Self-efficacy measurement instrument for neonatal resuscitation training: An integrative review.

Neonatal resuscitation is recognized by the World Health Organization as one of the priority interventions to reduce neonatal mortality rate. Measuring self-efficacy regarding neonatal resuscitation is one important criterion for evaluating the effectiveness of related training programs. This integrative review aims to critique evidence from high and low-to-middle-income countries. Additionally, guides appraisals of the instruments that measure self-efficacy in resuscitation training programs and adapt for low-to-middle-income countries. The databases searched for studies from 1980 to 2017 include: PubMed, CINAHL, SCOPUS, PyschINFO, and ERIC. and revealed 212 publications. Data extracted from eight instruments included theoretical framework, study location, instrument description and scoring, reliability and validity, and self-efficacy measurement outcomes. Six of eight self-efficacy instruments reported utilizing Bandura's Social Cognitive Theory while two of the eight instruments implied the use of self-efficacy. Most of the instruments reported acceptable internal consistency as Cronbach's alpha values ranged from 0.74 to 0.98 for reliability. Five of eight instruments were used in low-to-middle-income countries. A valid and reliable self-efficacy instrument is a necessary antecedent to evaluating the effectiveness of a neonatal resuscitation training program. Future studies may consider self-efficacy instruments with Visual Analog Scales in low-to-middle-income countries due to the ease of implementing the simple visual instrument.

Review of educational interventions to increase traditional birth attendants' neonatal resuscitation self-efficacy.

BACKGROUND: Annually, up to 2.7 million neonatal deaths occur worldwide, and 25% of these deaths are caused by birth asphyxia. Infants born in rural areas of low-and-middle-income countries are often delivered by traditional birth attendants and have a greater risk of birth asphyxia-related mortality. AIM: This review will evaluate the effectiveness of neonatal resuscitation educational interventions in improving traditional birth attendants' knowledge, perceived self-efficacy, and infant mortality outcomes in low-and-middle-income countries. METHODS: An integrative review was conducted to identify studies pertaining to neonatal resuscitation training of traditional birth attendants and midwives for home-based births in low-and-middle-income countries. Ten studies met inclusion criteria. FINDINGS: Most interventions were based on the American Association of Pediatrics Neonatal Resuscitation Program, World Health Organization Safe Motherhood Guidelines and American College of Nurse-Midwives Life Saving Skills protocols. Three studies exclusively for traditional birth attendants reported decreases in neonatal mortality rates ranging from 22% to 65%. These studies utilized pictorial and oral forms of teaching, consistent in addressing the social cognitive theory. Studies employing skill demonstration, role-play, and pictorial charts showed increased pre- to post-knowledge scores and high self-efficacy scores. In two studies, a team approach, where traditional birth attendants were assisted, was reported to decrease neonatal mortality rate from 49-43/1000 births to 10.5-3.7/1000 births. CONCLUSION: Culturally appropriate methods, such as role-play, demonstration, and pictorial charts, can contribute to increased knowledge and self-efficacy related to neonatal resuscitation. A team approach to training traditional birth attendants, assisted by village health workers during home-based childbirths may reduce neonatal mortality rates.