Validation of the Arabic version of the refugee health screener-13 among postpartum Syrian refugees in Lebanon

Abstract

PurposeRefugee mothers are at a significantly increased risk of suffering from postpartum depression. However, available tools to screen for it often use a Western paradigm of mental health, which may not be culturally appropriate, and may not account for the background stress experienced by refugees. The purpose of this study is to test and validate refugee health screener-13 (RHS-13), which was developed by consultation with refugees from different backgrounds among a group of Syrian refugee mothers living in Beqaa’s valley in Lebanon.Design/methodology/approachThe tool was tested on a sample of 103 women. Internal consistency of the items for each subscale was assessed using Cronbach’s alpha. An interitem correlation was performed to examine the most correlated items on the scale. Pearson correlation coefficient was calculated between each subscale and its diagnostic proxy. To find the best fit cutoff point between sensitivity and 1-specificity, ROC curves were used.FindingsRHS-13 is a reliable and valid tool to detect depression and anxiety among postpartum Syrian mothers (internal consistency 0.803, correlation with patient health questionnaire: 0.63 and correlation with generalized anxiety disorder-7: 0.73). The best fit cutoff points were 12, 15 and 25, indicating the severity of symptoms from mild to severe, respectively.Originality/valueRHS-13 is a valid tool among postpartum refugees in Lebanon and can be used by primary care physicians, mental health providers and social workers working with refugees from the Middle East to screen mothers for depression and anxiety.