Literature Review Essay

Postpartum depression is a significant mental health problem that is highly predisposed to pregnant women. Statistics show that one in every five pregnant women will experience depression during pregnancy or following childbirth. Pregnant women are increasingly predisposed to postpartum depression due to factors such as a history of postpartum depression, stress during pregnancy, cultural, and social factors (Amani et al., 2021). Postpartum depression affects the health of mothers, their infants, and their families. Nurses and other healthcare providers play essential roles in managing postpartum depression among the affected mothers and providing preventive care to those at risk. Treatment interventions that include the use of cognitive-behavioral therapy are effective in managing symptoms of postpartum depression (Jannati et al., 2020). However, its use has not been explored in the practice site. Therefore, the purpose of this paper is to review the selected articles for the project.

ORDER A PLAGIARISM-FREE PAPER HERE

Comparison of Research Questions

Eight articles were selected for the literature review. Each of the articles explored the effectiveness of cognitive-behavioral therapy in postpartum depression. Most of the articles did not explicitly state their research questions. However, the research questions can be inferred from the aims of each study. The research question in the study by Amani et al. (2021) is, What is the effect of cognitive-behavioral therapy intervention on postpartum depression, anxiety, and mother-infant relationship symptoms? The research question in the study by Dafei et al. (2021) is: What is the effect of cognitive-behavioral counseling of pregnant women with spouse’s presence on the level of postpartum depression, anxiety, and stress? The research question in the study by Huang et al. (2018) is: What is the combined effectiveness of cognitive-behavioral therapy for postnatal depression? While that of Jannati et al. (2020) is: What is the effect of mobile phone applications based cognitive behavioral therapy on postpartum depression? The research question in the study by Karami et al. (2018) is: What is the effectiveness of psychological treatments on reducing postpartum anxiety and depression in premature infants’ mothers? While that by Pinheiro et al. (2021) is: What is the effectiveness of preventive cognitive behavioral therapy on postpartum depression? The research question in the study by Stamou et al. (2018) is: What cognitive-behavioral treatments are effective for postnatal depression? What are the parameters that make those treatments have a successful clinical outcome? While that for Li et al. (2020) is: What is the efficacy of cognitive-behavioral therapy on mood in perinatal depression?

Comparison of Sample Populations

The selected studies utilized different populations in investigating the effect of cognitive-behavioral therapy on postpartum depression. The sample in the study by Amani et al. (2021) comprised 73 mothers living in Ontario, Canada who were at risk and affected by postpartum depression. The sample in the study by Dafei et al. (2021)comprised pregnant 40 women with 28-32 weeks gestational age. The sample in the study by Huang et al. (2018) comprised 20 randomized controlled trials involving 3623 participants. The research by Jannati et al. (2020) used 75 women with postpartum depression in Kerman, Iran. The sample in the study by Karami et al. (2018) comprised 45 mothers with anxiety and depression who had infants in the intensive care unit. The sample in the study by Pinheiro et al. (2021) comprised 48 pregnant women from Brazil, while Stamou et al. (2018) used six systematic reviews and fifteen studies. Lastly, the sample in the study by Li et al. (2020) was 13 randomized controlled trials with 966 participants.

Struggling to meet your deadline ?

Get assistance on

Literature Review Essay

done on time by medical experts. Don’t wait – ORDER NOW!

Comparison of Limitations

Each of the selected articles for the review has its limitations that threaten the reliability and validity of findings. Despite being a randomized controlled trial, the study by Amani et al. (2021) has the weakness of using a small sample size. The sample size limits the applicability of the findings to a larger population. The study by Dafei et al. (2021) also has the weakness of using a small sample size (40), which affects the generalizability of its findings. The authors also included multiparous and nulliparous women, which may affect the generalization of the findings to a specific population of women that is predisposed to postpartum depression. The study by Huang et al. (2018) also has the limitation of using a small number of randomized controlled trials and studies that had high heterogeneity. It also has the weakness of selection bias due to the selected studies being limited to those written in the English language. The study by Jannati et al. (2020) has the weaknesses of small sample size, which affects its applicability to a larger population and recall bias. Depressed mothers were also least likely to complete the provided questionnaires, affecting the accuracy of the obtained data. The study by Karami et al. (2018) has the weakness of using a small sample size. The research by Li et al., (2020) also utilized a small sample size. It also has the weakness of confounding factors that affect the reliability of the reported findings. The study by Pinheiro et al. (2021) had the weakness of a high refusal rate, which affected the accuracy and reliability of the methods used and results of the research. Lastly, the study by Stamou et al. (2018) was a narrative review, which used evidence from studies that had high confounding factors, affecting the validity and reliability of the reported findings.

