Post-Partum Depression, a Nurses’

Control

Valerie Sporsheva

Kaplan University

MN600 MIchelle Liken

Post-Partum Depression (PPD)

Abstract

This presentation examines nursing interventions that labor-and-delivery and maternity nurses perform to decrease Post-Partum Depression (PPD). It explores how nurses can assess, educate, intervene and provide support to a mother early in the labor progress. The need for change from the current practice was noted after an average 10-15% of

mothers are diagnosed with PPD. With the numbers so high, it is a must for early intervention to occur while the mother is in the hospital and all resources are available. The purpose of this research is for labor and delivery and maternity nurses to identify

risk factors and symptoms of PPD in all mothers during their hospital stay versus awaiting mothers to present with PPD at their six week post-partum doctor appointment. Furthermore, the Social Cognitive Theory framework is used to guide the PPD study as it

relates to behavioral patterns that can be used to understand PPD. In conclusion, it is hoped that nurses are able to provide interventions at early stage to decrease the high

PPD rates.

About me

I decided to received my MSN in education ever since I began nursing school three years ago. I know that teaching is where I belong. I currently work in labor and delivery and my dream position is to stay in my department and become the educator. My preceptor has been the current educator on the labor and delivery unit. I had a wonderful privilege to set up post-partum hemorrhage in-service and competencies. I was able to teach nurses and nursing students. Furthermore, I was able to assist my preceptor with a new hire intern program in which power-points and lectures were conduced. Overall, my experience throughout the past weeks has been fantastic and I’m looking forward to becoming an educator soon.

I love puzzles, sudoku, home decor, hiking, traveling and space.

Defining PPD

Depression that is suffered by a mother after childbirth.

Typically mothers are presented to their six week post-partum doctor visit with symptoms of PPD.

Background

PPD depression was identified as the key problem because by many obstetricians at Cedars Sinai Medical Center have brought up a concern.

More obstetricians are recognizing that mothers are experiencing PPD when showing up to their six week post-partum visit

PPD can happen for multiple reasons

Bonding:

The emotional bond formed between mother and baby allows the promotion of cognitive, socio-emotional, self-regulatory and moral development, and promotes an optimal development in childhood and adolescence (Thompson & Fox, 2010, p. 249).

For this to happen, maternal and infant needs must be met at an early post-partum period

Problem and Purpose

The purpose of this research is for labor and delivery and maternity nurses to identify risk factors and symptoms of PPD in all mothers during their hospital stay versus awaiting mothers to present with PPD at their six week post-partum doctor appointment.

The focus of the problem refers to mothers who are at risk for developing post-partum depression.

Goals & Aims

1) Nurse should identify risk factors that can lead the mother away or towards the possibility of experiencing PPD.

2) Nurse should identify symptoms the mother may possess that can lead towards PPD.

3) Nurse should provide nursing interventions to mothers who have been identified as a candidate for PPD.

Clinical Importance/Significant

Results were inconclusive

It is unsure if nursing interventions for prevention of PPD started during mothers hospital stay will decrease PPD rates

More research needs to performed

Literature Review

Various models have been proposed to explain PPD,

1) Article entitled “Post Partum Depression and Thyroid Function”

Is there a relationship between PPD and thyroid dysfunction?

results were not significant and in conclusion there was no correlation

2) Article entitled “Post-partum depression: a comprehensive approach to evaluate and treatment”

What are some treatment interventions for PPD?

Mother-infant psychodynamic psychotherapy (PPT), Watch, Wait, Wonder (WWW) and toddler-parent psychotherapy (TPP)

Literature Review Summary

Overall, articles didn’t possess any research if nursing interventions for prevention of PPD should be started while the mother is in the hospital during labor and post birth.

Does this mean that nurses should stop identifying risk factors and symptoms for PPD?

Theoretical Framework

Steps to Solve Problem

1) Questionnaire given to mothers as they are admitted to the hospital

2) The Edinburgh Postnatal Depression Scale

3) Nurses must assist all mothers with bonding

4) If PPD is high and the mother expresses symptoms of baby blues or PPD, the nurse must notify the doctor right away and make sure a social worker is ordered

Evaluation

Are obstetricians noticing a decrease in PPD when their patients show up for their six-week post partum appointment?

Where all preventative interventions performed during mother’s stay in the hospital?

Professional Role

An advanced nurse is an RN who has gone through “expanded clinical practice” by gaining a master degree in certain areas. This can include nurse practitioner, nurse specialist, nurse anesthetists, nurse midwife, and nurse educator.

This course has prepared me for the nursing role of an educator through the many skills that were taught.

Researching evidence-based practice

Setting up a course outline

Educating nursing students and staff nurses

References

Bandar, A. (1997). Self-efficacy: The Exercise of control. New York: Freeman.

Cedars-Sinai. (2012). Advanced practice nursing. Retrieved from http://www.cedars-sinai.edu/Medical-Professionals/Resources-for-Nurses/Advanced-Practice-Nursing/

MayoClinic. (2012). Postpartum depression. Retrieved from http://www.mayoclinic.com/health/ postpartum-depression/DS00546/DSECTION=symptoms

Sears, William. (2012). Bonding with Your Newborn. Retrieved from http://www.attachmentparenting.org/support/articles/artbonding.php

Thompson, K. S., & Fox, J. E. (2010). Post-partum depression: A comprehensive approach to evaluate and treatment. Mental Health in Family Medicine, 7, 249-257.

Thanks, Future Plans

Thank you to the wonderful, knowledgable nursing mentors and educators at Kaplan University.

Thank you to my preceptor, Pam, who has taken me under her wing.

In the future, I hope to teach with the skills that I have learned and be at least as half good as my educators.