Volume 16, Issue 11 (February 2023)
Qom Univ Med Sci J 2023, 16(11): 902-913 |
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Research code: A-10-2726-1
Ethics code: IR.MUQ.REC.1399.302
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Toosi H, Gharlipour Z, Eskandari N, Mohammadbeigi A. Development and Validation of a Questionnaire for Measuring Maternal, Nutritional, and Infant-Related Attitudes and Behaviours of Iranian Mothers in the Postpartum Period. Qom Univ Med Sci J 2023; 16 (11) :902-913
URL: http://journal.muq.ac.ir/article-1-3597-en.html
URL: http://journal.muq.ac.ir/article-1-3597-en.html
1- Department of Health Education and Health Promotion, School of Health, Qom University of Medical Sciences, Qom, Iran.
2- Department of Health Education and Health Promotion, School of Health, Qom University of Medical Sciences, Qom, Iran. ,gharlipourz@yahoo.com
3- Department of Midwifery, School of Medicine, Qom University of Medical Sciences, Qom, Iran.
4- Department of Biostatistics and Epidemiology, School of Health, Qom University of Medical Sciences, Qom, Iran.
2- Department of Health Education and Health Promotion, School of Health, Qom University of Medical Sciences, Qom, Iran. ,
3- Department of Midwifery, School of Medicine, Qom University of Medical Sciences, Qom, Iran.
4- Department of Biostatistics and Epidemiology, School of Health, Qom University of Medical Sciences, Qom, Iran.
Keywords: Social validity, Research, Reliability, Psychometrics, Postpartum Period, Attitude, Behavior
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Introduction
According to the report of the World Health Organization (WHO), 8 million maternal deaths occur annually in the perinatal period, 98% of which are seen in developing countries. In addition, 4 million newborns die within the first four weeks every year, 75% of which occur during the first week of life. The prevalence of stillbirth in Iran is 9.19 per 1000 live births. Different factors can affect the health of the mother and the fetus [1]. At the end of pregnancy period and the last weeks of pregnancy up to 42 days after delivery, more risk factors threaten the mother and the fetus [2]. The postpartum period refers to the first six weeks following childbirth [3]. The health behaviors of mothers during pregnancy and in the postpartum period are largely influenced by their attitude towards health standards [4]. Health attitudes and beliefs have a direct impact on individual and social health care [5]. They can act as a barrier to receiving specialized health care [6]. Health education is one of the most efficient methods of intervention to change health attitudes and behaviors for promoting or maintaining health [7].
It is currently agreed upon by all experts that the contents of an instrument should be directly approved by the people under study [8]. The instruments should be easy to use and have acceptable validity and reliability [9, 10]. To our knowledge, there is no valid questionnaire for measuring Iranian mothers’ health attitudes and behaviors in the postpartum period. Therefore, the present study aims to develop and determine the psychometric properties of the questionnaire of maternal, nutritional, and infant-related attitudes and behaviors in the postpartum period.
Method
This study is a qualitative-quantitative study. Based on previous studies [11, 12], 200 pregnant women were randomly (using lottery) selected from health centers in Qom, Iran based on the inclusion criteria. If some mothers did not want to participate in the study, they were replaced by new eligible samples. To design the questionnaire, first, the questions were formulated based on literature [13, 14, 15] and according to the opinions of the faculty professors. Then, their psychometric properties were assessed.
Results
In the validity assessment phase, four questions were removed based on the opinions of 10 experts, and the rest were confirmed in terms of content validity. The final draft of the questionnaire consisted of 56 items and 6 subscales including: general health behaviors (5 items), maternal behaviors (6 items), nutritional behaviors (7 items), infant-related behaviors (9 items), health attitudes (11 items), and standard health practices (18 items). Cronbach’s alpha for the overall questionnaire was obtained 0.84, and the Pearson correlation coefficient for the test-retest reliability was obtained 0.86.
Discussion
The results of this study showed acceptable validity, reliability, and factor structure of the designed tool for measuring Iranian mothers’ health attitudes and behaviors during the postpartum period. It can be used in similar and related studies in Iran.
