DePaul University

Via Sapientiae

Grace Peterson Nursing Research Colloquium

Aug 23rd, 9:00 AM

Effective Screening of Postpartum Depression and its Potential to

Increase Treatment: An Integrative Literature Review
Isabella C. Huminsky
DePaul University, isabellahuminsky@gmail.com

Follow this and additional works at: https://via.library.depaul.edu/nursing-colloquium

Part of the Clinical Psychology Commons, and the Nursing Commons

Huminsky, Isabella C., "Effective Screening of Postpartum Depression and its Potential to Increase
Treatment: An Integrative Literature Review" (2019). Grace Peterson Nursing Research Colloquium. 35.
https://via.library.depaul.edu/nursing-colloquium/2019/summer/35

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 Student:  Isabella  Huminsky,  MS  
Research  Advisor:  Dr.  Elizabeth  Hartman,  PhD,  RN  

Postpartum  Depression  Screening,  Is  it  Effec4ve?  

An  Integra4ve  Review  of  Literature  

Background:   Results  &  Discussion:  

Postpartum  depression  (PPD)  is  a  serious  and  concerning  health  
Research  Ques7on:   There  are  a  variety  of  screening  tools  for  postpartum  
problem  because  of  the  poten8al  detrimental  impact  it  can  have  on  a   Are  screenings  for  postpartum  depression  effec4ve  in  that  they   depression,  such  as  the  most  common  tool,  the  
child’s  development,  the  individual  who  experiences  it,  and  their  family   correctly  diagnose  depression  and  guide  further  treatment?   Edinburgh  Postnatal  Depression  Scale  (EDPS),  which  
as  a  whole  (La  Flair,  2008).  Michael  O’Hara  (2009)  advises  that   can  be  used  in  person,  online  or  over  the  telephone.  
postpartum  depression  is  a  type  of  depression  that  occurs  during  the   Other  screening  tools  include  symptom  analysis,  and  
postpartum  period,  typically  thought  of  up  to  a  year  aIer  childbirth   Conceptual Framework
Beck’s  Postpartum  Depression  Predictors  Inventory.  
(2009)  and  should  not  be  confused  with  the  “baby  blues.”  The  baby  
blues  is  defined  as  “mood  symptoms  such  as  irritability,  lability,   In  general,  both  women  and  their  healthcare  
insomnia  and  anxiety  that  occurs  between  one  week  and  ten  days  aIer   providers  are  open  to  increased  postpartum  
childbirth  and  typically  resolves  without  medical  interven8on.”       depression  screening.  First,  however,  certain  barriers  
Researchers  suggest  that  postpartum  depression  is  a  significant  issue   need  to  be  addressed  to  increase  the  amount  of  PPD  
for  both  the  family  affected  and  for  the  world  at  large  (La  Flair,  2008).     screening  done.  Providers  should  be  further  
  educated  on  what  PPD  is/how  to  screen  for  it/  the  
The  infancy  period  is  an  important  8me  for  the  mother-­‐child   seriousness  of  it  to  increase  their  priority  of  
rela8onship  to  form  and  grow,  as  it  is  the  first  rela8onship  the  child  will   screening  their  postpartum  pa8ents.  If  providers  felt  
have  in  their  life.  If  this  rela8onship  is  impaired,  the  plaSorm  for  
more  comfortable  about  postpartum  depression,  
forming  emo8ons  and  aTachments  can  be  impaired  (Wenzel,  2005).  
Young  children  of  those  experiencing  postpartum  depression,  may   they  would  screen  for  it  more,  and  more  women  
develop  an  increased  risk  for  preoccupied  aTachment,  behavioral   would  be  given  the  appropriate  resources  and  
problems,  and  cogni8ve  delays;  while  older  children  are  also  at  risk  for   The  theore8cal  framework  that  can  best  support  this  research  about  individuals  who  experience  postpartum   referrals  necessary.  Women  should  also  be  educated  
depression  is  Beck’s  Postpartum  Depression  Theory.  The  theory  suggests  that  there  is  a  four-­‐stage  process  of  
these  problems,  in  addi8on  to  symptoms  of  psychopathology  (Wenzel,   “teetering  on  the  edge”  into  postpartum  depression.  These  stages  include  1)  encountering  terror  which  includes  
on  the  signs  and  symptoms  and  difference  between  
