The Spanish version of the Childbirth Experience Questionnaire (CEQ-E): reliability and validity assessment

F J Soriano-Vidal, A Oliver-Roig, J Cabrero-García, N Congost-Maestre, A Dencker, M Richart-Martínez, F J Soriano-Vidal, A Oliver-Roig, J Cabrero-García, N Congost-Maestre, A Dencker, M Richart-Martínez

Abstract

Background: The Childbirth Experience Questionnaire (CEQ) was originally designed to study women's perceptions of labour and birth. The main objective of our study was to adapt the CEQ to the Spanish context and determine its psychometric properties. This would provide an opportunity to evaluate women's experiences in order to improve evidence in the Spanish context as recommended by national guidelines.

Methods: The CEQ was translated into Spanish using a standard forward and back translation method (CEQ-E). A convenience sample of 364 women was recruited from 3 Spanish hospitals; all participants were able to read and write in Spanish. Mothers with high risk pregnancies or preterm deliveries were excluded from the study. A self-administered questionnaire on sociodemographic variables was completed by participants before discharge. Data on childbirth variables were obtained from maternity records. Between 1 and 3 months postpartum a postal CEQ-E questionnaire was sent. The CEQ-E structure was examined by a confirmatory factor analysis of polychoric correlations using a diagonally weighted least squares estimator. Reliability was assessed using Cronbach's alpha. Construct validity was conducted by testing differences in CEQ-E scores between known-groups (to differ on key variables).

Results: 226 (62.1%) of the recruited participants completed the postal questionnaire. The CEQ-E factor structure was similar to the original one. The Spanish version showed fit statistics in line with standard recommendations: CFI = 0.97; NNFI = 0.97; RMSEA = 0.066; SRMS = 0.077. The internal consistency reliability of the CEQ-E was good for the overall scale (0.88) and for all subscales (0.80, 0.90, 0.76, 0.68 for "own capacity", "professional support", "perceived safety" and "participation", respectively) and similar to the original version. Women with a labour duration ≤ 12 h, women with a labour not induced, women with a normal birth and multiparous women showed higher overall CEQ-E scores and "perceived safety" subscale scores. Women with a labour duration ≤ 12 h and those with previous experience of labour obtained higher scores for the "own capacity" and "participation" subscales.

Conclusions: The results of this study indicate that the CEQ-E can be considered a valid and reliable measure of women's perceptions of labour and birth in Spain.

Keywords: Birth satisfaction; Childbirth experience questionnaire; Construct validity; Patient satisfaction; Postpartum period; Reliability.

