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Published in: BMC Women's Health 1/2015

Open Access 01-12-2015 | Research article

Group psychological intervention for postnatal depression: a nested qualitative study with British South Asian women

Authors: Yumna Masood, Karina Lovell, Farah Lunat, Najia Atif, Waquas Waheed, Atif Rahman, Rahena Mossabir, Nasim Chaudhry, Nusrat Husain

Published in: BMC Women's Health | Issue 1/2015

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Abstract

Background

Postnatal depression affects 10–15 % of all mothers in Western societies and remains a major public health concern for women from diverse cultures. British Pakistani and Indian women have a higher prevalence of depression in comparison to their white counterparts. Research has shown that culturally adapted interventions using Cognitive Behavioural Therapy (CBT) may be acceptable and may help to address the needs of this population. The aim of this study was to assess the acceptability and overall experience of the Positive Health Programme by British South Asian mothers.

Methods

This was a nested qualitative study, part of an exploratory randomized controlled trial (RCT) conducted to test the feasibility and acceptability of a culturally-adapted intervention (Positive Health Programme or PHP) for postnatal depression in British South Asian women. In-depth interviews (N = 17) were conducted to determine the views of the participants on the feasibility and acceptability of the intervention.

Results

The participants found the intervention acceptable and experienced an overall positive change in their attitudes, behaviour, and increased self-confidence.

Conclusions

The findings suggest that the culturally adapted Positive Health Programme is acceptable to British South Asian women. These results support that culturally sensitive interventions may lead to better health outcomes and overall satisfaction.

