Validation and factor structure of the Italian version of the Birth Satisfaction Scale-Revised (BSS-R)

ABSTRACT

Objective

To validate the Italian-language version of the Birth Satisfaction Scale-Revised (BSS-R) and report key measurement properties of the tool. To evaluate the impact of antenatal class attendance on BSS-R assessed birth satisfaction.

Background

Maternal satisfaction is one of the standards of care defined by the World Health Organisation (WHO) to improve the quality of services. The BSS-R is a multi-dimensional self-report measure of the experience of labour and birth.

Methods

Cross-sectional instrument evaluation design examining factor structure and key aspects of validity and reliability. Embedded between-subjects design to examine known-group discriminant validity and the impact of antenatal class attendance on BSS-R sub-scale and total scores as dependent variables. After giving birth, 297 women provided data for analysis.

Results

The Italian version of the BSS-R (I-BSS-R) was the key study measure. The established three-factor and bi-factor models of the BSS-R were found to offer an excellent fit to the data. Comparison of the tri-dimensional measurement model and the bi-factor model of the BSS-R found no significant differences between models. Women who attended antenatal classes had significantly lower stress experienced during childbearing sub-scale scores (I-BSS-R SE), compared to those who did not. Good convergent, divergent validity and known-groups discriminant validity were established for the I-BSS-R. Internal consistency observations were found to be sub-optimal in this population.

Conclusions

On all key psychometric indices, with the exception of internal consistency that requires further investigation, the I-BSS-R was found to be a valid translation of the original BSS-R. The impact of antenatal classes on birth satisfaction warrants further research.

KEYWORDS:

• Birth Satisfaction Scale-Revised (BSS-R)
• Birth satisfaction
• maternal satisfaction
• validation
• midwifery care

Acknowledgments

We would like to thank all women who participated in our study. We would also like to acknowledge the excellent comments of two anonymous referees for their very helpful and facilitative comments on an earlier version of this manuscript.

Disclosure statement

No potential conflict of interest was reported by the authors.

Professor Colin R Martin and Professor Caroline Hollins Martin hold the copyright of the BSS-R under creative commons Creative Commons Attribution-Non Commercial [CC-BY-NC] 4.0 International License.

Ethical approval

Ethical approval was gained from the Hospitals’ Ethical Review Board. Participants signed an informed consent.

Additional information

Funding

This research received no specific grant from any funding agency in the public, commercial or non-profit sectors.