|
Health problem detection, assessment and diagnosis
(study = 6)
|
The use of self‐reported measures can help to detect and assess health problems and identify important issues.
Evidence from survey studies
Healthcare providers (83%) agreed that self‐reported measures support identify what matters to their patients and it was clear in advance which subjects were important for their patients to address. (Depla et al.
61
) How professionals value self‐reported measures also appeared from thematic analysis, indicating better insight in subjects that are important to their patients and easier detection of psychological issues or pelvic floor problems. (Depla et al.
61
) Professionals agreed that the self‐reported measures aided in the detection of symptoms (100%) and supported the identification of subjects that mattered to patients (83%). (Depla et al.
61
) Relative advantages of discussing individual outcomes in clinical practice were experienced by both women and professionals, acknowledging it could improve insight into health status. (Depla et al.
61
)
Evidence from interview studies
The women generally agreed that one of the main purposes of the questionnaire was to assess whether they could be at increased risk during pregnancy. (Johnsen et al.
57
)
Evidence from observation studies
Two‐thirds of high‐risk women who were identified by self‐report mental health screening application were not identified by screening in‐clinic. (Doherty et al.
58
) Among mothers with 3‐ to 4‐month‐old babies in the community, 13.9% scored high (9 or above) on EPDS (detected by self‐reported approach). In 51.1% of high scorers (detected by self‐reported approach), nurses did not detect postnatal depression. Of the 96 women who scored 9 or above (by self‐reported questionnaires), 88 agreed to be interviewed in detail by community nurses. Among these women, 45 (51.1%) had not been identified by nurses for possible postnatal depression. (Nishizono‐Maher et al.
54
). Those (women) reporting not always being honest at face‐to‐face assessment showed a greater increase in psychosocial risk score when the assessment was repeated online via self‐report, compared with women who were always honest. The Time 2 EPDS, GAD‐7 and ANRQ‐R mean scores were also all significantly higher in the “not always honest (at face‐to‐face assessment)” group than in the “always honest (at face‐to‐face assessment)”. Moreover, 24.1% of the “not always honest (at face‐to‐face assessment)” women scored 10 or more on the EPDS vs 9.9% in the “always honest (at face to face assessment)” group; and 7.3% women who were “not always honest (at face‐to‐face assessment)” scored 13 or more on the EPDS vs 4.7% women who were “always honest (at face‐to‐face assessment)”, although this was not statistically significant ( p = 0.162). Overall, 11.2% of participants ( n = 193) reported not always being honest (at face‐to‐face assessment) when responding to the psychosocial questions with their midwife at the booking‐in assessment. There were 60 (3.4%) women in our sample who did not respond when asked about honesty at psychosocial health assessment with their midwife. Women who reported not always being honest (at face‐to‐face assessment) had higher ANRQ‐R total scores overall compared with women who were always honest (at face‐to‐face assessment) and the impact of mode of administration on their scores was more pronounced. Specifically, women who reported not always being honest with their midwife at assessment showed a significant increase in scores (moderate effect size) when completing the repeat ANRQ‐R via online self‐report ( M = 17.66) than face‐face with their midwife ( M = 13.87), compared with women who were always honest ( M = 12.37 vs M = 13.19, respectively). (Austin et al.
64
) There were no significant differences in the proportions of women meeting eMINI 6.0 criteria for current major depression, any current anxiety disorder, or lifetime panic or depressive disorder, by mode of administration (self‐reported vs interviewer‐administered). There are minimal discrepancies between the interviewer‐administered and self‐administered versions. However, a greater proportion of women in the interviewer‐administered phone group than in the self‐complete online group met criteria for current minor depression (2.0% vs 0.2%, p = 0.008). In this study, the difference in the overall proportions of pregnant women meeting criteria for a past depressive or past anxiety disorder were 19.0% for the interviewer‐administered and 14.3% for the self‐completed versions of the eMINI 6.0. Post‐hoc power analyses indicate that we only had 40% power to detect such a difference as being statistically significant. (Reilly et al.
60
)
|
|
Woman–health professional communication
(study = 2)
|
The use of self‐reported measures can support clinical visits.
Evidence from survey studies
Half (50%) of women recognized that patient‐reported outcome measures helped them prepare for the visit. (Depla et al.
61
)
Evidence from interview studies
Some women saw the questionnaire as an invitation to set the agenda for the coming midwifery visit. For these women, the questionnaire became a personal aid, which could ensure the visit was tailored according to their individual needs. (Johnsen et al.
57
)
|
|
Resources utilization
(study = 2)
|
The use of self‐reported measures can help to prepare clinical visits, properly use visit time, and save time for health professionals.
Evidence from survey studies
Over half (50%) of women recognized that patient‐reported outcome measures helped them prepare for the visit. (Depla et al.
61
) On average, discussing patient's answers took them 10 min (range 3–20 min). At two of five timepoints, the majority of professionals (50% at T1 and 75% at T5) felt they were short of time to discuss all issues raised in patient's questionnaires. Time spent on discussing the answers did not correlate with the amount of questions that patients had answered. Thematic analysis showed this time was more dependent on the amount of issues raised. Professionals could also gain time because it was clear in advance which subjects were important for their patient to address. To attain this advantage, they argued that insight in the answers before the visit is crucial, emphasizing the need for a well‐supporting IT system. Also, to relieve their time burden, support of administrative staff was proposed, for example, in explaining the purpose and process of the questionnaires to patients. (Depla et al.
61
)
Evidence from interview studies
Women saw the questionnaire as a way to ensure proper use of time during the first visit. (Johnsen et al.
57
) Some women saw the questionnaire as an invitation to set the agenda for the coming midwifery visit. For these women, the questionnaire became a personal aid, which could ensure the visit was tailored according to their individual needs. (Johnsen et al.
57
)
Evidence from observation studies
Observations indicated that the (self‐reported online) questionnaire contributed to a decrease in the midwives' documentation tasks during the visit. (Johnsen et al.
57
)
|
|
Shared decision making
(study = 1)
|
The use of self‐reported measures can support shared decision‐making.
Evidence from survey studies
Over half (58%) of women agreed self‐reported measures supported shared decision making. (Depla et al.
61
)
|
|
Woman–health professional relationship
(study = 2)
|
The use of self‐reported measures can support the woman–health professional relationship.
Evidence from survey studies
Over half (52%) of women agreed self‐reported measures supported the patient–clinician relationship. (Depla et al.
61
)
Evidence from interview studies
Women reported that utilization by the midwife of the information collected via self‐reported measures led to feelings of being heard and establishing a partnership with the midwife. (Johnsen et al.
57
)
|
|
Personalized care
(study = 2)
|
The use of self‐reported measures can support appropriate, personalized care.
Evidence from survey studies
Professionals (100%) agreed that the PROMs contributed to more appropriate care. (Depla et al.
61
)
Evidence from interview studies
Some women saw the questionnaire as an invitation to set the agenda for the coming midwifery visit. For these women, the questionnaire became a personal aid, which could ensure the visit was tailored according to their individual needs. (Johnsen et al.
57
)
|
