title: Development of the Pregnancy and Childbirth Questionnaire (PCQ): evaluating quality of care as perceived by women who recently gave birth.
abstract: OBJECTIVE
  To develop an instrument to the assess quality of care during pregnancy and delivery as perceived by women who recently gave birth.
  
  
  METHODS
  Prospective design from focus group interviews to validation of the questionnaire. The focus groups consisted of seven care providers, ten pregnant women and six women who recently gave birth. With the results of the focus group interviews, a draft questionnaire of 52 items was composed and its psychometric properties were tested in a first cohort of 300 women who recently gave birth (sample I) by means of exploratory factor analysis (EFA) and reliability analysis. The final version was further explored by confirmatory factor analyses (CFA) in another sample of 289 women (sample II) with similar characteristics as sample I.
  
  
  RESULTS
  EFA in sample I suggested an 18-item scale with two components concerning the quality of care during pregnancy: 'personal treatment' (11 items, Cronbach's alpha (α)=0.87) and 'educational information' (7 items, α=0.90); the 'delivery' scale showed a single domain (7 items, α=0.88). CFA in sample II confirmed both factor structures with an adequate model fit. Overall, satisfaction with care was highest among women who only received midwife-led care, while women who were referred to an obstetrician during pregnancy reported less satisfaction.
  
  
  CONCLUSIONS
  The 25-item PCQ, primarily based on the experiences and perceptions of pregnant women and women who recently gave birth, showed adequate psychometric properties evaluating the quality of care during pregnancy and delivery. This user-friendly instrument might be a valuable instrument for future research to further evaluate the quality of care to pregnant women.
authors: Department of Obstetrics and Gynaecology, Máxima Medical Centre, Veldhoven, The Netherlands. Electronic address: s.truijens@mmc.nl.
authors: Sophie E M
authors: SE
authors: Truijens
authors: Department of Medical and Clinical Psychology, Tilburg University, Tilburg, The Netherlands.
authors: Antoinette M
authors: AM
authors: Pommer
authors: Department of Obstetrics and Gynaecology, Máxima Medical Centre, Veldhoven, The Netherlands.
authors: Pieter J
authors: PJ
authors: van Runnard Heimel
authors: Department of Obstetrics and Gynaecology, Máxima Medical Centre, Veldhoven, The Netherlands.
authors: Corine J M
authors: CJ
authors: Verhoeven
authors: Department of Obstetrics and Gynaecology, Máxima Medical Centre, Veldhoven, The Netherlands.
authors: S Guid
authors: SG
authors: Oei
authors: Department of Medical and Clinical Psychology, Tilburg University, Tilburg, The Netherlands.
authors: Victor J M
authors: VJ
authors: Pop
mesh_terms: D000328:Adult; D005163:Factor Analysis, Statistical; D005260:Female; D017144:Focus Groups; D006801:Humans; D008875:Middle Aged; D008880:Midwifery; D036801:Parturition; D017060:Patient Satisfaction; D010820:Physicians; D011247:Pregnancy; D011295:Prenatal Care; D011446:Prospective Studies; D011787:Quality of Health Care; D015203:Reproducibility of Results; D011795:Surveys and Questionnaires; D055815:Young Adult
keywords: Childbirth; Patient perspective; Pregnancy; Quality of care; Satisfaction