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The general health questionnaire as a measure of emotional wellbeing in pregnant women

Yvonne Kuipers (Faculty of Medicine and Health Sciences, University of Antwerp, Wilrijk, Belgium) (University of Hull, Kingston upon Hull, UK)
Julie Jomeen (University of Hull, Kingston upon Hull, UK)
Tinne Dilles (Faculty of Medicine and Health Sciences, University of Antwerp, Wilrijk, Belgium)
Bart Van Rompaey (Faculty of Medicine and Health Sciences, University of Antwerp, Wilrijk, Belgium)

The Journal of Mental Health Training, Education and Practice

ISSN: 1755-6228

Article publication date: 18 September 2019

Issue publication date: 16 October 2019

201

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; p=<0.001) and external validity (r=0.57; p=<0.001) 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

Acknowledgements

This research did not receive any specific grant from funding agencies in the public, commercial or not-for-profit sectors.

Citation

Kuipers, Y., Jomeen, J., Dilles, T. and Van Rompaey, B. (2019), "The general health questionnaire as a measure of emotional wellbeing in pregnant women", The Journal of Mental Health Training, Education and Practice, Vol. 14 No. 6, pp. 447-456. https://doi.org/10.1108/JMHTEP-05-2019-0028

Publisher

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Emerald Publishing Limited

Copyright © 2019, Emerald Publishing Limited

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