CHAPTER 1 LO1

1.1 Research specification Outline

Introduction

This project will explain postnatal depression in fathers highlighting some of the causes and symptoms that
can lead to Post-Natal Depression (PND) including the effect on dads and relationships. The (NCT.2017) defines
that an estimated 10% of new mums suffer
from PND and it is now also recognised that dads
can experience PND, sometimes called Paternal depression, and either
parent is likely to be affected by concerns about the other.

Aim:

This project goal is to find out how does postnatal depression affect fathers and what methods is used to ensure a person-centred approach when it comes to caring for a client with postnatal depression.

Objectives are:

1. What are the Common symptoms?
2. How does postnatal depression affect fathers and relationships?
3. Treatment for Paternal postnatal depression (Recommendations).

Rationale:

The reason
for choosing postnatal depression in fathers is because
postnatal depression in dad has been overlooked
by many practitioners and could have an impact on relationships
break-down in families’ relationship. Also, as mum can have the baby blue after pregnancy and noticing that many changes come
with having a baby like physically, emotionally, mentally and social changes. Depression in dad can affect relationships after the
birth of the baby. Also as a practitioner working with babies and children
from 0-5 and their parent and often wonder about the effect postnatal depression can have on mums and dads. Most of the
time care professional in health care setting seem
to show a lot more interests when it comes to mum
and baby, but not so much the into the fathers.

Methods – the use of secondary research with existing evidence in the literature on PND.  I will search Medline, PubMed, Google scholar for articles in English that would fit my topic and objectives.

Data Analysis – I will analyse information about post natal depression from different articles. This will be presented in a tabular format to show similarities and differences between research works.

Plan – To complete this within 6 months

Budget – No financial requirement for this
project as all information.

Identify the factors that contribute to the process of research project

Limitations:

First of all, it was really hard to
choose the subject of my research project as it was first time I was doing it.
I wanted to choose something interesting and new. I was willing to use a
primary research project method but unfortunately because of my main aim of
research project I could i thought i could do it. To prepare a questionnaire
and find appropriate people for the research will be difficult. I would need
more than three years to analyse postnatal depression and how it affected the father
and relationship. Also, it is hard to analyse relationships and I would need
specialists to work with them which would be too expensive and limits me
financially. As a result of these limitations at this stage, I prefer secondary
research method. However, it also requires some money as I will need to visit
libraries and rent journals. For this method, I will need to analyse papers
which are already published. Another reason why I chose this method for the
subject is statistics. Since the figures already exist, I will not need to do
any sophisticated analysis.

Ethical consideration

I do not need ethical permission for this
research since i have already publised papers. I need to maintain Confidentiality and respect for cultural
differences in any case study I quote from.  In need to follow policies and procedures. (Duijnhoven,
2008).

Other Limitations

There
may be significant methodological limitations
of existing studies, including small sample sizes; the use of cross-sectional
projects; different measures of
depression; focus on depression in the postpartum only; and in the few research
studies, the addition of only one valuation point. The confines of the current
systematic review include the inclusion of only papers written in English and
likely publication bias, where studies with null findings are less likely to be
published (Johansson, 2016)

Full research specification

Title: Postnatal Depression in fathers.

Aim:

This project goal is to find
out how do postnatal depression affect fathers and methods is used to ensure a person-centred approach when it comes to caring for a client with postnatal depression.

Objectives are:

1. What are the Common symptoms?
2. How does postnatal depression affect fathers and relationships?
3. Treatment for Paternal postnatal depression (Recommendations).

Rationale:

The reason for choosing postnatal depression in fathers is because postnatal depression in dad has been overlooked by many practitioners and could have an impact on relationships break-down in families’ relationship. Also, as mum can have the baby blue after pregnancy and noticing that many changes come with having a baby like physically, emotionally, mentally and social changes. Depression in dad can affect relationships after the birth of the baby. Also as a practitioner working with babies and children from 0-5 and their parent and often wonder about the effect postnatal depression can have on mums and dads. Most of the time care professional in health care setting seem to show a lot more interests when it comes to mum and baby, but not so much the into the fathers.

Symptoms of depression found in 6.3% of the fathers and 12.0% of the mothers and the point prevalence of major
depression in fathers were 1.3%. The
strongest correlates of depressive symptoms in fathers were problems in the
partner relationship, a low educational level, previous depression, stressful
life events and low partner support (Johansson et al. 2016).