Trial registration

Protocol registered on Clinicaltrials.gov NCT01838889
Literature
1.
go back to reference Gaynes BN, Gavin N, Meltzer-Brody S, Lohr KN, Swinson T, Gartlehner G, et al. Perinatal depression: prevalence, screening accuracy, and screening outcomes. Summary, evidence report/technology assessment: number 119. AHRQ publication number 05‐E006‐1. Rockville, MD: Agency for Healthcare Research and Quality; 2005. http://www.ahrq.gov/clinic/epcsums/peridepsum.htm. Gaynes BN, Gavin N, Meltzer-Brody S, Lohr KN, Swinson T, Gartlehner G, et al. Perinatal depression: prevalence, screening accuracy, and screening outcomes. Summary, evidence report/technology assessment: number 119. AHRQ publication number 05‐E006‐1. Rockville, MD: Agency for Healthcare Research and Quality; 2005. http://​www.​ahrq.​gov/​clinic/​epcsums/​peridepsum.​htm.
2.
go back to reference Cox JL, Holden JM, Sagovsky R. Detection of postnatal depression. Development of the 10-item Edinburgh Postnatal Depression Scale. Brit J Psychiat. 1987;150:782–6.CrossRefPubMed Cox JL, Holden JM, Sagovsky R. Detection of postnatal depression. Development of the 10-item Edinburgh Postnatal Depression Scale. Brit J Psychiat. 1987;150:782–6.CrossRefPubMed
3.
go back to reference Onozawa K, Kumar RC, Adams D, Dore C, Glover V. High EPDS scores in women from ethnic minorities living in London. Arch Womens Ment Health. 2003;6(2):S51.CrossRefPubMed Onozawa K, Kumar RC, Adams D, Dore C, Glover V. High EPDS scores in women from ethnic minorities living in London. Arch Womens Ment Health. 2003;6(2):S51.CrossRefPubMed
4.
go back to reference Rowe R, Jayaweera H, Henderson J, Garcia J, Macfarlane A. Access to care for low income childbearing women: background: inequalities in mother and baby health in England. National Perinatal Epidemiology Perinatal Epidemiology Unit: University of Oxford; 2003. Rowe R, Jayaweera H, Henderson J, Garcia J, Macfarlane A. Access to care for low income childbearing women: background: inequalities in mother and baby health in England. National Perinatal Epidemiology Perinatal Epidemiology Unit: University of Oxford; 2003.
5.
go back to reference Pearlstein TB, Zlotnick C, Battle CL, Stuart S, O’Hara MW, Price AB, et al. Patient choice of treatment for postpartum depression: a pilot study. Arch Womens Ment Health. 2006;9(6):303–8.CrossRefPubMed Pearlstein TB, Zlotnick C, Battle CL, Stuart S, O’Hara MW, Price AB, et al. Patient choice of treatment for postpartum depression: a pilot study. Arch Womens Ment Health. 2006;9(6):303–8.CrossRefPubMed
6.
go back to reference Burt VK, Suri R, Altshuler L, Stowe Z, Hendrick VC, Muntean E. The use of psychotropic medications during breast-feeding. Am J Psychiatr. 2001;158(7):1001–9.CrossRefPubMed Burt VK, Suri R, Altshuler L, Stowe Z, Hendrick VC, Muntean E. The use of psychotropic medications during breast-feeding. Am J Psychiatr. 2001;158(7):1001–9.CrossRefPubMed
7.
go back to reference Prendergast J, Austin MP. Early childhood nurse-delivered cognitive behavioural counselling for postnatal depression. Australas Psychiat. 2001;9(3):255–9.CrossRef Prendergast J, Austin MP. Early childhood nurse-delivered cognitive behavioural counselling for postnatal depression. Australas Psychiat. 2001;9(3):255–9.CrossRef
8.
go back to reference O’Hara MW, Stuart S, Gorman LL, Wenzel A. Efficacy of interpersonal psychotherapy for postpartum depression. Arch Gen Psychiat. 2000;57(11):1039–45.CrossRefPubMed O’Hara MW, Stuart S, Gorman LL, Wenzel A. Efficacy of interpersonal psychotherapy for postpartum depression. Arch Gen Psychiat. 2000;57(11):1039–45.CrossRefPubMed
10.
go back to reference Gater R, Tomenson B, Percival C, Chaudhry N, Waheed W, Dunn G, et al. Persistent depressive disorders and social stress in people of Pakistani origin and white Europeans in UK. Soc Psychiat Psychiatr Epidemiol. 2009;44(3):198–207.CrossRef Gater R, Tomenson B, Percival C, Chaudhry N, Waheed W, Dunn G, et al. Persistent depressive disorders and social stress in people of Pakistani origin and white Europeans in UK. Soc Psychiat Psychiatr Epidemiol. 2009;44(3):198–207.CrossRef
11.
go back to reference Chaudhry N, Waheed W, Husain N, Bhatti S, Creed F. Development and pilot testing of a social intervention for depressed women of Pakistani family origin in the UK. J Ment Health. 2008;18(6):504–9.CrossRef Chaudhry N, Waheed W, Husain N, Bhatti S, Creed F. Development and pilot testing of a social intervention for depressed women of Pakistani family origin in the UK. J Ment Health. 2008;18(6):504–9.CrossRef
12.
