CE: Postpartum Depression: A Nurse's Guide

Relationship between postpartum psychological disorders and emotion regulation strategies: A cross-sectional study

To explore the relationship between postpartum psychological disorders and emotion regulation strategies and analyze the influencing factors of postpartum psychological disorders. This study was conducted using a cross-sectional design. A total of 230 postpartum women hospitalized in the Second Affiliated Hospital of Xuzhou Medical University from October 2022 to March 2023 were selected as the investigation objects. A general data questionnaire, Hamilton Anxiety Scale, Hamilton Depression Scale, Pittsburgh Sleep Quality Index, and Emotion Regulation Questionnaire were administered to the enrolled women. Pearson correlation analysis was used to assess the association between the Hamilton Anxiety Scale, Hamilton Depression Scale, Pittsburgh Sleep Quality Index, and Emotion Regulation Questionnaire. Furthermore, logistic regression was employed to assess the influencing factors of postpartum psychological disorders. Pearson correlation analysis showed that cognitive reappraisal was negatively correlated and expression inhibition was positively associated with anxiety, depression, and sleep quality symptoms (all P < .05). Logistic regression results demonstrated that the mode of delivery, number of births, feeding method, and pressure to breastfeed were risk factors affecting postpartum psychological disorders (P < .05). Cognitive reappraisal is an effective emotion regulation strategy that can relieve postpartum psycho-neurological symptoms by reducing the symptoms of anxiety, depression, and sleep disorders. Along with encouraging pregnant women to adopt positive emotional regulation strategies, medical personnel should focus on the stress associated with cesarean section, artificial feeding, and pressure to breastfeed and adopt required intervention measures to decrease the occurrence of postpartum psychological and neurological symptoms.

Use of cognitive-behavioral career coaching to reduce work anxiety and depression in public employees

BACKGROUND

Public employees worldwide are increasingly concerned about work anxiety and depression. Cognitive-behavioral career coaching has emerged as a promising strategy for addressing these mental health disorders, which can negatively impact on a person's overall well-being and performance.

AIM

To examine whether cognitive-behavioral career coaching reduces work anxiety and depression among Nigerian public employees.

METHODS

A total of 120 public employees (n = 60) suffering from severe anxiety and depression were randomly assigned to the treatment or control groups in this study. Cognitive behavioral coaching was provided twice a week to those in the treatment group, whereas no treatment was given to those in the control group. As part of the study, the Hamilton Anxiety Rating Scales and Beck Depression Inventory were used to collect data.

RESULTS

Analysis of covariance of the data from participants indicates a significant effect of cognitive-behavioral career coaching on work anxiety and depression.

CONCLUSION

Insights into the underlying mechanisms by which cognitive behavior career coaching exerts its effects have been gained from this study. Also, the study has gathered valuable data that can inform future practice and guide the development of strategies for supporting mental health at work.

Effect of Postpartum Depression on Infant Safety Practices in Korea

OBJECTIVE

To describe the prevalence of postpartum depression in a sample of Korean women and to examine the effect of postpartum depression on their adoption of safety practices for their infants.

DESIGN

Secondary, cross-sectional.

SETTING

South Korea.

PARTICIPANTS

A total of 3,127 women who gave birth in 2020.

METHODS

We applied a complex sample design analysis using the national survey data on postpartum care in South Korea. We analyzed the data using weighted multivariate logistic regression to determine the association between postpartum depression and the adoption of five safety practices for infants.

RESULTS

A total 42.7% (n = 1,319) of our participants had symptoms of postpartum depression during the initial 7 days after birth. Participants who had postpartum depression were less likely to engage in certain safety practices for infants.

CONCLUSION

We propose a proactive approach to promote an improved policy for postpartum depression screening alongside a comprehensive program that offers guidance and education to mothers suffering with postpartum depression. The primary objective is to empower these mothers with essential skills that can effectively ensure the safety of their infants.

Virtual simulated patient encounters: Bridging the gap in maternal mental health training for prelicensure nursing students

Postpartum mood disorders (PPMDs) can result in significant negative impacts for the mother, baby, and family. Nurses can be trained to effectively screen for and educate patients about PPMDs. However, available data suggest that clinical opportunities for practicing these important conversations in real-time can be limited. Focused practice discussing PPMDs with patients may improve a nurse's confidence to conduct screenings and help reduce stigma regarding PPMDs. When in-person clinical learning opportunities are limited, simulated patient encounters can serve as useful and accessible alternatives. Though traditional simulations are often conducted in-person with an actor, they can also be offered to students via a virtual platform. This article describes the creation of two virtual simulated patient encounters (vSPEs) designed to improve prelicensure nursing students' confidence in screening and caring for patients at risk for PPMDs. These vSPEs were implemented during the COVID-19 pandemic to fulfill required labor and birth/postpartum clinical rotation hours. A thorough description of the vSPE design and implementation is provided to encourage nursing and other health professions educators to explore a virtual approach to training students to screen and care for postpartum patients with suspected PPMDs.

