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http://dx.doi.org/10.4069/kjwhn.2021.09.08

Does a nurse-led postpartum self-care program for first-time mothers in Bangladesh improve postpartum fatigue, depressive mood, and maternal functioning?: a non-synchronized quasi-experimental study  

Khatun, Fahima (National Institute of Advanced Nursing Education and Research)
Lee, Tae Wha (College of Nursing, Mo-Im Kim Nursing Research Institute, Yonsei University)
Lee, Hye Jung (College of Nursing, Mo-Im Kim Nursing Research Institute, Yonsei University)
Park, Jeongok (College of Nursing, Mo-Im Kim Nursing Research Institute, Yonsei University)
Song, Ju Eun (College of Nursing, Ajou University)
Kim, Sue (College of Nursing, Mo-Im Kim Nursing Research Institute, Yonsei University)
Publication Information
Women's Health Nursing / v.27, no.3, 2021 , pp. 196-208 More about this Journal
Abstract
Purpose: This study aimed to test the efficacy of a nurse-led postpartum self-care (NLPPSC) intervention at reducing postpartum fatigue (PPF) and depressive mood and promoting maternal functioning among first-time mothers in Bangladesh. Methods: A non-synchronized quasi-experimental design was used. First-time mothers were recruited during postpartum and assigned to the experimental or control group (34 each). The experimental group received the NLPPSC in the hospital, a 1-day intervention that focused on increasing self-efficacy. The control group received usual care. Data on PPF, depressive mood, maternal functioning, self-care behaviors, postpartum self-efficacy, and self-care knowledge were collected at postpartum 2 weeks (attrition 23.5%) and 6 weeks (attrition 16.1%). Data were analyzed using descriptive statistics, bivariate statistics, and linear mixed model analysis. Results: One-third (33.3%) of new mothers experienced depressive mood (Edinburgh Postnatal Depression Scale scores of ≥13 points). The NLPPSC intervention was statistically significant in decreasing PPF (β=-6.17, SE=1.81, t=-3.39, p<.01) and increased maternal functioning at postpartum 6 weeks in the experimental group (β=13.72, t=3.73, p<.01) compared to the control. Knowledge was also statistically significant for increased maternal functioning over time (β=.37, SE=.18, t=2.03, p<.05). However, there were no statistically significant differences in depressive mood over time. Conclusion: The NLPPSC intervention was feasible and effective in improving fatigue and maternal functioning in Bangladeshi mothers by postpartum 6 weeks and thus supports implementing the NLPPSC intervention for new mothers after childbirth.
Keywords
Fatigue; Intervention; Postpartum depression; Postpartum period; Self-care;
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1 Barnes J, Stuart J, Allen E, Petrou S, Sturgess J, Barlow J, et al. Randomized controlled trial and economic evaluation of nurse-led group support for young mothers during pregnancy and the first year postpartum versus usual care. Trials. 2017;18(1):508. https://doi.org/10.1186/s13063-017-2259-y   DOI
2 Jolly SP, Rahman M, Afsana K, Yunus FM, Chowdhury AM. Evaluation of maternal health service indicators in urban slum of Bangladesh. PLoS One. 2016;11(10):e0162825. https://doi.org/10.1371/journal.pone.0162825   DOI
3 Birdsall KA. Quiet revolution: strengthening the routine health information system in Bangladesh. Eschborn, Germany: Deutsche Gesellschaft fur Internationale Zusammenarbeit (GIZ); 2014.
4 Des Jarlais DC, Lyles C, Crepaz N; TREND Group. Improving the reporting quality of nonrandomized evaluations of behavioral and public health interventions: the TREND statement. Am J Public Health. 2004;94(3):361-366. https://doi.org/10.2105/ajph.94.3.361   DOI
5 Bandura A. Social foundations of thought & action: a social cognitive theory. England Cliffs (NJ): Prentice-Hall, Inc; 1986.
6 Leahy-Warren P, McCarthy G. Maternal parental self-efficacy in the postpartum period. Midwifery. 2011;27(6):802-810. https://doi.org/10.1016/j.midw.2010.07.008   DOI
7 Milligan RA, Parks PL, Kitzman H, Lenz ER. Measuring women's fatigue during the postpartum period. J Nurs Meas. 1997;5(1):3-16. https://doi.org/10.1891/1061-3749.5.1.3   DOI
8 Khatun F, Lee TW, Rani E, Biswas G, Raha P, Kim S. The relationship among fatigue, depressive mood, self-care agency, and self-care action of first-time mothers in Bangladesh. Korean J Women Health Nurs. 2018;24(1):49-57. https://doi.org/10.4069/kjwhn.2018.24.1.49   DOI
9 Shin HS, Kim SH, Kwon SH. Effects of education on primiparas' postpartal care. Korean J Women Health Nurs. 2000;6(1):34-45.
10 Park MK. Effects of postpartum care program for primiparous women and care-givers on the knowledge and behavior of postpartum care and postpartum recovery in primiparous women [doctoral dissertation]. Gwangju: Chonnam University; 2003.
11 Molenda M. In search of the elusive ADDIE model. Perf Improv. 2003;42:34-36. https://doi.org/10.1002/pfi.4930420508   DOI
12 Bandura A. Self-efficacy. In: Ramachandran VS, editors. Encyclopedia of human behavior, Vol. 4. New York: Academic Press; 1994. p. 71-81.
