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Post one
In patients with postpartum depression (P), does a community-based screening and support system strategy (I) compared to individual personal strategies (C) reduce the severity of the effects of postpartum depression (O) in six months (T)?

Van der Zee-van den Berg et al. (2017) assessed the effectiveness of postpartum depression screening compared to care as usual (CAU). The post-up study involved a total of 3,089 women in their postpartum. The study used a quasi-experimental comparative design. The participants were divided into an intervention group that received regular PPD screening and a control group that usually received treatment. Various instruments, including the Spielberger State-Trait Anxiety Inventory, were used for screening of depressive symptoms. At the end of the study, the number of mothers in the intervention group who experienced PPD was significantly reduced. The researchers recommend the implementation of PPD screening in WCC. On a second study, Yawn, Bertram, Kurland, & Wollan (2015), conducted repeated depression screening for mothers during the first postpartum year. The study used a randomized trial are the research design. A total of 2,354 women were screened. The screening tools were the Translating Research into Practice for Postpartum Depression (TRIPPD) and Patient Health Questionnaire (PHQ-9). The screening was repeated at six and twelve months postpartum.

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The articles support the implementation of regular screening PPD are a part of postnatal care. Additionally, Yawn et al., found that repeated screenings increased the early identification of women at high risk of PPD.

Post 2

Bhelkar, Deshpande, Mankar, and Hiwarkar (2018) used a Case-Control study to explore the association between hypertension and stress within a population of volunteers 30 years of age and older. A total of 100 cases and 100 control subjects were assessed and exhibited that increased stress was significantly associated with hypertension. Case subjects with high stress were 2.52 times more likely to experience hypertension; however, increasing levels of stress was shown to not be significantly associated with hypertension. Overall, this study found that stress was an independent risk factor for hypertension. Because this study was a hospital-based study, the subjects utilized throughout it may not be deemed as true representatives of the population, limiting generalizability (Bhelkar et al., 2018). Data obtained from previously performed research related to the impact stress has on patients with hypertension not only helps to develop my argument, but also helps to establish its validity.

Hu, Liu, Yin, Fan, Feng, and Yuan (2015) used a Cross-Sectional study to explore the effects and relative contributions of stress as a risk factor for hypertension. A total of 5,976 subjects within the community, aged 40-60 included in this study. Individuals excluded were individuals with a prior history of hypertension, CVD, stroke, previously taken any antihypertensive or lipid-lowering medications in the previous month or had missing stress data. Of the 5,976 subjects used, 38.45% of the participants reported general stress and were found to have increased rates of hypertension (SBP and DBP) than in those subjects in the no general stress group. One limitation to this study was that it was a cross-sectional design, which did not allow for casual relationships to be inferred. Another limitation was that the study showed bias in the selection process, as subjects were chosen based on being a community member aged 40-60 years, not taking into consideration that the influence of psychological stress on blood pressure may vary across ages. A third limitation to this study was that only fatty foods, vegetables, and fruits, were examined in the subject’s diets, not including other types of foods such as nuts, sweetened drinks, snacks, and edible oils (Hu et al., 2015). Despite the limitations and bias presented in this study, it provides a significant amount of valuable resources and information pertaining to my PICOT question.

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