RESUMO
The Malay version of the Medical Outcome Study (MOS) Social Support Survey was validated among a sample of postpartum Malay women attending selected health centers in Kedah, North West of Peninsular Malaysia. 215 women between 4 to 12 weeks postpartum were recruited for the validation study. They were given questionnaires on socio-demography, the Malay-versions of the MOS Social Support Survey, Edinburgh Postnatal Depression Scale (EPDS) and the 21-items Beck Depression Inventory-II (BDI-II). 30 of the women, who were bilingual, were also given the original English version of the instrument. A week later, these women were again given the Malay version of the MOS Social Support Survey. The scale displayed good internal consistency (Cronbach's alpha = 0.93), parallel form reliability (0.98) and test-retest reliability (0.97) (Spearman's rho; p<0.01). The negative correlations of the overall support index (total social support measure) with the Malay versions of EPDS and BDI-II confirmed its validity. Extraction method of the 19 items (item 2 to item 20) from the MOS Social Support Survey using principle axis factoring with direct oblimin rotation converged into 3 dimensions of functional social support (informational, affectionate / positive social interaction and instrumental support) with reliability coefficients of 0.91, 0.83 and 0.75 respectively. The overall support index also displayed low but significant correlations with item 1 which represents a single measure of structural social support in the instrument (p <0.01). The Malay version of the MOS Social Support Survey demonstrated good psychometric properties in measuring social support among a sample of Malay postpartum Malay women attending selected health centers in Kedah, North West of Peninsular Malaysia and it could be used as a simple instrument in primary care settings.
RESUMO
AIM: To reevaluate the psychometric characteristics of the Malay version of the Edinburgh Postnatal Depression Scale among a sample of postpartum Malay women attending the Bakar Bata Health Center in Alor Setar, Kedah, North West of Peninsular Malaysia. MATERIALS AND METHODS: 64 women between 4 to 12 weeks postpartum were recruited for there validation study. They were given questionnaires on socio-demography, the 21-item Malay version of the Beck Depression Inventory II (BDI-II) and the 10-item Malay version of the Edinburgh Postnatal Depression Scale (EPDS). All the participants were later interviewed using the Hamilton Depression Rating Scale (HDRS-17) and the Composite International Diagnostic Interview (CIDI). All diagnoses were made based on the Tenth Edition of the International Classification of Diseases (ICD-10) RESULTS: 9 women (14.1%) were diagnosed to have significant depression (7 mild depressive episodes and 2 moderate depressive episodes according to ICD-10). EPDS was found to have good internal consistency (Cronbach alpha =0.86) and split half reliability (Spearman split half coefficient = 0.83). The instrument also showed satisfactory discriminant and concurrent validity as evidenced by the statistically significant difference in EPDS scores between the depressed group and their non-depressed counterparts (Mann Whitney U test: 2 tailed p value < 0.01) and good correlations between the instrument and both the Malay version of BDI-II and the HRDS-17 (Spearman rank correlation coefficients of 0.78 and 0.88 respectively). At the 11/12 cut-off score the sensitivity of the EPDS is 100%, with a specificity of 98.18%, positive predictive value of 90%, negative predictive value of 100 % and misclassification rate of 1.56%. CONCLUSION: This study confirmed the reliability and validity of the Malay version of the Edinburgh Postnatal Depression Scale in identifying postpartum depression among recently delivered Malay women attending the Bata Bata Health Center in Alor Setar, Kedah, North West of Peninsular Malaysia.
