Public Health Nurses and perinatal mental health: A qualitative meta-synthesis

Abstract Background: Perinatal mental health is a major public health issue and Public Health Nurses play a key role in supporting women who experience perinatal mental health problems and several qualitative studies have... [ view full abstract ]

Abstract
Background: Perinatal mental health is a major public health issue and Public Health Nurses play a key role in supporting women who experience perinatal mental health problems and several qualitative studies have explored their role in this area. Through a synthesis of these studies we can increase our understanding of public health nurses preparation for their role and strategies available to support them in their work.


Aim:
To synthesises original qualitative research on Public Health Nurses perceived role in Perinatal Mental Health (PMH).

Search and Review Methodology
A systematic review and meta-synthesis was undertaken beginning with a comprehensive search of multiple databases from 2000-2015. Studies that employed qualitative methods to explore experiences and perceptions of public health nurses in identifying and caring for women who experience perinatal mental health problems were included. Two reviewers independently assessed the methodological quality of studies using the Critical Appraisal Skills Programme (CASP). Themes, concepts and interpretations were extracted and synthesised using the process of thematic analysis.

Findings: Fifteen papers including 14 unique qualitative studies were included. Two overarching themes emerged: conceptualisation and detection of perinatal mental health problems, and barriers and facilitators to management. The former of these comprised a number of sub-themes including the use of formal screening tools to focus in on perinatal mental health during visits and barriers encountered in detection. . The latter theme, barriers to management included availability of referral pathways, time and training. In terms of facilitators, training, public health nursing interventions, support groups and referral pathways were identified as factors that optimise the care of women.

Conclusions: Public Health Nurses reported a commitment to supporting women who experience perinatal mental health problems. However, a number of support structures are needed to optimise identification and care of women including access to continuous professional development (CPD) opportunities, appropriate referral pathways, knowledge of support groups available for women and relationship continuity.