Women Living with Postpartum Depression a Grounded Theory Study

Transcription

1 Women Living with Postpartum Depression a Grounded Theory Study Dr. Susanne Knüppel Lauener 20. April 2017 Zurich Universities of Applied Sciences and Arts 1

2 Contents Introduction and methods Findings: the model encounter the collapse of everyday life Conclusions 2

3 Postpartum Depression (PpD) PpD is the major mental health complication after delivery. PpD impacts % women independent of ethnic background in the first 12 weeks after delivery. (O Hara & Swain, 1996, Oates et al., 2004) PpD impacts on the mood & causes changes in: emotions, communications patterns, social interactions,. and compromises daily routines. (Deutsches Institut für Medizinische Dokumentation und Information-DIMDI, 2014) 3

4 Research question How are everyday activities and parenting tasks affected by postpartum depression and what are the specific nursing support needs of women with postpartum depression and their families? 4

5 Methodology Grounded Theory Approach. (Charmaz 2006) 1 to 2 semi-structured interviews with women suffering from PpD & their partners were conducted in the Italian-spoken part of Switzerland. From June August

6 Recruitment and data collection Zurich Universities of Applied Sciences and Arts (Pattern, 2002) 6

7 Characteristics study population Edinburgh Postnatal Depression Scale (N=24) Screening process, M(±SD), range 13.2 (±3.8), 9-22 Demographic properties (N=29) Women s age in years, M(±SD), range 33.5 (±5.9), Child s age in weeks, 1. Interview, M(±SD), range 21.1 (±15.6), 8-76 n % First language Italian German French Other Professional education No professional education or VET Federal VET Diploma (2 years) Federal VET Diploma (3 years) Academic education Marital status Married Single Divorced Number of Child 1. Child Children Children Pregnancy/delivery Unproblematic Problematic

8 `Encounter the collapse of everday life` Susanne Knüppel Lauener 8

9 `Encounter the collapse of everday life` Susanne Knüppel Lauener 9

10 Occurance of depression being more sensitive and thin-skinned to think one is incapable to be sad - apathetic not have energy feel sluggish to be afraid 10

11 To think one is incapable Because I had the feeling of wanting to put an end to my life. So, I was confident, that it would be better for Mary (daughter) without me,( ). Since I would only inflict damage on her and in the end it would be better for everyone, if I didn t exist. ( ) (28.259) 11

12 `Encounter the collapse of everday life` Susanne Knüppel Lauener 12

13 Collapse of everday life So, because I simply couldn t go on any longer, I was no longer able to care for she (the daughter), I wasn t able to stand on my own, I was always tired (21.102) 13

14 Collapse of everday life hinders To develop new routines To learn new ways of dealing To tolerate difficulty and failure 14

15 To develope new routines the days, the heavy days, when I feel heavy myself and have no ambition to do anything ( ) even today I feel a heaviness ( ) also physically.. And it seems the muscles,.. even the tongue, it is really difficult. Zurich Universities of Applied Sciences and Arts 15

16 To learn new ways of dealing And I always thought: it has to work, it has to work somehow, or? At least this is what people tried talked me into. I was really talked into that is has to work but there is a time when you suddenly realise: It is not working. But it is working differently, it is working in your own manner. (27.667) Zurich Universities of Applied Sciences and Arts 16

17 To tolerate difficulty and failure If I am not feeling too well, my eldest son is the one who will feel it the most. Because I am unable to tolerate things than. ( ) If he isn`t listening, ( ) than I am reacting wrongly, ( ) I have less patience. (45.10) Zurich Universities of Applied Sciences and Arts 17

18 `Encounter the collapse of everday life` Susanne Knüppel Lauener 18

19 To shape a favorable everyday life ( ) for me the basic is the rhytm I have. ( ) and also that my children know exactly: after lunch they can have a rest and sleep ( ). Just this routine. I need it, and I also feel that it supports my children. (45.7) 19

20 `Encounter the collapse of everday life` Susanne Knüppel Lauener 20

21 Adoption process 21

22 `Encounter the collapse of everday life` Susanne Knüppel Lauener 22

23 Limited focus externally-directed everyday life" Maybe I was seated and watched Sarah [daugther] while she sleeps and I waited until she wakes up ( ) I became quasi slovenly, because I don t take care of myself, I haven t washed my hair in 2-3 weeks, haven t taken a shower. The only thing, that I have done, is, I have always cleaned my breast, because I know that Sarah eats from that. (28.451) 23

24 `Encounter the collapse of everday life` Susanne Knüppel Lauener 24

25 Conclusions & impact on practice It is known that PpD leads to a loss of control over their own life. (Beck, 2002a; Highet et al. 2014) New dimensions explaing the of loss of control are: (a) the interruption of routine, (b) the lack of daily structure. It is known that women natutrally focus on the child/children after delivery to manage difficult situations they keep control..(hjalmhult & Lomborg 2012) This study illustrated that women with PpD differ by loss of control of everyday life. 25

26 Questions? Thank you! For more information please contact: 26