A Survey on worries of pregnant women- testing the German version of the Cambridge Worry Scale

Institute for General Practice, Johann-Wolfgang Goethe-University Frankfurt/Main, Theodor-Stern-Kai 7, 60590 Frankfurt/Main, Germany.
BMC Public Health (Impact Factor: 2.26). 12/2009; 9(1):490. DOI: 10.1186/1471-2458-9-490
Source: PubMed


Pregnancy is a transition period in a woman's life characterized by increased worries and anxiety. The Cambridge Worry Scale (CWS) was developed to assess the content and extent of maternal worries in pregnancy. It has been increasingly used in studies over recent years. However, a German version has not yet been developed and validated.The aim of this study was (1) to assess the extent and content of worries in pregnancy on a sample of women in Germany using a translated and adapted version of the Cambridge Worry Scale, and (2) to evaluate the psychometric properties of the German version.
We conducted a cross-sectional study and enrolled 344 pregnant women in the federal state of Baden-Württemberg, Germany. Women filled out structured questionnaires that contained the CWS, the Spielberger-State-Trait-Anxiety Inventory (STAI), as well as questions on their obstetric history. Antenatal records were also analyzed.
The CWS was well understood and easy to fill in. The major worries referred to the process of giving birth (CWS mean value 2.26) and the possibility that something might be wrong with the baby (1.99), followed by coping with the new baby (1.57), going to hospital (1.29) and the possibility of going into labour too early (1.28). The internal consistency of the scale (0.80) was satisfactory, and we found a four-factor structure, similar to previous studies. Tests of convergent validity showed that the German CWS represents a different construct compared with state and trait anxiety but has the desired overlap.
The German CWS has satisfactory psychometric properties. It represents a valuable tool for use in scientific studies and is likely to be useful also to clinicians.

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    • "Therefore, it seems that the prevalence of anxiety may be affected by the time point of measurement during pregnancy and the type of instrument used (Nasreen et al., 2011). The overall mean score for pregnancy worry (1.62) was comparable to the mean CWS scores found in other studies of pregnant women (Green et al., 2003; Petersen et al., 2009). Findings regarding the prevalence and the Table 4 Results of multiple linear regression, including factors related to state anxiety (n ¼165). "
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    ABSTRACT: a wide range of psychosocial variables may influence pregnant women's psychological status. However the association between marital and social support, anxiety and worries during pregnancy is a relatively neglected area of research. Therefore, the aim of this study was to examine the relationship between marital support, social support, antenatal anxiety and pregnancy worries after controlling for the effects of background variables. public hospital in Athens, Greece. a cross-sectional study. 165 pregnant women attending an antenatal clinic for antenatal screening between January 2011 and March 2011. anxiety was measured using the State scale of the State-Trait Anxiety Inventory, pregnancy worries were measured with the Cambridge Worry Scale, social support with the Social Support Questionnaire-6 and marital satisfaction with the Quality of Marriage Index. Pearson's correlation coefficients were calculated among all study variables, followed by hierarchical multiple linear regression. a STAI score of ≥43 was taken as indicative of anxiety and 44.4% of participants responded with a score of 43 or above. Linear regression analysis showed that conception after IVF treatment and low marital satisfaction were both significantly related to anxiety and pregnancy worries. In addition, low income level was significantly related to pregnancy worry whereas low educational level was related to anxiety. the risk factors found in this study could help clinicians target anxiety screening to high-risk populations of pregnant women. Health care professionals and midwives in particular should be trained in the detection and management of anxiety and worries during pregnancy.
    Full-text · Article · Oct 2013 · Midwifery
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    • "Anxiety can affect an individual's ability to manage in general and to receive and process information and therefore make sound choices (Fogarty et al., 1999). The results of antenatal screening tests may increase worry rather than reassure (Petersen et al., 2009), with women who choose to go against the expected wisdom being seen as irresponsible further inducing anxiety (Snowden et al., 2011). Time is a complex issue in maternity care (McCourt, 2009) which affects how midwives see women, themselves and their work (Browne and Chandra, 2009). "
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    ABSTRACT: OBJECTIVE: by exploring midwives' communication techniques intended to promote a wellness focus in the antenatal period, this study identified strategies midwives use to amplify women's own resources and capacities, with the aim of reducing antenatal anxiety. DESIGN: a qualitative design utilising focus groups as a means of generating data. SETTING: two Australian cities: Canberra, ACT and Sydney NSW. PARTICIPANTS: 14 experienced, practising midwives across two states/territories, employed in multiple hospitals and community settings. FINDINGS: three themes emerged from the analysis: calm unhurriedness, speaking in wellness and reassuring bodies. Midwives in these focus groups used strategies in antenatal care that could be co-ordinated into a planned process for wellness focussed care. KEY CONCLUSIONS: individually midwives used a variety of strategies specifically intended to facilitate women's capabilities, to employ worry usefully and to reduce anxiety. Midwives in the study clearly viewed this kind of wellness focussed care as their responsibility and their right. IMPLICATIONS FOR PRACTICE: the midwives' collective wisdom could be shared and developed further into an overall salutogenic antenatal strategy to be used for the good of pregnant women and their infants.
    Full-text · Article · Jun 2013 · Midwifery
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    • "The Wijma Delivery Expectancy/Experience Questionnaire (W-DEQ) [8] introduced by Wijma in 1998 is mainly related to the aspects of fear, lack of positive anticipation and riskiness in childbirth, while the Childbirth Self-Efficacy Inventory (CBSEI) [9] introduced by Lowe in 1993 focuses on self-efficacy and coping expectancies. Finally, the Cambridge Worry Scale (CWS) was developed to assess the content and extent of maternal worries in pregnancy, which since 2009 is the only one with a validated German version [10]. "
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    ABSTRACT: Background Assessing expecting mother’s opinions prior to birth draws a comprehensive picture for the caregivers about their emotional state and their expectations. Some questionnaires to cover these aspects do exist. This study aims to present the psychometric properties of a new instrument, the Confidence and Trust in Delivery Questionnaire (CDTQ) a short but reliable a self-report instrument that focuses on confidence and trust as meaningful dimensions for expectant mothers. Methods A pilot validation study of 221 women 6 weeks before childbirth was conducted in Germany between October 2007 and June 2008. To detect structural relations between the items, factor and reliability analyses were applied to the CTDQ items. Factor analysis was performed by means of principal components analysis and varimax rotation. Internal reliability was assessed by Cronbach’s alpha. External validation was performed using the sense of coherence (SOC) scale. Results The CTDQ comprises of 11 items. We found a 4-factor structure. The internal consistency of the whole item pool (Cronbach’s α = 0.79) and the 4 subscales [confidence in labor (α = 0.82); partner’s support (α = 0.62); trust in medical competency (α = 0.68); being informed (α = 0.60)] can be regarded as sufficient or even excellent. The 4 factors explained 69.6% of total variance. Except for a high intercorrelation (0.70) between “partner’s support” and “trust in medical competence”, the subscales show low intercorrelations, indicating an adequate independence of the respective subscales. Regarding the external validity we found minor respective moderate correlations with the SOC scale. Conclusions Our data suggest that the CTDQ is a useful instrument to assess confidence and trust in delivery. With 4 clinically relevant dimensions, the CTDQ is now open for further studies in the field of labor.
    Full-text · Article · Sep 2012 · BMC Women's Health
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