INTRODUCTION
Depression and depression are examples of mental disorders that are usually common in women. Women usually find it difficult to balance between home duties and work. They are conditions common in developing countries where women earn low income, are exposed to health risks, and undergo domestic violence. Through advancement in technology, there are new diagnostic tools that are used to screen the population and detect those experiencing the common mental disorders such as depression, anxiety, and stress in the community.
Research has shown that anxiety and stress relate in so many ways and they have been proved to relate through a model called tripartite model. This means that they have the same signs and symptoms of elevated negative effect meaning that is distress and reliability. A person who is distressed he is usually unhappy, have low confidence, and is less enthusiastic. It is however important to note that the two overlap so that it becomes difficult to distinguish (Farrell, P. 2010).
The Depression, Anxiety and Stress Scales(DASS) is a statistical tool that helps in the assessment of the signs and symptoms of the three conditions in the community. It consists of three subscales, which include; depression scale that is used to measure hopelessness, persons self esteem and the low positive effect. The anxiety scale measures autonomic arousal, muscular-skeletal conditions, situational anxiety and anxious arousal. Stress scale on the other hand measures tension, agitation,, and negative effect.
There are very few psychometric instruments that are used to assess the three common mental disorders which have been validated in China. Our team combined a number of psychometric properties to realize this dream for instance it established; Zung’s Self-rated Scale, a number of postnatal depression scales As well as some General Health Questionnaire with 20 items aiming to establish in a move to establish psychiatric caseness in adult women. This is a screening instrument able to assess several domains and it is compatible with Anglophone and no-Anglophone settings. The study aims at establishing comprehensively and psychometric properties (Knight, I. 2013).
Method
Sample:
Participants were women living in Beijing, the capital city of China who had participated in an earlier study that established the prevalence and determinants of prenatal common mental disorders. 60 women participated in the study and most of them agreed to to be adequately informed about subsequent follow up studies. The participants were aged between 17 and 79 years old (M = 22.89; SD = 6.43).
Measurements:
The Depression Anxiety and Stress Scales was selected for this validation. The sacle was divide into three subscales and each subscale has seven items. Each item consists of atleast one statement and four brief response options showing severity and scored from 0 to 3. To compute an equivalent scores for the full scores the total two multiplies score for each scale and the range is from 0 to 42. The normative scale sample that was used for this case was an Australian based study of 1980 (Baum, A.1987)..
Procedure
In order to ensure appropriateness of cultural idioms as well as the language DASS21 had to be translated from English to Chinese and this was reviewed by a group of registered health professionals that is recognized worldwide. It was thereafter translated back to English for verification by the same team of professionals (Farrell, P. 2010).. The Chinese psychiatrist administered the interviews on the same day. All the 60 participants were able to complete all their interviews in private rooms in the community health centre under the help of the psychiatrists. The data collection process took place in January 2012.
Statistical analysis:
This involves the use of statistical techniques to analyze data so as to make it presentable and meaningful for decision making. The techniques like correlation have been used to make decisions that relates to the coefficient of variation as well as for emotions or life trends that follows a given pattern. Correlation and other forecasting techniques like regression analysis are very useful to predict the outcome of a given project because it involves the use of constants and several assumptions.
The use of statistical measurements like range was used in the research to study the range of variation between the psychological trends of the people at different ages or at different levels of income and wealth. These statistical techniques were used to evaluate each of the details and components of the subscales.The statistical techniques like time series modeling were used to predict the future trends that relate to psychological effects like anxiety and stress so as to know ways to curb them in the future. These techniques were used to determine the interval of the points of each subscale.
The statistical techniques were widely used in the formulation of conclusions that relates to the risks and uncertainties of these disorders and psychological effects which depends on the degree of variation of each variable concerned.
The use of flow charts in the research enabled data presentation in a clear and distinct manner which facilitated faster and accurate formulation of reasonable conclusions which are worthy making.
Ethics:
In relation to the ethical grounds, the means of data collection were genuine and reflect the true aspects and views of the participants in Beijing. The results of the research were not personalized or released to the public and they were only used for the intended purpose. The results of the research were not biased or prejudiced in any way and they reflected the views and observations in making the decisions with regard to each subscale. This ethical conduct boosted the validity of the research. The team which conducted the research was independent on their work making the results of the research trusted by the users of such data. The team was recognized by the government of China to conduct this research.
