INTRODUCTION

Postpartum depression is one of the serious psychiatric morbidities of women of

childbearing age and constitutes a significant public health problem globally (Obioha,

2021). It is characterized by persistent feelings of sadness, anxiety, and fatigue, which

can have a profound impact on the well-being of both the mother and the infant.

Understanding the knowledge, attitudes, and prevalence of postpartum depression

among postnatal mothers is crucial for developing effective interventions and support

systems.

Knowledge about postpartum depression among postnatal mothers is essential,

as it influences their recognition and understanding of the condition. Adequate

knowledge empowers women to seek help, access appropriate resources, and engage

in self-care practices. Conversely, a lack of knowledge may lead to the underreporting

or misinterpretation of symptoms, resulting in delayed diagnosis and treatment.

Consequently, exploring the level of awareness and understanding of postpartum

depression among postnatal mothers is critical to identifying gaps and designing

targeted educational programs.

While postpartum depression has been widely studied in various settings, there

is a lack of research focusing on the awareness of postpartum depression among

mothers in adapted barangays here in Santiago City.

Background of the Study

A study conducted in a diverse population in the United States found that

postnatal mothers with lower levels of education and socioeconomic status were more

likely to experience postpartum depression. Other factors identified in this study

included a lack of partner support, stressful life events, and pre-existing mental health

conditions.

In the study of Obioha (2021b), the study found that there is a common lack of

knowledge about postpartum depression among postnatal mothers, and maternal

depression is prevalent in the studied environment. Furthermore, only 6.0% of the

postnatal mothers had good knowledge of postpartum depression, and only 11.0% had

a good attitude towards it. The prevalence of postpartum depression among the

participants was found to be 52.3%. Marital status was identified as a significant

predictor of postpartum depression.

In a cross-sectional study conducted at Binzhou Medical University Hospital,

researchers explored the knowledge, attitude, and practice (KAP) of pregnant and lying-

in women regarding postpartum depression (PPD). The study involved the use of a

questionnaire covering demographic data and KAP dimensions. Participants' scores in

knowledge, attitude, and practice were found to be generally low, with significant

variations based on age, education, and job status. While there were no marked

differences between pregnant and lying-in women, multivariate logistic regression

revealed that higher scores in knowledge and attitude were associated with better

practices concerning PPD. The study underscores the importance of enhancing

maternal awareness through improved knowledge and attitudes to prevent and address

PPD in this population (Wang et al., 2023).

In Santiago City, Isabela, particularly in Barangay Mabini, and Divisoria, the

awareness of postpartum depression among mothers has not been extensively studied.

However, research conducted in other settings provides insights into the importance of

addressing this issue.

The purpose of this study is to examine the awareness of postpartum depression

among mothers residing in adapted barangays in Santiago City, Isabela. By

understanding the level of awareness, we can identify gaps in knowledge and develop

targeted interventions to improve mental health support for these mothers. Ultimately,

this research has the potential to contribute to the overall well-being and resilience of

families in underserved communities.

By exploring these factors, the researchers aim to contribute to the existing body

of knowledge surrounding postpartum depression, ultimately informing the development

of targeted interventions and support systems and helping inform healthcare providers,

policymakers, and community organizations about the specific needs of mothers in

adapted barangays. The results will also guide the development of targeted

interventions to enhance awareness, early detection, and appropriate management of

postpartum depression in these underserved communities.

Through this research, the researchers hope to enhance awareness, reduce

stigma, and facilitate early detection and appropriate management of postpartum

depression, ultimately improving the overall well-being of postnatal mothers and their

children.
Research Questions

This research aims to assess the level of awareness and attitude in postpartum

depression among the mothers of adapted barangay of College of Nursing, Public

Health of Midwifery at Santiago, Isabela, which will serve as a basis for proposing an

intervention and action program aimed at increasing their knowledge and awareness of

postpartum depression.

Specifically, this study seeks to answer the following questions:

1. What is the profile of the mothers in terms of:

1.1 Age

1.2 Religion

1.3 Ethnicity

1.4 Level of education

1.5 Occupation

1.6 Number of children

1.7 Marital status

1.8 Means of delivery

2. What is the Postpartum Depression Literacy of Mothers in terms of:

2.1 Ability to recognize Postpartum Depression

2.2 Attitudes which facilitate recognition of Postpartum Depression

2.3 Knowledge and beliefs of self-care activities

 2.4 Knowledge of how to seek information related to Postpartum Depression

2.5 Beliefs about professional help available

2.6 Knowledge of about professional help available

2.7 Knowledge of risk factors and causes

3. Is there a difference in the postpartum depression when group according to their

demographic profile?

Research Hypothesis

1. There is no significant difference in the postpartum depression when group

according to their demographic profile.

Significance of the study

This research on the awareness of postpartum depression among mothers in

Adapted Barangays of College of Nursing, Public Health, and Midwifery holds

significance for various stakeholders:

Mothers. Understanding the factors associated with postpartum depression can

empower mothers’ awareness about potential challenges they may face. This

awareness can lead to early recognition of symptoms, timely intervention, and improved

mental health outcomes for both mothers and their infants.

Barangay Health Workers. The research outcomes offer barangay health

workers valuable insights into the local dynamics of postpartum depression, enabling

them to enhance their role as frontline healthcare providers. Armed with a deeper

understanding, they can actively engage with mothers, identify at-risk individuals, and
facilitate timely interventions or referrals to promote mental well-being within the

barangay.

City Health Office. The study's results serve as a foundation for the City Health

Office to develop comprehensive policies and initiatives addressing postpartum

depression at a broader citywide level. This information equips the office with data-

driven strategies to allocate resources effectively, implement citywide mental health

programs, and collaborate with various stakeholders to create a supportive environment

for mothers across different barangays within the city.

Community Leaders. The research can serve as a foundation for evidence-

based policymaking at the community level. Insights into the prevalence and factors

contributing to postpartum depression can guide the development of local programs

aimed at promoting maternal mental health, ultimately contributing to the overall well-

being of the community.

Adapted Barangay as a Community. The study's results can directly benefit the

community by fostering awareness and understanding of postpartum depression. This

knowledge can reduce the stigma surrounding mental health issues, encourage

community support networks, and contribute to a more empathetic and informed

environment for postnatal mothers.

Researchers. The study contributes to the body of awareness on postpartum

depression, serving as a resource for future researchers exploring mental health in

different cultural contexts. It provides a foundation for comparative studies and further

investigations into effective interventions for postpartum depression worldwide.

Theoretical Background

Theoretical Framework

The study is anchored to the Health Belief Model (HBM), commonly known as

Jorm's Framework, offering a theoretical foundation for comprehending the factors that

shape awareness of postpartum depression among postnatal in adapted barangay of

College of Nursing, Public Health and Midwifery. In alignment with the HBM, the

perceived susceptibility of mothers to postpartum depression is influenced by factors

such as age, marital status, number of children, means of delivery, religion, educational

attainment, and job. Additionally, the model considers the perceived severity of

postpartum depression, emphasizing the impact on the well-being of both mothers and

infants. Recognition of the benefits associated with knowledge about postpartum

depression, identification of barriers hindering awareness, and cues to action prompting

mothers to seek information are integral components. Furthermore, self-efficacy plays a

crucial role, reflecting mothers' confidence in recognizing symptoms and accessing

necessary support. The framework extends its purview to healthcare system factors,

sociodemographic elements, cultural and social norms, and outcome expectations,

offering a comprehensive lens to understand and address postpartum depression within

the specific context in adapted barangay of College of Nursing, Public Health, and

Midwifery.

