INTRODUCTION:

“A woman who becomes pregnant and gives birth to son will be ceremonially unclean for seven days, just as she is unclean during her monthly period. On the eighth day, the boy is to be circumcised. Then the woman must wait thirty-three days to be purified from her bleeding. She must not touch anything sacred or go to the sanctuary until the days of her purification are over” (Leviticus 12:1-4, New International Version).¹

Post-natal depression is a type of depression that many parents experience after having a baby. It is a common problem, affecting more than one in every ten women within a year of giving birth. It can also affect the father. It is important to seek help as soon as possible if you think you might be depressed, as your symptoms could last months or get worse and have a significant impact on you, your baby and your family.²

Many women feel a bit down, tearful or anxious in the first week after giving birth this is often called the “baby blues” and is so common that it considered normal. The “baby blues” do not last for more than two weeks after giving birth. If your symptoms last longer or start later, you could have postnatal depression. It can start any time in the first year after giving birth. Signs that you or someone you know might be depressed include: A persistent felling of sadness and low mood, lack of enjoyment, lose of interest in the wider world, lack of energy, felling tired all the time, trouble sleeping at night, felling sleepy during the day, difficulty in bonding with your baby, withdrawing from contact with other people, problems in concentrating, making decisions, frightening thoughts- for e.g., about hurting your baby.³

Marital discord, lack of support from the husband, and single motherhood were other factors that have been identified as risk factors in this disorder. Few of surveys have reported post natal depression to be more common among woman with multiparty with the reason adduced for this, was that, the presence of other young children at home to be catered for inacurtently increases the stress of the mother. However, other studies reported a higher prevalence rate among the primi postnatal mothers.⁴

Post-natal depression is a lasting depression experienced by about 12% women after delivery. The incidence of post-natal depression is fairly similar around the world. In past 20 years, there has been increasing recognition that for some women, pregnancy may be burned with mood problems, in particular depression that may impact both mother and child.⁵

The postnatal depression affects many women globally. In the weeks and months that follow the birth of a child, between 10 and 20 percent of mothers experience serious or moderate symptoms of depression today, the postnatal depression is affecting 13% women from diverse culture. 10-15% women depends postnatal depression illness. In India, studies have shown that depression among young women (20-30years) is most common and illiterate (80%) house wives with (95%) from rural areas highly religious (60%) poor (90%) primi pare (80%) and with a live baby born (70%). The postnatal depression affects 10-20% of women in United States. Despite the well documented risk factors and health conscious of postnatal depression if often remains undetected and untreated. The prevalence rates varying from 4.4% to 73%. The most frequent psychiatric disorder seen after childbirth, with a prevalence rate of 10% to 15%. The setting up of relevant and efficient prevention and promotion programs requires a better understanding of the effect of stress and social support on the mental health of mothers.⁶

Postnatal depression is the most frequent psychiatric disorder seen after childbirth with a prevalence rate of 10% to 15%. According to one survey the women at risk need to be identified by a valid and reliable method, either using a screening instrument or an interview schedule. Its rates have increased significantly over the past 50 year up from 8% in the 1950s to 27% today and with a further 25 also feeling that they have possibly suffered. Hence, by reviewing this, investigators felt the need to assess the post-natal depression among primi post-natal mother and to provide booklet regarding its prevention.⁷

METHODOLOGY:

RESEARCH APPROACH:

The research approach adopted for this is descriptive approach used to assess the depression among prime post-natal primary mother.

RESEARCH DESIGN:

For the present study quantitative research design was used.

RESEARCH SETTING:

The Final study conducted in Lord Mahavir Civil Hospital Ludhiana, Punjab.

The Pilot study was conducted in Permjit Singh Memorial Government Hospital Sudhur, Punjab.

STUDY POPULATION:

The accessible population for study consisted of primi post-natal mothers (22-32 years) in selected hospitals, Ludhiana, Punjab.

SAMPLING TECHNIQUE:

Convenient sampling technique was used to select the sample for assessing the depression among post-natal mothers.

In this study, researcher fixed no. i.e. 60 from selected hospital.

