- Research
- Open access
- Published:
Psychometric evaluation of the birth participation scale for fathers (BPS-F): a methodological study
BMC Pregnancy and Childbirth volume 25, Article number: 277 (2025)
Abstract
Background
The participation of fathers in childbirth contributes primarily to the improvement of maternal and infant health and, consequently, to public health. To increase the participation of expectant fathers in childbirth, an appropriate screening tool is needed. This study was conducted to evaluate the psychometric properties of the “Birth Participation Scale” developed for expectant fathers.
Methods
The research involved a total of 250 expectant fathers who submitted applications to the Gynecology and Obstetrics Polyclinic of a university hospital. After translating the scale into a methodological and cross-sectional investigation, psychometric properties were evaluated. The validity of the scale was assessed by evaluating the content, construct, and face validity. Cronbach’s alpha, McDonald’s Omega, Spearman-Brown split-half and test-retest reliability coefficients were calculated to determine the item’s reliability.
Results
The average content validity index (CVI) values for relevance, clarity, and simplicity were found to be 0.99 for each. The impact score of the items was 1.5 and above. A factor structure with 17 items, and 3 sub-dimensions was obtained through Exploratory Factor Analysis. The factor loadings of the items ranged between 0.55 and 0.85. The validity of this structure was assessed by Confirmatory Factor Analysis and the model fit indices were “acceptable” or “good fit”. The reliability coefficients for Cronbach’s alpha, McDonald’s Omega, and Spearman-Brown split half were 0.89, 0.92, and 0.81, respectively. Moreover, the test-retest correlation was 0.96.
Conclusions
The Birth Participation Scale for Fathers has a suitable validity and reliability for assessing fathers’ participation in birth. It is a simple reporting tool that healthcare professionals in Turkey can easily implement.
Introduction
The expectant mother and father experience physiological, psychological, and social stressors concurrently during pregnancy and childbirth [1]. Men have historically been marginalized during this era due to gender and cultural biases, which have had a profound impact on both parents and have resulted in lifelong transformations [2, 3]. Despite the global practice of fathers participating in childbirth for over six decades, the level of paternal involvement in childbirth in Turkey remains notably low [2].
The literature reports that active participation of fathers in perinatal processes positively affects public health [1, 2, 4, 5]. Research indicates that active father participation in pregnancy and birth processes improves children’s mental-social-emotional development, maternal health, reduces prenatal depressive symptoms, fosters early father-infant attachment, accelerates the transition to parenthood, and improves maternal and infant health outcomes [5, 6]. Furthermore, research on fathers who assist their wives during pregnancy and while they await the birth of their children has revealed that such fathers and their partners experience greater harmony, reduced anxiety, and increased father-fetal attachment [5, 7].
In Turkey, fathers are mostly involved in childbirth within the private health care system. Many factors, such as gender-related traditions, the roles of parents at home, cultural reasons, the health system, policies, a lack of environment and practices that support men’s participation in childbirth, a lack of adequate knowledge of health professionals about spousal roles in childbirth and a lack of birth preparation classes, negatively affect fathers’ participation in childbirth [2]. Several studies have found that fathers exhibit varying degrees of interest in actively participating in the birth of their children [8,9,10,11,12]. Despite the global prevalence of this topic, few studies in Turkey have examined the process of paternal involvement in childbirth [1, 2, 4, 9, 12]. Apart from our Birth Participation Scale (BPS) adaptation study, there is also a study by Çiçek Özdemir and Kan to determine fathers’ attitudes towards birth participation in Turkey. Both studies were conducted in the same time period [13]. The fact that the BPS has been previously studied in different cultures and psychometrically tested [13,14,15] provides an opportunity to compare fathers’ attitudes towards childbirth in Turkish society with different cultures. It is reported that the Birth Participation Scale (BPS) can be utilized to determine whether fathers wish to participate in childbirth, to determine fathers’ perceptions about birth participation, their personal fears, concerns, attitudes, and needs regarding birth partnership, and to guide personalized birth preparation/education for fathers with the findings obtained [16].
