Psychologicalchangesduringpuerperium1 121109014209-phpapp02
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psychological changes in puerperium

psychological changes in puerperium

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Psychologicalchangesduringpuerperium1 121109014209-phpapp02 Psychologicalchangesduringpuerperium1 121109014209-phpapp02 Presentation Transcript

  • WELCOME
  • PSYCHOLOGICALCHANGESDURING PUERPERIUM
  • PSYCHOLOGICAL CHANGES DURINGPUERPERIUM :-1. Adjustment to all the new changes, newroles2. Postpartum blues3. Cultural influences4. Attachment
  • PSYCHOLOGICAL ADAPTATION DURINGPOSTPARTUM:-
  • REVA RUBIN
  • RUBIN’S STAGES OF MATERNALPSYCHOLOGICAL ADAPTATION:-
  • 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.
  • 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.
  • 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.
  • MATERNAL CONCERNS & FEELINGSDURING POSTPARTUM PERIOD:- Abandonment Disappointment Bonding( attachement)
  • POSTPARTUM DISORDERS:-
  • 1- Postpartum blues (Baby Blues)
  • 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.
  • 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
  • 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.
  •  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.
  • 2- Postpartum depression
  • 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.
  • 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
  •  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.
  • 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.
  •  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.
  • 3,Postpartum Psychosis
  • NURSING INTERVENTION TOWARDPSYCHOLOGICAL CHANGES &DISORDERS DURING POSTPARTUMPERIOD:-
  • 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
  • The thought of harming myself hasoccurred to me.Yes, quite oftenSometimesHardly everNeverEXAMPLE-QUESTION 10
  • SUMMARY Psychological changes Adaptation Maternal concerns Postpartum disorders Nursing interventions Patient education
  • RECAPITULATION
  • ASSIGNMENT
  • conclusion
  • 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
  • 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
  • THANKS ALOT