Essay on Postpartum Depression Nursing Teaching

Introduction and Thesis Statement

Depression is a disease that everyone is familiar with, but a branch of depression that people are not necessarily familiar with is postpartum depression or perinatal depression. When someone is having a child, the last thing that anyone would think is that the mom would be depressed, but depression is non-discriminatory. According to Grier & Geraghty (2015), postpartum depression has been defined by the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) as a major depressive condition that occurs in the first year period following childbirth, which is prevalent within the first three months postpartum, with a peak onset of four to six weeks, as well as being prevalent with approximately 25% of all childbearing woman. This is such an important disease to talk about and research because it can affect any childbearing woman and can be prevented. The basis of this paper will examine patient education, psychological interventions, as well as the use of yoga in preventing and treating postpartum depression.

Nursing Researched to Support Thesis

By providing pregnant patients with education in regards to the risk factors of postpartum depression, symptoms of postpartum depression, and preventative interventions for postpartum depression, the nurse can increase a woman’s health locus of control and empower the patient to look for support in the prevention and treatment of postpartum depression. According to Moshki, Baloochi Beydokhti, & Cheravi (2014), health locus of control is the degree to which the individual believes health outcomes are the result of the patient’s actions. In the study conducted by Moshki et al. (2014), they found that the stronger the patient’s health locus of control, the more likely that the patient is to pursue information about a life-threatening disease and then participate in behaviors that prevent the disease in question. The study directly correlated 230 pregnant women’s health locus of control, about postpartum depression, with the experimental group receiving not only education about postpartum depression from a nurse, but also received information from the other group. This study collected data from each of the pregnant women through a questionnaire, a health locus of control scale, and a depression scale, then evaluated the data as significant or not significant. The data was collected after every scheduled session, and one month later. The results were found significant in that the patient’s health locus of control was significantly increased, immediately after a scheduled session. It was also found that there was a reduction in the prevalence of postpartum depression one month after the scheduled session, signifying the intervention was working. The conclusion that Moshki et al. (2014) came to was that patient education intervention emboldened each patient and increased their awareness of postpartum depression when pregnant. Patient education, as well as psychological interventions, were found to increase “general health leading to improved psychological health for prevention of postpartum depression in mothers” (Moshki et al., 2014). This study showed that patient education is essential in the prevention, diagnosis, and awareness of women who are pregnant and possibly experiencing postpartum depression.

Psychological interventions are another key component when it comes to prevention and treating postpartum depression. Anti-depressant medications are effective in treating postpartum depression, but Stephens, Ford, Paudyal, and Smith (2016) found that there is poor medication adherence in perinatal mothers due to the fact they do not want the medication going to their baby; and that psychological interventions are a great alternative. This systematic review assessed the efficacy of psychological therapies for postpartum depression in a primary care setting. The research included 10 articles published between 2000 and 2014 that met the researcher’s strict criteria. The studies included interventions of cognitive behavioral therapies, interpersonal therapy, and counseling. After Stephens et al. (2016) analyzed the data, they found that the psychological interventions resulted in less depressed symptoms, immediately after the psychological intervention and then at 6 months. This study also found that there was no psychological intervention better than the other and that there should be further pursuance of what would be the most effective psychological intervention for a mother with postpartum depression.

The final intervention that has shown to be safe and effective is yoga throughout pregnancy and after to decrease postpartum depression. The systematic review was performed by

Sheffield & Woods-Giscombé (2016) where thirteen publications met the strict criteria. As previously mentioned in the last study, women are apprehensive to take any medications, which are shown most effective, because women do not want to take the chance of the medications affecting the fetus and/or baby negatively, in any way. Therefore, women are more open to using complementary and alternative medicine when it comes to choosing what is best for their children. The study came to several conclusions one of them being that there is a great level of appropriateness of yoga as a treatment for improvement of mental health and well-being. It was also found that “yoga is significantly associated with decreases in anxiety and depression in perinatal women” (Sheffield & Woods-Giscombé 2016). Throughout the study, Sheffield & Woods-Giscombé emphasized how the complementary and alternative medicine intervention of yoga was extremely safe for a perinatal woman. It was also stated that every yoga intervention performed was customized to meet the needs of every pregnant woman, with no adverse reactions reported.

Describe the Role of the Nurse in Implementing Interventions

The “Journal of Obstetric, Gynecologic, and Neonatal Nursing” has several interventions for a nurse to implement to prevent and treat postpartum depression. In this section, I will be going over many of the interventions aforementioned, that ensure patient safety while preventing and treating postpartum depression. Kendig et al. (2017) explain that the information in the article is not new, but that it brings all of the essential information to guide and aid practices in the healthcare setting.

The nurse must use a version of a mental health screening tool that is universal in the facility and then establish a protocol in response to the results of the screening based on the resources in the community. Another important step is activating an emergency referral protocol for women with suicidal or homicidal ideation or psychosis. Providing appropriate and appropriate support not only to the patient but to the patient’s family members. The family could be going through some form of depression at the same time as the mother who gave birth to the child. Lastly, it is important to have continuous care with these patients, meaning the patient has follow-ups as often as the doctor feels or the patient feels.

