Prenatal Attachment Inventory: Adaptation and Validation in the Indian Context.

Abstract

Background: This study aimed to translate and validate the Prenatal Attachment Inventory (PAI) into Malayalam to address a gap in Maternal-Fetal Attachment (MFA) research in India. The PAI was adapted based on John Bowlby's attachment theory and Mecca Cranley's Maternal-Fetal Attachment Scale (MFAS), incorporating expert feedback to reflect Indian cultural contexts better.

Methods: The translated PAI was administered to 250 pregnant women in Kerala. The translation process included adding three new items focused on maternal self-care, activities with the fetus, and resource usage, categorized as "personal reflection." These additions, alongside original factors of anticipation, differentiation, and interaction, were validated by reviewers, resulting in a Content Validity Ratio of 0.95.

Results: Initial Confirmatory Factor Analysis indicated a Comparative Fit Index (CFI) of 0.821, Tucker-Lewis Index (TLI) of 0.791, Standardized Root Mean Square Residual (SRMR) of 0.0631, and Root Mean Square Error of Approximation (RMSEA) of 0.0764. After removing four low-loading items, the revised model showed improved fit indices: CFI of 0.843, TLI of 0.811, SRMR of 0.0591, and RMSEA of 0.0802, with Akaike Information Criterion and Bayesian Information Criterion values decreasing to 9823 and 10,024.

Conclusion: The Cronbach's alpha of 0.868 for the Malayalam PAI demonstrated strong internal consistency. This validated tool provides a reliable and culturally appropriate measure for MFA in India, supporting future research and interventions to enhance maternal and fetal health outcomes.