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A qualitative study of the acceptability of routine screening of postnatal women using the Edinburgh Postnatal
Judy Shakespeare1, Fiona Blake, Jo Garcia
1Summertown Health Centre, 160 Banbury Road, Oxford OX2 7BS. judy@shake-speare.demon.co.uk
Background:
Screening for postnatal depression using the Edinburgh Postnatal Depression Scale (EPDS) has been widely recommended and implemented in primary care, although little is known about how acceptable it is to women.
Aim:
To explore the acceptability to women of postnatal screening by health visitors with the EPDS.
Design Of Study:
Qualitative interview study.
Setting:
Postnatal patients from 22 general practices within the area of Oxford City Primary Care Group.
Method:
Thirty-nine postnatal women from a purposive sample were interviewed, chosen on the basis of different general practices, EPDS results at eight weeks and eight months postnatal, and whether 'listening visits' were received. The interviews were analysed using the constant comparative method.
Results:
Just over half of the women interviewed found screening with the EPDS less than acceptable, whatever their postnatal emotional health. The main themes identified were problems with the process of screening and, in particular, the venue, the personal intrusion of screening and stigma. The women interviewed had a clear preference for talking about how they felt, rather than filling out a questionnaire.
Conclusion:
For this sample, routine screening with the EPDS was less than acceptable for the majority of women. This is of concern, as universal screening with the EPDS for the detection of postnatal depression is already recommended and widespread in primary care.