Identifying the support needs of fathers affected bypost-par.docx

Identifying the support needs of fathers affected by
post-partum depression: a pilot study
N . L E T O U R N E A U 1 , 2 , 3 p h d r n , L . D U F F E T T-
L E G E R 4 , 5 p h d ( c ) r n ,
C . - L . D E N N I S 6 , 7 p h d , M . S T E WA R T 8 , 9 p h d
f r s c f c a h s &
P. D . T RY P H O N O P O U L O S 1 0 b n r n p h d s t u d e n
t
1Canada Research Chair in Healthy Child Development,
2Professor, 4CIHR Allied Health Professional Doctoral
Fellow, 5Research Associate, 10Project Director, Faculty of
Nursing, and 3Research Fellow, Canadian Research
Institute for Social Policy, University of New Brunswick,
Fredericton, NB, and 6Canada Research Chair in
Perinatal Community Health, 7Associate Professor in Nursing
and Psychiatry, University of Toronto, Toronto,
ON, and 8Health Senior Scholar, Alberta Heritage Foundation
for Medical Research, and 9Professor, Faculty of
Nursing and School of Public Health, University of Alberta,
Edmonton, AB, Canada
Keywords: barriers to accessing
support, fathers, men’s mental health,
men’s support needs, pilot study, post-
partum depression
Correspondence:
N. Letourneau

University of New Brunswick
PO Box 4400
Fredericton
NB E3B 5A3
Canada
E-mail: [email protected]
Accepted for publication: 9 August
2010
doi: 10.1111/j.1365-2850.2010.01627.x
Accessible summary
• The purpose of this pilot study was to describe the
experiences, support needs,
resources, and barriers to support for fathers whose partners had
experienced
post-partum depression (PPD).
• Telephone interviews were conducted with a total of 11
fathers. We interviewed
seven fathers from New Brunswick and four fathers from
Alberta.
• The fathers we spoke with experienced a number of depressive
symptoms including:
anxiety, lack of time and energy, irritability, feeling sad or
down, changes in
appetite, and thoughts of harm to self or baby. The most

common barriers to
accessing support included not knowing where to look for PPD
resources and
difficulty reaching out to others.
• This study demonstrated the feasibility of a larger-scale
exploration of fathers’
experiences in supporting their spouses affected by PPD.
Abstract
The purpose of this pilot study was to describe the experiences,
support needs,
resources, and barriers to support for fathers whose partners had
post-partum depres-
sion (PPD) in preparation for a larger study. Qualitative
methods and community-
based research approaches were used in this
exploratory/descriptive multi-site study,
conducted in New Brunswick and Alberta. Telephone interviews
were conducted with
a total of 11 fathers in New Brunswick (n = 7) and Alberta (n =
4). Fathers experienced
a number of depressive symptoms including: anxiety, lack of
time and energy, irrita-
bility, feeling sad or down, changes in appetite, and thoughts of
harm to self or baby.
The most common barriers for fathers were lack of information
regarding PPD
resources and difficulty seeking support. This pilot study
establishes the feasibility of
the larger-scale exploration of fathers’ experiences in
supporting their spouses affected
by PPD.
Note: There are no conflicts-of-interest or financial disclosure

arrangements.
Journal of Psychiatric and Mental Health Nursing, 2011, 18, 41–
47
© 2010 Blackwell Publishing 41
Introduction
Post-partum mood disorders represent the most frequent
form of maternal morbidity following delivery (Stocky &
Lynch 2000, Gaynes et al. 2005). Post-partum depression
(PPD) is a major health problem for many women, charac-
terized by the disabling symptoms of dysphoria, emotional
lability, insomnia, confusion, significant anxiety, guilt, and
suicidal ideation. Frequently exacerbating these indicators
are low self-esteem, inability to cope, feelings of incompe-
tence and loss of self, and loneliness (Beck 1992, Mills et al.
1995, Righetti-Veltema et al. 1998, Ritter et al. 2000) A
meta-analysis of 59 studies reported an overall prevalence of
major PPD to be 13% (O’Hara & Swain 1996). Extrapo-
lating from Statistics Canada birth rate data, as many as
50 000 Canadian women experience PPD every year
(Statistics Canada 2010). The impact of maternal PPD on
child development is well documented in the literature.
Post-partum depression affects maternal–infant interaction
quality, stresses infants, and produces adverse child social
and cognitive developmental outcomes (Murray & Cooper
1996, 1997a,b,c, 1999, Murray et al. 1996, 1999, 2003).
While maternal PPD has been extensively studied in the
last decade, much less is known about the impact of PPD
on fathers. Goodman’s (2004b) meta-analysis revealed that
between 24% and 50% of men whose partners have PPD

