[Show abstract][Hide abstract] ABSTRACT: The purpose of this study is to review the main postpartum screening tools currently used in terms of their ability to screen for postnatal depression. Furthermore, the cultural characteristics of depressive postpartum symptomatology are examined.
A systematic literature search was conducted for the period 1987-2009, using the Medline electronic database for the following keywords: postpartum depression and postnatal depression. These terms were combined with: assessment, screening and psychometric tools.
Of the four screening tools reviewed and compared, the Edinburgh Postnatal Depression Scale (EPDS) and the Postpartum Depression Screening Scale (PDSS) presented substantial sensitivity and specificity as screening tools. However, none of the instruments could be rated flawless when applied to different cultural contexts.
In addition to the EPDS, a new generation of instruments is currently available. Supplementary research is needed to substantiate their use as screening tools in general practice. Additional studies are needed to adapt and test instruments to detect postnatal depression within a wider range of languages and cultures.
Full-text · Article · Nov 2010 · African Journal of Psychiatry
[Show abstract][Hide abstract] ABSTRACT: The aim of this study was to demonstrate the validity and reliability of the short form of the Postpartum Depression Screening Scale in Southern Brazil.
Research volunteers completed the Postpartum Depression Screening Scale-Short Form (PDSS-SF) and a Structured Clinical Interview for Mental Disorders (SCID). Evaluation parameters included reliability and correlational investigations analyses.
The proposed Portuguese version of the PDSS-SF attained significant Cronbach's alphas (0.71 or superior). The best cut-off score (≥17) accounted for 89% of sensitivity and 77% of specificity. In addition, nonparametric correlation procedures revealed a significant correlation between the screening results of the PDSS-SF and the assessment based on the SCID.
The Portuguese version of the PDSS-SF demonstrated sound psychometric properties. The results of the correlation analyses between the PDSS-SF and the SCID assessment also indicate a significant concurrent validity. The Portuguese version of the PDSS was adequately translated and adapted to Portuguese.
No preview · Article · Oct 2010 · Journal of Obstetrics and Gynaecology Research
[Show abstract][Hide abstract] ABSTRACT: The objective of this study was to translate and psychometrically assess a Portuguese version of the Breastfeeding Self-Efficacy Scale-Short Form (BSES-SF). The original English version of the BSES-SF was translated to Portuguese and tested among a sample of 89 mothers in southern Brazil from the 2nd to 12th postpartum week followed by face-to-face interviews. The mean total score of the Portuguese version of the BSES-SF was 63.6 +/- 6.22. The reliability analysis of each item in the scale attained significant Cronbach's alphas of 0.63 or superior. The Cronbach's alpha generated by the entire range of 14 questions was 0.71. A factor analysis identified one factor that contributed to 20% of the variance. This study demonstrates that the original English version of the BSES-SF was successfully adapted to Portuguese. The Portuguese version of the BSES-SF constitutes a reliable research instrument for evaluating breastfeeding self-efficacy in Brazil.
Full-text · Article · Feb 2010 · Journal of Human Lactation
[Show abstract][Hide abstract] ABSTRACT: The objectives of this investigation was to assess the prevalence of postpartum depression in a sample of 101 women and to validate a Portuguese version of the Postpartum Depression Screening Scale (PDSS) in Southern Brazil.
Research volunteers completed the PDSS and underwent an assessment based on the Structured Clinical Interview for DSM-IV disorders (SCID). Parameters under investigation included the demographic characteristics of the sample, internal structure, and discriminant validity.
All questions in the Portuguese version of the PDSS attained significant Cronbach's alpha of 0.62. The factorial analysis of the Portuguese version of PDSS identified one principal factor that contributed 38.8% of the variance. The best cut-off score for the Portuguese version of the PDSS was a score of 81, which accounted for a sensitivity of 89% and a specificity of 72% in this sample.
The Portuguese version of the PDSS demonstrated sound psychometric properties. The results of the factorial analysis also demonstrated that the Portuguese version of the PDSS assesses postpartum depressive disorders in a coherent and integrated manner. The original English version of the PDSS was successfully adapted to Portuguese.
