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Dubreucq M, Dupont C, Lambregtse-Van den Berg MP, Bramer WM, Massoubre C, Dubreucq J. A systematic review of midwives' training needs in perinatal mental health and related interventions. Front Psychiatry 2024; 15:1345738. [PMID: 38711873 PMCID: PMC11071341 DOI: 10.3389/fpsyt.2024.1345738] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/28/2023] [Accepted: 04/02/2024] [Indexed: 05/08/2024] Open
Abstract
Background Midwives may be key stakeholders to improve perinatal mental healthcare (PMHC). Three systematic reviews considered midwives' educational needs in perinatal mental health (PMH) or related interventions with a focus on depression or anxiety. This systematic review aims to review: 1) midwives' educational/training needs in PMH; 2) the training programs in PMH and their effectiveness in improving PMHC. Methods We searched six electronic databases using a search strategy designed by a biomedical information specialist. Inclusion criteria were: (1) focus on midwives; (2) reporting on training needs in PMH, perinatal mental health problems or related conditions or training programs; (3) using quantitative, qualitative or mixed-methods design. We used the Mixed Methods Appraisal Tool for study quality. Results Of 4969 articles screened, 66 papers met eligibility criteria (47 on knowledge, skills or attitudes and 19 on training programs). Study quality was low to moderate in most studies. We found that midwives' understanding of their role in PMHC (e.g. finding meaning in opening discussions about PMH; perception that screening, referral and support is part of their routine clinical duties) is determinant. Training programs had positive effects on proximal outcomes (e.g. knowledge) and contrasted effects on distal outcomes (e.g. number of referrals). Conclusions This review generated novel insights to inform initial and continuous education curriculums on PMH (e.g. focus on midwives' understanding on their role in PMHC or content on person-centered care). Registration details The protocol is registered on PROSPERO (CRD42021285926).
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Affiliation(s)
- Marine Dubreucq
- Centre referent de rehabilitation psychosociale, GCSMS REHACOOR 42, Saint-Étienne, France
- University Claude Bernard Lyon1, Research on Healthcare Performance (RESHAPE) INSERM U1290, Lyon, France
| | - Corinne Dupont
- University Claude Bernard Lyon1, Research on Healthcare Performance (RESHAPE) INSERM U1290, Lyon, France
- AURORE Perinatal Network, Hospices civiles de Lyon, Croix Rousse Hospital, Lyon, France
| | - Mijke P. Lambregtse-Van den Berg
- Departments of Psychiatry and Child & Adolescent Psychiatry, Erasmus MC, University Medical Center Rotterdam, Rotterdam, Netherlands
| | - Wichor M. Bramer
- Medical Library, Erasmus MC, University Medical Center Rotterdam, Rotterdam, Netherlands
| | - Catherine Massoubre
- University Hospital of Saint-Étienne & EA 7423 (Troubles du Comportement Alimentaire, Addictions et Poids Extrêmes (TAPE), Université Jean Monnet - Saint-Etienne), Saint-Etienne, France
| | - Julien Dubreucq
- University Hospital of Saint-Étienne, Department of Child and Adolescent Psychiatry, France & Marc Jeannerod Institute of Cognitive Sciences UMR 5229, CNRS & Claude Bernard University, Lyon, France
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Poreddi V, Gandhi S, Ramachandra, Ganjekar S, Desai G, Chandra PS. Evaluation of a manual-based training program in changing auxiliary nurse midwives (ANMs) knowledge, attitudes, and skills related to maternal mental health. Indian J Psychiatry 2023; 65:617-625. [PMID: 37485417 PMCID: PMC10358814 DOI: 10.4103/indianjpsychiatry.indianjpsychiatry_567_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/21/2022] [Revised: 04/26/2023] [Accepted: 05/23/2023] [Indexed: 07/25/2023] Open
Abstract
Background Globally, maternal mental health has been recognized as a priority public health issue. While it is crucial to integrate maternal mental health into mother and child health services, research on strengthening the knowledge and skills of primary healthcare providers on maternal mental health is limited in India. Aim To evaluate the effectiveness of a manual-based training program in improving auxiliary nurse midwives (ANMs) knowledge, attitudes, and skills related to maternal mental health. Methods The present study adopted an experimental design among ANMs (N = 110) working at primary health centers, Karnataka, India. The participants were randomly assigned to either experimental group (n = 53) or control group (n = 57). The training program delivered interactive sessions based on a facilitator's manual developed specifically for ANMs in India. The assessments were done in both groups at baseline, after the intervention, at three months and at six months using self-rated questionnaires and a case vignette. The descriptive and inferential statistics were used to analyze the data. Results After the training program the mean knowledge, attitudes and skills scores were significantly increased in the experimental group (P < 0.001) and significant differences were found between the mean scores of the groups at 3 months and 6 months follow-up (P < 0.05). Conclusion The training program was found to have a positive impact in enhancing ANMs' knowledge, attitudes, and skills related to maternal mental health in India as there is dearth for mental health professionals in primary care settings.
