Toward the development of a short multi‐country person‐centered maternity care scale

Abstract

Objective To develop a shortened, valid and reliable scale applicable across multiple settings for routine monitoring of person‐centered maternity care (PCMC). Methods Exploratory analysis was used to generate parsimonious versions of a 30‐item PCMC scale in four datasets from cross‐sectional surveys conducted between August 2016 and October 2017, involving women aged 15–49 years in Kenya, Ghana and India who had recently given birth. Analysis was informed by expert opinion via a separate online survey of global maternal and child health experts. Items retained in each dataset were compared, and those unique to a single setting removed. The remaining items were pooled and assessed for construct and criterion validity and reliability in each setting. Results Thirteen items were retained for a potential multi‐setting short PCMC scale, incorporating the domains of dignity and respect, communication and autonomy, and supportive care. Cronbach's alpha for the scale was >0.7 in each setting. Scores on the 13‐item scale were correlated with the 30‐item scale scores, and with global measures of care satisfaction in Kenya and India. Conclusion Analysis yielded a 47% shorter PCMC scale, that showed promise for routine assessment of women's experience of care during childbirth across multiple settings. However, further validation is needed.

Quality of measures on respectful and disrespectful maternity care: A systematic review

“…The tools included were the following: Respectful Maternity Care (Afulani, Diamond-Smith, Phillips, Singhal, & Sudhinaraset, 2018), and shortform PCMC (Afulani et al, 2019). The original PCMC-30 item scale was validated in India with 27 items loaded in the factor analysis (Afulani et al, 2018).…”

“…The original PCMC-30 item scale was validated in India with 27 items loaded in the factor analysis (Afulani et al, 2018). A short-form PCMC with 13 items was then developed from the original PCMC-30 scale (Afulani et al, 2019).…”

“…experts were asked to prioritize 15 of the original 30 PCMC items rather than independently assess all items for comprehensiveness, which may have resulted in more items being included (Afulani et al, 2019). The quality of the studies in terms of their measurement properties and level of evidence are shown in Tables 4 and 5, respectively.…”

“…Three studies used only exploratory factor analysis (EFA; Afulani et al, 2017;Ayoubi et al, 2020;Sheferaw et al, 2016), two used both EFA and confirmatory factor analysis (CFA; Afulani et al, 2018; Afulani et al, 2019), and 4-point response: "no, never," "yes, a few times," "yes, most of the time," and "yes, all the time" (for 2 questions on verbal and physical abuse, "no, never," "yes, once," "yes, a few times," and "yes, many times") 4-point response: "no, never," "yes, a few times," "yes, most of the time," and "yes, all the time" (for 2 questions on verbal and physical abuse, "no, never," "yes, once," "yes, a few times," and "yes, many times") one used CFA alone (Taavoni et al, 2018). Half of the studies were of "very good" methodological quality (Afulani et al, 2018;Afulani et al, 2019;Taavoni et al, 2018), while half were of "adequate" methodological quality (Afulani et al, 2017;Ayoubi et al, 2020;Sheferaw et al, 2016). The RMC, WP-RMC, PCMC-30 and PCMC-27 were given an "indeterminate rating" as no values for the factor analyses were provided.…”

“…Criterion validity is defined as the degree to which the scores of a scale are an adequate reflection of a gold standard (Mokkink et al, 2018). However, there was no gold standard for tools included in the review except for the short-form PCMC (Afulani et al, 2019).…”