School of Nursing, College of Medicine, Women Health Nursing, Soonchunhyang University, 31 Soonchunhyang 6-Gil, Dongnam-Gu, Cheonan City, 31151, Chungnam Province, Korea.
BMC Pregnancy Childbirth. 2023 Sep 16;23(1):668. doi: 10.1186/s12884-023-05975-x.
Preterm birth (PTB) is a complex and significant challenge in obstetrics. Thus, clinicians and researchers have paid a keen interest in the identification of women at a high risk for PTB. This study aimed to develop a PTB risk assessment scale based on the preliminary 32-item Preterm Birth Risk Assessment Scale-Korean version (PBRAS-K).
We enrolled 298 participants (167 in the exploratory factor analysis group from March 3, 2021 to August 31, 2021 and 131 in the confirmatory factor analysis group from December 3, 2021 to February 14, 2022) who delivered before 37 weeks after experiencing preterm symptoms and were admitted to high-risk pregnancy maternal-fetal intensive care units (MFICUs). After an item-reduction process in the exploratory factor analysis, the psychometric property scales were assessed using SPSS Statistics version 27.0, and the confirmatory factor analysis was conducted using AMOS version 27.0.
The Kaiser-Meyer-Olkin (KMO) test and Bartlett's χ test of sphericity confirmed the adequacy of the sample for factor analysis (KMO = .81 (> .80), χ = 1841.38, p < .001). The final version of the PBRAS-K comprised 23 items within seven dimensions. Factor analysis identified items explaining 65.9% of the total variance. The PBRAS-K achieved a mean score of 35.58 (± 10.35) and showed high internal consistency and satisfactory reliability (Cronbach's alpha = .85). Regarding concurrent validity, the PBRAS-K exhibited a low-to-moderate correlation with the PTB risk (r = .45, p < .001). As for criterion validity and convergent validity, the PBRAS-K showed a positive and high correlation with the Somatic Awareness Scale with Spontaneous Preterm Labor (SPL-SAS) (r = .65, p < .001) and pregnancy-related stress (r = .57, p < .001), respectively. Risk scoring for preterm delivery and SPL-SAS were moderately correlated (r = .53, p < .001).
PBRAS-23-K is a valid and reliable instrument for assessing the risk for PTB in pregnant women. Clinical nurses are encouraged to apply and obtain information regarding effective interventions in MFICUs. This scale provides meaningful results and reflects the opinions of women who had experienced PTB. The PBRAS-23-K should be evaluated for standardization and cut-off scores using larger sample sizes in the future.
早产 (PTB) 是产科的一个复杂而重大的挑战。因此，临床医生和研究人员对识别有早产高风险的女性产生了浓厚的兴趣。本研究旨在基于初步的 32 项早产风险评估量表-韩国版 (PBRAS-K) 开发一种 PTB 风险评估量表。
我们招募了 298 名参与者（2021 年 3 月 3 日至 8 月 31 日期间在探索性因素分析组的 167 名和 2021 年 12 月 3 日至 2022 年 2 月 14 日期间在验证性因素分析组的 131 名），他们在出现早产症状并被收入高危妊娠产妇胎儿重症监护病房 (MFICU) 后，在 37 周前分娩。在探索性因素分析的项目删减过程之后，使用 SPSS Statistics 版本 27.0 评估心理测量学特性量表，使用 AMOS 版本 27.0 进行验证性因素分析。
Kaiser-Meyer-Olkin (KMO) 检验和 Bartlett 的球形 χ 检验证实了因子分析样本的充分性（KMO =.81 (>.80)，χ = 1841.38，p <.001）。PBRAS-K 的最终版本由七个维度的 23 个项目组成。因素分析确定了解释总方差 65.9%的项目。PBRAS-K 的平均得分为 35.58（± 10.35），具有较高的内部一致性和令人满意的可靠性（克朗巴赫的 alpha =.85）。关于同时效度，PBRAS-K 与早产风险呈低到中度相关（r =.45，p <.001）。至于标准效度和收敛效度，PBRAS-K 与躯体意识量表自发性早产 (SPL-SAS)（r =.65，p <.001）和妊娠相关压力（r =.57，p <.001）呈正相关，分别。早产风险评分与 SPL-SAS 呈中度相关（r =.53，p <.001）。
PBRAS-23-K 是一种评估孕妇早产风险的有效且可靠的工具。鼓励临床护士在 MFICU 中应用并获得有关有效干预措施的信息。该量表提供了有意义的结果，并反映了经历过早产的女性的意见。未来应使用更大的样本量评估 PBRAS-23-K 的标准化和截断分数。
