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1 – 10 of 174Rose Tyldesley and Linda Phillips
Beat the Blues is a support group in Stockport providing information and support to anyone who thinks that they may be suffering from postnatal depression. Set up and run by a…
Abstract
Beat the Blues is a support group in Stockport providing information and support to anyone who thinks that they may be suffering from postnatal depression. Set up and run by a group of mothers who have lived with postnatal depression, the group offers a range of different activities and an opportunity to talk to others who feel the same. This article describes how the group was developed using a community development approach, and Rose Tyldesley describes her role as a community development worker in facilitating this. Linda Phillips describes how she got involved in group as a committee member, and what the group has meant for her.
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Post partum depression (PPD) is an important complication of child-bearing. It requires urgent interventions as it can have long-term adverse consequences if ignored, for both…
Abstract
Post partum depression (PPD) is an important complication of child-bearing. It requires urgent interventions as it can have long-term adverse consequences if ignored, for both mother and child. If PPD has to be prevented by a public health intervention, the recognition and timely identification of its risk factors is must. We in this review have tried to synthesize the results of Asian studies examining the risk factors of PPD. Some risk factors, which are unique to Asian culture, have also been identified and discussed. We emphasize on early identification of these risk factors as most of these are modifiable and this can have significant implications in prevention of emergence of post partum depression, a serious health issue of Asian women.
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Keshvar Samadaee Gelehkolaee, Mehrnaz Geranmayeh, Zahra Behboodi Moghadam, Mojgan Mirghafourvand, Armin Zareiyan and Fovziye Sanaati
Transition to parenthood (TTP) is a major life event that affects all aspects of one’s psychosocial function. Similar to their partners, men experience a lot of psychological…
Abstract
Purpose
Transition to parenthood (TTP) is a major life event that affects all aspects of one’s psychosocial function. Similar to their partners, men experience a lot of psychological changes during the TTP process. As there are a few studies on this subject, so the purpose of this study is to review previous studies on psychological and functional changes in men during TTP.
Design/methodology/approach
This is a review study that reports the findings from a review of previous studies on psychological and functional changes in men during TTP. This study searched from the electronic database between articles published in between 2005–20.
Findings
This study was carried out in five stages: framing research questions; searching databases with an effective strategy; selecting relevant studies; findings mining; summarizing and classifying findings; and providing results. After the literature review, relevant studies were categorized into three groups. The first, second and third groups included studies on prenatal, labor and delivery and postnatal TTP, respectively. Psychological and functional changes in men during TTP significantly affect child-father relationships, development of children and sexual relationship with a partner. Therefore, further attention should be given to this important process, along with changes, expectations, needs, etc.
Originality/value
This study reviews men’s functional changes along with their psychological changes during the parental transition. This study also reviews effective strategies and interventions for successful parental transition in men.
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Tara Flemington, Donna Waters and Jennifer A Fraser
Home visiting is a strategy widely implemented to support families following the birth of a baby. There is a broad consensus that home visiting programmes are successful. But…
Abstract
Purpose
Home visiting is a strategy widely implemented to support families following the birth of a baby. There is a broad consensus that home visiting programmes are successful. But there is little understanding of factors moderating this success. The purpose of this paper is to examine the relationship between maternal involvement in a nurse home visiting programme, maternal depression, and adjustment to the parenting role.
Design/methodology/approach
A retrospective design was employed in which the medical records of 40 mothers who had been enroled in a nurse home visiting programme were examined. The number of nurse home visits from birth to six months, maternal depressive symptoms, Home Observation for Measurement of the Environment (HOME) and responsivity scores were examined. Mothers had been selected for the programme if they had a history of mental illness, were in a violent relationship, or reported drug or alcohol problems.
Findings
A significant, positive relationship was found between maternal involvement, positive HOME environment and maternal responsivity scores. Furthermore, the mothers with the highest scores for HOME environment and responsivity to their infant ' s cues at six months were mothers experiencing deteriorating symptoms of depression. These mothers had the highest levels of involvement with the programme. Despite their mothers’ deteriorating mental health, infants whose mothers received the greatest number of visits from a nurse received the greatest benefit ameliorating their risk for developing poor attachment and impaired behavioural, emotional and cognitive development.
