Midwifery最新文献

{"title":"Midwives’ adaptation of their practice, role, and scope to ensure access to sexual and reproductive services during humanitarian crises: A scoping review","authors":"Susana E Ku Carbonell ,&nbsp;Patricia Ogba ,&nbsp;Meredith Vanstone ,&nbsp;Christy Gombay ,&nbsp;Elizabeth K Darling","doi":"10.1016/j.midw.2024.104065","DOIUrl":"10.1016/j.midw.2024.104065","url":null,"abstract":"<div><h3>Problem</h3><p>Limited research has examined and synthesized the adaptation of midwives and midwife-led interventions during crises.</p></div><div><h3>Background</h3><p>Evidence suggests that midwives are essential to respond to sexual and reproductive health care needs during disruptive times, and that they adapt to continue to provide their services during those circumstances.</p></div><div><h3>Aim</h3><p>To map the adaptations of midwives when providing care during crises globally. Secondary objectives include identifying which midwives adapted, what services were adapted and how, and the demographic receiving care.</p></div><div><h3>Study methods</h3><p>Scoping review using Levac's modifications of Arksey and O'Malley's methods. Publications and grey literature, in English and Spanish, with no limitations based on study design or date were included. Data was extracted and mapped using Wheaton and Maciver's Adaptation framework.</p></div><div><h3>Findings</h3><p>We identified 3329 records, of which forty-two were included. Midwives’ prior training impacted adaptation. Midwives adapted to the COVID-19 pandemic, epidemics, natural disasters, and World War II. They adapted in hospital and community settings around the provision of antenatal, labor and birth, postpartum, and contraceptive care. However, no specific data identified population demographics. Midwifery adaptations related to their practice, role, and scope of practice.</p></div><div><h3>Conclusion</h3><p>The limited available evidence identified the challenges, creativity, and mutual aid activities midwives have undertaken to ensure the provision of their services. Evidence is highly concentrated around maternal health services. Further high-quality research is needed to provide a deeper understanding of how midwifery-led care can adapt to guide sustainable responses to ensure access to sexual and reproductive health services during crises.</p></div>","PeriodicalId":18495,"journal":{"name":"Midwifery","volume":null,"pages":null},"PeriodicalIF":2.6,"publicationDate":"2024-06-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0266613824001487/pdfft?md5=dcda4cf888abb5a6a229f2f6be3d6bc2&pid=1-s2.0-S0266613824001487-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141534804","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The experience of miscarriage and its impact on prenatal attachment during the following pregnancy: A mixed-methods study","authors":"Myriam Chemouny,&nbsp;Jaqueline Wendland","doi":"10.1016/j.midw.2024.104072","DOIUrl":"10.1016/j.midw.2024.104072","url":null,"abstract":"<div><h3>Background</h3><p>In France, miscarriage affects nearly 200,000 women every year. This life event may generate negative effects on the mother-child relationship and the mother's mental health in the following pregnancy.</p></div><div><h3>Objectives</h3><p>To investigate the influence of body satisfaction, partner support, resilience and previous experience of a miscarriage on prenatal attachment in pregnant women.</p></div><div><h3>Design</h3><p>This is a cross-sectional mixed-methods study. Women answered an online questionnaire in the period between November 2022 to April 2023.</p></div><div><h3>Participants</h3><p>267 French pregnant women who had previously experienced a miscarriage were recruited for this study.</p></div><div><h3>Measurements</h3><p>Study outcomes included prenatal attachment, resilience, partner support, history of previous pregnancies and miscarriages, the current pregnancy, and questions relating to body experience.</p></div><div><h3>Findings</h3><p>Participants who reported a high investment in the current pregnancy, high partner support and a positive image of their body had higher levels of prenatal attachment. The experience of miscarriage also seems to influence prenatal attachment: pregnancy investment at the time of miscarriage had a positive influence, while medical experience had no significant impact. While the global resilience score was not related to prenatal attachment, sense of control was positively linked to prenatal attachment.