Pandemic anxiety stress scale for pregnant women(PASSP): Development and validation

Introduction Coronavirus disease (COVID-19) is a new pandemic caused by a newly discovered coronavirus.  This pandemic has caused increase in anxiety among people globally and more the pregnant women. Elevated levels of anxiety and stress may adversely affect the outcome. Aim & Objective: This study aimed at developing and validating a tool to assess the stress and anxiety due to pandemic which helps the health care professionals to identify the probable cases of anxiety associated with the coronavirus and can take adequate measures to improve the emotional well-being of the antenatal women. Methods & Material: A cross-sectional survey was carried out among the pregnant women in Kerala using a 29-itemtool through google forms during the month of June. Statistical Analysis:   Item analysis, Exploratory factor analysis and confirmatory factor analysis were done to evaluate scale dimensionality, factor loadings, and factor structure using the R Software version 4.0.2. Results: Factor analysis resulted in a 15-item short tool, Pandemic anxiety stress scale for pregnant women (PASSP) with the reliably index of Cronbach’s alpha of 0.93. Exploratory factor analysis extracted two factors. Confirmatory factor analysis confirmed the factor structure of the PASSP with Goodness of fit indices. Two factor model structure has good fit indices with GFI>0.90, DFI and TLI>0.95 and SRMR =0.04. Discussion: This study developed a new validated instrument PASSP for assessing the anxiety and stress due to a pandemic among pregnant women in Kerala. Keywords: COVID19, anxiety, pandemic, pregnancy, tool validation, factor analysis.