go back to reference Husain N, Cruickshank K, Husain M, Khan S, Tomenson B, Rahman A. Social stress and depression during pregnancy and in the postnatal period in British Pakistani mothers: a cohort study. J Affect Disord. 2012;140(3):268–76.CrossRefPubMedPubMedCentral Husain N, Cruickshank K, Husain M, Khan S, Tomenson B, Rahman A. Social stress and depression during pregnancy and in the postnatal period in British Pakistani mothers: a cohort study. J Affect Disord. 2012;140(3):268–76.CrossRefPubMedPubMedCentral
13.
go back to reference Husain N, Cruickshaw JK, Tomenson B, Khan S, Rahman A. Maternal depression and infant growth and development in British Pakistani women: a cohort study. BMJ Open. 2012;2(2):e000523.CrossRefPubMedPubMedCentral Husain N, Cruickshaw JK, Tomenson B, Khan S, Rahman A. Maternal depression and infant growth and development in British Pakistani women: a cohort study. BMJ Open. 2012;2(2):e000523.CrossRefPubMedPubMedCentral
14.
go back to reference Chaudhry N, Husain N, Tomenson B, Creed F. A prospective study of social difficulties, acculturation and persistent depression in Pakistani women living in the UK. Psychol Med. 2012;42(6):1217–26.CrossRefPubMed Chaudhry N, Husain N, Tomenson B, Creed F. A prospective study of social difficulties, acculturation and persistent depression in Pakistani women living in the UK. Psychol Med. 2012;42(6):1217–26.CrossRefPubMed
15.
go back to reference Miranda J, Bernal G, Lau A, Kohn L, Hwang WC, LaFromboise T. State of the science on psychosocial interventions for ethnic minorities. Annu Rev Clin Psychol. 2005;1:113–42.CrossRefPubMedPubMedCentral Miranda J, Bernal G, Lau A, Kohn L, Hwang WC, LaFromboise T. State of the science on psychosocial interventions for ethnic minorities. Annu Rev Clin Psychol. 2005;1:113–42.CrossRefPubMedPubMedCentral
16.
go back to reference Lau AS. Making the case for selective and directed cultural adaptations of evidence based treatments: examples from parent training. Clin Psychol Sci Pract. 2006;13(4):295–310.CrossRef Lau AS. Making the case for selective and directed cultural adaptations of evidence based treatments: examples from parent training. Clin Psychol Sci Pract. 2006;13(4):295–310.CrossRef
17.
go back to reference Gater R, Waheed W, Husain N, Tomenson B, Aseem S, Creed F. Social intervention for British Pakistani women with depression: randomised controlled trial. Br J Psychiat. 2010;197(3):227–33.CrossRef Gater R, Waheed W, Husain N, Tomenson B, Aseem S, Creed F. Social intervention for British Pakistani women with depression: randomised controlled trial. Br J Psychiat. 2010;197(3):227–33.CrossRef
18.
go back to reference Dowrick C, Gask L, Edwards S, Aseem S, Bower P, Burroughs H, et al. Researching the mental health needs of hard-to-reach groups: managing multiple sources of evidence. BMC Health Serv Res. 2009;9(1):226.CrossRefPubMedPubMedCentral Dowrick C, Gask L, Edwards S, Aseem S, Bower P, Burroughs H, et al. Researching the mental health needs of hard-to-reach groups: managing multiple sources of evidence. BMC Health Serv Res. 2009;9(1):226.CrossRefPubMedPubMedCentral
19.
go back to reference Chew-Graham C, Burroughs H, Hibbert D, Gask L, Beatty S, Gravenhorst K, et al. Aiming to improve the quality of primary mental health care: developing an intervention for underserved communities. BMC Fam Pract. 2014;15(1):68.CrossRefPubMedPubMedCentral Chew-Graham C, Burroughs H, Hibbert D, Gask L, Beatty S, Gravenhorst K, et al. Aiming to improve the quality of primary mental health care: developing an intervention for underserved communities. BMC Fam Pract. 2014;15(1):68.CrossRefPubMedPubMedCentral
20.
go back to reference Gask L, Bower P, Lamb J, Burroughs H, Chew-Graham C, Edwards S, et al. Improving access to psychosocial interventions for common mental health problems in the United Kingdom: narrative review and development of a conceptual model for complex interventions. BMC Health Serv Res. 2012;12:249.CrossRefPubMedPubMedCentral Gask L, Bower P, Lamb J, Burroughs H, Chew-Graham C, Edwards S, et al. Improving access to psychosocial interventions for common mental health problems in the United Kingdom: narrative review and development of a conceptual model for complex interventions. BMC Health Serv Res. 2012;12:249.CrossRefPubMedPubMedCentral
21.
go back to reference Beck AT, Rush AJ, Shaw BF, Emery G. Cognitive therapy of depression. New York: The Guilford Press; 1979. Beck AT, Rush AJ, Shaw BF, Emery G. Cognitive therapy of depression. New York: The Guilford Press; 1979.
22.
go back to reference Khan S, Lovell K, Husain N. Developing a culturally adapted cognitive behavioural therapy based intervention for British Pakistani mothers with persistent postnatal depression. Submitted Thesis: University of Manchester; 2011. Khan S, Lovell K, Husain N. Developing a culturally adapted cognitive behavioural therapy based intervention for British Pakistani mothers with persistent postnatal depression. Submitted Thesis: University of Manchester; 2011.
23.
