Mixed pattern study on the development of midwifery profession job satisfaction scale

doi:10.21203/rs.3.rs-3346156/v1

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Mixed pattern study on the development of midwifery profession job satisfaction scale

https://doi.org/10.21203/rs.3.rs-3346156/v1

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The aim of this study is to develop a measurement tool on midwifery job satisfaction. In the research, the "exploratory sequential mixed method" design was used. Case study in order to examine midwives' (n = 10) perceptions of midwifery job satisfaction in the qualitative phase of the research; Methodological research design was used to create a scale on the evaluation of factors affecting midwifery job satisfaction at the quantitative stage (n = 210). In the light of qualitative findings and literature review, a 41-item draft scale was created in line with the expert opinion created and received for the Midwifery Profession Job Satisfaction Scale. In order to test the construct validity of the scale, exploratory factor analysis was conducted using principal components method and varimax axis rotation. As a result of the analysis, a scale consisting of 40 items and a 6-factor structure with an eigenvalue above 1 and explaining 72.24% of the total variance was obtained. The confirmatory factor analysis results of the scale also show that the data fit well with the model. It was determined that the Cronbach Alpha internal consistency coefficient of the scale ranged from 0.94 and the sub-dimensions between 0.83 and 0.96. It has been determined that the developed scale is a valid and reliable measurement tool that can be used to evaluate the job satisfaction of midwives.

Job satisfaction

midwifery

scale development

validity

reliability

Job satisfaction is the general attitude of the employee toward their job (Mharapara et al., 2022). Another definition of job satisfaction is the case of “a person who perceives that their values related to work are met in their work and that these values are compatible with their needs” (Rouleau et al., 2012). In addition, job satisfaction is also expressed as the pleasure that the employee feels as a result of evaluating their job, work life, or emotional satisfaction (Khavayet et al., 2018).

According to Freud, the love of one's life and work are the two main factors that protect human health. It is known that business life affects the individual and the individual affects business life. This positive interaction results in the health of the employee and the success of the institution. As long as people are satisfied with the work environment, they work more efficiently (Rouleau et al., 2012).

In order for the existence of job satisfaction to be mentioned, the value judgments of the individual as well as their needs must be compatible with the work they do. Job satisfaction is not static. Therefore, satisfaction or dissatisfaction with job may arise from individual or other factors. Factors affecting job satisfaction or dissatisfaction can be classified as individual and organizational factors related to work or work environment (Rouleau et al., 2012; Mharapara et al., 2022).

It is important that all working people achieve job satisfaction. High level of job satisfaction is also very important in the midwifery profession, as it will increase the quality of health care midwives provide and patient satisfaction (Warmelink et al., 2015). Job satisfaction in midwives is one of the critical issues that managers should focus on due to the fact that it can also affect motivation and workforce performance (Newton et al., 2014; Fenwick et al., 2018). It is thought that it is important to examine the job satisfaction and corporate commitment of midwives and to manage these changes (Yoshida & Sandall, 2013; Mharapara et al., 2022).

In the literature, it has been found that midwives' job satisfaction levels are at a low or moderate level. In these studies, scales that are not specific to the midwifery profession and contain general expressions were used (Mharapara et al., 2022; Evans et al., 2020; Khavayet et al., 2018). There is no measurement tool that is used to evaluate job satisfaction in midwifery. This study was conducted to develop a “Job Satisfaction in Midwifery Scale.” This study is thought to bring a measurement tool to the field to determine the job satisfaction levels of midwives.

Type and time of the study

In the research, the "exploratory sequential mixed methods" design, which is one of the mixed method designs, was used. Exploratory sequential mixed methods design allows a researcher to start with discovering qualitative data and then use these findings in the quantitative research dimension (Creswell, 2013). In the qualitative stage of the research, a case study was employed to examine midwives' perceptions of job satisfaction. In the quantitative stage of the research, a methodological research design was used to create a scale for the assessment of factors affecting job satisfaction in midwifery.

The procedure for the qualitative dimension of the research

Research sample

Purposeful sampling method was used to determine the study group required for the collection of qualitative data. Accordingly, the sample of the research was composed of 10 midwives who worked in a state hospital in the south of Turkey and agreed to participate in the research.

