Adaptation Reaction, Anxiety Disorders, Behavior Disorders, Depression, Health Care Acceptability, Health Care Seeking Behavior, Health Care Utilization, Mental Disorder, Panic Disorder, Perinatal, Post Traumatic Stress Disorder, Psychosis, Substance Abuse
Conditions
Keywords
Social stigma, Access to care, Facilitators, Barriers
Brief summary
This qualitative study with quantitative elements examines the health care provided to women who suffered from mental disorder during pregnancy and / or in the first year after birth (i.e. during the perinatal phase). Investigators will perform individual interviews with former PMD patients, and health and social care professionals to gain insights into current health care for PMD patients.
Detailed description
Background: Perinatal mental disorders (PMD) are highly prevalent (up to 20%), and patients use mental health care at high rates (Berger et al 2018). It is not known if the health care for PMD patients meets the needs of the patients. Aim: The Investigators will identify factors that promote or hinder service provision and access to care, for a range of relevant PMD. The investigation will cover the user and provider perspectives. Methods: The qualitative study consists of two complementary parts to assess user and provider perspectives. In part 1 the Investigators will conduct individual semi-structured interviews with 24 women who have had PMD. The sample will comprise of 4 clusters of relevant ICD-10 F-diagnoses, covering a wide range of mental disorders. The sample will also comprise of participants who received or did not receive mental health care before the last pregnancy. In part 2, the Investigators perform 3 focus groups (with 6-8 participants per group) with health and social care professionals, and a health-insurance delegate, to collect their experiences and perspectives on perinatal health care for PMD patients. The Investigators are guided for data collection and analysis by Levesque's et al (2013) conceptual model on access to health care. Expected results: The study will identify barriers and facilitators for health care access (user perspective) and provision (provider perspective). The study will generate the evidence base needed to develop integrated, coordinated, patient- and family-centered care for patients with various types of PMD.
Interventions
None listed
Sponsors
University of Bern
Bern University of Applied Sciences
Study design
Observational model
OTHER
Time perspective
OTHER
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
Yes
Inclusion criteria
Sample 1: patients with former PMD Inclusion criteria: 1. PMD within the past 24 months before the interview, 2. Recovered from acute PMD and stable for at least 12 months before the interview; 3. Able to share experiences; 4. More than 18 years old 5. Speak and understand German 6. At least 1 diagnosis in the last perinatal phase out of 4 groups of psychiatric disorders (ICD-10 Chapter V, F00-F99): 1. Mood (affective) disorders (F30-F39); Anxiety disorders (F41); Reaction to severe stress, and adjustment disorders (F43); and Obsessive-compulsive disorder (F42); 2. Disorders of adult personality and behavior (F60-F69; especially F60.3 Emotionally unstable personality disorder); 3. Mental and behavioral disorders due to psychoactive substance use (F10-F19; excluding tobacco (F17) if it is the sole F-diagnosis of the patient); 4. Psychosis (F20-F29 Schizophrenia, schizotypal and delusional disorders). Exclusion criterion: Current pregnancy Sample 2: Professional health and social care providers Inclusion criteria: 1. Professional experience of at least two years, 2. Have cared for at least 2 PMD patients the year before the focus group, a 3. Speak and understand German.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Narratives of barriers to perinatal mental health care use | perinatal phase, i.e. pregnancy and first year after birth | Narratives of access-inhibiting factors, in semi-structured individual interviews with former PMD patients |
| Narratives of mentions of facilitators of perinatal mental health care use | Perinatal phase, i.e. pregnancy and first year after birth | Narratives of access-promoting factors, in semi-structured individual interviews with former PMD patients |
| Narratives of mentions of barriers to perinatal mental health care provision | Perinatal phase, i.e. pregnancy and first year after birth | Narratives of provision-inhibiting factors, in focus group interviews with health and social care providers |
| Narratives of mentions of facilitators of perinatal mental health care provision | Perinatal phase, i.e. pregnancy and first year after birth | Narratives of provision-promoting factors, in focus group interviews with health and social care providers |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Sociodemographic data of participating affected PMD patients | 2019-2020 | Sociodemographic data of participating affected PMD patients |
| Sociodemographic data of participating health care professionals | 2019-2020 | Sociodemographic data of participating health care professionals |
Countries
Switzerland
Contacts
Primary ContactAnke Berger, Dr.
Backup ContactEva Cignacco, Prof. Dr.
Outcome results
None listed