Main findings
To the best of the knowledge of the authors, the Maternal Emotional Well-Being Scale is the first scale with demonstrated validity and reliability that was developed to assess the emotional well-being of mothers within a theoretical framework. According to the results of this study, the Maternal Emotional Well-Being Scale was valid and reliable in terms of its usage in mothers who are ready to be discharged in the postpartum period. Its final form consists of 15 items, and higher scores indicate better emotional well-being.
The factor analyses of the Maternal Emotional Well-Being Scale revealed a 3-factor construct that included 15 items. The deck-chair theory proposed by Jean Ball was beneficial for the development of this scale. According to this theory, the emotional well-being of a mother is influenced by her personality and experiences, the social support she receives, and the healthcare services provided to her. By examining the components forming the structure of the identified factors in this context, the factors were named ”healthcare and education”, ”social support”, and ”mother’s personality and experiences”. The relevant literature was also reviewed in this process. In the literature, other studies in the context of Ball’s deck-chair theory also focused on the mother’s personality and experiences, social support, and healthcare. These factors were reported to affect the well-being of mothers.12,18 The emotional well-being of a mother is an issue that needs to be evaluated in the context of her motherhood. The scale that was developed in this study consists of items relevant to the emotional well-being of mothers. Positive responses of mothers to these items indicate a high level of emotional well-being. The emotional well-being of a mother is very important for the care and development of her baby. A negative emotional state will affect mother-infant bonding, communication, breastfeeding, baby care, and the development of the baby negatively. Considering the problems that can be encountered in the postpartum period, it is crucially important to prevent complications, improve health, and provide the mother with the necessary advice in terms of maternal and neonatal health, and important responsibilities fall upon healthcare professionals in this vital process.11,37,38 According to the deck-chair theory, the emotional well-being of a mother can be ensured if a shortcoming in one factor is balanced with the reinforcement of another factor. In this sense, negative personality traits and experiences of the mother and insufficient social support can be compensated by postpartum healthcare, and this will be effective in ensuring the comfort of the mother and her emotional response to postpartum changes.8,14Therefore, for the promotion of public health, it is important to determine the emotional well-being levels of mothers before they are discharged after childbirth and implement interventions if necessary. The formation of the item pool in this study based on these factors in the theory of Ball indicates that the scale is suitable for this theoretical framework and can guide healthcare professionals in the identification of the needs of mothers.
The homogeneity of the responses of the participants to all items was analyzed based on Hotelling’s T², and it was found that the participants responded to the items based on their own opinions, and there was no response bias (p=0.000).31,32,33 Additionally, the results of the Tukey’s test of additivity showed that a single total scale score could be obtained by the addition of the scores of all scale items (p=0.000).31
In this study, the overall Cronbach’s alpha (α) coefficient of the scale was found to be 0.860, which indicated its high reliability. Considering the psychometric properties of the Maternal Emotional Well-Being Scale, which was developed in Turkish, all results obtained in this study provided supportive evidence of the validity and reliability of the scale construct. It can be concluded that this scale is a valid and reliable measurement instrument that can be used by healthcare professionals providing care services to mothers in the postpartum period to assess the emotional well-being levels of these mothers.