目的:设计并验证一种工具,以评估妇女在分娩过程中是否遭受虐待或不尊重的感觉:“分娩虐待和尊重评估-产妇问卷”(CARE-MQ)。
方法:多学科专家小组(妇科医生,助产士,母亲)参与创建CARE-MQ。对901名在1至3个月前分娩的西班牙妇女进行了横断面研究,以确定心理测量特征。最后,探索性因素分析(EFA),验证性因子分析(CFA),采用患者观点-产时质量问卷(QPP-I)进行了收敛效度研究,以及使用内部一致性(Cronbach'sα)和组内相关系数(CCI)的可靠性研究。
结果:KMO测试的值为0.935,Bartlett的球形度测试为<0.001。全民教育确定了四个组成部分(“情感虐待”,\“专业能力不足\”,“身体虐待”y“失去联系”)解释了55.16%的差异。在CFA,对大多数评估指标都观察到了良好的拟合。CARE-MQ与QPP-I呈负相关(Spearman的rho=-0.641,95%CI:-0.679,-0.600;p<0.001),并且与分娩经验相关的变量(p<0.005)在统计学上相关,例如使用分娩计划,使用区域镇痛,出生类型,会阴切开术,严重的眼泪的存在,皮肤与皮肤的接触,住院时间和产后手术干预。克朗巴赫的α值为0.903。一周后给予问卷后的绝对一致ICC为0.927(95%CI:0.85-0.97)。
结论:CARE-MQ是一种有效且可靠的工具,可用于评估西班牙产后妇女在分娩期间可能遭受的虐待和/或不尊重情况。
OBJECTIVE: To design and validate a tool to assess a woman\'s perception of whether she has experienced a situation of
abuse or disrespect during childbirth attendance: \"Childbirth
Abuse and Respect Evaluation-Maternal Questionnaire\" (CARE-MQ).
METHODS: Multidisciplinary panel of experts (gynecologists, midwives, mothers) participated in creating CARE-MQ. A cross-sectional study was carried out on 901 Spanish women who had given birth between 1 and 3 months before to determine psychometric characteristics. Finally, an exploratory factor analysis (EFA), confirmatory factor analysis (CFA), and a convergent validity study were carried out with the Quality Questionnaire from the Patient\'s Perspective-Intrapartum (QPP-I), and a reliability study using internal consistency (Cronbach\'s α) and coefficient of intraclass correlation (CCI).
RESULTS: The KMO test gave a value of 0.935, and Bartlett\'s sphericity test was <0.001. The EFA identified four components (\"Emotional
Abuse\", \"Inadequate Professionalism\", \"Physical
Abuse\" y \"Lost contact\") that explained 55.16 % of variance. In the CFA, a good fit was observed for most of the evaluated indicators. CARE-MQ correlated negatively with QPP-I (Spearman\'s rho = -0.641, 95 % CI: -0.679, -0.600; p < 0.001) and was statistically associated with variables related to childbirth experience (p < 0.005) such as the use of a birth plan, use of regional analgesia, type of birth, episiotomy, presence of severe tears, skin-to-skin contact, length of hospital stay and postpartum surgical intervention. Cronbach\'s α value was 0.903. The ICC of absolute agreement after administering the questionnaire one week after was 0.927 (95 % CI: 0.85-0.97).
CONCLUSIONS: CARE-MQ is a valid and reliable instrument to evaluate the perception of a woman regarding the situation of
abuse and/or disrespect that she may have experienced during birth in a population of Spanish postpartum women.