Objective-To compare and measure the effects of sleep quality on women with and without postpartum depression (PPD).Design-A case-control repeated measures matched pairs design. Setting-Home and obstetric office.Participants-Forty-six women who were 6 to 26 weeks postpartum. Two participants were dropped from the final analysis because they were outliers.Methods-Participants underwent wrist actigraphy at home for 7 consecutive days to measure sleep quality (sleep latency, wake after sleep onset, sleep efficiency, wake episodes). The Postpartum Depression Screening Scale measured depression severity. Psychosocial variables were collected during a screening interview. A structured clinical interview was used to diagnose PPD. Correlations, t-tests, and hierarchical multiple regressions were run to analyze data.Results-With the exception of wake episodes, sleep latency (B = 1.80, S.E. = 0.73, P<0.05), wake after sleep onset (B = 6.85, S.E. = 2.85, P<0.05), and thus sleep efficiency (B = −6.31, S.E. = 3.13, P<0.05) predicted PPD symptom severity.Conclusions-Women with PPD experienced poorer sleep quality than women without PPD, and sleep quality worsened with increasing PPD symptom severity. Clinicians need to address measures to improve sleep quality in depressed mothers to decrease symptom severity, and researchers need to develop interventions to facilitate better sleep quality in women with PPD. KeywordsSleep quality; postpartum depression; wrist actigraphy Callouts:1. In women with postpartum depression, nighttime breastfeeding demands, high-needs infants, and little nighttime support may negatively impact on sleep quality and further exacerbate depressive symptoms. 2.Women with PPD experienced poorer sleep quality than women without PPD, and sleep quality worsened with increasing PPD symptom severity. 3.Because poor sleep quality may negatively impact on PPD symptom severity, clinicians need to address measures to improve sleep quality and minimize nighttime sleep interruptions.Women are vulnerable to poor sleep quality in part because of dramatic hormonal fluctuations occurring during the reproductive cycle (Soares & Murray, 2006 NIH-PA Author ManuscriptNIH-PA Author Manuscript NIH-PA Author Manuscript especially estrogen and progesterone mediate neurotransmitter levels in the brain responsible for maintaining the quality of sleep. Immediately after childbirth, precipitous decreases in estrogen and progesterone precipitate sleep disturbances in most women including difficulty initiating and maintaining sleep even in the absence of infant care (Lee, McEnany, & Zaffke, 2000). Postpartum women experience less total sleep time, less sleep efficiency (time asleep vs. time in bed), and decreased time to rapid eye movement (REM) compared to nonpostpartum women. In spite of being biologically programmed to be awake during the day and sleepy at night, new mothers normally experience less sleep and a 20% increase in wake time during the first 6 weeks postpartum (Goyal, Gay, & Lee, 2007). Because the same neurot...
CNM-IPT is effective and acceptable as a method of reducing the severity of PPD symptoms. Careful assessment of CNM availability is critical to intervention feasibility. Future research is needed to evaluate translation of this intervention into practice.
Moringa oleifera is an ancient tree that is historically known to possess numerous medicinal qualities. The purpose of this article is to familiarize nurses with the use of Moringa oleifera in traditional medicine, present the findings of evidence-based studies, and provide implications for clinical practice and further research.
Cancer-related fatigue (CRF) is the most common and debilitating side effect of patients receiving treatment of cancer. It is reported that 60% to 100% of patients will develop CRF as a result of the treatment or the cancer itself. The effects last for years posttreatment and lower overall quality of life. The purpose of this integrative review was to determine whether exercise interventions could reduce CRF and improve overall health-related quality of life (HRQOL) among selected cancer patients. Clinical Key, ProQuest Nursing and Allied Health Source, Cochrane Library, Mosby's Nursing Consult, and MEDLINE (Ovid) were the databases searched. Key terms searched were fatigue, exercise, cancer fatigue, holistic, spiritual, quality of life, and prevention. Findings from most studies suggest that exercise can decrease the effects of CRF among cancer patients, leading to an overall improved HRQOL. No negative results on the effects of exercise on CRF were reported. Nurses can be instrumental in developing holistic multidisciplinary exercise programs to assist in the management of CRF and improve HRQOL among cancer patients during and after cancer treatment. Recommendations for future research include the need for larger study sample sizes, a universal definition of fatigue, determination of the best exercise regimens, more consistent fatigue measures to facilitate better comparison across studies, and specifically assess patient improvements in overall mental and spiritual well-being within a holistic framework.
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