The development and testing of an algorithm for diagnosis of active labour in primiparous women

Authors: Cheyne, H., Dowding, D., Hundley, V., Aucott, L., Styles, M., Mollison, J., Greer, I. and Niven, C.

Journal: Midwifery

Volume: 24

Issue: 2

Pages: 199-213

ISSN: 0266-6138

DOI: 10.1016/j.midw.2006.12.005

Abstract:

Objectives: to describe the development and testing of an algorithm for diagnosis of active labour in primiparous women. Design: qualitative and quantitative methods were used. A literature review was first conducted to identify the key cues for inclusion in the algorithm. Focus groups of midwives were then conducted to assess content validity, finally a vignette study assessed the inter-rater reliability of the algorithm. Setting: midwives from two study sites were invited to participate. Data were collected during 2002 and 2003. Participants: midwives from the first site took part in the focus groups (n=13), completed vignettes (n=19), or both. Midwives from the second site then completed vignettes (n=17). Findings: an algorithm, developed from the key informational cues reported in the literature, was validated in relation to content validity by the findings from the focus groups. Inter-rater reliability was tested using vignettes of admission case histories and was found to be moderate in the first test (K = 0.45). However, after modifying the algorithm the kappa score was 0.86, indicating a high level of agreement. Key conclusions: diagnosis of labour may be straightforward on paper but is frequently problematic in practice. This may be because the diagnosis of labour is made in a high pressured environment where conflicting pressures of workload, limited resources and emotional pressures add to the complexity of the judgement. Implications for practice: we offer a valid and reliable decision-support tool as an aid for diagnosis of labour. The evaluation of the implementation of this tool is under way and will determine whether it is effective in reducing unnecessary admissions and improving clinical outcomes for women. © 2007 Elsevier Ltd. All rights reserved.

Source: Scopus

The development and testing of an algorithm for diagnosis of active labour in primiparous women.

Authors: Cheyne, H., Dowding, D., Hundley, V., Aucott, L., Styles, M., Mollison, J., Greer, I. and Niven, C.

Journal: Midwifery

Volume: 24

Issue: 2

Pages: 199-213

ISSN: 0266-6138

DOI: 10.1016/j.midw.2006.12.005

Abstract:

OBJECTIVES: to describe the development and testing of an algorithm for diagnosis of active labour in primiparous women. DESIGN: qualitative and quantitative methods were used. A literature review was first conducted to identify the key cues for inclusion in the algorithm. Focus groups of midwives were then conducted to assess content validity, finally a vignette study assessed the inter-rater reliability of the algorithm. SETTING: midwives from two study sites were invited to participate. Data were collected during 2002 and 2003. PARTICIPANTS: midwives from the first site took part in the focus groups (n=13), completed vignettes (n=19), or both. Midwives from the second site then completed vignettes (n=17). FINDINGS: an algorithm, developed from the key informational cues reported in the literature, was validated in relation to content validity by the findings from the focus groups. Inter-rater reliability was tested using vignettes of admission case histories and was found to be moderate in the first test (K=0.45). However, after modifying the algorithm the kappa score was 0.86, indicating a high level of agreement. KEY CONCLUSIONS: diagnosis of labour may be straightforward on paper but is frequently problematic in practice. This may be because the diagnosis of labour is made in a high pressured environment where conflicting pressures of workload, limited resources and emotional pressures add to the complexity of the judgement. IMPLICATIONS FOR PRACTICE: we offer a valid and reliable decision-support tool as an aid for diagnosis of labour. The evaluation of the implementation of this tool is under way and will determine whether it is effective in reducing unnecessary admissions and improving clinical outcomes for women.

Source: PubMed

The development and testing of an algorithm for diagnosis of active labour in primiparous women

Authors: Cheyne, H., Dowding, D., Hundley, V., Aucott, L., Styles, M., Mollison, J., Greer, I. and Niven, C.

