Critical Appraisal: Quantitative Nursing Research Article
Evidence-based practice has informed healthcare professionals to ask clinical questions and inform clinical practice (Rebar & Gersch, 2015, p. 11). The authors conducted an evidence-based research study to determine the effectiveness of telephone-based peer support (TBPS) for postpartum depression (PPD) up to two years after delivery. The primary goal for this paper is to synthesize and critically analyze the article. Therefore, nursing research knowledge is used to summarize and critique the article: problem and purpose; literature review; sampling; ethical considerations; research design; results and conclusion; and strengths and weaknesses.
Research Problem
The authors discussed the need for effective treatments to address the high global rates of PPD and maternal depression up to two years after delivery (Letourneau et al., 2015, p. 1588). The research problem is the efficacy of TBPS in diminishing maternal depression up to two years postpartum (Letourneau et al., 2015, p. 1588). This problem arose due to three main factors; increased PPD and maternal depression rates, and existent theoretical frameworks about TBPS with early PPD.
Research Purpose, and Questions The authors’ purpose is to evaluate the effectiveness of TBPS with depressed mothers up to 2 years postpartum (Letourneau et al., 2015, p. 1589). The researchers identified four questions: mothers’ and peers’ satisfaction with TBPS; if increased
Postpartum depression can have serious consequences for the health of both mother and child. Indeed, a recent study of 10, 000 postpartum women found 19.3% of women with postpartum depression had considered hurting themselves (5). In the United Kingdom suicide is the leading cause of maternal death in the postpartum period (6). Even in less severe cases, postpartum depression may compromise caregiving practices (e.g., are less likely to use car seats, breastfeed, or ensure that their child receives up to date vaccinations); (7;8) and maternal-infant bonding (e.g., are less responsive to their infants, engage in less face-to-face interactive play and participate in fewer enrichment activities); (7;9;10). These factors may be partly responsible for delayed cognitive, intellectual, social, and emotional development of the child (11-15). Given the negative consequences of postpartum depression, prevention and treatment is imperative.
Borra, C., Iacovou, M., & Sevilla, A. (2015). New Evidence on Breastfeeding and Postpartum Depression: The Importance of Understanding Women 's Intentions. Maternal & Child Health Journal, 19(4), 897-907. doi:10.1007/s10995-014-1591-z
Postpartum psychiatric disorders, particularly depression, has become the most underdiagnosed complication in the United States. It can lead to increased costs of medical care, inappropriate medical care, child abuse and neglect, discontinuation of breastfeeding, and family dysfunction and adversely affects early brain development (Earls, 2010). Over 400,000 infants are born to mothers that are depressed. One of 7 new mothers (14.5%) experience depressive episodes that impair maternal role function. An episode of major or minor depression that occurs during pregnancy or the first 12 months after birth is called perinatal or postpartum depression (Wisner, Chambers & Sit, 2006). Mothers with postpartum depression experience feelings of extreme sadness, anxiety, and exhaustion that may make it difficult for them to complete daily care activities for themselves or for others (Postpartum Depression). The six stages of postpartum are denial, anger, bargaining, depression, acceptance and PTSD. These stages may affect any women regardless of age, race, ethnicity, or economic status. However only a physician can diagnose a woman with postpartum depression. It does not occur because of something a mother does or does not do, it’s a combination of physical and emotional factors. After childbirth, the levels of hormones in a woman’s body quickly drop; which may lead to chemical changes in her brain (Postpartum Depression). Unbalanced hormones may trigger mood swings.
Postpartum depression, which is the most prevalent of all maternal depressive disorders, is said to be the hidden epidemic of the 21st century. (1) Despite its high prevalence rate of 10-15% and increased incidence, postpartum depression often goes undetected, and thus untreated. (2) Nearly 50% of postpartum depression cases are untreated. As a result, these cases are put at a high risk of being exposed to the severe and progressive nature of their depressive disorder. (3) In other words, the health conditions of untreated postpartum depression cases worsen and progress to one of their utmost stages, and they are: postpartum obsessive compulsive disorder, postpartum panic disorder, postpartum post traumatic stress, and postpartum psychosis.
The birthing process generally leaves women with overwhelming joy and happiness. However, some women do experience a period of postpartum blues lasting for a few days or at most a couple of weeks but goes away with the adjustment of having a baby (Postpartum Depression, 2013). A condition called Postpartum Depression Disorder (PPD) leaves a dark gray cloud over 10-20% of woman after birth that is recognized in individuals 3 weeks to a year after the delivery of their baby (Bobo & Yawn, 2014). PPD leaves new mothers feeling lonely, anxious, and hopeless (Bobo at el, 2014). Postpartum Depression is a cross cutting disorder that can affect any woman after the delivery of a baby regardless of race, socioeconomic status, age, or education level (Postpartum Depression, 2013). Although this disorder affects more than 10% of women the article Concise Review for Physicians and Other Clinicians: Postpartum Depression reports that less than half of women with PPD are actually diagnosed with this condition (Bobo at el, 2014). It is important that postpartum women and their support systems receive education on what PPD consist of and ways to recognize the signs and symptoms of PPD so that a diagnosis is not overlooked. Early diagnosis is important because early recognition and treatment of the disorder yields for better results when treating individuals with PPD. In this paper I will deliver information about PPD based on recent literature,
As mental health in America is finally being addressed and more research is seen, it is important to look at the potential causes or correlations that lead to common diagnoses for patients. According to Brummelte and Galea (2010), “depression affects approximately 1 in 5 people, with the incidence being 2-3x higher in women than in men.” Postpartum depression (PPD), a subset of this debilitating disease, has an estimated prevalence rate of 13-19% with another estimated 50% that are undiagnosed (O’hara and McCabe, 2013). As a whole, it has the same symptoms as major depressive disorder but diagnosis occurs within 0-4 weeks of giving birth (American Psychiatric Association, 2013). Part of this lack of diagnosis is due to a multitude of healthcare
The Center for Disease Control estimates that 1 in 20 people suffer from depression (2014). Although widely recognized and somewhat easy to diagnose, depression is an ignored and almost hidden, disease. In women, the statistics are especially grim for those who are pregnant or were recently pregnant. A great number of women suffer from postpartum depression; an illness which is often overlooked, misdiagnosed and untreated. Postpartum depression (PPD) has been defined as an emotional disorder that occurs in an estimated 10-15% of all women after childbirth (Liberto, 2010). Postpartum depression not only impacts the mother, but can cause long-term psychological challenges for the baby and create emotional turmoil for all family members.
