Women’s Views and Outcomes of an Educational Intervention Designed to Enhance Psychosocial Support for Women During Pregnancy

Authors: Hegarty, Kelsey; Brown, Stephanie1; Gunn, Jane2; Forster, Della3; Nagle, Cate1; Grant, Belinda4; Lumley, Judith5

Source: Birth, Volume 34, Number 2, June 2007 , pp. 155-163(9)

Publisher: Wiley-Blackwell

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Background: Identification of psychosocial issues in pregnant women by screening is difficult because of the lack of accuracy of screening tools, women’s reluctance to disclose sensitive issues, and health care practitioner’s reluctance to ask. This paper evaluates if a health professional education program, a new (ANEW) approach, improves pregnant women’s ratings of care and practitioner’s listening skills and comfort to disclose psychosocial issues. Methods: Midwives and doctors from Mercy Hospital for Women, Melbourne, Australia, were trained from August to December 2002. English-speaking women (< 20 wks’ gestation) were recruited at their first visit and mailed a survey at 30 weeks (early 2002) before and after (2003) the ANEW educational intervention. Follow-up was by postal reminder at 2 weeks and telephone reminder 2 weeks later. Results: Twenty-one midwives and 5 doctors were trained. Of the eligible women, 78.2 percent (584/747) participated in a pre-ANEW survey and 73.3 percent (481/657) in a post-ANEW survey. After ANEW, women were more likely to report that midwives asked questions that helped them to talk about psychosocial problems (OR 1.45, CI 1.09–1.98) and that they would feel comfortable to discuss a range of psychosocial issues if they were experiencing them (coping after birth for midwives [OR 1.51, CI 1.10–2.08] and feeling depressed [OR 1.49, 1.16–1.93]; and concerns relating to sex [OR 1.35, CI 1.03–1.77] or their relationships [OR 1.36, CI 1.00–1.85] for doctors). Conclusions: The ANEW program evaluation suggests trends of better communication by health professionals for pregnant women and should be evaluated using rigorous methods in other settings. (BIRTH 34:2 June 2007)

Keywords: antenatal care; communication skills; nurse-patient relationship; pregnancy; psychosocial risk assessment

Document Type: Research Article

DOI: http://dx.doi.org/10.1111/j.1523-536X.2007.00163.x

Affiliations: 1: Stephanie Brown is a Principal Research Fellow, and Cate Nagle is a Doctoral Student in the Murdoch Children’s Research Institute, University of Melbourne, Melbourne, Victoria 2: Kelsey Hegarty is an Associate Professor and Jane Gunn is a Professor in the Department of General Practice 3: Della Forster is a Midwifery Consultant in the Mercy Hospital for Women and a Research Fellow in the Mother and Child Health Research 4: Belinda Grant is a Research Assistant at Turning Point Alcohol and Drug Centre Inc., Melbourne, Victoria, Australia. 5: Judith Lumley is a Professor in the Mother and Child Health Research, La Trobe University, Melbourne, Victoria

Publication date: June 1, 2007

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