Förälderns inre representationer av sig och sitt barn har visat sig påverka förälderns förmåga att erbjuda sig som anknytningsperson till sitt specifika barn. Förälderns representation av omvårdnad har också visat samband med barnets förmåga att skapa en trygg anknytningsrelation. I denna pilotstudie undersöks det kvalitativa sambandet mellan förälderns inre representation av sig och sitt barn, prematuritet och självskattade depressiva symptom. Den svenska översättningen av den semistrukturerade intervjumetoden Working Model of the Child Interview – WMCI, har använts för bedömning av de inre representationsmönstren. Screeningsverktyget Edinburgh Postnatal Depression Scale – EPDS, har använts för skattning av depressions symptom. 12 mödrar, 7 med barn som fötts för tidigt och 5 med barn som fötts fullgångna har medverkat. Resultatet visar att mammans representationsmönster varierar. Prematuritet och depressiva symptom är hos de intervjuade mammorna relaterade till representationsmönster. Det avfärdande mönstret återfanns bland mödrar till för tidigt födda barn men inte bland mödrar till fullgångna barn. Depressionssymptomen som alla var lågt skattade var negativt kopplade till mödrarnas inre representationer.

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Hensikten med studien var å forstå hvordan helsesøstre jobber for å finne og hjelpe kvinnermed fødselsdepresjon, hvor effektivt dette arbeidet oppleves og deres holdning til ny kunnskap og til å ta nye metoder i bruk i arbeidet. Fødselsdepresjon er hyppig i barselperioden og flere studier viser at tilstanden ofte oversees. Fødselsdepresjon kan føre til forstyrrelser i ”bonding” mellom mor og barn som kan hanegativ innflytelse på barnets utvikling og helse. Hjelp og støtte til kvinnene vil ha betydning for mors- og barns fremtidige helse. I en kvalitativ studie ble 14 helsesøstre påhelsestasjoner i Oslo intervjuet om hvordan de finner frem til disse kvinnene og om de finner alle, samt deres holdning til å ta i bruk Edinburgh Postnatal Depression Scale (EPDS), som er et spørreskjema utviklet til bruk i primærhelsetjenesten for å oppdage kvinner med fødselsdepresjon. Det er benyttet en hermeneutisk/fenomenologisk tilnærming. Resultatet viser at helsesøstrene mangler en klar metode for å finne kvinner med fødselsdepresjon. De baserer seg på egen erfaring, personlighet og intuisjon og innser at de ikke finner alle. De er gjennomgående positive til å få mere kunnskap og ta i bruk EPDS . Denne studien bør følgesopp med en bred debatt om hvorvidt man ønsker en screening for fødselsdepresjon og hvordan man ser for seg organisering av oppfølging for kvinnene / The aim of this study was to understand how public health nurses work to trace women with postnatal depression, how effective they find their work and their attitude towards new knowledge and methods. Postnatal depression is common in the postnatal period and studies show that the conditionoften is not detected. Postnatal depression may lead to disturbances in the bonding between mother and child which can have a negative influence on the child’s development and health. Help and support given to these women will have a positive impact on both the mothers’ and the children’s future health. In a qualitative study 14 public health nurses wereinterviewed and asked how they trace these women, whether they miss some and their attitude towards using Edinburgh Postnatal Depression Scale (EPDS), which is aquestionnaire validated for use in primary health care to detect women with postnataldepression. The design had a hermeneutical/phenomenological approach. The results showed that the public health nurses do not have a method to trace women with postnatal depression. They rely on their experience, personality and intuition and are aware that they do not trace all.They are positive towards getting more knowledge about postnatal depression and to start using EPDS. Further research should include discussions about whether screening for postnatal depression is desired and how the follow-up for the women should be organized / <p>ISBN 91-7997-116-4</p>

