The mediating role of hope between perceived social support, basic psychological needs, and psychological adaptability in postpartum women with depression: a cross-sectional study 10.55131/jphd/2025/230202

Main Article Content

Zheng Shiyu
Nor Mazlina binti Ghazali
Voon Siok Ping
Shen JiLin

Abstract

Postpartum depression (PPD) is a significant public health concern among women globally. This study examines the mediating role of hope in the relationship between perceived social support (PSS), basic psychological needs (BPNS), and psychological adjustment (PA) through a cross-sectional design. A minimum sample size of 403 was determined using G-power. The study employed purposive sampling to recruit 501 participants from three hospitals in China, after excluding ineligible cases. The inclusion criteria required participants to have a Beck Depression Inventory score above 13, be at least 18 years old, possess a middle school diploma, be within 0 to 8 weeks postpartum, and have no postpartum illnesses or complications. The exclusion criteria included multiple deliveries. The instruments were the Psychological Adaptability Scale, Multidimensional Scale of Perceived Social Support, Basic Psychological Needs Scale,and Herth Hope Index,measuring PA, PSS, BPNS, and hope, respectively. Subsequently, three models were developed with BPNS and PSS as exogenous variables, hope as a mediator, and PA as the outcome. The findings revealed a significant positive correlation (p<0.01) among all variables in model 3. Hope partially mediated the connection between PSS and PA as well as between BPNS and PA. Moreover, alternative models 4 and 5 were created using BPNS, PSS, and PA as mediating variables to reinforce the credibility and validity of the model. Based on the Akaike Information Criterion (AIC) and Expected Cross-Validation Index (ECVI), model 3 was deemed the most statistically robust. These findings highlight the critical role of hope in enhancing PA among women with PPD. Healthcare providers and family members should focus on interventions that foster hope, alongside addressing social support and basic psychological needs, to improve psychological outcomes for women experiencing postpartum depression.

Article Details

How to Cite
1.
Zheng Shiyu, Nor Mazlina binti Ghazali, Voon Siok Ping, Shen JiLin. The mediating role of hope between perceived social support, basic psychological needs, and psychological adaptability in postpartum women with depression: a cross-sectional study: 10.55131/jphd/2025/230202. J Public Hlth Dev [internet]. 2025 Apr. 30 [cited 2025 Dec. 25];23(2):13-26. available from: https://he01.tci-thaijo.org/index.php/AIHD-MU/article/view/272165
Section
Original Articles
Author Biographies

Zheng Shiyu, Faculty of Cognitive Science and Human Development, Universiti Malaysia Sarawak, Kota Samarahan, Sarawak, Malaysia

Faculty of Cognitive Science and Human Development, Universiti Malaysia Sarawak, Kota Samarahan, Sarawak, Malaysia

Nor Mazlina binti Ghazali, Faculty of Cognitive Science and Human Development, Universiti Malaysia Sarawak, Kota Samarahan, Sarawak, Malaysia

Faculty of Cognitive Science and Human Development, Universiti Malaysia Sarawak, Kota Samarahan, Sarawak, Malaysia

Voon Siok Ping, Faculty of Cognitive Science and Human Development, Universiti Malaysia Sarawak, Kota Samarahan, Sarawak, Malaysia

Faculty of Cognitive Science and Human Development, Universiti Malaysia Sarawak, Kota Samarahan, Sarawak, Malaysia

Shen JiLin, Department of Obstetrics and Gynecology, Guiyang Maternal and Child Health Care Hospital, Guizhou, China

Department of Obstetrics and Gynecology, Guiyang Maternal and Child Health Care Hospital, Guizhou, China

References

Gelabert E, Gutiérrez-Zotes A, Navinés R, Labad J, Puyané M, Donadon M, et al. The role of personality dimensions, depressive symptoms and other psychosocial variables in predicting postpartum suicidal ideation: a cohort study. Arch Womens Ment Health. 2019;23(4):585-93. doi:10.1007/s00737-019-01007-w.

Liu X, Wang S, Wang G. Prevalence and risk factors of postpartum depression in women: a systematic review and meta‐analysis. J Clin Nurs. 2021;31(19-20):2665-77. doi:10.1111/jocn.16121.

Falana S, Carrington J. Postpartum depression. Nurs Clin North Am. 2019;54 (4):561-7. doi:10.1016/j.cnur.2019.07.006.

Setzer M, Yan J, Erby L, Similuk M. Perceived control is significantly associated with psychological adaptation in individuals with known or suspected inborn errors of immunity. J Community Genet. 2023;14(6):639-47. doi:10.1007/s12687-023-00670-y.

Yanes T, Humphreys L, McInerney-Leo A, Biesecker B. Factors associated with parental adaptation to children with an undiagnosed medical condition. J Genet Couns. 2016;26(4):829-40. doi:10.1007/s10897-016-0060-9.

