Made available in DSpace on 2016-03-22T17:26:31Z (GMT). No. of bitstreams: 1 cristina_schwanz2010.pdf: 1574413 bytes, checksum: 0af7b42529c49773136b8d2e7aca53f7 (MD5) Previous issue date: 2010-12-20 / Objective: To assess the relationship between maternal postpartum depression with motor development of infants at four months. Methods: A cross-sectional with women that receiving the National Health System Care (SUS) of Pelotas. The sample was of convenience, including women who gave birth between July 2008 and March 2009, and child born in this pregnancy. To assess maternal depression, we used the EPDS (Edinburgh Postnatal Depression Scale). The children were assessed by the Alberta Infant Motor Scale - AIMS - between 90 and 120 days after birth. Results: The sample comprised 166 dyads. The prevalence of postpartum depression in mothers was 13.3%. Children exposed to postpartum depression had 1.31 (CI: -2.15, -0.46) points lower in the mean in prone scale, 1.22 (CI: -1.95, -0.49) points lower in mean of the supine scale and 0.52 (CI: -0.98, -0.06) points lower on mean of the sitting scale than children that not was exposed to postpartum depression. Child born to older mothers, who were hospitalized and the lowest socioeconomic class were also underperformed in the assessment of child motor development.Conclusion: The results suggest that maternal postpartum depression may be related to poor motor development at four month of the baby. Importantly, the programs related to child health should be directed to the mother-infant interaction / Objetivo: Verificar a relação da depressão pós-parto (DPP) materna com o desenvolvimento motor de bebês aos quatro meses. Métodos: Estudo transversal com famílias atendidas pelo Sistema Único de Saúde (SUS), na cidade de Pelotas/RS. A amostra foi de conveniência, incluindo mulheres que tiveram seus bebês entre julho de 2008 e março de 2009, e bebês nascidos dessa gestação. Para avaliar a depressão materna, foi utilizada a EPDS (Edinburgh Postnatal Depression Scale). Os bebês foram avaliados pela Alberta Infant Motor Scale AIMS , entre 90 e 120 dias, após o nascimento. Resultados: A amostra foi composta por 166 díades. A prevalência da depressão pós-parto nas mães foi de 13,3%. Crianças expostas à depressão pós-parto tiveram 1,31 (IC 95%: -2,15; -0,46) pontos a menos na média da escala prono, 1,22 (IC 95%: -1,95; -0,49) pontos a menos na média da escala supino e 0,52 (IC 95%: -0,98; -0,06) pontos a menos na média da escala sentado do que crianças não expostas. Bebês filhos de mães mais velhas, que tiveram hospitalizados e de classe socioeconômica mais baixa também tiveram um desempenho inferior na avaliação do desenvolvimento motor infantil. Conclusão: Os resultados sugerem que a depressão pós-parto (DPP) materna está relacionada a um pior desenvolvimento motor no quarto mês de vida do bebê. É importante ressaltar que os programas vinculados à saúde infantil devem estar voltados para a interação mãe-bebê

A depressão pós-parto (DPP), tal como o episódio depressivo maior, é uma manifestação psiquiátrica comum, caracterizada pela presença de alterações de humor, cognitivas, comportamentais, psicomotoras e vegetativas. Afeta a qualidade da interação mãe-bebê prejudicando a responsividade materna o que pode repercurtir negativamente na manutenção salutar do desenvolvimento da criança. Esta manifestação apresenta prevalência estimada entre 10 e 20%, considerando as mulheres que desenvolvem sintomas nas primeiras semanas depois do parto. As opções de tratamento incluem drogas antidepressivas e eletroconvulsoterapia (com anestesia). Porém, como ambas terapêuticas envolvem abordagens farmacológicas, há contra-indicação devido à toxidade que impediria a amamentação. Entretanto, existe uma preocupação sobre como garantir a eficácia do tratamento sem prejudicar o bebê. A Estimulação Magnética Transcraniana Repetitiva (EMTr), por ser uma técnica já consagrada quanto a eficácia antidepressiva, não toxicológica, indolor, não invasiva e bem tolerada para estimular o cérebro, parece ser uma boa alternativa de tratamento. Nos quadros depressivos em geral, são observados prejuízos substanciais a várias funções cognitivas cujas alterações cognitivas apresentadas são, em grande parte, semelhantes àquelas relacionadas a alterações do funcionamento do córtex pré-frontal. A função executiva é um dos principais domínios cognitivos afetados nos transtornos depressivos, geralmente avaliada por testes como Trail Making e o teste de Stroop. A presença de depressão em pacientes puerperais parece intensificar as alterações cognitivas, especialmente as