| Abstract | Trudnoća, porod i razdoblje nakon poroda velike su životne promjene prepune novih izazova koji majkama mogu predstavljati stres, naročito onima koje se sa majčinstvom susreću po prvi put. Psihička prilagodba u postporođajnom razdoblju različita je u svake žene. Većina žena u postporođajnom razdoblju iskusi nekakav oblik psihičkih promjena blagog intenziteta koje su sasvim normalna pojava za to razdoblje. Međutim, u nekih žena, takve psihičke promjene mogu prerasti u ozbiljne psihičke poremećaje. Neki od najčešćih psihičkih poremećaja koji se javljaju u postporođajnom razdoblju su postporođajna tuga, postporođajna depresija, postporođajna psihoza i postporođajni post-traumatski stresni poremećaj. Osim u majki, ove promjene mogu se javiti i u očeva. Postporođajna depresija nastaje uobičajeno dva tjedna do tri mjeseca nakon poroda, no isto tako može nastati bilo kada tijekom prve godine nakon poroda. Na njen nastanak utječu brojni rizični čimbenici, a neke od skupina su fiziološki i biološki, psihološki, opstetricijski i pedijatrijski, socio-demografski i kulturalni rizični čimbenici. Pojavu postporođajne depresije karakterizira pogoršanje simptoma postporođajne tuge, prelazak tuge u depresivnost, osjećaj majke da nije dobra majka, da ne voli novorođenče, nemogućnost brige za sebe ili za novorođenče te u nekim slučajevima pojava suicidalnih misli. Dijagnoza se postavlja pomoću screening testova, a potvrđuje ju psihijatar. Liječenje se provodi ovisno o razini psihičkog poremećaja, a najčešći oblici liječenja su primjena medikamentozne terapije i psihoterapija. Uz navedeno, podrška i razumijevanje bližnjih, pomoć i podrška u svakodnevnom životu, zdrava prehrana, tjelesna aktivnost, dovoljno sna te edukacija budućih majki, njihove okoline, ali i šire javnosti, neki su od čimbenika kojima se može prevenirati nastanak postporođajne depresije, ali i ublažiti njen razvoj ukoliko nastane. Uloga medicinske sestre je upoznati pacijenticu sa prevalencijom postporođajne depresije, čimbenicima koji mogu utjecati na njen nastanak i simptomima koji ju karakteriziraju. Također, potrebno je pripremiti majku na sve nove izazove koji ju očekuju u razdoblju nakon poroda, savjetovati ju kako da se sa njima nosi, educirati je o svim postupcima koji su bitni u brizi oko novorođenčeta, ali i u brizi za sebe te joj biti podrška u procesu prilagodbe i učenja. Bitno je u sve to uputiti obitelj i okolinu majke te ih savjetovati da joj budu pomoć i podrška, kako u razdoblju do poroda, tako i nakon. Također, važno je educirati i zdravstvene radnike i širu javnost o postporođajnoj depresiji. |
| Abstract (english) | Pregnancy, childbirth and the postpartum period are major life changes full of new challenges that can be stressful for mothers, especially those who are facing motherhood for the first time. Psychological adjustment in the postpartum period is different for every woman. In the postpartum period most women experience some kind of psychological changes that are mild intensity and are a completely normal occurrence for that period. However, in some women, such psychological changes can become serious mental disorders. Some of the most common mental disorders that occur in the postpartum period are postpartum sadness, postpartum depression, postpartum psychosis and postpartum post-traumatic stress disorder. In addition to mothers, changes in the postpartum period can also occur in fathers. Postpartum depression usually occurs two weeks to three months after childbirth, but can also occur at any time during the first year after childbirth. Its occurrence is influenced by numerous risk factors and some of the groups are physiological and biological, psychological, obstetric and pediatric, socio-demographic and cultural risk factors. Postpartum depression is characterized by worsening symptoms of postpartum sadness, the transition of sadness into depression, the feeling of the mother that she is not being a good mother, that she does not love the newborn, the inability to take care of herself or the newborn and, in some cases, the appearance of suicidal thoughts. The diagnosis is made by screening tests and it is confirmed by a psychiatrist. Treatment is carried out depending on the level of mental disorder and the most common forms of treatment are medical therapy and psychotherapy. In addition, support and understanding from family and friends, help and support in everyday life, healthy diet, physical activity, normal sleep schedule and education of mothers to be, their environment and public, are some of the factors that can prevent the onset of postpartum depression, but also mitigate its development if it occurs. The role of the nurse is to inform the patient about the prevalence of postpartum depression, the factors that can affect its occurrence and the symptoms that characterize it. Also, it is necessary to prepare the mother for all the new challenges that await her in the postpartum period, advise her on how to deal with them, educate her about all the procedures that are important in caring for a newborn, but also in caring for herself and support her in the process of adaptation and learning. It is important to include the mother's family and environment in all off this and advise them to provide help and support, both in the period before and after childbirth. Also, it is important to educate both healthcare professionals and the general public about postpartum depression. |