The aim of the study is to evaluate the Turkish validity and reliability of the “Birth Participation Scale (BPS)” developed by Hollins Martin for fathers in 2008 by adapting it to Turkish culture. In this way, it will be possible to determine the attitudes of fathers in Turkish society regarding participation in childbirth and contribute to family-society health with the planning and studies to be carried out in line with the data obtained. Midwives and nurses have important roles in the protection and development of public health. Midwives and nurses are health professionals with whom families are in close and continuous communication while providing antenatal care services. Nurses can use psychometrically validated scales to determine the needs and attitudes of fathers while planning prenatal care services. Thus, they can provide a more effective health service thanks to the care and training they can provide by taking into account the attitudes of fathers. In this way, they can contribute to the improvement of family health.
Methods
Study design and sample
The design of the study was methodological and cross-sectional. We conducted the study through face-to-face interviews at the Obstetrics and Gynecology Outpatient Clinic of the Health Practice and Research Center of a university located in the Western Black Sea Region of Turkey between 01.11.2021-01.06.2022.
Factor analysis requires a minimum sample size ratio of 10:1 between the number of items and the number of participants [17, 18] when determining the sample size for scale validity and reliability studies. Accordingly, since the BPS consisted of 25 items, a total of 250 expectant fathers who were literate, did not have any health problems that would prevent them from communicating, and volunteered to participate in the study were included in the study.
Data collection tools
The data for the study were collected through Introductory Information Form which included the descriptive characteristics of the fathers and the Birth Participation Scale (BPS) prepared by the researchers.
Introductory information form
Researchers developed the scale by reviewing the literature [2, 11, 14, 15, 16]. There are a total of 12 questions that include socio-demographic characteristics of expectant fathers (age, marital status, educational status, income level), obstetric characteristics of their wives, previous participation in childbirth, and information about childbirth.
Birth participation scale (BPS)
The BPS was developed by Holins-Martin to determine whether fathers really want to be present at childbirth; to determine the perceptions that fathers may have about participation in childbirth, their personal fears, anxieties, and attitudes towards birth partnership. A 5-point Likert scale scores the 25 items of the BPS as “strongly agree 5, agree 4, uncertain 3, disagree 2, strongly disagree 1” based on the degree of agreement with each statement. The range of potential scores is 25 to 125, with 25 representing the most unfavourable perspective on birth participation and 125 representing the most favourable. The scoring of items 8–12, 17–20, and 22–24 is inverted. Hollins Martin suggested the inclusion of eight sub-dimensions in the scale and recommended additional research on this topic [16].
Translation and cultural adaptation process
Translation
Two experts, one with a master’s degree in English translation science and another with a PhD in Obstetrics and Gynecology Nursing, translated the scale items into Turkish. The researchers edited the translations by evaluating their similarities and differences. This version of the scale and the original scale were submitted to two obstetrics and gynecology specialists who are fluent in both languages, who are also childbirth preparation trainers, and an expert psychologist who is also a childbirth preparation trainer and a childbirth psychologist for the evaluation of the translation. The Turkish form, which was revised in line with the recommendations of the experts, was back-translated into the original language by two instructors with a master’s degree in English translation science and then submitted to the original scale author to be evaluated in terms of meaning and content and approval was obtained. Translation and cultural adaptation process is given Figure of Supplementary Material.
Content validity
Ten doctorate-holding obstetrics and gynaecology nursing specialists evaluated the content validity of the BPS instrument. The experts were asked to rate all items on the scale separately in terms of relevance, clarity, and simplicity according to a 4-point Likert scale (1: Item is not appropriate, 2: Item needs serious revision, 3: Item needs slight revision, 4: Item is appropriate). To assess content validity, the coefficients of the average content validity index (Ave-CVI), the universal content validity index (UA-CVI) and the average proportion of agreement across experts were calculated [19].
Face validity
In order to evaluate the face validity of the survey, ten potential fathers were requested to indicate the level of significance attributed to each item using a 5-point Likert scale (1: Not important, 2: Slightly important, 3: Quite important, 4: Important, 5: Very important). The impact score of each item was calculated [20].
Construct validity
The fitness of the structural model for the BPS was examined by construct validity.
Reliability
Cronbach’s alpha, McDonald’s omega, Spearman-Brown split-half internal consistency, and test-retest reliability coefficients were calculated to evaluate the reliability of the scale. We contacted 25 randomly selected expectant fathers a second time, around four weeks after the initial implementation, for the test-retest reliability analysis of the scale, taking into account the sample size. We asked them to complete the BPS during this second contact. Also, the scale was assessed whether it had a response bias using the Hotelling’ T2 test.
