastrophic thinking and child birth experiences. Cronbach's alpha coefficient (0.80) confirmed the high internal consistency of the scale.
CONCLUSION
The developed questionnaire appears to be a valid and reliable tool for health care providers to measure the women's decision making towards type of delivery. Therefore, this tool can be used in the Iranian community. The scale may help the midwives and obstetricians to be aware of the women's decision regarding their choice of delivery and as a result to plan appropriately in order to reduce unnecessary cesarean sections.
背景
一种有助于确定选择分娩方式决定因素的工具是朝着实现世界卫生组织目标迈出的有效一步。本研究旨在开发并评估基于伊朗文化的用于决定分娩方式的量表的心理测量特性。
方法
这是一项使用施耐德提出的问卷的方法学研究。采用以下步骤设计该项目。第一步，基于访谈和观察，运用聚焦民族志方法确定45名孕妇、产后妇女、助产士、妇科医生和非孕妇的看法和经历。第二步，对基于定性研究的问卷中的术语进行评估。然后，在第三步，对400名孕妇和产后妇女运用表面效度、内容效度、结构效度、内部一致性和信度，基于聚焦民族志中关于分娩方式的决策文化概念及其影响因素，对分娩方式决策量表（DMTDS）进行心理测量测试。
结果
最初开发的量表由60个5点李克特量表项目组成，在进行表面效度和内容效度测量后减少至43个项目。探索性因素分析结果得出36个项目和一个七因素结构，包括对阴道分娩的动机信念、对分娩的社会信念、对剖宫产的动机信念、个人信念、信息来源、灾难性思维和分娩经历。克朗巴赫α系数（0.80）证实了该量表的高内部一致性。
结论
所开发的问卷似乎是医疗保健提供者用于测量女性对分娩方式决策的有效且可靠的工具。因此，该工具可在伊朗社区使用。该量表可能有助于助产士和产科医生了解女性对分娩方式的选择决策，从而进行适当规划以减少不必要的剖宫产。
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