Bakgrund: Förlossningsdepression är ett tillstånd som kan uppstå under första året efter förlossningen, där modern upplever depressiva symtom samt humörsvängningar. Tillståndet är ett känsligt ämne och kan orsaka att mödrar lider i tysthet. Många mödrar söker inte vård för förlossningsdepression vilket påverkar modern, barnet och familjen.  Syftet: Syftet med studien är att beskriva mödrars erfarenhet av förlossningsdepression. Metod: En litteraturöversikt utfördes med deskriptiv design och kvalitativ ansats. Studiens resultat baseras på 15 artiklar som hämtades från databaserna CINAHL och PubMed. De inkluderade artiklarna granskades utifrån SBU’s granskningsmall.  Resultat: Resultatet identifierade tre teman: “Erfara stigma”, “Erfarenhet av ensamhet” och “Upplevelse av stöd”. Resultatet visade att mödrarnas erfarenhet av att ha en förlossningsdepression var en upplevelse av stigmatisering. Detta skapade en rädsla att bli dömd. Omgivningens förväntningar på moderskap skapade en press och svårigheter att hantera de utmaningar som uppstod. Mödrarna upplevde känsla av ensamhet och uttryckte både en positiv och negativ upplevelse av stöd från familjen och vården. De upplevde även att ekonomiska svårigheter hade en negativ inverkan på deras förlossningsdepression. Slutsats: Mödrarnas erfarenhet av förlossningsdepression kan ge distriktssköterskan fördjupad kunskap om deras upplevelser. Distriktssköterskan bör visa empati i möten med mödrar, vilket kan skapa en trygg miljö där mödrarna är bekväma att uttrycka sina känslor. Genom ökad kunskap inom ämnet kan förlossningsdepression hos mödrar upptäcks tidigt. Detta kan främja välbefinnande hos dessa mödrar och deras familjer. / Background: Postpartum depression is a condition that can occur during the first year after giving birth, where the mother experiences depressive symptoms and mood swings. The condition is a sensitive subject and can cause mothers to suffer in silence. Many mothers do not seek treatment for postpartum depression, which affects the mother, the child and the family. Aim: The aim of this study is to describe mothers' experience of postpartum depression. Method: A literature review was performed with a descriptive design and qualitative approach. The study's results are based on 15 articles that were retrieved from the CINAHL and PubMed databases. The included articles were reviewed based on SBU's review template. Result: The results identified three themes: “Experienced stigma”, “Experienced loneliness” and “Perceived support”. The results showed that the mothers' experience of having postpartum depression was an experience of stigma. This created a fear of being judged. The environment's expectations of motherhood created a pressure and difficulties in dealing with the challenges that arose. The mothers experienced feelings of loneliness and expressed both a positive and negative experience of support from family and health care. They also felt that financial difficulties had a negative impact on their postpartum depression. Conclusion: The mothers' experience of postpartum depression can give the district nurse indepth knowledge of their experiences. The district nurse should show empathy in meetings with mothers, which can create a safe environment where the mothers are comfortable expressing their feelings. Through increased knowledge in the subject, postpartum depression in mothers can be detected early. This can promote the well-being of these mothers and their families.

Bakgrund: I Mars 2020 infördes restriktioner i samhället på grund av covid-19 pandemin och detta påverkade distriktssköterskors arbete med förlossningsdepression. Syfte: Syftet med studien var att beskriva distriktssköterskors erfarenheter av arbetet med förlossningsdepression hos nyblivna mödrar under covid-19 pandemin. Metod: En kvalitativ intervjustudie med tio semistrukturerade intervjuer. Dataanalysen utfördes med en kvalitativ innehållsanalys. Resultat: I resultatet framkom två kategorier; förändrat arbetssätt och ökad arbetsbelastning samt underkategorierna screening, digitala och fysiska bedömningar, förändrat teamarbete, ökad psykisk ohälsa hos mödrarna och ökat stödbehov hos mödrarna. Konklusion: Arbetet med förlossningsdepression upprätthölls av samtliga distriktssköterskor. Arbetet såg dock olika ut beroende på förutsättningar som fanns och för att få en mer likvärdig vård för denna patientgrupp, om en ny pandemi uppstår, behöver gemensamma riktlinjer upprättas. Studien kan användas i sjuksköterskors specialistutbildningar för att uppmärksamma ämnet och förbättra vården för nyblivna mödrar. Bibehåller mödrar sin hälsa kan de i sin tur ge barnen en trygg uppväxt. Vidare forskning kan inriktas på hur teamet kring distriktssköterskan påverkar arbetet med förlossningsdepression. / Background: In March 2020, restrictions were introduced in society due to the covid-19 pandemic and this affected district nurses who working with postpartum depression. Purpose: The purpose of the studies was to describe district nurses´ experiences of working with postpartum depression in new mothers during the COVID-19 pandemic. Method: A qualitative interview study with ten semistructured interviews. Data analysis was performed using a qualitative content analysis. Results: In the results, two categories emerged; changed working methods and increased workload as well as the subcategories screening, digital and physical assessments, changed teamwork, increased mental illness among the mothers andincreased need for support among the mothers. Conclusion: The work with postpartum depression was maintained by all district nurses. However, the work differed depending on the conditions that existed, and to achieve more equal care for this patient group, if a new pandemic occurs, common guidelines need to be established. The study can be used in nurses' specialist training to draw attention to the subject and improve care for new mothers. If mothers maintain their health, they can, in turn, give their children a safe upbringing. Further research can focus on how the district nurse team affects the work with postpartum depression.