also experience depression in the first year after birth. A
more recent meta-analysis revealed a significant correlation
between maternal and paternal depression (r = 0.31) and
that 10% of new fathers experience PPD in community
samples (Paulsen & Bazemore 2010). Symptoms of pater-
nal depression typically appear with the onset of their
partners’ PPD and the number and severity of symptoms
increases during the first post-partum year. It is often the
consequence of more severe maternal symptoms (Pinheiro
et al. 2006) as well as decreased marital or relationship
satisfaction (Dudley et al. 2001, Buist et al. 2002,
Bielawska-Batorowicz & Kossakowska-Petrycka 2006),
resulting in greater parenting stress (Goodman 2004b),
paternal fatigue, and aggression (Roberts et al. 2006).
Paternal substance abuse (Tannenbaum & Forehand 1994)
and economic stress (Ram & Hou 2003) may further com-
pound these problems. Children with two depressed
parents are at significantly greater risk for poor develop-
mental outcomes compared to those with one affected
parent (Dierker et al. 1999, Brennan et al. 2002). Like
mothers, the emotional well-being of fathers has been
shown to have an impact on the father–infant interaction
(Goodman 2004a) and may result in long-term behavioural
problems in children (Ramchandani et al. 2005). The
degree to which fathers are affected by their partners’ PPD
merits exploration.
To date, no research has been found that explored
fathers’ support needs for coping with PPD. The objectives
of this pilot study were to describe the experiences, support
needs, resources, barriers and preferences for support of
fathers whose partners have had PPD. Stewart’s social
support framework (1993) guided the study with its
emphasis on understanding the pathway(s) between stress-
ful events, coping and social support. The perceived avail-
ability of social support in the face of a stressful event may

lead to a more benign appraisal of the situation, thereby
preventing a cascade of ensuing negative emotional and
behavioural responses. Indeed, perceived or received
support may either reduce the negative emotional or behav-
ioural response to stressful events or expand the coping
repertoire (Stewart 1993). Understanding how fathers per-
ceive or receive support when their partners suffer from
PPD may be useful to developing interventions to support
the couple’s coping repertoire. Thus, specific research ques-
tions included: (1) What are fathers’ experiences coping
with PPD in their partners? (2) What are fathers’ experi-
ences with personal PPD? (3) What demographic or
descriptive variables may be associated with fathers’ nega-
tive outcomes? (4) What are fathers’ support needs? (5)
What are fathers’ support resources? (6) What barriers do
fathers encounter in supporting their partners with PPD?
and (7) What support interventions do fathers prefer for
themselves and their partners?
Method
Research design and analysis
After receiving ethical approval for this qualitative pilot
study from the appropriate institutional review boards,
one-on-one interviews were conducted with male partners
of women who have experienced PPD. Fathers were made
aware of the legal requirement to report any disclosure of
threat of harm to a child or another adult prior to being
interviewed. The research team included skilled mental
health nurses and social workers who were available to
provide counselling, support and service referral to fathers
if required.
A pilot study was selected for several reasons. First,
while beginning research suggests that the telephone may

be a useful means to engage fathers in research (Kirsch &
Brandt 2002, Phares et al. 2005), it was uncertain how
effective this method would be for qualitative research with
this population. Second, while the interview guide had
been successfully used with mothers in previous research
(Letourneau et al. 2007) we wanted to adapt and thor-
oughly pilot the interview to ensure sensitivity to fathers.
Third, a pilot study was an essential first step to gain the
N. Letourneau et al.
42 © 2010 Blackwell Publishing
information needed to develop a supportive intervention
tailored to meet their needs. Finally, consistent with
community-based research methods (Hills & Mullett 2000,
Seifer & Vaughn 2004, Shallwani & Mohammed 2007),
the pilot study provided the time and opportunity to
develop an advisory committee comprised of mental health
service providers and policy makers/influencers from across
Canada that would be involved in both the pilot study and
the larger follow-up study. Advisory committee members
were regularly consulted regarding the feasibility of
methods, recruitment strategies and results.
Telephone interviews, lasting from one to 2 h in dura-
tion, were successfully conducted in locations of fathers’
choice, such as a community centre, participants’ homes, or
another location. A semi-structured interview guide was
utilized to collect demographic and exploratory data on
fathers’ experiences, support needs and resources, barriers
encountered in accessing, support and support intervention
preferences. The interview guide consisted of questions
gathering demographic information, followed by 27 ques-

