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" |
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"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