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BackgroundWhile the public is under serious pressure from the coronavirus disease 2019 (COVID-19), the final impact and possible contributing factors to postpartum depression symptoms (PPDS) remain unknown. Therefore, a meta-analysis to investigate the association between PPDS and the COVID-19 pandemic was carried out by comparing the data between pre-pandemic and post-pandemic timeframes and exploring the influencing factors.MethodsThis systematic review was prospectively registered and recorded in a study protocol (Prospero CRD42022336820, http://www.crd.york.ac.uk/PROSPERO). A comprehensive search of PubMed, Embase, Web of Science, CINALH, Cochrane and Scopus was cmpleted on June 6, 2022. Studies that compared the prevalence of PPD before and during the COVID-19 pandemic period were included.ResultsOf 1766 citations identified, 22 studies were included with 15,098 participates before the COVID-19 pandemic and 11,836 participants during the COVID-19 pandemic. Overall, the analysis showed that the epidemic crisis was associated with an increased prevalence of PPDS (OR: 0.81 [0.68, 0.95], P = 0.009, I2 = 59%). Subgroup analysis was conducted according to the study characteristics and regions. Within the study characteristics classification, results showed an obvious increase in the prevalence of PPDS during the COVID-19 pandemic if PPDS cutoff was defined as Edinburgh postpartum depression score (EPDS) ≥13 points (OR: 0.72 [0.52, 0.98], P = 0.03, I2 = 67%) and an increased prevalence in follow-ups that happened after 2 weeks (≥ 2 weeks postpartum) (OR: 0.81 [0.68, 0.97], P = 0.02, I2 = 43%). Selected studies that were high-quality (OR: 0.79 [0.64, 0.97], P = 0.02, I2 = 56%) demonstrated an increased prevalence of PPDS during the COVID-19 pandemic period. Sorting by regional factors, studies conducted in Asia (OR: 0.81 [0.70, 0.93], P = 0.003, I2 = 0%) showed an increase of PPDS prevalence rates during the COVID-19 period, while studies conducted in Europe (OR: 0.82 [0.59, 1.13], P = 0.23, I2 = 71%) and North America (OR: 0.66 [0.42, 1.02], P = 0.06, I2 = 65%) showed no significant difference. All studies conducted in the developed (OR: 0.79 [0.64, 0.98], P = 0.03, I2 = 65%) and developing countries (OR: 0.81 [0.69, 0.94], P = 0.007, I2 = 0%) showed an increase of PPDS during the COVID-19 period.ConclusionsThe COVID-19 pandemic is associated with an increased prevalence of PPDS, especially after long-term follow-up and among the group with a high possibility of depression. The negative influence from the pandemic, causing more PPDS was significant in studies from Asia.

Aims and objectives Gaining insight in how people living with chronic conditions experience primary healthcare within their informal network. Background The primary healthcare system is challenged by the increasing number of people living with chronic conditions. To strengthen chronic care management, literature and policy plans point to a person-centred approach of care (PCC). A first step to identify an appropriate strategy to implement PCC is to gain more insight into the care experiences of these people and their informal caregivers. Design A phenomenological-hermeneutical philosophy is used. The study is in line with the Consolidated Criteria for Reporting Qualitative Research Guidelines (COREQ). Method In-depth, semi-structured interviews with people living with chronic conditions and informal caregiver dyads (PCDs) (n = 16; 32 individuals) were conducted. An open-ended interview guide was used to elaborate on the PCDs' experiences regarding primary care. A purposive, maximal variation sampling was applied to recruit the participants. Results Based on sixteen PCDs' reflections, ten themes were identified presenting their experiences with primary care and described quality care as listening and giving attention to what people with chronic conditions want, to what they strive for, and above all to promote their autonomy in a context wherein they are supported by a team of formal caregivers, family and friends. Conclusion To meet the PCDs' needs, self-management should be addressed in an interprofessional environment in which the PCD is an important partner. The findings may facilitate a shift to encourage PCDs in their strengths by enabling them to share their personal goals and by working towards meaningful activities in team collaboration. Relevance to clinical practice Three strategies—self-management support, goal-oriented care, and interprofessional collaboration—have been suggested to improve the PCDs' primary care experiences. These strategies could guide nursing practice in using more and improve high-quality nursing care.

