Postpartum depression and life experiences of mothers with an immigrant background living in the south of Sweden.

PURPOSE: Postpartum Depression (PPD) -a common health problem for mothers' postpartum increases the risk of negative interaction between mothers and infants as it reduces the former's ability to respond to the latter's needs appropriately. Migrant mothers exhibit a higher prevalence of risk factors for PPD. Hence, this study aimed to investigate migrant mothers' life experiences pertaining to motherhood and PPD. METHODS: Qualitative interviews were conducted with 10 immigrant mothers in the south of Sweden during 2021. RESULTS: The qualitative content analysis revealed the following main themes: 1) PPD (two sub themes-psychosomatic symptoms and burden of responsibility due to feelings of loneliness); 2) mistrust of social services (one sub-theme-afraid of losing their children and Swedish social services' lack of understanding); 3) inadequate healthcare (two sub-themes-limited healthcare literacy for migrant mothers and language barrier; 4) women's coping strategy for well-being (two sub-themes-better awareness and understanding of the Swedish system and society, and freedom and independence in the new country). CONCLUSIONS: PPD, mistrust of social services, and inadequate healthcare lacking personal continuity were common among immigrant women, thus precipitating discrimination-including lack of access to services because of limited health literacy, cultural differences, language barriers, and insufficient support.

Feasibility and preliminary evaluation of internet-based compassion and cognitive-behavioral stress-management courses for health care professionals: A randomized controlled pilot trial.

Health care professionals (HCPs) are exposed to excessive demands in their work environment. In Sweden, work-related stress is one of the most common reasons for sick leaves. Finding cost-effective and easily accessible interventions for HCPs is crucial to counteract stress-related problems and reduce the number of sick leaves. The study aimed to evaluate the feasibility of two internet-based stress management courses and their preliminary effectiveness to reduce HCPs' stress of conscience and work-related stress, and act as a pilot for a larger randomized controlled trial (RCT). Thirty-two HCPs registered for the courses and were randomized to either an internet-based compassion course, ICOP (n = 18), or an internet-based cognitive-behavioral course, ICB (n = 14). Participants completed measures pre- (i.e., baseline, n = 32), post-intervention (at five weeks, n = 21), and at follow-up at 10 weeks (n = 17), 15 weeks (n = 13), and six months (n = 12). The study used the following scales: Stress of Conscience Questionnaires, Copenhagen Psychosocial Questionnaire, Self-Compassion Scale, and Professional Quality of Life Scale. Adherence of HCPs (n = 21) was measured using the number of logins, messages between course leaders and HCPs, and completed modules. Twelve interviews were conducted to explore participants' perceptions of the accessibility of the courses. Participants reported overall satisfaction with both the ICOP and ICB courses, stating that the courses contributed to new knowledge, individual insight, and behavior change. Both courses showed similar patterns of adherence. Quantitative analyses on pre-and post-intervention data (n = 21) showed that stress of conscience and secondary traumatic stress decreased, and self-compassion increased following ICOP. Following ICB, HCPs reported decreased burnout symptoms (according to one of two questionnaires) and increased compassion satisfaction. Both courses seemed feasible, showed promising results, and could be further evaluated in a larger study with a similar design.

An internet-based compassion course for healthcare professionals: Rationale and protocol for a randomised controlled trial.

Background: Severe stress is one of the most common causes of sick leave in Sweden. Previous research has shown that compassion interventions for healthcare professionals can decrease work-related stress through the introduction of self-care, self-awareness, and emotion regulation abilities when experiencing difficult situations. Internet-based stress management interventions have hitherto shown promising results in reducing stress. However, further research is needed to examine the effectiveness of internet-based compassion interventions for healthcare professionals. Objective: In the present study protocol, a randomised controlled trial is described, aiming to examine the effects of an internet-based compassion course for healthcare professionals on work-related stress and stress of conscience. Method: Healthcare professionals will be offered an internet-based stress management course of five modules across a period of five weeks. The design is a randomised controlled study consisting of three groups enrolled in one of the following: a compassion course (n = 120), a cognitive behavioural stress management course (n = 120), or placed on a waitlist followed by either the compassion course or the cognitive behavioural stress management course (n = 36). We hypothesise that the internet-based compassion course would reduce the participants' stress of conscience to a greater degree compared to the other two groups. The secondary hypothesis is that the compassion course would increase the participants' professional quality of life (i.e., higher job satisfaction and lower empathy fatigue) and self-compassion. In addition, the internet-based compassion course is expected to reduce the participants' work-related stress and sick leave rates to the same degree (non-inferiority) as the cognitive behavioural stress management course and to a higher degree when compared to the waitlist condition. The primary outcome measure is the Stress of Conscience Questionnaire (SCQ) and the secondary outcome measures are the Professional Quality of Life Scale (PROQOL), the Work-related Stress Copenhagen Psychosocial Questionnaire (COPSOQ), and the Self-compassion Scale (SCS). Assessments will be performed at baseline, four weekly assessments during treatment, post-treatment (5 weeks), and follow-ups at 10 weeks, 15 weeks, and 6 months. The repeated measures data will be analysed using a generalised estimating equation for repeated measurements to examine whether changes over time differ between the groups and whether the improvements persist over time. Discussion: The clinical trial is expected to provide novel data on the effects of compassion interventions and add to the existing knowledge of internet-based interventions for stress management in healthcare professionals.

