Postpartum Depression

Background

Postpartum depression is a health condition that affects women especially after childbirth (Goodman, 2004). The condition tends to be serious to such an extent that the affected woman fails to take care of herself, her new born baby as well as her families. Women are perceived to be the primary caregivers in a family, and this means that when they are unwell, the wellbeing of the entire family is jeopardized (Field, 2010). When any form of depression strikes, the affected individual becomes less productive and this translates to a number of losses to the family, organization, or the society (Taylor, 2016; Depression, 2015).

Apparently, numerous research studies have been performed to take a look at the reasons of postpartum despair, although the underlying issue is childbirth. Approximately one in every eight women suffer from this temper sickness of postpartum depression (Borra, Iacovou, & Sevilla, 2015). It’s also essential to understand the symptoms related to it in order that it can be efficaciously diagnosed. As a fruits of those, we can then have a look at the best interventions to be able to be carried out to relieve postpartum despair. Postpartum depression can be difficult to diagnose as it can present itself in numerous symptoms (Robertson et al., 2004). There are hence no unique signs and symptoms, but there are obvious ones which helps in diagnosing and differentiating this condition from other health conditions which may be having similar signs and symptoms.

Moreover, there are a number of interventions that may be embraced in order to prevent as well as treat postpartum depression. Among these interventions is the psychosocial and psychological interventions. In order to confirm the effectiveness of this interventions, Dennis, & Hodnett (2007) conducted a research study was conducted involving women who were at high risk of developing this condition as well as those who had already diagnosed with postpartum depression. Women who were categorized as at risk entailed expectant mothers who were within their first, second, and third trimester, as well as those who were within their initial months after delivery. The results of this study showed that this health condition is caused by isolation, low self-esteem, as well as lack of financial, psychological and physical support from friends, colleagues and family members. In addition, the study established that both psychological (such as interpersonal psychotherapy and cognitive behavioral therapy) and psychosocial (such as non-directive counselling and peer support) interventions were effective in both preventing the development of this condition, as well as reducing its signs and symptoms. Another study that was conducted by Dennis, Hodnett and Grigoriadis (2008), also stipulated three interventional measures for postpartum depression, which are not limited to psychosocial, psychological, and interpersonal psychotherapy. Interpersonal psychotherapy entails an intervention option that is embraced where there is a connection between depressive symptomatology onset and interpersonal problems. However, this study did not stipulate the long term benefits of these interventions, calling the need for larger trials to be embraced as a further research. In addition, the above studies did not provide precise conclusions concerning the specific benefits of each intervention strategy.

Objective

The objective of this study is to determine not only the interventions that are effective for treating women with postpartum depression, but also establishing the effectiveness of the identified interventions. In order to achieve this objective, a qualitative research method will be embraced, especially due to the fact that it is exploratory in nature, allowing not only effective contemplation of the phenomenon but also facilitating validity, reliability and more importantly, the acceptability of the results (Green & Thorogood, 2018). However, though there are a number of other research designs which may be better suited than qualitative methods, they are not effective in establishing the effectiveness of the interventions since the phenomenon under study requires in-depth exploration of the participants` feelings, thoughts and understanding (Smith & Sparkes, 2013).

Design

There are myriad of studies that have been conducted concerning postpartum depression. for this reason, it will be cheaper to compare the results of this qualitative study with the results of the previous studies (Lewis, 2015). In addition, the flexibility of the qualitative method will greatly benefit this study especially by providing extensive insights which will facilitate effective understanding of the phenomenon, as well as providing practical recommendations. In addition, the flexibility of the qualitative methods will help in gathering new or emerging trends concerning the phenomenon under study, and this will be greatly benefit the existing evidence. Moreover, hypothesis will be formulated and it will be evaluated based on the data that will be collected from the research methods. Considering that the grounded theory already has established grounds, the flexibility of the research method coupled by the structure of this study will greatly help in providing new and current insights concerning this phenomenon. Moreover, the evidence from the previous studies already gives a predetermination or clue concerning the likely findings of this study. For this reason, the researcher may highly likely be tempted to focus on some of the earlier results, and this is risky since the latter might fail to extensively explore the phenomenon of the current study (Brummelte & Galea, 2016). However, in order to lower this risk, it is important to ensure that the study is taken by reliable and ethical individuals, and this include ensuring that the selected individuals were not involved in conducting background research of this study and did not take part in writing its proposal.

In this study, the primary source of data will be the use entails the use of in-depth interviews. This is due to the fact that qualitative interviews are normally one-on-one engagements between the researcher and the respondent, and this enables the former to conduct in-depth exploration of the understanding, feelings and thoughts of the latter. Additionally, considering that it is unethical to expose health information of patients to unintended parties, it is important for the researcher to adhere to some study parameters while conducting collecting data including choosing an environment where the interviewee will be comfortable to share her health information (Zulman et al., 2011). This can only be achieved through the use of qualitative interviews. In addition, the use of interviews allows the research to assess the validity of the responses that are provided by the interviewee (Charmaz & Belgrave, 2012). In addition, this method enables the researcher to ask supplementary questions regarding the issue being studied, as well as seek for clarifications from the respondent especially if the answers provided by the latter appears to be insufficient within the parameters of the research. Consecutively, the use of interviews as a method of data collection enables the researcher to capture verbal and non-verbal ques of the respondent, such as body languages, which can help in assessing the level of discomfort or enthusiasm of the respondent. In addition, this method enables the researcher to maintain control over the respondent, especially by ensuring that he or she is not disrupted by other immediate things or individuals within the environment (DeFranzo, 2014). Precisely, the researcher ensures that the interviewee remains focused and on track until when the interview is over.

