Content area
Full text
Introduction
The Edinburgh postnatal depression scale, (EPDS) is a screening tool used to help professionals detect postnatal depression (PNO). The EPDS has been found to be a reliable and valid measure for detecting PND and major depression and validated in other countries.
Early detection and treatment of PND improves outcomes for women and decreases the duration of the illness. Professionals caring for women in the postnatal period play a vital role in early detection and improved outcomes for women with PND.
Nurses at the Kingston Maternal and Child Health Service (MCH) in South Melbourne, Victoria, conducted a Quality Improvement (Ql) project examining the usefulness of EPOS as a screening tool. Johns' says reflective practice is a 'developmental process to empower practitioners to achieve and sustain effective practice.' Reviewing the literature and providing an overview of PND, and the EPDS scale in particular, was seen as vital to the process. This enabled Kingston MCH nurses to reflect on current research and implement evidence-based practice.
Overview of PND
Postnatal depression (PND) is estimated to occur in 10%-20% of women, during the first year after birth.2 Research and clinical experience has not found a definitive cause of PND. It is thought to be multi-factorial in nature, with biological, socioculturel, environmental and personal history factors influencing the symptoms and severity of the disorder.
It is estimated that 50% of PND occurs during the first three months and 75% within six months.3 Postpartum disorders are not new phenomena, and were reported by Hippocrates. They also appear to be universal."
The symptoms fit within the Diagnostic and Statistical Manual IV (DSM IV) criteria for major depression but there are unique features specific to women in the postnatal period.5 6
Implications
A woman who is suffering from PND may feel distressed and not her usual self. This often impacts on her relationship with her baby.7, 8 Interpersonal relationships also suffer, particularly with partners,9 resulting in an increase in family discord and the risk of marital breakdown. Researchers have found that children whose mothers had PND exhibited behavioural, intellectual and emotional developmental problems.10
Diagnosis
Early detection and treatment of PND improves outcomes, decreasing the duration of the illness." In the antenatal period, MCH nurses can assess and identify women at risk of developing...