Abstract

Background: The Center for Epidemiologic Studies Depression (CESD) scale, which includes both somatic and psychosocial measurements, has been widely used to measure depression; however, its use in measuring postpartum depression was limited. The purpose of the study was to test reliability and validity of the Chinese CESD when used on Chinese postpartum mothers. Dimension of depressive symptoms of Chinese postpartum mothers was analyzed as well.

Methods: The study used a cross-sectional correlational design and included a pilot and a main study. Thirty Chinese postpartum mothers participated in the pilot study, which tested the readability and content validity of the Chinese CESD. Data from 120 Chinese postpartum mothers living in the United States were analyzed in the main study. Most mothers were homemakers, highly educated, primiparous, and gave birth vaginally. Instruments used included the Chinese CESD, mentally unhealthy days, and postpartum feelings. Cronbach's alpha, Pearson correlation, and confirmatory factor analysis were applied to test the reliability and validity of the Chinese CESD.

Results: Cronbach’s alpha for the Chinese CESD was .89. The convergent and divergent validities of the Chinese CESD were supported. Confirmatory factor analysis showed a three-factor model (Somatic Symptoms/Depressed Affect, Positive Affect, and Interpersonal Problems/Depressed) fit better with the data. The three factors correlated with each other (r ranged from .59 to .71).

Conclusion: The Chinese CESD was a reliable and valid instrument for measuring depressive symptoms in Chinese postpartum mothers. Instead of reporting depressed affect, Chinese mothers tend to report physical and interpersonal problems. Healthcare professionals taking care of Chinese postpartum mothers are suggested to assess their common physical conditions as well. Future studies are recommended to include larger samples and focus on relationships between physical symptoms and depression. Comparisons of models for postpartum depression among mothers of diverse ethnicities can increase our knowledge about postpartum depression.