K Minde1, L Tidmarsh, S Hughes. 1. Psychiatry Department, McGill University, Montreal, Quebec, Canada. klaus.minde@muhc.mcgill.ca
Abstract
OBJECTIVE: To examine the degree to which physicians and nurses use their first postnatal contact with mothers and babies to learn about their psychosocial strengths and problems. METHOD: Forty-two consecutively born infants and their mothers were observed during their initial postnatal visit with a public health nurse and their physician in Montreal. Both visits were audiotaped. Tapes were analyzed for the number of physical and psychosocial topics discussed during the visits. Observers also rated the professionals' communication skills. During a later home visit, mothers were given the Edinburgh Postnatal Depression Scale, the Symptom Checklist-90-Revised, and the Working Model of the Child Interview (WMCI). RESULTS: Nurses spent more time with families, discussed more psychosocial issues, and were rated to be more sensitive interviewers than physicians. They were also concerned about the psychological well-being and psychological difficulties of more mothers than were the physicians. In contrast, physicians were more sensitive to pregnancy complications in younger mothers. Mothers' satisfaction correlated with the number of psychosocial issues discussed by both professional groups. WMCI data suggest that recent non-Western immigrants are overrepresented among insecurely attached mothers. CONCLUSIONS: Nurses and physicians obtain different data from the same patients and should increase their collaboration.
OBJECTIVE: To examine the degree to which physicians and nurses use their first postnatal contact with mothers and babies to learn about their psychosocial strengths and problems. METHOD: Forty-two consecutively born infants and their mothers were observed during their initial postnatal visit with a public health nurse and their physician in Montreal. Both visits were audiotaped. Tapes were analyzed for the number of physical and psychosocial topics discussed during the visits. Observers also rated the professionals' communication skills. During a later home visit, mothers were given the Edinburgh Postnatal Depression Scale, the Symptom Checklist-90-Revised, and the Working Model of the Child Interview (WMCI). RESULTS: Nurses spent more time with families, discussed more psychosocial issues, and were rated to be more sensitive interviewers than physicians. They were also concerned about the psychological well-being and psychological difficulties of more mothers than were the physicians. In contrast, physicians were more sensitive to pregnancy complications in younger mothers. Mothers' satisfaction correlated with the number of psychosocial issues discussed by both professional groups. WMCI data suggest that recent non-Western immigrants are overrepresented among insecurely attached mothers. CONCLUSIONS: Nurses and physicians obtain different data from the same patients and should increase their collaboration.