Postpartum depression (PPD) is a common mental health disorder among first-time mothers. About 15% of women admit that they experience depressive episodes during pregnancy or the first year after childbirth (Sockol, Epperson, & Barber, 2014). In addition, negative mental outcomes and physical changes influence mother-infant and mother-father relationships (Maimburg & Væth, 2015). Mothers should receive help to recognize typical signs of depression. This paper aims to discuss the peculiarities of five one-hour classes on depression awareness, to implement this intervention among first-year mothers, and to evaluate its worth during the first year after giving birth.
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The Spirit of Inquiry Ignited
Women do not know how to deal with changes that occur during the postpartum period. PPD may lead to the risk of relapses and the development of a major depressive disorder (MDD) (Moraes, Lorenzo, Pontes, Montenegro, & Cantilino, 2017). Women feel helpless and do not understand how to cope with new problems and duties. An evidence-based practice (EBP) process is a chance to find out how to support first-time mothers and reduce the causes of depression during the postpartum period.
The PICOT Question Formulated
In recent first-time mothers (P), will five one-hour classes on depression awareness (I) in comparison to those not receiving the intervention (C) display a lower percentage rate of postpartum depression (O) in the first year after giving birth (T)?
Search Strategy Concluded
The Cochrane Database will be used for this EBP project. “First-time mother”, “postpartum depression”, “healthcare”, and “intervention” are the keywords applied to this search strategy. Cooper, Pascalis, Woolgar, Romaniuk, and Murray (2015) introduced a randomized controlled trial to define the preventive effects for women with postpartum depression. Maimburg and Væth (2015) discussed if antenatal education could reduce the risks of PPD within their study. Sockol et al. (2014) conducted a two-part controlled experiment to prove the relation between maternal attitudes and psychological factors.
Woolhouse, Gartland, Mensah, and Brown (2015) offered a cohort study to investigate mental health problems. The study by Zlotnick, Tzilos, Miller, Seifer, and Stout (2016) supported interpersonal therapy as the main intervention for mothers. All the studies considerably contribute to the chosen EBP project.
Critical Appraisal of the Evidence Performed
Evidence synthesis and an evaluation table will be developed to determine the validity and credibility of the sources. Several sources should meet the requirements for the Level I evidence, and some studies should have Level II evidence. These are the two strongest levels of evidence where authors demonstrate their ideas and practices in real-life settings. Home visits, educational programs, and interpersonal therapies helped to deal with PPD among mothers. The goal of this EBP change project is to introduce, implement, and evaluate an intervention after which the risks of PPD are decreased.
Evidence Integrated with Clinical Expertise and Patient Preferences to Implement the Best Practice
The plan for the current EBP project is to develop a one-hour class on depression awareness for first-time mothers and check if it reduces the number of PPD cases compared to a group of mothers without this intervention. Sometimes, not much is required to support first-time mothers and deprive them of doubts and fears. The comparison of post-intervention results between the groups who have and do not have access to one-hour classes five times should demonstrate if the study is successful.
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The outcome of Practice Change Evaluated
All the participants have to be divided into two groups to visit and neglect one-hour classes about PPD. The results must show if first-time mothers who get an opportunity to visit classes experience PDD less frequently compared to the mothers who do not learn this disorder. Aware mothers can communicate their problems and ask family members for help and understanding. They will be prepared for postpartum complications in a certain way and control their emotions.
- Purpose. This project aims to discuss PDD among first-time mothers and develop an intervention to reduce depressive symptoms. It is necessary not only to introduce an intervention but also to show how different the outcomes are. The main purpose is to reduce the cases of PPD using classes on depression awareness.
- Clinical question. Can one particular intervention offered to first-time mothers reduce the number of depression symptoms and PDD complications during the first postpartum year?
- Time. PPD is a specific mental health condition that is characterized by certain time frames. As a rule, mothers experience changes and depressive moods during the first 18 months after giving birth to a child. Therefore, this intervention should last a definite period, in this case, 12 months after giving birth.