Originality/value
This is the first study to examine the relationship between changes in maternal depression and programme outcomes in a home visiting programme. It is one of the first explorations of the relationship between maternal involvement and programme outcomes in a targeted nurse home visiting programme to prevent child maltreatment. The findings from this study are critical to future home visiting programme development and evaluation.
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The purpose of this paper is to look at the positive future gains of reaching women with perinatal mental illness at the first midwifery booking-in appointment, a unique…
Abstract
Purpose
The purpose of this paper is to look at the positive future gains of reaching women with perinatal mental illness at the first midwifery booking-in appointment, a unique opportunity that could be more widely used as a point of detection, awareness and prevention of illness in the perinatal period.
Design/methodology/approach
A more robust section of this appointment that includes focussed detection and awareness of prior and current mental health concerns as well as the stigma attached to these conditions will allow midwives to signpost women to get much needed treatment prior to delivery. Suitable treatment options also need to be available and in place at this point.
Findings
The existing booking-in process, for highlighting and diagnosing mental health conditions, has limited suitability. Detection in the postnatal period has inherent difficulties due to time pressures on women, the costs to the mother, baby, family and the economic costs to society, which are considerable. The postnatal period may be too late for treatment, with the harm already done to the woman, their baby and their family.
Research limitations/implications
Research is needed to assess the efficacy of such a strategy, including the costs to train the midwives to deliver this additional service, and the consideration of suitable treatment options at the antenatal stage. This may help to reduce the high levels of attrition within treatment programmes currently running.
Originality/value
This paper fulfils a need to diagnose and prevent perinatal mental illness at an earlier point in pregnancy.
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Perinatal mental illness is an important public health issue. Conditions such as postnatal depression increase mothers' risk of suicide and can herald onset of recurrent and…
Abstract
Purpose
Perinatal mental illness is an important public health issue. Conditions such as postnatal depression increase mothers' risk of suicide and can herald onset of recurrent and chronic mental health problems. Maternal mental illness can also adversely impact the cognitive, physical, and psychological health and development of children. In light of known psychosocial risks, there is concern that fewer than expected women from black and minority ethnic (BME) backgrounds access care and treatment. This paper aims to address this issue.
Design/methodology/approach
Responding to persistent reports of patchy service provision across the UK more generally and particular concerns about potentially unmet needs among BME women, mixed‐method research was undertaken between September 2009 and March 2010. Using survey questionnaires and telephone interviews, the study sought to explore professional stakeholders' perspectives on current perinatal mental health provision and the extent to which it meets the needs of BME women. Findings from the study were intended to inform policy and plans to improve provision by establishing managed care networks (MCNs) for perinatal mental healthcare.
Findings
In total, 45 questionnaires were returned from the national survey. One‐third of respondents (n=14) consented to follow‐up telephone interviews. There was evidence of multi‐agency working among the 27 professional groups which respondents reported as being directly involved in delivering perinatal mental healthcare across the country. However, there was also evidence of disjuncture and poor communication – particularly between statutory and voluntary sectors and NHS primary and secondary care. Some respondents had difficulty defining “BME” or identifying the women to whom the acronym might be applied. They also questioned the validity of providing “BME‐specific” services. Instead, they endorsed more ethnically “inclusive models” of provision and “signposting” women to appropriate “community” services.
Practical implications
Taken together, these findings suggests that whilst there might be a theoretical argument for perinatal mental health MCNs, considerable effort is required if policy‐makers' aspirations for more “joined‐up” services capable of meeting the needs of all women are to be fully realised. Furthermore, current proposals for public sector reform coupled with reduction in voluntary sector provision is likely to disproportionately affect women from BME and other marginalised communities as they provide significant amounts of “below the radar” care and support.
