Viirman Frida, Jidrot Reidun, Lundström Linn, Ljungman Lisa
Department of Women's and Children's Health, Akademiska Sjukhuset, Uppsala University, Uppsala, Sweden.
Primary Health Care Center Tierp, County of Uppsala, Uppsala, Sweden.
Acta Obstet Gynecol Scand. 2025 Apr;104(4):658-665. doi: 10.1111/aogs.15049. Epub 2025 Jan 16.
Overall childbirth experience scores are used both in research and in clinical settings. Since it is still not fully understood what assessment of childbirth experience on a single-item numeric rating scale or visual analog scale represents, the aim of this study was to explore women's reasoning and thoughts when rating overall childbirth experience numerically.
A qualitative interview study of 26 women was conducted using a think-aloud technique at a university referral hospital in Sweden. A manifest qualitative content analysis was performed to generate categories and sub-categories representing how women decided which single value should represent their experience of giving birth.
Two main categories emerged from the analysis. The first, Strategies for choosing a number, reflects variations in how the women approached the rating scale itself and includes five sub-categories, each relating to a different strategy: (1) Comparison, (2) Start from the maximum value, (3) Start from the middle, (4) Weigh certain experiences more heavily, and (5) A means to an end. The second category, Specific factors considered in the rating, includes four sub-categories, representing groups of factors contributing to the final childbirth experience score: (1) The time period, (2) Events linked to strong emotions, (3) Perceived support, and (4) Previous expectations. What the women included in their overall childbirth experience was hence translated into a number, using strategies from the first category and factors from the second category.
The considerable variations in how women approach the rating scale, and what they include in the assessment of overall childbirth experience, suggest that not only the childbirth experience itself but also the reasoning when evaluating it, is multifaceted. A standardized phrasing of the question and a clear purpose for the evaluation is warranted to strengthen the validity of the measurement. When used clinically for identifying women in need of support after childbirth, the rating should be followed by a conversation about the experience of giving birth, independent of the value chosen.
总体分娩体验评分在研究和临床环境中均有应用。由于目前仍未完全理解在单项数字评分量表或视觉模拟量表上对分娩体验进行评估所代表的含义，本研究的目的是探讨女性在对总体分娩体验进行数字评分时的推理过程和想法。
在瑞典一家大学附属医院，采用出声思考技术对26名女性进行了定性访谈研究。进行了显性定性内容分析，以生成代表女性如何决定用哪个单一数值来代表她们分娩经历的类别和子类别。
分析得出两个主要类别。第一个类别“选择数字的策略”反映了女性对待评分量表本身的方式差异，包括五个子类别，每个子类别与一种不同的策略相关：（1）比较，（2）从最大值开始，（3）从中值开始，（4）更重视某些经历，（5）达到目的的手段。第二个类别“评分时考虑的具体因素”包括四个子类别，代表导致最终分娩体验评分的几组因素：（1）时间段，（2）与强烈情绪相关的事件，（3）感知到的支持，（4）先前的期望。因此，女性将她们总体分娩体验中包含的内容，运用第一类别的策略和第二类别的因素转化为一个数字。
女性对待评分量表的方式以及她们在总体分娩体验评估中所包含的内容存在相当大的差异，这表明不仅分娩体验本身，而且评估时的推理过程都是多方面的。为了加强测量的有效性，有必要对问题进行标准化表述并明确评估目的。当在临床上用于识别分娩后需要支持的女性时，评分之后应紧接着进行关于分娩体验的对话，而不考虑所选的值。