Setting

The study participants will entail expectant women, mothers who have gave have just gave birth as well as those who have been mothers for few weeks. In addition, the study participants will be selected from different settings, including tier 2 (municipal hospitals), tier 3 (State hospitals) and private health facilities.

Sample

In this study, the targeted participants will be selected through purposive sampling and snowball sampling techniques. Purposive sampling will be the initial technique and will help in identifying the health facilities which will help in identifying women who are suffering from postpartum depression. In this case health facilities which offers maternal health will be selected and in-patient services will be selected. In this case, one municipal hospital, one State hospital and one private hospital will be selected. Secondly, a combination of both snowball and purposive sampling will also be used to identify mothers who are suffering from postpartum depression. Precisely, snowball sampling technique will entail selecting a nurse practitioner within the health facility who will help in identifying women who have been diagnosed with postpartum depression. Since it is challenging for the researcher to identify mothers who have been diagnosed with postpartum depression, the use of snowball will greatly help in identifying the required participants. In this case, one nurse, three expectant women and three women who have been diagnosed with this condition will be selected in each health facility.

Procedure

The specific time for conducting the interview will be scheduled based on the availability and comfortability of the respondent. The desirable duration of a single interview will range between 45 and 60 minutes, and it will be adjusted in order to correspond with the availability of the interviewee. In addition, the guide to the topic will be semi-structured, as this will help the interviewer to ensure that he or she asks the interviewee all the relevant questions regarding the phenomenon of the study. In addition, the respondents will be encouraged to provide in-depth explanation of their experience with this health condition. For example, the respondent may reveal some of the symptoms that she experienced before being diagnosed with postpartum depression, how the depression has affected her life, wellbeing of her newborn as well as those around her, and more importantly, the treatment interventions that she is currently receiving. Moreover, the interviewer will inquire from the respondents on how they feel concerning the effectiveness of the current interventions. If so, the interviewee will be required to explain how the interventions has been effective, as well as whether the effectiveness was enhanced by any factor (s).

In the process of conducting the interview, the researcher should guide the respondents in order for them to clearly contemplate the question, and this may entail using as simple terms as possible, depending on the respondent`s level of understanding. Moreover, the interview process will be organized in such a way that the expectant women are interviewed first, followed by those who have just delivered, and lastly those who have delivered some weeks ago. For the expectant mothers, follow up interviews will be conducted even after delivery, as this will enable the researcher to establish the effectiveness of the interventions. Subsequent interviews for the other two categories of respondents can also be embraced.

Ethical Considerations

The researcher will provide all the necessary information concerning the study to all respondents and seek informed consent from them concerning whether they are willing to participate or not (Connelly, 2014). Those who will decide not to participate will not be forced, persuaded, threatened, or coaxed to participate. The health information of the study participants as well as the collected data will be highly protected in a computer that is password protected. Actually, the researcher will ensure that he does not associate interview transcripts with the actual names of the respondents and instead, he or she can assign special codes to each respondent. In addition, during the sample selection process, the researcher will adhere to fairness by including diverse participants based on age, social-economic status, or physical attributes. Subsequently, the researcher will take into consideration the potential burden placed on the study participants due to repeat interviews.

Analysis

The collected data will first be transcribed, checked for accuracy and be read over and over again before any form of analysis is embraced. This will be followed by coding and description of the responses collected. This will entails labeling or naming the response of each respondent with a particular name or code in order to prevent a situation where the researcher will confuse the response of one respondent from the other. In addition, the researcher will provide a brief account of the particular response, especially by trying to gasp the core issue or issues that the respondent raised. Actually, at this point, the researcher will try to establish the main theme that a particular respondent raised.

The researcher will then embrace data conceptualization, and this will entail analyzing the various themes that have been raised by respondents. He or she will assess the properties of various themes, establish how they relate with each other and with the phenomenon under study and focus on organizing them into various categories. For example, the responses which appears to have a similar theme are put under one category. For example, the responses which shows that psychosocial interventions are effective are placed under one category. Subsequently, through the created categories, the researcher establishes the dominant theme, connect and interrelate with the phenomenon under study, and come up with a conclusion. For example, if most respondents indicated that psychological interventions had been effective to them compared to those who mentioned psychosocial interventions, then the researcher will manage establish that psychological interventions are the most effective method of treating postpartum depression among women.

Further work

Though this study is important especially in generating information concerning the effectiveness of various intervention measures for treating postpartum depression, there are still a number of gaps that future research studies should focus on. First, the study used qualitative research method, which does not allow the use of a large sample size. A large sample size enhances the generalizations of the research findings since it serves as a true representation or picture of the area under study (Hussein, 2015). A small sample size increases biasness, and this reduces its reliability, acceptability, and validity. For this reason, there is need for quantitative research methods to be used as well in order to establish whether similar results will be attained. In addition, this study examined a wide range of variables concerning women with postpartum depression, such as age and educational levels. This means that the selecting the most appropriate sample size was not only challenging but also required meticulous planning. For this reason, it is important for future research to focus on individual and specific variable at a time in order to establish whether similar results will be obtained.

References

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Charmaz, K., & Belgrave, L. (2012). Qualitative interviewing and grounded theory analysis. The SAGE handbook of interview research: The complexity of the craft, 2, 347-365.

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DeFranzo S., (2014). Advantages and Disadvantages of Face-to-Face Data Collection. Retrieved from, https://www.snapsurveys.com/blog/advantages-disadvantages-facetoface-data-collection/

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Zulman, D. M., Nazi, K. M., Turvey, C. L., Wagner, T. H., Woods, S. S., & An, L. C. (2011). Patient interest in sharing personal health record information: a web-based survey. Annals of internal medicine, 155(12), 805-810.