Clinical Psychology Unit, Department of Psychology, University of Sheffield, Sheffield.
Br J Gen Pract. 2010 Nov;60(580):e440-8. doi: 10.3399/bjgp10X532611.
Postnatal depression is a public health problem requiring intervention. To provide effective care, information is needed on the experiences of those with high levels of depressive symptoms who are offered and accept, or decline, psychological intervention postnatally.
To provide the first integrated in-depth exploration of postnatal women's experiences of the identification and management of symptoms of depression and the offer and acceptance of postnatal care by health visitors taking part in the PoNDER trial.
General practice: primary care within the former Trent regional health authority, England.
Thirty women with 6-week Edinburgh Postnatal Depression Scale (EPDS) scores ≥ 18 and probable depression completed semi-structured interviews. All women had taken part in the Post-Natal Depression Economic Evaluation and Randomised controlled (PoNDER) trial where intervention group health visitors received training in identification of depressive symptoms and provided psychologically informed sessions based on cognitive-behavioural therapy or person-centred counselling principles.
When accepted, psychological sessions were experienced as positive, effective, and 'ideal care'. Women approved of using the EPDS but did not understand the health visitor's role in supporting women. Seeking help and accepting sessions depended on women's perspectives of their health visitor as an individual.
Women's experience of their health visitors providing psychological sessions to help with postnatal depressive symptoms is highly positive. Women will better accept support from health visitors if they recognise their role in postnatal depression and find them easy to relate to on personal matters. There is a case for specific enhancement of interpersonal skills in health visiting, or alternatively offering a choice of health visitors to women.
产后抑郁症是一个需要干预的公共卫生问题。为了提供有效的护理，需要了解那些接受过产后心理干预的、有高水平抑郁症状的人的经历，包括他们接受或拒绝心理干预的原因。
首次全面深入探讨参与 PoNDER 试验的健康访视员在识别和管理产后抑郁症症状以及提供和接受产后护理方面，产后妇女的经历。
一般实践：前特伦特地区卫生当局的初级保健，英格兰。
30 名产后 6 周爱丁堡产后抑郁量表（EPDS）评分≥18 分且可能患有抑郁症的妇女完成了半结构化访谈。所有妇女都参加了产后抑郁症经济评估和随机对照（PoNDER）试验，干预组的健康访视员接受了识别抑郁症状的培训，并根据认知行为疗法或以人为中心的咨询原则提供心理知情的课程。
当被接受时，心理课程被体验为积极、有效和“理想的护理”。妇女赞成使用 EPDS，但不理解健康访视员在支持妇女方面的角色。寻求帮助和接受课程取决于妇女对健康访视员作为个体的看法。
妇女对健康访视员提供心理课程帮助产后抑郁症状的体验非常积极。如果妇女认识到健康访视员在产后抑郁症中的角色，并在个人事务上与他们容易产生共鸣，那么她们更有可能接受健康访视员的支持。有理由在健康访视中专门提高人际交往技能，或者为妇女提供选择健康访视员的机会。