tions and suitable probes addressing the seven research
questions. The questions were acceptable to fathers as they
were able to answer them with little need for clarification.
Individual interviews were audio taped and transcribed
verbatim. Thematic content analysis was used to answer
the primary research questions. The coding framework was
created iteratively by at least two team members having
read two to four transcripts each. After reading assigned
transcripts, an open coding process was used by individual
team members to categorize the data. The team members
then met and integrated their respective coding frameworks
into an all-encompassing framework. The integrated
coding framework was revised again after additional tran-
scripts were read; revision occurred until the team felt the
framework was sufficiently comprehensive and complete.
Two trained research assistants then coded the data using
the coding framework. An acceptable inter-rater reliability
of 77% was achieved by having coders individually code
the same interview transcripts and assessing the degree of
agreement in assignment of text segments to framework
codes.
Setting and sample
Fathers were selected in two study sites, one where exten-
sive services were available for PPD [Calgary, Alberta (AB)]
and the other where fewer services were available [rural
region of New Brunswick (NB)]. Convenience sampling
was employed to recruit men whose partners reported
symptoms of PPD during their last pregnancy and were no
more than 24 months post-partum. This upper limit was
selected to maximize fathers’ recall. Participants were
recruited via posters strategically placed in community
partners’ agencies, by self-nomination or by service pro-
vider nomination. The sample of 11 men included four

from the Calgary, AB and seven from NB. Selecting partici-
pants from two different provinces with different available
PPD services provided an opportunity to examine this
potential influence on participants’ perspectives of support
needs, available resources, barriers to support, and pre-
ferred interventions.
Findings
Demographic data provides a profile of the fathers from
NB and AB. Qualitative data describe the support needs,
resources, barriers to support, and preferences for support
from the perspectives of the majority of sampled fathers
affected by PPD. Exemplar quotes are highlighted that
illustrate the qualitative findings.
Description of participants
A total of 11 fathers were interviewed in NB (n = 7) and AB
(n = 4). The mean age of fathers was 37, with ages ranging
from 29 to 44. All fathers reported being born in Canada
with English as their first language. Ten fathers were
married at the time of interview while one father was
single. All 11 fathers were employed full-time, and most
were graduates of a technical school (n = 3), college or
university undergraduate degree (n = 3) or graduate (n = 3)
programme. A majority reported household incomes
greater than $70 000. For many of these fathers (n = 6),
their partners had only one pregnancy, and two of the
fathers reported that they had lost a child within the first
year of life.
Fathers’ experiences coping with partners’ PPD
All the fathers interviewed described a wide range of
emotions when their partners were experiencing PPD,

and three fathers actually identified themselves as being
depressed. Some revealed that they had experienced a
variety of depressive symptoms, including anxiety, sleep
disturbances, fatigue, irritability, sadness, changes in
appetite, and thoughts of bringing harm to self or baby.
Fathers described feelings of self doubt, helplessness and
worry about their inability to help their partners. For
example,
I thought I was doing a good job, and suddenly here it is
and I’m going is it something that I didn’t do or did too
much of? So there’s a lot of that self-doubt for sure
(DAD_02).
Support for fathers affected by post-partum depression
I think throughout the experience I had more or less the
feeling of like I wasn’t able to help her just because I
wasn’t – I couldn’t – I didn’t really understand why she
couldn’t sleep so and didn’t understand how bad her
anxiety was . . . and then if you’re worried about your
partner as well, that can be quite stressful (DAD_06).
Other fathers expressed feelings of anger, frustration
and even rage, often in response to their lack of preparation
for the possibility of PPD in their lives. As one father said,
fathers learn the hard way that ‘it’s not just freaky people
unbalanced to begin with who might feel this’ (DAD_08).
He went on to say:
But if people don’t talk a little bit about it and don’t say
look I’m a normal guy and I love my kid, but her crying

