Abstract
Purpose
The purpose of this study was to clarify what information concerning intrapartal care midwives focus on, and to analyze the relationship between the data, years of experience and the number of assisted deliveries.
Methods
The subjects of this study were 768 midwives (553 who worked at hospitals or clinics, and 215 who worked at maternity homes) in Japan. Data were collected using a self-reported questionnaire. The questionnaire consisted of demographic information and 177 items regarding provision of care for normal delivery. We asked the midwives to rate the importance levels of the 177 items using the five-point Likert scale. Factor analysis was used to clarify the importance of the factors and two-way analysis of variance (ANOVA) was used to analyze the effects of the number of years of experience and number of assisted deliveries. The midwives were divided into groups based on whether they had more or less than ten years of experience following the "ten-year rule", and into those with less than 300 assisted deliveries and more than 300 assisted deliveries based on the mean of the group with less than 10 years of experience.
Results
The response rate was 56.9% (n=437). To conduct statistical analysis, appropriate data from 433 respondents were used. As a result of factor analysis, 17 factors composed of 82 items were extracted from the 177 items (cumulative percentage contribution: 67.9%). The 17 factors included data about various physiological and psychological aspects of women, requests for care, the family situation and birth environment. ANOVA revealed a statistically significant main effect for the number of years of experience. Comparing the mean importance-level scores of the 17 factors for those with more than ten years of experience and those with fewer, the more experienced group had significantly higher scores for 9 factors (p<0.01). These 9 factors included psychological condition, family situation, requests for care, timing of cutting the cord, protection of the perineum or not, and the lunar cycle in nature. The 8 factors for which there was no significant difference with years of experience included the physiological condition of women, data obtained using medical equipment and the environment in the labor room. No significant main effect was observed between any of the 17 factors and the number of assisted deliveries.
Conclusion
Seventeen selected factors provided an overall picture of the concrete information that midwives considered to be important to provide intrapartal care. Of these, 8 factors for which there was no significant difference related to the number of years of experience consisted of visual and objective information. The 9 factors for which there were significant differences reflected midwives' competency related to more than ten years of experience such as insight, communication and responding to diverse needs. It is suggested that these 9 factors indicate midwives' competency acquired through accumulation of more than ten years of experience.
