1
|
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).
Collapse
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
| |
Collapse
|
2
|
McKellar L, Martinez L, De Sousa Machado T, Eden A, Stoodley C, Adelson P. Evaluation of a pilot online education program to develop midwives' knowledge, skill and confidence in perinatal mental health in rural South Australia. Women Birth 2024; 37:355-361. [PMID: 38072708 DOI: 10.1016/j.wombi.2023.11.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2023] [Revised: 11/23/2023] [Accepted: 11/23/2023] [Indexed: 03/05/2024]
Abstract
One in five women will experience perinatal anxiety and/or depression. In South Australia, a rural health service identified a high proportion of women with risk of perinatal mental health challenges and sought additional education for midwives. In response, a six-week facilitated, online perinatal mental health education program (e-PMHEP) was piloted. AIM The aim of this study was to evaluate the effectiveness of the (e-PMHEP) for rural midwives, nurses and Aboriginal maternal infant care practitioners. METHOD Program evaluation incorporated a validated online pre/post survey to assess self-reported knowledge, skill and confidence regarding perinatal mental healthcare. Additional questions sought feedback on satisfaction and feasibility. FINDINGS Sixteen participants from rural South Australia engaged in the project from June to August 2022. Twelve participants completed the online pre/post survey. The overall pre/post knowledge scores were statistically significant (t = 2.73, 8df, p = 0.025) with improvement from the pre to post-test. Pre/post data also showed a measurable increase in confidence and skills. All respondents agreed that the content addressed their learning needs and would recommend this program to other practitioners. DISCUSSION The e-PMHEP appeared beneficial in developing knowledge, skills and confidence regarding perinatal mental healthcare in rural midwives and practitioners. Only a third of practitioners routinely developed a mental health care plan with women. Key strengths of the program included the accessible content, and the combination of an experienced mental health clinician and a facilitator with lived experience. CONCLUSION Providing an accessible, facilitated online perinatal mental health education program could be beneficial for rural midwives.
Collapse
Affiliation(s)
- Lois McKellar
- School of Health and Social Care, Edinburgh Napier University, United Kingdom.
| | - Lee Martinez
- UniSA Department of Rural Health, University of South Australia, Australia
| | | | - Amye Eden
- UniSA Health and Clinical Sciences, University of South Australia, Australia
| | - Cathy Stoodley
- UniSA Health and Clinical Sciences, University of South Australia, Australia
| | - Pam Adelson
- Rosemary Bryant (AO) Research Centre, University of South Australia, Australia
| |
Collapse
|
3
|
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]
|
4
|
Coates D, Foureur M. The role and competence of midwives in supporting women with mental health concerns during the perinatal period: A scoping review. HEALTH & SOCIAL CARE IN THE COMMUNITY 2019; 27:e389-e405. [PMID: 30900371 DOI: 10.1111/hsc.12740] [Citation(s) in RCA: 37] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/25/2018] [Revised: 02/13/2019] [Accepted: 02/18/2019] [Indexed: 06/09/2023]
Abstract
Perinatal mental health problems are linked to poor outcomes for mothers, babies and families. Despite a recognition of the significance of this issue, women often do not receive the care they need and fall between the gap of maternity and mental health services. To address this, there is a call for reform in the way in which perinatal mental healthcare is delivered. This paper responds to this by exploring the role and competence of midwives in delivering mental healthcare. Using a scoping review methodology, quantitative and qualitative evidence were considered to answer the research question 'what is the nature of the evidence relevant to the provision of mental health interventions by midwives?' To identify studies, the databases PubMed, Maternity and Infant Care, Science Citation Index, Social Sciences Citation Index, Medline, Science Direct and CINAHL were searched from 2011 to 2018, and reference lists of included studies were examined. Studies relevant to the role of midwives in the management and treatment of perinatal mental health issues were included; studies focussed on screening and referral were excluded. Thirty papers met inclusion criteria, including studies about the knowledge, skills, and attitudes of midwives and student midwives; the effectiveness of educational interventions in improving knowledge and skills; the delivery of counselling or psychosocial interventions by midwives; and barriers and enablers to embedding midwife-led mental healthcare in practice. Synthesis of the included studies indicates that midwives are interested in providing mental health support, but lack the confidence, knowledge and training to do so. This deficit can be addressed with appropriate training and organisational support, and there is some evidence that midwife-led counselling interventions are effective. Further research is needed to test midwife-led interventions for women with perinatal mental health problems , and to develop and evaluate models of integrated perinatal mental healthcare.
