Barriers and facilitators of psychological help-seeking behaviors for perinatal women with depressive symptoms: A qualitative systematic review based on the Consolidated Framework for Implementation Research

Status and Perceived Barriers of Psychological Help-Seeking Behaviors for Perinatal Depressive Symptoms Among Chinese Women: A Cross-Sectional Study

PURPOSE

To investigate attitudes, intentions, and behaviors toward seeking professional psychological help among Chinese perinatal women with depressive symptoms, and further identify influencing factors and perceived barriers to such help-seeking.

METHOD

Individuals who were pregnant or within 42 days postpartum were recruited from two tertiary hospitals in Hunan Province, China. A comprehensive questionnaire and list of possible perceived barriers to seeking psychological help were collected from participants.

RESULTS

The prevalence of perinatal depressive symptoms was 28%, with only 11.3% of participants having sought psychological help. The most frequent perceived barriers to seeking psychological help were lack of knowledge of perinatal depressive symptoms and negative attitudes about perinatal depressive symptoms and psychological help-seeking.

CONCLUSION

Participants had low levels of professional psychological help-seeking behaviors. Further studies should explore this mechanism and develop interventions targeting perceived barriers. [Journal of Psychosocial Nursing and Mental Health Services, xx(xx), xx-xx.].

A mixed-methods study protocol: Perinatal depression screening systems and outcomes in obstetrics clinics

Perinatal depression (PND) is an underrecognized and underdiagnosed public health issue with long-term adverse impacts on birthing parents and their children. While obstetrics practices are increasingly encouraged to use existing evidence-based screening tools, there is little data describing the extent to which screening practices and subsequent referrals to care are implemented in clinical settings. The Screening and Treatment Enhancement for Perinatal Depression (STEPS for PPD) study aims to characterize PND screening and referral procedures and identify areas for system improvements. We describe a protocol for an observational study, guided by implementation science frameworks, examining the role of embedded perinatal social workers in managing PND across Mass General Brigham system obstetrics clinics. Our mixed-methods approach integrates qualitative and quantitative data from a variety of sources, including electronic health records, patient-reported surveys, and qualitative interviews, to capture complex screening and referral practices across a large academic medical system. We aim to characterize nuances within the screening and referral system and identify barriers and facilitators to care to inform future hybrid-implementation effectiveness research and improve patient outcomes.

Seeking help for perinatal depression and anxiety: a systematic review of systematic reviews from an interdependent perspective

BACKGROUND

Seeking help for perinatal mood and anxiety disorders is crucial for women's mental health and babies' development, yet many women do not seek help for their condition and remain undiagnosed and untreated. This systematic review of systematic reviews aimed at summarizing and synthesizing findings from all systematic reviews on seeking help for PMAD in the context of interdependence theory, highlighting the interdependent relationship between women and healthcare providers and how it may impact women's seeking-help process.

METHODS

Four electronic databases were searched, and 18 studies published up to 2023 met inclusion criteria for review.

RESULTS

The capability, opportunity and motivation model of behavior was used as a framework for organizing and presenting the results. Results demonstrate that seeking help for PMAD is a function of the interdependent relationship between perinatal women's and healthcare providers' psychological and physical capabilities, social and physical opportunities, and their reflective and automatic motivation.

CONCLUSIONS

Unmet needs in perinatal mental healthcare is an important public health problem. This systematic review of systematic reviews highlights key factors for policymakers, researchers, and practitioners to consider to optimize healthcare systems and interventions in a way that enhances perinatal women's treatment whenever necessary.

The effect of music intervention on depression in perinatal women: A systematic review

Objective

Perinatal depression has become a global public health problem, which not only harms the health of mothers and their offspring, but also increases the socio-economic burden, so early intervention is urgent. Music intervention is a low-cost and safe intervention method. This study endeavored to systematically integrate and quantitatively evaluate the effectiveness of music intervention for perinatal depression.

Methods

PubMed, Embase, Web of Science and Cochrane Library were searched systematically. The search period was up to September 1, 2024. The included studies were summarized and analyzed.

Results

A total of 1375 articles were obtained through preliminary search, and 13 of them were finally included. The effect of music intervention on perinatal depression was better than that of the control group (SMD = -0.53, 95%CI (-0.81, -0.26), p ＜ 0.05). Music intervention had no significant effect on alleviating anxiety (SMD = -0.47, 95%CI (-0.63, -0.31), p ＞ 0.05). However, the heterogeneity of the included studies was significant.

Conclusions

This study indicated that music intervention had a significant effect on alleviating perinatal depression, but the effect on anxiety was not significant. However, the results were highly heterogeneous, and large-scale, multi-center, and long-term studies are needed in the future to confirm this.

Stigma and its influencing factors for seeking professional psychological help among pregnant women: A cross-sectional study

BACKGROUND

Although the stigma associated with seeking professional psychological help has received significant attention, few studies have focused on the status and factors influencing this stigma among pregnant women, especially those with a Chinese cultural background. This study aimed to assess the status of stigma associated with seeking professional psychological help and its influencing factors.

