SERVICE MANAGERS
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Characteristics of assessment

Certain aspects of assessment/screening can impact implementation of assessment, as well as whether women find assessment acceptable.​

  • Wording of assessment tools.

  • Acceptability of assessment ​

Wording of assessment tools

The wording of some screening tools can be a barrier to implementation

"I have some moms [who] ask questions about it, like, ‘What does it mean where things are getting on top of me? What do you mean?’ You know, so they, they don’t always understand the questions" (Home visitor, about the EPDS)​​.

Evidence level: ​Moderate

​Parts of the care pathway affected: Assessment​.

Key literature: ​

Doering JJ, et al. 2017

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Acceptability of assessment ​

Women and health professionals finding assessment acceptable can be a facilitator to implementation. Poor acceptability of assessment is a barrier.​

"I remember being frustrated and ticking at the end, fine, fine, fine, or whatever it was, good, good, good, no I’m not depressed. I mean they are not going to give a job to my husband".​

"I thought it [screening] was a good idea from the beginning . . . It doesn’t take a lot of time. I think sometimes it can be challenging just to get people to complete it".

​Evidence level: Moderate​

​Parts of the care pathway affected: Assessment.

​Key literature: ​

Segre LS, et al. 2014

​Shakespeare J, et al. 2003

Recommendations 

Use easy to understand assessment tools. Collaborate with organisations such as The Motherhood Group to ensure cultural appropriateness.

Design or update assessment tools that use pictures alongside words for use with women whose English speaking and understanding is limited, e.g. “How are you feeling?” screening tools by Abi Sobowale (Sheffield South West NHS Trust). ​

Provide assessment in a woman-centred way. Explain questions or wording that women are not clear about. Clearly discuss results with women and explain next steps. ​

Service managers should ensure health professionals have enough time to do this by creating an adequate workforce​.