Validation of a Logic Model Program to Support Iranian Females During Labor: A Delphi Method

Abstract

Objectives: The development of comprehensive supporting programs for mothers during labor and childbirth based on their needs could play an important role in reducing elective cesarean section. The current study aimed at evaluating the logical model program to support mothers during labor and childbirth using a 3-round Delphi technique. Methods: The current study was a 3-round Delphi using 25 experts of different specialties. The program components were taken from the findings of a qualitative approach; i e, grounded theory study. In the next stage, the process of selecting expert panel members was carried out using the snowball method. They all had clinical experience in hospital and some had the experience of working in the Iranian ministry of health and Medical education. The 3rd stage of selecting expert groups was formally asking them for their willingness to join the panel and participate in the Delphi study. At this stage, the objective of the subject and the roles of experts as well as a brief explanation of the conducted activities were emailed to them. Results:The results of 3-round Delphi illustrated 6 domains in the logic model including preparation (10 sentences), equipment and facilities (3 sentences), education (8 sentences), process and activities (10 sentences),interventions (13 sentences), and assessment (2 sentences). The panelists approved 46 sentences out of original set of over 51 statements via Delphi technique. Conclusions: The current paper provided clear principles and standards regarding how to practically do a comprehensive supportive care during labor and delivery.Keywords: Delphi Technique, Labor Pain, Supporting Labor, Normal Delivery, Logic Model BackgroundChildbirth is an event with profound psychosocial and emotional impacts on mothers and its memory always remains in the minds (1-3). When the mothers face labor pain they experience negative and positive feelings that may cause hopelessness, fear, feeling of loneliness, and stress (4). To overcome these feelings in the labor and delivery room, it is important to provide support to the mothers based on their preferences and needs (2).On the other hand, childbirth is medicalized in many countries and most of the therapeutic and care plans in such countries take a biomedical approach (5, 6). Not paying enough attention to the mothers' needs and forgetting them in some cases due to adopting non-holistic approaches to the process of childbirth can increase the mothers' fear of delivery in such a way that cesarean section may be considered as the only way to escape from it (7,8). The results of a meta-analysis in Iran showed that Iranian females similar to other females worldwide mentioned fear as the main reason to choose cesarean section versus natural childbirth (7). Development and implementation of support programs based on a holistic approach and considering females' concerns and expectations during childbirth is a definite requirement, because the new health policy of the international community puts more emphasis on em...