One of the most common complications for mothers after childbirth is postpartum depression (PPD). This illness can occur in women who have given birth, who have miscarried or who have had a stillbirth. The American College of Obstetricians and Gynecologists (2010) indicate that PPD affects 1 in 8 women. These statistics are disturbing especially when 51 % of women may not be willing to seek treatment for PPD (Beck & Gable, 2001 ). Therefore, the number of women who are experiencing PPD is of national concern. The literature reveals that there is not a standard or protocol for the assessment of PPD symptoms, education delivery, or referral and treatment. With an absence of a standard or protocol, this devastating disorder will continue to go undiagnosed in thousands of women affecting not only their wellbeing but the wellbeing of their families. Nurses are in an optimal position to help prevent and identify women suffering from PPD. Establishing the nurse's role in assessing, educating and referring women and families suffering from PPD will assist in reducing the prevalence of this illness and identifying afflicted women for early intervention. Implementing a standard of practice in PPD assessment, education, and referral will assist healthcare providers in achieving the Healthy People 2010 objective of reducing mental illness and complications due to pregnancy.

Bakgrund: Ungefär en av fem kvinnor drabbas av psykisk ohälsa postpartum (PP). Trots detta är det inte alla som får hjälp. Det är därför viktigt att distriktssköterskan har goda kunskaper i att upptäcka och behandla psykisk ohälsa PP, och på så vis kunna mildra konsekvenserna för mor och barn. Det är sedan tidigare känt att kvinnor med psykisk ohälsa postpartum har sämre förutsättningar till en bra anknytning till barnet. Syfte: Syftet var att beskriva distriktssköterskans roll mot nyblivna mammor som visar tecken på psykisk ohälsa. Metod: Tidigare publicerad forskning har analyserats och sammanställts i en litteraturöversikt. Resultatet presenterades utifrån de fyra kategorier som framkom ur de kvalitativa artiklarna. Resultat: Distriktssköterskor har en viktig roll på barnavårdscentralen (BVC), för att upptäcka och behandla psykisk ohälsa postpartum. / Background: Approximately one out of five women suffers from mental illness in the postpartum stage. In spite that, several women suffer without any help. It is therefore important that the district nurse has a good knowledge in how to discover and treat mental illness in the postpartum stage. Aim: The aim was to describe the district nurse’s role towards new mothers with signs of mental illness. Method: Previous research have been analyzed and complied in a literature review. The result was presented from the four different categories, that was revealed in the analysis of the qualitative articles. Result: The districtnurses have an important role in the child care unit, in order to discover and treat mental illness in the postpartum stage. / <p>Godkännandedatum: 2020-11-23</p>

Diss. (sammanfattning) Stockholm : Karol. inst., 2004. / Härtill 5 uppsatser.

Diss. (sammanfattning) Stockholm : Karol. inst., 2004. / Härtill 5 uppsatser.