Ethical Considerations
Compliance with ethical guidelines
Ethical points include the principles of trustworthiness in the use of resources, compliance with ethical principles, coordination and presentation of an introduction letter to the place of research, obtaining written informed consent, not forcing people to participate in the study, and assuring the participants of the confidentiality of information in all stages of the research. became. This article with code IR.MUQ.REC.1399.302 is from Qom University of Medical Sciences.
Funding
This article is taken from the master's thesis of Houra Toosi in the field of health education and health promotion, Faculty of Health, Qom University of Medical Sciences and Health Services and did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.
Authors contributions
All authors contributed equally in preparing all parts of the research.
Conflicts of interest
The authors declared no conflict of interest.
Acknowledgements
The authors would like to thank Zabihollah Qarlipour, Narges Eskandari, Abolfazl Mohammad Beigi and all pregnant mothers participated in this study.
According to the report of the World Health Organization (WHO), 8 million maternal deaths occur annually in the perinatal period, 98% of which are seen in developing countries. In addition, 4 million newborns die within the first four weeks every year, 75% of which occur during the first week of life. The prevalence of stillbirth in Iran is 9.19 per 1000 live births. Different factors can affect the health of the mother and the fetus [1]. At the end of pregnancy period and the last weeks of pregnancy up to 42 days after delivery, more risk factors threaten the mother and the fetus [2]. The postpartum period refers to the first six weeks following childbirth [3]. The health behaviors of mothers during pregnancy and in the postpartum period are largely influenced by their attitude towards health standards [4]. Health attitudes and beliefs have a direct impact on individual and social health care [5]. They can act as a barrier to receiving specialized health care [6]. Health education is one of the most efficient methods of intervention to change health attitudes and behaviors for promoting or maintaining health [7].
It is currently agreed upon by all experts that the contents of an instrument should be directly approved by the people under study [8]. The instruments should be easy to use and have acceptable validity and reliability [9, 10]. To our knowledge, there is no valid questionnaire for measuring Iranian mothers’ health attitudes and behaviors in the postpartum period. Therefore, the present study aims to develop and determine the psychometric properties of the questionnaire of maternal, nutritional, and infant-related attitudes and behaviors in the postpartum period.
Method
This study is a qualitative-quantitative study. Based on previous studies [11, 12], 200 pregnant women were randomly (using lottery) selected from health centers in Qom, Iran based on the inclusion criteria. If some mothers did not want to participate in the study, they were replaced by new eligible samples. To design the questionnaire, first, the questions were formulated based on literature [13, 14, 15] and according to the opinions of the faculty professors. Then, their psychometric properties were assessed.
Results
In the validity assessment phase, four questions were removed based on the opinions of 10 experts, and the rest were confirmed in terms of content validity. The final draft of the questionnaire consisted of 56 items and 6 subscales including: general health behaviors (5 items), maternal behaviors (6 items), nutritional behaviors (7 items), infant-related behaviors (9 items), health attitudes (11 items), and standard health practices (18 items). Cronbach’s alpha for the overall questionnaire was obtained 0.84, and the Pearson correlation coefficient for the test-retest reliability was obtained 0.86.
Discussion
The results of this study showed acceptable validity, reliability, and factor structure of the designed tool for measuring Iranian mothers’ health attitudes and behaviors during the postpartum period. It can be used in similar and related studies in Iran.
Ethical Considerations
Compliance with ethical guidelines
Ethical points include the principles of trustworthiness in the use of resources, compliance with ethical principles, coordination and presentation of an introduction letter to the place of research, obtaining written informed consent, not forcing people to participate in the study, and assuring the participants of the confidentiality of information in all stages of the research. became. This article with code IR.MUQ.REC.1399.302 is from Qom University of Medical Sciences.
Funding
This article is taken from the master's thesis of Houra Toosi in the field of health education and health promotion, Faculty of Health, Qom University of Medical Sciences and Health Services and did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.
Authors contributions
All authors contributed equally in preparing all parts of the research.
Conflicts of interest
The authors declared no conflict of interest.
Acknowledgements
The authors would like to thank Zabihollah Qarlipour, Narges Eskandari, Abolfazl Mohammad Beigi and all pregnant mothers participated in this study.
Type of Study: Original Article |
Subject:
آموزش بهداشت
Received: 2022/10/21 | Accepted: 2022/12/17 | Published: 2023/01/30
Received: 2022/10/21 | Accepted: 2022/12/17 | Published: 2023/01/30
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