BACKGROUND: Both mood and anxiety disorders are more prevalent in women than men with the onset typically occurring during adolescence or early childbearing years. These disorders are particularly prevalent during pregnancy and the postpartum period. While depression during the perinatal period has received significant attention recently, anxiety has not received the same amount of attention. METHODS: The current study was a secondary analysis of a prospective cohort study that followed 91 women with mood disorders through pregnancy and the postpartum period. Our objective was to determine if a correlation existed between anxiety and suicidality. We hypothesized that pregnant women with a history of a mood disorder and comorbid anxiety are more likely to be suicidal than those without comorbid anxiety. The presence of anxiety was determined using the anxiety subscale of the Edinburgh Postnatal Depression Scale, EPDS; a cut off score of six or greater was used to indicate significant anxiety. Suicidality was determined using three separate measures: question ten on the EPDS, question eighteen on the Inventory of Depressive Symptomatology, and question ten on the Montgomery-Asberg Depression Rating Scale. ANALYSIS: Chi square tests were used to compare the demographics of the anxious and non-anxious women based on both diagnosis of anxiety disorders and symptoms of anxiety. Z proportion tests were then used to compare the proportion women with anxiety versus those without anxiety who were suicidal. Lastly, binary logistic regression was used to determine if patients with anxiety were more likely to be suicidal. RESULTS: Among the women in this study, 62 (68.1%) had a diagnosis of major depressive disorder and 29 (31.9%) had a diagnosis of bipolar disorder based on DSM-IV-TR diagnostic criteria. In addition, 45 (49.5%) had a lifetime history of an anxiety disorder. The prevalence of significant anxiety symptoms, as determined by the anxiety subscale on the EPDS, ranged from 9.1-37.5% depending on the time point. Suicidality prevalence also varied depending on both the time point and the scale used: 0-17.5% using the MADRS, 6.7-24.7% using the EPDS, and 2.4-14.7% using the IDS. Using a binary logistic regression, we determined that anxiety was a risk factor for suicidality at time T3 (OR 2.106; 95% CI 1.274-3.481) and M1 (OR 2.057; 95% CI 1.179-3.586) on the MADRS and at T3 (OR1.758; 95% CI 1.219-2.535) on the EPDS.

The purpose of this study is to explore and understand any correlation between a mother having postpartum depression and her now college-level child having a mental illness. The research question posed for this study was: Is there a correlation between maternal postpartum depression and the development of mental illnesses in college students? Studies have shown that there is a correlation in early childhood development, but there are deficits when it comes to long-term follow-up. Data for this study was collected via online surveys on SONA UCF. The results from the Chi-square test imply a strong association (p = .007) at n=85. Since many college students presently suffer from an array of mental illnesses, it is crucial to trace it back to the roots of the problem.

Despite PPD’s global extent, scarce research that addresses culturally competent alternative interventions exists. The purposes of this thesis were to 1) analyze the existing literature on non-pharmacological treatment of PPD in the US and across selected cultures; 2) determine the effectiveness of cross-cultural non-pharmaceutical therapy; and 3) examine and suggest ways health care providers can integrate non-pharmacologic interventions into PPD treatment in the US. The systematic electronic search comprised the databases Cumulative Index to Nursing and Allied Health Literature, Medline, PsycINFO and SAGE Research Methods. Searches were limited to English language, peer reviewed, and research articles between 2007 and 2017. A second search was performed through global Healthcare Organizations websites. The World Bank’s country classifications by income level were adopted to present the findings. This review found that passing el calor to the newborn, yoga; and cognitive-behavioral, interpersonal, family, and bright light therapies are successful interventions. Further, seclusion periods were identified as adequate interventions only when women voluntarily adopt the practice and have family support, with less social restrictions. While other non-pharmacological treatments’ effectiveness was not ascertained, this thesis encourages healthcare professionals to integrate cultural traditions congruent with clients’ preferences. Recommended nursing interventions and suggestions for improvement of current practice are also discussed.

