Psychologicalchangesduringpuerperium1 121109014209-phpapp02

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psychological changes in puerperium

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Psychologicalchangesduringpuerperium1 121109014209-phpapp02

  1. 1. WELCOME
  2. 2. PSYCHOLOGICALCHANGESDURING PUERPERIUM
  3. 3. PSYCHOLOGICAL CHANGES DURINGPUERPERIUM :-1. Adjustment to all the new changes, newroles2. Postpartum blues3. Cultural influences4. Attachment
  4. 4. PSYCHOLOGICAL ADAPTATION DURINGPOSTPARTUM:-
  5. 5. REVA RUBIN
  6. 6. RUBIN’S STAGES OF MATERNALPSYCHOLOGICAL ADAPTATION:-
  7. 7. TAKING IN PHASE(DEPENDENT PHASE):- First 3 days post partum. Focused on self ,not infant, on her own needs forsleep & rest. Passive , dependent & can’t make decisions. Need to discuss labor experiences. Sense of wonderment when looking at the neonate.
  8. 8. 2-TAKING HOLD PHASE (DEPENDENT TOINDEPENDENT PHASE):- Last from the 3rd to 10th day postpartum. Focus on infant. Active, independent & can make decisions. Initiates self care activities, focus onbowels, bladder & breastfeeding. Responds to instruction about infant care & selfcare. May express lack of confidence in caring for theneonate.
  9. 9. 3-LETTING GO- (INTERDEPENDENTPHASE):- Last from 10 days to 6 weeks postpartum. The woman finally redefines her new role. See self as separate from infant. Gives up fantasized image of her child and acceptsthe real one. Readjustment.
  10. 10. MATERNAL CONCERNS & FEELINGSDURING POSTPARTUM PERIOD:- Abandonment Disappointment Bonding( attachement)
  11. 11. POSTPARTUM DISORDERS:-
  12. 12. 1- Postpartum blues (Baby Blues)
  13. 13. SIGNS:- 50% of women experience some feelings ofoverwhelming sadness. Mood swings, sudden cryingepisodes, irritability, anxiety, loneliness&restlessness. Feeling of happiness and love for thenewborn may be accompanied by feelingsof helplessness, sadness and anxiety.
  14. 14. CAUSES:-Sudden & quick change in the hormones.The emotional &physical stress of givingbirth.It may be a response to dependence andlow self-esteem caused by exhaustion.increased sense of anxiety and tensionassuming by a new role.The fatigue and lack of sleep
  15. 15. HERE ARE SOME HELPFUL TIPS:- Advice woman to exercise regularly. Advice woman to eat a healthy, well-balanceddiet. A woman needs assurance that sudden cryingepisodes are normal. Allow time to verbalize feelings.
  16. 16.  Make time each day for her self to enjoy. Join a support group for new mothers. Talk with her partner about dividing up theparenting responsibilities so she don’t feel likeshe is doing everything by herself.
  17. 17. 2- Postpartum depression
  18. 18. CAUSES:- mood changes changes in hormone levels. non-hormonal factors Changes in your body Changes in work and social relationships. Having less time and freedom Lack of sleep. Worries about ability as a mother.
  19. 19. SYMPTOMS:- Irritability. Changes in appetite. Feeling depressed the majority of the day Feeling of worthlessness or guilt. Feeling withdrawn or unconnected. Lack of pleasure or interest in most activities
  20. 20.  Significant weight gain or weight loss. Extreme insomnia or sleeping all the time. Loss of energy. Problems doing tasks at home or work. Negative feelings toward the baby.
  21. 21. HELPFUL TIPS:- Ask the partner, family, and friends of thewoman for help with her baby. Advice the woman doesn’t hide her feelings.Talk about her feeling with her partner,family, and friends. Don’t make any major life changes during orright after giving birth.
  22. 22.  Advice her to take time to go out, visit friends, orspend time alone with her partner. Advice her to rest as much as she can. Sleepwhen the baby is sleeping. Talk with other mothers or join a support group.
  23. 23. 3,Postpartum Psychosis
  24. 24. NURSING INTERVENTION TOWARDPSYCHOLOGICAL CHANGES &DISORDERS DURING POSTPARTUMPERIOD:-
  25. 25. Postpartum Depression Predictors Inventory – Cheryl BeckPostpartum Depression Screening Scale – also Cheryl Beck –Self-administered followed by a clinician interview, copyrightissues, reliability studied have been done but are not yet publishedAnte Partum Questionnaire – self-report, not widely usedZung Self-Rating Depression Scale – 20 item, self report(Aaron) Beck Depression Inventory – not specifically forPPD, used in psychiatry, cost associatedEdinburgh Postnatal Depression Scale (EPDS)SCREENING TOOLS
  26. 26. The thought of harming myself hasoccurred to me.Yes, quite oftenSometimesHardly everNeverEXAMPLE-QUESTION 10
  27. 27. SUMMARY Psychological changes Adaptation Maternal concerns Postpartum disorders Nursing interventions Patient education
  28. 28. RECAPITULATION
  29. 29. ASSIGNMENT
  30. 30. conclusion
  31. 31. Physicians, nurse midwives and other licensed healthcare professionals providing prenatal and postnatalcare to women shall:•include fathers and other family members, asappropriate, in both the education and treatmentprocesses to help them better understand the natureand causes of PPDPATIENT & FAMILY EDUCATION
  32. 32. REFERNCES Adele Pilletteri,textbook Of Maternity Nursing D.C. Dutta ,Textbook Of Obstetrics,centralPublications,6th Edition Diane M .Fraser ,Margaret ,Cooper,myles TextbookFor Midwives,churchill Livingstone Publications,15thEdition Annamma Jacob.Textbook Of Midwifery AndGynecologic Nursing.Jaypee Publications,3rdEdition M.C.Kenzie Vestal K.W.High Risk PerinatalNursing,st .Louis.Saunders Publication Www.Drdonnica.Com.PostpartumDepression.Article154
  33. 33. THANKS ALOT

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