ปัจจัยทำนายความผิดปกติหลังเกิดความเครียดที่สะเทือนใจของมารดาหลังคลอดที่มารับบริการ ที่โรงพยาบาลราชวิถี

Soopussara   Komindr; Ekachai  Kovavisarach; Malee   Geounoppakul; Waralya  Sangpitak

Authors

Soopussara Komindr Boromarajonani College of Nursing, Bangkok, Faculty of nursing
Ekachai Kovavisarach School of Medicine, Siam University
Malee Geounoppakul Faculty of nursing, Rajamangala University of Technology Thanyaburi
Waralya Sangpitak Boromarajonani College of Nursing, Bangkok, Faculty of Nursing

Keywords:

Postpartum depression, Post Traumatic Stress Disorder of Postpartum mother

Abstract

Introduction: Post-traumatic stress disorder (PTSD) in postpartum mothers is a psychiatric disorder. The causes are from crisis or pressures that is greater than normal such as life-threatening and pain, resulting in fears or powerlessness in problem solving.

Research Objectives: This study aimed to investigate factors predicting PTSD among postpartum mothers at 4-6 weeks.

Research Method: This study employed a prospective and longitudinal design. A total of 500 postpartum mothers were recruited from two postpartum units at Rajavithi hospital from June 2017 to December 2018. The PTSD questionnaire was used to collect data. This questionnaire was adapted from the Depression Inventory developed by the Department of Mental Health, Thailand (2Q, 9Q). A set of questionnaires were used to collect data by interviewing the mothers twice. First, each mother was asked in the period of 48-72 hours after delivery to explore the received treatment and care during labor and general data, perceptions of intrapartum care, and the presence of trauma symptoms before mother discharge. Second, an interview was conducted with mothers using telephone 4 weeks after birth for postpartum depression screening. Demographic data and incidence of PTSD were analyzed using descriptive statistics (percentage, mean) Stepwise multiple regression analysis was used to determine which independent variables were predictors of PTSD in postpartum mothers.

Results: Four factors significantly predicted PTSD in postpartum mothers at 4-6 weeks including: 1) having a history of being psychologically abused during 4-6 weeks before child birth; 2) postpartum depression score before discharge; 3) family planning; and 4) having a history of bodily injury during 4-6 weeks before child birth. These four factors together explained 13.4% (Adj. R² =0.134; p<0.001) of the variance in PTSD.

Conclusion: The findings of this study show that family planning, a history of being psychologically abused, and a history of bodily injury during 4-6 weeks before child birth, and postpartum depression score before discharge are crucial factors predicting PTSD among postpartum mothers.

Implications: To monitor depression and PTSD among pregnant women and postpartum mothers, the depression screening (2Q, 9Q) should be used to reduce the potential loss of mothers who cannot resolve problems by themselves.

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