A concept analysis of panic

Postpartum onset of panic disorder: A metaphor analysis

Prevalence rates of postpartum panic disorder range from 0.5% to 2.9%. New mothers may not know the medical terminology to describe what they are experiencing. Metaphors can provide women with a different voice to help provide a basis for shared understanding with clinicians. The purpose of this secondary qualitative data analysis was to examine the metaphors used by women to describe their panic disorder after birth. Metaphor Identification Procedure was used to analyze the primary dataset. The process revealed the following eight metaphors: caged animal, Coke in my veins, bone-tired, imposter, escape artist, magnifying glass, detective, and hermit.

Searching for self: the layers and labels of panic disorder: a New Zealand study

The diagnosis and management of panic symptoms are relatively neglected. If not treated, people can develop a panic disorder, a condition that has an adverse effect on the client's quality of life and psychological well-being. The aim of this New Zealand research is to understand the clients' perspective of panic disorder and how it impacts on their quality of life. Ten participants were interviewed and the data were analyzed using thematic analysis. The research findings indicate that recovery from panic disorder occurs in a process of the search for self that is made up of self-understanding and the reclaiming the self. The findings provide a psychosocial perspective of panic disorder that will assist nurses who work with these clients. Nurses are pivotal in teaching clients about their body's response to stress and health anxiety, the giving of supplementary health information, and timely referral for specialist treatment. The recommendations for nurse specialist input and biopsychosocial assessments are discussed.

Cardiac pain or panic disorder? Managing uncertainty in the emergency department

Emergency department admissions for chest pain might be related to a psychological problem, such as panic. Panic disorder adversely affects the person's lifestyle, general health, and psychological well-being. Panic disorder is difficult to recognize, so nursing assessment and management of these clients is important. This paper presents research findings from a New Zealand study that explored emergency nurses' differentiation of non-cardiac chest pain from panic disorder and raised significant issues in the nursing assessment and management of such clients. The data were gathered from focus group interviews and were analyzed thematically. Three themes, prioritizing time, managing uncertainty and ambiguity, and the life-threatening lens, were identified. The findings confirm that a panic disorder is not always diagnosed when biomedical assessment is used in isolation from a psychosocial assessment. Emergency nurses are pivotal in reversing the cycle of repeat presenters with non-cardiac chest pain. Recommendations for assessing and managing this complex condition are presented.

A light in the fog: caring for women with postpartum depression

It is estimated that at least 1 in 10 women will experience postpartum depression, yet systematic screening for it in clinical practice is too often neglected. The foggy unreality of this affective disorder leads women to believe they are losing their minds, and their efforts to find help can be elusive. Women with postpartum depression who go undetected and untreated are at risk for immediate harm and potential lifelong sequelae for themselves and their families, and especially for their children. This article provides 1) an understanding of the woman's experience of postpartum depression, 2) a review of two instruments, developed through a focused program of research to screen for the disorder, 3) triage in clinical practice, and 4) an overview of the three dimensions of treatment: psychopharmacology, psychotherapy, and psychosocial care. Practical guidance and client information are provided to assist midwives and primary care providers to incorporate systematic screening into clinical practice, to identify effective interdisciplinary treatment teams, and to muster family and community resources to help with this commonly hidden childbearing crisis.

Postpartum onset of panic disorder

PURPOSE

To describe the experience of panic disorder in mothers during the postpartum period. The onset of panic disorder during the postpartum period has recently been reported. Clinicians are urged to differentiate between the more widely known presentation of postpartum depression and the newly reported postpartum panic disorder.

DESIGN

Phenomenology. The purposive sample consisted of six women with panic disorder during the postpartum period.

METHODS

In 1995, mothers were interviewed regarding their experiences with panic. The verbatim transcripts of these interviews were analyzed using Colaizzi's phenomenological method. In all, 214 statements regarding mothers' experiences of panic were extracted and clustered into six themes.

FINDINGS

Panic during the postpartum period seriously complicated mothers' lives as they struggled to maintain their composure during panic attacks. As a result of recurring panic attacks, negative changes in women's lifestyles ensued stripping them of their self-esteem and leaving them to bear the burden of disappointing not only themselves, but also their families.

CLINICAL IMPLICATIONS

Implications for nursing practice with mothers suffering from postpartum onset of panic disorder can be derived from each one of the six themes. Nurses can help women identify panic triggers to help prevent further panic attacks. Also, nursing interventions can target the guilt mothers experience over repeatedly disappointing themselves and their families.

Depression and anxiety disorders during multiple pregnancy and parenthood

Depression or anxiety disorders may affect more than 25% of multiple birth parents during the perinatal period. Such parents often are uninformed, suffer in silence and fear, and are reticent to seek help. When depression, panic attacks, and obsessive-compulsive disorder are not recognized or are left untreated, parent health, parent-infants interaction, child development, and family stability may be seriously compromised. Nurses, as partners in care at the family and community levels, have a pivotal role to play in prevention-focused health, education, and social support programs; the identification of parents at risk; and the early recognition and support of women and families affected by these disorders.