Episiotomy Skills Self-Efficacy Scale (ESSES): Development and psychometric properties

Background: Episiotomy is a surgical procedure that increases midwifery students' anxiety levels and reduces their self-efficacy levels. However, there is no valid and reliable tool to assess the student's episiotomy experience-related self-efficacy levels. Objectives: The study was aimed at developing the Episiotomy Skills Self-Efficacy Scale and investigating its psychometric properties. Design: In the study, the descriptive, cross-sectional and methodological design was used. Setting: The study was conducted at the midwifery department of a state university in western Turkey. Participants: The study sample included 209 midwifery students selected using the convenience sampling method. Methods: A comprehensive literature review and expert panel was conducted on episiotomy skills. Content validity was performed by 10 health professionals. Of them, one was an obstetrician and gynecologist, four were midwives and five were faculty members working in midwifery departments of different universities. The Episiotomy Skills Self-Efficacy Scale was administered to the 3rd and 4th grade students who had taken a course on childbirth. The inclusion criteria were as follows: having received episiotomy training, and having opened and closed an episiotomy on a model in the laboratory. Exploratory and confirmatory factor analysis was performed within the scope of validity. Reliability was evaluated with the Cronbach's alpha method and item-total correlations. Results: A two-factor structure which explained 77.96 % of the total variance was obtained by factor analysis. Its "Preparation for and Implementation of Episiotomy" dimension includes 11 items, and "Episiotomy Repair and Control" dimension includes 8 items. Model fit indices were at an acceptable level. The Cronbach's alpha coefficient of the scale was 0.97. Conclusions: The Episiotomy Skills Self-Efficacy Scale has sufficient psychometric validity and reliability. It is short and easily administered.