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González-Mesa E, González-Cazorla A, González-Cazorla E, Mozas-Moreno J, Gokce Isbir G, Abreu W, Lubián-López D. Contribution of the abbreviated CAVE-st questionnaire in Spanish: the attitudes toward childbirth experiences. J Psychosom Obstet Gynaecol 2024; 45:2380860. [PMID: 39044401 DOI: 10.1080/0167482x.2024.2380860] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/16/2023] [Accepted: 07/11/2024] [Indexed: 07/25/2024] Open
Abstract
There are several factors that influence women's childbirth experience, and personal interactions with health professionals are of particular significance. The main objective of this study was to present the validation of an abbreviated form of an existing questionnaire on attitudes about childbirth in medical and nursing students. We used a sample of 512 perinatal medicine and nursing students who received the original 52-item CAVE-st questionnaire to obtain a shorter version with proper psychometric properties. We used Cronbach's alpha coefficient to evaluate the new version's internal consistency. The Kaiser- Meyer-Olkin test and the Barlett sphericity test were performed to assess the suitability of exploratory factor analysis (EFA). Subsequently, confirmatory factor analysis (CFA) was performed using structural equation models in a second sample of 139 medical students. We obtained a 15-item version with a Cronbach's alpha of 0.82. The EFA revealed a four-dimensional structure, similar to the full 52-item version. In the CFA the adjustment indexes showed good model fitness, RMSEA= 0.046 [CI 0.00-0.07]; CFI = 0.978. We can conclude that the 15-item version is a valid tool for evaluating the attitude of students toward childbirth, pointing out the matters that should be improved in their training to avoid obstetric trauma by the promotion of a positive experience in women during childbirth.
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Affiliation(s)
- Ernesto González-Mesa
- School of Medicine, Obstetrics and Gynecology Department, University of Malaga, Málaga, Spain
- Grupo de investigación en Medicina Materno-fetal, epigenética, enfermedades de la mujer y salud reproductiva, Instituto de Investigación Biomédica de Málaga y Plataforma en Nanomedicina-IBIMA Plataforma BIONAND, Málaga, Spain
- UGC Obstetricia y Ginecología, Hospital Regional Universitario de Málaga, Málaga, Spain
| | - Ana González-Cazorla
- School of Medicine, Obstetrics and Gynecology Department, University of Malaga, Málaga, Spain
| | | | - Juan Mozas-Moreno
- School of Medicine, Obstetrics and Gynecology Department, University of Granada, Granada, Spain
| | | | - Wilson Abreu
- Psychology School, Centro de Investigacao en Tecnologias y Servicios de Saude, Porto University, Porto, Portugal
| | - Daniel Lubián-López
- Obstetrics and Gynecology Department, University Hospital of Jerez de la Frontera, Cádiz, Spain
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Huang J, Fu L, Fu Y, Creedy DK, Gamble J, Da Z, Yao J, Li J, Wang N. Exposure to disrespectful maternity care and perceptions of respectful maternity care among nursing and midwifery pre-registration students in China: A national cross-sectional study. Nurse Educ Pract 2024; 78:104026. [PMID: 38901276 DOI: 10.1016/j.nepr.2024.104026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2023] [Revised: 06/10/2024] [Accepted: 06/11/2024] [Indexed: 06/22/2024]
Abstract
AIMS To 1) determine the prevalence and types of disrespectful maternity care witnessed by students; 2) describe students' perceptions of respectful maternity care and associated factors; and 3) investigate whether witnessing disrespectful care influences their perceptions of respectful maternity care. BACKGROUND Limited evidence exists about nursing and midwifery students' perceptions of respectful maternity care and prevalence of disrespectful maternity care in China. Understanding students' perceptions can inform pre-registration curricula and clinical practice programs, promoting the implementation of respectful maternity care. DESIGN An exploratory national online survey was conducted. METHODS Data were analysed using bivariate analysis and multi-factor analysis of variance. RESULTS Among 733 students, positive perceptions towards respectful maternity care were common. Approximately one-fifth witnessed disrespect, with physical violence, lack of communication and untimely care most frequently reported. A better understanding of respectful maternity care was associated with female students of Han ethnicity, majoring in midwifery, undertaking a longer internship/practicum and reporting fewer instances of observed disrespect. Although students reported positive perceptions of respectful maternity care, inadequate understanding was evident. Incorporating relevant content about respectful care into the curriculum is suggested. Reducing students' exposure to disrespectful maternity care may ensure that certain forms of disrespect or abuse do not become normalized among students. This requires system-level efforts to create a safe and supportive working environment for maternity health providers. CONCLUSION To promote respectful maternity care in China, system-level changes are warranted. Respectful maternity care needs to be essential content in pre-registration midwifery and nursing curricula. Encouraging students to identify poor practice and discuss good practice in a safe learning environment is warranted.
