title: Reliability tests and validation tests of the client satisfaction questionnaire (CSQ-8) as an index of satisfaction with childbirth-related care among Filipino women.
abstract: BACKGROUND
  Satisfaction is an important indicator of the quality of care during childbirth. Previous research found that a good environment at a health facility can increase the number of deliveries at that facility. In contrast, an unsatisfying childbirth experience could cause postpartum mental disorder. Therefore it is important to measure mothers' satisfaction with their childbirth experiences. We tested whether the eight-item Client Satisfaction Questionnaire (CSQ-8) provided useful information about satisfaction with childbirth-related care. The government of the Philippines promotes childbirth at health facilities, so we tested the CSQ-8 in the Philippine cities of Ormoc and Palo.
  
  
  METHODS
  This was a cross-sectional study. We targeted multigravid mothers whose last baby had been delivered at a hospital (without complications) and whose 2nd-to-last baby had been delivered at a hospital or at home (without complications). We developed versions of the CSQ-8 in Cebuano and Waray, which are two of the six major Filipino languages. Reliability tests and validation tests were done with data from 100 Cebuano-speaking mothers and 106 Waray-speaking mothers.
  
  
  RESULTS
  Both the Cebuano and Waray versions of the CSQ-8 had high coefficients of internal-consistency reliability (greater than 0.80). Both versions were also unidimensional, which is generally consistent with the English CSQ-8 in a mental-health setting. As hypothesized, the scores for data regarding the second-to-last delivery were higher for mothers who had both their second-to-last and their last delivery in a hospital, than for mothers who had their second-to-last delivery at home and their last delivery in a hospital (Cebuano: p < 0.001, rho = 0.51, Waray: p < 0.001, rho = 0.55).
  
  
  CONCLUSIONS
  Scores on the CSQ-8 can be used as indices of general satisfaction with childbirth-related services in clinical settings. This study also exemplifies a convenient method for developing versions of the CSQ-8 in more than one language. These versions of the CSQ-8 can now be used to assess mothers' satisfaction, so that mothers' opinions can be taken into account in efforts to improve childbirth-related services, which could increase the proportion of deliveries in medical facilities and thus reduce maternal mortality.
authors.forename: Chieko
authors.initials: C
authors.lastname: Matsubara
authors.forename: Joseph
authors.initials: J
authors.lastname: Green
authors.forename: Linda Teresa
authors.initials: LT
authors.lastname: Astorga
authors.forename: Edgardo L
authors.initials: EL
authors.lastname: Daya
authors.forename: Honorato C
authors.initials: HC
authors.lastname: Jervoso
authors.forename: Edgardo M
authors.initials: EM
authors.lastname: Gonzaga
authors.affiliation: Graduate School of Medicine, The University of Tokyo, 7-3-1, Hongo, Bunkyo-ku, Tokyo 113-0033, Japan. mjimba@m.u-tokyo.ac.jp.
authors.forename: Masamine
authors.initials: M
authors.lastname: Jimba
mesh_terms: D000328:Adult; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008427:Maternal Health Services / Q000592:standards*; D036801:Parturition; D017060:Patient Satisfaction; D010679:Philippines; D011247:Pregnancy; D025341:Principal Component Analysis; D015203:Reproducibility of Results; D011795:Surveys and Questionnaires; D055815:Young Adult