Department of Obstetrics and Gynaecology, Regional Hospital of Randers, Randers NØ, Denmark.
Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark.
PLoS One. 2020 May 14;15(5):e0233122. doi: 10.1371/journal.pone.0233122. eCollection 2020.
When determining optimal treatment regimens, patient reported outcomes including satisfaction are increasingly appreciated. It is well established that the birth experience may affect the postnatal attachment to the newborn and the management of subsequent pregnancies and deliveries. As we have no robust validated Danish tool to evaluate the childbirth experience exists, we aimed to perform a transcultural adaptation of the Childbirth Experience Questionnaire (CEQ) to a Danish context.
In accordance with the COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN), we translated the Swedish-CEQ to Danish. The Danish-CEQ was tested for content validity among 10 new mothers. In a population of women who have had their labour induced, we then assessed the electronic questionnaire for validity and reliability using factor analytical design, hypothesis testing, and internal consistency. Based on these data, we determined criterion and construct responsiveness in addition to floor and ceiling effects.
The content validation resulted in minor adjustments in two items. This improved the comprehensibility. The electronic questionnaire was completed by 377 of 495 women (76.2%). The original Swedish-CEQ was four-dimensional, however an exploratory factor analysis revealed a three-dimensional structure in our Danish population (Own capacity, Participation, and Professional support). Parous women, women who delivered vaginally, and women with a labour duration <12 hours had a higher score in each domain. The internal consistency (Cronbach's alpha) ranged between 0.75 and 0.89 and the ICC between 0.68-0.93. We found ceiling effects of 57.6% in the domain Professional support and of 25.5% in the domain Participation.
This study offers transcultural adaptation of the Swedish-CEQ to a Danish context. The 3-dimensional Danish-CEQ demonstrates construct validity and reliability. Our results revealed significant ceiling effect especially in the domain Professional support, which needs to be acknowledged when considering implementing the Danish-CEQ into trials and clinical practice.
在确定最佳治疗方案时，患者报告的结果（包括满意度）越来越受到重视。众所周知，分娩经历可能会影响产后对新生儿的依恋以及对后续妊娠和分娩的管理。由于我们没有经过验证的丹麦语工具来评估分娩体验，因此我们旨在将瑞典版的分娩体验问卷（CEQ）进行跨文化改编，以适应丹麦的情况。
根据共识基础的健康测量工具选择标准（COSMIN），我们将瑞典版的 CEQ 翻译成丹麦语。丹麦版的 CEQ 在 10 位新妈妈中进行了内容有效性测试。然后，在已经进行引产的女性人群中，我们使用因子分析设计、假设检验和内部一致性来评估电子问卷的有效性和可靠性。基于这些数据，我们确定了标准和结构反应性，以及地板和天花板效应。
内容验证导致两个项目进行了细微调整，从而提高了理解性。电子问卷完成了 495 名女性中的 377 名（76.2%）。原始的瑞典版 CEQ 是四维度的，但是我们丹麦人群的探索性因子分析显示了三维度结构（自身能力、参与度和专业支持）。经产妇、阴道分娩的女性和产程<12 小时的女性在每个领域的得分都较高。内部一致性（Cronbach's alpha）在 0.75 到 0.89 之间，ICC 在 0.68-0.93 之间。我们发现专业支持领域的天花板效应为 57.6%，参与领域的天花板效应为 25.5%。
本研究提供了瑞典版 CEQ 到丹麦语的跨文化改编。3 维度的丹麦版 CEQ 显示出了结构有效性和可靠性。我们的结果显示出了显著的天花板效应，特别是在专业支持领域，这在考虑将丹麦版 CEQ 应用于试验和临床实践时需要注意。
