Exploring the influence of postnatal depression on neonatal care practices among mothers in Western Kenya: A qualitative study.
Exploring the influence of postnatal depression on neonatal care practices among mothers in Western Kenya: A qualitative study.
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DOI：
10.1177/17455057231189547
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发表时间：
2023-01
期刊：
影响因子：
2.4
通讯作者：
Nabwera, Helen M.
中科院分区：
文献类型：
--
作者：
Gribbin, Catherine;Achieng, Florence;K'Oloo, Alloys;Barsosio, Hellen C.;Kwobah, Edith;Kariuki, Simon;Nabwera, Helen M.
产后抑郁症（PND）与婴儿神经发育不良有关。关于PND如何影响低收入和中等收入国家（如肯尼亚）新生儿（<28天）结局的证据有限，这些国家承担着新生儿发病率和死亡率的全球负担。探讨PND如何影响肯尼亚西部农村妇女产后早期的新生儿喂养和护理实践。一项横向研究。在产后2周，在肯尼亚西部基苏穆县5个卫生设施的产后病房和诊所对新生儿母亲进行半结构化访谈，新生儿年龄<72 h。他们都进行了筛选功能暗示产后抑郁症使用爱丁堡产后抑郁量表。24位母亲接受了采访，其中13人的功能提示PND。所有母亲在围产期都经历过健康或社会经济逆境，包括创伤性分娩、经济拮据以及与伴侣/其他家庭成员的关系具有挑战性。喂养困难，由于认为母乳不足是一个特殊的挑战，母亲与PND的功能，谁更有可能引入补充饲料。产妇寻求保健的决定受到高财务费用、长时间等待和与保健提供者的不良互动的影响，这些因素引起了母亲的压力和恐惧。母亲的生育能力受到她兼顾其他家务的能力的影响，这对于具有PND特征的母亲来说是困难的。亲友的支持对母亲的情绪和生育能力有积极影响。母亲在围产期经历了许多应激诱导事件，这可能会加剧产后立即出现的PND特征。具有PND特征的妇女特别容易受到这些影响婴儿养育行为的压力因素的影响。应对社会经济挑战和卫生系统差距，包括扩大对怀孕和分娩期间妇女的同情和尊重护理，以及通过加强卫生设施和社区支助结构之间的转诊途径，对产后营养不良进行早期筛查和干预，可以减轻产后营养不良对新生儿的影响。
Postnatal depression (PND) is associated with adverse infant neurodevelopmental outcomes. Evidence is limited on how PND influences neonatal (<28 days old) outcomes in low- and middle-income countries, such as Kenya, which bear the global burden of neonatal morbidity and mortality. To explore how PND influences neonatal feeding and care practices among women in the early postnatal period in rural Western Kenya. A cross-sectional study. Semi-structured interviews were conducted at 2-weeks postpartum among mothers of newborn infants identified <72 h old from the postnatal wards and clinics across five health facilities in Kisumu County of Western Kenya. They were all screened for features suggestive of postnatal depression using the Edinburgh Postnatal Depression Scale. Twenty-four mothers were interviewed, 13 of whom had features suggestive of PND. All mothers experienced health or socio-economic adversities in the perinatal period, including traumatic deliveries, financial constraints, and challenging relationships with partners/other family members. Feeding difficulties due to perceived insufficient breastmilk were a particular challenge for mothers with features of PND, who were more likely to introduce complementary feeds. Maternal health-seeking decisions were influenced by high financial cost, long waiting times and poor interactions with health care providers that induced stress and fear among mothers. Maternal caregiving capacity was influenced by her ability to juggle other household duties, which was difficult for mothers with features suggestive of PND. Support from friends and relatives positively impacted maternal mood and caregiving ability. Mothers experienced many stress-inducing events in the perinatal period which potentially exacerbated features of PND in the immediate postnatal period. Women with features of PND were particularly vulnerable to these stressors that influenced infant caregiving practices. Addressing the socio-economic challenges and health system gaps that include scale up of compassionate and respectful care for women during pregnancy and childbirth, as well as early screening and intervention of PND, through enhanced referral pathways between health facilities and community support structures, could mitigate against the impact of PND on neonatal caregiving.
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影响因子：
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作者：
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影响因子：
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