EPDS refusal

Researcher response and comments

"My baby is now 10.5 months old. The study was supposed to be 6 weeks after birth. I was completely let down by the hospital and my OB

(obstetrician). I don't want to take part in any of your studies. Please take me off your database."

Researcher: "I am sorry to hear that. Can I help? I have left several messages previously with no reply. I'm happy to chat if you wish."

 

Participant Response: "No I'm fine thanks."

Text message received: "I do not want follow-up. I found the questions extremely personal and unexpected and they were not asked sensitively. I spoke with my OB regarding this as I was upset following the questionnaire. Thanks for following up though."

Researcher (by text): "I am sorry to hear that. By the way I did not ask the questions at booking-in. I only do follow-up's after the baby is born. Thank you for your feedback. If you would like to give me more feedback, I'm happy to listen. I am interested to know any problems with the screening to suggest changes to improve."

No response from participant.

"I've been working with my GP and getting the help I need from them. Thank you for following up."

Researcher: "Thank you for participating."

Husband answered: Wife in hospital post stroke and does not want follow-up

Researcher: "I'm so sorry to hear that, thank you for participating."

Text message received: "I'm too busy"

 

"Why didn't someone talk to me antenatally? I am a nurse, my husband is a Dr. I knew that I was depressed during the pregnancy and no one did anything or told me anything. I went and saw my GP myself."

Researcher: "I'm so sorry you did not receive the support you needed. It's great that you went to see your GP for help."

Table 1. Reasons for follow-up refusal

Participant EPDS follow-up score and comment

Researcher actions and comments

EPDS total score = 16 (potential high risk)

Question 10 score =1

Researcher: Referred to a psychologist and rang one week later to check on her, but-no answer.

Text received: "Thank you, yes I'm contacting the counsellor".

EPDS total score = 15 (potential high risk)

Question 10 score =0

Researcher: Rang one week later with no response. Sent a text message: "This is Tanya the midwife from the private hospital doing the study. I hope that you are doing OK. I am passing the phone number on to you for the counsellor.

Best wishes". Second text message: R U doing OK?

No response

EPDS total score = 20 (potential high risk/of concern) Question 10 score =0

Researcher: Referred to a psychologist. Rang back in one week.

Text received "Thankyou I have been seeing a therapist and am on medication and feel much better now, thanks for caring".

EPDS total score =16 (potential high risk)

Question 10 score = 0

Seeing a psychologist, history of postnatal depression (PND), good supports.

Researcher: Encouraged her proactive approach by seeing a psychologist already.

EPDS total score = 14 (potential high risk)

Question 10 score = 2

Seeing a psychologist and has joined a PND group.

Researcher: Encouraged her proactive approach by seeing a psychologist already. Had no self-harm plan, this was discussed and further encouraged to discuss with psychologist.

EPDS total score =12 (potential medium risk)

Question 10 score = 0

EPDS results discussed

Researcher: Recommended a GP/counsellor

EPDS total score = 20 (potential high risk/of concern) Question 10 score =0

Has seen a psychiatrist previously

Researcher: Encouraged her to follow up again with psychiatrist - she will call them today.

EPDS total score = 8

(low risk)

Question 10 score =0 History of PND and sees a psychologist

Researcher: Encouraged her proactive approach by seeing a psychologist already.

EPDS total score = 9

(low risk)

Question 10 score =0

Sounded stressed and anxious

Researcher: Recommended ATAPS (Access To Allied

Psychological Services) counselling through the GP. She said that she would see her GP and 'follow-up'

Table 2. EPDS follow-up comments and referral actions