Thesis (Ph.D.(Clin.)) - University of Queensland, 2004. / Includes bibliography.

Thesis (MA)--University of Stellenbosch, 2006. / Bibliography. Also available via the Internet.

Thesis (M.A.)-- San Diego State University, 2005. / Includes bibliographical references (leaves 20-23). Also available online (PDF file) by a subscription to the set or by purchasing the individual file.

Thesis (M.A.)-- San Diego State University, 2005. / Includes bibliographical references (leaves 20-23).

Thesis (M.Psych.Clin.) - University of Queensland, 2007. / Includes bibliography.

Alors qu’une maternité heureuse est une aspiration collective, il est établi que de nombreuses femmes souffrent de détresse psychologique dans la période périnatale. Or, la santé psychologique des femmes ne peut être considérée indépendamment de leurs rôles au sein de la société et des normes qui y sont attachées. Ce travail de recherche vise à tester un modèle psychosocial et culturel de compréhension des troubles de l'adaptation à la maternité, (symptômes dépressifs postpartum et burnout). Dans une première étude, différentes étapes auprès de plusieurs populations (N = 250, 22, 474, 249 et 231) ont mené à la validation en langue française d’une échelle de mesure des croyances associées au rôle maternel. Dans un second temps, un suivi longitudinal a été mis en place auprès de femmes rencontrées en fin de grossesse puis à 2 et 4 mois postpartum (N = 129). Ces travaux ont permis d’établir la validité convergente, prédictive et de construit du concept de burnout maternel. Par ailleurs, le poids des caractéristiques psychosociales et normatives du rôle maternel dans le développement de symptômes dépressifs et de burnout a été exploré. Pour finir, des analyses en cluster ont permis de dégager des profils d’articulation, plus ou moins adaptatifs, entre investissement dans la maternité et dans la vie professionnelle. Ces travaux ouvrent des perspectives de recherche concernant le concept de burnout maternel dans la période postpartum et la prise en compte des aspects socio-normatifs du rôle maternel dans la prévention et la prise en charge de ces troubles. / Whereas a happy motherhood is a collective aspiration, it is known that many women are reporting psychological distress during the perinatal period. Yet, women’s psychological health can not be considered regardless of their roles in society and norms associated. This research work aims to test a psychosocial and cultural model to understand adjustment disorder regarding motherhood (postpartum depressive symptoms and burnout). In a first study, various steps with different populations (N = 250, 22, 474, 249 and 231) have led to the validation in French of a scale assessing beliefs associated with the maternal role. Then, a longitudinal follow up was settled with women who were seen during late pregnancy and at 2 and 4 months postpartum (N = 129). This work has served to demonstrate the convergent, predictive and construct validity of maternal burnout. Furthermore, the impact of motherhood psychosocial and normative characteristics in the development of depressive and burnout symptoms have been explored. Finally, cluster analyses were conducted to identify more or less adaptive patterns regarding articulation of investment in motherhood and working life. This research work has opened research avenues regarding maternal burnout in the postpartum period and considerations of socio-normative aspects of the mothering role regarding prevention and care of those troubles.

