The Royal Berkshire NHS Foundation Trust, London Road, Reading, Berkshire RG1 5AN, United Kingdom.
Kingston University and St George's University of London, United Kingdom.
Midwifery. 2020 Jul;86:102690. doi: 10.1016/j.midw.2020.102690. Epub 2020 Mar 20.
Mental health disorders are estimated to affect between 10% and 20% of women who access maternity services and can be defined as a public health issue due to the potential consequences for women, children and families. Detecting problems early in pregnancy can significantly improve outcomes for women and their families. However, mental health problems are not being consistently identified in routine midwifery practice and little is known from current literature about midwives' practice in relation to current national guidelines or the impact models of care have on assessing maternal mental health.
To identify midwives' views about barriers and facilitators to screening for mental health in pregnancy using current UK guidelines.
Nine community midwives from a single district general hospital in the south of England were recruited to take part in focus groups. Thematic analysis was used to extract key themes from the data.
Three key themes were identified from the focus groups and included system factors, social factors and trust. Barriers and facilitators to screening maternal mental health were associated with the initial 'booking' appointment' and differences in models of care. Barriers to screening were defined as high workload, poor continuity, and a lack of trust between women and midwives.
This study highlights key barriers and facilitators associated with mental health screening during pregnancy, including issues of trust and uncertainty about women's willingness to disclose mental health conditions. Further research is required to evaluate the relationship between women and midwives in contemporary practice and the influence this may have on maternal mental health.
精神健康障碍估计影响 10%至 20%的接受孕产服务的女性，可以被定义为公共健康问题，因为这对女性、儿童和家庭都有潜在影响。在怀孕早期发现问题可以显著改善女性及其家庭的结果。然而，精神健康问题在常规助产实践中并没有得到一致识别，目前的文献对助产士在与当前国家指南相关的实践或护理模式对评估产妇精神健康的影响方面知之甚少。
使用当前英国指南，确定助产士对孕期精神健康筛查的障碍和促进因素的看法。
从英格兰南部一家地区综合医院的 9 名社区助产士中招募了参加焦点小组的人员。使用主题分析从数据中提取关键主题。
从焦点小组中确定了三个关键主题，包括系统因素、社会因素和信任。筛查产妇精神健康的障碍和促进因素与初始“预约”和护理模式的差异有关。筛查障碍被定义为工作量大、连续性差以及妇女和助产士之间缺乏信任。
本研究强调了与孕期精神健康筛查相关的关键障碍和促进因素，包括信任问题和对妇女是否愿意披露精神健康状况的不确定性。需要进一步研究来评估当代实践中妇女和助产士之间的关系及其对产妇精神健康的影响。