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Affiliation(s)
- Vijayalakshmi Poreddi
- College of Nursing, National Institute of Mental Health and Neuro Sciences, (Institute of National Importance), Bengaluru, Karnataka, India
| | - Sailaxmi Gandhi
- Department of Nursing, National Institute of Mental Health and Neuro Sciences, (Institute of National Importance), Bengaluru, Karnataka, India
| | - Ramachandra
- Department of Nursing, National Institute of Mental Health and Neuro Sciences, (Institute of National Importance), Bengaluru, Karnataka, India
| | - Sundarnag Ganjekar
- Department of Psychiatry, National Institute of Mental Health and Neuro Sciences, (Institute of National Importance), Bengaluru, Karnataka, India
| | - Geetha Desai
- Department of Psychiatry, National Institute of Mental Health and Neuro Sciences, (Institute of National Importance), Bengaluru, Karnataka, India
| | - Prabha S. Chandra
- Department of Psychiatry, National Institute of Mental Health and Neuro Sciences, (Institute of National Importance), Bengaluru, Karnataka, India
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Mackintosh N, Gong QS. Women voice their need for personalised risk messaging, effectively balancing a 'better safe than sorry' approach with a need for evidence-based risk communication. Evid Based Nurs 2023; 26:78. [PMID: 36549880 DOI: 10.1136/ebnurs-2022-103615] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/09/2022] [Indexed: 12/24/2022]
Affiliation(s)
- Nicola Mackintosh
- Department of Population Health Sciences, University of Leicester, Leicester, UK
| | - Qian Sarah Gong
- School of Media, Communication and Sociology, University of Leicester, Leicester, UK
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Midwives’ experiences of supporting women's mental health: a mixed-method study. Midwifery 2022; 111:103368. [DOI: 10.1016/j.midw.2022.103368] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2021] [Revised: 03/07/2022] [Accepted: 05/09/2022] [Indexed: 11/23/2022]
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Wigert H, Nilsson C, Dencker A, Begley C, Jangsten E, Sparud-Lundin C, Mollberg M, Patel H. Women's experiences of fear of childbirth: a metasynthesis of qualitative studies. Int J Qual Stud Health Well-being 2020; 15:1704484. [PMID: 31858891 PMCID: PMC6968519 DOI: 10.1080/17482631.2019.1704484] [Citation(s) in RCA: 65] [Impact Index Per Article: 16.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/15/2023] Open
Abstract
Purpose: Women’s experiences of pregnancy, labour and birth are for some pregnant women negative and they develop a fear of childbirth, which can have consequences for their wellbeing and health. The aim was to synthesize qualitative literature to deepen the understanding of women’s experiences of fear of childbirth. Methods: A systematic literature search and a meta-synthesis that included 14 qualitative papers. Results: The main results demonstrate a deepened understanding of women’s experiences of fear of childbirth interpreted through the metaphor “being at a point of no return”. Being at this point meant that the women thought there was no turning back from their situation, further described in the three themes: To suffer consequences from traumatic births, To lack warranty and understanding, and To face the fear. Conclusions: Women with fear of childbirth are need of support that can meet their existential issues about being at this point of no return, allowing them to express and integrate their feelings, experiences and expectations during pregnancy, childbirth and after birth. Women with fear after birth, i.e., after an earlier negative birth experience, need support that enables them to regain trust in maternity care professionals and their willingness to provide them with good care that offers the support that individual women require. Women pregnant for the first time require similar support to reassure them that other’s experiences will not happen to them.
