Postnatal depression (PND) is a common mental healthcare problem in the puerperal period. The aetiological factors have been researched extensively and research shows that PND develops due to the complex interaction of biological, psychological and social factors. The quality of the couples' relationship has been identified as an important contributing and maintaining factor, but also a protective factor in the prevention and faster recovery from depressive symptoms. Relationship difficulties and a lack of support are modifiable and could effectively be addressed through therapeutic intervention. Regardless, few parenting programmes focus on the parents as a unit and often excludes the father. This results in the elimination of a valuable and available source of support.The first aim of this study was to explore couples' experience of maternal postnatal depression in a group of parents in a South African setting. A qualitative approach was used in order to gain a deeper understanding of the nature and impact of PND from the perspective of couples who experience it first-hand. The design of the first research aim was exploratory and descriptive in nature. Purposive sampling was used in the selection of participants. The sample consisted of 13 multiparous couples with an infant younger than twelve months of age. The researcher engaged with couples who experience maternal PND in order to learn from their experience and gain an understanding of this population's unique needs. Data was collected by means of semi-structured interviews and was analysed through thematic data analysis. Themes that emerged highlighted a noteworthy physical, psychological and interpersonal impact on all members in the family system.The second aim was to identify themes by means of an analysis of the literature and from the data obtained through the semi-structured interviews, in order to determine what essential elements need to be included in an integrative parenting programme for parents where the mother suffers from postnatal depression. This was done with the purpose of compiling such a programme. The research design for aim two was interpretive. Through a thorough literature analysis and semi-structured interviews with couples who experience maternal PND, four categories of crucial elements for a programme of this nature was identified namely: support and debriefing; improved knowledge of the condition by means of psycho-education; cognitive restructuring and the acquisition of practical parenting and coping skills.The third aim entailed the presentation of the integrative parenting programme to a panel of experts with experience in the field of PND. Utilizing the Delphi method, experts were requested to critically evaluate the quality of the structure and content of the programme, with the aim of refining and finalising the proposed programme. The research design for this aim was exploratory, the researcher drew from the wealth of knowledge of experts who actively work with mothers or couples who experience maternal PND. Ten professionals from different mental health disciplines participated in the evaluation and commented on the arrangement, content, methods, strengths, limitations and probable challenges of the suggested programme. These recommendations served as a guide in the enhancement of the integrative parenting programme.In conclusion, this study offers a new parenting programme for couples who experience maternal PND, that serves to address the following needs: to strengthen the family's support system and to combat isolation; to educate couples about PND; to strengthen individual coping resources; to improve the couples' relationship; to increase the parents' sense of self-efficacy regarding the parenting role and to encourage moments of joyful interaction within the family
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Postnatal depression and the evaluation of an integrative parenting programme
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