產後憂鬱不僅是盛行於產後婦女的不適症狀，亦為影響產婦身心復原，甚至於角色執行能力的重要因素。雖然已有研究探討產後憂鬱，然而對近年來政府大力推行的產後憂鬱與生產結果的關連並不清楚。產後階段是產婦歷經辛苦的生產過程，身心皆在努力回復，又須擔負起母性工作的時期，也是銜接返家的過渡階段，因此有必要進一步的瞭解此時期憂鬱的程度、變化以及影響因 素，以作為改善產後憂鬱的基礎。本研究旨在描述產婦於產後初期憂鬱之變化，探討影響產婦於產後住院期間憂鬱之身心因素，以及探討產後住院期間母乳哺餵對產婦的影響。預計採前瞻性縱貫設計（prospective longitudinal design），以實地觀察及問卷調查法，在自然的情境下，於所設定之時間架構内，系統性的收集產婦憂鬱及生產結果的資料。本研究共收集110 名有效樣本，結果發現婦女生產後的心理狀態有明顯不同；其中低憂鬱組(EPDS=5.9 分)、高憂鬱組(EPDS=13 分)且在產後第一天即出現明顯的高憂鬱分數，甚至持續到產後一週後。並且，高憂鬱的產後婦女常伴隨高疲憊、高疼痛分數、與高焦慮分數。另外本研究也發現睡眠品質差的婦女容易具有高憂鬱分數。然而憂鬱分數的不同，與母乳哺餵、新生兒的Apgar 分數、體重、與行為表現等生產結果並無明顯相關。整體而言，本研究的結果提供本土取向的資料，高憂鬱婦女有相當的照護需求，故在臨床上及早辨認具有高憂鬱的婦女，並提高適時（timing）照護是相當重要的。另外，以客觀工具評估婦女的睡眠狀態也是不可或缺的照護重點。本研究結果不僅增進對國內產後初期婦女健康問題的瞭解，更可實際應用於護理實務、護理教育及未來護理研究層面，提供產後婦女的照護的參考。 Postpartum depression is prevalent among postpartum women. These distressful symptoms have great impact on the postpartum adjustment among women and their family. Given the benefits of breastfeeding, a lot of efforts were in place to encourage the mother adopting breastfeeding. However, the relationship between the great physical and psychological demanding of breastfeeding as well as postpartum depression is not clear. Hence, it is vital to examine such relationship in order to improve the maternity care in Taiwan. A total of 110 subjects included in this study. We identified two depression groups, i.e., the low depression group (mean EPDS =5.9), and the high depression group (mean EPDS =13). There exists a significant difference in depression score since postpartum day 1 (p<0.001). Women with high depression score tend to have high levels of fatigue symptoms, pain levels as well as anxiety levels. There were no significant differences in breastfeeding problems. The results showed that women with poor sleep index were more likely to have elevated depression score. The result of this study will provide the empirical knowledge regarding postpartum depression and its effects on maternity health.
