Empirical test of an explanatory theory of postpartum fatigue in Korea

Aim. This paper is a report of a study designed to test an explanatory theory of postpartum fatigue. Background. Postpartum fatigue is influenced by various factors and affects a mother's performance. A full understanding of postpartum fatigue is very important for developing effective nursing strategies to reduce postpartum fatigue and enhance mothers' performance. Methods. Healthy postpartum women were recruited from five medical centers and one midwifery office in urban area in Korea (n=291) by convenience sampling. Data were collected at 4- to 8-week follow-up visits after childbirth in 2006, using a self-report questionnaire. The proposed fatigue theory incorporated postpartum fatigue, postpartum depression, sleep quality, childcare stress, unsatisfactory feeding, social support, infant difficulty and satisfaction with Sanhujori, the Korean traditional postpartum care provided for 3weeks following delivery by non-professional caregivers. Structural equation modelling was used to test the explanatory theory of postpartum fatigue. Results. The modified fatigue theory showed good fit and high compatibility with the empirical data. In the final explanatory theory, postpartum depression and sleep quality directly affected postpartum fatigue, while childcare stress and the cultural phenomenon of Sanhujori had indirect effects on postpartum fatigue, via postpartum depression and sleep quality respectively. Conclusion. These findings suggest the potential role of comprehensive nursing focused on decreasing postpartum depression and improving sleep quality as a way to decrease postpartum fatigue. Also, nursing strategies for decreasing childcare stress and enhancing Sanhujori satisfaction may be helpful in reducing postpartum fatigue in Korean mothers.