Development and validation of the code of ethics for midwives in Iran

BMC Medical Ethics · 4 authors, 4 centres

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TL;DR

This mixed-methods study developed a 92-item code of ethics for midwives in Iran (ICEM) across six domains through qualitative interviews, a narrative review of international codes, and content validity assessment by experts. The resulting code achieved an average CVI of 0.92 and CVR of 0.85, indicating strong content validity.

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This mixed sequential study was conducted in three phases to develop and validate the Iranian Code of Ethics for Midwives (ICEM). Phase 1 involved a qualitative content analysis of semi-structured interviews with 14 midwifery and ethics experts, yielding 207 codes organized into 23 sub-categories and 6 main categories. Phase 2 was a narrative review of selected national and international midwifery ethics codes, including those from the ICM, ACNM, and UKNMC, which supplemented and completed the initial item set. Phase 3 assessed face and content validity using 15 experts, calculating the content validity ratio (CVR) and content validity index (CVI). Average CVI was 0.92 and CVR was 0.85.

STUDY TYPE

other

SPECIALTY

obstetrics and gynecology

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AI pipeline

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100% · A

ORIGINAL PAPER

PMC10548606

Development and validation of the code of ethics for midwives in Iran

BMC Medical Ethics

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ABSTRACT

Background Considering ethical issues in midwifery care is essential for improving the quality of health services and the client's satisfaction. This study aimed to develop and validate the code of ethics for Midwives in Iran (ICEM). Materials and methods This was a mixed sequential study that was performed in three phases including a qualitative study, a review, and the content validity assessment. The first phase was a qualitative study with a content analysis approach. The data were collected by conducting in-depth semi-structured individual interviews with 14 midwifery and ethics experts. The purposive sampling method was used to recruit the participants and sampling continued until data saturation. The data were analyzed using the conventional content analysis described by Graneheim and Lundman. Lincoln and Guba’s criteria were used to confirm the trustworthiness of the data. Then, a narrative review of the selected national and international codes of ethics for Midwives was performed to complete the items of the ICEM. For validity assessment, the face and content validity of the items of ICEM was assessed by 15 experts to calculate the content validity ratio (CVR) and index (CVI). Results Fourteen experts were interviewed in the qualitative phase, and 207 codes were extracted from a content analysis which were categorized into 23 sub-categories and 6 main categories. The extracted codes were considered as the items for ICEM that were completed by a review of the selected national and international code of ethics for Midwives. The content validity and ratio assessment of the items demonstrated an average CVI = 0.92 and CVR = 0.85. Then, the final version of ICEM was developed with 92 items in 6 domains about; 1) "professional Commitments" with 30 items; 2) "providing midwifery services to the client and her companions” with 26 items; 3) “relationship with colleagues" with 11 items; 4) “herself” with 6 items; 5) “education and research” with 8 items; and, 6) “management” with 11 items. Conclusion ICEM was prepared with 92 items in six sections that facilitate its use for midwives who are working in the different fields of care, counseling, education, research, and management. In this new version of the ICEM, the items related to recent social-, scientific, and technical improvements were considered for providing ethical midwifery care. Supplementary Information The online version contains supplementary material available at 10.1186/s12910-023-00963-4.

CITATION EXPORT

Masoumeh Simbar, Zahra Kiani, Soheila Nazarpour et al.. Development and validation of the code of ethics for midwives in Iran. BMC Medical Ethics. (2023). https://doi.org/10.1186/s12910-023-00963-4

AUTHORS

4 · 4 CENTRES

Masoumeh Simbar, Zahra Kiani, Soheila Nazarpour, Farah Babaei

1grid.411600.2Midwifery and Reproductive Health Research Center, Department of Midwifery and Reproductive Health, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran
2https://ror.org/034m2b326grid.411600.2Midwifery and Reproductive Health Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
3grid.508788.aDepartment of Midwifery, Chalous Branch, Islamic Azad University, Chalous, Iran
4Department of Midwifery, Deputy of Curative Affairs, Ministry of Health, Education and Treatment, Tehran, Iran