RT Journal Article
SR Electronic
T1 Healthcare professionals’ perspectives on identifying and managing perinatal anxiety: a qualitative study
JF British Journal of General Practice
JO Br J Gen Pract
FD British Journal of General Practice
SP bjgp19X706025
DO 10.3399/bjgp19X706025
A1 Victoria Silverwood
A1 Annabel Nash
A1 Carolyn A Chew-Graham
A1 Jacqualyn Walsh-House
A1 Athula Sumathipala
A1 Bernadette Bartlam
A1 Tom Kingstone
YR 2019
UL http://bjgp.org/content/early/2019/09/23/bjgp19X706025.abstract
AB Background Perinatal mental health problems are those that occur during pregnancy or up to 12 months postpartum, and affect up to 20% of women. Perinatal anxiety (PNA) is at least as common as depression during the perinatal phase and can adversely impact on both mother and child. Despite this, research into anxiety has received less attention than depression. The National Institute for Health and Care Excellence guidance on perinatal mental health has identified PNA as a research priority.Aim To explore the perspectives and experiences of healthcare professionals (HCPs) in the identification and management of PNA.Design and setting This was a qualitative study in primary and secondary care set in the West Midlands from February 2017 to December 2017.Method Semi-structured interviews (n = 23) with a range of HCPs. Iterative approach to data generation and analysis, using principles of constant comparison. Patient and Public Involvement and Engagement (PPIE) group was involved throughout the study.Results Twenty-three HCPs interviewed: 10 GPs, seven midwives, five health visitors, and one obstetrician. Four themes were uncovered: PNA as an ‘unfamiliar concept’; reliance on clinical intuition and not clinical tools; fragmentation of care; and opportunities to improve care.Conclusion Awareness and understanding of PNA among HCPs is variable, with debate over what is ‘normal’ anxiety in pregnancy. HCPs suggested that PNA can be challenging to identify, with mixed views on the use and value of case-finding tools. Opportunistic identification was noted to be significant to aid diagnosis. Care for women diagnosed with PNA was reported to be fragmented and interprofessional communication poor. Potential solutions to improve care were identified.