Collapse
Affiliation(s)
- Dominiek Coates
- Faculty of Health, Centre for Midwifery and Child and Family Health, University of Technology, Sydney, New South Wales, Australia
| | - Maralyn Foureur
- Faculty of Health, Centre for Midwifery and Child and Family Health, University of Technology, Sydney, New South Wales, Australia
- Hunter New England Nursing and Midwifery Research Centre, Newcastle, Australia
- University of Newcastle, Faculty of Health and Medicine, Newcastle, Australia
| |
Collapse
|
5
|
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.
Collapse
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
| |
Collapse
|
6
|
Bayrampour H, Hapsari AP, Pavlovic J. Barriers to addressing perinatal mental health issues in midwifery settings. Midwifery 2018; 59:47-58. [DOI: 10.1016/j.midw.2017.12.020] [Citation(s) in RCA: 32] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2017] [Revised: 11/08/2017] [Accepted: 12/21/2017] [Indexed: 12/18/2022]
|
7
|
Jomeen J, Jarrett P, Martin CR. Professional issues in maternal mental health scale (PIMMHS): The development and initial validation of a brief and valid measure. Eur J Midwifery 2018; 2:2. [PMID: 33537563 PMCID: PMC7846036 DOI: 10.18332/ejm/83276] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2017] [Accepted: 01/17/2018] [Indexed: 11/24/2022] Open
Abstract
INTRODUCTION The life-threatening consequences of perinatal mental health problems (PMHP) are well documented. Midwives are ideally placed to effectively identify women at risk and facilitate early intervention. However, a multitude of factors contribute to failure in recognition and treatment. It would be of value for service providers to be able to identify key professional issues in their own context. The present study sought to develop and evaluate a 'professional issues in maternal mental health' scale (PIMMHS), explore its psychometric properties and potential application. METHODS A cross-sectional design and instrument evaluation approach was taken to investigate the psychometric properties of the PIMMHS. A total of 266 student midwives from 10 UK institutions completed the PIMMHS via Survey Monkey. RESULTS PIMMHS comprises two sub-scales of emotion/communication (PIMMHSEmotion sub-scale) and training (PIMMHS-Training sub-scale). Both PIMMHS subscales demonstrate adequate divergent and convergent validity. Sub-optimal internal consistency was observed for the training sub-scale, however, the PIMMHS-Training had a more impressive effect size in terms of known-groups discriminant validity compared to PIMMHS-Emotion. CONCLUSIONS The PIMMHS appears to be a sound psychometric instrument for assessing professional issues that influence the practice of student midwives in PMH. The PIMMHS could support education providers to identify areas for curriculum development, as well as maternity services in proactive assessment of service provision, to identify training and service development opportunities.
Collapse
Affiliation(s)
- Julie Jomeen
- Faculty of Health Sciences, University of Hull, Hull, United Kingdom
| | | | - Colin R. Martin
- Faculty of Society and Health, Buckinghamshire New University, Uxbridge, United Kingdom
| |
Collapse
|
8
|
McGookin A, Furber C, Smith DM. Student midwives' awareness, knowledge, and experiences of antenatal anxiety within clinical practice. J Reprod Infant Psychol 2017. [PMID: 29517371 DOI: 10.1080/02646838.2017.1337270] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
OBJECTIVE The current study aimed to explore student midwives' awareness, knowledge, and experiences of supporting women with antenatal anxiety (ANA) within clinical practice. BACKGROUND ANA is associated with negative outcomes for mother and baby. Midwives play a key role in the screening of antenatal mental health and care of women suffering from ANA. METHODS This study was conducted with student midwives at one UK university in the north-west of England. Twenty-five midwifery students completed a brief online survey informed by National Institute of Health and Care Excellence (NICE) guidelines. Of these, seven volunteered to participate in semi-structured interviews exploring the survey data. The interview topic guide was designed based on the findings of the survey. RESULTS Thematic analysis of the seven interviews revealed four overarching themes: Perpetuating factors, Barriers to care, Skills required in role and Suggestions for future directions. Midwives had a varied knowledge and understanding of ANA and expressed a desire to learn more about their role in supporting women with ANA. CONCLUSION Although a small study, the results highlight the need for education to be improved in order to best prepare student midwives for cases of ANA, with emphasis on integrating psychology and mental health information into teaching as well as time spent in clinical practice. Midwives are key in the screening of women for ANA and are in an ideal position to signpost for specialist care.
