Validation of the Wijma delivery expectancy/experience questionnaire for pregnant women in Malawi: a descriptive, cross-sectional study

Abstract

Background: Fear of childbirth is a common health concern for women during pregnancy. The Wijma Delivery Expectancy/Experience Questionnaire (W-DEQ) is widely used to measure childbirth fear during pregnancy. However, this instrument is yet to be validated in Malawi, Africa. Our study aimed to assess the psychometric properties of the W-DEQ questionnaire in Malawi. Methods: Healthy pregnant women in the third trimester (N = 476) at a district hospital in Malawi were included. Fear of childbirth, depressive symptoms, and quality of life were assessed using the W-DEQ, the Edinburg Postnatal Depression Scale, and the World Health Organization Quality of Life scale, respectively. The construct validity, reliability, and convergent validity of the W-DEQ were examined using exploratory and confirmatory factor analyses, Cronbach's alpha, and Pearson correlations. Results: The mean age of participants was 28.2 (standard deviation = 6.8) years. Exploratory and confirmatory factor analysis of the Malawian version of the W-DEQ indicated a multidimensional structure with three factors: fear, negative appraisal, and a lack of self-efficacy, with acceptable goodness of model fit. The Malawian version of the W-DEQ showed a satisfactory internal consistency (α = 0.84) and was significantly correlated with depressive symptoms (r = 0.23, p < 0.001) and quality of life (r = − 0.17~-0.26, ps < 0.05). Conclusions: Our findings support the Malawian W-DEQ version being a reliable and valid instrument for measuring childbirth fear in African women.

Reliability and validity study of the Spanish adaptation of the “Wijma Delivery Expectancy/Experience Questionnaire” (W-DEQ-A)

“…The explained variance of the structure with four dimensions was 55%. This variance was very similar to that found in the majority of studies that have validated this questionnaire [ 13 , 33 , 34 , 37 , 41 – 44 , 47 ] and was only less than that found in the study carried out by Abedi et all., Moghaddam Hosseim et al y Pitel et al [ 45 , 46 , 49 ]. Although the percentage of explained variance found in this study could be considered to be low, it is not currently recommended to use the interpretation of explained variance as the only indicator of factors identified.…”

“…Since the questionnaire was developed it has been translated into several languages and has been used in different studies to explore fear of childbirth [23,[33][34][35][36][37][38][39][40][41][42][43][44][45][46][47]. However, although it was conceived as a unidimensional instrument, different analyses carried out in the different validations have shown a multifactorial structure [13,33,34,37,39,[41][42][43][44][45][46][47]. Table 1 shows the languages and populations where it has been validated and the principal characteristics of each validation.…”

The Prevalence and Associated Factors of Fear of Childbirth Among Pregnant Adolescents in Turkey: A Cross-Sectional Study

“…FOC was measured using the Turkish version of WDEQ-A, a self-assessment rating scale. 18 The WDEQ-A is a measurement tool validated to assess the FOC, contains 33 items measured on a 6-point Likert-type scale. 17 Questions are represented in positive and negative formats and each scoring from 0 to 5.…”

“…15 This self-scale assessment instrument has been translated and validated in numerous countries and considered as the gold standard method for defining severe FOC. 13,18 The WDEQ was identified to measure 4 subscales, including fear, absence of a positive appraisal, riskiness, and isolation, which may assist the clinicians' evaluation of the nature of FOC, combined with evaluating severity, as a result assisting more individual attention to support suggested to the patient. 19,20 To the best of our knowledge, no study to date has evaluated the level of FOC among Turkish pregnant adolescents.…”

Primigravida Women's Fear of Childbirth and Its Effect on Their Decision Regarding Mode of Delivery

“…This Expectation / Experience Questionnaire (WDEQA) (28,29) . W-DEQ is a selfassessment scale containing 12 items to measure primigravidas fear of childbirth, such as frightful, afraid, weak, panic and hopelessness.…”