Translation, Cross-Cultural Adaptation and Validation of the Chinese Version of the Perinatal Anxiety Screening Scale Among Antenatal and Postnatal Women: A Psychometric Study.

AIM: This work aimed to translate the Perinatal Anxiety Screening Scale into Chinese and test its validity and reliability. BACKGROUND: Anxiety symptoms are common in the perinatal period and negatively affect maternal and fetal outcomes. However, a sensitive anxiety screening tool specific to perinatal women, including a broad range of problematic anxiety symptoms, is not available in the Chinese language. METHODS: Based on the translation, adaptation and validation of instruments or scale guideline, the Chinese version of the Perinatal Anxiety Screening Scale was developed by translation, synthesis, back-translation, pilot testing and psychometric testing. By convenience sampling, 350 perinatal women participated in this study from a tertiary hospital in Guangzhou, China. RESULTS: The Chinese version of the Perinatal Anxiety Screening Scale comprised four dimensions with 31 items and demonstrated good internal consistency (Cronbach's α: 0.94) and acceptable test-retest reliability within a two-week interval (intraclass correlation coefficient: 0.81). An expert panel evaluated that the average Scale-Content Validity Index (S-CVI/Ave) was 0.96, and the Item Content Validity Index (I-CVI) ranged from 0.89 to 1.00. As expected, the PASS significantly correlated with the Pregnancy-specific Anxiety Questionnaire and Self-Rating Anxiety Scale (r = 0.74, p < 0.001; r = 0.67, p < 0.001). In exploratory factor analysis, the cumulative contribution rate of the four common factors was 66.19%. CONCLUSION: The PASS-C was rigorously developed following the translation, adaptation and validation guidelines. The PASS-C was evaluated to have good reliability and validity. Additionally, it was verified to be easy and fast to assess the severity of anxiety symptoms in perinatal women for clinicians in China. We therefore advise that the PASS-C be introduced into clinical practice as a rapid screening instrument of anxiety disorders in antenatal and postnatal women. This enables nurses or clinicians to initiate timely, evidence-based interventions, such as psychological support or referrals to mental health specialists, thereby improving maternal and infant outcomes.