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Affiliation(s)
- Jing Huang
- School of Nursing, Capital Medical University, No.10 Xitoutiao Road, Fengtai District, Beijing 100069, China; Florence Nightingale Faculty of Nursing, Midwifery and Palliative Care, King's College London, London SE18WA, UK
| | - Li Fu
- School of nursing, Liaoning University of Traditional Chinese Medicine Shenyang, No 79 Chongshan East Road, Huanggu District, Shenyang 110847, China; School of Nursing, Peking University, No.38 Xueyuan Road, Haidian District, Beijing 100191,China
| | - Yu Fu
- School of Nursing, Xinjiang Medical University, No.567 Shangde North Road, Shuimogou District, Urumqi 830017, China
| | - Debra K Creedy
- School of Nursing and Midwifery, Griffith University Logan Campus, University Drive, Meadowbrook, Queensland 4131, Australia
| | - Jenny Gamble
- School of Nursing and Midwifery, Griffith University Logan Campus, University Drive, Meadowbrook, Queensland 4131, Australia
| | - Zhen Da
- Tibet Medical University, No.36 Jiangsu Road, Lhasa, Tibetan Autonomous Region 850000, China
| | - Jiasi Yao
- School of Nursing, Hebei Medical University, No.309 Jianhua Street, Yuhua District, Shijiazhuang, Hebei Province, China
| | - Junying Li
- Handan Vocational College of Science and Technology, No.1 Fuyang Road, Jinan New District, Handan City, Hebei Province 056046, China
| | - Na Wang
- School of Nursing, Capital Medical University, No.10 Xitoutiao Road, Fengtai District, Beijing 100069, China.
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González-de la Torre H, González-Artero PN, Muñoz de León-Ortega D, Lancha-de la Cruz MR, Verdú-Soriano J. Cultural Adaptation, Validation and Evaluation of the Psychometric Properties of an Obstetric Violence Scale in the Spanish Context. NURSING REPORTS 2023; 13:1368-1387. [PMID: 37873822 PMCID: PMC10594477 DOI: 10.3390/nursrep13040115] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2023] [Revised: 09/27/2023] [Accepted: 10/01/2023] [Indexed: 10/25/2023] Open
Abstract
Obstetric violence refers to dehumanized or derogative treatment of women in their pregnancy, childbirth or postpartum periods and may be manifested in different ways. Currently, there is no tool validated in Spain to measure women's perception of obstetric violence. The objective of this study was to carry out the cultural adaptation and validation of an existing 14-item obstetric violence scale in the Spanish context and to evaluate its psychometric properties. The research was conducted in two phases: first, a methodological study designed to evaluate content validity, through assessments by eight experts (calculating the Aiken V coefficient) and face validity in a sample of 20 women; second, a cross-sectional study to evaluate construct validity (through confirmatory factor analysis and Rasch analysis), divergent validity against a scale of birth satisfaction, known-groups validity and, finally, reliability. In Phase 1, Aiken V values higher than 0.71 were obtained for all items. Phase 2 was conducted on a sample of 256 women and the fit values for the unidimensional model were RMSEA: 0.070 (95% CI: 0.059-0.105) and GFI: 0.982 (95% CI: 0.823-0.990). The Rasch analysis indicated poor performance of item 2, which was removed. The Omega and Cronbach's Alpha coefficients were 0.863 and 0.860, respectively. A final 13-item version of the Obstetric Violence Scale was produced, with a total score ranging from 0 (no obstetric violence perception) to 52 (maximum obstetric violence perception). The Obstetric Violence Scale is a reliable and useful tool to measure women's perception of obstetric violence. This study was not registered.