was just driving me nuts. Which is stupid because really
the feeling inside is you want to protect her and make
her feel better, but at the same time what is coming up is
holy cow, I’ve just got to shut her up (DAD_08).
Fathers also expressed fear or worry for their partners
and relationship uncertainty. For example,
In terms of anxiety, certainly some anxiety because we
would actually just walk around the house on eggshells
wondering if (wife) is going to have one of these epi-
sodes and what is the effect going to be on her and on
our little guy (DAD_10).
They attributed their feelings to a variety of factors
including infants’ health issues, interference by extended
family, a recent move, and employment or financial stress.
The reduced income associated with maternity leave and
the extra expenses associated with a new child were
regarded as stressful for some. Other fathers spoke about
their loss of freedom associated with the demands of new
parenthood and marital conflict as contributors to their
negative feelings.
Just not being able to pick up and go golfing or you
know, go out and shoot pool or whatever with a friend
or you know and I think that’s where the stress
was . . . and still sometimes I’d like to go out for a
movie but then you’ve got the kids to look after and
the babysitters and the money and all that stuff
(DAD_07).
Some fathers described escaping through work as a
coping mechanism. But many recognized that this was a
special privilege that only one of them (mother or father)
could use to advantage. As one father said ‘I was getting

on the freedom bus everyday. So what changed in my life?
Well not nearly the same degree of change that (wife) was
seeing’ (DAD_02). Others indicated that work prevented
them from becoming depressed themselves. Other coping
behaviours included: staying active, getting exercise,
getting out of the house, and self isolation or avoidance
of social situations. One father spoke about getting ‘out
and going for a run’ and needing to ‘just get out and
separate myself’ (DAD_05) from their partners and
situation.
Another common experience was fathers’ inability to
interpret what was wrong with their partners, attributing
their behaviours to being a first-time mother or having a
new baby in the home. Thus, some fathers spoke of mini-
mizing their partner’s symptoms by attributing her mood
changes to the stress of having a new baby. While a number
of fathers detected changes in partners’ emotional status,
they did not initially identify it as PPD. Most fathers
believed that their partners needed professional help;
however, nearly half were unaware that there was some-
thing ‘wrong’ with their partners until after she had
returned to her ‘old self’. As one father said after his
partner’s PPD was resolved:
I didn’t know what I was looking for. I didn’t recognize
there was as much of a problem as there actually was
(DAD_09).
Support needs and resources of fathers and mothers
Fathers reported numerous support needs for themselves
and their partners. Accessing information about PPD and
professional health services for their partners was identified
as important. Having someone who would listen was espe-

cially important to fathers whether for themselves or their
partners. As one father said, he relied on his ‘handful of
friends’ with whom he ‘felt comfortable talking about it
(PPD)’ (DAD_01). For many fathers, gaining friends’
insight into how they coped with similar experiences was
deemed helpful. Other fathers spoke about how finding
help from friends or professionals helped them both. For
example,
Just to meet people who were saying, yep I was bad.
And your situation was nothing like mine and mine is
nothing like yours but I made it. Whenever she could
find one of those people it was like hallelujah day
(DAD_04).
And she was on that unit and it was the best thing that
could have happened cause, it was so much easier for
me, because I’m obviously not trained to deal with that
kind of stuff (DAD_05).
Most fathers tried to be self-reliant, describing different
strategies for identifying PPD resources for their partners:
the most common of which was ‘digging for information’.
All the fathers reported an information gap regarding PPD
resources that contributed to the lack of recognition and
early detection of PPD. As one father said, ‘somebody
should be there talking about this we shouldn’t wait until it
happens and then have an intervention, should be preven-
tion’ (DAD_01). This lack of awareness was followed by
not knowing where to look for resources, reported by all

but one father. Three of the 11 fathers reported that family
and friends were their most significant sources of support.
Unfortunately, many participants reported that their family
and friends had limited understanding of PPD or lived too
distant to be helpful.
Barriers to support for fathers
All 11 fathers reported experiencing some form of barrier,
which impeded their ability to get support for their part-
ners and/or themselves. The most commonly reported
barrier was lack of information regarding PPD resources,
followed by not knowing where to look for resources,
and fear of the stigma associated with PPD. As one father
said:
I think just a lack of knowledge on the subject was
probably the only thing that was probably the only
stressful thing that was really bugging me at that time. It
was just because of the confusion of what’s happening
with my wife (DAD_06).
Fathers described their own lack of awareness and
understanding. Many fathers ‘naively thought everything
was okay’ (DAD_02). Others reported only knowing
about the ‘absolutely horrible cases’ and that ‘anytime I
heard about PPD, I kind of always associated it with
Andrea Yates . . . the one that drowned her babies’
(DAD_07). Only later did the fathers learn that that the
media example is ‘not even close to the actual experience’
(DAD_07).
On father commented on stigma linked to PPD:
I’d be aware of it but would I be digging out the pam-
phlet you know and checking off the points kind of
thing . . . Unfortunately mental illness is still one of

