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. 2021 Nov;39(5):516-531.
doi: 10.1080/02646838.2020.1836333. Epub 2020 Oct 21.

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

Antonella Nespoli  1 , Elisabetta Colciago  1 , Simona Fumagalli  1 , Anna Locatelli  1   2 , Caroline J Hollins Martin  3 , Colin R Martin  4
Affiliations

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

Antonella Nespoli et al. J Reprod Infant Psychol. 2021 Nov.

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; midwifery care; validation.

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