Development of a scale for perception of childbirth experience in regard to cesarean delivery

Abstract

Purpose

The aim of this study was to consider items and develop a scale that measures mothers’ perceptions of the childbirth experience in regard to cesarean delivery.

Subjects and Methods

An anonymous, self-administered questionnaire survey was conducted on puerperal patients in four hospitals who had undergone either emergency or planned cesarean delivery between March 13 and August 31, 2015. The survey was conducted using the placement method.

A draft scale composed of 26 items was designed for use in the questionnaire based on previous literature. After item analysis of the draft scale, the data were analyzed using principal factor analysis with promax rotation. The reliability of the scale was confirmed by Cronbach's α coefficient and item-total correlation, and the validity was confirmed by known-groups and content validity.

This study was approved by the Ethics Committee on Epidemiological Studies at the Kagoshima University Faculty of Medicine (Approval No. 327).

Results

Valid responses were collected from 134 mothers.

Three items were rejected based on item analysis of the draft scale. Factor analysis on the remaining 23 items identified 15 items and the following three factors: “feelings of fulfillment toward birth” (seven items), “adaptation to cesarean delivery” (five items), and “acceptance of my delivery method” (three items).

Regarding the reliability of the scale, Cronbach's α coefficient was 0.823 (0.636–0.840 for subordinate factors). Item-total correlation indicated a significant correlation between all items and total score (p<0.01). Therefore, the reliability of this scale was confirmed for each factor.

Regarding the validity of the scale, the mean scores for emergency cesarean delivery were significantly lower than those for planned cesarean delivery (p<0.01), which confirmed the known-groups validity of the scale; this result was similar to those reported in previous studies. Content validity was established because the extracted factors were generally consistent with the opinions expressed by a midwifery expert in the free descriptions in the questionnaire.

Conclusion

The newly developed scale used in this study, which was composed of three factors, showed good reliability and validity, which suggested that it was appropriate for measuring mothers’ perceptions of the childbirth experience in regard to cesarean delivery. This scale can be used during birth reviews to improve care for puerperal patients who had a cesarean delivery.