Exploration of the psychometric properties of the EPDS-US, a validation study.

INTRODUCTION: The purpose of this study was to explore the reliability and construct validity of the EPDS-US. METHODS: To enhance the perinatal mental health screen, we adapted the Edinburgh Postnatal Depression Screen (EPDS) for application in the United States, and evaluated reliability and construct validity of the EPDS-US in a sample of 100 postpartum individuals. We explored reliability by estimating internal consistency of the scale and evaluating concurrent validity with correlations to the Patient Health Questionnaire (PHQ-9) and the Generalized Anxiety Disorder Assessment (GAD-7); and construct validity using factor analysis and discriminant validity with correlations to the Perceived Stress Scale (PSS). RESULTS: We present both a one-factor (Cronbach's alpha of 0.83) and two-factor model consisting of depressive (Cronbach's alpha 0.76) and anxiety symptoms (Cronbach's alpha 0.78) of the EPDS-US. Related to discriminant validity, the EPDS-US and PSS exhibited a moderate correlation of 0.71. For measures of concurrent validity, correlations with the PHQ-9 and GAD-7 were moderate; 0.63 and 0.68, respectively. CONCLUSION: The EPDS-US was adapted to enhance the perinatal mental health screening experience for populations in the US while maintaining the reliability and validity of the original Edinburgh Postnatal Depression Scale. These findings contribute to the evidence of reliability and validity of the EPDS-US in perinatal populations in the United States; presenting initial evidence supporting construct validity and concurrent validity of this newly adapted 10-item scale.

Quality and Safety Practices Among Academic Obstetrics and Gynecology Departments.

The objective was to quantify resources devoted to quality and patient safety initiatives, to document the development and use of key performance indicator reports regarding patient outcomes and patient feedback, and to assess the culture of safety within academic obstetrics and gynecology departments. Chairs of academic obstetrics and gynecology departments were asked to complete a quality and safety assessment survey. Surveys were distributed to 138 departments, yielding 52 completed responses (37.7%). Five percent of departments reported including a patient representative on a quality committee. Most committee leaders (60.5%) and members (67.4%) received no compensation. Formal training was required in 28.8% of responding departments. Most departments monitored key performance metrics for inpatient outcomes (95.9%). Leaders scored their departments' culture of safety highly. Most departments provided no protected time to faculty devoted to quality efforts, generation of key performance indicators for inpatient activities was prevalent and integrating patient and community input remain unrealized opportunities.

Environmental Life Cycle Assessment in Medical Practice: A User's Guide.

IMPORTANCE: The environmental impacts of medical practice are becoming more important as the unsustainable activities of global societies continue to damage the environment and contribute to health problems. Life cycle assessment (LCA) is a methodology to quantify a wide range of environmental impacts, including global warming, over the full life cycle of products, processes, and systems, to allow for data-driven environmental decisions. OBJECTIVE: This article introduces the concepts, terminology, and methodology of LCA using examples from the medical industry. It provides guidance and best practices for the standard steps of an LCA study. EVIDENCE ACQUISITION: A review of the literature was done to provide examples of the use of LCA and carbon footprints in medicine. Hypothetical medical products were modeled using LCA software to illustrate the capabilities and limitations of this method. RESULTS: Life cycle assessment examples in medicine illustrate the ability of this method to compare environmental impacts for products that perform the same function. They also highlight the relative scale of damage across all life cycle phases for a variety of environmental impact categories. Resources have also been provided for various useful LCA tools. CONCLUSIONS AND RELEVANCE: Life cycle assessment can provide medical practitioners with quantified environmental metrics in order to make decisions that minimize the environmental impacts of medical products, processes, and systems. Carbon footprints are LCA studies that focus only on the impact of climate change. Life cycle assessment is expected to grow as a tool for environmental decisions in medical practice.