Literature review

In this study, systematic research reviews were carried out by
searched available publications on electronic databases. The review includes
qualitative or quantitative methods to investigate postnatal depression in
fathers. According to Thomas (2016), Postnatal depression (PND) refers to the onset
of depression after the birth of a child in the family. It may occur after the
first or subsequent births. However postnatal depression takes place in 1.25-25 percent of fathers, and
it can contribute to poor outcomes in fathering and in the child’s health.

However postnatal depression can also affect man from the birth of the baby associated with the increased independent risk of adverse in the outcome of the child.
Father with depression scored higher of a father of no depression fathers
(Edmoridson et al.,2010). Also, fathers increasingly involved in infant also
depression in postnatal father hurt the
child development and behaviour. All high
scoring father and a random sample of fathers scoring low were invited for a
diagnostic interview to assess the presence of any depression or anxiety disorder
Hwang, (Massouoli and Wickbery, 2013)

However, the most common correctable of paternal depressive symptoms
pre-and post-birth was having a partner with elevated depressive symptoms of
depression poor relationship satisfaction was also frequently associated with
elevated depression symptoms of depression in men (Milgrom et al., 2011).

 The substantial heterogeneity
observed among rates of paternal depression, with a meta-estimate of
10.4% (95% confidence interval [CI], 8.5%-12.7%). Higher rates of depression reported during the 3- to the 6-month postpartum period (25.6%; 95% CI,
17.3%-36.1%). The correlation between paternal and maternal depression was
positive and moderate in size (r = 0.308;
95% CI, 0.228-0.384). No evidence of significant publication bias was detected
(Paulson. et al. 2010).

The death of Child L in
2012 at Hull Royal Infirmary provides
a background upon which the issue of maternal depression and its effect on
child development should be studied. According to Cantrill (2013), Child L was
only five weeks old upon death and the post-mortem revealed that death had
occurred as a result of a severe fracture of the skull. Nevertheless, the
police considered the death of Child L to be suspicious and arrested the mother
(Adult N) on suspicion of murder. As the investigation and court proceeding
progressed, Adult N accepted the charge of infanticide caused by maternal
depression. Later investigations revealed that Child L’s mother had previously
reported to her GP that she was undergoing stress and could barely manage her
duties as a mother. Under the circumstances, the GP had diagnosed her condition
to be depression (Beck, 2013). Unfortunately, the GP did not escalate the
issue, and Child L died in the hands of her mother. Therefore, maternal
depression was to blame for the death of Child L.

Mother – child relationship and emotional development

The
relationship an infant has with its mother has a support on intellectual and
personality development of the child (Cogill et al. 1986). Psychiatric
disturbances in the parent can thus contribute to how children begin to develop
behavioral disorders. When women experience childbirth, they face the highest
likelihood of going through psychiatric disturbances; in the home is the
possibility of marital discord, other children in the house, and even social
disadvantage.

Women who are depressed and concurrently have infants to care for are
likely to be immobilised and unable to conduct their duties as mothers (Cogill
et al. 1986). Mothers provide very critical influences that are essential for a
child’s development, e.g. conversation and play, but these may be severely
lacking in situations of maternal depression. In essence, maternal depression
can have a significant effect on the interactions mothers have with their
children. This can affect child’s development (Cogill et al. 1986).