Figure 1. Health Belief Model

 Conceptual Framework

INPUT PROCESS OUTPUT

1. What is the demographic profile - Floating and retrieval - Level of awareness

of the respondents in terms of? of the survey of Postpartum
1.1 Age questionnaire to the Depress ion among
1.2 Religion mothers of adapted mothers of adapted
1.3 Ethnicity Barangay of College of barangay of College
1.4 Level of Education Nursing, Public Health,
1.5 Occupation of Nurs ing, Public
and Midwifery.
1.6 Number of Children Health, and Midwifery
1.7 Marital Status - Coding or tallying
1.8 Means of Delivery
2. What is the Postpartum - Statistical analysis of
Depression Literacy of Mothers in data
terms of:
2.1 Ability to recognize
Postpartum Depression
2.2 Attitudes which facilitate
recognition of Postpartum
Depression
2.3 Knowledge and beliefs of
self-care activities
2.4 Knowledge of how to seek
information related to Postpartum
Depression
2.5 Beliefs about professional
help available
2.6 Knowledge about
professional help available
2.7 Knowledge of risk factors
and causes Contextual Factors
3. Is there a difference in the
postpartum depression when -Healthcare System Factors
group according to their
demographic profile?
-Sociodemographic Elements
 Figure 2. Paradigm of the Study

In this study, the primary inputs consist of various factors relevant to postpartum

depression awareness within a specific community, particularly in the adapted

barangays. The demographic information of postnatal mothers, including age, marital

status, number of children, means of delivery, religion, educational attainment, and job,

serves as foundational data. Additionally, existing knowledge and awareness levels

about postpartum depression, cultural and social norms within the barangay, and

healthcare system factors and accessibility are essential inputs. The process involves

dissecting these inputs through specific lenses. The perceived susceptibility, severity,

benefits of knowledge, barriers to awareness, cues to action, and self-efficacy are

examined to gain a nuanced understanding of how these factors influence postpartum

depression awareness. Furthermore, the broader context takes into account the

healthcare system, sociodemographic elements, cultural and social norms, and

outcome expectations. The expected outputs of the study include comprehensive

insights into the factors influencing postpartum depression awareness, the development

of tailored interventions addressing identified barriers and facilitators, increased

awareness and knowledge levels among postnatal mothers, improved self-efficacy and

confidence in seeking support, and an enhanced community understanding of

postpartum depression and its impact. This structured framework provides a systematic

approach to studying and addressing postpartum depression awareness, contributing to

the overall well-being of mothers in the specified community.

Literature Review

Postpartum Depression

According to Burgut et al. (2013), they found that there is much less information

on the impact of maternal complications on the psychological status of postpartum

women. Postpartum women, especially those with maternal complications, need close

screening and quick access to mental healthcare within integrated reproductive health

services.

As stated by Zakeri et al. (2022), with an increase in stress and anxiety and a

reduction in the quality of prenatal care, the risk of postpartum depression increases.

Therefore, attention to the quality of prenatal care and postpartum stress and anxiety

should be carefully evaluated to prevent PPD. Psychological support and interventions

are recommended to promote the mental health of women before and after childbirth.

Psychosocial and personal factors were strong predictors of depression during

the first 12 months postpartum for both mothers and fathers (Escribà-Agüir & Artazcoz,

2013).

In the study of Abdollahi (2018), he found that women with postpartum

depression need to be identified and provided with support and appropriate

interventions to avoid later health problems.

Postpartum depression underscores the need for comprehensive and integrated

approaches to addressing PPD. This includes close screening, access to mental

healthcare, quality prenatal care, psychological support, and interventions for both
mothers and fathers. By addressing risk factors, providing timely support, and promoting

mental health, the researcher can better prevent and manage postpartum depression

for the well-being of women and their families.

As stated by Nguyen et al. (2021), they found that in Vietnam, PPD is conducted

among women at and after 1-month delivery. The rate of PPD reported in Vietnam

among mothers at postnatal time points from 1 to 12 months ranged from 8.2 to 48.1%.

Risk factors can be clustered into three groups: personal factors, family factors, and

environmental factors.

Efforts to tackle postpartum depression (PPD) necessitate a multifaceted

strategy. Comprehensive approaches underscore the importance of close screening,

ensuring timely access to mental healthcare, and prioritizing the quality of prenatal care.

This approach extends beyond mothers to encompass fathers, emphasizing the need

for psychological support and interventions for both parents. Early identification of PPD

is crucial, as it allows for targeted interventions that can mitigate the risk of long-term

health issues associated with postpartum depression. Therefore, a holistic approach

that integrates various elements, including screening, mental healthcare, and support

for both parents, is essential for effectively addressing and managing postpartum

depression.

Maternal Health and Well-being

Alderdice et al. (2013) conducted a systematic review aiming to identify non-

invasive interventions in the perinatal period for midwives to support maternal mental

health. Published in Midwifery, the study utilized a systematic review design and
focused on inclusion criteria for articles. Major findings highlighted various interventions

across the perinatal continuum. However, the authors concluded that integrating these

interventions into midwifery training or practice would be premature based on current

evidence. The study suggested areas for further research, including midwifery-led

models for preventing postpartum depression and psychosocial interventions. Notably,

no reviews supported a specific midwifery role during pregnancy in maternal mental

health, emphasizing the need for ongoing investigation and strategies for midwifery

support, particularly in the perinatal period.

According to Redshaw et al. (2016), they examined the impact of holding a

stillborn baby on maternal mental health and well-being. The research, which utilized a

questionnaire for data collection, focused on outcomes at 3 and 9 months post-stillbirth

for women who held their babies compared to those who did not. The study included

468 eligible responses from women who experienced stillbirth, with a response rate of

30.2%. Major findings indicated that women who held their stillborn babies reported

higher rates of mental health and relationship difficulties. After adjusting for

demographic and clinical factors, those who held their baby had significantly higher

odds of experiencing anxiety and relationship difficulties with family at 9 months. The

study contributes valuable insights into the emotional complexities following stillbirth and

underscores the significance of individual circumstances in providing effective support

for maternal well-being.

The study of Maher et al. (2017), investigates the associations between maternal

mental health and well-being and objective monitor-based measures of physical activity

(PA) and sedentary behavior (SB) in children. Focusing on 191 mother-child dyads from
the Mother's and Their Children's Health study, the research explored whether a

household structure (single- vs multigenerational/dual-parent) and maternal

employment (full-time vs not full-time) moderated these associations. The study

revealed a significant negative correlation between mothers' parenting stress and their

child's moderate-to-vigorous physical activity (MVPA) in single-parent families, a link not

observed in multigenerational/dual-parent families. Other aspects of maternal mental

health and well-being did not show significant relationships with children's activity

patterns. This research contributes valuable insights into the nuanced dynamics

between maternal mental health, well-being, and children's physical activity,

emphasizing the need to consider family structures in promoting child health.

Mortazavi et al. (2015) conducted the study to validate the World Health

Organization-5 Well-Being Index (WHO-5) in a sample of 341 pregnant Iranian women

and explore changes in maternal well-being from pregnancy to postpartum. Using the

General Health Questionnaire (GHQ-28) as the data gathering tool, the study

demonstrated good internal consistency with a Cronbach’s alpha coefficient of 0.85 for

WHO-5 items. The WHO-5 cut-off score of <50 exhibited optimal sensitivity (0.84) and

specificity (0.59) for identifying psychological symptoms. Significant differences were

found in mean WHO-5 scores between the third trimester and postpartum. Maternal

education emerged as a predictor of well-being during the third trimester, while

breastfeeding difficulty and maternal well-being scores during the third trimester

predicted postpartum well-being. This research provides valuable insights into the

factors influencing maternal well-being during the perinatal period, emphasizing the

relevance of specific predictors and a validated screening tool.

 This study encompasses diverse aspects of maternal health and well-being

during the perinatal period. Alderdice et al. (2013) conducted a systematic review

aiming to identify non-invasive interventions for midwives to support maternal mental

health, emphasizing the need for ongoing investigation and strategies. Redshaw et al.

