The Effectiveness of Facilitated Web-Mediated Postpartum Depression Education and Postpartum Discharge Instructions

Postpartum depression is a mental health mood disorder characterized by sadness and despair in patients within twelve months following birth.  At the microsystem level of care prior to the discharge of the postpartum patient, comprehensive education or screening for depressive symptoms is uncommon (Leahy-Warren, McCarthy, & Corcoran, 2012; Marsh, J. (2013).  As a result, patients and relatives do not receive the education required for early depression symptom recognition.  Consequently, depressive signs or symptoms often progressed in the postpartum patient without being identified, reported or treated (Abram & Curran, 2009).  This background information influenced the framing of the following PICOT question: will facilitated web-based postpartum depression patient and family education in conjunction with the traditional postpartum discharge instructions, promote patients’ postpartum depression symptom recognition, use a self-screening depression tool, and increase perceived general self-efficacy when compared to patients who received only the traditional postpartum discharge instructions?  The purpose of the project was to support a practice that facilitated patient and family web-mediated postpartum depression education plus routine postpartum discharge instructions.  Patient self-screening for depressive symptoms was also offered prior to discharge.  The project was implemented on an inpatient postpartum unit at a hospital.  Thirty-five postpartum patients received cell phone web-mediated postpartum depression education plus discharge instructions prior to discharge.  Another group of thirty-five postpartum patients on the same unit only received discharge instructions upon discharge.  Both cohorts were surveyed before and after the interventions.  The general self-efficacy (GSE) assessed decision making and coping skills before and after interventions.  There was no significant difference in GSE scores before and after interventions.  A symptom checklist questionnaire (SCQ) was used to identify recognition of postpartum depressive symptoms.  The group who received both interventions scored higher in postpartum depression symptom recognition.  The Edinburgh Postpartum Depression scale was completed by all patients to screen for early indicators of postpartum depression.  No significant early indicators of postpartum depression was identified during the twenty-four to ninety-six hours postpartum.  Nurses and nursing organization should consider supplemental postpartum depression education utilizing a mobile device for postpartum patients prior to discharge.  Nurses may also become involved in framing policies to address postpartum depression education and screening for depressive symptoms prior to the postpartum patient's discharge.