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| Reliability and validity of Chinese version of Maternal Blue Scale |
| WANG Wei1, LI Zhihui2, KONG Yan2, YU Guiling2
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1. School of Nursing, Qingdao University, Qingdao, Shandong 266021, China;
2. Qingdao Women and Children's Hospital, Qingdao, Shandong 266034, China |
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Abstract Objective To translate the Maternal Blue Scale (MBS) into Chinese, and evaluate the reliability and validity. Methods The MBS was translated back-translated, culturally adapted and pre-tested according to the Brislin translation model to develop the Chinese version of MBS. Postpartum women from obstetrics centers in three tertiary general hospitals in Shandong Province were selected using convenience sampling method to assess the reliability and validity of the Chinese version of MBS. Content validity was evaluated based on expert ratings. Criterion-related validity was evaluated using the Chinese version of the Edinburgh Postnatal Depression Scale (EPDS) as the criterion. Structural validity was evaluated using exploratory and confirmatory factor analyses. Reliability was assessed by calculating Cronbach's α and split-half reliability. Receiver operating characteristic (ROC) curve was plotted to evaluate predictive validity. Results Totally 500 questionnaires were allocated, and 479 valid ones were recovered, with an effective recovery rate of 95.80%. The Chinese version of MBS consisted of 32 items across 6 dimensions: mother-infant communication, infant feeding, role adaptation, maternal responsibilities, family acceptance and social support. The item-level content validity index ranged from 0.900 to 1.000, and the scale-level content validity index/average was 0.990. The correlation coefficient between the Chinese version of MBS scores and the Chinese version of EPDS scores was 0.675 (P<0.05). Exploratory factor analysis extracted 6 common factors, with a cumulative variance contribution rate of 74.581%. Confirmatory factor analysis indicated good model fit, with a root mean square error of approximation of 0.014, a goodness of fit index of 0.896, a comparative fit index of 0.996, an incremental fit index of 0.996, a normed fit index of 0.913, and a Tucker-Lewis index of 0.995. The overall Cronbach's α was 0.924, and the split-half reliability was 0.765. The Cronbach's α of each dimension ranged from 0.809 to 0.956, and the split-half reliability ranged from 0.807 to 0.966. The area under the ROC curve was 0.909 (95%CI: 0.880-0.937). At the optimal cutoff score of 75.5, the Youden index reached its maximum of 0.698, with a sensitivity of 0.874 and a specificity of 0.824. Conclusion The Chinese version of MBS has good reliability and validity, and it is suitable to evaluate maternal blue among Chinese postpartum women.
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Received: 05 August 2024
Revised: 07 November 2024
Published: 13 December 2024
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