Data collection tool

In the study, a semi-structured interview form prepared by the researchers was used to determine the perceptions of midwives' job satisfaction. The form included questions designed to collect data about participants’ descriptive characteristics and views about variables that positively and negatively affect their job satisfaction, and probing questions to obtain in-depth data about the answers (total 12 questions). In order to establish the content validity of the data collection tool, expert opinions were taken from two academicians, one specialized in qualitative research and the other in the field of midwifery, and necessary arrangements were made in accordance with the recommendations. In order to improve the intelligibility and applicability of the interview form, it was piloted to two participants. The pilot application showed that no changes were necessary to the interview form. Individuals who participated in the pilot application were also considered as samples of the study. In the preparation of the semi-structured interview form, necessary attention was paid to make questions easy to understand, not multidimensional, and not to guide the participant (Yıldırım & Şimşek, 2016).

Collection of data

The data were collected via face-to-face interview method from the midwives who volunteered to participate in the study. In the collection of data, the individual interview technique was applied by using the semi-structured interview form. The data provided by the women during the interview were recorded in detail in the interview form and on a voice recorder. Each interview lasted about 30–40 minutes.

Evaluation of the data: The content analysis method was used in the analysis of the data. The content analysis process included transcribing the interview data, organizing the data, identifying meaningful data units, creating an analysis matrix, the analysis process, and reporting the results. In the analysis of the data, participants’ voice recordings were transcribed and transferred to a Microsoft Word file, which yielded a 56-page-long raw data document. While the data were transcribed, participants’ names were not used; each participant was given a number respectively (M1, M2, … M10). The documented data was first encoded in a similar way, and then a list of codes was created, and themes were revealed. In order to increase the internal reliability of the research, the processes of coding and analyzing the data were performed independently by two people. For reliability, the intercoder agreement coefficient was calculated and found to be 0.87. While analyzing the qualitative data, the MAXQDA 2022 software was used.

Procedures for the quantitative dimension of the research

Research sample

The population of the research included midwives working in three public hospitals located in a province in the south of Turkey. The sample of the research consisted of 210 midwives working in maternity hospitals and maternity services. In the analyses carried out during the scale development studies, it has been stated that the number of participants should be at least five times the number of items on the scale (Bryman & Cramer, 2001). In this context, 210 participants can be considered enough to determine the factors related to the 41 items on the draft scale applied.

Data collection tool

In the quantitative stage, a descriptive information form including questions about the sociodemographic and professional characteristics of the participants and a Draft Job Satisfaction in Midwifery Scale were used. The stages related to the development process of the draft scale are given below.

A literature review on the writing of scale items (Weiss et al.,1967; Durmus & Günay, 2007; Eğinli, 2009; Yalnız & Karaca-Saydam, 2010; Hadizadeh-Talasaz et al., 2014; Bilgin et al., 2017) was conducted and a qualitative study was initiated in accordance with the data obtained. A pool of 56 items was created. As a result of interviews with the researchers, two midwife academicians, and two midwives working in the clinic, 45 of the items were included in the draft form. For the appropriateness of the content, expression, and spelling of the draft scale items, the draft scale was submitted to the opinions of two experts in the field of statistics and one expert in the field of Turkish Language and Literature, and the necessary changes were made. A five-point Likert- type structure with evaluation options, namely strongly disagree (1), disagree (2), neither agree nor disagree (3), agree (4), and strongly agree (5) was used.

After the item pool was created, steps to establish content validity were carried out. The content validity of the scale that was designed in this research was determined using the content validity index (CVI) after expert opinions were obtained. The scale items were examined by seven experts in terms of clarity, comprehensibility, appropriateness, measurability, the characteristics to be measured, and their suitability for the measurement group. As a result of the analysis carried out for content validity, four items were removed from the 45-item draft scale, and it was reduced to 41 items.

Before proceeding to the implementation phase of the research, the draft form of the scale consisting of 41 items was piloted to 30 midwives, and the items were evaluated for clarity, comprehensibility, time, etc. After the pilot application, no changes were made to the questions and midwives within the scope of the pilot application were not included in the sample group.

The data collection process was completed after the draft scale had been applied to 210 midwives and validity-reliability analyses had been performed. As a result of the analysis, the Job Satisfaction in Midwifery Scale (JSMS), consisting of 40 items, was developed.

The data were collected via face-to-face interview method from the midwives who volunteered to participate in the study. The midwives in the study group were interviewed in the staff resting rooms of the hospital and their consent was obtained after they were informed about the importance and purpose of the research. Filling out the questionnaires took an average of 20 minutes for each midwife.

Data analysis: The analysis of the data obtained as a result of the research was performed using appropriate statistical methods on IBM SPSS Statistics 22 (SPSS Inc., Chicago, IL) and AMOS 21.0 software packages. The content validity of the draft scale was analyzed according to the Lawshe technique. Reliability was tested using Cronbach's alpha reliability coefficient, item distinctiveness, item-total score correlations, and test retest method. For construct validity, exploratory factor analysis (EFA) and confirmatory factor analysis (CFA) were utilized.

