Secondary outcomes
depression, anxiety
SECONDARY
There were four secondary outcomes, as follows.Changes in the degree of depression and anxiety (K6) [The K6 is a psychological scale developed to screen for mental health in the general adult population. It is a 6-item tool with responses on a five-point scale (total 0–24 points) measuring depression and anxiety. It has been confirmed to be sufficiently reliable and valid [Degree of risk for postpartum depression (EPDS) at 1 month postpartum.The EPDS was developed by Cox et al. in the UK [Change in self-efficacy regarding CBT response.This program was based on CBT theory, whereby in the process of trying the skills repeatedly, the skills become one’s own and can be used in daily life. Therefore, we measured participants’ efficacy in accepting and using these skills in daily life. As no existing scales were available, we developed original self-efficacy assessment tool for CBT response in the perinatal period. The construct comprised three sub-concepts (21 items in total): value perception of CBT (seven items), self-efficacy for cognitive restructuring (seven items), and self-efficacy for behavioral change (seven items), on a five-point scale (21–105).To evaluate the construct validity of the scale, six CBT experts, including a psychiatrist and a psychologist, were consulted. To establish the content validity, we asked 10 participants (five midwives, two nurses, one childminder, and two office workers) to classify the items and confirm to which of the three subscales each question belonged.Program satisfaction (Japanese version of the Client Satisfaction Questionnaire-8; CSQ-8J).The CSQ-8J has eight items on a four-point scale (8–32), with higher scores indicating greater satisfaction. The reliability and validity of the CSQ-8J have been confirmed [