Hayes Barbara A
School of Nursing, Midwifery and Nutrition, James Cook University, Townsville, QLD, Australia.
Contemp Nurse. 2010 Apr-May;35(1):58-67. doi: 10.5172/conu.2010.35.1.058.
Perinatal anxiety and depression constitute one of the long term major public health issues in Australia and for too long they has been bundled under the over-arching term of 'postnatal depression'. However, the generation, funding, and implementation of the National Perinatal Depression Plan (NPDP) (Australian Government Department of Health and Ageing, 2008), across all Australian States and Territories, are proving to be wide-reaching and influential. Not only does the NDPD move from the umbrella term of 'postnatal depression' to establish the reality of perinatal anxiety and depression which women can experience from conception to the first year of the infant's life but also all States and Territories have made Individual Investment Plans for the implementation of the NPDP.
In these Investment Plans, each State and Territory will address the following three major goals of the NPDP differently and mainly within a primary health care setting: (1) Psychosocial assessment in addition to screening of women antenatally and postnatally; (2) Education of health professionals about the complexity of perinatal depression and the need for early assessment and intervention; (3) Development of quality pathways of care for follow-up support and care of women who are depressed and who are assessed as being at the risk for depression.
General nurses, maternal child health nurses, midwives, and mental health nurses are spread throughout primary health care settings. Three essential aspects of the NPDP are pertinent to their practice: (1) the Edinburgh Postnatal Depression Scale (EPDS); the 2008 beyondblue National Action Plan for Perinatal Mental Health (NAP); and the Draft beyondblue Clinical Practice Guidelines for depression and related disorders - anxiety, bipolar disorder, and puerperal psychosis - in the perinatal period (March 2010). The author addresses these three aspects of the NPDP by citing two personal accounts by women who have experienced perinatal anxiety and depression; these accounts are available in the public domain.
围产期焦虑和抑郁是澳大利亚长期存在的主要公共卫生问题之一，长期以来它们一直被归入“产后抑郁”这一笼统的术语之下。然而，事实证明，《国家围产期抑郁计划》（NPDP）（澳大利亚卫生与老龄部，2008年）在澳大利亚所有州和领地的制定、资金投入及实施都具有广泛影响。NPDP不仅摆脱了“产后抑郁”这一笼统术语，确认了女性在从怀孕到婴儿出生后第一年期间可能经历的围产期焦虑和抑郁的实际情况，而且所有州和领地都制定了实施NPDP的个人投资计划。
在这些投资计划中，每个州和领地将以不同方式且主要在初级卫生保健环境中实现NPDP的以下三个主要目标：（1）在产前和产后对妇女进行筛查的同时进行社会心理评估；（2）对卫生专业人员进行围产期抑郁复杂性以及早期评估和干预必要性的教育；（3）为抑郁及被评估有抑郁风险的妇女制定后续支持和护理的优质护理途径。
普通护士、母婴保健护士、助产士和心理健康护士分布在整个初级卫生保健环境中。NPDP的三个重要方面与她们的工作相关：（1）爱丁堡产后抑郁量表（EPDS）；2008年beyondblue围产期心理健康国家行动计划（NAP）；以及2010年3月beyondblue围产期抑郁及相关疾病——焦虑、双相情感障碍和产褥期精神病——临床实践指南草案。作者通过引用两位经历过围产期焦虑和抑郁的女性的个人经历来阐述NPDP的这三个方面；这些经历可在公共领域获取。
