Feasibility of Utilizing E-Mental Health with Mobile APP Interface for Social Support Enhencement: A Conceptional Solution for Postpartum Depression in Taiwan

  • Wen-Ko ChiouEmail author
  • Chun-Ying Kao
  • Liang-Ming Lo
  • Ding-Hau Huang
  • Ming-Hsu Wang
  • Bi-Hui Chen
Conference paper
Part of the Lecture Notes in Computer Science book series (LNCS, volume 10289)


Postpartum depression (PPD) is a common issue in global scale. Social support enhancement were proved to be effective for reducing PPD. Currently, there are few researches in Taiwan concerning the subject which were mentioned above. In the other hand, applying E-mental health (EMH) services for social support enhancement has become a trend in modern society. However, few EMH services were designed to target PPD audiences. This research aims to investigate the condition of PPD and social support in Taiwan, in addition, the research also took a look into local reception of EMH services. Questionnaire had been applied to 224 postpartum women through clinical field and forums on the Internet. The result indicates that 27.7% of participant shows potential high risk for PPD, the rate of potential high risk is higher than global average. Negative Correlation between PPD and social support were confirmed. Participants receive more informal social support compares to formal social support. Approximately 90% of the participants were user of EMH services (Social media, Chatroom, Internet forum/Bulletin Board System). About 30% of the participant utilize smartphone APP for EMH services, 25% the participant were unaware of the existence of smartphone APP for EMH services. According to the result, smartphone APP for EMH services were proposed to be a suitable solution for PPD in Taiwan.


Mobile application interface Postpartum depression Social support E-Mental health Edinburgh postnatal depression scale 



We have an appreciation for Drs. Zimet, Teng, and Shen, whom provide the permission of using the assessments. On the other hand, many thanks for Dr. Lo provide participants in the clinic to implement the experimental programs.


