Postpartum Depression and Evidence-Based Care

PICOT Question

Females 18-35 years of age discharged from the hospital after childbirth (p) who participate in a nurse practitioner home visit educational and assessment program (i) as opposed to non-participation in the nurse practitioner home visit educational and assessment program (c) have a decreased incidence of postpartum depression (o) within 90 days of hospital discharge.

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Search Strategy

To locate the recent high-quality evidence, the PubMed database was utilized. Only articles published after 2012 were eligible for the given evidence-based practice (EBP) project. The preference was given to empirical studies. However, one systematic literature review was selected as well to provide an overview of the selected topic. The keywords used: postpartum depression prevention, postnatal depression, nurse home visits.

Critical Appraisal of the Evidence Performed

The selected sources provided a slightly different type of evidence. For example, Milani et al. (2017) utilized the clinical trial quantitative research design with a large sample (n=276). The aim of their study was “to investigate the effect of home visiting on postpartum depression” (Milani et al., 2017). Their findings can be categorized as Level II evidence: it is of high-quality and is associated with strong practical recommendations. At the same time, the study by Werner, Miller, Osborne, Kuzava, and Monk (2015), provides the Level I evidence: the systematic review of randomized control trials provides the highest-quality evidence as it is filtered, pre-appraised, and exclusive of substantial biases. No significant limitations and drawbacks associated with the study designs in the selected articles were observed. The findings allowed researchers develop new hypotheses and formulate questions for the future research.

Overall, it seems there is a sufficient amount of evidence related to the given EBP project. Yet, a large part of the articles are outdated, and it is difficult to locate a source that includes all stated keywords and provides primary evidence at the same time. Nevertheless, it is possible to say that this issue may be related to an inappropriate use of keywords. Moreover, it is worth noticing that the analysis of evidence of different levels obtained by using both qualitative and quantitative tools can be beneficial for the research outcomes.

References

Milani, H. S., Amiri, P., Mohsey, M., Monfared, E. D., Vaziri, S. M., Malekkhahi, A., & Salmani, F. (2017). Effect of health care as the “home visiting” on postpartum depression: A controlled clinical trial. International Journal of Preventive Medicine, 8, 20.

Werner, E., Miller, M., Osborne, L. M., Kuzava, S., & Monk, C. (2015). Preventing postpartum depression: Review and recommendations. Archives of Women’s Mental Health, 18(1), 41–60.

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