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Validation of a perceptions of care adjective check list for labour and birth

Principal investigator
Maggie Redshaw (NPEU (Former member))
Colin Martin (School of Health, Nursing and Midwifery, University of Paisley)
Women's experience of maternity care
DH - Policy Research Programme
Start year
End year


Women’s individual experience and attitudes towards the care provided during labour and birth vary. An adjective checklist with equal numbers of positive and negative terms allows women to be both critical and positive about their care. Cognitive interviews had revealed a high face validity for this approach. This study aimed to describe the psychometric characteristics, validity and reliability of the revised version of the perceptions of care adjective checklist (PCACL-R) with women who had recently given birth, using data from nearly 3000 who had participated in the National Maternity Survey in 2006.

Key findings

  • Confirmatory factor analysis revealed a good fit to a bi-dimensional instrument structure entirely consistent with the negative and positive valencing of the 24 adjectives used in the measure, *The use of the instrument as a two subscale tool comprising positive and negative subscales was supported
  • The measure had good convergent validity against measures of satisfaction with care and good divergent validity characteristics assessed against duration of labour. Discriminant validity was assessed against measures of area-based maternal deprivation, partner status and type of delivery.
  • Internal consistency characteristics of the positive and negative subscales of the PCACL-R were acceptable and the predictive validity of the measure was confirmed.

It was conducted that the PCACL-R is a short, valid, reliable, respondent acceptable and easy to administer instrument that can be used to assess women's expereiences of their care druing labour and childbirth. The measurement characteristics of the PCACL-R suggest that it could be utilised in clinical and research contexts with confidence. The checklist terms used are applicable to other phases of maternity care and indeed to a wide range of health care contexts. Exploratory use in with women outside the UK is ongoing.


Journal Articles