LAUSR

AIM To develop and psychometrically test the Australian Midwifery Workplace Culture instrument. BACKGROUND Workplace culture is critical within midwifery settings. Culture determines not only the well-being and continued retention of maternity staff and managers but it also affects the quality and ultimate safety of the care they provide to women, infants and families. Several studies have identified cultural problems within maternity services. Relatively few instruments take account of the unique aspects of these workplaces and the relationship between midwives and women. DESIGN Three-stage instrument development involved item generation (based on the Culture of Care Barometer), expert content validation and a pilot test. METHODS During 2016, 38 midwifery experts reviewed the initial items, and 322 midwives then pilot-tested the draft instrument. We used exploratory factor analysis to identify key domains and to refine the instrument. RESULTS The refined instrument contained 22 items in three distinct domains: relationship with managers, empowerment and collegiality. CONCLUSION The instrument can contribute to understanding important dimensions of the culture in maternity workplaces and thus to examining problematic attitudes and practices. The instrument requires further development and testing with larger and more diverse samples of midwives and validation in specific midwifery settings and models of care.