those things that is kept in the closet for a large degree.
Unfortunately it is and people say oh I’d never judge
people on something like that, but hey, I’d beg to differ
(DAD_02).
Even when fathers overcame their feeling of stigma and
determined that they needed help, they also often reported
feeling too overwhelmed and exhausted to seek help.
Fathers cited lack of time and energy, particularly for those
caring for other children, as well as work commitments and
transportation challenges. For example:
I had a lot of responsibility but I think because so much
was going on I didn’t have the energy to seek out one
person to find out more about this (DAD_09).
Moreover, when help was found, fathers talked about
being ignored by health professionals. Some fathers
accompanied their partners to treatment, and while they
wanted to contribute to their partners’ care, health pro-
fessionals excluded them from the treatment process. As
one father said, ‘the issue is about how the doctor spoke
to (wife) and really didn’t include me in the conversation’
(DAD_10).
Several fathers reported that the stigma associated with
PPD significantly contributed to their partners’ denial of
the issue, which often proved to be another barrier to
support. Fathers described their partners’ resistance to
recognizing that they needed help. As one father said:
So it took awhile for her to be self aware and it also took
awhile for her to get over the stigma and to realize this
is serious enough that we had to do something. In terms
of me personally, it would be just my own character

flaws. Just really not being comfortable accepting help
from anyone (DAD_06).
The last quote reflects an independence that was identi-
fied by most fathers as an important barrier. As one father
said ‘it’s like that strong, stoic guy thing’ (DAD_03). In
spite of some fathers speaking about the value of help
provided by friends and professionals, they admitted that
they had difficulty reaching out to others and did not want
to burden others with their problems.
I guess looking back now I think I could have used some
support, somebody to talk to. Perhaps, like it’s a kind of
a guy thing – I’m not going to really seek it out. I think
most – a lot of guys are like that. I’m not going
to . . . like I say, I’ll talk to my friends and that’s prob-
ably as close as you’re going to go to opening up to
somebody (DAD_09).
Further, some fathers cited personal difficulties under-
standing or wanting to share their own feelings.
We’d definitely talk about it, especially in the presence of
our wives, but from my standpoint, I would make jokes
and laugh about it. It wouldn’t get into the deep, break
down crying sessions with another guy about how much
pressure it’s putting on you right now (DAD_03).
Societal views regarding parental-gender roles rein-
forced many fathers’ attitudes and posed a barrier to
support. While everyone asked the fathers about their
partners and the baby, no one asked the fathers about
how they were dealing with the transition to parenthood.
As a result, some felt that they had no one to talk to
about their own symptoms. These fathers appreciated it
when others appeared interested in their well-being, as

expressed by this man:
I think men and women have different experiences. It’s
more accepting for women to share with her female
friends about this stuff and men it’s not I don’t think, I
mean it’s changing, but I still think a lot of men are of
stuck in the idea that you can’t go out with your peers
and seek information out, you’re in your own solitude to
figure it out and hope to God you’ve got the resources
(DAD_08).
Discussion
The findings of this pilot study describe a wide range of
emotions experienced by fathers. Indeed, over a quarter of
these fathers described a variety of depressive symptoms,
consistent with other literature (Goodman 2004b, Pinheiro
et al. 2006). Many fathers discussed feelings of anger, frus-
tration and anxiety associated with their lack of understand-
ing and helplessness to do anything about their partners’
PPD. Thus it is not surprising that PPD is known to
negatively affect marital relationship quality (Bielawska-
Batorowicz & Kossakowska-Petrycka 2006). Fathers spoke
about both: (1) attributing PPD to stressors in adjusting to
parenthood, and (2) the stress of PPD itself. Fathers identi-
fied coping mechanisms associated with immersion in work
and seeking time for themselves. Others misattributed or
misidentified the symptoms of PPD as everyday reactions to
financial and infant health concerns. In spite of the differ-
ences in the availability of supports and services for PPD in

