The Spanish version of the Childbirth Experience Questionnaire (CEQ-E): reliability and validity assessment

Abstract

BackgroundThe Childbirth Experience Questionnaire (CEQ) was originally designed to study women’s perceptions of labour and birth. The main objective of our study was to adapt the CEQ to the Spanish context and determine its psychometric properties. This would provide an opportunity to evaluate women’s experiences in order to improve evidence in the Spanish context as recommended by national guidelines.MethodsThe CEQ was translated into Spanish using a standard forward and back translation method (CEQ-E). A convenience sample of 364 women was recruited from 3 Spanish hospitals; all participants were able to read and write in Spanish. Mothers with high risk pregnancies or preterm deliveries were excluded from the study. A self-administered questionnaire on sociodemographic variables was completed by participants before discharge. Data on childbirth variables were obtained from maternity records. Between 1 and 3 months postpartum a postal CEQ-E questionnaire was sent.The CEQ-E structure was examined by a confirmatory factor analysis of polychoric correlations using a diagonally weighted least squares estimator. Reliability was assessed using Cronbach’s alpha. Construct validity was conducted by testing differences in CEQ-E scores between known-groups (to differ on key variables).Results226 (62.1%) of the recruited participants completed the postal questionnaire. The CEQ-E factor structure was similar to the original one. The Spanish version showed fit statistics in line with standard recommendations: CFI = 0.97; NNFI = 0.97; RMSEA = 0.066; SRMS = 0.077. The internal consistency reliability of the CEQ-E was good for the overall scale (0.88) and for all subscales (0.80, 0.90, 0.76, 0.68 for “own capacity”, “professional support”, “perceived safety” and “participation”, respectively) and similar to the original version. Women with a labour duration ≤ 12 h, women with a labour not induced, women with a normal birth and multiparous women showed higher overall CEQ-E scores and “perceived safety” subscale scores. Women with a labour duration ≤ 12 h and those with previous experience of labour obtained higher scores for the “own capacity” and “participation” subscales.ConclusionsThe results of this study indicate that the CEQ-E can be considered a valid and reliable measure of women’s perceptions of labour and birth in Spain.Electronic supplementary materialThe online version of this article (doi:10.1186/s12884-016-1100-z) contains supplementary material, which is available to authorized users.

Measuring women’s experiences of decision-making and aspects of midwifery support: a confirmatory factor analysis of the revised Childbirth Experience Questionnaire

“…Like the original CEQ [18] the CEQ2 has 22 items in the same four hypothesised domains, showing satisfying Cronbach's alphas and ability to discriminate between known groups. These results indicate that the CEQ2, like the original CEQ [19,20], shows good psychometric properties and can be applied in assessing women's birthing experiences.…”

“…Negatively worded items are reversed in scoring, including the pain item [18]. Test-retest reliability and criterion validity of the CEQ are reassuring [19] and the model has been tested with a confirmatory factor analysis [20].…”

“…Whilst the observed ceiling effects counter this argument, the sensitivity of the item could be enhanced by distinguishing targets more explicitly. Notwithstanding these limitations, the strengths of this study include a thorough groundwork in item development, building on an existing and well validated instrument [18][19][20][21], and the inclusion of items addressing decision-making and aspects of midwifery support. A further strength is that the CEQ2 is also validated for multiparous women.…”

“…those with instrumental births, those in labour in excess of 12 h, and those who had their labours augmented with oxytocin). The CEQ has since been translated and validated in several languages [19][20][21][22][23], and has been successfully implemented in empirical studies including a large variety of culturally diverse samples [24][25][26][27][28][29][30]. However, measurement instruments always hold potential for improvement, and in validating the original Swedish version of the instrument, two domains showed weaker performance; Participation and Professional Support [18].…”

Making the best of the worst: Care quality during emergency cesarean sections

“…The study was conducted at Hillerod Hospital in Denmark between June 2015 and October 2017. The study was conducted in three parts: first, a literature review [1,2,4,11,12,15,17,[20][21][22][23][24][25][26][27][28][29][30][31][32] and brainstorm among a multi-professional team involved in ECS resulted in a semi structured interview guide (S1 Appendix). Subsequently, in-depth interviews with mothers and their partners were performed.…”