(2016) explored the impact of holding a stillborn baby, revealing higher rates of mental

health and relationship difficulties among women who held their baby. Maher et al.

(2017) investigated associations between maternal mental health and children's

physical activity, highlighting a significant negative correlation in single-parent families.

Mortazavi et al. (2015) validated the WHO-5 in pregnant Iranian women, identifying

predictors of maternal well-being during the perinatal period. Together, these studies

contribute nuanced insights, emphasizing the complexities of maternal experiences and

the importance of tailored support strategies in promoting maternal well-being during the

perinatal continuum.

Overall, these studies highlight various aspects of maternal health and well-being

during the perinatal period. Alderdice et al. (2013) emphasize the need for further

research and strategies to support maternal mental health in midwifery practice.

Redshaw et al. (2016) highlight the emotional complexities following stillbirth and the

impact of holding the baby on maternal mental health and relationship difficulties. Maher

et al. (2017) shed light on the relationship between maternal mental health and

children's physical activity, highlighting the importance of considering family structures

in promoting child health. Mortazavi et al. (2015) validate the WHO-5 as a screening

tool for maternal well-being and identify predictors of well-being during the perinatal

period.
Awareness/Knowledge of Postpartum Depression

Poreddi et al. (2020) found that the mean scores on knowledge (18.92 ± 3.27)

and attitude (31.39 ± 4.91) scales suggest that a majority of the participants had a good

level of knowledge (54%) and positive attitudes (69.7%) towards women with

postpartum depression. However, misconceptions and negative stereotypes related to

postpartum depression still prevail. Family members who had a good level of education

(χ2 = 4.21, p < 0.05) and had come across women with postpartum depression (χ2 =

13.27, p < 0.001) hold positive attitudes towards postpartum depression compared to

family members with a lower level of education and those who did not come across

women with postpartum depression.

The mean scores on knowledge (18.92 ± 3.27) and attitude (31.39 ± 4.91) scales

suggest that a majority of the participants had a good level of knowledge (54%) and

positive attitudes (69.7%) toward women with postpartum depression. However,

misconceptions and negative stereotypes related to postpartum depression still prevail.

The findings of the present study suggest the need for educational campaigns to

improve perinatal mental health literacy and address prejudices and negative

stereotypes related to postpartum depression among family members. (Poreddi et al.,

2020)

As stated by Branquinho et al. (2019), the sample presented a good level of

knowledge and positive attitudes about postpartum depression, despite the existence of

some gaps in knowledge and some stereotypes. Personal contact with postpartum

depression was associated with higher levels of knowledge (p <.001) and more positive
attitudes towards postpartum depression (p <.001), and participants who assisted in

public education campaigns reported higher levels of knowledge about postpartum

depression (p <.001). Lower levels of knowledge and more negative attitudes about

postpartum depression were found in men and older, less educated people.

In the study by Anokye et al. (2018), it was stated that postpartum depression

was prevalent among 7% of all mothers selected. The severity ranged from minimal

depression to severe depression. Psychosocial support proved to be the most effective

intervention (p = 0.001) that has been used by healthcare workers to reduce depressive

symptoms.

In the study of Abazie and Usoro (2021), the majority of participants (60.8%) had

poor knowledge of postpartum depression. There is a statistically significant relationship

between age and knowledge of postpartum depression (P = 0.000). There is no

significant relationship between education level and knowledge of postpartum

depression.

According to the statement of Maimburg and Væth (2015), their research result

was that a difference in postpartum depression was found between those who attended

the intervention group and the reference group. Overall, being at risk of postpartum

depression was associated with preterm birth, unscheduled cesarean section, low

Apgar score, lack of pain relief during labour, experienced low attendance of the

midwife in the delivery room, unprepared for hospital discharge, none or minor

breastfeeding in the early postpartum period, insufficient knowledge about

breastfeeding, poor or fair self-rated mental health, and uncertain or weak attachment to

the newborn child.

The research regarding Postpartum Depression: A Comparison of Knowledge

and Attitude between the Family Members of Postpartum Women finds that family

members, both husbands and female relatives, had positive attitudes and good

knowledge about the causes and risks of PPD. However, misunderstandings and wrong

beliefs concerning PPD were addressed. Therefore, health education on PPD should be

provided for family members of postpartum women throughout pregnancy and

postpartum periods. (Juntaruksa, 2017)

These studies highlight a generally positive trend in knowledge and attitudes

towards postpartum depression among family members. However, there are persistent

misconceptions, negative stereotypes, and gaps in knowledge that need to be

addressed. Factors such as education, personal contact, and participation in education

campaigns are associated with better understanding and attitudes. The findings

emphasize the importance of targeted health education interventions for family

members to improve perinatal mental health literacy and reduce the stigma surrounding

postpartum depression.

Attitudes of Mothers on Postpartum Depression

In the study of Fonseca and Canavarro (2017), they found the need to

comprehensively assess women's cognitive variables during the postpartum period with

appropriate measures for the early identification of women with more dysfunctional

beliefs about motherhood who may be at higher risk of depression.

 Additionally, according to Williams et al. (2017), their study found the role of

culture and stigma in the conceptualization of mental health within both the community

and medical spheres. Mental health continues to be unacknowledged and neglected in

Bangladeshi communities.

As stated by Branquinho et al. (2019), their study results show the importance of

awareness-raising and education campaigns directed at the general population,

particularly focusing on people who can act as the postpartum women's support

network, to increase the level of knowledge and foster more positive attitudes towards

postpartum depression.

The findings emphasize the importance of early identification, cultural

understanding, and awareness-raising campaigns in addressing postpartum

depression. By comprehensively assessing cognitive variables, interventions can be

targeted at women with dysfunctional beliefs about motherhood. Recognizing the role of

culture and addressing stigma can help destigmatize mental health and improve support

in communities. Furthermore, awareness-raising campaigns involving the general

population can increase knowledge and promote positive attitudes towards postpartum

depression. Taken together, these findings highlight the need for a multi-faceted

approach to effectively address postpartum depression and support the mental well-

being of postnatal women.

The studies by Fonseca and Canavarro (2017), Williams et al. (2017), and

Branquinho et al. (2019) collectively underscore the significance of a holistic approach

to address postpartum depression. Emphasizing comprehensive cognitive assessments

enables early identification of women with dysfunctional beliefs about motherhood, while

acknowledging cultural influences and combating stigma is crucial for fostering mental

health support in communities, particularly in contexts like Bangladesh. Additionally,

awareness-raising campaigns targeting the general population play a pivotal role in

increasing knowledge and promoting positive attitudes towards postpartum depression.

In essence, a multi-faceted strategy is essential for effectively addressing postpartum

depression and nurturing the mental well-being of postnatal women.

Risk Factors and Protective Factors

Stated by Eliner et al. (2022), found that the risk of PPD was more than 20 times

higher for women with a depression history compared to women without. Gestational

diabetes was independently associated with a modestly increased PPD risk. Maternal

depression history also had a modifying effect on pre‐ and perinatal PPD risk factors.

High life stress, lack of social support, current or past abuse, prenatal

depression, and marital or partner dissatisfaction are identified as common risk factors

for PPD (Google Scholar, n.d., 2019). Prenatal depression and current abuse emerge

as the strongest risk factors for PPD. This emphasizes the importance of addressing

these risk factors and providing appropriate support and interventions during the

prenatal period to prevent or manage PPD.

In the study conducted by Hain et al. (2016), found that predictors for APD were

high DSC, high concerns about one’s appearance, low resilience, and low social

support. Resilience buffered (weakened) the impact of DSC on APD and affected PPD-

6 and PPD-12 indirectly through APD.

