Date of Award

5-2010

Level of Access

Campus-Only Thesis

Degree Name

Master of Science (MS)

Department

Nursing

Advisor

Judy Kuhns-Hastings

Second Committee Member

Ursula Pritham

Third Committee Member

Erin Bellaire

Abstract

Postpartum depression has gathered increasing attention in recent years, but appears to be frequently overlooked with as many as 50% of cases going undiagnosed (Goldsmith, 2007). The negative consequences of postpartum depression are clearly stated in the literature yet the screening rates appear to be low. The purpose of this descriptive study is to identify current postpartum depression screening practices of obstetrician-gynecologists, family medicine physicians, nurse-midwives, pediatricians, and family nurse practitioners in rural midcoast Maine communities. In addition to screening practices, the beliefs and attitudes towards postpartum depression screening were explored along with the demographics of the participants. The research question to be answered is: Are clinicians in the midcoast Maine area screening for postpartum depression? A self completed survey was conducted of a purposive convenience sample of 100 participants including nurse midwives, obstetricians-gynecologists, family nurse practitioners, and family medicine physicians who practice 10 hours a week or more. The survey instrument is divided into 13 Likert scale questions to inquire about barriers to routine screening, five demographic questions, and seven questions regarding current screening practices and tools used. Of the 100 participants (50%) returned the survey. This study found that participants screen for postpartum depression in the following manners: 1 (2%) never screen, 8 (16%) sometimes screen, 19 (38%) often screen, and 22 (44%) always screen. Specifically relating to the screening practices during well child visits, it was found 3 (6%) never screen, 6 (12%) sometimes screen, 21 (42%) often screen, 11 (22%) always screen, and 9 (18%) answered non applicable as they did not perform well child visits. As for screening during the prenatal period it was shown that 1 (2%) never screen, 16 (32%) sometimes screen, 6 (12%) often screen, 6 (12%) always screen, and 21 (42%) were not applicable. When screening for postpartum depression the study shows that 38 (76%) do not use a screening tool while 12 (24%) do use a specific screening tool. Of the 12 participants that use a standardized screening tool 2 (17%) use the Beck Depression Inventory, 7 (58%) use the Edinburgh Postnatal Depression Scale (EPDS), 1 (8%) use a structured clinical interview, and 5 (42%) use the PHQ9, which is a ten question patient health questionnaire for postpartum depression. Of those surveyed, provider attitudes and beliefs indicate that they believe it is their responsibility to diagnose and treat postpartum depression yet screening rates remain low. Participants recognize the seriousness of the disorder and 41 (82%) agree that it is a treatable disorder. However, participants report difficulty screening for postpartum depression due to time constraints and a need for further education relating to the types of tools available. Recommendations are to decrease barriers to help increase screening rates, which would include providing education to providers on the screening tools available, strategies for training staff, and how to incorporate the screening process into practice without being time consuming for the practitioners

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