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Xiao M, Huang S, Liu Y, Tang G, Hu Y, Fu B, Lei J. Stigma and its influencing factors for seeking professional psychological help among pregnant women: A cross-sectional study. Midwifery 2024; 132:103973. [PMID: 38442529 DOI: 10.1016/j.midw.2024.103973] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2023] [Revised: 02/23/2024] [Accepted: 02/29/2024] [Indexed: 03/07/2024]
Abstract
BACKGROUND Although the stigma associated with seeking professional psychological help has received significant attention, few studies have focused on the status and factors influencing this stigma among pregnant women, especially those with a Chinese cultural background. This study aimed to assess the status of stigma associated with seeking professional psychological help and its influencing factors. METHODS A total of 1325 pregnant women were recruited from Hunan Province, China. The Stigma for Seeking Professional Psychological Help questionnaire, Patient Health Questionnaire-9, Perceived Social Support Scale, Simplified Coping Style Questionnaire, and questionnaires on sociodemographic characteristics and pregnancy-related information were used. Descriptive, univariate, correlation, and multivariate linear regression analyses were used to investigate the status of stigma and identify its influencing factors. FINDINGS Pregnant Chinese women experienced a mild to moderate level of stigma associated with seeking professional psychological help, and self-stigma was more common than social stigma associated with seeking psychological help. The results of the multivariate analysis suggested that perceived social support, positive coping styles, negative coping styles, and depressive symptoms were the factors influencing self-stigma and social stigma associated with seeking professional psychological help. Advanced age and a low educational level were the only predictors associated with self-stigma, while a history of multiple pregnancies had an effect only on social stigma associated with seeking professional psychological help. CONCLUSION Chinese pregnant women experienced a mild to moderate level of stigma associated with seeking professional psychological help. Destigmatizing interventions focusing on self-stigma and social stigma should be designed according to maternal characteristics, social support, coping style, and depressive symptoms.
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Affiliation(s)
- Meili Xiao
- Department of Nursing, Hunan Normal University School of Medicine, 371 Tongzipo Road, Yuelu District, Changsha, Hunan 410013, China.
| | - Sasa Huang
- Nursing Department, The Third Xiangya Hospital of Central South University, 138 Tongzipo Road, Yuelu District, Changsha, Hunan 410013, China; Xiang Ya Nursing School of Central South University, 172 Tongzipo Road, Yuelu District, Changsha, Hunan 410013, China
| | - Yongrong Liu
- Nursing Department, The Third Xiangya Hospital of Central South University, 138 Tongzipo Road, Yuelu District, Changsha, Hunan 410013, China; Department of Obstetrics and Gynecology, The Third Xiangya Hospital of Central South University, 138 Tongzipo Road, Yuelu District, Changsha, Hunan 410013, China
| | - Guanxiu Tang
- Nursing Department, The Third Xiangya Hospital of Central South University, 138 Tongzipo Road, Yuelu District, Changsha, Hunan 410013, China; Department of Obstetrics and Gynecology, The Third Xiangya Hospital of Central South University, 138 Tongzipo Road, Yuelu District, Changsha, Hunan 410013, China.
| | - Ying Hu
- Nursing Department, The Third Xiangya Hospital of Central South University, 138 Tongzipo Road, Yuelu District, Changsha, Hunan 410013, China; Xiang Ya Nursing School of Central South University, 172 Tongzipo Road, Yuelu District, Changsha, Hunan 410013, China
| | - Bing Fu
- Nursing Department, The Third Xiangya Hospital of Central South University, 138 Tongzipo Road, Yuelu District, Changsha, Hunan 410013, China; Department of Obstetrics and Gynecology, The Third Xiangya Hospital of Central South University, 138 Tongzipo Road, Yuelu District, Changsha, Hunan 410013, China
| | - Jun Lei
- Nursing Department, The Third Xiangya Hospital of Central South University, 138 Tongzipo Road, Yuelu District, Changsha, Hunan 410013, China; Department of Obstetrics and Gynecology, The Third Xiangya Hospital of Central South University, 138 Tongzipo Road, Yuelu District, Changsha, Hunan 410013, China.
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Schmidt-Hantke J, Jacobi C. Investigating perspectives on e-health interventions to enhance maternal mental well-being: Results of a stakeholder interview. PLOS DIGITAL HEALTH 2023; 2:e0000326. [PMID: 37611049 PMCID: PMC10446204 DOI: 10.1371/journal.pdig.0000326] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/20/2022] [Accepted: 07/12/2023] [Indexed: 08/25/2023]
Abstract
Peripartum mental disorders are highly prevalent conditions and associated with adverse outcomes for the mother, the infant and the whole family. Despite the high burden, help-seeking is low. E-mental health interventions could overcome help-seeking barriers and thus improve perinatal mental health. However, usage and adherence are rather low. This study aims to assess attitudes and needs of different stakeholder groups and to identify relevant topics to develop an intervention meeting the needs of pregnant and postpartum women and thus, increasing utilization and adherence. Therefore, semi-structured interviews and focus groups with pregnant women (n = 3), mothers (n = 4), women who have suffered from a postpartum mood disorder in the past (n = 5), gynaecologists (n = 5), and midwives (n = 5) were conducted. All interviews were audio-recorded, transcribed verbatim, and analyzed using a thematic analysis. Almost half of the stakeholders reported previous experiences with e-mental health services. Anonymity, flexibility, promoting help-seeking, or bridging waiting-time for treatment as usual were regarded as the main benefits. Concerns regarding the usefulness of e-mental health interventions, absence of face-to-face contact or lack of integration into routine care were considered as barriers. With regard to the desired program content, six main topics were identified: pregnancy and puerperium, peripartum mood swings and disorders, support options, self-care, partnership, and fatherhood. Regarding preferred characteristics of e-mental health programs, stakeholders mentioned customizability, individual guidance, evaluation of user-feedback and continuous adoption, as well as a responsive and user-friendly design. Overall, online interventions for perinatal mental health were mainly considered as beneficial. Stakeholders underlined the high need for education regarding the use and effectiveness of e-mental health, to overcome concerns and obstacles and improve acceptability. Furthermore, developing customizable and individually-guided interventions were considered as promising to increase utilization of and adherence to e-mental health interventions.
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Affiliation(s)
| | - Corinna Jacobi
- Department of Psychology, Technical University Dresden, Dresden, Germany
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Hu Y, Huang S, Xiao M, Fu B, Tang G, Lommel L, Lei J. Barriers and facilitators of psychological help-seeking behaviors for perinatal women with depressive symptoms: A qualitative systematic review based on the Consolidated Framework for Implementation Research. Midwifery 2023; 122:103686. [PMID: 37119670 DOI: 10.1016/j.midw.2023.103686] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2022] [Revised: 03/22/2023] [Accepted: 04/08/2023] [Indexed: 05/01/2023]
Abstract
OBJECTIVE To identify barriers and facilitators related to psychological help-seeking behaviors of perinatal depression from all related stakeholders (e.g., perinatal women, family members, mental health care providers, and policymakers). DESIGN A literature search of six English-language databases (PubMed, Web of Science, Embase, PsycINFO, the Cochrane Library, CINAHL) and three Chinese-language databases (China National Knowledge Infrastructure, Wan Fang, Chinese Biomedical Literature Databases). Studies published in English or Chinese using qualitative or mixed methods to explore the psychological help-seeking behaviors of women with perinatal depression were included. Data extraction was synthesized for common themes based on the Consolidated Framework for Implementation Research. The Joanna Briggs Institute Qualitative Assessment and Review Instrument was used to appraise methodologic quality. PARTICIPANTS AND SETTINGS Perinatal women with depression, mental health care providers (e.g., pediatricians/nurses, social workers, nurse-midwives, perinatal psychiatrists, community health workers, and administrators), partners and informal caregivers (e.g., community birth attendants, elderly mothers, and men of reproductive age) based in high, middle and low income countries. FINDINGS Forty-three articles were included in this review and presented according to the Consolidated Framework for Implementation Research domains (in parentheses). The most common barriers to help seeking were stigma (individual characteristics), misconceptions (individual characteristics), cultural beliefs (inner setting), and lack of social support (outer setting). The most common facilitators were providing adequate support (outer setting) and perinatal health care professional training on how to detect, manage and discuss depression; establishing supportive relationships with mental health care providers; and eroding stigma (all three implementation processes). KEY CONCLUSIONS AND IMPLICATIONS FOR PRACTICE This systematic review could serve as a reference framework for health authorities to develop diverse strategies for improving the psychological help-seeking behaviors of women with perinatal depression. More high-quality studies focused on the Consolidated Framework for Implementation Research characteristics of available interventions, and implementation processes are needed in future research.
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Affiliation(s)
- Ying Hu
- Department of Nursing, The Third Xiangya Hospital of Central South University, 138 Tongzipo Road, Yuelu District, Changsha, Hunan 410013, China; Xiang Ya Nursing School of Central South University, 172 Tongzipo Road, Yuelu District, Changsha, Hunan 410013, China
| | - Sasa Huang
- Department of Nursing, The Third Xiangya Hospital of Central South University, 138 Tongzipo Road, Yuelu District, Changsha, Hunan 410013, China; Xiang Ya Nursing School of Central South University, 172 Tongzipo Road, Yuelu District, Changsha, Hunan 410013, China
| | - Meili Xiao
- Department of Nursing, The Third Xiangya Hospital of Central South University, 138 Tongzipo Road, Yuelu District, Changsha, Hunan 410013, China; Xiang Ya Nursing School of Central South University, 172 Tongzipo Road, Yuelu District, Changsha, Hunan 410013, China; Department of Nursing, Hunan Normal University School of Medicine, 371 Tongzipo Road, Yuelu District, Changsha, Hunan 410013, China.
| | - Bing Fu
- Department of Obstetrics and Gynecology, The Third Xiangya Hospital of Central South University, 138 Tongzipo Road, Yuelu District, Changsha, Hunan 410013, China
| | - Guanxiu Tang
- Department of Geriatrics, the Third Xiangya Hospital of Central South University, 138 Tongzipo Road, Yuelu District, Changsha, Hunan 410013, China
| | - Lisa Lommel
- University of California, San Francisco, 1001 Potrero Ave, San Francisco, San Francisco, California 94110, United States
| | - Jun Lei
- Department of Obstetrics and Gynecology, The Third Xiangya Hospital of Central South University, 138 Tongzipo Road, Yuelu District, Changsha, Hunan 410013, China.
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Huang S, Xiao M, Hu Y, Tang G, Chen Z, Zhang L, Fu B, Lei J. Attitudes toward seeking professional psychological help among Chinese pregnant women: A cross-sectional study. J Affect Disord 2023; 322:163-172. [PMID: 36400148 DOI: 10.1016/j.jad.2022.11.034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/17/2022] [Revised: 11/09/2022] [Accepted: 11/11/2022] [Indexed: 11/17/2022]
Abstract
BACKGROUND There exists a gap between the high prevalence of mental health problems and negative attitudes toward seeking professional psychological help among Chinese pregnant women. This study aimed to investigate the attitudes and factors toward seeking professional psychological help among Chinese pregnant women to provide some suggestions for improving pregnant women's psychological help-seeking behaviors. METHODS A total of 1024 pregnant women were recruited. The Chinese version of the Attitude Toward Seeking Professional Psychological Help Scale (ATSPPH) was used to assess the attitudes toward professional psychological help-seeking. Demographic and socio-psychological factors were collected by self-developed questionnaire, Perceived Social Support Scale, Simplified Coping Style Questionnaire, and Patient Health Questionnaire-9 Scale. RESULTS 1006 pregnant women were included in the final analysis. Only 3.7 % of participants chose professionals as their first choice for psychological help-seeking. The attitudes toward seeking professional psychological help were relatively positive, with the highest score of stigma tolerance among four subscales in ATSPPH. Education level, perceived social support, and positive coping style had a positive predictive effect on the four subscales of ATSPPH. Women with prenatal depressive symptoms had a lower score in the subscales of recognition of need for psychotherapeutic help and confidence in mental health practitioner; women with higher scores of negative coping style had a lower score in the subscales of stigma tolerance and interpersonal openness. History of professional psychological help-seeking behaviors was only associated with the subscale of recognition of need for psychotherapeutic help; Maternal age was only associated with the subscale of interpersonal openness. CONCLUSION The attitudes toward seeking professional psychological help were relatively positive among Chinese pregnant women, and stigma tolerance was the significant barrier to professional psychological help-seeking. More attention should be paid to those women with older age, negative coping style, and women with prenatal depressive symptoms.
