4,165 research outputs found

    Qualitative Study of Perinatal Mental Health Services: Experiences and Perspectives of Health Workers and Patients

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    The perinatal period is a transitional period that is vulnerable to changes in women's relationships with partners, family, friends, and wider social networks. This study aims to determine how perinatal mental health services are based on the experiences of health workers and patients. This research is qualitative research with a case study design. The informants in this study were 6 informants, namely 2 health workers and 4 patients with a history of perinatal mental health disorders. The instruments used in this study were structured interview guidelines, interviews were conducted in health facilities and patients' homes. Thematic data analysis using the Collaizi protocol. Qualitative data from this study raised six themes, namely "symptoms of perinatal mental health disorders", "causes of perinatal mental health disorders", "management of mental health disorders", "prevention of perinatal mental health disorders", "barriers to perinatal mental health services", and "support". Pregnant, maternity and postpartum women are vulnerable to mental health problems, especially if a woman is faced with family neglect and lack of husband's support during pregnancy. It is important for health workers, especially midwives, to examine women's problems more comprehensively during antenatal care.Masa perinatal merupakan masa transisi yang rentan terhadap perubahan hubungan perempuan dengan pasangan, keluarga, teman, dan jejaring sosial yang lebih luas. Penelitian ini bertujuan mengetahui bagaimana pelayanan perinatal mental health berdasarkan pengalaman petugas kesehatan dan pasien. Penelitian ini merupakan penelitian kualitatif dengan desain studi kasus. Informan dalam penelitian ini adalah 6 informan yaitu 2 orang petugas kesehatan dan 4 pasien dengan riwayat gangguan perinatal mental health. Instrumen yang digunakan dalam penelitian ini adalah pedoman wawancara terstruktur, wawancara dilakukan di fasilitas kesehatan dan rumah pasien. Analisis data secara tematik menggunakan protokol Collaizi. Data kualitatif dari penelitian ini mengangkat enam tema yaitu “gejala gangguan perinatal mental health”, “penyebab gangguan perinatal mental health”, "penatalaksanaan gangguan kesehatan mental", “pencegahan gangguan perinatal mental health”, “hambatan pelayanan perinatal mental health”, dan “dukungan”. Wanita hamil, bersalin, dan nifas rentan mengalami gangguan kesehatan mental, terutama jika seorang wanita dihadapkan pada pengabaian keluarga dan kurangnya dukungan suami selama hamil. Penting bagi tenaga kesehatan khususnya bidan untuk mengkaji permasalahan perempuan secara lebih komprehensif pada saat pemeriksaan kehamilan

    Survey of midwives' perinatal mental health knowledge, confidence, attitudes and learning needs

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    BackgroundMidwives have a primary role in facilitating the first stage of perinatal mental health risk reduction through inquiring about perinatal mental health, identifying risk factors and current perinatal mental health problems, providing support or crisis intervention, referring for treatment and decreasing stigmatisation.AimsThe aims of this study were to determine midwives’ (a) knowledge of and confidence to identify and manage perinatal mental health problems, (b) attitudes towards women who experience severe mental illness and (c) perceived learning needs.DesignA cross-sectional survey design.MethodsThe study was conducted between September 2016 and April 2017 in seven Maternity services in the Republic of Ireland with a purposeful non-random convenience sample of midwives (n = 157). Data was anonymously collected utilising the Perinatal Mental Health Questionnaire, the Mental Illness: Clinician’s Attitudes scale and the Perinatal Mental Health Learning Needs questionnaire.FindingsMidwives indicated high levels of knowledge (71.1%) and confidence (72%) in identifying women who experience depression and anxiety however, they reported less confidence in caring (43.9%) for women. Only 17.8% (n = 28) of midwives felt equipped to support women whilst 15.3% (n = 24) reported having access to sufficient information. Midwives desire education on the spectrum of perinatal mental health problems. The mean score for the Mental Illness: Clinician’s Attitudes scale was 36.31 (SD = 7.60), indicating positive attitudes towards women with severe mental illness.ConclusionMidwives require further education on perinatal mental health across cultures with a skill focus and which explores attitudes delivered in a study day format