SAMMANFATTNING Bakgrund: Förlossningsdepression är en depressiv sjukdom som varar i några veckor upp till ett år efter en förlossning och som drabbar 10 - 15 procent av nyblivna mammor. Förlossningsdepression påverkar mammans livskvalitet och ökar risken för att bli deprimerad igen senare i livet. Detta tydliggör hur viktigt det är för sjuksköterskor att identifiera kvinnor med symtom av förlossningsdepression och att ha vetskap kring vilka åtgärder som finns. Syftet: Syftet med litteraturstudien var att undersöka kvinnors upplevelser kring förlossningsdepression och vilka åtgärder det finns för att lindra symtomen av förlossningsdepression. Metodbeskrivning: En litteraturöversikt utfördes med 11 originalartiklar från olika länder som valdes från databasen PubMed. Artiklarna granskades och tre kategorier utformades. Katie Erikssons omvårdnadsteori användes som teoretisk referensram i studien. Resultat: Det finns en stor rädsla för att bli stigmatiserad på grund av sin förlossningsdepression. Många kvinnor hade svårt att erkänna att de hade ett problem, vilket i sin tur hindrade dem från att söka hjälp. Något som var mycket viktigt för dem var behovet av socialt och professionellt stöd. Olika åtgärder identifierades, exempelvis gruppsamtal, mindfulness, och yoga. Det fanns även olika utbildningsprogram samt program baserade på kognitiv beteendeterapi. Slutsats: Kvinnor med förlossningsdepression känner sig stigmatiserade vilket leder till att de inte söker hjälp. Gruppaktiviteter och utbildning kring förlossningsdepression hade en positiv inverkan på kvinnornas mående. Genom att aktivt normalisera förlossningsdepression och erbjuda olika åtgärder, kan sjuksköterskor bryta stigma och bemöta kvinnor med insikt och förståelse. / ABSTRACT Background: Postpartum depression is a depressive disorder which lasts for a few weeks up to a year after childbirth, and it affects 10 - 15 percent of new mothers. Postpartum depression affects the mother’s quality of life and increases the risk of becoming depressed later in life. This highlights the importance of nurses identifying women with symptoms of postpartum depression and having awareness of existing standards of care. Aim: The aim of this literature review was to examine women’s experiences concerning postpartum depression and which standards of care that exist to relieve symptoms of postpartum depression. Method: A literature review was conducted with 11 original articles from different countries, which were chosen from the PubMed database. The articles were audited and three categories were developed. The nursing theory of Katie Eriksson was used as theoretical framework in this study. Results: There existed a great fear towards becoming stigmatised because of postpartum depression. Many women had trouble acknowledging that they had a problem, which in turn hindered them from seeking help. One aspect which was very important to them was the need for social and professional support. Different standards of care were identified, for example group discussion, mindfulness and yoga. There were also varying educational programmes as well as programmes based on cognitive behavioural therapy. Conclusion: Women with postpartum depression feel stigmatised which leads to them not seeking help. Group activities and education concerning postpartum depression had a positive effect on women’s wellbeing. Through active normalisation of postpartum depression and by offering varying standards of care, nurses are able to break the stigma, and receive women with insight and understanding.

Orientador: Olga Maria Piazentim Rolim Rodrigues / Banca: Patrícia Alvarenga / Banca: Bárbara Fernandes Carvalho Figueiredo / Resumo: Desde o nascimento a interação do recém-nascido com o mundo é facilitada pela mãe. Estudos indicam que a saúde mental materna pode afetar a qualidade desta interação e, por exemplo, mães deprimidas podem interagir pouco com seu bebê, podendo gerar déficits comportamentais e cognitivos, identificáveis ao longo do desenvolvimento. Este trabalho, composto por dois estudos, pretendeu descrever e relacionar o índice de depressão pós-parto apresentado por mães de bebês com as variáveis sociodemograficas e avaliar a relação entre a presença da depressão e a qualidade da interação mãe-bebê. Participaram mães e seus bebês, usuárias do Projeto de Extensão "Acompanhamento do desenvolvimento de bebês: avaliação e orientação aos pais". No primeiro estudo pretendeu-se identificar fatores de risco para a depressão pós-parto considerando variáveis sociodemograficas maternas, dos bebês e familiares. Uma amostra de 103 mães participou da primeira etapa em que responderam a uma entrevista inicial para a coleta de dados sociodemográficos e a "Escala de Depressão Pós-Parto de Edimburgo" (EDPE). Os resultados apontaram que 33% das mães apresentaram depressão pós-parto. Segundo o teste estatístico ρ de Pearson observou-se correlação linear negativa com a escolaridade materna (p=0,008), ou seja, quanto maior o índice de depressão, menor o número de anos de estudo. Além disso, houve uma correlação linear positiva entre a depressão e a condição socioeconômica (p=0,044), sendo que a variação da ABEP é ... (Resumo completo, clicar acesso eletrônico abaixo) / Abstract: The newborn interaction with the world is facilitated by his mother. Studies indicates that maternal mental health can affect the quality of this interaction, for example, depressed mothers may interact less with their baby and it can cause behavioral and cognitive deficits throughout the development. This work, consisting on two studies which describe and relate the index of postpartum depression presented on the baby's mothers with socio-demographic variables and evaluate the relationship between the presence of depression and quality of mother-infant interaction. Participated mothers and their babies, Extension Project users "Monitoring the development of babies: evaluation and guidance for parents." In the first study aimed to identify risk factors for postpartum depression considering maternal, babies and family socio-demographic variables. A sample of 103 mothers participated in the first step in responding to an initial interview to collect demographic data and "Edinburgh Postpartum Depression Scale" (EPDS). The results showed that 33% of the mothers had postpartum depression. The average age of the infants was 4.4 months, the gestational age of 36.9 weeks, with respect to risk condition (prematurity, low birth weight and teen mom), 46% had some of these characteristics. The average age of the mothers was 27.2, about the type of family, 78% of the sample is nuclear family and the socioeconomic level of the sample is Class B (68%). In the second study was intended to de... (Complete abstract click electronic access below) / Mestre

