PubMed Health⌕ Search

Biomedical subjects

J Milgrom

Publications and source records attributed to J Milgrom.

6 recordsLinked to original sources

Health professional's knowledge and awareness of perinatal depression: results of a national survey.

INTRODUCTION: Postnatal depression affects 14% of women, occurring also antenatally, with potential long-term consequences, making it an important disorder to detect and manage early. In this study we sought to examine knowledge and awareness of perinatal depression in health professionals involved in perinatal care throughout Australia prior to the implementation of a comprehensive screening program, aimed at improving detection and access to appropriate management. METHODS: A random sample of General Practitioners (GPs) and Maternal Child Health Nurses (MCHNs) and Midwives, in regions throughout Australia to be subsequently targeted by a screening and education program, were invited to participate. Responses to a hypothetical vignette and a knowledge questionnaire, as well as details of experience were completed. FINDINGS: Questionnaires were completed by 246 GPs, 338 MCHNs and 569 midwives, with overall response rates; GP's 23%; MCHN's 55% and midwives 57%. Although knowledge level was similar among professional groups, MCHNs had higher levels of awareness of perinatal depression. Both GPs and MCHNs were more likely than midwives to recognize the need for providing help to women with emotional distress. Depression was more likely to be considered postnatally than antenatally in all groups, with GPs most likely to provide this diagnosis. GPs had a significant propensity to recommend antidepressants, and midwives to select non-specific medications. CONCLUSIONS: Health professionals responding to this survey had a high awareness and similar knowledge base. Further education on antenatal depression and the safety risks and alternatives to medication is important for all groups, but particularly important for midwives and GPs. The latter is especially relevant given the preference for women with perinatal depression not to use pharmacological interventions to treat their emotional distress.

Analysis of Variance↗

Breaking the bad news: dilemmas in shared decision-making in medical practice.

In a review of the literature, very little empirically based research was uncovered to guide the practice of health professionals who need to tell their patients bad news and help them to decide on their preferred treatment option. Various practising styles and guidelines are presented, and ethical and crosscultural challenges discussed. An enormous amount of research still needs to be done to discover the least stressful ways of dealing with these issues in health care settings.

Communication↗

Psychiatric illness in women: a review of the function of a specialist mother-baby unit.

OBJECTIVE: The aim of this paper is to describe a specialist program in a psychiatric mother-baby unit and to review the characteristics (including mothering skills) and outcomes on discharge of 36 women consecutively admitted to the unit over an intensive 6-month observation period. Changes in admissions to the same unit over 10 years were also compared. METHOD: Consecutive admissions were studied in terms of demographics, ethnicity, diagnosis, psychiatric history, psychiatric information and mother-infant data. RESULTS: The majority of women admitted suffered from schizophrenia or other psychotic disorders, with the second largest diagnostic criteria being depression. For 20 mothers, this was the first psychiatric admission and most admissions were voluntary. The mean length of stay was 21.7 days, representing a highly significant decrease in stay when compared to the past 10 years in the same unit. Mothering skills were found to be incompetent or only passable in 57% of women. A small improvement occurred by discharge, and the majority of women were not separated from their infants. CONCLUSIONS: The critical need to support these women and their infants in the long term was highlighted, with recommendations of outpatient and day programs, as well as supported accommodation.

Adult↗

Group treatment for postpartum depression: a pilot study.

OBJECTIVE: There are few reports on the efficacy of treatment programs for women with postpartum depression, despite the long-term nature of this disorder. This study describes a pilot evaluation of a treatment program with educational, social support and cognitive-behavioural components. METHOD: Ten women with persistent depression originating in the postpartum period were offered a 10-week group treatment program and compared to a wait-list control group. RESULTS: Following treatment, a significant improvement in depression was demonstrated on the Edinburgh Post-Natal Depression Scale, Beck Depression Inventory, and Profile of Mood States. Several common factors in women suffering from postpartum depression were also identified, as were drop-out characteristics. CONCLUSION: These results are encouraging and suggest that a cognitive-behavioural group program might be effective as a treatment for depression in the postpartum period. However, further detailed studies are required to conform this pilot study.

Adult↗

Do infants of depressed mothers cry more than other infants?

OBJECTIVE: This study compared the crying behaviour of infants of depressed and non-depressed mothers at 3 and 6 months of age. METHODOLOGY: Twenty-nine depressed and 44 non-depressed mothers, their infants and partners participated in this study. Mothers were asked to complete 24-hour diaries of the amount their infants cried for 1 week. RESULTS: The diurnal variations in crying patterns of infants of depressed and non-depressed mothers were not significantly different. However, infants of depressed mothers were found to cry significantly more in total per day than infants of non-depressed mothers at 3 months of age, but not at 6 months. The results could not be explained by differences in infant temperament. CONCLUSION: Maternal depression may be a contributory factor to infant crying at 3 months of age.

Adult↗

Mother-infant interactions in postpartum depression: an early intervention program.

This paper examines the role of postnatal intervention in the prevention of the negative consequences of postpartum depression on developing mother-infant relationships. It is argued that, once difficulties in these interactions have been identified, direct attempts to modify the interactions must occur within a framework that includes maternal, paternal, partnership/marital and social variables. An intervention program that may be instituted by nurses is described. The Baby Happiness, Understanding, Giving and Sharing (HUGS) Programme is an attempt to integrate direct intervention in mother-infant interactions into a systemic framework which takes into account contextual variables such as cognitive style and social support.

Cognition↗