Adaption and validation of the childbirth experience questionnaire (CEQ-SK) in Slovakia

Abstract

INTRODUCTION Using validated and reliable instruments to examine women's birth experiences is important to ensure respectful care. There is a lack of validated instruments for evaluating childbirth care in the Slovak context. In this study, we aimed to adapt and validate the childbirth experience questionnaire (CEQ) in Slovakia (CEQ-SK). METHOD The CEQ-SK was developed and modified from the English version of the CEQ/CEQ2. Face validity was tested in two pre-tests. A convenience sample, recruited through social media, included 286 women who had given birth within the last six months. Reliability was assessed using Cronbach's alpha. Construct and discriminant validity was assessed by exploratory factor analysis and known-group comparison. RESULTS The exploratory factor analysis revealed a three-dimensional structure, explaining 63.3% of the total variance. The factors were labelled 'Own capacity', 'Professional support' and 'Decision making'. No items were excluded. Internal consistency was demonstrated with an overall Cronbach's alpha of 0.94 for the total scale. Primiparous women, women who had an emergency cesarean section, and women who had been exposed to the Kristeller manoeuvre had a lower overall score on the CEQ-SK compared to parous women, women having a vaginal birth and women not exposed to the Kristeller manoeuvre. CONCLUSION The CEQ-SK was found to be a valid and reliable tool for evaluating childbirth experience in Slovakia. The original CEQ is a four-dimensional questionnaire; however, factor analysis showed a three-dimensional structure in the Slovak sample. This needs to be taken into consideration when comparing the results from the CEQ-SK with studies that use the four-dimensional structure.

Cultural adaptation, validation and evaluation of the psychometric properties of Childbirth Experience Questionnaire version 2.0 in the Spanish context

“…This can also be seen in other studies, where this item obtained sufficient but lower factor loads than the rest [ 31 , 45 ]. Other studies report adequate factor load values for the item [ 34 , 36 , 64 , 65 ]. This finding could not be compared in all studies since either they did not conduct factor analysis [ 32 , 40 , 42 ] or did not report factor loads obtained for the items [ 30 , 33 , 66 ].…”

“…Despite these two items, the fit for the proposed four-domain model was good. Most published models for CEQ and CEQ 2.0 advocate for the existence of 4 factors-domains [ 30 , 31 , 34 , 36 , 41 – 43 , 45 ], although some studies propose models based on 3 factors-domains [ 35 , 64 , 65 ] or even 6 [ 33 ]. Most versions eliminate or make changes to the assignment of items to domains.…”

“…As the main strength of this work, along with the exhaustive evaluation of internal consistency previously mentioned, is the rigor of the factorial analysis conducted. Most validation studies have used the principal component extraction approach and/or varimax rotation [ 33 , 34 , 45 , 65 ], which is as commonly used as it is discouraged today according to current recommendations for factor analysis [ 53 , 55 , 61 ].…”