Evaluating satisfaction with maternity care in women from minority ethnic communities: development and validation of a Sylheti questionnaire

Objective. To develop a reliable and valid questionnaire to evaluate satisf action with maternity care in Sylheti-speaking Bangladeshi women. Design. Two-stage, psychometric study. Firstly focus groups, in-depth inter views and iterative methods for translation and cultural adaptation were us ed to develop a Sylheti questionnaire, called the survey of Bangladeshi wom en's experience of maternity ser;ices from an English language questionnair e. Secondly; quantitative psychometric methods were used to field test and evaluate the acceptability; reliability and validity of this questionnaire. Setting. Four hospitals providing maternity services in London, UK. Study participants. Two hundred and forty-two women from re London Banglade shi communities, who were in the antenatal (at least 4 months pregnant) or postnatal phase (up to 6 months after delivery). Women spoke Sylheti; a lan guage with no accepted written form. Two purposive samples of 40 women in t he antenatal or postnatal phase, one convenience sample of sis women in the antenatal phase and three consecutive samples of 60 women in the postnatal phase participated in stage one. In stage two, 135 women (main sample) com pleted the questionnaire two months after delivery (82% response rare); in women (retest sample) from the main sample completed a second questionnaire two weeks later (96% response rate). Main outcome measures. Women's views about maternity care elicited by quali tative methods and measured quantitatively using the sun ev of Bangladeshi women's experience of maternity services. Results. The 121-item questionnaire was acceptable to women and showed good internal consistency (Cronbach's alphas 0.76-0.91), stability (test-retest reliability 0.72-0.84) and construct validity (e.g. able to detect group d ifferences). Conclusion. By combining qualitative and quantitative methods, it is possib le to adapt an instrument to provide an acceptable, reliable and valid Sylh eti questionnaire. The approach taken in developing this questionnaire prov ides a model for developing outcome measures for use with other minority et hnic communities.