open access

Ahead of Print
Research paper
Published online: 2021-10-13
Get Citation

Validation of the Numerical Anxiety Rating Scale in postpartum females: a prospective observational study

Anna Prokopowicz1, Bartlomiej Stanczykiewicz2, Izabella Uchmanowicz3
DOI: 10.5603/GP.a2021.0197
Affiliations
  1. 2nd Chair and Department of Gynecology and Obstetrics, Wroclaw Medical University, Wroclaw, Poland
  2. Department of Nervous System Diseases, Faculty of Health Science, Wroclaw Medical University, Wroclaw, Poland
  3. Department of Clinical Nursing, Faculty of Health Sciences, Wroclaw Medical University, Wroclaw, Poland

open access

Ahead of Print
ORIGINAL PAPERS Gynecology
Published online: 2021-10-13

Abstract

Objectives: Perinatal anxiety is important for the quality of life of mothers and their offspring. The Numerical Anxiety Rating Scale (NRS-A) allows the level of anxiety in patients to be quickly assessed. Until now, the NRS-A has not been validated in the postpartum female population. The aim of this study was to assess the accuracy and reliability of the NRS-A when compared with the reference methods for measuring anxiety.

Material and methods: The observational prospective study included a group of 200 adult postpartum females of a hospital maternity ward. The validity between the Numerical Rating Scale for Anxiety (NRS-A) and the State and Trait Anxiety Inventory (STAI), and between the NRS-A and the Hospital Anxiety and Depression Scale (HADS-A), was determined. The detection thresholds for high anxiety were examined.

Results: Both measurements showed a positive high correlation between the NRS and STAI-S (in T1 rho = 0.807, in T2 rho = 0.778; p < 0.001), and a comparable relationship of both scales (STAI-S and NRS-A) with the STAI-T and HADS-A. The analysis of the ROC curve indicated that the value of the NRS-A equal to 3.5/10 can be considered the threshold that allows for a differentiation of patients with high anxiety from those without high anxiety in the studied population.

Conclusions: The NRS-A is an accurate tool for measuring anxiety in Polish postpartum females. Routine anxiety measurements using the NRS-A can be used to identify people with high anxiety in order to provide emotional support to patients in the early postpartum period.

Abstract

Objectives: Perinatal anxiety is important for the quality of life of mothers and their offspring. The Numerical Anxiety Rating Scale (NRS-A) allows the level of anxiety in patients to be quickly assessed. Until now, the NRS-A has not been validated in the postpartum female population. The aim of this study was to assess the accuracy and reliability of the NRS-A when compared with the reference methods for measuring anxiety.

Material and methods: The observational prospective study included a group of 200 adult postpartum females of a hospital maternity ward. The validity between the Numerical Rating Scale for Anxiety (NRS-A) and the State and Trait Anxiety Inventory (STAI), and between the NRS-A and the Hospital Anxiety and Depression Scale (HADS-A), was determined. The detection thresholds for high anxiety were examined.

Results: Both measurements showed a positive high correlation between the NRS and STAI-S (in T1 rho = 0.807, in T2 rho = 0.778; p < 0.001), and a comparable relationship of both scales (STAI-S and NRS-A) with the STAI-T and HADS-A. The analysis of the ROC curve indicated that the value of the NRS-A equal to 3.5/10 can be considered the threshold that allows for a differentiation of patients with high anxiety from those without high anxiety in the studied population.

Conclusions: The NRS-A is an accurate tool for measuring anxiety in Polish postpartum females. Routine anxiety measurements using the NRS-A can be used to identify people with high anxiety in order to provide emotional support to patients in the early postpartum period.