Ethical aspects

The ethics committee approval of the study was obtained from the Non-Interventional Clinical Research Ethics Committee of a state university (date: December 3, 2021 and no: 117/80). In addition, before interviews were initiated, participants were informed about the study and written informed consent was obtained from the volunteers.

In this section, the findings obtained by analyzing the data obtained at the end of the data collection process were presented. Accordingly, first, qualitative research findings, which formed the basis of the quantitative research phase, and then quantitative research findings were presented.

Qualitative research findings

The examination of the descriptive characteristics of the 10 midwives included in the research sample indicated the mean age of the midwives was 31.90 ± 5.52 (min: 25 and max: 41), three of them were graduates of a health vocational high school, the rest were university graduates, and the mean working years was 8.30 ± 6.41 (min: 2 and max: 21). Also, it was determined that four of the midwives were married and two of them had children.

According to the qualitative data on the factors affecting participants’ job satisfaction from midwifery profession, the theme was collected under six subcategories, namely individual characteristics, management and salary, personal development and promotion, working environment conditions, communication, and general features of the profession. Table 1 shows the codes related to the sub-themes and the opinions of the participants about factors that they emphasized the most.

Table 1

The qualitative research participants’ views on the factors that affect their job satisfaction in midwifery
Sub-themes	Codes	Quotes
Individual characteristics	• Increasing occupational satisfaction as age progresses (n = 7) • Having a female-specific profession (n = 6) • The personality structure (irritable, cold-blooded, etc. affect the satisfaction (n = 4) • The level of education increases self-confidence and satisfaction (n = 4)	E6: ... From my own point of view, as I get older, my satisfaction with the job I do increases. E7: ... First of all, I am a mother and a woman. Since the person I provide care for is the same as me, I approach them putting myself in place of them. When I approach a baby, I approach it with love and affection like my own baby... E2: And there is another issue; of course, if I had graduated from a university, it would have increased my satisfaction even more, because I think there would have been even more self-confidence.
Management and salary	• Satisfaction with the salary received (n = 10) • Being appreciated by managers (n = 9) • Being respected by superiors (n = 6) • Planned distribution of tasks (n = 2) • Having trouble using holidays (n = 1) • Fear of losing the job (n = 1)	E2: ... Most importantly, of course, the salary we get affects it a lot. When you get the amount you want, you approach each issue more positively and constructively; when there is a smaller amount than you want, that does not increase it at all; it causes a negative result. So, to be honest, this is often the case unfortunately. E1: ... We can say that this is the most important factor that affects our business in a positive and negative way. We are human beings, and we like to be appreciated just like every human being. We also want to be appreciated by our managers, and we want our efforts to be noticed... E3: There are meetings on specific topics in our hospital... No matter what, even if it's something easy and simple for them, they respect and listen. Whether it is the search for solutions to our problems, they help us in every way... I would say it even affects my work pace.
Personal development and promotion	• Promotion-possibility of promotion (n = 9) • Attending in-service training programs (n = 8) • Reward for success (n = 2)	E9: Being promoted is very important for businesses and people in every field. You understand how well you do your job and how much you are appreciated by employers. In this case, your love of work increases more and more. You work more vigorously, and you are more energetic and loving. E3: ... in-service training is a program conducted to improve a person's performance, as this training will also affect a person positively, job satisfaction will be positively affected. In in-service training, we work towards the needs. If a person has problems, solutions are offered to them. This also affects job satisfaction, of course, I think… E1: ... But, getting a certificate of achievement or getting a plaque because I'm doing my job well, of course, affects me in a positive way.
Working environment conditions	• Adequate lighting of the environment (n = 5) • Good ventilation of the environment (n = 4) • A clean working environment (n = 4) • Provision of a security service (n = 3) • Adequate and high quality materials (n = 1) • No noisy environment (n = 1) • Giving a feeling of home environment (n = 1)	E7: ...The environment that the hospital offers us, especially the environment and lighting during shifts, are very important things, or ventilation, these are important factors. E5: Of course, where I am is very important in my profession, sometimes the place gets so stuffy that I want to open a window and breathe, but you know that this is not possible in hospital environments. Or, for example, when we are constantly exposed to a stuffy environment in the operating room, we look for an environment where we can breathe comfortably, and when we cannot, of course, we are negatively affected... E3: The environment in which I work affects the conditions. Would you like to work in a dirty, stuffy, dark, and low-ceiling environment? ...I don't want to do anything because I feel very uncomfortable, and I can't, even if I do, I don't think I will get efficiency, so the circulation of the environment is also very important. Lighting, cleaning, safety are all very, very effective and important things in general, I think.
General features of the profession	• View of society on the profession (n = 8) • Having a sacred profession (n = 6) • Experiencing the happiness of helping someone else (n = 4) • Intensive working hours (n = 4) • It requires patience (n = 2) • It needs to be careful (n = 2) • It requires working standing up (n = 1) • Working hours of the profession (n = 1)	E2: For example, when you go to a different environment, and say that you are a midwife, people praise the work I do and say how enjoyable it must be to deal with babies and so on. I get even more interested in my profession, which, of course, affects my perspective on my job a lot... E8: I think that my profession is sacred and very different... The feeling at that moment when the baby is born is priceless at that moment. These situations increase my job satisfaction enough. E4: The happiness of the mother when she sees her baby or hears its voice at the moment of birth, the happiness of the relatives waiting outside when the baby leaves the maternity ward, the prayers and thanks they give us are really just one of the situations that we feel very important and happ. Such positive feedback significantly affects our professional satisfaction.
Communication	• Ability to communicate positively with patients (n = 10) • Ability to communicate positively with teammates (n = 6) • Positive communication with patient relatives (n = 4 )	E5: Interpersonal communication is important on job satisfaction. The more beautiful and sound the communication with my patient is, the more sound and beautiful the results I get are. But if I have a bad communication, I know that in this case, my job will definitely become very difficult and my professional satisfaction will be negatively affected, regardless of me. E9: But when I develop any negative situation related to the patient, seeing the reaction of the patient's relatives as if we were responsible for the incident and the fact that the health professionals do not see enough value negatively affects us, and my professional satisfaction is inevitably affected negatively by this situation. E3: If I can agree on everything with the teammates I work with, of course, the desire to work more selflessly will follow and positively affect my professional satisfaction. I think that it will be much more difficult to do the same job with a person I don't agree with, which will reduce my professional satisfaction very much.

