Perinatal Depression

Capstone Project: Perinatal Depression
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Due Date Table of Contents Background. 2 Clinical Problem Statement 4 Purpose of the Change Proposal Concerning Providing Patient Care in the Changing Health Care System   5 PICOT Question. 6 Literature Search Strategy. 6 Evaluation of Literature. 7 Factors Leading to PD.. 7 Pharmacological and Non-Pharmacological Interventions. 8 A Comparison of Research Questions. 8 A Comparison of Sample Populations. 9 A Comparison of the Limitations of Study. 9 Perceived Hurdles to Treatment of Perinatal Depression. 10 Conclusion and Recommendations. 10 Applied Nursing Theory. 11 Proposed Implementation Plan with Outcome Measures. 11 Use of Evidence-Based Practice in the Creation of an Intervention Plan. 12 Evaluating Proposed Nursing Intervention. 12 Potential Barriers to Plan Implementation. 12 References. 14 Appendix. 16 Appendix A: Evaluation Tool 16
Capstone Project: Perinatal Depression
Background
Perinatal depression (PD) has attracted widespread research in the last decade due to its life-limiting ramifications among women. Hutchens and Kearney (2020) describe it as a disruption of motherhood because it deprives these individuals of the joy associated with pregnancy and caring for infants. O’Connor et al. (2019) define this condition as the emergence of minor or major depressive incidents among pregnant women or within the first year after giving birth. Wang et al. (2021) also consider this disease a concerning occurrence because of its impacts on the mother, the infant, and immediate family members. This recognition underscores the importance of investigating PD to determine the appropriate intervention approaches.
The burden of PD is far-reaching. One of the worrying aspects is that its frequency of occurrence appears significantly higher, as demonstrated by diverse statistics in various studies. For instance, many studies reveal that the prevalence rates are as high as 11% to 20% (Hardman et al., 2022; Wang et al., 2021). The estimates presented by O’Connor et al. (2019) report that the United States reported up to 180,000 women suffering from this condition annually in 2012. Falek et al. (2022) further reveal that out of every ten women, at least one grapples with PD symptoms. The authors expound this estimation by presenting findings from studies that confirmed satisfaction of depression criteria by up to 7.4%, 12.8%, 12.0%, and 10-15% among women in their first, second, third, and postpartum periods, respectively (Falek et al., 2022). Rollи et al. (2020) report that variations occur across different contexts, with some statistics for high-income societies indicating a prevalence ranging from 5% to 25%. The primary concern is that prenatal depression stabilizes in up to 50% of women, demanding thorough assessment and treatment of the illness to avert its associated consequences.
Women suffering from PD present with diverse signs and symptoms. According to O’Connor et al. (2019), the condition manifests as mood swings, sleep disorders, appetite disruption, and elevated fears that trigger increased concern for the baby. The mother may display uncontrolled sadness, self-doubt, disinterest in routine activities, and crying. O’Connor et al. (2019) support this observation by adding that the victim may depict feelings of hopelessness and withdrawal. Other classic symptoms include challenges bonding with their child and, sometimes, self-harm thoughts. Healthcare providers often focus on the risk factors for PD to identify women that require increased attention during this period. For instance, Hardman et al. (2022) indicate that persons with a family or personal history of psychological complications, insufficient sleep, and concerning experiences in their childhood, including violence, have an increased probability of developing classic symptoms. O’Connor et al. (2019) further highlight that intimate partner abuse, sexual violence, and pregnancy-related complications are other primary risk factors. As a result, recognizing these experiences is critical for identifying women with increased vulnerability.
Identifying PD within healthcare facilities is fundamental for timely and proper treatment. This understanding explains the increased interest in the condition and the emergence of the need to routinely assess the mothers in various phases of their pregnancy journey for effective intervention. For instance, Falek et al. (2022) confirm the existence of recommendations by renowned bodies like the American Academy of Pediatrics to conduct this exercise during the first, second, fourth, and sixth months after the delivery. This schedule aligns with the well-child visits making it an integrated approach that considers the health of the mother and the child concurrently. Hardman et al. (2022) agree that embracing this approach eradicates diverse challenges associated with PD that make it a persistent problem, including shame and criticism. Thus, these complications demonstrate the importance of exploring PD and determining appropriate intervention approaches.
Clinical Problem Statement
PD is an important and devastating condition that affects women throughout pregnancy and after childbirth. According to Falek et al. (2022), the problem is life-limiting, and its impacts go as far as disrupting the child’s growth and the stability of the immediate family members. The authors indicate that the condition remains one of the leading causes of premature mortality and disability among adults. Hardman et al. (2022) acknowledge this effect by underscoring the destructive nature of PD on the infant’s health and the mother’s. Evidence proves that infants from depression-experiencing women are more vulnerable to poor cognitive performance, low birth weight, anger issues, and behavioral challenges (Falek et al., 2022). Such aspects arise from the disease’s impact on parenting quality due to diminished warmth, involvement, and likely maltreatment. These consequences confirm that PD is a concerning clinical problem that requires urgent attention in contemporary times.
