Questionnaire development: midwives' knowledge and attitude on liberal birthing position in 2nd stage

How to improve the women's childbirth experience and ensure mother and child safety has always been the goal of global healthcare professionals. Liberal birthing position referrs to woman can choose the position she is comfortable in for labor. Midwives play a vital role in the second stage of labor. Improving the use of liberal birthing position during the second stage of labor requires an assessment of midwives' attitudes and knowledge to identify gaps. However, there is a lack of relevant assessment tools.

Based on a Delphi expert consultation, the knowledge and attitude questionnaire for the second stage liberal birthing position was developed in conjunction with a literature review and clinical practice. Selection of midwives to participate in the questionnaire as a means of rating the reliability of the questionnaire. Internal reliability was assessed using Cronbach's alpha, the content validity of the scale was calculated by expert consultation, the internal consistency was evaluated by convergent validity tests, and the structural validity of the scale was evaluated by exploratory factor analysis.

The knowledge section of the questionnaire initially had 35 items with a S-CVI of 0.98 and an I-CVI of 0.89-1. After factor analysis, 4 metric factors were extracted, explaining 41.0% of the variance. Following rotation, the number of retained items was reduced to 28, with most factor loadings having a value greater than 0.5. Cronbach's alpha was calculated to be 0.890. The attitudes section of the questionnaire contained 19 items with a S-CVI of 0.93 and an I-CVI of 0.78-1. After conducting factor analysis, two metric factors were extracted, explaining 60.6% of the variance. All items had factor loadings greater than 0.5, and Cronbach's alpha was 0.879. The correlation coefficients of the questionnaire's convergent validity test between each entry and its corresponding dimension, as well as between items of the same dimension, were all greater than 0.3 or 0.7.

The evaluation indicated good validity and reliability. The questionnaire is a useful tool for assessing midwives' knowledge and attitudes toward liberal birthing position during the second stage of labor, and can assist educators in providing more targeted training.