Validation and factor structure of the Italian version of the Birth Satisfaction Scale-Revised (BSS-R)

Antonella Nespoli,Elisabetta Colciago,Simona Fumagalli,Anna Locatelli,Caroline J Hollins Martin,Colin R Martin

doi:10.1080/02646838.2020.1836333

Abstract

ABSTRACT Objective To validate the Italian-language version of the Birth Satisfaction Scale-Revised (BSS-R) and report key measurement properties of the tool. To evaluate the impact of antenatal class attendance on BSS-R assessed birth satisfaction. Background Maternal satisfaction is one of the standards of care defined by the World Health Organisation (WHO) to improve the quality of services. The BSS-R is a multi-dimensional self-report measure of the experience of labour and birth. Methods Cross-sectional instrument evaluation design examining factor structure and key aspects of validity and reliability. Embedded between-subjects design to examine known-group discriminant validity and the impact of antenatal class attendance on BSS-R sub-scale and total scores as dependent variables. After giving birth, 297 women provided data for analysis. Results The Italian version of the BSS-R (I-BSS-R) was the key study measure. The established three-factor and bi-factor models of the BSS-R were found to offer an excellent fit to the data. Comparison of the tri-dimensional measurement model and the bi-factor model of the BSS-R found no significant differences between models. Women who attended antenatal classes had significantly lower stress experienced during childbearing sub-scale scores (I-BSS-R SE), compared to those who did not. Good convergent, divergent validity and known-groups discriminant validity were established for the I-BSS-R. Internal consistency observations were found to be sub-optimal in this population. Conclusions On all key psychometric indices, with the exception of internal consistency that requires further investigation, the I-BSS-R was found to be a valid translation of the original BSS-R. The impact of antenatal classes on birth satisfaction warrants further research.

Highlights

Giving birth is a complex psychological individual experience, with elements of universal physiological processes and life event significance (Larkin et al, 2009)
Comparison of the tri-dimensional measurement model and the bi-factor model of the Birth Satisfaction Scale-Revised (BSS-R) found no significant differences between models
Women who attended antenatal classes had significantly lower stress experienced during childbearing sub-scale scores (I-BSS-R stress experienced during child-bearing (SE)), compared to those who did not

Summary

Introduction

Giving birth is a complex psychological individual experience, with elements of universal physiological processes and life event significance (Larkin et al, 2009). There is consensus that satisfaction with care (Christiaens & Bracke, 2007; Larkin et al, 2009) is a complex psychological individual experience, with elements of universal physiological processes and life event significance, influenced by a variety of factors. Maternal satisfaction is one of the standards of care defined by the World Health Organization (WHO) to improve the quality of maternity services and to evaluate the organization of Health Care Systems (World Health Organization, 2016); it should be considered as one of the most relevant indicators within both the midwifery and obstetric fields. Childbirth is one of the most common reason for accessing health facilities, planners, managers and health care providers should assess women’s satisfaction with care to evaluate services (Goodman et al, 2004; Hodnett, 2002)

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Conclusion