Immigrant women’s experiences of postpartum depression in Canada: a protocol for systematic review using a narrative synthesis

Abstract

BackgroundLiterature documents that immigrant women in Canada have a higher prevalence of postpartum depression symptomatology than Canadian-born women. There exists a need to synthesize information on the contextual factors and social determinants of health that influence immigrant women’s reception of and behavior in accessing existing mental health services. Our research question is: what are the ethnoculturally defined patterns of help-seeking behaviors and decision-making and other predictive factors for therapeutic mental health care access and outcomes with respect to postpartum depression for immigrant women in Canada?Methods/designOur synthesis incorporates a systematic review using narrative synthesis of reports (peer- and non-peer reviewed) of empirical research and aims to provide stakeholders with perspectives on postpartum mental health care services as experienced by immigrant women. To reach this goal we are using integrated knowledge translation, thus partnering with key stakeholders throughout the planning, implementation and dissemination stages to ensure topic relevancy and impact on future practice and policy. The search and selection strategies draw upon established systematic review methodologies as outlined by the Centre for Reviews and Dissemination and also incorporate guidelines for selection and appraisal of gray literature. Two search phases (a database and a gray literature phase) will identify literature for screening and final selection based on an inclusion/exclusion checklist. Quality appraisal will be performed using the tools produced by the Centre for Evidence Based Management. The narrative synthesis will be informed by Popay et al. (2006) framework using identified tools for each of its four elements. The integrated knowledge translation plan will ensure key messages are delivered in an audience-specific manner to optimize their impact on policy and practice change throughout health service, public health, immigration and community sectors.DiscussionThe narrative synthesis methodology will facilitate understandings and acknowledgement of the broader influences of theoretical and contextual variables, such as race, gender, socio-economic status, pre-migration history and geographical location. Our review aims to have a substantive and sustainable impact on health outcomes, practice, programs and/or policy in the context of postpartum mental health of immigrant women. PROSPERO registration number CRD42012003020.

Pogimdyminių Depresinių Sutrikimų Ankstyvoji Diagnostika - Efektyvios Prevencijos Pagrindas

“…Pogimdyminė depresija gali prasidėti per pirmus 6 mėnesius po gimdymo ir trukti keletą mėnesių ar net metų [33]. Ši depresija gali būti pirmoji moters gyvenime arba pasikartoti moterims, kurios anksčiau jau yra sirgusios depresija ar kitais emociniais sutrikimais.…”

“…Hormonų ir miego pokyčiai pirmųjų 3 mėn. po gimdymo laikotarpiu yra galimas pogimdyminės depresijos rizikos faktorius [33].…”

“…Pogimdyminė depresija yra sunkesnė, labiau varginanti būsena nei pogimdyminis liūdesys [33]. Sergančios moterys būna nusiminusios, liūdnos, prislėgtos, greit pravirksta, išgyvena nepilnavertiškumo jausmą, nerimą, sumišimą ir nuovargį.…”

“…Sergančios moterys būna nusiminusios, liūdnos, prislėgtos, greit pravirksta, išgyvena nepilnavertiškumo jausmą, nerimą, sumišimą ir nuovargį. Taip pat jas vargina fiziniai negalavimai: galvos skausmas, sustingulys, krūtinės skausmas ir hiperventiliacija [33]. Be to, sutrinka miegas ir apetitas, stinga energijos, tampa sunku sutelkti dėmesį [26]; gali nedžiuginti kūdikis, ji gali save laikyti bloga motina, nesugebančia pasirūpinti vaiku, gali kilti minčių, kad ji neverta būti motina, kad visiems būtų geriau jai mirus [2].…”

“…Dažni motinos ir vaiko prisirišimo sutrikimai (dažnas kūdikio atstūmimas, nepriėmimas ir užgaulus elgesys). Postpartum depresija taip pat yra susijusi su laigalaikių kognityvinių sutrikimų rizika, emociniais ir elgesio sutrikimais [33,34].…”