funções associadas ao lobo frontal, além do que, também prejudicam o comportamento causando danos no funcionamento social global. No presente estudo, randomizado, controlado e duplo-cego, investigaram-se os possíveis efeitos da EMTr no funcionamento cognitivo e sua repercussão comportamental: Estimulação Magnética Transcraniana de repetição (EMTr) aplicada ao córtex prefrontal dorsolateral esquerdo (CPFDLE). Uma amostra inicial de dez pacientes com DPP foram distribuídos em dois grupos. Sete participantes de um dos grupos receberam EMTr ativa e três, do grupo controle, EMTr placebo. Os parâmetros utilizados na EMTr foram: freqüência de 5 Hz, intensidade de 120% do limiar motor, em intervalos de 10 segundos ligado e 20 segundos desligado, com 25 séries por dia (2500 pulsos), durante 20 dias (quatro semanas) com dois dias de pausa semanal. Os pacientes e os avaliadores eram cegos ao tipo de tratamento de cada grupo. A avaliação neuropsicológica se deu através de testes cognitivos relacionados às funções prejudicadas em quadros depressivos e com a área estimulada (CPFDLE). Foram também aplicadas as escalas de Adequação Social (EAS) de Weissmann e Bothwell para avaliar o comportamento funcional social global, de depressão de Hamilton, 17 itens, e de depressão pós-parto de Edinburgh. As avaliações foram realizadas em três momentos: antes do início do tratamento (T0), após 4 semanas (T2) e após 6 semanas (T3). Como principais resultados foram observadas: melhora significativa no quadro depressivo ao longo do tratamento e um melhor ajustamento comportamental no funcionamento social global geral, especialmente no contexto das relações familiares; ausência de efeitos negativos em todos os testes cognitivos após o tratamento com EMTr; desempenho superior do grupo EMTr ativa em comparação com o grupo EMTr placebo, principalmente no teste de Rey auditory Verbal Learning (RAVLT) evocação pós-interferência e tardia pós-trinta minutos, no teste Trail Making Parte A e no teste de Stroop Cores. Além disso, o melhor desempenho cognitivo observado no grupo EMTr ativa viii comparado ao grupo EMTr placebo, entre T0 e T4, foi mantido na semana 6 (T6) e por vezes até melhorou sutilmente, indicando que o efeito da estimulação mantém-se estável por, pelo menos 2 semanas após o término do tratamento. Discutem-se como possíveis fatores para esses resultados: ação local da EMTr, alteração dos níveis de alguns neurotransmissores como dopamina e serotonina, relação com a melhoria do quadro depressivo e possível efeito de aprendizado pela repetição em curto período de tempo entre as testagens. Concluí-se que, baseados em uma amostra de apenas 10 pacientes, a EMTr, no que diz respeito aos efeitos antidepressivos, no comportamento frente ao funcionamento social global e às funções cognitivas, não produziu efeitos negativos e sim, produziu alguns efeitos positivos. Esta melhora é de fundamental importância, para o bem estar da mãe e conseqüentemente para o desenvolvimento neuropsicomotor, afetivo e comportamental do bebê. Isto trará desdobramentos que poderão perdurar por toda uma vida para esta criança. Além disto, a segurança da EMT, já amplamente comprovada em outros estudos, poderá, em um futuro próximo, torná-la terapêutica de primeira escolha para este grupo de pacientes. / The postpartum depression (PPD) as the major depressive episode is a common psychiatric manifestation, characterized by the presence of mood, cognitive, behavioral, psychomotor and vegetative changes. It affects the quality of mother-infant interaction jeopardizing the maternal responsiveness, which may adversely affect the maintenance of a healthy development of children. This event presents the estimated dominance between 10 and 20%, taking into account women who develop symptoms in the first weeks after delivery. Treatment options include antidepressant drugs and electroconvulsive therapy (with anesthetic). However, as both treatments involve pharmacological approaches, there is counter-indication because of toxicity that would preclude breastfeeding. Nevertheless, there is concern about the efficiency of the treatment without causing any harm to the baby. The repetitive Transcranial Magnetic Stimulation (rTMS), as it is a technique already established for antidepressant efficacy, non-toxic, painless, non-invasive and well-tolerated to stimulate the brain, it seems to be a good alternative for treatment. For general depressive conditions, substantial damages have been noticed to several cognitive functions, in which the presented cognitive changes are, in large part, similar to those related to changes in the