Identifying psychosocial vulnerabilities in pregnancy: A mixed-method systematic review of the knowledge base of antenatal conversational psychosocial assessment tools

IF 2.6 3区医学 Q1 NURSING Midwifery Pub Date : 2024-06-12 DOI:10.1016/j.midw.2024.104066

Pernille Gram , Clara Graugaard Andersen , Kirsten Schultz Petersen , Marianne Stistrup Frederiksen , Louise Lund Holm Thomsen , Charlotte Overgaard

{"title":"Identifying psychosocial vulnerabilities in pregnancy: A mixed-method systematic review of the knowledge base of antenatal conversational psychosocial assessment tools","authors":"Pernille Gram , Clara Graugaard Andersen , Kirsten Schultz Petersen , Marianne Stistrup Frederiksen , Louise Lund Holm Thomsen , Charlotte Overgaard","doi":"10.1016/j.midw.2024.104066","DOIUrl":null,"url":null,"abstract":"<div><h3>Background</h3><p>Early identification of psychosocial vulnerability among expectant parents through psychosocial assessment is increasingly recommended within maternity care. For routine antenatal assessment, a strong recognition exists regarding conversational assessment tools. However, the knowledge base of conversational tools is limited, inhibiting their clinical use.</p></div><div><h3>Objective</h3><p>Synthesising existing knowledge pertaining to antenatal conversational psychosocial assessment tools, including identifying characteristics, acceptability, performance, effectiveness and unintended consequences.</p></div><div><h3>Design</h3><p>Mixed-method systematic review based on searches in CINAHL, PubMed, Embase, PsycINFO, Cochrane and Scopus. 20 out of 5394 studies were included and synthesised with a convergent integrated approach using a thematic analysis strategy.</p></div><div><h3>Findings</h3><p>We identified seven antenatal psychosocial assessment tools that partially or completely utilised a conversational approach. Women's acceptability was high, and tools were generally found to support person-centred communication and the parent-health care professional relationship. Evidence regarding effectiveness and performance of conversational tools was limited. Unintended consequences were found, including some women having negative experiences related to assessment of intimate partner violence, lack of preparation and lack of relevance. High acceptability was reported by health care professionals who considered the tools as valuable and enhancing of identification of vulnerability. Unintended consequences, including lack of time and competencies as well as discomfort when assessment is very sensitive, were reported.</p></div><div><h3>Conclusions</h3><p>Evidence regarding conversational tools' effectiveness and performance is limited. More is known about the acceptability of conversational tools, which is generally highly acceptable among women and health care professionals. Some unintended consequences of the use of included conversational tools were identified.</p></div>","PeriodicalId":18495,"journal":{"name":"Midwifery","volume":null,"pages":null},"PeriodicalIF":2.6000,"publicationDate":"2024-06-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0266613824001499/pdfft?md5=80a7e68ece0a7de1f98dbf2c3221dc83&pid=1-s2.0-S0266613824001499-main.pdf","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Midwifery","FirstCategoryId":"3","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S0266613824001499","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"NURSING","Score":null,"Total":0}

引用次数: 0

Abstract

Background

Early identification of psychosocial vulnerability among expectant parents through psychosocial assessment is increasingly recommended within maternity care. For routine antenatal assessment, a strong recognition exists regarding conversational assessment tools. However, the knowledge base of conversational tools is limited, inhibiting their clinical use.

Objective

Synthesising existing knowledge pertaining to antenatal conversational psychosocial assessment tools, including identifying characteristics, acceptability, performance, effectiveness and unintended consequences.

Design

Mixed-method systematic review based on searches in CINAHL, PubMed, Embase, PsycINFO, Cochrane and Scopus. 20 out of 5394 studies were included and synthesised with a convergent integrated approach using a thematic analysis strategy.

Findings

We identified seven antenatal psychosocial assessment tools that partially or completely utilised a conversational approach. Women's acceptability was high, and tools were generally found to support person-centred communication and the parent-health care professional relationship. Evidence regarding effectiveness and performance of conversational tools was limited. Unintended consequences were found, including some women having negative experiences related to assessment of intimate partner violence, lack of preparation and lack of relevance. High acceptability was reported by health care professionals who considered the tools as valuable and enhancing of identification of vulnerability. Unintended consequences, including lack of time and competencies as well as discomfort when assessment is very sensitive, were reported.

Conclusions

Evidence regarding conversational tools' effectiveness and performance is limited. More is known about the acceptability of conversational tools, which is generally highly acceptable among women and health care professionals. Some unintended consequences of the use of included conversational tools were identified.

查看原文

微信好友朋友圈 QQ好友复制链接

本刊更多论文

识别孕期社会心理脆弱性：产前对话式社会心理评估工具知识库的混合方法系统性回顾

背景越来越多的产科护理机构建议通过社会心理评估来早期识别准父母的社会心理脆弱性。在常规产前评估中，对话式评估工具得到了广泛认可。目的综合与产前对话式社会心理评估工具相关的现有知识，包括确定其特点、可接受性、性能、有效性和意外后果。设计基于在 CINAHL、PubMed、Embase、PsycINFO、Cochrane 和 Scopus 的检索，采用混合方法进行系统综述。在 5394 项研究中，我们纳入了 20 项研究，并采用主题分析策略对这些研究进行了综合归纳。妇女对这些工具的接受度很高，而且普遍认为这些工具支持以人为本的沟通以及父母与医疗保健专业人员之间的关系。有关对话式工具的有效性和性能的证据有限。研究发现了一些意想不到的后果，包括一些妇女在评估亲密伴侣暴力、缺乏准备和缺乏相关性方面的负面体验。据报道，医护专业人员对对话工具的接受度很高，他们认为对话工具很有价值，能增强对脆弱性的识别。有报告称，会话工具会产生意想不到的后果，包括缺乏时间和能力，以及在评估非常敏感时会产生不适感。人们对对话工具的可接受性了解较多，妇女和医护人员对对话工具的接受程度普遍较高。使用对话工具会产生一些意想不到的后果。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文去求助

来源期刊

Midwifery 医学-护理

CiteScore

4.50

自引率

7.40%

发文量

221

审稿时长

13.4 weeks

期刊介绍： Midwifery publishes the latest peer reviewed international research to inform the safety, quality, outcomes and experiences of pregnancy, birth and maternity care for childbearing women, their babies and families. The journal’s publications support midwives and maternity care providers to explore and develop their knowledge, skills and attitudes informed by best available evidence. Midwifery provides an international, interdisciplinary forum for the publication, dissemination and discussion of advances in evidence, controversies and current research, and promotes continuing education through publication of systematic and other scholarly reviews and updates. Midwifery articles cover the cultural, clinical, psycho-social, sociological, epidemiological, education, managerial, workforce, organizational and technological areas of practice in preconception, maternal and infant care. The journal welcomes the highest quality scholarly research that employs rigorous methodology. Midwifery is a leading international journal in midwifery and maternal health with a current impact factor of 1.861 (© Thomson Reuters Journal Citation Reports 2016) and employs a double-blind peer review process.