</p></div><div><h3>Key conclusions and implications for practice</h3><p>These results highlight the importance of considering miscarriage as a perinatal loss with potential for long-lasting impact on women, which deserves particular attention from professionals. Enhancing partner support and helping women build a positive image of their pregnant body can also have a role in fostering prenatal attachment to the foetus.</p></div>","PeriodicalId":18495,"journal":{"name":"Midwifery","volume":null,"pages":null},"PeriodicalIF":2.6,"publicationDate":"2024-06-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0266613824001554/pdfft?md5=b33d37fb1886889a9dafbff66b758fc4&pid=1-s2.0-S0266613824001554-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141469337","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A very, very lonely, unmagical time. The lived experience of perinatal anxiety: A longitudinal interpretative phenomenological analysis","authors":"Kelda J Folliard ,&nbsp;Kenda Crozier ,&nbsp;Meghana M Wadnerkar Kamble","doi":"10.1016/j.midw.2024.104070","DOIUrl":"10.1016/j.midw.2024.104070","url":null,"abstract":"<div><h3>Problem</h3><p>Minimal longitudinal qualitative evidence examining lived experience of anxiety over the perinatal continuum limits holistic understanding of the course of antenatal and postnatal anxiety.</p></div><div><h3>Background</h3><p>Perinatal anxiety has deleterious effects on the mother and infant and is more commonly experienced yet less well investigated than perinatal depression.</p></div><div><h3>Aim and method</h3><p>To explore women's experiences living with perinatal anxiety to increase understanding of the condition; inform support given by midwives and other health professionals and provide practice, education, and research recommendations. Five women were interviewed at three timepoints, producing 15 datasets. Data was analysed using longitudinal interpretative phenomenological analysis.</p></div><div><h3>Findings</h3><p>Nine Group Experiential Themes emerged: the anxious mother, transformation, sets of ears and the anxious pregnancy (antenatal); baby as external focus, returning to oneself and the emotional unknown (early postnatal); and moving on, and shifting sands (late postnatal). Three Longitudinal Experiential Concepts explicated lived experience over time: maternal eyes, transforming existence, and emotional kaleidoscope. The lived experience of perinatal anxiety was revealed as socially constructed, with relationships with self, others, and the world key. The collision between anxiety and motherhood as social constructs provides perinatal anxiety with its unique characteristics.</p></div><div><h3>Conclusion</h3><p>Midwives and other healthcare professionals should understand the significance of perinatal anxiety, enabling disclosure of stigmatising and uncomfortable feelings without judgement. Research examining whether perinatal specific screening tools should be used by midwives and exploring the relationship between perinatal anxiety and depression is recommended. Education for clinicians on the significance of perinatal anxiety is essential.</p></div>","PeriodicalId":18495,"journal":{"name":"Midwifery","volume":null,"pages":null},"PeriodicalIF":2.6,"publicationDate":"2024-06-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0266613824001530/pdfft?md5=8e24339b0e62928095e6866d50bd1544&pid=1-s2.0-S0266613824001530-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141432190","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Maternity support workers’ experiences of workplace trauma and post-traumatic stress symptoms","authors":"Pauline Slade ,&nbsp;Charlotte Smart ,&nbsp;Charlotte Krahé ,&nbsp;Helen Spiby","doi":"10.1016/j.midw.2024.104071","DOIUrl":"10.1016/j.midw.2024.104071","url":null,"abstract":"<div><h3>Background</h3><p>Maternity support workers (MSWs) are now a key part of the maternity workforce. They work in environments with potential exposure to traumatic events, but little is known about their rates of exposure or psychological responses.