Good practices in normal childbirth: reliability analysis of an instrument by Cronbach’s Alpha

Gottems, Leila Bernarda Donato; Carvalho, Elisabete Mesquita Peres De; Guilhem, Dirce; Pires, Maria Raquel Gomes Maia

doi:10.1590/1518-8345.2234.3000

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Revista Latino-Americana de Enfermagem

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Original Articles • Rev. Latino-Am. Enfermagem 26 • 2018 • https://doi.org/10.1590/1518-8345.2234.3000 copy

Good practices in normal childbirth: reliability analysis of an instrument by Cronbach’s Alpha¹ 1 FUNDAÇÃO DE APOIO A PESQUISA DO DISTRITO FEDERAL Processo nº 193.000.175-2013.

Authorship SCIMAGO INSTITUTIONS RANKINGS

ABSTRACT

Objectives:

to analyze the internal consistency of the evaluation instrument of the adherence to the good practices of childbirth and birth care in the professionals, through Cronbach’s Alpha Coefficient for each of the dimensions and for the total instrument.

Method:

this is a descriptive and cross-sectional study performed in obstetric centers of eleven public hospitals in the Federal District, with a questionnaire applied to 261 professionals who worked in the delivery care.

Results:

The study was attended by 261 professionals, 42.5% (111) nurses and 57.5% (150) physicians. The reliability evaluation of the instrument by the Cronbach Alfa resulted in 0.53, 0.78 and 0.76 for dimensions 1, 2 and 3, after debugging that resulted in the exclusion of 11 items.

Conclusions:

the instrument obtained Cronbach’s alpha of 0.80. There is a need for improvement in the items of dimension 1 that refer to attitudes, knowledge, and practices of the organization of the network of care to gestation, childbirth, and birth. However, it can be applied in the way it is used to evaluate practices based on scientific evidence of childbirth care.

Descriptors:
Validation Studies; Data Accuracy; Statistical Analysis; Perinatal Care; Health Evaluation; Humanizing Delivery

Escola de Enfermagem de Ribeirão Preto / Universidade de São Paulo Av. Bandeirantes, 3900, 14040-902 Ribeirão Preto SP Brazil, Tel.: +55 (16) 3315-3451 / 3315-4407 - Ribeirão Preto - SP - Brazil
E-mail: rlae@eerp.usp.br

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[1] Corresponding Author: Leila Bernarda Donato Gottems Escola Superior de Ciencias da Saude/Fundação de Ensino e Pesquisa em Ciencias Da Saude Programa de Pos Graduação Stricto Senso em Ciencias para a Saude Setor Médico Hospitalar Norte Conjunto A, Bloco 01, Edifício Fepecs Bairro: Plano Piloto, Asa Norte CEP:70710-907, Brasilia, DF, Brasil E-mail: leila.gottems@gmail.com

Variable	M*	SD^†	Correlation item-total	α Cronbach if excluded
V1 - I do not know the area of coverage of this service of delivery and birth.	82.85	30.39	0.04	0.51
V2 - I got a bed in another care unit when there was no vacancy in this service.	64.08	35.97	0.16	0.48
V3 - I get pregnant to know the place of birth, routinely.	52.11	38.67	0.32	0.43
V4 - Educational activities are carried out with the pregnant women and partners to favor the attachment to maternity when the previous visit.	54.69	38.47	0.38	0.41
V5 - We usually treat more parturients than the number of beds.	12.36	25.25	0.25	0.46
V6 - The staff is insufficient for the number of parturients attended daily.	17.24	30.38	0.28	0.45
V7 - We receive pregnant women without the individual birth plan done during prenatal care.	13.79	27.23	0.05	0.5
V8 - In general, we received the women without the results of the prenatal risk screening tests.	32.18	32.87	0.18	0.47
V9 - We can easily contact the prenatal team of primary care and/or the high-risk clinic when needed.	31.70	33.73	0.12	0.49
V10 - I participate in meetings with prenatal teams to discuss improvements in gestation, delivery and birth care.	26.92	35.51	0.13	0.49
V11 - When we need support, diagnosis and therapeutic procedures that are not available, we have difficulties in getting other services.	21.36	30.48	0.19	0.47
V12 - Access to information made by the other health units is facilitated by the electronic medical record.	66.38	33.86	0.14	0.48

