Volume 19, Issue 1 (3-2025)
Qom Univ Med Sci J 2025, 19(1): 24-37 |
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Research code: 981071
Ethics code: IR.MUQ.REC.1399.092
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Raisi M, Eskandari N, Ahmari Tehran H, Bakouie S, Jafarbegloo E, Khaki I. Evaluating the Psychometric Properties of the Persian Version of the Birth Satisfaction Scale –Revised (BSS-R) for Persian-speaking Foreign Women living in Iran. Qom Univ Med Sci J 2025; 19 (1) : 352.2
URL: http://journal.muq.ac.ir/article-1-4044-en.html
URL: http://journal.muq.ac.ir/article-1-4044-en.html
Marzieyh Raisi1 
, Narges Eskandari *2 , Hoda Ahmari Tehran3 , Sareh Bakouie1 , Esmat Jafarbegloo1 , Imaneh Khaki1
, Narges Eskandari *2 , Hoda Ahmari Tehran3 , Sareh Bakouie1 , Esmat Jafarbegloo1 , Imaneh Khaki1
1- Department of Midwifery, School of Nursing and Midwifery, Qom University of Medical Sciences, Qom, Iran.
2- Department of Midwifery, School of Nursing and Midwifery, Qom University of Medical Sciences, Qom, Iran. ,neskandari@muq.ac.ir
3- Department of Medical Education, School of Medicine, Qom University of Medical Sciences, Qom, Iran.
2- Department of Midwifery, School of Nursing and Midwifery, Qom University of Medical Sciences, Qom, Iran. ,
3- Department of Medical Education, School of Medicine, Qom University of Medical Sciences, Qom, Iran.
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Introduction
Birth satisfaction and its assessment have been increasingly considered owing to their effect on childbearing intention and choosing the labor method. Women who are dissatisfied with their childbirth experience, since they remember pain, fear, or sadness during the birth of their child, suffer from complications such as postpartum anxiety and depression, decreased ability to breastfeed, miscarriage in subsequent pregnancies, decreased sexual ability, and inappropriate behavior toward the child [2]. Currently, various scales are available to assess satisfaction with childbirth and its care, including the birth satisfaction scale-revised (BSS-R), a 10-item scale developed by Hollins Martin and Fleming (2011) [15]. The present study aimed to translate and evaluate the psychometric properties of the Persian version of the BSS-R for Persian-speaking foreign women living in Qom, Iran.
Methods
This is a psychometric study with a cross-sectional design, conducted with the participation of Persian-speaking foreign women residing in Qom. The BSS-R was first translated into Persian. Then, its psychometric properties, including face validity, content validity, construct validity, and reliability, were examined. The face validity was determined based on the opinions of 15 women. The content validity was determined based on the opinions of 10 experts. The confirmatory factor analysis was performed in LISREL to examine the construct validity. Due to the lack of model fit, the data were transferred to SPSS software, version 21, and exploratory factor analysis (principal component analysis method) was utilized to extract the factors. Cronbach’s α coefficient and intra-class correlation coefficient (ICC) were utilized to determine the reliability of the Persian version.
Results
Most of the women were housewives with less than a high school diploma, had low incomes, lived in rented houses with their husbands, and were satisfied with their lives. One item during the assessment of formal validity and three items during the assessment of content validity were revised. In assessing the construct validity using the exploratory factor analysis, KMO was obtained as 0.678, and Bartlett’s sphericity test was significant (P<0.001). Seven terms with commonalities (factor loading) ≥0.4 were kept as suitable items. According to the results of the scree plot, three factors (personnel communication, labor pain/stress, and labor length) were determined, explaining 71.285% of the cumulative changes in the variance of BSS-R. The internal consistency using Cronbach’s α coefficient was 0.48 for the entire scale. Also, ICC was 0.166 for the entire scale, and the Pearson correlation coefficient was 0.361, but it was not statistically significant.
Conclusion
According to data analysis, the Persian version of BSS-R with seven items has sufficient validity to measure birth satisfaction in Persian-speaking foreign women living in Iran, but has poor reliability. Therefore, further modifications and studies are recommended to evaluate the reliability of this tool for other populations in Iran.