Quantitative research findings

The sample of this study included 210 midwives who were aged between 23 and 58 (mean age = 37.61 ± 6.80). The mean working years of the participants was 16.99 ± 7.859. Participants’ demographic data are presented in Table 2.

Table 2

Demographic data about the participants in the quantitative research
Variables		n	%
Level of education	Health Vocational High School	23	11.0
	Associate Degree	46	21.9
	Undergraduate	128	61.0
	Graduate	13	6.2
Marital status	Single	56	26.7
Marital status	Married	154	73.3
The number of children	None	55	26.2
	One child	63	30.0
	Two children	74	35.2
	Three children	16	7.6
	Four children	2	1.0
Level of income	Less income than expenses	62	29.5
	Equal income and expenses	136	64.8
	More income than expenses	12	5.7
Status of choosing the profession willingly	Yes	132	62.9
Status of choosing the profession willingly	No	78	37.1
Liking the profession	Yes	187	89.0
Liking the profession	No	23	11.0
Status of work experience in another field	Yes	20	9.5
Status of work experience in another field	No	190	90.5

Content validity

When the content validity is determined according to the Lawshe technique, the opinions of at least five and at most forty experts are required. According to the Lawshe method, draft items that fall below the content validity ratio (CVR) should be removed from the scale (Lawshe, 1975). According to Veneziano and Hooper (1997), the minimum CVR value was calculated at a significance level of α = 0.05. The minimum CVR value should be 1.000 in an assessment including seven experts. In other words, any item that falls below the minimum CVR value should be removed from the scale. In this context, four items on the 45-item draft scale prepared for expert opinion were found to fall below the CVR value and removed from the scale. Necessary spelling, language, punctuation, meaning, and expression corrections were made on the items, and 41 items remained on the draft form.

Item total – item remainder analysis: Items with an item-total correlation coefficient of below 0.20 are removed from a draft scale. This correlation coefficient is also equal to the item discrimination index. After the removal of these items, the reliability analysis is performed again on the remaining items (Tavşancıl, 2014). In the study, the 41st item was removed from the scale as its correlation coefficient (.178) was below 0.20.

Item discrimination analysis: In order to provide additional evidence for the validity of the scale, the difference between the mean scores of the lower and upper 27% groups of the scale total scores was examined using the independent samples t-test, and it was determined that there was a significant difference between the mean scores of the lower and upper 27% groups that were obtained from all items (p < 0.05).

