Effectiveness of Edinburgh Postnatal Depression - Research Paper Example

Postnatal-Depression Care The current paper presents evidence supporting the effectiveness of the Edinburgh Postnatal Depression Scale. The paper enquires what prior studies have found on the use and benefits of this tool. The shortcomings of the tool are highlighted and recommendations of enhancing the effectiveness of the tool are provided. The paper seeks to establish the usefulness of the tool on people of different ages and races. It provides an insightful account of the causes of high scores of postnatal depression among minority and low income women. The paper closes with suggestions that community health nurses can use to aid the access to healthcare for minority and low income women. Postnatal-Depression Care Research reveals that postnatal depression affects about ten to fifteen out of every one hundred women before and after delivery. Edinburgh Postnatal Depression Scale helps test for postnatal depression and normal mental health counseling treats postnatal depression. There are socio-demographic factors that influence the level of severity of postnatal depression in different women and their initiative or choice to seek help. This paper presents evidence-based research knowledge on the effectiveness of Edinburgh Postnatal Depression Scale tool. The paper also discusses why minority and low income women have high scores in the diagnosis of postnatal depression. The paper closes with suggestions on what community health nurses can do to help these women to get the healthcare they need. Effectiveness of Edinburgh Postnatal Depression There has been recent research seeking to establish the effectiveness of Edinburgh Postnatal Depression Scale. Majority of this research submit that the tool is effective and is widely used. A study conducted in 2010 tested the effectiveness of Edinburgh postnatal depression scale in testing for adolescent depression (Anderson, 2010). The sample of the study included one hundred and forty one adolescent participants of Latina, African-American, and Caucasian origin. The study offered that postpartum depression affects up to sixty-nine percent adolescent women after childbirth. The study noted that adolescent postpartum depression was often overlooked and when noted, it was tested through normal clinical assessment. The study concluded that Edinburgh postnatal depression scale is an accurate tool to use for testing postpartum in adolescents. In 2011, another group of researchers conducted a study to test for the results of a postnatal depression-screening program that uses the Edinburgh postnatal depression scale (Leung et. al., 2011). An observation of the lack of well-documented evidence on how postnatal depression screening programs reduce morbidity informed this study. They used a sample of four hundred and sixty two mothers who sought postnatal health in Hong Kong health centers. They used Edinburgh postnatal depression scale on the intervention group and normal clinical screening on their control group. Patients diagnosed with postnatal depression were put on follow-up care for a period of six months (Choi et. al., 2012). The researchers found that the screening program that used Edinburgh postnatal depression scale improved the mental health of the patients better than the one that used normal clinical assessment. A study conducted in 2012 used the Edinburgh postnatal depression scale tool to test its efficiency and simplify it (Choi et. al., 2012). The researchers used the tool on four hundred and ninety four pregnant women who were nearing delivery and were receiving antenatal care. Their training set included two hundred and fifty women whereas their validation set included two hundred and forty-four women. They issued the training set with a simplified version of Edinburgh postnatal depression tool crossed check its efficacy with its results from the validation set. It gave results of 92.4% sensitivity, 86.3% specificity, a positive predictive value of 56.2% and a negative predictive value of 98.4%. The study concluded that, with a little modification, Edinburgh postnatal depression scale is an efficient tool for the diagnosis of depression during pregnancy. These and many other studies provide evidence for the effectiveness of Edinburgh postnatal depression scale. The tool has been tried and found to work for both antenatal and postpartum cases of postnatal depression. It is worth noting that the tool works effectively in connection with other screening programs and for patients of different ages and ethnic backgrounds. High scores for postnatal depression among minority and low-income women There is documented evidence showing high scores for prenatal depression among minority and low-income women. Studies have sought to document the patterns of screening and referral for postpartum depression among low-income women from a perspective of community health workers. Minority and low-income women register more cases for postnatal depression than do women from other income classes. The sad truth is that despite the higher chances of postnatal depression among these women, there is evidence that they do not seek healthcare as women from other income classes do (Choi et. al., 2012). Poverty and low income denies individuals access to healthcare services and important advice such as on family planning. This accounts for the big family size among poor and low-income families. Poor family planning causes minority and low-income women to conceive unexpectedly. The shock that results from unexpected pregnancy causes distress on these women. In addition, it drains women when they bear many children consecutively without the sufficient planning to help them heal and recover from the impact that comes with childbirth. Family size is tied to one’s culture and minority cultures tend to prefer big family sizes. There are beliefs associated with them. Undoubtedly, many hardships come with bringing up big families especially in terms of providing them with the basics of life. These hardships weigh heavy on parents especially women and cause them depression (Choi et. al., 2012). Many women form these cultures conform to these cultural beliefs and deviation from them is considered taboo. Poverty and low income deny these women the affordability for healthcare and when they have access, it is to poor healthcare services or from lay people. Prenatal and postnatal care provides women with important information on how to take care of themselves and their babies during pregnancy and beyond. Doctors advise them on the things to avoid and the things that would not risk their pregnancy. This is the valuable advice that women from minority and low-come cultures miss thus predisposing them to all risks. Complications during childbirth and the risk for miscarriage are the risks that these women have to live through. These are factors to distress that can cause these women to develop postnatal depression (Choi et. al., 2012). Women from minority and low income cultures lack information about how to monitor themselves for postnatal depression. There are women who develop and heal from postnatal depression without knowing. Even if they knew suspected that