The general health questionnaire as a measure of emotional wellbeing in pregnant women
| Published date | 24 October 2019 |
| Date | 24 October 2019 |
| Pages | 447-456 |
| DOI | https://doi.org/10.1108/JMHTEP-05-2019-0028 |
| Author | Yvonne Kuipers,Julie Jomeen,Tinne Dilles,Bart Van Rompaey |
| Subject Matter | Health & social care,Mental health,Mental health education |
The general health questionnaire as a
measure of emotional wellbeing in
pregnant women
Yvonne Kuipers, Julie Jomeen, Tinne Dilles and Bart Van Rompaey
Abstract
Purpose –The purpose of this paper is to measure reliability, validity and accuracy of the 12-item General
Health Questionnaire (GHQ-12) as a measure of emotional wellbeing in pregnant women; utility and threshold
in particular.
Design/methodology/approach –The authors measured self-reported emotional wellbeing responses of
164 low-risk pregnant Dutch women with the GHQ-12 and a dichotomous case-finding item (Gold standard).
The authors established internal consistency of the 12 GHQ-items (Cronbach’s coefficient α); construct
validity: factor analysis using Oblimin rotation; convergent validity (Pearson’s correlation) and discriminatory
ability (area under the receiver operating characteristics curve and index of union); and external validity of the
dichotomous criterion standard against the GHQ-12 responses (sensitivity, specificity, likelihood ratios and
predictive values), applying a cut-off value of ⩾12 and ⩾17, respectively.
Findings –A coefficient of 0.85 showed construct reliability. The GHQ-12 items in the pattern matrix showed
a three-dimensional factorial model: factor 1, anxiety and depression; factor 2, coping; and factor 3,
significance/effect on life, with a total variance of 59 per cent. The GHQ-12 showed good accuracy (0.84;
p¼o0.001) and external validity (r ¼0.57; p ¼o0.001) when the cut-off value was set at the ⩾17 value.
Using a cut-off value of ⩾17 demonstrated higher sensitivity (72.32 vs 41.07 per cent) but lower specificity
(32.69 vs 55.77 per cent) compared to the commonly used cut-off value of ⩾12.
Research limitations/implications –Findings generally support the reliability, validity and accuracy of the
Dutch version of the GHQ-12. Further evaluation of the measure, at more than one timepoint during
pregnancy, is recommended.
Practical implications –The GHQ-12 holds the potential to measure antenatal emotional wellbeing and
women’s emotional responses and coping mechanisms with reduced antenatal emotional wellbeing.
Social implications –Adapting the GHQ-12 cut-off value enables effective identification of reduced
emotional wellbeing to provide adequate care and allows potential reduction of anxiety among healthy
pregnant women who are incorrectly screened as positive.
Originality/value –A novel aspect is adapting the threshold of the GHQ-12 to ⩾17 in antenatal care.
Keywords GHQ-12, Emotional wellbeing, Pregnancy, Psychometric, Factor-analysis, Validation
Paper type Research paper
Introduction
Although pregnancy is primarily thought of as a physiological process –its life-altering aspects
together with the social, physical and emotional changes and challenges associated with being
pregnant and becoming a mother –mark it as a dynamic psychological process ( Jomeen and
Martin, 2008). It is therefore no surprise that women’s emotional wellbeing can be affected during
pregnancy (Martin and Jomeen, 2003; Magill-Cuerden, 2006). Maternal emotional wellbeing is
described as a good or satisfactory sense of welfare, health and happiness (Ridner, 2004).
Antenatal emotional wellbeing has been described as a complex construct of psychological
mood states such as depression, anxiety, stress, fear and worry –being either pregnant or
non-pregnant originated –often co-occurring and being inter-related during the antenatal period
Received 31 May 2019
Revised 7 August 2019
Accepted 7 August 2019
This research did not receive any
specific grant from funding
agencies in the public, commercial
or not-for-profit sectors.
Yvonne Kuipers is based at
Faculty of Medicine and Health
Sciences, University of
Antwerp, Wilrijk, Belgium and
University of Hull, Kingston
upon Hull, UK.
Julie Jomeen is based at the
University of Hull, Kingston
upon Hull, UK.
Tinne Dilles and
Bart Van Rompaey are both
based at Faculty of Medicine
and Health Sciences, University
of Antwerp, Wilrijk, Belgium.
DOI 10.1108/JMHTEP-05-2019-0028 VOL. 14 NO. 6 2019, pp. 447-456, © Emerald Publishing Limited, ISSN 1755-6228
j
THE JOURNAL OF MENTALHEALTH TRAINING, EDUCATION AND PRACTICE
j
PAGE447
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