An exploratory study to assess the acceptability of an antenatal quality-of-life instrument (the Mother-generated Index)

Objective: to assess whether the Mother-generated Index (MGI), a validated postnatal tool, was acceptable during late pregnancy; minor modifications to the wording of the existing tool were made. The MGI allows for qualitative and quantitative assessment. Design face-to-face interviews were conducted by a single researcher using the modified MGI and the General Health Questionnaire (GHQ-30). The women wrote up to eight comments describing the most important areas of their lives, indicated whether these were positive, negative or neither, and then scored and ranked them. Setting two health centres in East Scotland, during a scheduled antenatal clinic visit. Participants 35 women (20 nulliparous and 15 parous) in the third trimester of pregnancy. Findings interviews lasted for 15–25 mins and none of the women found the MGI difficult to complete. The mean number of comments was 4.9 (standard deviation 1.1); most were directly related to the pregnancy and some were life issues that remained pertinent during the pregnancy. Face validity was good; criterion validity could not be assessed formally, but the MGI scores and the GHQ-30 scores were well correlated (Pearson r=-0.62; p<0.001). While some comment categories were universally positive (‘looking forward to baby’, ‘relationship with partner’) and others were universally negative (‘tiredness’, ‘aches and pains’), other categories were mixed (e.g. ‘social life’, ‘work’). Women who expected their birth partner to be ‘very helpful’ had significantly higher MGI scores than women without such expectations (t=2.5, degrees of freedom=33; p=0.018). Key conclusions in this comparatively small study, the MGI was acceptable to pregnant women as an assessment tool during late pregnancy. While the sample size precluded definitive statistical evaluation, the apparently logical associations between overall MGI scores and particular comments, and the good correlation between MGI and GHQ-30 scores suggest that the MGI is a feasible tool for use in late pregnancy. Implications for practice: holistic care is advocated; this subjective tool allows pregnant women to state what is most important to them, thus avoiding a ‘top-down’ pathological approach. The MGI can help to uncover important quality-of-life issues that may not appear obvious to the midwife, and which may otherwise be missed. A larger study is required for formal evaluation of the quantitative potential of the antenatal MGI.