Women's views of the Edinburgh Postnatal Depression Scale

Abstract

Background: Family Start Buller-Grey has been using the Edinburgh Postnatal Depression Scale (EPDS) as a screening tool, as part of the service provided to women clients. Feedback from some clients who were not comfortable with the EPDS raised issues that required consideration regarding its continued use. Furthermore it highlighted the need for research to investigate the views of Family Start Buller-Grey clients.

Aim: 1. To explore women’s views regarding the acceptability of the (EPDS). 2. To explore women’s views regarding what they find helpful when adjusting to motherhood.

Design of study: A mixed-method research process was used for this study that comprised of two sequential parts. The first part involved a questionnaire with both quantitative and qualitative responses. The second part involved semi-structured qualitative interviews.

Method: The first stage of the research involved forty two Family Start women clients from a purposive sample completing the questionnaire. The quantitative data results from the closed questions on the questionnaire were entered, and basic descriptive statistics were produced, using the PASW Statistics 18 computer program (IBM SPSS Inc, 2009). This provided a break down of the data collected, in table form. The qualitative results from the questionnaires were entered into Microsoft word. An a priori template of five initial codes based on the research questions shaped the code manual used to organize the data. The second stage involved interviewing six women selected by random draw, who had completed the first stage. A hybrid approach to thematic analysis using both deductive and inductive approaches was employed. The interviews were transcribed verbatim into Microsoft word and then coded using the a priori template used to encode the questionnaire data.

Results: Initially the quantitative results of this study suggested that the EPDS was acceptable to the majority of the participants however the combined qualitative results from the questionnaire and interviews challenged this finding. A significant issue identified was that participants were tempted to withhold the truth regarding how they were feeling to avoid being judged, labeled as having a mental illness, and the impact of the associated stigma. Furthermore, a preference for talking as opposed to filling in a form was also identified and concerns were expressed about the ability of the EPDS to provide a comprehensive picture of the changeable reality of motherhood.

Participants identified three types of support that they thought were most helpful when adjusting to motherhood. Family and friends were viewed as an important form of support as they can be accessed when needed. Support provided by community agencies like Family Start, Plunket and Midwives was identified by participants as essential for providing information regarding motherhood and particularly important for mothers that were new to the area. Practical support was also identified, and included respite from childcare and help with household tasks.