Evaluation of changes in postnatal care using the "Parents' Postnatal Sense of Security" instrument and an assessment of the instrument's reliability and validity.

Linda J Kvist,Eva K Persson

doi:10.1186/1471-2393-9-35

Linda J Kvist, Eva K Persson

Open Access

https://doi.org/10.1186/1471-2393-9-35

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Abstract

BackgroundA sense of security is important for experiences of parenthood in the early postpartum period. The objectives of this study were to evaluate two models of postnatal care using a questionnaire incorporating the Parents' Postpartum Sense of Security (PPSS) instrument and to test the validity of the PPSS instrument.MethodsPostal surveys were sent to 234 mothers who had experienced two different forms of postnatal care (study group and control group) and returned by 86.8%. These two groups of mothers were compared for total scores on the PPSS instrument. Demographic variables and mothers' opinions about care interventions were also compared and these variables were tested for correlations with the total PPSS score. A regression analysis was carried out to assess areas of midwifery care which might affect a sense of security. The internal consistency and concurrent validity of the instrument were tested for the total population.Resultsthere were no significant differences between the groups for scores on the PPSS instrument. A total of three variables predicted 26% of the variability on the PPSS scores for the study group and five variables predicted 37% of the variability in the control group. One variable was common to both: "The midwives on the postnatal ward paid attention to the mother as an individual". There were significant correlations between the total PPSS scores and scores for postpartum talks and visits to the breastfeeding clinic. There was also a significant correlation between the single question: "I felt secure during the first postpartum week" and the total PPSS score. Tests for internal consistency and concurrent validity were satisfactory.ConclusionThe proposed new model of care neither improved nor impaired mothers' feelings of security the week following birth. Being seen as an individual by the midwife who provides postnatal care may be an important variable for mothers' sense of postnatal security. It is possible that postpartum talks may encourage the processing of childbirth experiences in a positive direction. Availability of breastfeeding support may also add to a sense of security postpartum. The PPSS instrument has shown acceptable reliability and validity.

Highlights

A sense of security is important for experiences of parenthood in the early postpartum period
Mothers who experienced the new model of care are referred to as the study group and mothers who did not experience the new model of care are the control group
There were no differences between study and control groups for numbers cared for on the two hospital wards before discharge but there was a difference in the number of mothers who chose discharge direct from the delivery suite (6 hours postpartum); 12 in the study group and 1 in the control group (p < 0.01)

Summary

Introduction

A sense of security is important for experiences of parenthood in the early postpartum period. The objectives of this study were to evaluate two models of postnatal care using a questionnaire incorporating the Parents' Postpartum Sense of Security (PPSS) instrument and to test the validity of the PPSS instrument. Studies show that mothers' and fathers' experiences during the childbirth period influence the child and their own subsequent well-being [3,4,5]. Earlier Swedish research into factors which influence choice and experiences of early discharge after childbirth has indicated the importance of a sense of security for the individual's experience of parenthood in the early postpartum period [7,8,9]

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