The Research Journey for the Development of the Hung Postpartum Stress Scale

Tuesday, 23 July 2013: 1:30 PM

Chich-Hsiu Hung, PhD, RN
School of Nursing, Kaohsiung Medical University, Kaohsiung City, Taiwan

Learning Objective 1: The learner will be able to explain the defining attributes for the concept of Postpartum Stress.

Learning Objective 2: The learner will be able to describe the conceptual and operational definitions for the concept of Postpartum Stress.

Purpose: Existing measures of general stress, which have also been used to assess postpartum stress, fail to measure women’s specific childbearing stressors during the postpartum period.  The purpose of the this study was to evaluate two studies for testing and validating the Hung Postpartum Stress Scale based on an early concept analysis.

Methods: The concept of postpartum stress was analyzed in early stage using a concept analysis strategy proposed by Walker and Avant. Then the first version of the Hung Postpartum Stress Scale was developed with a total of 861 low-risk postpartum women who had given birth to a single, healthy, and full-term baby without complications; had no major postnatal complications or underlying medical problems; were married Taiwanese residents; and could speak Mandarin Chinese. Then the first version of the Hung Postpartum Stress Scale was revalidated to the second version by expanding the contexts to cover all postpartum women regardless of low- or high-risk status. A total of 859 postpartum women, who could speak Mandarin Chinese and read Chinese, and whose newborn baby was alive, were recruited with proportional stratified quota sampling by birth rate from 11 hospitals and 7 clinics in the Kaohsiung area of southern Taiwan. According to the concept analysis and the two studies, the construct validity and reliability was examined.

Results: With exploratory factor analysis, three attributes for postpartum stress were identified in both low- and high-risk postpartum women,  including concerns about negative body changes, concerns about maternal role attainment, and concerns about lack of social support. Its generality, internal consistency, and readability were also high enough in the two studies.

Conclusion:  Nursing interventions can be tailored to address the items on the Hung Postpartum Stress Scale that postpartum women indicate to be the most stressful. Additional research is recommended using confirmatory factor analysis to determine the stability of the factor structure identified in the studies regardless of high- or low-risk postpartum women.