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Affiliation(s)
- Sasa Huang
- Xiang Ya Nursing School of Central South University, 172 Tongzipo Road, Yuelu District, Changsha 410013, Hunan, China
| | - Meili Xiao
- Xiang Ya Nursing School of Central South University, 172 Tongzipo Road, Yuelu District, Changsha 410013, Hunan, China
| | - Ying Hu
- Xiang Ya Nursing School of Central South University, 172 Tongzipo Road, Yuelu District, Changsha 410013, Hunan, China
| | - Guanxiu Tang
- Department of Geriatrics, The Third Xiangya Hospital of Central South University, 138 Tongzipo Road, Yuelu District, Changsha 410013, Hunan, China
| | - Zhihong Chen
- Pediatric Intensive Care Unit, The Third Xiangya Hospital of Central South University, 138 Tongzipo Road, Yuelu District, Changsha 410013, Hunan, China
| | - Lijuan Zhang
- Department of Emergency Pediatrics, The Third Xiangya Hospital of Central South University, 138 Tongzipo Road, Yuelu District, Changsha 410013, Hunan, China
| | - Bing Fu
- Department of Obstetrics and Gynecology, The Third Xiangya Hospital of Central South University, 138 Tongzipo Road, Yuelu District, Changsha 410013, Hunan, China
| | - Jun Lei
- Department of Obstetrics and Gynecology, The Third Xiangya Hospital of Central South University, 138 Tongzipo Road, Yuelu District, Changsha 410013, Hunan, China.
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Marshman A, Saunders E, Chaves D, Morton Ninomiya ME. Barriers to perinatal mental health care experiences by midwives and obstetricians and their patients: A rapid review. Midwifery 2023; 117:103544. [PMID: 36580794 DOI: 10.1016/j.midw.2022.103544] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2022] [Revised: 10/19/2022] [Accepted: 10/31/2022] [Indexed: 11/13/2022]
Abstract
INTRODUCTION While perinatal mental health concerns are common, little attention is paid to noticing or addressing these concerns. Midwives and obstetricians are uniquely positioned to universally screen their patients for mental health conditions during the perinatal period, and provide referrals for additional mental health supports if relevant. Previous studies on perinatal mental health care have focused primarily on midwifery care, excluding perinatal healthcare providers such as obstetricians. This rapid review aims to examine the barriers to accessing mental health care during the perinatal period as experienced by obstetricians, midwives, and their patients. METHODS A rapid review of literature was conducted on barriers to perinatal mental health care as experienced by patients, midwives, and obstetricians. The search strategy included published literature from PubMed, CINAHL, PsycINFO, and Web of Science published between 2000 and 2020. All documents were screened by two researchers and disagreements were resolved through consensus with a third reviewer. After data from all included articles were extracted, thematic analysis was conducted, and findings were compared with related reviews that focused on mental health access for individuals who accessed midwifery care. RESULTS Of the 539 references and documents that were screened, 31 articles met the inclusion criteria. In the extraction phase, country, study objective(s), study design, perspective(s), barriers, and the dimension(s) impacted along the pathway to accessing care were retrieved from the 31 included articles. After all barriers were classified using the Supply-Side Dimensions of Access, we developed a classification framework to further examine stigma at the societal, institutional, and individual levels. DISCUSSION While midwives utilize a more holistic approach to care as compared with obstetricians, the barriers identified through this rapid review indicate that obstetricians and their patients face similar struggles to accessing and providing mental health care. Moreover, stigma plays a large role in the barriers experienced by patients, midwives, and obstetricians - at individual and institutional levels. CONCLUSION Obstetricians encounter similar stigma-related barriers as midwives in detecting mental health concerns, as well as connecting clients to available mental health resources and supports. Therefore, to effectively eliminate barriers to accessing perinatal mental health care, a systemic change must be enacted throughout all three layers to address the deep-rooted stigma associated with accessing mental health care during the perinatal period.
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Affiliation(s)
| | | | | | - Melody E Morton Ninomiya
- Wilfrid Laurier University; Centre for Addiction and Mental Health; Canada Research Chair (Tier II) in Community-Driven Knowledge Mobilization and Pathways to Wellness.
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Ezirim N, Younes LK, Barrett JH, Kauffman RP, Macleay KJ, Newton ST, Tullar P. Reproducibility of the Edinburgh Postnatal Depression Scale during the Postpartum Period. Am J Perinatol 2023; 40:194-200. [PMID: 33882587 DOI: 10.1055/s-0041-1727226] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
OBJECTIVE This study was aimed to evaluate the efficacy of the Edinburgh Postnatal Depression Scale (EPDS) in the immediate postpartum period, which we defined as between 3 and 24 hours postpartum for the purpose of this research. This is such that if it can predict scores obtained at the postpartum visit, it will be an opportunity to access psychiatric services for the patient that may otherwise be more difficult to access in the outpatient setting. STUDY DESIGN Longitudinal observational study, which included an analysis of 848 consecutive participants screened with the EPDS in the hospital and at the 6-week postpartum visit. RESULTS Receiver-operating characteristic (ROC) curve suggested >3 at delivery as a more optimal score to predict depression at the postpartum visit with sensitivity 76.5% and specificity 65.9%. The commonly accepted EPDS cut-off value of >9 was far less sensitive at 28.8% but reasonably specific at 93.2% for predicting elevated scores (>9) 6 weeks postpartum. In subgroup analysis, only a prior mental health disorder was found to be predictive of elevated scores at the postpartum visit (relative risk: 1.97, 95% confidence interval: 1.17-3.32, p = 0.01). CONCLUSION The EPDS, originally designed to screen for postpartum depression (PPD) in the outpatient setting, does not predict the development of PPD, as determined by the EPDS (validated at the 6-week postpartum time interval) when administered during hospitalization shortly after delivery. KEY POINTS · EPDS is a validated screening tool for PPD that is validated in the outpatient setting, but various guidelines are presently unclear on the exact timing for PPD screening.. · EPDS scores from 3 to 24 hours postpartum does not reliably predict elevated scores 6 weeks later.. · EPDS scores >3 from 3 to 24 hours postpartum may identify need to "rule out" PPD 6 weeks later..
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Affiliation(s)
- Nkechi Ezirim
- Department of Obstetrics and Gynecology, Texas Tech University Health Sciences Center, Amarillo, Texas
| | - Lena K Younes
- Department of Obstetrics and Gynecology, University of Texas Medical Branch, Galveston, Texas
| | - Joel H Barrett
- Department of Psychiatry, Texas Tech University Health Sciences Center, Lubbock, Texas
| | - Robert P Kauffman
- Department of Obstetrics and Gynecology, Texas Tech University Health Sciences Center, Amarillo, Texas
| | - Katie J Macleay
- Department of Family Medicine, Texas A&M Health Sciences Center, Bryan, Texas
| | - Scott T Newton
- Department of Psychiatry, University of Texas Southwestern, Medical Center, Dallas, Texas
| | - Paul Tullar
- Department of Obstetrics and Gynecology, Texas Tech University Health Sciences Center, Amarillo, Texas
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Warran K, Smith C, Ugron H, Frøkjær Carstens L, Zbranca R, Ottow M, Blaga OM, Lund Ladegaard N, Davis RE, Fancourt D, Fietje N. Scalability of a singing-based intervention for postpartum depression in Denmark and Romania: protocol for a single-arm feasibility study. BMJ Open 2022; 12:e063420. [PMID: 36523227 PMCID: PMC9748965 DOI: 10.1136/bmjopen-2022-063420] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
INTRODUCTION Postpartum depression (PPD) affects around one in seven women globally, with these women in need of non-pharmaceutical treatment strategies. There is a long history of the benefits of singing for maternal mental health, and promising research exists showing the clinical effectiveness of group singing. Group singing interventions are being scaled up to support new mothers in the United Kingdom, but we do not know if such an intervention may benefit women in different cultural contexts. This protocol focuses on exploring the feasibility of implementation and perceived impact of a 10-week group singing intervention for new mothers in Romania and Denmark eliciting signs of PPD. METHODS AND ANALYSIS Data will be collected from up to 48 women with a score ≥10 on the Edinburgh Postnatal Depression Scale (EPDS) participating in a 10-week group singing intervention in Denmark or Romania, as well as a range of project stakeholders. The singing classes will take place in person and be facilitated by professional singing leaders. Feasibility of implementation will be analysed through qualitative data (eg, focus groups, interviews) and quantitative data (eg, the Feasibility of Intervention Measure). Perceived impact will be explored via surveys that include mental health measures (EPDS, Multidimensional Scale of Perceived Social Support, WHO Five Well-Being Index) from singing intervention participants (at weeks 1, 6, 10) and focus groups. Descriptive statistics, repeated measures analysis of variance and analysis of covariance will be used to analyse quantitative data. Framework method and thematic analysis will be used to analyse qualitative data. ETHICS AND DISSEMINATION The national ethics committees in Romania (IRB-PH Protocol #2021-211217-012) and Denmark (case number 1-10-72-274-21) have approved the study, as has the Ethics Review Committee at the World Health Organization (ERC.0003714). All participants will be required to provide informed consent. Results will be disseminated by reports published by the WHO Regional Office for Europe, peer-reviewed publications and at conferences.
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Affiliation(s)
- Katey Warran
- Research Department of Behavioural Science and Health, University College London, London, UK
| | - Calum Smith
- Behavioural and Cultural Insights Unit, WHO Regional Office for Europe, Copenhagen, Denmark
- Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | - Hanna Ugron
- Centrul Cultural Clujean, Cluj-Napoca, Romania
| | | | | | | | - Oana Maria Blaga
- Center for Health Policy and Public Health, Babeș-Bolyai University, Cluj-Napoca, Romania
| | | | - Rachel E Davis
- Centre for Implementation Science, King's College London, London, UK
| | - Daisy Fancourt
- Research Department of Behavioural Science and Health, University College London, London, UK
| | - Nils Fietje
- Behavioural and Cultural Insights Unit, WHO Regional Office for Europe, Copenhagen, Denmark
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Briscoe L, Marsland L, Doyle C, Docherty G, Flynn A, Gichuru P. A mixed method study to explore the maternal impact and outcomes of a specialist Building Attachment and Bonds Service (The BABS Study). Health Care Women Int 2022:1-22. [PMID: 36322644 DOI: 10.1080/07399332.2022.2129643] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2022] [Revised: 09/23/2022] [Accepted: 09/23/2022] [Indexed: 06/16/2023]
Abstract
Our intent was to explore if maternal anxiety, depression, reflective functioning and level of attachment significantly changed after the Building Bonds and Attachment Service (BABS) Intervention. We measured outcomes for 46 at risk mothers via HADS; MAAS; MPAS and P-PRFQ. Our findings, triangulated with 32 semi structured interviews identified that BABS intervention made a significant difference to participants who were admitted during the antenatal period (Pregnant group: depression 9.63[CI:7.63-11.63; p < 0.001]; anxiety 9.40[CI: 7.56-11.24]; p < 0.001]; reflective functioning 30.78[CI:24.84-36.72; p < 0.001] and maternal attachment 8.78[CI:4.08-13.48]; p 0.001). Suicidal contemplation was prevented for two women. Our conclusions explained the service made a significant difference to the lives of mothers between baseline and post intervention for pregnant mothers with anxiety and depression who struggled to bond with their baby. Appropriate referral may help to increase accessibility to those who may benefit most. Further research needs to test if this care model would be acceptable to culturally diverse populations.
