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The psychiatric units were those providing the Comprehensive Child Development Service (CCDS) for the early identification and management of postnatal depression in Chinese women in Hong Kong.
Current guidelines state that health visitors and GPs should continue to have a major role in the detection and management of postnatal depression.
Because of the adverse consequences for the mother, the child and the family as a whole, the early identification and management of postnatal depression is an important public health concern.
The construction of 'depression' as a clinical condition is contested amongst GPs[ 22- 24] but there is little published work on the role played by GPs in the management of postnatal depression.
An interview guide provided a flexible framework for questioning and explored a number of topics: models of postnatal depression; diagnosis and management of postnatal depression; the patient-professional relationship; professional-professional relationships and ways of working.
Glazener et al 2005 [ 17] in their 6 year follow-up of a randomised controlled trial of conservative management of postnatal urinary and faecal incontinence found no differences between their intervention and standard care groups at 6 years following a 1 year difference of 9%.
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No studies were identified which had evaluated models of management of pregnant or postnatal women with the conditions of interest.
Respondents were asked to nominate colleagues they felt to be particularly influential in their day-to-day practice in the clinical management of women with postnatal depression.
On the basis of very limited evidence NICE in 2007 [ 17] recommended in their guidance on the management of antenatal and postnatal mental health that exercise should be considered as a treatment for women who develop mild or moderate depression during the postnatal period.
Instead, we suggest that a whole system approach[ 35], with intervention at the level of the patient, practice and extended primary care team, will be necessary to improve women's willingness to disclose, health professionals' ability to listen and intervene, and a system that will facilitate management of women with postnatal depression.
Based on general population evidence and findings from two very small trials (total n = 39) that recruited women with PND, in 2006 NICE [ 17] recommended in their guidance on the management of antenatal and postnatal mental health, that health professionals should consider exercise as a treatment for PND.
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