Effect of nursing intervention based on Ratu's model for preventing postpartum blues and depression among primiparous women: A treatment-control design

Abstract

Background: Postpartum is a period of physiological and psychological adaptations among women. This period may negatively impact the mother's life quality, mother-to-baby relationship, and family dynamics because of some psychological issues (e.g., postpartum blues (PPB) or postpartum depression (PPD)) they are experiencing.

Objectives: To investigate the effect of nursing interventions based on Ratu's model for preventing PPB and PPD among primiparous women.

Design: A treatment-control design included 120 primiparous women attending a university hospital's Obstetrics and Gynecology Outpatient Department.

Methods: We used five validated self-report scales (Maternal Attitudes Questionnaire, Coping Orientation for Problem Experiences, Multidimensional Scale of Perceived Social Support, Edinburgh Postnatal Depression Scale, and Kennerley's Blues Questionnaire) to collect data from December 2022 to October 2023. The control group received routine postpartum care (e.g., dietary guidance, maternal, and newborn care). The study group received routine postpartum care and educational intervention based on Ratu's model. The intervention was conducted for three sessions (every 9 days for 50-60 min) within 27 days. Both groups answered all questionnaires using the same tools before and after the study. Fisher's exact test, paired t-test, and logistic regression were used for data analyses.

Results: The nursing intervention based on Ratu's model demonstrated significant differences between the two groups relative to the stimulus of pregnant women (p = 0.001), coping mechanism (p = 0.001), behavioral response (p = 0.001), and social support (p = 0.002). Results showed that 91.7% (study) and 56.6% (control) reported without PPD after the intervention, depicting a significant difference between the two groups (p = 0.005). Finally, participants' age (p = -0.002), educational level (p = 0.0031), social support (p = 0.001), and pregnancy outcome (p = 0.01) were associated with lower PPB and PPD incidence.

Conclusion: Nurses, midwives, and other healthcare professionals working with pregnant and postpartum women may utilize the nursing intervention program based on Ratu's model to prevent or minimize PPB and PPD.

Keywords: Ratu’ model; nursing intervention; postpartum blues; postpartum depression; primiparous.

Figure 1.

Ratu’s model (Kusuma et al., 2019).

Figure 2.

Flow diagram of enrollment to analysis.