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Affiliation(s)
- Lesley Briscoe
- Maternal and Neonatal Health Researcher, Medical Education Department, Edge Hill University, Lancashire, UK
| | - Lisa Marsland
- Parent Infant Mental Health & Service Lead for Mersey Care NHS Foundation Trust, Liverpool, UK
| | - Carmel Doyle
- Midwifery Department, Liverpool Women's Hospital NHS Trust, Liverpool, UK
| | - Gemma Docherty
- Administration Department Mersey Care, NHS Foundation Trust, UK
| | - Anita Flynn
- Department of Nursing, Faculty of Health Social Care and Medicine, Edge Hill University, Lancashire, UK
| | - Phillip Gichuru
- Medical Education Department, Edge Hill University, Lancashire, UK
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Guo P, Cui N, Mao M, Zhang X, Chen D, Xu P, Wang X, Zhang W, Zheng Q, Zhang L, Xiang Z, Jin Y, Feng S. Cross-cultural adaptation and psychometric properties of the Chinese version of the postpartum depression literacy scale. Front Psychol 2022; 13:966770. [PMID: 36017447 PMCID: PMC9397490 DOI: 10.3389/fpsyg.2022.966770] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2022] [Accepted: 07/25/2022] [Indexed: 11/13/2022] Open
Abstract
Background and aim The postpartum depression literacy (PoDLi) of perinatal women is closely related to the occurrence, recognition, and treatment of postpartum depression, therefore valid instruments for evaluating the level of PoDLi are of great significance for both research and clinical practice. This study aimed to cross-culturally adapt the postpartum depression literacy scale (PoDLiS) into Chinese and to test its psychometric properties among Chinese perinatal women. Materials and methods A cross-sectional study was conducted from April to May 2022 in a tertiary hospital in Hangzhou, Zhejiang Province, China. 619 out of the 650 perinatal women that were approached via a convenience sampling method completed the Chinese version of the PoDLiS (C-PoDLiS). Content validity [the content validity index of items (I-CVI) and scale-level content validity index (S-CVI)] was evaluated by an expert panel. Psychometric properties, including item analysis, structure validity (exploratory factor analysis, confirmatory factor analysis), convergent and discriminant validity, reliability (internal consistency, test-retest reliability), criterion validity (concurrent validity, predictive validity), and floor/ceiling effect were examined. Results The final version of C-PoDLiS is a six-factor structure consisting of 27 items, which explained 61.00% of the total variance. Adequate content validity (I-CVI = 0.833–1.00, S-CVI = 0.920) was ensured by the expert panel. The modified confirmatory factor analysis model revealed that the 6-factor model fitted the data well (χ2/df = 1.532, root mean square error of approximation = 0.042, goodness of fit = 0.900, incremental fit index = 0.949, comparative fit index = 0.948, Tucker–Lewis index = 0.940). The total Cronbach’s α was 0.862, the total McDonald’s ω was 0.869, and the test-retest reliability coefficient was 0.856. Results of convergent validity (average variance extracted = 0.486–0.722) and discriminant validity provided good or acceptable psychometric support. Significant correlations between scores of the C-PoDLiS and Mental health literacy scale (r = 0.155–0.581, p < 0.01) and Attitudes toward seeking professional psychological help short form scale (r = 0.361–0.432, p < 0.01) supported good concurrent and predictive validity, respectively. No floor/ceiling effect was found. Conclusion The C-PoDLiS was demonstrated to be a sound instrument with good reliability and validity for evaluating Chinese perinatal women’s PoDLi levels. Its use in the future can facilitate data aggregation and outcome comparisons across different studies on this topic.
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Affiliation(s)
- Pingping Guo
- Women’s Hospital, Zhejiang University School of Medicine, Hangzhou, China
- Faculty of Nursing, Zhejiang University School of Medicine, Hangzhou, China
| | - Nianqi Cui
- Faculty of Nursing, Zhejiang University School of Medicine, Hangzhou, China
| | - Minna Mao
- Women’s Hospital, Zhejiang University School of Medicine, Hangzhou, China
- Faculty of Nursing, Zhejiang University School of Medicine, Hangzhou, China
| | - Xuehui Zhang
- School of Nursing, Jining Medical University, Jining, China
| | - Dandan Chen
- Faculty of Nursing, Zhejiang University School of Medicine, Hangzhou, China
| | - Ping Xu
- Women’s Hospital, Zhejiang University School of Medicine, Hangzhou, China
- Faculty of Nursing, Zhejiang University School of Medicine, Hangzhou, China
| | - Xiaojuan Wang
- Women’s Hospital, Zhejiang University School of Medicine, Hangzhou, China
- Faculty of Nursing, Zhejiang University School of Medicine, Hangzhou, China
| | - Wei Zhang
- Women’s Hospital, Zhejiang University School of Medicine, Hangzhou, China
- Faculty of Nursing, Zhejiang University School of Medicine, Hangzhou, China
| | - Qiong Zheng
- Women’s Hospital, Zhejiang University School of Medicine, Hangzhou, China
- Faculty of Nursing, Zhejiang University School of Medicine, Hangzhou, China
| | - Le Zhang
- Women’s Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Zhenzhen Xiang
- Women’s Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Yin Jin
- Women’s Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Suwen Feng
- Women’s Hospital, Zhejiang University School of Medicine, Hangzhou, China
- *Correspondence: Suwen Feng,
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Ruiz-Segovia N, Rodriguez-Muñoz MF, Olivares ME, Izquierdo N, Coronado P, Le HN. Healthy Moms and Babies Preventive Psychological Intervention Application: A Study Protocol. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:12485. [PMID: 34886212 PMCID: PMC8656746 DOI: 10.3390/ijerph182312485] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/28/2021] [Revised: 11/21/2021] [Accepted: 11/24/2021] [Indexed: 11/16/2022]
Abstract
Depression is the most common psychological disorder during the perinatal period, and its negative effects extend to mothers, babies, their family and society. Scientific evidence points to the urgency of designing preventive interventions and concludes that the gestational period is the most appropriate time to implement these interventions. However, many pregnant women do not seek professional help due to a lack of knowledge about the importance of mental health, its impact, and the available intervention options, as well as a lack of time and financial resources. E-health interventions can be an efficient, cost-effective, and accessible resource for preventing postpartum depression that can circumvent the barriers that pregnant women face. This randomized clinical trial will examine the efficacy of Healthy Moms and Babies, an app aimed at preventing postpartum depressive symptomatology. The second objective of this study is to analyze the effectiveness of the tool in preventing anxious symptomatology. The primary outcome measure is the difference in the mean score between the intervention and control groups on the Patient Health Questionnaire-9 (PHQ-9) at the end of the intervention and at 3 and 6 months postpartum. The secondary outcome will be determined by using the Generalized Anxiety Disorder Screener (GAD-7) at the same time points. The research findings can be used to determine pregnant women's use of the e-health application for the prevention of postpartum depression, whether the Healthy Moms and Babies intervention app is an effective and useful resource, and what modifications will need to be made to the tool in future updates.
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Affiliation(s)
- Natalia Ruiz-Segovia
- Department of Psychology, Universidad Nacional de Educación a Distancia (UNED), 28040 Madrid, Spain;
| | - Maria Fe Rodriguez-Muñoz
- Department of Psychology, Universidad Nacional de Educación a Distancia (UNED), 28040 Madrid, Spain;
| | - Maria Eugenia Olivares
- Department of Gynecology and Obstetrics, Instituto de Salud de la Mujer José Botella Llusiá, Hospital Clínico San Carlos, Faculty of Medicine, Universidad Complutense de Madrid, 28040 Madrid, Spain; (M.E.O.); (N.I.); (P.C.)
| | - Nuria Izquierdo
- Department of Gynecology and Obstetrics, Instituto de Salud de la Mujer José Botella Llusiá, Hospital Clínico San Carlos, Faculty of Medicine, Universidad Complutense de Madrid, 28040 Madrid, Spain; (M.E.O.); (N.I.); (P.C.)
| | - Pluvio Coronado
- Department of Gynecology and Obstetrics, Instituto de Salud de la Mujer José Botella Llusiá, Hospital Clínico San Carlos, Faculty of Medicine, Universidad Complutense de Madrid, 28040 Madrid, Spain; (M.E.O.); (N.I.); (P.C.)
| | - Huynh-Nhu Le
- Department of Psychology, George Washington University, Washington, DC 20052, USA;
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Ruybal AL, Siegel JT. Increasing social support for women with postpartum depression through attribution theory guided vignettes and video messages: The understudied role of effort. JOURNAL OF EXPERIMENTAL SOCIAL PSYCHOLOGY 2021. [DOI: 10.1016/j.jesp.2021.104197] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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12
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Contemplating Help-Seeking in Perinatal Psychological Distress-A Meta-Ethnography. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18105226. [PMID: 34069073 PMCID: PMC8156805 DOI: 10.3390/ijerph18105226] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/24/2021] [Revised: 04/23/2021] [Accepted: 05/08/2021] [Indexed: 12/02/2022]
Abstract
Perinatal psychological distress (PPD) may cause delays in help-seeking in the perinatal period, which is crucial for families with small children. Help-seeking theories focus on rational processes of behavior wherein ‘help-seeking’ is viewed as a decision-making process, in which action is preceded by recognizing a problem. We identified the phase prior to actual help-seeking actions as a life situation and a phenomenon through which to gain a deeper understanding from women’s own perspectives. The aim of this study was to integrate and synthesize knowledge of women’s experiences of contemplating seeking help for PPD. We chose interpretative meta-ethnography by Noblit and Hare (1988) and implemented eMERGe guidelines in reporting. The search was performed systematically, and the 14 included studies were evaluated with Critical Appraisal Skills Programme checklist (CASP). We identified seven themes and a metaphor in a lines-of-argument synthesis, showing that contemplating help-seeking is a multidimensional phenomenon. We did not observe a straightforward and linear process (as previous research suggests) but instead a complex process of contemplating help-seeking. A clinical implication is that service providers should work with outreach and develop their tools to connect with mothers with PPD. Another suggestion is to improve training in mental health literacy prior to or during pregnancy.
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Rosander M, Berlin A, Forslund Frykedal K, Barimani M. Maternal depression symptoms during the first 21 months after giving birth. Scand J Public Health 2020; 49:606-615. [PMID: 33308010 PMCID: PMC8512257 DOI: 10.1177/1403494820977969] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Aims: The first year after childbirth involves a major transition for women, which
can accentuate inadequacies and feelings of powerlessness, making them
vulnerable to depression. The aim of this study was to investigate the
prevalence and frequency of maternal postpartum depressive symptoms at
different times after giving birth (0–21 months). Methods: Data were collected cross-sectionally using a web questionnaire containing
the Edinburgh Postnatal Depression Scale (EPDS). A total of 888 mothers with
children in the age range 0–21 months responded. Results: The results showed different levels of depression over the range of months
included in the study. The overall prevalence using EPDS ⩾ 12 was 27.8%.
There were higher levels at 9–12 months and 17–21 months. The highest levels
of symptoms of depression were found at nine, 12, and 17 months after birth,
and the lowest levels at two and 16 months. Conclusions: Many mothers experience symptoms of depression after giving birth that
can continue well beyond the child’s first year. We have identified
different levels of depression at different points in time after giving
birth, with highs and lows throughout the first 21 months. This
highlights a need to screen for depression more than once during the
first years, as well as a closer cooperation between midwives and child
healthcare nurses in supporting mothers in the transition to motherhood.
This is an important aspect of public health, which not only involves
mothers with symptoms of depression, but also their ability to care for
their child and a possible negative impact on the child’s
development.
