Identifying and supporting women with psychosocial issues during the postnatal period: evaluating an educational intervention for midwives using a before-and-after survey.

Objective: women experience a range of psychosocial issues during pregnancy, childbirth and the postnatal period. A review of hospital postnatal care in Australia found that many midwives who provide postnatal care find dealing with psychosocial issues a challenge, further complicated by heavy workloads that reduce the opportunity for quality interactions between midwives and women. This study aimed to evaluate an advanced communication skills education package for midwives caring for women during the postnatal period.
Design: a before-and-after survey design was used. Midwives attended seven sessions over a six-month period in 2006 and completed a survey before and after the sessions to evaluate the programme. Surveys included items about communication skills, willingness to change, learning style, and knowledge of and attitudes towards psychosocial issues.
Setting: the programme was implemented at two sites in Victoria, Australia: a tertiary metropolitan referral hospital and a regional hospital.
Participants: 25 midwives participated in the study.
Findings: 21 of the 25 participating midwives (84%) completed both the pre and post survey. Following the educational intervention, participants were more likely to feel competent at identifying women in an abusive relationship (p = 0.002); encouraging women to talk about any psychosocial issues (p = 0.02); actively encouraging women to talk about things on their mind (p = 0.01); and encouraging women to talk about how they are really feeling (p = 0.02). Participants also felt more confident in their knowledge of psychosocial issues (p=0.01) and in supporting women experiencing psychosocial issues in the early postnatal period (p = 0.02). Participants were very positive about the programme.
Key Conclusions and Implications for Practice: the advanced communication programme, implemented for the first time in the postnatal setting, increased the self-reported comfort and competency of midwives to identify and care for women with psychosocial issues during the postnatal period. The effect of this approach should now be evaluated in terms of women's outcomes.
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