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Development and psychometric validation of the perinatal depression help-seeking intention (PNDHSI) scale
Qianqian Zhao1, Liangzhentian Yu2, Zhou Pei3
1School of Nursing, Southern Medical University, Guangzhou, 510515, China.
Background:
Perinatal depression affects maternal and infant well-being, yet many women do not seek help. Existing measures focus on attitudes towards professional help or were developed for general populations, leaving perinatal-specific help-seeking intention insufficiently assessed.
Objective:
To develop and psychometrically validate a scale based on the Theory of Planned Behavior (TPB) for assessing help-seeking intention (HSI) related to perinatal depressive symptoms.
Methods:
A literature review and the TPB informed the initial item pool. Two Delphi rounds with 19 experts assessed content validity and guided item revisions. A convenience sample of 592 perinatal women from three tertiary hospitals in Guangdong Province, China, was randomly split for exploratory factor analysis (EFA, n = 304) and confirmatory factor analysis (CFA, n = 288).
Results:
The Perinatal Depression Help-Seeking Intention (PNDHSI) scale comprised 22 items measuring four TPB constructs: six assessing attitudes toward seeking help (ATS), eight assessing subjective norms (SN), five assessing perceived behavioral control (PBC), and three assessing HSI. Within SN, each normative-belief item was multiplied by its matching motivation-to-comply item, giving four product indicators and an 18-indicator measurement model. EFA supported a four-factor structure, confirmed by CFA (CFI = 0.959, TLI = 0.952, RMSEA = 0.065, SRMR = 0.047). Convergent and discriminant validity were satisfactory, as were internal consistency (Cronbach's α 0.807-0.953) and two-week test-retest reliability (ICC 0.719-0.918). In the structural model, ATS and PBC were directly associated with HSI (β = 0.431 and 0.434, respectively), whereas the direct path from SN was not significant. A mediation model showed an indirect association of SN with HSI through ATS and PBC (total indirect β = 0.392).
Conclusions:
The PNDHSI scale demonstrated satisfactory psychometric properties for assessing HSI and related TPB constructs among perinatal women. The associations suggest that ATS and PBC warrant consideration in future intervention research. Predictive validity for actual help-seeking and cut-offs for individual clinical assessment remain to be established.
