Validation of a scale to measure the workload of midwives

García, Lorena Gómez; Valcarcel, Maria Dolores Roldan; Llor, Ana Myriam Seva; Gil, Maria Fuensanta Hellín; Merino, Guadalupe Ruiz; Guerrero, Francisco Javier Navarro; Cano, Esperanza De La Iglesia

doi:10.37689/acta-ape/2024AO00026322

Acessibilidade / Reportar erro

Brasil

Acta Paulista de Enfermagem

Español English

Brasil

Español English

sumário « anterior atual seguinte »

Sumário

Original Article • Acta Paul Enferm 37 • 2024 • https://doi.org/10.37689/acta-ape/2024AO00026322 copy

Validation of a scale to measure the workload of midwives

Authorship SCIMAGO INSTITUTIONS RANKINGS

Abstract

Objective

To validate the design of a scale to measure the workload of the midwives based on Classification of Nursing Interventions (NIC), through their multicentric application in different delivery units.

Methods

Quantitative, longitudinal, study multicentric character, conducted in three general university hospitals of the public system of health. The sample consisted of fifty midwives, who examined the validity of the construct of the designed scale, for a total of 370 births. Data collection began through the scale designed ad hoc by the research team, accounting for the time and average number of NIC interventions, performed at each birth.

Results

The midwives of the study, are subject to an increase in their workload regarding the number and average time spent conducting interventions NIC in each attended delivery. In their working day (12-hour shift) they allocate 960.61 minutes (16 hours in day shift) and 840.29 minutes (14 hours in night shift), to execute their roles in childbirth attendance.

Conclusion

The data indicate the validity of the scale designed ad hoc, as this instrument reflects the actual workload experienced by the midwives of the study.

Midwifery; Labor obstetric; Workloads; Standardized nursing terminology; Personnel management

Ítems	Day Shift			Night Shift
Ítems	Average number of NIC intervention		Half Times (minutes)	Average number of NIC intervention		Half Times (minutes)
Self-care	6.08		18.87	5.53		16.25
Prevention	10.52		10.52	9.35		9.35
General medication	4.29		17.15	3.45		13.94
Epidural medication	2.14		6.42	1.97		5.87
Sample	1.22		2.44	1.16		2.30
Health Education (HE)	11.53		137.92	10.40		123.71
HE lactation	2.37		28.44	2.47		30.11
Deletion	2.14		4.32	2.00		3.98
Invasive procedures natural	1.78		9.08	1.57		7.75
Wounds	1.03		14.38	1.08		14.18
Maternal monitoring	4.07		8.19	3.72		7.48
Fetal monitoring	5.00		294.04	4.19		252.23
Position	5.70		5.70	4.87		4.87
Comfort	3.79		3.79	3.48		3.48
Accompaniment	12.64		151.64	11.06		132.84
Patient support and care	2.78		130.03	2.63		123.83
Patient management	2.31		53.62	2.00		46.16
Unit management	3.59		21.27	3.07		18.43
Teaching	3.64		83.34	3.23		74.03
Research	1.00		23.80	1.00		23.00
Nutrition	2.50		28.80	2.25		27.00
Emergency	2.50		150.00	a		a
Alternatives to pain	2.27		27.20	5.00		60.00
Complex	a		a	a		a
Insulation	8.00		24.00	a		a
Instrumental	a		a	a		a
Breastfeeding	1.00		38.00	a		a

Midwife functions	Day shift		Night Shift		Full Day- Night Shift
Midwife functions	Average number of Nic	Half Times (minutes)	Average number of Nic	Half Times (minutes)	Average number of Nic	Half Times (minutes)
Hethcare function	72.98	822.16	63.86	725.78	78.06	887.64
Manage- ment function	5.70	73.84	4.98	63.47	6.13	79.21
Educational function	b	46.75	b	32.97	1.82	41.48
Research function	b	23.29	b	23.00	1.11	25.59
Total of the 4 functions.	80.41	960.61	70.01	840.29	87.34	1034.20