Postpartum Depression is important because too often it affects the mother, her spouse, and the newborn child. This affects the relationship between the mother and child based on Erikson’s Psychosocial developmental Theory and the idea of trust vs. mistrust. If the child’s basic needs are not met that could lead to mistrust, anxiety, and insecurities. This could also lead to Reactive Attention Disorder, where the neglect a child experiences leads to difficulty making relationships. It’s also found to be more likely in mothers of colicky babies because if the child cries a lot the mothers are less likely to make an emotional connection.
Postpartum depression (PPD) is a major event occurring in eight to fifteen percent of the woman population after delivering their child (Glavin, Smith, Sørum & Ellefsen, 2010). The symptoms and causes of PPD are similar to depression symptoms in other periods of life (Glavin et al., 2010). These symptoms may include feelings of helplessness and hopelessness, loss of interest in daily activities, sleep changes, anger or irritability, loss of energy, self-loathing, reckless behavior and concentration problems. These symptoms may lead to other factors that are detrimental to the child bearing and rearing family.
According to two recent studies, 7-13% of all postpartum women suffer from depression. Even more alarming, the prevalence of postpartum depression (PPD) in mothers who have pre-term infants rises to 30-40% according to a recent review (Robertson E, Grace S, Wallington T, Stewart DE., 2004; Schmied V, Johnson M, Naidoo N, et al., 2013). Mood and anxiety disorders, specifically PPD, are severe, yet common complications in women of reproductive age. Undertreated depression in postpartum women is associated with health risks for both the mother and infant, making the goal of euthymia a top priority in the care of postpartum women. Current practice regarding PPD focuses on the triad approach of early detection and prevention, the use of pharmacotherapy, and the use of psychotherapy. However, the treatment of mental illness during pregnancy requires weighing the benefits of pharmacological treatment for the mother, to the risk of the medications on the growth and development of the fetus as well as the theoretical risks associated with undertreated depression. However, many studies are showing that the risks of postpartum depression to both the mother and infant significantly outweigh the risks of pharmacological treatment during pregnancy. Also, due to the ethical issues surrounding trials of pharmacotherapy during pregnancy, further research to determine evidenced-based methods of treatment are still necessary. The most important intervention to date is a
Depression, in general, affects more than 340 million people around the world and is reported to be the highest cause of disability in high-income countries (Demissie). 15% to 85% of mothers can experience postpartum “blues” with postpartum depression rates between 11.7% and 20.4% in the United States alone (Ersek). This depression can occur at anytime from post-delivery up to one year (Ersek).
“Postpartum depression affects 10% to 20% of women after delivery, regardless of maternal age, race, parity, socioeconomic status, or level of education”.( Consise) Postpartum depression is a major depression episode that occurs after childbirth affecting not only the mother but also the child and family members. After the delivery of the placenta extending for about six weeks this is considered as as the postpartum period. This a critical period for the mother and new born physiological and psychological because the woman’s body is returning to a non-pregnant state in which hormones, sleep parttters, emotions and relationship are changing. Therefore, up to 80% of mothers experience the "baby blues during the first week in which
Postpartum depression (PPD) affects about eighty-five percent of new mothers and persists as long as a year after childbirth (Texas Medical Association, 2015). In spite of the scope of this problem and the benefits of screening women, it’s not standard procedure (New York State Department Of Health, 2016). This policy brief was written for healthcare providers that treat new mothers at risk for PPD with the goal of improving screening and the number of women receiving appropriate treatment. The recommendations address measures to improve early identification and follow-up care for women found to have PPD.
What is Postpartum Depression (PPD)? How would you know if you had it? Is it unavoidable, something you just have to endure? Fortunately, Postpartum depression is more akin to a temporary condition that can be managed and counterbalanced with insight, sensitivity, and support. What begins as the “baby blues” is estimated to affect as many as upwards of 80% of women after a birth. Although some purport it is caused by hormonal changes, there remains a lack of consensus as to
Postpartum depression is a mood disorder in females that is known to be present within the 4 to 6 weeks after childbirth (Battle et al). This condition is the most common complication after childbirth (Mosses-Kolko et al.,2009).Studies have shown predictors which lead to postpartum depression such as maternal childhood maltreatment and lifetime posttraumatic stress disorder (PTSD)in pregnancy (Seng 2013).A variety of factors exist among certain subgroups of women that may lead to postpartum depression. Postpartum depression affects approximately “one out of eight of the more than four million women who give birth in the United States every year”(Kruse et al. 2013a). The estimation of PPD in the US, UK, and Australia is from 7% to 20 % (Fitelson