Originality/value
This paper is of particular relevance to policy makers and practitioners. Findings suggest that women from BME backgrounds might be particularly vulnerable to perinatal mental illness. Contraction of voluntary sector provision increases the likelihood that the needs of BME women will remain unmet with deleterious consequences for their health and wellbeing of their families. This has potentially serious public health implications. MCNs/clinical networks have the potential to reduce inequalities by providing more “joined up” care for all women. However, the evidence base for levels of need and appropriate service response to perinatal mental illness among BME women is weak. Further research is required to bridge the evidence gap and to evaluate the impact of health and social care reform on vulnerable groups.
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Yvonne Fontein-Kuipers and Julie Jomeen
The purpose of this paper is to investigate the validity and accuracy of the Whooley questions for routine screening of maternal distress in Dutch antenatal care.
Abstract
Purpose
The purpose of this paper is to investigate the validity and accuracy of the Whooley questions for routine screening of maternal distress in Dutch antenatal care.
Design/methodology/approach
In this cohort design, the authors evaluated self-reported responses to the Whooley questions against the Edinburgh Depression Scale screening for antenatal depression, State-Trait Anxiety Inventory for general anxiety and the pregnancy-related anxiety questionnaire-revised screening for pregnancy-related anxiety, among Dutch pregnant women during the first and third trimester of pregnancy. The authors used standard diagnostic performance measures for the two case-finding items.
Findings
The Whooley items in this study showed a higher specificity than sensitivity. The Whooley results showed good evidence to identify women who are depressed or (trait)anxious in both trimesters of pregnancy, but the results showed weak to moderate evidence to identify pregnancy-related anxiety. The Whooley items had a low to moderate predictive ability for depression, trait-anxiety and pregnancy-related anxiety and a good ability for negative case-finding. The Whooley items proved to be more able to report how effective the case-finding questions are in identifying women without depression, trait-anxiety and pregnancy-related anxiety (ruling out) rather than how effective these are in identifying women with depression, trait-anxiety and pregnancy-related anxiety (ruling in). The Whooley items were accurate in identifying depression and trait-anxiety in both trimesters but were not very accurate to identify pregnancy-related anxiety.
Research limitations/implications
Assessment of pregnancy-related anxiety using a case-finding tool requires further attention.
Practical implications
The two-item Whooley case-finding tool has shown good utility as a screening instrument for maternal distress. The continuous assessment of maternal emotional health during the childbearing period or, at least, revisiting the topic, would both support the woman and the midwife in regarding perinatal emotional wellbeing as an important remit of midwifery care.
Originality/value
A novel aspect of this paper is the proposition of applying the Whooley questions at later stages of pregnancy or presenting the Whooley questions in a written or digital form.
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Tkaya Giscombe, Ada Hui and Theodore Stickley
Refugee and asylum-seeking women are particularly vulnerable to experiencing mental health difficulties during the perinatal period, with social factors compounding these…
Abstract
Purpose
Refugee and asylum-seeking women are particularly vulnerable to experiencing mental health difficulties during the perinatal period, with social factors compounding these experiences. Research is limited into the mental health needs of perinatal women who are refugees or seeking asylum. The purpose of this paper is to examine the best available international evidence on this topic and to discuss the findings with relevance to the UK context.
Design/methodology/approach
A modified population, intervention, comparison, outcome was used to formulate the research question and search strategy. Databases searched were: cumulative index of nursing and allied health literature, Medline, PsychINFO, Web of Science and Scopus. Guided by the Preferred Reporting Items for Systematic Reviews and Meta-analysis framework, results were screened against an inclusion and exclusion criteria. Each study underwent a quality assessment in which they were appraised using the mixed methods appraisal tool.
Findings
Eight papers were retrieved, and a thematic analysis was conducted. Two major themes were identified: mental health needs and social influences. Refugees and asylum seekers are likely to have experienced trauma as reasons for migration. Post-migration stressors, including hostility and dispersal from social networks, lead to cumulative trauma. These each add to the mental health needs of perinatal refugee and asylum-seeking women that cannot be ignored by policymakers, health and social care services or professionals.