Get Citation

Keywords

anxiety; postpartum period; patient-oriented outcomes; emotional support

About this article
Title

Validation of the Numerical Anxiety Rating Scale in postpartum females: a prospective observational study

Journal

Ginekologia Polska

Issue

Ahead of Print

Article type

Research paper

Published online

2021-10-13

DOI

10.5603/GP.a2021.0197

Keywords

anxiety
postpartum period
patient-oriented outcomes
emotional support

Authors

Anna Prokopowicz
Bartlomiej Stanczykiewicz
Izabella Uchmanowicz

References (34)
  1. Ross LE, McLean LM. Anxiety disorders during pregnancy and the postpartum period: A systematic review. J Clin Psychiatry. 2006; 67(8): 1285–1298.
  2. House SJ, Tripathi SP, Knight BT, et al. Obsessive-compulsive disorder in pregnancy and the postpartum period: course of illness and obstetrical outcome. Arch Womens Ment Health. 2016; 19(1): 3–10.
  3. Grekin R, O'Hara MW. Prevalence and risk factors of postpartum posttraumatic stress disorder: a meta-analysis. Clin Psychol Rev. 2014; 34(5): 389–401.
  4. Schobinger E, Stuijfzand S, Horsch A. Acute and post-traumatic stress disorder symptoms in mothers and fathers following childbirth: a prospective cohort study. Front Psychiatry. 2020; 11: 562054.
  5. Agbaje OS, Anyanwu JI, Umoke PIC, et al. Depressive and anxiety symptoms and associated factors among postnatal women in Enugu-North Senatorial District, South-East Nigeria: a cross-sectional study. Arch Public Health. 2019; 77: 1.
  6. Alipour Z, Lamyian M, Hajizadeh E. Anxiety and fear of childbirth as predictors of postnatal depression in nulliparous women. Women Birth. 2012; 25(3): e37–e43.
  7. Wisner KL, Sit DKY, McShea MC, et al. Onset timing, thoughts of self-harm, and diagnoses in postpartum women with screen-positive depression findings. JAMA Psychiatry. 2013; 70(5): 490–498.
  8. Giardinelli L, Innocenti A, Benni L, et al. Depression and anxiety in perinatal period: prevalence and risk factors in an Italian sample. Arch Womens Ment Health. 2012; 15(1): 21–30.
  9. Accortt EE, Wong MS. It is time for routine screening for perinatal mood and anxiety disorders in obstetrics and gynecology settings. Obstet Gynecol Surv. 2017; 72(9): 553–568.
  10. Ahmed A, Bowen A, Feng CX, et al. Trajectories of maternal depressive and anxiety symptoms from pregnancy to five years postpartum and their prenatal predictors. BMC Pregnancy Childbirth. 2019; 19(1): 26.
  11. Rozporządzenie Ministra Zdrowia z dnia 16 sierpnia 2018 r. w sprawie standardu organizacyjnego opieki okołoporodowej (Dz.U. 2018 poz. 1756).
  12. Borges Nd, Pereira LV, de Moura LA, et al. Predictors for moderate to severe acute postoperative pain after cesarean section. Pain Res Manag. 2016; 2016: 5783817.
  13. Gamez BH, Habib AS. Predicting severity of acute pain after cesarean delivery: a narrative review. Anesth Analg. 2018; 126(5): 1606–1614.
  14. Gorkem U, Togrul C, Sahiner Y, et al. Preoperative anxiety may increase postcesarean delivery pain and analgesic consumption. Minerva Anestesiol. 2016; 82(9): 974–980.
  15. Hayes SC, Strosah lKD, Willson KG. Terapia akceptacji i zaangażowania: Proces i praktyka uważnej zmiany. Wydawnictwo Uniwersytetu Jagiellońskiego, Kraków 2013.
  16. Silverwood V, Nash A, Chew-Graham CA, et al. Healthcare professionals' perspectives on identifying and managing perinatal anxiety: a qualitative study. Br J Gen Pract. 2019; 69(688): e768–e776.
  17. National Institute for Health and Care Excellence. Principles of care in pregnancy and the postnatal period. In: Antenatal and postnatal mental health: clinical management and service guidance. 2014.
  18. Julian LJ. Measures of anxiety: State-Trait Anxiety Inventory (STAI), Beck Anxiety Inventory (BAI), and Hospital Anxiety and Depression Scale-Anxiety (HADS-A). Arthritis Care Res (Hoboken). 2011; 63 Suppl 11: S467–S472.
