Psychometric properties of the Decisional Conflict Scale in a sample of perinatal women with depressive symptoms: a study in Portugal and Norway

Objective To assess the psychometric properties, i.e., reliability and construct validity of the 16-item Decisional Conflict Scale (DCS) and sub-scales in women with perinatal depression symptoms in Norway and Portugal. Methods We included 415 women in Portugal and 163 in Norway (≥18 years) who were pregnant or had given birth in the last 12 months and presenting with active depressive symptoms. Women replied to the original DCS items. We conducted confirmatory factor analysis, estimated internal consistency reliability, and examined factorial invariance across country, perinatal status, and treatment uptake. Results The DCS factor model had good fit to the data, with all items loading significantly on their respective factor (.585 to.958). There was configural invariance of the DCS across countries, treatment, and perinatal status. The internal consistency of the total DCS (Cronbach’s alpha) was.958, and for the subscales it ranged from.798 to.947. Conclusions The DCS is a valid and reliable measure of the decisional conflict in women with perinatal depressive symptoms in Portugal and Norway. Practice Implications Measuring the extent of decisional conflict regarding treatment and the effect of multiple interventions towards its reduction is critical to facilitate the decision-making process of women with perinatal mental illness.