Addressing PD faces many challenges, including perception, treatment options, and availability of knowledge. For instance, Hardman et al. (2022) report that many women fail to seek appropriate health intervention due to criticism and shaming of their experience’s deviation from societal expectations. The authors also note that low literacy about mental health may complicate the ability of these individuals to recognize depression and make appropriate decisions for seeking health assistance. Other issues include the healthcare providers’ lack of awareness about psychological resources and confidence in addressing the disease. As a result, this issue has led to diagnoses of a paltry 26% of all pregnant women satisfying the depression criteria by their obstetrics (Falek et al., 2022). Such a gap leaves many women grappling with this mental health issue without appropriate intervention.
Although many treatment approaches exist for treating PD, trends indicate that pregnant women display varying preferences while choosing appropriate options. For instance, Johansen et al. (2019) suggest that women prefer non-pharmacological interventions despite the pharmacological approach being the first-line treatment option. This hesitance arises from their increased concern about the likely effect of medications on the unborn fetus. In this context, Park et al. (2021) recommend that healthcare experts involve the patients in weighing the drawbacks and benefits of a treatment method before its application. Such awareness has increased the preference for non-pharmacological approaches, including psychotherapy and other interpersonal therapies (Curry et al., 2019). McCloskey and Reno (2019) also recognize the increasing importance of these approaches due to their perceived safety, even when breastfeeding. Thus, healthcare providers should identify preferred and acceptable treatment strategies for PD for desirable outcomes among this population.
Purpose of the Change Proposal Concerning Providing Patient Care in the Changing Health Care System
This change proposal demonstrates the increasing preference for non-pharmacological interventions such as psychotherapy for treating PD among women. Johansen et al. (2019) illustrate that non-drug intervention has gained significant attention due to the safety perception compared to the prescription of drugs. Even Park et al. (2021) highlight the need for integrative management to involve pregnant women and mothers while addressing depression issues. Although McCloskey and Reno (2019) note that antidepressants remain widely used by healthcare professionals in treating this condition, the authors acknowledge the shifting landscape underlining the preference for non-pharmacological interventions. Such an aspect demonstrates the changing healthcare system in managing this disease. As a result, exploring the emerging options in patient care is critical to determine their effectiveness through this change proposal.
PICOT Question
The PICOT question for this change proposal focuses on PD. O’Connor et al. (2019) consider this condition as the emergence of depressive symptoms during pregnancy and the first year after childbirth. Falek et al. (2022) clarify that this period is delicate and may trigger adverse outcomes for the infant, the mother, and the supporting family. The authors highlight diverse consequences of depression in this timeline, including developmental delays, psychological health complications, and other associated challenges for the mother and the family. As a result, accurate diagnosis, treatment, and effective management of the condition during the perinatal period are vital for promoting maternal and child health. This understanding led to the need to determine the appropriate strategies for addressing the problem in healthcare settings through a PICOT question. It states, among expectant mothers(population), how effective are non-pharmacological interventions(intervention) compared to pharmacological interventions (comparison) in managing depression(outcome) during the perinatal period (Time)?
Literature Search Strategy
Identifying research materials for this change proposal project required adherence to specific rules to ensure they were appropriate for the study. For instance, the process started by formulating keywords and search phrases such as “perinatal depression,” “treatment of perinatal depression,” “perinatal depression intervention,” and perinatal depression screening,” informed by the PICOT question. The second step was identifying different databases and sites for researching the materials and including inclusion and exclusion criteria to limit the results to the required resources. For instance, the researchers excluded all materials older than five years to ensure the information in the literature evaluation section remains recent. It also focused on peer-reviewed journal materials due to their credibility and accuracy of facts. As a result, this search strategy enabled the retrieval of various journals from google scholar, EBSCO, and PubMed. The next step comprised a review of their title and abstract to ensure they relate to the PICOT question before thoroughly analyzing the findings they provide.
Evaluation of Literature
PD is a critical mental health condition that affects women during and after childbirth. The disease negatively influences maternal and baby health and well-being, including delayed cognitive, emotional, and social development in children (Falek et al., 2022). The researchers indicate that despite rising awareness, prenatal depression continues to remain underdiagnosed and undertreated. This review analyzes and contrasts the study goals, sample populations, and limitations of eight PD studies.
Factors Leading to PD
The reviewed studies reveal that diverse factors interact to...