Keeping the Pace between Research and Clinical in Covid-19 Pandemic: A Psychological Experience in a High-Risk Pregnancy Ward

ABSTRACT

Background: From the literature emerges that having a pregnancy and especially a high-risk pregnancy in time of pandemic can lead to an increase of the levels of anxiety, which are usually already higher in relation to maternal-fetal disease. Furthermore, the literature shows that significant organizational and methodological changes have been introduced in the detection of psychological conditions, such as the introduction of telehealth intervention. Particularly in our experience about psychological health screenings there was a period of care interruption (between 11.03.2020 and 04.05.2020) and a clinical activity restructuring on the ward according to the new needs that have accrued. The aim of this experience is to analyze the progress of psychological health perinatal screening in women during the Covid-19. Specifically, we aimed to understand the percentage of positive screening and management compared to the pre-pandemic period. Method(s) Perinatal psychological screening was administered to women with high-risk pregnancy hospitalized in a Obstetric ward in a period between May 2020 to December 2021. The data were then compared with those recorded from September 2019 to February 2020 (pre-Covid-19). Screening consists in the description of the Obstetrical Psychology Service, the case history, the self-administration questionnaire GHQ-12 (General Health Questionnaire- 12) and the assessment interview if necessary. Result(s) A total of 469 screenings were administered during the pandemic, about 30% of which were found to be positive in the screenings (2020-21). Specifically in 2020, the positivity amounted to 28.69%. Of these 64 women, 56 performed the assessment, and in particular 22 were taken to the Psychology Service, 6 were referred to the territorial counseling centers, and 28 didn't receive further treatment indication. In 2021, the positivity was 32.93%. Especially of these 81 women, 32 were taken to the Psychology Service, 10 were sent to the territorial counseling centers and, 16 refused the assessment interview, 6 were already in treatment, 11 didn't receive further treatment indications and 6 cases dropped out. In the pre-pandemic phase the rate of positivity was 27%. Of the 30 women who tested positive at the screening, 5 were taken to the Psychology Service, 9 were referred to family counseling centers in the area, 11 refused the assessment interview, and 5 didn't receive further therapeutic indication. Conclusion(s) The importance of psychological care continuity and the feasibility of administering psychological health screenings clearly emerges in the ward despite the changed health situation due to Covid-19. The results show how the positivity rate for psychological health screening increases over the years (27% from September 2019 to February 2020/pre-Covid-19, 28,69% from May to December 2020 and 32,93% in 2021).