Depressive symptoms, parental stress, and attachment style in mothers and fathers two and a half years after childbirth: Are fathers as affected as mothers?

The study aimed to determine the prevalence of depressive symptoms and whether parental stress and attachment style affected depression in mothers and fathers two and a half years after the birth of a child. The parents completed several questionnaires including the Edinburgh Postnatal Depression Scale, the Swedish Parenthood Stress Questionnaire and the Relationship Questionnaire. The prevalence rate of depressive symptoms in mothers was 14.9%, while for fathers it was 11.5%. Differences between the parents identified as depressed and those without depressive symptoms were also analysed. There were no significant differences between depressed and non-depressed parents on the secure, avoidant and fearful attachment styles. However, there was a significant difference between groups on the preoccupied subscale. The final aim was to calculate if attachment style contributed to the level of depression while accounting for the impact of parental stress. Parental stress (incompetence, social isolation and spouse relationship problems) was the best predictor for mothers' depressive symptoms, while parental stress (social isolation and health) and the preoccupied attachment style were the best predictors for such symptoms in fathers. The findings indicated that parental stress and depressive symptoms are closely related and can explain the difficulties parents face.

Mothers' and fathers' lived experiences of postpartum depression and parental stress after childbirth: a qualitative study.

Purpose: The study aims are to explore the lived experiences of mothers and fathers of postpartum depression and parental stress after childbirth.Methods: Qualitative interviews conducted, and analysed from an interpretative phenomenological analysis (IPA) perspective.Results: Both mothers and fathers described experiences of inadequacy, although fathers described external requirements, and mothers described internal requirements as the most stressful. Experiences of problems during pregnancy or a traumatic delivery contributed to postpartum depression and anxiety in mothers and affected fathers' well-being. Thus, identifying postpartum depression with the Edinburgh Postnatal Depression Scale, mothers described varying experiences of child health care support. Postpartum depression seemed to affect the spouses' relationships, and both mothers and fathers experienced loneliness and spouse relationship problems. Experiences of emotional problems and troubled upbringing in the parents' family of origin may contribute to vulnerability from previous trauma and to long-term depressive symptoms for mothers.Conclusions: The findings of this study demonstrate the significant impact of postpartum depression and parental stress has in parents' everyday lives and on the spouse relationship. These results support a change from an individual parental focus to couples' transition to parenthood in child health care.

Depressive symptoms and parental stress in mothers and fathers 25 months after birth.

The aim of this study was to determine the prevalence of depressive symptoms, feelings of incompetence and spouse relationship problems and their mutual relations. Data from a Swedish parent-infant population-based cohort 25 months after childbirth was used. A questionnaire containing Edinburgh Postnatal Depression Scale (EPDS) and a modified Swedish Parental Stress Questionnaire (SPSQ) regarding depression and parental stress was answered by 646 fathers and 700 mothers. Parents with depressive symptoms experienced more feelings of incompetence and spouse relationship problems than parents without depressive symptoms. The prevalence of depressive symptoms (EPDS ≥ 12) was more than11% for mothers and nearly 5% for fathers in the sample, 25 months after childbirth. The result indicated that feelings of incompetence and spouse relationship problems could be important constructs for understanding parental stress and depressive symptoms in the parents of young children. In conclusion, it is important that Child Health Care is attentive to both mothers' and fathers' depressive symptoms and parental stress after the first year.