Schulz Anja Alexandra, Wirtz Markus Antonius
Research Methods in the Health Sciences, University of Education Freiburg, Freiburg, Germany.
Front Psychol. 2023 May 22;14:1143110. doi: 10.3389/fpsyg.2023.1143110. eCollection 2023.
Interprofessional collaboration of physicians and midwives is essential for appropriate and safe care of pregnant and parturient women as well as their newborns. The complexity of woman-centered care settings requires the continuous exchange of information and the coordinated implementation of multi-and interprofessional care concepts. To analyze the midwives' perspective on the multi-and interprofessional care process during pregnancy, birth and postpartum period, we aimed to adapt and psychometrically evaluate the Interprofessional Collaboration Scale (ICS).
The ICS (13 items) was answered by 299 midwives for (i) prenatal and postpartum care as well as (ii) perinatal care. Three items on equitable communication (EC) identified in qualitative interviews with = 6 midwives were added as further aspects of quality in collaborative midwifery care. Confirmatory factor analysis was used to test competing theoretically hypothesized factorial model structures, including both care settings simultaneously, i.e., birth and prenatal/postpartum.
A two-dimensional structure assuming the 13 original ICS items and the 3 items on EC as psychometric distinct item groups accounts for the data best. After deleting 5 ICS items with insufficient indicator reliability, a very good-fitting model structure was obtained for both prenatal/postpartum as well as perinatal care: = 226.35, = 0.045, CFI = 0.991, RMSEA = 0.025 (90%CI: [0.004; 0.037]). Both the reduced ICS-R and the EC scale (standardized response mean = 0.579/1.401) indicate significantly higher interprofessional collaboration in the birth setting. Responsibility in consulting, attitudes toward obstetric care and frequency of collaboration with other professional groups proved to be associated with the ICS-R and EC scale as expected.
For the adapted ICS-R and the EC scale a good construct validity could be confirmed. Thus, the scales can be recommended as a promising assessment for recording the collaboration of midwives with physicians working in obstetric care from the perspective of midwives. The instrument provides a validated assessment basis in midwifery and obstetric care to identify potentially divergent perspectives within interprofessional care teams in woman's centered care.
医生和助产士的跨专业协作对于为孕妇、产妇及其新生儿提供恰当且安全的护理至关重要。以女性为中心的护理环境的复杂性要求持续进行信息交流，并协调实施多专业和跨专业护理理念。为了分析助产士对孕期、分娩期和产后多专业和跨专业护理过程的看法，我们旨在对跨专业协作量表（ICS）进行改编并进行心理测量学评估。
299名助产士回答了ICS（13个项目），内容涉及（i）产前和产后护理以及（ii）围产期护理。在对6名助产士进行的定性访谈中确定的关于公平沟通（EC）的3个项目被添加进来，作为助产士协作护理质量的进一步方面。验证性因素分析用于检验理论上假设的相互竞争的因素模型结构，同时涵盖两种护理环境，即分娩以及产前/产后。
一个二维结构，将13个原始ICS项目和3个关于EC的项目视为心理测量学上不同的项目组，最能解释数据。在删除5个指标信度不足的ICS项目后，获得了一个对产前/产后护理以及围产期护理都非常拟合的模型结构：χ² = 226.35，p = 0.045，CFI = 0.991，RMSEA = 0.025（90%CI：[0.004；0.037]）。精简后的ICS-R和EC量表（标准化反应均值 = 0.579/1.401）均表明在分娩环境中的跨专业协作显著更高。咨询责任、对产科护理的态度以及与其他专业团体的协作频率正如预期的那样与ICS-R和EC量表相关。
对于改编后的ICS-R和EC量表，可以确认其具有良好的结构效度。因此，这些量表可作为一种有前景的评估工具推荐，用于从助产士的角度记录助产士与从事产科护理工作的医生之间的协作情况。该工具在助产和产科护理中提供了一个经过验证的评估基础，以识别以女性为中心的护理中跨专业护理团队内潜在的不同观点。
