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Bipolar Disorder and Postpartum Psychosis Pregnancy Planning (PREP) Study: developing an interactive guide for women at high risk

Thomas, Elen 2021. Bipolar Disorder and Postpartum Psychosis Pregnancy Planning (PREP) Study: developing an interactive guide for women at high risk. PhD Thesis, Cardiff University.
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Women with bipolar disorder or previous postpartum psychosis have a high risk of experiencing severe mental illness during the perinatal period. Women have reported difficulty in obtaining the information they need when planning and making decisions relating to pregnancy. The aim of this project was to develop a pregnancy planning guide for women with bipolar disorder and / or previous postpartum psychosis. The specific aims were to determine the following: the critical components of the guide, its acceptability, and the feasibility of a larger scale Randomised Controlled Trial (RCT) of the guide. The process followed Medical Research Council (MRC) Guidance on developing and evaluating complex interventions (Craig et al. 2008). A review of online information available to women, along with qualitative interviews with women with lived experience of bipolar disorder and / or postpartum psychosis (n=8), and professionals involved in their care (n=14), informed the initial prototype of the guide. Qualitative interviews were analysed using a process of reflexive thematic analysis (Braun and Clarke 2006; Braun and Clarke 2019). The initial prototype of the guide was piloted twice (pilot one: 9 participants; pilot two: 8 participants) and refined based on qualitative and quantitative feedback. The final prototype of the guide was an 88-page loose leaf guide with sections for women to personalise. Overall, the guide was acceptable to women. Decisional conflict scores were reduced (representing less uncertainty) after using the guide compared to before; participant data on depression and anxiety symptoms showed no clear direction in whether scores increased or decreased after using the guide. The guide appeared best suited to those who had received specialist professional input. For those without this input, at times the guide seemed overwhelming. To conclude, I recommend that the current iteration of the guide could be used to complement care within specialist perinatal mental health contexts. Prior to conducting a larger scale RCT of its use, I recommend further development work. For example, this could involve further tailoring of the guide and trialling its use alongside input from professionals.

Item Type: Thesis (PhD)
Date Type: Completion
Status: Unpublished
Schools: Medicine
Date of First Compliant Deposit: 29 March 2022
Last Modified: 29 Mar 2022 10:55

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