Construct validity (Exploratory factor analysis): The factor structure of the scale was examined using exploratory factor analysis (EFA). During the analyses, the varimax rotation method and principal components analysis were used, assuming that the factors were independent of each other. Bartlett’s test and Kaiser-Meyer-Olkin (KMO) test results were taken into account for the suitability of the data for factor analysis (Table 3) (Tavşancıl, 2014). In the study, Kaiser-Meyer-Olkin (KMO) value was found to be 0.898, which indicated that the sample size was highly suitable for factor analysis (Kaiser, 1974). Bartlett’s test result showing the correlation between the variables (\({\varvec{\chi }}^{2}\)=8348.167, sd = 741, p < 0.001) was significant and there was a correlation between the variables.

Table 3

The results of the KMO and Bartlett's test for the Job Satisfaction in Midwifery Scale
Kaiser-Meyer-Olkin (KMO) value		0.898
Bartlett's Test	Approximate value of Chi-Square	8348.167
	Degree of freedom (sd)	741
	p	0.000

As a result of the EFA applied to the 40 questions on the scale, it was found that the scale consisted of six factors that explained 72.24% of the total variance and had an eigenvalue above 1 and that factors were named according to the items they contained (Table 4).

Internal consistency

Cronbach's alpha reliability coefficient was found to be 0.94 in the internal consistency analysis performed to determine the reliability of the Job Satisfaction in Midwifery Scale. When all the items on the scale were evaluated, it was determined that there was no item that reduced the reliability of the scale. Therefore, no article was removed as a result of the reliability analysis.

As a result of the Pearson correlation analysis conducted to examine the test-retest reliability of the scale, the correlations between the subscales ranged from 0.81 to 0.90. This result showed that the time-dependent invariance of the scale was high.

Table 4

The results of exploratory factor analysis and reliability analysis of the Job Satisfaction in Midwifery Scale
Items	Factors
Items	1	2	3	4	5	6
36. In the working environment, I find the areas where I care for my physical needs (dressing, feeding, toilet, etc.) sufficient.	.904
39. I find the ventilation of the working environment sufficient.	.897
40. I find the cleanliness of the working environment sufficient.	.866
34. Working harder due to the small number of midwives	.858
38. I find the lighting of the working environment sufficient.	.838
37. I feel safe in the work environment.	.835
35. I can find enough time to take a break at work.	.764
33. I have to deal with a lot of paperwork at work.	.753
30. I can communicate well with the women I care for.		.909
27. There is a lot of bickering and arguing going on in my workplace.		.909
28. I can easily discuss any problems with the managers.		.909
29. Managers can find permanent solutions to my problems.		.896
31. I can communicate well with the families of the women I care for.		.869
26. I work in harmony with my teammates.		.808
32. I feel cared for by midwifery professional associations.		.437
9. I have the opportunity to implement my own decisions while doing my profession.			.861
13. I think my profession has brought joy to my life.			.840
10. I stay up a lot because of my profession.			.810
7. My profession requires me to bear conscientious responsibility.			.784
6. My profession makes me feel that I am doing useful things for the woman and her family.			.708
5. My profession requires me to be careful.			.655
8. My profession gives me the chance to become a respected person in society.			.636
12. I am able to offer midwifery care to the woman and her family at the standards of care they deserve.			.625
11. My profession requires me to work on duty.			.609
20. I can make a living with the midwife's salary.				.811
19. My opinions are respected by the managers.				.795
25. I have no problem using my permissions.				.791
23. The midwifery profession gives me a guarantee of the future.				.788
18. I am appreciated by managers for the work I do.				.772
24. I can be in a decision-making position in corporate policies.				.663
22. The functioning of the midwifery profession is carried out in accordance with the laws and regulations.				.490
21. There are additional allowances I should have received at work that I did not receive.				.364
4. I think that my personality traits are suitable for the midwifery profession.					.912
2. I think my age is suitable for my work performance.					.890
3. I find the midwifery education I have received sufficient to fulfill my professional duties.					.889
1. I think that the midwifery profession is a profession unique to women.					.826
14. I find the in-service trainings in the field of midwifery in the institution where I work sufficient.						.819
15. Books, magazines, etc. to improve my professional knowledge and skills. I have access to sources.						.799
17. I have the opportunity to rise according to my professional qualification in the institution I work at.						.787
16. I can find the opportunity to participate in activities such as vocational courses, meetings, events.						.707
Total Variance Unveiled	36.24	45.44	53.52	61.17	67.07	72.24
Eigenvalue	14.50	3.68	3.23	3.06	2.36	2.07
Cronbach Alpha	0.96	0.88	0.91	0.83	0.94	0.83
F1: Working environment conditions, F2: Communication - organizational environment, F3: General features of the profession, F4: Management and salary, F5: Individual characteristics, F6: Personal development and promotion

Confirmatory factor analysis: Confirmatory factor analysis (CFA) was conducted to provide evidence for the validity of the structure determined as a result of exploratory factor analysis. The fit values obtained regarding the model created as a result of the confirmatory factor analysis are given in Table 5.