Statistical analysis
The multivariate Mardia’s Kurtosis normality test and the variance inflation factor (VIF) approach, respectively, analyzed the suitability of the data set in terms of multivariate normality and multicollinearity assumptions prior to the validity and reliability study. The Kaiser-Meyer Olkin statistic (KMO) was performed to examine the sampling adequacy, and Bartlett’s test of sphericity (BS) was utilized to examine the suitability of the input matrix for the analysis. First, MINRES factor analysis (varimax rotation) was implemented to reach the most appropriate and valid measurement model. To test the validity of this factor structure, the maximum likelihood estimation technique and confirmatory factor analysis (CFA) were employed. Root Mean Square Error of Approximation (RMSEA), Standardized Root Mean Square Residual (SRMR), Comparative Fit Index (CFI), Non-Normed Fit Index (NNFI), Goodness of Fit Index (GFI), Adjusted Goodness-of-Fit Index (AGFI) were employed to evaluate the fit of the model (χ2/df). SPSS v.22, LISREL 8.54 and RStudio 2023.06.0 programs were utilized for statistical evaluations. p < 0.05 was considered statistically significant.
Results
The mean age of the 250 expectant fathers who participated in the study was 30.9 ± 5.4 years, and all of them were married. Of the participants, 44% were high school graduates, 62.4% had their first baby, 94.8% stated that they had never received any education about childbirth, and 98% stated that they had never participated in childbirth. Table 1 provides a detailed breakdown of the sociodemographic characteristics of the expectant fathers.
The average content validity index (CVI), universal CVI and average proportion of agreement across experts coefficients calculated to reveal the content validity of the BPS were founded as 0.99, 0.92, 0.99 for relevance, 0.99, 0.88, 0.99 for clarity, 0.88, and 0.99, 0.88, 0.99 for simplicity, respectively. The CVI estimations and average proportions of agreement across experts are given in Table S1 of Supplementary Material. The impact score of all items was 1.5 or above. It was observed that the data set satisfied the multivariate normality assumption (p > 0.05) and there was no multicollinearity problem. The Kaiser-Meyer-Olkin-KMO statistic used to assess the sampling adequacy was 0.90 and the Barlett’s test of sphericity used to assess the suitability of the input matrix was BS-χ2 = 2083.75 (p < 0.001). We considered items in the MinRes factor analysis if their communalities surpassed 0.40, and excluded those that displayed similar factor loadings across multiple factors. Moreover, the corrected item-total-correlation coefficients of all items were controlled in each stage. As a result of the Exploratory Factor Analysis (EFA), a three-dimensional model was obtained for 17 items by excluding items 4, 5, 8, 10, 11, 15, 24, 25, and the total variance explained by this factor model was 59.92%. Table 2 presents the factor loadings and descriptive statistics of the items. The items’ factor loadings ranged between 0.55 and 0.85.
For the purpose of assessing the structural model’s validity, a CFA was conducted with the model obtained (χ2 = 178.43, df = 111, p < 0.001), which incorporated the modification indices. The t-values and path coefficient diagrams for the standardized solution are illustrated in Figs. 1 and 2, respectively. The model fit indices are displayed in Table 3, whereas the items that were eliminated from the scale are detailed in Table 4.
Each of the seventeen items significantly and positively impacted the scale. Table 5 provides standardized factor loadings, t-values, and multiple correlation coefficients for each item comprising the measurement model. The top three most important items on the Desire to be present at the birth (DPB) dimension were I1, I13, I2, on the Attitude towards involvement during the birth (AIB) dimension were I17, I9, I20, and on the Desire to play only the observer role during birth (DOB) dimension were I18, I23 and I22. The top 3 most important items of the scale in general are I1, I13 and I17 respectively, and their values are 0.86 and above (Table 5).
All the correlations between the sub-dimensions of the scale were significant and positive. Accordingly, there was a strong correlation between AIB and DOB (r = 0.73), a moderate correlation between DPB and AIB (r = 0.53), and a weak correlation between DPB and DOB (r = 0.36) (Figs. 1 and 2) (Table 5).
