Faculty of Medicine, Department of Health Sciences, Lund University, Sweden.
Faculty of Medicine, Department of Clinical Sciences, Lund University, Sweden.
PLoS One. 2022 Jul 14;17(7):e0271318. doi: 10.1371/journal.pone.0271318. eCollection 2022.
Postpartum depression is considered a major public health problem, which immigrant mothers are at particular risk of being affected by, but it can also have long-lasting traumatic effects on the child's health and development. The Edinburgh Postnatal Depression Scale is the world's most commonly employed screening instrument for postpartum depression, used in connection with a clinical interview to screen for symptoms of postpartum depression. The aim of this study was to synthesize health care professionals (HCPs) experiences of identifying signs of postpartum depression and performing screening on immigrant mothers, since previous research suggested that this task might be challenging.
The databases CINAHL, PubMed, PsycINFO, SocINDEX, Embase and Cochrane were searched for papers published January 2000-December 2020, reporting qualitative data on immigrants, postpartum depression and the Edinburgh Postnatal Depression Scale. Eight papers representing eight studies from four countries were included and the Critical Appraisal Skills Program was used to assess their quality. The synthesis of studies was guided by Noblit & Hare's seven-step method based on meta-ethnography.
The synthesis resulted in two final themes: "I do my best, but I doubt that it's enough" and "I can find no way forward". The themes convey the fear and frustration that health care professionals experienced; fear of missing mothers with signs of postpartum depression, related to feeling uncomfortable in the cross-cultural setting and frustration in handling difficulties associated with communication, translated versions of the Edinburgh Postnatal Depression Scale and cultural implications of postpartum depression.
By supporting HCPs' self-efficacy in handling cultural implications of postpartum depression and by developing evidence-based clinical guidelines for the use of interpreters and translated versions of the Edinburgh Postnatal Depression Scale the screening of immigrant mothers may be facilitated.
产后抑郁症被认为是一个重大的公共卫生问题，移民母亲尤其容易受到影响，但它也会对孩子的健康和发育产生长期的创伤影响。爱丁堡产后抑郁量表是世界上最常用的产后抑郁筛查工具，与临床访谈结合使用，以筛查产后抑郁的症状。本研究旨在综合医疗保健专业人员（HCP）识别产后抑郁症迹象和对移民母亲进行筛查的经验，因为之前的研究表明，这项任务可能具有挑战性。
检索了 CINAHL、PubMed、PsycINFO、SocINDEX、Embase 和 Cochrane 数据库，以获取 2000 年 1 月至 2020 年 12 月期间发表的关于移民、产后抑郁症和爱丁堡产后抑郁量表的定性数据论文。共纳入 8 篇论文，代表来自 4 个国家的 8 项研究，使用批判评估技巧方案评估其质量。研究的综合采用了 Noblit 和 Hare 的基于元民族学的七步方法。
综合研究结果得出了两个最终主题：“我尽力了，但我怀疑这还不够”和“我找不到前进的路”。这两个主题传达了医疗保健专业人员的恐惧和沮丧；担心错过有产后抑郁症迹象的母亲，这与跨文化环境中的不适感有关，以及在处理与沟通、爱丁堡产后抑郁量表的翻译版本和产后抑郁症的文化含义相关的困难时感到沮丧。
通过支持 HCP 处理产后抑郁症的文化含义的自我效能，并为使用口译员和爱丁堡产后抑郁量表的翻译版本制定基于证据的临床指南，可能会促进对移民母亲的筛查。
