Validation of the Italian version of the Revised Prenatal Coping Inventory (NuPCI) and its correlations with Pregnancy-Specific Stress.

Abstract

Background: Pregnancy is a period of happiness but also of physical and psychological changes that can lead to distress. Functional coping strategies can reduce the pregnancy specific-stress. This study aimed to assess the psychometric properties of the Revised Prenatal Coping Inventory (NuPCI) in an Italian sample and to investigate how coping strategies were associated with pregnancy-specific stress.Methods: In this cross-sectional study, low-risk pregnant women (N=211) were assessed with NuPCI, NuPDQ (Revised-Prenatal Distress Questionnaire), Brief-COPE (Coping Orientation to the Problems Experienced), and STAI (State-Trait Anxiety Inventory). The reliability of NuPCI was evaluated by assessing its internal consistency and factor structure (with a Confirmatory Factor Analysis, CFA). The concurrent validity between NuPCI and Brief-COPE and NuPDQ and STAI was investigated. Lastly, the relationship between NuPCI and NuPDQ was analyzed, as well as the ability of these scales to predict Apgar score at birth.Results: Internal consistency of NuPCI scales was good for Planning-Preparation (ɑC=0.84) and Spiritual-Positive Coping (ɑC=0.81) scales, acceptable for Avoidance (ɑC=0.76) scale. Moreover, the original three-factor structure was confirmed using a Confirmatory Factor Analysis with 29 of the 32 items (χ2374=618.06; RMSEA=0.056, 95% confidence interval: [0.048, 0.063]); CFI=0.920; and TLI=0.913). Statistically significant correlations between NuPCI scales and Brief-COPE subscales ranged between r=+0.217 and r=+0.624; also, NuPDQ score was positively correlated with STAI scales (State scale: r=+0.539; Trait scale: r=+0.462). Concurrent validity was confirmed reporting that NuPDQ score was predicted by NuPCI scores (R2=0.423, p<0.001), positively by Avoidance (β=+0.572) and Planning-Preparation (β=+0.215) and negatively by Spiritual-Positive Coping (β=-0.132). Finally, considering the stress, the effect of the Avoidance and Spiritual-Positive Coping scores respectively in decreasing (+155%) and increasing (+16%) the Apgar score became stronger.Conclusions: Italian NuPCI has sound psychometric properties and it is a useful coping measure. NuPDQ showed also a good validity. Our results may suggest a significant role for coping strategies, particularly in modulating the condition of the newborn at birth.