Translation and validation of the Swahili version of the Wijma Delivery Expectancy/Experience Questionnaire version A (W-DEQ-A)

Background: Prenatal fear of childbirth is a common health concern that negatively affects the emotional wellbeing of women during pregnancy. Wijma Delivery Expectancy/Experience Questionnaire version A (W-DEQ-A) is used extensively to measure fear of childbirth during pregnancy. Nevertheless, previous studies have not evaluated its psychometric characteristics among the Swahili-speaking pregnant women. Therefore, the aim was to translate and test the validity and reliability of the questionnaire into Swahili as the popular language in Kenya.

Methods: In the current descriptive cross-sectional study, the W-DEQ-A, together with the Edinburgh Postnatal Depression Scale (EPDS) and Beck Anxiety Inventory (BAI) were administered to a group of 628 pregnant women to explore the dimensionality of W-DEQ-A using Exploratory Factor Analysis (EFA) and Confirmatory Factor Analysis (CFA), respectively.

Results: EFA and CFA of the Swahili version of W-DEQ-A identified five-factor loadings: lack of self-efficacy, fear, negative emotions, negative appraisal, and social isolation. However, this model failed to support the unidimensional structure of the original W-DEQ-A. The Swahili version of the W-DEQ-A correlated well with EPDS and BAI at acceptable levels. The Cronbach alpha values of the subscales ranged from 0.867 to 0.967, an indication of an excellent internal consistency of the instrument.

Conclusion: The current study findings provide support for the Swahili version of the W-DEQ-A to be considered as a valid and reliable measuring tool for the fear of childbirth among Swahili-speaking pregnant women in Kenya, and the entire East and Central African region. Also, due to its multidimensional structure, the original W-DEQ-A should not be used in its original form.