The Development And Preliminary Application Of Readiness For Childbirth Scale Based On Meleis’ Transitions Theory

Objectives1.To develop a readiness for childbirth scale based on Meleis’ transitions theory and test its reliability and validity,and provide a assessment tool for evaluating the preparation for childbirth level of women with advanced pregnancy.2.To apply the compiled scale to investigate the status of women with advanced pregnancy about preparation for childbirth,and explore its related influencing factors.Methods1.Development of readiness for childbirth scale(1)Based on Meleis’ transitions theory,through the literature review and qualitative interviews,scale dimensions were preliminarily established and scale item pools were formed.After the initial selection of the scale items through Delphi expert consultation,the readability and operability of the scale were further evaluated through pre-investigation,and the pretest scale of readiness for childbirth was formed.(2)The convenience sampling method was used to select 264 women with advanced pregnancy from a top three hospitals in Qingdao to conduct a pretest scale investigation,and the items were screened through item analysis.A total of 618 women with advanced pregnancy from a top three hospitals in Qingdao were investigated by using the scale after item selection.The reliability and validity of the scale were tested by using content validity index,structural validity,standard validity,convergent validity and discriminant validity,Cronbach’s α coefficient,and split-half reliability to form a formal scale.2.Application of readiness for childbirth scale213 women with advanced pregnancy from a top three hospitals in Qingdao were selected by the convenience sampling method to take part in a survey.The general information questionnaire and the readiness for childbirth scale were used as survey tools.The statistical methods including descriptive statistics,t test for two independent samples,univariate analysis,multiple linear regression were used to explore the status of women with advanced pregnancy about preparation for childbirth and its related influencing factors.Results1.Development of readiness for childbirth scale(1)The literature review involved the contents of delivery-related guidelines and scale-related literature,which were taken as the source of the scale item pool,and 28 items of item pools were preliminarily formed.Semi-structured interviews were conducted with postpartum women,family members and medical staff,and 33 items of item pools were formed according to the supplement of the semi-structured interviews results.The questionnaire recovery rates of the two rounds of Delphi expert consultation were 100%and 89.47% respectively,the authoritative coefficients were 0.919 and 0.921 respectively,the Kendall’s W were 0.337 and 0.416 respectively,and the items were screened for the first time after two rounds of Delphi expert consultation,and the revised scale contains 34 items belonging to 4 dimensions.The pre-investigation showed that the scale was clear and readable,and the scale was confirmed that 0～10 scoring method was used to response the scale,and the pretest scale of readiness for childbirth was formed.(2)After items analysis,the screened scale contains 29 items by deleting 5 items.After reliability and validity test,the content validity index of item level was 0.941～1.000,the content validity index of scale level was 0.931;6 common factors were revealed by exploratory factor analysis,and the cumulative contribution rate was 69.107%;The confirmatory factor analysis confirmed that the 6 common factors model fitted well(χ~2/df=2.260,RMSEA=0.064,GFI=0.847,NFI=0.853,IFI=0.912,TLI=0.901,CFI=0.912);The correlation index with the perceived social support scale was 0.510(P<0.01);The correlation coefficients of each item with its dimension were all greater than 0.4,which were higher than the correlation with other dimensions,and the success rate of both convergent validity and discriminant validity tests reached 100%;The Cronbach’s αcoefficient was 0.932,the split-half reliability was 0.797 for the total scale,and the formal scale formed after testing its reliability and validity which contains 6 dimensions and 29 items.2.Application of readiness for childbirth scaleThe total score of preparation for childbirth of women with advanced pregnancy was(201.22±34.05),the item average score was(6.94±1.17),the preparation for childbirth was at an above medium level;The results of univariate analysis showed that age,degree of education,self-image during pregnancy,history of childbirth,history of fetal protection and gestational weeks were affecting preparation for childbirth of women with advanced pregnancy(P<0.05);Multiple linear regression analysis showed the factors affecting the preparation for childbirth of women with advanced pregnancy were the gestational weeks,age and degree of education(P<0.001).Conclusions1.The readiness for childbirth scale developed in this study has good reliability,validity and scientificity,which can be used in the related research of the preparation for childbirth of women with advanced pregnancy and provide a scientific and reliable assessment tool for the preparation for childbirth of women with advanced pregnancy.2.The preparation for childbirth of women with advanced pregnancy was at an above medium level.The factors affecting the preparation for childbirth of women with advanced pregnancy were the gestational weeks,age and degree of education.In the future,personalized intervention strategies should be developed based on the factors influencing preparation for childbirth and the stage characteristics of women with advanced pregnancy to improve the level of preparation for childbirth.