Kamonthip Tanglakmankhong, MNS, RN, Doctoral student.

1
Thai version of Childbirth Self-efficacy
Inventory (CBSEI) and Childbirth Attitudes
Questionnaire (CAQ)
Kamonthip Tanglakmankhong, MNS, RN, Doctoral
student. Nancy K. Lowe, CNM, PhD, FACNM, FAAN,
Elnora Thomson Distinguished Professor email
contact tanglakm_at_ohsu.edu, lowen_at_ohsu.edu
Background Childbirth is a life event that is
potentially threatening because of the likelihood
of pain and the risk of injury or even death for
mother and child. In Thailand, most hospital
delivery units do not allow family members to go
into the delivery unit. Therefore, women have to
deal with their birth experiences alone in
unfamiliar environments and in the company of
strangers. In addition, no one can tell a woman
exactly when labor will occur, how long it will
last, or exactly what she will experience during
its course. These uncertainties may cause a woman
to come to doubt her confidence to get through
labor and birth. Research by a number of
investigators in the US and other countries has
supported that the CBSEI and CAQ by Lowe were
well-developed instruments to evaluate womens
self-efficacy for labor and childbirth fears.
However, quality of translation and validation of
the translated instruments play significant roles
in ensuring that the results obtained in
cross-cultural research are not due to errors in
translation, but rather are due to real
differences or similarities between cultures in
the phenomena being measured.

• Results
• _________CVI___________
• of Fit Clear Appropriate
  
• items definition in Thai
  culture
• CBSEI 16 1 0.81 0.94
• CAQ 16 1 0.75 0.94
• All translated items were determined to fit the
  conceptual definitions. Most items were clear and
  evaluated as appropriate in Thai culture.
• Three CBSEI items and 4 CAQ items needed further
  revision based on the suggestions from the
  content experts. Because some words may not have
  exactly the same meaning when directly translated
  into the Thai language, these items were
  paraphrased in order to clarify the conceptual
  meaning for Thai people.
• The modified Thai instruments were back
  translated as previously described. Comparison of
  the back translations with the original English
  versions of the CBSEI and CAQ indicated that only
  one CAQ item did not accurately reflect the
  English version and needed to be modified.

• Method
• The CBSEI and CAQ were forward- translated from
  English into Thai by 2 bilingual experienced
  midwives.
• Content validity of the translated instruments
  was evaluated by separate expert panels.
• The Thai-CBSEI panel consisted of 4 Thai
  nurse-midwife instructors and 3 Thai nurse
  researchers who specialized in the concept of
  self-efficacy.
• The Thai CAQ panel consisted of 5 Thai
  nurse-midwife instructors.
• The experts were requested to determine if the
  translated CBSEI and CAQ items 1) fit the
  definition of each concept, 2) were clear, and 3)
  were appropriate for use with Thai pregnant
  women. Content validity indexes (CVI) were
  calculated for each criterion as the proportion
  of items rated as meeting the criterion by the
  content experts.
• Back-translation to English was done by 2 Thai
  English department university professors. These
  translators had no prior knowledge of the
  original English versions and were not clinical
  or theory experts.
• The original versions and the back
• translated versions were compared
• and discussed for clarity,
• comprehensiveness, appropriateness, and
  cultural relevance.

Further Research Field testing of the Thai-CBSEI
and Thai-CAQ with Thai pregnant women will be
conducted to evaluate translation quality and
practical aspects of test administration. A
convenience sample of 20 Thai pregnant women will
be asked to read and listen to the items, item by
item, and asked to paraphrase their
understanding. The match of their responses to
the original versions will be qualitatively
evaluated and additional item revisions
considered as indicated. Psychometric
evaluation of the translated instruments also
will be conducted.

Acknowledgements The support and assistance of
Dr. Nittaya Sinsuksai, PhD, RN, Assistant
Professor, Faculty of Nursing, Mahidol
University, Thailand is gratefully acknowledged.

• Aim
• To translate the CBSEI and CAQ into Thai and
  evaluate the content validity of the translated
  instruments.

School of Nursing A Passion for
Nursing