Pregnant rats given caffeine had offspring The work could help advance research into development as well as inform But diurnalism is by far the exception rather the rule in mammals. About million years ago, the mammalian ancestors, called Research shows even small amounts of alcohol consumed during pregnancy can cause The results might have impact on fertility counseling and in the longer term for treatment of Mechanisms Behind Women's Biological Clock.
But because LPI do not have fully developed brains, they may experience A new study shows the number of mutations a child has compared to her parents varies dramatically with some Papers should describe the development or test psychometric properties of an instrument. Papers published in English or French were included as the researchers could understand these languages.
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Dissertations, non-original research, or conference papers were excluded. The search strategy was designed and developed following consultation with a healthcare librarian. Before the final search all authors commented and agreed on the search string that was adapted for the individual databases see Additional file 2. No restriction in the dates of publishing was made. For the initial screening all the search results were imported into reference management software EndNote and duplicates were removed, leaving titles and abstract to be screened for inclusion.
First, papers clearly irrelevant to our topic, such as papers assessing childhood development, contraceptives etc. The remaining titles and abstract were assessed independently by two researchers HN and an assistant, JC. This identified residual papers which were assessed independently by two of the reviewers HN and MB to include papers for more in-depth full text assessment. Any potential conflicts were solved by the third reviewer. Fourteen additional studies were found through search of reference lists of included papers and were assessed in full-text by two independent reviewers for eligibility criteria HN and MB.
Three of these papers were included after assessment in full text. No further papers on the development or testing of psychometric properties of the identified instruments were found. The flow of selection for studies are shown in Fig. This was done using criteria specified by Terwee et al. Terwee et al.
In addition to quality assessment of these properties we added another two criteria. The first one considers the need for the instrument and, for a positive rating, a search for existing instruments had to have been done, demonstrating the need to develop and test a new instrument. The second rating item added is related to face validity. For a positive rating, members of the target population should have been asked about the appropriateness of the questionnaire and of each question.
When ratings differed between the pairs, it was discussed and, when conflict remained, the third reviewer was included in the discussion to reach consensus. This is only a rough guide to the overall quality of the instrument and must be interpreted with caution. For example, two tools that both received a mark of 6 may be of very different quality, depending on the criteria that were awarded the points.
In conducting this review, our focus and aim was on identifying measures and conducting a broad assessment of their psychometric properties. Given the large number of instruments found, and their very different foci, it was not possible to make clear recommendations as to one particular instrument that would suit all purposes. Instead, some general suggestions are made as to the instruments that appear to be emerging as the top ranking tools in terms of the quality measurement performed, and the overall mark given.
The data extraction was made by the first author HN and then checked by the other authors for accuracy. One of the individual papers was conducted by one of the authors MB. To avoid conflict of interest this paper was assessed for eligibility criteria, and quality assessment was made, by the two other authors HN and CB. Different surrogate terms and related concepts used in identified instruments were described by authors as: childbirth experience Most of the instruments were developed and tested in the United States 6 and in the United Kingdom 6.
Number of items in the instruments varied from three to Instruments are reported in alphabetical order by first author. A few of the tools gained a low quality rating, which would indicate the need for further development and evaluation of their psychometric properties.
Labor, Delivery, and Postpartum Issues
These included: The Childbirth Trauma Index for adolescents [ 22 ] overall quality mark of 2 ; The Perception of Birth Scale [ 23 , 24 ] overall quality marks of 3 ; Support and Control in Birth [ 25 ] overall quality marks of 4 ; The Childbirth Experience Perception Questionnaire [ 26 ] and The Birth satisfaction scale and the Birth satisfaction scale - revised [ 27 — 29 ] overall quality marks of 4.
In general, we would suggests that tools with marks of 2 to 4. Tools with a mark of 5 may be suitable if they are the only instrument developed in that topic area, but not otherwise, and further testing before use is recommended. These included: The Childbirth Experience Questionnaire [ 34 ], The maternal satisfaction scale for caesarean section [ 35 ], The Responsiveness in Perinatal and Obstetric Health Care Questionnaire [ 36 , 37 ], Pregnancy and maternity care patients experiences questionnaire [ 38 ] and The Childbirth Perception Scale [ 39 ].
However, a number of different cut-off points are used to define severe fear of childbirth, resulting in different prevalence rates, and these should be standardised. By including surrogate terms and related concepts to the childbirth experiences, a broader and more holistic overview of existing instruments was achieved. Identified instruments demonstrated a wide range in purpose and content as well as in the quality of psychometric properties. When choosing between different instruments, one needs to consider all ratings together as well as taking into account those measurement properties that are most important for a specific application, setting and population, e.
If the researcher chooses an inappropriate or poor quality measurement instrument, this may lead to bias in the conclusion, resulting in wasted resources and unethical procedures for the women that participated [ 71 ].
