Educational technologies to encourage (self) care in postpartum women

an integrative review of the literature. The articles were collected from the CINAHL, SCOPUS, PubMed, SciELO, LILACS and Cochrane databases; the time period for the articles referred to January/2004 to July/2014; the languages used in the articles were Portuguese, English, Spanish and French; the articles were selected from the following descriptors: postpartum care period, educational technology, nursing and self care. Twenty-seven articles were selected for analysis

Results:

based on the information found, the scales, counseling and home visits were among the most recommended educational technologies.

Conclusion:

the technologies promote communication, but are sometimes dependent on computer and internet access, which hinder their use by low-income women.

Descriptors:
Postpartum Period; Educational Technology; Nursing; Self Care; Review

N°	Title	Year Country	Design Number of patients	Treatments	Outcomes *P value, Odds ratio* or RR and CIs**
1	Documentation system prototype for postpartum nursing	2013 Brazil	Applied technological development research	Software on the Systematization of Nursing Care	Documentation system: nursing records by means of standardized language.
2	Influence of an educative intervention on the knowledge level about the practice of self-care during the postpartum period in adolescents	2008 Peru	Quasi-experimental study n = 86	Interviews, image exhibitions and a self-care pamphlet	Before the intervention, there was an average level (52.3%), with an overall average of 24.5 ± 10.4; after the intervention, the level of knowledge increased (100%), with an average of 94.5 ± 1.2.
3	Practices used by women at post-birth on nipple problems	2006 Brazil	Qualitative study, of convergent-assistential type n = 14	Interview during a home visit	Promoting breastfeeding by discussing the topic in the mass media is the suggestion to achieve a greater number of children being exclusively breastfed until at least six months of age.
4	A randomized controlled trial of the effectiveness of a postnatal psychoeducation programme on outcomes of primiparas: study protocol	2015 (first online publication in June 2014) Singapore	Randomized controlled study n = 114	Psychoeducation program using home visits and telephone calls	The psychoeducation program is potentially beneficial, guaranteeing greater social support to primiparas.
5	Does telephone lactation counselling improve breastfeeding practices?: a randomised controlled trial	2013 Malaysia	Single blind, randomized controlled trial n = 357	Telephone lactation counseling	There was a higher percentage of mothers in the intervention group (84.3%) who practiced exclusive breastfeeding, compared to the control group (74.7%)
6	Nurse home visits improve maternal/infant interaction and decrease severity of postpartum depression	2013 United States	Randomized clinical trial with three phases n = 134	Behavioral coaching to increase relational efficacy between depressed mothers and their babies	Treatment and control groups had significant increases in the quality of mother/infant interaction and decreases in depression severity (p ≤ 0,001).
7	The prevention and reduction of postpartum complications: Orem’s Model	2013 Turkey	Quasi-experimental study n = 63	Nursing process using Orem’s self-care model	Self-care agency pretest mean score was 97.13 ± 17.20, while the posttest mean score was 114.44 ± 13.72.
8	Communication technologies and maternal interest in health-promotion information about postpartum weight and parenting practices	2012 United States	Cross-sectional study n = 145	Internet and mail based program regarding parenting and weight loss counseling	The women were very interested in weight loss programs on the internet (35.9%) and by mail (38.9%) as they were in parenting counseling on the internet (44.8%) and by mail (38.6%).
9	The effect of health visitors’ postpartum home visit frequency on first-time mothers: cluster randomised trial	2011 Ireland	Randomized clinical trial n = 295	Home visits	Mothers from the intervention group were the most satisfied with the service and were less likely to use the emergency services for their babies at 8 weeks.
10	Psychometric testing of the Breastfeeding Self-Efficacy Scale-Short form among adolescents	2011 Canada	Methodological study n = 103	Scale to evaluate breastfeeding self-efficacy among adolescents	The Cronbach’s alpha coefficient was 0.84 for the antenatal evaluation and 0.93 for the postnatal evaluation.
11	Assessing women’s sexual life after childbirth: The role of the postnatal check	2011 Sweden	Descriptive, qualitative study n = 10	Counseling on sexual life after childbirth	The task-oriented counseling strategy was the obstetricians from the women and the subject-oriented one allowed the women to express their feelings and emotions better.