All items exhibited corrected item-total correlation coefficients of 0.34 or above (Table 2). Table 6 contains descriptive statistics values, as well as Cronbach’s alpha and McDonald’s Omega coefficients, pertaining to the BPS and its sub-dimensions. The range of Cronbach’s alpha coefficients for the BPS and its sub-dimensions was 0.74 to 0.92. McDonald’s omega coefficients ranged from 0.76 to 0.94 for the total and each sub-dimension of the BPS. The reliability coefficient for the Spearman-Brown split-half was 0.81. The test-retest coefficient was 0.96 (95% CI: 0.93–0.98 p < 0.001). The test-retest coefficient was 0.96 (95% CI: 0.93–0.98 p < 0.001). There was a difference between the means of the items as a result of Hotelling’s T2 test (F = 31.86, p < 0.001).
Discussion
The aim of this study was to translate the Birth Participation Scale (BPS) for fathers developed by Holins-Martin (2008) into Turkish and verify that it is a measurement instrument with adequate validity and reliability indicators. The scale measures fathers’ attitudes toward childbirth participation.
Content, face, and construct validity were examined for the validity of the scale. Content validity is defined as the degree to which an assessment tool relates to and represents the construct targeted for a specific assessment purpose [21, 22]. Polit and Beck (2006) reported that for an instrument to have excellent content validity, the Ave-CVI value should be 0.90 or higher [19, 23]. According to the average content validity index (CVI), universal CVI and average proportion of agreement across experts coefficients calculated to reveal the content validity of the BPS, it was concluded that content validity was achieved and there was an excellent level of agreement among experts. The CVI value of BPS (0.99) is higher than the study of Özdemir Çiçek and Kan (0.84) [13].
Face validity is the extent to which respondents evaluate that the items of an assessment tool are appropriate for the targeted construct and assessment objectives [24, 25]. In this study, it was determined that the face validity of the tool was ensured because the impact score of all items was 1.5 and above [20].
We applied EFA and CFA to assess the construct validity of the BPS. The KMO statistic should be above 0.60 to ensure the sampling adequacy for factor analysis and the p value of the BS test should be below 0.05 to ensure the suitability of the data matrix. In this study, sampling adequacy for factor analysis was ensured by the KMO measure value (0.9) while the suitability of the data entry matrix was confirmed by the significance of the BS test (p < 0.001) [26]. Lopes (2012) obtained KMO = 0.884 and BS-χ2 = 1623.551 (p < 0.001) for the adaptation of the same scale into Portuguese [15].
As a result of EFA procedures, eight items (4,5,8,10,11,15,24,25) were removed from the scale in this study. According to the literature, the factor structure is sufficient if the factor loadings are 0.30 and above and the total explained variance is between 40 and 60% [27]. One item (I5) in Lopes’ study and six items (I4, I5, I10, I15, I18, I23) in Goncalves’ study were removed from the scale [14, 15]. The fifth item was removed from the scale in all three studies, and items I4, I10, and I15 were also removed from the scale in Goncalves’ study, similar to this study. As a result of this study, a three-dimensional model was obtained for 17 items, and the variance explained in the factor model was 59.92% and the factor loadings of the items ranged from 0.55 to 0.85 (Table 2). In Lopes’ study [15], a five-dimensional model was obtained for 24 items. The explained variance rate was 62.86% and the factor loadings of the items ranged between 0.37 and 0.86. With this feature, the explained variance rate was higher than in this study, and the factor loadings of the items were distributed in a wider range. Goncalves’ study [14] obtained a three-dimensional model similar to this study for 19 items.
