- Title
- Healthcare professionals' knowledge of postnatal depression in mothers with infants in the neonatal intensive care unit: a mixed methods approach
- Creator
- Riches, Fiona Patricia Juliet
- Relation
- University of Newcastle Research Higher Degree Thesis
- Resource Type
- thesis
- Date
- 2023
- Description
- Research Doctorate - Doctor of Philosophy (PhD)
- Description
- PROBLEM: Mothers of infants on the neonatal intensive care unit (NICU) are at an increased risk for developing postnatal depression (PND). NICU nurses are in an ideal position to help identify NICU mothers who are displaying symptoms of PND and provide early screening and intervention for those needing it. However, to initiate such processes, it is important to first understand what is already known about PND by the NICU staff, secondly to establish what is already done for mothers with PND on the units, and thirdly to propose how things could be done within the constraints of each NICU. AIMS:1. Explore the level of knowledge and awareness frontline clinicians have about PND in mothers of NICU patients. 2. Identify the clinical resources available in the NICU for assessing and intervening with women suspected of or suffering from PND. 3. Explore how NICU staff, NICU nurses and allied health professionals, experience and feel when conversing about PND with mothers of NICU patients. 4. Identify the elements necessary to establish a future clinical pathway that could be implemented to introduce universal screening to detect PND in the NICU. METHOD: This project utilised a mixed method concurrent triangulation design. The quantitative component of the study included an online survey which was designed and piloted, before being sent to members of the Australian College of Neonatal Nurses (N=500). The qualitative arm of the research was comprised of three focus groups at two separate NICUs in two separate area health districts in NSW Australia. Triangulation of the data occurred after the two data sets had been independently analysed. RESULTS: Quant: 203 participants responded to the online survey. Participants with higher ranked subjective knowledge were more likely to have used more than one screening tool to assess women for PND in the NICU (p=0.0001). NICU staff who stated they had awareness of a referral policy for PND cases on the NICU were more likely to have taken steps on the ward to implement that policy in their practices (p<0.0001). Those who strongly agreed with universal screening believed that all four health care professionals were best equipped to do the screening (p=0.0044). Qual: The conceptual area of Knowledge was divided into two themes, theoretical ‘know that’ or clinical ‘know how’. Each of these were further divided into three subthemes, - negative attitude and judgement; lack of discernment; and data and task focused. Clinical acumen; professional conscientiousness; sensitivity to the mother – respectively. The conceptual area of barriers and enablers to implementing evidence-based practice was divided into two themes intrinsic; divided into two subthemes, lived experiences and beliefs, - and extrinsic, support and team morale. CONCLUSIONS:NICU staff are knowledgeable about PND and its heightened risk in the NICU, however there is very little consensus in how to manage and intervene in cases of PND in a NICU mother. Confidence, strong working relationships and team cohesion were positive indicators for evidence-based intervention strategies for PND management. Participants who believed themselves to be the most knowledgeable had used the most intervention tools and had taken steps to intervene. Those with less knowledge and less confidence were less likely to have assessed a mother for PND. NICU nurses believed themselves to be critical in assessing and intervening in PND for mothers in the NICU. They believed that universal screening could be an effective measure to ensure all mothers get effective and timely management for symptoms of PND. Referral pathways and intervention policies need to be determined on a ward-by-ward basis to ensure that they can meet the needs of the mothers while being attainable and achievable by the NICU staff and their resources. Future research should build upon this preliminary work; ensure that staff in each NICU receive appropriate education surrounding PND management and screening, and an internal team helps to determine the most effective referral pathway.
- Subject
- postnatal depression; neonatal intensive care unit; mothers; knowledge; experiences; mixed methods research; health care professionals; PND; NICU; postpartum; postpartum women
- Identifier
- http://hdl.handle.net/1959.13/1481575
- Identifier
- uon:50747
- Rights
- Copyright 2023 Fiona Patricia Juliet Riches
- Language
- eng
- Full Text
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| Thumbnail | File | Description | Size | Format | |||
|---|---|---|---|---|---|---|---|
| View Details Download | ATTACHMENT01 | Thesis | 3 MB | Adobe Acrobat PDF | View Details Download | ||
| View Details Download | ATTACHMENT02 | Abstract | 556 KB | Adobe Acrobat PDF | View Details Download |