Abstract
BackgroundPostnatal depression (PND) can be experienced by 13% of women who give birth, and such women often exhibit disabling symptoms, which can have a negative effect on the mother and infant relationship, with significant consequences in terms of the child's later capacity for affect regulation. Research has shown that providing support to mothers experiencing PND can help reduce their depressive symptoms and improve their coping strategies. The Mums4Mums study aims to evaluate the impact of telephone peer-support for women experiencing PND.Methods/DesignThe study design adopts the MRC framework for the development and evaluation of complex interventions. Health visitors in Warwickshire and Coventry Primary Care Trusts are screening potential participants at the 8-week postnatal check using either the Edinburgh Postnatal Depression Scale (EPDS > = 10) or the three Whooley questions recommended by NICE (http://guidance.nice.org.uk/CG45). The Mums4Mums telephone support intervention is being delivered by trained peer-supporters over a period of four months. The primary outcome is depressive symptomatology as measured by the Edinburgh Postnatal Depression Scale. Secondary outcomes include mother-child interaction, dyadic adjustment, parenting sense of competence scale, and self-efficacy. Maternal perceptions of the telephone peer-support are being assessed using semi-structured interviews following the completion of the intervention.DiscussionThe proposed study will develop current innovative work in peer-led support interventions and telecare by applying existing expertise to a new domain (i.e. PND), testing the feasibility of a peer-led telephone intervention for mothers living with PND, and developing the relationship between the lay and clinical communities. The intervention will potentially benefit a significant number of patients and support a future application for a larger study to undertake a full evaluation of the clinical and cost effectiveness of telephone based peer-support for PND.Trial registrationISRCTN: ISRCTN91450073. The study has received a major funding grant from National Institute for Health Research (NIHR) (UK) - Research for Patient Benefit (RfPB) programme (ref: PB-PG-0407-13232).
Highlights
The proposed study will develop current innovative work in peer-led support interventions and telecare by applying existing expertise to a new domain (i.e. Postnatal depression (PND)), testing the feasibility of a peer-led telephone intervention for mothers living with PND, and developing the relationship between the lay and clinical communities
The intervention will potentially benefit a significant number of patients and support a future application for a larger study to undertake a full evaluation of the clinical and cost effectiveness of telephone based peer-support for PND
General Practitioners (GPs) (n = 6), health visitors (n = 7) and mothers who had recovered from PND (n = 10) were interviewed and the results indicated that stakeholders perceived a need for a telephone-based peer-support intervention for women currently experiencing PND in the UK
Summary
A reduction in a woman’s depressive symptomatology could potentially produce an improved mother-infant relationship in affected dyads, with significant consequences in terms of the capacity of the infant for affect regulation. Poor emotional and behavioural adjustment in the early years is associated with a range of poor long-term outcomes including delinquency, drug abuse, and a range of mental health and relationship problems, which are very costly for NHS and other services. This form of provision could have an immediate impact on health service use and in the long-term improve a range of public health outcomes about which there is currently considerable concern, and to which postnatal depression undoubtedly makes a significant contribution.
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