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Uvod: Posttravmatska stresna motnja je duševna motnja, ki se lahko pojavi pri osebah po izpostavljenosti travmatični izkušnji ali dogodku. Tudi porod se lahko razume kot povod za posttravmatsko stresno motnjo, če ga ženska tako doživi. Porodna travma je lahko objektivna, ko pride pri porodu do zapletov, ali pa subjektivna, ko ženska porod dojema kot stresni dogodek, čeprav poteka brez zapletov. Ta stresna motnja ovira ženskino vsakodnevno delovanje uničevalen vpliv ima tudi na medsebojne odnose, predvsem na odnos s partnerjem ter otrokom. Namen: Z diplomskim delom smo želeli opredeliti pojem manj poznane poporodne posttravmatske stresne motnje ter določiti vlogo medicinske sestre pri bolj okrnjenih temeljnih življenjskih aktivnostih. Metode dela: V diplomskem delu smo uporabili deskriptivno metodo in pregledali literaturo, objavljeno med leti 2009-2022. Uporabili smo vse dostopne članke, objavljene v angleškem ali slovenskem strokovnem jeziku, ki so bili skladni z vsebino teme. Do njih smo z oddaljenim dostopom Univerze Ljubljana dostopali v podatkovnih bazah Cinahl, Medline, ScienceDirect, Wiley online library ter v spletnem brskalniku Google učenjak. Iskanje literature je potekalo od februarja do aprila 2022 za diplomsko nalogo smo na koncu uporabili 50 enot literature. Razprava in zaključek: Identifikacija pacientk, ki so ogrožene v smislu razvoja poporodne posttravmatske stresne motnje je ključnega pomena. Medicinske sestre, zaposlene na perinatalnih področjih, so postavljene v položaj, da jih z opazovanjem ter ustrezno komunikacijo prepoznajo in omogočijo nadaljnjo oskrbo tudi po odpustu iz porodnišnice. S pacientko moramo vzpostaviti zaupljiv odnos, v katerem se bo počutila varno in nam lahko opisala svojo porodno izkušnjo. Če se poporodna posttravmatska stresna motnja razvije, se pri teh pacientkah pojavljajo težave predvsem pri življenjskih aktivnostih spanja, čustvovanja ter medsebojnih odnosih, gibanja in rekreacije ter prehranjevanja. Medicinska sestra mora v tej fazi izvajati predvsem svetovanje ter zdravstveno-vzgojno izobraževanje, da se bo pacientka lahko s simptomi posttravmatske stresne motnje učinkovito spopadala in ta ne bo prizadela kvalitete njenega življenja. Introduction: Post-traumatic stress disorder is a mental disorder that can occur in individuals after exposure to a traumatic experience or event. Childbirth can be a cause of post-traumatic stress disorder too if a woman perceives it to be traumatic. Childbirth trauma can either be objective or subjective. Complications in birth are not necessary for a woman to perceive birth as a traumatic experience as it can be a matter of personal experience as well. This stress-related disorder interferes with a woman's daily activities and has a devastating effect on interpersonal relationships, especially with her partner and child. Purpose: The purpose of the bachelor’s thesis was to define the concept of lesser-known postpartum post-traumatic stress disorder and to determine the role of a nurse in the basic life activities of a patient with this illness. Methods: We used the descriptive method and reviewed the literature published between 2009-2010. We used fully accessible articles published in English or Slovenian language. Articles also had to be relevant to the topic of our bachelor’s thesis. We used remote access to the University of Ljubljana to browse databases Cinahl, Medline, Wiley online library, Science direct, and web browser Google Scholar. The literature search took place from February to April 2022. For the bachelor’s thesis, we finally used 50 units of literature. Discussion and conclusion: Identification of patients at risk for developing postpartum post-traumatic stress disorders remains crucial. Perinatal nurses are placed in an ideal position to recognize such patients and enable further care even after discharge from maternity wards. The nurse needs to establish a trusting relationship in which patients feel safe and can describe and express their feelings about their birth experience. In patients with postpartum post-traumatic stress disorder, problems, such as sleeping disorders, damaged relationships, eating disorders, and a lack of exercise, occur. At this stage, the nurse provides counseling and health education primarily so that women can improve their quality of life and deal with symptoms of post-traumatic stress disorder effectively.

