Supporting women with mild to moderate anxiety during pregnancy: the development of an intervention to be facilitated by midwives

Evans, Kerry (2018) Supporting women with mild to moderate anxiety during pregnancy: the development of an intervention to be facilitated by midwives. PhD thesis, University of Nottingham.

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Aim: To develop an intervention that could be facilitated by midwives to improve symptoms of mild to moderate anxiety in pregnant women

Background: Many women experience symptoms of anxiety during pregnancy. Severe anxiety is associated with negative health outcomes for women and babies. Psychological interventions may be beneficial for pregnant women with mild to moderate symptoms of anxiety. Interventions require evaluation in pregnant populations to strengthen the evidence base.

Methods: An intervention was developed according to the Medical Research Council theoretical and modelling phases for developing complex interventions. The study comprised three phases: 1. systematic reviews exploring the effectiveness and acceptability of interventions for pregnant women with anxiety; 2. development of an intervention which comprised individual support from midwives, peer group discussion and self-help resources; 3. a feasibility study of the intervention. Data collection comprised baseline and post-intervention self-report anxiety measures and semi-structured interviews conducted post-intervention. Data analysis used descriptive statistics for the quantitative data and template analysis for the qualitative data.

Findings: Ten women participated in the feasibility study. Two midwife facilitators and two midwifery support worker co-facilitators were recruited and trained to facilitate the intervention. Women reported that the intervention was acceptable and beneficial. The findings highlighted how the intervention could be improved to maximise participant recruitment and improve the benefit derived by pregnant women with symptoms of anxiety. Facilitators provided positive comments about their involvement and said they felt prepared to deliver the intervention. Areas were identified where the training of intervention facilitators, study manuals and use of self-help resources could be enhanced to improve performance and fidelity of the intervention.

Conclusions: Midwives have the potential to facilitate supportive interventions to enhance the current provision of emotional support in pregnancy. Minor refinements to the intervention are recommended prior to further testing. The next stage of development should be to conduct a randomised pilot trial. This should determine robust research methods and procedures for conducting a main trial to assess the effectiveness of the intervention on self-report symptoms of anxiety in pregnant women.

Item Type: Thesis (University of Nottingham only) (PhD)
Supervisors: Spiby, Helen
Morrell, Jane
Keywords: Anxiety; Psychological intervention; Pregnancy
Subjects: W Medicine and related subjects (NLM Classification) > WQ Obstetrics
Faculties/Schools: UK Campuses > Faculty of Medicine and Health Sciences > School of Health Sciences
Item ID: 51301
Depositing User: Evans, Kerry
Date Deposited: 30 Aug 2018 10:18
Last Modified: 07 May 2020 17:16

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