The postpartum period, also know as postpartum, is a time of great physical and psychological changes, increasing the risk for onset of musculoskeletal discomfort, postural changes and depressive symptoms, which are directly related to muscle and physiological functions and may affect function and the musculoskeletal control, reflecting the postural pattern. In clinical practice, postural changes are frequently observed among the mothers, both either due to biomechanical compensations during pregnancy or the tensions and burdens generated by baby care. In the literature, there are few studies that relate postural alignment and depressive symptoms. This relationship will add up to knowledge that helps identify the obstacles to recovery and lead to the development of strategies and targeted interventions for postpartum women. The objective of the study is to investigate depressive symptoms in postpartum women, and the influence of this posture. Eighty women were evaluated; with postpartum time of two to 30 weeks; pregnancy with resolution between 34 and 42 weeks and calving and healthy live baby. Depressive symptoms were screened through Depression Scale Edinburgh Postnatal (EPDS). Postural assessment was conducted through computerized photogrammetry and visual. Approximately 33% (n = 26) of evaluated postpartum women had scores indicating postpartum depression. Postpartum women showed distinct global postural patterns in relation to depressive symptoms and these compensation patterns generated in the body segments, more significantly in the pelvis. / Submitted by Ramon Santana (ramon.souza@ufpe.br) on 2015-03-10T18:15:57Z No. of bitstreams: 2 Alterações posturais e sintomas depressivos em puérperas.pdf: 1368202 bytes, checksum: b6e598bc074a49361d58ae8cf28c0f12 (MD5) license_rdf: 1232 bytes, checksum: 66e71c371cc565284e70f40736c94386 (MD5) / Made available in DSpace on 2015-03-10T18:15:57Z (GMT). No. of bitstreams: 2 Alterações posturais e sintomas depressivos em puérperas.pdf: 1368202 bytes, checksum: b6e598bc074a49361d58ae8cf28c0f12 (MD5) license_rdf: 1232 bytes, checksum: 66e71c371cc565284e70f40736c94386 (MD5) Previous issue date: 2014-09-04 / O puerpério, também chamado de pós-parto, é um período de grandes mudanças físicas e psicológicas, aumentando os riscos para desencadeamento de desconfortos musculoesquelético, alterações posturais e sintomas depressivos, os quais estão diretamente relacionados às funções musculares e fisiológicas e podem afetar a função e o controle musculoesquelético refletindo no padrão postural. Na prática clínica, as alterações posturais são frequentemente observadas entre as puérperas, tanto pelas compensações biomecânicas durante a gestação, como pelas tensões e sobrecargas geradas com os cuidados com o bebê. Na literatura, são escassos os estudos que relacionam alinhamento postural e sintomas depressivos. Tal relação será um conhecimento a mais para ajudar a identificar os obstáculos para a recuperação e levar ao desenvolvimento de estratégias e intervenções direcionadas às puérperas. O objetivo do estudo foi rastrear a sintomatologia depressiva em puérperas e verificar a influência desta na postura. Foram avaliadas 80 mulheres, com tempo de pós-parto entre duas e 30 semanas; gestação com resolução entre 34 e 42 semanas e parição de bebê saudável e vivo. Os sintomas depressivos foram rastreados através da Escala de Depressão Pós-natal de Edimburgo (EDPE). A avaliação postural foi efetuada através de fotogrametria computadorizada e visual. Aproximadamente, 33% (n=26) das puérperas avaliadas apresentaram escores indicativos de depressão pós-parto. As puérperas apresentaram padrões posturais globais distintos em relação à sintomatologia depressiva e estes padrões geraram compensações nos segmentos corporais, de modo mais significativo na pelve.

Project (Ed.S.)--James Madison University, 2009. / Includes bibliographical references.

