Abstract
BackgroundEvaluating women’s satisfaction should reflect the entire maternity care experience (antenatal, intrapartum and postnatal). The Women’s Experience Maternity Care Scale (WEMCS) questionnaire enables this assessment. The purpose of this study was to translate in French, adapt and explore the psychometric properties of the WEMCS and to determine the best cut-off on the optimal satisfaction for the three scales.MethodsBackward, forward translation and cross-cultural adaptation were processed to validate the French version of WEMCS: Échelle de Satisfaction de l’Experience des soins en Maternité (ESEM). Psychometric tests assessed the questionnaire, which includes three scales, such as construct validity, internal consistency, Cronbach’s alpha coefficients and ceiling and floor effects. A receiver operating characteristic (ROC) curve was used to determine the best cut-off values for optimal satisfaction. Reproducibility was verified by test–retest reliability.ResultsPrimiparas with uncomplicated pregnancies were recruited antenatally at the University Hospital of Geneva. Of the 229 patients who agreed to participate, 202 women (88.2%) returned the test and retest questionnaires. Principal component analysis for the antenatal, intrapartum and postnatal scales suggested the unidimensional character of the three scales; Cronbach’s alpha coefficients were high for the three scales with values of > 0.85. Construct validity based on the five-point Likert scale values showed a Spearman’s rho correlation of r = 0.56 for the antenatal scale (p < 0.001) and r = 0.62 for the intrapartum scale (p < 0.001), as well as a strong correlation with the postnatal scale, with r = 0.78 (p < 0.001). Optimum cut-off scores for the ROC curve of the antenatal, intrapartum and postnatal scores were equal to or higher than 48, 50 and 70, respectively. The three scales showed good sensitivity and good specificity. The stability of the ESEM questionnaire was confirmed by intra-class correlation coefficients of > 0.80. However, the three scales revealed ceiling effects.ConclusionThe psychometric proprieties of the ESEM demonstrate it’s ability to evaluate the quality of perinatal health care. The ESEM should be tested in the context of different models of women’s care and with women with different degrees of pregnancy complications to explore the validity of this scale.
Highlights
Evaluating women’s satisfaction should reflect the entire maternity care experience
Scales are available to measure the expectations of control or experience of the patient and her environment during childbirth, such as the Labour Agentry Scale (LAS) [13], the Birth Satisfaction Scale (BSC) [14], the Childbirth Experiences Questionnaire (CEQ) [15], the Women’s Views of Birth Labour Satisfaction Questionnaire (WOMBLSQ) [16] and the Edinburgh Postnatal Depression Scale (EPDS) [17]
Translation and cultural adaptation The process of translation and cross-cultural adaptation from the English version to a French version was conducted through a precise, rigorous method according to recent guidelines using the five steps of translation and cross-cultural adaptation developed by Beaton, Bombardier, Guillemin and Bosi Ferraz (2000)
Summary
Evaluating women’s satisfaction should reflect the entire maternity care experience (antenatal, intrapartum and postnatal). Scales are available to measure the expectations of control or experience of the patient and her environment during childbirth, such as the Labour Agentry Scale (LAS) [13], the Birth Satisfaction Scale (BSC) [14], the Childbirth Experiences Questionnaire (CEQ) [15], the Women’s Views of Birth Labour Satisfaction Questionnaire (WOMBLSQ) [16] and the Edinburgh Postnatal Depression Scale (EPDS) [17]. These scales only measure some specific aspects of perinatal care. Given that several satisfaction scales exist to evaluate the maternity experience, there is a lack of available satisfaction scales in French for collecting data regarding specific moments of maternity care
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