Alzyoud F, Khoshnood K, Alnatour A, Oweis A. Exposure to verbal abuse and neglect during childbirth among Jordanian women. Midwifery. 2018; 58:71-76

Bartlett M. A note on multiplying factors for various chi squared approximations. J R Stat Soc. 1954; 16:296-298

Carmona Monge FJ, Peñacoba-Puente C, Marín Morales D, Carretero Abellán I. Factor structure, validity and reliability of the Spanish version of the Cambridge worry scale. Midwifery. 2012; 28:(1)112-119

Costa ECV, Castanheira E, Moreira L, Correia P, Ribeiro D, Graça Pereira M. Predictors of emotional distress in pregnant women: the mediating role of relationship intimacy. J Ment Health. 2020; 29:(2)152-160

Costello AB, Osborne JW. Best practices in exploratory factor analysis: four recommendations for getting the most from your analysis. Pract Assess Res Eval. 2005; 10:(7)1-9

DeSocio JE. Epigenetics, maternal prenatal psychosocial stress, and infant mental health. Arch Psychiatr Nurs. 2018; 32:(6)901-906

Gourounti K, Lykeridou K, Taskou C, Kafetsios K, Sandall J. A survey of worries of pregnant women: reliability and validity of the Greek version of the Cambridge Worry Scale. Midwifery. 2012; 28:(6)746-753

Gourounti K, Anagnostopoulos F, Sandall J. Poor marital support associate with anxiety and worries during pregnancy in Greek pregnant women. Midwifery. 2014; 30:(6)628-635

Green JM, Kafetsios K, Statham HE, Snowdon CM. Factor structure, validity and reliability of the Cambridge worry scale in a pregnant population. J Health Psychol. 2003; 8:(6)753-764

Gunay EY, Gul A. Reliability and validity of the Cambridge Worry Scale in pregnant Turkish women. Midwifery. 2015; 31:(3)359-364

Hatamleh R, Shaban IA, Homer C. Evaluating the experience of Jordanian women with maternity care services. Health Care Women Int. 2013; 34:(6)499-512

Houser J. Precision, reliability, and validity: essential elements of measurement in nursing research. J Spec Pediatr Nurs. 2008; 13:(4)297-299

Jomeen J, Martin CR. The factor structure of the Cambridge worry scale in early pregnancy. JOPPPAH. 2005; 1:(20)25-48

Juniper EF, Guyatt GH, Streiner DL, King DR. Clinical impact versus factor analysis for quality of life questionnaire construction. J Clin Epidemiol. 1997; 50:(3)233-238

Kaiser HF. An index of factorial simplicity. Psychometrika. 1974; 39:(1)31-36

Laux L, Glanzmann PSP, Spielberger CD. Das State-Trait-Angstinventar (STAI).Weinheim: Beltz; 1981

Lawshe CH. A quantitative approach to content validity. Person Psychol. 1975; 28:(4)563-575

Mohammad KI, Gamble J, Creedy DK. Prevalence and factors associated with the development of antenatal and postnatal depression among Jordanian women. Midwifery. 2011; 27:(6)e238-e245

Mohammad KI, Alafi KK, Mohammad AI, Gamble J, Creedy D. Jordanian women's dissatisfaction with childbirth care. Int Nurs Rev. 2014a; 61:(2)278-284

Mohammad KI, Shaban IA, Homer CS, Creedy DK. Women's satisfaction with hospital-based intrapartum care: a Jordanian study. Int J Nurs Midwifery. 2014b; 6:(3)32-39

Mohammad KI, Abu Awad D, Creedy DK, Gamble J. Postpartum depression symptoms among Syrian refugee women living in Jordan. Res Nurs Health. 2018; 41:(6)519-524

Mohammad K, Al-Farajat E, Creedy D, Gamble J. Sociocultural factors associated with the development of postnatal anxiety symptoms. Br J Midwifery. 2019; 27:(6)362-367

Mortazavi F, Akaberi A. Worries of pregnant women: testing the Farsi Cambridge worry scale. Scientifica (Cairo). 2016; 2016:1-10

Peñacoba-Puente C, Monge FJC, Morales DM. Pregnancy worries: a longitudinal study of Spanish women. Acta Obstet Gynecol Scand. 2011; 90:(9)1030-1035