Conclusion

The reviewed studies support the use of cognitive-behavioral therapy in postpartum depression. The studies demonstrate that cognitive-behavioral therapy improves depressive symptoms in postpartum depression. It also reduces anxiety and stress levels that pregnant women experience. The evidence also shows that cognitive-behavioral therapy reverses the progression of postpartum depression and improves the coping abilities of mothers affected and at risk of the disorder. Therefore, the authors recommend the need for incorporating cognitive-behavioral therapies into the treatment of postpartum depression. They also recommend the undertaking of large multicenter studies to determine the effect of cognitive-behavioral therapy in a wider population. The reviewed articles had weaknesses related to study methods, which threaten the reliability and validity of findings. As a result, the authors recommend the consideration of potential confounding factors and biases that may affect the study outcomes. Based on the above, the implementation of the project is recommended to improve care outcomes of mothers at risk or affected by postpartum depression.

References

Amani, B., Merza, D., Savoy, C., Streiner, D., Bieling, P., Ferro, M. A., & Van Lieshout, R. J. (2021). Peer-Delivered Cognitive-Behavioral Therapy for Postpartum Depression: A Randomized Controlled Trial. The Journal of Clinical Psychiatry, 83(1), 21m13928. https://doi.org/10.4088/JCP.21m13928

Dafei, M., Mojahed, S., Dastjerdi, G., Dehghani, A., & Ardakani, T. S. (2021). The effect of cognitive–behavioral counseling of pregnant women with the presence of a spouse on stress, anxiety, and postpartum depression. Journal of Education and Health Promotion, 10, 131. https://doi.org/10.4103/jehp.jehp_926_20

Huang, L., Zhao, Y., Qiang, C., & Fan, B. (2018). Is cognitive behavioral therapy a better choice for women with postnatal depression? A systematic review and meta-analysis. PloS One, 13(10), e0205243. https://doi.org/10.1371/journal.pone.0205243

Jannati, N., Mazhari, S., Ahmadian, L., & Mirzaee, M. (2020). Effectiveness of an app-based cognitive behavioral therapy program for postpartum depression in primary care: A randomized controlled trial. International Journal of Medical Informatics, 141, 104145. https://doi.org/10.1016/j.ijmedinf.2020.104145

Karami, A., Omrani, R., & Danaei, N. (2018). Comparison of the Effectiveness of Cognitive Behavioral Therapy (CBT) and Acceptance and Commitment Therapy (ACT) on Anxiety and Depression in Premature Infants Mothers. Clinical Psychology Studies, 8(31), 139–156. https://doi.org/10.22054/jcps.2018.8797

Li, Z., Liu, Y., Wang, J., Liu, J., Zhang, C., & Liu, Y. (2020). Effectiveness of cognitive behavioural therapy for perinatal depression: A systematic review and meta-analysis. Journal of Clinical Nursing, 29(17–18), 3170–3182. https://doi.org/10.1111/jocn.15378

Pinheiro, R. T., Trettim, J. P., de Matos, M. B., Pinheiro, K. A. T., da Silva, R. A., Martins, C. R., da Cunha, G. K., Coelho, F. T., Motta, J. V. dos S., Coelho, F. M. da C., Ghisleni, G., Nedel, F., Ardais, A. P., Stigger, R. S., Quevedo, L. de A., & Souza, L. D. de M. (2021). Brief cognitive behavioral therapy in pregnant women at risk of postpartum depression: Pre-post therapy study in a city in southern Brazil. Journal of Affective Disorders, 290, 15–22. https://doi.org/10.1016/j.jad.2021.04.031

Stamou, G., García-Palacios, A., & Botella, C. (2018). Cognitive-Behavioural therapy and interpersonal psychotherapy for the treatment of post-natal depression: A narrative review. BMC Psychology, 6(1), 28. https://doi.org/10.1186/s40359-018-0240-5

BUY A CUSTOM-PAPER HERE

Literature Evaluation Table

Student Name:

Postpartum depression is a health problem with adverse effects on the affected populations. Nurses are responsible for selecting evidence-based interventions to promote the prevention and effective management of postpartum depression. Therefore, this paper proposes a change topic entailing the use of cognitive behavioral therapy to reduce the risk and treat postnatal depression in pregnant mothers. A comparison will be the usual care for the affected and pregnant mothers at risk.

