Admissions Summary and Analysis Postpartum Depression (PPD) Admission Essay

Admissions Summary and Analysis

Postpartum depression (PPD) represents increased symptoms of depression that are correlated to having recently given birth. Although rather un-discussed in mainstream social communications, it often tends to have a relevantly strong presence in new mothers. Its recorded prevalence has ranged dramatically, from some reports of as low as 5.5%, and others as high as 25% (Lee et al. 2011). Various literature also poses the idea that rates of PPD can depend on cultural factors as well, with some cultures having much higher rates of PPD incidences than others. This incredibly variant nature of PPD often makes it hard for clinical practice to understand and predict. Moreover, postpartum depression can occur over a wide period of time, ranging independently based on individual women. Lee et al. (2011) show that it occurs more so in cases of earlier periods after birth rather than longer stretches of time. In fact, the research shows that it occurs most frequently within the first month after giving birth. However, postpartum depression symptoms can also occur often throughout the first year as well.

Lee et al. (2011) show how PPD can also be witnesses in heightened levels within the cases of women who had previously undergone in vitro fertilization (IVF). Unfortunately, dealing with the systematic stresses of the process of conceiving through IVF methods can be damaging on the mental state of the soon to be mother. The stresses of having to deal with previous assumptions of infertility can greatly impact the later development of PPT symptoms in new mothers. Lee et al. posits that assisted reproductive technology (ART) does impact the potential for new mothers to develop symptoms of PPD. Here, the research suggests that "successful ART treatment, mostly through in vitro fertilization (IVF), or infertility produces a special obstetric experience that contributes to particular concerns about women's postnatal mental health," (Lee et al. 2011). Still, previous research had not exposed statistically significant differences between the rates of IVF impregnated mothers and traditional cases of conception. The previous research has left this category of women relatively unrecognized through contemporary clinical trials and research. Lee et al. states that "little is known about the prevalence of PPD among mothers who conceived by IVF," (Lee et al. 2009). This leaves open numerous questions in terms of how conceiving through IVF and PPD really correlate with one another.

Thus, this study aims to answer some of those unanswered questions. Essentially, the study objective of this research was to examine potential correlations between IVF treatments and increased rates of PPD. Lee et al. (2011) wanted to not only understand how IVF factored into cases of PPT, but also to name and categorize other potential factors in the persistence of PPT. Thus, the research aimed to explore and categorize potential elements that may contribute to later PPD symptoms as a way to help provide pre-emptive services to a potentially high risk population. By understanding elements that help contribute to cases of PPD, physicians can better provide for patients through more effective strategies and even methods of prevention. Therefore, Lee et al. (2011) wants to help create predictable categories of women that might benefit from progressive counseling and treatment.

The study relied on statistical testing of PPD frequency when compared to numbers of women with IVF treatments. Methods were designed to incorporate a number of relative elements that may or may not contribute to cases of PPD in new mothers. The study structure reflected a cross-sectional design. Lee et al. (2011) incorporated 71 new mothers who had conceived their children through methods of IVF participated in the research. These mothers were recruited from a single infertility treatment located in Taiwan, where the study took place from September 2003 to February 2004. Invitations to participate in the study were given to mothers within the first five to eight weeks after having given birth. After gaining approval by the Institutional Review Board of the Chung Shan Medical University, women who had been identified has having conceived through methods of IVF were asked to join the study process. The primary method of the study included the use of an independently executed questionnaire. According to Lee et al. (2011), "Potentially eligible women were invited to participate in the study and complete a structured questionnaire." This questionnaire was then rated into numerical form using the Chinese version of the Beck Depression Inventory, Second Edition. It is a very carefully designed questionnaire of twenty-one questions that cover the potential presence of depression symptoms.It was designed "to measure women's self-confidence and maternal parenting skills," (Lee et al. 2011). Moreover the element of family function was measured through a series of five questions revolving around family adaptation after the birth of a child. The Interpersonal Support Evaluation List was also incorporated to help "measure personal perception of social resources," (Lee et al. 2011). This allowed researchers to ask close-ended questions listed on scale responses using the Likert scale. Finally, the Perceived Stress Scale was also used within the context of this research. This scale was designed to measure how much stress an individual mother reported going through, both before and after conception of her new child. Results were then tested using regression through SPSS, with a defined P. value of less than .05.

Results showed clear statistically significant correlations between certain elements and incidences of PPD cases. Out of all the 71 participants incorporated into the study, 25% were labeled at having been experiencing symptoms of PPD. Out of this 25%, 16.7% were reported with mild symptoms, 6.7% moderate, and 1.7% severe (Lee et al. 2011). Results showed that the average time period of infertility before conception was around four years. However, this tended to prove unimportant in terms of later rates of PPD symptoms. What elements did prove statistically important were several categories that could be defined and labeled by researchers. First, results showed that the stress of undergoing IVF treatments does show to statistically correlate with more prevalent numbers of PPD cases in new mothers. In fact, the rate of PPD was higher in cases were IVF was used compared to general data collection of new mothers in general. Still, there were other, more specific factors that augmented the increased rates of PPD seen in cases were IVF was the method of conception. In fact, family and social support proved to be elements that helped decrease rates of reported PPD symptoms. Using the scales and designed questions, the research found that new mothers with a greater perception of social and familial support had less rates of PPD symptoms, where mothers with little social support showed higher risk rates for experiencing PPD. Additionally, the study also found that the method of birth was another common factor in potential predispositions to PPD. In fact, the research shows that cesarean births can also come with higher frequencies of PPD conditions.

Such findings lead to the development of the conclusions posited by Lee et al. (2011). It is clear that there are higher rates of PPD in women who had undergone infertility treatments, most often due to the stress caused by the process of IVF itself. Additionally, the existence of other crucial elements, including social support and method of birth also impacted PPD rates significantly. The more elements present in the individual responses, the higher the rates of PPD was. Thus, the author concludes that this research should be used to help allocate appropriate resources available to mothers labeled in the most vulnerable positions offering education and counseling services to those in higher risk situations.

Lee et al. (2011) proved to have several major strengths in terms of its research design and structure. First, the questionnaire used to gather data from the new mother participants. The use of the Chinese form of the Beck Depression Inventory, Second Edition scale helps provide their research methods with previously structured successes. The scale has been used in numerous previous studies, and has been shown to be a reliable scale to determine levels of present depression in individuals in question. This scale successfully provided a way to translate the participants' answers in open ended form into a measurable numerical format which could later be used for the purpose of regression analysis which was the backbone of the study. The scale used help create reliable transformation of open ended question responses into measurable data. Additionally, the study used a number of other measurement devices to help relate the women's answer responses to statistically graspable data measurements. This included not only the previously discussed scale, but also the Family APGAR Index which measured "problems in family adaptation" within the scope of 5 questions on the questionnaire (Lee et al. 2011). Other measurement devices used included the Interpersonal Support Evaluation List and the Perceived Stress Scale.

There are a number of clear weaknesses within the context of the research conducted by Lee et al. In 2011. First, there is.....