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.
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Acknowledgments
The authors are very grateful to the staff, in particular the Nurse Unit Manager Ms. Patsy Thean, at the Masada Private Hospital Mother Baby Unit, Melbourne, Australia.
Ethical standards
Ethics approval was obtained from the Masada Private Hospital Human Research Ethics Committee (Trial 148) and the Monash University Human Research Ethics Committee (Project No. 2012001221). The study was conducted in accordance with the ethical standards laid down in the 1964 Declaration of Helsinki and its later amendments. All persons gave their informed consent prior to inclusion in the study.
Funding
Dr. Irene Bobevski is funded by a National Health and Medical Research Council (NHMRC) Postgraduate Scholarship. Jane Fisher is supporterd by a Monash Professorial Fellowship and the Jean Hailes Professorial Fellowship. Jane Fisher and Dr. Heather Rowe receive a funding from the Australian Government Department of Families, Housing, Community Services and Indigenous Affairs. Dr. Dean McKenzie was funded by a NHMRC Postdoctoral Fellowship. The funding bodies were not involved in any way in data collection, analysis or interpretation of outcomes.
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The authors declare no conflict of interest.
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Bobevski, I., Rowe, H., Clarke, D.M. et al. Postnatal demoralisation among women admitted to a hospital mother-baby unit: validation of a psychometric measure. Arch Womens Ment Health 18, 817–827 (2015). https://doi.org/10.1007/s00737-014-0486-8
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DOI: https://doi.org/10.1007/s00737-014-0486-8