These 3 sub-dimensions were named “Desire to be present at the birth (DPB) (items 1, 2, 3, 6, 7, 13, 14, 16, 21)”, “Attitude towards involvement during the birth (AIB) (items 9, 12, 17, 20), and “Desire to play only the observer role during birth (DOB) (items 18, 19, 22, 23)” in this study. Hollins Martin (2008) reported that the scale could consist of eight sub-dimensions: 1. Desire to be present at the birth (items 1, 17), 2. Need to prepare for the role of birth partner (items 2, 20), 3. Perception of social pressure to participate at birth (items 3, 8, 25), 4. Fears such as expressing emotion (items 4, 10) squeamishness (items 9, 11, 12), obstetric complications (items 15) and feeling ineffective (item 18), 5. Perceived value of fathers’ support during labour, and delivery (items 5, 7, 21), 6. Attitude towards active involvement during labour, and delivery (items 6, 14, 19, 22), 7. Self-efficacy in relation to the role of birth partner (items 13, 23), 8. Perceived self-suitability for the role of birth partner (items 16, 24) and suggested that further analyses should be conducted on this issue [16]. In his study, Lopes defined the sub-dimensions of the scale as follows: 1-The desire to be present and play the role of the father (items 1,2,3,6,7,13,14,16,21,25), 2-Social pressure for role performance (items 8,9,11,12,17,24), 3-The desire to play the role of the “observer” father (items 19,20,22), 4-Fears related to role performance: Expressing emotions / obstetric complications (items 4,10,15), 5-Fears related to role performance: Feeling of ineffectiveness (items 18,23) [15]. Goncalves named 1. Desire to be present and play the role of father (items 1,2,3,6,7,7,13,14,16,21,25), 2. Perception of social pressure to perform the role (items 8,9,11,12,17,24) and 3. Desire to play the role of observant parent (items 19,20,22).
Similar to the studies of Martin, Lopes and Goncalves, the “desire” sub-dimensions related to participation in childbirth were also included in this study. The absence of “social pressure” in this adaptation study, unlike the other three studies, could potentially stem from Turkey’s lack of cultural expectations regarding fathers’ participation in childbirth. In Turkey, issues related to reproductive health such as pregnancy, childbirth, and contraception are mostly seen as women’s duties in accordance with gender roles, so fathers are traditionally not expected to participate in childbirth [2, 28]. Therefore, it is believed that cultural differences may not have contributed to this sub-dimension, as observed in both the original publication and the two subsequent adaptation studies. This study identified “the desire to play only the role of observer in childbirth” as another sub-dimension, mirroring the findings of Lopes and Goncalves. Fathers’ participation in childbirth, which is quite limited in Turkey, is generally possible for fathers with high educational-economic income and mostly in private health institutions [2]. For this reason, it is understandable that fathers do not want to take an active role even if they participate in childbirth and that they are cautious by playing the role of observers only. Unlike the other three studies, it is thought that the sub-dimension of “attitude towards participation in childbirth”, which was found only in this study, may have emerged due to cultural differences. When the structural model obtained by CFA (p < 0.001) and model fit indices are evaluated together, the proposed model indicates “acceptable” or “good fit” (Table 4) [29]. However, the factor structure was not examined with CFA in the studies of Hollins Martin (2008) and Lopes (2012), and Goncalves (2018).
In the structural model of this study, all correlations between the sub-dimensions of the scale were significant and positive. But Lopes (2012) examined the correlations between factors with simple correlation analysis instead of a structural model. Accordingly, there was a strong correlation between AIB and DOB (r = 0.73) in this study, while there were moderate correlations between Factor 2 (similar to AIB), Factor 3 (similar to DOB) (r = 0.49), Factor 5 (similar to DOB) (r = 0.47) in study of Lopes (2012). Moreover, a moderate correlation (r = 0.53) was found between DPB and AIB in this study. Similarly, moderate correlation (r = 0.65) between Factor 1 (similar to DPB) and Factor 2 (similar to AIB) in Lopes (2012)’ study. In this study, a weak correlation was found between DPB and DOB (r = 0.36). But moderate correlations were calculated between Factor 1 (similar to DPB) and Factor 3 (similar to DOB) (r = 0.49), Factor 5 (similar to DOB) (r = 0.46) in Lopes (2012)’ study. Also, there was a weak correlation (r = 0.39) between Factor 3 (similar to DOB) and Factor 5 (similar to DOB) in his study.