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Affiliation(s)
- Michael Rosander
- Department of Behavioural Sciences and
Learning, Linköping University, Linköping, Sweden
- Michael Rosander, Department of Behavioural
Sciences and Learning, Linköping University, 581 83 Linköping, Sweden. E-mail:
| | - Anita Berlin
- Department of Neurobiology, Care
Sciences and Society, Karolinska Institutet, Stockholm, Sweden
| | - Karin Forslund Frykedal
- Department of Behavioural Sciences and
Learning, Linköping University, Linköping, Sweden
- Department of Social and Behavioural
Studies, University West, Trollhättan, Sweden
| | - Mia Barimani
- Academic Primary Care Centre, Region
Stockholm, Stockholm, Sweden
- Division of Family Medicine and Primary
Care, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet,
Stockholm, Sweden
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Moore D, Drey N, Ayers S. A meta-synthesis of women's experiences of online forums for maternal mental illness and stigma. Arch Womens Ment Health 2020; 23:507-515. [PMID: 31646392 DOI: 10.1007/s00737-019-01002-1] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/12/2019] [Accepted: 09/11/2019] [Indexed: 11/24/2022]
Abstract
Perinatal mental illness affects 15% of women; however, only half of these women access treatment. Some women with untreated perinatal mental illness may continue to suffer with mental illness after the perinatal period. Evidence suggests that one barrier to accessing treatment is stigma. Forums may provide an acceptable place for women to converse about the stigmatised symptoms of maternal mental illness. Reducing stigma may increase treatment uptake. This study aimed to review and synthesise the qualitative research on maternal mental illness forums and stigma so that stigma can be addressed and treatment improved. A meta-synthesis was conducted to describe and interpret qualitative studies regarding forum use and maternal mental illness stigma. A systematic search of seven electronic databases and Google Scholar was performed. Additional references were collected through screening references of the identified studies. Five studies were identified that reported women's experiences of online forums for maternal mental illness and stigma. The synthesis identified four key themes: (1) a safe place to talk; (2) virtual support; (3) stigma and identity; and (4) repair of the mother identity. Stigma maybe reduced by forum discourse that reconceptualises what is to be a "good mother" and separates stigma and maternal identity. This synthesis provides a novel and more detailed framework for the stigma of maternal mental illness and forum use. This suggests forums may enable women to explore their dual identity and repair their maternal identity, and this may reduce stigma. Healthcare providers could discuss forum use with their clients.
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Affiliation(s)
- D Moore
- School of Health Sciences, City, University of London, Northampton Square, London, EC1V 0HB, UK. .,The Open University, Walton Hall, Milton Keynes, UK.
| | - N Drey
- School of Health Sciences, City, University of London, Northampton Square, London, EC1V 0HB, UK
| | - S Ayers
- School of Health Sciences, City, University of London, Northampton Square, London, EC1V 0HB, UK
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15
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Cacciola E, Psouni E. Insecure Attachment and Other Help-Seeking Barriers among Women Depressed Postpartum. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:E3887. [PMID: 32486285 PMCID: PMC7313466 DOI: 10.3390/ijerph17113887] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/06/2020] [Revised: 05/23/2020] [Accepted: 05/27/2020] [Indexed: 11/16/2022]
Abstract
When untreated, postpartum depression (PPD) can severely, negatively affect maternal health, child development, and the wellbeing and functioning of the entire family. Yet, despite screening and treatment programs for PPD, many women who experience depression with onset in the postpartum year do not communicate their symptoms. Negative relational experiences early in life, such as not receiving sensitive help and support when needed, often result in so-called insecure attachment styles, and there is evidence that these may contribute to the development and maintenance of PPD. However, the role of insecure attachment styles in non-help-seeking is unknown for this group. Using mixed quantitative and qualitative methodology, we identified help-seeking barriers of women who experienced depression with onset in the postpartum year but who had not sought help for their depression (N = 37), and explored links to their attachment orientations as assessed through both self-reported attachment style and narrative based attachment script assessment. The sample was non-normative regarding attachment, with an over-representation of avoidant attachment styles. Help-seeking barriers varied systematically with the mother's adult attachment style. Specifically, convictions of a strong self and lack of trust in healthcare professionals constituted a common barrier among women with avoidant attachment styles, while unrealistic expectations about motherhood constituted a barrier for women with secure attachment styles. This new knowledge on how barriers to communicating symptoms and seeking help when suffering from PPD vary systematically with attachment orientation can help formulate individualized, and therefore more efficient, approaches to addressing non-help-seeking behavior in women who suffer in silence.
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Affiliation(s)
| | - Elia Psouni
- Department of Psychology, Lund University, P.O. Box 213, SE221-00 Lund, Sweden;
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16
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Predictors of postpartum depression service use: A theory-informed, integrative systematic review. Women Birth 2020; 33:e24-e32. [DOI: 10.1016/j.wombi.2019.01.006] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2018] [Revised: 01/15/2019] [Accepted: 01/16/2019] [Indexed: 12/14/2022]
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Baldisserotto ML, Miranda Theme M, Gomez LY, Dos Reis TBQ. Barriers to Seeking and Accepting Treatment for Perinatal Depression: A Qualitative Study in Rio de Janeiro, Brazil. Community Ment Health J 2020; 56:99-106. [PMID: 31512080 DOI: 10.1007/s10597-019-00450-4] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/11/2019] [Accepted: 09/05/2019] [Indexed: 01/29/2023]
Abstract
Few studies have investigated the reasons why pregnant and puerperal women fail to seek or accept treatment for perinatal depression in low- and middle-income countries, where there is a high prevalence of this disorder. To help fill this gap, this study investigated the factors influencing the decision not to seek or to refuse treatment for perinatal depression in a low-income community in Rio de Janeiro, Brazil. Qualitative research was conducted in two primary health care units in Rio de Janeiro, Brazil in 2017-2018. Five focus groups were held with 26 women. Convenience sampling was used, and the sample size was determined by data saturation. A content analysis methodology was used to identify theme categories to objectively describe the group's manifest contents. Ten categories were obtained: stigma and misconception, self-image as a mother, socioeconomic stigma, lack of knowledge, lack of a health service approach to mental health, difficulty recognising depression symptoms, fear of children being removed, negative reaction to patient referral, denial of the problem and previous experience with the care unit. Perinatal depression is permeated with stigma and prejudice, and there is a belief that women with depression are unable to be good mothers. It is important to conduct programmes disseminating information about perinatal depression and implementing an approach that includes routine consultations so that women can access perinatal mental health services.
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Affiliation(s)
- Márcia Leonardi Baldisserotto
- Escola Nacional de Saúde Pública Sergio Arouca, Fundação Oswaldo Cruz, Leopoldo Bulhões, 1480 - Manguinhos, Rio de Janeiro, CEP: 21041-210, Brazil.
| | - Mariza Miranda Theme
- Escola Nacional de Saúde Pública Sergio Arouca, Fundação Oswaldo Cruz, Leopoldo Bulhões, 1480 - Manguinhos, Rio de Janeiro, CEP: 21041-210, Brazil
| | - Liliana Yanet Gomez
- Escola Nacional de Saúde Pública Sergio Arouca, Fundação Oswaldo Cruz, Leopoldo Bulhões, 1480 - Manguinhos, Rio de Janeiro, CEP: 21041-210, Brazil
| | - Talita Borges Queiroga Dos Reis
- Escola Nacional de Saúde Pública Sergio Arouca, Fundação Oswaldo Cruz, Leopoldo Bulhões, 1480 - Manguinhos, Rio de Janeiro, CEP: 21041-210, Brazil
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Luís C, Canavarro MC, Fonseca A. Men's Intentions to Recommend Professional Help-Seeking to Their Partners in the Postpartum Period: the Direct and Indirect Effects of Gender-Role Conflict. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16204002. [PMID: 31635045 PMCID: PMC6843949 DOI: 10.3390/ijerph16204002] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/30/2019] [Revised: 10/17/2019] [Accepted: 10/18/2019] [Indexed: 01/20/2023]
Abstract
Women's partners may act as facilitators of professional help-seeking for mental health problems in the postpartum period. This study aimed to examine the sociodemographic and clinical correlates of men's intentions to recommend professional help-seeking to their partners if they display postpartum mood and anxiety disorders and to explore the relationship between gender-role conflict and the intention to recommend help-seeking. A cross-sectional study included 214 adult men in a heterosexual relationship with a partner within the reproductive age. Men presented a high intention to recommend professional help to their partners. All dimensions of gender-role conflict were directly associated with the intention to recommend professional help-seeking (p < 0.05). High levels of gender-role conflict (dimensions success, power and competition, and restricted emotionality) were found to lead to increased levels of stigma and lower levels of intention to seek professional help, which, in turn, translated into lower intention to recommend help-seeking. These results emphasize the importance of developing universal awareness-raising and education campaigns directed at men aiming to reduce levels of gender-role conflict and stigma, and normalize the use of mental health services, to increase men's intentions to recommend professional help-seeking to their partners.
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Affiliation(s)
- Catarina Luís
- Faculty of Psychology and Educational Sciences, University of Coimbra; Coimbra, 3000-115 Coimbra, Portugal.
| | - Maria Cristina Canavarro
- Center for Research in Neuropsychology and Cognitive-Behavioral Intervention, Faculty of Psychology and Educational Sciences, University of Coimbra, Coimbra, 3000-115 Coimbra, Portugal.
| | - Ana Fonseca
- Center for Research in Neuropsychology and Cognitive-Behavioral Intervention, Faculty of Psychology and Educational Sciences, University of Coimbra, Coimbra, 3000-115 Coimbra, Portugal.
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Jahani Shoorab N, Mirteimouri M, Taghipour A, Latifnejad Roudsari R. Women's Experiences of Emotional Recovery from Childbirth-Related Perineal Trauma: A Qualitative Content Analysis. INTERNATIONAL JOURNAL OF COMMUNITY BASED NURSING AND MIDWIFERY 2019; 7:181-191. [PMID: 31341917 PMCID: PMC6614353 DOI: 10.30476/ijcbnm.2019.44993] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Received: 01/21/2019] [Revised: 03/17/2019] [Accepted: 04/10/2019] [Indexed: 02/04/2023]
Abstract
BACKGROUND The postpartum health care program in Iran is limited to the first six weeks of delivery and only focuses on women's physical problems. It seems that the issue of emotional recovery is underestimated in postnatal women with prenatal injuries. This study was designed to explore women's experiences of emotional recovery from childbirth-related perineal trauma. METHODS This qualitative content analysis was performed on 22 postnatal women with perineal trauma during labor at Omol-banin Hospital from the 20th of April to 25th of December in Mashhad, Iran in 2016. The participants were purposively selected between 10 days to one year after childbirth. Data were collected through semi-structured interviews and saturated after 26 interviews. The analysis of data was concurrently carried out using conventional content analysis adopted by Elo and Kyngas (2008). The MAXQDA software (Ver.10) was used for data organization. RESULTS Emotional recovery after birth trauma is defined as going on a journey from negative emotions to subjective well-being. Two super-ordinate generic categories emerged from the analysis: 1) feeling trapped in multifaceted issues, and 2) regaining possession of life. The participants encountered numerous concerns initially and with the help of family and community support, they regained the ability to dominate life and develop a pleasant mood. Improving physical functions had an essential role in regaining emotional well-being and enjoying daily life. CONCLUSION The results of this study promoted our understanding of the emotional recovery in women with childbirth-related perineal trauma. This helps the caregivers to understand woman's emotional concerns and needs in order to offer appropriate counseling services.
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Affiliation(s)
- Nahid Jahani Shoorab
- Nursing and Midwifery Care Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Masoumeh Mirteimouri
- Department of Obstetrics and Gynecology, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Ali Taghipour
- Social Determinants of Health Research Centre, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Robab Latifnejad Roudsari
- Nursing and Midwifery Care Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
- Department of Midwifery, School of Nursing and Midwifery, Mashhad University of Medical Sciences, Mashhad, Iran
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Russomagno S, Waldrop J. Improving Postpartum Depression Screening and Referral in Pediatric Primary Care. J Pediatr Health Care 2019; 33:e19-e27. [PMID: 31227124 DOI: 10.1016/j.pedhc.2019.02.011] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/02/2019] [Revised: 02/22/2019] [Accepted: 02/25/2019] [Indexed: 10/26/2022]
Abstract
INTRODUCTION Postpartum depression (PPD) affects up to 20% of American mothers and, if left untreated, can have serious, lifelong effects on women and their children. The American Academy of Pediatrics recommends that pediatric practices screen for PPD at the 1-, 2-, 4-, and 6-month well-child checks; however, few pediatric practices oblige. METHODS This project standardized the PPD screening schedule and developed a novel referral algorithm that was concurrently implemented in a rural primary care pediatric practice. RESULTS The project significantly increased the clinic's screening rate from 33% to 80% (p < .001) and improved referral rates from 66% to 79%. DISCUSSION By standardizing PPD screening and implementing a referral algorithm in the ambulatory pediatric setting, more PPD cases can be identified, further evaluated, and, hopefully, treated to improve maternal and infant health outcomes.
