No abstract

The purpose of this study was to examine the screening of depression among pregnant and postpartum participants in a community-based program. This cross-sectional study used archival data from 98 women participating in a community-based visiting nurse program in a midwestern U.S. city. Depression screening was accomplished using the Center for Epidemiologic Studies Depression scale (CES-D) and Edinburgh Postnatal Depression scale (EPDS); both instruments ask respondents to answer questions regarding their mood during the past week. The CES-D identified more pregnant and postpartum women as depressed than did the EPDS. A standard regression analysis using previous pregnancies, history of depression, married versus nonmarried, presence of support, and breast-feeding as predictor variables did not produce statistically significant findings for predicting depression among the pregnant and postpartum women in this study. This finding underscores the value of brief depression screening instruments for nurses working with pregnant and postpartum women.

Patients with heart failure (HF) face significant challenges in maintaining quality of life (QOL), particularly for sexual intimacy. Although recommended for all cardiac patients, it has been suggested that few HF patients receive sexual counseling. This study explored sexual counseling needs, sexual concerns, and sexual activity using a descriptive survey with HF patients (n = 45), recruited from a HF clinic or cardiology office. Most (77%) had not discussed sexual concerns with a health care professional (HCP). Sexual concerns that were rated as occurring 'occasionally/frequently' included partner overprotectiveness (63%), partner fear of sex (36%), lack of sexual interest (42%), erectile problems (74%), orgasmic difficulties (51%). Frequency of sexual intercourse before HF to present was striking, with 53% reporting no sexual activity in the last 2 months compared with 11% before diagnosis of HF. HCPs must provide sexual counseling to HF patients and partners to enhance QOL and to assist in any adaptations to sexual activity.

Predominant themes included alterations in self-identity, specifically physical and psychological health state. Communication issues involved a lack of sexual information and intimacy concerns. Perception of patients with MI on family concerns, particularly the influence of spouses upon return to sexual activity, was reflected within the comments. Trends in early, middle, and later recovery periods were similar to findings across the 8-year period. All 3 determinants of sexual integrity were represented in the data. Our findings clearly illustrate the need for sexual counseling for patients with MI by healthcare professionals and help to inform providers about content for patient education.