بررسی ارتباط حمایت اجتماعی با افسردگی بعد از زایمان در زنان مبتلا به پره اکلامپسی

نوع مقاله: اصیل پژوهشی

نویسندگان

1 مربی گروه مامایی، مرکز تحقیقات مراقبت مبتنی بر شواهد، دانشکده پرستاری و مامایی، دانشگاه علوم پزشکی مشهد، مشهد، ایران.

2 مربی گروه مامایی، دانشکده پزشکی، دانشگاه علوم پزشکی بیرجند، بیرجند، ایران.

3 دانشیار گروه روانپزشکی، مرکز تحقیقات روانپزشکی و علوم رفتاری، دانشکده پزشکی، دانشگاه علوم پزشکی مشهد، مشهد، ایران.

4 دانشیار گروه آمار زیستی، مرکز تحقیقات علوم بهداشتی، دانشکده بهداشت، دانشگاه علوم پزشکی مشهد، مشهد، ایران.

چکیده

مقدمه: افسردگی، مهم ترین اختلال خلقی پس از زایمان است. حمایت اجتماعی به عنوان یک عامل خطر برای افسردگی پس از زایمان شناخته شده است. از آنجایی که زنان مبتلا به پره اکلامپسی با شکایات غیر قابل انتظار در حول و حوش زایمان مواجه هستند، به حمایت بیشتری نیاز دارند، لذا مطالعه حاضر با هدف تعیین ارتباط حمایت اجتماعی با افسردگی بعد از زایمان در مبتلایان به پره اکلامپسی انجام شد.
روش کار: این مطالعه همبستگی در سال 1392 بر روی 122 زن مبتلا به پره اکلامپسی بستری در زایشگاه بیمارستان های دولتی و تأمین اجتماعی مشهد انجام شد. پرسشنامه افسردگی بک II در هفته 6 پس از زایمان و پرسشنامه حمایت اجتماعی در هفته 2 و 6 پس از زایمان تکمیل شد. تجزیه و تحلیل داده ها با استفاده از نرم افزار آماری SPSS (نسخه 16) و آزمون های ضریب همبستگی پیرسون و کروسکال والیس انجام شد. میزان p کمتر از 05/0 معنی دار در نظر گرفته شد.
یافته ها: میانگین نمره حمایت اجتماعی در هفته دوم بعد از زایمان 39/1±1/34 و در هفته 6 بعد از زایمان 04/1±3/23 بود. بین حمایت اجتماعی هفته 2 با حمایت اجتماعی هفته 6 بعد از زایمان ارتباط آماری معنی داری وجود داشت (001/0=p). میانگین نمره افسردگی 5/5±1/11 بود. بین حمایت اجتماعی هفته 2 (01/0=p) و هفته 6 (02/0=p) بعد از زایمان با افسردگی هفته 6 بعد از زایمان، ارتباط مثبت و معنی داری وجود داشت.
نتیجه گیری: بین حمایت اجتماعی و افسردگی بعد از زایمان همبستگی مثبت وجود داشت. با افزایش میزان نمره حمایت اجتماعی بعد از زایمان میزان افسردگی افزایش می یافت.

کلیدواژه‌ها


عنوان مقاله [English]

Relationship between social support and postpartum depression in women with preeclampsia

نویسندگان [English]

  • Zahra Abedian 1
  • Narges Soltani 2
  • Naghmeh Mokhber 3
  • Habibollah Esmaily 4
1 Instructor of Midwifery, Evidence –Based Caring Research Centre, School of Nursing and Midwifery, Mashhad University of Medical Sciences, Mashhad, Iran.
2 Instructor of Midwifery, School of Medicine, Birjand University of Medical Sciences, Brigand, Iran.
3 Associate Professor, Department of Psychiatry, Psychiatry and Behavioral Sciences Research Center, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
4 Associate professor, Department of Biostatistics, School of Health, Mashhad University of Medical Sciences, Mashhad, Iran.
چکیده [English]