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Knowledge and attitudes about postpartum depression in the Portuguese general population. Midwifery 2019; 77:86-94. [PMID: 31276960 DOI: 10.1016/j.midw.2019.06.016] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2018] [Revised: 06/14/2019] [Accepted: 06/25/2019] [Indexed: 01/10/2023]
Abstract
OBJECTIVE This study aimed to characterize the Portuguese general population's knowledge and attitudes about postpartum depression, and analyze its sociodemographic and clinical correlates. DESIGN A cross-sectional internet survey. SETTING Participants were recruited through advertisements on social media websites, in thematic forums and by email. PARTICIPANTS A total of 621 people in the general population (88.1% women) participated in the study. MEASUREMENTS Participants were questioned about sociodemographic and clinical data, personal contact with postpartum depression, awareness of public education campaigns about postpartum depression and knowledge and attitudes towards postpartum depression (outcome variables). FINDINGS The sample presented a good level of knowledge and positive attitudes about postpartum depression despite the existence of some gaps in knowledge and some stereotypes. Personal contact with postpartum depression was associated with higher levels of knowledge (p < .001) and more positive attitudes towards postpartum depression (p < .001) and participants who assisted to public education campaigns reported higher levels of knowledge about postpartum depression (p < .001). Lower levels of knowledge and more negative attitudes about postpartum depression were found in men and older and less educated people. KEY CONCLUSIONS AND IMPLICATIONS FOR PRACTICE These results show the importance of awareness-raising and education campaigns directed at the general population, particularly focusing on people who can act as the postpartum women's support network (e.g., partners, parents, in-laws), to increase the level of knowledge and to foster more positive attitudes towards postpartum depression.
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Engagement with perinatal mental health services: a cross-sectional questionnaire survey. BMC Pregnancy Childbirth 2019; 19:170. [PMID: 31088414 PMCID: PMC6518724 DOI: 10.1186/s12884-019-2320-9] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2018] [Accepted: 04/29/2019] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND Perinatal depression and/or anxiety disorders are undertreated pregnancy complications. This is partly due to low rates of engagement by women. This study aimed to identify barriers and facilitators to women accessing perinatal mental health services in an outer metropolitan hospital in Queensland, Australia. METHODS Data was collected from pregnant women through a cross-sectional survey. Women rated the extent certain factors influenced their engagement. Respondents were separated into three groups: women who were not offered a referral to perinatal mental health services, women who were offered a referral but did not engage, and women who engaged. RESULTS A total of 218 women participated. A response rate of 71% was achieved. 38.1% of participants did not believe themselves knowledgeable about mental illness in the perinatal period, and 14.7% did not recall being asked about their mental health during their pregnancy. Of those participants who recalled being asked about their mental health, 37.1% were offered a referral. Of these, just over a third (36.2%) accepted, and out of this group, 40% attended an appointment. Regardless of referral and engagement status, the factors identified as influencing participant engagement were time restraints, lack of childcare support, and encouragement by family and health care professionals. Stigma was not identified as a barrier. CONCLUSIONS Perinatal mental health service engagement could be improved by health services: ensuring universal screening and actively engaging women in the process: assisting with childcare; improving appointment immediacy and accessibility; and educating health care professionals about their influence on women's engagement.
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Yapp E, Howard LM, Kadicheeni M, Telesia LA, Milgrom J, Trevillion K. A qualitative study of women's views on the acceptability of being asked about mental health problems at antenatal booking appointments. Midwifery 2019; 74:126-133. [PMID: 30953968 DOI: 10.1016/j.midw.2019.03.021] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2018] [Revised: 03/08/2019] [Accepted: 03/28/2019] [Indexed: 01/28/2023]
Abstract
OBJECTIVE To explore women's views on the acceptability of being asked about mental health problems at antenatal booking. DESIGN Qualitative study. SETTING Brief semi-structured qualitative interviews were conducted with women in a private setting at a hospital, or at women's homes. Interview discussions centered around three key questions: "What was it like for you answering the questions about your mood?", "Were there any questions you found upsetting, distressing or confronting?" and "Did the midwife give you some feedback about your answers?" MEASUREMENTS Interviews were audio-recorded, transcribed verbatim, and analysed using thematic and framework approaches. PARTICIPANTS An ethnically diverse sample [32% white British/Irish, 68% non-white, non-British] of 52 women living in the study area. FINDINGS Most women found mental health enquiry acceptable. A smaller proportion reported difficulties and many of these women had a past or current mental health problem and/or a history of abuse. These women reported difficulty due to the emotional responses triggered by the questions and the way disclosures were handled. In general, women wanted to be asked clear questions about mental health problems, to have sufficient time to discuss issues, and to receive responses from midwives which were normalising and well-informed about mental health. CONCLUSIONS This study highlights that women want midwives to ask clearly-framed questions about mental health problems [addressing past and current mental health concerns], and value responses from midwives that are normalising, well-informed and allow for discussion. IMPLICATIONS FOR PRACTICE Training should be provided to midwives on how to appropriately respond to women's distress during mental health enquiry, and on referral to support services.
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Affiliation(s)
- Emma Yapp
- King's College London, Section of Women's Mental Health, Health Service and Population Research Department, Institute of Psychiatry, Psychology & Neuroscience, De Crespigny Park, London SE5 8AF, UK
| | - Louise M Howard
- King's College London, Section of Women's Mental Health, Health Service and Population Research Department, Institute of Psychiatry, Psychology & Neuroscience, De Crespigny Park, London SE5 8AF, UK.
| | - Meeriam Kadicheeni
- King's College London, Section of Women's Mental Health, Health Service and Population Research Department, Institute of Psychiatry, Psychology & Neuroscience, De Crespigny Park, London SE5 8AF, UK.
| | - Laurence A Telesia
- King's College London, Section of Women's Mental Health, Health Service and Population Research Department, Institute of Psychiatry, Psychology & Neuroscience, De Crespigny Park, London SE5 8AF, UK.
| | - Jeanette Milgrom
- Parent-Infant Research Institute (PIRI®), Austin Health, Melbourne School of Psychological Sciences, University of Melbourne, Australia.
| | - Kylee Trevillion
- King's College London, Section of Women's Mental Health, Health Service and Population Research Department, Institute of Psychiatry, Psychology & Neuroscience, De Crespigny Park, London SE5 8AF, UK.
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Moore D, Harrison V. Advice for Health Care Professionals and Users: An Evaluation of Websites for Perinatal Anxiety. JMIR Ment Health 2018; 5:e11464. [PMID: 30573444 PMCID: PMC6320400 DOI: 10.2196/11464] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/02/2018] [Revised: 09/29/2018] [Accepted: 09/29/2018] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Many websites are available with information and resources for perinatal anxiety; however, there is limited research on the quality and content of these sites. OBJECTIVE This study aims to identify what sites are available on perinatal anxiety, identify any information and therapeutic advice given, and review its accuracy and website design. METHODS We conducted an evaluation of websites for perinatal anxiety. Eligible websites (N=50) were evaluated for accuracy of information, resources for mothers, website quality, and readability. RESULTS Information was often incomplete and focused on symptoms rather than risk factors or impact of untreated perinatal anxiety. Websites often had information on treatment (46/50, 92%), but much less on screening (19/50, 38%). Most sites provided at least some resources to support mothers (49/50, 98%), but active, guided support was infrequent (25/50, 50%). Website quality was extremely variable and mostly difficult to read (42/50, 84%). CONCLUSIONS This study recommends the top 4 websites on perinatal anxiety for health care professionals and users. There is a need for websites to be developed that provide accurate, evidence-based information that women can relate to with quality support resources. Furthermore, these sites should be easy to use and readable.
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Affiliation(s)
- Donna Moore
- School of Psychology, Open University, Milton Keynes, United Kingdom
| | - Virginia Harrison
- School of Psychology, Open University, Milton Keynes, United Kingdom
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Moore D, Ayers S, Drey N. The City MISS: development of a scale to measure stigma of perinatal mental illness. J Reprod Infant Psychol 2018. [PMID: 29517314 DOI: 10.1080/02646838.2017.1313967] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
OBJECTIVE This study aimed to develop and validate a scale to measure perceived stigma for perinatal mental illness in women. BACKGROUND Stigma is one of the most frequently cited barriers to seeking treatment and many women with perinatal mental illness fail to get the treatment they need. However, there is no psychometric scale that measures how women may experience the unique aspects of perinatal mental illness stigma. METHOD A draft scale of 30 items was developed from a literature review. Women with perinatal mental illness (n = 279) were recruited to complete the City Mental Illness Stigma Scale. Concurrent validity was measured using the Internalised Stigma of Mental Illness Scale. Factor analysis was used to create the final scale. RESULTS The final 15-item City Mental Illness Stigma Scale has a three-factor structure: perceived external stigma, internal stigma and disclosure stigma. The scale accounted for 54% of the variance and had good internal reliability and concurrent validity. CONCLUSION The City Mental Illness Stigma Scale appears to be a valid measure which provides a potentially useful tool for clinical practice and research in stigma and perinatal mental illness, including assessing the prevalence and characteristics of stigma. This research can be used to inform interventions to reduce or address the stigma experienced by some women with perinatal mental illness.
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Affiliation(s)
- Donna Moore
- a Centre for Maternal and Child Health, School of Health Sciences, City , University of London , London , UK
| | - Susan Ayers
- a Centre for Maternal and Child Health, School of Health Sciences, City , University of London , London , UK
| | - Nicholas Drey
- b School of Health Sciences, City , University of London , London , UK
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Murphy H, Strong J. Just another ordinary bad birth? A narrative analysis of first time mothers' traumatic birth experiences. Health Care Women Int 2018; 39:619-643. [PMID: 29474791 DOI: 10.1080/07399332.2018.1442838] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
A difficult birth experience can have long lasting psychological effects on both mother and baby and this study details four in-depth accounts of first time mothers who described their birth experience as traumatizing. Narrative analysis was used to record discrepancies between the ideal and the real and produced narrative accounts that highlighted how these mothers felt invisible and dismissed in a medical culture of engineering obstetrics. Participants also detailed how their birth experience could be improved and this is set in context alongside current recommendations in maternal health care and the complexities of delivering such care in UK health settings.
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Affiliation(s)
- Helen Murphy
- a School of Psychology, University of East London , London , England
| | - Joanna Strong
- a School of Psychology, University of East London , London , England
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Bina R, Glasser S. Factors associated with attitudes toward seeking mental health treatment postpartum. Women Health 2018; 59:1-12. [DOI: 10.1080/03630242.2017.1421286] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- Rena Bina
- School of Social Work, Bar Ilan University, Ramat Gan, Israel
| | - Saralee Glasser
- Gertner Institute for Epidemiology and Health Policy Research, Ramat Gan, Israel
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Hadfield H, Wittkowski A. Women's Experiences of Seeking and Receiving Psychological and Psychosocial Interventions for Postpartum Depression: A Systematic Review and Thematic Synthesis of the Qualitative Literature. J Midwifery Womens Health 2017; 62:723-736. [PMID: 29210501 DOI: 10.1111/jmwh.12669] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2017] [Revised: 07/20/2017] [Accepted: 07/25/2017] [Indexed: 12/11/2022]
Abstract
INTRODUCTION Postpartum depression (PPD) is a serious maternal disorder that can have adverse effects on maternal and infant health. The importance of offering effective and acceptable treatments is well recognized, particularly given the numerous barriers women in many settings face in accessing interventions for PPD. The aim of this systematic review was to synthesize qualitative research exploring women's experiences of professional psychological and psychosocial support for PPD. METHODS A systematic review of the literature was conducted in April 2017 by searching 5 electronic databases (CINAHL, MEDLINE, PubMed, Ovid, and Web of Science). Qualitative research studies published in English that explored women's experiences of professional psychosocial support for PPD were included, whereas studies exploring women's experiences of antidepressant medication only were excluded. Seventeen articles met inclusion criteria and were appraised for methodologic quality. Data were synthesized using the interpretive thematic synthesis method. RESULTS Four main themes were identified: the process of help-seeking, barriers to seeking and accepting support, valued aspects of support, and outcomes. Women found the process of seeking help difficult, with several barriers preventing them from both seeking and accepting professional support. Despite this, women described the support received as beneficial and particularly valued the therapeutic relationship. Women reported 1) feeling more positive and confident after receiving a psychological and/or psychosocial intervention and 2) experiencing better relationships with their infant and other family members. DISCUSSION Although seeking and accepting professional support for PPD was a difficult process, women highly valued mental health care support and perceived it as beneficial. Clinical services should aim to address the barriers women face in accessing mental health care and empower women to feel in control throughout the process, offering interventions appropriate to each woman's personal circumstance.
