Implementing Paternal Postpartum Depression Screening in the Newborn Intensive Care Unit

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McDonnell, Sara
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Background: Postpartum depression (PPD) in mothers has been widely studied however PPD in fathers has been overlooked. Maternal PPD screening in the NICU has become routine while very few units routinely screen fathers. Postpartum depression screening in NICU fathers has been largely ignored despite evidence that NICU fathers experience PPD at higher rates than their non-NICU father counterparts. This population of fathers would benefit from PPD screening and referral to appropriate resources if applicable during their infant’s NICU stay.|Purpose: The purpose of this process improvement project was to implement routine screening for paternal PPD in the NICU using the Edinburgh Postnatal Depression Scale (EPDS) and describe the incidence of PPD in NICU fathers at this institution.|Methods/Research Strategy: The population sample and setting is a convenience sampling of fathers of infants in a 36 bed, Level III NICU in a non-profit, academic hospital, in a Midwestern metropolitan area. The EPDS was used as the screening tool to detect PPD symptoms in fathers. The goal was to screen fathers at one week post-birth and then monthly thereafter until discharge of the patient. A flowsheet was developed in the electronic medical record to record father’s EPDS responses. A mental health referral sheet was updated to include information for fathers. Staff education was provided regarding paternal PPD screening and how to screen fathers.|Findings/Results: 64 fathers had infants in the NICU for ≥7 days and therefore were eligible for screening. Twenty-four fathers (37.5%) completed the initial screening. 12.5% of the fathers screened had scores indicative of possible depression. Zero follow-up screens were completed.|Implications for Practice: NICU fathers do exhibit symptoms of paternal PPD and would benefit from routine screening, support, and referral to mental health resources. NICUs should implement routine paternal PPD screening into their parental support. Screening parents regardless of gender or sexual orientation should be considered. Follow-up education and compliance checks for staff should be considered to ensure proper screening. Follow-through with fathers is important to ensure screening is completed. Fathers are not at the bedside as often as mothers so other avenues of screening may need to be included such as phone screening. Fathers should be encouraged to answer honestly without fear of retribution. Fathers should be encouraged to seek out mental health without fear of discrimination.|Implications for Research: Further research is needed to find the best ways to support NICU fathers during their child’s NICU stay and beyond. It would be beneficial to compare both maternal and paternal PPD scores for correlations in depressive symptoms. Consideration of screening for PPD in LGBTQI parents should be included in postpartum depression research. PPD Research should include mental health symptoms fathers experience that my not include depressive symptoms.
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