Postpartum depression final

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The Effect of Socioeconomic Factors on Postpartum Depression:

The Effect of Socioeconomic Factors on Postpartum Depression Elise Welsh Kathryn Ensign Cortnee Hanson Creighton University School of Nursing

Problem:

Problem The delayed detection of post partum depression (PPD) increases the severity of symptoms that post partum mothers experience before detection and treatment.

Cost:

Cost Therapy: $100/50 min Hormones: $25/month supply Antidepressants: range from $4/month-$4/pill, very variable (3)

Morbidity:

Morbidity 10-15% of all women during at least one pregnancy 52% of women during their first pregnancy have low to moderate levels of postpartum depression (PPD) 7% of women during their first pregnancy have severe levels of PPD (3)

Morbidity :

Morbidity decrease in severe levels with an increase number of years decrease in PPD with an increase in age No significant difference in race The largest factor appearing to contribute to PPD is financial stress: 6-8% decrease if finances were not a stress (3)

Mortality:

Mortality not specifically the cause of death depression (any kind, but specifically to the first time mothers) contributes to suicide (3)

Nursing Significance:

Nursing Significance Hospital stay Healthcare cost Risk for self harm Risk for infant harm Pt. quality of life

Project Purpose:

Project Purpose To examine if socioeconomic factors have an effect on the prevalence of postpartum depression.

PICO Question :

PICO Question Do socioeconomic factors have an influence on the prevalence of postpartum depression in postpartum mothers?

Examined Research Studies:

Examined Research Studies

Investigating quality of life and depressive symptoms in the postpartum period:

Investigating quality of life and depressive symptoms in the postpartum period Purpose to determine if there was a correlation between postpartum depression (PPD) and quality of life (QOL). Sample 101 postpartum women aged 14 – 42 years who delivered at the General Hospital of UCS located in Brazil. Study Level 3 Quality of Evidence Moderate

Screening of postpartum depression: comparison between mothers in the neonatal intensive care unit and in the neonatal section:

Screening of postpartum depression : comparison between mothers in the neonatal intensive care unit and in the neonatal section Purpose to compare the risk factors and occurrence of postpartum depression (PPD) in mothers with babies in the Neonatal Intensive Care Unit (NICU) to mothers with healthy babies Sample 209 subjects were used, the majority of them coming from the nursery at San Giovanni di Dio hospital in Cagliari. Study Level 4 Quality of Evidence Moderate

A Community-Based Screening Initiative to Identify Mothers at Risk for Postpartum Depression:

A Community-Based Screening Initiative to Identify Mothers at Risk for Postpartum Depression Purpose to demonstrate the feasibility of a large-community based postpartum-depression (PPD) screening and recommend screening practices Sample postpartum women, ages 14-49, a total of 5,169 took the Edinburgh Postnatal Depression Scale (EPDS); 185 out of 674 who had a score greater than 10 consented to the interview to confirm PPD Study Level 5 Quality of Evidence Moderate

Synthesis of Examined Research Articles:

Synthesis of Examined Research Articles

Overall Sample:

Overall Sample 984 postpartum mothers age ranges 14-49 Outpatient Variety of health among the mothers 178 mothers had a confirmed diagnosis of Post Partum Depression Locations Brazil (3) Italy (1) United States (2).

Overall Results in Relation to PICO:

Overall Results in Relation to PICO Two studies found a correlation between socioeconomic status and PPD (2,4). The other study did not find a significant correlation between socioeconomic status and PPD (1).

Overall Quality of Evidence:

Overall Quality of Evidence Moderate Not Controlled: Reactive effects Interrater reliability Instrumentation Validity

Recommendations for Practice:

Recommendations for Practice Examine the possibility of postnatal depression episodes for those who are detected to have a poor quality of life Prevention programs aimed at early identification

Recommendations for Practice:

Recommendations for Practice 2010 study conducted by Carlos Zubaran and Katia Foresti Level 3 Findings confirmed the notion that socio-economic deficiencies can facilitate the expression of depressive symptoms during the postpartum period Also supported in June Andrews Horowitz, Christine A. Murphy, Katherine E. Gregory, and Joanne Wojcik 2011 study

Future Research:

Future Research Research which specific socioeconomic factors have an impact on the prevalence of PPD. Research the socioeconomic status of the father to determine if the father’s socioeconomic status has an impact on PPD of the mother.

References:

References 1. De Magistris , A., Coni , E., Puddu , M., Zonza , M., Fanos , V. (2010). Screening of postpartum depression: comparison between mothers in the neonatal intensive care unit and in the neonatal section. The Journal of Maternal-Fetal and Neonatal Medicine , 23, 101-103. doi : 10.3109/14767058.2010.506759 2. Horowitz, J. A., Murphy, C. A., Gregory, K. E. and Wojcik , J. (2011), A Community-Based Screening Initiative to Identify Mothers at Risk for Postpartum Depression. Journal of Obstetric, Gynecologic, & Neonatal Nursing, 40: 52–61. doi : 10.1111/j.1552-6909.2010.01199.x 3. Kinniburgh , B., Morrow, B., Lipscomb, L. (2009). Pregnancy Risk Assessment Monitoring System (PRAMS): PRAMS and Postpartum Depression. CDC. http://www.cdc.gov/PRAMS/PPD.htm 4. Zubaran , C., Foresti , K. (2011). Investigating quality of life and depressive symptoms in the postpartum period. Women and Birth , 24, 10-16. doi:10.1016/j.wombi.2010.05.00

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