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  1. Siti Roshaidai Mohd Arifin, Cheyne, Helen, Maxwell, Margaret
    MyJurnal
    Sociocultural contexts of motherhood have been found to have a link with postnatal depression. Malaysia has a wide-range of cultural and ethnic backgrounds that offers a wonderful chance to understand the different role of cultures and postnatal practices in relation to postnatal depression. The purpose of this paper is to discuss the link between the Malaysian healthcare system, social and cultural context, the existing health policy and postnatal depression. This paper highlights that while there are different levels of nurses who work collaboratively to manage pregnant and postnatal mothers in the maternal and child health clinic, the focus of their care is more on physical health. The international guidelines for diagnosing PND were not commonly used within the clinics, although the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) has been widely used within psychiatric setting in Malaysia. There is no formal mechanism or assessment to detect PND in the clinics. There were no guidelines found that specifically focused on the management of PND. It is questionable whether the current approaches to promote and manage maternal mental health in Malaysia have a sense of cultural-based strategies. These significant gaps call for empirical evidence that explicitly focussed on the experiences and perceptions of PND in Malaysia.
  2. Siti Roshaidai Mohd Arifin, Cheyne, Helen, Maxwell, Margaret
    MyJurnal
    The World Health Organisation recommends healthcare practitioners to equip themselves with appropriate skills to assess the psychological distress in women attending the antenatal and postnatal healthcare. Nevertheless, little is known about the healthcare practitioners’ perceptions of postnatal depression and its management. The aims of this review were: (1) to explore the experiences of healthcare practitioners in caring for women with postnatal depression in different countries and (2) to identify any qualitative study conducted in Malaysia regarding the healthcare practitioners’ perceptions of postnatal depression. To achieve these objectives, a qualitative synthesis of studies reporting the healthcare practitioners’ experience of managing women with postnatal depression was conducted. A search in CINAHL, PubMed, MEDLINE, PsycINFO and ASSIA databases was performed using specific keywords and published peer-reviewed articles from 2006 to 2016 were screened for inclusion criteria. A total of 15 relevant studies were identified and reviewed. The studies included were conducted in eight different countries: America, Australia, United Kingdom, Brazil, Canada, Greek, Mexico and Slovenia. No study conducted in Malaysia was found. This review suggestedthat the experiences of managing women with postnatal depression were relatively similar among the healthcare professionals in different countries. The main limitations reported by the healthcare practitioners were the lack of resources on maternal mental health and the absence of policy regarding the management of postnatal depression. Further research should investigate how Malaysian healthcare practitioners perceive postnatal depression and their roles in its management to provide more insights into the current clinical practice in Malaysia for postnatal depression.
  3. Arifin SRM, Cheyne H, Maxwell M
    AIMS Public Health, 2018;5(3):260-295.
    PMID: 30280116 DOI: 10.3934/publichealth.2018.3.260
    The purpose of this review was to examine articles related to recent epidemiological evidence of the prevalence of maternal postnatal depression (PND) across different countries and cultures and to identify specific epidemiological studies that have been carried out exclusively in Malaysia on the prevalence of maternal PND. The review was undertaken in two stages, an initial review and an updated review. At both stages systematic literature searches of online databases were performed to identify articles on the prevalence of maternal PND. A total of 124 articles concerning research conducted in more than 50 countries were included in the final analysis. There were wide variations in the screening instruments and diagnostic tools used although the Edinburgh Postnatal Depression Scale (EPDS) was the most common instrument applied to identify PND. The prevalence of maternal PND ranged from 4.0% to 63.9%, with Japan and America recording the lowest and highest rates, respectively. Within continents, a wide variation in reported prevalence was also found. The reported rates of maternal PND in Malaysia were much higher than that previously documented with a range of 6.8-27.3%. This review indicated that the widely cited prevalence of maternal PND of 10-15% underestimates rates of PND worldwide. The reasons for this variability may not be fully explained by review methods. Future studies should evaluate the nature of women's PND experiences across cultures to explain these wide variations.
  4. Arifin SRM, Cheyne H, Maxwell M, Pien LS
    Enferm Clin, 2019 09;29 Suppl 2:739-746.
    PMID: 31311739 DOI: 10.1016/j.enfcli.2019.04.112
    OBJECTIVE: Framework analysis is a pragmatic approach for real-world investigations and has been commonly used in health care research. Although the theoretical part of framework analysis has been well documented, there is limited literature describing its practical use. The objective of this paper is to demonstrate systematic and explicit guidance in using framework analysis by giving an example of a study exploring women's experience of postnatal depression.

    METHOD: Data presented in this paper comes from semi-structured interviews of 33 women (from three different cultural backgrounds) attending for a child or postnatal care in six purposively selected maternal and child health (MCH) clinics in Kuala Lumpur.

    RESULTS: Data were analyzed using framework analysis, which consists of three interrelated stages. In the first stage (data management), a careful selection of the data (transcripts) to be reviewed was made. The initial categories were developed based on the selected transcripts, and the initial themes were decided (known as a thematic framework). In the second stage (descriptive accounts), the thematic framework was investigated to identify any linkage and similarity between one category to another. The third stage of the analysis (explanatory accounts) involved checking exactly how the level of matching between the phenomena was distributed across the whole set of data. Using framework analysis, four themes were identified to explain the women's experience of postnatal depression namely the changes, causal explanations, dealing with postnatal depression, and perceived impacts.

    CONCLUSIONS: The details of each stage of the analysis were explained to guide researchers through essential steps in undertaking framework analysis. Health care researchers may find a worked example addressed in this paper as useful when analyzing qualitative data.

  5. Arifin SRBM, Cheyne H, Maxwell M, Yousuf A
    PMID: 34040649 DOI: 10.2174/1745017902117010010
    Objectives: Early detection and intervention for Maternal Postnatal Depression (PND) are imperative to prevent devastating consequences for mothers, babies, and families. However, there are no guidelines that explicitly focus on the management of PND in Malaysia. Consequently, it is unclear whether women with PND are receiving proper care and treatment. Therefore, this study aimed to explore Malaysian Women's experience in managing PND symptoms.

    Methods: A qualitative study was conducted among 33 women attending Maternal and Child Health (MCH) clinics in Kuala Lumpur. Data were obtained through a face-to-face semi-structured interview and analysed using framework analysis.

    Results: The women considered PND as a personal and temporary issue. Therefore, professional care was deemed unnecessary for them. Additionally, all Malay women considered religious approach as their primary coping strategy for PND. However, this was not the case for most Indian and Chinese women.

    Conclusion: The findings of this study indicated that women did not acknowledge the roles of Healthcare Practitioners (HCPs) in alleviating their emotional distress.Also, they perceived PND as a personal problem and less serious emotional condition. It is due to this perception that the women adopted self-help care as their primary coping strategy for PND. However, the coping strategy varied between different cultures. These findings underscore the importance of HCPs' proactive action to detect and alleviate PND symptoms as their attitude towards PND may influence Women's help-seeking behaviour.

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