the two study regions, very little difference was observed in
the findings of fathers from the two regions. As this was a
pilot study with a relatively homogeneous sample, cultural
differences in fathers’ perspectives of support needs,
resources, barriers and preferences were not examined;
however, this could be the subject of future research.
Fathers reported needing support from both formal
(professional) and informal (friends and family) support
resources. However, a dominant theme suggested that both
men’s and societal attitudes about gendered approaches to
help-seeking roles challenged many men to find support for
themselves or their partners. This finding is consistent with
other research suggesting that men feel they should be
reluctant to seek help (O’Brien et al. 2005). Fathers’ per-
ceptions that insufficient social support would be available
to them to help them cope with the stress of PPD may have,
according to Stewart (1993), prevented them from more
benign appraisals of their situations and from seeking help.
Given that perceived or received support is believed to
reduce the negative emotional or behavioural response to
stressful events (Stewart 1993), it was not surprising that so
many fathers experienced anger, frustration and anxiety in
response to their partners’ PPD.
Although supportive fathers can protect their partners
from a depressive relapse (Misri et al. 2000) and are fre-
quently the source of support most relied on by mothers,
their role and experience as support provider have not been
well explored or utilized (Murray & Cooper 2003). Indeed,
in previous research exploring the support needs of women
with PPD, the women perceived their husbands as support-
ive but restricted by their limited understanding of PPD
and how to offer support (Letourneau et al. 2007). Many
women recognized that their partners wanted to do more;

however, interventions for women with PPD have not
focused on supporting fathers as they care for their part-
ners affected by PPD. Moreover, men’s and societal atti-
tudes toward help-seeking by fathers may impede the full
utilization of innovative interventions (O’Brien et al.
2005). To date, best practices to help fathers support their
partners affected by PPD are unknown.
For fathers who overcame stigma and gender roles, they
faced other barriers to accessing support including diffi-
culty identifying other sources of support, even in areas
where services were available. Moreover, when support
was found, fathers reported feeling excluded. These find-
ings suggest that much work is needed to educate new
parents about PPD, to normalize this highly stigmatizing
mental health issue, and to include fathers in treatment
planning for mothers affected by PPD.
This pilot study provided a preliminary investigation of
fathers’ support needs, resources, and barriers to accessing
support. In addition to contributing to our understanding
of the impact of PPD on fathers, the pilot study provided
the evidence necessary to support an expanded emphasis
on obtaining participants’ views on preferred support inter-
ventions in the follow-up study. Most importantly, this
project provided a foundation for guiding the development
of a supportive intervention for fathers and their partners
affected by PPD.
References
Beck C.T. (1992) The lived experience of postpartum
depression:
a phenomenological study. Nursing Research 41, 166–170.
Bielawska-Batorowicz E. & Kossakowska-Petrycka K. (2006)

Depressive mood in men after the birth of their offspring
in relation to a partner’s depression, social support, fathers’
personality and prenatal expectations. Journal of Reproductive
& Infant Psychology 24, 21–29.
Brennan P.A., Hammen C., Katz A.R., et al. (2002) Maternal
depression, paternal psychology, and adolescent diagnostic out-
comes. Journal of Consulting and Clinical Psychology 70,
1075–1085.
Buist A., Morse C.A. & Durkin S. (2002) Men’s adjustment to
fatherhood: implications for obstetric health care. Journal of
Obstetric, Gynecologic, and Neonatal Nursing 32, 172–
180.
Dierker L.C., Merikangas K.R. & Szatmari P. (1999) Influence
of
parental concordance for psychiatric disorders on psychopa-
thology in offspring. Journal of the American Academy of Child
& Adolescent Psychiatry 38, 280–288.
Dudley M., Roy K., Kelk N., et al. (2001) Psychological
correlates
of depression in fathers and mothers in the first postnatal
year. Journal of Reproductive & Infant Psychology 19, 187–
202.
Gaynes B., Gavin N., Meltzer-Brody S., et al. (2005) Perinatal
Depression: Prevalence, Screening, Accuracy, and Screening
Outcomes. Agency for Healthcare Research Quailty, Research
Triangle Park, NC.

Goodman J.H. (2004a) Influences of Maternal Postpartum
Depression on Fathers and the Father-Infant Relationship.
University Microfilms International, Ann Arbor, MI.
Goodman J.H. (2004b) Paternal postpartum depression, its rela-
tionship to maternal postpartum depression, and implications
for family health. Journal of Advanced Nursing 45, 26–35.
Hills M. & Mullett J. (2000) Community-Based Research and
Evaluation: Collaborative Action for Health and Social Change.
Community Health Promotion Coalition, Victoria, BC.
Kirsch S.E.D. & Brandt P.A. (2002) Telephone interviewing: a
method to reach fathers in family research. Journal of Family
Nursing 8, 73–84.
Letourneau N., Duffett-Leger L., Stewart M., et al. (2007)
Cana-
dian mothers’ perceived support needs during postpartum
depression. Journal of Obstetric, Gynecologic, and Neonatal
Nursing 36, 441–449.
Mills E.P., Finchilescu G. & Lea S.J. (1995) Postnatal
depression:
an examination of psychosocial factors. South African Medical
Journal 85, 99–105.
Misri S., Kostaras X., Fox D., et al. (2000) The impact of
partner
support in the treatment of postpartum depression. Canadian
Journal of Psychiatry 45, 554.
Murray L. & Cooper P. (1996) The impact of postpartum
depres-