Syftet med föreliggande studie är att undersöka i hur några BVC-sjuksköterskor arbetar för att belysa och upptäcka postpartum depression hos nyblivna pappor. Studiens empiriska material bygger på en kvalitativ metod i form av semistrukturerade intervjuer. Totalt har åtta BVC-sjuksköterskor intervjuats, varav sju av intervjuerna har använts för att presentera studiens resultat. Uppsatsens teoretiska referensram utgörs av Travelbees omvårdnadsteori, Von Bertalanffys generella systemteori samt Antonovskys KASAM. Resultatet visar bland annat att BVC-sjuksköterskorna inte aktivt arbetar för att belysa och upptäcka postpartum depression hos nyblivna pappor, men att några av dem i enstaka fall har erbjudit pappan en EPDS-screening eller pappasamtal. Samtliga av BVC-sjuksköterskorna önskar däremot en implementering av pappasamtal i basprogrammet, för att de i framtiden ska ha de verktyg som de anser behövs för att kunna arbeta mer aktivt med att upptäcka eventuell psykisk ohälsa hos pappan. / The main purpose of this study is to examine how some child health nurses work to illuminate and detect postpartum depression among new fathers. The study's empirical material is based on qualitative semi-structured interviews. A total of eight child health nurses were interviewed and seven of the interviews have been used to present the study's results. The theoretical framework consists of Travelbees Nursing theory, Von Bertalanffys General Systems theory, and Antonovsky's SOC. The result shows that the child health nurses are not actively working to illuminate and detect postpartum depression among new fathers, but some of them occasionally have offered the father an EPDS-screening or conversation with the father. All of the child health nurses would however like an implementation of continuous conversation with fathers in the base program for child health nurses, that they in the future will have the tools that they think are needed in order to work more actively to detect the possible psychiatric health of the father.

Submitted by Cristiane Chim (cristiane.chim@ucpel.edu.br) on 2017-04-24T14:36:33Z No. of bitstreams: 1 Clarissa Martins.pdf: 1616707 bytes, checksum: 7d6ba6c5f2c247d0a5ccd351abde1ebe (MD5) / Made available in DSpace on 2017-04-24T14:36:33Z (GMT). No. of bitstreams: 1 Clarissa Martins.pdf: 1616707 bytes, checksum: 7d6ba6c5f2c247d0a5ccd351abde1ebe (MD5) Previous issue date: 2014-10-28 / This dissertation refers to an epidemiological study of screening scales for depression in pregnant adolescents. The main objective of the research was to adjust the cutoff scales for screening for depression, Edinburgh Postnatal Depression Scale (EPDS) and Beck Depression Inventory (BDI), for pregnant teenagers. It is a cross-sectional, population-based study carried out with pregnant adolescents (10-19 years old), which consulted the service prenatal Unified Health System (SUS) of Pelotas. Was carried out from October 2009 to March 2011. The sample was composed based on the SIS-Prenatal program records along the municipal health department and the Basic Health Units, and specialized clinics in the urban area of Pelotas / RS. The women answered a questionnaire with socio demographic and obstetric data, besides the two scales for screening for depression during pregnancy. Also participated in a structured clinical interview Mini International Neuropsychiatric Interview 5.0 (MINI) for the clinical diagnosis of depression. Demographic, obstetric and psychiatric social variables were assessed according to the WHO questionnaire. The accuracy of the scales was calculated by their Area under the curve (AUC) of ROC, as well as their respective sensitivity, specificity and predictive values. The best cutoff (PC) found for this sample was ≥10 EPDS scale, with sensitivity 81.1% and specificity 82.7% and AUC of 0.899. BDI for the best cutoff point was ≥11, sensitivity 81.1%, sensitivity 76.8% and an AUC of 0.869. Since the difference between the two AUC were statistically significant (p = 0, 0215). Based on the results, it is concluded that the EPDS scale has become more predictive and sensitive in screening for depression in pregnant adolescents, with respect to BDI. / A presente dissertação refere-se a um estudo epidemiológico sobre escalas de rastreamento para depressão em gestantes adolescentes. O objetivo principal da pesquisa foi verificar os pontos de corte das escalas para rastreamento da depressão Edinburgh Postnatal Depression Scale (EPDS) e Beck Depression Inventory (BDI), em gestantes adolescentes. Trata-se de um estudo transversal, de base populacional, realizado com gestantes adolescentes (10 a 19 anos de idade), as quais consultaram o serviço de pré-natal do Sistema Único de Saúde (SUS) de Pelotas-RS. Desenvolvido no período de outubro de 2009 a março de 2011. A amostra foi composta com base nos registros do programa SIS-Pré-Natal, junto a secretaria municipal de saúde e nas Unidades Básicas de Saúde, além de ambulatórios especializados na zona urbana de Pelotas/RS. As gestantes responderam a um questionário com dados sócio demográfico e obstétricos, além das duas escalas para o rastreamento da depressão durante a gestação. Também participaram de uma entrevista clínica estruturada Mini Internacional Neuropsychiatric Interview 5.0 (MINI) para o diagnóstico clínico da depressão. As variáveis sócio demográficas, obstétricas e psiquiátricas foram avaliadas nos domínios do questionário da OMS. A precisão das escalas foi calculada através de suas Áreas sob a curva (AUC) de ROC, assim como suas respectivas sensibilidade, especificidade e valores preditivos. O melhor ponto de corte (PC) encontrado para esta amostra na escala EPDS foi ≥10, com sensibilidade 81,1% e especificidade 82,7% e AUC de 0,899. Para a escala BDI o melhor ponto de corte foi ≥11, sensibilidade 81,1%, sensibilidade 76,8% e uma AUC de 0,869. Sendo que a diferença entre as duas AUC mostraram-se estatisticamente significativas (p=0,0215). Com base nos resultados, conclui-se que a escala EPDS apresenta-se mais preditiva e sensível no rastreamento para depressão em gestantes adolescentes, quando contrastada com a escala BDI.

