Psychometric properties of the Urdu version of the Postpartum Bonding Questionnaire (PBQ): a validation study among mothers with prenatal anxiety symptoms in Pakistan.
Academic Article
Overview
abstract
PURPOSE: Mother-infant bonding is crucial for the child's development and the parent's well-being, but research in this area in low- and middle-income countries is rare. We sought to evaluate the psychometric properties of the Urdu version of the Postpartum Bonding Questionnaire (PBQ) among women with prenatal anxiety symptoms in Pakistan. METHODS: This validation study used cross-sectional data within the context of a large randomized clinical trial, called Happy Mother, Healthy Baby (HMHB), conducted from April 2019 to October 2022 among women with at least mild prenatal anxiety symptoms receiving antenatal care from a large tertiary care hospital in Rawalpindi, Pakistan. Exploratory factor analysis (EFA), confirmatory factor analysis (CFA), and analysis of convergent validity were performed. RESULTS: The analysis included 720 mothers with a mean age of 25.23 years (SD = 4.61). The EFA suggested that 19 items (the five-factor model) out of 25 original items (the four-factor model) provided a good fit for the data, explaining a total variance of 64.7%. The CFA demonstrated poor fit for the four-factor model, but acceptable fit for the five-factor model of the PBQ (i.e., Love and affection [eight-item], Rejection [four-item], Withdrawal [two-items], Anger [three-items], and Irritation [two-items]) (CFI = 0.94, TLI = 0.93, RMSEA = 0.07, SRMR = 0.04), with good reliability (ordinal alpha = 0.71-0.93). A moderate positive correlation between impaired bonding and depressive symptoms supported convergent validity; and a negative correlation between impaired bonding and maternal-infant responsiveness supported convergent validity. Potential limitations are that test-retest validity and cutoff specification were not carried out. CONCLUSIONS: Findings indicate that the 19-item Urdu version of the PBQ is valid and reliable to assess postpartum bonding among Pakistani women with prenatal anxiety symptoms.
