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A mixed methods review to develop and confirm a framework for assessing midwifery practice in perinatal mental health

Wadephul, Franziska; Jarrett, Patricia M.; Jomeen, Julie; Martin, Colin R.


Franziska Wadephul

Patricia M. Jarrett

Julie Jomeen

Colin R. Martin


Aim: To ascertain whether a new framework examining midwifery practice in perinatal mental health is supported by the research literature.
Background: The identification and care of women with perinatal mental health problems is increasingly considered part of midwifery practice. Research suggests that many midwives lack knowledge, skills and confidence. It would be useful to be able to determine barriers and facilitators to effective clinical practice. The authors propose a framework comprising five potentially measurable domains which impact on midwives’ ability to identify, assess and care for women with perinatal mental health problems.
Design: This mixed-methods review uses an innovative qualitative convergent design based on framework synthesis.
Data sources: Relevant electronic databases were searched for the period from January 2007 to December 2016; 33 studies from nine countries met the inclusion criteria.
Review methods: Study quality was assessed using critical appraisal tools. Study findings were mapped onto the five domains of the framework: knowledge, confidence, attitudes, illness perception and infrastructure. Findings were then synthesized for each domain.
Results: All five domains are substantially represented in the literature, thus supporting the proposed framework. A number of sub-domains and relationships between domains were identified. Varying levels of knowledge, confidence, attitudes and illness perceptions were found; evidence suggests that midwives benefit from further training within these domains. Features of organisational infrastructure act as barriers or facilitators to effective care; these need to be addressed at organisational level.
Conclusion: The proposed framework was confirmed and can be used to inform practice, policy and research.


Wadephul, F., Jarrett, P. M., Jomeen, J., & Martin, C. R. (2018). A mixed methods review to develop and confirm a framework for assessing midwifery practice in perinatal mental health. Journal of advanced nursing, 74(10), 2258-2272.

Journal Article Type Review
Acceptance Date Jun 5, 2018
Online Publication Date Jul 10, 2018
Publication Date 2018-10
Deposit Date Jul 9, 2018
Publicly Available Date Jul 11, 2019
Print ISSN 0309-2402
Electronic ISSN 1365-2648
Publisher Wiley
Peer Reviewed Peer Reviewed
Volume 74
Issue 10
Pages 2258-2272
Keywords Midwifery; Midwives; Perinatal mental health; Postnatal depression; Antenatal depression; Midwifery education; Mixed-methods review; Framework synthesis
Public URL
Publisher URL
Contract Date Jul 9, 2018


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