A depressão pós-parto é um transtorno mental de alta prevalência que surge nas primeiras semanas, após o parto, e provoca alterações emocionais, cognitivas comportamentais e físicas. Mães adolescentes apresentam risco aumentado para a depressão pós-parto. Estudos mostram que a prática do aleitamento materno não se dá de forma efetiva nos casos em que a nutriz apresenta alterações emocionais. Diante do exposto, buscamos compreender quais as representações sociais sobre amamentação na perspectiva de mães adolescentes com sintomas de depressão pós-parto. Trata-se de uma pesquisa qualitativa, desenvolvida com 14 mulheres, mães de crianças com até um ano de idade e usuárias de um serviço público de saúde de Ribeirão Preto-SP. A primeira etapa consistiu na aplicação da Escala de Depressão Pós-natal de Edimburgo para rastrear as mães adolescentes que apresentavam sintomas de depressão, no puerpério. As mães que apresentavam pontuação de 12 ou mais pontos eram convidadas a continuar a participar do estudo. Para as mulheres que aceitavam ser incluídas na pesquisa, foram aplicados questionário sociodemográfico e a entrevista semiestruturada que foram gravados e transcritos na íntegra e realizados no local de escolha da participante. Para a análise dos dados, utilizamos o Método de Interpretação dos Sentidos à luz das representações sociais na perspectiva socioantropológica. Emergiram três categorias temáticas: 1) \"Ser mãe na adolescência com sintomas de depressão no pós-parto\"; 2) \"Amamentando na adolescência com sintomas de depressão no pós-parto\"; 3) \"A rede de apoio: eu e a amamentação\". A gravidez é considerada indesejada no contexto investigado, pois é vista como empecilho para se dar continuidade à vida. E isto se reflete negativamente na amamentação, visto que, há dificuldades para se desempenhar papéis maternos, nesse momento da vida. Com relação à amamentação, observamos que os conhecimentos se restringem aos aspectos nutricionais e imunológicos, sendo desconsiderados os aspectos relacionais e de construção de vínculo da prática de amamentar. Este pensamento se justifica quando fazemos um olhar para o modo como as participantes se sentem somado ao contexto cultural em que vivem, um meio que trata a amamentação como mera prática de alimentação infantil. Há a ideia de que o leite materno é fraco, sendo a mamadeira vista como uma aliada, pois além de proporcionar sensação de saciedade do bebê por mais tempo, ainda impede que ele chore e incomode principalmente no período noturno, já no período diurno evita constrangimentos por ter de amamentar em locais públicos e pode ser oferecida por outra pessoa. A mamadeira é algo que proporciona sensação de liberdade, ocasionando a independência do bebê em relação à mãe. A mulher tem como maior fonte de influência e apoio sua mãe, o parceiro ainda permanece distante à realidade da amamentação e o profissional de saúde oferece orientações pontuais, nas quais desconsideram os contextos de vida nas quais as adolescentes estão inseridas. A internet é usada para se ter conhecimento, sendo considerada veículo de forte influência. Mesmo com apoio materno, a mulher ainda permanece sozinha, com dificuldades para falar sobre sua real situação emocional e sobre suas limitações para amamentar / Postpartum depression is a mental disorder of high prevalence that arises in the first weeks after childbirth and causes emotional, cognitive, behavioral and physical changes. Adolescent mothers present an increased risk for postpartum depression. Studies show that the practice of breastfeeding does not occur effectively in cases where the mother presents emotional changes. In view of the above, we aimed to understand which are the social representations regarding breastfeeding, in the perspective of adolescent mothers with symptoms of postpartum depression. This is a qualitative research conducted with 14 women, mothers of children up to one year of age and users of a public health service in Ribeirão Preto - SP. The first phase consisted in the application of the Edinburgh Postnatal Depression Scale for screening adolescent mothers with symptoms of depression in the puerperal period. Mothers who achieved a score of 12 or more were invited to proceed participating in the research. For those who accepted to be included, socio demographic questionnaires were applied and, semi- structured interviews were conducted and recorded in a participant\'s choice location and then, fully transcribed. For the data analysis, we used the Interpretation of the Meaning Method, in accordance with the social representations in a socio anthropological approach. Three thematic categories emerged: 1) \"Being a mother in adolescence with symptoms of postpartum depression\"; 2) \"Breastfeeding in adolescence with symptoms of postpartum depression\"; 3) \"The network support: the breastfeeding and I.\" Pregnancy is considered undesirable in the context investigated, as it is seen as an impediment to give continuity to life. And this reflects negatively on breastfeeding, since there are difficulties to play maternal roles at this moment of life. Regarding breastfeeding, we observed that adolescent mother\'s knowledge is restricted to nutritional and immunological aspects, and the relational and building link aspects of breastfeeding practice are not considered. This thought is justified when observed how the participants feel in their cultural context, in which they deal with breastfeeding as a simple infant feeding practice. There is the idea that breast milk is weak, and the bottle is seen as an allied, since, as well as providing baby satiety feeling for longer, still prevents him to cry and bother, especially at night. Even during the day, the bottle avoids embarrassments when breastfeeding in public places and it can be offered by someone else. It is something that gives sense of freedom, causing the baby\'s independence from the mother. The woman has the greatest source of influence and support in her mother, while her partner remains distant to the reality of breastfeeding and the health professional provides specific guidelines in which disregards the life contexts in which the adolescents live. Internet is used in order to acquire knowledge, being considered vehicle of strong influence. Even with maternal support, the woman remains alone, struggling to talk about her real emotional situation and limitations to breastfeed. Thus, the social representations that support the breastfeeding practice, for these adolescents, bring with them the ambiguity of willing to give the best for your child - the breast milk, but also the will to be free and independent in life

