Development and Validation of the Immediate Postpartum Care Adherence Questionnaire: An Application of the Theory of Planned Behavior among Healthcare Professionals
Abstract
Background: The postpartum period is critical for women and newborns. Many complications, such as deaths, are preventable by utilizing appropriate postpartum care. We aimed to assess healthcare professionals’ adherence to the World Health Organization’s (WHO) immediate postpartum care guidelines, investigating factors influencing their adoption at Jordanian hospitals.
Materials and Methods: A methodological study design, developing, and testing the psychometric properties of the Immediate Postpartum Care Adherence Questionnaire (IPCAQ) was created based on the Theory of Planned Behavior, extensive literature review, and the WHO guidelines following a manual construct questionnaire, and using a deductive method. The IPCAQ was developed using four steps: domain identification, scale construction, judgmental evidence, and psychometric evaluation.
Results: The final draft of IPCAQ consisted of four domains and 63 items deductively formulated from the theoretical constructs. The domains are attitudes, behavioral intention, subjective norms, and perceived behavioral control. They were subsumed by four subthemes, general caring assessment, counseling, subjective norms, and perceived behavioral control. The IPCA showed high content (0.94) and face validity indices (0.97), moderate content scale universal agreement (0.77), and excellent face agreement (0.81) for the 63 items. IPCAQ is a reliable instrument that measures adherence to immediate postpartum care guidelines.
Conclusions: IPCAQ is reliable and valid in the current sample. The IPCAQ can be used to assess healthcare professionals’ adherence to immediate postpartum care guidelines, identify factors influencing the adoption of standardized care to overcome barriers to adherence, and facilitate high‑quality care.
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World Health Organization. WHO recommendations: intrapartum care for a positive childbirth experience; 2018. Available from: https://www.who.int/reproductivehealth/publications/intrapartumcare- guidelines/en/. [Last accessed on 2022 Apr].
Sisay MM, Geremew TT, Demlie WY, Alem AT, Beyene DK, Melak MF, et al. Spatial patterns and determinants of postnatal care use in Ethiopia: findings from the 2016 demographic and health survey. BMJ Open 2019;9:e025066.
Benova L, Owolabi O, Radovich E, Wong K, Macleod D, Langlois EV, et al. Provision of postpartum care to women giving birth in health facilities in sub-Saharan Africa: A crosssectional study using Demographic and Health Survey data from 33 countries. PLoS Medicine 2019:16:e1002943.
Tsegaye B, Amare B, Reda M. Prevalence and Factors Associated with Immediate Postnatal Care Utilization in Ethiopia: Analysis of Ethiopian Demographic Health Survey 2016. International Journal of Women's Health. 2021;13:257-66.
World Health Organization. WHO recommendations on postnatal care of the mother and newborn. 2013. Available from: https:// www.who.int/reproductivehealth/publications/intrapartum-careguidelines/ en/. [Last accessed on 2022 Apr].
Miller S, Abalos E, Chamillard M, Ciapponi A, Colaci D, Comandé D, et al. Beyond too little, too late and too much, too soon: A pathway towards evidence-based, respectful maternity care worldwide. Series of Maternal Health 2016;2.
Fogel N. The inadequacies in postnatal health care. Current Medicine Research and Practice 2017;7:16-7.
De Groot N, Birnie E, Vermolen JH, Dorscheidt J, Bonsel GJ. The prevalence of adverse postnatal outcomes for mother and infant in the Netherlands. PloS One 2018;13:e0202960.
Obrochta CA, Chambers C, Bandoli G. Psychological distress in pregnancy and postpartum. Women and birth: journal of the Australian College of Midwives. 2020;33:583-91.
