Collaborative evaluation of a pilot involvement opportunity: Cochrane Common Mental Disorders Voice of Experience College.

BACKGROUND: Involving consumers in systematic reviews can make them more valuable and help achieve goals around transparency. Systematic reviews are technically complex and training can be needed to enable consumers to engage with them fully. The Cochrane Common Mental Disorders group sought to engage people with lived experience of mental health problems in the Voice of Experience College, three workshops introducing them to systematic review methods and to opportunities to contribute as Cochrane consumers. We aimed to collectively evaluate the College from the perspective of both facilitators and consumers, to critically reflect on the experience, and to identify how the College could be sustained and spread to other review groups. METHODS: This study was a longitudinal qualitative and collaborative evaluation, structured around normalisation process theory. Both facilitators and consumers were involved in not only providing their perspectives but also reflecting on these together to identify key learning points. RESULTS: The workshops were positively evaluated as being engaging and supportive, largely due to the relational skills of the facilitators, and their willingness to engage in joint or two-way learning. The College suffered from a lack of clarity over the role of consumers after the College itself, with a need for greater communication to check assumptions and clarify expectations. This was not achieved due to pandemic disruptions, which nevertheless demonstrated that resources for involvement were not prioritised as core business during this period. CONCLUSIONS: Soft skills around communication and support are crucial to effective consumer engagement. Sustaining involvement requires sustained communication and opportunities to reflect together on opportunities and challenges. This requires committed resources to ensure involvement activity is prioritised. This is critical as negative experiences later in the involvement journey can undermine originally positive experiences if contributors are unclear as to what their involvement can lead to. Open discussions about this are necessary to avoid conflicting assumptions. The spread of the approach to other review groups could be achieved by flexibly adapting to group-specific resources and settings, but maintaining a core focus on collaborative relationships as the key mechanism of engagement. PATIENT AND PUBLIC CONTRIBUTION: Public contributors were collaborators throughout the evaluation process and have co-authored the paper.

Support and services for perinatal low mood and depression: A qualitative study exploring women's and healthcare professionals' experiences.

This study aimed to explore women's experiences of support and care received from maternity healthcare professionals for perinatal low mood or depression, and healthcare professionals' experiences of providing support and care for women experiencing perinatal low mood or depression. In this qualitative study, face-to-face individual semistructured interviews and focus groups were conducted with 15 women and 19 healthcare professionals living or working in Yorkshire and the Humber, England in 2019. Thematic analysis was used to analyze the qualitative data. The following themes were identified: (1) lack of standardization in identification and support for perinatal low mood and depression; (2) unclear and nonstandardized pathways for perinatal low mood and depression; and (3) enablers and barriers of receiving support and care for perinatal low mood and depression. Providing training opportunities for healthcare professionals, especially midwives, may be helpful for filling the gray area for women who do not need a referral to mental health services but require support from healthcare professionals. Improving the variety of psychological therapies for the treatment of perinatal depression may also be helpful to meet women's expectations of treatments.

A brief report informing the adaptation of a behavioural activation intervention for delivery by non-mental health specialists for the treatment of perinatal depression.

BACKGROUND: Behavioural activation (BA) is recommended by the National Institute for Health and Care Excellence guidelines for the treatment of perinatal depression; however, there is limited evidence about whether it is effective when delivered by non-mental health specialists (NMHS) in a perinatal setting in the UK. AIMS: This study aimed to adapt a BA intervention manual and guided self-help booklet intended for delivery by NMHSs for the treatment of perinatal depression. METHOD: Interviews were conducted with 15 women and 19 healthcare professionals (HCP) within the first study element. Four experience-based co-design (EBCD) workshops were held, with the involvement of 14 women and three HCPs, to modify the BA documents for the specific needs of perinatal women. Thematic analysis was used to analyse the data. FINDINGS: The findings from the study elements were presented with themes. The co-designers (women and HCPs) pointed out that having sleeping problems, changes in appetite, feeling exhausted and feeling emotional, may be experienced by non-depressed mothers as well during pregnancy or in the postpartum period, especially around the fourth day after giving birth. Therefore, it was important to differentiate these feelings from depression. The women also wanted to see an example for each activity before being asked to do it. Having examples would help them to see the possibilities before creating their own diary sheets or tables of activities. CONCLUSIONS: Aside of the tool adaptation, the findings of this study provide a foundation to assess the effectiveness of the adapted intervention in a subsequent feasibility trial.

Women's experiences of perinatal depression: Symptoms, barriers and enablers to disclosure, and effects on daily life and interaction within the family.

OBJECTIVE: Nearly half of all cases of perinatal depression are not detected, despite routine appointments with healthcare professionals (HCP) during pregnancy and after childbirth. Early identification of perinatal depression is crucial to provide the required support and offer timely treatment. This study aimed to explore women's experiences of perinatal depression to help identification and management of perinatal depression by HCPs. DESIGN: Theoretical perspective of symbolic interactionism and methodological design of ethnography was adopted. Face-to-face individual interviews were used. Thematic analysis was conducted to analyse interview data. PARTICIPANTS: Fifteen women who had experienced perinatal depression in the last five years were interviewed. FINDINGS: Three themes were identified: 1) Getting closer to the perinatal depression; 2) Decision to disclose or hide real feelings; 3) Hidden face of perinatal depression. KEY CONCLUSIONS AND IMPLICATIONS FOR PRACTICE: Findings demonstrate the importance of HCPs' attitudes towards women, as if women perceive they being dismissed or neglected by HCPs, may have an impact on women refraining from disclosing their feelings.

Applying fundal pressure in the second stage of labour and its impact on mother and infant health.

We examine the prevalence of the practice of applying fundal pressure in the second stage of labour, the technique used, and its impact on mother and infant health. This analytical cross-sectional study was conducted in a state hospital in the city of Bursa, Turkey with 350 women giving vaginal birth in gestational weeks 37-42. We found that fundal pressure is commonly applied but that this is done without a specific indication, that it is more associated with the performance of an episiotomy, and at the same time, the use of the technique does not have an adverse impact on maternal satisfaction or the health of the mother and infant.