Validation of Edinburgh post natal depression scale in post-natal woman from a tertiary referral center in South India

Background: Pregnancy and childbirth are two most important life-changing events. Post-partum depression can affect mother and has a wide spectrum of presentation depending upon various social factors. Studies suggest that the incidence of postnatal depression among women of high social strata is 13-19% while the incidence is 11-42% among women with limited social support. The present study aims to study postnatal depression and its causes in a postnatal mother in all the aspects of social, physical, cultural and psychiatric grounds in the Indian scenario with the help of the Edinburgh postnatal depression scale (EPDS).Methods: From 1st July 2019 to 31st December 2019, a total 300 postnatal women between 1 to 6 weeks of the postpartum period participated and during their stay in the hospital responded to EPDS. The study was purposive sampling, and full consent of the study subjects was taken before the start of the study.Results: In this study, we found 20.1% of a woman affected by post-partum in South India. The higher percentage of severe depression was seen in the primary gravida (20%). The risk factors such as availability of postnatal care (with NICU admission), the woman with medical complications, late childbirth or delayed childbirth after marriage, multiparity, delivery via caesarean and nuclear family showed significant relationship (p<0.005) with depression.Conclusions: The present study, with a Post-natal depression of 20.1% along with the enumerated risk factors, suggest that the causes for postpartum depression (PPD) among working Indian woman, reflect a change to an urban-centric lifestyle. Further evaluation of these risk factors needs to be made and a routine screening of Postpartum depression (PPD) can help in improving maternal and child health.

Effect of Muscle Energy Technique on Pain Perception and Functional Disability of Women with Postnatal Low Back Pain.

Aims: To determine the effect of muscle energy technique (MET) on postnatal low back pain. Place and Duration of Study: Department of obstetrics and gynecology, Ain Shams University Hospital, and Outpatient Clinic of Faculty of Physical Therapy, Cairo University, between January and May 2013. Methodology: This study was carried out upon forty women diagnosed as postnatal low back pain. They were selected from outpatient clinics of gynecology of Ain Shams University Hospital, Cairo University. Their age ranged from 25-35 years, BMI<30kg/ m², they were all after normal vaginal delivery using local anaesthesia. Patients with radicular pain distal to the knee, previous low back surgery, low back pathology diagnosed by a physician, spondylolisthesis and chronic low back pain were excluded from the study. They were randomly assigned into two equal groups (A& B). Group (A) consisted of twenty subjects, with an average age 29.2±1.9Yrs, and BMI 27.28±2.1kg/m2 who received MET. Group (B) consisted of twenty patients, with an average age 28.58±2.2Yrs, and BMI 28.92±0.7kg/m2 who received sham technique. A hot pack was used for 15 minutes for both groups (A&B) before the treatment. This is to decrease pain, muscle spasm, and provide vasodilatation of the blood vessels supplying the area. The MET was applied three times per week for four weeks for patients in group A, and the sham technique was applied three times per week for four weeks for subjects of group (B). Assessment of all subjects in both groups (A&B) was carried out before and after the treatment program using Visual Analogue Scale (VAS) and Stratford Back Pain Functional Scale (BPFS). Results: There was a statistically highly significant decrease (P<0.001) in VAS scores and a statistically highly significant increase (P<0.001) in BPFS, after 4 weeks of the treatment program for group A than group B. Conclusion: Muscle energy technique is an effective and safe method in alleviating postnatal low back pain.

A clínica da depressão pós-parto / The clinic of the postpartum depression

O objetivo deste artigo é a discussão clínica da depressão pós-parto, baseada em uma revisão teórica na literatura atual e clássica sobre o tema. A compreensão dos principais fenômenos do puerpério possibilita o diagnóstico da sua expressão patológica em forma de depressão pós-parto. Esse estado emocional regredido, com revivência da história pré-consciente e inconsciente da mulher, bem como a necessária reorganização interna e externa quando do nascimento do bebê propiciam abertura para o tratamento psicoterápico. A postura indicada do terapeuta é de acolhimento do sofrimento materno, facilitação da expressão de sentimentos e ansiedades e o reconhecimento da maternidade como um fenômeno psíquico. Desta forma, além do bem estar da mãe, fica assegurado o nascimento psíquico da criança e o equilíbrio familiar.