Results:
Sample:
The results of the research done in China in relation to depression anxiety and stress scale it involved a variety of sampling techniques used to analyze the results of this research. The modes of judgmental sampling were used in interpretation and presentation of the results. The sample of the population was taken from the participants of the population who engaged actively in the study. The majority of the population consisted of women whose their level of education is basically high school. The participants of the research were local China people where their main economic activity is agriculture. Most the women were confirmed to be manual workers in the locality as the way to generate income. The sample also consisted of the middle age women where most of them were pregnant and had young children. The majority of the participants were diagnosed with conditions related to depression, anxiety and stress. The DASS scale was used to determine the type of conditions depending on the characteristics and degrees of the disorders. The mentally related disorders were also diagnosed in the population.
The sample reflected several aspects like age, level of education, occupation and the various skills as well as the level of income of the individuals who participated in the study in order to .determine the various traits and characteristics to the symptoms of the disorders. The degrees of the conditions relates to the nature of disorders associated to the conditions of the participants.
Reliability:
In the context of internal reliability, each subscale was used to keenly identify the extent to which this research can be relied in measurement and determination of these conditions related to psychological trauma and emotions. The consistency of these subscales was emphasized by the researchers making them crucial aspects and components of the whole process of emotional effects determination. Each subscale had one very crucial factor in the determination of depression, stress and anxiety levels in the lives of the participants.
The participants viewed various life perspectives to be worthy while some of them regarded life to be meaningless at points where they are stressed up by the emotional conditions which deprives them of their happiness.
In relation to validity and the cut-off points which are optimal in forming valid results and ways to interpret these results. The use of statistical techniques like measures of central tendency, for instance, is to use to determine levels of various scales pertaining to each emotional aspect. The degrees of these aspects and scales are determined using various techniques. Some traits of emotional disorders may be found to relate more than one subscale.
The means used to collect the data were accurate and reliable making the data sensible and meaningful in making decisions as well as solving problems relating to various psychological conditions.
Discussion
The research study made wide use of gold standard validation tools in a systematically acquired women representative sample. The study also utilized standard validation of inner dependability of psychometric tools and methods of establishing benchmark scores necessary in detecting clinically important symptoms of anxiety and depression (Bickerstaff, L. 2007).
The research teams acknowledge a disparity in their research work that the sample size utilized was only made up young women with children of the same age set. This acted as a source of some major limitations to some extent. The sampling technique used for the study allowed the researchers recruit a representative sample made up of young women with children from Beijing, one of the Chinese major capitals.
The social and the economic demographic characteristics of the sample population was proved to be identical with those of other young women with children according to the UNICEF report on the Multiple Cluster indicator Survey Index of the year 2006. This therefore develops the confidence that the data collected and utilized in the research process can be generalized with high degrees of precision and confidence levels to represent the levels of stress and depression among urban women with children across various parts of the globe.
The results from the EFA in depth analysis of the median scores attained for the used three sub-scales. Through the diagnostic groups and the ROC analysis of the diagnostic group also reveals that there is consistency in revealing that there is only one aspect and dimension of psychological functioning principal to the 21 components of the DASS21-Chinese validation in this specific research setting (Bickerstaff, L. 2007)..
In the entire subscales used in the research process, non was capable to successfully distinguish between women experiencing an anxiety disorder from those experiencing psychological depression. The findings were exactly similar to the previously studied validations of numerous other psychometric tools of this setting (Baum, A.1987). This reveals that screening instruments are capable of detecting clinically important psychological states but at the same time, they are not capable of determining and distinguishing which specific psychological state an individual woman is experiencing at the specific given moment.
These findings brought us to the highly important conclusion that; it is possible that the clinical symptoms, which differentiate between anxiety and depression in Beijing women, were not included in the screening instruments. This calls and warrants for further and in depth investigations in the future studies.
Conclussion
In conclusion, the data on DASS21-V has a very high internal reliability and sensitivity and therefore there is no doubt that the mental disorders in Beijing city yamong the Chinese women with young children was accurately detected. The tools used to undertake the study clearly proofs that among the 60 women taken as the sample there is non who had the condition and was not identified. The 60 women who participated in the study were just a representative samp-le and therefore reflected the rest of the populations living in the same vicinity.It is yhowever important to note that using the sub-scale to distinguish the difference between depression and stress is not the most appropriate for such a setting. In general Depression, Anxiety, and Stress Scales in one of the comprehensive and psychometrically sound tool that can be successfully used in primary health care, community interventions as well as in screening tool for common mental conditions in Beijing and other big cities not only in China but also in the other parts of the world (Knight, I. 2013)..`
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