Authors: Chew-Graham, Carolyn¹; Chamberlain, Elizabeth²; Turner, Katrina³; Folkes, Liz⁴; Caulfield, Layne⁵; Sharp, Deborah³

Source: British Journal of General Practice, Volume 58, Number 548, March 2008 , pp. 169-176(8)

Publisher: Royal College of General Practitioners

Abstract:

Background

In the UK, 8-15% of women suffer from postnatal depression, with long-term consequences for maternal mood and child development. Previous literature suggests that health visitors struggle with their conflicting roles with respect to mother and infant. Current policy is redirecting the emphasis and organisation of health visitor work, but guidelines state that health visitors and GPs should continue to have a major role in the detection and management of postnatal depression.

Aim

To explore the views of GPs and health visitors on the diagnosis and management of postnatal depression.

Design of study

A qualitative study nested within a multicentre randomised controlled trial.

Setting

Nine primary care trusts in Bristol, Manchester, and London.

Method

In-depth interviews with GPs and health visitors from primary care trusts participating in a randomised controlled trial of antidepressants versus health visitor-delivered non-directive counselling. Interviews were audiotaped and fully transcribed. Thematic analysis with an iterative approach was used to develop conceptual categories from the transcripts.

Results

Nineteen GPs and 14 health visitors were interviewed. GPs and health visitors described their work in making and negotiating the diagnosis of postnatal depression, the value of a long-term relationship with the woman, and how labelling affects management of women with postnatal depression. Responders described how they viewed others' roles in the management of postnatal depression, and how national policy and local organisational changes had an impact on patient care, so that no one health professional was assuming overall responsibility for the care of women with postnatal depression.

Conclusion

Ongoing organisational changes within primary care, such as the implementation of corporate working by health visitors, affect care provided to women after birth, which in turn has an impact on the diagnosis and management of postnatal depression.

References: 21 references open in new window

Articles that cite this article?

Keywords: health visitors; qualitative research; postnatal depression; primary care

Document Type: Research article

DOI: http://dx.doi.org/10.3399/bjgp08X277212

Affiliations: 1: School of Community-Based Medicine, University of Manchester; and National School for Primary Care Research, National Institute of Health Research, UK 2: Centre for Women's Studies, University of Manchester 3: Academic Unit of Primary Health Care, University of Bristol; and National School for Primary Care Research, National Institute of Health Research, UK 4: Academic Unit of Primary Health Care, University of Bristol 5: North West Deanery

Publication date: 2008-03-01

More about this publication?

• The British Journal of General Practice is an international journal publishing articles of interest to family practitioners and primary care researchers worldwide. The journal's 2010 Impact Factor is 2.07, making it the world's second most highly cited journal of general practice and primary health care.

  Recent issues: members of the Royal College of General Practitioners receive complimentary access to the British Journal of General Practice. Access is via the members' login area using your RCGP membership details. All users can freely access articles published up to 1 year ago, and the BJGP archive is available via PubMed Central.
  
  Email alerts can be enabled by registering with IngentaConnect. For information, see Help for web users.

• Information for Authors
• Subscribe to this Title
• Membership Information
• BJGP Archive
• ingentaconnect is not responsible for the content or availability of external websites

Related content

• In this: publication
• By this: publisher
• In this Subject: Public Health
• By this author: Chew-Graham, Carolyn ;  Chamberlain, Elizabeth ;  Turner, Katrina ;  Folkes, Liz ;  Caulfield, Layne ;  Sharp, Deborah

Website © Publishing Technology. Article copyright remains with the publisher, society or author(s) as specified within the article.

• Terms and conditions
• Privacy policy
• Information for advertisers