| Abstract | Broj žena koje traže pomoć zbog depresije tijekom trudnoće i poslije porođaja (PPD) je tek vrh sante leda kako u svijetu, a pretpostavljamo i kod nas jer nemamo točnih podataka.
Cilj: procijeniti pojavnost depresivnosti kod trudnica i mladih majki u skrbi patronažne sestre. Istražiti povezanost depresivnosti s određenim psihosocijalnim karakteristikama 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. u Virovitičko-podravskoj županiji, su provele 20 patronažnih sestara koje u skrbi imaju 80 000 ispitanika. Uzorak je činilo 1125 ispitanica od kojih je 937 (83%) pristalo sudjelovati i to 200 trudnica, 180 majki novorođenčadi, 286 majki dojenčadi oko 6 mjeseci., te 271 majka 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: Po Edinburšku skalu za postporođajnu depresiju (engl. Edinburgh Postnatal Depression Scale, EDPS) depresivno je bilo 253 ispitanica (27%), a temeljem 2 pitanja o depresiji njih 458 (49%). Broj depresivnih ispitanica se statistički značajno smanjuje sa starošću djeteta (P<0,001); depresivnih trudnica je bilo 37,5%, majki novorođenčadi 36,7%, majki dojenčadi od 6 mjeseci je 26,9% a majki jednogodišnjaka 12,9%. Socioekonomske karakteristike statistički značajno povezane s depresivnošću su bili mlađa dob <21 god., te starija >35 god, osnovnoškolsko obrazovanje, nezaposlenost te niži prihodi uglavnom ispod prosjeka i izvan bračne zajednice. Logističkom regresijom depresivnost je povezana s nižim prihodom, prisustvom kroničnih bolesti, prisustvom prethodnih mentalnih bolesti, neplaniranom neprihvaćenom trudnoćom, samohranim majkama, spontanim pobačajima i lošim odnosom sa suprugom te velikim svakodnevnim opterećenjem.
Zaključak: Prepoznata je visoka stopa depresivnosti od 27% po Edinburškoj skali za procjenu postporođajne depresije (EPDS), a po dva pitanja za procjenu depresivnosti prisutna je jos veća stopa od 49%. Obzirom na velike razlike u zabilježenoj pojavnosti depresivnosti u ovom istraživanju ovisno o korištenom upitniku, neophodno je validirati upitnike za našu populaciju. Također je potrebno senzibilizirati javnost i zdravstvene radnike na veličinu problema. Intervencije bi trebalo usmjeriti osobito na trudnice i majke novorođenčadi te žene s prepoznatim rizičnim čimbenicima. |
| Abstract (english) | The number of women who are seeking help for depression during pregnancy and after childbirth (PPD) is just the tip of the iceberg in the world, as well, we assume, in our country because we do not have accurate data.
Objective: Evaluate the prevalence of depression in pregnant women and in young mothers in the care of visiting nurses. To investigate the association of depression with certain psychosocial characteristics and factors related to pregnancy, childbirth and child care.
Patients and methods: A cross-sectional study (cross-sectional) for a period of six months from 11.01.2013 to 30.04.2014.god in Virovitica, were implemented by 20 nurses who care for 80 000 participants. The sample consisted of 1125 respondents, of which 937 (83%) agreed to participate, 200 pregnant women, 180 new mothers, 286 mothers with child around 6 months, and 271 mothers who have 1 year old child. The questionnaire compiled for this study consisted of socio-economic data, on morbidity of mental and somatic diseases, on progress, on the outcome of pregnancy, on the newborn and on questions about the relationship with partner and perception of care for the child. For the assessment of depression EPDS and two questions about depression were used.
Results: Based on EPDS 253 respondents (27%) were depressed and based on two questions about depression 458 of them (49%). Depression is significantly reduced by increasing age of the child (P <0.001).; there were 37.5% depressed pregnant women, 36.7% mothers of newborns, 26,9% mothers with 6 month old child and 12.9% mothers who have 1 year old child. Socio-economic characteristics significantly associated with depression were: younger age <21 years., and older>35 years, primary education, unemployment and lower incomes generally below average and out of wedlock. By logistic regression depression is associated with lower income, with presence of chronic diseases, with presence of previous mental illnesses, with unplanned and unaccepted pregnancy, with single mothers, with miscarriages, with poor relationship between partners and with huge daily load.
Conclusion: In the study has been recognized the high rate of depression of 27% by the Edinburgh scale for evaluating postpartum depression (EPDS), and two questions for assessing depression is present even higher rate of 49%. Considering the large differences in the incidence of recorded depression in this study, it is necessary to validate the appropriate questionnaire for our population and to sensitize the public and health professionals on the size of the problem. Interventions should be focused particularly on pregnant women and mothers of infants and on women with identified risk factors. |
