Department of Social Medicine and Health Management, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, No.13 Hangkong Road, 430030, Wuhan, P. R. China.
Department of Child Heath Care, Hainan Women and Children's Medical Center, NO.15 South of Longkun Road, Haikou, P.R. China.
BMC Psychiatry. 2022 Aug 4;22(1):526. doi: 10.1186/s12888-022-04161-1.
Maternal anxiety induced by neonatal jaundice has adverse effects on maternal and infant health, but there was no specific tool to identify the anxiety level of mothers. This study aims to develop a Maternal Anxiety for Neonatal Jaundice Scale (MANJS) and to validate it in the target population.
An initial 11-items MANJS was developed through literature review, expert panel consultation, and a pilot-test. Subsequently, mothers of neonates with jaundice were recruited from the Maternal and Child Health Hospital of Hainan Province, China, from June to December 2018, for a formal questionnaire survey. Based on the data collected, the scale was validated for construct validity, convergent validity, discriminant validity, content validity, and internal consistency reliability after the items screening.
The reliability and validity of MANJS were validated in 1127 mothers of jaundiced neonates. After the item with cross-loadings was removed using exploratory factor analysis, MANJS consisted of two dimensions and 10 items, with a cumulative variance contribution of 74.36% and factor loadings above 0.6 for all items. The confirmatory factor analysis identified three items with cross-factor loading or error correlation and then they were removed orderly. The further confirmatory factor analysis showed a good construct validity for the 7-item MANJS, with standardized root mean square residual (SRMR) = 0.029, root mean square error of approximation (RMSEA) = 0.068, comparative fit index (CFI) = 0.961, Tucker-Lewis index (TLI) = 0.937, incremental fit index (IFI) = 0.961, normed fit index (NFI) = 0.954, goodness of fit index (GFI) = 0.998, adjusted goodness of fit index (AGFI) = 0.996, respectively. The average variance extracted values (AVE) of the two factors were 0.80 and 0.72, and the combined reliability (CR) were 0.94 and 0.88, respectively. Cronbach's alpha was 0.90 for the MANJS, and split-half reliability was 0.72.
MANJS was demonstrated to have satisfactory reliability and validity in evaluating maternal anxiety caused by neonatal jaundice among Chinese postpartum women.
新生儿黄疸引起的产妇焦虑对母婴健康有不良影响，但目前尚无专门的工具来识别产妇的焦虑水平。本研究旨在开发一种新生儿黄疸产妇焦虑量表（Maternal Anxiety for Neonatal Jaundice Scale，MANJS），并在目标人群中对其进行验证。
通过文献回顾、专家小组咨询和试点测试，初步制定了包含 11 个条目的 MANJS。随后，于 2018 年 6 月至 12 月，从海南省妇幼保健院招募了患有黄疸的新生儿的母亲，对其进行正式的问卷调查。根据收集到的数据，在条目筛选后，对量表进行了结构效度、收敛效度、判别效度、内容效度和内部一致性信度的验证。
对 1127 例患有黄疸的新生儿的母亲进行了 MANJS 的信度和效度验证。使用探索性因子分析去除具有交叉负荷的条目后，MANJS 由两个维度和 10 个条目组成，累积方差贡献率为 74.36%，所有条目的因子负荷均大于 0.6。验证性因子分析确定了三个具有交叉因子负荷或误差相关性的条目，然后依次将其删除。进一步的验证性因子分析表明，7 条目 MANJS 具有良好的结构效度，标准化残差均方根（SRMR）=0.029，近似均方误差（RMSEA）=0.068，比较拟合指数（CFI）=0.961，Tucker-Lewis 指数（TLI）=0.937，增量拟合指数（IFI）=0.961，归一化拟合指数（NFI）=0.954，拟合优度指数（GFI）=0.998，调整拟合优度指数（AGFI）=0.996。两个因子的平均方差提取值（AVE）分别为 0.80 和 0.72，组合信度（CR）分别为 0.94 和 0.88。MANJS 的克朗巴赫 α 系数为 0.90，分半信度为 0.72。
MANJS 在中国产后妇女中评估新生儿黄疸引起的产妇焦虑具有良好的信度和效度。