To examine the reliability of the scale, Cronbach’s α, McDonald’s Omega and Spearman-Brown split half reliability coefficients were calculated along with the corrected item-total correlation coefficients. It is emphasized in the literature that the corrected item-total correlation coefficients must be a minimum of 0.30 [30]. In this study, the corrected item-total-correlation coefficients of all items were 0.34 and above, and all items satisfied this requirement. Cronbach’ alpha and McDonald’s Omega values above 0.7, 0.8 and 0.9 can be interpreted as acceptable, good, and excellent for reliability, respectively [31, 32]. According to these values, it can be stated that the reliability levels are good/excellent for the total scale and excellent for DPB, respectively, while they are acceptable for AIB and DOB [31,32,33]. In the studies of Lopes (2012) and Goncalves (2018), the Cronbach’s alpha values for the BPS were obtained as 0.916 and 0.917, respectively, while they were 0.89 in this study (Table 6), and it is observed that these values are quite similar to each other. The Cronbach’s alpha value of the scale developed by Çiçek Özdemir and Kan was calculated as 0.969 [13]. The statistical measure of test-retest reliability indicates whether a scale remains constant over time [24]. The test-retest coefficient of this study (0.96) revealed excellent reliability [34]. The test-retest reliability coefficient of the scale developed by Çiçek Özdemir and Kan was 0.82, which is lower than that of this study [13]. These reliability coefficients for the BPS indicate that this scale is reliable. Response bias can have important implications for the validity and reliability of scale [35]. In this study, it was determined that the BPS was not affected by response bias (p < 0.001 for Hotelling’ T2 test).
Limitations of the study
In the region and hospital where the study was conducted, the participation of fathers in childbirth is quite limited and is not supported both culturally and by the health system. The data of the study consisted of individuals who came to the public hospital for pregnancy controls with their spouses and generally had middle-upper education and economic income; therefore, the limitation of the study is that the data do not cover all expectant fathers.
Conclusions
According to the results obtained from the study, it was determined that the BPS is a valid and reliable scale for the Turkish society. All health professionals who take an active role in antenatal care services and birth preparation processes can use this scale to measure fathers’ attitudes towards participation in childbirth. In this direction, they can increase fathers’ participation in childbirth through the care services and trainings they plan. Thus, the positive effects of fathers’ participation in childbirth on mother-child health such as supporting children’s mental-social-emotional development, improving maternal health, reducing prenatal depressive symptoms, promoting early father-infant attachment, and accelerating the transition to parenthood can be benefited more. In addition, the scale may provide new research opportunities for researchers who wish to study in this field. It is recommended that the scale be utilized in future studies to determine the attitudes of fathers towards participation in childbirth in different cultures.
Data availability
Data is provided within the manuscript or supplementary information files.
Abbreviations
- AGFI:
-
Adjusted Goodness-of-Fit Index
- AIB:
-
Attitude towards Involvement during the Birth
- Ave-CVI:
-
Average Content Validity Index
- BPS-F:
-
Birth Participation Scale for Fathers
- BS:
-
Bartlett’s Test of Sphericity
- CFA:
-
Confirmatory Factor Analysis
- CFI:
-
Comparative Fit Index
- CVI:
-
Content Validity Index
- DOB:
-
Desire to Play Only the Observer Role During Birth
- DPB:
-
Desire to be Present at the Birth
- EFA:
-
Exploratory Factor Analysis
- GFI:
-
Goodness of Fit Index
- KMO:
-
Kaiser-Meyer Olkin
- NNFI:
-
Non-Normed Fit Index
- RMSEA:
-
Root Mean Square Error of Approximation
- SRMR:
-
Standardized Root Mean Square Residual
- UA-CVI:
-
Universal Content Validity Index
- VIF:
-
Variance Inflation Factor
References
Ozcan H, Arar İ, Çakır A. Process of the father and pregnancy. Zeynep Kamil Tıp Bülteni. 2018;49(1):72–6. https://doi.org/10.16948/zktipb.334583.
Ergin A, Özdilek R. The changing role of fatherhood and its effects on Men’s health. J Educ Res Nurs. 2014;11(1):3–8. https://link.gale.com/apps/doc/A419764067/HRCA?u=anon~9f251f3b. &sid=googleScholar&xid=1c9ca7cc.
Coşkun A, Özdilek R. Gender inequality: reflections on the Nurse’s role in women’s health. J Educ Res Nurs. 2012;9(3):30–9.
Bal S, Koç G. Nurse’s role about fathers baby care participation. Samsun Sağ Bil Der. 2020;5(2):90–6. https://doi.org/10.47115/jshs.755020.
Zwedberg S, Bjerkan H, Asplund E, Ekéus C, Hjelmstedt A. Fathers’ experiences of a vacuum extraction delivery–a qualitative study. Sex Reproductive Healthc. 2015;6(3):164–8. https://doi.org/10.1016/j.srhc.2015.05.003.
