ABSTRACT
Diagnosis of psychiatric conditions is a topic that is currently receiving significant attention in light of the release of the 5th edition of the Diagnostic and Statistical Manual of Mental Disorders in 2013. The process of the revisions is complex and involves political, social, and economic influences, all of which are amplified in an evolving corporate health care system in the United States. Of particular concern in the development of the revised nosology is the representation of gender-specific diagnoses and course specifiers to reflect the distinct manifestations of the psychiatric symptoms of women. Based on a growing body of psychobiological evidence related to gender differences in symptom manifestation, gender specific diagnoses remain palpably absent from the taxonomy. This article explores the issue of invisibility of women-specific diagnosis from the perspective of a women's health advanced practice nurse.
Subject(s)
Diagnostic and Statistical Manual of Mental Disorders , Mental Disorders/diagnosis , Women's Health , Female , Humans , Mental Disorders/classification , Mental Disorders/psychology , Nurse's Role , Reproducibility of Results , Sex FactorsSubject(s)
Depression, Postpartum/diagnosis , Depression, Postpartum/therapy , Maternal-Child Nursing/organization & administration , Nurse's Role , Nursing Assessment/organization & administration , Adaptation, Psychological , Attitude to Health , Depression, Postpartum/epidemiology , Depression, Postpartum/psychology , Female , Health Services Needs and Demand , Humans , Lactation/drug effects , Mass Screening , Models, Nursing , Postnatal Care/methods , Postnatal Care/psychology , Psychiatric Status Rating Scales , Psychotropic Drugs/therapeutic use , Referral and Consultation , Risk FactorsSubject(s)
Depression, Postpartum , Depression, Postpartum/diagnosis , Depression, Postpartum/epidemiology , Depression, Postpartum/therapy , Evidence-Based Medicine , Female , Humans , Mass Screening , Maternal-Child Nursing , Models, Nursing , Nurse's Role , Nursing Assessment , Obstetric Nursing , Patient Care Planning , Practice Guidelines as Topic , Prevalence , Psychiatric Status Rating Scales , Referral and Consultation , Risk FactorsABSTRACT
Women's reproductive events may coincide with the onset of a mood or anxiety disorder or the exacerbation of a previously existing one due to the interconnection of neurotransmitters, stress, and reproductive hormones. The women's health nurse plays a critical role in the identification of mood and anxiety disorders during a woman's life span. This article provides nurses with a mental health assessment model, describes the common mood and anxiety disorders, and discusses simple management and referral strategies.
Subject(s)
Anxiety Disorders/diagnosis , Anxiety Disorders/nursing , Mood Disorders/diagnosis , Mood Disorders/nursing , Nursing Assessment/methods , Women's Health , Adolescent , Adult , Age of Onset , Anxiety Disorders/epidemiology , Anxiety Disorders/physiopathology , Depression/diagnosis , Depression/nursing , Depression/physiopathology , Depression, Postpartum/diagnosis , Diagnosis, Differential , Female , Humans , Incidence , Menstrual Cycle/psychology , Models, Nursing , Mood Disorders/epidemiology , Mood Disorders/physiopathology , Prevalence , Referral and Consultation/organization & administration , United States/epidemiologyABSTRACT
PURPOSE: To describe in greater depth the profiles of the dimensions of the Postpartum Depression Screening Scale (PDSS), with a focus on those women identified with postpartum depression (PPD), and to provide a discussion of the implications for early detection in the community. METHOD AND DESIGN: Subanalysis of data from 150 new mothers who completed the PDSS and had a DSM-IV diagnostic interview conducted by a nurse psychotherapist. Data analysis focused on exploring the profiles of women who were diagnosed with PPD as well as those who were not. RESULTS: The respondents within the major PPD group averaged scores twice as high as those in the nondepressed group, and described more profound emotional responses to their maternal role transitions. CLINICAL IMPLICATIONS: PPD should be conceptualized as occurring in a continuum, with symptoms worsening over time for some women. Nurses working across healthcare settings can use the PDSS for identifying women with PPD. All healthcare providers who are in contact with postpartum women should be open to discussing these women's emotional needs, and should assess women on an ongoing basis. Using all opportunities to listen to women's unique stories that unfold during the postpartum period can help identify women who require treatment for this curable illness.
Subject(s)
Depression, Postpartum/diagnosis , Depression, Postpartum/nursing , Nurse's Role , Nurse-Patient Relations , Nursing Assessment , Psychiatric Status Rating Scales/standards , Female , Humans , Logistic Models , Mothers/psychology , Psychometrics , Risk Factors , Sensitivity and Specificity , Severity of Illness Index , Stress, Psychological/diagnosis , Stress, Psychological/nursingABSTRACT
It is estimated that at least 1 in 10 women will experience postpartum depression, yet systematic screening for it in clinical practice is too often neglected. The foggy unreality of this affective disorder leads women to believe they are losing their minds, and their efforts to find help can be elusive. Women with postpartum depression who go undetected and untreated are at risk for immediate harm and potential lifelong sequelae for themselves and their families, and especially for their children. This article provides 1) an understanding of the woman's experience of postpartum depression, 2) a review of two instruments, developed through a focused program of research to screen for the disorder, 3) triage in clinical practice, and 4) an overview of the three dimensions of treatment: psychopharmacology, psychotherapy, and psychosocial care. Practical guidance and client information are provided to assist midwives and primary care providers to incorporate systematic screening into clinical practice, to identify effective interdisciplinary treatment teams, and to muster family and community resources to help with this commonly hidden childbearing crisis.
Subject(s)
Depression, Postpartum/nursing , Depression, Postpartum/psychology , Midwifery , Mothers/psychology , Postnatal Care/methods , Stress, Psychological/nursing , Child , Female , Humans , Nurse's Role , Nurse-Patient Relations , Nursing Assessment/methods , Practice Guidelines as Topic , Primary Health Care , Risk Factors , Women's HealthABSTRACT
This article describes two models of assessment that nurses can use with women throughout their life span: (1) knowledge attainment (Belenky, Clinchy, Goldberger, & Tarule, 1986) and (2) skill attainment (Dreyfus & Dreyfus, 1996). These models consider each woman's unique reality, acknowledging that how she experiences pregnancy and postpartum is based on how she has lived her life. Her integration of experiences, coping strategies, and life events may be the foundation upon which she will incorporate the new experiences of pregnancy and motherhood. Using these models can help provide the maternal-child nurse with a blueprint for the development of appropriate care plans and teaching plans.
