Feasibility of use of the anxiety thermometer in antenatal services
Of the 102 women approached, 101 (99%) completed the anxiety thermometer (AnxT). The women were aged between 22–44 years (mean age 34.5 years); about half were primigravida and half multigravida. Almost two-thirds rated their current anxiety as four or above out of a maximum of 10. The most frequently reported concern was health of baby, followed by fears and worries, tiredness, and sleep problems. The high participation rate suggests that the AnxT can be developed to screen anxiety and elicit perinatal and related concerns to facilitate consultation and appropriate triaging. The problem checklist was refined based on the current results.
In many countries, pregnant women experience an increasing range of testing and monitoring procedures. Early identification of risk factors can facilitate appropriate triaging to specialist clinics with concentrated expertise, for example to address hypertension, fetal growth issues, multiple pregnancy, and risk of preterm birth. These clinics can improve the prediction, prevention and treatment of pregnancy complications but they could also increase anxiety. For example, a study reported that fetal fibronectin testing predicted preterm delivery in high-risk women but the procedure also raised anxiety (Shennan et al, 2005).
A first recorded investigation of pregnancy and birth-related psychological distress was carried out in 1956 when 50 pregnant women were asked to report on areas that they had felt anxious about during pregnancy and the postpartum period (Pleshette et al, 1956). Amidst a range of concerns, women reported worrying about fetal abnormalities and stillbirth. A recent review suggests that the number of studies reporting perinatal anxiety has grown and with wide variations in prevalence estimates (2.6–39%) (Leach et al, 2017). Qualitative research has further identified psychological distress associated with specific perinatal risks such as preterm birth (O'Brien et al, 2017). The offer of appropriate reassurances and education or triaging to psychological care is dependent on consistent recognition of anxiety and worries in an environment characterised by the high volume of clinical throughout. How can maternity staff consistently detect pregnancy related anxiety without burdening service users?
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