Translation and validation of the Childbirth Experience Questionnaire (CEQ) into Sinhala Language in Sri Lanka

Introduction The Childbirth Experience Questionnaire (CEQ) was initially produced to assess women’s perceptions regarding their first birth experience. A robust validated instrument to evaluate first birth experience is currently lacking in Sri Lankan obstetric practice. Objectives Main objectives of our study were to adapt the CEQ among Sri Lankan Sinhala speaking women and to determine the psychometric properties of CEQ. This would yield an opportunity to evaluate childbirth experience among our women. Method Validation study was carried out by translating the English CEQ into Sinhala language following standard methodology comprising of forward and back translation. Total of 390 postpartum women were recruited through convenience sampling method at University Unit, North Colombo Teaching Hospital, Ragama, Sri Lanka, from February 2017 to January 2018. Initially CEQ was given to be completed four weeks after delivery and again two weeks postnatal. Mothers were asked to post the completed CEQ. Face validity was tested among twenty-five postnatal mothers and with seven labour ward staff members. Psychometric properties; internal consistency and validity of the CEQ were evaluated. Known-groups validation was used for construct validity. Results A total of 226 (57.9%) of the recruited postnatal mothers completed the CEQ after one month postpartum. Face validity in Sri Lankan sample was demonstrated with all participants stating that CEQ was easy to understand and complete. Internal consistency was acceptable for the overall score (0.85) and for all four domains in CEQ (0.65, 0.80, 0.70, 0.83 for “own capacity”, “professional support”, “perceived safety” and “participation”, respectively). Women with spontaneous onset of labour (except for “professional support” in women with spontaneous onset of labour) and women with a normal delivery showed significantly higher CEQ scores. However, oxytocin augmentation could not yield a difference in CEQ scores. A weighted kappa of 0.61-0.80 for all 22 items in CEQ demonstrated a good test-retest reliability. Conclusions This study shows that Sinhala version of CEQ can be used as a reliable and valid tool of childbirth experience among Sri Lankan Sinhala speaking women.