Evaluating Perceived Control in the Inpatient Antepartum Setting: Development and Validation of a Novel Antepartum...

Antepartum hospitalization during pregnancy can compromise patients' sense of control and are associated with higher rates of depression or anxiety. There are no validated scales that measure this sense of control in this hospitalized setting. The authors adapted the Labour Agentry Scale (LAS) to the antepartum inpatient setting by developing and preliminarily validating a novel Antepartum Agentry Scale (AAS).Fifty-nine candidate statements were derived from the LAS original source material. These statements were iteratively reviewed in three rounds using a content valuation index by Maternal Fetal Medicine providers, resulting in 25 statements that comprised the AAS. The AAS, Patient Health Questionnaire (PHQ-9), and General Anxiety Disorder (GAD-7) scale were administered to 50 individuals hospitalized for a complication during pregnancy. Factor analysis was performed to assess construct validity and evaluate whether the AAS measured a construct distinct from the PHQ-9 or GAD-7. The AAS scores were then classified as "Low," "Average," or "High" based on the mean score and standard deviation in the study population. Fisher's exact test was used to evaluate the relation between scores on the AAS and scores of 10 or higher on the PHQ-9 and GAD-7.The AAS had a Cronbach alpha of 0.902. Factor analysis demonstrated minimal overlap between the AAS and items on the PHQ-9 or GAD-7. There was a significant relationship between "Low," "Average," and "High" AAS scores and PHQ-9 scores of 10 or more (67 vs. 13 vs. 10%, p = 0.003) and GAD-7 of 10 or more (67 vs. 19 vs. 0%, p = 0.002).Those with higher agentry are less likely to concurrently report clinically significant symptoms of depression or anxiety. Initial results suggest strong internal consistency of the AAS, which may measure a construct distinct from measures of depression or anxiety. · The LAS is a measure of perception of control during labor and delivery.. · The AAS was adapted from the LAS focusing on antenatal hospitalization.. · Higher scores on the AAS inversely correlated with symptoms of anxiety and depression.. · The AAS has strong internal consistency with a Cronbach's alpha of 0.902.. · The AAS appears to measure a construct distinct from the PHQ-9 or GAD-7..