Childbirth experience assessment tools based on COSMIN guidelines: A systematic review.
Yifan Cheng, Ruxue Bai, Siyu Shan and 2 others
PMID 39990987WHAT IT FOUND
No childbirth experience tool met the highest evidence standard.
The QACE is recommended first for identifying women with negative experiences, but it lacks data on cross-cultural validity and stability, so scores may not be reliable across different settings or over time.
Key findings
01All 15 included tools received a grade B recommendation, with none achieving grade A.
02The QACE is recommended first because it has moderate evidence for content validity and high evidence for internal consistency, and is designed to help clinicians identify women needing intervention.
03None of the tools reported data on cross-cultural validity, measurement error, or responsiveness, limiting confidence in their use across different populations or for tracking change over time.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
Only Chinese and English literature was included. COSMIN ratings involve subjective judgement, which may introduce bias. Few measurement attributes were evaluated for most tools, making the conclusions less stable.
Declared interests
The authors declared no conflict of interest.
The easy way to misread this
Do not treat the QACE as a validated diagnostic instrument. It is a screening tool with unproven stability and cross-cultural validity, so a low score should prompt clinical assessment rather than a definitive conclusion about the patient's experience.