Table 5

Goodness of fit indices related to confirmatory factor analysis (CFA)
Good fit	Acceptable fit	Values
CMIN/DF < 3	CMIN/DF < 5	0.25
0.95 ≤ GFI ≤ 1	0.85 ≤ GFI ≤ 0.89	0.98
0.97 ≤ CFI ≤ 1	0.95 ≤ CFI ≤ 0.97	0.95
0.95 ≤ NFI ≤ 1	0.90 ≤ NFI ≤ 0.95	0.97
0 < RMSEA < 0.05	0.06 < RMSEA < 0.08	0.08

As can be seen in Table 5, the model had a goodness of fit according to the fit index values: χ2/df = 0.25, CFI = 0.95, NFI = 0.97, GFI = 0.98, AGFI = 0.98, and RMSEA = 0.08.

Job satisfaction has attracted plenty of interest, has been debated much, and has always been up-to-date throughout history. It is of utmost importance for midwifery as a profession, which is directly related to the protection of community health care. There is limited research in the literature into job satisfaction in midwifery, but these studies do not include a specific scale that measures job satisfaction in midwifery. The Minnesota Job Satisfaction Scale has been used in some studies in the literature to measure midwives’ job satisfactions (Yalnız & Karaca-Saydam, 2010; Hadizadeh-Talasaz et al., 2014; Bilgin et al., 2017). In this sense, this study was conducted to develop a valid and reliable scale to measure job satisfaction in midwifery. For this purpose, exploratory mixed research methods design was used.

The JSMS was developed to measure job satisfaction in midwifery. The scale had six sub-dimensions, namely individual characteristics, management and salary, personal development and promotion, working environment conditions, communication, and general features of the profession. It consisted of 40 items, six of which are negative. The items of the scale are similar to those of the Minnesota Job Satisfaction Scale, which has been used widely. The short form of the Minnesota Job Satisfaction Scale consists of 20 items and internal (such as success in the work environment, recognition, appreciation, job itself, job responsibility, job change due to promotion, and promotion) and external (corporate policy and management, type of control, managers, and decision-making) sub-factors. This scale is used to measure satisfaction factors (such as relationships with colleagues and subordinates, working conditions, wages, etc.) (Weiss et al., 1967).

The success of a newly-developed scale in the scientific area depends on two factors. These factors are the validity and reliability of the scale. Validity is the measurement of what is intended to be measured without confusing it with other aspects. Reliability, on the other hand, expresses the consistency of the items with each other and the extent to which the scale used reflects the problem (Şencan, 2005). In this study, content validity and construct validity were used to test the validity of the scale, and Cronbach's alpha internal consistency coefficient and item total-remainder correlation analyses, item discrimination analyses, and test-retest reliability analysis were used to test reliability.

EFA is a method used to understand and clarify the structural feature of a scale prepared in scale development studies. According to EFA results, as the value of the total variance increases, the factor power also increases. In addition, the ideal limit of the factor load value is 0.30, and a factor load value of 0.45 or more indicates that it can be a good measurement tool (Şencan, 2005; Çokluk et al., 2014). The EFAs performed separately for each sub-dimension of the newly-developed JSMS indicated that factor loading values were greater than 0.30 and explained total variances varied between 36.24% and 72.24%.

In scale validity and reliability studies, CFA is performed to evaluate whether the structure determined by EFA is confirmed and to evaluate the integrity of the data model. CFA has an important place because it is a method that is used to reveal this relationship pattern and examine whether the findings obtained are consistent with the theoretical structure (Erkorkmaz et al., 2013). In CFA, fit indices are examined to evaluate the validity of the model. Acceptable fit indices are as follows: 0 ≤ RMSEA ≤ 0.050, good fit and 0.050 ≤ RMSEA ≤ 0.080, acceptable fit; 0.970 ≤ CFI ≤ 1.000, good fit and 0.950 ≤ CFI ≤ 0.970, acceptable fit (Eray et al., 2016). Accordingly, the developed scale was found to fit the model well and was accepted as valid.

