Introduction
Most of the existing research conducted on pregnancy-related anxiety (PrA) in Sub-Saharan African and low and middle income countries (LMICs) relies on scales and measures which fail to adequately capture the unique determinants of PrA in these settings. Our objective was to identify and pilot a comprehensive, translatable scale suitable for use in evaluating PrA in Ghana.
Methods
From a preliminary pool of 25 scales, 5 scales were selected based on practicality and suitability to setting. These scales were evaluated to determine if they assessed the nine elements of pregnancy-related anxiety as determined by Bayrampour. The Tilburg Pregnancy Distress Scale (TPDS) was selected as the best fit, and a 2-question addendum from the Pregnancy-related Anxiety Scale (PRAS) was added for complete assessment. The TPDS and PRAS were translated from English to the two primary local languages in Ghana (Twi and Ga), back-translated, and reviewed.
Results
This scale was piloted and administered to 51 pregnant women presenting for antenatal visits at a tertiary hospital in Accra, Ghana. Women completed the surveys, and underwent a cognitive interviewing process to assess their opinions on the survey and willingness to complete the survey. For this population, the 50th percentile TPDS score was 17.13, while the 90th percentile TPDS was 28.02, with a range of scores from 4-32 out of a possible 48 points. 11.76% (6/51) of women were identified as being above the 90th percentile of anxiety as determined by the TPDS. . Participants expressed generally positive sentiments towards the TPDS during interviews, praising the brevity of the survey and its understandable translation into local languages, and expressing a desire to discuss PrA with providers in the future. 88.24% (42/46) of women stated that they would complete this survey again.