Screening Method In The Immediate Postpartum Period And The Study About Efficacy Of Interpersonal Psychological Nursing For For Women Of High-risk Postpartum Depression

Objective To analyze risk factors for postpartum depression and predictive validation study of EPDS in the first week after delivery in order to assist in targeted screening in the immediate postpartum period and to evaluate the efficacy of interpersonal psychological nursing(IPN) for women of high-risk postpartum depression,providing guidance for further clinical psychological nursing.Methods A population-based sample of 180 primiparas were recruited and 159 primiparas completed questionnaires at 1-week postpartum that included EPDS,EPQ, SSRS,LES and general status questionnaire.Measures of depressive symptomatology were administered at 4 weeks,8 weeks again,analyzing predictive validation of EPDS and risk factors for postnatal depression in the first week.In addition,a total of 40 women of high-risk postpartum depression primipara were recruited and randomly assigned to 2 groups(20 respectively).The control group was given routine nursing,while 2 months of IPN from the first week after delivery was applied to the intervention group.Both group were assessed by EPDS at 4 weeks,8 weeks again,the results of which were analyzed statistically.Results 1.The multivariate factors analysis identified the following as risk markers for postpartum depression in the immediate postpartum period:vulnerable personality characteristics,lack of objective support and knowledge about postnatal depression, negative life events recently,dissonant couple relationship,anxiety during pregnancy,of which knowledge deficiency about postpartum depression plays the most important role. 2.The sensitivity,specificity of the 1-week EPDS in relation to identifying mothers with elevated EPDS scores at 4 weeks was measured as 81.3%,93.7%,which was 84.4%, 85.0%at 8 weeks;while the AUC of 4-week and 8-week was 0.911 and 0.878 respectively.The 1-week EPDS was significantly correlated to the 4-week(r =0.707,P＜0.01) and 8-week(r =0.641,P＜0.01) EPDS.Parturients with a 1-week EPDS score＞9 were more likely to exhibit postpartum depression symptoms,which were 34.02 times at 4 weeks and 3.58 times at 8 weeks.3.EPDS scores of women receiving IPN declined from12.10±1.45 to 6.60±2.76,which was a significant decrease in contrast with those that occurred in the control group(12.30±1.26 to 9.05±2.01).A significantly greater percentage of women(90%) who received IPN recovered from their depressive episode when compared to women in the control group(60%).Conclusion 1.The EPDS can be used as a conventional screening instrument in the 1st week postpartum.Comprehensive assessment on risk factors for postpartum depression for women with EPDS score＞9 should be administered.EPDS score＞9 is accompanied by one or more risk factors,which can be regarded as screening method for women of high-risk postpartum depression.2.IPN can relieve clinical symptoms for women suffering from postpartum depression,reducing incidence of postpartum depression.