According to Murray and Cooper
(1997), three aspects of infant development have been examined in relation to
postnatal depression in their mothers. Firstly, the quality of communication
between an infant and its mother has been the subject of study. In mothers with
postnatal depression, it has been found that their children are less sociable,
had reduced levels of interactive behaviours, as well as low levels of
affective sharing compared to children of mothers without prenatal depression.
Secondly, infant attachment has been measured using the Ainsworth strange
situation procedure (Murray and Cooper 1997). Through this method, insecure infant
attachment has been evidenced among infants of mothers with prenatal
depression. Thirdly, behavioural problems have been reported among mothers with
prenatal depression; they include temper tantrums, difficulty eating and
sleeping, and difficulties with separation. Thus, the emotional development of
children of mothers with prenatal depression has been found to be poor. The
fact that maternal depression may predict depressive disorder among infants has
prompted studies to understand the biological mechanisms causing one generation
to affect another. Such studies have targeted the hypothalamic pituitary adrenal (HPA) axis, what is known to play a
role in how human responds to stress, especially depression (Barry et al.
2015). Since the HPA axis regulates the
concentration of basal cortisol (hormone), such levels may rise when there is
depression in both adults and children. Not surprisingly, a twenty-two-yearlong
study among participants raised by mothers suffering from postnatal depression
found that cortisol reactivity to be higher in the group undergoing the test
than in the control group. In essence, exposure to maternal depression at an
early age can lead to a higher likelihood of more biological sensitivity
resulting from social stress during adult years (Barry et al. 2015). The death of Child L in 2012 at Hull
Royal Infirmary provides a background
upon which the issue of maternal depression and its effect on child development
should be studied. According to Cantrill (2013), Child L was only five weeks
old upon death and the post-mortem revealed that death had occurred as a result
of a severe fracture of the skull. Nevertheless, the police considered the
death of Child L to be suspicious and arrested the mother (Adult N) on
suspicion of murder. As the investigation and court proceeding progressed,
Adult N accepted the charge of infanticide caused by maternal depression. Later
investigations revealed that Child L’s mother had previously reported to her GP
that she was undergoing stress and could barely manage her duties as a mother.
Under the circumstances, the GP had diagnosed her condition to be depression
(Beck, 2013). Unfortunately, the GP did not escalate the issue, and Child L
died in the hands of her mother. Therefore, maternal depression was to blame
for the death of Child L.

Mother – child relationship and emotional development

The
relationship an infant has with its mother has a support on intellectual and
personality development of the child (Cogill et al. 1986). Psychiatric
disturbances in the parent can thus contribute to how children begin to develop
behavioural disorders. When women experience childbirth, they face the highest
likelihood of going through psychiatric disturbances; in the home is the
possibility of marital discord, other children in the house, and even social
disadvantage.

Women who are depressed and concurrently have infants to care for are
likely to be immobilised and unable to conduct their duties as mothers (Cogill
et al. 1986). Mothers provide very critical influences that are essential for a
child’s development, e.g. conversation and play, but these may be severely
lacking in situations of maternal depression. In essence, maternal depression
can have a significant effect on the interactions mothers have with their children.
This can affect child’s development (Cogill et al. 1986).

According to Murray and Cooper
(1997), three aspects of infant development have been examined in relation to
postnatal depression in their mothers. Firstly, the quality of communication
between an infant and its mother has been the subject of study. In mothers with
postnatal depression, it has been found that their children are less sociable,
had reduced levels of interactive behaviour, as well as low levels of affective
sharing compared to children of mothers without prenatal depression. Secondly,
infant attachment has been measured using the Ainsworth strange situation
procedure (Murray and Cooper 1997). Through this method, insecure infant
attachment has been evidenced among infants of mothers with prenatal
depression. Thirdly, behavioural problems have been reported among mothers with
prenatal depression; they include temper tantrums, difficulty eating and
sleeping, and difficulties with separation. Thus, the emotional development of
children of mothers with prenatal depression has been found to be poor.

The fact that maternal depression may predict depressive disorder among
infants has prompted studies to understand the biological mechanisms causing
one generation to affect another. Such studies have targeted the hypothalamic
pituitary adrenal (HPA) axis, what is known to play a role in how human
responds to stress, especially depression (Barry et al. 2015). Since the HPA axis regulates the concentration of
basal cortisol (hormone), such levels may rise when there is depression in both
adults and children. Not surprisingly, a twenty-two-yearlong study among
participants raised by mothers suffering from postnatal depression found that
cortisol reactivity to be higher in the group undergoing the test than in the
control group. In essence, exposure to maternal depression at an early age can
lead to a higher likelihood of more biological sensitivity resulting from
social stress during adult years (Barry et al. 2015

Methodology for data collection

There are a number of methods that are
used in qualitative research for data collection. They include being an active
participant in the research setting, being and observer, conducting interviews,
or collecting and analyzing articles on the subject under study (Marshal &
Rossman 2006). This study has elected to do the latter; collect and analyse
secondary data through a narrative review of the literature

Secondary data collection through
review of literature

According to Andrews, Higgins, Andrews and Lalor (2012), secondary data is data which is already in existence. This makes the job of a secondary analyst simpler because participants do not have to be recruited and the researcher does not have to be involved in the collection of data. In effect, analysing secondary data is a method which uses data already in existence either in quantitative or qualitative form to verify previous research or examine new research questions. It may not be necessary that secondary data is used for its previous purpose. Rather, it may be utilised for another purpose.