Introduction: Postpartum depression is the most important mood disorder. Social support has been known as one of the risk factor for postpartum depression. Since preeclamptic women are faced with unexpected perinatal complaints, they need to receive more support; therefore this study was performed with aim to evaluate the relationship between social support and postpartum depression in women with preeclampsia.
Methods: This Correlational study was performed on 122 women with preeclampsia admitted in public and Tamin Ejtemaei Hospitls of Mashhad in 2013. Beck Depression Inventory II (BDI-II) was completed six weeks after delivery, and Social support Questionnaire was completed two and six weeks after delivery. Data was analyzed by SPSS software (version 16) using Pearson Correlation and Kruskal-Wallis tests. PResults: The mean social support score after two weeks of delivery was 34.1±1.39 and after six weeks of delivery 23.3±1.04. There was significant relationship between social support 2 weeks after delivery with social support 6 weeks after delivery (P=0.001). Mean depression score was 11.1 ± 5.5. There was positive significant relationship between social support score 2 weeks (p=0.01) and 6 weeks (p=0.02) after delivery with depression 6 weeks after delivery.
Conclusion: There was positive correlation between social support and postpartum depression. Depression increased by increasing the postpartum social support.

کلیدواژه‌ها [English]

  • Depression
  • Postpartum
  • Preeclampsia
  • Social Support
  1. Masoudnia E. Relationship between Perceived Social Support and Risk of Postpartum Depression Disorder. Iran Journal of Nursing (IJN) 2011; 24(70):8-18.(Persian).
  2. Prife J, Magowan B. Clinical obstetrics and gynecology. Philadelphia: Saunders; 2004. P. 34.
  3. Cunningham F, Leveno K, Bloom S, Hauth J, Rouse D, Spong C. Williams Obstetrics. 23rd ed. New York: The McGraw Hill Medical publishing; 2010.
  4. Fraser DM, Coope MA. Myles textbook for midwifery. 14th ed. London: Churchill Livingstone; 2003. P.653-661.
  5. Diane M, Cunnigham M, Jankowski K, Zayas L. Health related functional status in pregnancy: relationship to depression and social support in a multi-ethnic population. Obstet Gynecol; 2001; 97(6):988–93.
  6. Wong DL, Perry SE. Maternal Child Nursing Care. Boston: Mosby; 1998. P.502.
  7. Nikpoor M, Abedian Z, Mokhber N, Khaleghi Z, Bani Hussein SZ, Ebrahim Zadeh S. Relationship Between Delivery Method And Postpartum Depression. Journal of Fundamentals of Mental 2012; 14(1):46-53.
  8. Salari P, Banafshe E, Hebrani P, Jabbari Nooghabi H. On the relationship between maternal fatigue and postpartum depression. Journal of Fundamentals of Mental Health 2010; 11(4): 302-11.
  9. Hosseini H, Naghibi A.H, KhademlooM. Postpartum depression and its relationship with some related factors. Journal of Babol University of Medical Sciences 2008; 10(2):76-81.(Persian).
  10. Khodadady N, Mahmoodi H, Mir Haghjoo SN. Relationship of postpartum depression
  11. withPsychosocial effects of maternal. Journal of Ardabil University of Medical Sciences 2009; 2(8): 142-8. (Persian).
  12. Rahmani F, Seyed Fatemi N, Asadollahi M, Seyed Rasooli A. Predisposing factors for postpartum depression. Iran Journal of Nursing 2011;24(72): 78-87.(Persian).
  13. Xie R, He G, Koszycki D, Walker M, Wen SH. Prenatal Social Support, Postnatal Social Support, and Postpartum Depression.Ann Epidemiol 2009; 19(9): 637–43.
  14. Chaaya M, Campbell OMR, El Kak F, Shaar D, Harb H, Kaddour A. Postpartum depression: prevalence and determinants in Lebanon. Arch Womens Ment Health 2002; 5(2): 65–72.
  15. Kurki T, Hiilesmaa V, Raitasalo R, Mattila H, Ylikorkala O. Depression and Anxiety in Early Pregnancy and Risk for Preeclampsia.  Obstet Gynecol 2000; 95(4):487-90.
