Shelley Doucet

Interventions for the prevention and treatment of postpartum psychosis: a systematic review.

Postpartum psychosis is a serious disorder that can cause negative consequences for the mother, infant, and entire family. While reports of this condition date back for centuries, little is known about what interventions are most effective for this population. The purpose of this systematic review was to examine the research evidence on interventions for the prevention and treatment of postpartum psychosis. Studies were searched using CINAHL, EMBASE, MEDLINE, PsycINFO, and PubMed databases. All primary research studies published in English since 1970 that explored interventions for the prevention or treatment of postpartum psychosis were included. The search resulted in 26 studies on interventions for postpartum psychosis, with 10 focusing on prevention and 17 focusing on treatment. Studies on the prevention of postpartum psychosis have examined the effects of mood stabilizers, antipsychotics, and hormone therapy, while those examining treatment have included electroconvulsive therapy, mood stabilizers, antipsychotics, hormones, and the beta blocker propranolol. Only preliminary evidence suggests which interventions may be effective strategies to prevent (e.g., lithium) and treat (e.g., electroconvulsive therapy) postpartum psychosis. Due to methodological limitations in the studies reviewed, extensive evidence-based recommendations for the prevention and treatment of postpartum psychosis cannot be made. The known risk factors and negative consequences of postpartum psychosis point to the importance of preventative and acute treatment measures. Well-designed prospective studies are needed to determine the efficacy of prevention and treatment interventions for women who experience postpartum psychosis.

Differentiation and Clinical Implications of Postpartum Depression and Postpartum Psychosis

Postpartum depression and postpartum psychosis are serious mood disorders encountered by nurses working in a variety of settings. Postpartum depression refers to a nonpsychotic depressive episode, while postpartum psychosis refers to a manic or affective psychotic episode linked temporally with childbirth. The nursing profession plays a crucial role in the early identification and treatment of these postpartum mood disorders. This article explains the classification, clinical presentation, epidemiology, management, and long-term outcomes of postpartum depression and postpartum psychosis.

The historical social positioning of nursing and medicine: implications for career choice, early socialization and interprofessional collaboration

Abstract For almost half a century, research has identified that effective teamwork is essential in order to enhance care provision and health outcomes for patients. Although the value of teamwork is well-recognized in healthcare, the historically rooted dynamics of workplace relationships create a myriad of challenges to creating collaborative teams. Understanding the history of interpersonal dynamics between health professionals can provide direction for future interprofessional education and collaboration strategies. The aim of this paper is to provide a historical overview of the social positioning of nursing and medicine in the context of interprofessional collaboration. Few professions work as closely as nursing and medicine. Despite the well-recognized benefits of interprofessional collaboration, these two professions are often socially positioned in opposition to one another and depicted as adversarial. This analysis will seek to advance our understanding of the historical roots between these two professions and their relationships with and among each other in relation to career choice, early socialization and patient care delivery. An exploration of the historical social positioning of nursing and medicine can provide an enhanced understanding of the barriers to interprofessional collaboration and inform future successes in interprofessional education and practice among all health and social care professions.

Support Needs of Mothers Who Experience Postpartum Psychosis and Their Partners

OBJECTIVES To explore the perceived support needs and preferences of women with postpartum psychosis and their partners. DESIGN A multisite, exploratory, qualitative descriptive design was used. SETTING AND PARTICIPANTS A purposive sample of nine mothers (Canada, n = 7, United States, n = 2) and eight fathers (Canada, n = 7, United States, n = 1) was obtained. METHODS Data were collected through one-on-one, in-depth, semistructured interviews. Inductive thematic analysis was used to explore the qualitative transcripts. RESULTS Couples who experienced postpartum psychosis looked to health professionals to provide reassurance and information on the illness, its management, and prognosis. The quality of support and interactions with staff varied, and participants reported difficulty identifying and obtaining professional support upon discharge. All participants felt that support groups for postpartum illnesses would help to normalize the experience and dissipate feelings of isolation. Participants reported that informal support networks provided practical help but were limited or hindered recovery and management due to lack of knowledge of the illness. Despite feeling overwhelmed and isolated, fathers were reluctant to identify their own support needs and struggled to ask for help from professionals and their informal support network. CONCLUSION These findings suggest that clinical interventions are needed to address the support needs and aid in the recovery of families affected by postpartum psychosis.