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Fonseca A, Canavarro MC. Women's intentions of informal and formal help-seeking for mental health problems during the perinatal period: The role of perceived encouragement from the partner. Midwifery 2017; 50:78-85. [DOI: 10.1016/j.midw.2017.04.001] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2016] [Revised: 03/31/2017] [Accepted: 04/02/2017] [Indexed: 12/24/2022]
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Depression Literacy and Awareness of Psychopathological Symptoms During the Perinatal Period. J Obstet Gynecol Neonatal Nurs 2017; 46:197-208. [DOI: 10.1016/j.jogn.2016.10.006] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/01/2016] [Indexed: 11/22/2022] Open
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Psychological Distress in Healthy Low-Risk First-Time Mothers during the Postpartum Period: An Exploratory Study. Nurs Res Pract 2017; 2017:8415083. [PMID: 28191350 PMCID: PMC5278222 DOI: 10.1155/2017/8415083] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2016] [Revised: 10/02/2016] [Accepted: 11/08/2016] [Indexed: 12/18/2022] Open
Abstract
Psychological distress, defined as depression, anxiety, and insomnia in this study, can occur following the birth of a baby as new mothers, in addition to marked physiological changes, are faced with adapting to new roles and responsibilities. We investigated the cooccurrence of stress, depression, anxiety, and insomnia in mothers during the postpartum period; tested the feasibility of study methods and procedures for use in this population; and identified new mothers interest in using cranial electrotherapy stimulation (CES) as an intervention for reducing psychological distress. We recruited healthy, low-risk, English speaking first-time mothers, ages 18-32 years, with healthy babies (N = 33), within 12 months of an uncomplicated birth. Participants completed the PSS, HAM-D14, HAM-A17, and PSQI19. No problems were encountered with study procedures. Mothers reported a high interest (4.9) in the potential use of CES to treat or prevent the occurrence of psychological distress. All participants (N = 33) reported moderate levels of depression and anxiety, while 75.8% (n = 25) reported insomnia. PSS scores were within the norms for healthy women. Further research is recommended to investigate if our findings can be replicated or if different patterns of associations emerge. Implications for clinical practice are addressed.
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Bollard M. Health promotion and intellectual disability: listening to men. HEALTH & SOCIAL CARE IN THE COMMUNITY 2017; 25:185-193. [PMID: 26434374 DOI: 10.1111/hsc.12291] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 08/13/2015] [Indexed: 06/05/2023]
Abstract
Taking responsibility for your own health has been a central tenet of public health policy internationally for a number of decades. Governments in the UK and internationally continue to promote a plethora of health promotion strategies, encouraging individuals and communities to adopt healthy lifestyle choices. Although it is widely recognised that men are not as proactive in seeking out medical help or taking on health promotion advice as women, limited gender-sensitive research exists in the field of intellectual disability. Despite many health promotion policy and practice strategies targeted at this population, little research exists exploring whether men with intellectual disability acknowledge health promotion advice. The study aimed to explore how men with mild-to-moderate intellectual disability understood and perceived their health and what health promotion messages they acted upon. The study was based on a participatory approach which enabled 11 men with intellectual disability to contribute as steering group members and as participants through one-to-one interviews. Data were collected between September 2011 and July 2012. Thematic analysis was undertaken. The participants demonstrated a capacity to understand their own health. This was inclusive of a concern about associating being obese with being unhealthy. The participants reported good relationships with their general practitioners (GPs) and felt valued, in particular when the GP was prepared to offer specific intellectual disability and health promotion advice. More gendered research inclusive of the views of this male population is required and the study reiterates the importance of promoting the health of men and women with intellectual disability.
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Affiliation(s)
- Martin Bollard
- Department of Nursing, Midwifery and Healthcare Practice, Faculty of Health and Life Sciences, Coventry University, Coventry, UK
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Bell L, Feeley N, Hayton B, Zelkowitz P, Tait M, Desindes S. Barriers and Facilitators to the Use of Mental Health Services by Women With Elevated Symptoms of Depression and Their Partners. Issues Ment Health Nurs 2016; 37:651-659. [PMID: 27192032 DOI: 10.1080/01612840.2016.1180724] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
This qualitative descriptive study explored the barriers and facilitators to the use of mental health services reported by women with elevated symptoms of depression in the postpartum period and their partners. Data were collected through individual semi-structured interviews of 30 heterosexual couples. Content analysis revealed five principal barriers and facilitators: (a) accessibility and proximity, (b) appropriateness and fit, (d) stigma, (e) encouraged to seek help, and (f) personal characteristics. The study highlights the importance of barriers and facilitators to be taken into consideration in order to promote the use of mental health services for women with elevated symptoms of depression in the postpartum period.
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Affiliation(s)
- Linda Bell
- a Sherbrooke University , Faculty of Medicine and Health Science , Sherbrooke , Quebec , Canada
| | - Nancy Feeley
- b Jewish General Hospital , Centre for Nursing Research , Montreal , Quebec , Canada
| | - Barbara Hayton
- c Jewish General Hospital Institute of Community and Family Psychiatry , Montreal , Quebec , Canada
| | - Phyllis Zelkowitz
- c Jewish General Hospital Institute of Community and Family Psychiatry , Montreal , Quebec , Canada
| | - Madeleine Tait
- c Jewish General Hospital Institute of Community and Family Psychiatry , Montreal , Quebec , Canada
| | - Sophie Desindes
- d Centre Hospitalier Universitaire de Sherbrooke , Sherbrooke , Quebec , Canada
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Feeley N, Bell L, Hayton B, Zelkowitz P, Carrier ME. Care for Postpartum Depression: What Do Women and Their Partners Prefer? Perspect Psychiatr Care 2016; 52:120-30. [PMID: 25711930 DOI: 10.1111/ppc.12107] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/17/2014] [Revised: 01/09/2015] [Accepted: 01/29/2015] [Indexed: 11/30/2022] Open
Abstract
PURPOSE To compare the preferences of those who accept a mental health assessment and those who do not. DESIGN AND METHODS Thirty couples participated in a qualitative study. Nineteen couples accepted a mental health assessment and 11 declined. FINDINGS Acceptors wanted more contact with professionals. Decliners preferred support from their informal network, parental leave, and exercise. However, acceptors also cited these preferences. PRACTICE IMPLICATIONS Nurses should tailor care to couples' preferences, helping them identify and utilize preferred resources. Mental health care might be more acceptable to decliners if provided in obstetrical care.
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Affiliation(s)
- Nancy Feeley
- Ingram School of Nursing, McGill University, Montreal, Quebec, Canada.,Centre for Nursing Research and Lady Davis Institute, Jewish General Hospital, Montreal, Quebec, Canada
| | - Linda Bell
- Faculty of Medicine and Health Sciences, University of Sherbrooke, Sherbrooke, Quebec, Canada
| | - Barbara Hayton
- Perinatal Mental Health Service, Institute of Community and Family Psychiatry, Lady Davis Institute, Jewish General Hospital, Montreal, Quebec, Canada.,Department of Psychiatry, McGill University, Montreal, Quebec, Canada
| | - Phyllis Zelkowitz
- Department of Psychiatry, McGill University, Montreal, Quebec, Canada.,Institute of Community and Family Psychiatry, Lady Davis Institute, Jewish General Hospital, Montreal, Quebec, Canada
| | - Marie-Eve Carrier
- Institute of Community and Family Psychiatry, Lady Davis Institute, Jewish General Hospital, Montreal, Quebec, Canada
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Wittkowski A, Patel S, Fox JR. The Experience of Postnatal Depression in Immigrant Mothers Living in Western Countries: A Meta-Synthesis. Clin Psychol Psychother 2016; 24:411-427. [PMID: 26987569 DOI: 10.1002/cpp.2010] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2014] [Revised: 01/31/2016] [Accepted: 01/31/2016] [Indexed: 11/08/2022]
Abstract
BACKGROUND Postnatal depression affects women from all cultures and countries. The postnatal period is thought to be a vulnerable time for all mothers. Immigrant women may be at particular risk as they attempt to adhere to childbirth rituals in western societies which might exacerbate stress, while navigating through the multiple stressors they face from migration in the transition to motherhood. METHODS This study utilized a meta-synthesis approach to synthesize qualitative studies exploring postnatal depression in immigrant mothers living in western countries. Searching six databases identified 16 studies that met criteria. RESULTS The synthesis revealed two overarching themes of migration and cultural influences on immigrant mothers that interact and give rise to psychosocial understandings of postnatal depression, remedies and healthcare barriers. Mothers used self-help coping strategies in line with this. CONCLUSIONS Immigrant mothers living in western countries are subject to multifactorial stressors following childbirth, increasing their susceptibility to postnatal depression. These stressors relate to being an immigrant in a western society and cultural influences, which may be harder to comply with, when removed from their sociocultural context. Social support appears to play a mediating role for these immigrant mothers. There were several similarities between immigrant and non-immigrant mothers including their views of healthcare and medication, their health-seeking behaviours and their fears of having their baby removed. All these findings have implications for healthcare settings in terms of assessments and service delivery. Copyright © 2016 John Wiley & Sons, Ltd. KEY PRACTITIONER MESSAGE In this meta-synthesis, we explored the experience of postnatal depression in immigrant women living in western countries, including the UK, the USA and Canada. Sixteen qualitative studies were reviewed, and their methodological quality was examined. The findings are based a total sample of 337 women. Two overarching themes were identified that are termed 'cultural influences' and 'migration factors', which influenced how these mothers coped with their postnatal depression. Social support played a mediating role for these immigrant mothers.
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Affiliation(s)
- Anja Wittkowski
- University of Manchester, School of Psychological Sciences, Clinical Psychology, Manchester, United Kingdom.,Manchester Mental Health and Social Care Trust, Manchester, United Kingdom
| | - Sonia Patel
- Royal Manchester Children's Hospital, Paediatric Psychosocial Department, Manchester, United Kingdom
| | - John R Fox
- Department of Psychology, Royal Holloway University of London and Complex Care Team, Barnet, Enfield and Haringey NHS Trust
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BenDavid DN, Hunker DF, Spadaro KC. Uncovering the Golden Veil: Applying the Evidence for Telephone Screening to Detect Early Postpartum Depression. J Perinat Educ 2016; 25:37-45. [PMID: 26848249 DOI: 10.1891/1058-1243.25.1.37] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
Postpartum depression (PPD) is often detected later than symptom onset, or even undetected, because of lack of prompt or adequate screening. An evidence-based PPD screening protocol using a telephone-based format within a primary care practice was developed to identify symptoms and initiate treatment between 2 and 3 weeks postpartum. The Edinburgh Postnatal Depression Scale was used, with positive screens referred for provider and support services, and then tracked for follow-through. Fifty-two percent of women screened positive. Sixty-four percent accepted both provider and support referrals, with 89% follow-through with provider referrals and 78% follow-through with support referrals. Outcomes support early screening for PPD using a telephone-based format to effectively identify symptoms and acceptance of referrals by participants.