Secondary data collection can be used to aggregate a number of studies so that key issues can be understood and to use the results to arrive at new ways of conceptualizing the issue under study (Andrews et al. 2012). Through a literature review, therefore, new research questions can be applied. In addition, existing research can be refined, refuted, and verified. Significantly, the same data obtained from the literature review can be used to analyse an issue from a different viewpoint.

An important reason for selecting the secondary data collection method is the fact that a sample which is difficult to reach or an issue which is sensitive is better analysed through secondary data analysis (Andrew et al. 2012). In addition, this method is beneficial because original research may be easier to verify thus controlling for quality, and enhancing trustworthiness, transparency, and credibility of the original research results.

Most of all, collecting secondary data saves time and resources that are usually needed in primary data collection methods (Andrew et al. 2012). For example, primary data collection may involve the use of a devise for recording, transport, as well as costs associated with transcription. Most importantly for this study, analysing secondary data enables beginners’ researchers to learn and be taught. In fact, learners can experiment through experiential learning, thus protecting live participants while engaged in the learning (Andrew et al. 2012).

Data analysis – Synthesising and analysing the data

According to Cronin, Ryan & Coughlan (2008), it
is a requirement for nurses to conduct a literature review sometime in their
career, either in school or in a research process, or when involved policy and
development of clinical practice. Conducting a literature review means that the
subject must be searched and retrieved, and the resulting data should be
synthesised and analysed in a short period of time. The latter is one reason
that a review of the literature has been preferred in this study. Accordingly,
data analysis will be conducted in the following manner.

• The data will first be indexed and summarised. This involves compiling the following data from each article:

• Author
• Title of the article
• Findings and outcomes
• Purpose of research
• Methodology of research

• The research objective will be applied for each article

A
summary of the findings from these researches will be used to generate a
discussion around the topic with recommendations for improvement.

Scope

This
study will be conducted to determine the extent to which PND affects fathers
and relationship. The issues that will be addressed include statistics of women
who experience postnatal depression in the UK, the behaviours mothers’ exhibit
to their children when undergoing postnatal depression, incidents resulting
from postnatal depression, and long-term effects of postnatal depression on the
father. Notably, all these issues will be confined to postnatal depression
occurring in the UK within the last ten years.

Limitations

There are several limitations in this study. Firstly, the study relies on secondary data to analyse and draw conclusions; secondary data can be perceived to be second hand data and the selection of articles to include can similarly be perceived as subjective. Secondly, as in all types of qualitative research, a review of the literature relies on the conclusions the researcher will draw. This is also subjective. Thirdly, a narrative review does not allow for synthesis of a large number of studies. If it were possible; more generalisable conclusions can be drawn from a large number of articles. In this review, the number of articles is fourteen. It also required financial resources to buy some of those articles. In researching independent for qualitative/ quantitative research and collect data from my place of work on policies and procedure around potential depression. There were significant methodological limitations of existing studies, including small sample sizes; the use of cross-sectional projects; different measures of depression; focus on depression in the postpartum only; and in the few research studies, the addition of only one valuation point. The confines of the current systematic review include the inclusion of only papers written in English and likely publication bias, where studies with null findings are less likely to be published. (Johansson, 2016)

PLAN OF ACTIVITIES

Planned cost/Budget

This research was part of a college project which widens my understanding of post-natal
depression in fathers. I may not incur any cost
except if i need to get access to full articles that may not be online. I have
budgetted about £100 for this. All the printing and online article will be
given by the school at no extra cost. I will conduct this work on my own and
will not require the assistance of any specialist.

 Chapter 2 Research Methodology: LO2

I am looking at postnatal
depression in fathers.In this study, systematic
research reviews were carried out by searched available publications on several electronic databases (Hick,
2006).

