Understanding barriers to women seeking and receiving help for perinatal mental health problems in UK general practice: development of a questionnaire

Ford, Elizabeth, Roomi, Hannah, Hugh, Hannah and van Marwijk, Harm (2019) Understanding barriers to women seeking and receiving help for perinatal mental health problems in UK general practice: development of a questionnaire. Primary Health Care Research and Development, 20. a156. ISSN 1463-4236

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Abstract

Aim
To develop a questionnaire to measure quantitatively barriers and facilitators to women’s disclosure of perinatal mental health problems in UK primary care. To pilot and evaluate the questionnaire for content validity and internal consistency.
Background
Around 15% of women develop a mental illness in the perinatal period, such as depression, anxiety or PTSD. In the United Kingdom, 90% of these women will be cared for in primary care, yet currently in as many as 50% of cases, no discussion of this issue takes place. One reason for this is that women experience barriers to disclosing symptoms of perinatal mental illness in primary care. These have previously been explored qualitatively, but no tool currently exists with which to measure these barriers quantitatively.
Methods
Questionnaire items, drawn from qualitative literature and accounts of women’s experiences, were identified, refined iteratively, and arranged in themes. The questionnaire was piloted using cognitive debriefing interviews to establish content validity. Women completed a refined version online. Responses were analysed using descriptive statistics. Internal consistency of subscales was calculated using Cronbach’s alpha.
Findings
Cognitive debriefing interviews with five women showed the majority of questionnaire items were relevant, appropriate and easy to understand. The final questionnaire was completed by 71 women, and the majority of subscales had good internal consistency. The barrier scoring most highly was fear and stigma, followed by willingness to seek help and logistics of attending an appointment. Family/partner support and GPs’ reaction were the lowest scoring barriers. Factors facilitating disclosure were GPs being empathetic and non-judgemental, and listening during discussions. In the future this questionnaire can be used to examine which barriers are most important for particular groups of women. This may enable development of strategies to improve acknowledgement and discussion, and prevent under-recognition and under-treatment, of perinatal mental health problems in primary care.

Item Type: Article
Keywords: barriers; general practice; help-seeking; perinatal mental health; postnatal depression; questionnaire
Schools and Departments: Brighton and Sussex Medical School > Primary Care and Public Health
Subjects: R Medicine > R Medicine (General)
R Medicine > RG Gynecology and obstetrics > RG0500 Obstetrics > RG0940 Maternal care. Prenatal care services
Depositing User: Elizabeth Ford
Date Deposited: 25 Nov 2019 08:26
Last Modified: 24 Jan 2020 15:30
URI: http://sro.sussex.ac.uk/id/eprint/88234

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