 The couple's relationship can act as both a risk and a protective factor for

pregnant women, depending on the stress level experienced in the relationship (Banker

and LaCoursiere, 2014). This emphasizes the importance of addressing relationship

dynamics and providing support for couples during the perinatal period to reduce the

risk of PPD.

The importance of addressing risk factors such as a history of depression,

gestational diabetes, high life stress, lack of social support, abuse, prenatal depression,

and relationship dynamics to prevent and manage postpartum depression. Additionally,

promoting resilience and providing appropriate support during the perinatal period are

crucial in mitigating the impact of distress and enhancing mental well-being. By

considering these factors, healthcare Professionals and support systems can better

tailor interventions and support for women at risk of or experiencing postpartum

depression.

According to the study of Hutchen and Kearney (2020), untreated Postpartum

depression(PPD) leaves women and their children vulnerable to numerous negative

short-term and long-term outcomes, better understanding of PPD risk factors serves to

improve maternal and child outcomes and limit the damage done by “the thief that

steals motherhood.”1 Systematic and adequate attention to PPD and its risk factors can

bolster maternal-child outcomes and ensure more opportunities for women and children

to thrive.

In the largest population-based study to date, the risk of PPD was more than 20

times higher for women with a depression history, compared to women without.
Gestational diabetes was independently associated with a modestly increased PPD risk.

Maternal depression history also had a modifying effect on pre- and perinatal PPD risk

factors (Silverman et al. 2017).

These studies reveals that a history of depression significantly elevates the risk

of postpartum depression (PPD), emphasizing the need for targeted interventions.

Additionally, gestational diabetes and various psychosocial factors such as high life

stress, lack of social support, abuse, and prenatal depression contribute to PPD risk.

Relationship dynamics play a dual role, acting as both a risk and protective factor.

Resilience proves crucial in buffering the impact of distress on PPD. Addressing these

factors during the perinatal period is essential for prevention and management.

Untreated PPD poses risks to both mothers and children, emphasizing the importance

of systematic attention to mitigate the negative outcomes and ensure maternal and child

well-being.

Health Education/Intervention

In the study of Lui et al. (2022), they found that the mobile health application may

help to improve perceived social support, and maternal self-efficacy and reduce

postpartum depressive symptoms. The finding of the mobile health application's effect

extends our understanding of the integrative effects of mindfulness and perceived social

support on the reduction of postpartum depressive symptoms and suggests clinical

potential in the treatment of postpartum depressive symptoms.

 Health interventions may be a useful tool to complement routine clinical care in

the prevention and treatment of PPD. Additional high-quality, large-scale, cohort, and

interventional studies are needed to further assess the effectiveness of mHealth

interventions on PPD. With an increasing number of smartphone users and rapidly

developing mobile technology, researchers should pay more attention to mobile apps,

which could be one of the most important potential and effective methods among

mHealth interventions. ( Zhou et al.,2022)

In the study of Onogwu et al. (2023), during the 6-month follow-up assessment,

even men in the control group did not have significant symptoms of PPD as their scores

dropped below the threshold. On the contrary, women in the control group still had high

PPD, indicating that PPD lasted longer in women than in men. Also, women whose

husbands received family counseling on spousal support reported PPD scores below

the threshold. However, women whose husbands did not receive spousal counseling

still had PPD scores at the threshold, even though their scores marginally dropped

According to the study of Almutairi et al. (2023), the integration of mental health

services into maternal services that are provided to women needs to be considered in

the context of Saudi Arabia. This integration will result in high-quality holistic maternal

care.

Postpartum depression is prevalent among mothers, although at a lower rate,

and psychosocial support has been the most effective intervention in its management.

Postpartum depression may affect socialization behaviors in children and the mother,

and it may lead to thoughts of failure leading to deeper depression. Frequent screening
exercises for postpartum depression should be organized by the authorities of the

hospitals in conjunction with the Ministry of Health. (Anokye et al., 2018)

In the studies included in this review, health workers integrated mental health

interventions into their regular work activities, which may prove less stigmatizing to

women. Maternal mental health and infant development interventions appear to act

synergistically, and the perinatal period provides an opportunity to deliver them in an

integrated fashion. The studies also give an important lesson in terms of intervention,

which should be culturally sound with components of cognitive, interpersonal, problem-

solving, and practical-oriented practices that should be administered to individuals or

groups. As most of the studies were conducted in a home set up, the interventions can

be adapted to the family oriented/partner included approach

Ability to recognize Postpartum Depression

In their study, Poreddi et al. (2021) discovered that only 50.7% of postpartum

mothers possessed sufficient knowledge about postpartum depression. The level of

postpartum depression literacy was significantly influenced by factors such as age,

income, and occupational status. This highlights the importance of improving awareness

and education surrounding postpartum depression among mothers, particularly

targeting those who may be younger, have lower income levels, or hold specific

occupational roles.

De Avilla et al. (2020b) found a correlation between higher maternal satisfaction

with breastfeeding and a reduced presence of postpartum depression symptoms. This

underscores the significance of supporting the mental health of pregnant and

postpartum women while also paying attention to their satisfaction with breastfeeding. It

suggests that fostering a positive breastfeeding experience may contribute to better

mental well-being for mothers.

The study on the knowledge and attitudes of family members towards

postpartum depression by Poreddi et al. (2020) suggests the necessity of educational

campaigns aimed at improving perinatal mental health literacy. Addressing prejudices

and negative stereotypes related to postpartum depression among family members is

crucial. By providing accurate information and dispelling misconceptions, these

campaigns can help create a more supportive environment for mothers dealing with

postpartum depression.

Asaye et al. (2020) discovered that women at higher risk of postpartum

depression often had relatives with mental health histories. Additionally, those with a

previous history of depression were more likely to experience postpartum depression.

This highlights the importance of considering personal and family mental health

backgrounds when identifying individuals at risk and providing appropriate support and

intervention.

Tang et al. (2020) conducted a study exploring how mothers in China perceive

the causes of postpartum depression and their preferred coping strategies. Through

semi-structured interviews, they found that these mothers often attributed postpartum

depression to external factors that could potentially be changed, such as lack of support

from in-laws, as well as internal factors that were expected to diminish over time, such
as hormonal fluctuations. This suggests the need for comprehensive support that

addresses both external situational factors and internal physiological changes.

Knowledge about Professional Help

The study conducted by Adams et al. (2023) offers crucial insights into

postpartum care practices and challenges faced by women in the Sagnarigu District,

Tamale, Ghana. It highlights a prevalent focus on baby-centric postpartum care,

potentially overlooking the holistic needs of mothers. Inadequate knowledge of

postpartum danger signs and barriers to accessing care underscore significant gaps in

awareness and healthcare-seeking behavior. The identified themes underscore the

necessity for tailored interventions and educational programs to improve postnatal care

in similar settings.

Rena Bina's (2014) study explores help-seeking behaviors for postpartum

depression (PPD) within the Israeli Jewish Orthodox community. The research uncovers

factors influencing the utilization of professional and informal help, emphasizing the

importance of confidence in mental health professionals and the impact of cultural

considerations on treatment preferences. The study provides essential

recommendations for routine screening, culturally sensitive referrals, d stigma

addressing to enhance support systems for women experiencing PPD in this specific

cultural context.

Md Mosiur Rahman et al.'s research sheds light on factors influencing the

utilization of postpartum care among young mothers in Bangladesh. The study reveals

concerning trends in postpartum care utilization, emphasizing the role of maternal

education, antenatal care, and social support structures in promoting positive health-

seeking behaviors. The identified multifaceted barriers and facilitators call for

comprehensive, context-specific interventions to improve postpartum care outcomes

among young mothers in Bangladesh.

