Project Summary Given previous findings of a strong relationship between postpartum fatigue and depressive symptoms in the first postpartum month, a clinically valuable intervention should reduce early postpartum fatigue and continue to suppress it over several months to slow or stop the trajectory towards postpartum depression. Specific Aims: In this multi-phase study, Phase 1 will investigate the relationships among postpartum fatigue factors, postpartum fatigue, postpartum depression, and functional status at 1, 3 and 6 months in poor, urban women. In Phase 2, we will conduct a phase II nursing clinical trial to test the feasibility of a self-management intervention for postpartum fatigue. Phase 1: A correlational, predictive design using repeated measures will be employed. Over-sampling will be employed (n = 84) to obtain a final sample of 62 in order to detect a .35 correlation between postpartum fatigue and depressive symptoms with 80% power using a one-tailed test at the 0.05 level. Postpartum fatigue risk factors to be measured include: Iron deficiency anemia, BMI, sleep-wake patterns, anxiety, social support, infant temperament, work status and number of children. Postpartum fatigue will be subjectively measured with the Lee Fatigue Scale. Outcome measures include depressive symptoms and functional status. Multivariate statistical analyses will be used. Phase 2: We will develop and pilot test the feasibility and cost of a postpartum fatigue self-management intervention that will target the first postpartum weeks using a randomized, controlled trial design sampling poor, urban women. Because the intervention content, structure, and evaluation are dependent on phase 1 results, a systematic process is outlined to develop and test the intervention. This approach will consist of: 1) Phase 1 results, 2) Synthesis of relevant intervention literature, and 3) Consultation with the Center for Enhancement of Self-Management Methodology Core. The intervention’s feasibility and cost will be evaluated in relation to its effect on postpartum fatigue and health outcomes.
Self-Management of Postpartum Fatigue in Poor Urban Women
Jennifer J. Doering, PhD, RN, Project Director
Karen H. Morin, PhD, RN, Co-Investigator
Relevance Postpartum depression is a multifaceted public health problem. The long-term goal of our program of research is to reduce depression-related health disparities in poor, urban women and infants. The purpose of this study is to develop and then test the feasibility of a targeted intervention to enhance self-management of postpartum fatigue and its possible influence on depression-related health disparities.
College of Nursing, University of Wisconsin–Milwaukee. Milwaukee, WI