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Affiliation(s)
- Helena Wigert
- Institute of Health and Care Sciences, The Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden.,Division of Neonatology, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Christina Nilsson
- Institute of Health and Care Sciences, The Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden.,Faculty of Caring Science, Work Life and Social Welfare, University of Borås, Borås, Sweden
| | - Anna Dencker
- Institute of Health and Care Sciences, The Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden
| | - Cecily Begley
- Institute of Health and Care Sciences, The Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden.,Chair of Nursing and Midwifery, School of Nursing and Midwifery, Trinity College Dublin, Dublin, Ireland
| | - Elisabeth Jangsten
- Institute of Health and Care Sciences, The Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden
| | - Carina Sparud-Lundin
- Institute of Health and Care Sciences, The Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden
| | - Margareta Mollberg
- Institute of Health and Care Sciences, The Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden
| | - Harshida Patel
- Institute of Health and Care Sciences, The Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden
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Silverwood V, Nash A, Chew-Graham CA, Walsh-House J, Sumathipala A, Bartlam B, Kingstone T. Healthcare professionals' perspectives on identifying and managing perinatal anxiety: a qualitative study. Br J Gen Pract 2019; 69:e768-e776. [PMID: 31548296 PMCID: PMC6758931 DOI: 10.3399/bjgp19x706025] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2019] [Accepted: 04/11/2019] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND Perinatal mental health problems are those that occur during pregnancy or up to 12 months postpartum, and affect up to 20% of women. Perinatal anxiety (PNA) is at least as common as depression during the perinatal phase and can adversely impact on both mother and child. Despite this, research into anxiety has received less attention than depression. The National Institute for Health and Care Excellence guidance on perinatal mental health has identified PNA as a research priority. AIM To explore the perspectives and experiences of healthcare professionals (HCPs) in the identification and management of PNA. DESIGN AND SETTING This was a qualitative study in primary and secondary care set in the West Midlands from February 2017 to December 2017. METHOD Semi-structured interviews (n = 23) with a range of HCPs. Iterative approach to data generation and analysis, using principles of constant comparison. Patient and Public Involvement and Engagement (PPIE) group was involved throughout the study. RESULTS Twenty-three HCPs interviewed: 10 GPs, seven midwives, five health visitors, and one obstetrician. Four themes were uncovered: PNA as an 'unfamiliar concept'; reliance on clinical intuition and not clinical tools; fragmentation of care; and opportunities to improve care. CONCLUSION Awareness and understanding of PNA among HCPs is variable, with debate over what is 'normal' anxiety in pregnancy. HCPs suggested that PNA can be challenging to identify, with mixed views on the use and value of case-finding tools. Opportunistic identification was noted to be significant to aid diagnosis. Care for women diagnosed with PNA was reported to be fragmented and interprofessional communication poor. Potential solutions to improve care were identified.
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Affiliation(s)
- Victoria Silverwood
- School of Primary, Community and Social Care, Keele University, Staffordshire
| | - Annabel Nash
- Midlands Partnership NHS Foundation Trust, St George's Hospital, Stafford
| | - Carolyn A Chew-Graham
- School of Primary, Community and Social Care, Keele University, Staffordshire; honorary professor of primary care mental health, Midlands Partnership NHS Foundation Trust, St George's Hospital, Stafford
| | | | - Athula Sumathipala
- School of Primary, Community and Social Care, Keele University, Staffordshire; honorary consultant psychiatrist, Midlands Partnership NHS Foundation Trust, St George's Hospital, Stafford
| | - Bernadette Bartlam
- Family Medicine and Primary Care, Lee Kong Chian School of Medicine, Nanyang Technical University, Singapore; honorary research fellow, School of Primary, Community and Social Care, Keele University, Staffordshire
| | - Tom Kingstone
- School of Primary, Community and Social Care, Keele University, Staffordshire; research associate in mental health, Midlands Partnership Foundation Trust, St George's Hospital, Stafford
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Promoting maternal mental health in Ghana: An examination of the involvement and professional development needs of nurses and midwives. Nurse Educ Pract 2019; 39:105-110. [PMID: 31446219 DOI: 10.1016/j.nepr.2019.08.008] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2019] [Revised: 08/13/2019] [Accepted: 08/18/2019] [Indexed: 12/11/2022]
Abstract
Insight into the involvement and professional development needs (PDNs) of non-mental health nurses and midwives with respect to promoting maternal mental health is necessary to integrate mental health services into primary healthcare delivery. Using a cross-sectional survey and self-report methodology, the study investigates the involvement, PDNs, knowledge and attitudes of 309 nurses and midwives in promoting maternal mental health in Ghana. Data were analyzed using descriptive and inferential statistics, namely Analysis of Variance, bivariate and logistic regression, and cluster analysis. The results showed that the majority of the participants (94%) indicated they were involved in promoting maternal mental health. Knowledge about maternal mental health correlated significantly with involvement in promoting maternal mental health (p < .05), whereas attitude towards maternal mental health did not. An overwhelming proportion of the participants (83%-94%) expressed profound interest in professional development education across a range of maternal mental health areas. Enhancing the mental health knowledge-base of nurses and midwives could contribute significantly to promoting maternal mental health.