Abstract A longitudinal follow-up study of postnatal depression was performed in the years 1995-2000 in the University of Oulu. A volunteer, ramdomly selected group of 187 mothers from maternal wards of the University Hospital of Oulu were studied with different questionnaires in the first postpartum week. Depressive symptoms were re-assessed with Edinburgh Postnatal Depression Scale four months postpartum when paternal depression was evaluated with Beck Depression Inventory. 16.2% of the women were immediately after delivery screened as being depressed. Four months postpartum 13.0% of the mothers were depressed whereas 5.1 % of the fathers were having depressive symptoms. The cumulative incidence of maternal postnatal depression within the first four months was 22.2%. These mothers who immediately showed depressive symptoms were at a higher risk to be depressed later. Maternal age 30 years or less predicted postnatal depression. The occurrence of maternal postnatal depression varied slightly during different seasons; during dark time immediate depressive symptoms increased and the spring seemed to protect from later postnatal depression. Analgesia during vaginal delivery, e.g. nitrous oxide, epidural analgesia or paracervical blockade, protected from postnatal depression as well. Caesarean section, either elective or emergency, did not predict postpartum mental well-being. Scores from the GHQ and the EPDS were strongly interrelated. Seven (5%) fathers were depressed four moths postpartum. They all were men whose partners also scored high in the EPDS. Those mothers who were depressed interpreted infant facial signals differently, seeing less joy, disgust and anger, but more sadness in the infant facial pictures. Cultural variability was found in complex blended facial features of emotions, e.g. distress, in the Infant Facial Expression from Looking at Picture scale, although remarkable agreement was achieved and reinforced. In the videotaped early mother-infant interaction small, but essential, changes were observed at 10 months postpartum. Overall, mothers who had had persistent depressive symptoms showed less negative expressions and had less anger and anxiety in their interaction. Their children were slightly less impulsive and seemed to have less visual and communicative contact with their mothers. The dyad was characterised by short periods of uninvolvement between the mother and the infant; e.g. the moments of reciprocity were less frequent than in the non-depressed mothers. At 42 months postpartum, the children of the persistently depressed mothers scored lower on the Expressive language scale than the children of the mothers who were depressed in one measurement or never.