Sleep Quality, Fatigue, and Postpartum Depression of Mother at Six Months after Delivery

Comparison of factors associated with postpartum depression from two cohorts of nurses: the Korea Nurses' Health Study and the Nurses' Health Study 3

OBJECTIVES

This study aimed to identify whether differences exist in postpartum depression (PPD) in US and Korean nurses and its related factors. Identifying occupational and personal factors that underlie potential differences will be helpful for women's occupational health.

METHODS

Baseline and postpartum survey data from employed nurses in the Korea Nurses' Health Study and Nurses' Health Study 3 (1244 Korean; 2742 US nurses) were analysed. Postpartum data collection was done via online survey. PPD was analysed based on cultural validation from prior studies using the Edinburgh Postnatal Depression Scale (cut-off of 10 for Korea and 13 for USA); depressive symptoms prior to pregnancy and childbirth, general characteristics and sleep satisfaction were also measured. Descriptive statistics, χ2 tests and t-tests and multivariate ordinal logistic regression analysis were performed.

RESULTS

45.9% of Korean participants had clinical symptoms of PPD (≥10), whereas US participants presented with 3.4% (≥13). Prior depressive symptoms were also higher in Korean participants (22.5%) compared with their US counterparts (4.5%). Prior depressive symptoms and poor sleep satisfaction were significant risk factors of PPD in both cohort groups, and vaginal birth was an additional influencing factor in Korean participants.

CONCLUSIONS

Differences in PPD rates and related factors suggest the role of stress, cultural variation and differing work systems. Nurses and other women shift-workers noted to have depressive symptoms before and during pregnancy and exhibit PPD symptoms should especially be followed closely and offered supportive mental health services that include greater flexibility in returning to work.

Longitudinal Relationship Study of Depression and Self-Esteem in Postnatal Korean Women Using Autoregressive Cross-Lagged Modeling

Individuals with low self-esteem are vulnerable to depression. Depressed individuals process information related to themselves in a distorted way, thereby negatively affecting their self-esteem. The purpose of this study was to examine the relationship between depression and self-esteem in postnatal Korean women using longitudinal data and an autoregressive cross-lagged analysis. This study was conducted in postpartum women who had consistently participated in the Panel Study on Korean Children (PSKC) from Wave 1 through to Wave 8. The study results showed that depression and self-esteem in postnatal women had a significant positive correlation over time. Moreover, the longitudinal relationship between depression and self-esteem in postnatal women was affected by weight gain during pregnancy. This study overcomes the limitations of cross-sectional studies by using longitudinal data on the correlations between depression and self-esteem in postnatal women; the study findings may be used in developing weight control programs for pregnant and postnatal women.

[Effects of a Reinforcement Program for Postpartum Care Behavioral Skills of Couples with Their First Baby]

PURPOSE

This study aimed to investigate the effects of a reinforcement program for behavioral skills in postpartum care for couples with their first baby.

METHODS

The study used a non-equivalent control group and pretest-posttest design. It was conducted from January 14 to April 10, 2016 at a postpartum care center in D city. It analyzed 43 couples (22 in the experimental group and 21 in the control group.) For data analysis, descriptive statistics, test of homogeneity in pretest, independent t-tests, and repeated measures ANOVA were used.

RESULTS

For maternal fulfillment of postpartum care and postpartum fatigue, there was no significant difference in the interaction between group and time. In terms of parent-newborns attachment, the interaction between group and time showed a significant difference for mothers (F=13.63, p=.001) and fathers (F=6.51, p=.001). In marital intimacy, the interaction between group and time showed a significant difference for mothers (F=14.40, p<.001) and fathers (F=9.46, p=.004). In parenting stress, the interaction between group and time showed a significant difference for mothers (F=31.8, p<.001) and fathers (F=11.69, p=.001). A significant difference was found for the mothers' postpartum sleeping hours (F=0.14 p=.004).

CONCLUSION

This program for behavioral skills in postpartum care, which is based on the information-motivation-behavioral skills model, improves postpartum care, parent-newborn attachment, marital intimacy, parenting stress, and maternal postpartum sleeping, by reinforcing behavioral skills required for postpartum care.

Factors Influencing Health Promoting Behavior in Postpartum Women at Sanhujoriwon

PURPOSE

The purpose of this study was to identify degrees of mood states, perceived health status, social support, and health promoting behavior, and to explore factors influencing health promoting behavior in postpartum women who were at Sanhujoriwon.

METHODS

A cross-sectional survey design was used. Data were collected using questionnaires from 197 postpartum women who were at Sanhujoriwon from May 28 to June 18, 2015. Data were analyzed using descriptive statistics, Pearson's correlation analyses, and a multiple linear regression.

RESULTS

The mean age of the participants was 31.8 years. About a half (47.2%) participants had a plan to receive 2 weeks of Sanhujoriwon care service. The mean health promoting behavior score was 123.5 ranged from 72 to 171. The health promoting behavior was explained by perceived health status (β=.25) and social support (β=.24). These factors accounted for 14% of the health promoting behavior.

CONCLUSION

The findings of this study reveal an important role of perceived health status, social support in health promoting behavior of postpartum women at Sanhujoriwon.

Bladder Symptoms, Fatigue and Physical Activity in Postpartum Women

PURPOSE

Physical activity is important for postpartum women. The objective of this study was to evaluate bladder symptoms, fatigue, and physical activity according to time after birth and birth modes.

METHODS

This was a cross-sectional study using web-based questionnaire or one-to-one contact. A total of 290 women after giving birth responded to self-administered questionnaires. Multivariate analysis of variance determined the differences in variables.

RESULTS

Bladder symptoms were significantly different by time after birth and birth mode; they were the highest in the first week after birth and in Cesarean birth. Postpartum fatigue showed a significant tendency by birth mode, but not by time after birth. Physical activity was significantly different by birth mode. The lowest level of physical activity was found for women who gave Cesarean birth. Moderate physical activity was also significantly different by time after birth, but vigorous physical activity was not significantly different.

CONCLUSION

In conclusion, bladder symptoms and physical activity are different by time after birth and birth mode in postpartum women. The first week after giving birth is an important period for postpartum women whose bladder symptoms and physical activity should be of concern.