A scale needs to be reliable as much as it needs to be valid. Reliability can be defined as the consistency between the answers given by individuals as a response to the items of the scale. It is related to the degree of accuracy in the measurement of the factors that are needed to be measured. Cronbach's alpha coefficient is a method that is used to determine reliability and measure internal consistency, and a high alpha value indicates that the items are consistent with each other (Erbil & Bakır, 2009). It is stated that if the alpha coefficient is below < 0.39, the scale is unreliable, it has low reliability between 0.4 and 0.59, it is reliable between 0.6 and 0.79, and it has high reliability between 0.8 and 1.00 (Kula-Kartal & Mor-Dirlik, 2016). Accordingly, it was determined that Cronbach's alpha coefficient of the JSMS was 0.94 and ranged between 0.83 and 0.96 for the sub-dimensions, and it was seen that the scale had high reliability.

Invariance, which is a must-have feature for a reliable measurement tool, expresses the power of the measurement tool to give consistent results from application to application and to show time-dependent invariance (Esin, 2014). Accordingly, the final form of the scale was administered to 30 midwives with an interval of 14 days, and as a result of the Pearson correlation analysis carried out to examine the test-retest reliability of the scale, the correlation values between the subscales were found to vary between 0.81 and 0.90. The correlation values obtained were 0.70 and above, which meant that it provided test-retest reliability.

In this study, which was carried out to determine midwives’ job satisfaction, it was concluded that the Job Satisfaction in Midwifery Scale was a valid and reliable measurement tool. It can be applied to all midwives and can be used in research. It consists of 40 items and six sub-dimensions. Each item on the scale is scored from 5 to 1 ("strongly agree" to "strongly disagree"). There are six negative items on the scale (items 10, 11, 21, 27, 33, and 34). Higher scores mean that midwives have better satisfaction from their jobs. Since there is no device to measure job satisfaction in midwifery in the literature, this scale is considered to fill this gap and further contribute to the literature.

Conflict of interests: The authors report no actual or potential conflicts of interest.

Ethics approval: Ethics approval was obtained from the Çukurova University Medikal

Faculity Ethics Committee (date: 03.12.2021; issue: 117/80).

Funding: The authors received no financial support for the research, authorship, and

publication of this article.

Acknowledgements: We are thankful to all midwives.