12	Identifying and supporting women with psychosocial issues during the postnatal period: evaluating an educational intervention for midwives using a before-and-after survey	2011 Australia	Quasi-experimental study n = 25	Educational program on psychosocial aspects	The participants felt more confident and competent to identify women in an abusive relationship (p = 0.002), encouraging them to talk about psychosocial issues (p = 0.02) and supporting them (p = 0.02).
13	A community-based screening initiative to identify mothers at risk for postpartum depression	2011 United States	Descriptive correlational n = 5169	Postpartum depression scale	674 women had EPDS scores ≥ 10; 185 women with elevated EPDS scores agreed to have a SCID diagnostic interview, and 144 were diagnosed with minor or major depression.
14	Translation and validation in French of a multidimensional scale to evaluate the degree of satisfaction during childbirth	2010 Switzerland	Validation study n = 116	Multidimensional scale to evaluate the degree of satisfaction during childbirth	The Cronbach’s alpha was 0.85. The mean score of satisfaction was 65.2 (± 12) with a minimum of 35.5 and a maximum of 86.4.
15	Effects of antenatal education on maternal prenatal and postpartum adaptation	2010 Turkey	Quasi-experimental study n = 120	Individual and group education for postpartum adaptation	While there was a statistically significant difference between the groups in terms of prenatal adjustment (p < 0.01), no difference was found in postpartum adaptation (p = 0.077).
16	breastfeeding knowledge and practices among mothers in Manisa, Turkey	2009 Turkey	Cross-sectional, descriptive study n = 158	breastfeeding counseling	The educational intervention was effective, with a mean pre-test score of 9.9 (SD 2.4; range 3-13) and post-test of 12.6 (SD 0.8; range 9-13), paired t = 15.3, df = 157, P < 0.001.
17	Prenatal and postpartum focus groups with primiparas: breastfeeding attitudes, support, barriers, self-efficacy, and intention	2006 United States	Descriptive, prospective study n = 8	Focus groups with primiparas on breastfeeding self-efficacy, attitude and intention, perception of support and anticipated barriers	In the prenatal groups, the major themes included beliefs that breastfeeding benefits both the mother and baby (benefits for mother and baby, availability of support, uncertainty regarding breastfeeding), and in the postpartum groups there were themes on the perception of breastfeeding itself and the importance and role of supportive others).
18	The effectiveness of a nurse-managed perinatal smoking cessation program implemented in a rural county	2006 United States	Quasi-experimental study n = 194	Nurse-managed smoking cessation program	Smoking cessation: 37.3% of the women from the experimental groups. 16.7% of the women from the control group (Pearson’s Chi2 test (n = 87) = 4.37, p = 0.037).
19	The association between depressive symptoms and social support in Taiwanese women during the month	2004 China	Correlational study n = 240	Chinese ritual as social support to reduce risk of depression	It was found that a higher the level of social support received by women in the first postpartum month resulted in a smaller the risk of depressive symptoms.It was found that a higher the level of social support received by women in the first postpartum month resulted in a smaller the risk of depressive symptoms.
20	Physical activity patterns and maternal well-being in postpartum women	2004 United States	Descriptive study n = 91	Physical activity for maternal well-being	Individuals with older children or those with no other children increased domestic activity and decreased maternal occupation compared to individuals with younger children or more than one child.
21	Effectiveness of an internet-based intervention enhancing Finnish parents’ parenting satisfaction and parenting self-efficacy during the postpartum period	2011 Finland	Quasi-experimental study n = 1300	Internet discussion forum on breastfeeding and baby care	The parenting satisfaction and parenting self-efficacy increased significantly both in the treatment group and in the control group during the postpartum period.
22	Parents’ experiences of using videoconferencing as a support in early discharge after childbirth	2009 Sweden	Descriptive study n = 9	Parent counseling through videoconferencing	The parents felt confident with using the technology and taking control of their privacy and also felt confident having their concerns heard and receiving replies.
23	Prevalence, self-efficacy and perceptions of conflicting advice and self-management: effects of a breastfeeding journal	2007 Australia	Clinical trial n = 276	Journal on breastfeeding	No statistically significant differences were noted between the treatment and control groups in breastfeeding prevalence at 12 weeks or in self-efficacy during hospitalization (65% versus 64.7%, p = 0.83).
24	Effects of listening to music on postpartum stress and anxiety levels	2010 China	Randomized clinical trial n = 77	Relaxing music	The study does not provide evidence that preselected music reduces stress and anxiety levels among postpartum women.

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[1] CORRESPONDING AUTHOR Eryjosy Marculino Guerreiro Barbosa E-mail: eryjosy@msn.com