SAMPLE:

In this study, sample comprised of 60 primi post-natal mothers in selected Lord Mahavir Civil Hospital, Ludhiana, Punjab. N= 60

DEVELOPMENT AND DESCRIPTION OF TOOL

The tool is divided into two parts:

· Part 1:

socio–demographic data – It included age, sex of child, religion, income, educational status, type of family, occupation, marital status, sex of child, type of delivery, family income and source of information.

· Part 2:

EPDS (Edinburgh Post-natal depression scale) is used to assess post-natal depression among primi post-natal mothers.

CRITERION MEASUREMENT:

· QUESTION 1, 2 and 4 (without an*)

are scored 0, 1, 2 or 3 with top box scored as 0 and the bottom box scored as 3.

· QUESTION 3, 5-10 (marked with an*):

are reverse scored, with the top box scored as 3 and the bottom box scored as 0.

Maximum score: 30

Possible depression: 10 or greater

Always look at item 10 (suicidal thoughts)

CONTENT VALIDITY OF TOOL:

The tool is valid, if it tests what it supposed to test. The content validity of tool was determined by expert’s opinion on the relevance of items.

PILOT STUDY:

It was conducted in November, 2019 to ensure the reliability and feasibility of the study. It was being conducted in Premjit Singh memorial government hospital Ludhiana, Punjab on 6 primi post- natal mothers to check the reliabilityand feasibility of tool.

RELIABILITY OF TOOL:

Reliability of measuring instrument is a major criterion for assessing the quality, adequacy. Reliability was calculated by using Karl Pearson co-efficient co-relation formula.

r = 0.9

DATA COLLECTION PROCEDURE:

Permission was taken from ethical committee of SKSS CON, Principal of SKSS CON Sarabha, SMO of selected hospitals and also from selected mothers. Written consent was taken from selected primi postnatal mothers and they were free to participate in the study according to their willingness. Data was collected in the month of Dec, 2019 through Edinburgh Postnatal Depression Scale and then analyzed by inferential and statistical method. Confidentiality was maintained by researcher.

PLAN FOR DATA ANALYSIS:

The analysis of data was done in accordance with objectives by using descriptive and inferential statistics e.g. mean standard deviation, t-test, and ANOVA test.

RESULT AND DISCUSSION:

The first objective of the study was to assess post-natal depression among primi post-natal mothers the Findings revealed that, majority 41.3% of primi post-natal mothers had minimum depression regarding post-natal period, followed by 58.7% of primi post-natal mothers had possible depression, followed by 0% of primi post-natal mothers had maximum depression regarding post-natal period.

The second objective of the study was to find out association between the level of depression with selected demographic variables such as age, religion, education, occupation, marital status, type of family, family income, gender of child and type of delivery.

Findings revealed that on the basis of age of primi post-natal mothers (in year), depicts that the highest mean level of depression i.e. 12.63 found within age group of 28-32 years, followed by 10.14 with in age group of <22 years, followed by 9.90 with in age group of 22-28 years and lowest i.e. 3.75 in age group of >32 years. On the basis of ANOVA test tabulated value for df (3/56) is 2.76 and the calculated value ‘F’ was 4.0758. The calculated value was more than tabulated value which was found to be statically significant at p≤0.05 level of significance.

On the basis of religion of primi post-natal mothers, depicts that the highest mean level of depression i.e. 13.50 were Muslim, followed by 10.66 were Sikh and lowest i.e. 9.14 were Hindu. On the basis of ANOVA test tabulated value for df value (2/57) is 3.15 and the calculated value ‘F’ was 1.3361. The calculated value was less than tabulated value which was found to be statically non-significant at p≤0.05 level of significance.

On the basis of education of mother, depicts that the highest mean level of depression of education of mothers i.e. 11.10 was found who were illiterate, followed by 10.70 who were primary passed, i.e. 10.06 who were metric passed, followed by 9.50 who were above graduate and least i.e. 8.16 who were graduate. On the basis of ANOVA test, the tabulated value for df (4/55) is 2.52 and the calculated value ‘F’ was 0.6957. The calculated value was less than the tabulated value which was found to be statically non-significant at p≤0.05 level of significance.

On the basis of occupation of mother, depicts that the maximum mean level of depression of occupation of mother i.e. 10.06 were working and minimum i.e. 10.04 were non-working.On the basis t-test, the calculated value was 0.0157 and tabulated value is 2.00 which found to be statistically non significant at p≤ 0.05 level of significance.