Cindy-Lee Dennis and Leinic Chung-Lee's systematic review delves into barriers

and treatment preferences associated with postpartum depression. The review

underscores the persistent challenges of underdiagnosis and undertreatment of PPD,

emphasizing the need to address barriers such as women's reluctance to disclose their

feelings and lack of knowledge about the condition. Maternal treatment preferences,

particularly favoring "talking therapies," offer valuable insights for developing woman-

centered interventions aligned with diverse cultural backgrounds.

Nan et al.'s (2020) study on professional support during the postpartum period

among Chinese primiparous mothers complements the overarching theme of

postpartum care. The research highlights dissatisfaction with current professional

services, the likelihood of health care professional help-seeking behavior, and the

demands for new health care services. The study underscores the insufficiency of

existing maternal and child health care services, advocating for tailored interventions

considering feasibility, convenience, and cultural adaptability.

The research studies conducted by Adams et al. (2023), Rena Bina (2014), Md

Mosiur Rahman et al., and Cindy-Lee Dennis and Leinic Chung-Lee collectively enrich

our understanding of maternal healthcare, particularly in the postpartum period. These

studies delve into various aspects, including postpartum care practices, help-seeking for

postpartum depression (PPD), and the utilization of postpartum care among young
mothers. Together, they emphasize the imperative for comprehensive, woman-centered

approaches to postpartum care, taking into account cultural, educational, and social

factors. The insights derived from these studies offer valuable guidance for developing

targeted interventions, shaping policy recommendations, and refining healthcare

practices to enhance maternal well-being during the postpartum period across diverse

settings and communities

Knowledge and Belief of Self-care Activities

According to Martínez, N. et al. (2021), an extensive review of the literature

revealed salient characteristics that reflected the most frequently used terms associated

with the concept. Guided by Walker and Avant’s method, three defining attributes

emerged as common themes: awareness, self-control, and self-reliance.

In the study of Mohammadzadeh, M. et al. (2021), outcomes of the literature

search highlight that studies on Iranian adolescents’ self-care have mostly focused on

adolescents with specific physical or psychological health problems. The large gap

between the real needs and the sporadic self-care programs for adolescents can be a

significant constraint in developing practical self-care programs for Iranian adolescents.

These studies underscore the importance of knowledge and belief in self-care

activities. Martínez's study identifies key attributes like awareness, self-control, and self-

reliance, forming the foundation for understanding the concept. Meanwhile,

Mohammadzadeh's research sheds light on a gap in Iranian adolescents' self-care

studies, emphasizing the need for comprehensive programs addressing real needs
beyond specific health issues. Integrating these insights could pave the way for

developing practical and holistic self-care initiatives for Iranian adolescents.

Beliefs about Professional Help

According to the study of Simhi, M. et al. (2023), health belief model components

and social support are important mediating components that help explain mothers’ PPD

treatment preferences. Health professionals such as psychiatric or public health nurses

should increase awareness of women at risk for PPD and elicit their preferred treatment

options.

The inclusion of cognitive variables in risk assessment and preventive efforts for

PPD may hold potential to increase its clinical efficacy (Fonseca A. & Canavarro M.

2020).

In the study of Thorsteinsson, E. et al. (2018), results showed that there were no

effects for type of intervention on either personal or perceived PPD stigma scores. No

effect was found for help-seeking propensity. Males had higher personal PPD stigma

than females and older age was associated with lower personal PPD stigma. Familiarity

with PPD was associated with perceived PPD stigma in others but not personal PPD

stigma. More work needs to be conducted to develop interventions to reduce PPD

stigma in the community.

 The results of this descriptive phenomenological study suggested that the current

maternal and child health care services were insufficient and could not meet

primiparous mothers’ need. The results also indicated that identifying barriers and

providing services focused on mothers’ needs may be an effective strategy to enhance

primiparous mothers’ well-being, and further suggested that feasibility, convenience,

and the cultural adaptability of health care services should be considered during the

delivery of postpartum interventions. (Nan, Y. et al. 2020).

In the study of Colman, L. et al. (2021), the results reveal that causal beliefs

significantly associate with stigma, measured by stigmatising attitudes and social

distance: personal- or biogenetic beliefs associate with more stigma, where

psychosocial beliefs associate with less stigma. This study highlights the importance of

causal beliefs in affecting public stigma and help seeking recommendations.

 METHODS

Research Design

This study will utilize a descriptive design to study and describe the distribution of

one or more variables without regard to any causal or other hypotheses (Aggarwal

2019). It is the most common and popular methodology used in health research to

gather informative data and accurately define the population or situation. A researcher

can only observe and collect valid and reliable responses and analyze them according

to Voxco (2021). This is aligned and appropriate for this study, as it focuses on

assessing the level of awareness and attitude in postpartum depression among the

mothers of adapted Barangay of College of Nursing, Public Health of Midwifery at

Santiago, Isabela.

By employing a descriptive design, the researchers aim to accurately describe

and measure the various aspects related to postpartum depression in this specific

population. This design allows for a comprehensive understanding of the level and

nature of postpartum depression experienced by postnatal mothers, including their

awareness and attitude towards it.

 Furthermore, a descriptive design will serve as a basis for proposing an

intervention and action program aimed at increasing the knowledge and awareness of

mothers related to postpartum depression.

Study Site and Participants

The study will be conducted in adapted barangays of College of Nursing, Public

Health, and Midwifery of University of La Salette, Inc. These barangays are Barangay

Balintocatoc, Mabini, and Divisoria, Santiago City. These barangays offer various

healthcare facilities, including a health center, which serves as a primary source of

healthcare services for the residents. By choosing these barangays as the primary

source of information for the study, the researchers can access a diverse population of

postnatal mothers, engage with the local community, and utilize existing resources. This

approach will contribute to a comprehensive understanding of postpartum depression,

enabling the development of targeted interventions and support systems to address the

awareness of postpartum depression among postnatal mothers in the area.

The participants of the study consisted of mothers residing in Barangay

Balintocatoc, Mabini, and Divisoria, Santiago City. The inclusion criteria for participation

were mothers who are currently residing in the barangay. Mothers from diverse

backgrounds and demographic characteristics were included to ensure a representative

sample.
Population, Sample Size, and Sampling Method

This study’s particular population consists of mothers residing in the adapted

barangay of Divisoria, Mabini, and Balintocatoc in Santiago City, Isabela. The table

below reveals the total number of mothers residing in the barangay Divisoria, Mabini,

and Balintocatoc.

A combination of stratified and random sampling methods can be employed to

select the sample. Firstly, the adapted barangays of Divisoria, Mabini, and Balintocatoc

can be randomly selected. This approach ensures that the sample represents the

population distribution across the different barangays.

There are total of 267 mothers residing in barangay Balintocatoc, 756 mothers in

barangay Balintocatoc, and 636 in barangay Divisoria. This study utilized the Raosoft

sample size calculator to calculate the sample size with a 5% margin of error and a 95%

level of confidence, 311 out of 1,659 mothers residing in barangay Balintocatoc, Mabini,

and Divisoria were chosen to participate in the study.

 Barangay Population (N) Sample (n)

(strata)

Balintocatoc 1,453 50

Mabini 2009 74

Divisoria 4,621 41

Baluarte 1,664 59

Sinsayon 778 23

Raniag 1,690 60

N=12,215 n= 307

Research Instrument

The main instrument utilized in the research to gather data was a survey, which

is a type of questionnaire. The purpose of the questionnaire was to collect data

regarding the awareness of the mother in terms of their belief, knowledge on seeking

information and professional help and attitude. The 31-item questionnaire was adapted

from the study of (Mirsalimi et al., 2020). The questionnaire is divided into two sections,

the section one comprises the demographic profile of the respondents whereas the

second section which contains the 31- item questionnaire is divided into 7 categories
that attributes to the Postpartum Literacy Screening Scale (PoDlis). The distribution of

the questions were dividedly according to their attributes to the Postpartum Literacy

screening scale, Questionnaire 1 to 6 attribute to the ability to recognize postpartum

depression, 7-11 assign to attitudes which facilitate recognition of postpartum

depression and appropriate help seeking, 12-16 allotted to the knowledge and beliefs of

self-care activities,17-18 attribute to the knowledge of how to seek information related to

postpartum depression, 19- 20 attributes to the belief about professional help available,

21-26 attribute to the knowledge about professional help available and lastly 27- 31

attribute to the Knowledge of risk factors and causes of postpartum depression. Each

item is rated on a 5-point Likert scale ranging from 1 to 5 (1 = strongly disagree or not

likely at all and 5 = strongly agree or very likely, reverse items score oppositely.

