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Early labour experience questionnaire: Psychometric testing and women's experiences in a Swedish setting
Karlstad University, Faculty of Health, Science and Technology (starting 2013), Department of Health Sciences (from 2013).ORCID iD: 0000-0001-7729-7912
Karlstad University, Faculty of Health, Science and Technology (starting 2013), Department of Health Sciences (from 2013).ORCID iD: 0000-0003-1382-4386
Karlstad University, Faculty of Health, Science and Technology (starting 2013), Department of Health Sciences (from 2013).ORCID iD: 0000-0002-2667-4025
Karlstad University, Faculty of Health, Science and Technology (starting 2013), Department of Health Sciences (from 2013).ORCID iD: 0000-0001-7082-6834
2018 (English)In: Midwifery, ISSN 0266-6138, E-ISSN 1532-3099, Vol. 64, p. 77-84Article in journal (Refereed) Published
Abstract [en]

Objective: (a) to psychometrically test the Early Labour Experience Questionnaire (ELEQ) among both primi- and multiparous women giving birth in a Swedish setting, and (b) to describe and compare their experiences during early labour in relation to background characteristics. Design: a cross-sectional study. Setting: a county in Sweden. Participants: primi- and multiparous women with a spontaneous onset of labour after gestational week 37 + 0. In total, n = 1193 women were invited, and n = 754 responded the questionnaire, with a final total of n = 344 primi and n = 410 multiparous women. Methods: the ELEQ was translated with cross-cultural adaptation. The validity was determined using exploratory factor analysis with principal axis factoring analyses. Reliability was estimated from the internal consistency using Cronbach's alpha. The relationship between the questionnaire and the demographic characteristics of the participating women were analysed using ANOVA and t-test. Findings: an explorative factor analysis showed a three-factor solution for primiparas women (SWE-ELEQ-PP) consist of 23 items and a stable factor structure that explained 49.2% of the total variance with sufficient reliability coefficients (0.81–0.86). A four-factor solution for multiparous women (SWE-ELEQ-MP) consist of 22 items, with 52.62% of the total variance explained and with adequate internal consistency reliability coefficients (0.77–0.86) for three factors and relatively low stability (0.62) for the fourth factor with two items. Primiparous women scored significantly higher on items about feeling confused, and significantly lower on some items measuring emotional wellbeing and perceptions of midwifery care compared to multiparous women. Primiparous women with longer early labour (>18 h), scored significantly lower on the perceptions of midwifery care. Primi- and multiparous women who were dissatisfied with their telephone conversation or with not being admitted during early labour, scored significantly lower on emotional wellbeing, higher regarding emotional distress, and significantly lower about perceptions of midwifery care. Key conclusions: the SWE-ELEQ-PP and SWE-ELEQ-MP are considered valid questionnaires for use in a Swedish setting. Differences exist between parity and the factor structure and experiences in early labour vary. Women less content with early labour management decisions rated perceived midwifery care lower regardless of parity. Implication for practice: the questionnaire can be used to evaluate early labour care in a Swedish setting. The result suggests that differences according to parity exist and should be addressed when managing early labour care and a more individualised approach requires considerations.

Place, publisher, year, edition, pages
Churchill Livingstone , 2018. Vol. 64, p. 77-84
Keywords [en]
Early Labour, Early Labour Experience, Factor analysis, Psychometric test, Questionnaire
National Category
Nursing
Identifiers
URN: urn:nbn:se:kau:diva-69018DOI: 10.1016/j.midw.2018.06.008PubMedID: 29966880Scopus ID: 2-s2.0-85049358036OAI: oai:DiVA.org:kau-69018DiVA, id: diva2:1245543
Available from: 2018-09-05 Created: 2018-09-05 Last updated: 2018-10-23Bibliographically approved
In thesis
1. Prolonged latent phase of labour: Prevalence, labour outcomes, quality of care, women’s experiences and preferences, and psychometric properties of a questionnaire
Open this publication in new window or tab >>Prolonged latent phase of labour: Prevalence, labour outcomes, quality of care, women’s experiences and preferences, and psychometric properties of a questionnaire
2018 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

The overall aim of this thesis was to investigate the prevalence and labour outcome of a prolonged latent phase of labour, quality of care, women’s experiences and preferences during labour, and to psychometrically test a questionnaire.

