Reviewer's report
Title:Digging over that old ground: an Australian perspective of women's
experience of psychosocial assessment and depression screening in pregnancy
and following birth
Version: 2Date:14 December 2012
Reviewer: Sally Chan
Reviewer's report:
Thanks for inviting me to review this paper. The paper addresses an important
practice issue - women's experience of psychosocial assessment and depression
screening in pregnancy and following birth. The findings of the study would be
important to guide service improvement. However, there were issues related to
the title, the objectives, findings and discussion of the paper. The following is my
comments:
Major compulsory revision:
1. Abstract: Paragraph one: Need to revise the objectives of the paper in line with
the objectives in the text (p 4, last line, and p.5 first line). The authors only
mentioned the objectives of the paper but not objectives of the study. Please
clarify.
2. The design of the study needs clarification. If the paper focused on describing
women's experience, why observe the nurses and midwives? If the study was
about nurse-client interaction, it was not the women's subjective experience
then?
3. The study visited the women twice. Would the authors please clarify the
purposes of the two visit: booking visit and FU/home visit?
4. There were two sites in the study. It appeared that the two sites had different
arrangement of the visit, such as home or clinic and duration. What would be the
implications to findings by different methods of data collection? Please justify the
inconsistencies.
5. Recruitment: p.6, first paragraph described sending information through mail
and then stated that no women made contact this way. If so, why mentioned it?
Was it a deviation from the protocol? What was the implication?
6. Women who had previous pregnancies would have different experience from
the first time pregnancy, why recruited women with different experience? Why
recruit 34 women, please justify.
7. An observation tool (4D & 4R) was developed for the study. Please provide
evidence to support this framework.
8. Who performed the observation? How the person was being trained? How to
ensure reliability in observation?
9. P. 9 last two lines, it was not clear about taking field notes but 'these
interactions were not recorded due to the sensitive nature of the content in these
discussion'. Please clarify.
10. Findings: p.22, there was an observation that women was distressed
because the nurse surveyed her kitchen area and then involved women's in-laws
in a discussion about the breastfeeding routines. Why this was reported? How
was it related to psychological assessment and depression screening, it was
related to the nurse's work but not the aim of the paper which was to describe
women’s experience. It appeared that the paper reported the experience of the
women, and the nurses.
11. Discussion: There are many repetitions of findings in the discussion that
could be removed. There is also detailed description of past studies in the
discussion which is not appropriate. Perhaps those detailed discussion of
previous studies could be moved to literature review and referred to in the
discussion.
12. There were many areas in the discussion trying to justify what the nurses did
and supporting the psychosocial assessment and home visits were essential. It
appeared that the authors tried to downplay women’s feelings of being violated.
Thus it appeared that the study focused on healthcare professionals’
perspectives rather than from women’s perspectives. I would expect an in-depth
discussion on the content of the assessment and the whole assessment process
based on women’s comments but it was not done in the paper. Instead the
authors recommended training the nurses would solve all the problems.
13. I would recommend the authors review the title of the paper, the objectives of
the paper, the findings and discussion so that all these will be consistent.
Level of interest: An article of limited interest
Quality of written English: Needs some language corrections before being
published
Statistical review: No, the manuscript does not need to be seen by a
statistician.
Declaration of competing interests:
I declare that I have no competing interests' below