Paper
Saturday, July 24, 2004
Measurement of Prenatal Depression: Issues and Solutions
Kathie Records, RN, PhD, Washington State University College of Nursing, Spokane, WA, USA and Michael Rice, PhD, ARNP, BC, Washington State University College Of Nursing, Spokane, WA, USA.
| Learning Objective #1: State two reasons current depression screening tools are inaccurate during the prenatal period |
| Learning Objective #2: Identify modifications needed to effectively screen for prenatal depression
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Objective: Prenatal depression has become a focus of investigations after a 2001 Rand study identified a 29% prevalence rate. Despite significant sequelae to prenatal depression, measurement indices may not be as well developed for use during the prenatal period as they are for the postpartum or non-childbearing periods. The purpose of this presentation is to examine the empirical use of the Centers for Epidemiologic Depressed Mood Scale during the third trimester of pregnancy. Design: Data for the current presentation comes from a larger NINR-funded longitudinal study of childbearing health. Selye’s stress response theory guides the study. Population, Sample, Setting: Women in their third trimester of pregnancy were eligible to participate in the study. There were no exclusion criteria, beyond an ability to speak and read English. The sample consisted of 139 women recruited from care provider’s offices. Concept or Variables Studied Together: The main variable of interest was prenatal depression as measured by the CES-D. Methods: Subjects completed the CES-D and demographic data after informed consent was obtained. An evaluation of high response items was conducted using principle components factor analysis for construct validity. Findings: Prior to instrument analysis, 70% of the sample screened positive for prenatal depression using the CES-D. Prenatal depression prevalence after pregnancy adjustments were completed was 32% using 6 key items. Conclusions: Over-estimation of the prevalence of prenatal depression can occur with current depression screening. The lack of a clear delineation between depression symptoms and late pregnancy symptoms can also result in women not being diagnosed for depression. Implications: Findings are significant to the community of obstetrical care providers. Current depression screening instruments provide an inaccurate representation of depression during pregnancy. Health care providers and researchers must work together to develop clinically relevant tools so the health of childbearing women and their newborns can be optimized.
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Sigma Theta Tau International
July 22-24, 2004