Ethical Considerations
Compliance with ethical guidelines
This study was approved by the Ethics Committee of Qom University of Medical Sciences, Iran (code: IR.MUQ.REC.1399.092). Informed consent was obtained from all participants after providing comprehensive information about the study objectives and methods. Their voluntary participation, anonymity, and the right to leave the study were considered.
Funding
This research did not receive any specific grant from funding agencies in the public, commercial, or not-for profit sectors.
Authors contributions
All authors contributed equally to the conception and design of the study, data collection and analysis, interpretation of the results, and drafting of the manuscript. Each author approved the final version of the manuscript for submission.
Conflicts of interest
The authors declared no conflict of interest.
Acknowledgments
The authors would like to thank all women who participated in this study for their cooperation.
Birth satisfaction and its assessment have been increasingly considered owing to their effect on childbearing intention and choosing the labor method. Women who are dissatisfied with their childbirth experience, since they remember pain, fear, or sadness during the birth of their child, suffer from complications such as postpartum anxiety and depression, decreased ability to breastfeed, miscarriage in subsequent pregnancies, decreased sexual ability, and inappropriate behavior toward the child [2]. Currently, various scales are available to assess satisfaction with childbirth and its care, including the birth satisfaction scale-revised (BSS-R), a 10-item scale developed by Hollins Martin and Fleming (2011) [15]. The present study aimed to translate and evaluate the psychometric properties of the Persian version of the BSS-R for Persian-speaking foreign women living in Qom, Iran.
Methods
This is a psychometric study with a cross-sectional design, conducted with the participation of Persian-speaking foreign women residing in Qom. The BSS-R was first translated into Persian. Then, its psychometric properties, including face validity, content validity, construct validity, and reliability, were examined. The face validity was determined based on the opinions of 15 women. The content validity was determined based on the opinions of 10 experts. The confirmatory factor analysis was performed in LISREL to examine the construct validity. Due to the lack of model fit, the data were transferred to SPSS software, version 21, and exploratory factor analysis (principal component analysis method) was utilized to extract the factors. Cronbach’s α coefficient and intra-class correlation coefficient (ICC) were utilized to determine the reliability of the Persian version.
Results
Most of the women were housewives with less than a high school diploma, had low incomes, lived in rented houses with their husbands, and were satisfied with their lives. One item during the assessment of formal validity and three items during the assessment of content validity were revised. In assessing the construct validity using the exploratory factor analysis, KMO was obtained as 0.678, and Bartlett’s sphericity test was significant (P<0.001). Seven terms with commonalities (factor loading) ≥0.4 were kept as suitable items. According to the results of the scree plot, three factors (personnel communication, labor pain/stress, and labor length) were determined, explaining 71.285% of the cumulative changes in the variance of BSS-R. The internal consistency using Cronbach’s α coefficient was 0.48 for the entire scale. Also, ICC was 0.166 for the entire scale, and the Pearson correlation coefficient was 0.361, but it was not statistically significant.
Conclusion
According to data analysis, the Persian version of BSS-R with seven items has sufficient validity to measure birth satisfaction in Persian-speaking foreign women living in Iran, but has poor reliability. Therefore, further modifications and studies are recommended to evaluate the reliability of this tool for other populations in Iran.
Ethical Considerations
Compliance with ethical guidelines
This study was approved by the Ethics Committee of Qom University of Medical Sciences, Iran (code: IR.MUQ.REC.1399.092). Informed consent was obtained from all participants after providing comprehensive information about the study objectives and methods. Their voluntary participation, anonymity, and the right to leave the study were considered.
Funding
This research did not receive any specific grant from funding agencies in the public, commercial, or not-for profit sectors.
Authors contributions
All authors contributed equally to the conception and design of the study, data collection and analysis, interpretation of the results, and drafting of the manuscript. Each author approved the final version of the manuscript for submission.
Conflicts of interest
The authors declared no conflict of interest.
Acknowledgments
The authors would like to thank all women who participated in this study for their cooperation.
Type of Study: Original Article |
Subject:
مامایی
Received: 2024/11/24 | Accepted: 2025/05/26 | Published: 2025/03/30
Received: 2024/11/24 | Accepted: 2025/05/26 | Published: 2025/03/30
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