Barriers and facilitators for referring women with positive perinatal depression screening results in China: a qualitative study.

Publisher: BioMed Central Country of Publication: England NLM ID: 100967799 Publication Model: Electronic Cited Medium: Internet ISSN: 1471-2393 (Electronic) Linking ISSN: 14712393 NLM ISO Abbreviation: BMC Pregnancy Childbirth Subsets: MEDLINE

Original Publication: London : BioMed Central, [2001-

Depression* ; Maternal Health Services* ; Mothers*/psychology; Female ; Humans ; Pregnancy ; Mental Health ; Qualitative Research ; China ; Health Services Accessibility ; Referral and Consultation

Background: Timely screening and referral can improve the outcomes of perinatal depression (PND). However, uptake rates of referral after PND screening are low in China and the reasons are unclear. The aim of this article is to explore the barriers and facilitators for referring women with positive results of PND screening in the Chinese primary maternal health care system.
Methods: Qualitative data were collected from four primary health centers located in four different provinces of China. Each of the four investigators conducted 30 days of participant observations in the primary health centers from May to August 2020. Data were collected via participant observations and semi-structured in-depth interviews with new mothers who had positive results of PND screening, their family members, and primary health providers. Two investigators analyzed qualitative data independently. A thematic analysis was conducted, and data were framed using the social ecological model.
Results: A total of 870 hours of observation and 46 interviews were carried out. Five themes were identified: individual (new mothers' knowledge of PND, perceived need to seek help), interpersonal (new mothers' attitudes towards providers, family support), institutional (providers' perception of PND, lack of training, time constraints), community (accessibility to mental health services, practical factors), and public policy (policy requirements, stigma).
Conclusions: The likelihood of new mothers accepting PND referral is related to factors in five areas. Intervention strategies can be developed around these themes and may include educating new mothers and their families about PND, training primary health providers to improve their awareness of condition and indication for referral, building mental health support in routine postpartum home visits, and providing support through mobile technology.
(© 2023. The Author(s).)

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CX20200269 the Postgraduate Scientific Research Innovation Project of Hunan Province; 81973059 National Natural Science Foundation of China

Keywords: Barriers; Facilitators; Perinatal depression; Referral

Date Created: 20230405 Date Completed: 20230430 Latest Revision: 20230430

20231215

PMC10074342

10.1186/s12884-023-05532-6

37020285