Tezel Ayfer, Gözüm Sebahat
Atatürk University Erzurum Health School, Nursing Department, Erzurum, Turkey.
Patient Educ Couns. 2006 Oct;63(1-2):64-73. doi: 10.1016/j.pec.2005.08.011. Epub 2006 Jan 31.
The aim of this study was to compare the effect of nursing intervention to the effect of problem solving training on the level of postpartum depressive symptom.
We utilized a pretest-posttest mutual controlled semi experimental model for this study. The study consisted of 62 women (30 in care group and 32 in training group), all of who were at risk for postpartum depression, but without major depressive symptoms. These women were not undergoing pharmacologic or psychotherapeutic treatment, were all literate and consented to join the study in Erzurum, Turkey. Participants (N=62), recruited over a 9 month, were randomly assigned to one of two groups. Women in care group (average age=21, 33.3% primaparus) were given nursing care for her depressive symptoms. Women in training group (average age=25, 33.9% primaparus) were taught problem solving skills.
Depressive symptoms were assessed before and after nursing interventions. We found that nursing care was effective women for with depressive symptoms (McNemar test, p<0.001), and problem-solving training was also effective (McNemar test, p<0.05). When the effectiveness of nursing care and the problem solving education was compared utilizing the BDI, it was found out that the nursing care was more effective than education alone (t=4.529, p<0.05).
Results from this study suggest that nursing care and problem solving training may be use confidently in the primary care setting by nurses for women with postpartum depressive symptoms.
Nurses play on important role in its detection and can reduce depressive symptoms. Public health nurses are equipped with care paths addressing specific health needs of depressed women in the primary care setting. Our finding indicate that these two programs of study can converge with meaningful results, and perhaps future research could address these points in a theoretical framework.
本研究旨在比较护理干预与问题解决训练对产后抑郁症状水平的影响。
本研究采用前后测相互对照的半实验模型。该研究纳入了62名女性（护理组30名，训练组32名），她们均有产后抑郁风险，但无重度抑郁症状。这些女性未接受药物或心理治疗，均识字且同意在土耳其埃尔祖鲁姆参与本研究。在9个月内招募的62名参与者被随机分配到两个组之一。护理组女性（平均年龄=21岁，初产妇占33.3%）针对其抑郁症状接受护理。训练组女性（平均年龄=25岁，初产妇占33.9%）学习问题解决技巧。
在护理干预前后对抑郁症状进行评估。我们发现护理对有抑郁症状的女性有效（McNemar检验，p<0.001），问题解决训练也有效（McNemar检验，p<0.05）。当使用贝克抑郁量表比较护理和问题解决教育的效果时，发现护理比单纯教育更有效（t=4.529，p<0.05）。
本研究结果表明，护士可在初级保健环境中放心地对有产后抑郁症状的女性使用护理和问题解决训练。
护士在产后抑郁的检测中发挥着重要作用，且能减轻抑郁症状。公共卫生护士具备针对初级保健环境中抑郁女性特定健康需求的护理路径。我们的研究结果表明，这两个研究项目能产生有意义的结果，或许未来的研究可以在理论框架中探讨这些问题。
