| Abstract | Trudnoća, postporođajno razdoblje i roditeljstvo predstavljaju mnoštvo izazova za mnoge žene. Istraživanja pokazuju da mnoge nove majke doživljavaju razne fizičke i emocionalne simptome nakon rođenja djeteta.
Cilj: istražiti povezanost depresivnosti s određenim psihosocijalnim karkteristikama te čimbenicima u svezi trudnoće, poroda i njege djeteta.
Ispitanici i metoda: Presječno istraživanje u periodu od 6 mjeseci od 01.11.2013. do 30.04.2014.g u Domu zdravlja Gospić, prevele su medicinske sestre kroz ginekološku i pedijatrijsku ambulantu. Uzorak je činilo 154 ispitanica od kojih je 136 (88.3%) pristalo sudjelovati i to 54 trudnice, 22 majke djeteta u dobi od 1 mjesec, 25 majki dojenčadi oko 6 mjeseci, te 35 majki jednogodišnjaka. Upitnik sastavljen za ovo istraživanje sadržavao je socioekonomske podatke, o morbiditetu mentalnih i somatskih bolesti, tijeku, ishodu trudnoće i o novorođenčetu te pitanja o odnosu sa partnerom i percepciji skrbi za dijete. Za procjenu depresivnosti korištena je Edinburška skala za postporođajnu depresiju (engl. Edinburgh Postnatal Depression Scale, EDPS) i 2 pitanja za procjenu depresije.
Rezultati: Od 136 ispitanica procijenjenih sa EPDS depresivno je bilo 33 ispitanice (24,3%), temeljem probirnog pitanja depresivnosti u proteklom mjesecu njih 35 (25,7%). Prema procjeni gubitka interesa i zadovoljstva 55 ispitanica osjeća da je izgubilo interes za neke stvari (40,4%). Karakteristike statistički značajno povezane s depresivnošću u našem istraživanju su prisutnost mentalnih oboljenja ispitanica, loš odnos sa suprugom, veća opterećeost, te viši stupanj obrazovanja. Logističkom regresijom depresivnost majki procijenjena po EPDS također se povezuje s dosadašnjim iskustvom s mentalnim oboljenjima, lošijim odnosom sa suprugom, prijevremenim ili porodom s komplikacijama, (ne)dojenjem, povećanom opterećenošću i zabrinutošću majčinstvom. Logističkom regresijom kod skupine majki prilikom probira depresivnosti definiranom sa 2 probirna pitanja pokazalo se da je rizik za pojavu depresivnosti povezan s većim stupnjem edukacije, prethodnim mentalnim poteškoćama ispitanica, lošijim odnosom sa suprugom, većom razinom opterećenosti i potrebom za pomoći, povećanom zabrinutošću s majčinstvom. Logističkom regresijom depresivnost trudnica samoprocjenom po EPDS dobiveni su rezultati koji ukazuju na povezanost depresivnosti s manjim prethodnim mentalnim bolestima ispitanica i s lošijim odnosom sa suprugom. Rezultati logističke regresije prema 2 probirna pitanja ukazuju na povezanost depresivnosti s prethodnim mentalnim tegobama ispitanica, s lošijim odnosom sa suprugom, s planiranjem trudnoće, te neimanjem želje za savršenstvom i povećanom razinom opterećenosti.
Zaključak: Premda oba upitnika korištena u ovom istraživanju nisu validirani za našu populaciju, EPDS i pitanje o depresivnosti daju gotovo identične rezultate o četvrtini depresivnih ispitanica. Ciljne skupine kojima je probir i pomoć najneophodnija, su majke koje imaju jednomjesečnu djecu, trudnice, a potom majke novorođenčadi i mlađe dojenačke dobi. I to ispitanice sa prethodnim mentalnim oboljenjima, lošijim odnosom sa suprugom, višim obrazovanjem, povećanim opterećenjem i zabrinutošću za majčinstvom. |
| Abstract (english) | Pregnancy, postpartum period and parenthood represent a multitude of challenges for many women. Research shows that many new mothers experience a variety of physical and emotional symptoms after childbirth.
Objective: To investigate the relationship of depression with certain psychosocial characteristics and factors concerning pregnancy, childbirth and child care.
Patients and methods: A cross-sectional study over a period of six months from 01.11.2013. to 30.04.2014. in the Helth center Gospic, were implemented by nurses through gynecological and pediatric practice. The sample consisted of 154 respondents, of which 136 (88.3%) agreed to participate; 54 pregnant women, 22 mother of a child aged from 1 month, 25 mothers of infants around 6 months, and 35 mothers who have 1 year old child. The questionnaire drawn up for this study consisted socio-economic data, morbidity of mental and somatic illness, pending the outcome of the pregnancy and of the newborn, and questions about the relationship with the partner and the perception of care for the child. For the assessment of depression was used Edinburgh scale for postpartum depression (Eng. Edinburgh Postnatal Depression Scale, the EDPS) and two questions to assess depression.
Results: Of all of the 136 respondents, with an estimated depressed EPDS were 33 women ( 24.3 % ) , based on screening questions of depression in the past month 35 of them ( 25.7 % ) . According to the assessment of loss of interest or pleasure 55 respondents feel that it has lost interest in things ( 40.4 % ) . Characteristics significantly associated with depression in our study were the presence of mental illness subjects , bad relationship with partner , higher load and higher level of education . By logistic regression depression mothers evaluated by EPDS has also been linked with the experience with mental illness , poor relationship with husband , early or childbirth complications , ( not ) breastfeeding , increased load, concern about maternity . Logistic regression in a group of mothers on screening depression defined with two screening questions showed that the risk for depression is associated with higher levels of education , previous mental disabilities subjects , poor relationship with husband , a higher level of workload and the need for help , growing concern with motherhood , and mainly to the decreased satisfaction with care for the child . Logistic regression depression pregnant women self-assessment by EPDS show an association between depression with smaller previous mental illness and poor relations with husband . Results of logistic regression to the two screening questions show an association between depression with previous mental problems respondents , with a poor relationship with husband , planning pregnancy , not having a desire for perfection and increased levels of workload .
Conclusion: Although both questionnaires used in this study are not validated for our population both of them give almost identical results about quarter of depressed respondents . The target group which is screening and assistance most needed are mothers who have a one-month children , pregnant women , then mothers of infants and young infant. Especially women with previous mental health problems, poor relationship with husband, higher education, increased load and concern for motherhood . |
