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Development of a Prediction Model for Postpartum Depression: Based on the Mediation Effect of Antepartum Depression

산후우울 예측모형 개발: 산전우울의 매개효과 검증을 중심으로

  • Received : 2014.08.05
  • Accepted : 2015.01.15
  • Published : 2015.04.30

Abstract

Purpose: This study was done to develop a prediction model for postpartum depression by verifying the mediation effect of antepartum depression. A hypothesized model was developed based on literature reviews and predictors of postpartum depression by Beck. Methods: Data were collected from 186 pregnant women who had a gestation period of more than 32 weeks and were patients at a maternity hospital, two obstetrics and gynecology specialized hospitals, or the outpatient clinic of K medical center. Data were analysed with descriptive statistics, correlation and exploratory factor analysis using the SPSS/WIN 18.0 and AMOS 18.0 programs. Results: The final modified model had good fit indices. Parenting stress, antepartum depression and postpartum family support had statistically significant effects on postpartum depression, and defined 74.7% of total explained variance of postpartum depression. Antepartum depression had significant mediation effects on postpartum depression from stress in pregnancy and self-esteem. Conclusion: The results of this study suggest that it is important to develop nursing interventions including strategies to reduce parenting stress and improve postpartum family support in order to prevent postpartum depression. Especially, it is necessary to detect and treat antepartum depression early to prevent postpartum depression as antepartum depression can affect postpartum depression by mediating antepartum factors.

Keywords

References

  1. Smith M, Jaffe J. Depression in women: Causes, symptoms, treatment, and self-help [Internet]. Santa Monica, CA: Helpguide; 2014 [cited 2014 March 3]. Available from: http://www.helpguide.org/articles/depression/depression-in-women.htm.
  2. Centers for Disease Control and Prevention. Depression among women of reproductive age [Internet]. Atlanta, GA: Author; 2013 [cited 2014April 11]. Available from: http://www.cdc.gov/reproductivehealth/Depression/.
  3. Park YJ, Shin HJ, Ryu HS, Cheon SH, Moon SH. The predictors of postpartum depression. Journal of Korean Academy of Nursing. 2004;34(5):722-728. https://doi.org/10.4040/jkan.2004.34.5.722
  4. Cho HJ, Choi KY, Lee JJ, Lee IS, Park MI, Na JY, et al. A study of predicting postpartum depression and the recovery factor from prepartum depression. Korean Journal of Perinatology. 2004;15(3):245-254.
  5. Beck CT. Predictors of postpartum depression: An update. Nursing Research. 2001;50(5):275-285. https://doi.org/10.1097/00006199-200109000-00004
  6. Youn JH, Jeong IS. Predictive validity of the postpartum depression predictors inventory-revised. Asian Nursing Research. 2011;5(4):210-215. http://dx.doi.org/10.1016/j.anr.2011.11.003
  7. Robertson E, Grace S, Wallington T, Stewart DE. Antenatal risk factors for postpartum depression: A synthesis of recent literature. General Hospital Psychiatry. 2004;26(4):289-295. http://dx.doi.org/10.1016/j.genhosppsych.2004.02.006
  8. Kim JY, Kim JG. Psycho-social predicting factors model of postpartum depression. The Korean Journal of Health Psychology. 2008;13(1):111-140. https://doi.org/10.17315/kjhp.2008.13.1.007
  9. Cho HW, Woo JY. The relational structure modeling between variables related with postpartum depression. The Korean Journal of Counseling and Psychotherapy. 2013;25(3):549-573.
  10. Leigh B, Milgrom J. Risk factors for antenatal depression, postnatal de-pression and parenting stress. BMC Psychiatry. 2008;8:24. http://dx.doi.org/10.1186/1471-244x-8-24
  11. Bae JY. Construction of a postpartum depression model. Journal of Korean Academy of Psychiatric and Mental Health Nursing. 2002;11(4):572-587.
  12. Kim KS, Kam S, Lee WK. The influence of self-efficacy, social support, postpartum fatigue and parenting stress on postpartum depression. Journal of the Korean Society of Maternal and Child Health. 2012;16(2):195-211. https://doi.org/10.21896/jksmch.2012.16.2.195
  13. Chandran M, Tharyan P, Muliyil J, Abraham S. Post-partum depression in a cohort of women from a rural area of Tamil Nadu, India. Incidence and risk factors. The British Journal of Psychiatry. 2002;181:499-504. https://doi.org/10.1192/bjp.181.6.499
  14. Cox JL, Holden JM, Sagovsky R. Detection of postnatal depression. Development of the 10-item Edinburgh postnatal depression scale. The British Journal of Psychiatry. 1987;150:782-786. https://doi.org/10.1192/bjp.150.6.782
  15. Han K, Kim M, Park JM. The Edinburgh postnatal depression scale, Korean version: Reliability and validity. Journal of the Korean Society of Biological Therapies in Psychiatry. 2004;10(2):201-207.
  16. Park JW. A study to development a scale of social support. Journal of Nursing Science. 1986;9(1);22-31.
  17. Song JM. In the parenting stress situation, the effect of social support to parental perceptions of child behavior [master's thesis]. Seoul: Sookmyoung Women's University; 1992.
  18. Ahn HL. An experimental study of the effects of husband's supportive behavior reinforcement education on stress relief of primigravidas. The Journal of Nurses Academic Society. 1985;15(1):5-16.
  19. Jo JA, Kim YH. Mothers' prenatal environment, stress during pregnancy, and children's problem behaviors. Journal of Human Ecology. 2007;11(2):43-62.
  20. Rosenberg M. Society and the adolescent self-image. Princeton, NJ: Princeton University Press; 1965.
  21. Jon BJ. Self-esteem: A test of its measurability. Yonsei Forum. 1974;11(1):107-130.
  22. Lee J, Nam S, Lee MK, Lee JH, Lee SM. Rosenberg' self-esteem scale: Analysis of item-level validity. The Korean Journal of Counseling and Psychotherapy. 2009;21(1):173-189.
  23. Hopkins J, Campbell SB, Marcus M. Role of infant-related stressors in postpartum depression. Journal of Abnormal Psychology. 1987;96(3):237-241. https://doi.org/10.1037/0021-843X.96.3.237
  24. Cutrona CE. Social support and stress in the transition to parenthood. Journal of Abnormal Psychology. 1984;93(4):378-390. https://doi.org/10.1037/0021-843X.93.4.378
  25. Cheon JA. The effect of postpartum stress and social network on the postpartum [master's thesis]. Seoul: Korea University; 1990.
  26. Kwon JH. A test of a vulnerability-stress model of postpartum depression. Korean Journal of Clinical Psychology. 1997;16(2):55-66.
  27. Silva R, Jansen K, Souza L, Quevedo L, Barbosa L, Moraes I, et al. Sociodemographic risk factors of perinatal depression: A cohort study in the public health care system. Revista Brasileira de Psiquiatria. 2012;34(2):143-148. https://doi.org/10.1590/S1516-44462012000200005
  28. American Psychiatric Association, editor. Diagnostic and statistical manual of mental disorders. 5th ed. Washington, DC: American Psychiatric Press, Inc.; 2013.
  29. Lee MK. A structural model for depression during pregnancy [dissertation]. Daejeon: Eulji University; 2014.
  30. Choi MR, Lee IH. The moderating and mediating effects of self-esteem on the relationship between life stress and depression. Korean Journal of Clinical Psychology. 2003;22(2):363-383.

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