April_eMagazine Volume 40

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OUR PEOPLE, OUR MISSION Global Health eMagazine April 2022 Watch this video!! Bani Adam by Saadi Shirazi Highlights Perspectives Behind the Scenes Announcements Spotlight Reflections Nursing Division SARS COV-2 Pandemic and Us Clinical Case Report A New Column Global Health and the Arts Articles of the Month Videos of the Month Calendar Resources NURSING DIVISION Editor: Catherine Winkler, PhD, Nurse Practitioner - BC Written by Mary Kincart, MS, RN Corporate Director Quality and Patient Safety New York Presbyterian Palliative Care As nurses, we may have been drawn to the profession because we wanted to help others and alleviate suffering. The heart of nursing is a call to palliate: to relieve human suffering, both physical and mental. It is what we are called to do. Mark Lazenby, PhD, APRN, FAAN, reminds us in his book Caring Matters Most that “caring about and for others is a specific kind of calling.” He quotes the philosopher-nurse Patricia Benner’s saying that the calling of nursing demands that we care “for the disenfranchised, the vulnerable and the suffering.” (M. Lazenby Caring Matters Most p.6) The World Health Organization (WHO) describes palliative care as an approach that improves the quality of life of patients by managing pain, relieving symptoms, and providing physical and emotional comfort. We provide palliative care in many different ways. Palliative care is influenced by many factors including the culture, beliefs, and socioeconomic factors of the patients we care for. The WHO calls us to understand that ‘‘relieving serious health-related suffering, be it physical, psychological, social, or spiritual, is a global ethical responsibility.” (WHO Health topics / Palliative care) “In 2014, the first ever global resolution on palliative care, World Health Assembly resolution WHA67.19, called upon WHO and Member States to improve access to palliative care as a core component of health systems, with an emphasis on primary health care and community/home-based care. WHO’s work to strengthen palliative care focuses on the following areas: • integrating palliative care into all relevant global disease control and health system plans; • developing guidelines and tools on integrated palliative care across disease groups and levels of care, addressing ethical issues related to the provision of comprehensive palliative care; • supporting Member States in improving access to palliative care medicines through improved national regulations and delivery systems; • a special focus on palliative care for people living with HIV, including development of guidelines; • promoting increased access to palliative care for children (in collaboration with UNICEF); • monitoring global palliative care access and evaluating progress made in palliative care programmes; • developing indicators for evaluating palliative care services; • encouraging adequate resources for palliative care programmes and research, especially in resource-limited countries; and building evidence of models of palliative care that are effective in low- and middle-income settings.” (WHO Health topics / Palliative care) Palliative care is influenced by many factors including our culture, ethnic background, and religious beliefs. As nurses, we value and integrate all these things in the care we render to our patients. I invite all to share your knowledge and experience from your own culture to enhance a greater and more global understanding of our efforts to provide palliative care and the challenges we face in supporting this human right. 22 Nursing continued on next page >>
OUR PEOPLE, OUR MISSION Women’s Health Education Postpartum Depression Written by Sarah Cordisco Global Health eMagazine April 2022 Watch this video!! Bani Adam by Saadi Shirazi Senior Nursing Student at the University of Vermont Postpartum depression is a major health concern in all countries and is the most common mental health problem in the postnatal period. Generally, postpartum depression (PPD) occurs four to six weeks after childbirth, with symptoms similar to major depressive disorder. These symptoms include “depressed mood, loss of interest or pleasure in activities, sleep disturbance, appetite disturbance, loss of energy, feelings of worthlessness or guilt, diminished concentration, irritability, anxiety, and thoughts of suicide” (Slomian et al., 2019). Many women may experience a phenomenon called “baby blues,” a transient, self-limiting mood disorder that begins two to three days after birth and resolves within two weeks. Both postpartum depression and baby blues occur from the sudden drop and change in estrogen and progesterone after having a baby. In addition to hormonal changes, the role and life changes that occur after add additional stress that can affect mental health. Highlights Perspectives Behind the Scenes Announcements Spotlight On average, PPD affects about one in five women, although this statistic varies from country to country. In higher-income countries, the prevalence of PPD varies from 10-15% in the first year after birth while in lower and lower middle-income countries the prevalence is around 18.6% (Wang et al., 2021), although some studies have shown these numbers to be up to 60% of the population. Southern Africa has been seen to have the highest prevalence rate at 39.96%, followed by Southern Asia with 22.32%, South American at 21.71%, Western Asia at 19.83% and Northern Africa at 18.75% (Wang et al., 2021). These numbers are likely significantly higher, as not everyone reports their symptoms. Some mothers may not report due to the fear of being judged for their symptoms or for not bonding with their baby as easily. Others may be unaware that this condition exists and fail to mention their feelings to their healthcare providers. The rate of this mental health disorder is also affected by other factors such as “marital status, education level, social support, spouse care, violence, gestational age, breastfeeding, child mortality, pregnancy plan, financial difficulties, partnership, life stress, smoking, alcohol intake, and living conditions” (Wang et al., 2021). Reflections Nursing Division SARS COV-2 Pandemic and Us Clinical Case Report A New Column Global Health and the Arts Articles of the Month Videos of the Month When dealing with PPD, women need a lot of support and must develop coping strategies. Coping is the cognitive and behavior process that a person uses to deal with stressful circumstances that are demanding, challenging, threatening, or have a potential for harm or loss. Coping styles are broken into three categories: problem-focused, emotion-focused, and dysfunction or avoidance coping. Problem-focused coping involves the person dealing with the source of the stress, whereas emotion-focused coping is when the person attempts to handle the thoughts and feelings associated with the stressor. Dysfunctional or avoidant coping is a strategy in which a person avoids dealing with both the stressor and the emotions associated (Azale et al., 2018). While coping strategies vary from culture to culture, it is important that postpartum women develop coping mechanisms that will be healthy and beneficial to their mental health. They must have a support system which may consist of family, friends, or community. Many women may also find spirituality or religion to be very beneficial when dealing with postpartum depression. It is important that women identify their own support systems and where they can turn to when experiencing these feelings. They must be encouraged to talk about their feelings and emotions after having a baby without shame or judgment from others. In the next article I would like to talk about women’s rights and the differences we see across the globe, as well as different women’s activist groups. If anyone has anything to share or questions to ask about any topic I write about, please feel free to email me at: sarah.cordisco@gmail.com Calendar Resources References Azale, T., Fekadu, A., Medhin, G., & Hanlon, C. (2018). Coping strategies of women with postpartum depression symptoms in rural Ethiopia: A cross-sectional community study. BMC Psychiatry, 18(1), 41. https://doi.org/10.1186/s12888-018-1624-z Slomian, J., Honvo, G., Emonts, P., Reginster, J.-Y., & Bruyère, O. (2019). Consequences of maternal postpartum depression: A systematic review of maternal and infant outcomes. Women’s Health, 15, 1745506519844044. https://doi. org/10.1177/1745506519844044 Wang, Z., Liu, J., Shuai, H., Cai, Z., Fu, X., Liu, Y., Xiao, X., Zhang, W., Krabbendam, E., Liu, S., Liu, Z., Li, Z., & Yang, B. X. (2021). Mapping global prevalence of depression among postpartum women. Translational Psychiatry, 11(1), 1–13. https://doi. org/10.1038/s41398-021-01663-6 Nursing continued on next page >> 23
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