Hung Hsiao-Ying, Hung Su-Pin, Chang Ying-Ju
Department of Nursing, College of Medicine, National Cheng Kung University, Tainan, Taiwan.
Center of Teacher Education & Institute of Education, National Cheng Kung University, Tainan, Taiwan.
BMC Pregnancy Childbirth. 2020 Oct 31;20(1):659. doi: 10.1186/s12884-020-03347-3.
Antepartum activity restriction (AAR) is a common recommendation given to women at risk for preterm delivery. However, such treatment has been shown to cause heavy emotional burdens on the women receiving it since it requires them to face many challenges derived from the intervention. Nevertheless, current existing scales lack effective items that can reflect the distress of these women. The aim of this study was to develop a reliable instrument to assess the distress of women experiencing AAR.
The Prenatal Activity Restriction Stress Questionnaire (PARSQ) was developed according to comprehensive literature review, women's interviews, and existing pregnancy-special stress scales from August 2016 to July 2017 in southern Taiwan. Six experts evaluated its content validity; the Rasch rating scale model (RSM) was used to examine its item-fit, dimensionality, and reliability with 200 women with AAR experience. Furthermore, the concurrent validity was assessed through computing the correlation of AAR women's scores on the PARSQ and Perceived Stress Scale (PSS), and discriminant validity of the PARSQ was assessed to compare the scores' differences between the AAR women and the healthy pregnant women.
The PARSQ was constructed with 23 items in the 4-dimensional scale: Role function changes (8 items), Fetal safety and health (5 items), Physical and psychological care issues (5 items), and Socioeconomic and medical issues (5 items). It was confirmed to have satisfactory content vitality (CVI = 0.78 to 1.0), reasonable item-fit (0.77 to 1.51), and good reliability in RSM model, as well as adequate concurrent validity (p = 0.005) and discriminant validity (p < 0.001).
Understanding the distress of women undergoing AAR is necessary for developing appropriate prenatal care to assist women in coping with their situation to alleviate their emotional burdens. The developed PARSQ with satisfied psychometric properties can be an informative instrument for clinicians/researchers to assess the specific stress of pregnant women with AAR.
产前活动限制（AAR）是针对有早产风险的女性的常见建议。然而，这种治疗已被证明会给接受治疗的女性带来沉重的情感负担，因为这要求她们面对许多因干预而产生的挑战。尽管如此，现有的量表缺乏能够反映这些女性痛苦的有效项目。本研究的目的是开发一种可靠的工具来评估经历AAR的女性的痛苦程度。
2016年8月至2017年7月在台湾南部，根据综合文献综述、女性访谈以及现有的孕期特殊压力量表，编制了产前活动限制压力问卷（PARSQ）。六名专家评估了其内容效度；采用拉施评分量表模型（RSM）对200名有AAR经历的女性进行项目拟合、维度分析和信度检验。此外，通过计算AAR女性在PARSQ和感知压力量表（PSS）上的得分相关性来评估同时效度，并通过比较AAR女性与健康孕妇的得分差异来评估PARSQ的区分效度。
PARSQ由23个项目构成，分为4个维度：角色功能变化（8项）、胎儿安全与健康（5项）、身心护理问题（5项）以及社会经济与医疗问题（5项）。经证实，它在RSM模型中具有令人满意的内容效度（CVI = 0.78至1.0）、合理的项目拟合度（0.77至1.51）和良好的信度，以及充分的同时效度（p = 0.005）和区分效度（p < 0.001）。
了解经历AAR的女性的痛苦对于制定适当的产前护理以帮助女性应对自身状况、减轻情感负担是必要的。所开发的具有满意心理测量特性的PARSQ可为临床医生/研究人员评估有AAR的孕妇的特定压力提供有用的工具。