- Stakeholders. In addition to mothers who give their agreement to participate, the role of nurses should be underlined. Nurses can be the main lecturer of one-hour classes for mothers. Their possibility to observe associated changes can offer mothers helpful pieces of advice. The hospital leaders and administrators should also participate in this intervention to approve the decisions and solve organizational issues.
Organizational interventions help to improve health and achieve positive results, removing problems and reducing challenges. This project should be properly evaluated in terms of its methods and information. Participation of all mothers and nurses should be anonymous and voluntary.
- Theoretical framework. A behavioral theoretical framework will be used in this project. The work by Lewinsohn on the psychology of depression should help to clarify if there are the stressors that make women suffer from PDD for a long period. This intervention is connected to the development of personal skills and knowledge of depression and the necessity to be prepared for new psychological concerns.
- Design. Participant observation will be used in the study in which the observation of people’s behavior and the evaluation of the outcomes that happen after classes. There will be an experimental group and a control group. Therefore, a causal research design should be approved to explain the cause and effect of a particular intervention.
- Confidentiality. Each participant of the observation stays anonymous during and after the investigation. Informed consent should be obtained from every mother after clearly explained the details of the work. The ethical committee should approve and follow the intervention process.
- Sample/Setting/Procedure. Forty first-time mothers registered in the local hospital will be invited. The participants will be randomly divided into two groups (experimental and control). When an intervention is implemented, first outcomes and observations will be noted. A questionnaire should be offered at the end of the study.
- Instrument. Several tests during the first year after giving birth will be offered to the participants. Observations during classes for young mothers have to be approved. An intervention and a questionnaire are the main methods to gather the material.
Data Analysis and Outcomes to Be Evaluated
Coding schemes will be used to analyze the data obtained from observations and a questionnaire. The main outcomes to be evaluated are the frequency of PPD cases, general behaviors of the participants, and the ability to recognize depressive symptoms. The opinion of the researcher/observer should be objective during the study.
This project should be introduced to the research team and the hospital setting where the intervention is organized. These class visits must be approved at the national conference to become a standard practice for hospital nurses and first-time mothers. The prevention of depressed mothers and ruined families is the goal that cannot be ignored. This project is a serious step to success and recognition in postpartum care.
To conclude, this EBP project is characterized by a serious goal and significant outcomes for mothers and child well-being. Sometimes, it is enough to talk to destroy personal fears and doubts. First-time mothers are full of controversies and unpredictability. This intervention is a chance to support such mothers and get them prepared for PPD and its possible outcomes. Mothers who are vulnerable to PPD should learn how to deal with these conditions and improve their mental health.
Cooper, P. J., Pascalis, L. D., Woolgar, M., Romaniuk, H., & Murray, L. (2015). Attempting to prevent postnatal depression by targeting the mother-infant relationship: A randomized controlled trial. Primary Health Care Research & Development, 16(4), 383-397. Web.
Maimburg, R. D., & Væth, M. (2015). Postpartum depression among first-time mothers – results from a parallel randomised trial. Sexual & Reproductive Healthcare, 6(2), 95-100. Web.
Moraes, G., Lorenzo, L., Pontes, G., Montenegro, M., & Cantilino, A. (2017). Screening and diagnosing postpartum depression: When and how? Trends in Psychiatry and Psychotherapy, 39(1), 54-61. Web.
Sockol, L. E., Epperson, C. N., & Barber, J. P. (2014). The relationship between maternal attitudes and symptoms of depression and anxiety among pregnant and postpartum first-time mothers. Archives of Women’s Mental Health, 17(3), 199-212. Web.
Woolhouse, H., Gartland, D., Mensah, F., & Brown, S. (2015). Maternal depression from early pregnancy to 4 years postpartum in a prospective pregnancy cohort study: Implications for primary health care. BJOG: An International Journal of Obstetrics & Gynaecology, 122(3), 312-321. Web.
Zlotnick, C., Tzilos, G., Miller, I., Seifer, R., & Stout, R. (2016). Randomized controlled trial to prevent postpartum depression in mothers on public assistance. Journal of Affective Disorders, 189, 263-268. Web.