Reliability And Validity Of The Chinese Version Of The Traumatic Childbirth Perception Scale

ObjectiveThe study aims to Chineseize the Traumatic Childbirth Perception Scale(TCPS)and to test the reliability and validity of the Chinese version of TCPS(TCPS-C),to provide national researchers with a tool to assess traumatic childbirth.Methods(1)Translation: Contact the scale developer,Prof.Yalniz,to obtain authorization for the scale.A translation team of six bilingual staff members translated and localized the adaptation of the scale following the guideline of translation,adaptation,and validation of instruments,and a modified version of the Brislin translation model.(2)Preliminary survey: Thirty women who met the inclusion criteria were recruited for the pre-survey.Participants were tested on their level of understanding of the scale content,their feelings about filling out the scale,recording the time of filling out the scale,and related suggestions.(3)Expert Consultation: Six experts were invited to choose the relevance of each item of the Chinese scale to the content reflected by the instrument,according to the actual situation and language habits in China.The experts evaluated the content of the entries based on their theoretical practical experience and knowledge and proposed opinions.According to the participants’ feedback and the expert group’s suggestions,the entries with problems were appropriately adjusted to form a formal TCPS-C for the formal survey.(4)Reliability and validity test: A convenience sampling method was used to select645 cases of women as study subjects from Anhui province,China,who were students in a university,patients in the gynecological clinic and obstetric clinic of a tertiary general hospital,and planned immunization department of a community hospital,to test reliability and validity of the TCPS-C.Item analysis was used to test the discrimination and homogeneity of the scale entries.Reliability tests were conducted using test-retest reliability,split-half reliability,and Cronbach’s alpha coefficient.Validity tests include content validity,structural validity,and criterion-related validity.content validity expressed as Item-Level Content Validity Index(I-CVI)and Scale-Level Content Validity Index(S-CVI),structural validity examined using Exploratory Factor Analysis(EFA)and Confirmatory Factor Analysis(CFA),and criterion-related validity expressed by the Pearson correlation coefficient.Results(1)Of the 645 study subjects,232 were women who had not been pregnant,212 were pregnant women,and 201 were fertile women.(2)Item analysis: The mean scores of the high and low subgroups of women who had not been pregnant,women who were pregnant,women who were fertile,and all study subjects were compared on each entry,and the differences were statistically significant.The correlation coefficient between each item and the scale’s total score was0.476～0.746 for women who had not been pregnant,0.579～0.849 for women who were pregnant,0.586～0.778 for women who were fertile,0.555～0.791 for all participants,and all P<0.001.(3)Reliability Analysis: The test-retest reliability of the Chinese version of TCPS was 0.853(P<0.001).Split-half reliability of 0.759 and a Cronbach’s alpha coefficient of 0.897 for women who had not been pregnant.Split-half reliability of 0.890 and a Cronbach’s alpha coefficient of 0.918 for women who were pregnant.Split-half reliability of 0.805 and a Cronbach’s alpha coefficient of 0.907 for women who were fertile.Split-half reliability of 0.833 and a Cronbach’s alpha coefficient was 0.916 for the whole study population.(4)Validity analysis: The I-CVI ranged from 0.83 to 1.00 and the S-CVI was 0.92 for the scale.Three factors were extracted from women who had not been pregnant,women who were pregnant,women who were fertile,and all the study subjects,but the entries were attributed slightly differently,Cumulative variance contribution rates were69.89%,68.51%,66.63%,and 74.40%,respectively,and the CFA showed a good model fit.Correlation analysis showed that the Chinese version of TCPS was positively correlated with Childbirth Fear Prior to Pregnancy,fear of childbirth,post-traumatic stress disorder,anxiety,and depression.Conclusion The TCPS-C has good reliability and validity and can be used to determine the perceived level and severity of traumatic childbirth in women.