Journal: MIDWIFERY

Volume: 24

Issue: 2

Pages: 199-213

eISSN: 1532-3099

ISSN: 0266-6138

DOI: 10.1016/j.midw.2006.12.005

Source: Web of Science (Lite)

The development and testing of an algorithm for diagnosis of active labour in primiparous women

Authors: Cheyne, H., Dowding, D., Hundley, V., Aucott, L., Styles, M., Mollison, J., Greer, I. and Niven, C.

Journal: Midwifery

Volume: 24

Pages: 199-213

ISSN: 0266-6138

DOI: 10.1016/j.midw.2006.12.005

Abstract:

Objectives to describe the development and testing of an algorithm for diagnosis of activelabour in primiparous women.

Design qualitative and quantitative methods were used. A literature review was first conducted to identify the key cues for inclusion in the algorithm. Focus groups of midwives were then conducted to assess content validity, finally a vignette study assessed the inter-rater reliability of the algorithm.

Setting midwives from two study sites were invited to participate. Data were collected during 2002 and 2003.

Participants midwives from the first site took part in the focus groups (n=13), completed vignettes (n=19), or both. Midwives from the second site then completed vignettes (n=17).

Findings an algorithm, developed from the key informational cues reported in the literature, was validated in relation to content validity by the findings from the focus groups. Inter-rater reliability was tested using vignettes of admission case histories and was found to be moderate in the first test (K=0.45). However, after modifying the algorithm the kappa score was 0.86, indicating a high level of agreement.

Key conclusions diagnosis of labour may be straightforward on paper but is frequently problematic in practice. This may be because the diagnosis of labour is made in a high pressured environment where conflicting pressures of workload, limited resources and emotional pressures add to the complexity of the judgement.

Implications for practice we offer a valid and reliable decision-support tool as an aid for diagnosis of labour. The evaluation of the implementation of this tool is under way and will determine whether it is effective in reducing unnecessary admissions and improving clinical outcomes for women.

http://dx.doi.org/10.1016/j.midw.2006.12.005

Source: Manual

Preferred by: Vanora Hundley

The development and testing of an algorithm for diagnosis of active labour in primiparous women.

Authors: Cheyne, H., Dowding, D., Hundley, V., Aucott, L., Styles, M., Mollison, J., Greer, I. and Niven, C.

Journal: Midwifery

Volume: 24

Issue: 2

Pages: 199-213

eISSN: 1532-3099

ISSN: 0266-6138

DOI: 10.1016/j.midw.2006.12.005

Abstract:

Objectives

to describe the development and testing of an algorithm for diagnosis of active labour in primiparous women.

Design

qualitative and quantitative methods were used. A literature review was first conducted to identify the key cues for inclusion in the algorithm. Focus groups of midwives were then conducted to assess content validity, finally a vignette study assessed the inter-rater reliability of the algorithm.

Setting

midwives from two study sites were invited to participate. Data were collected during 2002 and 2003.

Participants

midwives from the first site took part in the focus groups (n=13), completed vignettes (n=19), or both. Midwives from the second site then completed vignettes (n=17).

Findings

an algorithm, developed from the key informational cues reported in the literature, was validated in relation to content validity by the findings from the focus groups. Inter-rater reliability was tested using vignettes of admission case histories and was found to be moderate in the first test (K=0.45). However, after modifying the algorithm the kappa score was 0.86, indicating a high level of agreement.

Key conclusions

diagnosis of labour may be straightforward on paper but is frequently problematic in practice. This may be because the diagnosis of labour is made in a high pressured environment where conflicting pressures of workload, limited resources and emotional pressures add to the complexity of the judgement.

Implications for practice

we offer a valid and reliable decision-support tool as an aid for diagnosis of labour. The evaluation of the implementation of this tool is under way and will determine whether it is effective in reducing unnecessary admissions and improving clinical outcomes for women.

Source: Europe PubMed Central