</p></div><div><h3>Objectives</h3><p>We aimed to identify the proportion of MSWs reporting exposure to a traumatic work event and consequential rates of post-traumatic stress disorder (PTSD). We also aimed to identify factors associated with PTSD and to describe levels of burnout, empathy, and functional impairment, and to explore their potential associations with PTSD symptoms.</p></div><div><h3>Methods</h3><p>MSWs were recruited via the Royal College of Midwives newsletter, which is sent to all MSW members, and via social media on the College MSW Facebook page. Participants completed an online survey. They provided information on demographic details, job role, and exposure to traumatic events, and completed questionnaires covering PTSD symptoms related to work events, related functional impairment, burnout, and empathy. Data were analysed via correlations and multiple regression.</p></div><div><h3>Findings</h3><p>Of 98 respondents, 88 had been exposed to a traumatic work event; 79 of these through being present and nine through hearing about traumatic events. Of those exposed, 14.8% (<em>n</em> = 13) participants had probable PTSD, while a further 5.7 % (<em>n</em> = 5) met the subclinical threshold. Over a third (35.2 %) of the sample showed high levels of emotional exhaustion, a key feature of burnout, and 27.3 % reported functional work impairment. PTSD symptoms were associated with younger age, higher empathic concern, and direct exposure to traumatic perinatal events.</p></div><div><h3>Conclusions and clinical implications</h3><p>MSWs are routinely exposed to traumatic events at work and are at risk of work-related PTSD. Younger and more empathic staff appear more at risk, although our methods could not distinguish cause and effect. It must also be noted that the survey took place during the COVID-19 pandemic, and findings could be influenced by this context. MSWs need to be routinely included in programmes to support staff in relation to trauma exposure at work.</p></div>","PeriodicalId":18495,"journal":{"name":"Midwifery","volume":null,"pages":null},"PeriodicalIF":2.6,"publicationDate":"2024-06-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0266613824001542/pdfft?md5=c22fc290498ae9316e26d13a0976b266&pid=1-s2.0-S0266613824001542-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141555218","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Underlying beliefs of preventive health behaviours among women with a history of gestational diabetes mellitus: A descriptive qualitative study","authors":"Mei Qi Ang ,&nbsp;Xi Vivien Wu ,&nbsp;Hong-Gu He","doi":"10.1016/j.midw.2024.104068","DOIUrl":"10.1016/j.midw.2024.104068","url":null,"abstract":"<div><h3>Aims</h3><p>To explore the underlying beliefs of preventive health behaviours among women with a history of GDM who had low levels of preventive health behaviours during their postpartum period in Singapore.</p></div><div><h3>Methods</h3><p>This paper reports on the qualitative arm of a mixed method study. The qualitative descriptive design was adopted. Individual interviews were conducted between 7th September 2020 and 25th September 2020 using a semi-structured interview guide. Data collected were analysed using thematic analysis.</p></div><div><h3>Results</h3><p>A total of 18 women completed the interview. The participants’ ages ranged from 26 to 40 years with a mean age of 33.17 years (SD= 4.09). The duration since childbirth was 8.78 months (SD = 1.35). Through thematic analysis, five themes were developed: lifestyle adjustment, self-motivation, supportive environment, barriers to practising a healthy lifestyle, and risk perception. A total of 14 subthemes emerged from the five main themes. The beliefs of women with a history of GDM were described according to the Theory of Planned Behaviour.</p></div><div><h3>Conclusions</h3><p>Having a newborn brings changes to the lifestyle of a woman and her family, which can affect the health behaviours in the postpartum period. This study revealed several novel findings relating to the unmet needs of women who had GDM, specifically to the need for information and emotional support to safely resume healthy behaviours after childbirth, for which participants have provided suggestions on how to enhance the continuity of care in the postpartum period.