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.

Abstract

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.

Citation

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. https://doi.org/10.1111/jan.13786

• 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
• DOI: https://doi.org/10.1111/jan.13786
• Keywords: Midwifery; Midwives; Perinatal mental health; Postnatal depression; Antenatal depression; Midwifery education; Mixed-methods review; Framework synthesis
• Public URL: https://hull-repository.worktribe.com/output/917163
• Publisher URL: https://onlinelibrary.wiley.com/doi/abs/10.1111/jan.13786