 The
reference lists included studies were also examined to identify studies found in the electronic database
search. The databases used are, PubMed,
CINAHL, Web of Science, science direct
and PsycINFO, Medline and AMED, EBSCOhost
and Wiley online library, were searched.
The literature review included studies with using either qualitative or
quantitative method to investigate issues
related to postnatal depression in men. Recent research
from 2005–2017 included, and the review
comprised the policies and other applicable confidential documents, articles,
journals, books and internet resources to provide up-to-date information on
postnatal depression (Hicks, 2006). The advantage of using qualitative research
methods is that they provide flexibility in combining observation and analysis
of facts; moreover, they allow behaviour, experience and meaning to explored in the literature. They allow insight
into individuals’ experience in investigating the chosen topic. Another
advantage of using qualitative methods in primary research is that they allow
exploration of the subject (May and Pope,
2006). They can be used to separate attitudes, opinions, behaviours and other
defined variables and generalise result from a
sample to a wider population (May and Pope 2006).

This is a narrative review which has searched for academic
articles and other relevant sources such as books. The intent of this study is
to find peer reviewed journal articles and other academic sources focusing on
postnatal depression among fathers in the UK.

Inclusion Criteria

The following are the inclusion criteria:

• All articles must be in the English language
• Articles are not limited in study design; they can be quantitative or qualitative
• The key words postnatal depression and paternal depression are utilised in different combinations as search terms
• Articles must have a bearing on depression among fathers in UK and/or its impact on offspring and family relationships

Exclusion criteria

• Articles which do not indicate from the abstract or title that they are focused on depression in fathers are excluded
• Articles which have a focus on depression; post-partum but do not originate from the UK are eliminated
• Articles older than 15 years are excluded

The process above is illustrated below:

Validity and reliability

According to Noble and
Smith (2015), findings of a study can be assessed for reliability if the
methods that have been used and the conclusions reached are judged to be
appropriate. Qualitative research is usually criticised for little scientific
rigor, poor justification of methodology, opaque procedures of analysis, and
the fact that conclusions reached are subjective and prone to researcher bias. Even
though measures and tests applied in quantitative research for validity and
reliability cannot be used in qualitative research, these terms are
contextually applicable. In that sense, validity is a measure of the
reliability of methods that have been used and the relationship of findings
with data. On the other hand, reliability is a measure of how consistent the
procedures for analysis have been (Noble & Smith, 2015).

These views are supported
by Brink (1993) who argues that a qualitative study will be found to be
trustworthy and credible if attention is paid to issues of validity and
reliability. In his view, validity and reliability are very important in
qualitative studies because they are prone to a researcher’s subjectivity which
can possibly cloud how data is interpreted. In such a situation, the findings
can be taken sceptically by academics. As such, it is imperative that
strategies for overcoming factors that pose risk to the validity and
reliability of conclusions are implemented. However, Brink (1993) posits the
view that qualitative research uses descriptions such as trustworthiness,
credibility, and consistency in place of the terms validity and reliability.

In this study, therefore,
risks to validity and reliability have been overcome in the following way: Since
the researcher can be a source of error through researcher bias (Brink 1993),
the researcher in this study has attempted to be as objective as possible. This
researcher has also spent some time in the clinical setting as suggested by
Brink (1993) as a means to understand the phenomenon under study prior to
collecting data. Importantly, the methods used in this study have been
explained clearly, including how data has been collected. In addition, a number
of data sources have been used. These include journal articles, other scholarly
sources, government websites, and credible news articles.

This study has used a “thick description”, described by Brick
(1993) as that which gives a detailed account of the procedures used from the
beginning to the end. In that respect, this author has explained initial
interest in the study, the aims, and objectives of the study, and how the data
has been collected.

Chapter 3 Results and Discussion

Information
from various researches has revealed that depression was present not only in
mothers but also in fathers. The most important correlates of
depressed mood in men were as follows: the level of women’s depression, the
high discrepancy between prenatal expectations and experiences related to
family and social life after childbirth, and low satisfaction with the marital
relationship.