</p></div>","PeriodicalId":18495,"journal":{"name":"Midwifery","volume":null,"pages":null},"PeriodicalIF":2.6,"publicationDate":"2024-06-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141415327","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Novel grouping of planned coping strategies for managing the intensity of labour: A survey study of Australian nulliparous women","authors":"Janine Shifman ,&nbsp;Lester E. Jones ,&nbsp;Mary-Ann Davey ,&nbsp;Christine E. East ,&nbsp;Laura Y. Whitburn","doi":"10.1016/j.midw.2024.104055","DOIUrl":"10.1016/j.midw.2024.104055","url":null,"abstract":"<div><h3>Background</h3><p>It is common for women to explore and plan strategies to cope during labour. These strategies are usually focused on pain control and described as either pharmacological or non-pharmacological. As labour is an individual experience, each woman should be enabled to choose strategies that best suit them, and that reflect what they feel influences their sense of capacity to cope.</p></div><div><h3>Aim</h3><p>By exploring women's intentions and choices of strategies, this study aimed to understand how coping strategies can better reflect women's individual needs and expectations.</p></div><div><h3>Methods</h3><p>Fifty-six primiparous women were recruited from one tertiary hospital in Melbourne, Australia between February and May 2021. Data were collected via a survey in late pregnancy using open-ended questions. Content and thematic analyses were used to analyse responses.</p></div><div><h3>Results</h3><p>Themes related to how women frame the intensity of labour, how they strive for a relationally safe environment and a need to be prepared and knowledgeable. Strategies chosen by women could be grouped into two categories: intrinsic and extrinsic. Intrinsic strategies could be self-generated by women (such as breathing techniques and movement), while extrinsic strategies required either equipment (such as a bath) or others to administer (such as epidural analgesia).</p></div><div><h3>Conclusions</h3><p>Women value having a range of intrinsic and extrinsic strategies that enable autonomy or require external support. This moves beyond the ‘pharmacological and non-pharmacological’ categorisation of strategies, and we propose that reframing strategies as intrinsic and extrinsic could have a number of benefits on women's sense of autonomy and utilisation of strategies. The findings provide a foundation for more targeted research into how women can be supported to individualise and implement these coping strategies in labour.</p></div>","PeriodicalId":18495,"journal":{"name":"Midwifery","volume":null,"pages":null},"PeriodicalIF":2.6,"publicationDate":"2024-06-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0266613824001384/pdfft?md5=6e60792823f4d1faeedb7c4c8ad99219&pid=1-s2.0-S0266613824001384-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141396889","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Validation of the Chinese version of the Whooley questions for community screening of postpartum depression","authors":"Xia Wu ,&nbsp;Yanping Bai ,&nbsp;Xiaoyu Li ,&nbsp;Kar Keung Cheng ,&nbsp;Wenjie Gong","doi":"10.1016/j.midw.2024.104054","DOIUrl":"10.1016/j.midw.2024.104054","url":null,"abstract":"<div><h3>Background</h3><p>The study aims to validate the Whooley questions for screening postpartum depression in Chinese women in a community setting.</p></div><div><h3>Methods</h3><p>The Whooley questions was translated into Chinese following Beaton's intercultural debugging guidelines. From December 1, 2020 to June 30, 2021, primary maternal and child health workers in Kaifu District and Changsha County in Changsha City recruited women aged 18 years or older who had recently given birth during home visits within seven days of discharge from hospital. Participants women completed the Whooley questions online and underwent a diagnostic interview for DSM-IV within 7 days of the visit. We evaluated Cronbach's alpha, split-half reliability, area under the ROC curve (AUC), sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and optimal cut-off value of the Whooley questions.</p></div><div><h3>Results</h3><p>Of the 3,004 eligible women, 1,862 completed the Whooley questions and diagnostic interviews. Sixty-two women (3.3%) were diagnosed with depressive disorders. The Cronbach's alpha coefficient was 0.64, the split-half reliability was 0.64. The optimal cut-off value was when at least one questions was answered “yes”, with an AUC of 0.84 (SE=0.03, 95%CI 0.78–0.90, P&lt;0.001), sensitivity of 0.77 (95%CI 0.65–0.87), specificity of 0.89 (95%CI 0.88–0.90), PPV of 0.20 (95%CI 0.15–0.25) and NPV of 0.99 (95%CI 0.98–1.00).