sion on child development. International Review of Psychiatry
8, 55–63.
Murray L. & Cooper P. (1997a) Effects of postnatal depression
on
infant development. Archives of Disease of Childhood 77,
97–101.
Murray L. & Cooper P. (1997b) Postpartum depression and
child
development. Psychological Medicine 27, 253–260.
Murray L. & Cooper P. (1997c) The role of infant and maternal
factors in postpartum depression, mother-infant interactions,
and infant outcome. In: Postpartum Depression and Child
Development (eds Murray, L. & Cooper, P.J.), pp. 111–135.
Guilford Press, New York.
Murray L. & Cooper P., eds (1999) Postpartum Depression and
Child Development. Guilford Press, New York.
Murray L. & Cooper P. (2003) Intergenerations transmission of
affective and cognitive processes assiociated with depression:
infancy and the preschool years. In: Unipolar Depression: A
Lifespan Perspective (ed Goodyear, I.M.), pp. 17–46. Oxford
University Press, New York.
Murray L., Fiori-Cowley A., Hooper R., et al. (1996) The
impact
of postnatal depression and associated adversity on early
mother-infant interactions and later infant outcomes. Child
Development 67, 2512–2526.
Murray L., Sinclair D., Cooper P., et al. (1999) The socioemo-
tional development of 5-year-old children of postnatally
depressed mothers. Journal of Child Psychology and Psychiatry

& Allied Disciplines 40, 1259–1271.
Murray L., Cooper P.J., Wilson A., et al. (2003) Controlled trial
of
the short- and long-term effect of psychological treatment of
post-partum depression: impact on the mother-child relation-
ship and child outcome. British Journal of Psychiatry 182,
420–427.
O’Brien R., Hunt K. & Hart G. (2005) It’s caveman stuff, but
that
is to a certain extent how guys still operate: men’s accounts of
masculinity and help seeking. Social Science and Medicine 61,
503–516.
O’Hara M.W. & Swain A. (1996) Rates and risk of postpartum
depression: a meta-analysis. International Review of Psychiatry
8, 37–54.
Paulsen J. & Bazemore S. (2010) Prenatal and postpartum
depres-
sion in fathers and its association with maternal depression.
JAMA 303, 1961–1969.
Phares V., Lopez E., Fields S., et al. (2005) Are fathers
involved
in pediatric Psychology research and treatment? Journal of
Pediatric Psychology 30, 631–643.
Pinheiro R.T., Magalhaes P., Horta B.L., et al. (2006) Is
paternal
postpartum depression associated with maternal postpartum
depression? Population-based study in Brazil. Acta Psychiatrica
Scandinavica 113, 230–232.

Ram B. & Hou F. (2003) Changes in family structure and child
outcomes: roles of economic and familial resources. The Policy
Studies Journal 31, 309–330.
Ramchandani P., Stein A., Evans J., et al. (2005) Paternal
depres-
sion in the postnatal period and child development: a prospec-
tive population study. Obstetrical & Gynecological Survey 60,
789–790.
Righetti-Veltema M., Conne-Perreard E., Bousquet A., et al.
(1998) Risk factors and predictive signs of postpartum depres-
sion. Journal of Affective Disorders 49, 167–180.
Ritter C., Hobfoll S.E., Lavin J., et al. (2000) Stress,
psychosocial
resources, and depressive symptomatology during pregnancy in
low-income, inner-city women. Health Psychology 19, 576–585.
Roberts S.L., Bushnell J.A., Collings S.C., et al. (2006) Psycho-
logical health of men with partners who have post-partum
depression. Australian & New Zealand Journal of Psychiatry
40, 704–711.
Seifer S.D. & Vaughn R.L. (2004) Community-campus partner-
ships for health: making a positive impact. Retrieved from
http://depts.washington.edu/ccph/guide.html.
Shallwani S. & Mohammed S. (2007) Community-Based Partici-
patory Research: A Training Manual for Community-Based
Researchers. University of Toronto, Toronto, ON.
Statistics Canada (2010) Births. Statistics Canada, Ottawa, ON.
Stewart M. (1993) Integrating Social Support in Nursing. Sage,
New York.