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When recognizing and preventing postpartum depression in every woman, there are some important steps. One of them includes obtaining a thorough individual and family mental health history. Another includes conducting a validated mental health screening during patient encounters that are timed appropriately, during and after pregnancy. Finally, the most important nursing intervention is providing pregnant women with perinatal depression and anxiety education and awareness. This information needs to be provided to the patient’s family and friends as well. This will ensure support for the patient and aid the family and friends in recognizing when the pregnant patient is displaying signs and symptoms of postpartum depression and to whom the information can be reported. Even if only one family member or loved one is educated on the signs and symptoms of postpartum depression, the patient is more likely to get the treatment they need in a timely matter. This will prevent possible negative effects that postpartum can not only have on the mother but the child as well.

The final, yet crucial part in treating a patient with a diagnosis of postpartum depression, is establishing and maintaining therapeutic communication with the patient at all interactions. It is vital to also establish a nonjudgmental culture of safety through educated mental health nurses as well as educated mental health staff. Once repour is established with the patient, standards can be placed with the patient, once diagnosed, to ensure the patient is on the path of treatment and not a downward spiral.

Describe how Interventions learned will be applied to YOUR Future Nursing Practice

I have not decided where I want to work when I graduate from school, but a few of my interests are working in the neonatal intensive care unit or pediatrics. Honestly, I would be happy with any job I could get after graduating from school, but I will narrow it down to those three. If I were a neonatal intensive care unit nurse, I would be able to assess the mothers and families that are at the bedside with the child in the neonatal intensive care unit for postpartum depression. This is another opportunity for the mother to have another set of trained eyes on her to ensure the health and safety of her and her child while they are in my care.

If I was working in pediatrics, I would be able to use these tools to assess mothers who are bringing their newborns and younger children to their doctor’s appointments. Not only would I be able to assess the mother for signs and symptoms of postpartum depression, but I would be able to provide the mother with education and resources to try and stop the disease in its tracks. According to Moshki et al. (2014), providing education at any time can prevent relapse and postpartum occurring with the following pregnancies.

No matter the type of nurse I become, I know that if I ever come across a woman who is pregnant or recently pregnant, I will provide education and resources to any mother who is displaying any signs of postpartum depression if and when the time is appropriate for the mother. Moshki et al. (2014), stated that people with a strong health locus of control have a decreased risk for postpartum depression. If as a nurse, I can educate mothers, it is shown that “people with internal belief, particularly about health, have more incentive in helping themselves and see them as the decisive factor in implementing changes” (Moshki et al. 2014). When I can educate a mother, it hopefully will make her that much more confident in the decisions that she is making about the mental and physical health of herself, and her child as well.

Conclusion

The prevention and treatment of postpartum depression starts with recognition of the signs and symptoms of postpartum depression. Not only does the nurse need to know these signs and symptoms, but so does the patient and the patient’s family. This is to ensure that if those signs and symptoms do present themselves, everyone is educated enough to identify them accurately. Psychological interventions are another huge factor in ensuring that the patient is being treated for postpartum depression accurately and that the interventions are what the patient wants. Yoga is the last factor in preventing and treating postpartum depression. It is a CAM that is not conventionally used with a perinatal patient, but it was shown that it had a significant effect in decreasing the occurrence of postpartum depression. I know that when I become a nurse, I want to provide education to each patient that I have the privilege to take care of, especially patients with mental health problems. I feel that there is always a resource or someone out there to help. I hope that when I become a nurse, I will be able to provide an increase in a patient’s health locus of control. I hope that each patient and the patient’s family are provided the best care, the newest information, and the tools to ensure that not only is the patient safe but also the family, particularly the baby.

References

1. Emmanuel, E., & Sun, J. (2014). Health-related quality of life across the perinatal period among Australian women. Journal of Clinical Nursing, 23(11-12), 1611–1619. https://doi.org/10.1111/jocn.12265
2. Grier, G., & Geraghty, S. (2015). Mind matters: Developing skills and knowledge in postnatal depression. British Journal Of Midwifery, 23(2), 110-114.
3. Kendig, S., Keats, J., Hoffman, M., Kay, L., Miller, E., Moore Simas, T., … Lemieux, L. (2017). Consensus Bundle on Maternal Mental Health: Perinatal Depression and Anxiety. Journal of Obstetric, Gynecologic, and Neonatal Nursing : JOGNN, 46(2), 272– 281. https://doi.org/10.1016/j.jogn.2017.01.001
4. Moshki, M., Baloochi Beydokhti, T., & Cheravi, K. (2014). The effect of educational intervention on prevention of postpartum depression: an application of health locus of control. Journal of Clinical Nursing, 23(15-16), 2256–2263. https://doi.org/10.1111/jocn.12505
5. Sheffield, K., & Woods-Giscombé, C. (2016). Efficacy, Feasibility, and Acceptability of Perinatal Yoga on Women’s Mental Health and Well-Being: A Systematic Literature Review. Journal of Holistic Nursing, 34(1), 64–79. https://doi.org/10.1177/0898010115577976
6. Stephens, S., Ford, E., Paudyal, P., & Smith, H. (2016). Effectiveness of psychological interventions for postnatal depression in primary care: A meta-analysis. Annals Of Family Medicine, 14(5), 463-472. doi:10.1370/afm.1967