Childbirth Experience Questionnaire: Cross-cultural validation and psychometric evaluation for European Portuguese

Abstract

Background: Self-reported measures are relevant both for the clinic and for health evaluation because they provide an interpretation of quality parameters. Women who experience labour can express themselves through these measures, identifying indicators that need improvement. Objective: The objective of this study is to adapt the Childbirth Experience Questionnaire to the Portuguese context and to determine its psychometric properties. Method: A methodological study carried out with a convenience sample where the participants were 161 female users of a hospital in southern Portugal. They were aged between 20 and 43 years (M = 31.05, SD = 4.87) and answered a questionnaire approximately 48 h postpartum, preserving the ethical principles. The original instrument, with 22 items, underwent the linguistic and cultural adequacy process. Results: Factor analysis with Varimax rotation was performed, revealing a set of 19 items with factor weights above .400. The set of items remained four-dimensional as the original, explaining 62.517% of the variance. In the retest, the reliability results showed that similar characteristics to the original study are maintained in the two subscales that express ‘Participation’ (three items) and ‘Professional Support’ (four items), with internal consistency values of .807 and .782. The ‘Own Performance’ and ‘Own Threshold’ subscales were elaborated from the results of the Varimax rotation, presenting Cronbach’s alpha coefficients of .840 and 714, respectively. The total scale showed alpha values of .873 and .823 in the test and retest, respectively. Time stability showed a positive association, with r = .659 (p < .001). Accuracy through the split-half method reached an alpha value of .880 with Spearman–Brown correction. The floor effect was high in the ‘Participation’ subscale, both in the test and in the retest. Convergent validity between the instrument and the ‘Index of Strategies for Pain Relief in Labour’ discrete variable showed a Spearman’s rho value of .209 (p = .011) in the total scale. In discriminating validity, the Mann–Whitney test reveals that the women who recognize interactions with the midwife have more favourable scores in Childbirth Experience Questionnaire (U = 2748.000; Z = 2.905; p = .004). Conclusion: The current version in European Portuguese suggests that it is a valid and reliable measure. This study may facilitate other validation processes in Lusophony countries.