Báo cáo nghiên cứu khoa học: Nghiên cứu về bệnh trầm cảm sau khi sinh tại tỉnh Thừa Thiên Huế, miền Trung Việt Nam.

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Báo cáo nghiên cứu khoa học: "Nghiên cứu về bệnh trầm cảm sau khi sinh tại tỉnh Thừa Thiên Huế, miền Trung Việt Nam."JOURNAL OF SCIENCE, Hue University, N0 61, 2010EXPLORING POSTNATAL DEPRESSION IN THUA THIEN HUE PROVINCE, CENTRAL VIETNAM Linda Murray, Michael Dunne, Nigar Khawaja School of Public Health, Queensland University of Technology (QU) Cao Ngoc Thanh College of Medicine and Pharmacy, Hue University SUMMARY Introduction: Postnatal depression (PND) is an important public health issue due to itsimpact on maternal wellbeing, infant development, and family cohesion. The estimatedprevalence of PND during the first 12 months post-partum ranges between10-20% worldwide.Whilst PND used to be considered a syndrome only occurring in western countries, there is nowevidence that it occurs throughout the world, and often at higher rates in low and middle-income countries. To date, there has been little research into PND in South East Asia and onlytwo community-based surveys in Vietnam, one in Ho Chi Minh City in 1999 and one in Hanoiand Ha Nam in 2009. This study will investigate health worker attitudes about risk andprotective factors for PND among women in Thua Thien Hue province in central Vietnam.Methodology: In 2009, 23 health professionals participated in qualitative exploratory researchof postnatal depression in Hue. This included two focus groups with 12 health professionals whocompleted a concept mapping process, and in-depth interviews with another 11 healthprofessionals. Results: Many factors relating to postnatal depression were identified includingsocio-economic status, son preference, mother’s health, infant health, social support from familyand the community, and health promoting behaviours. In-depth interviews highlightedcommunity knowledge and attitudes surrounding PND such as traditional confinement practicesand fear of experiencing stigma. Conclusion: The findings of this research will be used to plana substantial community-based quantitative survey in order to establish prevalence of PND andsurrounding social determinants in central Vietnam.1. Introduction Postnatal depression (PND) is a significant public health issue which not onlyimpacts maternal wellbeing, but also infant growth and development, and familycohesion. Prevalence of PND is estimated to be between 10-20% worldwide, althoughrates vary within and between countries. Before the 1980’s, it was assumed that PNDonly occurred in western countries. However once PND began to be measuredinternationally using standardised tools, it became apparent it was a genuine universal 303disorder showing similar symptoms across cultures. Emerging evidence suggests theprevalence of PND may be higher in low and middle income countries than in highincome countries, and carry considerable social and economic consequences. Howeverless than 10% of low and middle income countries have data available. Socio-cultural factors are very influential in the aetiology and progression ofperinatal mental health disorders. Social risk factors of PND identified in Hong Kong,China, Singapore and Thailand include unwanted pregnancy, intimate partner violence,relationships with extended family (particularly in-laws), maternal self esteem, infanttemperament and socio-economic status. Son preference is cited as an influential factorof PND in China, Hong-Kong, Taiwan and Korea. In mainland China, mothers whogave birth to a girl are twice as likely to suffer from PND. A study of 252 postpartumwomen in Goa, India, also found that the risk of PND following disappointment aboutthe infant’s gender had an odds ratio of 3.3 (p = 0.002). In Vietnam, son preference hasnot been studied in relation to PND. However Pham et al (2008) state that the nationalreproductive health policy can create pressure to have a son within two births. Studies of perinatal mental health have been conducted in both the north andsouth of Vietnam. In a sample of 506 women in HCMC, 33% of women were found tohave PND, and 19% of participants acknowledged thinking about suicide. In the northof Vietnam, a study of 364 postpartum women from Hanoi and Ha Nam province foundthat 29.9% had a common mental disorders (CMD) and that CMD were more commonin rural areas. Other studies have found that 20% of mothers of one year olds hadanxiety or depression in Vietnam, and that between 8 and 16.9% of recorded perinataldeaths could be attributed to suicide. There is currently no data on PND from centralVietnam. The purpose of this research is to identify risk and protective factors thathealth profess ...