Assessing and Managing Women With Depression: A Midwifery Perspective

Principle-based concept analysis: recognition in the context of nurse-patient interactions

AIM

This paper is a report of a principle-based concept analysis of recognition in the context of nurse-patient interactions.

BACKGROUND

Recognition is a concept employed in practice and research. Since nursing is patient-centred and care is problem-driven, the specificity and accuracy of recognition may have an impact on how nurses label patient phenomena, interventions initiated and patient outcomes.

DATA SOURCES

The data set included 98 English language articles published from 1997 to 2008 and retrieved through Medline and CINAHL searches.

METHODS

Principle-based concept analysis was used to examine the state of the science according to major perspectives of the philosophy of science. Conceptual components were integrated into a theoretical definition and the process of recognition was conceptually modelled.

FINDINGS

The scientific literature dealing with recognition in the context of nurse-patient interactions relies on implied meaning. Recognition is a process marked by an awareness of evidence coupled with the formulation of a conceptual label summarizing the identified pattern of patient phenomena. Contextual features of the nurse, patient and organization are relevant during nurse-patient interactions, resulting in pivotal points in nursing care. These pivotal points are the moments of recognition when the nurse consciously applies a summary label to interpreted evidence. Outcomes of recognition include a choice to act or not to act, each option carrying significant outcomes for nurses, patients, and at times, organizations.

CONCLUSION

A working definition was produced that will serve as a foundation for future concept-driven research to advance the concept toward greater precision and usefulness in nursing science.

A qualitative study of mild to moderate psychological distress during pregnancy

BACKGROUND

Psychological distress is common in the antenatal period. In England, psychological distress is classified as mild, moderate or severe but only those who suffer severe psychological distress are referred to the specialist mental health services. Those who suffer mild to moderate psychological distress are managed by the primary care services. However, little is know about the psychosocial experiences of pregnant women who suffer from mild-moderate psychological distress.

OBJECTIVE

This study explored the experiences of pregnant women who self-reported mild to moderate psychological distress during antenatal care.

DESIGN

A qualitative study. Data were collected using digitally recorded, face-to-face, semi-structured interviews. Data were analysed using framework analysis.

SETTING

A large teaching maternity hospital in North West England.

PARTICIPANTS

Twenty-four pregnant women who self-reported mild to moderate psychological distress to their midwife during routine antenatal care.

RESULTS

Three main themes emerged: the causes of, impact of, and ways of controlling self-reported mild to moderate psychological distress. A range of experiences caused psychological distress including past life and childbearing experiences, and current pregnancy concerns. Mild to moderate psychological distress took over the lives of these pregnant women. The strategies used to control mild to moderate psychological distress included both positive and negative coping elements.

CONCLUSIONS

Psychological distress that is categorised as mild to moderate can be extremely debilitating for pregnant women. Identification of these women in clinical practice is crucial so that effective interventions can be targeted appropriately. Screening criteria that has the efficacy to identify depression and anxiety is needed. We recommend that a multidisciplinary approach to the management of care is developed to address the range of experiences that pregnant women who suffer mild to moderate prenatal psychological distress may have.