Additional file 1: Supplementary File 1. Services for postpartum women during ‘doing the month’ period in different settings in Qingdao

Additional file 1. Interview guide.

Additional file 1. Informed consent file PINO-project (Dutch).

Additional file 2. Ethical considerations.

Background The impact of the COVID-19 pandemic on mental health in general practice remains uncertain. Several studies showed an increase in terms of mental health problems during the pandemic. In Belgium, especially during the first waves of the pandemic, access to general practice was limited. Specifically, it is unclear how this impacted not only the registration of mental health problems itself but also the care for patients with an existing mental health problem. Objective This study aimed to know the impact of the COVID-19 pandemic on (1) the incidence of newly registered mental health problems and (2) the provision of care for patients with mental health problems in general practice, both using a pre–COVID-19 baseline. Methods The prepandemic volume of provided care (care provision) for patients with mental health problems was compared to that from 2020-2021 by using INTEGO, a Belgian general practice morbidity registry. Care provision was defined as the total number of new registrations in a patient’s electronic medical record. Regression models evaluated the association of demographic factors and care provision in patients with mental health problems, both before and during the pandemic. Results During the COVID-19 pandemic as compared to before the COVID-19 pandemic, the incidence of registered mental health problems showed a fluctuating course, with a sharp drop in registrations during the first wave. Registrations for depression and anxiety increased, whereas the incidence of registered eating disorders, substance abuse, and personality problems decreased. During the 5 COVID-19 waves, the overall incidence of registered mental health problems dropped during the wave and rose again when measures were relaxed. A relative rise of 8.7% and 40% in volume of provided care, specifically for patients with mental health problems, was seen during the first and second years of the COVID-19 pandemic, respectively. Care provision for patients with mental health problems was higher in older patients, male patients, patients living in center cities (centrumsteden), patients with lower socioeconomic status (SES), native Belgian patients, and patients with acute rather than chronic mental health problems. Compared to prepandemic care provision, a reduction of 10% was observed in people with a low SES. Conclusions This study showed (1) a relative overall increase in the registrations of mental health problems in general practice and (2) an increase in care provision for patients with mental health problems in the first 2 years of the COVID-19 pandemic. Low SES remained a determining factor for more care provision, but care provision dropped significantly in people with mental health problems with a low SES. Our findings suggest that the pandemic in Belgium was also largely a “syndemic,” affecting different layers of the population disproportionately.

Background: Computerised decision support (CDS) based on trustworthy clinical guidelines is a key componentof a learning healthcare system. Research shows that the effectiveness of CDS is mixed.Multifaceted context, system, recommendation and implementation factors may potentially affect the success ofCDS interventions. This paper describes the development of a checklist that is intended to support professionals toimplement CDS successfully.Methods: We developed the checklist through an iterative process that involved a systematic review of evidenceand frameworks, a synthesis of the success factors identified in the review, feedback from an international expertpanel that evaluated the checklist in relation to a list of desirable framework attributes, consultations with patientsand healthcare consumers and pilot testing of the checklist.Results: We screened 5347 papers and selected 71 papers with relevant information on success factors forguideline-based CDS. From the selected papers, we developed a 16-factor checklist that is divided in four domains,i.e. the CDS context, content, system and implementation domains. The panel of experts evaluated the checklistpositively as an instrument that could support people implementing guideline-based CDS across a wide range ofsettings globally. Patients and healthcare consumers identified guideline-based CDS as an important qualityimprovement intervention and perceived the GUIDES checklist as a suitable and useful strategy.Conclusions: The GUIDES checklist can support professionals in considering the factors that affect the success ofCDS interventions. It may facilitate a deeper and more accurate understanding of the factors shaping CDSeffectiveness. Relying on a structured approach may prevent that important factors are missed.Keywords: Clinical computerised decision support systems, Practice Guidelines, Guideline adherence,Evidence-based medicine, Implementation