Validation of the Mainland Chinese version of the Edinburgh Postnatal Depression Scale in Chengdu mothers

Background

The Mainland Chinese version of the Edinburgh Postnatal Depression Scale (EPDS) has been validated among antenatal women, subsequent validation among postnatal women is necessary.

Objectives

This study investigated the prevalence of postnatal depression and the psychometric characteristics of the Mainland Chinese version of the EPDS among postnatal women.

Design

Two studies were used for validating the EPDS with specific aims. Study I established the psychometric properties of the EPDS by examining the convergent, discriminant and construct validity, internal consistency and stability of the scale. Study II established its sensitivity, specificity and the optimal cut-off score of the EPDS according the DSM-IV-TR criteria using the Structured Clinical Interview.

Setting

: Four regional public hospitals in Chengdu.

Participants

: A convenience sample was composed of 300 and 342 postnatal women in study I and II, respectively.

Method

A receiver operating characteristic (ROC) analysis was carried out to evaluate the global functioning of the scale. The Beck Depression Inventory (BDI), Dyadic Adjustment Scale (DAS) and standard SF-12 Health Survey (SF-12) were used to investigate the convergent, discriminant and construct validity. An exploratory factor analysis was used to investigate the structural validity of the scale. Confirmatory factor analysis (CFA) was tested the proposed factor module by Linear Structural Relations (LISREL). The Cronbach's alpha reliability coefficient, split-half reliability and test-retest reliability were used to examine the internal consistency and stability of the scale.

Results

The prevalence of postnatal depression was 4.7%. Structural validity revealed a three-factor structure for the EPDS and the CFA showed a good overall fit of this three-factor model. Convergent and construct validity was supported and discriminant validity suggested that the EPDS successfully discriminated among the nondepressed, mildly and clinically depressed groups. The area under curve (AUC) was 89.6% and the logistic estimate for the threshold score was 10.5 (sensitivity, 81.25%; specificity, 80.67%) for clinical depression. The split-half reliability of the EPDS was 0.74, Cronbach's alpha was 0.78 and test-retest reliability was 0.90.

Conclusions

Our data confirm the validity of the Mainland Chinese version of EPDS in identifying postnatal depression among postnatal women in Chengdu by using >10 cut-off point. Because of its brevity and acceptability, it is recommended that the EPDS be used in routine postnatal screening.     

Replicability and stability of the multidimensional model of the Edinburgh Postnatal Depression Scale in late pregnancy

The Edinburgh Postnatal Depression Scale (EPDS) is a widely used screening tool for post-natal depression (PND). Recent factor analytic investigations of the EPDS have suggested the instrument may be useful in the prediction of PND as the instrument appears to be multidimensional, thus facilitating sub-scale development for this purpose. The psychometric properties of the EPDS were evaluated in women in the third trimester of pregnancy. Confirmatory factor analyses found support for the multidimensionality of the instrument; however, there was clear variability in model fit to data suggesting previous reports of the stability of the underlying factor structure of this instrument may be over-optimistic. The potential for development of the EPDS as a predictive screening measure of PND is likely to be optimistic because of variability in the factor structure of the instrument over the course of pregnancy and in the post-natal period.     

Use of the Edinburgh Postnatal Depression Scale in Some Swedish Child Health Care Centres

A Swedish version of the Edinburgh Postnatal Depression Scale was validated in 53 women, in comparison with an interview based on the Comprehensive Psychopathological Rating Scale (CPRS-Depression). The EPDS was then applied to 258 women on four occasions, first at 2 and 6 weeks and then at 3 and 8 months post partum. At 2 weeks the proportion of women with signs of depression was 26%, 8% at 6 weeks, 13% at 3 months and 8% at 8 months. An analysis of the 10 items in the EPDS was performed. The subjects felt the questionnaire to express their situation accurately and relevantly. It was also regarded as easy to complete.     

Psychometric properties of the Chinese version of the European Heart Failure Self-care Behaviour Scale

Background

Effective self-care is the cornerstone of the successful management of heart failure (HF). The European Heart Failure Self-care Behaviour Scale is a brief, reliable and valid scale to measure this important construct among patients with HF. Although the EHFScBS has been translated to different languages, no Chinese version is available. Indeed, previous findings investigating the psychometric properties of EHFScBS indicated ambiguity of the conceptual structure of this scale.

Aim

The aim of this study was to translate the European Heart Failure Self-care Behaviour Scale (EHFScBS) into Chinese and to test its psychometric properties in the Chinese patients with HF.

