Turkish Adaptation and Psychometric Evaluation of the Tilburg Pregnancy Distress Scale—Revised in Three Independent Gestational Groups


Kececi Oguzhanoglu M., MUTLU P., Oguzhanoglu K., Ayguler E., Seker Atas B., Karacabey Cakmak S., ...Daha Fazla

Healthcare (Switzerland), cilt.14, sa.15, 2026 (SCI-Expanded, SSCI, Scopus)

  • Yayın Türü: Makale / Tam Makale
  • Cilt numarası: 14 Sayı: 15
  • Basım Tarihi: 2026
  • Doi Numarası: 10.3390/healthcare14152354
  • Dergi Adı: Healthcare (Switzerland)
  • Derginin Tarandığı İndeksler: Science Citation Index Expanded (SCI-EXPANDED), Social Sciences Citation Index (SSCI), Scopus, CINAHL, Health Research Premium Collection (ProQuest)
  • Anahtar Kelimeler: pregnancy distress, Tilburg Pregnancy Distress Scale, psychometrics, confirmatory factor analysis, measurement invariance
  • Sağlık Bilimleri Üniversitesi Adresli: Evet

Özet

Background/Objectives: Pregnancy-specific distress is distinct from generic anxiety and depression and predicts adverse perinatal outcomes. This study adapted the 14-item Tilburg Pregnancy Distress Scale—Revised (TPDS-R), which assesses childbirth-related worries, pregnancy-related worries, and partner involvement, into Turkish and evaluated its measurement properties at three defined gestational stages. Methods: In this cross-sectional study, 450 pregnant women (150 each at 12, 22, and 32 gestational weeks) completed the Turkish TPDS-R and the Edinburgh Postnatal Depression Scale (EPDS). Adaptation followed an eight-stage procedure including expert panel review and pilot testing. Structural validity, reliability, measurement invariance, and convergent and known-groups validity were examined, with factor analyses estimated by robust diagonally weighted least squares in split-half samples. Results: Parallel analysis supported three factors. The three-factor model fitted adequately in the independent confirmatory half (CFI = 0.947) and the total sample (CFI = 0.962), although the TLI fell below the prespecified 0.90 criterion in all three gestational subgroups (0.877–0.899). Internal consistency was acceptable for the total scale (α = 0.70) but weak for pregnancy-related worries (α = 0.60); test–retest reliability was excellent (ICC = 0.94). Only configural invariance was supported. The total score correlated with the EPDS (r = 0.42), and primiparous women reported higher childbirth-related distress (d = 0.47). Pregnancy-related distress was lower in the later gestational groups. A 12-item version omitting items 3 and 10 fitted better but showed weaker external validity. Conclusions: The Turkish TPDS-R reproduces the original three-factor structure with excellent temporal stability, supporting dimensional assessment in research and clinical evaluation. Because measurement invariance was not established, between-group differences are descriptive. Criterion-validity studies and cut-off scores are needed before screening use.