INTRODUÇÃO: Alimentação adequada e saudável é essencial para o pleno desenvolvimento infantil. A alimentação complementar (AC) deve ser iniciada de maneira oportuna e segura, suprindo as necessidades nutricionais da criança. Mães com depressão pós-parto (DPP) apresentam dificuldades nos cuidados gerais e nas práticas relacionadas à alimentação da criança. O objetivo do presente estudo é verificar a associação entre DPP e introdução precoce de alimentos complementares (IPAC), aos 4 meses de idade da criança, e descrever a frequência de alimentos introduzidos precocemente. METODOLOGIA: Estudo transversal, realizado entre agosto de 2013 a agosto de 2014, a partir de dados coletados entre 6 e 9 meses após o parto de 326 puérperas que já haviam participado de ensaio de comunidade (PROGRAVIDA). Dados referentes a IPAC e outras informações foram coletados por meio de questionário estruturado. A DPP foi avaliada por meio do \"Patient Health Questionnaire-9\". Modelos de regressão de Poisson com variância robusta, seguindo modelo hierárquico, foram usados para avaliar a associação entre DPP e IPAC. No modelo bruto foi estimada a razão de prevalência (RP) e o intervalo de confiança de 95% (IC95%) entre DPP e IPAC, levando-se em conta a randomização das participantes no estudo original. No modelo multivariado foram estimadas as RP e IC95% entre DPP e IPAC, ajustadas por variáveis sócio demográficas e socioeconômicas (etnia, escolaridade, renda familiar mensal, situação de trabalho materno e situação conjugal), dados maternos (idade, número de filhos e tipo de parto), dados perinatais (idade da criança e peso ao nascer) e dados da criança (uso de chupeta e aleitamento materno). A análise estatística foi realizada com uso do programa STATA 12 e o nível de significância estatística foi considerado igual ou inferior a 5%. RESULTADOS: A prevalência geral de IPAC foi de 75,8% (IC95% 0,71-0,80). No modelo bruto, não foi encontrada associação entre depressão e IPAC (RP:0,97; IC 95% 0,83 - 1,14). Na análise multivariada, constatou-se menor prevalência de IPAC entre mulheres que ainda amamentavam aos 6 meses, naquelas que trabalhavam fora e entre aquelas com menor renda familiar. A estimativa da associação bruta entre DPP e IPAC não se modificou significativamente após ajustes para possíveis variáveis confundidoras. Portanto, puérperas com depressão grave à moderada não apresentaram diferenças na IPAC, comparadas às mulheres sem depressão ou com depressão leve (RP:0,96; IC 95% 0,81 - 1,12). Os alimentos com maior proporção de introdução precoce foram água, chá e outros leites, e os com menor proporção foram carnes, arroz e feijão e massas, não havendo diferenças entre os grupos¸ segundo depressão materna. CONCLUSÃO: Verificou-se elevada prevalência de IPAC, independentemente dos níveis de depressão. Intervenções para restringir a IPAC não devem priorizar o estado de humor da mulher no puerpério, mas sim a prática do aleitamento e aspectos sociais, tais como renda familiar e trabalho externo da mãe / INTRODUCTION: Adequate and healthy feeding is essential for infant and child development. Complementary feeding must occur in timing and appropriately, supplying child´s nutritional needs. Postpartum depressed (PPD) mothers show difficulties in general care and practices related to child´s feeding. The aim of this study is to verify the association between PPD and early complementary foods introduction (IPAC), at 4 months old, and to describe the frequency of early food\'s introduction. METHODOLOGY: Cross-sectional study, performed from August 2013 to August 2014, through data collected between 6 to 9 months after labor, from 326 puerperal women who had participated in a community trial (PROGRAVIDA). IPAC data and other information were collected via structured questionnaire. PPD was evaluated through the \"Patient Health Questionnaire-9\". Poisson regression models with robust variance, following a hierarchical model, were used to evaluate the association between PPD and IPAC. In the simplified model, the prevalence ratio (PR) and 95% confidence level (95%CI) between PPD and IPAC was estimated, taking into consideration the randomization of participants in the community trial. Multivariate models estimated the PR and 95%CI between PPD e IPAC, adjusted for socio-demographic and socioeconomic variables (ethnicity, education, monthly family income, employment and marital status), maternal data (age, number of children and type of delivery), perinatal data (age and birth weight) and child data (pacifier use and breastfeeding). The statistical analysis was performed with STATA 12 software and the significance level was considered equal or lower than 5%. RESULTS: The IPAC general prevalence was 75.8% (95%IC 0.71 - 0.80). In the simplified model no association was found between depression and IPAC (PR: 0.97; 95%CI 0.83 - 1.14). In the multivariate analysis, it was encountered a lower prevalence of IPAC among women who were still breastfeeding at 6 months, in those who worked out and among women with lower family income. The estimate of the simplified association between PPD and IPAC did not change significantly after adjustment for possible confounding variables. Therefore, postpartum women with severe to moderate depression did not present differences in IPAC, compared to women without depression or mild depression (PR: 0.96; 95%CI 0.81 - 1.12). Foods with a higher proportion of early introduction were water, tea and other milks, and the ones with the lowest proportion were meats, rice and beans and pasta, and there were no differences between the groups¸ according to maternal depression. CONCLUSION: There was a high prevalence of IPAC, independently of depression levels. Interventions to restrict IPAC should not prioritize woman\'s mood in the puerperium, but rather the practice of breastfeeding and social aspects, such as family income and mother\'s external work

