Psychometric Testing of the Caregiver Attitudes on Substance Use in Pregnancy Instrument.

ABSTRACT

OBJECTIVE: To modify an existing instrument used to measure the attitudes of perinatal nursing caregivers about pregnant women with substance use disorder (SUD) and to psychometrically test the new instrument Caregiver Attitudes on Substance Use in Pregnancy (CASUD-OB). DESIGN: Instrument modification and psychometric testing of results from a modified instrument. SETTING: Multi-hospital health care system in the midwestern United States. PARTICIPANTS: A total of 147 perinatal nursing caregivers (perinatal nurses n = 131; unlicensed assistive personnel n = 16) who worked on obstetric and neonatal nursing units. METHODS: We modified the existing instrument, and 12 experts in perinatal nursing (1 who also had expertise in SUD in the perinatal period) evaluated the items for content validity. We administered the CASUD-OB via online survey between November 2019 and December 2019. We used item reduction, calculated item-total correlations, and conducted exploratory factor analysis to modify the instrument and assessed its internal consistency. RESULTS: After psychometric testing, we reduced the number of items from 26 to 16. Through item reduction and exploratory factor analysis, we identified three subscales (Caregiver Bias, Caregiver Self-Awareness, and Caregiver Perception of Parental Fitness). The Cronbach's alpha for the overall instrument was .92. CONCLUSION: This study provides preliminary evidence to suggest that the CASUD-OB may be a valid and reliable instrument for measuring nurses' attitudes toward pregnant women with SUD. Through additional testing, this instrument has the potential to become a valuable resource to evaluate quality improvement initiatives, staff education programs, and other interventions designed to transform the attitudes of nursing caregivers toward pregnant women with SUD.