Methods: Qualitative and quantitative methods. Sixteen primiparous women’s preferences for care during a prolonged latent phase of labour were studied with focus-group and individual interviews and analysed with content analysis (I). From a one-year cohort of 2660 women, 1554 women with a spontaneous onset of labour were invited to participate and 1389 women accepted invitation (II-IV). Data from 1343 women’s birth records were analysed with descriptive and analytic statistics (II). 758 women, (RR 64%), 343 primiparous and 415 multiparous, responded to the Intrapartal-specific Quality from Patients Perspective Questionnaire, QPP-I (III), the Early Labour Experience Questionnaire, ELEQ (IV) and additionally birth-related items. Data were analysed with descriptive, analytic, and psychometric statistics.

Main findings: According to women’s self-reports, 23% of women with a spontaneous onset of labour had a prolonged latent phase (>18 hours), which was associated with more obstetrical interventions and instrumental births (II). These women preferred individualised care (I), rated the quality of their intrapartum care lower, were less content with the birth experience, and had more negative feelings during labour and birth than women with a shorter latent phase (III). The ELEQ was translated and adapted to Swedish and resulted in two questionnaires, one for primiparous women, SWE-ELEQ-PP, and one for multiparous women, SWE-ELEQ-MP. Both are valid and reliable and can be used to evaluate early labour care in Sweden (IV).

Conclusions: A prolonged latent phase of labour can be regarded as a risk factor. It can result in more obstetrical interventions, more instrumental births, a lower perceived quality of care, and a more negative birth experience regardless of parity. Differences in parity must be considered when evaluating early labour care during the latent phase of labour, with special focus to primiparous women.

Abstract [en]

Women’s preferences are not always adequately met during the latent phase of labour. Further exploration is needed to investigate the experiences, preferences, and labour outcome of women with a prolonged latent phase. The overall aim of this thesis was to investigate the prevalence and labour outcomes of a prolonged latent phase, quality of care, women’s experiences and preferences during labour, and to psychometrically test a questionnaire. The prevalence of a prolonged latent phase of labour was 23% of women with a spontaneous onset of labour and was associated with more obstetrical interventions and instrumental births. These women preferred individualised care, rated the quality of their intrapartum care lower, were less content with the birth experience, and had more negative feelings during labour and birth than women with a shorter latent phase. A questionnaire about experiences during early labour was adapted and can be used to evaluate early labour care in Sweden for both primiparous and multiparous women. A prolonged latent phase of labour can be regarded as a risk factor, and differences in parity must be considered when evaluating early labour care. Special focus should be on primiparous women, and a women-centred perspective is required for management during the latent phase of labour, regardless of parity.

Place, publisher, year, edition, pages
Karlstads universitet, 2018. p. 76
Series
Karlstad University Studies, ISSN 1403-8099 ; 2018:49
Keywords
birth experience, prolonged latent phase of labour, quality of care, psychometric evaluation
National Category
Health Sciences
Research subject
Nursing Science
Identifiers
urn:nbn:se:kau:diva-69804 (URN)978-91-7063-889-3 (ISBN)978-91-7063-984-5 (ISBN)
Public defence
2018-12-07, Lagerlöfsalen, 1A 305, Karlstads universitet, Karlstad, 13:00 (Swedish)
Opponent
Supervisors
Funder
Landstinget i Värmland
Available from: 2018-11-13 Created: 2018-10-23 Last updated: 2018-11-13Bibliographically approved

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Ängeby, KarinSandin-Bojö, Ann-KristinPersenius Wentzel, MonaWilde-Larsson, Bodil

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