  19. Guillén-Riquelme A, Buela-Casal G. [Meta-analysis of group comparison and meta-analysis of reliability generalization of the State-Trait Anxiety Inventory Questionnaire (STAI)]. Rev Esp Salud Publica. 2014; 88(1): 101–112.
  20. Wrześniewski K, Sosnowski T, Jaworska A et al., [State-Trait Anxiety Inventory. Polish adaptation of STAI], Warszawa: Pracownia Testów Psychologicznych, 2006.
  21. Karcioglu O, Topacoglu H, Dikme O, et al. A systematic review of the pain scales in adults: Which to use? Am J Emerg Med. 2018; 36(4): 707–714.
  22. Crandall M, Lammers C, Senders C, et al. Initial validation of a numeric zero to ten scale to measure children's state anxiety. Anesth Analg. 2007; 105(5): 1250–1253.
  23. Walawender I, Roczniak W, Nowak D, et al. Applicability of the Numeric Scale for Anxiety Evaluation in Patients Undergoing Dental Treatment. Dent Med Probl. 2015; 52(2): 205–214.
  24. Spielberger C, Gorsuch R, Lushene R. Manual for the State-Trait Anxiety Inventory (Form Y1 – Y2). CA:Consulting Psychologists Press 1983.
  25. Zigmond AS, Snaith RP. The hospital anxiety and depression scale. Acta Psychiatr Scand. 1983; 67(6): 361–370.
  26. Majkowicz M. Praktyczna ocena efektywności opieki paliatywnej – wybrane 133 techniki badawcze. In: de Walden-Gałuszko K, Majkowicz M. ed. Ocena jakości opieki paliatywnej w teorii i praktyce. Akademia Medyczna w Gdańsku, Gdańsk 2000: 21–42.
  27. Davey HM, Barratt AL, Butow PN, et al. A one-item question with a Likert or Visual Analog Scale adequately measured current anxiety. J Clin Epidemiol. 2007; 60(4): 356–360.
  28. Gustafson LW, Gabel P, Hammer A, et al. Validity and reliability of State-Trait Anxiety Inventory in Danish women aged 45 years and older with abnormal cervical screening results. BMC Med Res Methodol. 2020; 20(1): 89.
  29. Delgado AM, Freire Ad, Wanderley EL, et al. Analysis of the construct validity and internal consistency of the State-Trait Anxiety Inventory (STAI) State-Anxiety (S-Anxiety) Scale for Pregnant Women during Labor. Rev Bras Ginecol Obstet. 2016; 38(11): 531–537.
  30. Quek KF, Low WY, Razack AH, et al. Reliability and validity of the Spielberger State-Trait Anxiety Inventory (STAI) among urological patients: a Malaysian study. Med J Malaysia. 2004; 59(2): 258–267.
  31. Labaste F, Ferré F, Combelles H, et al. Validation of a visual analogue scale for the evaluation of the postoperative anxiety: A prospective observational study. Nurs Open. 2019; 6(4): 1323–1330.
  32. Hepp P, Hagenbeck C, Burghardt B, et al. MAGIC Group. Measuring the course of anxiety in women giving birth by caesarean section: a prospective study. BMC Pregnancy Childbirth. 2016; 16: 113.
  33. Facco E, Stellini E, Bacci C, et al. Validation of visual analogue scale for anxiety (VAS-A) in preanesthesia evaluation. Minerva Anestesiol. 2013; 79(12): 1389–1395.
  34. Castarlenas E, Jensen MP, von Baeyer CL, et al. Psychometric properties of the numerical rating scale to assess self-reported pain intensity in children and adolescents: a systematic review. Clin J Pain. 2017; 33(4): 376–383.

Regulations

Important: This website uses cookies. More >>

The cookies allow us to identify your computer and find out details about your last visit. They remembering whether you've visited the site before, so that you remain logged in - or to help us work out how many new website visitors we get each month. Most internet browsers accept cookies automatically, but you can change the settings of your browser to erase cookies or prevent automatic acceptance if you prefer.

By "Via Medica sp. z o.o." sp.k., ul. Świętokrzyska 73, 80–180 Gdańsk
tel.:+48 58 320 94 94, faks:+48 58 320 94 60, e-mail:  viamedica@viamedica.pl