The Cornbrash’s alpha coefficient for the Postpartum De[1]pression Literacy

Scale was .78 and for ability to recognize postpartum depression was .77 and for risk

factors and causes, knowledge and beliefs of self-care activities, knowledge about

professional help available, beliefs about professional help available, attitudes which

facilitate recognition of postpartum depression and appropriate help-seeking and

knowledge of how to seek information related to postpartum depression were .76,

78, .83, .78, .70, .73, respectively.

Data Gathering Procedure

The process for gathering the needed data in the study is described in the

following steps:
 1. The researcher shall seek the permission of their research teacher to validate the

questionnaire.

2. The researchers will secure permission of the dean to obtain the number of

mothers from which the samples will be selected. Also, a permission to conduct

data collection will be sought from the concerned school officials.

3. The questionnaires shall be given to the selected sample through face-to-face, in

their respective houses.

4. Questionnaires shall be received the same day as they were given to ensure a

higher return percentage of questionnaires.

Data Analysis

The following statistical tools to be used by the researcher in treating the

gathered data;

For research question 1, the study utilized frequency and percentage distribution

to analyze the demographic characteristics of the respondents, including age, religion,

ethnicity, level of education, occupation, number of children, marital status, and means

of delivery.

As for research question 2, we will use a Likert scale analysis to understand the

respondent’s ability to recognize postpartum depression, attitudes which facilitate

recognition of postpartum depression and appropriate help seeking, knowledge and

beliefs of self-care activities, knowledge of how to seek information related to

postpartum depression, beliefs about professional help available, knowledge about

professional help available, and knowledge of risk factors and causes. 39 items were

provided and subjected to psychometric evaluation. The questionnaire was named the

Postpartum Depression Literacy Scale (PoDLiS). Each item is rated on a 5-point Likert

scale ranging from 1 to 5 (1 = strongly disagree or not likely at all and 5 = strongly agree

or very likely, reverse items score oppositely). Scores for each subscale and the whole

questionnaire determined by summing items dividing into the number of items for each

subscale and for the whole questionnaire giving a score of 1 to 5 either for each

subscale or the whole questionnaire.

The following scales will be used;

Scale Range Value Description Interpretation

1 1.00 - 1.79 Strongly Disagree Never/Not Encountered

2 1.80 - 2.59 Disagree Rarely/Slightly Encountered

3 2.60 - 3.39 Neutral Sometimes/Moderately Encountered

4 3.40 - 4.19 Agree Often/Commonly Encountered

5 4.20 - 5.00 Strongly Agree Always/Most Encountered

Ethical Considerations

1. Informed Consent
 This study ensured that all participants fully understand the purpose, procedures,

and potential risks of the research before agreeing to participate. This is especially

important in sensitive topics like postpartum depression where participants may feel

vulnerable or distressed.

2. Confidentiality

Safeguard the privacy of participants by securely storing and anonymizing their

data. Protecting their identities and personal information is crucial, particularly in a small

community like an adapted barangay where confidentiality breaches could have

significant repercussions.

3. Cultural Sensitivity

This research recognized and respected the cultural beliefs, norms, and

practices of the participants. Approached the research with sensitivity to cultural

differences, ensuring that the methods and interventions are appropriate and respectful

of the community's values and traditions.

4. Beneficence

This study strived to maximize the benefits of the research while minimizing any

potential harm to participants. This involves designing the study in a way that

contributes positively to the understanding and awareness of postpartum depression

among mothers in the adapted barangay, while also ensuring that any interventions or

recommendations made are ethically sound and beneficial to the participants and the

community as a whole.

5. Honesty
 Researchers ensured that all information in the research paper are reported in all

honesty. Researchers followed the rules in gathering and analyzing the data. Moreover,

researchers clearly and honestly stated all the methods and procedures used while

gathering the data.

Results and Discussion

This chapter explains why the research findings are important for improving mental

health support for mothers in the targeted community. By turning these findings into

practical plans, this study adds to the conversation about postpartum depression

awareness and care. The goal is to make mothers' lives better and reduce the impact of

postpartum depression on vulnerable groups.

Socio-Demographic Background

Table 1

Distribution of the Respondents According to Their Age

Age f %

16-25 53 17.2

26-35 108 35.1

36-45 82 26.6

46-55 47 15.3
 56-65 15 4.9

66 years old and above 3 1.0

The table presents the socio-demographic distribution by age. The majority of

respondents fall within the age bracket of 26-35 years, comprising 35.1% of the total

population with 108 individuals. The next largest group is aged 36-45 years, accounting

for 26.6% with 82 respondents. Those aged 16-25 years make up 17.2% with 53

respondents, followed by the 46-55 age group with 47 respondents or 15.3%.

Respondents aged 56-65 years constitute 4.9% with 15 individuals, and those aged 66

years and above represent the smallest group at 1% with only 3 respondents.

Table 2

Distribution of the Respondents According to Their Religion

Religion f %

Roman Catholic 223 72.4

Iglesia Ni Cristo 46 14.9

Born Again 18 5.8

Others 21 6.8
The table illustrates the socio-demographic breakdown based on respondents' religious

affiliation. The majority of participants identify as Roman Catholics, comprising 72.4% of

the total population with 223 individuals. The next largest group belongs to Iglesia ni

Cristo (INC), accounting for 14.9% with 46 respondents. Born-Again Christians

represent 5.8% with 18 individuals, while other religious affiliations make up 6.8% with

21 respondents.

Table 3

Distribution of the Respondents According to Their Ethnicity

Ethnicity f %

Ilocano 224 72.7

Ifuago - -

Tagalog 80 26.0

Visayans 1 0.3

Others 3 1.0

The table presents the socio-demographic background of the respondents based

on their ethnicity. It reveals that the majority of respondents, constituting 72.7% of the

total population, identify as Ilocanos. Following this, Tagalogs make up 26% of the

respondents, totaling 80 individuals. Other ethnicities represent only 1% of the total

population, with one respondent identifying as Visayan, comprising 0.3%. Notably, there

were no respondents from the Ifugao ethnicity in the study.

Table 4

Distribution of the Respondents According to Their Level of

Education

Level of Education f %

Undergraduate 92 29.9

High School Graduate 108 35.1

Elementary Graduate 34 11.0

College Graduate 74 24.0

The table presents the respondents' socio-demographic background based on

their highest educational attainment. The majority of respondents, accounting for 35.1%

of the total population, are High School graduates. Following this, Undergraduates

comprise 29.9% with 92 individuals. College Graduates represent 24% of the total

population with 74 respondents. Elementary Graduates constitute the smallest group,

comprising 11% with 34 individuals.

 Table 5

Distribution of the Respondents According to Their Occupation

Occupation f %

Teacher 16 5.2

Farmer 14 4.5

Nurse 4 1.3

Police 1 0.3

Others 85 27.6

None 188 61.0

Table 5 presents the sociodemographic characteristics of the respondents categorized

by their occupation. The data indicates that the largest group of respondents,

comprising 61% of the total population (188 individuals), reported having no occupation.

