Paper
Thursday, 20 July 2006
This presentation is part of : Maternal-Child Care Strategies
The Influence of Post Partum Disruption on Maternal Functional Status
Sheron Salyer, RN, MSN, DNSc, College of Health Science, Belmont University, Nashville, TN, USA
Learning Objective #1: identify aspects women living in a rural southern geographical area identified as disruptive or problematic during the first three months post partum.
Learning Objective #2: describe the relationship between disruption experienced during the first three months post partum and the mother's functional status at survey completion.
Objectives: Identify aspects women found disruptive during the first three months post partum (PP) then explore the relationship between PP disruption and maternal functional status (FS) at survey completion, three to 12 months following birth. Design: Descriptive non-experimental survey design Setting: Rural Southern geographical region with woman cared for by obstetricians, family practice physicians and midwives during their target pregnancy. Participants: Convenience sample of 50 women, 19 years or older. Most women were Caucasian (96%), lived with their partners (96%), worked prior to birth (58%) and either returned or planned to return to work (42%).  Outcome Measures:  1. Post Partum Transitional Experience 2 (PPTE2), 37 item disruption scale, (Cronbach’s Alpha, 0.93); 2.Edinburgh Postnatal Depression Scale (EPDS) (Cronbach’s Alpha, 0.80); 3.RAND 36 (Cronbach’s Alpha, 0.94). Results:  Fatigue, marital disruption and emotional concerns were identified by women as disruptive during PP. An inverse relationship existed between PP disruption and maternal FS beyond the first three months PP for the Rand 36; between physical disruption PP and the Rand Physical Summary Scale (PSC) score; and between mental health disruption and the Rand 36 Mental Summary Scale (MSS) score. Many women continued to report physical and marital problems at survey completion. The mean time interval was 8 months between birth and survey completion. The mean score on the EPDS was 10. 4, above the lower cut off recommended for identifying women with depressive symptoms. Over 36% of the women reported depressive scores of 14 to 24 on the EPDS. Even though problems persisted, few women reported the problems to their caregivers. Conclusion: Caregivers need to evaluate the adequacy and timing of post partum health services. Findings suggest the need to modify the content of well-women exams the year following birth to include assessment of the marital relationship, depression and maternal functional status.

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