  16. Palmsten K, Setoguchi S, Margulis AV, Patrick AR, Hernández-Díaz S. Elevated Risk of Preeclampsia in Pregnant Women With Depression: Depression or Antidepressants?. Am J Epidemiol 2012; 175(10):988–97.
  17. Habli M, Eftekhari N, Wiebracht E, Bombrys A, Khabbaz M, How H, et al. Long-term maternal and subsequent pregnancy outcomes 5 years after hemolysis, elevated liver enzymes, and low platelets (HELLP) syndrome. Am J Obstet Gynecol 2009; 201(4): 385.e1–5.
  18. Brussé I, Duvekot J, Jongerling J, Steegers E, De Koning I. Impaired maternal cognitive functioning after pregnancies complicated by severe pre-eclampsia: a pilot case-control study. Acta Obstet Gynecol Scand 2008; 87(4):408-12.
  19. Qiu CH, Sanchez SE, Lam N, Garcia P, Williams MA. Associations of depression and depressive symptoms with preeclampsia: results from a Peruvian case-control study. BMC Women's Health 2007; 7:15.
  20. Ezzati A, Nouri R, Hasani J. Model between Social Support, Coping Strategies, Stigma and Depression in Infertile Women in Tehran. Iranian Journal of Obstetrics, Gynecology and Infertility 2013;16(45):20-8.(Persian).
  21. Pampus MGv, Wolf H, Schultz WCMW, Neeleman J, Aarnoudse JG. Posttraumatic Stress Disorder following Preeclampsia and HELLP Syndrome. J Psychosom Obstet  Gynecol 2004; 25(3-4):183.
  22. Cunningham F, Leveno K, Bloom S, Hauth J, Rouse D, Spong C. Williams Obstetrics. 23rd Edition, New York: The Mc Graw Hill Medical; 2010.
  23. Morrell C, Spiby H, Stewart P, Walters S, Morgan A. Costs and benefits of community postnatal support workers: a randomized controlled trial. Health Technol Assess 2000; 4(6):1-100.
  24. Ghassemzadeh H, Mojtabai R, Karamghadiri N, Ebrahimkhani N. Psychometric Properties of a Persian-Language Version of the Beck Depression Inventory – Second Edition (BDI-II). Depress Anxiety 2005;21(4):185-92.
  25. Bahrami N, Araban, M, Bahrami S. The Impact of antenatal education on postpartum depression, Dezful, Iran.  Medical Journal Of Hormozgan University 2010;13(4),276-283.
  26. Sehati Shafaei F, RanjbarKuchaksarayi F, Qujazadeh M, Mohamad Rezaei J. Evaluation of risk factors associated with postpartum depression. Journal of Ardabil University of Medical Sciences. 2009;1(8): 54-61.(Persian).
  27. Yagmur Y, Uiukoca N. Social support and postpartum depression in low-socioeconomic level postpartum women in Eastern Turkey. Int J Public Health 2010; 55:543–9.
  28. Chen H- H,  Hwang F-M, Tai C-J, Chien L-Y. The Interrelationships Among Acculturation, Social Support, and Postpartum Depression Symptoms Among Marriage-Based Immigrant Women in Taiwan: A Cohort Study. J Immigr Minor Health 2013; 15: 17-23.
  29. Kim ،T HM, Connolly J A,Tamim H. The effect of social support around pregnancy on postpartum depression among Canadian teen mothers and adult mothers in the maternity experiences survey. BMC Pregnancy and Childbirth 2014; 14:162.
  30. Hopkins J, Campbell SB. Development and validation of a scale to assess social support in the postpartum period. Arch Womens Ment Health 2008; 11(1):57-65.
  31. Dolatian M, Maziar P, AlaviMajd H, Yazdjerdi M. The relationship between mode of delivery with postpartum depression. J Reprod Fertil 2006;7(3):260-8.
  32. Hopkins J, Campbell SB, Marcus M. Role of infant-related stressors in postpartum  depression. J Abnorm Psychol 1987; 96(3): 237-41..
  33. Goyal D, Murphy SO, Cohen J. Immigrant Asian Indian women and postpartum depression. J Obstet Gynecol Neonatal Nurs 2006; 35(1): 98-104.
  34. Hoedjes M, Berks D, Vogel I, Franx A, Bangma M, Darlington AS, et al. Postpartum depression after mild and severe preeclampsia. J Womens Health (Larchmt)  2011; 20(10):1535-42.
  35. Clark Stacy L, Illinois C. The role of school, family, and peer support in moderating the relationship between stress and subjective well-being:an examination of gender differences among early adolescents living in an urban area[PhD thesis].Chicago:Loyola university chicaco;2008.