Variables		n Half Times (minutes)	Hethcare	Managemet	Educational	Research	Total^a
Variables		n Half Times (minutes)	Half Times (minutes)	Half Times (minutes)	Half Times (minutes)	Half Times (minutes)	Total^a
Hospital	A	20	818.85	87.45	9.20	29.90	945.40
	B	99	866.41	81.94	26.26	26.25	1001.36
	C	289	899.68	77.72	48.92	25.07	1051.60
	Total	408	887.64	79.21	41.48	25.59	1034.20
Work shift	Day	238	889.71	80.84	46.75	23.29	1041.11
	Night	120	822.23	72.28	32.97	23.00	950.06
	Day-Night	38	1064.79	88.74	40.58	41.76	1236.71
	Night- Day	12	940	86.42	24.92	46.00	1097.33
	Total	408	887.64	79.21	41.48	25.59	1034.20
Ethnicity	Spanish	317	902.38	80.16	42.64	25.83	1051.68
	Arab	66	802.45	73.91	26.88	24.39	927.59
	African	2	925.50	76.00	.00	23.00	1024.50
	South American	22	942.95	79.41	71.09	26.14	1113.77
	Eastern Europe	1	547.00	134.00	69.00	23.00	801.00
	Total	408	887.64	79.21	41.48	25.59	1034.20
Obstetric formula	Nullipara	188	894.63	80.53	49.51	25.45	1049.59
	Seconded	155	881.94	78.42	35.31	26.12	1022.54
	Multipara	65	881.05	77.28	32.95	24.77	1017.52
	Total	408	887.64	79.21	41.48	25.59	1034.20
Medical diagnostic	Active Labor	208	897.38	74.62	39.27	24.77	1036.64
	RPM	58	921.16	77.84	44.41	26.97	1071.97
	HTA	6	967.50	85.50	19.17	30.67	1102.83
	CIR	11	999.73	91.55	39.73	27.18	1158.18
	Diabetes	3	809.67	79.67	61.33	23.00	973.67
	Previous Placenta	1	1134.00	41.00	.00	23.00	1198.00
	Prolonged Pregnancy	75	956.57	80.89	44.77	26.37	1107.09
	Stillbirth	2	529.50	55.00	.00	23.00	607.50
	Cholestasis	2	1043.50	67.00	80.50	23.00	1214.00
	Previous Caesarean	9	488.56	95.00	38.33	23.00	644.78
	Podalic	23	539.26	105.09	31.00	24.00	698.39
	Altered amniotic fluid	5	1000.20	96.80	90.40	32.20	1220.80
	Chorioamnionitis	5	892.00	92.00	92.00	23.00	1099.00
	Twin	1	1064.33	89.33	46.00	38.33	1237.33
	Total	408	887.64	79.21	41.48	25.59	1034.20
Start of labor	Spontaneous	221	891.84	75.68	39.77	24.77	1032.74
	Induced	187	882.69	83.41	43.50	26.57	1035.94
	Total
Type of delibery	Eutocic	238	901.75	76.22	43.50	25.32	1047.07
	Dystocic	70	901.75	73.24	43.26	24.64	1104.41
	Caesarean section	99	803.08	91.19	34.39	26.95	955.42
	Total	407	888.20	79.32	41.24	25.60	1034.64

Dependent variables		I^a	J^b	Mean difference (I-J)	Significance
Hospital	Educational	A	C	-39.72	0.005
		B	C	-22.66	0.001
		C	A	39.72	0.005
		C	B	22.66	0.001
	Research	B	A	4.83	0.017
	Research	B	A	-4.83	0.017
Work shift	Hethcare	Day Shift	Night Shift	67.48	0.049
		Day Shift	Day-Night Shift	-175.08	0.00
		Night Shift	Day Shift	-67.48	0.049
			Day-Night Shift	-242.56	0.00
		Day-Night Shift	Day Shift	175.08	0.00
			Night Shift	242.56	0.00
	Management	Day Shift	Night Shift	8.56	0.030
		Night Shift	Day Shift	-8.56	0.30
			Day-Night Shift	-16.46	0.008
		Day-Night Shift	Night Shift	16.46	0.008
	Research	Day Shift	Day-Night Shift	-18.47	0.00
		Day Shift	Day-Night Shift	-22.71	0.00
		Night Shift	Day-Night Shift	-18.76	0.00
			Day-Night Shift	-23.00	0.00
		Day-Night Shift	Day Shift	18.47	0.00
			Night Shift	18.76	0.00
			Day-Night Shift	-4.23	0.10
		Day-Night Shift	Day Shift	22.71	0.00
			Night Shift	23.00	0.00
			Day-Night Shift	4.23	0.10
	Total (4 functions)	Day Shift	Night Shift	91.05	0.005
		Day Shift	Day-Night Shift	-195.59	0.00
		Night Shift	Day Shift	-91.05	0.005
			Day-Night Shift	-286.65	0.00
		Day-Night Shift	Day Shift	195.59	0.00
			Night Shift	286.65	0.00
Obstetric formula	Educational	Nullipara	Seconded	14.20	0.048
Obstetric formula	Educational	Seconded	Nullipara	-14.20	0.048
Type of delibery	Hethcare	Eutocic	Caesarean section	98.65	0.001
		Dystocic	Caesarean section	159.43	0.00
		Caesarean section	Eutocic	-98.65	0.001
			Dystocic	-159.43	0.00
	Management	Eutocic	Caesarean section	-14.97	0.00
		Dystocic	Caesarean section	-17.95	0.00
		Caesarean section	Eutocic	14.97	0.00
			Dystocic	17.95	0.00
	Total (4 functions)	Eutocic	Caesarean section	91.64	0.007
		Dystocic	Caesarean section	148.99	0.001
		Caesarean section	Eutocic	-91.64	0.007
			Dystocic	-148.99	0.001

Dependent variables				Comparative	Significance
Ethnicity			Hethcare	Intergroup-Intragroup^d	0.013
			Educational		0.015
			Total^c		0.003
Medical diagnostic			Hethcare	Intergroup-Intragroup^d	0.000
			Management		0.001
			Research		0.049
			Total^c		0.000
Start of labor			Hethcare	Intergroup-Intragroup^d	0.028
			Research		0.000
			Total^c		0.011

Escola Paulista de Enfermagem, Universidade Federal de São Paulo R. Napoleão de Barros, 754, 04024-002 São Paulo - SP/Brasil, Tel./Fax: (55 11) 5576 4430 - São Paulo - SP - Brazil
E-mail: actapaulista@unifesp.br

Acompanhe os números deste periódico no seu leitor de RSS

[1] Corresponding author: Lorena Gómez García E-mail: lorenagomez_20@hotmail.com