they were suffering from postnatal depression, there are studies that have found that there are cultural beliefs that hinder women from minority groups from seeking health care for such conditions. This can lead to a history of depression that is one of the predisposing factors of postnatal depression. The choice and intention for pregnancy influences the psychological wellbeing of women (Choi et. al., 2012). Minority and low-income women lack a significant say in the decision to get pregnant. This affects their appreciation for pregnancy and babies born out of such pregnancies. This lack of appreciation causes mothers to feel guilty and can easily develop depression. Studies have suggested a relationship between a baby’s wellbeing after birth and the mother’s mental health. Babies born with deformities or exhibit certain defects cause minority and low income women agony. Some of them blame these deformities on themselves whereas others blame them on God and the supernatural. A common occurrence recorded among low income and minority women is low-weight births (URMC, 2010). This results from poor nutrition observed by mothers during pregnancy. The agony that these conditions and deformities cause on these women can drive them into depression because of the feeling of guilt and helplessness (Choi et. al., 2012). Although prenatal care is free in most public hospitals and health clinics, minority and low income women lack the knowledge of the importance of this care. There is, therefore, a need to have measures that can help minority and low-income women access healthcare. How community health nurses can help minority and low income-women access healthcare Community health nurses can play a critical role in helping minority and low-income women access health care. Community-based organizations can serve as good channels for community health nurses to get to local communities. Community-based organizations bring local people together to address specific issues affecting members of the community (Choi et. al., 2012). If community health workers can have contact with community members, they would get a platform to sensitize women on the need for prenatal and postnatal care. Sensitization and awareness rising can be the key to getting minority and low income women to seek and emphasize the importance of healthcare to both them and their babies. This is because many of them are not persuaded of the implications that the lack of prenatal care can have on them. Besides collaborating with community-based organizations, community health nurses can put up non-profit community agencies in minority and low-income communities. These agencies operate largely with referrals so that the women who visit the agencies refer and recommend the agencies to others (Guo et. al., 2012). Women feel secure and free with these agencies because they are not as formal as hospitals and health clinics. Also, heath workers at these agencies bond and cultivate rapport and friendly relations with their patients making them feel secure and persuaded to keep coming back for health care. In fact, patients also get to make acquaintance with fellow patients and can eventually accompany each other to the agency. This way, the agency fosters bonding that can help these women draw hope, strength, and support from one another. Community health nurses need to bridge the gap between community members and health providers. Visiting minority and low income women in their homes can serve as a good way of bridging this gap. Home visits are an efficient mechanism because they save the women from having to go to hospital especially when they are ailing. Homes are good place to get health care services and advice, as they are the patients’ natural environments. As such, they provide a chance for the community health nurses to meet and attend to both the women and their husbands. Most men, especially from minority and low income communities do not accompany their partners to the hospital or health centers (Choi et. al., 2012). This denies healthcare the chance to benefit from the contribution that would come from men informed of how to take care of their pregnant partners. Focused groups are an important way of reaching out to low income and minority women. Community health nurses can organize women in groups and appoint leaders to help guide them through important discussions about their health and that of their babies. Focus groups are a good avenue to break through the barriers that prevent low income and minority women not to seek health care (Choi et. al., 2012). Such barriers could be cultural practices and taboos that women would be free to share and address when in their community. Community health nurses will need to be careful not to overstep the allowances of community members. Overstepping such can elicit mistrust and hostility thus causing community members not to seek health care or even harm the community health nurses. Conclusion In conclusion, there is evidence that suggests that Edinburgh Postnatal Depression Scale is an effective tool. This is in light of the many research studies that have tested it against many parameters. These studies have found that the tool only needs a little modification to work for certain cases. Overall, though, the tool works and is in fact widely used to test for postpartum depression in mature women. Some of the studies have confirmed that the tool can work for adolescent mothers and in combinations with some assessment programs. Poverty, lack of information, beliefs, and taboos are some of the things that account for the high scores for postnatal depression among minority and low income women. Communities can use different ways to help such women access healthcare. Such ways include collaborating with community based organizations, sensitization, non-profit community agencies and focus groups. References Anderson, Cheryl. (2010). Using the Edinburgh Postnatal Depression Scale to Screen for Symptoms of Depression among Latina, African American and Caucasian Adolescents. Southern Online Journal of Nursing Research. 10(1). 1 – 20. Choi, S. K., Kim J.J., Park, Y.G., Ko, H.S., Park, I.Y., & Shin, J. C. (2012). The Simplified Edinburgh Postnatal Depression Scale (EPDS) for Antenatal Depression: Is It a Valid Measure for Pre-Screening? Int J Med Sci; 9(1): 40-46. Guo Wei, Frankie D. Powell, Veronica K. Freeman and Leonard D. Holmes (2012). Perinatal Depression in Minority and Underserved Rural Women, Perinatal Depression, Dr. María Graciela Rojas Castillo (Ed.), ISBN: 978-953-307-826-7. InTech. Retrieved from: http://www.intechopen.com/books/perinatal-depression/perinatal-depression-in-minority-and-underserved-rural-women Leung, Shirley S.L., Leung, Cynthia, Lam, T.H., Hung, S.F., Chan, Ruth, Yeung, Timothy, Miao, May, Cheng, Sammy, Leung, S.H., Lau, Aster, & Lee, Dominic T.S. (2011). Outcome of a postnatal depression screening programme using the Edinburgh Postnatal Depression Scale: a randomized controlled trial. Journal of Public Health. 33 (2): 292-301. University of Rochester Medical Center. (2010). Low-income urban mothers have high rate of postpartum depression. ScienceDaily. Retrieved from: www.sciencedaily.com/releases/2010/02/100218125524.htm Read More