Postpartum depression : perceived social support and stress among Hong Kong Chinese women

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Postpartum depression : perceived social support and stress among Hong Kong Chinese women


Author: Leung, Shuk-kam Sharron
Title: Postpartum depression : perceived social support and stress among Hong Kong Chinese women
Degree: Ph.D.
Year: 2001
Subject: Postpartum depression -- China -- Hong Kong
Women -- China -- Hong Kong
Chinese -- China -- Hong Kong
Hong Kong Polytechnic University -- Dissertations
Department: Dept. of Nursing and Health Sciences
Pages: v, 477 leaves : col. ill. ; 30 cm
Language: English
InnoPac Record:
Abstract: A longitudinal prospective study triangulated with the quantitative and qualitative approaches and was pioneer in this kind to study social support, stress and postpartum depression in the context of Chinese culture. It was conducted on 385 Hong Kong Chinese women who were recruited from five major hospitals of Hong Kong at their third trimesters and were followed up at six weeks postpartum. At six months after delivery, a subsample of 59 women from both the depressed and non-depressed groups was included for in-depth interviews. Postpartum depression, social support and stress were assessed with the Edinburgh Postnatal Depression Scale, Postpartum Support Questionnaire, Postpartum Social Support Questionnaire, Perceived Stress Scale and the Childcare Stress Inventory. Cutoff of 12/13 was adopted to identify the high risk group for postpartum depression. There were 20% of postnatal respondents scored 13 or above on the Edinburgh Postnatal Depression Scale. Results showed that antenatal depression, social support factors (particularly emotional and material support, importance of support, family support and dissatisfaction of support) and stress factors (including global stress level and specific childcare stress level) were all significant association factors and predictors of postpartum depression. Unmet desired support instead of the unmet expectation of support that indicated dissatisfaction of support was a significant association factor. There was no stress-buffering effect found in this study as all interaction terms of social support and stress failed to be predictive in the multiple regression model. Ten major themes emerged from the interviews that reported the stress and support related to postpartum adjustment that differentiated the depressed and non-depressed groups. They included antenatal worries, unexpected delivery experiences, childcare competence, adjustment to the new roles, baby related problems, planning: expectation and actual situation, childcare arrangement, traditional pressure, support and stress from helpers, as well as support and stress from health care professionals. Traditional postpartum ritual, 'doing the month', was not found to be protective against postpartum depression. On the contrary, it caused stress in some respondents. Support from in-law was not welcomed by some respondents and thus exerted negative impact on the respondents' emotional and psychological well-being. Results of this study informed nursing practice to facilitating perinatal women to plan and solicit effective support from their social network and reduce possible stress. Guidelines for improving the cultural sensitive prevention and intervention were formulated based on the study results.

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