Masoi Theresia J, Kibusi Stephen M, Sirili Nathanael, Mselle Lilian Teddy
Department of Clinical Nursing, The University of Dodoma, Dodoma, Tanzania.
Department of Public Health and Community Nursing, The University of Dodoma, Dodoma Tanzania.
PLoS One. 2025 Jun 18;20(6):e0326362. doi: 10.1371/journal.pone.0326362. eCollection 2025.
Despite the known consequences of obstetric violence, studies have encountered challenges in defining and fully understanding obstetric violence. This difficulty arises from a relative scarcity of research addressing the definition of obstetric violence across various cultures and contexts. As a result, there is a lack of consensus regarding the operational definitions of the components of obstetric violence and variations that may be influenced by geographical and cultural factors.
This study describes the process of developing and validating the context specific components of obstetric violence in the Central Zone of Tanzania.
An iterative mixed-methods design was used, using the following stages; 1. collecting and analysing qualitative data on context specific components of obstetric violence along with a literature review 2. assessing the content validity with 24 maternal health experts and face validity with 27 postnatal mothers and nine health care providers. Descriptive analysis was employed to analyse participants' characteristics and Likert scale responses from experts, postnatal mothers and health care providers. Item-level Content Validity Index (I-CVI) and Item-face Validity Index (I-FVI) was computed for each component.
Seven categories of obstetric violence components were identified through this process.These included: physical violence, lack of supportive care and treatment, subjugation care, an unfavourable care environment, sexual violence, verbal violence, emotional and psychological violence. In addition, 24 subcategories of obstetric violence were identified. The Item-Level Content Validity Index (I-CVI) ranged from 0.791 to 0.958, while the Item-Face Validity Index (I-FVI) ranged from 0.777 to 0.925.
The validated components of obstetric violence in Tanzania will contribute to a better understanding of the issue within the Tanzanian context.This in turn, may facilitate a more accurate assessment of the magnitude and impact of obstetric violence while helping to identify key areas for intervention and policy development to promote respectful maternity care.
尽管产科暴力的已知后果已为人所知，但研究在定义和全面理解产科暴力方面遇到了挑战。这种困难源于针对不同文化和背景下产科暴力定义的研究相对较少。因此，对于产科暴力各组成部分的操作定义以及可能受地理和文化因素影响的差异，缺乏共识。
本研究描述了在坦桑尼亚中部地区制定和验证产科暴力特定背景下组成部分的过程。
采用迭代混合方法设计，包括以下阶段：1. 收集和分析关于产科暴力特定背景下组成部分的定性数据，并进行文献综述；2. 由24名孕产妇健康专家评估内容效度，由27名产后母亲和9名医疗保健提供者评估表面效度。采用描述性分析来分析参与者的特征以及专家、产后母亲和医疗保健提供者的李克特量表回答。为每个组成部分计算项目级内容效度指数（I-CVI）和项目表面效度指数（I-FVI）。
通过这一过程确定了七类产科暴力组成部分。这些包括：身体暴力、缺乏支持性护理和治疗、屈辱性护理、不利的护理环境、性暴力、言语暴力、情感和心理暴力。此外，还确定了24个产科暴力子类别。项目级内容效度指数（I-CVI）范围为0.791至0.958，而项目表面效度指数（I-FVI）范围为0.777至0.925。
在坦桑尼亚验证的产科暴力组成部分将有助于在坦桑尼亚背景下更好地理解这一问题。这反过来可能有助于更准确地评估产科暴力的严重程度和影响，同时有助于确定促进尊重产妇护理的关键干预领域和政策制定方向。
