Updated Decision Aid Enabling Women to Choose between with or without Epidural Analgesia during Childbirth, and Confirmation of Validity

Background: The use of a decision aid for choosing whether to have or not have anesthesia during childbirth has been shown to increase both knowledge about birth and the proportion of women who made their own decisions compared with women who did not use a decision aid. Herein, we updated the first version of our decision aid into a second version and evaluated this updated decision aid. We evaluated the face validity and content appropriateness of the updated decision aid developed to enhance the ability of women to choose between childbirth with or without epidural analgesia.

Methods: This was a descriptive study based on a literature review of updated information for addition to the first version. PubMed and Cochrane Library were searched from 2003 to May 2021. Thereafter, obstetricians, anesthesiologists, and midwives were asked to respond to a questionnaire regarding the face validity and content appropriateness of the updated decision aid regarding whether it meets the IPDASi (Version 4.0) quality standards.

Results: One obstetrician, one anesthesiologist, and three midwives who had performed epidural anesthesia for at least three years responded to the questionnaire. The responses to the evaluation items of face validity (i.e., style and clarity) were positive. There were 38 specific comments regarding content appropriateness classified into seven categories: "addition or revision of text", "unification of expressions", "need for explanation/information", "lack of evidence", "potential to mislead", "questionable", and "structure".

Conclusion: The face validity and content appropriateness of the updated decision aid was confirmed. The next step is evaluation of the updated decision aid by pregnant women who give birth.