Methods

The EHFScBS (English Version) was translated to Chinese using Brislin's forward and backward translation method. Panel review was used to examine its semantic equivalence and content validity. The EHFScBS (Chinese Version) was then tested with a convenience sample of 143 Chinese HF patients who attended a specialist clinic from January to September 2007.

Results

The content validity index (CVI) of the EHFScBS (Chinese version) was satisfactory (Item CVI = 0.96; Scale CVI = 0.89), with Cronbach's alpha 0.82. Convergent validity was supported by a moderate relationship, statistical significant with a measure for social support (r = −0.36, p < 0.001). However, the findings did not support the hypothesised three-factor structure of the EHFScBS (Chinese Version). Instead, all items except one fit well a two-factor structure to measure help-seeking and regimen-complying behaviours.

Conclusion

The adequate psychometric properties and clear conceptual structure of EHFScBS (Chinese Version) warrant its use in Chinese patients with HF.     

Psychometric evaluation of the Chinese version of the State Anxiety Scale for Children

The assessment of anxiety in children undergoing surgery must be addressed before any intervention can be appropriately planned, provided, and evaluated. The purpose of this study was to evaluate the psychometric properties of the Chinese version of the State Anxiety Scale for Children. Two hundred and thirty-seven children from a primary school and 112 children admitted for day surgery were recruited for this study. The instrument demonstrated adequate internal-consistency reliability, appropriate concurrent validity, and construct validity. Factor analyses further confirmed the construct validity of the scale, with a good fit between the factor structure of the scale and the observed data. Results suggest that the Chinese version of the State Anxiety Scale for Children can be used as a self-report assessment tool in measuring the anxiety level of Chinese children ages 7-12 years.     

Psychometric evaluation of the Chinese version of the Cornell Scale for Depression in Dementia

Elders with cognitive impairments frequently experience concomitant unidentified depressive symptoms due to an impaired capacity for verbal communication. Therefore, determination of a valid and reliable instrument with which to detect depression in this population requires confirmation through observation. The Cornell Scale for Depression in Dementia (CSDD) has been employed worldwide. However, no formally established psychometric properties have yet been made available for its Chinese version. For this study, we attempted to translate and test the validity and reliability of the CSDD Chinese version (CSDD-C). After completing translation and expert validity, a convenient sample of 145 older adults with dementia was assessed by their caregivers in several care facilities in Southern Taiwan. The CSDD-C was administered to collect data along with the Geriatric Depression Scale short form (GDS-SF). Results found an expert content validity index (CVI) of .92 and concurrent validity between CSDD-C and GDS-SF of .322 (p < .001). The number of factors extracted through our samples is consistent with the original CSDD; inter-rater agreement over a two-week period on each item was significant (Kappa = .43-89); and the Cronbach's alpha for internal consistency reliability was .84. Results indicate the CSDD-C to be a reliable and valid instrument to help Chinese speaking caregivers determine signs and symptoms of depression in elders with dementia under their care.     

Psychometric evaluation of Chinese version of Violence Scale for objective rating among inpatients with schizophrenia

Aim. The psychometric properties of the Chinese version of Violence Scale in clinical service setting were examined. Background. Psychiatric inpatient’s aggressive act is a significant clinical issue in psychiatric service. A useful objective rating scale for prospective study and clinical application was mandatory. Design. A prospective panel study. Methods. The Chinese version of Violence Scale developed from Morrison’s Violence Scale. Sampled patients (n = 107) with schizophrenia spectrum, fulfilling the DSM‐IV criteria, were recruited consecutively in a psychiatric acute ward of a university hospital over a period of one‐year. The patients’ counts of the aggressive acts measured by the Chinese version of Violence Scale occurred in the past one‐month prior to admission and in the prospective initial‐week after admission were collected during their hospitalisation. The prospective occurrence was observed daily and summed at a fixed weekly point. The internal consistency, content validity and predictive validity of the Chinese version of Violence Scale were examined. Also, a confirmatory factors analysis by LISREL was conducted to examine its measurement structure. Results. The Chinese version of Violence Scale follows a Poisson distribution of a fair quality (Cronbach’s α = 0·67). The Chinese version of Violence Scale with panel’s content validity has good predictive validity (r = 0·51, p < 0·001). Those correlated to one latent variable with six items, which constructs a core meaning of ‘threatening aggression toward others’. Conclusions. This panel study provides evidence for fair reliability and satisfactory validity of the Chinese version of Violence Scale. Internal consistency of the Chinese version of Violence Scale is limited and it may be because of the time‐varying characteristic and hierarchical pattern of the behaviour items. To further investigate the count scale of the Chinese version of Violence Scale follows a Poisson distribution, the over‐dispersion and weighting issues of aggressive acts were suggested to approach. Relevance to clinical practice. This study highlights the measurement issues and implications of the Chinese version of Violence Scale for objectively rating psychiatric patients’ aggressive acts to further develop fitted nursing care and prevention program.     