Patients as educators: the challenges and benefits of sharing experiences with students

Medical Education 2012: 46: 992–1000

Contemporary Paradigms for Research Related to Women's Mental Health

Mental health problems are serious health concerns that affect women across diverse settings internationally. Knowledge of this population historically has been informed by research using a positivist approach. This article is a critical examination of contemporary paradigms for research related to womens mental health. We begin the article with an introduction to womens mental health, followed by an overview of the postpositivist, critical theory, and constructivist paradigms. We then present a critical examination of the benefits and limitations of these paradigms in relation to the study of womens mental health. We conclude with implications for research and practice.

The use of information and communications technologies in the delivery of interprofessional education: A review of evaluation outcome levels

Abstract Interprofessional education (IPE) in health and human services educational and clinical settings has proliferated internationally. The use of information and communication technologies (ICTs) in the facilitation of interprofessional learning is also growing, yet reviews of the effectiveness of ICTs in the delivery of pre- and/or post-licensure IPE have been limited. The current studys purpose was to review the evaluation outcomes of IPE initiatives delivered using ICTs. Relevant electronic databases and journals from 1996 to 2013 were searched. Studies which evaluated the effectiveness of an IPE intervention using ICTs were included and analyzed using the Barr et al. modified Kirkpatrick educational outcomes typology. Fifty-five studies were identified and a majority reported evaluation findings at the level 1 (reaction/satisfaction). Analysis revealed that learners react favorably to the use of ICTs in the delivery of IPE, and ICT-mediated IPE can lead to positive attitudinal and knowledge change. A majority of the studies reported positive evaluation outcomes at the learner satisfaction level, with the use of web-based learning modalities. The limited number of studies at other levels of the outcomes typology and deficiencies in study designs indicate the need for more rigorous evaluation of outcomes in ICT-mediated IPE.

IN-2-THEORY – Interprofessional theory, scholarship and collaboration: A community of practice

Theoretical awareness is essential in the development and delivery of effective interprofessional education and collaborative practice (PECP). The objective of this paper was to explain the origins and purpose of an international network, IN-2-THEORY – interprofessional theory, scholarship and collaboration: a community of practice (CoP) that aims to build theoretical rigor in IPECP. It explains why the network is viewed as a CoP and lays out the way forward for the community based on the principles for developing a CoP outlined by Wenger, McDermott, and Snyder (2002).

The Dalhousie Health Mentors Program: Introducing students to collaborative patient/client-centered practice

The Dalhousie Health Mentors Program builds on a long history of interprofessional health education initiatives by introducing students in health and social care professions to chronic conditions and disabilities, patient/client-centredness, interprofessional learning, and team functioning. This large interprofessional education program (16 participating programs, 650 students) connects interprofessional student teams with Health Mentors, who are adult volunteers with chronic conditions, for a learning experience that extends over one academic year. Students explore their mentors life story and chronic condition journey, the impact the condition has had on her/his life, and her/his experience with health care in general and interprofessional collaboration in particular. All aspects of the program planning, management, implementation, and evaluation have been interprofessional in nature. Lessons have been learned regarding

Coping and Suicidal Ideations in Women with Symptoms of Postpartum Depression

Objective To explore the relationship between coping mechanisms and suicidal ideations among women who experience symptoms of postpartum depression. Design This exploratory descriptive study used secondary data from a study of women who experienced symptoms of postpartum depression. Participants Convenience and purposive sampling were used to obtain the community sample of 40 women who experienced symptoms of postpartum depression. Methods Binary logistic regression was employed to explore emotion-focused coping, avoidance-focused coping, problem-focused coping, and religious coping as predictors of suicidal ideations. Results Approximately 27% of the sample reported suicidal ideations within the past seven days. The results showed that lower levels of emotion-focused coping and higher levels of avoidance-focused and religious coping predicted suicidal ideations in participants. Problem-focused coping did not predict suicidal ideations. Conclusion Overall, our findings provide support for the importance of coping mechanisms as predictors of suicidal ideations among women who experience symptoms of postpartum depression. The results illustrate the need for health professionals to conduct routine assessments on coping strategies and thoughts of suicide when caring for postpartum women, as well as the need to integrate coping approaches in the prevention and treatment of suicidal ideations.