functioning of the pre-frontal cortex (PFC). The executive function is one of the major cognitive domains affected in depressive disorders, usually assessed by tests such as Trail Making and Stroop test. The presence of depression in puerperal patients seems to strengthen cognitive changes; especially those associated to frontal lobe functions, in addition to that, it also affects the behavior causing harm to the overall social functioning. In this study, randomized, controlled and double-blind, possible effects of rTMS in the cognitive functioning and its behavioral effect were assessed: Repetitive Transcranial Magnetic Stimulation (rTMS) applied to left-dorsum-lateral-prefrontal-cortex (LDLPC). An initial sample of ten patients with PPD was divided into two groups. Firstly, seven participants in one of the groups received active rTMS and, three, of the control group, placebo rTMS. The parameters used in rTMS were: frequency of 5 Hz, intensity of 120% of the motor threshold, at intervals of 10 seconds on and 20 seconds off, with 25 sets per day (2500 pulses), during 20 days (four weeks) with two days of rest per week. Patients and evaluators were blinded to the type of treatment for each group. The neuropsychological assessment was carried out by means of cognitive tests related to impaired functions in depressive conditions and with the stimulated area (LDLPC). Social Adjustment Scal (SAS-SR) of Weissmann & Bothwell was also applied to assess the overall social functional behavior, of Hamilton depression, 17 items, and Edinburg postpartum depression. Evaluations were performed on three occasions: before starting the treatment (T0), after 4 weeks (T2) and after 6 weeks (T3). The main results were: significant improvement regarding the depression condition throughout the treatment and a better behavioral adjustment in the general overall social functioning, especially in the context of family relationships, lack of negative effects on all cognitive tests after treatment with rTMS; superior performance of the active rTMS group compared to the placebo rTMS group, especially in the Rey Auditory Verbal Learning Test (RAVLT) post-interference and late evocation after thirty minutes in the Trail Making Test - Part A and the Colors - Stroop Test. Further, the best cognitive performance was observed in the active rTMS group compared to placebo rTMS group, between T0 and T4, was maintained at week 6 (T6) and sometimes even improved slightly, indicating that the effect of the stimulation remains stable by at least 2 x weeks after the end of the treatment. It has been discussed as possible factors for these results: local rTMS action, change in the levels of some neurotransmitters such as dopamine and serotonin, relationship with the improvement of the depressive condition and possible learning effect by repetition within a short period of time between tests. Ergo, based on a sample of only 10 patients, the rTMS, regarding antidepressant effects, the behavior compared to the overall social functioning and cognitive functions, it did not yield negative effects, however it rendered some positive effects. This improvement is of primary importance for the welfare of the mother hence to the babys neuro-psychomotor, emotional and behavioral development. This will bring further outcomes that may last for the whole life for this child. In addition, the safety of TMS, which has been already proven in other researches, may, in the near future, make it a first-choice therapy for this group of patients

O vínculo afetivo mãe-bebê, que se cria desde as primeiras interações, afeta o desenvolvimento emocional da criança. A depressão pós-parto (DPP) é um transtorno de humor que pode prejudicar a qualidade destas interações. Sendo o primeiro ano de vida um período em que o bebê está especialmente suscetível aos estímulos externos e totalmente dependente de cuidados, o objetivo da pesquisa relatada na dissertação de mestrado foi verificar o impacto da DPP no desenvolvimento neuropsicomotor em uma amostra representativa de crianças moradoras de uma região urbana da cidade de São Paulo, Brasil. Este estudo faz parte de um Projeto Temático FAPESP que teve por objetivo investigar os fatores de risco relacionados à DPP e sua influência no desenvolvimento das crianças ao longo de três anos. A Escala de Depressão Pós-parto de Edinburgh (EDPE) foi aplicada aos quatro e oito meses e o desenvolvimento neuropsicomotor dos bebês foi avaliado aos quatro (N=144), oito (N=127) e doze meses de vida (N=94), por itens baseados nos Testes Gesell e Amatruda, M-Chat, Denver e IRDI. Foram consideradas informações