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      The Experience of Healthcare Professionals Providing Mental Health Services to Mothers with Postpartum Depression : A qualitative study

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          Abstract

          Objectives

          This study aimed to describe the experience of healthcare professionals in providing mental health services to women with postpartum depression (PPD).

          Methods

          In this qualitative study, data were collected through semi-structured interviews with five physicians, five midwives and five psychologists from 14 urban healthcare centres in Kerman, Iran, from April 2019 to September 2019. Purposeful sampling was used to select the participants. Data were qualitatively analysed using a content analysis approach.

          Results

          Data analysis revealed the main theme of the study: ‘the long way ahead for comprehensive, integrated and responsive mental health services’. This theme included four categories: ‘postpartum depression challenges’, ‘social and personal factors’, ‘structural challenges’ and ‘need for change in mental health services’. The participants described that depression diagnosis is difficult due to insufficient knowledge among healthcare providers and the hidden signs of PPD. They also described how different factors such as economic and cultural factors, personality traits, a community’s lack of knowledge, negative attitude towards depression and limited family support might cause depression. Moreover, providing mental health services involves certain challenges, such as limited human resources, insufficient financial resources and incomplete or inefficient policy-making.

          Conclusion

          Although measures have been taken to provide mental health services, there are many challenges regarding providing mental health services to mothers. Therefore, serious measures should be taken to improve mental health services and re-define the existing measures. Informing the community, empowering the healthcare providers and attempting to change the community’s attitudes and beliefs can affect the mental healthcare of women with depression.

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          Most cited references41

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          Consolidated criteria for reporting qualitative research (COREQ): a 32-item checklist for interviews and focus groups.

          Qualitative research explores complex phenomena encountered by clinicians, health care providers, policy makers and consumers. Although partial checklists are available, no consolidated reporting framework exists for any type of qualitative design. To develop a checklist for explicit and comprehensive reporting of qualitative studies (in depth interviews and focus groups). We performed a comprehensive search in Cochrane and Campbell Protocols, Medline, CINAHL, systematic reviews of qualitative studies, author or reviewer guidelines of major medical journals and reference lists of relevant publications for existing checklists used to assess qualitative studies. Seventy-six items from 22 checklists were compiled into a comprehensive list. All items were grouped into three domains: (i) research team and reflexivity, (ii) study design and (iii) data analysis and reporting. Duplicate items and those that were ambiguous, too broadly defined and impractical to assess were removed. Items most frequently included in the checklists related to sampling method, setting for data collection, method of data collection, respondent validation of findings, method of recording data, description of the derivation of themes and inclusion of supporting quotations. We grouped all items into three domains: (i) research team and reflexivity, (ii) study design and (iii) data analysis and reporting. The criteria included in COREQ, a 32-item checklist, can help researchers to report important aspects of the research team, study methods, context of the study, findings, analysis and interpretations.
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            Qualitative content analysis in nursing research: concepts, procedures and measures to achieve trustworthiness.

            Qualitative content analysis as described in published literature shows conflicting opinions and unsolved issues regarding meaning and use of concepts, procedures and interpretation. This paper provides an overview of important concepts (manifest and latent content, unit of analysis, meaning unit, condensation, abstraction, content area, code, category and theme) related to qualitative content analysis; illustrates the use of concepts related to the research procedure; and proposes measures to achieve trustworthiness (credibility, dependability and transferability) throughout the steps of the research procedure. Interpretation in qualitative content analysis is discussed in light of Watzlawick et al.'s [Pragmatics of Human Communication. A Study of Interactional Patterns, Pathologies and Paradoxes. W.W. Norton & Company, New York, London] theory of communication.
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              What's in a name? Qualitative description revisited.

              "Whatever Happened to Qualitative Description?" (Sandelowski, 2000) was written to critique the prevailing tendency in qualitative health research to claim the use of methods that were not actually used and to clarify a methodological approach rarely identified as a distinctive method. The article has generated several misconceptions, most notably that qualitative description requires no interpretation of data. At the root of these misconceptions is the persistent challenge of defining qualitative research methods. Qualitative description is a "distributed residual category" (Bowker & Star, 2000). Cambridge, MA: The MIT Press) in the classification of these methods. Its value lies not only in the knowledge its use can produce, but also as a vehicle for presenting and treating research methods as living entities that resist simple classification.
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                Author and article information

                Journal
                Sultan Qaboos Univ Med J
                Sultan Qaboos Univ Med J
                Sultan Qaboos University Medical Journal
                Sultan Qaboos University Medical Journal, College of Medicine & Health Sciences
                2075-051X
                2075-0528
                November 2021
                25 November 2021
                : 21
                : 4
                : 554-562
                Affiliations
                [3 ]Neuroscience Research Center, Institute of Neuropharmacology
                [1 ]Kerman University of Medical Sciences, Kerman, Iran
                [2 ]Nursing Research Center, School of Nursing and Midwifery, Kerman University of Medical Sciences, Kerman, Iran
                Author notes
                [* ]Corresponding Author’s e-mails: ahmadianle@ 123456yahoo.com and l.ahmadian@ 123456kmu.ac.ir
                Article
                squmj2111-554-562
                10.18295/squmj.4.2021.031
                8631231
                34888074
                8213b315-31e9-4e42-ac0e-d4a9be7ce029
                © Copyright 2021, Sultan Qaboos University Medical Journal, All Rights Reserved

                This work is licensed under a Creative Commons Attribution-NoDerivatives 4.0 International License .

                History
                : 28 April 2020
                : 11 June 2020
                : 19 August 2020
                : 15 October 2020
                : 02 July 2020
                : 01 September 2020
                : 21 October 2020
                : 27 October 2020
                Categories
                Clinical & Basic Research

                postpartum depression,mental health services,community mental health services,mental disorders,depressive disorder,iran

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