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Development, Psychometric Assessment, and Predictive Validity of the Postpartum Childcare Stress Checklist

Dennis, Cindy-Lee; Brown, Hilary K.; Brennenstuhl, Sarah

doi: 10.1097/NNR.0000000000000308

Background Childcare stress has been shown to predict postpartum depression; however, there is little research exploring and validating the dimensions of childcare stress instruments such that preventive interventions can be created.

Objectives The aim of this study was to develop and psychometrically test an instrument to measure parental perceptions of postpartum childcare stress.

Methods Using research based on postpartum stress and childcare stress, the Postpartum Childcare Stress Checklist (PCSC) was developed, and content validity was judged by experts. The PCSC was psychometrically assessed in a cohort of 541 women in a health region near Vancouver, Canada, who were followed to 8 weeks postpartum in 2002. The psychometric assessment analyses comprised internal consistency, exploratory factory analysis, concurrent validity, and predictive validity.

Results The 19-item PCSC had good internal consistency (Kuder–Richardson Formula 20 coefficient: 0.81). Exploratory factor analysis revealed the following dimensions: (a) relationship with the partner, (b) caring for the infant, (c) maternal social interactions, and (d) establishing a new routine. Predictive validity analyses showed that PCSC total and subscale scores at 4 weeks were positively correlated with depressive symptomatology, anxiety, and perceived stress and negatively correlated with global and partner support at 8 weeks postpartum.

Discussion The PCSC is a measure of childcare stress with excellent reliability and validity. Upon further testing, it may be used to identify women and couples in need of greater support, individualize postpartum care, and evaluate the effectiveness of preventive interventions.

Cindy-Lee Dennis, PhD, is Professor, Lawrence S. Bloomberg Faculty of Nursing and Department of Psychiatry, University of Toronto, and Li Ka Shing Knowledge Institute, St. Michael’s Hospital, Toronto, Canada.

Hilary K. Brown, PhD, is Assistant Professor, Interdisciplinary Centre for Health & Society, University of Toronto Scarborough; Dalla Lana School of Public Health and Department of Psychiatry, University of Toronto; and Women’s College Research Institute, Women’s College Hospital, Toronto, Canada.

Sarah Brennenstuhl, PhD, is Research Data Analyst, Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Canada.

Accepted for publication April 25, 2018

Ethics approval for this study was obtained from the university research ethics board and study authorization was granted by the health region.

The authors have no conflicts of interest to report.

Corresponding author: Cindy-Lee Dennis, PhD, Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, 155 College Street, Toronto, Ontario M5T 1P8, Canada (e-mail:

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