Looking at research on the
common symptoms the effect it has on
relationships and treatments for postnatal depression. Postnatal Depression (PND) However, new fathers, are often not recognised or thought to
deserve treatment. However, it is a significant cause of psychological distress and may
result in physical symptoms, deterioration in family relationships, negative
father-baby bonding, and domestic violence, as well as substance abuse and
addiction. (Thomas. 2016)

The causes of PPND are varied, ranging from
the presence of marital dissatisfaction before
the birth of the baby to comorbid mental health conditions such as
obsessive-compulsive disorder. These may hinder proper father-infant bonding,
contribute to increased stress after the baby’s birth, result in negative
thoughts about the baby, and lead to an
overall decline in the functioning of the father in the family. (Thomas. 2016)

Moreover, sex: For most couples, intimacy and the frequency of intercourse changes or weeks or months after having a baby. After delivery, there is common discomfort and pain with intercourse for women, and most couples are exhausted after sleepless days and nights of caring for a newborn. Combine that with the demand of breastfeeding for those who go this route, and many couples will spend much less time being intimate. In fact, one study showed that 50% women and 20% men report reduced sexual responsiveness for 6-12 months postpartum (NHS Choice 2015).  Moreover, one-third of couples with a report this 2/3 years after birth. Women who are struggling with depression will have an extra challenge here as lowered libido is one of the general symptoms of depression and at times a side effect of antidepressant medication. (Kripke, 2011)

Depression in the mother increases the risk
of paternal PND by a factor of 2.5, leading to an incidence of 24-50 percent in
fathers. Thus, it is important to provide support for both parents in a family
where maternal PND is present and to
actively explore the possibility of PND in the father in such settings. Men are
less likely to speak about or even recognise
such feelings, and they may, therefore,
need more assistance to seek intervention promptly (Thomas, 2016)

According to (Ramachandran et al., 2008) What symptoms to look for and how long after and during pregnancy does it affect fathers. Children whose fathers were depressed in both the prenatal and postnatal periods had the highest risks of subsequent psychopathology, measured by total problems at age 3½ years Odds Ratio 3.55; 95% confidence interval 2.07, 6.08 and psychiatric diagnosis at age seven years or 2.54; 1.19, 5.41.  Therefore, few differences emerged when prenatal and postnatal depression exposure directly compared, but when compared to fathers who were not depressed (Bazemore, 2010).

Boys whose fathers had
postnatal depression had higher rates of conduct problems aged 3½ years or
2.14; 1.22, 3.72 whereas sons of the prenatal group did not or 1.41; .75, 2.65. These associations changed little when
controlling for maternal depression and other potential confounding factors. Postnatal depression is most likely to affect dads during the
first year of parenthood (Bazemore, 2010)

Dads appear to be most vulnerable to depression when their baby is between
three months and six months’ age of dad can play a part as a young dad are a
more likely to become depressed (Baby Centre Medical Advisory
Board, 2014). However, the hypothesis is more than 10% of fathers suffer from psychiatric morbidity in the
postnatal period. Depression amongst fathers associated with having depressed partners,
having an unsupportive relationship and being unemployed (Baby Centre Medical
Advisory Board, 2014)

Paternal postpartum
depression may affect not only the mental health and wellbeing of fathers but
their partners and children. We investigated the point and period prevalence of
paternal postpartum depression and its association with factors measured during
pregnancy in a regional longitudinal study in Nishio City, Aichi Prefecture,
Japan, between December 1, 2012, and April 30, 2013. Data were collected once
in pregnancy and five times in the first three months postpartum (Suto et al., 2016).

The Edinburgh Postnatal
Depression Scale was used to assess parental
depression, and data collected in
pregnancy on demographic and psychosocial factors. Of 215 fathers who returned
at least one of the five postpartum assessments, 36 (17%) reported symptoms of
depression in the first three months after birth. In logistic regression
analyses, among some demographic and
psychosocial characteristics that previously had
linked to paternal postpartum depression, only fathers’ history of
psychiatric treatment and depressive symptoms during pregnancy were associated
with paternal depressive symptoms in the postnatal period. (YiongWee, 2010)

The results add to the
growing body of evidence on the prevalence
of paternal postnatal depression and indicate that assessment and support for
fathers are necessary starting in
pregnancy (Massoudi
et al., 2016). It most likely that parents
who are affected by postnatal depression occurred within the first year of parenthood. Between three months and six months, it plays a big part where the dad needs
to adjust everyday life which can make them feel overwhelmed.

They can become stress because of increased
responsibility, and they take on more
pressure with supporting their families. They have less spare time for them
self because they need to develop a new routine around the baby. Which then affect their social life, they
then feel isolated. Spending less time with their partners because mums are more
focussing on baby and they start to feel life out and becoming unsure of their
roles as dads. Also, can bring changes in the relationship which
leads to arguments and stress (Edmondson, 2010).

