Tool validation

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The idea for research came as:
From my experience, in practice area, the health consumers (women) didn’t know or distinguished between midwife and nurse, so I decided to study this phenomena and the factors influencing it.
The issue to be discussed was: What factors influencing women attitudes toward midwifery as a profession and midwife as a professional. As a researcher, I followed research steps:
 
Firstly: I reviewed the current literature to find how the concept of ‘factors influencing women view and attitudes toward midwifery’ was used in the literature . The following terms were used: The concepts which exactly covered my search, and how the women view the midwives, what is the meaning of professional midwife were: ‘professionalism’, ‘attitudes’, ‘midwifery profession’, and ‘standards of midwifery care’.
 
The review revealed that all instruments had different scopes for the categories of professional care in midwifery practice and education. There was hardly any instrument providing a reliable and accurate measure that served the purpose of the study. So, my colleague DR Louranc & I decided to develop a new instrument. By this way I mastered the first step in developing the instrument and covered the content validity.
 
Secondly: Thematic analysis was performed.
Themes were examined, similar ones were collected into groups and categories were formulated. These groups were transformed next into statements reflecting their meanings each under its underlying general theme. A semi-structured questionnaire was developed to collect data on the themes from ten experts in midwifery practice. The questionnaire consisted of the following themes: women general view towards midwives' duties, professional ethics, media role, qualification of midwife, de-motivating professional factors.
They produced as many descriptions for each level and each category of the themes. These descriptions were then matched with the themes. We highlighted similarities, and discussed differences. 
 
Thirdly, the questionnaire was reviewed to evaluate their relevance by using a self-administered questionnaire submitted to 6 experienced midwives; their experience range was from 8-15 years. Relevance was validated using a 5-point scale; 0 indicated ‘not relevant/complete’; and 4 indicated ‘strongly relevant/complete’. No changes were introduced on the 43 items.
 
Fourthly, the questionnaire was pilot tested on 15 women; Cronbach’s alpha value was 0.92. This reliability estimate was encouraging. Women suggested some changes for greater clarity and 8 items were reworded and the results from analyzing these questionnaires were not included in the data analysis.
 
Statistical analysis
All data analyses were performed using SPSS version 19.
The central tendency and distribution of the scores were examined. The normality of distributions of the scores was tested using Kolmogorov-Smirnov goodness of fit statistic and the quantile- quantile probability plot (Q-Q plot). Exploratory factor analysis (EFA) using principal components was used on the original 43 items of the questionnaire represented by 6 factors. Item loadings greater or equal to the cut-off point of 0.40 were considered significant. The items that loaded significantly were 29 and 5 factors ( The internal consistency and reliability of the scale were calculated using Cronbach’s alpha, Guttman Split-Half and Spearman-Brown measures. All items in the questionnaire are exactly related to midwifery and midwives 'responsibilities & duties.
 
Article: Factors influencing women's attitudes towards midwifery: Tool validation Omaymah Al-Rajabi RN MSN Nurse and Midwife Educator, Lourance Al-Hadid RN PhD Assistant Professor and Maha Subih RN MSN Assistant Professor,
 
Article first published online: 17 DEC 2014 DOI: 10.1111/ijn.12320 © 2014 Wiley Publishing Asia Pty Ltd Issue
Omymah Alrajaby