Background: A systematic use of the Edinburgh Postnatal Depression Scale (EPDS), symptoms of postpartum depression (PPD) can be identified at an early stage, followed by timely required actions. Mental health and well-being can be perceived as sensitive objective. Joyce Travelbee and Johan Cullberg advocate nursing theoretical approaches to promote good communication and crisis management, which is the fundamental base of this master thesis. Purpose: To study risk factors for postpartum depression (PPD). Method: A descriptive literature review based on 16 quantitative studies with different study designs. Results: Risk factors for PPD may be previous or current mental and physical health issues, childbirth experiences, and socioeconomic factors. Conclusion: The results indicates association between PPD and, ill health, delivery and socioeconomics. With increased knowledge about risk factors and the value of early measures and preventive efforts, chances to prevent PPD may increase.

Magister Public Health - MPH / Common perinatal mental disorders (CPMDs) are increasingly being recognised as an important public health issue including depression and anxiety. In low and middle income countries such as Rwanda, CPMDs are prevalent among women in perinatal period. In Africa, the estimated prevalence rates of depression are 11.3% and 18.3% during ante-postnatal respectively, while ante-postnatal anxiety rates are 14.8% and 14% respectively. However, in Rwanda there is limited literature on CPMDs. This study was aimed at determining the occurrence of CPMDs in a selected district hospital of the Eastern Province in Rwanda as well as the factors associated with CPMDs in the selected study area. A descriptive quantitative cross-sectional survey was conducted with a sample of one hundred and sixty five mothers in perinatal period, who were selected systematically. Demographic data and factors associated with CPMDs were determined using structured questionnaire and combined screening tools such as Zungu Self-rating anxiety scale (SAS) and Edinburgh Postnatal Depression Scale (EPDS). The Cronbach alpha values were 0.87 and 0.89 for SAS and EPDS respectively. SPSS Version 21 was utilized to analyse data. Univariate, bivariate correlational and multivariate analyses were performed. Most of the respondents (38.2%) were aged 25-29 years; Protestants (77.6%); married (44.8%); unemployed (77%) and had a primary school level of education (60.6%). With respect to participants in antenatal period (51.5%); 14.5% had a clinical level of anxiety and 19.4% had depression. In terms of participants in postnatal period (46.7%); 22.5% had a clinical level of anxiety and 29.7% had depression. However, participants in both periods (1.8%) all had a normal level of anxiety and 1.2% had depression.

