Nurses' attitudes toward provision of care and related health outcomes.

BACKGROUND: Supportive care during childbirth is as old as humankind and has been a cornerstone of intrapartum practice for decades. Researchers have postulated that supportive care during labor leads to positive outcomes by enhancing normal labor physiology and the mother's childbirth experience. Questions, however, have risen about the ability of intrapartum nurses to provide effective supportive care within today's medicalized hospital birth environment.

OBJECTIVES: The aims of this study were to examine the contribution of attitudinal, normative, and control influences on intrapartum nurses' intentions to provide professional labor support (PLS) to parturient women and to assess if behavioral intent could predict the outcome of length of labor.

METHODS: A retrospective exploratory study was used to survey 39 registered nurses and 419 nurse-patient dyads to understand the relationship between predictor variables, behavioral intention, and health outcomes. Multiple regression analysis was used for statistical analysis.

RESULTS: The Theory of Planned Behavior (TPB) explained 70% of the variance in intrapartum nurses' intentions to provide PLS to their patients. Behavioral intent (beta = -.08, rho =.677) had no statistically significant impact on a patient's length of labor.

DISCUSSION: Both attitude and social pressures had a significant impact on the intention to perform PLS, and results show the relative importance of these variables in understanding the nurse's intention to provide support. Although behavioral intent had no significant influence on behavior, as measured by the patient's length of labor, clinical significance needs to be addressed. The regression correlation suggested that as the behavioral intent scores increased, length of labor decreased in the nurse's parturient population. Further studies are required to determine if the TPB can predict health outcomes through nurses' intentions to provide care.