sobre a gestação, condições do parto e a avaliação neonatal obtidas nos prontuários do Hospital Universitário. A razão sexual no nascimento foi viesada no sentido de maior nascimento de meninas, o que é compatível com a Teoria de Trivers e Willard de viés da razão sexual por condições adversas. Aplicou-se uma análise de Regressão Logística aos dados de desenvolvimento, considerando-se no modelo a depressão pós-parto, o sexo, a idade e a frequência de creche. Os resultados mostraram que a depressão pós-parto materna foi um fator que prejudicou o desenvolvimento infantil nas avaliações realizadas aos oito e doze meses, mas não aos quatro meses. O sexo do bebê mostrou-se uma variável significativa. Aos oito meses os bebês do sexo masculino mostraram pior desempenho neuropsicomotor quando comparados aos bebês do sexo feminino. A literatura tem apontado nesta direção, evidenciando maior prejuízo dos meninos em função da depressão materna. Ao contrário do esperado, aos 12 meses as crianças que frequentavam creche mostraram pior desempenho quando comparadas às crianças que não frequentavam. A prevalência de DPP na amostra foi alta (26,7%) e os resultados sobre o desenvolvimento, preocupantes, apontando para a necessidade de políticas públicas de prevenção e intervenção precoce. Mesmo em condições adversas, podem surgir soluções criativas de grande impacto, a exemplo do método canguru. Além disso, os resultados desta investigação contribuem para o esforço multidisciplinar, relevante para o enfrentamento da questão da DPP / The mother-infant bond, created from the earliest dyadic interactions, affects the infant emotional development. The postpartum depression (PPD) is a depressive disorder that can impair the quality of these interactions. During the first year of life the infant is particularly susceptible to external stimuli and totally dependent on parental care. The goal of the research reported in the dissertation was to investigate the impact of PPD on psychomotor development in a sample of children living in an urban area of the city of Sao Paulo, Brazil. This study is part of a FAPESP Thematic Project which aimed to investigate the risk factors related to Postpartum Depression (PPD) and its influence on children\'s development over the first three years of life. Mothers mental state was assessed by the Edinburgh Postpartum Depression Scale (EPDS) at four and eight months after delivery and neurodevelopmental milestones were evaluated at four (N = 144), eight (N = 127) and twelve months (N = 94) through items based on Gesell and Amatruda, M-Chat, Denver and IRDI. Information was also collected about pregnancy, birth and neonatal evaluation from University Hospital reports. The sex ratio was biased at birth in favor of girls, consistent with Trivers and Willard Theory that harsh environmental conditions affects sex-ratio. Data were analyzed through logistic regression, considering the influence of postpartum depression, sex, age and day-care support. The results showed that child development was negatively affected by maternal postpartum depression at eight and twelve months, but not at four months. The baby\'s sex was also significant. At eight month male babies had worse psychomotor performance when compared to female, in accordance with literature showing that boys of PPD mothers are at greater risk of poor development. Unlike expected, at 12 months children attending day-care service showed poorer performance when compared to children who stayed at home. The high prevalence of PPD in this population (26,7%) and the results of the developmental evaluation are worrying, pointing to the need for mental health public policies and early intervention. Even in adverse conditions high impact solutions can be created, as Kangaroo care method. Furthermore, the results of this research can contribute to a multidisciplinary effort, relevant to address issues related to depression