On the basis of husband’s education, depicts that the highest mean level of depression score of husband’s education i.e. 14.50 were illiterate, followed by 10.47 who were primary passed, followed by 10.17 were graduate and lowest 8.81 who were metric passed. On the basis of ANOVA test, the tabulated value for df (3/56) is 2.76 and the calculated value ‘F’ was 1.8253. The calculated value was less than the tabulated value which was found to be statistically Non-Significant at p≤0.05 level significance.

On the basis of husband’s occupation, depicts that the maximum mean level of depression of husband’s occupation i.e. 14.0 were non-working and minimum 9.91 were working. On the basis t-test, the calculated value was 1.2149 and tabulated value is 2.00 which found to be statistically non significant at p≤ 0.05 level of significance.

On the basis of marital status, depicts that the highest mean level of depression of marital status i.e.15.3 were divorce, followed by i.e. 9.77 were married and lowest 0 were unmarried and widow. On the basis t-test, the calculated value was 2.0533 and tabulated value is 1.67 which found to be statistically significant at p ≤0.05 level of significance.

On the basis of type of family, depicts that the highest mean level of depression of type of family i.e. 10.65 were nuclear and lowest i.e. 9.48 were joint. On the basis t-test, the calculated value was 0.9919 and tabulated value is 2.00 which found to be statistically non significant at p ≤0.05 level of significance.

On the basis of family monthly income (in Rs.), depicts that the highest mean level of depression of family monthly income (in Rs.) i.e. 13.50 were had income of 25000-35000, followed by 10.00 were had income of 15000-25000, lowest i.e.9.82 were had income of <15000.On the basis of ANOVA test, the tabulated value for df (2/57) is 3.15 and the calculated value ‘F’ was 0.5762. The calculated value was less than the tabulated value which was found to be statistically non-significant at p≤0.05 level of significance.

On the basis of gender of children, depicts that the highest mean level of depression of gender of children i.e. 10.70 were male and lowest i.e. 9.45 were female. On the basis t-test, the calculated value was 1.0304 and tabulated value is 1.67 which found to be statistically non significant at p≤ 0.05 level of significance.

On the basis of type of delivery, depicts that the highest mean level of depression i.e.11.62 were undergone normal delivery and lowest i.e. 8.94 were L.S.C.S. On the basis t-test, the calculated value was 0.3694 and tabulated value is 1.67 which found to be statistically significant at p≤ 0.05 level of significance.

IMPLICATIONS:

The study findings have certain important implications for nursing prevention that is nursing education, nursing practices, nursing research and nursing administration.

Nursing Education:

· Continue education should be provided to health care workers. so, they can educate and assess the post-natal depression occurring among post-natal mothers.

· Educate primi post-natal mothers during their post-natal period to take proper diet.

· Health talks in mother child hospital should be conducted by medical students and staff collaboratively for providing knowledge regarding post-natal period.

Nursing Practices:

· The nurses working in hospital has important role in helping mothers develops self-care potentials to cope up with post-natal depression.

Nursing Research

· The present study can be used as source of review of literature for future researches.

· Further study can be conducted to prepare evidence based practices.

RECOMMENDATIONS:

· Similar study can be replicated by using large sample.

· A comparative study to assess the postnatal depression among mothers with normal delivery and mothers with L.S.C.S in selected Hospital, Ludhiana, Punjab.

· A descriptive study to assess the knowledge on postnatal depression during postnatal period among family members of mother in selected Community Area, Ludhiana, Punjab.

CONCLUSION:

On the basis of result of data analysis the following conclusion were reached:

· The findings of present study indicates that most of selected primi post-natal mothers i.e. 58.3% falls in minimum depression followed by some of them i.e. 41.7% falls in possible depression and no another was fall in maximum depression.

· The statistical significant variables were age, marital status and type of delivery of p≤0.05 at level of significance and non-significant variables were religion, education, occupation, husband’s education, husband’s occupation, type of family, family monthly income (in Rs.), Gender of children at p≤0.05 at level of significance.

REFERENCES:

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Received on 12.03.2020 Modified on 02.04.2020

Int. J. of Advances in Nur. Management. 2020; 8(3):219-222.

DOI: 10.5958/2454-2652.2020.00050.5