Zaradi pomanjkanja tovrstnih raziskav in literature na slovenskem območju smo si z našo raziskavo zadali nalogo preučiti poporodno posttravmatsko stresno motnjo (PP-PTSM), njeno prevalenco v slovenski populaciji in komorbidnost s poporodno depresijo (PPD). Zanimal nas je tudi vpliv travme iz otroštva tako na razvoj PP-PTSM kot tudi na PPD. Vprašalnik je v celoti izpolnilo 361 žensk, ki so rodile v zadnjih 12 mesecih, delno pa 434 žensk, a smo jih zaradi izpolnitve vsaj dveh vprašalnikov vseeno vključili v raziskavo. Večina (72,1 %) udeleženk je bilo starih od 25 do 35 let. Za merjenje poporodnega depresivnega razpoloženja smo uporabili Edinburško lestvico poporodne depresije – EPDS, z Lestvico porodne travme – CityBiTS smo merili poporodno PTSM, izkušnje travme v otroštvu in mladostništvu pa smo ocenjevali z retrospektivnim merskim instrumentom CTQ. Pri 116 udeleženkah je bila izmerjena visoka verjetnost depresije. 10 udeleženk je izpolnjevalo vse kriterije za PP-PTSM. Največ udeleženk (17,3 %) je v otroštvu doživelo emocionalno zanemarjanje, temu sledijo emocionalna zloraba (10,9 %), fizično zanemarjanje (10,6 %), spolna zloraba (9,7 %) in fizična zloraba (5,8 %). Zaznali smo razlike v izraženosti depresivnega razpoloženja in simptomov PTSM med skupinama žensk, ki so porodile zdravega otroka, in tistimi, ki so izgubile otroka med nosečnostjo, po porodu ali s prisotnimi zdravstvenimi zapleti pri novorojencu. Skupini, razdeljeni glede na izkušnjo poroda, se razlikujeta v izraženosti depresivnega razpoloženja. Rezultati raziskave so pokazali povezavo med travmo iz otroštva in pojavnostjo simptomov PPD in PP-PTSM. Na našem vzorcu sta s PP-PTSM najizraziteje povezana emocionalna zloraba in fizično zanemarjanje, s PPD pa emocionalna zloraba. Analiza je pokazala tudi visoko, statistično pomembno korelacijo med simptomi PPD in PP-PTSM. Due to the lack of such research and literature in Slovenian language, our study aimed to investigate postpartum post-traumatic stress disorder (PP-PTSD), its prevalence in the Slovenian population and comorbidity with postpartum depression (PPD). We were also interested in the impact of childhood trauma on the development of both PP-PTSD and PPD. The questionnaire was fully completed by 361 women who gave birth in the past 12 months. 434 completed the survey only partially, but were still included because they completed at least two of the questionnaires. Majority (72.1 %) participants were between 25 and 35 years old. The Edinburgh Postnatal Depression Scale (EPDS) was used to measure postnatal depressed mood, the Childbirth Trauma Scale (CityBiTS) was used to measure postnatal PTSD, and childhood and adolescent trauma experiences were assessed with the CTQ retrospective instrument. 116 participants were measured as having a high probability of depression and 10 participants met full criteria for PP-PTSM. Most female participants (17.3 %) experienced emotional neglect in childhood, followed by emotional abuse (10.9 %), physical neglect (10.6 %), sexual abuse (9.7 %) and physical abuse (5.8 %). We found differences in the expression of depressed mood and symptoms of PTSD between the groups of women who gave birth to a healthy baby and those who lost a baby during pregnancy, after delivery or with medical complications for the newborn. The two groups divided according to the experience of childbirth differ in the expression of depressed mood. The results of the study showed an association between childhood trauma and the incidence of PPD and PP-PTSD symptoms. In our sample, emotional abuse and physical neglect are most strongly associated with PP-PTSD, while emotional abuse is most strongly associated with PPD. The analysis also showed a high statistically significant correlation between PPD symptoms and PP-PTSD.