Self Efficacy and PPD Teaching Behaviors in Hospital Based Maternity Nurses

Problem: About 13% of new mothers experience postpartum depression (PPD) in the first year after childbirth with deleterious effects on the woman’s quality of life, her ability to work and to care for her infant, and her relationships.  To avoid lengthy and complicated episodes of PPD, it is important to identify the depression and to begin treatment as soon as possible.  However, few women recognize that they are experiencing PPD, and they seldom discuss their feelings with their health care provider.  Hospital based maternity nurses have a unique opportunity to provide a remedy: to educate new mothers about PPD so that the mothers will later recognize PPD symptoms and seek treatment.  However, hospital based maternity nurses may feel unprepared for PPD patient education. 

Purpose: To explore the relationship between self efficacy and postpartum depression (PPD) teaching behaviors of hospital based maternity nurses.

Conceptual Framework: The study was guided by Self Efficacy Theory.  Nursing interventions are influenced by one’s self efficacy (belief in one’s capability to produce a given attainment) for particular practice behaviors.Method

Design:  Cross sectional, descriptive study of hospital based maternity nurses from suburban hospital (2500 deliveries per year) in the southern United States.

Procedure:  After receiving human studies approval, questionnaire packets were placed in the mail boxes of labor and delivery and mother baby registered nurses inviting them to participate in a research study.  A preamble cover letter of invitation was used rather than informed consent so that no identifying information was collected. Questionnaire packets were returned to a sealed box on each unit, and retrieved by the first author.

Sample: The sample consisted of labor and delivery and mother baby registered nurses

(n=43)Instruments: Based upon variables that were identified to be related to self efficacy in the literature, instruments included a research- team- developed measure of self efficacy related to PPD teaching, Rosenberg’s Self Esteem instrument, Attitude Toward Seeking Psychological Help Scale, Stigma Scale for Receiving Psychological Help, and demographic questions. 

Results:  Results indicate that teaching new mothers about PPD was related to a hospital based maternity nurse’s self efficacy related to PPD teaching (r=.502, p=.001), expectations for teaching from their supervisor (r=.41, p=009), self esteem (r=.49, p=.001), PPD continuing education (r=.35, p=.02), and experience with observing other nurses teach patients about PPD (r=.31, p=.04).  Clinical Implications:  It is important to identify variables related to PPD teaching behaviors so that self efficacy related to PPD teaching can be fostered in individual hospital based maternity nurses, and continuing education can be tailored to those identified as less likely to perform patient teaching.  Hospital based maternity nurses have a unique and important role in teaching new mothers about PPD.