Propriedades psicométricas do questionário “Mackey Childbirth Satisfaction Rating Scale” na avaliação da satisfação das mulheres com o parto
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Data
2023-08-28
Autores
Lopes, Fernanda {UNIFESP]
Orientadores
Nomura, Roseli Mieko Yamamoto [UNIFESP]
Tipo
Tese de doutorado
Título da Revista
ISSN da Revista
Título de Volume
Resumo
A satisfação com o parto é um conceito multidimensional e está relacionada com a qualidade
da assistência obstétrica. Objetivos: avaliar as propriedades psicométricas da escala Mackey
Childbirth Satisfaction Rating Scale (MCSRS) e avaliar a satisfação das mulheres com o parto.
Métodos: Estudo transversal de validação de instrumento. Dados coletados de 411 puérperas
de uma maternidade pública de baixo risco. Critérios de inclusão: idade materna entre 18 e 34
anos, idade gestacional maior que 36 semanas, feto único, vivo e saudável. A versão da escala
MCSRS-Brasil contém 34 itens (Q1 a Q34) com seis subescalas que avaliam: satisfação
própria, parceiro, bebê, enfermagem, médicos e satisfação geral e 4 itens (Q37 a Q40) que
avaliam a experiência do parto. A escala MCSRS é questionário de autopreenchimento. A
Análise Fatorial Confirmatória (AFC), confiabilidade (alfa de Cronbach e ômega de
McDonald) e validação discriminante foram determinadas, pacote Lavaan do software R. Na
análise da satisfação com o parto foram incluídas 372 mulheres que tiveram parto vaginal (itens
Q1 a Q34). Testes U de Mann-Whitney, qui-quadrado ou Exato de Fisher e análise de regressão
múltipla foram aplicados. Resultados: A AFC confirmou seis subescalas identificadas nos 34
itens (Q1 a Q34) da escala original e para os itens Q37 a Q40 confirmou- se uma única
dimensão “Experiência Geral no Parto”. As cargas fatoriais dos itens foram acima de 0,70. A
confiabilidade geral alfa de Cronbach de 0,96 (Q1 a Q34) e 0,90 (Q37 a Q40) e o ômega de
McDonald de 0,97 (Q1 a Q34) e 0,89 (Q37 a Q40). Na análise da satisfação, a mediana do
MCSRS foi significativamente maior nas mulheres que moram com o companheiro do que às
que não moram (145,5 vs 133,0; p = 0,019), com acompanhante durante o parto do que
naquelas sem (146,0 vs 136,5; p=0,047), e que amamentaram na primeira hora de vida
comparadas com as que não o fizeram (146,0 vs 137,0; p=0,001). Regressão múltipla
identificou morar com companheiro (coeficiente 6,205; p=0,043) e amamentar na primeira
hora (coeficiente 7,856; p=0,005) variáveis independentes que determinaram o escore total da
satisfação do MCSRS. Os maiores coeficientes de satisfação foram com a parteira e o médico.
Conclusões: A escala MCSRS-Brasil é um instrumento confiável e válido. Residir com
companheiro e iniciar precocemente a amamentação no pós- parto são fatores que aumentam
a satisfação com o parto vaginal.
