Locating existing instruments available to measure key variables is critical to the success of a research study. However, this process can be a time-consuming activity. In this article, selected instruments available for use in research during the postpartum period are reviewed. These instruments are divided into two categories. The first category deals with instruments that focus on mothers only. These questionnaires measure mothers' perceptions of their deliveries, their adaptation to motherhood, and their breastfeeding experiences. The second category centers on instruments that both parents can complete. These instruments measure parents' perceptions of their parenting role, sense of competence, problem-solving ability, and perceptions of their newborns. The psychometric properties of each instrument are described, and selected nursing research studies that used the instrument are reviewed.

Breast Feeding↗

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Available instruments for research on prenatal attachment and adaptation to pregnancy.

Research, clinical practice, and cost-effective nursing care are all interrelated and are dependent on the use of reliable and valid instruments. Critical to the success of any research study is the choice of instruments to measure key variables. Locating existing instruments for use in nursing research is an important but often labor-intensive activity. This article provides a review of some available instruments that measure two key clinical phenomena particular to the prenatal period: maternal-fetal and paternal-fetal attachment and adaptation to pregnancy. Examples of specific nursing studies that utilize these instruments are presented along with an assessment of the instruments' reliability and validity. Both nurse researchers and clinicians can benefit from this review of selected instruments used during the prenatal period.

Adaptation, Psychological↗

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Trends in nursing education since 1976.

Since the first issue of MCN was published, many changes have transpired in nursing education on all levels. These trends in nursing education since 1976 are addressed for diploma, associate, baccalaureate, master's, and doctoral programs. Examples of such trends focus on enrollments, graduations, and minority students. Trends to watch for in nursing education over the next quarter century are forecasted along with recommendations for nurse educators.

Education, Nursing↗

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Postpartum depressed mothers' experiences interacting with their children.

A phenomenological study was conducted to investigate the meaning of postpartum depressed mothers' interactions with their infants and older children. A purposive sample of 12 mothers participated. Nine theme clusters emerged when the formulated meaning were organized into categories. Participants were overwhelmed by the responsibilities of caring for their children. Guilt, irrational thinking, loss and anger filled their day-to-day interactions with their children. Mothers went through the motions, acting like robots while caring for their infants. At times, to survive, they erected a wall to separate themselves emotionally from their children and consequently failed to respond to their infants' cues. Detrimental relationships with their older children materialized as mothers were enveloped by postpartum depression.

Adaptation, Psychological↗

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Use of a meta-analytic database management system.

Explore the source record for details and available documents.

Computer Graphics↗

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A meta-analysis of the relationship between postpartum depression and infant temperament.

A meta-analysis of 17 studies was conducted to determine the magnitude of the relationship between postpartum depression and infant temperament during the infant's first year. Interrater reliabilities for coding of substantive and methodological characteristics for each study ranged from 87% to 100%. The meta-analytic combinations were calculated in three different ways: unweighted, weighted by sample size, and weighted by a quality index score. A significant, moderate correlation between postpartum depression and infant temperament was found. The mean r index of effect size was .31 when the studies were weighted by sample size; .36 when the studies were unweighted; and .35 when they were weighted by the quality score. All three r indexes were in Cohen's range of moderate effect sizes. The calculated 95% confidence interval ranged from .261 to .369, indicating a significant relationship between postpartum depression and infant temperament. Sample size and year of publication were significantly correlated with the effect size of temperament in infants of postpartum depressed mothers.

Animals↗

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A meta-analysis of predictors of postpartum depression.

A meta-analysis of 44 studies was conducted to determine the magnitude of the relationship between postpartum depression and each of the following predictor variables: prenatal depression, history of previous depression, social support, life stress, child care stress, maternity blues, marital satisfaction, and prenatal anxiety. Effect sizes were calculated three ways: unweighted, weighted by sample size, and weighted by quality index score. Moderate to large significant effect sizes were revealed between these eight predictor variables and postpartum depression. The mean r effect size indicator range for each predictor variable was as follows: prenatal depression (.49 to .51), child care stress (.48 to .49), life stress (.36 to .40), social support (.37 to .39), prenatal anxiety (.30 to .36), maternity blues (.35 to .37), marital satisfaction (.29 to .37), and history of previous depression (.27 to .29).

Child Care↗

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Postpartum Depression Screening Scale: development and psychometric testing.

BACKGROUND: Approximately 400,000 mothers in the United States experience postpartum depression each year. However, only a small proportion of these women are identified as depressed by health care professionals. OBJECTIVES: To improve detection of this postpartum mood disorder, the purpose of this study was to assess the psychometric properties of a newly devised instrument, the Postpartum Depression Screening Scale (PDSS), a 35-item Likert-type self-report instrument. METHODS: Content validity was supported through the literature and the judgments rendered by a panel of five content experts and a focus group. The PDSS was administered to 525 new mothers. RESULTS: Confirmatory factor analysis provided empirical support for the existence of the hypothesized seven dimensions. A Tucker-Lewis goodness-of-fit index of 0.87 and a root mean square residual of 0.05 were judged supportive of model fit. Item response theory techniques provided further construct validity support for finer interpretations of the respective seven dimensions. Analysis of the Likert 5-point response categories further supported meaningful score interpretations. Alpha internal consistency reliabilities ranged from 0.83 (sleeping/eating disturbances) to 0.94 (loss of self). CONCLUSIONS: Empirically, all of the reliability and validity analyses supported the score interpretations posited for the PDSS. Currently, the sensitivity, specificity, and positive predictive value of the PDSS are being determined.

Adult↗

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Further validation of the Postpartum Depression Screening Scale.

BACKGROUND: Up to 50% of all cases of postpartum depression go undetected. The Edinburgh Postnatal Depression Scale (EPDS) has been the only instrument available that was specifically designed to screen for this mood disorder. None of the items on the EPDS, however, are written in the context of new motherhood. OBJECTIVE: The purpose of this study was to further assess the construct validity of the newly designed Postpartum Depression Screening Scale (PDSS) along with its sensitivity, specificity, and predictive values. METHOD: A total sample of 150 mothers within 12 weeks postpartum participated in the study. Each mother completed in random order three questionnaires: The PDSS, EPDS, and The Beck Depression Inventory-II (BDI-II). Immediately after completing these three questionnaires, each woman was interviewed by a nurse psychotherapist using the Structural Clinical Interview for DSM-IV Axis 1 Disorders. RESULTS: Twelve percent (n = 18) of the mothers were diagnosed with major postpartum depression, 19% (n = 28) with minor postpartum depression, and 69% (n = 104) with no depression. The PDSS was strongly correlated with both the BDI-II (r = 0.81) and the EPDS (r = 0.79). The ability of the PDSS to explain variance in diagnostic classification of postpartum depression above that explained by the BDI-II and EPDS (i.e., incremental validity) was assessed using hierarchical regression. After explaining variance in group classification by the other two depression instruments, the PDSS explained an additional 9% of the variance in depression diagnosis. Using receiver operating characteristic (ROC) curves, a PDSS cut-off score of 80 (sensitivity 94% and specificity 98%) is recommended for major postpartum depression and a cut-off score of 60 (sensitivity 91% and specificity 72%) for major or minor depression. CONCLUSION: Based on the results of this psychometric testing, the PDSS is considered ready for use in routine screening of mothers.

Adult↗