Fear of Childbirth: Validation of the Kiswahili Version of Wijma Delivery Expectancy/Experience Questionnaire Version A&B in Tanzania
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Date
2022
Authors
Journal Title
Journal ISSN
Volume Title
Publisher
BMC Pregnancy and Childbirth
Abstract
Abstract
Background: Fear of childbirth is common both before and after childbirth, often leading to complications in
mother and new-born. The Wijma Delivery Expectancy/Experience Questionnaires (W-DEQ) are commonly used to
measure fear of childbirth among women before (version A) and after childbirth (version B). The tools are not yet
validated in the Tanzanian context. This study aimed to validate the reliability, validity, and factorial structure of their
Kiswahili translations.
Methods: A longitudinal study was conducted in six public health facilities in the Pwani region, Tanzania. In all, 694
pregnant and 625 postnatal women were concurrently selected and responded to W-DEQ-A and W-DEQ-B. Validation
involved: translating the English questionnaires into Kiswahili; expert rating of the relevancy of the Kiswahili versions’
items; computing content validity ratio; piloting the tools; data collection; statistical analysis with reliability evaluated
using Cronbach’s alpha and the intraclass correlation coefficient. Tool validity was assessed using factor analysis, con-
vergent and discriminant validity. Exploratory factor analysis and confirmatory factor analysis were conducted on data
collected using W-DEQ-A and W-DEQ-B, respectively.
Results: Exploratory factor analysis revealed seven factors contributing to 50% of the total variation. Four items did
not load to any factor and were deleted. The factors identified were: fear; lack of self-efficacy; lack of positive anticipa-
tion; isolation; concerns for the baby; negative emotions; lack of positive behaviour. The factors correlated differently
with each other and with the total scores. Both Kiswahili versions with 33 items had good internal consistency, with
Cronbach’s alphas of .83 and .85, respectively. The concerns for the baby factor showed both convergent and discrimi-
nant validity. The other six factors showed some problems with convergent validity. The final model from the con-
firmatory factor analysis yielded 29 items with good psychometric properties (χ2
/df = 2.26, p = < .001, RMSEA = .045, CFI = .90 and TLI = .81)
Conclusions: The Kiswahili W-DEQ-A-Revised and W-DEQ-B-Revised are reliable tools and measure fear of childbirth
with a multifactorial structure, encompassing seven factors with 29 items. They are recommended for measuring fear
of childbirth among pregnant and postnatal Tanzanian women. Further studies are needed to address the inconsist-
ent convergent validity in the revised versions and assess the psychometric properties of W-DEQ-A among pregnant
women across gestational ages.
Keywords: Fear of childbirth, Pregnancy, Postnatal, W-DEQ, Validity, Reliability, Tanzania
Description
Keywords
Fear of childbirth, Pregnancy, Postnatal
Citation
Massae, A.F., Larsson, M., Leshabari, S., Mbekenga, C., Pembe, A.B. and Svanberg, A.S., 2022. Fear of Childbirth: Validation of the Kiswahili Version of Wijma Delivery Expectancy/Experience Questionnaire Version A&B in Tanzania. BMC Pregnancy and Childbirth 22, pp.882