13 Ho SM, Heh SS, Jevitt CM, Huang LH, Fu YY, Wang LL. Effectiveness of a discharge education program in reducing the severity of postpartum depression: a randomized controlled evaluation study. Patient Educ Couns. 2009;77(1):68-71. https://doi.org/10.1016/j.pec.2009.01.009   DOI
14 Gausia K, Fisher C, Algin S, Oosthuizen J. Validation of the Bangla version of the Edinburgh Postnatal Depression Scale for a Bangladeshi sample. J Reprod Infant Psychol. 2007;25(4):308-315. https://doi.org/10.1080/02646830701644896   DOI
15 Oleiwi SS, Ali RM. Effectiveness of instruction-oriented intervention for primipara women upon episiotomy and self-perineal care at ibn Al-Baladi Hospital. Iraqi National J Nurs Sci. 2010;23(2):8-17.
16 Giallo R, Cooklin A, Dunning M, Seymour M. The efficacy of an intervention for the management of postpartum fatigue. J Obstet Gynecol Neonatal Nurs. 2014;43(5):598-613. https://doi.org/10.1111/1552-6909.12489   DOI
17 Kim Y, Dee V. Self-care for health in rural Hispanic women at risk for postpartum depression. Matern Child Health J. 2017;21(1):77-84. https://doi.org/10.1007/s10995-016-2096-8   DOI
18 Kamiya Y, Yoshimura Y, Islam MT. An impact evaluation of the safe motherhood promotion project in Bangladesh: evidence from Japanese aid-funded technical cooperation. Soc Sci Med. 2013;83:34-41. https://doi.org/10.1016/j.socscimed.2013.01.035   DOI
19 Williams A, Sarker M, Ferdous ST. Cultural attitudes toward postpartum depression in Dhaka, Bangladesh. Med Anthropol. 2018;37(3):194-205. https://doi.org/10.1080/01459740.2017.1318875   DOI
20 Jeon M, Hwang Y. Effects of an educational program on preand postpartum self-care knowledge, efficacy of self-care, and interest in health of marriage immigrant women in South Korea. J Converg Inf Technol. 2013;8(14):508-514.
21 Mobile Alliance for Maternal Action (MAMA) Bangladesh. MAMA "Aponjon" formative research report [Internet]. Dnet, and Johns Hopkins University Global mHealth Initiative; 2013 [cited 2016 Dec 6]. Available from: Available from: http://www.mobilemamaalliance.org/sites/default/files/MAMA%20Bangladesh%20Formative%20Research%20Report.pdf
22 Cox JL, Holden JM, Sagovsky R. Detection of postnatal depression. Development of the 10-item Edinburgh Postnatal Depression Scale. Br J Psychiatry. 1987;150:782-786. https://doi.org/10.1192/bjp.150.6.782   DOI
23 Barkin JL, Wisner KL. The role of maternal self-care in new motherhood. Midwifery. 2013;29(9):1050-1055. https://doi.org/10.1016/j.midw.2012.10.001   DOI
24 Denyes MJ. Denyes self-care instrument. Detroit (MI): College of Nursing, Wayne state University; 1990.
25 Bangladesh Bureau of Statistics. Health and morbidity status survey-2012 [Internet]. Dhaka, Bangladesh: Statistics and Informatics Division, Ministry of Planning: 2013 [cited 2021 Sep 14]. Available from: http://bbs.portal.gov.bd/sites/default/files/files/bbs.portal.gov.bd/page/4c7eb0f0_e780_4686_b546_b4fa0a8889a5/HMSS.pdf
26 Dunning M, Seymour M, Cooklin A, Giallo R. Wide awake parenting: study protocol for a randomised controlled trial of a parenting program for the management of post-partum fatigue. BMC Public Health. 2013;13:26. https://doi.org/10.1186/1471-2458-13-26   DOI
27 Shafaie FS, Mirghafourvand M, Bagherinia M. The association between maternal self-confidence and functional status in primiparous women during postpartum period, 2015-2016. Int J Women's Health Reprod Sci. 2017;5(3):200-204. https://doi.org/10.15296/ijwhr.2017.36   DOI
28 Barbosa EM, Sousa AA, Vasconcelos MG, Carvalho RE, Oria MO, Rodrigues DP. Educational technologies to encourage (self) care in postpartum women. Rev Bras Enferm. 2016;69(3):545-553. https://doi.org/10.1590/0034-7167.2016690323i
29 Schaar GL, Hall M. A nurse-led initiative to improve obstetricians' screening for postpartum depression. Nurs Womens Health. 2013;17(4):306-316. https://doi.org/10.1111/1751-486X.12049   DOI
30 National Institute of Population Research and Training (NIPORT), Mitra and Associates, and ICF International. Bangladesh demographic and health survey 2014. Dhaka, Bangladesh, and Rockville (MD): NIPORT, Mitra and Associates, and ICF International; 2016.
31 Bagherinia M, Mirghafourvand M, Shafaie FS. The effect of educational package on functional status and maternal self-confidence of primiparous women in postpartum period: a randomized controlled clinical trial. J Matern Fetal Neonatal Med. 2017;30(20):2469-2475. https://doi.org/10.1080/14767058.2016.1253061   DOI
32 Phipps MG, Raker CA, Ware CF, Zlotnick C. Randomized controlled trial to prevent postpartum depression in adolescent mothers. Am J Obstet Gynecol. 2013;208(3):192.e1-192.e1926. https://doi.org/10.1016/j.ajog.2012.12.036   DOI