Cross-cultural adaptation and validation of the psychometric properties of the Quality from the Patient's Perspective I Questionnaire translated into Spanish

Midwifery. 2017 Dec:55:75-82. doi: 10.1016/j.midw.2017.09.005. Epub 2017 Sep 14.


Objective: translate the questionnaire Quality from the Patient's Perspective-Intrapartal (QPP-I) into Spanish, carrying out a cross-cultural adaptation and validation of its validity and reliability DESIGN: observational multi-centre transversal study, with transcultural adaptation and validation of a scale.

Setting: the study was carried out in two public Spanish hospitals.

Participants: 248 women in their postpartum period.

Methods: the instrument was translated and back translated. Validity was determined in different ways: by comparing the QPP-I with an instrument which had already been validated (the COMFORTS scale); by carrying out an exploratory factor analysis by means of a principal component analysis (PCA), and by studying the relationship between the QPP-I and sociodemographic variables (level of studies, age, place of birth of the mother), clinical variables (number of children, type of childbirth, use of epidural, gestational age), positive feelings (control, pride, safety, being paid attention to) and negative feelings (failure, feeling ignored) experienced during childbirth, as well as physical and mental state as assessed by the woman. Reliability was estimated from the internal consistency, with the Cronbach's alpha (α), and the test-retest, with the intraclass correlation coefficient (ICC).

Findings: eleven factors obtained an eigenvalue greater than the unit value in the PCA, explaining 70.5% of the total variance. A statistically significant association was found with the variables place of birth of the mother, level of studies, type of birth, positive and negative feelings during childbirth, and state of health of the mother. On comparing the QPP-I with the COMFORTS scale, the area under the received operating characteristic (ROC) curve was 0.824 (confidence interval of 95%, 0.764-0.884). For the total scale, the value of α was 0.96. The consistency ICC was 0.76 (CI 95%, 0.65-0.84) and the absolute agreement ICC was 0.76 (CI 95%, 0.66-0.84).

Key conclusions: the QPP-I with 39 items distributed among 11 factors seems adequate to measure women's satisfaction with the care received during childbirth in our setting.

Implications for practice: this tool can be used in both a clinical and a research setting for women to be able to evaluate the care they receive when they give birth. It is therefore a way of improving the care given to these users.

Keywords: Childbirth; Patient satisfaction; Surveys and questionnaires; Validation studies.

MeSH terms

  • Adult
  • Cross-Cultural Comparison
  • Female
  • Humans
  • Patient Satisfaction*
  • Pregnancy
  • Psychometrics / instrumentation
  • Psychometrics / methods*
  • Psychometrics / standards*
  • Quality of Health Care / standards*
  • Reproducibility of Results
  • Spain
  • Surveys and Questionnaires
  • Translating