POSTPARTUM DEPRESSION: SCREENING PRACTICES IN RURAL MAINE

POSTPARTUM DEPRESSION: SCREENING PRACTICES IN RURAL MAINE

By Melissa Goodwin

Thesis Advisor: Dr. Judy Kuhns-Hastings

A Lay Abstract of the Thesis Presented

in Partial Fulfillment of the Requirements for the

Degree of Master of Science

(In Nursing)

May, 2010

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.  Screening practices specific to well child visits and prenatal visits are also explored along with the specific screening tools used.

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.