Spiritual Care Empowerment and Midwives' Adherence to the Maternal Rights Charter: A Quasiexperimental Study Using 360-Degree Evaluation.

AIM: This study examined whether participation in a spiritual care empowerment programme was associated with changes in midwives' adherence to the Maternal Rights Charter using a 360-degree evaluation.

BACKGROUND

Adherence to maternal rights reflects respectful, person-centred, dignity-preserving maternity care. Spiritual care empowerment may enhance relational and communication competencies, but its association with observable adherence to the Maternal Rights Charter remains underexplored.

METHODS

This quasiexperimental, pretest-posttest control group study was conducted in a labour and delivery ward in Qom, Iran, from May to August 2023. Fifty-six eligible midwives were recruited through convenience sampling and assigned to the intervention or control group using simple random allocation by lottery. The final complete-case analysis included 51 midwives: 23 intervention and 28 control. The intervention group participated in an 8-h spiritual care empowerment workshop over 2 days, followed by 2 weeks of educational support; the control group received routine education only. Adherence was evaluated at baseline, 2 weeks and 2 months postworkshop using self, peer, supervisor and mother assessments. Data were analysed using two-way repeated-measures analysis of variance.

RESULTS

Significant time-by-group interactions were observed for total scores across all evaluator perspectives: self-assessment (F = 22.38, p < 0.001, ηp2 = 0.314), peer assessment (F = 29.72, p < 0.001, ηp2 = 0.378), supervisor assessment (F = 41.74, p < 0.001, ηp2 = 0.460) and mother assessment (F = 21.56, p < 0.001, ηp2 = 0.306).

CONCLUSION

Participation in the spiritual care empowerment programme was associated with improved midwives' adherence scores for the Maternal Rights Charter across evaluator perspectives.

IMPLICATIONS FOR NURSING MANAGEMENT: Nursing and midwifery managers may consider structured spiritual care empowerment as one component of continuing professional development. Multisource assessment, including mothers' perspectives, may help identify training needs and monitor changes in rights-based maternity care.