Measuring postnatal demoralisation: adaptation of the Demoralisation Scale-II (DS-II) for postnatal use

ABSTRACT

Objective: To examine the psychometric properties of the Demoralisation Scale II (DS-II) and adapt it for use with women in the postnatal period.

Background: Demoralisation is a psychological state characterised by a sense of incompetence and feelings of helplessness and hopelessness in response to a stressful situation. The postnatal period is a life stage of many disruptions. Women may lose their confidence and become demoralised if feeling unprepared for the tasks of motherhood. The DS-II is a 16-item scale developed among cancer patients, but with content that is also relevant postnatally, including items on sense of failure, helplessness, hopelessness, isolation, entrapment and loss of purpose.

Methods: Rasch analysis was used to investigate the psychometric properties of the DS-II and refine the scale for postnatal use.

Results: Participants were 209 women admitted with their babies to a residential early parenting programme. A 14-item revised scale was derived, the Postnatal DS-II, showing good psychometric properties, discriminant validity and sensitivity to change, and being well targeted to the sample.

Conclusion: The Postnatal DS-II could have utility as an assessment tool, helping clinicians to understand better women’s postnatal experiences, assess the effectiveness of interventions and communicate with women in a meaningful and non-stigmatising way.

KEYWORDS:

• Demoralisation
• postpartum period
• mental health
• women
• parenting
• psychometrics

Acknowledgements

The authors are very grateful to the staff, in particular Nurse Unit Manager Ms Patsy Thean, at the Masada Private Hospital Mother Baby Unit, Melbourne, Australia.

Disclosure statement

No potential conflict of interest was reported by the authors.

Additional information

Funding

Dr Irene Bobevski was supported by a National Health and Medical Research Council (NHMRC) Postgraduate Scholarship, grant number 1039396. Professor Jane Fisher is supported by a Monash Professorial Fellowship and the Jean Hailes Professorial Fellowship. The funding bodies were not involved in any way in any aspects of this study; National Health and Medical Research Council [1039396].