Abstract
The purpose of this review was to critically analyse existing tools to measure perinatal mental health risk and report on
the psychometric properties of the various approaches using defined criteria. An initial literature search revealed 379 papers,
from which 21 papers relating to ten instruments were included in the final review. A further four papers were identified
from experts (one excluded) in the field. The psychometric properties of six multidimensional tools and/or criteria were assessed.
None of the instruments met all of the requirements of the psychometric properties defined. Some had used large sample sizes
but reported low positive predictive values (Antenatal Risk Questionnaire (ANRQ)) or insufficient information regarding their
clinical performance (Antenatal Routine Psychosocial Assessment (ARPA)), while others had insufficient sample sizes (Antenatal
Psychosocial Health Assessment Tool, Camberwell Assessment of Need—Mothers and Contextual Assessment of Maternity Experience).
The ANRQ has fulfilled the requirements of this analysis more comprehensively than any other instrument examined based on
the defined rating criteria. While it is desirable to recommend a tool for clinical practice, it is important that clinicians
are made aware of their limitations. The ANRQ and ARPA represent multidimensional instruments commonly used within Australia,
developed within large samples with either cutoff scores or numbers of risk factors related to service outcomes. Clinicians
can use these tools, within the limitations presented here, to determine the need for further intervention or to refer women
to mental health services. However, the effectiveness of routine perinatal psychosocial assessment continues to be debated,
with further research required.
the psychometric properties of the various approaches using defined criteria. An initial literature search revealed 379 papers,
from which 21 papers relating to ten instruments were included in the final review. A further four papers were identified
from experts (one excluded) in the field. The psychometric properties of six multidimensional tools and/or criteria were assessed.
None of the instruments met all of the requirements of the psychometric properties defined. Some had used large sample sizes
but reported low positive predictive values (Antenatal Risk Questionnaire (ANRQ)) or insufficient information regarding their
clinical performance (Antenatal Routine Psychosocial Assessment (ARPA)), while others had insufficient sample sizes (Antenatal
Psychosocial Health Assessment Tool, Camberwell Assessment of Need—Mothers and Contextual Assessment of Maternity Experience).
The ANRQ has fulfilled the requirements of this analysis more comprehensively than any other instrument examined based on
the defined rating criteria. While it is desirable to recommend a tool for clinical practice, it is important that clinicians
are made aware of their limitations. The ANRQ and ARPA represent multidimensional instruments commonly used within Australia,
developed within large samples with either cutoff scores or numbers of risk factors related to service outcomes. Clinicians
can use these tools, within the limitations presented here, to determine the need for further intervention or to refer women
to mental health services. However, the effectiveness of routine perinatal psychosocial assessment continues to be debated,
with further research required.
- Content Type Journal Article
- Category Original Article
- Pages 1-12
- DOI 10.1007/s00737-012-0297-8
- Authors
- M. Johnson, Centre for Applied Nursing Research, South Western Sydney Local Health District/University of Western Sydney, Sydney, NSW, Australia
- V. Schmeid, School of Nursing and Midwifery, University of Western Sydney, Sydney, NSW, Australia
- S. J. Lupton, School of Medicine, University of Western Sydney, Sydney, NSW, Australia
- M.-P. Austin, Perinatal and Women’s Mental Health Unit, St John of God Health Care, University of New South Wales, Sydney, NSW, Australia
- S. M. Matthey, School of Psychology, University of Sydney, Sydney, NSW, Australia
- L. Kemp, Centre for Health Equity Training Research and Evaluation (CHETRE), part of the Centre for Primary Health Care and Equity, School of Public Health and Community Medicine, University of New South Wales, Liverpool Hospital, Locked Bag 7103, Liverpool BC, NSW 1871, Australia
- T. Meade, School of Psychology, University of Western Sydney, Sydney, NSW, Australia
- A. E. Yeo, Ingham Institute, South Western Sydney Local Health District, Sydney, NSW, Australia
- Journal Archives of Women’s Mental Health
- Online ISSN 1435-1102
- Print ISSN 1434-1816