Knowledge And Perception About Post-Partum Psychosis Among Nurse-Midwives

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Abstract

Despite growing awareness of the impact of maternal depression on the health and well‐ being of children, mothers, and health care, providers continue to ignore mental disorders in the perinatal period. Since nurses and midwives are in constant contact with women during pregnancy and during the first year after birth, they need to be able to recognize mental disorders and educate pregnant women and parents about postpartum depression. The aim of this study was to study the knowledge of nurses about postpartum depression in order to develop quality postpartum care among nurses and midwives in Nigeria. A quantitative research method was applied. An electronic questionnaire was used to collect data. The participants consisted of 212respondents. The data were analyzed using descriptive statistics. The results of the study showed that in Nigeria, there are gaps in the knowledge of midwives and nurses about the prevalence, assessment, and treatment of depression in the prenatal and postpartum periods, and almost 90% of Nigeriai respondents did not attend additional training courses on postpartum depression. It is necessary to increase the level of education by motivating self‐learning, organizing a new journal club and additional education for current nurse practitioners. To close these gaps in knowledge, a strategy for training midwives and nurses in perinatal mental health and symptom screening needs to be developed. It is also necessary to develop clinical protocols for assessing the mental state of women in the perinatal period. The application of these protocols by practicing midwives in Nigeria will bring medical practice for assessing mental health in the perinatal period closer to international standards, making healthcare better and more cost‐effective.

Chapter One

Introduction
1.1 Background to study

Maternal mental health problems are a serious public health problem worldwide. Currently, researchers estimate that up to 18% of women worldwide experience postpartum depression (PPD).Postpartum depression affects the mother’s daily work, social relationships, and child development. (Hahn‐Holbrook, Cornwell‐ Hinrichs, & Anaya 2018.)
Despite growing awareness of the effects of maternal depression on the health and well‐being of children and mothers, healthcare providers continue to ignore mental disorders in the perinatal period. Since nurse-midwives and midwives constantly communicate with women during pregnancy and the first year after birth, they need to be able to recognize mental disorders and educate pregnant women and parents about postpartum depression. (Carroll, Downes, Gill, Monahan, Nagle, Madden, & Higgins 2018.)
Midwives and nurse-midwives are ideal not only for educating women about mental health but also for screening for mental disorders in the perinatal period. Evidence suggests that there are barriers to identifying mental disorders and addressing women’s mental health problems during the perinatal period. These barriers are related to organizational factors such as high workload, time pressure, and lack of knowledge and skills regarding PPD (Higgins, Downes, Monahan, Gill, Lamb, & Carroll 2018.)
The purpose of this study is to study nurse-midwives and midwives’ knowledge of PPD and the competencies of midwives and nurse-midwives to identify and treat PPD in the Nigeria

1.2 Statement of problem
The potential effects of Puerperal psychosis involve the physical, mental, and social health of the mother, child, and family. The financial healthcare burden of treating the ailment is significant. Research done by Dagher, McGovern, Dowd and Gjerdingen (2012) showed that health care spending is considerably higher in women with psychosis. Puerperal psychosis can contribute to poor mother-child bonding, difficulty with breastfeeding, and child abuse or neglect. One of the most concerning consequences of Puerperal psychosis is the risk of suicide and infanticide. As described in the DSM-IV (American Psychiatric Association, 2013). Symptoms that are common in Puerperal psychosis -onset episodes include fluctuation in mood, mood liability, and preoccupation with infant well-being, the intensity of which may range from over concern to frank delusions. The presence of severe ruminations or delusional thoughts about the infant is associated with a significantly increased risk of harm to the infant. In a study conducted by Lucic (2013) cited O’Hara, Zekoski, Philipps & Wright (1990) found that the prevalence of nonpsychotic mental disorders does not increase in the postpartum period as compared to the general population. In that study, the incidence of Puerperal psychosis was found to be 10.4%, which is not significantly higher than the rate of depression experienced by non-childbearing women. O’Hara et al (1990) cited in Lucic (2013) summarize studies that have investigated the prevalence of depression across the general population and it ranges from 8% to 23%. Therefore this study evaluated perceived causes of Puerperal psychosis among Post Cesarean section patients in general hospital, Wushishi, Niger State. Nigeria.

Purpose of research
The purpose of the research is to examine the knowledge of nurse-midwives and midwives about postpartum depression to develop quality postpartum care among nurse-midwives and midwifes in Nigeria
Aims and objectives:

  • Examine the knowledge of nurse-midwives and midwives about the prevalence, assessment, and treatment of postpartum depression.
  • Develop recommendations for the development of quality mental health care in the perinatal period.

Research question:

• What is the level of nursing knowledge about postpartum depression?

End of chapter one