Putting woman-centered care into practice: a new (ANEW) approach to psychosocial risk assessment during pregnancy.
BACKGROUND
When antenatal care is provided, identification and management of challenging problems, such as depression, domestic violence, child abuse, and substance abuse, are absent from traditional midwifery and medical training. The main objective of this project was to provide an alternative to psychosocial risk screening in pregnancy by offering a training program (ANEW) in advanced communication skills and common psychosocial issues to midwives and doctors, with the aim of improving identification and support of women with psychosocial issues in pregnancy.


METHODS
ANEW used a before-and-after survey design to evaluate the effects of a 6-month educational intervention for health professionals. The setting for the project was the Mercy Hospital for Women in Melbourne, Australia. Surveys covered issues, such as perceived competency and comfort in dealing with specific psychosocial issues, self-rated communication skills, and open-ended questions about participants' experience of the educational program.


RESULTS
Educational program participants (n = 22/27) completed both surveys. After the educational intervention, participants were more likely to ask directly about domestic violence (p = 0.05), past sexual abuse (p = 0.05), and concerns about caring for the baby (p = 0.03). They were less likely to report that psychosocial issues made them feel overwhelmed (p = 0.01), and they reported significant gains in knowledge of psychosocial issues, and competence in dealing with them. Participants were highly positive about the experience of participating in the program.


CONCLUSIONS
The program increased the self-reported comfort and competency of health professionals to identify and care for women with psychosocial issues.
Gunn
Jane
J
Department of General Practice, University of Melbourne, Australia.
Hegarty
Kelsey
K
Nagle
Cate
C
Forster
Della
D
Brown
Stephanie
S
Lumley
Judith
J
D000328:Adult; D002649:Child Abuse / Q000175:diagnosis; D002983:Clinical Competence; D003142:Communication; D003863:Depression / Q000175:diagnosis; D017579:Domestic Violence; D004501:Education, Medical; D005260:Female; D006801:Humans; D007223:Infant; D007224:Infant Care; D007231:Infant, Newborn; D008880:Midwifery / Q000193:education*; D009035:Mothers / Q000523:psychology; D010818:Practice Patterns, Physicians'; D011247:Pregnancy; D011295:Prenatal Care / Q000592:standards*; D011296:Prenatal Diagnosis; D011594:Psychometrics; D018570:Risk Assessment; D012307:Risk Factors; D019966:Substance-Related Disorders / Q000175:diagnosis