Kamuzu University of Health Sciences, School of Nursing, P/Bag 360, Blantyre, Malawi.
District Nursing Officer, Blantyre District Health and Social Office, Chipatala Avenue, Blantyre, Malawi.
BMC Psychiatry. 2022 Aug 12;22(1):544. doi: 10.1186/s12888-022-04195-5.
Depression is one of the most common perinatal mental health problems that affect pregnant women. Antenatal depression can adversely affect the well-being of the pregnant woman and her foetus. Depression is rarely detected by midwives due to the unavailability of relevant screening instruments in Malawi. A Screening Protocol for Antenatal Depression (SPADe) was developed and recommended for possible use to screen for depression in antenatal clinics in the country. The acceptability and feasibility of using the SPADe protocol to screen for depression has not been established. The aim of this study was to assess the acceptability and feasibility of screening for depression by midwives using SPADe in antenatal clinics in Blantyre district.
This study used a quantitative survey design to collect data among 60 midwives in three antenatal clinics in primary care settings. All inclusive sampling of all 60 midwives were used. The Structured Assessment of FEasibility and Ottawa Acceptability of Decision Rules Instruments were used to collect the data. Descriptive statistics and Chi square tests were used to analyse the data.
This study found that it was feasible to implement SPADe and the following enablers for screening depression had the highest ratings: the SPADe is applicable to pregnant women (M = 3.9, sd = 0.4); the intended goal of the SPADe matches the prioritised goals of Malawi Ministry of Health (M = 3.9, sd = 0.5); and the SPADe is likely to be effective (M = 3.8, sd = 0.6). On the other hand, barriers for implementing the SPADe were: the need for specific training to deliver the SPADe (M = 3.7, sd = 0.7); ongoing support and supervision (M = 3.5, sd = 0.8); and additional resources (M = 3.0, sd = 0.9). This study also found that the implementation of the SPADe was acceptable to respondents. The overall mean score for respondents on acceptability of screening antenatal depression using SPADe was found to be high (M = 4.6, sd = 0.6). However the differences in the respondents' mean scores on acceptability of screening for depression in antenatal clinics using SPADe in relation to their demographic characteristics were not significant (p > .05).
This study suggests that midwives feel that it is feasible and acceptable for them to implement the SPADe in antenatal clinics with ongoing training, support and clinical supervision.
抑郁症是影响孕妇的最常见围产期心理健康问题之一。产前抑郁症会对孕妇及其胎儿的健康产生不利影响。由于马拉维缺乏相关的筛查工具，因此助产士很少发现抑郁症。已经开发了产前抑郁症筛查协议（SPADe），并建议在该国的产前诊所使用该协议进行筛查。尚未确定使用 SPADe 协议筛查抑郁症的可接受性和可行性。本研究旨在评估在布兰太尔地区的初级保健环境中的产前诊所中使用 SPADe 筛查抑郁症的可接受性和可行性。
本研究采用定量调查设计，在三个初级保健产前诊所中收集了 60 名助产士的数据。对所有 60 名助产士进行了全纳入抽样。使用结构化评估可行性和渥太华决策规则接受度工具来收集数据。使用描述性统计和卡方检验分析数据。
本研究发现，实施 SPADe 是可行的，并且以下促成因素对筛查抑郁症的评价最高：SPADe 适用于孕妇（M=3.9，sd=0.4）；SPADe 符合马拉维卫生部的优先目标（M=3.9，sd=0.5）；SPADe 可能有效（M=3.8，sd=0.6）。另一方面，实施 SPADe 的障碍包括：需要特定的培训来实施 SPADe（M=3.7，sd=0.7）；持续的支持和监督（M=3.5，sd=0.8）；以及额外的资源（M=3.0，sd=0.9）。本研究还发现，实施 SPADe 得到了受访者的认可。受访者对使用 SPADe 筛查产前抑郁症的可接受性的总体平均得分为高（M=4.6，sd=0.6）。但是，在使用 SPADe 筛查产前诊所中抑郁的受访者在可接受性方面的平均得分与他们的人口统计学特征之间的差异并不显著（p>.05）。
本研究表明，助产士认为在接受持续培训、支持和临床监督的情况下，在产前诊所实施 SPADe 是可行且可接受的。
