Creating the Capacity to Screen Deaf Women for Perinatal Depression: A Pilot Study.
Melissa L Anderson, Kelly S Wolf Craig, Sheri Hostovsky and 5 others
PMID 33166783WHAT IT FOUND
No measured background factor clearly predicted depression screening scores in Deaf perinatal women, although racial or ethnic minority status came closest.
The sign-language screening tool may be usable as a whole, but its anxiety and depression subscales did not meet the study's standard.
Key findings
01No measured background factor reached significance as a predictor of ASL EPDS total score, although racial or ethnic minority status approached significance (Mann-Whitney U = 94.5, p = .142).
02The full ASL EPDS showed acceptable internal consistency (alpha = 0.788), but the anxiety and depression subscales did not (alpha = 0.435 and alpha = 0.678).
03Participants' mean ASL EPDS total score was 5.6 out of 30, total scores ranged from 0 to 17, and no participant reported a score in the severe depression range.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
The sample was small, and depression scores had a restricted range, with no participant in the severe range, so it cannot show how the tool performs in sicker or more distressed women. Recruitment used flyers, vlogs, social media, and Deaf service agencies, which may have missed women with severe depression or weaker community connection. The live videophone interview may have reduced disclosure because participants could feel shame or fear of being judged. The study did not compare ASL EPDS scores with another ASL-accessible mental health measure or clinical diagnosis, so validity was not shown. Only 13 of 36 interviews were checked for fidelity, and one had very low fidelity because the participant could not use the Likert response options. The anxiety and depression subscales did not meet the pre-set threshold, so they should not be used as separate screens. Removing two high scores lowered the full-scale alpha from 0.788 to 0.690. The reliability estimate may be sensitive to score range. The sample was too small for factor analysis, so the study could not confirm how the EPDS items group in ASL.
Declared interests
The authors declared no conflicts of interest.
The easy way to misread this
Do not treat the ASL EPDS as validated or ready for routine clinical use. The pilot was small, the anxiety and depression subscales did not meet the study's reliability threshold, and no participant scored in the severe range.