NRS 433 Week 1 Nursing project A Research Critique

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A Research Critique

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A critique of Preventing and treating postpartum depression in women – a municipality model

Postpartum depression (PPD) is the most frequent psychiatric disorder that occurs after childbirth; and the prevalence rate has been found to be at 10–15%. If well understood, this is a fact about PPD that could be used to significantly improve health care delivery or patient outcomes. According to the researchers, women at their pregnancy as well as the period that follows delivery is a major transition in their lives, and it is a period when they are very vulnerable to depression, which cannot be easily detected. A mother’s depression can affect her relationship with the child, and subsequently the quality of care that she provides to her. Due to the disturbed maternal sensitivity, the child may even develop an attachment that is insecure to his/her mother, which may affect the child’s emotional and cognitive development later in life. Despite the danger that looms under the severity of the condition, there remain several barriers to the detection and treatment of PPD. The women lack the necessary knowledge about PPD, and by denying or minimizing their symptoms, they assume that their problems are just common problems that come with birth and after giving birth, and therefore may not be aware of the treatment options. These are some of the barriers that clinicians and in the health care system face in treatment of PPD, as well as other economic and personal barrier that causes low treatment rates among the sampled at-risk women

The main objective of this study was to describe and explain a municipal model for preventing, identifying and treating of postpartum depression (PPD). The study also sought to suggest a basis for the municipality model, which will gives the health care system (primary) better possibilities so as to help women in the postpartum period with mental health problems. The study sought to answer questions like “how is postpartum depression prevented and treated in women?” “What are the effects of depression in women on the quality of parenting? The research paper’s main objective was also to discuss and describe the municipality model for the prevention, identification and treatment for this disorder, for a permanent solution. The objectives and the research questions are related to the problem statement. This is because they seek to solve the problem caused. The research questions on the other hand are well framed, and the quantitative methods applied were so appropriate as to answer the questions. The study suggests how treatment as well as prevention should be done, within a municipality model.

In pursuit of the answers to the above question, the author in his literature review cited many works and book. These are books that were timely for him, because he looked back on what other studies said concerning the issue and other related topic of interests. He for example quotes Dennis (2004) and McLearn et al., (2006) who claimed that a child may develop an attachment that is so insecure to its mother, which will ultimately affect the child later, in terms of his/her emotional as well as cognitive development, because of the disturbed maternal sensitivity. The reason for all that is to show the urgency that is there to identify and treat PPD as early as possible. The study’s literature review goes further to offer solutions, where McLearn et al., (2006) suggests Universal PPD screening during the well-child care visits, since it had been proven to be effective in the increase of PPD detection. Early intervention after the detection through primary health services that exists in the system has been proven to prevent long-term PPD, and it is better that way than curing it. But in the cases of already detected PPD, it has been proven through a study by Morrell et al. (2009) that health visitors can as well be trained in the identification and treatment of PPD. The author’s list of used material range from the use of books to peer reviewed articles and even other research materials. For quantitative research, the author used sources that are older than the rest, even though the others are relatively older as well. The author seemed to agree with all of his literature, and did not seem to disagree with even one of them, because it all formed part of the foundation of his own research. He therefore did not find any weaknesses in the sources, but on the contrary he utilized the sources well, and came up with a logical argument for his case, from the information provided in the sources that he cited.

In the research, the author came up with an exact framework for conducting his research formulated it as a diagram, where he had the Descriptive model for identification and treatment of PPD in the municipalities. This diagram held that as a precondition, the municipalities should have trained public health nurses to handle this condition, sufficient time for the nurses’ follow up and possibilities for referrals for further treatment. The prevention part of it should involve having ample time for home visits by the public health nurses, where they will share information with the mothers out there and an invitation for them to contact the nurses if possible. The next thing in the model is identification of PPD, where mothers should fill the Edinburgh Postnatal Depression Scale, where they will be counselled by the nurses and then evaluated for further follow up. Once a woman has been identified to be depressed, they should be counselled extensively by the public health nurses, based on their individual needs. In the same level of intervention, referral treatment should be done, according to the requirements. Lastly, there is follow up, where during the first year, the nurses will ask the mothers of their mental health in all the selected appointments. The mothers will then fill in the Edinburgh Postnatal Depression Scale during the first year, so that the recovery progress is tracked. The perspective I gathered from this research was one that encouraged a lot of nurse involvement in the Prevention and treatment of postpartum depression in women.

References

Dennis CL (2004) Treatment of postpartum depression, part 2: A critical review of non-

biological interventions. Journal of Clinical Psychiatry 65(9): 1252–1265.

McLearn KT, Minkovitz CS, Strobino DM, et al. (2006) Maternal depressive symptoms at 2 to 4

months postpartum and early parenting practices. Archives of Pediatrics & Adolescent Medicine 160(6): 279–284.

Morrell CJ, Slade P, Warner R, et al. (2009) Clinical effectiveness of health visitor training in

psychologically informed approaches for depression in postnatal women: Pragmatic cluster randomized trial in primary care. British Medical Journal 338: a3045, DOI: 10.1136/bmj.a3045.




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