Risk Factors for Postpartum Depression Based on Genetic and Epigenetic Interactions

Postpartum depression (PPD) is a serious mood disorder that tends to occur after the delivery, which may bring lifelong consequences to women and their families in terms of family relationships, social relationships, and mental health. Currently, various risk factors including environmental factors and genetic factors that may induce postpartum depression have been extensively studied. In this review, we suggest that postpartum women's susceptibility to postpartum depression may be the result of the interaction between the genes associated with postpartum depression as well as the interaction between genetic and environmental factors. We reviewed the genes that have been studied in postpartum depression, including genes related to the synthesis, metabolism, and transport of monoamine neurotransmitters, key molecules of the HPA axis, and the kynurenine pathway. These studies have found more or less gene-gene and gene-environment interactions, so we will discuss these issues in more detail. However, so far, the conclusions of these risk factors, especially genetic factors, are not completely consistent in the occurrence and exacerbation of symptoms in postpartum depression, and it is not clear how these risk factors specifically participate in the pathological mechanism of the disease and play a role. We conclude that the role of genetic polymorphisms, including genetic and epigenetic processes, in the occurrence and development of postpartum depression, is complex and ambiguous. We also note that interactions between multiple candidate genes and the environment have been suggested as causes of depression, suggesting that more definitive research is needed to understand the heritability and susceptibility of PPD. Overall, our work supports the hypothesis that postpartum depression is more likely to be caused by a combination of multiple genetic and environmental factors than by a single genetic or environmental influence.

Modifiable Maternal Factors and Their Relationship to Postpartum Depression

The purpose of the study was to examine how modifiable maternal factors (body mass index (BMI), household income, fatigue, sleep, breastfeeding status, diet, and physical activity) relate to postpartum depression (PPD) at 6 and 12 months postpartum. Participants (n = 26) participated in two study visits (6 and 12 months postpartum) where vitals, weight, body composition (skinfold anthropometrics), and physical activity levels (Actigraph GTX9 accelerometer) were assessed. Validated instruments (BRUMS-32, Subjective Exercise Experience Scale, Pittsburg Sleep Quality index, NIH breastfeeding survey, NIH Dietary History Questionnaire, and Edinburg Postnatal Depression Scale) assessed lifestyle and demographic factors of interest. PPD at six months was correlated to PPD at 12 months (r = 0.926, p < 0.001). At six months postpartum, PPD was positively correlated to BMI (r = 0.473, p = 0.020) and fatigue (r = 0.701, p < 0.001), and negatively correlated to household income (r = -0.442, p = 0.035). Mothers who were breastfeeding had lower PPD scores (breastfeeding 3.9 ± 3.5 vs. not breastfeeding 7.6 ± 4.8, p = 0.048). At 12 months, PPD was positively correlated to sleep scores (where a higher score indicates poorer sleep quality) (r = 0.752, p < 0.001) and fatigue (r = 0.680, p = 0.004). When analyzed collectively via regression analyses, household income and fatigue appeared to be the strongest predictors of PPD at six months postpartum.

Online and Offline Intervention for the Prevention of Postpartum Depression among Rural-to-Urban Floating Women: Study Protocol for a Randomized Control Trial

Background: As a higher-risk group of postpartum depression (PPD), rural to urban floating women urgently require effective and accessible mental health care after childbirth to prevent PPD. Even though there were various interventions, only a small number of women have sought professional help to reduce their depressive symptoms after childbirth, suggesting the need for an innovative intervention delivery to overcome women’s help-seeking barriers. Online and offline (OTO) interventions, which combine face-to-face and internet-based interventions, provide apparent benefits. As a result, the protocol for a randomized controlled study (RCT) was designed to examine the effectiveness and acceptability of OTO intervention on psychosocial outcomes for Chinese rural-to-urban floating women including the reduction of PPD symptoms and PPD stigma, and the improvement of social support and quality of life. Methods: A double blind, multicenter, RCT will be used and a total of 226 participants will be recruited. The OTO intervention called the “Hi, Mom” program will integrate two face-to-face consulting sessions with online sessions comprising an information module, a communication module, an ask-the-expert module, and a peer story module over a period of three months. The control group will receive routine postpartum care. Outcome measures including PPD symptoms, PPD stigma, social support, quality of life, mother–child bonding, and satisfaction with health care received will be conducted at baseline, postintervention, and three-month follow-up. Results and Discussion: If the intervention is effective, it will provide a convenient and effective intervention program on postpartum mental well-being for rural-to-urban floating women. As the first study to test the effects of an OTO intervention for the prevention of PPD in China, the outcomes gained from this study will provide evidence-based knowledge for clinical practice on PPD prevention based on online and offline health technologies. Moreover, it could be used to plan a culturally appropriate OTO intervention for migrant mothers from different countries.