INTRODUÇÃO: As mães deprimidas apresentam redução do contato afetivo e dificuldade em expressar sentimentos positivos pelo bebê. O objetivo do presente estudo é avaliar a associação entre depressão pós-parto (DPP) e confiança materna baixa (CMB) em mulheres com histórico de depressão na gravidez prévia. METODOLOGIA: Estudo transversal, realizado entre junho de 2013 a maio de 2015, a partir de dados coletados entre 6 e 9 meses após o parto de 344 puérperas que já haviam participado de ensaio de comunidade (PROGRAVIDA). A Confiança Materna foi avaliada por meio do Questionário de Confiança Parental (MCQ) e as informações sócio-demográficas, socioeconômicas e de saúde das participantes foram avaliadas por meio de questionário estruturado. A DPP foi avaliada por meio do \"Patient Health Questionnaire\" (PHQ-9). A razão de prevalência (RP), não ajustada e ajustada, e o IC 95% foram calculados usando regressão de Poisson com variância robusta. Foram usados 3 modelos: no modelo bruto (modelo 1) foi estimada a RP entre DPP e CMB levando em conta a randomização das participantes no ensaio de comunidade. No modelo multivariado foram estimadas as RP entre DPP e CMB ajustadas por variáveis sócio-demográficas (escolaridade, renda familiar mensal em tercis, etnia e estado civil) (modelo 2) e por características maternas (idade materna, número de filhos e gravidez planejada (modelo 3). A análise estatística foi realizada com uso do programa STATA 12 e o nível de significância estatística foi considerado igual ou inferior a 5%. RESULTADOS: Na análise univariada, a prevalência de CMB em mulheres com depressão moderada/grave é 36% maior na comparação com mulheres sem depressão. Mulheres com 3 ou mais filhos apresentaram menor prevalência de CMB na comparação com mulheres com apenas 1 filho (RP: 0,76, IC 95% 0,58:0,99). Na análise multivariada, a associação entre CMB e DPP na forma moderada/grave se manteve após ajustes para possíveis variáveis confundidoras (socioeconômicas e características maternas). A estimativa da associação bruta entre CMB e depressão moderada/grave não se modificou significativamente após ajustes, mostrando que puérperas com depressão moderada/grave apresentaram aumento do risco de CMB de 42% (RP 1,42, IC95% 1,14:1,77). DISCUSSÃO: No presente estudo, as mulheres com sintomas depressivos moderados/graves apresentaram aumento no risco de CMB em comparação com mulheres sem sintomas depressivos. Por outro lado, CMB não se associou com DPP na forma leve. Esses resultados corroboram evidências da literatura que afirmam que a DPP pode perturbar a expressão da confiança e as práticas de cuidado materna. Os resultados reforçam a importância da avaliação do sentimento de confiança materna no primeiro ano de vida da criança, particularmente nas mulheres com formas mais graves de depressão / INTRODUCTION: Depressed mothers show reduced affective contact and difficulty in expressing positive feelings towards the baby. The objective of the present study is to evaluate the association of postpartum depression (PPD) and low maternal confidence (LMC) in women with a history of depression in the past pregnancy. METHODOLOGY: Transversal study, performed from June 2013 to May 2015, through data collected from the sixth to the ninth month after labor, from 344 puerperal women who had participated in a community trial (PROGRAVIDA). Maternal Confidence was assessed through the Maternal Confidence Questionnaire (MCQ) while socio-demographic, socioeconomic and health information on the participants was collected via structured questionnaire. PPD was evaluated through the \"Patient Health Questionnaire\" (PHQ-9). The prevalence ratio (PR), adjusted and non-adjusted, and the 95% CI were calculated using Poisson regression with robust variance. Three models were used: in the gross model (model 1), the PR between PPD and LMC was estimated, taking into account the randomization of participants in the community trial. The multivariate models estimated the PR between PPD and LMC adjusted for socio-demographic variables (education, monthly family income in tertiles, ethnicity and marital status) (model 2) and for maternal characteristics (mother\'s age, number of children and planned pregnancy) (model 3). The statistical analysis was performed with the STATA 12 software and the significance level was considered equal or lower than 5%. RESULTS: In the univariate analysis, the prevalence of LMC in women with moderate/severe depression was 35% higher in comparison to women without depression. Women with three or more children presented a lower prevalence of LMC in comparison to women with only one child (PR: 0.76, CI 95% 0.58:0.99). In the multivariate analysis, the association between LMC and PPD in its moderate/severe form remained after adjustment for possible confounding variables (socioeconomic variables and maternal characteristics). The estimation of the gross association between LMC and moderate/severe depression did not significantly change after the adjustments, evidencing that puerperal women with moderate/severe depression presented an increase of 42% in the risk of LMC (PR 1.42, IC 95% 1.14:1.77). DISCUSSION: In the present study, women with moderate/severe depressive symptoms showed increased risk of LMC in comparison to women without depressive symptoms. On the other hand, LMC was not associated to PDD in its minor form. These results corroborate evidence in the literature which state that PPD can disturb the expression of confidence and maternal care practices. The results reinforce the importance of the evaluation of maternal trust feeling in the first year of the child\'s life, particularly for women with more severe forms of depression

