Validitas dan Reliabilitas Stirling Antenatal Anxiety Scale (SAAS) Versi Bahasa Indonesia

Abstract

Validity and Reliability of the Indonesian Version of the Stirling Antenatal Anxiety Scale (SAAS) Rini Adriany Lubis, Vita Camellia, M.Surya Husada, Elmeida Effendy, Mustafa M.Amin. Departemen Kedokteran Jiwa, Fakultas Kedokteran, Universitas Sumatera Utara, Medan, Indonesia ABSTRACT Background: Antenatal anxiety is a common psychological problem during pregnancy that may adversely affect maternal health and fetal development. Pregnancy represents a critical transitional period for women, characterized by heightened vulnerability to psychological disorders. This highlights the need for valid and reliable screening instruments to enable early detection and timely intervention. The Stirling Antenatal Anxiety Scale (SAAS), originally developed in English, has been validated in several countries; however, no Indonesian version has yet been available. Methods: This diagnostic study applied a corrected correlation analysis approach and included 400 pregnant women in their second and third trimesters, aged 20–35 years, recruited from primary health care facilities in Medan, Indonesia. Cross cultural adaptation followed international guidelines, comprising forward backward translation, expert review, and pilot testing. Psychometric testing included content validity (expert judgment), construct validity (exploratory factor analysis, EFA), convergent validity (Pearson’s correlation with the Generalized Anxiety Disorder-7 [GAD-7]), and reliability (Cronbach’s Alpha and Intraclass Correlation Coefficient [ICC]). Results: The Indonesian version of SAAS showed satisfactory content validity (S CVI/Ave = 0.88; S-CVI/UA = 0.50). EFA confirmed a one-factor structure (KMO = 0.908; factor loadings 0.485–0.799), explaining 45.8% of total variance. Convergent validity demonstrated a strong correlation with GAD-7 (r = 0.897; p < 0.001). Reliability analysis indicated high internal consistency (Cronbach’s Alpha = 0.860) and ICC = 0.860. Conclusion: These findings establish the Indonesian version of SAAS as a valid and reliable instrument for screening antenatal anxiety. Its concise format, clarity, and strong psychometric properties support its implementation in clinical practice and research, thereby enhancing early identification and intervention for anxiety among pregnant women in Indonesia. Keywords: Antenatal anxiety, psychometric validation, reliability, Stirling Antenatal Anxiety Scale, pregnancy