Hassanie S, Olugbade O, Karadaş G, Altun Ö. The impact of workload on workers’ traumatic stress and mental health mediated by career adaptability during COVID-19. Sustainability. 2022;14(19):12010. doi:10.3390/su141912010.

Ortega J, Vázquez N, Flores C, Amayra I. Mental health and psychological adaptation on parents of children with neuromuscular diseases. Child Health Care. 2021;51(1):62-78. doi:10.1080/02739615.2021.1961581.

Waugh CE, Koster EHW. A resilience framework for promoting stable remission from depression. Clin Psychol Rev. 2015;41:49-60.doi.org/10.1016/j.cpr.2014.05.004

Zhang K, Mi Z, Parks-Stamm EJ, Cao W, Ji Y, Jiang R. Adaptability protects university students from anxiety, depression, and insomnia during remote learning: a three-wave longitudinal study from China. Front Psychiatry. 2022;13:868072. doi.org/10.3389/fpsyt.2022.868072

Öztürk M, Sürücü ŞG, Ozel TE, Inci H. Evaluation to adaptation of motherhood in postpartum period. LIFE Int J Health Life Sci. 2017;3(2):65-76. doi.org/10.20319/lijhls.2017.32.6576

Zhang G, Li P, Jia Y. Relationship between family cohesion/adaptability and postpartum depressive symptoms: a single-center retrospective study. World J Psychiatry. 2023;13(2):50-9.doi.org/10.5498/wjp.v13.i2.50

Sun X, Li B, Zhang H, Zhang G. Social media use for coping with stress and psychological adjustment: a transactional model of stress and coping perspective. Front Psychol. 2023;14:1-10. doi:10.3389/fpsyg.2023.1140312.

Taylor S. Adjustment to threatening events: a theory of cognitive adaptation. Am Psychol. 1983;38(11):1161-73. doi:10.1037/0003-066X.38.11.1161.

Wang J, Mann F, Lloyd-Evans B, Ma R, Johnson S. Associations between loneliness and perceived social support and outcomes of mental health problems: a systematic review. BMC Psychiatry. 2018;18(1):156-72. doi:10.1186/s12888-018-1736-5.

McDougall M, Walsh M, Wattier K, Knigge R, Miller L, Stevermer M, et al. The effect of social networking sites on the relationship between perceived social support and depression. Psychiatry Res. 2016;246:223-9. doi:10.1016/j.psychres.2016.09.018.

Tang M, Wang D, Guerrien A. A systematic review and meta‐analysis on basic psychological need satisfaction, motivation, and well‐being in later life: contributions of self‐determination theory. PsyCh J. 2019;9(1):5-33. doi:10.1002/pchj.293.

Nishimura T, Suzuki T. Basic psychological need satisfaction and frustration in Japan: controlling for the big five personality traits. Jpn Psychol Res. 2016;58(4):320-31. doi:10.1111/jpr.12131.

Marques S, Pais-Ribeiro J, Lopez S. The role of positive psychology constructs in predicting mental health and academic achievement in children and adolescents: a two-year longitudinal study. J Happiness Stud. 2011;12(6):1049-62. doi:10.1007/s10902-010-9244-4.

Demetriou L, Drakontaides M, Hadjicharalambous D. Psychological resilience, hope, and adaptability as protective factors in times of crisis: a study in Greek and Cypriot society during the COVID-19 pandemic. SSRN Electron J. 2020;2(1):20-34. doi:10.2139/ssrn.3713732.

Snyder C. Target article: hope theory: rainbows in the mind. Psychol Inq. 2002;13(4):249-75. doi:10.1207/s15327965pli1304_01.

Finkelstein E, Baid D, Cheung Y, Schweitzer M, Malhotra C, Volpp K, et al. Hope, bias and survival expectations of advanced cancer patients: a cross-sectional study. Psychooncology. 2021;30(5):780-8. doi:10.1002/pon.5675.

García-Castro F, Alba A, Blanca M. Association between character strengths and caregiver burden: hope as a mediator. J Happiness Stud. 2019;21(4):1445-62. doi:10.1007/s10902-019-00138-2.

Seppänen M, Lankila T, Auvinen J, Korpelainen R, Timonen M. Cross- cultural comparison of depressive symptoms on the Beck Depression Inventory-II, across six population samples. BJPsych Open. 2022;8(2):1-8. doi:10.1192/bjo.2022.13.

Gjerdingen D, Crow S, McGovern P, Miner M. Changes in depressive symptoms over 0–9 months postpartum. J Womens Health. 2011;20(3):381-6. doi:10.1089/jwh.2010.2355.

Wolf E, Harrington K, Clark S, Miller M. Sample size requirements for structural equation models. Educ Psychol Meas. 2013;73(6):913-34. doi:10.1177/0013164413495237.

Fan L, Cai J, Li L, Yi L. Mediating effect of self-efficacy between social support and compassion fatigue among geriatric services and management interns: a cross-sectional study. Geriatr Nurs. 2024;59:662-8. doi.org/10.1016/j.gerinurse.2024.08.041

Chuan CL, Penyelidikan J. Sample size estimation using Krejcie and Morgan and Cohen statistical power analysis: a comparison. Jurnal Penyelidikan IPBL. 2006;7(1):78-86.

