Taavoni Simin, Goldani Zahra, Rostami Gooran Narges, Haghani Hamid
Department of Medical Education, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran.
Department of Midwifery, School of Nursing and Midwifery, Iran University of Medical Sciences, Tehran, Iran.
Int J Community Based Nurs Midwifery. 2018 Oct;6(4):334-349.
Disrespectful and undignified care during childbirth has been documented in health facilities all over the world. The purpose of this study was to develop and pretest a new instrument, the Quality of Respectful Maternity Care Questionnaire in Iran (QRMCQI), with an ensured validity and reliability to evaluate and measure Respectful Maternity Care (RMC) in three sections of labor, delivery and post-partum.
This is a study with mixed sequential exploratory design. Here, the questionnaire design is a part of descriptive survey study and consists of five phases implemented in one year. The phases include item or questions generation, face validation, content validity assessment, confirmatory factor analysis and reliability assurance of the questionnaire. The participants were selected from the mothers referring to health care centers affiliated to Iran University of Medical Sciences in five cities after recruitment from hospital for after-care services of delivery.
The primary questionnaire was developed, face validity was performed by experts and their comments were implemented. The content validity index (CVI), Kappa index and Content Validity Ratio (CVR) were calculated for each item and they were satisfactory in an acceptable range. Confirmatory factor analysis (CFA) showed good fit of the hypothesized model for 453 participants in the interview. Testing showed an acceptable internal consistency and reliability by calculating Cronbach's alpha coefficient for questions in labor (0.86), in delivery (0.85), and in postpartum care (0.78).
We have developed a new instrument as the 59-item QRMCQI for evaluating respectful maternity care in Iran through a rigorous process of item generation and validity-reliability assessment besides confirmatory factor analysis that were in an acceptable range and can be used as a reliable instrument for RMC in Iran.
世界各地的医疗机构都记录了分娩期间存在的不尊重和有失尊严的护理情况。本研究的目的是开发并预测试一种新工具——伊朗尊重孕产妇护理质量问卷（QRMCQI），以确保其有效性和可靠性，从而在分娩、接生和产后三个阶段评估和衡量尊重孕产妇护理（RMC）。
这是一项采用混合序贯探索性设计的研究。在此，问卷设计是描述性调查研究的一部分，包括在一年内实施的五个阶段。这些阶段包括条目或问题生成、表面效度验证、内容效度评估、验证性因素分析以及问卷的信度保证。参与者是从伊朗医科大学附属医疗保健中心的母亲中挑选出来的，这些母亲来自五个城市，她们是在医院招募来接受分娩后护理服务的。
编制了初始问卷，由专家进行表面效度验证并采纳了他们的意见。计算了每个条目的内容效度指数（CVI）、卡帕指数和内容效度比率（CVR），结果在可接受范围内令人满意。验证性因素分析（CFA）表明，假设模型与访谈中的453名参与者拟合良好。通过计算分娩期问题（0.86）、接生期问题（0.85）和产后护理问题（0.78）的克朗巴赫α系数，测试显示出可接受的内部一致性和信度。
我们通过严格的条目生成以及效度 - 信度评估过程，外加在可接受范围内的验证性因素分析，开发了一种新工具——59个条目的QRMCQI，用于评估伊朗的尊重孕产妇护理情况，该工具可作为伊朗RMC的可靠工具使用。