Satisfaction with childbirth is a multidimensional concept and is related to the quality of obstetric care. Objectives: to evaluate the psychometric properties of the Mackey Childbirth Satisfaction Rating Scale (MCSRS) and to assess women's satisfaction with childbirth. Methods: Cross-sectional instrument validation study. Data collected from 411 postpartum women at a low-risk public maternity hospital. Inclusion criteria: maternal age between 18 and 34 years, gestational age greater than 36 weeks, single, live, and healthy fetus. The version of the MCSRS-Brasil scale contains 34 items (Q1 to Q34) with six subscales that assess: selfsatisfaction, partner, baby, nursing, doctors and general satisfaction and 4 items (Q37 to Q40) that assess the childbirth experience. The MCSRS scale is a self-administered questionnaire. Confirmatory Factor Analysis (CFA), reliability (Cronbach's alpha and McDonald's omega) and discriminant validation were determined, Lavaan package of R software. In the analysis of satisfaction with childbirth, 372 women who had vaginal delivery were included (items Q1 to Q34). Mann-Whitney U, chi-square or Fisher's exact tests and multiple regression analysis were applied. Results: AFC confirmed six subscales identified in the 34 items (Q1 to Q34) of the original scale and for items Q37 to Q40 a single dimension “General Experience in Childbirth” was confirmed. The factor loadings of the items were above 0.70. General reliability Cronbach's alpha of 0.96 (Q1 to Q34) and 0.90 (Q37 to Q40) and McDonald's omega of 0.97 (Q1 to Q34) and 0.89 (Q37 to Q40). In the analysis of satisfaction, the median of the MCSRS was significantly higher in women who live with a partner than in those who do not (145.5 vs 133.0; p = 0.019), with a companion during childbirth than in those without (146 .0 vs 136.5; p=0.047), and who breastfed in the first hour of life compared with those who did not (146.0 vs 137.0; p=0.001). Multiple regression identified living with a partner (coefficient 6.205; p=0.043) and breastfeeding in the first hour (coefficient 7.856; p=0.005) as independent variables that determined the total MCSRS satisfaction score. The highest satisfaction coefficients were with the midwife and the doctor. Conclusions: The MCSRS-Brazil scale is a reliable and valid instrument. Living with a partner and early initiation of breastfeeding in the postpartum period are factors that increase satisfaction with vaginal delivery.
Satisfaction with childbirth is a multidimensional concept and is related to the quality of obstetric care. Objectives: to evaluate the psychometric properties of the Mackey Childbirth Satisfaction Rating Scale (MCSRS) and to assess women's satisfaction with childbirth. Methods: Cross-sectional instrument validation study. Data collected from 411 postpartum women at a low-risk public maternity hospital. Inclusion criteria: maternal age between 18 and 34 years, gestational age greater than 36 weeks, single, live, and healthy fetus. The version of the MCSRS-Brasil scale contains 34 items (Q1 to Q34) with six subscales that assess: selfsatisfaction, partner, baby, nursing, doctors and general satisfaction and 4 items (Q37 to Q40) that assess the childbirth experience. The MCSRS scale is a self-administered questionnaire. Confirmatory Factor Analysis (CFA), reliability (Cronbach's alpha and McDonald's omega) and discriminant validation were determined, Lavaan package of R software. In the analysis of satisfaction with childbirth, 372 women who had vaginal delivery were included (items Q1 to Q34). Mann-Whitney U, chi-square or Fisher's exact tests and multiple regression analysis were applied. Results: AFC confirmed six subscales identified in the 34 items (Q1 to Q34) of the original scale and for items Q37 to Q40 a single dimension “General Experience in Childbirth” was confirmed. The factor loadings of the items were above 0.70. General reliability Cronbach's alpha of 0.96 (Q1 to Q34) and 0.90 (Q37 to Q40) and McDonald's omega of 0.97 (Q1 to Q34) and 0.89 (Q37 to Q40). In the analysis of satisfaction, the median of the MCSRS was significantly higher in women who live with a partner than in those who do not (145.5 vs 133.0; p = 0.019), with a companion during childbirth than in those without (146 .0 vs 136.5; p=0.047), and who breastfed in the first hour of life compared with those who did not (146.0 vs 137.0; p=0.001). Multiple regression identified living with a partner (coefficient 6.205; p=0.043) and breastfeeding in the first hour (coefficient 7.856; p=0.005) as independent variables that determined the total MCSRS satisfaction score. The highest satisfaction coefficients were with the midwife and the doctor. Conclusions: The MCSRS-Brazil scale is a reliable and valid instrument. Living with a partner and early initiation of breastfeeding in the postpartum period are factors that increase satisfaction with vaginal delivery.