Development and Assessment of Respectful Maternity Care Questionnaire in Iran

Background: Disrespectful and undignified care during childbirth has been documented in health facilities all over the world. The purpose of this study was to develop and pretest a new instrument, the Quality of Respectful Maternity Care Questionnaire in Iran (QRMCQI), with an ensured validity and reliability to evaluate and measure Respectful Maternity Care (RMC) in three sections of labor, delivery and post-partum. Methods: This is a study with mixed sequential exploratory design. Here, the questionnaire design is a part of descriptive survey study and consists of five phases implemented in one year. The phases include item or questions generation, face validation, content validity assessment, confirmatory factor analysis and reliability assurance of the questionnaire. The participants were selected from the mothers referring to health care centers affiliated to Iran University of Medical Sciences in five cities after recruitment from hospital for after-care services of delivery. Results: The primary questionnaire was developed, face validity was performed by experts and their comments were implemented. The content validity index (CVI), Kappa index and Content Validity Ratio (CVR) were calculated for each item and they were satisfactory in an acceptable range. Confirmatory factor analysis (CFA) showed good fit of the hypothesized model for 453 participants in the interview. Testing showed an acceptable internal consistency and reliability by calculating Cronbach’s alpha coefficient for questions in labor (0.86), in delivery (0.85), and in postpartum care (0.78). Conclusion: We have developed a new instrument as the 59-item QRMCQI for evaluating respectful maternity care in Iran through a rigorous process of item generation and validity-reliability assessment besides confirmatory factor analysis that were in an acceptable range and can be used as a reliable instrument for RMC in Iran.