The objective of this article is the clinical discussion about postpartum depression starting from a theorical review based on modern and classical works on the theme. The comprehension of main postpartum emotional phenomena leads to the diagnosis of its pathological expression: postpartum depression. This regressed emotional state with the reliving of woman’s pre conscious and unconscious history and the necessary internal and external organization, when the baby is born, provides an opening for psychological monitoring. The psychotherapist’s most appropriate position is as the holder of the maternal suffering, facilitating the expression of feelings and anxiety and recognizing maternity as a psychological phenomenon. This manner, besides ensuring the mother’s well-being, psycotherapy protectsthe child’s psychological birth and maintains the family balance.

Support group: interpersonal relationships among puerpera with hospitalized newborn children / Grupo de apoio: relações interpessoais entre puérperas com filhos recém-nascidos hospitalizados / Grupo de apoyo: relaciones interpersonales entre puérperas con hijos recién nacidos hospitalizados

OBJECTIVE: To check interpersonal relationships among puerpera with hospitalized newborn children, experienced in the support group. METHODS: Action research carried out at "Cara da Mamãe" (Mommy's Home), annexed to a philanthropic hospital in Sobral, Ceará State, in April 2005. The support group was formed by using, in the group approach, the theoretical construct proposed by Loomis. A preparatory and six group sessions were performed. Nine mothers participated in the study. RESULTS: Both isolation and sadness of the new puerpera hinder other mothers approximation, influencing on the experience adaptation process. These mothers coping time is linked to the number of relationships established by them. The roles developed and the power of influence may be related to factors such as: educational background, age group and skills in providing support. CONCLUSION: The group approach may be used by nurses during intervention with mothers who accompany their hospitalized children. It may stimulate integration and support, favoring adaptation.

OBJETIVO: Verificar as relações interpessoais entre puérperas com filhos recém-nascidos hospitalizados vivenciadas no grupo de apoio/suporte. MÉTODOS: Pesquisa-ação realizada na "Casa da Mamãe", anexo de um hospital filantrópico de Sobral-CE, em abril de 2005. Formamos um grupo de apoio/suporte, utilizando como referencial teórico, na abordagem grupal, a proposta referida por Loomis. Realizamos uma sessão preparatória e seis sessões grupais. Participaram do estudo nove mães. RESULTADOS: O isolamento e a tristeza da puérpera recém-chegada dificulta a aproximação das outras mães, influenciando no processo de adaptação à experiência. O tempo de convivência dessas mães está ligado à qualidade das relações estabelecidas entre elas. Os papéis desenvolvidos e o poder de influência parecem estar relacionados a fatores como: nível de instrução, faixa etária e capacidade de oferecer apoio. CONCLUSÃO: A abordagem grupal pode ser utilizada pelos enfermeiros na intervenção junto a mães que acompanham os filhos hospitalizados, como forma de estimular a integração entre estas, buscando oferecimento de apoio/suporte e favorecendo a adaptação.

OBJETIVO: Verificar las relaciones interpersonales entre puérperas con hijos recién nacidos hospitalizados vivenciadas en el grupo de apoyo/soporte. MÉTODOS: Se trata de una investigación-acción realizada en la "Casa de la Mamá", anexo de un hospital filantrópico de Sobral-CE, en abril del 2005. Formamos un grupo de apoyo/soporte, utilizando como referencial teórico, en el abordaje grupal, la propuesta referida por Loomis. Realizamos una sesión preparatoria y seis sesiones grupales. Participaron en el estudio nueve madres. RESULTADOS: El aislamiento y la tristeza de la puérpera recién llegada dificulta la aproximación de las madres, influenciando en el proceso de adaptación a la experiencia. El tiempo de convivencia de esas madres está ligado a la calidad de las relaciones establecidas entre ellas. Los papeles desarrollados y el poder de influencia parecen estar relacionados a factores como: nivel de instrucción, grupo etáreo y capacidad de ofrecer apoyo. CONCLUSIÓN: El abordaje grupal puede ser utilizado por los enfermeros en la intervención con madres que acompañan a sus hijos hospitalizados, como forma de estimular la integración entre ellas, buscando ofrecimiento de apoyo/soporte y favoreciendo la adaptación.