Graduate Publications and Other Selected Works - Doctor of Nursing Practice (DNP)

Document Type

Poster

Abstract

Abstract

Background: Perinatal anxiety affects 11-21% of individuals and can lead to maladaptive behaviors that adversely impact maternal health, pregnancy outcomes, and child development. Screening for perinatal anxiety is lacking yet is essential for identifying at-risk individuals and supporting clinicians to provide appropriate treatment.

Local Problem: An East Tennessee midwifery clinic leading care for low-risk pregnancies served as the project site, where there was no established anxiety screening process. Participants presented for routine visits in the second trimester and at two and six weeks postpartum. The purpose of this project was to improve the quality of perinatal mental healthcare by developing a screening process for perinatal anxiety, with the aim of increasing the screening rate by 75% within three months.

Methods: Guided by the Evidence-Based Practice Improvement Model, a literature search and critical appraisal was conducted, which demonstrated good and consistent evidence for perinatal anxiety screening during pregnancy and the postpartum period. Anxiety screening rates were measured using descriptive statistics, and mental health referrals were compared pre and post intervention using a chi-square test.

Interventions: Anxiety screening using the Generalized Anxiety Disorder-7 (GAD-7) was added at the time of routine depression screening. Interventions for positive GAD-7 scores differed based on severity and included counseling on lifestyle modifications, distribution of a community resource list, and referral to a mental health provider.

Results: Screening for anxiety using the GAD-7 occurred in 68.9% of patients. There was a statistical difference in screening rates between perinatal stages (p < 0.001). Nearly 45% of second trimester participants were screened, while 85-90% of postpartum participants were screened. There was a clinically significant increase in mental health referrals, which increased from 8.2% pre-intervention to 11.5% post-intervention.

Conclusions: Screening for perinatal anxiety identifies at-risk individuals and increases mental health referrals. Continued efforts to increase screening rates will enhance quality of life for patients and their families.

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