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Cross-cultural validation and psychometric evaluation of the revised emancipated decision-making scale in Portuguese pregnant women

dc.contributor.authorLopes, Marlene Isabel
dc.contributor.authorNeves, Teresa Margarida Almeida
dc.contributor.authorWittmann-Price, Ruth A.
dc.contributor.authorVieira, Margarida
dc.contributor.authorCardoso, Alexandrina
dc.date.accessioned2026-04-14T11:38:06Z
dc.date.available2026-04-14T11:38:06Z
dc.date.issued2026-06-01
dc.description.abstractObjective: Active participation in healthcare decisions during childbirth is strongly associated with greater satisfaction and improved health outcomes. Shared decision-making is particularly critical in women's health, where choices have often been shaped by patriarchal norms and a historically paternalistic healthcare system. This study aimed to evaluate the psychometric properties of a culturally adapted Portuguese version of the Revised Emancipated Decision-Making Scale (EDMr) for use among pregnant women. Methods: A two-phase methodological approach was employed, involving the cultural adaptation of the instrument and the assessment of its psychometric properties in a non-probabilistic sample of 241 pregnant women in Portugal. Exploratory Factor Analysis and Confirmatory Factor Analysis were performed on separate subsamples to enhance methodological rigor. Results: The original three-factor model evolved into a five-factor structure: Personal Knowledge, Flexible Environment (subdivided into Feeling Supported and Feeling Respected), and Social Norms (subdivided into Sense of Pressure and Negative Reactions). The final model demonstrated solid psychometric properties, with acceptable to high internal consistency across subscales, with Cronbach's alpha values ranging from 0.68 (Sense of Pressure) to 0.86 (Personal Knowledge). Conclusion: The findings support its theoretical soundness and cultural relevance, confirming its utility in assessing women's autonomy in healthcare decision-making during pregnancy and childbirth. Further research is recommended to explore its applicability in broader populations and across diverse clinical contexts. Innovation: This represents the first validation of the EDMr outside the United States.eng
dc.identifier.doi10.1016/j.pecinn.2026.100471
dc.identifier.eid105033247326
dc.identifier.otherbcd2fa38-d146-4e46-a5e9-58d7d0c0a6e4
dc.identifier.pmcPMC13020063
dc.identifier.pmid41907352
dc.identifier.urihttp://hdl.handle.net/10400.14/57508
dc.identifier.wos001724568600001
dc.language.isoeng
dc.peerreviewedyes
dc.publisherElsevier B.V.
dc.rights.urihttp://creativecommons.org/licenses/by/4.0/
dc.subjectDecision making, sharedeng
dc.subjectEmpowermenteng
dc.subjectPrenatal careeng
dc.subjectPsychometriceng
dc.subjectWomen's healtheng
dc.titleCross-cultural validation and psychometric evaluation of the revised emancipated decision-making scale in Portuguese pregnant women
dc.typeresearch article
dspace.entity.typePublication
oaire.citation.volume8
oaire.versionhttp://purl.org/coar/version/c_970fb48d4fbd8a85

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