2005).     terrible  anxiety  aTacks,  obsessive  thinking  and  persistent  fogginess,  2)  dying  of  self  which  includes  isola8on  of  self,   postpartum  blues  and  postpartum  depression  and  
.     thoughts  of  self-­‐harm,  and  disturbing  “unrealness”,  3)  struggling  to  survive  which  includes  praying  for  relief,  
searching  for  consola8on,  and  4)  regaining  control  which  includes  making  changes,  increasing  lost  8me,  and  recovery   that  it  is  completely  normal  to  experience  these  
(McEwen  &  Wills,  2014).  This  model  informs  nurses  of  the  frequency  and  significance  of  postpartum  depression  so   disorders.  All  healthcare  providers  should  aTempt  to  
proper  screening  can  be  done  to  iden8fy  new  mothers  who  may  be  suffering  from  this  disorder  (McEwen  &  Wills,  
2014).  Beck  also  produced  a  list  of  twenty-­‐two  key  proposi8ons  of  the  postpartum  depression  theory  that  consists  of   decrease  the  s8gma  of  PPD  to  help  increase  the  
risk  factors,  predictors,  and  symptoms/consequences.   amount  of  amount  of  women  experiencing  PPD  
actually  following  through  with  treatment.    
Methods:    
The  literature  review  was  conducted  using  searches  of  PubMed,  ProQuest  Nursing  &  Allied  Health  
Source,  and  Cumula8ve  Index  to  Nursing  and  Health  Literature  (CINAHL)  Complete.  Mul8ple  text  
combina8ons  were  used  in  to  search  these  databases  over  the  years  of  2007-­‐2018.  These  terms  
include  postpartum  depression,  nursing,  screening,  and  treatment.    
  Nursing  Prac7ce  Implica7ons:    
Inclusion  criteria:  Sources  reviewed  were   Ineffec8ve  follow-­‐up  care  and  inadequate  discharge  educa8on  about  
 limited  to  peer-­‐reviewed  ar8cles  over     mental  health  resources  on  PPD  could  lead  new  mothers  to  not  receive  
the  past  eleven  years.  Ar8cles  needed   treatment  aIer.  Nurses  play  a  vital  component  in  discharge  teaching  and  
 to  be  available  in  English  and  be  of  the   educa8on  and  are  in  an  important  posi8on  to  make  adequate  referrals  and  
 nursing  discipline.    The  ar8cles  must     to  stress  the  importance  of  follow-­‐up  care.  AIer  screening  for  PPD,  nurses  
Problem  Statement:   examine  methods  of  screening     can  iden8fy  poten8al  vulnerable  mothers  and  create  individualized  plans  of  
postpartum  depression  or  diagnosis     care  to  increase  the  likelihood  of  appropriate  and  effec8ve  follow-­‐up  care.  
The  present  concern  of  researchers  is  early  detec8on  and  treatment  of  
of  postpartum  depression  and  rates     discharge.  Nurses  should  be  educated  on  how  to  screen  for  and  how  to  
postpartum  depression  is  typically  associated  with  beTer  outcomes  for  the   of  sought  treatment.  It  was  also     make  appropriate  referrals  based  on  results.  They  should  also  have  a  list  of  
mothers  and  their  babies  (Habarth,  Mahmodi,  2017).  Therefore,  nursing  that   required  within  the  search  criteria     providers  who  can  see  and  treat  those  women  who  are  at  risk  for  
specializes  in  women’s  health,  pediatrics,  and  family  health,  have  a  cri8cal  role   that  the  full  text  ar8cle  be  available.     postpartum  depression.    At  the  minimum,  each  organiza8on  should  
Exclusion  criteria:  Ar8cles  that  are     designate  an  individual  in  charge  of  screening  for  postpartum  depression  
in  the  quick  iden8fica8on  and  treatment  of  postpartum  depression.  Due  to  a   secondary  sources  will  not  be  used  in  this   and  adherence  to  a  follow-­‐up  protocol  for  those  who  iden8fy  as  at-­‐risk.  It  is  
lack  of  knowledge  of  postpartum  depression  and  differences  among    literature  review.  Any  ar8cles  that  did  not     also  important  for  nurses  to  understand  that  all  mothers  receive  screening,  
assessments,  it  is  es8mated  that  40-­‐50%  of  postpartum  depression  cases  go   focus  on  screening  of  postpartum     regardless  of  demographics.    
undiagnosed  and  untreated  (Habarth  &  Mahmoodi,  2017).   depression  were  excluded.    

References
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