Effectiveness of home visits by mental health nurses for Japanese women with post‐partum depression

Abstract

Post-partum depression affects 10-13% of Japanese women, but many do not receive appropriate treatment or support. This intervention study evaluated the effectiveness of home visits by mental health nurses for Japanese women with post-partum depression. Eighteen post-partum women met the inclusion criteria and were randomly allocated into the intervention (n = 9) or control (n = 9) group at 1-2 months after giving birth. The intervention group received four weekly home visits by a mental health nurse. Control group participants received usual care. Two women in the intervention group did not complete the study. Depressive symptoms and quality of life were measured at 1 and 6 weeks' postintervention. In addition, participants completed an open-ended questionnaire on satisfaction and meaning derived from the home visits. Women in the intervention group had significant amelioration of depressive symptoms over time and reported positive benefits from the home visits, but there were no statistically significant differences between groups. Significant differences (P < 0.05) were observed at times 2 and 3 between groups in terms of increased median scores of physical, environmental, and global subscales, and the total average score of the World Health Organization/quality of life assessment instrument. On the psychological subscale, significant differences (P = 0.042) were observed between groups at time 2. The qualitative analysis of comments about home visitation revealed four categories related to 'setting their mind at ease', 'clarifying thoughts', 'improving coping abilities', and 'removing feelings of withdrawal from others'. These results suggest that home visits by mental health nurses can contribute to positive mental health and social changes for women with post-partum depression. A larger trial is warranted to test this approach to care.

Women's Experiences of Seeking and Receiving Psychological and Psychosocial Interventions for Postpartum Depression: A Systematic Review and Thematic Synthesis of the Qualitative Literature

“…One study reported that the women had learned a “psychological language,” and many studies referred to an improvement in the understanding and perception of PPD. Women also reported that their confidence in parenting had increased as a result of information they received in this respect during their intervention . Many women reported improvements in their relationships both with their infant and significant others .…”

“…Based on the criteria set by Walsh and Downe, the majority of studies included were of very good methodologic quality, with only one exception . Finally, only 2 of the 17 included studies referred to reflexivity, a key component of quality control in qualitative research …”

“…The 17 studies represented the views of 585 women from the United Kingdom, Canada, Japan, and Australia [27][28][29][30][31][32][33][34][35][36][37][38][39][40][41][42][43] (Table 2). Two studies investigated the experiences of Black Caribbean women living in the United Kingdom, 30,31 and one study focused on South Asian British women.…”

Postpartum depression: the (in) experience of Brazilian primary healthcare professionals

“…Two examples of nursing care could be applicable to primary health care in Brazil: (1) a qualitative study of Japanese women's perceptions about nurses' home visits indicated women believed their PPD improved because they had opportunities to clarify their thoughts with nurses and disperse negative feelings (Tamaki ); and (2) a study that investigated American women's perceptions about screening and counselling during PPD found nurses can play a fundamental role in identifying perinatal depression; the women were receptive to being screened and counselled by them (Segre et al . ).…”

Factors causing stress in women with babies 0–3 months old and their coping styles

“…Several studies have shown that home visits by nurses can contribute to positive mental health, social changes and an increase in the women's quality of life in postpartum (Beeber et al . , Tamaki ).…”