Petersen JJ, Paulitsch MA, Guethlin C, Gensichen J, Jahn A. A survey on worries of pregnant women - testing the German version of the Cambridge worry scale. BMC Public Health. 2009; 9:(1)

Polit D, Beck C. Nursing research: generating and assessing evidence for nursing practice.Philadelphia, PA: Lippincott Williams & Wilkins; 2011

Öhman SG, Grunewald C, Waldenström U. Women's worries during pregnancy: testing the Cambridge worry scale on 200 Swedish women. Scand J Caring Sci. 2003; 17:(2)148-152

Osborne LM, Voegtline K, Standeven LR High worry in pregnancy predicts postpartum depression. J Affect Disord. 2021; 294:701-706

Shaban IA, Hatamleh R, Khresheh R, Homer C. Childbirth practices in Jordanian public hospitals: consistency with evidence-based maternity care?. Int J Evid-Based Healthc. 2011; 9:(1)25-31

Shrestha S, Adachi K, Petrini MA, Shrestha S. Factors associated with post-natal anxiety among primiparous mothers in Nepal. Int Nurs Rev. 2014; 61:(3)427-434

Terwee CB, Mokkink LB, van Poppel MNM, Chinapaw MJM, van Mechelen W, de Vet HCW. Qualitative attributes and measurement properties of physical activity questionnaires: a checklist. Sports Med. 2010; 40:(7)525-537

Thorsness KR, Watson C, LaRusso EM. Perinatal anxiety: approach to diagnosis and management in the obstetric setting. Am J Obstet Gynecol. 2018; 219:(4)326-345

Tsang S, Royse C, Terkawi A. Guidelines for developing, translating, and validating a questionnaire in perioperative and pain medicine. Saudi J Anaesth. 2017; 11:(5)

Psychometric proprieties of the Arabic Cambridge worry scale among pregnant women

02 July 2023
Volume 31 · Issue 7



The reliability and validity of an Arabic version of the Cambridge worry scale have not been established among Arabic-speaking women. The aim of this study was to validate the Arabic version of the scale with a sample of pregnant women in Jordan.


A descriptive cross-sectional study was conducted with pregnant women (n=369) in their third trimester. Exploratory factor analysis and confirmatory factor analysis were conducted to explore the underlying structure of the Arabic scale.


The exploratory factor analysis suggested a four-factors construct jointly accounting for 83.7% of variance. The factors were sociomedical, socioeconomic, health of the mother/others and baby, and relationships. The confirmatory factor analysis supported a four-factor model with a root mean square error of approximation of 0.073. The alpha coefficient for the Arabic subscales ranged from 0.86–0.97.


The Arabic version of the scale is a valid and reliable measure of common worries during pregnancy. It can provide valuable information on common concerns experienced by Jordanian women and guide psychosocial care. Understanding women's concerns will enable healthcare professionals to provide assistance and support, as well as to better meet pregnancy-related and psychosocial needs of pregnant women.

Dur ing pregnancy, many women experience multiple psychological changes, and may worry about various elements of pregnancy and birth (Osborne et al, 2021). Multiple factors may increase worry among pregnant women, such as a confirmed diagnosis of fetal malformation during the antenatal period or the risk of miscarriage (Thorsness et al, 2018). Pregnant women may also worry about their ability to mother, employment and career disruptions, having adequate savings or changes to the marital relationship (Mortazavi and Akaberi, 2016).

Worry adversely affects maternal and infant health (Gourounti et al, 2012). As a result of worry, pregnant women may experience cardiac palpitations, muscle weakness, insomnia, stomach pain and headaches (Costa et al, 2020). Enhanced worry can also decrease maternal blood flow, contributing to complicated perinatal outcomes, including premature birth (DeSocio, 2018). Given the importance and significance of maternal wellbeing, assessing worry during pregnancy is crucial.

Register now to continue reading

Thank you for visiting British Journal of Midwifery and reading some of our peer-reviewed resources for midwives. To read more, please register today. You’ll enjoy the following great benefits:

What's included

  • Limited access to our clinical or professional articles

  • New content and clinical newsletter updates each month