To choose the right instrument for clinicians and researchers for their specific context is a complex process. All instruments in our review did get a positive rating of content validity. But a more thorough investigation would still be advisable to see which instruments have the strongest content validity to aid in choosing an appropriate instrument. Many of the instruments that we identified would need further testing of their psychometric properties to determine which would be best. This is consistent with the finding of Sawyer et al.
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Most of the instruments in our review did report on several tests of psychometric properties, but further evaluation of validity and reliability was needed. Before using a specific instrument, we suggest that a thorough investigation of the development and testing of the instrument should be done to ensure good psychometric properties. As we found a large number of questionnaires and instruments, we agree with this suggestion. When conducting studies of psychometric properties of an instrument, we recommend applying standards such as the COSMIN checklist [ 75 , 76 ] and Terwee et al.
Several of the papers included in our review consisted of development and validation of existing questionnaires [ 23 , 26 , 41 ]. As well, several of the questionnaires have been culturally translated and validated in other languages and cultures [ 67 — 69 , 77 — 80 ]. The attempt with this review was to identify all studies and instruments that meet the eligibility criteria, but it is possible that we have missed relevant articles, written in other languages than English and French, or indexed in other databases than those chosen.
We suggest that this review can be used as a tool for identification of existing instruments, while acknowledging that each researcher will have to assess their chosen tool themselves in the light of the lack of, in most cases, sufficient testing. Our review consists of a large number and wide range of instruments, making it difficult to make those recommendations, particularly as a more thorough evaluation of psychometric properties and quality assessment of included studies was needed.
Nevertheless, we have made some suggestions in relation to use of tools depending on their overall quality score. It is a detailed and rigorous checklist [ 75 , 76 ], useful in future systematic literature reviews that have a more narrowed construct of interest, so it could be manageable to do a more in-depth assessment of each instrument comprising both psychometric properties and methodological quality of the development process of each instrument.
Most of the instruments require further validation and reliability testing. Given the plethora of instruments in use in the literature, and the lack of complete testing for many of them, we recommend that researchers do not develop any more new tools, but try to test thoroughly, adapt and improve those that already exist. This makes reviews of measurement instruments important as they aid researchers in finding appropriate, established and tested instruments instead of developing new ones.
When different instruments are used to measure the same construct of interest, e. We trust that this review can contribute in helping clinicians and researchers to find the right instrument for their specific context. We thank librarian Tobias Prenler at Gothenburg university library who provided support and knowledge in develop and perform the literature search. HN conducted the literature search and initial screening of papers.
HN and MB screened papers for full text assessment. All authors screened full text articles for inclusion and were involved with quality assessment of included instruments. HN extracted descriptive data and characteristics of included instruments. This was checked by MB and CB. HN drafted the manuscript. All authors contributed to the intellectual content, read and approved the final manuscript. One of the reviewers, MB, was involved in the development and validation of the Childbirth experience questionnaire [ 30 ], one of the instruments included in the review. The inclusion and quality assessment where therefore assessed and evaluated by the other two reviewers HN and CB.
This is a systematic review of already published primary sources and as such no further ethical approval was required. Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
Electronic supplementary material. Cecily Begley, Email: ei. Marie Berg, Email: es. National Center for Biotechnology Information , U. BMC Pregnancy Childbirth. Published online Jun Author information Article notes Copyright and License information Disclaimer. Corresponding author. Received Dec 14; Accepted May This article has been cited by other articles in PMC. Additional file 2: Search strategy. Results In total citations were screened, of which were excluded by title and abstract. Electronic supplementary material The online version of this article doi Keywords: Systematic review, Validated questionnaires, Measurement instruments, Psychometric properties, Childbirth experiences, Childbirth satisfaction.
Background Childbirth experiences can have immediate as well as long-term positive or negative effects on life, well-being and health [ 1 ]. Methods A systematic review is a rigorous method of research that follows a systematic procedure to enable a summary of all findings from multiple studies on a specific topic. Eligibility criteria First a review protocol was developed see Additional file 1. Papers reporting original research, published in peer-reviewed journal. Reviews were included to enable us to find original papers. Search strategy The search strategy was designed and developed following consultation with a healthcare librarian.
Table 1 Excluded papers with reason. Dissertation Callahan JL, Hynan MT: Identifying mothers at risk for postnatal emotional distress: further evidence for the validity of the perinatal posttraumatic stress disorder questionnaire. J Perinatol ; 22 6 — Revista Chilena de Obstetricia y Ginecologia ; 79 3 : — Revista Chilena de Obstetricia y Ginecologia ; 73 1 :4— J Perinat Educ ; 16 4 :9— Not able to distinguish childbirth experience as separate scale from rest of questionnaire. Not able to separate childbirth experience from the rest of the questionnaire.
J Psychosom Obstet Gynaecol ; 32 3 — Midwifery ; 18 4 — Kaohsiung J Med Sci ; 13 4 — J Adv Nurs , 51 6 — J Clin Nurs ; 17 3 — J Perinat Educ ; 20 1 — Not able to distinguish childbirth experience from the rest of the questionnaire.