Collapse
Affiliation(s)
- Alex McGookin
- a Division of Psychology and Mental Health , University of Manchester , Manchester , UK
| | - Christine Furber
- b School of Nursing, Midwifery & Social Work , University of Manchester , Manchester , UK
| | - Debbie M Smith
- a Division of Psychology and Mental Health , University of Manchester , Manchester , UK
| |
Collapse
|
9
|
Noonan M, Doody O, Jomeen J, Galvin R. Midwives’ perceptions and experiences of caring for women who experience perinatal mental health problems: An integrative review. Midwifery 2017; 45:56-71. [DOI: 10.1016/j.midw.2016.12.010] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2016] [Revised: 12/01/2016] [Accepted: 12/11/2016] [Indexed: 10/20/2022]
|
10
|
Davies L, Page N, Glover H, Sudbury H. Developing a perinatal mental health module: An integrated care approach. ACTA ACUST UNITED AC 2016. [DOI: 10.12968/bjom.2016.24.2.118] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
| | - Nadine Page
- Teaching Fellow Mental Health University of Surrey
| | | | | |
Collapse
|
11
|
Higgins A, Carroll M, Sharek D. Impact of perinatal mental health education on student midwives' knowledge, skills and attitudes: A pre/post evaluation of a module of study. NURSE EDUCATION TODAY 2016; 36:364-369. [PMID: 26431740 DOI: 10.1016/j.nedt.2015.09.007] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/02/2015] [Revised: 09/02/2015] [Accepted: 09/10/2015] [Indexed: 06/05/2023]
Abstract
BACKGROUND Whilst midwives are well-placed to identify and address the mental health need of women in their care, many report lacking the ability to do so. Therefore, they ignore or brush aside women's mental health needs. To improve midwives' competency in this area, the first authors developed and delivered a module on perinatal mental health issues within their university. The module aimed to improve knowledge, skills, and attitudes in relation to working with women about mental health issues. In 2012, a post-survey evaluation of the module demonstrated positive findings; following a number of revisions to the module, this more robust pre/post evaluation was conducted. OBJECTIVES The objective of this study was to examine the impact of the perinatal mental health module on student midwives' knowledge, skills, and attitudes in addressing mental health issues with women. Design Pre-module and Post-module Surveys were Used. PARTICIPANTS Participants were students undertaking a 4-year undergraduate direct entry midwifery degree programme in Ireland. The pre-survey had 28 participants, the post-survey had 26 participants, and there were 25 matched pairs. METHODS The data were analysed using SPSS Version 21.0. Descriptive, frequencies and paired sample t-tests were calculated. Qualitative data were analysed thematically. RESULTS Comparison of the pre and post measures, based on paired samples t-tests, showed that the programme statistically increased participants' knowledge and skills. Whilst students' self-reported attitudes towards women and mental health issues were already quite positive, they reported even more positive attitudes following the course. Written feedback provided by students also supported these positive findings. CONCLUSION This evaluation provides evidence that a module on perinatal mental health is effective at improving the self-reported knowledge, skills, and attitudes of student midwives towards women with mental health issues. It is recommended that educators consider the opportunity of including a similar module in their curriculum.
Collapse
Affiliation(s)
- Agnes Higgins
- School of Nursing and Midwifery, Trinity College Dublin, Ireland.
| | - Margaret Carroll
- School of Nursing and Midwifery, Trinity College Dublin, Ireland
| | - Danika Sharek
- School of Nursing and Midwifery, Trinity College Dublin, Ireland
| |
Collapse
|