  1. 1.
    Wisner, K.L., Parry, B.L., Piontek, C.M.: Postpartum depression. N. Engl. J. Med. 347(3), 194–199 (2002)CrossRefGoogle Scholar
  2. 2.
    Gavin, N.I., et al.: Perinatal depression: a systematic review of prevalence and incidence. Obstet. Gynecol. 106(5, Part 1), 1071–1083 (2005)CrossRefGoogle Scholar
  3. 3.
    Vesga-López, O., et al.: Psychiatric disorders in pregnant and postpartum women in the United States. Arch. Gen. Psychiatry 65(7), 805–815 (2008)CrossRefGoogle Scholar
  4. 4.
    Milgrom, J., et al.: Antenatal risk factors for postnatal depression: a large prospective study. J. Affect. Disord. 108(1), 147–157 (2008)CrossRefGoogle Scholar
  5. 5.
    Robertson, E., et al.: Antenatal risk factors for postpartum depression: a synthesis of recent literature. Gen. Hosp. Psychiatry 26(4), 289–295 (2004)MathSciNetCrossRefGoogle Scholar
  6. 6.
    Cox, J.L., Holden, J.M., Sagovsky, R.: Detection of postnatal depression: development of the 10-item Edinburgh postnatal depression scale. Br. J. Psychiatry 150(6), 782–786 (1987)CrossRefGoogle Scholar
  7. 7.
    Boyd, R.C., Le, H., Somberg, R.: Review of screening instruments for postpartum depression. Arch. Women’s Mental Health 8(3), 141–153 (2005)CrossRefGoogle Scholar
  8. 8.
    Hirst, K.P., Moutier, C.Y.: Postpartum major depression. Women 100, 17–19 (2010)Google Scholar
  9. 9.
    Field, T., et al.: Yoga and social support reduce prenatal depression, anxiety and cortisol. J. Bodywork Mov. Ther. 17(4), 397–403 (2013)MathSciNetCrossRefGoogle Scholar
  10. 10.
    Beck, C.T.: Predictors of postpartum depression: an update. Nurs. Res. 50(5), 275–285 (2001)CrossRefGoogle Scholar
  11. 11.
    Robertson, E., Celasun, N., Stewart, D.: Risk Factors for Postpartum Depression (2003)Google Scholar
  12. 12.
    Gottlieb, B.H., Bergen, A.E.: Social support concepts and measures. J. Psychosom. Res. 69(5), 511–520 (2010)CrossRefGoogle Scholar
  13. 13.
    Thoits, P.A.: Mechanisms linking social ties and support to physical and mental health. J. Health Soc. Behav. 52(2), 145–161 (2011)CrossRefGoogle Scholar
  14. 14.
    Hogan, B.E., Linden, W., Najarian, B.: Social support interventions: do they work? Clin. Psychol. Rev. 22(3), 381–440 (2002)CrossRefGoogle Scholar
  15. 15.
    Logsdon, M.C., Davis, D.W.: Social and professional support for pregnant and parenting women. MCN Am. J. Matern. Child Nurs. 28(6), 371–376 (2003)CrossRefGoogle Scholar
  16. 16.
    Wilkins, C.: A qualitative study exploring the support needs of first-time mothers on their journey towards intuitive parenting. Midwifery 22(2), 169–180 (2006)CrossRefGoogle Scholar
  17. 17.
    Doucet, S., Letourneau, N., Blackmore, E.R.: Support needs of mothers who experience postpartum psychosis and their partners. J. Obstet. Gynecol. Neonatal. Nurs. 41(2), 236–245 (2012)CrossRefGoogle Scholar
  18. 18.
    Leahy Warren, P.: First-time mothers: social support and confidence in infant care. J. Adv. Nurs. 50(5), 479–488 (2005)CrossRefGoogle Scholar
  19. 19.
    Leahy-Warren, P., McCarthy, G., Corcoran, P.: First-time mothers: social support, maternal parental self-efficacy and postnatal depression. J. Clin. Nurs. 21(3–4), 388–397 (2012)CrossRefGoogle Scholar
  20. 20.
    Häggman-Laitila, A.: Early support needs of Finnish families with small children. J. Adv. Nurs. 41(6), 595–606 (2003)CrossRefGoogle Scholar
  21. 21.
    Dennis, C.-L.: Postpartum depression peer support: maternal perceptions from a randomized controlled trial. Int. J. Nurs. Stud. 47(5), 560–568 (2010)CrossRefGoogle Scholar
  22. 22.
    Santor, D.A., et al.: Online health promotion, early identification of difficulties, and help seeking in young people. J. Am. Acad. Child Adolesc. Psychiatry 46(1), 50–59 (2007)CrossRefGoogle Scholar
  23. 23.
    Heron, K.E., Smyth, J.M.: Ecological momentary interventions: incorporating mobile technology into psychosocial and health behaviour treatments. Br. J. Health. Psychol. 15(1), 1–39 (2010)CrossRefGoogle Scholar
  24. 24.