Elangovan N, Sundaravel E. Method of preparing a document for survey instrument validation by experts. MethodsX. 2021;8:101326. Published 2021. doi:10.1016/j.mex.2021.101326
Millogo T, AgbreYace ML, Kourouma RK, Yaméogo ME, Tano-Kamelan A, Sissoko FB, et al. Quality of maternal and newborn care in limited-resource settings: A facility-based crosssectional study in Burkina Faso and Côte d’Ivoire. BMJ Open 2020;10:e036121.
Pugliese-Garcia M, Radovich E, Campbell OMR, Hassanein N, Khalil K, Benova L. Childbirth care in Egypt: a repeat crosssectional analysis using Demographic and Health Surveys between 1995 and 2014 examining the use of care, provider mix and immediate postpartum care content. BMC Pregnancy Childbirth. 2020;20:46.
Institute of Medicine (US) Committee on Standards for Developing Trustworthy Clinical Practice Guidelines; Graham R, Mancher M, Miller Wolman D, Greenfield S, Steinberg E, editors. Clinical Practice Guidelines We Can Trust. Washington (DC): National Academies Press (US); 2011.
Davies P, Walker AE, Grimshaw JM. A systematic review of the use of theory in the design of guideline dissemination and implementation strategies and interpretation of the results of rigorous evaluations. Implementation Science 2010;5.
Légaré F, Borduas F, Freitas A, Jacques A, Godin G, Luconi F, et al. Development of a Simple 12-Item Theory-Based Instrument to Assess the Impact of Continuing Professional Development on Clinical Behavioral Intentions. PLoS ONE 2014;9:e91013.
Liang L, Bernhardsson S, Vernooij RW, Armstrong MJ, Bussières A, Brouwers MC, et al. Use of theory to plan or evaluate guideline implementation among physicians: a scoping review. Implementation Science 2017;12:26.
Alatawi SF. From theory to practice: a conceptual framework to facilitate implementation of evidence in stroke rehabilitation for local context in Saudi Arabia. Journal of Multidisciplinary Healthcare. 2019;12:515-25.
Salbach NM, MacKay-Lyons M, Solomon P, Howe JA, McDonald A, Bayley MT, et al. The role of theory to develop and evaluate a toolkit to increase clinical measurement and interpretation of walking speed and distance in adults poststroke. Disability and Rehabilitation 2021:1-17.
Jonas K, Reddy P, van den Borne B, Sewpaul R, Nyembezi A, Naidoo P, et al. Predictors of nurses’ and midwives’ intentions to provide maternal and child healthcare services to adolescents in South Africa. BMC health services research 2016;16:658.
Kortteisto T, Kaila M, Komulainen J, Mäntyranta T, Rissanen P. Healthcare professionals' intentions to use clinical guidelines: A survey using the theory of planned behavior. Implementation Sci 2010;5:51.
Ajzen I. From intention to actions: A theory of planned behavior. In J. Kuhl, & J. Beckman (Eds.), Action control: From cognition to behavior. New York: Springer-Verlag. 1985:pp. 11-39.
Ajzen I. The theory of planned behavior. Organ Behavior Human. 1991;50:179-211.
Zamanzadeh V, Rassouli M, Abbaszadeh A, AlaviMajd H, Nikanfar A, Ghahramanian A. Details of content validity and objectifying it in instrument development. NPT. 2014;1:163-71.
Moher D, Liberati A, Tetzlaff J, Altman DG, PRISMA Group. Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. PLoS Medicine. 2009;6:e1000097.
Francis J, Eccles KP, Johnston M, Walker AE, Grimshaw JM, Foy R, et al. Constructing questionnaires based on the theory of planned behavior: A manual for health services researchers. 2004, Newcastle upon Tyne, UK: Centre for Health Services Research, the University of Newcastle upon Tyne.
Jun J, Kovner CT, Stimpfel AW. Barriers and facilitators of nurses’ use of clinical practice guidelines: An integrative review. International Journal of Nursing studies. 2016;60:54-68.
Fischer F, Lange K, Klose K, Greiner W, Kr نmer A. Barriers and Strategies in Guideline Implementation—A Scoping Review. Healthcare 2016;4:36.
