Designing a Valid and Reliable Questionnaire for Evaluation of Professional Ethics of Midwives by Parturients
Authors: Zare Soolmaz , Faghihi Seyed Ali Akbar , Seif Samira , Hayat Ali Asghar 
Published: August 2021

Background: Pregnancy and childbirth are sensitive and particular periods in women’s lives. Midwives play an essential role in ensuring mother’s and fetus’s health by the recognition of the needs and complexities of this period. Midwives increase the quality of care, gain the trust of pregnant women, communicate more effectively with them, and increase their satisfaction and cooperation by following the ethical principles and standards that express their professional commitment to society. Therefore, the awareness of the principles of professional ethics and adherence to the Charter of Patients’ Rights is a critical element of the midwife’s success in ensuring mother’s and neonate’s health. Therefore, monitoring the observance of these principles by midwives, similar to other health care providers, is essential to improve the quality of services and ultimately parturients’ satisfaction. For this purpose, it is necessary to have a valid and reliable tool to assess midwives’ professional ethics status. Objectives: In this study, a questionnaire was developed to assess this issue by parturients, who are primary stakeholders in this process. Methods: This qualitative and quantitative study was performed to design a reliable and valid questionnaire evaluating midwives’ professional ethics by parturients. Based on the literature review and consultation with midwifery professors and staff, the initial questionnaire was prepared with 26 items. A survey of 15 experts evaluated the content and face validity ratio. The final questionnaire with 20 items was completed by 200 parturients hospitalized in Valiasr Hospital of Fasa University of Medical Sciences, Fars, Iran, within 2018 - 2019. Exploratory factor analysis (EFA) and confirmatory factor analysis (CFA) assessed the construct validity. The reliability was confirmed by the determination of internal consistency. Results: The 26 items of the questionnaire defined in the first step were reduced to 20 items with a content validity ratio higher than 0.49 and a content validity index higher than 0.79. Using EFA and CFA, 20 items were included in two dimensions and confirmed. Its reliability was reported as 0.89 using Cronbach’s alpha. Conclusions: This study aimed to design a valid and reliable questionnaire for the assessment of midwifery professional ethics in the delivery process. One strength of the present study, compared to those of mentioned studies, is performing both EFA and CFA. In this study, some goals of EFA consist of determining questionnaire dimensions, standardizing questionnaires, reducing the items (from variables to factors), and assessing homogeneity and discrimination in construct validity. The EFA is often used in the early stages of research to collect information about the interactions in a set of variables. The obtained results revealed that the designed questionnaire is a valid and reliable tool for the evaluation of midwifery professional ethics by parturients, which can be applied in other studies in Iran.