Stocky A. & Lynch J. (2000) Acute psychiatric disturbance in
pregnancy and the puerperium. Baillieres Best Practices Res
Clinical Obstetrical Gynaecological 14, 73–87.
Tannenbaum L. & Forehand R. (1994) Maternal depressive
mood: the role of fathers in preventing adolescent problem
behaviors. Behaviour Research & Therapy 32, 321–325.
Copyright of Journal of Psychiatric & Mental Health Nursing is
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may not be copied or emailed to multiple sites or posted to a
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written permission. However, users may print, download, or
email articles for individual use.
Critique Process
Chapter Thirteen
Definition of Critique
Critique is defined as “a critical review or commentary,
especially one dealing with works of art or literature; a critical

discussion of a specific topic; the art of criticism”
(Yahoo!Education, 2005,
http://education.yahoo.com/reference/dictionary/entry/critique)
Webster (1999) defines it as “a critical review or commentary,
especially one dealing with a literary or artistic work” (p. 268)
Rationale for Doing a Research Critique
Immediate reaction to seek answers to critical questions in
nursing practice
Mechanism to provide feedback for improvement
Allows for the advancement of the professional
Elements of a Research Critique
Purpose of a study
Design of the research
Literature review
Research question
Sample
Data collection process
Results
Recommendations
Process for Doing a Critique
Read the entire study carefully
Examine the organization and presentation
Make a photocopy of the article to allow highlighting
Identify terms you don’t understand and look them up
Identify the strengths and limitations but be objective

Purpose of the Study
Is it Clear?
Is it relevant to your practice?
Is there a need for this study?
Will the study improve nursing practice?
Will the study add to the body of nursing knowledge?
Research Design
Is there a theory/framework that guides the study?
If no, can you identify how information was collected?
Who will be studied?
What is the plan for the study?
Are the plan decisions justified?
Literature Review
Is it comprehensive?
Is it current? Last 5 years?
Are the majority of the sources primary or secondary?
Is the literature review section well organized? (an
introduction/summary)
Does the literature review include a section for a model/theory?
Research Question
Clearly stated?
Does it match the purpose of the study?
Are the research questions justified?
Does the theory/framework/model establish a connection with
the question?

Hypothesis?
May be used instead of a research question
Shows a relationship
Make sure:
All variables described
Clearly stated
Reflects the purpose of the study
Has a relationship with the theory/framework/model
Sample
Who is the target population?
How were they chosen?
Who is included? Excluded?
How large is the sample? (N=)
Were sampling plan decisions justified adequately?
Were ethical considerations clearly addressed with the sampling
process?
Data Collection
What steps were taken?
How often was data collected?
Which tools/instruments used?
Who designed the tools/instruments?

Are the tools valid? Reliable?
Were tools described to research population?
Study Results
Was the research question/hypothesis proved?
What were the limitations?
Can any generalizations be made?
Did the research results support the literature?
Any unexpected findings?
Did the outcomes explain the basis of the study?
Study Recommendations
Are there suggestions for use in future practice?
Is there the need for more research?
Could you change your practice based on these results?
What are the benefits from the information learned in the
research?
Process of conducting a research critique
Will show both strengths and weakness of the study.
This skill is developed through repeated practice.
Decisively Evaluating Quantitative Evidence

Slightly easier to do since quantitative research design tends to
be more concrete.
Usual section – introduction, literature review, hypothesis (es),
sampling, research design, statistical testing, and discussion
Conceptual framework principle aspect for this type
Decisively Evaluating Qualitative Evidence
Slightly different focus
Must discuss researcher-participant relationship
Ethical consideration
Data collection and management
Data analysis which allows for audit of process
Decisively Evaluating Mixed Evidence
Embraces both quantitative and qualitative aspects
Rationale for utilization of this method must be provided
Quantitative data discussion usually provided followed by
qualitative data but can be in any order
Discussion section must bring both data results together for an
integration of the recommendations.
Summary Points
Essential to Evidence Based practice
Several different types of critiques
Series of questions guide critiques
Critique skills developed by repetition
Eight general areas of a research study

Don’t need to be a statistician to do a critique
Quantitative critiques differ from qualitative critiques
What do I do now?
Read the entire study
Look at the layout and organization
Identify any terms you do not know
Highlight each step of the nursing process
Look for strengths and weaknesses
Suggest modifications for future studies
Fill out the worksheets associated with the critique!

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