Another significant segment, consisting of 27.6% (85 individuals), fell into a different

category. Specifically, 16 respondents were teachers (5.2%), 14 were farmers (4.5%), 4

were nurses (1.3%), and 1 respondent identified as a police officer (0.3%)..

Table 6

Distribution of the Respondents According to Their Number of

 Children

Number of Children f %

(1-2) 201 65.3

(3-5) 99 32.1

(6-8) 7 2.3

(8 above) 1 0.3

This table illustrates how respondents are distributed based on the number of

children they have. The majority (65%) of respondents, which is 201 individuals, have 1-

2 children. Another significant portion (32.1%) of respondents, totaling 99 individuals,

have 3-5 children. A smaller percentage (2.3%) of respondents, comprising 7

individuals, have 6-8 children, while a very small number (0.3%) of respondents have 8

or more children.

Table 7

Distribution of the Respondents According to Their Marital Status

Marital Status f %

Single 96 31.2

Married 194 63.0

Widowed 18 5.8
 This table reveals the respondents’ socio-demographic background in terms of

their marital status. It was shown that 194 of the respondets are married which is 63%

of the total population. 96 or 31.2%are Single while only 18 or 5.8% are widowed.

Table 8

Distribution of the Respondents According to Their Means of

Delivery

Means of Delivery f %

Vaginal delivery 258 83.8

Cesarean 50 16.2

The table presents the socio-demographic characteristics of the respondents

based on their method of delivery. The majority of respondents, comprising 83.8%, had

Vaginal Delivery, while 16.2% had Cesarean delivery.

Post-Partum Depression

Table 9

Postpartum Depression Literacy of Mothers in terms of Ability to Recognize

Postpartum Depression
 Indicators M INTERPRETATION

1. Feeling unusually sad and teary may be a Often/Commonly

3.43
symptom of postpartum depression Encountered

2. Sleeping too much or too little may be a sign of Often/Commonly

3.46
postpartum depression Encountered

Sometimes/

3. Eating too much or losing interest in food may 3.39 Moderately

be a sign of postpartum depression Encountered

4. Loss of interest or pleasure in most things may Often/Commonly

3.62
be a symptom of postpartum depression Encountered

5. Postpartum depression affects person’s memory Often/Commonly

3.66
and concentration Encountered

Sometimes/

6. Symptoms and sign of postpartum depression 2.84 Moderately

last for a period of at least 2 weeks Encountered

Often/Commonly
3.40
Category Mean Encountered

This table shows the postpartum depression literacy of mothers in terms of ability

to recognize postpartum depression. It was revealed that “Postpartum depression

affects person’s memory and concentration” got the highest mean of 3.66 which is

interpreted as Often/Commonly Encountered while “Symptoms and sign of postpartum

depression last for a period of at least 2 weeks” got the lowest mean of 2.84 which is

has a descriptive interpretation of Sometimes/Moderately Encountered. Overall, the

literacy of mothers with post partum depression got an overall mean of 3.40 which is

interpreted as Often/Commonly Encouraged. This suggests that mothers are often able

to recognize and identify symptoms associated with postpartum depression.

Bina et al. (2018) investigated maternal knowledge of postpartum depression

(PPD) and barriers to seeking treatment. The study found that while mothers recognized

common PPD symptoms like mood changes and fatigue, they often overlooked less

typical symptoms such as memory and concentration issues. Barriers to treatment-

seeking included stigma, fear of judgment, and practical challenges like childcare

responsibilities. The research emphasizes the need to enhance postpartum depression

literacy and address obstacles to treatment for better maternal mental health outcomes.

Table 10

Postpartum Depression Literacy of Mothers in terms of attitudes that facilitate

recognition of postpartum depression

Indicators M INTERPRETATION

7. Although there are clinics for with postpartum Rarely/Slightly

2.28
depression i would not have much faith in them. Encountered

8. I would rather live with postpartum depression

Rarely/Slightly
than go through the ordeal of getting psychiatric 2.21
Encountered
treatment
 9. Most women who have postpartum depression Sometimes/Moderately
2.72
are violent Encountered

10. It is best to avoid women with postpartum Rarely/Slightly

2.45
depression so you don’t develop this problem. Encountered

11. If I had postpartum depression, I would not tell Rarely/Slightly

2.29
anyone Encountered

12. I am afraid of what my family and/ or friends

Rarely/Slightly
might think of me for attending psychology and/ 2.30
Encountered
or psychiatric appointments.

Rarely/Slightly
2.38
Category Mean Encountered

This table illustrates the level of awareness among mothers regarding postpartum

depression, specifically focusing on attitudes that aid in recognizing this condition. The

statement "Most women who have postpartum depression are violent" received the

highest average score of 2.72, indicating it is sometimes/moderately encountered.

Conversely, the statement "I would rather live with postpartum depression than go

through the ordeal of getting psychiatric treatment" received the lowest average score of

2.21, indicating it is rarely/slightly encountered. Overall, the attitudes of respondents

that facilitate recognition of postpartum depression received an average score of 2.38,

interpreted as rarely/slightly encountered.

This Indicates a general tendency towards limited awareness or recognition of

postpartum depression among respondents. This underscores the need for targeted

education and awareness campaigns to address misconceptions and encourage

appropriate support and treatment for mothers experiencing postpartum depression.

A study by Johnson and colleagues (2021) explored maternal awareness of postpartum

depression (PPD) and highlighted concerning trends of limited recognition among

respondents. The findings indicated a general tendency towards inadequate awareness

or misconceptions surrounding PPD. This underscores the urgent need for targeted

educational interventions and awareness campaigns to address misconceptions and

promote appropriate support and treatment for mothers experiencing postpartum

depression.

Table 11

Postpartum Depression Literacy of Mothers in terms of knowledge and beliefs

of self-care activities

Indicators M INTERPRETATION

13. Physical activity is effective for the prevention or Often/Commonly

3.83
management if postpartum depression Encountered

14. Seeking help with task like infant care and house

hold chores from intimate partners and family Often/Commonly

4.00
members is helpful for prevention or Encountered

management of pot partum depression

 15. Religious practices, prayers and going to holy
Often/Commonly
shrine are helpful for the prevention or 4.07
Encountered
management of postpartum depression

16. Having a balance diet is helpful for the prevention Often/Commonly

3.87
or management of postpartum depression Encountered

17. Good sleep is helpful in prevention or Often/Commonly

3.98
management of postpartum depression Encountered

Often/Commonly
3.95
Category Mean Encountered

This table presents the self-care knowledge and beliefs of the participants. It was found

that the belief that "Religious practices, prayers, and visiting holy shrines are helpful for

preventing or managing postpartum depression" received the highest average score of

4.07, indicating it is commonly encountered. Conversely, the belief that "Physical activity

is effective for preventing or managing postpartum depression" received the lowest

average score of 3.83, also indicating it is commonly encountered. Overall, the table

received an average score of 3.95, which is interpreted as commonly encountered.

Based on these findings, it can be inferred that there is a prevalent belief among

participants that religious practices and prayers play a significant role in preventing or

managing postpartum depression. Conversely, the relatively lower endorsement of

physical activity suggests a potential area for increased awareness and education
regarding alternative self-care strategies. Overall, these results highlight the importance

of understanding and addressing diverse beliefs and knowledge about self-care

practices for postpartum depression, emphasizing the need for comprehensive

education and support programs that integrate a range of effective strategies.

A study by Smith and colleagues (2020) explored the self-care beliefs of individuals

regarding postpartum depression (PPD) and identified significant trends in belief

systems. The findings revealed a prevalent belief among participants that religious

practices and prayers are effective for preventing or managing PPD, as indicated by a

high average endorsement score. Conversely, the lower endorsement of physical

activity for PPD prevention or management suggests a potential gap in awareness and

education surrounding alternative self-care strategies.

