Cross-cultural adaptation and psychometric properties of the Brazilian-Portuguese version of the Quality of Prenatal Care Questionnaire (QPCQ)

Nunes, Rodrigo Dias; Parma, Gabriel Cremona; Campos, Andressa Cardoso de; Locatelli, Paula; Traebert, Jefferson

doi:10.11606/S1518-8787.2019053000565

Acessibilidade / Reportar erro

Brasil

Español English

sumário « anterior atual seguinte »

Sumário

Original Article • Rev. Saúde Pública 53 • 2019 • https://doi.org/10.11606/S1518-8787.2019053000565 copy

Cross-cultural adaptation and psychometric properties of the Brazilian-Portuguese version of the Quality of Prenatal Care Questionnaire (QPCQ)

Authorship SCIMAGO INSTITUTIONS RANKINGS

ABSTRACT

OBJECTIVE

To translate and to observe the psychometric measures of the Brazilian version of the Quality of Prenatal Care Questionnaire.

METHODS

The translation protocol followed the standards of the International Society for Pharmacoeconomics and Outcomes Research. Descriptive statistics were performed to identify characteristics of 280 literate postpartum women in a public hospital. We examined the internal consistency using Cronbach's alfa. To determine the test-retest reproducibility and the instrument's stability, we performed the intraclass correlation coefficient and Bland and Altman plot between two applications. We investigated the item's properties using the item response theory.

RESULTS

The overall Cronbach's alpha index was 0.975. The intraclass correlation coefficient was 0.995 (95%CI 0.993-0.996) and a uniform distribution was visualized at the Bland and Altman plot. The item response theory identified the discriminatory power and the difficulty level of the instrument and of each item. The instrument showed acute angulation of the expected total score, and good concentrate information and good standard error curves, preserving the latent construct and its original items.

CONCLUSIONS

This analysis concluded that the Brazilian version of the Quality of Prenatal Care Questionnaire is a high-quality, reliable and valid questionnaire to determine the quality of prenatal care among Brazilian women. The questionnaire is suitable for the cultural context represented.

DESCRIPTORS
Prenatal Care, psychology; Psychometrics; Surveys and Questionnaires, utilization; Translations; Health Care Quality, Access, and Evaluation

Characteristics		Distribution n (%)	95%CI
Skin color
	White	228 (81.4)	76.8-86.0
	Non-white	52 (18.6)	14.0-23.2
Living with partner
	Yes	232 (82.9)	78.5-87.3
	No	48 (17.1)	12.7-21.5
Schooling (years completed)
	Up to 8	162 (57.9)	52.1-63.7
	> 8	118 (42.1)	36.3-47.9
Delivery route
	Vaginal	220 (78.6)	73.8-83.4
	Cesarean	60 (21.4)	16.6-26.2
Parity
	Primipara	120 (42.9)	37.1-48.7
	Multipara	160 (57.1)	51.3-62.9
Previous vaginal births
	0	149 (53.2)	47.4-59.0
	1	74 (26.4)	21.2-31.6
	2	30 (10.7)	7.1-14.3
	≥ 3	27 (9.6)	6.2-13.0
Previous cesareans
	0	227 (81.1)	76.5-85.7
	1	42 (15.0)	10.8-19.2
	2	7 (2.5)	0.7-4.3
	≥ 3	4 (1.4)	0.0-2.8
Previous abortions
	0	227 (81.1)	76.5-85.7
	1	41 (14.6)	10.5-18.7
	2	10 (3.6)	1.4-5.8
	≥ 3	2 (0.7)	0.0-1.7
Newborn weight (grams)
	< 2,500	16 (5.7)	3.0-8.4
	2,500-4,000	252 (90.0)	86.5-93.5
	> 4,000	12 (4.3)	1.9-6.7

