Abstract
BackgroundCardiac arrest is rare in pregnancy, and up-to date competence can be difficult to assess and maintain. The objective of this study was to develop and validate a questionnaire to assess healthcare personnel experiences, self-assessed competence and perception of role and resposibility related to cardiac arrest and cardio-pulmonary resuscitation (CPR) in pregnancyMethodsThe study had a cross-sectional design, developing and validating a questionnaire: the Competence in cardiac arrest and CPR in pregnancy (ComCA-P). Development and validation of the ComCA-P was conducted in three stages: 1) Literature review and expert group panel inputs, 2) a pilot study and 3) a cross-sectional questionnaire study. In stage one, the ComCA-P was developed over several iterations between the researchers, including inputs from an expert group panel consisting of highly competent professionals (n = 11). In stage two, the questionnaire was piloted in a group of healthcare personnel with relevant competence (n = 16). The ComCA-P was then used in a baseline study including healthcare personnel potentially involved in CPR in pregnancy (n = 527) in six hospital wards. Based on these data, internal consistency, intra-class correlations, and confirmatory factor analysis were utilized to validate the questionnaire.ResultsThe expert group and pilot study participants evaluated the appropriateness, relevance and accuracy to be high. Formulation of the items was considered appropriate, with no difficulties identified related to content- or face validity. Cronbach’s alpha was 0.8 on the thematic area self-assessment, and 0.73 on the theoretical knowledge area of the ComCA-P. On both the self-assessed competence items and the teoretical knowledge items, Kaiser-Meyer-Olkin was 0.8. Moreover, the Bertletts’ test of sphericity was greater than the critical value for chi-square, and significant (p < .0001).ConclusionsFindings indicate that the ComCA-P is a valid questionnaire that can be used to assess healthcare personnel competence in cardiac arrest and resuscitation in pregnancy.
Highlights
In Norway, cardiac arrest and deaths in pregnancy is a rare incident, and the maternal mortality rate in 2015 was 5 in 100,000 pregnancies [1]
Findings indicate that the Competence in Cardiac Arrest in Pregnancy (ComCA-P) is a valid questionnaire that can be used to assess healthcare personnel competence in cardiac arrest and resuscitation in pregnancy
A sketch of 37 items in the ComCA-P was developed by the researchers based on earlier guidelines and research, as well as the earlier non-validated questionnaires: Fourteen of the items in the ComCA-P were developed based on contents and findings from two previously used questionnaires: 1. The Einav questionnaire, which include field of expertise and resuscitation experience, a single case vignette of maternal cardiac arrest, followed by nine questions to examine knowledge of existing recommendations for maternal cardiopulmonary resuscitation [24], and
Summary
In Norway, cardiac arrest and deaths in pregnancy is a rare incident, and the maternal mortality rate in 2015 was 5 in 100,000 pregnancies [1]. At 20 weeks pregnancy (or when the uterus reach umbilicus level), the uterus can lead to aortacaval compression syndrome in patients lying on their back, which results in decreased venous return to the heart. This subsequently limits blood flow to the placenta, and may result in increased morbidity and mortality in both mother and fetus [7]. Emptying the uterus may lead to ROSC, and increase survival rate of the fetus [9,10,11], dependent on where the cardiac arrest occur [12, 13]. The objective of this study was to develop and validate a questionnaire to assess healthcare personnel experiences, self-assessed competence and perception of role and resposibility related to cardiac arrest and cardio-pulmonary resuscitation (CPR) in pregnancy
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