Determining the psychometric properties of the Enhancing Decision-making Assessment in Midwifery (EDAM) measure in a cross cultural context

© 2016 Jefford et al. Background: The ability to act on and justify clinical decisions as autonomous accountable midwifery practitioners, is encompassed within many international regulatory frameworks, yet decision-making within midwifery is poorly defined. Decision-making theories from medicine and nursing may have something to offer, but fail to take into consideration midwifery context and philosophy and the decisional autonomy of women. Using an underpinning qualitative methodology, a decision-making framework was developed, which identified Good Clinical Reasoning and Good Midwifery Practice as two conditions necessary to facilitate optimal midwifery decision-making during 2nd stage labour. This study aims to confirm the robustness of the framework and describe the development of Enhancing Decision-making Assessment in Midwifery (EDAM) as a measurement tool through testing of its factor structure, validity and reliability. Method: A cross-sectional design for instrument development and a 2 (country; Australia/UK) x 2 (Decision-making; optimal/sub-optimal) between-subjects design for instrument evaluation using exploratory and confirmatory factor analysis, internal consistency and known-groups validity. Two 'expert' maternity panels, based in Australia and the UK, comprising of 42 participants assessed 16 midwifery real care episode vignettes using the empirically derived 26 item framework. Each item was answered on a 5 point likert scale based on the level of agreement to which the participant felt each item was present in each of the vignettes. Participants were then asked to rate the overall decision-making (optimal/sub-optimal). Findings: Post factor analysis the framework was reduced to a 19 item EDAM measure, and confirmed as two distinct scales of 'Clinical Reasoning' (CR) and 'Midwifery Practice' (MP). The CR scale comprised of two subscales; 'the clinical reasoning process' and 'integration and intervention'. The MP scale also comprised two subscales; women's relationship with the midwife' and 'general midwifery practice'. Conclusion: EDAM would generally appear to be a robust, valid and reliable psychometric instrument for measuring midwifery decision-making, which performs consistently across differing international contexts. The 'women's relationship with midwife' subscale marginally failed to meet the threshold for determining good instrument reliability, which may be due to its brevity. Further research using larger samples and in a wider international context to confirm the veracity of the instrument's measurement properties and its wider global utility, would be advantageous

The Evolution of the Crafts from Function to Pure Sculpture

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Re-reading Adorno: The 'after-Auschwitz' Aporia

It is difficult to think of another area of literary discourse in which a critic has brought such a profound influence to bear, as Theodor W. Adorno has, in the area of literature concerning the Shoah. It is also difficult to think of another area of literary discourse in which a critic’s pronouncements have been misinterpreted so often and to such a degree as have Adorno’s reflections concerning the status of art after the Shoah. Reference here is of course being made to Adorno’s (supposed) ‘dictum’ concerning the barbarity of poetry after Auschwitz. The principle aims of this paper are to restore his reflections to their argumentative context and to restore the dialectical tension conferred on them in the original text. I will examine what I have termed the “after-Auschwitz” aporia, so evident in Adorno’s reflections on post-Shoah art and yet overlooked all too frequently in the research literature. Defined as an irresolvable impasse as a result of equally plausible yet inconsistent premises the term “aporia” succinctly captures the essence of Adorno’s deliberations on post-Shoah art: the imperative to represent the egregious crimes and the impossibility of doing so. I will demonstrate that Adorno’s pronouncements were never meant as silence-inducing taboos, but rather as concrete theoretical reflections upon the moral status of art in the aftermath of the Shoah and as warnings of the moral peril involved in the artistic rendering of mass extermination

A Small Story Concerning a Big Mistake: Returning Voice to a Breast Cancer Narrative

This article arose from an error. In 2000, I began recording the story of myself and nine other university women with later stage breast cancer. Following the fifth death, I took on the task to make what I could of the archive. An introduction to Cathy Riessman and narrative research began to direct and support this work. Of major significance was the performative aspects of our storytelling, especially our vocality. Text and reason, not voice and utterance, is privileged in the academy, but still I committed to honouring vocality in telling our story. My initial attempts failed, but this paper begins the redress

Targeting and Customizing Research Data Management Services (RDM)

Designing library services is not new to our field. Service design done right is both challenging and rewarding. In this issue of the Journal of eScience Librarianship, librarians across the country write about the importance of providing a solid Research Data Management (RDM) Service, coupled with targeting institutional partners and solid education practices

JESLIB: Evolution of eScience Librarianship in the New England Region and Beyond

JESLIB Editor Elaine Martin introduces the articles in Volume 1, Issue 2 and discusses the strategic approaches for advancing eScience in the New England region and across the U.S

Risk perception and precautionary intent for common consumer products

This study attempted to determine if accident scenario analysis reduces accident frequency misestimations and leads to heightened precautionary intent for products. Subjects generated or were provided with scenarios and made estimates. Other subjects made estimates at varying paces without analysis. These and an additional group then rated their precautionary intent for the products. Subjects also gave rating\u27s for confidence in their estimations reported injury experience related to the products. No differences were found among the group correlations. Analyses showed that the Scenario groups performed no better and sometimes worse than the other groups. The Hurried subjects reported lower precautionary intent ratings than other groups. Subjects with injury experience reported higher precautionary intent than subjects without such experience. No relationship was found between precautionary intent and frequency estimates. It is concluded that personal knowledge of accidents rather than general knowledge of accidents or frequencies may be a better predictor of intended behavior

Editorial: Welcome to the Journal of eScience Librarianship

JESLIB Editor Elaine Martin\u27s inaugural editorial introducing the first issue of the Journal of eScience Librarianship

Charting a New Path: The Evolution of the Journal of eScience Librarianship

The Journal of eScience Librarianship (JeSLIB) has been successful in providing quality and timely scholarship in the area of data science and library services. However, it is a wise strategy to gather feedback and suggestions from readership when planning future changes and initiatives

Hospital Administrator Perceptions of the Library

This presentation summarizes results of a qualitative study of perceptions of hospital libraries by New England hospital administrators conducted in fall 2008. The purpose of this study is two-fold: 1) to investigate the views of hospital administrators about librarians and library services in their institutions and how they make decisions around what services are provided and funded in their hospital; and 2) to explore the views of health sciences librarians, informed by interviews with hospital administrators on the value of the hospital library. Presented at the Massachusetts Health Sciences Library Network (MAHSLIN) Annual Meeting, Waltham, MA, April 24, 2009