| Description |
The purpose of this study was 1) to survey physicians' opinions toward the ability of the nurse-midwife to deliver normal obstetric care, and 2) to examine the relationship between their attitudes and other experience factors. From the more specific attitudes a general trend was identified regarding the overall attitudes and impressions of physicians throughout the State of Utah toward the utilization of nurse-midwifery services. A mailed questionnaire was used for the survey. This tool was a replication of a questionnaire, Physician-Nurse-Midwife Study (PNMWS), designed by Seth Goldsmith for his doctoral dissertation in 1969 on Physicians' Attitudes Toward Nurse-Midwives." The study was conducted in Maryland and designed to examine the relationship between attitudes of physicians and the background and experience which could affect these attitudes. The sample surveyed in this investigation included physicians with an indicated specialty of Obstetrics and Gynecology or a General Practitioner, who was assumed to have an obstetrical practice. The sample of physicians surveyed consisted of 252 General Practitioners and 94 Obstetricians and Gynecologists, with a total number of 346. The response rate was 69.6% witn 231 physicians returning the questionnaire. Of this total, 211 returns (60.9%) were analyzed. Of the total number of responses analyzed 69.7% were from General Practitioners and 28.4% from Obstetricians and Gynecologists. The remaining 1.9% of the responses was unidentifiable. According to the physicians in Utah responding to the study, the general attitude towards the ability of the nurse-midwife to deliver normal obstetric care was overwhelmingly favorable with an overall 83.9% favorable attitude, a 10.9% undecided, and a 4.5% unfavorable attitude towards nurse-midwifery. Previous experience with nurse-midwives was correlated highly (P < .00l) with both general feeling about the previous experience, and with present association with nurse-midwives. Positive or negative feeling toward the previous experience with nurse-midwives was correlated (P < .001), with present association, also with the general attitude (P = .05) of the physician towards nurse-midwifery functions. Therefore, the finding of Goldsmith, that past experience with nurse-midwives does not influence as much as the impression left by a positive or negative experience with the nurse-midwife, was supported. As was shown by the significantly correlated findings, one way analysis of variance also showed statistical significance, P< .0000 (19.9 F-ratio), regarding the type of previous experience a physician had with a nurse-midwife is important to his present association with nurse-midwives. This study's finding showed similarity between the group with no previous experience with nurse-midwives, and the group of physicians having had a negative experience, while the positive and undecided groups were similar, but at opposing ends. Analysis of all the attitudinal items in relation to the type of previous experience revealed many statistically significant findings. More often than not, for all the significant items, the negative experience group tended to be less favorable toward the nurse-midwife performing certain procedures. On the other hand, the positive experience group tended to have more favorable opinions concerning the items of statistical significance. Therefore, general opinion was found to be statistically significant, P = .047 (2.69 F-ratio) in relation to the reaction and feeling about the type of experience physicians have had with nurse-midwives. The group of physicians with negative experience expressed undecided opinions, as well as but more so than, the no association and undecided groups. The more positive the previous experience, the more favorable was the general attitude. The fact remains, however, that even the physicians who had a negative experience were not generally unfavorable toward the nurse-midwife performing the various functions in normal obstetric care. |
