Paper
Friday, July 13, 2007
Care Seeking Experiences of Women Following Referral for Probable Postpartum Depression
Wendy Sword, RN, PhD1, Dianne Busser, BScN2, Rebecca Ganann, BScN1, and Marilyn Swinton, BA1. (1) School of Nursing, McMaster University, Hamilton, ON, Canada, (2) Family Health Division, City of Hamilton Public Health Services, Hamilton, ON, Canada
| Learning Objective #1: identify factors that hinder and facilitate care seeking among women following referral for probable postpartum depression |
| Learning Objective #2: describe strategies that can be implemented to promote care seeking among women following referral for probable postpartum depression |
Postpartum depression is the most common psychiatric problem experienced by women postnatally, with an incidence rate of 10 to 15%. Because it can have profound effects on the woman as well as on her infant, other children and partner, early identification and intervention are important. A qualitative descriptive study conducted in Ontario, Canada explored care seeking among women following public health nurse referral for probable postpartum depression. The focus was on women’s responses to the referral and their experiences of seeking professional help for a possible mental health problem. Semi-structured interviews with 18 study participants revealed factors that hindered and facilitated care seeking. These factors reflected individual, social network and health system level influences. At the individual level, normalizing of symptoms, instrumental challenges, and fears related to stigma and perceptions of others deterred care seeking whereas awareness of symptoms was a facilitating influence. Responses of family and friends sometimes hindered care seeking because they, too, normalized symptoms or were uncertain how to help. They assisted care seeking when they encouraged a visit to a health professional, expressed concern, or provided support that was instrumental to the woman getting care. Factors at the health system level that deterred care seeking again included normalizing of symptoms along with long waiting times, limited hours of availability, communication issues, lack of relationship with the care provider, and offering of unacceptable interventions. Care seeking was facilitated by timeliness of referral, ease of appointment scheduling, geographic availability and accessibility, having established relationships within the system, legitimization of the problem by a health care professional, and a supportive, non-judgmental approach. The findings of this study will be instrumental in guiding clinical practice, and in providing direction for the improvement and development of services for women with postpartum depression locally and elsewhere.