Responding to maternal distress: from needs assessment to effective intervention.
OBJECTIVE
To perform a needs assessment of maternal distress to plan the development of an intervention for the prevention and reduction of antenatal maternal distress.


METHODS
We searched PubMed, OVID and EBSCO and applied the PRECEDE logic model to select the data. Experts in the field validated the findings.


RESULTS
We identified 45 studies. Maternal distress was associated with diminished maternal and child's quality of life. Aetiological factors of maternal distress included past and present circumstances related to obstetric factors and to a woman's context of living, coping behaviour, and support mechanisms. Lacking knowledge of coping with (maternal) distress was identified as a predisposing factor. Reinforcing factors were relaxation, partner support, counselling experiences and positive interaction with the midwife. Enabling factors were the availability of a support network.


CONCLUSIONS
When planning the development of an antenatal intervention for maternal distress, it is advisable to focus on assessment of antenatal emotional wellbeing, the context of the woman's past and present circumstances, her coping behaviour and her environment. The identified predisposing factors, enabling and reinforcing factors should also be taken into consideration.
Midwifery Education and Studies Maastricht-ZUYD, Research Department Midwifery Science, PO Box 1256, 6201 BG, Maastricht, The Netherlands. j.a.c.a.fontein-kuipers@hr.nl.
Yvonne
Y
Fontein-Kuipers
Midwifery Education and Studies Maastricht-ZUYD, Research Department Midwifery Science, PO Box 1256, 6201 BG, Maastricht, The Netherlands.
Evelien
E
van Limbeek
Midwifery Education and Studies Maastricht-ZUYD, Research Department Midwifery Science, PO Box 1256, 6201 BG, Maastricht, The Netherlands.
Marlein
M
Ausems
Midwifery Education and Studies Maastricht-ZUYD, Research Department Midwifery Science, PO Box 1256, 6201 BG, Maastricht, The Netherlands.|Maastricht University Medical Centre/CAPHRI, PO Box 5800, 6202 AZ, Maastricht, The Netherlands.|Center for Bioethics and Social Sciences in Medicine, University of Michigan Medical School, 300 North Ingalis Street, Rm 7C27, Ann Arbor, MI, 48109-5429, USA.
Raymond
R
de Vries
Midwifery Education and Studies Maastricht-ZUYD, Research Department Midwifery Science, PO Box 1256, 6201 BG, Maastricht, The Netherlands.
Marianne
M
Nieuwenhuijze
D000223:Adaptation, Psychological; D005260:Female; D006293:Health Promotion; D006801:Humans; D008427:Maternal Health Services; D020380:Needs Assessment; D011247:Pregnancy; D011295:Prenatal Care
Health promotion; Intervention; Intervention mapping; Maternal distress; PRECEDE; Pregnancy