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Sambrook Smith M, Lawrence V, Sadler E, Easter A. Barriers to accessing mental health services for women with perinatal mental illness: systematic review and meta-synthesis of qualitative studies in the UK. BMJ Open 2019; 9:e024803. [PMID: 30679296 PMCID: PMC6347898 DOI: 10.1136/bmjopen-2018-024803] [Citation(s) in RCA: 109] [Impact Index Per Article: 21.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/16/2023] Open
Abstract
OBJECTIVE Lack of access to mental health services during the perinatal period is a significant public health concern in the UK. Barriers to accessing services may occur at multiple points in the care pathway. However, no previous reviews have investigated multilevel system barriers or how they might interact to prevent women from accessing services. This review examines women, their family members' and healthcare providers' perspectives of barriers to accessing mental health services for women with perinatal mental illness in the UK. DESIGN A systematic review and meta-synthesis of qualitative studies. DATA SOURCES Qualitative studies, published between January 2007 and September 2018, were identified in MEDLINE, PsycINFO, EMBASE and CINAHL electronic databases, handsearching of reference lists and citation tracking of included studies. Papers eligible for inclusion were conducted in the UK, used qualitative methods and were focused on women, family or healthcare providers working with/or at risk of perinatal mental health conditions. Quality assessment was conducted using the Critical Appraisal Skills Programme for qualitative studies. RESULTS Of 9882 papers identified, 35 studies met the inclusion criteria. Reporting of emergent themes was informed by an existing multilevel conceptual model. Barriers to accessing mental health services for women with perinatal mental illness were identified at four levels: Individual (eg, stigma, poor awareness), organisational (eg, resource inadequacies, service fragmentation), sociocultural (eg, language/cultural barriers) and structural (eg, unclear policy) levels. CONCLUSIONS Complex, interlinking, multilevel barriers to accessing mental health services for women with perinatal mental illness exist. To improve access to mental healthcare for women with perinatal mental illness multilevel strategies are recommended which address individual, organisational, sociocultural and structural-level barriers at different stages of the care pathway. PROSPERO REGISTRATION NUMBER CRD42017060389.
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Affiliation(s)
- Megan Sambrook Smith
- Global Mental Health, King’s College London, Institute of Psychiatry, Psychology & Neuroscience, London, UK
| | - Vanessa Lawrence
- Health Service & Population Research Department, Institute of Psychiatry, Psychology & Neuroscience, King’s College London, London, UK
| | - Euan Sadler
- Centre for Implementation Science, Health Service & Population Research Department, King’s College London, Institute of Psychiatry, Psychology and Neuroscience, London, UK
| | - Abigail Easter
- Centre for Implementation Science, Health Service & Population Research Department, King’s College London, Institute of Psychiatry, Psychology and Neuroscience, London, UK
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Wadephul F, Jarrett PM, Jomeen J, Martin CR. A mixed methods review to develop and confirm a framework for assessing midwifery practice in perinatal mental health. J Adv Nurs 2018; 74:2258-2272. [PMID: 29989193 DOI: 10.1111/jan.13786] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2017] [Revised: 04/27/2018] [Accepted: 06/01/2018] [Indexed: 11/30/2022]
Abstract
AIM To ascertain whether a new framework examining midwifery practice in perinatal mental health (PMH) is supported by the research literature. BACKGROUND The identification and care of women with PMH problems is increasingly considered part of midwifery practice. Research suggests that many midwives lack knowledge, skills and confidence. It would be useful to be able to determine barriers and facilitators to effective clinical practice. The authors propose a framework comprising five potentially measurable domains which have an impact on midwives' ability to identify, assess and care for women with PMH problems. DESIGN This mixed-methods review uses an innovative qualitative convergent design based on framework synthesis. DATA SOURCES Relevant electronic databases were searched for the period from January 2007-December 2016; 33 studies from nine countries met the inclusion criteria. REVIEW METHODS Study quality was assessed using critical appraisal tools. Study findings were mapped onto the five domains of the framework: knowledge, confidence, attitudes, illness perception and infrastructure. Findings were then synthesized for each domain. RESULTS All five domains are substantially represented in the literature, thus supporting the proposed framework. Several sub-domains and relationships between domains were identified. Varying levels of knowledge, confidence, attitudes and illness perceptions were found; evidence suggests that midwives benefit from further training within these domains. Features of organizational infrastructure act as barriers or facilitators to effective care; these need to be addressed at organizational level. CONCLUSION The proposed framework was confirmed and can be used to inform practice, policy and research.
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Affiliation(s)
- Franziska Wadephul
- School of Health and Social Work, Faculty of Health Sciences, University of Hull, Hull, UK
| | | | - Julie Jomeen
- School of Health and Social Work, Faculty of Health Sciences, University of Hull, Hull, UK
| | - Colin R Martin
- Institute for Clinical and Applied Health Research, Faculty of Health Sciences, University of Hull
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