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INTRODUCTION The Birth Satisfaction Scale (BSS) is an important screening instrument that is used with mothers during the postpartum period for the identification of postnatal birth satisfaction. The purpose of this study was to validate and adapt the Greek version of the BSS to test its sensitivity, specificity and predictive values. METHODS Childbearing women (n=310) were recruited from the perinatal care registers of the Maternity Departments of 3 Hospitals of Athens municipality (public Maternity Departments) in 2014. Inclusion criteria included fluency in spoken and written Greek language, within 1-4 postpartum days, and delivery of a healthy infant. Exploratory Factor Analysis (EFA) on the 30-items on the BSS revealed 7 orthogonal factors (KMO measure of sampling adequacy=0.856 and Bartlett’s test of sphericity=2999.806, df=435, p<0.0005). A Receiver Operating Characteristic (ROC) analysis was conducted to evaluate global functioning of the scale. Within this context the scoring of the BSS was reversed from the original, to indicate that a lower score was a worse outcome. RESULTS The Greek BSS showed high overall internal consistency (Cronbach’s alpha value: 0.876, p<0.0001). The internal consistency characteristics of the Greek BSS showed good reliability: Cronbach’s alpha was 0.876 for the total scale (Items 1-30), Standardized alpha 0.859 and Guttman split-half 0.864, Spearman-Brown 0.866. Our findings confirm the multidimensionality of BSS, demonstrating a seven-factor structure that contained subscales, reflecting the postnatal birth satisfaction. Exploratory Factor Analysis (EFA) demonstrated that the 7-factor model offered a very good fit to our data. The area under the minor satisfaction ROC curve is 0.796 (SD=0.025, Asymp. Sig.=0.0005; CI=0.748-0.845), sensitivity=73.8%, and specificity=70%. CONCLUSIONS Our data confirm the validity of the Greek version of the BSS at identifying postnatal birth satisfaction. Hence, the Greek BSS could be used as a useful instrument in both clinical practice and research. List of abbreviations used BSS: Birth Satisfaction Scale ROC: Receiver Operating Characteristic AUC: Area Under Curve KMO: Kaiser-Meyer-Olkin INTRODUCTION Birth satisfaction is important in terms of both ‘cost’ and ‘quality’1. In this respect, healthcare cannot be high quality unless the woman is satisfied with the care she has received2, within a prescribed system and budget. Since every woman creates childbirth expectations differently and appreciation varies3, 4, it is important that women’s birth experiences are evaluated. In terms of quantitative research, a woman’s The reversed Birth Satisfaction Scale: Translation, adaptation and validation for a Greek sample Victoria G. Vivilaki1, Eleni Zemperligkou1, Eirini Iliopoulou1, Eirini Anastasopoulou1, Paraskevi Giaxi1, Katerina Lykeridou1 AFFILIATION 1 Midwifery Department of Athens, Technological Educational Institute of Athens, Athens, Greece CORRESPONDENCE TO Midwifery Department of Athens, Technological Educational Institute of Athens, Passionos 44-46, 11631 Athens, Greece. E-mail: v.vivilaki@gmail.com

The reversed Birth Satisfaction Scale: translation, adaptation and validation for a Greek sample