Perinatal Sonuçların Değerlendirilmesinde Kullanılan Optimalite Indeksi-United States(Us)'In Türkçe'Ye Uyarlanması

Abstract

This study is carried out as a methodological research to adapt the Optimality Index-United States (OI-US) for the evaluation of perinatal outcomes to Turkish. The OI-US is a clinimetric index which contains 56 items. It consists of two parts which are Perinatal Background Index (PBI) and Optimality Index (OI). The PBI is a 14 item instrument that is used to categorize maternity care clientele. The OI portion of the instrument contains 42 items in four perinatal domains. This research was conducted between 1st February 2011 and 27th May 2012. Data were collected by using “Demographic Information Questionnaire” and “Case Report Form”. Data were analysed with percentage, mean, standart deviation, t test for independent samples, Fisher’s Exact test, Pearson chi square test, Kendall coefficient of agreement and Kappa statistic. Psycholinguistic and psychometric (validty-reliablity) properties of the OI-US were evaluated within the context of adaptation of OI-US to Turkish. In the part of evaluating psycholinguistic properties of the OI-US, index items were translated to Turkish from English and back translated from Turkish to English and necessary changes were done in the index items. In the context of validty study, content validity based on the opinion of experts and discriminant validty were evaluated. In the part of evaluating content validty, high level study results were provided in support for each item in the index to the experts and taken their opinions. 5 new items which affect negatively perinatal outcomes in our country were added to the index. According to results of content validity ratio (CVR), one item was deleted from the index. Content validity index (CVI) was calculated as 0,71 and it was found that the index is statistically significiant. However, as a result of Kendall’s W test, rater agreement coefficient was found 0,162 and it was determined that agreement between the raters was weak. For evaluating discriminant validity, 300 pregnant women who were admitted to Etlik Zubeyde Hanim Maternity and Women’s Health Teaching and Research Hospital for giving vaginal birth were included into the study. OI-US scores of 150 healthy and 150 high risk pregnant women were compared. It was found that the mean PBI score for healthy pregnant women (88.05%) was higher than those who were high risk pregnant (85,49%) (p<0.05). Altough the PBI scores were found different, it was determined that the mean OI scores for healthy and high risk pregnant women were 77.65% and 78.60%, respectively (p<0.05). In the part of evaluating realiabilty, percentage of agreement between 2 raters was 96,19%. It was found that interrater agreement is provided for all items in the index according to Kappa statistic results. We conclude that OI-US which adapted to Turkish is valid and reliable for evaluating perinatal outcomes based on our study results. It is suggested to use the OI-US which adapted to Turkish and evidence based care during delivery and birth in accordance with the study results.