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37
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A systematic review on the acceptability of perinatal depression screening. J Affect Disord 2015; 188:284-303. [PMID: 26386439 DOI: 10.1016/j.jad.2015.06.015] [Citation(s) in RCA: 48] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/02/2015] [Revised: 06/01/2015] [Accepted: 06/02/2015] [Indexed: 12/17/2022]
Abstract
BACKGROUND Perinatal depression (PND) affects approximately 10-15% of women, worldwide. PND screening, using screening tools, has been undertaken by a broad range of healthcare professionals in different settings. Our objective was to explore the acceptability of PND screening and how acceptability was being assessed. METHODS A systematic literature review of studies that explored the acceptability of PND screening was carried out throughout MEDLINE, PsycINFO, PubMed, CINAHL, Embase, Maternity and Infant Care and Joanna Briggs Institute databases. RESULTS Twenty-eight out of twenty-nine publications reported PND screening to be acceptable to most participants. A wide range of terms, questions and statements was used to infer, assess or report on acceptability. There was no uniform, psychometrically tested tool used to measure acceptability across the studies. LIMITATIONS Broad inclusion criteria and methodological differences limited comparisons, but are overcome by the comprehensiveness of the data and the lack of uniformity across studies. CONCLUSIONS Even though PND screening appears acceptable, it is difficult to draw conclusions about PND screening acceptability as studies used different methods to infer, assess or report on acceptability. The lack of a uniform, psychometrically tested tool to measure acceptability is not unique to PND. Nonetheless, the majority of perinatal women and healthcare professionals reported positive attitudes towards PND screening using different tools in different settings, indicating that it may be the responsibility of all healthcare professionals who come into contact with perinatal women.
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Kingston DE, Biringer A, McDonald SW, Heaman MI, Lasiuk GC, Hegadoren KM, McDonald SD, Veldhuyzen van Zanten S, Sword W, Kingston JJ, Jarema KM, Vermeyden L, Austin MP. Preferences for Mental Health Screening Among Pregnant Women: A Cross-Sectional Study. Am J Prev Med 2015; 49:e35-43. [PMID: 26143952 DOI: 10.1016/j.amepre.2015.03.026] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/12/2014] [Revised: 03/12/2015] [Accepted: 03/12/2015] [Indexed: 10/23/2022]
Abstract
INTRODUCTION The process of mental health screening can influence disclosure, uptake of referral, and treatment; however, no studies have explored pregnant women's views of methods of mental health screening. The objectives of this study are to determine pregnant women's comfort and preferences regarding mental health screening. METHODS Pregnant women were recruited (May-December 2013) for this cross-sectional descriptive survey from prenatal classes and maternity clinics in Alberta, Canada, if they were aged >16 years and spoke/read English. Descriptive statistics summarized acceptability of screening, and multivariable logistic regression identified factors associated with women's comfort with screening methods. Analysis was conducted in January-December 2014. RESULTS The participation rate was 92% (N=460/500). Overall, 97.6% of women reported that they were very (74.8%) or somewhat (22.8%) comfortable with mental health screening in pregnancy. Women were most comfortable with completing paper- (>90%) and computer-based (>82%) screening in a clinic or at home, with fewest reporting comfort with telephone-based screening (62%). The majority of women were very/somewhat comfortable with provider-initiated (97.4%) versus self-initiated (68.7%) approaches. Women's ability to be honest with their provider about emotional health was most strongly associated with comfort with each method of screening. CONCLUSIONS The majority of pregnant women viewed prenatal mental health screening favorably and were comfortable with a variety of screening methods. These findings provide evidence of high acceptability of screening--a key criterion for implementation of universal screening--and suggest that providers can select from a variety of screening methods best suited for their clinical setting.
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Affiliation(s)
- Dawn E Kingston
- Department of Obstetrics and Gynecology, University of Alberta, Edmonton, Alberta, Canada.
| | - Anne Biringer
- Department of Family and Community Medicine, University of Toronto, Toronto, Ontario, Canada; Ray D. Wolfe Department of Family Medicine, Mount Sinai Hospital, Toronto, Ontario, Canada
| | - Sheila W McDonald
- Population, Public, and Aboriginal Health, Alberta Health Services, Edmonton, Alberta, Canada
| | - Maureen I Heaman
- College of Nursing, Faculty of Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Gerri C Lasiuk
- Faculty of Nursing, University of Alberta, Edmonton, Alberta, Canada
| | - Kathy M Hegadoren
- Faculty of Nursing, University of Alberta, Edmonton, Alberta, Canada
| | - Sarah D McDonald
- Department of Obstetrics and Gynecology, Radiology, McMaster University, Hamilton, Ontario, Canada; Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, Ontario, Canada
| | | | - Wendy Sword
- Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, Ontario, Canada
| | - Joshua J Kingston
- Faculty of Nursing, University of Alberta, Edmonton, Alberta, Canada
| | - Karly M Jarema
- Faculty of Nursing, University of Alberta, Edmonton, Alberta, Canada
| | - Lydia Vermeyden
- Faculty of Nursing, University of Alberta, Edmonton, Alberta, Canada
| | - Marie-Paule Austin
- St. John of God Chair Perinatal and Women's Mental Health, School Psychiatry, University of New South Wales, Sydney, New South Wales, Australia
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Fonseca A, Gorayeb R, Canavarro MC. Women׳s help-seeking behaviours for depressive symptoms during the perinatal period: Socio-demographic and clinical correlates and perceived barriers to seeking professional help. Midwifery 2015; 31:1177-85. [PMID: 26433622 DOI: 10.1016/j.midw.2015.09.002] [Citation(s) in RCA: 84] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2015] [Revised: 09/07/2015] [Accepted: 09/13/2015] [Indexed: 11/16/2022]
Abstract
OBJECTIVE This study aims to characterize the help-seeking behaviours of women who were screened positive for perinatal depression, to investigate its sociodemographic and clinical correlates, and to characterize the perceived barriers that prevent women from seeking professional help. DESIGN Cross-sectional internet survey. SETTING Participants were recruited through advertisements published in pamphlets and posted on social media websites (e.g., Facebook) and websites and forums that focused on pregnancy and childbirth. PARTICIPANTS 656 women (currently pregnant or who had a baby during the last 12 months) completed the survey. MEASUREMENTS Participants were assessed with the Edinburgh Postpartum Depression Scale, and were questioned about sociodemographic and clinical data, help-seeking behaviours and perceived barriers to help-seeking. FINDINGS Different pathways of help-seeking were found, with only 13.6% of women with a perinatal depression seeking help for their emotional problems. Married women, currently pregnant women, and women without history of psychological problems had a higher likelihood of not engaging in any type of help-seeking behaviour. The majority of women who had not sought professional assistance identified several barriers to help-seeking, particularly knowledge barriers. KEY CONCLUSIONS Strategies to increase women׳s help-seeking behaviours should be implemented, namely improving mental health literacy, introducing screening procedures for mental health problems in pre/postnatal health care settings, and offering women innovative opportunities (e.g., web-based tools) that allow them to overcome the practical barriers to help-seeking.
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Affiliation(s)
- Ana Fonseca
- Cognitive-Behavioral Center for Research and Intervention (CINEICC) of the Faculty of Psychology and Educational Sciences, University of Coimbra, Rua do Colégio Novo, Apartado 6153, 3001-802 Coimbra, Portugal.
| | - Ricardo Gorayeb
- Faculty of Medicine of Ribeirão Preto, University of São Paulo, Department of Neurosciences and Behavior Sciences, Avenida Bandeirantes, 3900, Monte Alegre - Campos Universitário, 14048-900 Ribeirão Preto, São Paulo, Brazil.
| | - Maria Cristina Canavarro
- Cognitive-Behavioral Center for Research and Intervention (CINEICC) of the Faculty of Psychology and Educational Sciences, University of Coimbra, Rua do Colégio Novo, Apartado 6153, 3001-802 Coimbra, Portugal.
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Rowe H, Wynter K, Lorgelly P, Amir LH, Ranasinha S, Proimos J, Cann W, Hiscock H, Bayer J, Burns J, Ride J, Bobevski I, Fisher J. A cluster randomised controlled trial of a brief couple-focused psychoeducational intervention to prevent common postnatal mental disorders among women: study protocol. BMJ Open 2014; 4:e006436. [PMID: 25248497 PMCID: PMC4173107 DOI: 10.1136/bmjopen-2014-006436] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/21/2014] [Accepted: 09/01/2014] [Indexed: 11/21/2022] Open
Abstract
INTRODUCTION Postnatal common mental disorders among women are an important public health problem internationally. Interventions to prevent postnatal depression have had limited success. What Were We Thinking (WWWT) is a structured, gender-informed, psychoeducational group programme for parents and their first infant that addresses two modifiable risks to postnatal mental health. This paper describes the protocol for a cluster randomised controlled trial to test the clinical effectiveness and cost-effectiveness of WWWT when implemented in usual primary care. METHODS AND ANALYSIS 48 maternal and child health (MCH) centres from six diverse Local Government Areas, in Victoria, Australia are randomly allocated to the intervention group (usual care plus WWWT) or the control group (usual care). The required sample size is 184 women in each group. English-speaking primiparous women receiving postpartum healthcare in participating MCH centres complete two computer-assisted telephone interviews: baseline at 4 weeks and outcome at 6 months postpartum. Women attending intervention MCH centres are invited to attend WWWT in addition to usual care. The primary outcome is meeting Diagnostic and Statistical Manual-IV (DSM-IV) diagnostic criteria for major depressive episode; generalised anxiety disorder; panic disorder with or without agoraphobia, agoraphobia with or without panic, social phobia, adult separation anxiety or adjustment disorder with depressed mood, anxiety or mixed depressed mood and anxiety within the past 30 days at 6 months postpartum. Secondary outcomes are self-rated general and emotional health, infant sleep problems, method of infant feeding, quality of mother-infant relationship and intimate partner relationship, and healthcare costs and outcomes. ETHICS AND DISSEMINATION Approval to conduct the study has been granted. A comprehensive dissemination plan has been devised. TRIAL REGISTRATION NUMBER Australian New Zealand Clinical Trials Registry ACTRN12613000506796. UTN: U1111-1125-8208.
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Affiliation(s)
- Heather Rowe
- Jean Hailes Research Unit, School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Karen Wynter
- Jean Hailes Research Unit, School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Paula Lorgelly
- Faculty of Business and Economics, Centre for Health Economics, Monash University, Clayton, Victoria, Australia
| | - Lisa H Amir
- Judith Lumley Centre, La Trobe University, Melbourne, Victoria, Australia
| | - Sanjeeva Ranasinha
- Monash Centre for Health Research and Implementation, School of Public Health and Preventive Medicine, Monash University, Clayton, Victoria, Australia
| | - Jenny Proimos
- Department of Education and Early Childhood Development, Melbourne, Victoria, Australia
| | - Warren Cann
- Parenting Research Centre, East Melbourne, Victoria, Australia
| | - Harriet Hiscock
- Centre for Community Child Health, The Royal Children's Hospital, Parkville, Victoria, Australia; Murdoch Childrens Research Institute, Parkville, Victoria, Australia; Department of Paediatrics, University of Melbourne, Parkville, Victoria, Australia, Parkville, Victoria, Australia
| | - Jordana Bayer
- School of Psychology, Faculty of Science, Technology and Engineering, La Trobe University, Bundoora, Victoria, Australia
| | - Joanna Burns
- Jean Hailes Research Unit, School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Jemimah Ride
- Faculty of Business and Economics, Centre for Health Economics, Monash University, Clayton, Victoria, Australia
| | - Irene Bobevski
- Jean Hailes Research Unit, School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Jane Fisher
- Jean Hailes Research Unit, School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
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Mehta D, Newport DJ, Frishman G, Kraus L, Rex-Haffner M, Ritchie JC, Lori A, Knight BT, Stagnaro E, Ruepp A, Stowe ZN, Binder EB. Early predictive biomarkers for postpartum depression point to a role for estrogen receptor signaling. Psychol Med 2014; 44:2309-2322. [PMID: 24495551 DOI: 10.1017/s0033291713003231] [Citation(s) in RCA: 76] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
BACKGROUND Postpartum depression (PPD) affects approximately 13% of women and has a negative impact on mother and infant, hence reliable biological tests for early detection of PPD are essential. We aimed to identify robust predictive biomarkers for PPD using peripheral blood gene expression profiles in a hypothesis-free genome-wide study in a high-risk, longitudinal cohort. METHOD We performed a genome-wide association study in a longitudinal discovery cohort comprising 62 women with psychopathology. Gene expression and hormones were measured in the first and third pregnancy trimesters and early postpartum (201 samples). The replication cohort comprised 24 women with third pregnancy trimester gene expression measures. Gene expression was measured on Illumina-Human HT12 v4 microarrays. Plasma estradiol and estriol were measured. Statistical analysis was performed in R. RESULTS We identified 116 transcripts differentially expressed between the PPD and euthymic women during the third trimester that allowed prediction of PPD with an accuracy of 88% in both discovery and replication cohorts. Within these transcripts, significant enrichment of transcripts implicated that estrogen signaling was observed and such enrichment was also evident when analysing published gene expression data predicting PPD from a non-risk cohort. While plasma estrogen levels were not different across groups, women with PPD displayed an increased sensitivity to estrogen signaling, confirming the previously proposed hypothesis of increased sex-steroid sensitivity as a susceptibility factor for PPD. CONCLUSIONS These results suggest that PPD can be robustly predicted in currently euthymic women as early as the third trimester and these findings have implications for predictive testing of high-risk women and prevention and treatment for PPD.