Factor (Subscale) items of Brazilian version of the QPCQ		Cronbach's alpha	Item response theory
Factor (Subscale) items of Brazilian version of the QPCQ		Cronbach's alpha	a^* * Parameter a: discrimination of the item.	b^ Parameter b: mean difficulty of the item.
Factor 1 - Information Sharing (9 items) Cronbach's alpha = 0.920
3	I was given adequate information about prenatal tests and procedures	0.743	2.805	-0.292
6	I was always given honest answers to my questions	0.628	1.800	-0.691
11	Everyone involved in my prenatal care received the important information about me	0.796	3.179	0.717
17	I was screened adequately for potential problems with my pregnancy	0.762	3.006	0.022
22	The results of tests were explained to me in a way I could understand	0.723	2.509	1.447
33	My prenatal care provider(s) gave straightforward answers to my questions	0.798	3.603	-0.412
39	My prenatal care provider(s) gave me enough information to make decisions for myself	0.703	2.540	1.534
43	My prenatal care provider(s) kept my information confidential	0.549	1.453	-0.179
45	I fully understood the reasons for blood work and other tests my prenatal care provider(s) ordered for me	0.703	2.449	-0.289
Factor 2 - Anticipatory Guidance (11 items) Cronbach's alpha = 0.876
2	My prenatal care provider(s) gave me options for my birth experience	0.832	4.109	-0.612
4	I was given enough information to meet my needs about breastfeeding	0.475	1.307	0.606
10	My prenatal care provider(s) prepared me for my birth experience	0.806	4.627	0.393
13	My prenatal care provider(s) spent time talking with me about my expectations for labor and delivery	0.774	2.783	-1.086
16	I was given enough information about the safety of moderate exercise during pregnancy	0.723	2.176	-0.628
20	I received adequate information about my diet during pregnancy	0.445	1.108	0.863
24	My prenatal care provider(s) was interested in how my pregnancy was affecting my life	0.740	3.119	0.596
27	I was linked to programs in the community that were helpful to me	0.375	0.737	-1.879
31	I received adequate information about alcohol use during pregnancy	0.401	0.944	1.581
42	I was given adequate information about depression in pregnancy	0.468	1.065	-2.408
46	My prenatal care provider(s) took time to ask about things that were important to me	0.726	2.585	-1.180
Factor 3 - Sufficient Time (5 items) Cronbach's alpha = 0.863
1	I had as much time with my prenatal care provider(s) as I needed	0.678	1.922	-0.827
8	My prenatal care provider(s) was rushed	0.619	1.627	0.408
18	My prenatal care provider(s) always had time to answer my questions	0.808	3.126	-2.378
30	My prenatal care provider(s) made time for me to talk	0.747	2.298	-0.661
44	My prenatal care provider(s) took time to listen	0.714	2.228	-0.465
Factor 4 - Approachability (4 items) Cronbach's alpha = 0.778
15	My prenatal care provider(s) was abrupt with me	0.444	1.158	2.153
23	I was rushed during my prenatal care visits	0.692	2.201	-0.089
28	My prenatal care provider(s) made me feel like I was wasting their time	0.583	1.383	-0.103
40	I was afraid to ask my prenatal care provider(s) questions	0.645	1.678	2.006
Factor 5 - Availability (5 items) Cronbach's alpha = 0.843
9	I knew how to get in touch with my prenatal care provider(s)	0.613	1.413	-0.728
12	Someone in my prenatal care provider(s)'s office always returned my calls	0.587	1.374	-2.666
32	My prenatal care provider(s) was available when I had questions or concerns	0.692	1.935	0.175
35	I could always reach someone in the office/clinic if I needed something	0.576	1.272	-0.476
38	I could reach my prenatal care provider(s) by phone when necessary	0.618	1.540	-1.646
Factor 6 - Support and Respect (12 items) Cronbach's alpha = 0.938
5	My prenatal care provider(s) respected me	0.402	1.063	0.892
7	My prenatal care provider(s) respected my knowledge and experience	0.746	3.097	0.534
14	My decisions were respected by my prenatal care provider(s)	0.843	4.786	1.915
19	My prenatal care provider(s) was patient	0.601	1.575	-0.198
21	I was supported by my prenatal care provider(s) in doing what I felt was right for me	0.825	4.742	-2.214
25	My prenatal care provider(s) supported me	0.753	3.191	-0.567
26	My prenatal care provider(s) paid close attention when I was speaking	0.750	2.316	0.203
29	My concerns were taken seriously	0.736	2.647	1.018
34	I was in control of the decisions being made about my prenatal care	0.788	3.630	-1.887
36	My prenatal care provider(s) supported my decisions	0.808	3.938	-0.106
37	I was at ease with my prenatal care provider(s)	0.716	2.485	1.042
41	My values and beliefs were respected by my prenatal care provider(s)	0.727	2.804	-0.476

Faculdade de Saúde Pública da Universidade de São Paulo Avenida Dr. Arnaldo, 715, 01246-904 São Paulo SP Brazil, Tel./Fax: +55 11 3061-7985 - São Paulo - SP - Brazil
E-mail: revsp@usp.br

Acompanhe os números deste periódico no seu leitor de RSS

[1] Correspondence: Rodrigo Dias Nunes Deputado Paulo Preis, 274 Jurerê 88053-580 Florianópolis, SC, Brasil E-mail: rodrigo.dias.nunes@hotmail.com