Bilgin, Z., Kocabey, M.Y., Yeşilyurt, G., & Öztürk, D. (2017). Ebelerde örgütlenme ve iş doyumunun belirlenmesi. Sağlık Bilimleri ve Meslekleri Dergisi, 4(2), 105-110.
Bryman, A., & Cramer, D. (2002). Quantitative data analysis with SPSS release 10 for Windows: A guide for social scientists. Routledge.
Creswell, J.W. (2013). Araştırma deseni. (Çev Edt: Demir, S.B.). Ankara: Eğiten Kitap
Çokluk, Ö., Şekercioğlu, G., & Büyüköztürk, Ş. (2014). Sosyal bilimler için çok değişkenli istatistik: SPSS ve LISREL uygulamaları. Ankara: Pegem Akademi Yayınları.
Durmuş, S., & Günay, O. (2007). Hemşirelerde iş doyumu ve anksiyete düzeyini etkileyen faktörler. Erciyes Tıp Dergisi, 29(2), 139-146.
Eğinli, A.T. (2009). Çalışanlarda iş doyumu: Kamu ve özel sektör çalışanlarının iş doyumuna yönelik bir araştırma. Atatürk Üniversitesi İktisadi ve İdari Bilimler Dergisi, 23(3), 35-52.
Eray-Çelik, H., & Yılmaz, V. (2016). Lisrel 9.1 ile yapısal eşitlik modellemesi. Ankara: ANI Kitapları.
Erbil, N., & Bakır, A. (2009). Developing inventory of professional attitude at occupation. J Hum Sci, 6, 290-302.
Erkorkmaz, Ü., Etikan, İ., Demir, O., Özdamar, K., & Sanisoğlu, S.Y. (2013). Doğrulayıcı faktör analizi ve uyum indeksleri. Turkiye Klinikleri Journal of Medical Sciences, 33, 210-223.
Esin, M. (2014). Veri toplama yöntem ve araçları &Veri toplama araçlarının güvenirlik ve geçerliği (Data collection methods and tools & reliability and validity of data collection tools). Hemşirelikte Araştırma (Research in Nursing). İstanbul: Nobel Tıp Kitabevleri.
Evans, J., Taylor, J., Browne, J., Ferguson, S., Atchan, M., Maher, P., Homer, C.S., & Davis, D. (2020). The future in their hands: Graduating student midwives’ plans, job satisfaction and the desire to work in midwifery continuity of care, Women and Birth,33(1), 59-66. doi:10.1016/j.wombi.2018.11.011.
Fenwick, J., Sidebotham, M., Gamble, J., & Creedy D. (2018). The emotional and professional wellbeing of Australian midwives: a comparison between those providing continuity of midwifery care and those not providing continuity. Women and Birth, 31(1), 38-43. doi:10.1016/j.wombi.2017.06.013
Hadizadeh-Talasaz, Z., Nourani-Saadoldin, S., & Taghi-Shakeri, M. (2014). The relationship between job satisfaction and job performance among midwives working in health care centers of Mashhad, Iran. Journal of Midwifery and Reproductive Health, 2(3), 157-164.
Kaiser, H. (1974). An index of factorial simplicity. Psychometrika, 39, 31-36.
Khavayet, F., Tahery, N., Alizadeh-Ahvazi, M., & Tabnak, A. (2018). A survey of job satisfaction among midwives working in hospitals. JMRH,6(1), 1186-1192. doi:10.22038/JMRH.2017.9943.
Kula-Kartal, S., & Mor-Dirlik, E. (2016). Geçerlik kavramının tarihsel gelişimi ve güvenirlikte en çok tercih edilen yöntem: Cronbach alfa katsayısı. Bolu Abant İzzet Baysal Üniversitesi Eğitim Fakültesi Dergisi, 16, 1865-1879.
Lawshe, C.H. (1975). A quantitative approach to content validity. Personnel Psychology, 28, 563-575.
Mharapara, T. L., Staniland, N., Stadler, M., Clemons, J. H., & Dixon, L. (2022). Drivers of job satisfaction in midwifery-A work design approach, Women and Birth, 35(4), 348-355. doi:10.1016/j.wombi.2021.07.004.
Newton, M., McLachlan, H., Willis, K., & Foster, D. (2014). Comparing satisfaction and burnout between case load and standard care midwives: findings from two cross-sectional surveys conducted in Victoria, Australia. BMC Pregnancy Childbirth, 14(1), 426 doi:10.1186/s12884-014-0426-7.
Rouleau, D., Fournier, P., Philibert, A., Mbengue, B., & Dumont, A. (2012). The effects of midwives’ jobsatisfaction on burnout, intention to quit and turn over: a longitudinal study in Senegal. Hum Resourch Health. 10, 9. doi:10.1186/1478-4491-10-9.
Sevimli, F., & İşcan, Ö. F. (2005). Bireysel ve iş ortamına ait etkenler açısından iş doyumu. Ege AcademicReview, 5(1), 55-64.
Şencan, H. (2005). Sosyal ve Davranışsal Ölçümlerde Güvenilirlik ve Geçerlilik. Ankara: Seçkin Yayıncılık.
Tavşancıl, E. (2014). Tutumların ölçülmesi ve SPSS ile veri analizi. Ankara: Nobel Yayın Dağıtım.
Türe-Yılmaz, A., & Yıldırım, A. (2016). Hemşire iş doyum ölçeğinin Türkçe geçerlilik ve güvenirliği. Sağlık ve Hemşirelik Yönetimi Dergisi, 3(3), 158-168.
Veneziano, L., & Hooper, J. (1997). A method for quantifying content validity of health-relatedquestionnaires. American Journal of Health Behavior, 21(1),67-70.
Warmelink, J.C., Hoijtink, K., Noppers, M., Wiegers, T.A., de Cock, T.P., Klomp, T., & Hutton, E.K. (2015). An explorative study of factors contributing to the satisfaction of primary care midwives. Midwifery, 31(4), 482-488. doi:10.1016/j.midw.2014.12.003
Weiss, D. J., Dawis, R. V., England, G. W., & Lofquist, L. H. (1967). Manual for the Minnesota satisfaction questionnaire. Minnesota Studies in Vocational Rehabilitation. University of Minnesota, Minneapolis.
Yalnız, H., & Karaca-Saydam B. K. (2010). Ebelerde iş stresinin iş doyumuna etkisi. Balıkesir Sağlık Bilimleri Dergisi, 4(1), 16-23.
Yıldırım, A., & Şimşek, H. (2016). Sosyal bilimlerde nitel araştırma yöntemleri. Ankara: Seçkin Yayıncılık.
Yoshida, Y., & Sandall J. (2013). Occupational burnout and work factors in community and Hospital midwives: a survey analysis. Midwifery, 29(8), 921-926. doi:10.1016/jmidw. 2012.11.002.

No competing interests reported.

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Mixed pattern study on the development of midwifery profession job satisfaction scale

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