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Affiliation(s)
- Héctor González-de la Torre
- Department of Nursing, University of Las Palmas de Gran Canaria, Edificio Ciencias de la Salud, C/Blas Cabrera Felipe s/n, CP 35016 Las Palmas de Gran Canaria, Spain
- Research Support Unit of Insular Maternal and Child University Hospital Complex of Gran Canaria, Canary Health Service, Avda Marítima del Sur s/n, CP 35016 Las Palmas de Gran Canaria, Spain
| | - Paula Nikola González-Artero
- Department of Obstetrics and Gynaecology, Insular Maternal and Child University Hospital Complex of Gran Canaria-Canary Health Service, Avda Marítima del Sur s/n, CP 35016 Las Palmas de Gran Canaria, Spain; (P.N.G.-A.); (D.M.d.L.-O.)
| | - Daniel Muñoz de León-Ortega
- Department of Obstetrics and Gynaecology, Insular Maternal and Child University Hospital Complex of Gran Canaria-Canary Health Service, Avda Marítima del Sur s/n, CP 35016 Las Palmas de Gran Canaria, Spain; (P.N.G.-A.); (D.M.d.L.-O.)
| | - María Reyes Lancha-de la Cruz
- Delivery Room Service, General Hospital of Fuerteventura Virgen de la Peña-Canary Health Service, Carretera del Aeropuerto, Km 1, CP 35600 Puerto del Rosario, Spain;
| | - José Verdú-Soriano
- Department of Community Nursing, Preventive Medicine, Public Health and History of Science, Faculty of Health Sciences, University of Alicante (UA), CP 03690 Alicante, Spain;
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Çamlibel M, Uludağ E. The Turkish version of the students' perceptions of respectful maternity care scale: An assessment of psychometric properties. Nurse Educ Pract 2023; 70:103684. [PMID: 37379697 DOI: 10.1016/j.nepr.2023.103684] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2023] [Revised: 06/08/2023] [Accepted: 06/13/2023] [Indexed: 06/30/2023]
Abstract
AIM The aim of the research was to evaluate the psychometric properties of the Turkish validity and reliability of the Students' Perceptions of Respectful Maternity Care (SP-RMC) scale. BACKGROUND Respectful maternity care is an important contributor to intrapartum care quality and maternal birth satisfaction. Determining students' perceptions of respectful maternity care can identify knowledge gaps and inform their future practice. DESIGN A descriptive, methodological and cross-sectional design was used. METHODS This study was conducted with 226 undergraduate nursing and midwifery students in the western region of Turkey. Data were collected between May and December 2022 from students who completed their birth courses (theory and clinical practicum). Data included sociodemographic details and the Students' Perceptions of Respectful Maternity Care scale (Turkish version). Factor analysis, Cronbach's alpha and item-total score analyses were conducted. RESULTS The mean age of the students was 21.88 (SD 1.39). The average number of births observed was 2.57 (SD 3.16). The scale comprised 18 items including three subdimensions. In both exploratory and confirmatory factor tests, the overall factor loading was greater than 0.30, and the total explained variance was 64.89%. The Cronbach's alpha coefficient of the scale was 0.91, with Cronbach's alpha values ranging between 0.80 and 0.91 for the subscales. Pearson correlation coefficients of all the items ranged between 0.42 and 0.78. CONCLUSIONS The SP-RMC (Turkish version) is a valid and reliable measure, with 18 items and three dimensions. In this regard, measuring and reporting respectful maternity care perceptions and intrapartum care experiences of students, who are future members of the profession, could contribute to the improvement of the quality of care and the development of educational interventions for behavioral changes.
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Affiliation(s)
- Merve Çamlibel
- Burdur Mehmet Akif Ersoy University, Faculty of Health Sciences, Obstetrics and Gynecology Nursing Department, Burdur, Turkey.
| | - Elif Uludağ
- Pamukkale University, Faculty of Health Sciences, Obstetrics and Gynecology Nursing Department, Denizli, Turkey
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Dhakal P, Mohammad KI, Creedy DK, Gamble J, Newnham E, McInnes R. Midwifery and nursing students' perceptions of respectful maternity care and witnessing of disrespect and abuse: A comparative study from Nepal and Jordan. Midwifery 2022; 112:103426. [PMID: 35839569 DOI: 10.1016/j.midw.2022.103426] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2022] [Revised: 06/21/2022] [Accepted: 07/06/2022] [Indexed: 10/17/2022]
Abstract
OBJECTIVES To compare Nepalese and Jordanian midwifery and nursing students' perceptions of respectful maternity care (RMC) and witnessing of disrespect and abuse; and determine factors that predict scores on a scale measuring perceptions of RMC. DESIGN A descriptive, comparative design was used. SETTING Recruitment took place from two medical colleges in Nepal and one University in Jordan. METHODS A convenience sample of students (n = 276) enrolled in a Bachelor or Diploma level midwifery or nursing degree who were undertaking or had recently completed their midwifery clinical placement were recruited. The online or hard copy survey included the Students' Perceptions of Respectful Maternity Care (SPRMC) Scale and nine questions on witnessing different types of disrespect and abuse. FINDINGS Nepalese students were slightly older (mean = 23.68 years) than Jordanian students (mean = 21.36). Mean duration of clinical placement was longer for Jordanian students (11.24 compared to 6.28 weeks). However, mean number of births observed was higher among Nepalese students (19.6 compared to 18.62). Overall, perceptions of RMC were more positive among Jordanian students (t (199.97) = 6.68, p < 0.001). A multiple regression analysis found that duration of clinical placement (beta = 0.22, p < 0.001), witnessing disrespect and abuse (beta = 0.11, p = 0.08) and age (beta = -0.14, p = 0.03) explained 12.2% of variance in SPMRC scores. Compared to students in Nepal, all Jordanian students had observed non-consented care during their clinical practicum. However, Nepalese students were more likely to observe poor adherence to women's privacy and confidentiality. KEY CONCLUSION AND IMPLICATIONS FOR PRACTICE This is the first study to compare midwifery and nursing students' perceptions of RMC across two middle-income countries. Although Jordanian students held more positive perceptions of RMC than those in Nepal, more had witnessed different forms of disrespect and abuse. Variations in students' perceptions of RMC and witnessing of abuse across countries highlight the need for assessment of workplace cultures to inform the development of tailored education and practice interventions for students, clinicians, and managers. Future research needs to explore how to best support students to consistently offer RMC and how to improve the experiences of childbearing women.