Biesecker B, Erby L, Woolford S, Adcock J, Cohen J, Lamb A, et al. Development and validation of the psychological adaptation scale (PAS): use in six studies of adaptation to a health condition or risk. Patient Educ Couns. 2013;93(2):248-54. doi:10.1016/j.pec.2013.05.006.

Liu D, Wei W, Xin Z, Li C, Zhong J. Study on the current status and influencing factors of psychological adaptation of relatives and caregivers of patients after esophageal cancer. Psychol. 2022;13(8):1151-61. doi:10.4236/psych.2022. 138075.

Zimet G, Dahlem N, Zimet S, Farley G. The multidimensional scale of perceived social support. J Pers Assess. 1988;52(1):30-41. doi:10.1207/s15327752 jpa5201_2.

Wang D, Zhu F, Xi S, Niu L, Tebes J, Xiao S, et al. Psychometric properties of the multidimensional scale of perceived social support (MSPSS) among family caregivers of people with schizophrenia in China. Psychol Res Behav Manag. 2021;14:1201-9. doi:10.2147/PRBM.S320126.

Ryan RM, Sapp AR. Basic psychological needs: a self-determination theory perspective on the promotion of wellness across development and cultures. In: Gough I, McGregor JA, editors. Wellbeing in Developing Countries From Theory to Research. Cambridge: Cambridge University Press; 2007. p. 71-92.

Johnston M, Finney S. Measuring basic needs satisfaction: evaluating previous research and conducting new psychometric evaluations of the basic needs satisfaction in general scale. Contemp Educ Psychol. 2010;35(4):280-96. doi:10.1016/j.cedpsych.2010.04.003.

Xiao X, Zheng X. The effect of parental phubbing on depression in Chinese junior high school students: the mediating roles of basic psychological needs satisfaction and self-esteem. Front Psychol. 2022;13:868354. doi:10.3389/fpsyg. 2022.868354.

Pleeging E, Exel J, Burger M. Characterizing hope: an interdisciplinary overview of the characteristics of hope. Appl Res Qual Life. 2021;17(3):1681-723. doi:10.1007/s11482-021-09967-x.

Chan K, Li W, Chan S, Lopez V. Herth hope index: psychometric testing of the Chinese version. J Adv Nurs. 2011;68 (9):2079-85. doi:10.1111/j.1365-2648.2011.05887.x.

Herth K. Abbreviated instrument to measure hope: development and psychometric evaluation. J Adv Nurs. 1992;17 (10):1251-9. doi:10.1111/j.1365-2648.1992.tb01843.x.

Hu L, Bentler P. Cutoff criteria for fit indexes in covariance structure analysis: conventional criteria versus new alternatives. Struct Equ Modeling. 1999;6(1):1-55. doi:10.1080/10705519909540118.

Jain V, Ajmera P. Modelling of the factors affecting lean implementation in healthcare using structural equation modelling. Int J Syst Assur Eng Manag. 2019;10(4):563-75. doi:10.1007/s13198-019-00770-4.

Atkinson AK, Rickel AU. Depression in women: the postpartum experience. Issues Ment Health Nurs. 1983;5(1-4):197-218. doi.org/10.3109/01612848309009440

Low S, Bono S, Azmi Z. The effect of emotional support on postpartum depression among postpartum mothers in Asia: a systematic review. Asia Pac Psychiatry. 2023;15(2):e12528. doi:10.1111/appy.12528.

Acton G, Malathum P. Basic need status and health-promoting self-care behavior in adults. West J Nurs Res. 2000;22(7):796-811. doi:10.1177/01939450022044764.

Gorman D. Maslow's hierarchy and social and emotional wellbeing. Aborig Isl Health Work J. 2010;34(1):27-9.

Jones PS. Adaptability: a personal resource for health. Sch Inq Nurs Pract. 1991;5(2):95-108.

Griggs S. Hope and mental health in young adult college students: an integrative review. J Psychosoc Nurs Ment Health Serv. 2017;55(2):28-35. doi:10.3928/ 02793695-20170210-04.

Snyder C, Feldman D, Taylor J, Schroeder L, Adams V. The roles of hopeful thinking in preventing problems and enhancing strengths. Appl Prev Psychol. 2000;9(4):249-69. doi:10.1016/s0962- 1849(00)80003-7.

Pallini S, Milioni M, Laghi F, Vecchio G. The ant and the grasshopper: adolescents' time perspective, satisfaction with life and the mediating role of hope. J Happiness Stud. 2016;15:361-74. doi:10.1007/s10902-016-9821-2.

Deci E, Ryan R. The "what" and "why" of goal pursuits: human needs and the self-determination of behavior. Psychol Inq. 2000;11(4):227-68. doi:10.1207/s15327965pli1104_01.