</p></div><div><h3>Conclusion</h3><p>This study shows that the Chinese version of the Whooley questions is a reliable tool for screening postpartum depression in the community, but it may lead to many false positive cases.</p></div>","PeriodicalId":18495,"journal":{"name":"Midwifery","volume":null,"pages":null},"PeriodicalIF":2.6,"publicationDate":"2024-06-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141406493","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The reliability and validity of the Postpartum Partner Support Scale among Chinese women","authors":"Xiaojuan Su ,&nbsp;Huifang Wang ,&nbsp;Karen McQueen ,&nbsp;Cindy-Lee Dennis ,&nbsp;Yuezhen Zhang ,&nbsp;Meide Chen ,&nbsp;Guihua Liu","doi":"10.1016/j.midw.2024.104067","DOIUrl":"10.1016/j.midw.2024.104067","url":null,"abstract":"<div><h3>Background</h3><p>The benefits of partner support have been well documented for maternal and child health and wellbeing. Chinese women who practice traditional postpartum rituals may lack support during the confinement and often rely heavily on their partners. Currently, there is no validated measure to assess postpartum partner support in China.</p></div><div><h3>Aim</h3><p>To translate the Postpartum Partner Support Scale (PPSS) into Chinese, evaluate its psychometric properties and assess postpartum support among Chinese women.</p></div><div><h3>Methods</h3><p>The PPSS was translated into Chinese using a validated process and administered to 428 postpartum women residing in the city of Quanzhou in the Fujian Province in China between September 2021 and July 2022.</p></div><div><h3>Results</h3><p>Reliability analysis demonstrated a Cronbach's α coefficient of 0.97, a split-half coefficient of 0.93, and a retest correlation coefficient of 0.91 (<em>p</em> &lt; 0.01). The item analysis and content validity results fell within the recommended range, with no items requiring deletion. Exploratory factor analysis revealed the extraction of a single common factor, which accounted for 74.05% of the cumulative variance. Confirmatory factor analysis yielded a χ2/df ratio of 1.48 and an RMSEA value of 0.05. Several demographic variables were associated with significantly lower levels of postnatal partner support including older maternal and paternal age, lower maternal education, higher household income, fair relationship with in-law family, female infant sex, and premature birth.</p></div><div><h3>Conclusion</h3><p>The Chinese version of the PPSS exhibited good reliability and validity providing evidence that it may be suitable for evaluating partner support among postpartum women in China.</p></div>","PeriodicalId":18495,"journal":{"name":"Midwifery","volume":null,"pages":null},"PeriodicalIF":2.6,"publicationDate":"2024-06-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141403228","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Augmented reality simulation-based training for midwifery students and its impact on perceived knowledge, confidence and skills for managing critical incidents","authors":"Kristina Vogel ,&nbsp;Annette Bernloehr ,&nbsp;Tabea Willmeroth ,&nbsp;Jonas Blattgerste ,&nbsp;Claudia Hellmers ,&nbsp;Nicola H. Bauer","doi":"10.1016/j.midw.2024.104064","DOIUrl":"10.1016/j.midw.2024.104064","url":null,"abstract":"<div><h3>Problem</h3><p>Emergency obstetric management is essential in midwifery training to prevent fetal and maternal morbidity. Repeating this management in practice is often not possible. Sustainable confidence in these procedures is usually achieved in the first few years of practice.</p></div><div><h3>Background</h3><p>Simulation training complements hands-on learning and improves practical skills, benefiting both students and patients. Research on obstetric emergency simulation training have demonstrated this, but the use of digital simulation approaches, such as augmented reality (AR), is under-researched.</p></div><div><h3>Aim</h3><p>To investigate whether AR simulation training influences midwifery students' subjective perceptions of knowledge, confidence and practical skills in emergency situations.