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Affiliation(s)
- Prativa Dhakal
- School of Nursing and Midwifery, Griffith University, Logan Campus, University Drive, Meadowbrook, Queensland 4131, Australia.
| | | | - Debra K Creedy
- School of Nursing and Midwifery, Griffith University, Logan Campus, University Drive, Meadowbrook, Queensland 4131, Australia
| | - Jenny Gamble
- School of Nursing, Midwifery and Allied Health, Coventry University, United Kingdom
| | - Elizabeth Newnham
- School of Nursing and Midwifery, University of Newcastle, New South Wales, Australia
| | - Rhona McInnes
- School of Nursing and Midwifery, Griffith University, Logan Campus, University Drive, Meadowbrook, Queensland 4131, Australia
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Dhakal P, Creedy DK, Gamble J, Newnham E, McInnes R. Effectiveness of an online education intervention to enhance student perceptions of Respectful Maternity Care: A quasi-experimental study. NURSE EDUCATION TODAY 2022; 114:105405. [PMID: 35598456 DOI: 10.1016/j.nedt.2022.105405] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/15/2021] [Revised: 04/26/2022] [Accepted: 05/10/2022] [Indexed: 06/15/2023]
Abstract
BACKGROUND Childbearing women's relationship with maternity care providers enhance childbirth outcomes. Students need to understand and offer respectful care. OBJECTIVE Evaluate effectiveness and impact of an online education intervention on nursing students' perceptions towards respectful maternity care during labour and childbirth in Nepal. DESIGN A quasi-experimental pre-post design was used. PARTICIPANTS A total of 89 Third Year Bachelor of Nursing students (intervention n = 40; control n = 49) from three participating colleges. METHODS Students completed online pre and post-test surveys using the Students' Perceptions of Respectful Maternity Care scale and questions about impact of the intervention. The intervention group received six hours of education delivered online (three sessions x three weeks). ANCOVA and non-parametric Wilcoxon signed-rank tests measured effects. RESULTS Compared to controls, students in the intervention group reported a significant increase in perceptions towards respectful maternity care (F (1, 86) = 28.19, p < 0.001, ηp2 = 0.25). Participants reported a good understanding of respectful maternity care (75%), positive views about providing such care (82.5%), and a desire to use their new knowledge in practice (65%). CONCLUSION Relatively few intervention studies to promote respectful maternity care in students have been published. This brief online intervention improved students' perceptions. The intervention package can be integrated into nursing or midwifery curricula and in-service training. A larger study with longer follow-up is needed to support current findings.
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Affiliation(s)
- Prativa Dhakal
- School of Nursing and Midwifery, Griffith University, Logan Campus, University Drive, Meadowbrook 4131, Queensland, Australia.
| | - Debra K Creedy
- School of Nursing and Midwifery, Griffith University, Australia; Transforming Maternity Care Collaborative, Australia.
| | - Jenny Gamble
- Transforming Maternity Care Collaborative, Australia; School of Nursing, Midwifery and Allied Health, Coventry University, United Kingdom.
| | - Elizabeth Newnham
- School of Nursing and Midwifery, University of Newcastle, Australia.
| | - Rhona McInnes
- School of Nursing and Midwifery, Griffith University, Australia.
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