| dc.description.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 | en_US |
