Early labour experience questionnaire: Translation and cultural adaptation into German

Problem: Evidence on early labour care suggests that women's needs are not adequately met. Background: Women's perceptions of early labour management impact on their overall birth experience. Valid measurement tools are needed for evaluation and improvement of early labour care. Aim: Translation and cultural adaptation of the Early Labour Experience Questionnaire for use in a German context. Methods: Translation and adaptation followed internationally recognised guidelines. The process comprised for- and backward translation, an expert panel review using a three-round modified Delphi process and cognitive interviews with representatives of the target group using paraphrasing and retrospective probing. The interviews were conducted online, video-recorded and transcribed. Based on the results of the interviews the pilot version of the questionnaire was compiled. Findings: Nine experts, including a representative of the target group, participated in the Delphi process. Twelve cognitive interviews were conducted. Most of the translation and adaptation issues needing clarification related to differences in the organisation of maternity care, the term early labour and the translation of the single word expressions for women's affective state in early labour. Few problems emerged during cognitive interviews and related to conceptual understanding, reference points, instructions, and response categories. The pilot version of the German Early Labour Experience Questionnaire (G-ELEQ) comprises a total of 25 items. Conclusion: With the G-ELEQ a tool for measuring women's early labour experience in the German context with good face and content validity is available. Psychometric testing is now needed to assess the instrument's validity and reliability.