References

    1. Ten H-BP, De Bernis L, Campbell J, Downe S, Fauveau V, Fogstad H, et al. Improvement of maternal and newborn health through midwifery. Lancet. 2014;384:1226–1235. doi: 10.1016/S0140-6736(14)60930-2.
    1. Ketting E, Esin A. Integrating sexual and reproductive health in primary health care in Europe: position paper of the European Forum for Primary Care. Qual Prim Care. 2010;18:269–282.
    1. Clinical Practice Guideline on Care in Normal Childbirth. Clinical Practice Guideline on Care in Normal Childbirth. Quality Plan for the Spanish National Healthcare System of the Spanish Ministry for Health and Social Policy. Health Technology Assessment Agency of the Basque Country (OSTEBA). Health Technology Assessment Agency of Galicia (Avalia-t). 2010. Clinical Practice Guidelines in the Spanish National Healthcare System: OSTEBA No. 2009/01. Available from:
    1. Escuriet R, White J, Beeckman K, Frith L, Leon-Larios F, Loytved C, et al. Assessing the performance of maternity care in Europe: a critical exploration of tools and indicators. BMC Health Serv Res. 2015;15:491. doi: 10.1186/s12913-015-1151-2.
    1. Escuriet R, Llavoré M, Canalis B, De Molina I, Brull H. Maternity care in different countries. In: Escuriet R, editor. Midwife’s contribution. Barcelona: Consell de Col · legis d’Infermeres i Infermers de Catalunya; 2016.
    1. Renfrew MJ, McFadden A, Bastos MH, Campbell J, Channon AA, Cheung NF, et al. Midwifery and quality care: findings from a new evidence-informed framework for maternal and newborn care. Lancet. 2014;384:1129–1145. doi: 10.1016/S0140-6736(14)60789-3.
    1. National Institute for Health and Care Excellence (NICE) Guideline: Intrapartum care: care of healthy women and their babies during childbirth. London: NICE; 2014.
    1. Epstein RM, Street RL. The Values and Value of Patient-Centered Care. American Academy of Family Physicians. 2011;9:100–103.
    1. Hudon C, Fortin M, Haggerty JL, Lambert M, Poitras M-E. Measuring Patients’ Perceptions of Patient-Centered Care: A Systematic Review of Tools for Family Medicine. Ann Fam Med. 2011;9:155–164. doi: 10.1370/afm.1226.
    1. Lawrence HC, Copel J, O’Keeffe DF, Bradford WC, Scarrow PK, Kennedy HP, et al. Quality patient care in labor and delivery: a call to action. Am J Obstet Gynecol. 2012;207:147–148. doi: 10.1016/j.ajog.2012.07.018.
    1. Ministry of health social services and equality. National Strategy for Sexual and Reproductive Health [Internet]. Madrid; 2012. Available from:
    1. Staniszewska S, Herron-Marx S, Mockford C. Measuring the impact of patient and public involvement: the need for an evidence base. Int J Qual Heal Care. 2008;20:373–374. doi: 10.1093/intqhc/mzn044.
    1. Howell E, Concato J. Obstetric patient satisfaction: asking patients what they like. Am J Obstet Gynecol. 2004;190:175–182. doi: 10.1016/j.ajog.2003.06.006.
    1. Larkin P, Begley CM, Devane D. “Not enough people to look after you”: An exploration of women’s experiences of childbirth in the Republic of Ireland. Midwifery. 2012;28:98–105. doi: 10.1016/j.midw.2010.11.007.
    1. Sawyer A, Ayers S, Abbott J, Gyte G, Rabe H, Duley L. Measures of satisfaction with care during labour and birth: a comparative review. BMC Pregnancy and Childbirth. 2013;13:108. doi: 10.1186/1471-2393-13-108.
    1. Ministry of health and social policy. Quality plan for the national health system of Spain. Madrid, 2010. Available from: .
    1. Reisz S, Jacobvitz D, George C. Birth and motherhood: childbirth experience and mothers' perceptions of themselves and their babies. Infant Ment Health J 2015;36:167–78. Available from: .
    1. Goodman P, Mackey MC, Tavakoli AS. Factors related to childbirth satisfaction. J Adv Nurs. 2004;46:212–219. doi: 10.1111/j.1365-2648.2003.02981.x.
    1. Pang MW, Leung TN, Lau TK, Hang Chung TK. Impact of First Childbirth on Changes in Women’s Preference for Mode of Delivery: Follow-up of a Longitudinal Observational Study. Birth. 2008;35:121–128. doi: 10.1111/j.1523-536X.2008.00225.x.
    1. Hauck Y, Fenwick J, Downie J, Butt J. The influence of childbirth expectations on Western Australian women’s perceptions of their birth experience. Midwifery. 2007;23:235–247. doi: 10.1016/j.midw.2006.02.002.
