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.