Morris Zoë, Halabi Soha El, Hanson Claudia, Kandeya Bianca, Ayebare Elizabeth, Houngbo Gisele, Månsson Anastasia, Al-Beity Fadhlun Alwy, Annerstedt Kristi Sidney
Department of Global Public Health, Karolinska Institutet, Solna, Sweden.
Department of Disease control, London School of Hygiene & Tropical Medicine, London, UK.
BMC Pregnancy Childbirth. 2025 Mar 21;25(1):329. doi: 10.1186/s12884-025-07319-3.
The importance of respectful maternity care on optimal maternal outcomes is increasingly acknowledged globally. However, mistreatment and abuse are still experienced by women during hospital childbirth in many parts of the world, with sub-Saharan Africa being one of the places where it is most common. Interventions aiming to improve respectful maternity care must be able to assess the prevalence of responsiveness and mistreatment women experience. This is usually done with questionnaires, though these are not always validated. Scores to represent the level of responsiveness and mistreatment experienced can be created from questionnaire results and have many uses, though no score is consistently used in this field. A new questionnaire measuring responsiveness and respectful treatment was developed for use in the ALERT project, as a questionnaire covering both of these concepts did not exist. This study aimed to validate this questionnaire and to create a scoring method.
Psychometric analyses, including exploratory and confirmatory factor analysis, were performed on cross-sectional data collected from the ALERT study to identify and confirm underlying factors. Using these factors, simple summation and factor-weighted methods were used to create scores and their results compared.
Six factors were identified: "Communication & supportive care", "Hospital environment", "Maintained respect & dignity", "Social support", "Maintained privacy & confidentiality" and "Lack of physical & verbal abuse". The results of the two scoring methods developed were similar.
The responsiveness and respectful treatment questionnaire has high validity in the ALERT study population for the six factors identified. The two scoring methods developed are useful for different aspects of the ALERT intervention and can be used to facilitate comparisons or measure progress towards improving respectful maternity care in these settings.
全球范围内，尊重产妇护理对实现最佳孕产妇结局的重要性日益得到认可。然而，在世界许多地区，妇女在医院分娩期间仍遭受虐待和不当对待，撒哈拉以南非洲是此类情况最为常见的地区之一。旨在改善尊重产妇护理的干预措施必须能够评估产妇所经历的响应性和虐待情况的发生率。这通常通过问卷调查来完成，不过这些问卷并非总是经过验证的。可以根据问卷结果创建代表所经历的响应性和虐待程度的分数，这些分数有多种用途，尽管该领域并未始终一致地使用某一特定分数。由于不存在涵盖这两个概念的问卷，因此为“Alert项目”开发了一种新的测量响应性和尊重性待遇的问卷。本研究旨在验证该问卷并创建一种评分方法。
对从“Alert研究”收集的横断面数据进行心理测量分析，包括探索性和验证性因素分析，以识别和确认潜在因素。利用这些因素，采用简单求和法和因素加权法创建分数，并比较其结果。
确定了六个因素：“沟通与支持性护理”、“医院环境”、“维护尊重与尊严”、“社会支持”、“维护隐私与保密性”以及“无身体和言语虐待”。所开发的两种评分方法的结果相似。
对于所确定的六个因素，响应性和尊重性待遇问卷在“Alert研究”人群中具有较高的效度。所开发的两种评分方法对“Alert干预”的不同方面有用，可用于促进比较或衡量在这些环境中改善尊重产妇护理方面的进展。
