Validation of the Chinese version of the Pregnancy-related Anxiety Questionnaire-Revised (PRAQ-R) and its distinction from general anxiety and depression in pregnant women

Abstract

Objective: This study aims to evaluate the reliability and validity of the translated Chinese-Cantonese version of the Pregnancy-Related Anxiety Questionnaire-Revised (PRAQ-R) in a sample of pregnant women in Hong Kong, China. It also aims to determine whether pregnancy-related anxiety changes significantly across trimesters and if it is differentiated from general anxiety and depression.

Method: This study adopts a prospective longitudinal design with a quantitative approach. A consecutive sample of 186 Chinese pregnant women from hospitals in Hong Kong are assessed using the translated Chinese-Cantonese version of the PRAQ-R and other standardized instruments at three time points during the first to third trimester.

Results: A confirmatory factor analysis revealed a three-factor structure of the Chinese-Cantonese version of the PRAQ-R, including fear of giving birth, fear of bearing a physically or mentally handicapped child, and concern about one’s appearance. The internal consistency was excellent (α = 0.88 to 0.91) for all of the items in the PRAQ-R across the three trimesters. The average variance extract (AVE) and composite reliability (CR) for each factor were greater than the recommended level of CR > 0.70 and AVE > 0.50. Multiple regression analyses showed that a combination of general anxiety and depression explained a small proportion of the variance (10–29%) in the PRAQ-R subscales during the three trimesters.

Conclusions: The Chinese-Cantonese version of the PRAQ-R has good validity and reliability, and the results provide evidence of its relevance for Chinese pregnant women with pregnancy-related anxiety in Hong Kong. The finding also shows that pregnancy-related anxiety is a relatively distinctive form of anxiety that is different from general anxiety and depression.

Keywords:

• Pregnancy
• antenatal anxiety
• pregnancy-related anxiety
• general anxiety
• scale validation

Acknowledgements

We are thankful to Dr. Chin Peng Lee and Dr. Kwok Yin Leung for facilitating data collection in this study. We are thankful to Prof. Dr. Anja C. Huizink, Department of Clinical Developmental Psychology, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands, for having given permission to use her devised scale on pregnancy anxiety, namely, the Pregnancy Related Anxieties Questionnaire-Revised (PRAQ-R).

Disclosure statement

The authors declare that they have no conflict of interest.

Additional information

Funding

This study was supported by a grant from the General Research Fund of the Research Grants Council of the Hong Kong Special Administrative Region (Ref: CERG HKU7470/06H).