No preview · Article · Dec 2009 · Journal of Psychosomatic Obstetrics & Gynecology
[Show abstract][Hide abstract] ABSTRACT: To investigate a purported correlation between postpartum depression and self-rated maternal general health status in a sample of mothers in Southern Brazil. As part of this process, the Personal Health Scale (PHS), a self-rated health status measure, was tested for the first time among postpartum women. Research volunteers completed the Structured Clinical Interview for DSM-IV Disorders (SCID), the 12-item General Health Questionnaire (GHQ), the PHS, the Postpartum Depression Screening Scale (PDSS), and the Edinburgh Postnatal Depression Scale (EPDS). Correlation coefficients were computed among the scores of the health status questionnaires and the postnatal depression scales. Bivariate linear regression analyses were conducted to evaluate the prediction of scores of postnatal depression scales having the scores of health status questionnaires as predictors. Significant correlations among both health status questionnaires and both postnatal screening tools attest to a significant interconnection between the expression of depressive symptoms and maternal health status in the postpartum period. The health status measures predicted the scores of postpartum depression scales. This study demonstrates that both general health questionnaires and postpartum depressive rating scales are useful tools for detecting depressive phenomena in postpartum women. The association between self-rated health measures and postpartum depression may be even more significant in the context of socioeconomic deprivation.
No preview · Article · Sep 2009 · Maternal and Child Health Journal
[Show abstract][Hide abstract] ABSTRACT: To assess maternal quality of life (QoL) during the postpartum period and to compare the performance of two QoL questionnaires across a sample of 101 women in southern Brazil. To our knowledge, this is the first study that measures maternal quality of life during the postpartum period in Brazil.
There is limited information about postpartum maternal quality of life in Brazil. The are no Portuguese versions of instruments specifically designed to measure quality of life during the postpartum period.
Research participants completed the Portuguese version of the World Health Organization Quality of Life Assessment-Bref (WHOQOL-BREF) and Multicultural Quality of Life Index (MQLI) questionnaires. The correlations between the MQLI and the discrete areas of WHOQOL-BREF were examined using Pearson Product-Moment Correlation Coefficients.
We report a significant correlation between the global MQLI and the four domains of the WHOQOL-BREF scores (p < 0.01). An analysis of variance revealed a significant difference in mean scores in the Psychological and Environment domains according to different socio-economic strata: F (3, 97) = 3.81, p = 0.012 and F (3, 97) = 4.03, p = 0.01, respectively.
The WHOQOL-BREF questionnaire may be more sensitive than the MQLI in detecting the impact of socioeconomic status on the QoL of postpartum women.
The sample of postpartum women evaluated in this study presented favorable QoL scores according to both the MQLI and WHOQOL-BREF questionnaires. Our results also indicate that the WHOQOL-BREF and the MQLI questionnaires have a significant correlation in terms of their assessments of postpartum mothers.
Preview · Article · Aug 2009 · Clinics (São Paulo, Brazil)
[Show abstract][Hide abstract] ABSTRACT: Type 2 diabetes mellitus is a high prevalent disease all over the world. It is considered a public health problem due to the high morbidity and mortality related to its complications. Among these, the cardiovascular disease deserves emphasis, because it is the main cause of death in diabetic individuals. Many risk factors, such as dislipidemia, hypertension and obesity, are present in diabetes and are associated with a higher risk for the occurrence of cardiovascular events. However, other elements, like endothelial dysfunction, inflammation and insulin resistance, have been related to the development of atherosclerotic cardiovascular disease. This article reviews the role of these related factors and others on the genesis of cardiovascular disease in diabetic patients.