Originality/value
Refugee and asylum-seeking women are particularly vulnerable to mental health difficulties in the perinatal period. Stressors accumulated pre-, during and post-migration to the host country exacerbate mental distress. In the UK, the treatment of this population may be detrimental to their mental health, prompting the need for greater critical awareness of the socioecological environment that refugee or asylum-seeking women experience.
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Yvonne Kuipers, Julie Jomeen, Tinne Dilles and Bart Van Rompaey
The purpose of this paper is to measure reliability, validity and accuracy of the 12-item General Health Questionnaire (GHQ-12) as a measure of emotional wellbeing in pregnant…
Abstract
Purpose
The purpose of this paper is to measure reliability, validity and accuracy of the 12-item General Health Questionnaire (GHQ-12) as a measure of emotional wellbeing in pregnant women; utility and threshold in particular.
Design/methodology/approach
The authors measured self-reported emotional wellbeing responses of 164 low-risk pregnant Dutch women with the GHQ-12 and a dichotomous case-finding item (Gold standard). The authors established internal consistency of the 12 GHQ-items (Cronbach’s coefficient α); construct validity: factor analysis using Oblimin rotation; convergent validity (Pearson’s correlation) and discriminatory ability (area under the receiver operating characteristics curve and index of union); and external validity of the dichotomous criterion standard against the GHQ-12 responses (sensitivity, specificity, likelihood ratios and predictive values), applying a cut-off value of ⩾ 12 and ⩾ 17, respectively.
Findings
A coefficient of 0.85 showed construct reliability. The GHQ-12 items in the pattern matrix showed a three-dimensional factorial model: factor 1, anxiety and depression; factor 2, coping; and factor 3, significance/effect on life, with a total variance of 59 per cent. The GHQ-12 showed good accuracy (0.84; p=<0.001) and external validity (r=0.57; p=<0.001) when the cut-off value was set at the ⩾ 17 value. Using a cut-off value of ⩾ 17 demonstrated higher sensitivity (72.32 vs 41.07 per cent) but lower specificity (32.69 vs 55.77 per cent) compared to the commonly used cut-off value of ⩾ 12.
Research limitations/implications
Findings generally support the reliability, validity and accuracy of the Dutch version of the GHQ-12. Further evaluation of the measure, at more than one timepoint during pregnancy, is recommended.
Practical implications
The GHQ-12 holds the potential to measure antenatal emotional wellbeing and women’s emotional responses and coping mechanisms with reduced antenatal emotional wellbeing.
Social implications
Adapting the GHQ-12 cut-off value enables effective identification of reduced emotional wellbeing to provide adequate care and allows potential reduction of anxiety among healthy pregnant women who are incorrectly screened as positive.
Originality/value
A novel aspect is adapting the threshold of the GHQ-12 to ⩾ 17 in antenatal care.
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Cosme Alvarado-Esquivel, Antonio Sifuentes-Alvarez and Carlos Salas-Martinez
We sought to evaluate the capacity of the Edinburgh Postnatal Depression Scale (EPDS) in discriminating mental disorders other than depression in pregnant women in northern…
Abstract
We sought to evaluate the capacity of the Edinburgh Postnatal Depression Scale (EPDS) in discriminating mental disorders other than depression in pregnant women in northern Mexico. Three hundred pregnant women attending prenatal consultations in a public hospital in Durango City, Mexico submitted a validated EPDS and were examined for mental disorders other than depression using the Diagnostic and Statistical Manual of Mental Disorders - 4th Ed. (DSM-IV) criteria. Sensitivity and specificity of cut-off points of the EPDS, and positive and negative predictive values were calculated. Of the 300 pregnant women studied, 21 had mental disorders other than depression by the DSM-IV criteria. The best EPDS score for screening mental disorders other than depression was 8/9. This threshold showed a sensitivity of 52.4%, a specificity of 67.0%, a positive predictive value of 11.5%, a negative predictive value of 95.4%, and an area under the curve of 0.643 (95% confidence interval: 0.52-0.76). The EPDS can be considered for screening mental disorders other than depression in Mexican pregnant women whenever a cut-off score of 8/9 is used. However, the tool showed small power to separate pregnant women with and without mental disorders other than depression.
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