A qualitative meta-synthesis of challenges in screening and intervention for paternal depression

Abstract

Purpose The purpose of this study was to identify the following two research questions for paternal depression through a meta-analysis of relevant qualitative studies: 1. How has paternal depression been screened for by professionals? 2. What are the coping strategies /support available for paternal depression and the challenges in providing strategies/ support for paternal depression? Methods Relevant articles were identified using the following databases: CINAHL, MEDLINE, and Google Scholar. The search keywords used were 'support' AND 'postpartum depression of father' OR 'paternal depression' OR 'mental health of fathers' AND 'qualitative study' in the database. There were 32 qualitative articles retrieved from the database and through hand searching, of which 5 articles were included in the analysis. Meta-ethnography were utilised in this study. All analysed papers were scored and guaranteed by the Critical Appraisal Skills Program (CASP; 0-10 points) as valuable qualitative studies. The analysis was performed using NVivo 12 for Windows. Results In the present meta-synthesis, the Patient Health Questionnaire -9 (PHQ-9), Generalized Anxiety Disorder-7 (GAD-7), the Patient Health Questionnaire -15 (PHQ-15), and the List of Threatening Events were used to identify depression in fathers. Additionally, one study used the six criteria of the definition of postnatal depression to identify paternal depressive symptoms. As a result of the meta-synthesis, the following eight metaphors were extracted from all analyses articles: 'Triggers of paternal depression'; 'Awareness of paternal depression'; 'The Impact of paternal depression'; 'Coping'; 'Lack/unhelpful of information resources'; 'Barriers to seeking help'; 'Reasons for needing supports'; and 'Helps for paternal depression'. Paternal depression due to a sequence of triggering events and the perceived symptoms varied. Once fathers realized they had depression, they attempted to cope with it. However, there were inadequate therapies and information to cope with depression. Moreover, embarrassment of seeking help due to being male was also a barrier to coping with depression. In contrast, the responsibility to protect the family motivated them to acknowledge their depression and seek social support and professional help. Conclusion Anxiety and general depression scales were used to screen for paternal depression, and no measures for paternal depression were not used. Men who were aware of paternal depression tried to cope with it; however, it is possible that support for paternal depression was not sufficiently available and that masculinity may also be a barrier to seeking help for depression. On the other hand, the responsibility of protecting their families motivated fathers to be proactive in seeking help to overcome depression.