Dept. of Maternal and Child Health, School of Public Health, Peking University, Beijing, China.
School of Nursing, Peking University, Beijing, China.
PLoS One. 2019 Apr 24;14(4):e0215373. doi: 10.1371/journal.pone.0215373. eCollection 2019.
The childbirth experience of women represents a significant aspect of quality care. Due to the lack of a reliable Chinese language tool for assessing childbirth experiences, examples must be adapted from other countries. The aim of this study was to translate an English version of the Childbirth Experience Questionnaire (CEQ) into Chinese and adapt this tool to the Chinese context.
A questionnaire validation study was conducted. A forward-backward translation procedure involving the developer of the CEQ was conducted. The data were collected in postnatal wards at 50 birth facilities in 4 regions of Zhejiang Province, China. Women who gave birth vaginally at the investigated facilities during the study period completed an online questionnaire that included the Chinese version of the CEQ (CEQ-C), demographic information and clinical information. Psychometric analyses were performed to assess the internal and content consistency. After subdividing the sample into subsamples, an exploratory factor analysis (EFA) and confirmatory factor analysis (CFA) were applied to examine the structural validity. Known-group comparisons were performed to assess the discriminant validity.
Overall, 1747 women participated in this study. The content validity index (CVI) of the CEQ was 0.92. Based on the comments of the experts combined with the statistical results, we removed 3 items related to pain, sense of control and sense of security and changed 3 items to different dimensions. The CFA supported the four dimensions of the CEQ-C (standard root mean square residual (SRMR) = 0.037, root mean square error of approximation (RMSEA) = 0.036, comparative fit index (CFI) = 0.966, and Tucker-Lewis index (TLI) = 0.959). Cronbach's alpha of the CEQ-C was 0.88, and McDonald's omega value was 0.91. The duration of labor, delivery mode, parity, oxytocin augmentation, pain management, companionship, prenatal education and pain experienced exerted significant effects on the women's childbirth experiences.
Although some items performed differently in our analysis comparing the English and Chinese versions of the CEQ, the CEQ-C is reliable and valid. Additionally, the CEQ-C is an easy-to-use and promising tool for measuring childbirth experiences among Chinese women in facility settings that can be used to improve the quality of intrapartum care. Efforts are needed to provide women with respectful, evidence-based intrapartum care to facilitate positive childbirth experiences.
女性的分娩体验是优质护理的重要组成部分。由于缺乏可靠的中文工具来评估分娩体验，因此必须从其他国家借鉴示例。本研究旨在将英文版的分娩体验问卷（CEQ）翻译成中文，并使其适用于中国情境。
进行问卷验证研究。采用正向-反向翻译程序，邀请 CEQ 的开发者参与。数据收集于中国浙江省 4 个地区的 50 个分娩机构的产后病房。在研究期间，在调查机构经阴道分娩的女性完成了一份在线问卷，该问卷包括中文版的 CEQ（CEQ-C）、人口统计学信息和临床信息。进行心理测量学分析以评估内部和内容一致性。在将样本细分后，进行探索性因子分析（EFA）和验证性因子分析（CFA）以检验结构效度。进行已知组比较以评估判别效度。
共有 1747 名女性参与了本研究。CEQ 的内容效度指数（CVI）为 0.92。根据专家的意见并结合统计结果，我们删除了 3 个与疼痛、控制感和安全感相关的项目，并将 3 个项目改为不同的维度。CFA 支持 CEQ-C 的四个维度（标准根均方残差（SRMR）=0.037、近似均方误差（RMSEA）=0.036、比较拟合指数（CFI）=0.966 和 Tucker-Lewis 指数（TLI）=0.959）。CEQ-C 的克朗巴赫α系数为 0.88，麦克唐纳ω值为 0.91。分娩持续时间、分娩方式、产次、催产素增强、疼痛管理、陪伴、产前教育和经历的疼痛对女性的分娩体验有显著影响。
尽管我们对英文版和中文版 CEQ 的分析中某些项目的表现不同，但 CEQ-C 是可靠且有效的。此外，CEQ-C 是一种易于使用且有前途的工具，可用于测量中国女性在医疗机构中的分娩体验，有助于提高产时护理质量。需要努力为女性提供尊重、基于证据的产时护理，以促进积极的分娩体验。
