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Fear of childbirth: Validation study of the Chinese version of Wijma delivery expectancy/experience questionnaire
Theodora Hei Tung Lai1, Shuk Tak Kwok1, Weilan Wang1
1Department of Obstetrics and Gynaecology, Queen Mary Hospital, the University of Hong Kong, Hong Kong.
Introduction:
Fear of childbirth causes significant distress and impact on women's wellbeing. It contributed to the rising trend of non-medically indicated Caesarean births worldwide. The objective of this study was to translate and validate the Chinese version of the Wijma Delivery Expectancy/Experience Questionnaire (Version A) (W-DEQ-A), which is a comprehensive instrument for the assessment of fear of childbirth among antenatal women.
Methods:
The translated questionnaire was finalised after back-translation and review by an expert panel. Hong Kong Chinese women at an antenatal clinic completed the translated questionnaire, Edinburgh Postpartum Depression Scale (EPDS), and State-trait Anxiety Inventory (STAI). The reliability of the translated questionnaire was analysed using Cronbach's alpha coefficient and intraclass correlation coefficient. Convergent validity was measured by Pearson's correlation between the W-DEQ-A and STAI or EPDS scores. The subscales of the questionnaire were determined using exploratory factor analysis.
Results:
One hundred and fifty women completed the study. The Cronbach's alpha coefficient and test-retest reliability of the Chinese version were 0.907 and 0.867, respectively. Convergent validity was demonstrated by the moderate correlation between the translated W-DEQ-A and STAI or EPDS. Exploratory factor analysis of the W-DEQ-A revealed a multi-dimensional structure with four factors: sense of isolation, moment of birth, negative emotion, and lack of positive self-evaluation. Using a standard cut-off of 85, 11.3% of women were found to suffer from fear of childbirth.
Conclusion:
The Chinese version of the Wijma Delivery Expectancy/Experience Questionnaire (Version A) is a reliable and valid instrument to measure antenatal fear of childbirth among Chinese women.
