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      Postnatal Depression Is a Public Health Nursing Issue: Perspectives from Norway and Ireland

      review-article
      1 , * , 2
      Nursing Research and Practice
      Hindawi Publishing Corporation

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          Abstract

          The framework provided by the Millennium Development Goals includes maternal health as an area of priority. Postnatal depression (PND) is a serious public health issue because it occurs at a crucial time in a mothers' life, can persist for long periods, and can have adverse effects on partners and the emotional, behavioural, and cognitive development of infants and children. Internationally, public health nurses (PHNs) are key professionals in the delivery of health care to mothers in the postpartum period, and international research collaborations are encouraged. Two researchers from the European Academy of Nursing Science (EANS) identified a need to collaborate and strengthen research capacity and discussion on postnatal depression, a public health nursing issue in both countries. Within the context of public health and public health nursing in Ireland and Norway, the aim of this paper is to present a discussion on the concept of PND, prevalence, and outcomes; screening issues for PHNs; and the research evidence of the benefits of social support in facilitating recovery for new mothers.

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          Most cited references53

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          Detection of postnatal depression. Development of the 10-item Edinburgh Postnatal Depression Scale.

          The development of a 10-item self-report scale (EPDS) to screen for Postnatal Depression in the community is described. After extensive pilot interviews a validation study was carried out on 84 mothers using the Research Diagnostic Criteria for depressive illness obtained from Goldberg's Standardised Psychiatric Interview. The EPDS was found to have satisfactory sensitivity and specificity, and was also sensitive to change in the severity of depression over time. The scale can be completed in about 5 minutes and has a simple method of scoring. The use of the EPDS in the secondary prevention of Postnatal Depression is discussed.
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            Case-finding instruments for depression. Two questions are as good as many.

            To determine the validity of a two-question case-finding instrument for depression as compared with six previously validated instruments. The test characteristics of a two-question case-finding instrument that asks about depressed mood and anhedonia were compared with six common case-finding instruments, using the Quick Diagnostic Interview Schedule as a criterion standard for the diagnosis of major depression. Urgent care clinic at the San Francisco Department of Veterans Affairs Medical Center. Five hundred thirty-six consecutive adult patients without mania or schizophrenia. Measurements were two questions from the Primary Care Evaluation of Mental Disorders patient questionnaire, both the long and short forms of the Center for Epidemiologic Studies Depression Scale, both the long and short forms of the Book Depression Inventory, the Symptom-Driven Diagnostic System for Primary Care, the Medical Outcomes Study depression measure, and the Quick Diagnostic Interview Schedule. The prevalence of depression, as determined by the standardized interview, was 18% (97 of 536). Overall, the case-finding instruments had sensitivities of 89% to 96% and specificities of 51% to 72% for diagnosing major depression. A positive response to the two-item instrument had a sensitivity of 96% (95% confidence interval [CI], 90-99%) and a specificity of 57% (95% CI 53-62%). Areas under the receiver operating characteristic curves were similar for all of the instruments, with a range of 0.82 to 0.89. The two-question case-finding instrument is a useful measure for detecting depression in primary care. It has similar test characteristics to other case-finding instruments and is less time-consuming.
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              Validation of the Edinburgh Postnatal Depression Scale (EPDS) in non-postnatal women.

              J. Cox (1996)
              This paper reports the validation of the EPDS against a Research Diagnostic Criteria diagnosis of Major and Minor depression. The EPDS was administered to non-postnatal women with older children (mean age of youngest child 3 years 9 months) and to postnatal women (baby aged 6 months). All who scored 9 or above and one third of low scorers were interviewed, using Goldberg's Clinical Interview Schedule. The study confirmed good user acceptability of the EPDS when administered as a postal questionnaire (92% response rate). The EPDS was found to have satisfactory sensitivity (79%) and specificity (85%). Our findings suggest that the EPDS take a place alongside other screening scales for depression in Community samples. It is proposed that when used in these settings it is referred to as the Edinburgh Depression Scale.
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                Author and article information

                Journal
                Nurs Res Pract
                Nurs Res Pract
                NRP
                Nursing Research and Practice
                Hindawi Publishing Corporation
                2090-1429
                2090-1437
                2013
                5 September 2013
                : 2013
                : 813409
                Affiliations
                1Department of Nursing, Diakonova University College, Fredensborgveien 24 Q, 0177 Oslo, Norway
                2School of Nursing & Midwifery, Brookfield Health Sciences Complex, University College Cork, Ireland
                Author notes

                Academic Editor: Megan Aston

                Article
                10.1155/2013/813409
                3780656
                24089636
                c560e041-90af-4a3d-af1e-3ddd91141ce6
                Copyright © 2013 K. Glavin and P. Leahy-Warren.

                This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                : 2 March 2013
                : 16 July 2013
                : 1 August 2013
                Categories
                Review Article

                Nursing
                Nursing

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