Made available in DSpace on 2016-03-22T17:26:02Z (GMT). No. of bitstreams: 1 Renata_Muenzer.pdf: 274027 bytes, checksum: 96793540f286000aea6639859fe1c001 (MD5) Previous issue date: 2007-12-18 / Purpose: To verify if therapeutic alliance in the end of the treatment is able to predict the effectiveness of cognitive psychotherapy approach within a six months period after the end of intervention with depressive postpartum mothers. Method: Clinical trial proceeding study with depressive postpartum women. This study included 60 women that were evaluated in the last session with the Beck Depression Inventory (BDI) and the Working Alliance Inventory (WAI). The therapists have also answered to the WAI Inventory. After six months the BDI was re-applied to the clients. Results: The therapeutic alliance when evaluated by the client was not able to predict the treatment effectiveness six months after the therapy (WAI total; p=0,71). On the contrary, when evaluated by the therapist, an elevated alliance was able to predict a worsening on depressive symptoms of the mothers in the period after the treatment (WAI total; p=0,003). Conclusion: The therapist´s perception of an elevated alliance with his client was able to predict a worsening on depressive symptoms of the mothers six months after intervention / Objetivo: Verificar se aliança terapêutica ao final do tratamento é capaz de predizer a efetividade da psicoterapia de fundamentação cognitivista após seis meses do término da intervenção em mulheres deprimidas no pós-parto. Método: Estudo de seguimento de ensaio clínico em mulheres deprimidas no pós-parto. No ensaio foram incluídas 60 mulheres que foram avaliadas na última sessão psicoterápica pelo Beck Depression Inventory (BDI) e Working Alliance Inventory (WAI). Os terapeutas também responderam ao WAI neste momento. Após seis meses o BDI foi re-aplicado às clientes. Resultados: A aliança terapêutica quando avaliada pelo cliente não foi preditora da efetividade do tratamento após seis meses pós-psicoterapia (WAI total; p=0,71). Quando avaliada pelo terapeuta, a aliança alta foi preditora de uma piora dos sintomas depressivos das mães no período pós-tratamento (WAI total; p=0,003). Conclusão: A percepção do terapeuta de uma elevada aliança com seu cliente foi capaz de predizer uma piora da sintomatologia depressiva das mães após seis meses da intervenção

Background: Postnatal depression (PND) is one of the most common maternal mental health problems for women worldwide. Yet the wide range of reported rates of PND in different countries raises questions about how PND is experienced by women in different cultures and whether interventions developed in western cultures are appropriate in very different settings. It is important to establish how PND is defined, experienced and managed in different cultures in order to create culturally relevant interventions. No previous studies of experience of PND and its management have been conducted in Malaysia. The aim of this study was to explore women’s experiences and healthcare practitioners’ (HCPs) perspectives of PND in a multicultural country, Malaysia. Methods: This was a qualitative study informed by a critical realist approach. Semi-structured interviews were carried out with 33 women (from three different cultural backgrounds) attending for child or postnatal care and 18 HCPs in six purposively selected maternal and child health (MCH) clinics and a female psychiatric ward in Kuala Lumpur, Malaysia. Data were analysed using framework analysis. Findings: There were some differences in the women’s perceptions of PND experience across three different cultural backgrounds in Malaysia. Malay women were more likely to describe the symptoms of PND based on a combination of emotional and behavioural changes, whereas Chinese and Indian women talked more about emotional changes. Traditional postnatal practices were described as contributing to PND by some Malay women but were accepted as promoting maternal and infant well-being by the majority of Indian women. Religious activities were reported as an effective strategy for the Malay women but were not seen as helpful by the majority of Chinese women. Considering HCPs, it appeared that the absence of a clear and specific policy and guideline in the management of PND within the Malaysian healthcare system has resulted in a lack of professional ownership in the management of PND, especially among HCPs in MCH clinics. Conclusion: The women and the HCPs had distinct ways of conceptualising PND experiences, although they agreed on several symptoms and causal explanations. This study calls for a system-based enhanced PND care with an initiation of culturally appropriate care for PND within the healthcare system.