No description available.

No description available.

Perinatal depression (PND), depression that occurs during pregnancy or in the first year following delivery, is a common and debilitating mental health condition. In New York City, it is estimated that at least one in ten women suffer from PND. The clinicians who serve these women require training in acceptable, feasible, and effective treatments. Interpersonal psychotherapy (IPT) is a time-limited, evidence-based psychotherapy that has been found to be effective in the treatment of PND in community and primary care settings. The present study investigates the nuances of an IPT training program for licensed mental health providers who treat perinatal depression within integrated care settings in NYC. Using a qualitative-focused mixed-methods design, this study aims to systematically and comprehensively evaluate the acceptability, feasibility, sustainability, and preliminary effectiveness of the training program, and of the providers’ perceptions of IPT as a treatment for the patients they serve. To achieve these aims, five of the eight providers who participated in the training program were interviewed at two timepoints and quantitative data including demographics, use of IPT, satisfaction with training experience, and effectiveness of the training program were collected. Results indicate that providers viewed their training experience as acceptable and feasible and viewed IPT as an appropriate, relevant, and helpful treatment for their perinatal patients’ depression. Quantitative results provide preliminary support for the training model’s potential effectiveness, demonstrating that provider-trainees were able to obtain and retain knowledge of IPT and achieve certification as IPT practitioners. Overall, Patient Health Questionnaire (PHQ-9) scores show that patients who were treated by the study’s provider-trainees self-reported depression symptoms improved over the course of their IPT treatment. Recommendations for future directions and implications for future provider training programs are discussed.

Objective 1: To examine the influence of maternal depression and/ or anxiety on infant, maternal and dyadic FFSF task performance Objective 2: To investigate the changes in infant and maternal FFSF task performance before and after Cognitive Behavioural Therapy (CBT) treatment of maternal depression / Background: Research suggests that postpartum depression (PPD) and postpartum anxiety (PPA) impact both mothers and their infants, leading to adverse behavioural outcomes across the lifespan. The face-to-face still-face (FFSF) task is a validated observational tool used to measure the quality of mother-infant interactions. This thesis aimed to investigate the differences in responses to the FFSF task between dyads consisting of mothers with PPD and/or PPA and healthy dyads. Another goal was to examine whether PPD treatment could improve mother and infant FFSF outcomes. Methods: A systematic search was performed in PubMed/MEDLINE, EMBASE, CINAHL, PsycINFO and Web of Science. Meta-analyses were conducted to examine the differences in infant, maternal and dyadic FFSF outcomes in mothers with PPD, PPA or comorbid PPD and PPA in comparison to healthy control dyads. Second, we examined whether group cognitive behavioural therapy (CBT) for PPD could help improve infant and maternal FFSF outcomes. A case-control design study was conducted with three different assessment points (i.e., pre-CBT treatment, immediately after CBT and three months post-CBT). Results: Meta-analyses suggested that the infants of mothers with PPD display lower levels of positive affect during the play and reunion phases compared to the infants of healthy non-depressed mothers. Also, mothers with PPD may engage less positively with their infants at the reunion phase, and mother-infant dyads affected by PPD show less positive interactive matching during the play phase compared to healthy control dyads. Finally, object/environment engagement was higher in infants of PPA mothers compared to healthy controls at still-face. Conclusion: The results suggest that mothers with PPD and/or PPD (and their infants) may exhibit different interaction patterns compared to healthy dyads. Also, it appears that the benefits of CBT for maternal PPD may extend to their infants through reductions in maladaptive infant withdrawn behaviours to normal, healthy levels. / Thesis / Master of Science (MSc) / Maternal postpartum depression (PPD) and postpartum anxiety (PPA) are the most common mental health complications of birth. Apart from unfavourable effects PPD and PPA have on mothers, it may also impact the mother-infant relationship, leading to adverse infant outcomes. Given the relatively high prevalence of maternal PPD, PPA, and comorbid PPD and PPA, this thesis aimed to examine the differences in how mothers suffering from PPD and/or PPA and their infants coordinate their behaviour, in comparison to healthy mothers and their infants using a validated observational task (face-to-face still-face [FFSF] task). Another goal of this thesis was to investigate whether the benefits of maternal treatment for PPD with cognitive behavioural therapy may extend to infants and improve mother, as well as infant behaviour. These investigations may provide new insights on how maternal PPD and/or PPA affects mother-infant interactions, and consequently, infant socio-emotional development.

