Postpartum depression is a significant public health issue which has not only negative effects on maternal postpartum health but also on family relationship and infant growth and development. In Vietnam, postpartum depression is not usually cared in the community as well as in the health care system because it is insufficiently screened or diagnosed and followed up during the postpartum period. Moreover, there is very little research analyzing, predicting factors of postpartum depression. Especially there is less study of the mediating effects of maternal role strain among self-efficacy, social support, infant temperament, and postpartum depression in Vietnam. Moreover, the support of the theoretical model in which self-efficacy, social support, and infant temperament were linked to postpartum depression symptoms through their effects on maternal role strain is important both contribute to conceptual understanding of these processes and to seek effective interventions for postpartum depression in Vietnamese women. Thus, the purposes of this study are to identify the predictors for postpartum depression and determine the mediating effects of the maternal role strain on the relationship among the degree of self-efficacy, infant temperament, social support, and postpartum depression.
Methods: The focus of correlational descriptive research design was performed on 190 mothers who were the first birth from four weeks to six months and be enrolled to give vaccination in 12 community health centers of Hue city in Vietnam. Data gathering tools included the “Perceived Self-Efficacy Scale”, “Maternal Social Support Scale”, “Difficult Infant Temperament Scale”, “Maternal Role Strain Scale”, and “Edinburgh Postnatal Depression Scale (EPDS)”. Data analysis was done by using the SPSS software, which was based on descriptive statistics and statistical independent t-test or one-way ANOVA test, mediation. These were tested by a series of multiple regressions by using Baron and Kenny methods. The Sobel test was used to test the significance of the mediating effects.
Results: The prevalence of probable postpartum depression which had the EPDS score at or greater cut-off of 13 points was 18.9%. There were a significant differences between postpartum depression and mother’s occupation (t=-2.86, p=.005), relationship with her husband (F=5.91, p=.003), stressful life events (t=2.94, p=.004), paid maternity leave (F=6.83, p=.001), and gestational age (t=3.32, p=.001), history of mental health (t=3.86, p<.001), self-efficacy (r=-.15, p=.030), and social support (r=-.38, p<.001), infant temperament (r=.40, p<.001), and maternal role strain (r=.59, p<.001). Furthermore, there was identified paid maternity leave (β=-.16, p=.004), gestational age (β=.15, p=.005), history of mental health (β=-.19, p=.002), self-efficacy (β=.12, p=.031), and the maternal role strain (β=.47, p<.001) as the prediction of postpartum depression. The regression model with significant predictors explains 46% of the variance. As the mediating effects, maternal role strain had a full mediating effect on the relationship between self-efficacy and postpartum depression. Besides, maternal role strain was also a partial mediating effect on the relationship between maternal social support, infant temperament and postpartum depression among postpartum women.
Conclusion: The findings of this study contribute to nursing science by identifying the mediating effects of maternal role strain on postpartum depression in Vietnam. Future research suggests solutions for professional experts of community mental health to develop effective intervention strategies which aims at the reduction of maternal role strain to decrease the impact of self-efficacy, social support, infant temperament on postpartum depression.
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