Variable	M*	SD^†	Correlation item-total	α Cronbach if excluded
V13 - Normal delivery is performed in PPP^‡ beds at this service.	84.96	29.52	0.19	0.74
V14 - I restrict the fluid intake and food intake of the parturient during the TP^§, routinely.	64.56	35.47	0.32	0.73
V15 - I use curtains and/or screens to preserve the parturient’s privacy in the prenatal group.	78.07	33.97	0.3	0.73
V16 - I encourage the presence of free choice partner of the parturient.	78.26	33.17	0.32	0.73
V17 - I recognize that the partner hinders the woman´s care.	65.90	35.64	0.34	0.73
V18 - The partner is rarely informed about the condition of the parturient.	75.29	32.78	0.21	0.74
V19 - Guidance on ways of relaxation for pain relief during TP^§ and childbirth.	85.06	24.26	0.39	0.73
V20 - I stimulate the ambulation of pregnant women during TP^§.	93.39	16.02	0.36	0.73
V21 - I use non-pharmacological methods for pain relief, such as massage and relaxation techniques.	67.82	33.95	0.42	0.72
V22 - I encourage the freedom of the woman’s position during the TP^§ and childbirth.	81.90	26.41	0.45	0.72
V23 - In the active phase of the TP^§, I undergo heart rate auscultation every 30 min, routinely.	70.40	30.90	0.36	0.73
V24 - I use a deliverygraph to follow the TP^§.	50.00	39.65	0.44	0.72
V25 - I offer information to the parturient on the TP^§.	90.13	21.28	0.36	0.73
V26 - I promote skin-to-skin contact between mother and child within the first half hour after childbirth.	91.19	19.21	0.32	0.73
V27 - The enema is routinely done in preparation for childbirth.	96.26	13.97	0.12	0.74
V28 - The trichotomy is performed routinely in this service.	88.98	25.59	0.22	0.74
V29 - Intravenous hydration is used during the TP^§ and childbirth.	35.92	31.17	0.36	0.73
V30 - Intravenous oxytocin is used to TP^§.	31.13	26.14	0.37	0.73
V31 - I encourage the parturient to push at the time of the expulsion of the fetus.	19.64	29.33	0.43	0.72
V32 - A routine episiotomy is performed in this service.	54.89	34.43	0.29	0.73
V33 - It is avoided to perform vaginal touches by more than one professional.	56.13	36.50	-0.12	0.77
V34 - I perform Kristeller´s maneuver when necessary.	54.21	38.75	0.43	0.72
V35 - Early amniotomy is rarely performed in this service.	66.57	34.12	-0.03	0.76

Variable	M*	SD^†	Correlation item-total	α Cronbach if excluded
V36 - I follow the recommendations of the Ministry of Health the childbirth and birth care.	86.21	18.38	0.28	0.61
V37 - Parturients are informed before the interventions that accelerate the TP^‡.	80.46	28.19	0.49	0.57
V38 - In this service, clinical decisions are shared with the on-call staff.	71.84	33.57	0.63	0.54
V39 - Each professional attends the delivery according to their experience.	26.25	30.32	-0.14	0.66
V40 - I discuss the scientific evidence on childbirth and birth care with my team.	71.07	31.26	0.40	0.58
V41 - I feel out of date with the scientific evidence.	66.86	36.27	0.29	0.60
V42 - Doctors and nurses work in an integrated way in this service.	62.36	33.51	0.42	0.58
V43 - Here normal labor is stimulated by the multi-professional team.	79.12	26.94	0.50	0.57
V44 - I assist low-risk childbirth similar to high-risk childbirth.	58.81	37.65	-0.30	0.70
V45 - In this service, the professionals are trained periodically.	47.99	32.05	0.45	0.57
V46 - Here patients´ satisfaction surveys are carried out.	25.77	28.58	0.37	0.59
V47 - I record information about care at childbirth and birth only in the electronic medical record.	67.53	37.17	0.12	0.63
V48 - I rarely consult the information about prenatal care registered on the pregnant woman’s record.	92.62	21.27	0.11	0.62
V49 - The training offerings for the professionals of this team are rare.	30.27	33.30	0.17	0.62
V50 - Nursing care is restricted to some shifts (scarce).	31.99	35.58	0.23	0.61

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Good practices in normal childbirth: reliability analysis of an instrument by Cronbach’s Alpha1 1 FUNDAÇÃO DE APOIO A PESQUISA DO DISTRITO FEDERAL Processo nº 193.000.175-2013.

ABSTRACT

Objectives:

Method:

Results:

Conclusions:

Good practices in normal childbirth: reliability analysis of an instrument by Cronbach’s Alpha¹ 1 FUNDAÇÃO DE APOIO A PESQUISA DO DISTRITO FEDERAL Processo nº 193.000.175-2013.