A Supportive –Educative Program for Perinatal Depression Utilizing Orem's Theory of Self-Care

Background: Childbearing women experiencing perinatal depression often exhibit a deficit in capabilities to perform the tri-dimensional structure for self-care operations delineated in Orem's Theory of Self Care. Incidence of perinatal depression is estimated at 15% and higher. Guided by the conceptual tri-dimensional requirements that must be performed to meet therapeutic self-care demands, this study proposes an extension of these deficits to infant care and maternal-infant bonding; providing a nursing role to support therapeutic self-care techniques.

Methods: A supportive-educative model was developed, utilizing the Orem Self-Care framework within a phenomenological design. Pregnant and postpartum women (n=11) from a WIC program were voluntarily enrolled in this IRB-approved study; to attend a 10-wk support program. The Edinburgh Postnatal Depression Scale (EPDS) and NCAST Parent-Child-Interaction (PCI) Feeding Scales were administered to monitor progress throughout the program. The program, entitled “New Mother's Support Group,” addressed maternal self-care and infant care and bonding.

Results: The theme of anxiety was identified within categories of: infant care, relationships with significant other, and financial constraints. Relationship between complications in pregnancy and perinatal depression were also identified. 9/11 participants scored lower on the EPDS and 5/6 postpartum participants improved on NCAST-PCI Feeding Scales at the completion of the program.

Conclusions: Involvement in this supportive-educative program utilizing the Orem Self-Care Framework decreased depressive symptoms and increased maternal-infant attachment, in the majority of participants. Orem's Self-Care theory can be extended to both maternal and infant care, within a perinatal depression support group; which provides a nursing role to decrease this deficit.