Performance of the Swedish version of the Revised Piper Fatigue Scale

PurposeThe Revised Piper Fatigue scale is one of the most widely used instruments internationally to assess cancer-related fatigue. The aim of the present study was to evaluate selected psychometric properties of a Swedish version of the RPFS (SPFS).MethodsAn earlier translation of the SPFS was further evaluated and developed. The new version was mailed to 300 patients undergoing curative radiotherapy. The internal validity was assessed using Principal Axis Factor Analysis with oblimin rotation and multitrait analysis. External validity was examined in relation to the Multidimensional Fatigue Inventory-20 (MFI-20) and in known-groups analyses.ResultsTotally 196 patients (response rate = 65%) returned evaluable questionnaires. Principal axis factoring analysis yielded three factors (74% of the variance) rather than four as in the original RPFS. Multitrait analyses confirmed the adequacy of scaling assumptions. Known-groups analyses failed to support the discriminative validity. Concurrent validity was satisfactory.ConclusionThe new Swedish version of the RPFS showed good acceptability, reliability and convergent and- discriminant item-scale validity. Our results converge with other international versions of the RPFS in failing to support the four-dimension conceptual model of the instrument. Hence, RPFS suitability for use in international comparisons may be limited which also may have implications for cross-cultural validity of the newly released 12-item version of the RPFS. Further research on the Swedish version should address reasons for high missing rates for certain items in the subscale of affective meaning, further evaluation of the discriminative validity and assessment of its sensitivity in detecting changes over time.     

Psychometric validation of the Chinese version of the Illness Perception Questionnaire‐Revised for patients with hypertension

Title. Psychometric validation of the Chinese version of the Illness Perception Questionnaire‐Revised for patients with hypertension. Aim. This paper is a report of a study to evaluate the psychometric properties of the Chinese version of the Illness Perception Questionnaire‐Revised using the technique of confirmatory factor analysis. Background. The Illness Perception Questionnaire‐Revised is the most commonly used instrument for assessing patients’ views of illness, and there is good evidence for the psychometric properties of the English version. However, there is inconsistency in the literature about how scores of the Illness Perception Questionnaire‐Revised should be used. Method. A cross‐sectional survey was conducted in three teaching hospitals in central Taiwan. The Chinese Illness Perception Questionnaire‐Revised was administered to a purposive sample of 358 patients with hypertension in 2005–2006. Results. Confirmatory factor analysis provided evidence of satisfactory factorial validity, convergent validity and discriminant validity of the Chinese Illness Perception Questionnaire‐Revised. Internal consistency was supported by adequate Cronbach’s alphas (ranging 0·67–0·87) and composite reliability (0·57–0·88). The factor structures of the identity and cause subscales were found to be an acceptable fit to the data. The findings of model evaluations supported the seven‐factor structure, after removal of six poorly fitting items. Second‐order analysis indicated two factors (control and negative illness representation) representing latent constructs underlying the factors of personal control, treatment control, consequence, timeline‐cyclic and emotional representation. Conclusion. The Chinese Illness Perception Questionnaire‐Revised is a reliable and valid instrument for the measurement of illness perceptions in patients with hypertension.     

Psychometric evaluation of the Chinese version of motivation for nursing student scale (MNSS): A quantitative and cross-sectional design

