Promoting mental health and wellbeing

Using EITHER Scenario A or Scenario B below please answer the following questions:

1. Investigate and outline the prevalence/incidence of Depression or Postnatal Depression (depending on the scenario you have chosen) in Australia – Your answer needs to cover: hospitalisations, gender, age groups and specific risk groups.

2. Using current literature discuss TWO (2) factors that may have contributed to the development of either Sally or Marie’s mental illnesses.

3. Using current literature discuss TWO (2) ethico-legal issues related to your scenario.

4. Identify TWO (2) nursing/midwifery problems with evidence from your chosen scenario- Your risk identification should be focused on the next 1-5 days of nursing/midwifery care for Sally or Marie.

5. For each nursing/midwifery problem you have identified in Question 4, outline and describe TWO (2) evidenced based nursing/midwifery interventions and rationales – Your interventions should be focused on nursing/midwifery care for Sally or Marie over the next 1-5 days. Each intervention and rationale must be supported by current literature.

Important details about your assessment

• The use of tables or column layouts to answer questions 4 and 5 is encouraged

Scenario A- Sally Weston

Sally is a 35-year-old woman who has ‘never had a sick day in her life’. She and her partner, Pete, have recently had Becky, their first baby, after five years trying to conceive. The couple achieved this pregnancy following several attempts using Assisted Reproductive Technology. Sally gave up work as a primary school teacher at 36 weeks and plans to spend the next 5 years at home looking after Becky. Sally attended all antenatal care; her Edinburgh Postnatal Depression Scale (EPDS) during pregnancy was scored at two (2) and her Antenatal Risk Questionnaire (ANRQ) score was eleven (11), (the highest scoring item indicated that she “likes to have a tidy house”). Pete and Sally have attended the post natal clinic at the local hospital to see the midwife this morning. It is now five weeks since Becky’s birth. They have left Becky with her grandmother while they have come to the clinic. Pete states he has been worried and concerned about Sally, she seems to be crying all the time for no reason and the house is more untidy than he has ever seen it. Pete and Sally are both complaining that Becky won’t sleep. Sally states “I feel really distant from her, I am tired all of the time”. On further assessment the following details were revealed: Sally has a family history of depression, she describes her mother as always “being down”, “it was hard as a kid with mum being like that” and has an aunt that is “always anxious”. Pete has no history of mental illness in his family “that I know of”. Sally states she is on no medication as “I don’t want to hurt Becky”. Today Sally has scored a ten (10) on the EPDS. Sally states “isn’t this meant to be a happy time, I cannot seem to do anything right, I was not meant to be a mother after all”. The midwife outlines that what is happening for Sally right now could be symptoms of postnatal depression, but further assessment is required. The midwife explains to Sally she would like her to see the on-call medical officer in the next hour. Sally is reluctant but agrees to the assessment.

Scenario B-Marie Malouf

Marie Malouf is a 45 year old woman and lives with her husband David and their four children (three boys aged 15, 12 & 9 and one 4 year old daughter). Marie’s elderly parents live three doors down the road from her. Marie and her family migrated to Australia from Lebanon 10 years ago. Marie’s primary role has been caring for her family and her parents over the past 10 years. She has supported her husband in his business activities for many years. Marie enjoys cooking and spending time with her friends from the soccer club, which she has not done for some time as she has felt that she has not had time since her husband became unwell. David Malouf, her husband, has recently undergone treatment for bowel cancer and he is recovering at home following bowel surgery. Marie has found the past few months very stressful. Marie has today made an appointment to see her local GP to talk about her problems sleeping. Marie reports that over the past 4-6 weeks her sleeping problem is getting worse. I can’t get to sleep and when I do I wake up at 4 am I cannot get back to sleep”, She reports she has lost weight in the past few weeks, but states “I have not felt like eating, no enjoyment any more, I cook for the family”. Marie states “I feels tired all the time and have no energy, and I feel down”. Marie’s mother Miriam suffered from depression many years ago when Marie was a teenager in Lebanon. Marie reports her motherwould often stay in bed all day for a few days at a time. Her GP asks her if she has had any thoughts of suicide and Marie states “no, I would not do that, never. I have the children”. Her GP informs her he believes she is suffering from depression and makes an appointment for her to see a psychologist and gives her a script for antidepressant medications to start right away.

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