Discipline of Psychiatry and Mental Health, University of New South Wales, Sydney, New South Wales, Australia.
Karitane, Carramar, New South Wales, Australia.
Aust N Z J Obstet Gynaecol. 2023 Feb;63(1):42-51. doi: 10.1111/ajo.13550. Epub 2022 Jun 27.
Universal mental health screening and psychosocial assessment during pregnancy have been recommended as best practice, but uptake of universal programs in the private hospital system has been slow.
The aim of this study was to evaluate the Pre-admission Midwife Appointment Program (PMAP), an antenatal mental health screening program at the Mater Hospital, Sydney.
In this mixed-methods design study, PMAP interview data were collected for a consecutive series of 485 women who attended the PMAP during a 10-month period. Women also completed two postnatal telephone interviews (10 weeks and 9 months postpartum). The interviews involved depression screening and questions about the program.
Of the 485 participants, 4.1% screened positive for depression on the Edinburgh Postnatal Depression Scale. In total, 19% were identified as currently suffering from, or at risk of developing, perinatal mental health issues; referrals to support services were provided for the 13% who were not already linked in with appropriate supports. All women displayed a decrease in depressive symptom severity from pregnancy to 10 weeks and 9 months postpartum. The PMAP was viewed positively by consumers, with >93% viewing the program as helpful and >98% saying that they would recommend the program to others. Additional program benefits identified included opportunities to gain practical information and prepare for motherhood and to think/reflect on their emotional well-being.
Given the observed rates of psychosocial risk among this sample, related referral opportunities and positive consumer feedback, we recommend other Australian private hospitals consider implementing PMAP or similar programs.
普遍的孕期心理健康筛查和心理社会评估已被推荐为最佳实践，但在私立医院系统中，普遍项目的采用率一直很低。
本研究旨在评估 Mater 医院的产前心理保健筛查项目——预入院助产士预约计划（PMAP）。
在这项混合方法设计研究中，对在 10 个月期间参加 PMAP 的 485 名连续系列妇女进行了 PMAP 访谈数据收集。妇女还完成了两次产后电话访谈（产后 10 周和 9 个月）。访谈包括抑郁筛查和关于该计划的问题。
在 485 名参与者中，4.1%在爱丁堡产后抑郁量表上筛查出抑郁阳性。共有 19%的人被确定为目前患有或有患围产期心理健康问题的风险；对于那些尚未与适当支持联系起来的人，提供了支持服务的转介。所有妇女的抑郁症状严重程度从怀孕到产后 10 周和 9 个月均有所下降。PMAP 受到消费者的积极评价，超过 93%的人认为该计划有帮助，超过 98%的人表示会向他人推荐该计划。确定的其他项目益处包括获得实用信息和为母亲身份做准备以及思考/反思自己的情绪健康的机会。
鉴于该样本中观察到的心理社会风险率、相关的转介机会和积极的消费者反馈，我们建议其他澳大利亚私立医院考虑实施 PMAP 或类似的计划。
