Transcultural adaptation and validation of the Tilburg Pregnancy Distress Scale (TPDS) in the Brazilian cultural context

Abstract

Objective The purpose of this study was to perform the translation, cross-cultural adaptation and validation of the Tilburg Pregnancy Distress Scale (TPDS) in the Brazilian cultural context and to verify its psychometric properties.Design Cross-cultural adaptation and validation of a distress scale.Setting The study was carried out in a prenatal clinic of a reference maternity hospital in southern Brazil.Participants 160 childbearing women.Methods The adaptation of the TPDS to the Portuguese language in its Brazilian version met the methodological criteria proposed by the International Society for Pharmacoeconomics and Outcomes Research. To validate the proposed Brazilian version, the questionnaire was applied to 160 childbearing women from the prenatal clinic of a reference maternity hospital in southern Brazil on two occasions between February and May 2018. The stability of the instrument, its internal consistency through Cronbach's alpha and the construct validity were all evaluated through exploratory factorial analysis. The extraction of main components by rotation of Varimax enabled definition of the communalities of the items of the proposed Brazilian version. The study was approved by the local Ethics Committee.Findings The test-retest technique demonstrated strong stability, with a Pearson correlation coefficient of 0.93 (p < 0.001) and an intraclass correlation coefficient of 0.92 (p < 0.001). The general Cronbach's alpha was found to be 0.73. All items presented a factorial load > 0.44 populations in the factorial analysis. Through the method of extracting components, three domains were obtained among the 16 issues of the proposed tool: (1) affection and involvement of the partner, (2) feelings about childbirth and (3) feelings about the future.Key Conclusions The proposed Brazilian version of the Tilburg Pregnancy Distress Scale to evaluate stress and anxiety in pregnancy maintained the original context of the instrument while adding features specific to Brazilian reality.Implications for Practice This is an easily understood scale that is reliable, valid and adequate to the Brazilian social context; it will aid in the assessment of anxiety and stress in childbearing women during prenatal care.