Bakgrund: Postpartumdepression är ett vanligt hälsoproblem hos mödrar efter en förlossning. Postpartumdepression drabbar inte enbart mödrar utan leder även till en negativ påverkan på barnens hälsa och utveckling. Barnhälsovårdssjuksköterskorna har en central roll i att tidigt upptäcka tecken på postpartumdepression genom screening som utförs på mödrar från sex till åtta veckor efter barnafödande. Mödrar i behov av tolk uppmärksammades och identifierades inte i lika hög grad som inrikes födda mödrar för sina symtom som kunde vara tecken på PPD. Syfte: Studiens syfte var att belysa barnhälsovårdssjuksköterskors erfarenheter av mötet med mödrar som screenas för postpartumdepression med hjälp av tolk.Metod: Kvalitativ intervjustudie genomfördes med totalt nio barnhälsovårdssjuksköterskor som arbetade inom barnhälsovården i södra Sverige. Datainsamlingen analyserades med hjälp av kvalitativ innehållsanalys.Resultat: Resultatet skapade två kategorier som var minskad kontroll och gynnsamma faktorer och fem tillhörande underkategorier. Kategorierna lyfter barnhälsovårdssjuksköterskorna erfarenheter kring de svårigheter som påverkar screeningen med mödrar som är i behov av tolk samt vilka faktorer som är av vikt för ett lyckat samtal.Konklusion: Tydlig information till mödrarna, ett bra förhållande mellan barnhälsovårdssjuksköterskorna, mödrarna, tolkarna och tolkarnas erfarenheter av screening var enligt barnhälsovårdssjuksköterskorna viktiga faktorer för att optimera samtalen i samband med screening med hjälp av tolk. / Background: Postpartum depression is a common health problem in mothers after childbirth. Postpartum depression not only affects mothers but also leads to a negative impact on children’s health and development. Child health nurse´s play a key role in detecting early signs of postpartum depression through screening performed on mother´s from six to eight weeks after childbirth. Mother´s in need of interpreters were not recognized and identified to the same extent as domestically born mothers for their symptoms that could be signs of PPD. Objective: The aim of the study was to elucidate the experiences of child health nurse´s with the meeting with mothers screened for postpartum depression with the help of an interpreter.Method: A qualitative interview study was conducted with a total of nine child health nurse´s working in child health care in southern Sweden. The data collection was analyzed using qualitative content analysis. Results: The result created two categories that were reduced control and favorable factors and five associated subcategories. The categories highlight child health nurses´ experiences of the difficulties that affect screening with mothers who are in need of an interpreter as well as what factors are important for a successful conversation.Conclusion: Clear information to the mothers, a good relationship between the child health nurses, the mothers, the interpreters and the interpreter´s experience of screening were according to the child health nurses important factors in optimizing the conversations in connection with screening with the help of an interpreter.

Paternal postnatal depression has begun to receive attention during the last decade. Studies have shown that the consequences of paternal and maternal postnatal depression are equally serious. There are currently no validated instrument for screening of paternal postnatal depression. In this cross-sectional study a self-report questionnaire, the Edinburgh Gotland Depression Scale (EGDS) is validated against the clinical interview SCID-CV as gold standard, and is further developed. A convenience sample of Swedish fathers (N = 95) who had children in the past year, answered an online questionnaire and a subsample (n = 52) of them were later interviewed with the SCID-CV. The revised EGDS showed improved criterion-related validity, sensitivity and specificity. The scale has problems disciminating between mildly and non-depressed fathers. A cut-off score of ≥8 on the revised EGDS results in sensitivity of 91.7 per cent and specificity of 85.0 per cent. This study should be replicated and cross-validated to provide further evidence of validity. / Postnatal depression hos fäder har börjat uppmärksammas under det senaste decenniet. Studier har visat att konsekvenserna av postnatal depression hos fäder och mödrar är lika allvarliga. Det finns för närvarande inga validerade instrument för screening av postnatal depression hos fäder. I denna tvärsnittsstudie har självskattningsformuläret, Edinburgh Gotland Depression Scale (EGDS) valideras mot den kliniska intervjun SCID-CV som gold standard, och vidareutvecklas. Ett bekvämlighetsurval av svenska fäder (N = 95) som fått barn under det senaste året, besvarade en webbenkät och en undergrupp (n = 52) av dem blev senare intervjuade med SCID-CV. Det reviderade EGDS visade förbättrad kriteriumrelaterad validitet, sensitivitet och specificitet. Skalan har problem med att diskriminera mellan milt och icke-deprimerade pappor. En cut-off poäng ≥8 för den reviderade EGDS resulterar i sensitivitet på 91,7 procent och specificitet på 85,0 procent. Denna studie bör replikeras och korsvalideras för att ge ytterligare belägg för validiteten.