Dudeney Elizabeth, Meades Rose, Ayers Susan, McCabe Rose
Centre for Maternal and Child Health Research, School of Heath and Psychological Sciences, City, University of London, London, United Kingdom.
Centre for Maternal and Child Health Research, School of Heath and Psychological Sciences, City, University of London, London, United Kingdom.
Midwifery. 2025 Mar;142:104309. doi: 10.1016/j.midw.2025.104309. Epub 2025 Jan 27.
Suicide is a leading cause of maternal death. Maternity healthcare practitioners (HCPs) are uniquely positioned to identify perinatal mental health (PMH) problems and/or suicidality. Research exploring HCPs attitudes towards suicide-related screening items and their experiences of asking about perinatal suicidality is limited.
(i) to explore HCPs attitudes towards 16 suicide-related screening items; and (ii) to explore HCPs broader views, experiences and implications of discussing suicide with perinatal women in maternity care settings.
Fifteen semi-structured interviews were conducted with maternity HCPs. The sample included midwives, health visitors, general practitioners, and specialist PMH practitioners working in the United Kingdom (UK). Inductive thematic analysis was used to explore the data and identify themes.
Most HCPs felt uncomfortable with, disliked, or found half of the suicide-related items unhelpful. Reasons included use of ambiguous or emotive terms. HCPs preferred not to use the word 'suicide' with pregnant or postnatal women. In the thematic analysis, four themes were identified: (i) Approaches for discussing and identifying PMH problems and suicidality; (ii) Competing demands and continuity of carer; (iii) PMH and suicidality training and support; and (iv) Availability of PMH services and referral pathways. These factors affected HCPs capacity, willingness, and confidence to ask women suicide-related questions.
HCPs need targeted PMH and suicidality training and support in maternity care contexts to enable them to feel more equipped, comfortable, and available to have conversations with women about PMH and suicide. Timely detection and intervention may help to improve care for women experiencing perinatal suicidality.
自杀是孕产妇死亡的主要原因。产科医护人员在识别围产期心理健康（PMH）问题和/或自杀倾向方面具有独特的地位。关于医护人员对自杀相关筛查项目的态度以及他们询问围产期自杀倾向经历的研究有限。
（i）探讨医护人员对16项自杀相关筛查项目的态度；（ii）探讨医护人员在产科护理环境中与围产期妇女讨论自杀的更广泛观点、经历和影响。
对产科医护人员进行了15次半结构化访谈。样本包括在英国工作的助产士、健康访视员、全科医生和围产期心理健康专科医生。采用归纳主题分析法对数据进行探索并确定主题。
大多数医护人员对一半的自杀相关项目感到不舒服、不喜欢或认为无用。原因包括使用了模糊或情绪化的术语。医护人员更倾向于不与孕妇或产后妇女使用“自杀”这个词。在主题分析中，确定了四个主题：（i）讨论和识别围产期心理健康问题及自杀倾向的方法；（ii）相互竞争的需求和护理人员的连续性；（iii）围产期心理健康和自杀倾向培训与支持；（iv）围产期心理健康服务的可用性和转诊途径。这些因素影响了医护人员询问女性自杀相关问题的能力、意愿和信心。
在产科护理环境中，医护人员需要有针对性的围产期心理健康和自杀倾向培训与支持，以使他们更有能力、更自在并有时间与女性谈论围产期心理健康和自杀问题。及时的检测和干预可能有助于改善对有围产期自杀倾向女性的护理。