</p></div><div><h3>Methods</h3><p>A descriptive exploratory study was conducted using a pre-post design. AR scenarios were developed on the topics of 'preparing emergency tocolysis', 'preparing a pregnant woman for caesarean section' and ‘resuscitation of newborns'. The AR simulation was conducted in the fourth to fifth semester of the midwifery programme. A questionnaire was developed for students (<em>N</em> = 133) to self-assess their competence in the categories of knowledge, confidence and practical skills.</p></div><div><h3>Results</h3><p>Students rated their competence significantly better in the post-survey than in the pre-survey (<em>p</em>=&lt;0.05). Simulation has an impact on self-assessment of professional knowledge, confidence and practical skills in emergency situations. It enhances students' procedural knowledge and practical skills in complex contexts, complements subject knowledge and builds confidence.</p></div><div><h3>Conclusion</h3><p>The results provide initial evidence that AR simulation is an effective learning strategy for emergency management preparedness. Future studies should validate the effect with control cohorts and measure competence through practical examinations.</p></div>","PeriodicalId":18495,"journal":{"name":"Midwifery","volume":null,"pages":null},"PeriodicalIF":2.6,"publicationDate":"2024-06-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0266613824001475/pdfft?md5=3f561d142af1ef2dbdd0efb43ab20394&pid=1-s2.0-S0266613824001475-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141398064","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Identifying psychosocial vulnerabilities in pregnancy: A mixed-method systematic review of the knowledge base of antenatal conversational psychosocial assessment tools","authors":"Pernille Gram ,&nbsp;Clara Graugaard Andersen ,&nbsp;Kirsten Schultz Petersen ,&nbsp;Marianne Stistrup Frederiksen ,&nbsp;Louise Lund Holm Thomsen ,&nbsp;Charlotte Overgaard","doi":"10.1016/j.midw.2024.104066","DOIUrl":"10.1016/j.midw.2024.104066","url":null,"abstract":"<div><h3>Background</h3><p>Early identification of psychosocial vulnerability among expectant parents through psychosocial assessment is increasingly recommended within maternity care. For routine antenatal assessment, a strong recognition exists regarding conversational assessment tools. However, the knowledge base of conversational tools is limited, inhibiting their clinical use.</p></div><div><h3>Objective</h3><p>Synthesising existing knowledge pertaining to antenatal conversational psychosocial assessment tools, including identifying characteristics, acceptability, performance, effectiveness and unintended consequences.</p></div><div><h3>Design</h3><p>Mixed-method systematic review based on searches in CINAHL, PubMed, Embase, PsycINFO, Cochrane and Scopus. 20 out of 5394 studies were included and synthesised with a convergent integrated approach using a thematic analysis strategy.</p></div><div><h3>Findings</h3><p>We identified seven antenatal psychosocial assessment tools that partially or completely utilised a conversational approach. Women's acceptability was high, and tools were generally found to support person-centred communication and the parent-health care professional relationship. Evidence regarding effectiveness and performance of conversational tools was limited. Unintended consequences were found, including some women having negative experiences related to assessment of intimate partner violence, lack of preparation and lack of relevance. High acceptability was reported by health care professionals who considered the tools as valuable and enhancing of identification of vulnerability. Unintended consequences, including lack of time and competencies as well as discomfort when assessment is very sensitive, were reported.</p></div><div><h3>Conclusions</h3><p>Evidence regarding conversational tools' effectiveness and performance is limited. More is known about the acceptability of conversational tools, which is generally highly acceptable among women and health care professionals. Some unintended consequences of the use of included conversational tools were identified.</p></div>","PeriodicalId":18495,"journal":{"name":"Midwifery","volume":null,"pages":null},"PeriodicalIF":2.6,"publicationDate":"2024-06-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0266613824001499/pdfft?md5=80a7e68ece0a7de1f98dbf2c3221dc83&pid=1-s2.0-S0266613824001499-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141404631","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}