Correa VC, Lugo-Agudelo LH, Aguirre-AcevedoDC, Plata Contreras JA, Borrero AMP, Patioٌ-Lugo DF, et al. An individual, health system, and contextual barriers and facilitators for the implementation of clinical practice guidelines: a systematic metareview. Health Res Policy Sys 2020;18:74.
Almazrou SH, Alfaifi S, Alfaifi SH, Hakami SE, Al-Aqeel SA. Barriers to and Facilitators of Adherence to Clinical Practice Guidelines in the Middle East and North Africa Region: A Systematic Review. Healthcare 2020;8:564.
Cook DA, Beckman TJ. Current concepts in validity and reliability for psychometric instruments: theory and application. Am J Med 2006;119:166.7e-16.
Ardian N, Afshani SA, Morowatisharifabad MA, Mahmoodabad S, Vaezi AA, Refahi S, et al. Evaluating Reliability of Theory of Planned Behaviour Questionnaire for Withdrawal of Divorce Petition. Open Access Macedonian Journal of Medical Sciences 2018;6:1512-6.
Vakili MM, Jahangiri N. Content Validity and Reliability of the Measurement Tools in Educational, Behavioral, and Health Sciences Research. J Med Educ Dev 2018;10:105-17.
Tsang S, Royse CF, Terkawi AS. Guidelines for developing, translating, and validating a questionnaire in perioperative and pain medicine. Saudi Journal of Anaesthesia. 2017;11:80-9.
Yusoff MSB. ABC of response process validation and face validity index calculation. Education in Medicine Journal 2019;11:55-61.
Connell J, Carlton J, Grundy A, Taylor Buck E, Keetharuth AD, Ricketts T, et al. The importance of content and face validity in instrument development: lessons learned from service users when developing the Recovering Quality of Life measure (ReQoL). Quality of life research: An International Journal of Quality of Life Aspects of Treatment, Care and Rehabilitation2018;27:1893–1902.
Polit DF, Beck CT, Owen SV. Is the CVI an acceptable indicator of content validity? Appraisal and recommendations. Res Nurs Health. 2007;30:459–67.
Rodrigues IB, Jonathan D, Adachi A, Beattie KA, MacDermid JC. Development and validation of a new tool to measure the facilitators, barriers and preferences to exercise in people with osteoporosis. BMC Musculoskeletal Disorders. 2017;18:1-9.
Shi J, Mo X, Sun Z. Zhong nan da xuexue bao. Yi Xue ban (Journal of Central South University. Medical Sciences) 2012;37:152-5.
Frey B. The SAGE Encyclopedia of educational research, measurement, and Evaluation Thousand Oaks, CA: SAGE Publications, Inc. 2018;vols. 1-4.
Lawshe CH. A quantitative approach to content validity. Personnel Psychology 1975;28:563-75.
Taherdoost H. Validity and Reliability of the Research Instrument; How to Test the Validation of a Questionnaire/Survey in a Research. International Journal of Academic Research in Management. 2016;5:28-36.
Taber KS. The Use of Cronbach’s Alpha When Developing and Reporting Research Instruments in Science Education. Res SciEduc 2018;48:1273-96.
Hales D, Evenson KR, Wen F, Wilcox S. Postpartum physical activity: measuring theory of planned behavior constructs. American Journal of Health Behavior 2010;34:387-401.
Ghaffari M, Afshari A, Rakhshanderou S, Armoon B. Using the theory of planned behavior for prediction of delivery mode among pregnant women: theory-based cross-sectional research. International Journal of Adolescent Medicine and Health 2017;32.
Moshi FV, Kibusi SM, Fabian F. Using the theory of planned behavior to explain birth in health facility intention among expecting couples in a rural setting Rukwa Tanzania: a crosssectional survey. Reproductive Health. 2020;17:2.
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