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Top1. Introduction
Postnatal Depression [PND] is a mental disorder of significant public health concern. Previous studies report that 13% of women having babies suffer from PND (Glover, Onozawa, & Hodgkinson, 2002; O’Mahen et al., 2014). It is one of the leading causes of maternal morbidity and mortality (Shefaly et al., 2019). PND can make individuals feel lonely, anxious, and afraid, putting them and their families in danger. It has well-documented health consequences for the mother, child and her family (Dennis & Chung-Lee, 2006; Dennis et al., 2012). Children of moms with PND have a higher chance of developing mental health problems during adolescence (Milgrom et al., 2021).
Several effective interventions for PND have emerged in recent years (Huang et al., 2018: Kaltenthaler et al., 2008; Morrell, 2006; Proudfoot et al., 2004; Torous, Friedman & Keshavan, 2014; Yonkers et al., 2008; Nisris, Reebye, Corral & Mills, 2004; Hoffbrand, Howard, Crawley, 2001). A primary concern, however, is that only very few women with PND consistently comply with using treatments provided to them (Goodman, Tyer-Viola, 2010; Thombs et al., 2015). A growing body of literature recognises the importance of adherence to PND treatment intervention. Adherence refers to the extent to which a patient follows a prespecified treatment regimen or protocol (Vandenberk, et al., 2019). Research confirms that non-adherence to treatment is a significant problem. It is estimated that one out of every three depressed patients does not complete their prescribed treatment (Pampallona et al., 2002). In addition, due to barriers, receiving treatment for PND and sustaining it over the long term has been proven to be very difficult. Obstacles could include difficulties with newborn feeding demands and napping schedules, making it difficult to keep regular treatment schedules (O'Mahen et al., 2015).
Non-adherence has been identified as a critical factor impeding increased treatment outcomes for PND (Cuijpers et al., 2008; De Graaf et al., 2009; Dennis & Chung-Lee, 2006; Gonzalez et al., 2005; Omisade et al., 2020; Pampallona et al., 2002). This can increase the cost of service in financial terms and in the investment of time and effort. Therefore, interventions are needed to overcome the barriers to treatment adherence, sustained outcome and overall, the poor well-being of women with PND. Unfortunately, to the best of our knowledge, no research has examined the techniques to improve the quality of adherence to PND-prescribed treatments to date.