Meltzer-Brody S, Bledsoe-Mansori SE, Johnson N, Killian C, Hamer RM, Jackson C, Thorp J. A prospective study of perinatal depression and trauma history in pregnant minority adolescents. Am J Obstet Gynecol. 2013;208(3):211–7. https://doi.org/10.1016/j.ajog.2012.12.020.
Latifses V, Estroff DB, Field T, Bush JP. Fathers massaging and relaxing their pregnant wives Lowered anxiety and facilitated marital adjustment. J Bodyw Mov Ther. 2005;9(4):277–82. https://doi.org/10.1016/j.jbmt.2005.02.004.
Johansson M, Fenwick J, Premberg AA. A Meta-synthesis of fathers’ experiences of their. Midwifery. 2015;31(1):9–18. https://doi.org/10.1016/j.midw.2014.05.005.
Karacam Z, Karatepe E. The opinions and needs of the fathers on participating to labour. Celal Bayar Universitesi Saglık Bilimleri Enstitüsü Dergisi. 2020;7(3):360–6. https://doi.org/10.34087/cbusbed.700561.
Bal S. The status of men regarding baby care involvement and baby care participation opinions who lived first time fatherhood experiences [Master’s thesis]. Ankara: Hacettepe University Institute of Health Sciences; 2014.
Güngör İ. Effects of fathers’ attendance to labor and delivery on experience of childbirth [Master’s thesis]. Istanbul: Istanbul University Institute of Health Sciences; 2014.
Kululanga LI, Malata A, Chirwa E, Sundby J. Malawian fathers’ views and experiences of attending the birth of their children: a qualitative study. BMC Pregnancy Childbirth. 2012;12:1–10. https://doi.org/10.1186/1471-2393-12-141.
Çiçek Özdemir S, Kan A. A study developing attitude scale towards participation in birth for father candidates. J Nursology. 2022;25(3):146–52. https://doi.org/10.5152/JANHS.2022.936036.
Goncalves CSP. Envolvimento Do Pai No Nascimento [Doctoral thesis]., Viseu. Fevereiro: Repositório Científico do Instituto Politécnico de Viseu Comunidades & Colecções;2018.
Lopes STraduçãoEValıdação. The birth participation scale Um instrumento Para avaliar as necessidades e atitudes do Pai Em relação Ao parto. Escola Superıor de enfermagem do Porto. Porto: Curso de Mestrado em Enfermagem de Saúde Materna e Obstetrícia; 2012.
Hollins Martin CJ. A tool to measure fathers’ attitudes and needs in relation to birth. Br J Midwifery. 2008;16(7):432–7. https://doi.org/10.12968/bjom.2008.16.7.30463.
Lyu QY, Kong SK, Wong FK, You LM, Yan J, Zhou XZ, Li XW. Psychometric validation of an instrument to measure family coping during a child’s hospitalization for cancer. Cancer Nurs. 2017;40(3):194–200. https://doi.org/10.1097/NCC.0000000000000382.
Norman GR, Streiner DL. Biostatistics: the bare essentials. 3rd edition. Lewiston, NY: BC Decker; 2008.
Almanasreh E, Moles R, Chen TF. Evaluation of methods used for estimating content validity. Res Social Administrative Pharm. 2019;15(2):214–21. https://doi.org/10.1016/j.sapharm.2018.03.066.
Lacasse Y, Godbout C, Series F. Health-related quality of life in obstructive sleep Apnoea. Eur Respir J. 2002;19(3):499–503. https://doi.org/10.1183/09031936.02.00216902.
Yusoff MSB. ABC of content validation and content validity index calculation. Educ Med J. 2019;11(2):49–54. https://doi.org/10.21315/eimj2019.11.2.6.
Zamanzadeh V, Rassouli M, Abbaszadeh A, Majd HA, Nikanfar A, Ghahramanian A. Details of content validity and objectifying it in instrument development. Nurs Pract Today. 2014;1(3):163–71.
Polit DF, Beck CT. The content validity index: are you sure you know what’s being reported? Critique and recommendations. Res Nurs Health. 2006;29(5):489–97. https://doi.org/10.1002/nur.20147.
