Linguistic and Psychometric Validation of Sinhala Version of Pregnancy related Anxiety Questionnaire-Revised 2

Abstract

Background: Pregnancy-related anxiety (PrA) is a specific type of anxiety that can occur during the perinatal period. PrA has negative impacts on childbirth. Pregnancy-related Anxiety Questionnaire-Revised 2 (PRAQ-R2) is one of the most frequently used instruments to assess PrA. Considering its ability to assess PrA in pregnant mothers, PRAQ-R2 will be a worthy questionnaire to be validated in Sri Lankan setting for future usage. Objectives: To validate the Sinhala version of PRAQ-R2. Methods: A validation study was conducted among a consecutive sample of 111 mothers who attended the antenatal clinics in the Akmeemana MOH area in Galle district, Sri Lanka. The PRAQ-R2 was translated to Sinhala using the standard translation/back-translation method. Content and face validity were evaluated. Internal consistency was assessed using Cronbach’s alpha and test-retest reliability was assessed using intraclass correlation coefficient (ICC). To assess concurrent validity, along with the PRAQ-R2, previously validated Sinhala version of Pregnancy Anxiety Screening Scale (PASS) was administered. Concurrent validity was evaluated by calculating Pearson correlation coefficients. Results: The participants were aged between 24-29 years (n=42, 37.8%). There were 39.6% (n=44) of primi mothers. The questionnaire demonstrated high internal consistency (α=0.87) and that indicates the questionnaire has a consistent structure. The ICC (with a 95% confidence interval) was 0.997, showing consistent results if the test was repeated. Based on the expert opinion, the modified 12 items of the Sinhala version of the PRAQ-R2 questionnaire were clear, understandable, and related to the Sri Lankan culture. Significant correlation between the scores of PRAQ-R2 and PASS scales showing a high concurrent validity (r=0.745, p<0.001) and that indicates both scales measured similar constructs. Conclusions: The Sinhala translation of the PRAQ-R2 is a valid and reliable instrument to assess PrA among women in Sri Lanka.