Validity and reliability of the Farsi version of Wijma delivery expectancy questionnaire: an exploratory and confirmatory factor analysis

BACKGROUND Fear of childbirth may cause complications such as experiencing severe labour pain, postpartum depression, and impaired mother-fetus attachment. OBJECTIVE To validate the Farsi version of the Wijma Delivery Expectancy/Experience Questionnaire (W-DEQ) (versions A & B) in a sample of Iranian women. METHODS The WDE-Q (versions A & B) was translated into Farsi, and the content validity of the scales was confirmed. In a cross-sectional study conducted in 2015, 405 pregnant women in the third trimester of pregnancy and 320 postpartum women completed the Farsi W-DEQ versions A & B, respectively. The construct validity and reliability of the scales were examined using exploratory and confirmatory factor analyses (EFA and CFA) and Cronbach's alpha coefficient, respectively. SPSS version 18 and Lisrel version 8.80 were used for statistical analyses. RESULTS Results of the CFA on 33 items could not confirm the one-factor structure proposed by Wijma (RMSEA= 0.14, SRMR=0.11, Chi-square/df=8.95, p<0.05, CFI=0.86, IFI=0.86) or other structures suggested by previous studies. We conducted an EFA on 33-item version A and found six factors with eigenvalue > 1. One item was not loaded on any factor. A CFA on 32 items of the W-DEQ (version B) yielded acceptable fit for the factorial structure found on version A (RMSEA= 0.075 (CI [0.071, 0.08]), SRMR=0.078, Chi-square/df=2.93, p<0.05, CFI=0.95, IFI=0.95). Cronbach's Alpha coefficients for the 32-item Farsi W-DEQ (versions A & B) were 0.914 and 0.919, respectively. CONCLUSIONS Both Farsi W-DEQ are reliable and valid instruments to assess fear of childbirth in Iranian pregnant and postpartum women. Further research should be designed to examine the validity of the W-DEQ (A) in pregnant women regardless of gestational age.