Perceptions and experiences of interventions to prevent postnatal depression: a systematic review and qualitative evidence synthesis

Background More women experience depressive symptoms antenatally than postnatally. Supporting women through the antenatal period is recognised as important in mitigating negative outcomes and in preventing postnatal depression (PND). A systematic review was conducted which aimed to provide a detailed service user and service provider perspective on the uptake, acceptability, and perception of harms of antenatal interventions and postnatal interventions for preventing PND. Methods A comprehensive literature search was conducted in 12 major bibliographic databases in November 2012 and updated in December 2014. Studies were included if they contained qualitative evidence on the perspectives and attitudes of pregnant women and postnatal women who had taken part in, or healthcare professionals (HCPs) involved in delivering, preventive interventions for PND. Results Twenty-two studies were included. Support and empowerment through education were identified as particularly helpful to women as intervention components, across all intervention types. Implications for accessing the service, understanding the remit of the service and women's preferences for group and individual care also emerged. Limitations The majority of the included studies were of moderate or low quality, which may result in a lack of rich data consistently across all studies, limiting to some degree interpretations that can be made. Conclusion The synthesis demonstrated important considerations for devising new interventions or adapting existing interventions. Specifically, it is important that individual or group interventions are carefully tailored to women's needs or preferences and women are aware of the remit of the HCPs role to ensure they feel able to access the support required

Alien knowledge: Preparing student midwives for learning about infant feeding-Education practice at a UK university

Infant feeding education forms a key element in undergraduate midwifery education in the UK. Students must be prepared to provide women with support and information to make appropriate health choices for themselves and their infants. However, student midwives may already have developed opinions about infant feeding prior to commencing a midwifery education programme. The education literature suggests that existing attitudes may present a barrier to learning for some students. This particularly applies to learning in relation to sensitive or emotionally laden subjects. A review of the literature was undertaken to identify potential teaching approaches which might help students to overcome barriers to learning. Following this the evidence was utilised at a UK university to develop activities which prepare student midwives for effective learning around infant feeding. Students enrolled in the midwifery education programme were introduced to a number of activities aimed at encouraging them to accommodate unfamiliar ideas or 'alien knowledge'. These included placing students in situations which challenged their ideas, as well as engaging in group discussions and reflective exercises. The impact of these educational interventions was identified through formative and summative assessment, and through evaluation of the teaching strategy at the end of the programme. This demonstrated that, amongst those students with previously negative attitudes towards infant feeding, there was a move towards more positive attitudes and a greater confidence in providing evidence based information to parents

The BARRIERS scale -- the barriers to research utilization scale: A systematic review

<p>Abstract</p> <p>Background</p> <p>A commonly recommended strategy for increasing research use in clinical practice is to identify barriers to change and then tailor interventions to overcome the identified barriers. In nursing, the BARRIERS scale has been used extensively to identify barriers to research utilization.</p> <p>Aim and objectives</p> <p>The aim of this systematic review was to examine the state of knowledge resulting from use of the BARRIERS scale and to make recommendations about future use of the scale. The following objectives were addressed: To examine how the scale has been modified, to examine its psychometric properties, to determine the main barriers (and whether they varied over time and geographic locations), and to identify associations between nurses' reported barriers and reported research use.</p> <p>Methods</p> <p>Medline (1991 to September 2009) and CINHAL (1991 to September 2009) were searched for published research, and ProQuest^®digital dissertations were searched for unpublished dissertations using the BARRIERS scale. Inclusion criteria were: studies using the BARRIERS scale in its entirety and where the sample was nurses. Two authors independently assessed the study quality and extracted the data. Descriptive and inferential statistics were used.</p> <p>Results</p> <p>Sixty-three studies were included, with most using a cross-sectional design. Not one study used the scale for tailoring interventions to overcome identified barriers. The main barriers reported were related to the setting, and the presentation of research findings. Overall, identified barriers were consistent over time and across geographic locations, despite varying sample size, response rate, study setting, and assessment of study quality. Few studies reported associations between reported research use and perceptions of barriers to research utilization.</p> <p>Conclusions</p> <p>The BARRIERS scale is a nonspecific tool for identifying general barriers to research utilization. The scale is reliable as reflected in assessments of internal consistency. The validity of the scale, however, is doubtful. There is no evidence that it is a useful tool for planning implementation interventions. We recommend that no further descriptive studies using the BARRIERS scale be undertaken. Barriers need to be measured specific to the particular context of implementation and the intended evidence to be implemented.</p

Care home workers experiences of stress and coping during COVID‐19 pandemic: A mixed methods study

Aim: The aim of the study was to explore the stress and coping experiences of healthcare workers (HCWs) in care home settings in Scotland during the COVID‐19 pandemic. Design: A cross‐sectional mixed methods study was conducted using an online survey and interviews. Methods: Mean scores were calculated for both stress and coping and t‐tests used to explore possible links to demographics. Qualitative data were analysed thematically using Braun and Clarke's method. Results: For 52 survey participants, the mean score for the PSS was M = 39.75 and CSE‐M = 150.6 indicating high stress and medium coping skills. From the t‐test, only absence of health issues was associated with higher levels of coping. Thirteen HCWs participated in one‐to‐one interviews. Qualitative data analysis generated four themes contributing to stress: 1. personal factors, 2. changed care environment, 3. amplified scrutiny and 4. psychological responses. Coping was represented as three main themes: 1. personal factors, 2. organizational culture and 3. safety and security. There is a critical need for a strategic approach to provide psychological support to care home staff both during and beyond the context of the pandemic

Development of a breastfeeding website for women with pre-pregnancy diabetes : A mixed method study

This study identified the breastfeeding information and support needs of women with pre-pregnancy diabetes and as a result, developed an informed educational resource. The study utilised a mixed-methods design. Women with pre-pregnancy diabetes recruited from a health service in Melbourne and a consumer organisation were invited to complete a survey about perceptions of breastfeeding information and support. Health professionals were invited to participate in a focus group about breastfeeding resources for women with pre-pregnancy diabetes. An educational website was developed, and subsequently reviewed by women and an expert advisory panel. Six women completed the survey. Four health professionals attended a focus group. Both groups identified current sources of information about breastfeeding to be lacking, irrelevant and inapplicable to Australian conditions. A mobile-phone-friendly breastfeeding website was developed, based on the preferences of women and health professionals. Preliminary review indicates the website is informative, easy to read and appealing. It is important for health professionals to discuss breastfeeding support needs and preferences with women with pre-pregnancy diabetes at the earliest opportunity. Provision of tailored evidence-based breastfeeding information and support during pregnancy and the postpartum period will assist women with pre-pregnancy diabetes to make informed breastfeeding decisions, enhancing rates of breastfeeding intentions, initiation, and duration