Criteria	Article 1	Article 2	Article 3	Article 4
Author, Journal (Peer-Reviewed), and Permalink or Working Link to Access Article	Amani et al. The Journal of Clinical Psychiatry, 83(1), 21m13928.https://doi.org/10.4088/JCP.21m13928	Dafei et al. Journal of Education and Health Promotion, 10(1), 131.https://doi.org/10.4103/jehp.jehp_926_20	Huang et al. PloS One, 13(10), e0205243. https://doi.org/10.1371/journal.pone.0205243	Jannati et al. International Journal of Medical Informatics, 141, 104145.https://doi.org/10.1016/j.ijmedinf.2020.104145
Article Title and Year Published	Peer-Delivered Cognitive-Behavioral Therapy for Postpartum Depression: A Randomized Controlled Trial. 2021	The effect of cognitive-behavioral counseling of pregnant women with the presence of a spouse on stress, anxiety, and postpartum depression. 2020	Is cognitive-behavioral therapy a better choice for women with postnatal depression? A systematic review and meta-analysis. 2018	Effectiveness of an app-based cognitive behavioral therapy program for postpartum depression in primary care: A randomized controlled trial. 2020.
Research Questions (Qualitative)/Hypothesis (Quantitative)	What is the effect of cognitive-behavioral therapy intervention on postpartum depression, anxiety, and mother-infant relationship symptoms?	What is the effect of cognitive-behavioral counseling of pregnant women with spouse’s presence on the level of postpartum depression, anxiety, and stress?	What is the combined effectiveness of cognitive-behavioral therapy for postnatal depression?	What is the effect of mobile phone applications based cognitive behavioral therapy on postpartum depression?
Purposes/Aim of Study	This study aimed to determine the effect of 9-week group cognitive behavioral therapy intervention on women who have recovered from postpartum depression on postpartum depression, anxiety, social support, and mother-infant-relationship symptoms.	The purpose of this study was to determine the effect of cognitive-behavioral counseling of pregnant women with the presence of a spouse on the level of postpartum depression, anxiety, and stress.	The purpose of the study was to evaluate the combined effectiveness of cognitive-behavioral therapy for postnatal depression.	This study aimed to compare the effectiveness of application-based cognitive behavioral therapy with a control condition for mothers with postpartum depression.
Design (Type of Quantitative, or Type of Qualitative)	Quantitative	Quantitative	Quantitative	Quantitative
Setting/Sample	Seventy-three mothers who were living in Ontario, Canada	The sample comprised forty pregnant women with 28-32 weeks gestational age.	The sample comprised of twenty randomized controlled trials involving 3623 participants.	The sample comprised seventy-five women obtained from three health care centers in Kerman, Iran.
Methods: Intervention/Instruments	The participants were randomly assigned into intervention, and control groups. The selection was based on inclusion and exclusion criteria. Peer-delivered group cognitive-behavioral therapy were used in participants in the intervention group to determine its effect compared to those of the control group.	The participants were assigned randomly into intervention and control groups using developed inclusion and exclusion criteria. A midwife under the psychologist’s supervision offered Cognitive-behavioral group counseling in the presence of the spouses. Data were collected using questionnaires and Depression-Anxiety-Stress Scale 21.	The study was a systematic review of articles. A literature search on databases that included Cochrane, Embase, and PubMed was performed. Two reviewers extracted data from the selected articles.	The participants were randomly assigned to treatment and control groups. The participants completed the Edinburg Postnatal Depression Scale at the start of the study and two months after the baseline. A cognitive-behavioral intervention called ‘Happy Mom’ was delivered to the participants in the intervention group via mobile applications. Cognitive-behavioral therapy lessons were conducted for eight weeks.
Analysis	Quantitative data analysis methods were used, including descriptive statistics and analysis of variance.	Data analysis was performed using independent t-test, repeated measures test, Kolmogorov-Smirnov test, and Bonferroni post hoc test.	Data analysis was done using Review Manager 5.3 and Stata 11.0. They were used in calculating the synthesized effect of cognitive-behavioral therapy on depression and anxiety.	SPSS version 19 was used for data analysis. The statistical analyzes performed included chi-square, paired t-test, independent sample t-test, and linear regression tests for inferential statistics.
Key Findings	There were statistically and clinically significant improvements in the symptoms of depression and anxiety in the intervention group compared to the control group. There was also a decline in pathological anger and rejection in the experimental group compared to the control group. The improvements were sustained six months after the study.	There were statistically significant reductions in stress, anxiety, and depression in the intervention group compared to the control group.	The results showed that cognitive-behavioral therapy improved Edinburg Postnatal Depression Scale Score in the short-term and Beck Depression Inventory Score in the short and long-term. Cognitive-behavioral therapy also improved long- and short-term depressive symptomatology, anxiety, and stress.	The intervention led to statistical improvement in the Edinburg Postnatal Depression Scale score in the experiment group compared to the control group.
Recommendations	Peer-delivered cognitive behavioral therapy improves symptoms of postpartum depression and anxiety. Healthcare providers and institutions should adopt its use to strengthen the health and outcomes of postnatal mothers at risk of postpartum depression.	Cognitive-behavioral counseling is an effective intervention for treating and preventing postpartum depression. Healthcare providers should plan cognitive-behavioral counseling to enhance pregnant mothers’ anxiety, depression, and stress management.	Cognitive-behavioral therapy should improve symptoms of postnatal depression and its progression.	Integration of technology-based cognitive behavioral therapy is effective in treating postnatal depression.
Explanation of How the Article Supports EBP/Capstone Project	The article shows that cognitive-behavioral therapy effectively treats symptoms of postpartum depression.	The article shows that cognitive-behavioral interventions effectively prevent and treat postpartum depression.	The article supports the effectiveness of cognitive-behavioral therapy in improving the symptoms of postnatal depression and its severity.	The article supports the capstone project by showing the enhanced effectiveness of incorporating technology into cognitive behavioral therapy for postpartum depression.