Therefore, in some changes that fathers may experience in their
body are a loss of appetite, tearfulness,
poor sleep, restlessness, poor memory or concentration. Therefore, may also notice changes in their behaviour like finding it
difficult to bond with their baby and participating in everyday family
activities. Because of how they feel, cutting himself away from their families
and friends, finding it difficult to see the fun side of the situation, getting
obsessive with certain routine around the house like cleaning and doing
physical activities (Massoudi et al., 2016).

 Also putting a plan in action, take a timeout for 20-30 minutes a
day, going for walks with mum and baby as
a family who
can help to settle the baby and can be therapeutic for both dad and mum. Also
talking to the family general practitioner (GP) who can offer guidance and help
to the family . also can prescribe medication if needed,  such as antidepressant that can help with
symptoms of depression. Also getting counselling or seeking therapy contribute
who also can underline the factors that contribute to postnatal depression and
aid to changes in feeling. (NHS Choice, 2015)

Project
Outcomes:
postnatal depression is most likely to affect dads during the first year of
parenthood. Dads appear to be most vulnerable to depression when their baby is
between three months and six months’ however the age of dad can play a part as
a young dad are more likely to become depressed (Baby Centre
Medical Advisory Board. 2014).

The
most common correlate of paternal depressive symptoms pre- and post-birth was
having a partner with elevated depressive symptoms, depression and poor
relationship satisfaction was also frequently associated with elevated
depressive symptoms and depression in men. (Milgrom et al., 2011)

Recommendations for the future

In using
a planning outcome for this project is to develop an approach that encourages a person-centred approach in dealing
with dads that have postnatal depression.
Moreover, to provide staff with the
information to prevent outburst behaviour in the work setting.

This project
will enable my development, more
understanding and awareness of postnatal depression in men and explores what
risk associated with the support needed for dads. Also, to give guidance to help dads and the role the early year practitioner
plays in the deterrence of postnatal depression.

I would also evaluate my understanding to develop my
knowledge around this project, and my learning needs enhance strategies to support
dad who use our childcare provision to prevent further currents in depression.

Also by completing a self-evaluation of an
understanding of my development needs to
give further support where needed however to review the resources of myself learning needs, and the use of advice
and tip from my tutors to prepare me for independent study. Also by using a structured time frame, and use
a planning solution to any problem risen. By use
of articles, books, the internet, booklets, library facilities, feedback from
the class teacher, journals, manager assistance, trainer input, discussion with
colleagues. Considering Policies and the
well-being of families. Eventually to
encourage staff to be a life-long learner.

Also, to
develop and gather more in-depth information, in widen the understanding and
support the emotional side of this topic, and the way in going forward in
promoting a good standard of service. Also using of my
development tools through supervision and appraisals, working practice,
communication within the multi-disciplinary
team. Moreover, the practice based evidence of parent in postnatal depression
issues.

Also, to use some of this
research information to help and support our new fathers in the future and my current workplace. Working together with
information centres to gather feedback information to parents who are having difficulty
in working together in picking up the children and having confrontation regard
relation. Also, to identifying training needs for staff so they can have better knowledge and understanding of
postnatal depression so they can support dads and inform them where to access
help.

Recommendations Several
general principles underpin the process of postnatal depression in men, and some have studied in randomised trials and systematic reviews. Substantial
evidence supports multidisciplinary team in support men with postnatal
depression. Research on integrated care pathways is limited by the lack of
randomised trials in postnatal depression in men, suggesting that such formal
paths might be no more effective than support from a well-functioning
multidisciplinary team. Good support outcomes seem to associate with high patient motivation and engagement firmly in working
together in parental partnership. Setting goals that replicate the
specific aims of an individual may improve outcome, although no extensive
published work yet exists on goal setting in postnatal depressive support for
men.

Conclusion

In conclusion to this research in general, about one to ten fathers have postnatal depression which can sometimes be hard to find so to make improvements on supporting dads in general, health visitors, and midwives should develop a care plan where it supports both mums, dads within the first year of baby life. They should implement transferability strategy into the training and home visiting to guide staff of awareness of postnatal depression in fathers.

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