Merton Catherine, Pasciak Katarzyna, Lightbourne Taber, Peacock-Chambers Elizabeth, Lemon Stephenie C, Byatt Nancy, Zimmermann Martha
Department of Psychiatry, UMass Chan Medical School - Worcester, Chang Building 222 Maple Avenue, Shrewsbury, MA, 01545, USA.
Department of Healthcare Delivery and Population Science, Department of Pediatrics, UMass Chan Medical School - Baystate, 3601 Main St, Springfield, MA, 01199, USA.
Psychiatr Q. 2025 May 26. doi: 10.1007/s11126-025-10153-7.
Depression and anxiety disorders are prevalent in the perinatal period and disproportionately impact individuals who experience economic marginalization. <15% of at-risk individuals are referred for recommended preventative counseling interventions. Little is known about the attitudes of care professionals and perinatal individuals towards prevention. This study's objective was to elicit attitudes of perinatal care professionals and individuals with lived experience of perinatal depression and anxiety who have been marginalized due to their economic status towards prevention interventions for perinatal mood and anxiety disorders in routine perinatal care settings.
We conducted semi-structured qualitative interviews with economically marginalized individuals with lived experience of perinatal anxiety or depression (n = 12) and perinatal care professionals (n = 12). We used a thematic analysis approach for data analysis.
Participants endorsed generally positive attitudes towards prevention. Both individuals and professionals identified gaps in current practices and expressed interest in prevention because they felt that it could improve outcomes. Both groups described skepticism that prevention is possible. Perinatal individuals also described concerns about professional capacity, stigma, and medical mistrust while professionals had concerns about potential for harm and resource limitations. Participants emphasized the importance of professional-patient relationships and multidisciplinary teams in effective delivery of prevention care.
Current approaches to prevention of mood and anxiety disorders in the perinatal period are lacking. Integration of prevention into routine obstetric care is of interest to perinatal individuals and professionals as a strategy to improve outcomes and reduce care inequities. Improving education and awareness of prevention interventions may reduce skepticism towards these interventions. Steps to build communication and trust between patients and professionals are needed to improve comfort and engagement with prevention interventions.
抑郁症和焦虑症在围产期很常见，对经历经济边缘化的个体影响尤甚。不到15%的高危个体被转介接受推荐的预防性咨询干预。关于护理专业人员和围产期个体对预防的态度知之甚少。本研究的目的是了解围产期护理专业人员以及因经济状况而被边缘化的有围产期抑郁和焦虑生活经历的个体对常规围产期护理环境中围产期情绪和焦虑障碍预防干预措施的态度。
我们对有围产期焦虑或抑郁生活经历的经济边缘化个体（n = 12）和围产期护理专业人员（n = 12）进行了半结构化定性访谈。我们采用主题分析方法进行数据分析。
参与者对预防普遍持积极态度。个体和专业人员都指出了当前实践中的差距，并对预防表示出兴趣，因为他们认为预防可以改善结果。两组都对预防是否可行表示怀疑。围产期个体还描述了对专业能力、耻辱感和医疗不信任的担忧，而专业人员则担心潜在危害和资源限制。参与者强调了专业医患关系和多学科团队在有效提供预防护理方面的重要性。
围产期情绪和焦虑障碍的当前预防方法存在不足。将预防纳入常规产科护理是围产期个体和专业人员感兴趣的策略，可改善结果并减少护理不平等。提高对预防干预措施的教育和认识可能会减少对这些干预措施的怀疑。需要采取措施建立患者与专业人员之间的沟通和信任，以提高对预防干预措施的舒适度和参与度。
