Validity and reliability of the Iranian preterm birth experiences and satisfaction scale: A methodological and cross-sectional study

Maryam Najjarzadeh, Sakineh Mohammad-Alizadeh-Charandabi, Shamsi Abbas-Alizadeh, Mohammad Jafarabadi, Mojgan Mirghafourvand, Nahid Tagipour-Amidi, Alexandra Sawyer, Susan Ayers

Research output: Contribution to journalArticlepeer-review


Background: Women’s experience and satisfaction with childbirth care are increasingly being addressed by health care providers, managers, and policymakers. Due to need for a validated special scale for assessing satisfaction of women with preterm birth, we aimed to translate and adapt the first specific tool, Preterm Birth Experiences and Satisfaction Scale (P-BESS), into Persian language and evaluate its psychometric properties. Methods: A methodological and cross-sectional study was conducted in two tertiary levels of maternal hospitals in Tabriz. The Iranian version of the scale was developed from the original English version using forward-backward translation. After confirmation of its face and content validity, the scale was completed by 201 women who had given birth prematurely. Results: Exploratory factor analysis revealed three factors (staff professionalism and empathy, confidence in Staff, information and explanations) with eigenvalues greater than 1, explaining a total variance of 55.4%. Confirmatory factory analysis showed that the 17-item, three factor model fitted the data well: the root mean square error of approximation 0.060. There were moderate correlations between the total and sub-scales of Iranian P-BESS and overall satisfaction (r = 0.45 to 0.66), as well as need for improvement (r = -0.46 to -0.61), which confirm convergent validity. Internal consistency and test–retest reliability of the scale and its sub-scales were satisfactory (α = 0.852 to 0.922, intraclass correlation coefficient; 0.83 to 0.92). Conclusion: The Iranian version of P-BESS is a valid and reliable scale which can be used by policy makers, managers, health care providers and researchers.

Original languageEnglish
Pages (from-to)97-108
Number of pages12
JournalHealth Promotion Perspectives
Issue number1
Publication statusPublished - 7 Feb 2021

Bibliographical note

© 2021 The Author(s). This is an open access article distributed under the terms of the Creative Commons Attribution License (http://, which permits unrestricted use, distribution, and reproduction in any medium, provided the original
work is properly cited

Funding Information:
We would like to thank authorities of the University for the scientific and ethical approval and financial support of this research. We also sincerely thank all participating women, authorities and personnel of Alzahra and Taleghani hospitals for their cooperation in this study.


  • Iran
  • Patient satisfaction
  • Premature birth
  • Psychometrics
  • Validation study


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