Born in Brussels screening tool: the development of a screening tool measuring antenatal psychosocial vulnerability

Kelly Amuli,Florence Talrich,Anne Renders,Kim Decabooter,Katrien Beeckman

doi:10.1186/s12889-021-11463-8

Abstract

BackgroundAntenatal psychosocial vulnerability is a main concern in today’s perinatal health care setting. Undetected psychosocially vulnerable pregnant women and their unborn child are at risk for unfavourable health outcomes such as poor birth outcomes or mental state. In order to detect potential risks and prevent worse outcomes, timely and accurate detection of antenatal psychosocial vulnerability is necessary. Therefore, this paper aims to develop a screening tool ‘the Born in Brussels Screening Tool (ST)’ aimed at detecting antenatal psychosocial vulnerability.MethodsThe Born in Brussels ST was developed based on a literature search of existing screening tools measuring antenatal psychosocial vulnerability. Indicators and items (i.e. questions) were evaluated and selected. The assigned points for the answer options were determined based on a survey sent out to caregivers experienced in antenatal (psychosocial) vulnerability. Further refinement of the tool’s content and the assigned points was based on expert panels’ advice.ResultsThe Born in Brussels ST consists of 22 items that focus on 13 indicators: communication, place of birth, residence status, education, occupational status, partner’s occupation, financial situation, housing situation, social support, depression, anxiety, substance use and domestic violence. Based on the 168 caregivers who participated in the survey, assigned points account between 0,5 and 4. Threshold scores of each indicator were associated with adapted care paths.ConclusionGeneralied and accurate detection of antenatal psychosocial vulnerability is needed. The brief and practical oriented Born in Brussels ST is a first step that can lead to an adequate and adapted care pathway for vulnerable pregnant women.

Highlights

Pregnant women are considered psychosocially vulnerable when facing one or more unfavourable personal and environmental situation(s) [1, 2]
Antenatal psychosocial vulnerability stays undetected due to a lack of systematic screening [10]. Elements such as domestic violence, social isolation, poverty or depression that might be present during pregnancy are often not visible and as such not discussed or interpreted during a consultation [2, 11]
De Waal et al analysed that only 5.3% of pregnant women are detected as being vulnerable during an antenatal consultation, compared to 27% when using a screening tool

Summary

Introduction

Pregnant women are considered psychosocially vulnerable when facing one or more unfavourable personal and environmental situation(s) [1, 2] (for e.g. health problems, psychological distress, substance abuse, low economic status, poor housing situation, domestic violence, poor social support or others). Antenatal psychosocial vulnerability stays undetected due to a lack of systematic screening [10]. Elements such as domestic violence, social isolation, poverty or depression that might be present during pregnancy are often not visible and as such not (correctly) discussed or interpreted during a consultation [2, 11]. The use of a standardised screening tool, in which these and other sensitive elements are incorporated, can open a conversation on sensitive topics and lead to an increased detection of antenatal psychosocial vulnerability [14,15,16]. Undetected psychosocially vulnerable pregnant women and their unborn child are at risk for unfavourable health outcomes such as poor birth outcomes or mental state. This paper aims to develop a screening tool ‘the Born in Brussels Screening Tool (ST)’ aimed at detecting antenatal psychosocial vulnerability

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Methods

Results

Discussion

Conclusion