Translation and validation of the German version of the Mother-Generated Index and its application during the postnatal period

a b s t r a c t Objective: the Mother-Generated Index (MGI) is a validated tool to assess postnatal quality of life. It is usually administered several weeks or months after birth and correlates with indices of post partum mood states and physical complaints. The instrument had not been translated into German before or validated for use among German-speaking women, nor have the results of the tool been assessed specifically for the administration directly after birth. This paper aims to describe the systematic translation process of the MGI into German and to assess the convergent validity of the German version of the instrument directly after birth and seven weeks post partum. Design: prospective two-stage survey. Setting: two rural hospitals in the south of Germany and in the north of Switzerland. Participants: all women giving birth between 1st October and 15th December 2012 with sufficient knowledge of German and whose babies were not referred to a neonatal care unit; 226 women were eligible to participate. Measurement instruments: two questionnaires including questions relating to socio-demographic factors and perinatal care, and incorporating the MGI, the Hospital Anxiety and Depression Scale (HADS) and the Postnatal Morbidity Index (PMI). All instruments were subjected to forward and back translation and pilot-tested; the first questionnaire was then administered in the first two days after birth and the second six weeks post partum. Parametric and non-parametric tests were computed using SPSS. Findings: 129 surveys were returned an average of three days after birth and 83 after seven weeks. Higher postnatal quality of life showed a significant correlation with a lower anxiety and depression score (po0.01), fewer maternal physical complaints (po0.05) and more favourable baby adjective scores (po0.05) after birth. Significant associations were found between MGI scores and sufficient help (p¼0.03) as well as ability to cope at home (po0.01). MGI scores three days and seven weeks after birth correlated highly significantly and positively (po0.001). Key conclusions: convergent validity of the MGI with the HADS and the PMI suggests that the German version of the MGI is a valid indicator of physical and emotional post partum well-being. Implication for practice: the German version of the MGI can be used in the post partum period to identify women whose quality of life is impaired during the first days after birth, in order to initiate extended midwifery care and referral if necessary