The Birth Satisfaction Scale (BSS-R): process of translation and adaptation in an italian contest



Introduction. The Birth Satisfaction Scale-Revised (BSS-R) is a tool to assess women’s childbirth satisfaction. The aim of this research was to achieve the cross-cultural and conceptual equivalence of the BSS-R tool in Italian. Method. The World Health Organization (WHO) method was adopted to achieve the BSS-R in Italian. This is a well-established method using forward-translations and backtranslations. This process has been refined in the course of several WHO studies to result in five steps: forward translation, expert panel translation, back-translation, pre-testing and cognitive interviewing, final version. Results. The forward translation step developed an Italian version of the BSS-R, this was revised by an expert panel. During the pretesting and cognitive interviewing step, 100 women were involved to check if the instrument was understandable and they did not report any difficulties to comprehend the questionnaire. Women repeated with different expressions and words items 1, 7 and 9. After a conceptual analysis of the sentences used by women during the debriefing stage, items 1 and 9 have been changed. At the end of the process, we had a final version of the questionnaire in Italian. Discussion. The BSS-R should be a reliable instrument to be adopted by healthcare professionals, researches and managers in order to improve Italian maternity services with the aim to offer a positive experience of childbirth.


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Antonella Nespoli

Elisabetta Colciago

Silvia Pedroni

Sofia Perego

Simona Fumagalli - Università degli studi di Milano Bicocca

How to Cite
Nespoli, A., Colciago, E., Pedroni, S., Perego, S., & Fumagalli, S. (2018). The Birth Satisfaction Scale (BSS-R): process of translation and adaptation in an italian contest. Annali dell’Istituto Superiore Di Sanità, 54(4), 340–347. Retrieved from
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