    Khanna, M.S., Kendall, P.C.: Computer-assisted cognitive behavioral therapy for child anxiety: results of a randomized clinical trial. J. Consult. Clin. Psychol. 78(5), 737 (2010)CrossRefGoogle Scholar
  25. 25.
    Scharer, K.: An internet discussion board for parents of mentally ill young children. J. Child Adolesc. Psychiatr. Nurs. 18(1), 17–25 (2005)CrossRefGoogle Scholar
  26. 26.
    Shaw, L.H., Gant, L.M.: In defense of the Internet: The relationship between Internet communication and depression, loneliness, self-esteem, and perceived social support. Cyberpsychol. Behav. 5(2), 157–171 (2002)CrossRefGoogle Scholar
  27. 27.
    Cavallo, D.N., et al.: A social media–based physical activity intervention: a randomized controlled trial. Am. J. Prev. Med. 43(5), 527–532 (2012)CrossRefGoogle Scholar
  28. 28.
    Herring, S.J., et al.: Using technology to promote postpartum weight loss in urban, low-income mothers: a pilot randomized controlled trial. J. Nutr. Educ. Behav. 46(6), 610–615 (2014)CrossRefGoogle Scholar
  29. 29.
    Martínez-Pérez, B., De La Torre-Díez, I., López-Coronado, M.: Mobile health applications for the most prevalent conditions by the World Health Organization: review and analysis. J. Med. Internet Res. 15(6), e120 (2013)CrossRefGoogle Scholar
  30. 30.
    Shen, N., et al.: Finding a depression app: a review and content analysis of the depression app marketplace. JMIR mHealth uHealth 3(1), e16 (2015)CrossRefGoogle Scholar
  31. 31.
    Zimet, G.D., et al.: The multidimensional scale of perceived social support. J. Pers. Assess. 52(1), 30–41 (1988)CrossRefGoogle Scholar
  32. 32.
    Teng, H.-W., et al.: Screening postpartum depression with the Taiwanese version of the Edinburgh Postnatal Depression Scale. Compr. Psychiatry 46(4), 261–265 (2005)CrossRefGoogle Scholar
  33. 33.
    Navaratne, P., Foo, X.Y., Kumar, S.: Impact of a high Edinburgh Postnatal Depression Scale score on obstetric and perinatal outcomes. Sci. Rep. 6 (2016)Google Scholar
  34. 34.
    Nielsen, D., et al.: Postpartum depression: identification of women at risk. BJOG Int. J. Obstet. Gynaecol. 107(10), 1210–1217 (2000)MathSciNetCrossRefGoogle Scholar
  35. 35.
    Onozawa, K., et al.: High EPDS scores in women from ethnic minorities living in London. Arch. Women’s Ment. Health 6, s51–s55 (2003)CrossRefGoogle Scholar
  36. 36.
    Huang, Y.C., Mathers, N.: Postnatal depression–biological or cultural? A comparative study of postnatal women in the UK and Taiwan. J. Adv. Nurs. 33(3), 279–287 (2001)CrossRefGoogle Scholar
  37. 37.
    Heh, S.-S., Coombes, L., Bartlett, H.: The association between depressive symptoms and social support in Taiwanese women during the month. Int. J. Nurs. Stud. 41(5), 573–579 (2004)CrossRefGoogle Scholar
  38. 38.
    Horowitz, J.A., et al.: A community-based screening initiative to identify mothers at risk for postpartum depression. J. Obstet. Gynecol. Neonatal. Nurs. 40(1), 52–61 (2011)CrossRefGoogle Scholar
  39. 39.
    Nicole, L., et al.: Canadian mothers’ perceived support needs during postpartum depression. J. Obstet. Gynecol. Neonatal. Nurs. 36(5), 441–449 (2007)CrossRefGoogle Scholar
  40. 40.
    Declercq, E.R., et al.: Listening to Mothers III: Pregnancy and Birth, p. 53. Childbirth Connection, New York (2013)Google Scholar

Copyright information

© Springer International Publishing AG 2017

Authors and Affiliations

  • Wen-Ko Chiou
    • 1
    Email author
  • Chun-Ying Kao
    • 1
  • Liang-Ming Lo
    • 2
  • Ding-Hau Huang
    • 3
  • Ming-Hsu Wang
    • 4
  • Bi-Hui Chen
    • 5
  1. 1.Department of Industrial DesignChang Gung UniversityTao-YuanTaiwan
  2. 2.Department of Obstetrics and GynecologyChang Gung Memorial HospitalTaipeiTaiwan
  3. 3.College of Management and DesignMing Chi University of TechnologyNew TaipeiTaiwan
  4. 4.Graduate School of ManagementChang Gung UniversityTao-YuanTaiwan
  5. 5.Department of Business AdministrationChihlee University of TechnologyNew TaipeiTaiwan

Personalised recommendations