Criteria	Article 5	Article 6	Article 7	Article 8
Author, Journal (Peer-Reviewed), and Permalink or Working Link to Access Article	Karami et al. Clinical Psychology Studies, 8(31), 139–156. https://doi.org/10.22054/jcps.2018.8797	Pinheiro et al. Journal of Affective Disorders, 290, 15–22. https://doi.org/10.1016/j.jad.2021.04.031	Stamou et al. BMC Psychology, 6(1), 28.https://doi.org/10.1186/s40359-018-0240-5	Li et al. Journal of Clinical Nursing, 29(17–18), 3170–3182. https://doi.org/10.1111/jocn.15378
Article Title and Year Published	Comparison of the Effectiveness of Cognitive Behavioral Therapy (CBT) and Acceptance and Commitment Therapy (ACT) on Anxiety and Depression in Premature Infants Mothers. 2018	Brief cognitive-behavioral therapy in pregnant women at risk of postpartum depression: pre-posttherapy study in a city in southern Brazil. 2021.	Cognitive-behavioral therapy and interpersonal psychotherapy for the treatment of post-natal depression: A narrative review. 2018.	Effectiveness of cognitive-behavioral therapy for perinatal depression: A systematic review and meta-analysis. 2020.
Research Questions (Qualitative)/Hypothesis (Quantitative)	What is the effectiveness of psychological treatments on reducing postpartum anxiety and depression in premature infants’ mothers?	What is the effectiveness of preventive cognitive behavioral therapy on postpartum depression?	What cognitive-behavioral treatments are effective for postnatal depression? What are the parameters that make those treatments have a successful clinical outcome?	What is the efficacy of cognitive-behavioral therapy on mood in perinatal depression?
Purposes/Aim of Study	The purpose of this study was to determine and compare the effectiveness of psychological treatments in reducing postpartum anxiety and depression in mothers at risk.	The study aimed to evaluate the effectiveness of preventive cognitive behavioral therapy for postpartum depression.	This study examined cognitive-behavioral treatments effective for postnatal depression and their associated parameters.	The study aimed to systematically review the efficacy of cognitive-behavioral therapy for improving mood in perinatal depression.
Design (Type of Quantitative, or Type of Qualitative)	Quantitative	Quantitative	Quantitative	Quantitative
Setting/Sample	The sample comprised forty-five mothers with infants in the ICU who had anxiety and depression above the cutoff point.	Four hundred eighty-eight pregnant women from Brazil	A narrative review of six systematic reviews and fifteen studies	The sample comprised thirteen randomized controlled trials with 966 participants.
Methods: Intervention/Instruments	The participants were randomly assigned to three groups of fifteen. Two groups were intervention, while one was a control group. The Zung anxiety test and Edinburg postpartum depression test were undertaken pre and post-test.	The study was a pre-post therapy study. The participants were divided into two groups that included intervention and control groups. Those in the intervention group received preventive psychotherapy while those in control did not. Data collection was done using the Outcome Questionnaire, Beck Depression Inventory-II, and Mini International Neuropsychiatric Interview questionnaires.	A literature search for relevant articles was performed on databases that included Cochrane, Scopus, and PsycINFO. A developed protocol was used for data extraction and analysis.	Literature search on databases that included EMBASE, CINAHL, PsycINFO, Web of Science, Cochrane Library, CNKI, and VIP digital database was done. The studies were screened, data extracted, and two researchers determined the methodological quality of the selected studies.
Analysis	Statistical tests, including paired t-test, chi-square, and independent-sample t-test, were performed.	Data analysis was performed using Poisson regression. The analyzes included t-tests, chi-square, standard deviation, ANOVA, and multivariate analysis.	Narrative analysis of themes contained in the selected studies was done.	Data analysis was performed using meta-analyst software (Rev Man 5.3).
Key Findings	There was a statistically significant reduction in anxiety and depression among participants in the intervention groups compared to the control group.	Therapy sessions led to a significant reduction in anxiety, stress, and depression levels in the intervention group compared to those in the control group.	The results showed that cognitive-behavioral therapy could be delivered individually or within a group. Its effectiveness can be in the short-term or up to six months post-intervention. The components of cognitive-behavioral therapy that contribute to its success include psychoeducation, goal setting, and cognitive restructuring.	The results showed that cognitive-behavioral therapy was superior to the usual care for mothers at risk of postnatal depression. It reduced the symptoms of depression in pregnant women.
Recommendations	Acceptance commitment therapy can be combined with cognitive-behavioral therapy to improve outcomes in postnatal depression.	Cognitive-behavioral therapy should be used in caring for mothers at risk since it prevents the manifestation of postnatal depression.	Cognitive-behavioral therapy and its parameters should be considered to enhance the treatment outcomes.	Clinical studies should be undertaken to determine the long-term effects of cognitive-behavioral therapy.
Explanation of How the Article Supports EBP/Capstone	The article supports the capstone project by showing the comparative effectiveness of cognitive-behavioral therapy over other psychological treatments.	The article supports the capstone topic by showing the enhanced effectiveness of cognitive-behavioral therapy in treating postnatal depression.	The article supports the capstone project by showing parameters of cognitive-behavioral therapy that should be considered for its enhanced effectiveness for postnatal depression.	The article supports the capstone project by showing that cognitive-behavioral therapy reduces depressive symptoms in pregnant mothers at risk of postnatal depression.

