Validation of the Traditional Chinese version of Mothers on Respect Index (MORi) and Mother's Autonomy in Decision Making (MADM) Scale.

OBJECTIVE

This study aimed to translate and culturally adapt the Mothers on Respect Index (MORi) and the Mothers' Autonomy in Decision Making (MADM) scale into Chinese, and to assess their reliability and validity among postpartum women in Hong Kong, China.

METHODS

The MORi and MADM scales were translated into Chinese following a rigorous forward-backward translation procedure. Between December 2023 and February 2024, Chinese-speaking women who had given birth in Hong Kong within the past five years were recruited through social media platforms. The instruments' validity was examined through content validity, construct validity, convergent validity, discriminant validity, and known-groups validity. Reliability was assessed using internal consistency.

RESULTS

A total of 1,395 mothers participated. The Mothers on Respect Index-Revised (MORi-R) and MADM showed perfect content validity (S-CVI = 1.00). Confirmatory factor analysis identified a revised three-factor model MORi-R with satisfactory fit indices (CFI = 0.953; TLI = 0.94; SRMR = 0.07; RMSEA = 0.08). The MORi-R consisted of 13 items after Item 4 was removed. The MADM scale, comprising seven items within a single factor, remained unchanged and demonstrated good model fit (CFI = 0.995; TLI = 0.99; SRMR = 0.01; RMSEA = 0.05). The Cronbach's α was 0.86 for the MORi-R and 0.91 for the MADM scale. The MORi-R and MADM scores were moderate and showed a positive correlation (r = 0.57).

CONCLUSIONS

The MORi-R and MADM scales were used to assess perceived disrespectful care experiences and decision-making autonomy among postpartum women in Hong Kong, China. Both instruments demonstrated desirable psychometric properties, with satisfactory reliability and validity, and may serve as valuable tools to inform clinical nursing practice and improve the quality of maternity care.