    Perinatal mental health : preparing the future nursing workforce

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    Perinatal mental health (PMH) problems occur during pregnancy and up to a year after giving birth. They can have a significant effect on the mother and family, and can affect the social, emotional and cognitive development of the child. PMH nursing is gaining increasing recognition in national policy; additional funding has been announced to align national perinatal services with agreed standards and the perinatal workforce has been identified as an area of growth. The PMH competency framework published by Health Education England and the Tavistock and Portman NHS Foundation Trust, London, is aimed at training staff to deliver high-quality care to women who experience mental health problems during the perinatal period. However, the framework does not address the competencies required from the emerging workforce: nursing students. The pre-registration nursing curriculum must align with PMH competencies to ensure that nursing students become competent practitioners who are adequately prepared to care for the PMH needs of the mother and family

    Costs of perinatal mental health problems

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    Perinatal mental health problems carry a total economic and social long-term cost to society of about £8.1 billion for each one-year cohort of births in the UK. Written with the London School of Economics, our report also finds that the NHS would need to spend just £337 million a year to bring perinatal mental health care up to the level recommended in national guidance. The report is part of the Maternal Mental Health Alliance's ‘Everyone's Business' campaign, which calls on national Government and local health commissioners to ensure that all women throughout the UK who experience perinatal mental health problems, receive the care they and their families need, wherever and whenever they need it

    Perinatal mental health during the COVID-19 pandemic

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    The COVID-19 pandemic has influenced many aspects of life, including women's pregnancy, birth and postnatal period. Due to physically and immunologically adaptive perinatal changes, it is well known that pregnant women usually have an increased susceptibility to infection. Despite this, the majority of women affected by COVID-19 to date have exhibited mild symptoms and make a good recovery. However, there is no reliable evidence for transmission of COVID-19 from mother to infant during pregnancy. COVID-19 infection does not seem to increase likelihood of need for obstetric intervention at birth, with healthy infants born vaginally to mothers with the infection

    But what about us? Partner and family experiences of perinatal mental health care

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    Partners and wider families play a vital role in relation to women’s perinatal mental health. Clinical guidelines in the UK and internationally recommend that services treating women with perinatal mental health difficulties involve and support their families too. Yet, little is known about experiences of family inclusion in practice. I set out to address this. This thesis was connected to a wider study exploring experiences of perinatal mental health care in England. The broader study (for which I was the main researcher) included semi-structured interviews with 52 women who received treatment for a perinatal mental health difficulty, and 32 partners/family members identified by the women as offering them some support. I included questions within these 84 interviews about how services work with partners and families and examined responses using dyadic and thematic analysis. I found that families and family dynamics are central to understanding women’s perinatal mental health and interactions with services. Although it was the women who were diagnosed with perinatal mental health problems, their difficulties were often embedded within a complex and fraught interpersonal and wider social context. Yet instead of seeking to understand perinatal distress within this broader context – or critiquing the structures and gender norms that contributed to producing and maintaining it – services tended to focus on individual women (and babies), marginalising their families and diverting attention from the need for broader social change. The complexity of involving and supporting partners and wider families, coupled with anxiety about this among women and their families, reinforced the tendency to exclude families. I conclude that involving women’s families and providing the support they need is challenging but important. Services need to find ways to overcome barriers to family inclusion and to proactively challenge problematic gender norms and expectations, rather than allowing these to shape and guide practice

    Association of psychosocial-spiritual experiences around childbirth and subsequent perinatal mental health outcomes: an integrated review.