Boateng GO, Neilands TB, Frongillo EA, Melgar-Quiñonez HR, Young SL. Best practices for developing and validating scales for health, social, and behavioral research: a primer. Front Public Health. 2018;6:149. https://doi.org/10.3389/fpubh.2018.00149.
DeVellis RF, Thorpe CT. Scale development: theory and applications. California: Sage; 2021.
Hahs-Vaughn DL. Applied multivariate statistical concepts. New York: Routledge; 2016.
Soeken LK. Validity of Measures. Waltz CF, Strickland OL, Lenz ER, editors. In: Measurement in Nursing and Health Research. New York: Springer, 2005; pp. 163–202.
Kara M, Çetinkaya Ş. The father concept in Turkish society and nursing in the attachment of father and baby. Turkiye Klinikleri J Nurs Sci. 2019;11(2):200–10. https://doi.org/10.5336/nurses.2018-62565.
Cangur S, Ercan I. Comparison of model fit indices used in structural equation modeling under multivariate normality. J Mod Appl Stat Methods. 2015;14(1):152–67. https://doi.org/10.22237/jmasm/1430453580.
Pallant J. SPSS survival manual: A step by step guide to data analysis using IBM SPSS. UK: McGraw-hill education; 2020.
Sharma B. A focus on reliability in developmental research through Cronbach’s alpha among medical, dental and paramedical professionals. Asian Pac J Health Sci. 2016;3(4):271–8. https://doi.org/10.21276/apjhs.2016.3.4.
Feißt M, Hennigs A, Heil J, Moosbrugger H, Kelava A, Stolpner I, et al. Refining scores based on patient reported outcomes–statistical and medical perspectives. BMC Med Res Methodol. 2019;19(1):1–9. https://doi.org/10.1186/s12874-019-0806-9.
Kerlinger FN, Howard BL. Foundations of behavioural research. 4th ed. USA: Earl Mcpeek; 2000.
Koo TK, Li MY. A guideline of selecting and reporting intraclass correlation coefficients for reliability research. J Chiropr Med. 2016;15(2):155–63. https://doi.org/10.1016/j.jcm.2016.02.012.
Paulhus DL. Measurement and control of response bias. Robinson JP. In: Shaver PR, Wrightsman LS, editors. Measures of personality and social psychological attitudes. Academic; 1991. pp. 17–59. https://doi.org/10.1016/B978-0-12-590241-0.50006-X.
Acknowledgements
We would like to convey our sincere appreciation to every participant who assisted us in conducting this research. Additionally, we appreciate Professor Caroline J. Hollins Martin’s assistance during the course of this research. Caroline is affiliated with Napier University’s School of Nursing, Midwifery, and Social Care in Edinburgh, Scotland, United Kingdom.
Funding
Not applicable.
Author information
Authors and Affiliations
Contributions
H.G.S., H.K., S.C. contributed to the design of the manuscript. H.K. and S.C. contributed to the implementation and analysis plan. H.K. contributed in data collection. H.G.S., H.K., S.C. have written the first draft of this manuscript. All authors read and approved the final manuscript.
Corresponding author
Ethics declarations
Ethics approval and consent to participate
In addition to obtaining institutional permission from the Duzce University Health Application and Research Center, the Duzce University Scientific Research and Publication Ethics Committee granted approval on 2021/222. We used email correspondence to obtain permission from the researchers who created the first scale. The expectant fathers who agreed to participate in the study provided written informed consent. We adhered to the protocols outlined in the Declaration of Helsinki (2015) throughout the entire research investigation.
Consent for publication
Not applicable.
Competing interests
The authors declare no competing interests.
Additional information
Publisher’s note
Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
Electronic supplementary material
Below is the link to the electronic supplementary material.
Rights and permissions
Open Access This article is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License, which permits any non-commercial use, sharing, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if you modified the licensed material. You do not have permission under this licence to share adapted material derived from this article or parts of it. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by-nc-nd/4.0/.
About this article
Cite this article
Savas, H.G., Karadeniz, H. & Cangur, S. Psychometric evaluation of the birth participation scale for fathers (BPS-F): a methodological study. BMC Pregnancy Childbirth 25, 277 (2025). https://doi.org/10.1186/s12884-025-07350-4
Received:
Accepted:
Published:
DOI: https://doi.org/10.1186/s12884-025-07350-4