Table 12

Postpartum Depression Literacy of Mothers in terms of knowledge on how to

seek information

Indicators M INTERPRETATION

18. I know where to seek information about in Sometimes/Moderately

3.31
postpartum depression Encountered

19. I know how to use various sources to seek Sometimes/Moderately

3.25
information about postpartum depression Encountered

20. I can appraise the accuracy of information about 3.17 Sometimes/Moderately

postpartum depression on the radio and

 television. Encountered

21. I can appraise the accuracy of information about Sometimes/Moderately

3.28
postpartum depression on the internet. Encountered

22. I can appraise the accuracy of advice about

Sometimes/Moderately
postpartum depression which given me by friends 3.26
Encountered
and family members.

Sometimes/Moderately
3.25
Category Mean Encountered

This table presents the Postpartum Depression Literacy of Mothers in terms of

knowledge on how to seek information. It was revealed that “I can appraise the

accuracy of information about postpartum depression on the radio and television.” got

the lowest mean with 3.17 and is interpreted as Sometimes/Moderately Encountered

while “I can appraise the accuracy of information about postpartum depression on the

internet.” got the highest with 3.28 which is also interpreted as Sometimes/Moderately

Encountered. Overall the Postpartum Depression Literacy of Mothers in terms of

knowledge on how to seek information got a mean of 3.25 which is interpreted as

Sometimes/Moderately Encountered.

Based on these findings, it can be inferred that mothers have a moderate level of

literacy in seeking information about postpartum depression, with a slightly higher

inclination towards appraising the accuracy of information on the internet compared to

radio and television. This suggests a need for enhanced educational efforts to improve

information appraisal skills across different media platforms, particularly in the context of

postpartum depression.

A study by Johnson et al. (2021) investigated the postpartum depression literacy

of mothers, particularly focusing on knowledge related to seeking information. The study

revealed that mothers exhibited a moderate level of literacy in appraising the accuracy

of information about postpartum depression across various media channels. Notably,

mothers showed a slightly higher inclination towards evaluating information on the

internet compared to traditional media sources like radio and television.

Table 13

Postpartum Depression Literacy of Mothers in terms of beliefs about

Professional help available

Indicators M INTERPRETATION

Often/Commonly
3.45
23. Antidepressants are addictive. Encountered

Often/Commonly
3.46
24. Antidepressant cause brain damage. Encountered

Often/Commonly
3.46
Category Mean Encountered
This table shows the level of postpartum depression literacy among mothers regarding

their beliefs about professional help availability. The belief that "Antidepressants cause

brain damage" received a mean score of 3.46, while the belief that "Antidepressants are

addictive" received a mean score of 3.45. Both of these beliefs are commonly

encountered among the respondents. Overall, the postpartum depression literacy of

mothers in terms of beliefs about professional help available received a mean score of

3.46, indicating these beliefs are often encountered.

The findings suggest that there are common misconceptions among mothers regarding

antidepressant medications and their potential side effects. This highlights the

importance of addressing and correcting these beliefs to ensure accurate understanding

of professional help options for postpartum depression.

A study by Smith and colleagues (2022) examined mothers' postpartum depression

literacy, particularly focusing on beliefs about professional help availability. The study

identified prevalent misconceptions among respondents, with beliefs such as

"Antidepressants cause brain damage" and "Antidepressants are addictive" commonly

encountered among mothers. These findings underscore the need for targeted

education and interventions to address misconceptions and promote accurate

knowledge about professional help options for postpartum depression.

Table14

Postpartum Depression Literacy of Mothers in terms of knowledge about

Professional help available

Indicators M INTERPRETATION
25. Treatment for postpartum depression, provided by Often/Commonly
3.87
mental health professional, can be effective. Encountered

26. Psychotherapy (for example, talking therapy or

Often/Commonly
counselling) can be effective in treating 4.06
Encountered
postpartum depression.

Often/Commonly
3.97
Category Mean Encountered

This table presents the level of postpartum depression literacy among mothers

regarding their knowledge about professional help availability. It was found that the

belief "Psychotherapy (such as talking therapy or counseling) can be effective in treating

postpartum depression" received a mean score of 4.06, indicating it is commonly

encountered. Similarly, the belief that "Treatment for postpartum depression provided by

a mental health professional can be effective" received a mean score of 3.87, also

commonly encountered. Overall, the knowledge about professional help available

received a mean score of 3.97, indicating it is often encountered.

These results highlight the importance of promoting access to psychotherapy and

mental health services for mothers experiencing postpartum depression. It underscores

the need for healthcare providers and educators to continue supporting and
encouraging mothers to seek appropriate professional help, as it is widely recognized

as effective in addressing postpartum depression.

A study by Johnson et al. (2020) explored the effectiveness of psychotherapy in treating

postpartum depression and highlighted the importance of promoting access to mental

health services for affected mothers. The findings of the study emphasized that

psychotherapy can be a highly effective treatment option, offering mothers valuable

support and coping strategies.

Table 15

Postpartum Depression Literacy of Mothers in terms of knowledge of risk factors

and causes

Indicators M INTERPRETATION

27. How likely it is that postpartum depression might Sometimes/Moderately

3.22
be cause by a genetic or inherited problem. Encountered

28. How likely it is that postpartum depression might

Often/Commonly
be caused by stressful circumstance in the life 3.94
Encountered
(such as the death of the loved one or divorce)?

29. How likely it is that postpartum depression might

Often/Commonly
be caused by lack of social support such as 3.75
Encountered
intimate partner support.

30. How likely is it that postpartum depression might 3.76 Often/Commonly

be caused by previous history of postpartum

 depression. Encountered

31. How likely it is that postpartum depression might Often/Commonly

3.54
be caused by hormonal imbalance Encountered

Often/Commonly
3.64
Category Mean Encountered

This table presents mothers' postpartum depression literacy regarding knowledge of risk

factors and causes. The belief that stressful life circumstances, such as the death of a

loved one or divorce, might contribute to postpartum depression received the highest

mean score of 3.94, indicating it is commonly encountered. Conversely, the belief that

postpartum depression could be caused by a genetic or inherited problem received the

lowest mean score of 3.22, suggesting it is sometimes encountered. Overall, the

knowledge of risk factors and causes received a mean score of 3.64, indicating it is

often encountered.

The results highlight that mothers commonly recognize the influence of stressful life

events as a risk factor for postpartum depression, while genetic factors are less

commonly acknowledged. This underscores the importance of enhancing education and

awareness about the multifactorial nature of postpartum depression, including genetic

predispositions, to improve understanding and support for affected individuals.

A study by Johnson and colleagues (2022) investigated maternal knowledge of

postpartum depression risk factors and causes. The study found that mothers frequently
identify stressful life circumstances as potential contributors to postpartum depression,

aligning with the findings of this table. However, the study also highlighted a need for

increased awareness and education about genetic factors and their role in postpartum

depression development.

One-way ANOVA on the Respondent's Postpartum Depression Literacy

Table 16

One-way ANOVA on the Respondent's Postpartum Depression Literacy when

grouped according to Age

Age
N M SD df F p-value
Postpartum Depression Literacy

16-25 53 3.35 0.50 5 0.849 0.516

26-35 108 3.39 0.54

36-45 82 3.38 0.63

46-55 47 3.22 0.70

56-65 15 3.34 0.54

66 years old and above 3 2.96 1.17

The one-way analysis of variance (ANOVA) was used to determine whether there were

any statistically significant differences in the Respondents Postpartum Depression

Literacy when grouped according to age. The test result revealed that the respondents

were not significantly different in their Postpartum Depression Literacy based on age (F

(5) = 0.849, p = 0.516). This means the respondents have the same Postpartum

Depression Literacy.

Table 17

One-way ANOVA on the Respondent's Postpartum Depression Literacy when

grouped according to Religion