Postpartumdepression (PPD) drabbar ca 10–15 procent av alla mödrar efter förlossning. Det finns flera riskfaktorer för att drabbas vilket kräver kännedom om dessa hos vårdpersonalen samt fungerande screeningmetoder för att kunna identifiera depressiva symtom. Att leva med postpartumdepression innebär en svårighet att anpassa sig till den nya mödrarollen samt att fungera i det vardagliga livet. Det finns olika behandlingsmetoder för PPD varav de vanligaste i Sverige idag är psykoterapi och antidepressiva läkemedel. Barnmorskor bör utarbeta etablerade rutiner för att kunna upptäcka kvinnor i riskzonen samt för att kunna ge stöd efter förlossning. Mödrar upplever att de generellt erhåller ett otillräckligt stöd för PPD och önskar ett ökat stöd från hälso- och sjukvården. Syftet var att belysa hur barnmorskor kan ge stöd åt mödrar med postpartumdepression. En allmän litteraturöversikt med systematiskt tillvägagångssätt genomfördes med sökning i databaserna CINAHL, PubMed och PsycINFO vilket resulterade i inklusion av fyra kvalitativa och 15 kvantitativa studier. En integrerad dataanalys genomfördes vilket resulterade i tre huvudkategorier. Följande tre huvudkategorier identifierades: personcentrerat förhållningssätt, kontinuitet och kommunikation och att vägleda och hitta strategier. I studierna framgick det att stöd bör ges genom att se hela modern, vara inlyssnande och tillgänglig, bygga en relation till modern, att inte övermedikalisera samt att avstigmatisera psykisk ohälsa. Andra betydande stöd var att anpassa kommunikation och information, att ställa riktade frågor, använda adekvata screeningmetoder, att skapa kontinuitet, erbjuda adekvat smärtlindring, ge vägledning i föräldraskapet, uppmuntra och skapa förutsättningar för socialt stöd, uppmuntra hälsosamma levnadsvanor samt att använda lämpliga terapeutiska metoder och strategier för hantering av negativa känslor. Barnmorskan bör erbjuda ett adekvat stöd för kvinnor med PPD och för kvinnor som löper risk att drabbas av PPD. Resultatet indikerar att stöd kan ges i form av att barnmorskan har ett personcentrerat förhållningssätt, främjar kontinuitet och god kommunikation samt att vägleda kvinnor och hitta lämpliga strategier. Ett flertal studier visade vikten av att modern har ett socialt stöd i form av närstående, vilket författarna i fråga anser att barnmorskor bör uppmuntra. Det är väsentligt att barnmorskor har en god kunskap om psykisk ohälsa och om remitteringsvägar under den perinatala perioden för att kunna erbjuda rätt stöd. / Postpartum depression (PPD) affects approximately 10–15 percent of all mothers after birth. There are many risk factors which are important for medical staff to have knowledge of, including adequate screening methods to identify depressive symptoms. With postpartum depression the mother could have difficulties to adapt to the mother role and to function in everyday life. There are different treatments for PPD, the most common in Sweden being psychotherapy and antidepressants. Midwives should develop established routines to detect women at risk and to give support after birth. Mothers experience insufficient support for PPD in general and wish for more support from healthcare. The aim was to illustrate how midwives could support mothers with postpartum depression. A general literature review with a systematic approach was used. Four qualitative and 15 quantitative studies were found using the search result from the databases CINAHL, PubMed and PsycINFO. An integrative data analysis was implemented which resulted in three main categories. Three main categories were identified: person-centered approach, continuity and communication and to guide and find strategies. The studies showed that support should be given by seeing the mother as a whole, to listen and be available, to build a relationship with the mother, not over-medicate and to destigmatize mental illness. Other types of significant support were to adjust communication and information, to ask targeted questions, use adequate screening methods, establish continuity, offer adequate pain relief, give guidance in parenthood, encourage and create conditions for social support, encourage healthy habits and to use appropriate therapeutic methods and strategies for dealing with negative emotions. The midwife should offer adequate support for women with PPD and for women at risk of PPD. The results indicate that support can be given from the midwife by having a personcentered approach, promote continuity, good communication and also to guide women and find appropriate strategies. Several studies have shown the importance for mothers to have social support from relatives, which the authors believe should be encouraged by midwives. It is essential that midwives have the essential knowledge of mental illness and of referral routes during the perinatal period in order to be able to offer the correct type of support.