ArticleFrontiers in public health2025
Assessing fear of childbirth in Malaysia: development and psychometric testing of the Malaysian Fear of Birth questionnaire (MyFOB).
Article in Frontiers in public health, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Introduction: Fear of childbirth or tokophobia refers to the pathological fear of childbirth, which affects the daily life of pregnant women. Childbirth fear is multidimensional and differs across cultures. We aimed to develop and validate the first Malaysian Fear of Birth questionnaire (MyFOB) among the multiethnic Malaysian women. Methods: The research was conducted in the antenatal clinic, Hospital Canselor Tuanku Muhriz, Kuala Lumpur. A mixed-methods, exploratory sequential approach was applied. Phase 1 involved a qualitative exploration of childbirth fear through one-to-one interviews, while phase 2 comprised questionnaire development based on the qualitative results, literature review and experts' input. Psychometric properties of the questionnaire were assessed through exploratory factor analysis (EFA), face validation, and reliability testing. Subsequently, confirmatory factor analysis (CFA) was performed to determine the model fit of the final version of MyFOB. EFA and CFA were conducted on two separate cohorts. Results: Twelve qualitative interviews yielded five themes. Subsequently, one hundred thirty-seven items were generated and underwent content validation by five experts. The construct validity of the initial 43-item questionnaire was assessed through EFA. Phase 2 cohorts for EFA and CFA were 257 and 341, respectively. Principal component analysis resulted in MyFOB, which comprised 20 items accounting for 65.6% of the total variance. These items were grouped into four factors: 1) Labour & delivery, 2) Pain, 3) Maternal emotion, and 4) Healthcare professionals. The pilot study on sixty-one women revealed good reliability (Cronbach Discussion: The Malaysian Fear of Childbirth Questionnaire (MyFOB) is a reliable and valid tool that can be utilised in routine antenatal care to identify vulnerable women.
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