[Show abstract][Hide abstract] ABSTRACT: OBJETIVO: Avaliar as variáveis que influenciam no controle glicêmico de indivíduos diabéticos tipo 2 que freqüentam um serviço de saúde terciário. MÉTODOS: Estudo retrospectivo realizado através de revisão de prontuários dos pacientes atendidos no Ambulatório de Diabetes da Universidade de Caxias do Sul. Avaliamos os pacientes quanto ao controle glicêmico e metabólico e os subdividimos em compensados e descompensados segundo à hemoglobina glicada no início e no final do período avaliado. Analisamos os fatores associados ao controle glicêmico. RESULTADOS: Incluímos na análise 73 pacientes. Em média, observamos que houve melhora de parâmetros relacionados com o controle glicêmico, pressórico e lipídico no período médio de 20 meses de tratamento. No início do acompanhamento, 25% estavam com hemoglobina glicada < 7%, 22,7% com colesterol LDL < 100 mg/dL e 8,7% com pressão arterial sistólica < 130 mmHg e diastólica < 80 mmHg e nenhum paciente estava com todos os parâmetros dentro das metas preconizadas. Na última consulta, estas proporções foram de 42,3%, 37,5%, 30,2% e 9,6%, respectivamente. Na análise multivariada, menor idade, níveis mais elevados de colesterol LDL e uso de insulina foram fatores associados a um controle glicêmico insatisfatório. CONCLUSÃO: Uma pequena porção dos pacientes atingiu de forma simultânea as metas para controle de glicemia, lipídeos sangüíneos e pressão arterial. Alguns fatores como idade e sexo podem ser determinantes na obtenção de um controle satisfatório do diabetes. Maiores esforços são ainda necessários para atingir as metas de tratamento em pacientes diabéticos tipo 2.
Preview · Article · Aug 2008 · Revista da Associação Médica Brasileira
[Show abstract][Hide abstract] ABSTRACT: Evaluate the factors influencing blood glucose control of type 2 diabetic patients attended at a tertiary health care center.
A retrospective study by review of medical records of patients who attended the Diabetes Clinic at the University of Caxias do Sul was carried out. Patients were evaluated for glycaemic and metabolic control and divided according to glycated hemoglobin at the beginning and end of the period in question, in compensated and not compensated. The factors associated with glycaemic control were analyzed.
Seventy three patients were included in the analysis. On the average, improvement of parameters related to glycaemic, pressure and lipid control during the average of 20 months of treatment was observed. In the beginning of the follow-up period, 25% of patients had glycated hemoglobin < 7%, 22.7% had LDL cholesterol < 100mg/dL, 8.7% had systolic blood pressure < 130 mmHg and diastolic < 80 mmHg and no patients had all parameters meeting the recommended goals. At the last visit the percentages were, 42.3%, 37.5%, 30.2% and 9.6% respectively. In the multivariate analysis, younger age, higher levels of LDL cholesterol and insulin use were associated with poor blood glucose control.
A small part of the sample simultaneously achieved the goals for blood glucose, lipids and blood pressure control. Some factors, such as age and gender can be determinants to achieve control of diabetes. Greater efforts are still needed to achieve the goals for treatment in type 2 diabetic patients.
Full-text · Article · Jul 2008 · Revista da Associação Médica Brasileira
[Show abstract][Hide abstract] ABSTRACT: Maternal postpartum depression is a prevalent health disorder with important consequences to the family and child development. Research evidence demonstrates that fathers can also suffer from psychological distress in the postpartum period and that paternal depression has a detrimental effect on the child's behavioral and emotional development. This study aims to review the current literature available about birth-related paternal depression.
A literature search from 1980 to 2007 was conducted through Medline electronic database, using the following Mesh terms: postpartum, postnatal, depression, fathers and paternal. Studies on maternal postpartum depression that examined issues related to paternal depression were also selected.
Understanding about paternal depressive disorders during the postnatal period has advanced considerably in the last decade. Various studies demonstrate that birth-related paternal depression is a significant problem and closely associated with maternal depressive symptoms. Children of depressive fathers are also at risk for emotional and behavioral problems.
Men may suffer from psychological distress after childbirth and birth-related paternal depression is not a rare phenomenon. Since this disorder, also called 'paternal postpartum depression', presents potential deleterious effects for the child, an increased level of public health awareness and scientific interest is warranted. In addition, a more detailed assessment of fathers during the postnatal period is recommended, especially when their partners are also depressed, so that the condition will be promptly recognized and treated.