    1. Dwamena F, Holmes-Rovner M, Gaulden CM, Jorgenson S, Sadigh G, Sikorskii A, et al. Interventions for providers to promote a patient-centred approach in clinical consultations. In: Holmes-Rovner M, et al., editors. Cochrane Database Syst. Rev. Chichester: John Wiley & Sons, Ltd; 2012.
    1. Larkin P, Begley CM, Devane D. Women’s experiences of labour and birth: an evolutionary concept analysis. Midwifery. 2009;25:e49–e59. doi: 10.1016/j.midw.2007.07.010.
    1. Christiaens W, Bracke P. Assessment of social psychological determinants of satisfaction with childbirth in a cross-national perspective. BMC Pregnancy Childbirth. 2007;7:26. doi: 10.1186/1471-2393-7-26.
    1. Dencker A, Taft C, Bergqvist L, Lilja H, Berg M. Childbirth experience questionnaire (CEQ): development and evaluation of a multidimensional instrument. BMC Pregnancy Childbirth. 2010;10:81. doi: 10.1186/1471-2393-10-81.
    1. Muñiz J, Elosua P, Hambleton RK, International Test Commission [International Test Commission Guidelines for test translation and adaptation: second edition. Psicothema. 2013;25:151–157.
    1. Walker KF, Wilson P, Bugg GJ, Dencker A, Thornton JG. Childbirth experience questionnaire: validating its use in the United Kingdom. BMC Pregnancy Childbirth. 2015;15:86. doi: 10.1186/s12884-015-0513-4.
    1. Acquadro C, Conway K, Giroudet C, Mear I. Linguistic Validation Manual for Health Outcome Assessments. Lyon: MAPI Research Institute; 2012.
    1. Fayers PM, Machin D. Quality of Life. Chichester: John Wiley & Sons, Ltd; 2000.
    1. Terwee CB, Mokkink LB, Knol DL, Ostelo RWJG, Bouter LM, De Vet HCW. Rating the methodological quality in systematic reviews of studies on measurement properties: a scoring system for the COSMIN checklist. Qual Life Res. 2012;21:651–657. doi: 10.1007/s11136-011-9960-1.
    1. Nystedt A, Högberg U, Lundman B. The negative birth experience of prolonged labour: A case-referent study. J Clin Nurs. 2005;14:579–586. doi: 10.1111/j.1365-2702.2004.01105.x.
    1. Waldenström U, Hildingsson I, Rubertsson C, Rådestad I. A negative birth experience: prevalence and risk factors in a national sample. Birth. 2004;31:17–27. doi: 10.1111/j.0730-7659.2004.0270.x.
    1. Ayers S, Joseph S, McKenzie-McHarg K, Slade P, Wijma K. Post-traumatic stress disorder following childbirth: current issues and recommendations for future research. J Psychosom Obstet Gynaecol. 2008;29:240–50. Available from: .
    1. Henderson J, Redshaw M. Who is well after childbirth? Factors related to positive outcome. Birth. 2013;40:1–9. doi: 10.1111/birt.12022.
    1. Waldenström U. Experience of labor and birth in 1111 women. J Psychosom Res 1999;47:471–82. Available from: .
    1. Cohen J. Statistical Power Analysis for the Behavioural Sciences. 2nd ed. Hillsdale, New Jersey: Lawrence Erlbaum Associates; 1988.
    1. Lavender T, Walkinshaw S, Walton I. A prospective study of women’s views of factors contributing to a positive birth experience. Midwifery [Internet]. 1999 [cited 2014 Nov 29]; Available from: .
    1. Rowlands IJ, Redshaw M. Mode of birth and women’s psychological and physical wellbeing in the postnatal period. BMC Pregnancy Childbirth. 2012;12:138. doi: 10.1186/1471-2393-12-138.
    1. OSIP. Observatorio de Salud Infantil y Perinatal (OSIP). Situación de la salud infantil y perinatal en la Comunitat Valenciana 2009 [Internet]. Valencia; 2010. Available from: .
    1. EURO-PERISTAT Project with SCPE and EUROCAT. European Perinatal Health Report. The health and care of pregnant women and babies in Europe in 2010. May 2013. Available from: .
    1. Waldenström U. Why Do Some Women Change Their Opinion About Childbirth Over Time? Birth. 2010;31:102–107. doi: 10.1111/j.0730-7659.2004.00287.x.
    1. Waldenstrom U. Women’s Memory of Childbirth at Two Months and One Year after the Birth. Birth. 2003;30:248–254. doi: 10.1046/j.1523-536X.2003.00254.x.
    1. Tinti C, Schmidt S, Businaro N. Pain and emotions reported after childbirth and recalled 6 months later: the role of controllability. J Psychosom Obstet Gynecol. 2011;32:98–103. doi: 10.3109/0167482X.2011.557756.

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