The development and testing of an instrument to measure maternal confidence in African-American pregnant teens.

Abstract

The purpose of this study was the development and psychometric testing of the Young Adult Maternal Confidence Scale (YAMCS), designed to measure maternal confidence in African American pregnant teens. Instrument development was conducted using a three phase process involving a literature review with concept analysis, focus groups of pregnant teens similar to the target population, and expert review. Thirteen experts were selected based on their clinical expertise and research experience in maternal child nursing, instrument development, literacy, and published research in which the phenomenon was maternal confidence. Testing of the instrument was conducted with 124 African American pregnant teens, 13 to 21 years of age. Subjects were randomly selected from three primary health care agencies and local teen health centers. The study was guided by Pender's Health Promotion Model (1990) integrated with Erikson's Theory of Development (1968). Based on responses from 124 African American pregnant teens the YAMCS was evaluated using item analysis, factor analysis, and reliability measures. Factor analysis isolated three dimensions: Perception of Ability, Uncertainty, and Mothering Behaviors. The three factors accounted for 42.2% of the variance in the 38-item measure. Cronbach's coefficient alpha for the total scale is .89. Alpha coefficients for the subscales range from .61 to .89. The Mothering Behaviors subscale (.61) needs further evaluation and testing. Test-retest reliability (<italic>n</italic> = 89) confirmed the scales stability at 2 to 3 weeks. Path analysis was conducted to examine the relationship of age and self-concept (predictor variables) and self-efficacy for self and health care, self-efficacy for infant care, prior experience with infants, and social support (mediating variables) and maternal confidence. Age had a significant indirect relationship with perception of ability and uncertainty, and a significant negative relationship with mothering behaviors. Self-concept had an indirect relationship with all three subscales as mediated by self-efficacy for infant care. No significant relationship was found between age, self-concept, prior experience with infants, or social support. This finding warrants further investigation. This study supports the validity and reliability of the YAMCS as a measure of maternal confidence in African American pregnant teens. However, further evaluation of the YAMCS with different populations is warranted.