Förstagångsmammors välbefinnande är ett diskuterat ämne med mycket tidigare forskning bakom sig. Studiens syfte var att undersöka huruvida det finns ett samband mellan förstagångsmammors fysiska och psykiska välbefinnande och olika faktorer som relationer samt stöd från social omgivning och sjukvård med en kvantitativ analysmetod. Enkäter skickades ut till sociala medier och utefter det sammanställdes resultatet via SPSS. Resultatet av denna studie visar att förstagångsmammor är i behov av stöd från sjukvård och social omgivning. En bra relation till framförallt partner och vänner är viktigt för det mentala måendet. Tidigare psykiska besvär, medicinering för psykiska besvär och diagnostisering av personlighetsstörning påvisar en stor risk att drabbas av förlossningsdepression. En besvärlig förlossningsupplevelse kan också bidra till en förlossningsdepression och deltagarna upplevde att de fått bättre information från sjukvården kring de psykiska bieffekterna av att föda barn än de fysiska bieffekterna, något som sa emot tidigare forskning. / The wellbeing of first-time mothers is a well discussed subject with previous research from all over the world. The aim of this study was to see whether there is a connection between the physical and mental wellbeing of first-time mothers and several factors such as relationships, social support and support from healthcare with a quantitative analysis method. Surveys were sent out on social media and the results were compiled via SPSS. The results of this study indicates that first-time mothers are in need of both support from healthcare and their social surrounding. A good relationship to especially partner and friends are important for their mental health. Previous mental disorders, medication for mental disorders or that the person is diagnosed with a personality disorder could increase the risk of experiencing postpartum depression. A difficult birth experience could also contribute to a postpartum depression and the participants experienced that they received better information about the mental side effects of giving birth rather than the physical side effects, which contradicts previous research.

O vínculo afetivo mãe-bebê, que se cria desde as primeiras interações, afeta o desenvolvimento emocional da criança. A depressão pós-parto (DPP) é um transtorno de humor que pode prejudicar a qualidade destas interações. Sendo o primeiro ano de vida um período em que o bebê está especialmente suscetível aos estímulos externos e totalmente dependente de cuidados, o objetivo da pesquisa relatada na dissertação de mestrado foi verificar o impacto da DPP no desenvolvimento neuropsicomotor em uma amostra representativa de crianças moradoras de uma região urbana da cidade de São Paulo, Brasil. Este estudo faz parte de um Projeto Temático FAPESP que teve por objetivo investigar os fatores de risco relacionados à DPP e sua influência no desenvolvimento das crianças ao longo de três anos. A Escala de Depressão Pós-parto de Edinburgh (EDPE) foi aplicada aos quatro e oito meses e o desenvolvimento neuropsicomotor dos bebês foi avaliado aos quatro (N=144), oito (N=127) e doze meses de vida (N=94), por itens baseados nos Testes Gesell e Amatruda, M-Chat, Denver e IRDI. Foram consideradas informações sobre a gestação, condições do parto e a avaliação neonatal obtidas nos prontuários do Hospital Universitário. A razão sexual no nascimento foi viesada no sentido de maior nascimento de meninas, o que é compatível com a Teoria de Trivers e Willard de viés da razão sexual por condições adversas. Aplicou-se uma análise de Regressão Logística aos dados de desenvolvimento, considerando-se no modelo a depressão pós-parto, o sexo, a idade e a frequência de creche. Os resultados mostraram que a depressão pós-parto materna foi um fator que prejudicou o desenvolvimento infantil nas avaliações realizadas aos oito e doze meses, mas não aos quatro meses. O sexo do bebê mostrou-se uma variável significativa. Aos oito meses os bebês do sexo masculino mostraram pior desempenho neuropsicomotor quando comparados aos bebês do sexo feminino. A literatura tem apontado nesta direção, evidenciando maior prejuízo dos meninos em função da depressão materna. Ao contrário do esperado, aos 12 meses as crianças que frequentavam creche mostraram pior desempenho quando comparadas às crianças que não frequentavam. A prevalência de DPP na amostra foi alta (26,7%) e os resultados sobre o desenvolvimento, preocupantes, apontando para a necessidade de políticas públicas de prevenção e intervenção precoce. Mesmo em condições adversas, podem surgir soluções criativas de grande impacto, a exemplo do método canguru. Além disso, os resultados desta investigação contribuem para o esforço multidisciplinar, relevante para o enfrentamento da questão da DPP / The mother-infant bond, created from the earliest dyadic interactions, affects the infant emotional development. The postpartum depression (PPD) is a depressive disorder that can impair the quality of these interactions. During the first year of life the infant is particularly susceptible to external stimuli and totally dependent on parental care. The goal of the research reported in the dissertation was to investigate the impact of PPD on psychomotor development in a sample of children living in an urban area