Multidisciplinary Model of Nurse Midwife
| Status: | Completed |
|---|---|
| Conditions: | Depression, Depression, Women's Studies |
| Therapuetic Areas: | Psychiatry / Psychology, Reproductive |
| Healthy: | No |
| Age Range: | 16 - 45 |
| Updated: | 4/21/2016 |
| Start Date: | July 2010 |
| End Date: | June 2014 |
Multidisciplinary Model of Nurse Midwife Psychotherapy for Postpartum Depression
HYPOTHESES:
The hypotheses are that:
1. nurse midwives will be able to safely deliver interpersonal psychotherapy by telephone
to women with postpartum depression
2. women receiving interpersonal psychotherapy will have less symptoms of postpartum
depression, better functioning, better bonding with their babies, and better
relationships with their partners
3. women with postpartum depression will be more satisfied with their care than women in
the group that was referred to a mental health center.
The hypotheses are that:
1. nurse midwives will be able to safely deliver interpersonal psychotherapy by telephone
to women with postpartum depression
2. women receiving interpersonal psychotherapy will have less symptoms of postpartum
depression, better functioning, better bonding with their babies, and better
relationships with their partners
3. women with postpartum depression will be more satisfied with their care than women in
the group that was referred to a mental health center.
The specific aims of this pilot non-randomized clinical trial are to evaluate among women
with PPD recruited between 6 and 24 weeks postpartum:
1. The (a) feasibility, (b) acceptability and (c) safety of a psychological intervention
(Interpersonal Psychotherapy [IPT]) provided by nurse midwives in collaboration with a
mental health team (psychiatrist team leader and a licensed social worker) for
treatment of PPD in a pilot two-armed non-randomized clinical trial.
2. The preliminary evidence of efficacy of IPT in decreasing depressive symptoms when
administered via telephone by nurse-midwives/ women's health nurse practitioner
3. The proposed study will also evaluate preliminary evidence for the efficacy of IPT
administered by nurse midwives in
1. Improving the general level of maternal functioning
2. Specific improvement in marital adjustment
3. Increase in maternal infant bonding
This pilot study is the first step in developing an intervention to decrease depressive
symptoms, improve functioning, improve interpersonal relationships between mother and spouse
and infant, improve access to care, and improve treatment engagement among postpartum women
diagnosed with PPD. The intervention will be cost-effective, brief and acceptable to both
patients and nurse midwives for incorporation into current midwifery practice. If the IPT
program is found to be feasible, acceptable and safe with preliminary evidence of efficacy,
a postpartum IPT manual for advanced practice nurses will be finalized in order to test
whether other advanced practice nurses such as pediatric nurse practitioners and family
nurse practitioners can also safely and effectively administer IPT in a full-scale
randomized clinical trial
with PPD recruited between 6 and 24 weeks postpartum:
1. The (a) feasibility, (b) acceptability and (c) safety of a psychological intervention
(Interpersonal Psychotherapy [IPT]) provided by nurse midwives in collaboration with a
mental health team (psychiatrist team leader and a licensed social worker) for
treatment of PPD in a pilot two-armed non-randomized clinical trial.
2. The preliminary evidence of efficacy of IPT in decreasing depressive symptoms when
administered via telephone by nurse-midwives/ women's health nurse practitioner
3. The proposed study will also evaluate preliminary evidence for the efficacy of IPT
administered by nurse midwives in
1. Improving the general level of maternal functioning
2. Specific improvement in marital adjustment
3. Increase in maternal infant bonding
This pilot study is the first step in developing an intervention to decrease depressive
symptoms, improve functioning, improve interpersonal relationships between mother and spouse
and infant, improve access to care, and improve treatment engagement among postpartum women
diagnosed with PPD. The intervention will be cost-effective, brief and acceptable to both
patients and nurse midwives for incorporation into current midwifery practice. If the IPT
program is found to be feasible, acceptable and safe with preliminary evidence of efficacy,
a postpartum IPT manual for advanced practice nurses will be finalized in order to test
whether other advanced practice nurses such as pediatric nurse practitioners and family
nurse practitioners can also safely and effectively administer IPT in a full-scale
randomized clinical trial
Inclusion Criteria:
- 6 to 24 weeks postpartum
- 16 years and older
- English-speaking
- Have access to a telephone
- Consents to enter the trial
- Postpartum onset of postpartum depression
- Current use of antidepressant medication as long as dose does not have to be adjusted
by subject's healthcare provider during clinical trial
Exclusion Criteria:
- Infant complications requiring medical care beyond 6 weeks postpartum
- Infant birth defects
- Infant being placed for adoption by 6 weeks postpartum
- Maternal mental retardation
- Current use of antidepressant medication that requires dosage adjustment by subject's
healthcare provider during clinical trial
- Diagnosis of depression prior to postpartum period
- Active substance or alcohol abuse or dependence
- Active suicidality, homicidality, or current psychosis as assessed by the MINI
- Disabling pain that interferes with the ability to carry out activities of daily
living
- Concurrent serious medical co-morbidities (e.g. active lupus, multiple sclerosis,
severe cardiac disease severe hypertension, cancer, etc).
We found this trial at
2
sites
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