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Affiliation(s)
- D Mehta
- Max Planck Institute of Psychiatry, Munich,Germany
| | - D J Newport
- Emory University School of Medicine,Department of Psychiatry and Behavioral Sciences, Atlanta, GA,USA
| | - G Frishman
- Institute for Bioinformatics and Systems Biology, Helmholtz Zentrum München, German Research Center for Environmental Health, Neuherberg,Germany
| | - L Kraus
- Max Planck Institute of Psychiatry, Munich,Germany
| | | | - J C Ritchie
- Department of Pathology and Laboratory Medicine,Emory University,Atlanta, GA,USA
| | - A Lori
- Department of Human Genetics,Emory University,Atlanta, GA,USA
| | - B T Knight
- Psychiatry Research Institute,University of Arkansas for Medical Sciences,Little Rock, AR,USA
| | - E Stagnaro
- Emory University School of Medicine,Department of Psychiatry and Behavioral Sciences, Atlanta, GA,USA
| | - A Ruepp
- Institute for Bioinformatics and Systems Biology, Helmholtz Zentrum München, German Research Center for Environmental Health, Neuherberg,Germany
| | - Z N Stowe
- Psychiatry Research Institute,University of Arkansas for Medical Sciences,Little Rock, AR,USA
| | - E B Binder
- Max Planck Institute of Psychiatry, Munich,Germany
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42
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Bina R. Seeking Help for Postpartum Depression in the Israeli Jewish Orthodox Community: Factors Associated with Use of Professional and Informal Help. Women Health 2014; 54:455-73. [DOI: 10.1080/03630242.2014.897675] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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McMahon C. Sixteen per cent of mothers who present their young infants to the emergency department with non-time-critical conditions screen positive for postnatal depression. Evid Based Nurs 2014; 17:8-9. [PMID: 23696229 DOI: 10.1136/eb-2013-101285] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Affiliation(s)
- Catherine McMahon
- Centre for Emotional Health, Department of Psychology, Macquarie University, , North Ryde, New South Wales, Australia
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Browne J, O'Brien M, Taylor J, Bowman R, Davis D. 'You've got it within you': the political act of keeping a wellness focus in the antenatal time. Midwifery 2013; 30:420-6. [PMID: 23747292 DOI: 10.1016/j.midw.2013.04.003] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2012] [Revised: 04/18/2013] [Accepted: 04/22/2013] [Indexed: 10/26/2022]
Abstract
OBJECTIVE by exploring midwives' communication techniques intended to promote a wellness focus in the antenatal period, this study identified strategies midwives use to amplify women's own resources and capacities, with the aim of reducing antenatal anxiety. DESIGN a qualitative design utilising focus groups as a means of generating data. SETTING two Australian cities: Canberra, ACT and Sydney NSW. PARTICIPANTS 14 experienced, practising midwives across two states/territories, employed in multiple hospitals and community settings. FINDINGS three themes emerged from the analysis: calm unhurriedness, speaking in wellness and reassuring bodies. Midwives in these focus groups used strategies in antenatal care that could be co-ordinated into a planned process for wellness focussed care. KEY CONCLUSIONS individually midwives used a variety of strategies specifically intended to facilitate women's capabilities, to employ worry usefully and to reduce anxiety. Midwives in the study clearly viewed this kind of wellness focussed care as their responsibility and their right. IMPLICATIONS FOR PRACTICE the midwives' collective wisdom could be shared and developed further into an overall salutogenic antenatal strategy to be used for the good of pregnant women and their infants.
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Affiliation(s)
- Jenny Browne
- Disciplines of Nursing and Midwifery, Faculty of Health, University of Canberra, ACT 2601, Australia.
| | - Maureen O'Brien
- Disciplines of Nursing and Midwifery, Faculty of Health, University of Canberra, ACT 2601, Australia
| | - Jan Taylor
- Disciplines of Nursing and Midwifery, Faculty of Health, University of Canberra, ACT 2601, Australia
| | - Rebekah Bowman
- Canberra Midwifery Program, The Canberra Hospital, ACT Health, Canberra, Australia
| | - Deborah Davis
- Disciplines of Nursing and Midwifery, Faculty of Health, University of Canberra, ACT 2601, Australia; ACT Health Directorate, Canberra, Australia
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Montgomery P, Mossey S, Adams S, Bailey PH. Stories of women involved in a postpartum depression peer support group. Int J Ment Health Nurs 2012; 21:524-32. [PMID: 22738350 DOI: 10.1111/j.1447-0349.2012.00828.x] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
Living through postpartum depression (PPD) might lead women to seek a variety of support to re-establish their well-being, including a hybrid of traditional and non-traditional services. Within this mix, some women participate in peer groups; however, there is a paucity of research regarding their subjective experiences of engaging in this type of support. The purpose of this study was to describe how women talked about living through PPD in the context of a peer support group. This focused ethnography was a component of a larger participatory action study in northern Ontario, Canada. The seven members of a 5-week peer support group described their postpartum experiences through written, visual, and spoken stories. Using structural narrative analysis, stories about recovery were identified across the data. Three groups of recovery stories were labelled as illness, mothering wisdom, and mobilizing. The findings suggested that women actively sought and established a therapeutic space for PPD recovery with peers. As such, health-care providers are encouraged to acknowledge the merits and advocate for the multiple and diverse alliances women might require to actualize recovery.
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Patel S, Wittkowski A, Fox JRE, Wieck A. An exploration of illness beliefs in mothers with postnatal depression. Midwifery 2012; 29:682-9. [PMID: 22882968 DOI: 10.1016/j.midw.2012.06.012] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2012] [Revised: 05/31/2012] [Accepted: 06/10/2012] [Indexed: 10/28/2022]
Abstract
OBJECTIVE to explore illness beliefs in women with postnatal depression and suggest an appropriate health belief model. About 10% of recently delivered mothers suffer from depression. Postnatal depression may differ from depression occurring at other times in an individual's life not only symptomatically but also experiences, perceptions and beliefs about the illness differ because of the individual's specific role as a carer for a newborn baby. Whilst illness beliefs have been extensively examined using models from physical health, recent studies have pointed out that physical health models may not provide an appropriate framework to explore mental health difficulties and require adapting. DESIGN qualitative study using face-to-face interviews for data collection. SETTING Greater Manchester, England. METHODS as illness beliefs have not yet been formally assessed using established questionnaires, the present study employed qualitative methodology to explore illness beliefs in mothers with postnatal depression (PND). Semi-structured interviews were conducted with 11 participants who were depressed following the birth of their child. Interview transcripts were analysed using grounded theory methodology. The point of theoretical sufficiency was reached with this sample size. FINDINGS the rich data allowed for a theory of illness beliefs in PND to be developed encompassing six core categories: 'unmet expectations', 'identifying stressors in their life context', 'conflict over label', 'antidepressants: the lesser of two evils', 'loss of time' and 'uncertain futures.' KEY CONCLUSIONS AND IMPLICATIONS FOR PRACTICE participants made multiple appraisals of their PND in light of their initial difficulties, their improvements and consequences, the future and subsequent service involvement. Participants' narratives were conflicting and uncertain with internal struggles evident as mothers were torn between their desire to be good mothers and their perceptions that PND meant that they were not good enough mothers. Thus, the themes identified in this study did not match onto the key dimensions postulated by Leventhal's self-regulation model of illness beliefs.
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Affiliation(s)
- Sonia Patel
- Division of Clinical Psychology, University of Manchester, Manchester, UK
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Segre LS, McCabe JE, Stasik SM, O'Hara MW, Arndt S. Implementation of an evidence-based depression treatment into social service settings: the relative importance of acceptability and contextual factors. ADMINISTRATION AND POLICY IN MENTAL HEALTH AND MENTAL HEALTH SERVICES RESEARCH 2012; 39:180-6. [PMID: 21461974 DOI: 10.1007/s10488-011-0345-0] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
Listening Visits (LV), an empirically supported depression treatment delivered by non mental health specialists, were implemented into two distinctly structured programs. The relative importance of providers' views and organizational context on implementation were examined. Thirty-seven home visitors completed pre- and post-LV training surveys assessing their views toward implementing LV. Implementation rates markedly differed in the two organizations (73.9% vs. 35.7%). Logistic regression results showed that when predicting the implementation rate, the impact of the organizational setting outweighed home visitors' personal views. These results underscore the importance of organizational context in the implementation of empirically supported treatments.
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Affiliation(s)
- Lisa S Segre
- College of Nursing, University of Iowa, Iowa, IA, USA.
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Rossiter C, Fowler C, McMahon C, Kowalenko N. Supporting depressed mothers at home: their views on an innovative relationship-based intervention. Contemp Nurse 2012. [DOI: 10.5172/conu.2012.1647] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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Screening for depression and help-seeking in postpartum women during well-baby pediatric visits: an integrated review. J Pediatr Health Care 2012; 26:109-17. [PMID: 22360930 DOI: 10.1016/j.pedhc.2010.06.012] [Citation(s) in RCA: 73] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/06/2010] [Revised: 06/10/2010] [Accepted: 06/13/2010] [Indexed: 01/09/2023]
Abstract
PURPOSE The purposes of this integrated review are to examine the literature on screening for depression and help-seeking behaviors by postpartum women during pediatric well-baby visits; to identify gaps in the literature relating to depression and help-seeking behaviors; and to discuss implications for practice and future research. METHOD An extensive search of primary source documents was conducted in Academic Search Premier, CINAHL, MEDLINE, Mental Measurements Yearbook, PsycINFO, PsycARTICLES, and Women's Studies International using the key words postpartum, postpartum depression (PPD), help seeking, and pediatric setting or pediatrician. Thirty-five articles relevant to help seeking, PPD, and screening in the pediatric setting were included in this review. Research studies included both quantitative and qualitative articles. RESULTS PPD affects 10% to 15% of all women after birth. Postpartum women generally do not seek help for depression. Untreated PPD has significant adverse affects on parenting, maternal bonding, and the infant's emotional and behavioral development. Interaction with the woman's obstetric provider ends shortly after the baby's birth. However, interactions with the pediatric office are initiated and continue throughout the infant's first two years of life. DISCUSSION Early recognition of PPD and appropriate treatment are imperative for positive maternal-infant outcomes. A majority of women do not seek help for depression from any source. Because mothers have routine interactions with pediatric office staff during the first few years after giving birth, pediatric nurse practitioners and pediatricians have the perfect opportunity to screen and educate women regarding symptoms, treatment, and available resources for PPD.
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