of the city of Sao Paulo, Brazil. This study is part of a FAPESP Thematic Project which aimed to investigate the risk factors related to Postpartum Depression (PPD) and its influence on children\'s development over the first three years of life. Mothers mental state was assessed by the Edinburgh Postpartum Depression Scale (EPDS) at four and eight months after delivery and neurodevelopmental milestones were evaluated at four (N = 144), eight (N = 127) and twelve months (N = 94) through items based on Gesell and Amatruda, M-Chat, Denver and IRDI. Information was also collected about pregnancy, birth and neonatal evaluation from University Hospital reports. The sex ratio was biased at birth in favor of girls, consistent with Trivers and Willard Theory that harsh environmental conditions affects sex-ratio. Data were analyzed through logistic regression, considering the influence of postpartum depression, sex, age and day-care support. The results showed that child development was negatively affected by maternal postpartum depression at eight and twelve months, but not at four months. The baby\'s sex was also significant. At eight month male babies had worse psychomotor performance when compared to female, in accordance with literature showing that boys of PPD mothers are at greater risk of poor development. Unlike expected, at 12 months children attending day-care service showed poorer performance when compared to children who stayed at home. The high prevalence of PPD in this population (26,7%) and the results of the developmental evaluation are worrying, pointing to the need for mental health public policies and early intervention. Even in adverse conditions high impact solutions can be created, as Kangaroo care method. Furthermore, the results of this research can contribute to a multidisciplinary effort, relevant to address issues related to depression

Childbirth can be associated with short and long-term psychological morbidity including depression, anxiety and trauma symptoms. Some previous studies have used psychological interventions to reduce postpartum distress but have primarily focussed on attempting to relieve symptoms of depression with little recognition of trauma symptoms. Furthermore, the intervention used in these studies has generally been poorly documented. The first aim of the present study was to develop a counselling framework, suitable for use by midwives, to address psychological trauma following childbirth. Multiple methods were used to develop the intervention including focus groups with women and midwives. Both the women and midwives gave unequivocal support for postpartum debriefing. Themes that emerged from the focus groups with women included the need for opportunities to talk about their birth experience, an explanation of events, an exploration of alternative courses of action that may have resulted in a different birth experience, talking about their feelings such as loss, fear, anger and self-blame, discussing social support, and discussing possible future childbearing. There was a high level of agreement between the women's and midwives' views. These themes were synthesized with contemporary literature describing counselling interventions to assist in reconciling a distressing birth experience and a model for understanding women's distressing birth experiences to develop a counselling framework. The counselling intervention was then tested using a randomised controlled study involving 400 women recruited from antenatal clinics of three public hospitals. When interviewed within seventy-two hours of birth, 103 women reported a distressing birth experience and were then randomised into either the treatment or control group. Women in the intervention group had the opportunity to debrief at the initial postpartum interview (< 72 hours postpartum) and at four to six weeks postpartum. The prevalence of posttraumatic stress disorder was quite high; 9.6% of participants meeting the diagnostic criteria for acute PTSD at four to six weeks postpartum. Fewer participants (3.5%) met the diagnostic criteria for chronic PTSD at three months postpartum. As with previous research relating to childbearing women, few demographic factors or antenatal psychological factors were associated with the development of a PTSD symptom profile following childbirth. The development of PTSD symptom profile was strongly associated with obstetric intervention and a perception of poor care in labour. This finding is also consistent with previous research. Emotional distress was reduced for women in the intervention group in relation to the number of PTSD