Validation of the Arabic Childbirth Care Satisfaction Survey

Background: Measuring maternal satisfaction in Arab countries is an essential indicator of care quality. However, existing surveys have limited psychometric properties and inclusion criteria. Aims: To present the psychometric properties of the Arabic Childbirth Care Satisfaction Survey (CCSS). Methods: The Arabic CCSS was developed from 2 English surveys. In 2017, 13 mothers assessed survey items in terms of clarity, importance and acceptability. The CCSS was distributed to all mothers who delivered a live baby during the 4-week study period in 9 hospitals in Oman. A sample of 461 participants was used for principal component analysis (PCA) and another sample of 408 participants (after removing missing data) was used for confirmatory factor analysis (CFA). Two-sample independent t tests were conducted to establish discriminant validity. Stata software was used for the analysis. Results: The survey demonstrated good face and content validity with all items rated above 3 out of 5. Out of the 3566 targeted population, 958 (26.9%) mothers participated. PCA identified 2 factors labelled as communication and control (Cronbach's alpha = 0.90) and care organization (Cronbach's alpha = 0.68) with good internal reliability. CFA demonstrated good model fit, confirming construct validity. Mothers who had vaginal delivery were more satisfied (P < 0.05) compared with those who underwent caesarean section, thus establishing good discriminant validity. Conclusion: A short Arabic CCSS tool was developed. This new 10-item tool had good face and content validity, good internal reliability, construct validity and discriminant validity. It can provide valuable information to clinicians and decision-makers about the quality of maternity services.