Abstract：
OBJECTIVE: Adapt Fear of Birth Scale (FOBS) for the Chinese context, evaluate psychometric properties and determine optimal cutoff point for pregnant women in 3rd trimester.
METHODS: This is a descriptive cross-sectional study. Cultural guidelines informed the development of the Chinese version of FOBS (FOBS-C) incorporating validation on translation, equivalence index, content validity index, and cognitive debriefing. Thirty pregnant women took a test-retest survey and another 1019 took three cross-sectional surveys. Convergent validation of the FOBS-C involved comparison with Childbirth Attitudes Questionnaire (CAQ), Wijma Delivery Expectancy Questionnaire (WDEQ-A), Edinburgh Postnatal Depression Scale (EPDS), Generalized Anxiety Disorder Scale (GAD-7), and physiological indicators. Cutoff points for FOBS-C were identified using receiver operating characteristic analysis against medical indicators.
RESULTS: FOBS-C demonstrated high translation equivalence (0.833-1), content validity (0.800-0.933), internal consistency (0.897), and test-retest reliability (0.860). Convergent validity was supported by statistically significant correlations between FOBS scores, heart rate, skin conductance changes, as well as scores from WDEQ-A, CAQ, EPDS, and GAD-7. Known-group validity was observed with different medical indicators. FOBS-C cutoff points indicating severe fear of childbirth were identified as 65, 68, 71, and 56, respectively, against WDEQ-A ≥ 85, CAQ ≥ 52, preference for C-section birth, and preference for analgesia, demonstrating known-group validity. A cutoff point of 65 showed the FOBS-C\'s strongest known-group validity.
CONCLUSIONS: The FOBS-C exhibits robust psychometric properties, making it a valid screening tool for identifying severe fear of birth. Establishing a cutoff point at 65 facilitates effective screening.
METHODS: This is a descriptive cross-sectional study. Cultural guidelines informed the development of the Chinese version of FOBS (FOBS-C) incorporating validation on translation, equivalence index, content validity index, and cognitive debriefing. Thirty pregnant women took a test-retest survey and another 1019 took three cross-sectional surveys. Convergent validation of the FOBS-C involved comparison with Childbirth Attitudes Questionnaire (CAQ), Wijma Delivery Expectancy Questionnaire (WDEQ-A), Edinburgh Postnatal Depression Scale (EPDS), Generalized Anxiety Disorder Scale (GAD-7), and physiological indicators. Cutoff points for FOBS-C were identified using receiver operating characteristic analysis against medical indicators.
RESULTS: FOBS-C demonstrated high translation equivalence (0.833-1), content validity (0.800-0.933), internal consistency (0.897), and test-retest reliability (0.860). Convergent validity was supported by statistically significant correlations between FOBS scores, heart rate, skin conductance changes, as well as scores from WDEQ-A, CAQ, EPDS, and GAD-7. Known-group validity was observed with different medical indicators. FOBS-C cutoff points indicating severe fear of childbirth were identified as 65, 68, 71, and 56, respectively, against WDEQ-A ≥ 85, CAQ ≥ 52, preference for C-section birth, and preference for analgesia, demonstrating known-group validity. A cutoff point of 65 showed the FOBS-C\'s strongest known-group validity.
CONCLUSIONS: The FOBS-C exhibits robust psychometric properties, making it a valid screening tool for identifying severe fear of birth. Establishing a cutoff point at 65 facilitates effective screening.
摘要：
目的：使出生恐惧量表（FOBS）适应中国语境，评估心理测量特性并确定妊娠晚期孕妇的最佳临界点。
方法：这是一项描述性横断面研究。文化指南为FOBS中文版（FOBS-C）的开发提供了信息，其中包括翻译验证，等效指数，内容效度指数，和认知汇报。30名孕妇进行了重测调查，另有1019名孕妇进行了三项横断面调查。FOBS-C与分娩态度问卷(CAQ)比较的趋同验证，Wijma交付期望问卷(WDEQ-A)，爱丁堡产后抑郁量表（EPDS），广义焦虑症量表（GAD-7），和生理指标。使用针对医学指标的接收器操作特性分析来确定FOBS-C的截止点。
结果：FOBS-C表现出高翻译对等（0.833-1），内容效度(0.800-0.933)，内部一致性(0.897)，和重测可靠性（0.860）。收敛效度得到了FOBS得分之间统计上显著相关性的支持，心率,皮肤电导变化，以及WDEQ-A的分数，CAQ,EPDS,GAD-7用不同的医学指标观察已知组效度。FOBS-C分界点表明严重害怕分娩，分别为65、68、71和56。对于WDEQ-A≥85，CAQ≥52，偏好剖腹产，以及对镇痛的偏好，证明已知的群体有效性。65的截止点显示FOBS-C的最强已知组有效性。
结论：FOBS-C表现出强大的心理测量特性，使其成为识别对出生的严重恐惧的有效筛查工具。在65处建立截止点有利于有效筛选。
方法：这是一项描述性横断面研究。文化指南为FOBS中文版（FOBS-C）的开发提供了信息，其中包括翻译验证，等效指数，内容效度指数，和认知汇报。30名孕妇进行了重测调查，另有1019名孕妇进行了三项横断面调查。FOBS-C与分娩态度问卷(CAQ)比较的趋同验证，Wijma交付期望问卷(WDEQ-A)，爱丁堡产后抑郁量表（EPDS），广义焦虑症量表（GAD-7），和生理指标。使用针对医学指标的接收器操作特性分析来确定FOBS-C的截止点。
结果：FOBS-C表现出高翻译对等（0.833-1），内容效度(0.800-0.933)，内部一致性(0.897)，和重测可靠性（0.860）。收敛效度得到了FOBS得分之间统计上显著相关性的支持，心率,皮肤电导变化，以及WDEQ-A的分数，CAQ,EPDS,GAD-7用不同的医学指标观察已知组效度。FOBS-C分界点表明严重害怕分娩，分别为65、68、71和56。对于WDEQ-A≥85，CAQ≥52，偏好剖腹产，以及对镇痛的偏好，证明已知的群体有效性。65的截止点显示FOBS-C的最强已知组有效性。
结论：FOBS-C表现出强大的心理测量特性，使其成为识别对出生的严重恐惧的有效筛查工具。在65处建立截止点有利于有效筛选。
