Labor support: Nurses' self-efficacy and views about factors influencing implementation

Objective: To develop and evaluate a questionnaire assessing nurses' self-efficacy for labor support and to describe nurses' perceptions of factors assisting and preventing the provision of labor support. Design: Two surveys completed by participants. Setting: Five, Canadian hospitals. Participants: For Phase 1, 81% (55/68) of maternity nurses at one hospital participated; for Phase 2, 88% (152/173) of labor and delivery (L&D) nurses at four hospitals participated. Main Outcomes: Phase 1, psychometric properties of a new scale; Phase 2, nurses' self-efficacy for labor support and content analysis of nurses' comments. Results: Phase 1: The Cronbach's alpha coefficient of the self-efficacy scale was .98, with a test-retest correlation of r(s) = .93. Higher (more positive) self-efficacy scores were found for L&D nurses compared with postpartum nurses, p < .0001. Phase 2: Mean self-efficacy scores for L&D nurses were high (range 86.9 to 92.1 out of 98). Written comments (n = 304) about the influencing factors in each work setting were coded into the following categories: staffing, physical environment, teamwork, management support, and negative staff attitudes. Conclusions: Phase 1 provided beginning evidence of the reliability and validity of the Self-Efficacy Labor Support Scale. Phase 2 found that L&D nurses' self-efficacy or confidence to provide labor support was high. Therefore, it is recommended that future attention needs to be focused on factors related to the provision of labor support (staffing, physical environment, teamwork,, management support, and negative staff attitudes). Attention to organizational factors is vital if nurses are-the professional group to provide the evidence-based practice of continuous support for women in labor.