The Iranian Version of Theory-Based Intention for Cesarean Section (IR-TBICS) Scale: Development and First Evaluation
Abstract Background: The rate of mothers experiencing a cesarean section in the absence of medical signs is growing in the world. Women's beliefs and intentions have an essential role in the request or choosing a delivery method. At present, there is no comprehensive, validated scale for assessing pregnant women's beliefs about the cesarean section in the Iranian population. This study performed to develop and assess the validity and reliability of the belief-based cesarean section scale using the theory of reason action (TRA) constructs as a theoretical framework for measuring intention toward delivery method selection. Methods: In this cross-sectional validation study, 480 pregnant women were recruited from Sari, north of Iran, through a multi-stage random sampling approach. Content validity was examined using the content validity index (CVI) and content validity ratio (CVR). Furthermore, both exploratory factor analyses (EFA) and confirmatory factor analyses (CFA) were applied to assess the construct validity of the developed scale. Reliability was measured by internal consistency and intraclass correlation coefficient (ICC). Quality criteria for floor and ceiling effects were derived from existing guidelines and consensus within our research group. Results: Results obtained from factor analysis showed that the data were fit to the model (χ2= 2298.389, P<0.001), and TRA consisted of 24 items assessing five domains, which describing 62.46% of the common variance. The CFA showed a model with suitable fitness for the data. Cronbach’s alpha coefficient for the domains of the scale ranged from .609 to .843, and the ICC value ranged from .71 to .84, which is within satisfactory ranges. The IR-TBICS scale had no floor and ceiling effect in the total score or any of the dimensions. Conclusion: The belief-based cesarean section scale appears to be a reliable instrument and now is suitable and can be applied in other researches in Iran. Keywords: Cesarean section, Intention, Scale development, Psychometrics, Pregnant women