title: Impact of midwives' training on postnatal depression screening in the first week post delivery: a quality improvement report.
abstract: BACKGROUND
  postnatal depression (PND) is a major public health problem. The objective of this study was to improve early PND screening by midwives in a maternity unit. Professional screening techniques were evaluated and compared with reference screening techniques [Edinburgh Postnatal Depression Scale (EPDS), Mini International Neuropsychiatric Interview (MINI-DSM-IV)].
  
  
  METHODS
  the evaluation took place before and after the midwife training in order to determine the effectiveness of specific clinical recommendations for two successive 10-week inclusion periods (from November 2004 to September 2005). A short training course and posters were used to convey the recommendations, agreed by obstetricians, paediatricians and psychiatrists.
  
  
  RESULTS
  a total of 463 postpartum women were included in the two phases of the study. Quantitative and qualitative PND screening by midwives improved significantly following training (Z=2.07, p=0.04; Z=2.62, p=0.008, respectively). Early detection of major depressive episodes increased by 37.7% (95% confidence interval 25.7-49.7) following training. A combination of midwives' perception of poor emotional well-being and the EPDS led to a significant improvement in early detection of PND (Q=8.00, p=0.04).
  
  
  CONCLUSIONS
  targeted recommendations given to the midwives led to an improvement in the early detection of PND. Suitable programmes need to be offered to reduce the number of cases of PND. Perinatal psychiatrists should be seen to be meticulous and available for such prevention action.
authors.affiliation: Child and Adolescent Psychiatry Department, University Hospital Centre of Lille, Lille, France. r-jardri@chru-lille.fr
authors.forename: Renaud
authors.initials: R
authors.lastname: Jardri
authors.forename: Michel
authors.initials: M
authors.lastname: Maron
authors.forename: Jérôme
authors.initials: J
authors.lastname: Pelta
authors.forename: Pierre
authors.initials: P
authors.lastname: Thomas
authors.forename: Xavier
authors.initials: X
authors.lastname: Codaccioni
authors.forename: Michel
authors.initials: M
authors.lastname: Goudemand
authors.forename: Pierre
authors.initials: P
authors.lastname: Delion
mesh_terms: D000328:Adult; D019052:Depression, Postpartum / Q000451:nursing* / Q000517:prevention & control; D004509:Education, Nursing, Continuing / Q000379:methods*; D005260:Female; D005602:France; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008403:Mass Screening / Q000379:methods*; D008880:Midwifery / Q000193:education* / Q000379:methods; D024802:Nurse's Role; D049590:Postpartum Period / Q000523:psychology; D011594:Psychometrics; D058996:Quality Improvement / Q000458:organization & administration*; D011787:Quality of Health Care; D018570:Risk Assessment; D055815:Young Adult