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A New Tool to Measure Nurse Attitudes Toward Childbirth
RESEARCH Proceedings of the 2016 AWHONN Convention
Use of Peanut Labor Ball for Pelvic Positioning for Nulliparous Women Following Epidural Anesthesia Sarah J. Evans, BSN, RN, Good Objective Samaritan Hospital, Cincinnati, o evaluate the use of the peanut labor ball (PLB) OH
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Michelle M. Cremering, BSN, RNC-OB, Good Samaritan Hospital, Cincinnati, OH Keywords peanut labor ball cesarean birth rate quality improvement
Obstetric Poster Presentation
for nulliparous women after epidural analgesia in terms of length of labor and rates of cesarean birth, operative vaginal birth (using vacuum or forceps), and third- and fourth-degree laceration. Design Randomized controlled trial. Setting The labor and delivery unit at a large urban hospital the Midwest. Sample Nulliparous women who presented in labor or for induction at 37 0/7 to 41 6/7 weeks gestation: N ¼ 191, with 100 in the control group (CG) and 91 in the intervention group (IG). Methods Study participants were randomized to the IG (implemented the use of the PLB within 30
minutes after epidural placement) or the CG (received standard care for positioning using pillows and wedges) for the duration of the first stage of labor. Results When compared to the CG, participants in the IG experienced clinically significant lower cesarean (IG 23.1%, CG 31%), operative vaginal delivery (forceps use: IG 4.4%, CG 7%; vacuum use: IG 2.2%, CG 5%) and third- and fourth-degree laceration rates (IG 2.2%, CG 5%). While the differences are considered clinically significant, they were not statistically significant. We found no difference in length of labor (IG 36.7 minutes, CG 35.1 minutes). Conclusion/Implications for Nursing Practice Use of a PLB can improve patient outcomes by lowering rates of cesarean birth, operative birth, and third- and fourth-degree lacerations.
A New Tool to Measure Nurse Attitudes Toward Childbirth Martha S. Levine, PhD, RNCOB, C-EFM, University of Colorado Denver, Anschutz Medical Campus, Aurora, CO Keywords labor/delivery nurse attitudes and beliefs psychometrics
Obstetric Poster Presentation
Objective o measure nurse attitudes and beliefs about physiologic childbirth using the 42-item Nurse Attitudes and Beliefs QuestionnaireRevised (NABQ-R). Each item is scored with a 4point Likert scale from 1 (strongly disagree) to 4 (strongly agree); a higher total score indicates a more positive attitude toward physiologic childbirth.
T
Design Descriptive study. Setting Online electronic survey. Sample For this study, I evaluated the psychometric properties of the NABQ-R in a large national sample of labor and delivery nurses. An e-mail invitation containing a link to a secure electronic survey was sent to 4,000 randomly selected members of the Association of Women’s Health, Obstetric and Neonatal Nurses. The response rate was 11.1%, with complete surveys returned from 443 labor and delivery nurses with a mean age of 47.3 years (range 23 to 73 years) and 17.9
JOGNN 2016; Vol. 45, Supplement 3S
years of perinatal nursing experience (range 1 to 44 years). Methods The NABQ-R total attitude scores ranged from 84 to 153, with a mean of 121.3 and standard deviation of 11.29. The Cronbach’s alpha for the full 42-item scale was .88 with no improvement by deletion of any items. Test-retest reliability at one month was r ¼ .91 (p < .000). The validity of the NABQ-R was supported by a moderately strong correlation (r ¼ .58, p < .000) with the Intrapartum Nurse’s Beliefs Related to Birth Practice, a theoretically similar construct. Results These results support acceptable psychometric properties for the NABQ-R. Conclusion/Implications for Nursing Practice A theoretically and psychometrically sound instrument to measure nurse attitudes toward physiologic birth will enhance knowledge and understanding about how nursing care affects perinatal outcomes and may improve care for women and infants.
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Use of Peanut Labor Ball for Pelvic Positioning for Nulliparous Women Following Epidural Anesthesia Sarah J. Evans, BSN, RN, Good Objective Samaritan Hospital, Cincinnati, o evaluate the use of the peanut labor ball (PLB) OH
T
Michelle M. Cremering, BSN, RNC-OB, Good Samaritan Hospital, Cincinnati, OH Keywords peanut labor ball cesarean birth rate quality improvement
Obstetric Poster Presentation
for nulliparous women after epidural analgesia in terms of length of labor and rates of cesarean birth, operative vaginal birth (using vacuum or forceps), and third- and fourth-degree laceration. Design Randomized controlled trial. Setting The labor and delivery unit at a large urban hospital the Midwest. Sample Nulliparous women who presented in labor or for induction at 37 0/7 to 41 6/7 weeks gestation: N ¼ 191, with 100 in the control group (CG) and 91 in the intervention group (IG). Methods Study participants were randomized to the IG (implemented the use of the PLB within 30
minutes after epidural placement) or the CG (received standard care for positioning using pillows and wedges) for the duration of the first stage of labor. Results When compared to the CG, participants in the IG experienced clinically significant lower cesarean (IG 23.1%, CG 31%), operative vaginal delivery (forceps use: IG 4.4%, CG 7%; vacuum use: IG 2.2%, CG 5%) and third- and fourth-degree laceration rates (IG 2.2%, CG 5%). While the differences are considered clinically significant, they were not statistically significant. We found no difference in length of labor (IG 36.7 minutes, CG 35.1 minutes). Conclusion/Implications for Nursing Practice Use of a PLB can improve patient outcomes by lowering rates of cesarean birth, operative birth, and third- and fourth-degree lacerations.
A New Tool to Measure Nurse Attitudes Toward Childbirth Martha S. Levine, PhD, RNCOB, C-EFM, University of Colorado Denver, Anschutz Medical Campus, Aurora, CO Keywords labor/delivery nurse attitudes and beliefs psychometrics
Obstetric Poster Presentation
Objective o measure nurse attitudes and beliefs about physiologic childbirth using the 42-item Nurse Attitudes and Beliefs QuestionnaireRevised (NABQ-R). Each item is scored with a 4point Likert scale from 1 (strongly disagree) to 4 (strongly agree); a higher total score indicates a more positive attitude toward physiologic childbirth.
T
Design Descriptive study. Setting Online electronic survey. Sample For this study, I evaluated the psychometric properties of the NABQ-R in a large national sample of labor and delivery nurses. An e-mail invitation containing a link to a secure electronic survey was sent to 4,000 randomly selected members of the Association of Women’s Health, Obstetric and Neonatal Nurses. The response rate was 11.1%, with complete surveys returned from 443 labor and delivery nurses with a mean age of 47.3 years (range 23 to 73 years) and 17.9
JOGNN 2016; Vol. 45, Supplement 3S
years of perinatal nursing experience (range 1 to 44 years). Methods The NABQ-R total attitude scores ranged from 84 to 153, with a mean of 121.3 and standard deviation of 11.29. The Cronbach’s alpha for the full 42-item scale was .88 with no improvement by deletion of any items. Test-retest reliability at one month was r ¼ .91 (p < .000). The validity of the NABQ-R was supported by a moderately strong correlation (r ¼ .58, p < .000) with the Intrapartum Nurse’s Beliefs Related to Birth Practice, a theoretically similar construct. Results These results support acceptable psychometric properties for the NABQ-R. Conclusion/Implications for Nursing Practice A theoretically and psychometrically sound instrument to measure nurse attitudes toward physiologic birth will enhance knowledge and understanding about how nursing care affects perinatal outcomes and may improve care for women and infants.
S47