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

J Reprod Infant Psychol. 2018 Nov;36(5):561-577. doi: 10.1080/02646838.2018.1519781. Epub 2018 Sep 25.

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; mental health; parenting; postpartum period; psychometrics; women.

MeSH terms

  • Adaptation, Psychological*
  • Adult
  • Female
  • Humans
  • Infant
  • Mothers / psychology
  • Parenting / psychology*
  • Postpartum Period*
  • Psychometrics*
  • Reproducibility of Results
  • Self Concept
  • Stress, Psychological / diagnosis
  • Stress, Psychological / epidemiology*
  • Stress, Psychological / etiology
  • Surveys and Questionnaires*