Conclusion

The reviewed literature supports cognitive behavioral therapy in treating postpartum depression. Cognitive-behavioral therapy improves symptoms including depression, anxiety, and stress that the affected experience. Nurses will lead the implementation of the project. Therefore, effective project implementations expected to result in optimum outcomes.

References

Dafei, M., Mojahed, S., Dastjerdi, G., Dehghani, A., &Ardakani, T. S. (2021). The effect of cognitive–behavioral counseling of pregnant women with the presence of a spouse on stress, anxiety, and postpartum depression.Journal of Education and Health Promotion, 10(1), 131. https://doi.org/10.4103/jehp.jehp_926_20

Huang, L., Zhao, Y., Qiang, C., & Fan, B. (2018). Is cognitive behavioral therapy a better choice for women with postnatal depression? A systematic review and meta-analysis.PloS One, 13(10), e0205243. https://doi.org/10.1371/journal.pone.0205243

Jannati, N., Mazhari, S., Ahmadian, L., &Mirzaee, M. (2020).Effectiveness of an app-based cognitive behavioral therapy program for postpartum depression in primary care: A randomized controlled trial.International Journal of Medical Informatics, 141, 104145. https://doi.org/10.1016/j.ijmedinf.2020.104145

Karami, A., Omrani, R., &Danaei, N. (2018).Comparison of the Effectiveness of Cognitive Behavioral Therapy (CBT) and Acceptance and Commitment Therapy (ACT) on Anxiety and Depression in Premature Infants Mothers.Clinical Psychology Studies, 8(31), 139–156. https://doi.org/10.22054/jcps.2018.8797

Li, Z., Liu, Y., Wang, J., Liu, J., Zhang, C., & Liu, Y. (2020). Effectiveness of cognitive behavioral therapy for perinatal depression: A systematic review and meta-analysis.Journal of Clinical Nursing, 29(17–18), 3170–3182. https://doi.org/10.1111/jocn.15378

Stamou, G., García-Palacios, A., &Botella, C. (2018). Cognitive-Behavioral therapy and interpersonal psychotherapy for the treatment of post-natal depression: A narrative review.BMC Psychology, 6(1), 28. https://doi.org/10.1186/s40359-018-0240-5

Literature Review Essay