title: Postnatal demoralisation among women admitted to a hospital mother-baby unit: validation of a psychometric measure.
abstract: Demoralisation is a psychological state characterised by experiences of distress and sadness, helplessness, subjective incompetence and hopelessness, in the context of a stressful situation. Experiences of demoralisation may be particularly relevant to women who have recently given birth, who can feel incompetent, isolated and helpless. The psychometric properties of the Demoralisation Scale among women in the postnatal period participating in a clinical program were examined. Women admitted with their infants to a hospital mother-baby unit in Australia for five nights were recruited consecutively (N = 209) and assessed at admission and discharge. The Demoralisation Scale was perceived as relevant and exhibited high reliability, acceptable construct validity and good sensitivity to change. The mean demoralisation score was high (M = 30.9, SD = 15.5) and associated with negative experiences of motherhood and functional impairment, independent of depression and anxiety symptoms. Mean demoralisation decreased significantly after program completion (M = 18.4, SD = 12.4). More participants showed a significant improvement in demoralisation (57.5 %) than in depression (34.8 %) and anxiety (9.8 %) symptoms. Demoralisation can provide a useful framework for understanding and measuring the experiences of women participating in postnatal clinical programs and in directing treatment towards helping women to acquire the necessary caregiving skills and increasing parental efficacy. The Demoralisation Scale is a useful clinical tool for assessing intervention effects.
authors.affiliation: Jean Hailes Research Unit, School of Public Health and Preventive Medicine, Monash University, 6th Floor, Alfred Centre, 99 Commercial Road, Prahran, Melbourne, Victoria, 3004, Australia. irene.bobevski@monash.edu.|Department of Psychiatry, Southern Clinical School, Monash University, Melbourne, Australia. irene.bobevski@monash.edu.
authors.forename: I
authors.initials: I
authors.lastname: Bobevski
authors.affiliation: Jean Hailes Research Unit, School of Public Health and Preventive Medicine, Monash University, 6th Floor, Alfred Centre, 99 Commercial Road, Prahran, Melbourne, Victoria, 3004, Australia.
authors.forename: H
authors.initials: H
authors.lastname: Rowe
authors.affiliation: Department of Psychiatry, Southern Clinical School, Monash University, Melbourne, Australia.
authors.forename: D M
authors.initials: DM
authors.lastname: Clarke
authors.affiliation: Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia.
authors.forename: D P
authors.initials: DP
authors.lastname: McKenzie
authors.affiliation: Jean Hailes Research Unit, School of Public Health and Preventive Medicine, Monash University, 6th Floor, Alfred Centre, 99 Commercial Road, Prahran, Melbourne, Victoria, 3004, Australia.
authors.forename: J
authors.initials: J
authors.lastname: Fisher
mesh_terms: D000328:Adult; D001007:Anxiety; D001315:Australia; D003863:Depression / Q000175:diagnosis* / Q000523:psychology; D019052:Depression, Postpartum / Q000175:diagnosis* / Q000523:psychology; D005260:Female; D006760:Hospitalization; D006801:Humans; D009013:Morale; D009035:Mothers / Q000523:psychology*; D049590:Postpartum Period; D011569:Psychiatric Status Rating Scales / Q000592:standards*; D011594:Psychometrics / Q000295:instrumentation* / Q000706:statistics & numerical data; D015203:Reproducibility of Results; D013315:Stress, Psychological / Q000175:diagnosis* / Q000209:etiology / Q000523:psychology; D011795:Surveys and Questionnaires; D055815:Young Adult
keywords: Demoralisation; Early parenting; Mother-baby units; Postnatal mental health