BackgroundAcademic motivation is the psychological factor that promotes learning activities. The persistence of learning activities in nursing education is directly influenced by academic motivation. However, there are currently no specialist instruments for nursing students in China.ObjectiveTo translate the Motivation for nursing student scale (MNSS) into Chinese and evaluate its validity and reliability among nursing students in China.DesignA quantitative and cross-sectional design.SettingThe survey was conducted at a medical university in Jinzhou, China between March and May 2022.ParticipantsA total of 688 Chinese nursing students were surveyed by questionnaire in this study.MethodThe Chinese version of MNSS adopted Brislin's transition model and conducted expert consultations to validate the facial validity and testing of the transition version. Reliability and validity were tested using exploratory factor analysis, confirmatory factor analysis, and internal consistency reliability.ResultsNursing experts confirm the high content validity of the Chinese version of the 20-item scale. An exploratory factorial analysis revealed a four-factor solution, with a total variance of 64.1% and confirmatory factor analysis results showed a satisfactory fit (χ2/df=2.738, RMSEA =0.073, SRMR = 0.0719, CFI = 0.914, IFI = 0.915, NFI =0.872, RFI =0.849,). Cronbach's alpha coefficient for the scale was 0.869, and the split-half reliability is 0.727.ConclusionThe Chinese version of MNSS has satisfactory reliability and validity and is a reliable instrument to assess the academic motivation of Chinese nursing students.     

Psychometric evaluation of multidimensional pain inventory (Swedish version) in a sample of elderly people.

OBJECTIVES: The aim was to psychometrically evaluate the Swedish version of the Multidimensional Pain Inventory (MPI-S) and the "brief screening version of MPI-S" for use in an elderly sample. METHODS: This study comprised 175 people aged 76-99 years reporting pain and in need of help to manage daily living. The instrument's factor structures were investigated through factor analyses, convergent and discriminant validity were assessed through inter-scale correlations and correlations with items from SF-12. Reliability was assessed by Cronbach's alpha. RESULTS: The full-length version of MPI-S did not, in general, show any satisfactory validity and reliability when used among elderly. It had acceptable convergent and discriminant validity, but the factor analysis did not show a good model fit. Low alpha values were found for most of the sub-scales. However, the brief screening version of MPI showed acceptable validity and reliability, except for rather low alpha values in sections 3 and 4. CONCLUSION: The MPI-S instrument may not be very useful for measuring pain among frail elderly. The brief screening version may instead be a better alternative to the full version of the MPI-S. However, the small number of observations may be the reason to the lack of fit, and further studies are warranted.     

Psychometric properties of the Persian version of the parental stress scale: NICU

AimThe aim was to translate the Parental Stressor Scale: Neonatal Intensive Care Unit (PSS: NICU) into the Persian language and to evaluate the psychometric properties of the Persian version.MethodThe PSS: NICU was translated into Persian using the process of forward–backward translation. Thereafter, an internal panel of neonatal nurses (n = 10) assessed face and content validity and a panel of parents (n = 20) assessed content validity. A sample of 260 parents recruited from two different neonatal units completed the PSS: NICU and answered some open-ended questions in which they could comment on language and wording. Psychometric properties including internal consistency, Cronbach's alpha (if item deleted) and corrected item total were evaluated.ResultThe result indicates that the Persian version of PSS: NICU, has acceptable psychometric properties and can be considered in clinical practice in NICUs in Iran.ConclusionIn order to support parents, healthcare providers need to diagnose their sources of stress in the Neonatal Intensive Care Unit. The Persian version of the PSS: NICU can be used for this purpose.     

Psychometric testing of the brief screening version of Multidimensional Pain Inventory (Swedish version)

Background:  The brief screening version of the Multidimensional Pain inventory (MPI) is a shorter version of the West Haven-Yale Multidimensional Pain Inventory that measures pain in a multidimensional way and is theoretically linked to a cognitive-behavioural perspective on chronic pain.
Objectives:  The aim of this study was to psychometrically evaluate the 'brief screening version' of the Multidimensional Pain inventory Swedish version (MPI-S).
Methods:  An age-stratified cross-sectional study, comprising 384 people aged 18–102 years, was carried out in southern Sweden in 2005. Factor analyses were performed to investigate the factor structure of the instrument and inter-correlation between the sub-scales as well as external measures were used to assess convergent and discriminant validity. Reliability was assessed by internal consistency (Cronbach's alpha).
Results:  Mean scores and standard deviations are presented for the total sample as well as for each stratum. The inter-correlations revealed that discriminant validity was not satisfactory in the total sample, although the correlation analysis in each stratum showed acceptable discriminant validity in most age groups. The factor structure was the same as in the MPI-S in all age groups, except for those aged ≥90 years. Reliability tests (Cronbach's alpha) showed alpha values ranging between 0.68 and 0.93.
Conclusion:  The result showed that the instrument had acceptable validity and reliability in all age groups except for those aged ≥90 years. Thus, the instrument can be seen as a useful (multidimensional) form of screening for chronic pain.