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    Background: Perinatal mental health is a concern for women, families, communities and maternity care providers internationally. However, there is little understanding of poor perinatal maternal mental health and association with women’s experiences of childbirth. Further understanding of psychosocial–spiritual experiences in childbirth and subsequent perinatal mental health is required. Aim: Systematically identify and synthesise the range of evidence available on psychosocial–spiritual experiences around childbirth and foreground possible associations with subsequent perinatal mental health outcomes. Method: Integrated analysis of a range of literature types was undertaken. A comprehensive search strategy was created, and nine databases were searched from 2000 to 2018. Defined inclusion and exclusion criteria were applied independently by two reviewers. Critical appraisal was carried out independently by two reviewers and a third reviewer to resolve differences. The Ecology of Childbirth conceptual framework guided the review. Findings: Six articles were included and four synthesised themes were developed: relationships and kinship matter; significance of childbirth and spiritual experiences; honouring spiritual growth and well-being; and physical manifestations and embodiment. Discussion of the themes using the Ecology of Childbirth framework highlight new perspectives and reveal phenomena lying within and beyond childbirth experiences that may influence perinatal mental health. A new conceptual model is proposed. Conclusions: New insights highlight a paucity of research in the area of perinatal mental health and psychosocial–spiritual childbirth experiences. Further research needs to include postnatal mood disorders and the possible associations with psychosocial–spiritual experiences

    Men’s Perinatal Mental Health in the Transition to Fatherhood

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    While fathers have come to be more involved with their partners and infants throughout the perinatal period, recent research has shown that roughly 10% of new dads experience mental health difficulties including depression and anxiety. Unfortunately, few psychologists receive focused training regarding conceptualizing, assessing, or treating common men’s issues in the period spanning from conception through a year post-partum. Because men tend not to seek mental health services during this period, the lack of scholarly attention to this vulnerable group reflects a commonly overlooked public mental health disparity. This article provides an overview of the key factors which research and theory suggest inform new fatherhood, along with an in-depth look at paternal postpartum depression. Implications for further practice and research are discussed. Specifically, the authors review psychosocial factors including masculine socialization, self-efficacy, social support, involvement with babies, and paternal postpartum mood and anxiety disorders. Finally, implications for research and practice are discussed

    Perinatal mental health screening trial

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    Background: Pregnancy is a time of great joy and happiness but is also a time of great change, where the woman is at increased risk of onset and relapse of mental health disorders. However, unfortunately many patients go undiagnosed. --- Method: A trial for perinatal mental health screening was set up at Mater Dei Hospital. Mothers under the care of four consultant obstetricians were included in the study. All were asked a series of screening questions to assess necessity of referral to mental health services. If positive for one of the questions, a telephone consultation was carried out by one of the perinatal mental health midwives, giving them the necessary information about the mental health services available. The services offer a multidisciplinary approach with perinatal midwives, a specialised psychiatric team, social worker and psychologists. --- Results: A total of 283 mothers were screened. 105 of which were positive for a screening question, requiring mental health services. 8 accepted an office session with the perinatal midwives, and 12 were followed-up up by psychiatric team in the perinatal mental health clinic. --- Conclusion: Previous data at Mater Dei Hospital stated that 3% of all mothers delivering in labour ward were being referred to the perinatal mental health clinic. During this trial 6% of the mothers screened were making use of the service. This points towards ⁓3% of mothers who would otherwise have been suffering in the dark, proving the necessity of a screening program.peer-reviewe

    Perinatal Mental Health: Improving the Quality and Consistency of Health Care Delivery in Kootenai County

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    Elisha, Leanne. Perinatal Mental Health: Improving the Quality and Consistency of Health Care Delivery in Kootenai County. Unpublished Doctor of Nursing Practice scholarly project, University of Northern Colorado, 2019. Perinatal mental health issues including depression, anxiety, posttraumatic stress disorder, mania, and psychosis occur frequently during pregnancy and after delivery; these issues have potentially devastating impacts on mothers, infants, other family members, and communities. Despite increasing awareness of perinatal mental health issues and formal recommendations to implement universal screening and ensure access to appropriate follow-up, there is wide variation in clinical practice across regions and providers. Inconsistent screening, paired with limited local resources for follow up, might prevent women from receiving appropriate treatment. The objective of this project was to develop a guide for clinician use to improve screening, referral, and follow up of perinatal mental health issues. The guide identifies an appropriate screening instrument, screening intervals, methods, recording practices, and follow-up recommendations. Additionally, an integrated mental health model was proposed for ongoing treatment and coordination of care. The project was developed using the Delphi method and ongoing engagement with seven local stakeholders to create a streamlined, consistent process that would match clinician needs with available resources
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