Cultural adaptation and psychometric validation of the Pregnancy Experience Scale-Brief version (PES-Brief) in Pakistani women with antenatal anxiety symptoms

Ahmed Zaidi, Aasia Khan, Armaan Rowther, Huma Nazir, Jamie Perin, Nida Rauf, Sidra Mumtaz, Hina Naseem, Najia Atif, Atif Rahman, Pamela J Surkan, Abid Malik, Ahmed Zaidi, Aasia Khan, Armaan Rowther, Huma Nazir, Jamie Perin, Nida Rauf, Sidra Mumtaz, Hina Naseem, Najia Atif, Atif Rahman, Pamela J Surkan, Abid Malik

Abstract

Background: Pregnancy experiences influence fetal and birth outcomes. There is scarcity of locally validated tools to assess pregnancy experiences. We aimed to validate the Pregnancy Experience Scale-Brief (PES-Brief) in pregnant Pakistani women with anxiety symptoms.

Methods: A two-step process was used including 1) adaptation via translation/back-translation followed by cognitive interviewing with 10 participants and 2) factor analysis and validation with 605 women in Rawalpindi Pakistan who had mild-moderate symptoms of anxiety, attended the antenatal clinic, and were ≤22 weeks of gestation and ≥18 years old. We calculated internal consistency and reliability and conducted exploratory and confirmatory factor analyses.

Results: Cultural adaptation led to inclusion of one item of the hassles subscale and exclusion of one item in the uplifts subscale, resulting in 9 uplifts and 11 hassles. Exploratory factor analysis supported a two-factor structure, with the adapted items exhibiting loading values of ≥0.24 for their respective factors. Internal consistency was demonstrated for uplifts (Cronbach's alpha = 0.89) and hassles (Cronbach's alpha = 0.85) subscales. Uplift intensity was moderately correlated with the Hospital Anxiety and Depression Scale anxiety subscale (r = 0.54, 95% CI:0.30-0.77).

Conclusion: The Urdu PES-Brief is a reliable and valid tool for use in Pakistani pregnant women with antenatal anxiety. Future studies on its validity are needed on women without symptoms anxiety.

Keywords: Cultural adaptation; Factor analysis; PES-Brief; Pregnancy experience; Psychometrics; Validation.

Conflict of interest statement

Declaration of competing interests The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.

Figures

Fig. A.1.
Fig. A.1.
Scree plot displaying the eigenvalues for different numbers of factors in the Pregnancy Experience Scale-Brief (N = 605).

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