分娩介助実習における助産師の教授活動尺度の開発と信頼性・妥当性の検討

Development of a Scale to Evaluate Skilled Birth Attendance Supervision by Midwives and Its Reliability/Validity

要旨

目的：分娩介助実習における助産師の教授活動尺度を開発し，信頼性と妥当性の検討を目的とする．

方法：半構造化面接法で得られたデータを基に，79項目の分娩介助実習における助産師の教授活動尺度原案を作成した．分娩を扱う全国医療機関501施設に所属する3,988人を対象に調査を行い，項目の信頼性分析，探索的因子分析の後，併存尺度による基準関連妥当性を検討した．

結果：回収数906人，有効回答数は875人であった．7因子52項目が採択され，【分娩進行に伴う診断ができるよう思考を促す】【安全・安楽な分娩と学生の学びを同時に保証する】【バースレビューの関わり方を伝える】【産婦の気持ちに沿うよう促す】【学生の自立を促す】【児娩出時は手に手を添える】【準備の極意を伝える】と命名された．Cronbach's α係数は .960であり内的整合性が確認された．また助産師の専門職的自律性尺度，看護職の職業認識尺度との相関から基準関連妥当性が確認された．

Objectives: A scale was developed to evaluate supervision by midwives during skilled birth attendance training, and its reliability and validity were examined.

Methods: Based on the data obtained through semi-structured interviews, a draft consisting of 79 items was created. To examine this, a survey was conducted, involving 3,988 individuals who belonged to 501 medical institutions providing maternity services throughout Japan. After reliability and exploratory factor analyses of each item, the criterion-related validity was examined in relation to existing scales.

Results: Out of a total of 906 responses, valid responses were obtained from 875 participants. Consequently, 56 items of 7 factors were adopted, each of the latter was named as follows: [Leading students to develop thoughts as a basis for appropriate diagnosis during delivery] [Ensuring both safe and comfortable delivery and sufficient learning opportunities for students] [Providing guidance on birth reviews] [Leading students to consider parturient females' emotions] [Leading students to adopt appropriate actions independently] [Put instructor's hands on the student's hands at birth] [Confirming important points of preparation]. The internal consistency of the developed scale was sufficient, with Cronbach's α of .960. Its criterion-related validity was also regarded as sufficient, as it was correlated with the Professional Autonomy in Midwifery, in addition to a scale to measure occupational recognition among nurses.