symptoms [t (101) = 2.144, p = .035], depression [c2 (1) = 9.188, p = .002], stress [c2 (1) = 4.478, p = .029] and feelings of self-blame [t (101) = -12.424, p <.001]. Confidence about a future pregnancy was higher for these women [t (101) = -9.096, p <.001]. Although there was not a statistically significant difference in the number of women with a PTSD symptom profile at three months postpartum, fewer women in the intervention group (n=3) than in the control group (n=9) met PTSD criteria. Likewise, there were fewer women in the intervention group (n=1) with anxiety levels above mild than in the control group (n=6). Importantly, this study found that offering women who have had a traumatic birth the opportunity for counselling using the framework documented in this dissertation was not harmful. This finding is in contrast to previous findings of other studies. The intervention was well received by participants. All the women in the intervention group found the counselling sessions helped them come to terms with their birth experience. Maternity service providers need to be cognizant of the prevalence of this debilitating condition and be able to identify women at risk for early intervention and referral to a mental health practitioner if appropriate. This research offers further support for the compelling need to implement changes to the provision of maternity services that reduce rates of obstetric intervention and humanise service delivery as a means of primary prevention of birth-related PTSD.

University of Macau / Faculty of Social Sciences and Humanities / Department of Psychology

Bakgrund: En moder som lider av post partum depression har svårare att knyta an till sitt barn. Barnets kognitiva och känslomässiga utveckling kan då hämmas. Det är viktigt att tidigt upptäcka dessa mödrar för att på så vis kunna erbjuda stöd och förkorta moderns sjukdomstid. Syfte: Syftet var att belysa BVC-sjuksköterskors erfarenheter av att ge stöd till mödrar med post partum depression. Metod: Datamaterialet analyserades med kvalitativ innehållsanalys med induktiv ansats. Data insamlades genom intervjuer med åtta BVC-sjuksköterskor med specialistexamen som distriktssköterska verksamma inom barnhälsovård. Resultat: Ur analysen av datamaterialet framträdde sex kategorier så som; följsam till moderns behov, erbjuda råd och vägledning, bygga upp moderns insikt om post partum depression, initiera samarbete runt modern, känsla av egen otillräcklighet, kommunikationsproblem med 14 underkategorier. Konklusion: För att kunna erbjuda modern ett optimalt stöd behöver en relation byggd på förtroende skapas mellan BVC-sjuksköterskan och modern. Kommunikation är ett viktigt verktyg för att skapa tillit vilket är en förutsättning för relationen. / Background: A mother who is suffering from post partum depression has difficulties with the attachment to her child. As a result of this, the child’s cognitive and emotional development can be harmed. It is important to detect these mothers at an early stage, to offer support in order to shorten the time of suffering. Aim: The aim of this study was to illustrate child health care nurses’ experiences of giving support to mothers with postpartum depression. Method: The data were analyzed using qualitative content analysis technique with inductive approach. Eight interviews with child health care nurses’ who work with childrens’ health care were performed. Results: Six categories emerged from the analysis; Responsive to the needs of the mother, offer advice and guidance, build awareness of postpartum depression, initiate collaboration around the mother, sense of their own inadequacy, communication problem and 14 subcategories. Conclusion: In order to offer the mother optimal support needs a relationship between the child health care nurse and the mother be created, which is built on trust. Communication is an important tool to build trust, which is essential for the relationship.

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

An ethnographic method was used for data collection and analysis. Three interrelated themes from the data analyses informed study findings: (1) being cut off from family and feeling lonely, (2) what's the point? and (3) not depression, just depressed. Understanding young mothers' depression after the birth of their babies is important to inform future research and gain insights into relevant nursing interventions for this population. More knowledge of the phenomenon will lead to earlier identification and prevention of the long-term sequelae of depression and potentially promote healthier mother-baby interactions.