METHODS

A total of 1325 pregnant women were recruited from Hunan Province, China. The Stigma for Seeking Professional Psychological Help questionnaire, Patient Health Questionnaire-9, Perceived Social Support Scale, Simplified Coping Style Questionnaire, and questionnaires on sociodemographic characteristics and pregnancy-related information were used. Descriptive, univariate, correlation, and multivariate linear regression analyses were used to investigate the status of stigma and identify its influencing factors.

FINDINGS

Pregnant Chinese women experienced a mild to moderate level of stigma associated with seeking professional psychological help, and self-stigma was more common than social stigma associated with seeking psychological help. The results of the multivariate analysis suggested that perceived social support, positive coping styles, negative coping styles, and depressive symptoms were the factors influencing self-stigma and social stigma associated with seeking professional psychological help. Advanced age and a low educational level were the only predictors associated with self-stigma, while a history of multiple pregnancies had an effect only on social stigma associated with seeking professional psychological help.

CONCLUSION

Chinese pregnant women experienced a mild to moderate level of stigma associated with seeking professional psychological help. Destigmatizing interventions focusing on self-stigma and social stigma should be designed according to maternal characteristics, social support, coping style, and depressive symptoms.

Examination of Risk of Depression and Perception of Social Support in Pregnant Women Undergoing Intrauterine Intervention

BACKGROUND

Interventions during pregnancy might increase the risk of depression becausethey may cause anxiety and stress in the mother. In these cases, it is important to provide social support to pregnant women.

AIM

This study aimed to determine the relationship between the risk of depression and the perception of social support in pregnant women who had undergone intrauterine intervention (IUI).

METHODS

The population of this descriptive study consisted of all pregnant women (n = 267) who attended a state hospital in Izmir between March and September 2022 and who had undergone IUI. Data were obtained using a sociodemographic data form, the Beck Depression Inventory (BDI), and the Multidimensional Scale of Perceived Social Support (MSPSS). Descriptive statistics and the Chi-square test were used in the study.

RESULTS

In this study, of the women, 42.7% had ≥3 pregnancies; the gestational week of 93.6% of the pregnant women was between 13-24 weeks. The mean scores of the pregnant women were 11.12 ± 8.04 on the BDI and 61.06 ± 19.84 on the MSPSS. According to the results of the correlation analysis, there was a weak (<0.05) negative reverse correlation between the scales.

CONCLUSIONS

In the results of this study, it has been determined that as perceived social support increases in pregnant women, symptoms of depression are less likely to occur. This result is important in terms of indicating the need for providing social support to pregnant women. Women should be able to identify depression risk factors during this process to receive appropriate care and support.

Longitudinal impact of an online interdisciplinary perinatal mental health module on Healthcare Professionals' knowledge, skills, attitudes and confidence: A qualitative evaluation

AIM/OBJECTIVE

The current study aimed to explore the following research question; 'What is the longitudinal impact, if any, of an online interdisciplinary perinatal mental health module on HCP knowledge, skills, attitudes and confidence'.

BACKGROUND

Research suggests that one in five women/people will experience a mental health issue during the perinatal period. Healthcare Professionals (HCPs) play a critical role in identifying, supporting and referring those who disclose health or psychosocial concerns in pregnancy or after birth and consistent research findings highlight the need for appropriate targeted perinatal mental health education among this cohort. To address this need, a thirteen-week (Masters Level) interdisciplinary online module in perinatal mental health was collaboratively developed between one Irish Higher Education Institution and national mental healthcare specialists. The module aims to develop HCP knowledge, skills, attitude and confidence in sustainably supporting women/people and families experiencing perinatal mental health issues. However, a recent scoping review concluded that there was insufficient evidence with respect to the longitudinal impact of such courses on HCP practice.

DESIGN/METHODS

The study design adopted a qualitative descriptive design that used online individual interviews for data collection. The evaluation was informed by the Kirkpatrick and Kirkpatrick Evaluation Model. The study group consisted of six voluntarily self-selected perinatal mental health module participants. Longitudinal impacts of the module were explored 8-10 months following module completion. Thematic Analysis was undertaken using Braun and Clarkes Framework. Ethical approval for the study was obtained from the author's Higher Education Institution (HEI).

RESULTS

Findings revealed several interrelated and reinforcing themes that had an impact on the longer-term application of enhanced knowledge, skills, attitude and confidence in practice. These were; pedagogical features of the interdisciplinary perinatal mental health education module, sociocultural and professional influences, persistent enthusiasm and commitment to improve care in spite of systemic obstacles and, ongoing need for perinatal mental health education.

CONCLUSIONS

Provision of targeted, agile and manageable professional education courses on perinatal mental health care will continue to be required. However, despite sustained commitment and enthusiasm to implement enhanced knowledge and skills, systemic obstacles continue to exist and these may have an impact on the efficacy of such courses in the longer term.