McCarter-Spaulding Deborah, Shea Stephen
Deborah McCarter-Spaulding is an Assistant Professor, Department of Nursing, Saint Anselm College, and Staff Nurse, The Mom's Place, Catholic Medical Center, Manchester, NH. She can be reached via e-mail at
MCN Am J Matern Child Nurs. 2016 May-Jun;41(3):168-72. doi: 10.1097/NMC.0000000000000236.
To determine effectiveness of an educational intervention in reducing or preventing symptoms of postpartum depression (PPD).
English-speaking women age 18 or older with a singleton, term, healthy newborn were recruited from an 11-bed maternity unit in Southern New Hampshire. Using a quasi-experimental design, the first 120 respondents received usual care (control), and the following 120 respondents received the education (treatment) including PPD predictors, symptoms, prevention, and management. Current risk factors were measured using the Postpartum Depression Predictors Inventory-Revised (PDPI-R). Symptoms of depression were measured using the Edinburgh Postnatal Depression Scale (EPDS) at 6 weeks, 3 months, and 6 months postpartum. Two-proportion z-tests were used to determine whether the education had a significant impact on EPDS scores at each of the three follow-ups.
There was no significant difference in symptoms of depression as measured by the EPDS between the treatment and control group at 6 weeks, 3 months, or 6 months postpartum. However, consistent with previous studies, low socioeconomic status and a history of depression or anxiety prior to or during the pregnancy were significant predictors of PPD.
Postpartum nursing discharge education did not decrease depression symptoms up to 6 months after discharge. More research is needed to determine the most appropriate timing and content of education about PPD. Many women at risk can be identified prior to birth. Education to improve literacy about PPD may need to be provided prenatally and reinforced during postpartum hospitalization and after discharge.
确定一项教育干预措施在减轻或预防产后抑郁症（PPD）症状方面的有效性。
从新罕布什尔州南部一家拥有11张床位的产科病房招募年龄在18岁及以上、单胎、足月、健康新生儿的英语-speaking女性。采用准实验设计，前120名受访者接受常规护理（对照组），随后的120名受访者接受包括PPD预测因素、症状、预防和管理的教育（治疗组）。使用修订后的产后抑郁症预测因素量表（PDPI-R）测量当前的风险因素。在产后6周、3个月和6个月时，使用爱丁堡产后抑郁量表（EPDS）测量抑郁症状。采用双比例z检验来确定该教育在三次随访中的每一次对EPDS评分是否有显著影响。
在产后6周、3个月或6个月时，治疗组和对照组通过EPDS测量的抑郁症状没有显著差异。然而，与先前的研究一致，社会经济地位低以及怀孕前或怀孕期间有抑郁或焦虑史是PPD的显著预测因素。
产后护理出院教育在出院后6个月内并未降低抑郁症状。需要更多的研究来确定关于PPD教育最合适的时间和内容。许多有风险的女性在分娩前就可以被识别出来。可能需要在产前提供提高对PPD认知的教育，并在产后住院期间和出院后加强。