go back to reference Peters S. Qualitative research methods in mental health. Evid Based Ment Health. 2010;13(2):35–40.CrossRefPubMed Peters S. Qualitative research methods in mental health. Evid Based Ment Health. 2010;13(2):35–40.CrossRefPubMed
24.
go back to reference Sim J. Collecting and analysing qualitative data: issues raised by the focus group. J Adv Nurs. 1998;28(2):345–52.CrossRefPubMed Sim J. Collecting and analysing qualitative data: issues raised by the focus group. J Adv Nurs. 1998;28(2):345–52.CrossRefPubMed
25.
go back to reference Silverman D. Instances or sequences? Social Research: Improving the state of the art of qualitative research. Qualitative; 2005. p. 6(3). Silverman D. Instances or sequences? Social Research: Improving the state of the art of qualitative research. Qualitative; 2005. p. 6(3).
26.
go back to reference Lewis G, Pelosi AJ, Araya R, Dunn G. Measuring psychiatric disorder in the community: a standardised assessment for use by lay interviewers. Psychol Med. 1992;22:465–86.CrossRefPubMed Lewis G, Pelosi AJ, Araya R, Dunn G. Measuring psychiatric disorder in the community: a standardised assessment for use by lay interviewers. Psychol Med. 1992;22:465–86.CrossRefPubMed
27.
go back to reference Braun V, Clarke V. Using thematic analysis in psychology. Qual Res Psychol. 2006;3(2):77–101.CrossRef Braun V, Clarke V. Using thematic analysis in psychology. Qual Res Psychol. 2006;3(2):77–101.CrossRef
28.
go back to reference Liamputtong P, Ezzy D. Qualitative research methods. Oxford: Oxford University Press; 2005. Liamputtong P, Ezzy D. Qualitative research methods. Oxford: Oxford University Press; 2005.
29.
go back to reference Miles MB, Huberman AM. Qualitative data analysis: an expanded sourcebook. New York: Sage; 1994. Miles MB, Huberman AM. Qualitative data analysis: an expanded sourcebook. New York: Sage; 1994.
30.
go back to reference Villegas L, McKay K, Dennis CL, Ross LE. Postpartum depression among rural women from developed and developing countries: a systematic review. J Rural Health. 2011;27(3):278–88.CrossRefPubMed Villegas L, McKay K, Dennis CL, Ross LE. Postpartum depression among rural women from developed and developing countries: a systematic review. J Rural Health. 2011;27(3):278–88.CrossRefPubMed
31.
go back to reference Horowitz JA, Goodman J. A longitudinal study of maternal postpartum depression symptoms. Res Theory Nurs Pract. 2004;18(2–3):149–03.CrossRefPubMed Horowitz JA, Goodman J. A longitudinal study of maternal postpartum depression symptoms. Res Theory Nurs Pract. 2004;18(2–3):149–03.CrossRefPubMed
32.
go back to reference Rahman A. Challenges and opportunities in developing a psychological intervention for perinatal depression in rural Pakistan – a multi-method study. Arch Womens Ment Health. 2007;10(5):211–9.CrossRefPubMedPubMedCentral Rahman A. Challenges and opportunities in developing a psychological intervention for perinatal depression in rural Pakistan – a multi-method study. Arch Womens Ment Health. 2007;10(5):211–9.CrossRefPubMedPubMedCentral
33.
go back to reference Reay R, Fisher Y, Robertson M, Adams E, Owen C. Group interpersonal psychotherapy for postnatal depression: a pilot study. Arch Womens Ment Health. 2006;9(1):31–9.CrossRefPubMed Reay R, Fisher Y, Robertson M, Adams E, Owen C. Group interpersonal psychotherapy for postnatal depression: a pilot study. Arch Womens Ment Health. 2006;9(1):31–9.CrossRefPubMed
34.
go back to reference Miranda J, Chung JY, Green BL, Krupnick J, Siddique J, Revicki DA, et al. Treating depression in predominantly low-income young minority women. J Am Med Assoc. 2003;290(1):57–65.CrossRef Miranda J, Chung JY, Green BL, Krupnick J, Siddique J, Revicki DA, et al. Treating depression in predominantly low-income young minority women. J Am Med Assoc. 2003;290(1):57–65.CrossRef
35.
go back to reference Crockett K, Zlotnick C, Davis M, Payne N, Washington R. A depression preventive intervention for rural low-income African-American pregnant women at risk for postpartum depression. Arch Womens Ment Health. 2008;11(5):319–25.CrossRefPubMed Crockett K, Zlotnick C, Davis M, Payne N, Washington R. A depression preventive intervention for rural low-income African-American pregnant women at risk for postpartum depression. Arch Womens Ment Health. 2008;11(5):319–25.CrossRefPubMed
Metadata
Title
Group psychological intervention for postnatal depression: a nested qualitative study with British South Asian women
Authors
Yumna Masood
Karina Lovell
Farah Lunat
Najia Atif
Waquas Waheed
Atif Rahman
Rahena Mossabir
Nasim Chaudhry
Nusrat Husain
Publication date
01-12-2015
Publisher
BioMed Central
Published in
BMC Women's Health / Issue 1/2015
Electronic ISSN: 1472-6874
DOI
https://doi.org/10.1186/s12905-015-0263-5

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