# Adaptation and validation of the Polish version of the Quality from Patient Perspective-Intrapartal (QPP-I) questionnaire to assess childbirth care

## TL;DR

This study adapts and validates a Polish version of a questionnaire to assess childbirth care quality from the patient's perspective, ensuring it is reliable and culturally appropriate.

## Contribution

The study provides a validated, culturally adapted Polish version of the QPP-I questionnaire for assessing childbirth care quality.

## Key findings

- The Polish QPP-I questionnaire showed high internal consistency (α=0.935) and good validity (mean Kendall W=0.65).
- The questionnaire was well-received and required minimal cultural adaptation.
- Some items related to decision-making and midwifery attendance showed poor internal consistency.

## Abstract

As midwifery shifts to a holistic, women-centered model, assessing care quality from the patient's perspective is crucial. The lack of standardized tools in Poland forces reliance on invalidated ad hoc measures. This study bridges the gap by translating and validating the QPP-I questionnaire.

The Polish QPP-I was adapted and validated through a cross-cultural study. A pilot (25 women) and a multicenter study (153 women) were conducted 2–3 days postpartum, with a test-retest after 2–4 weeks. Convenience sampling was used, with data collected via online and paper questionnaires. The pilot ran in late 2019, and the main study (February 2020–March 2021) spanned five maternity wards. Internal consistency, test-retest reliability, and criterion relevance were analyzed.

The questionnaire was well-received by the target group, requiring minimal cultural adaptation. QPP-I PL demonstrated high internal consistency (α=0.935 for the 1st testing, α=0.95 for the test-retest) and good validity (mean Kendall W=0.65). Reliability was assessed using Cronbach’s alpha. Most items showed good reliability (α >0.70). The Perceived Reality (PR) subscale had high reliability (α=0.90), while the Subjective Importance (SI) subscale reached α=0.93, confirming the appropriateness of all items. However, indicators related to participation in decision-making and midwifery attendance showed poor internal consistency. The mean alpha coefficient in the test-retest further supported good reliability (α=0.65).

The Polish version of the QPP-I questionnaire demonstrates good validity and reliability for assessing the quality of perinatal care from the patient's perspective. The questionnaire reflects the Polish perinatal care context while maintaining the original tool's integrity.