Established Evidence Results

Intervention Components (click on component to see a list of all articles that use that intervention): Psychoeducation, Referrals, Presentation/Meeting/Information Session/Event,

Intervention Description: The intervention was a transdiagnostic mental health center offering brief psychological assessment and treatment for children and young people and/or their families with mental health needs in the context of long-term physical conditions. The intervention included a suite of empirically grounded interventions, including single sessions, signposting or referral to appropriate services, a comprehensive diagnostic and/or supplementary neurodevelopmental assessment, and brief modular transdiagnostic psychological treatment delivered in the form of guided self-help.

Intervention Results: The results showed that the intervention was feasible and acceptable, with high levels of retention and satisfaction reported by participants. Changes in SDQ scores demonstrated statistical significance, but the effect size was small and does not equate to clinically significant change.

Conclusion: The conclusion from the study was that it is possible to deliver brief transdiagnostic psychological interventions to patients in a pediatric hospital who are experiencing mental health needs alongside long-term physical conditions, as part of a stepped-care pediatric psychology health service. The study provides evidence that such interventions could have an important role in reducing symptoms and improving quality of life.

Study Design: The study design/type was an uncontrolled trial.

Setting: The setting for the study was a national pediatric hospital.

Population of Focus: The target audience for the study was children and young people with mental health needs in the context of long-term physical conditions, as well as their families and caregivers.

Sample Size: The sample size was 186 consented participants.

Age Range: The age range of the participants was not specified in the article.

Intervention Components (click on component to see a list of all articles that use that intervention): PATIENT/CONSUMER, Intensive Therapy, PATIENT_CONSUMER, Psychoeducation

Intervention Description: Higher rates of obstetric intervention and caesarean section (CS) are experienced in fearful women. The efficacy of interventions to reduce childbirth fear is unclear, with no previous randomised controlled trials reporting birth outcomes or postnatal psychological wellbeing following a midwife led intervention. The outcomes of the RCT on obstetric outcomes, maternal psychological well-being, parenting confidence, birth satisfaction, and future birth preference were analysed by intention to treat and reported here.

Intervention Results: Compared to controls the intervention group had a clinically meaningful but not statistically significant reduction in overall caesarean section (34 % vs 42 %, p = 0.27) and emergency CS rates (18 % vs 25 %, p = 0.23). Fewer women in the intervention group preferred caesarean section for a future pregnancy (18 % vs 30 %, p = 0.04). All other obstetric variables remained similar. There were no differences in postnatal depression symptoms scores, parenting confidence, or satisfaction with maternity care between groups, but a lower incidence of flashbacks about their birth in the intervention group compared to controls (14 % vs 26 %, p = 0.05). Postnatally women who received psycho-education reported that the ‘decision aid’ helped reduce their fear (53 % vs 37 %, p = 0.02).

Conclusion: Following a brief antenatal midwife-led psycho-education intervention for childbirth fear women were less likely to experience distressing flashbacks of birth and preferred a normal birth in a future pregnancy. A reduction in overall CS rates was also found. Psycho-education for fearful women has clinical benefits for the current birth and expectations of future pregnancies.

Study Design: RCT

Setting: 3 antenatal clinics in three teaching hospitals

Population of Focus: Nulliparous women with measured fear of childbirth who gave birth after recruitment between May 2012 and June 20132,4

Data Source: Not specified

Sample Size: Total (n=104) Intervention (n=51) Control (n=53)

Age Range: Not Specified

Intervention Components (click on component to see a list of all articles that use that intervention): HOSPITAL, Peer-Review of Provider Decisions, Elective Induction Policy, Guideline Change and Implementation, PATIENT_CONSUMER, Intensive Therapy, Psychoeducation

Intervention Description: We conducted a retrospective study was conducted in the Centre Hospitalier Universitaire Vaudois (CHUV) including all births between the 1st January 1997 and 31st December 2011 to analyze the cesarean section (CS) rate using the different groups of the Robson classification in a Swiss maternity hospital.

Intervention Results: The overall CS rate was 29 %, mainly related to group 5 (multiparous with previous CS) and group 2 (nulliparous women induced or who had CS before labor). The study also shows that induction of labor on maternal request in nulliparous at term (group 2a) increased significantly the risk of CS compared to induction of labor for medical reason (p<0.001).

Conclusion: The Robson classification system appears as a simple tool for monitoring CS rates. The main strategies for reducing CS rates will be through better selection of women for VBAC (vaginal birth after caesarean) and limitation of induction of labor, especially in nulliparous women.

Intervention Components (click on component to see a list of all articles that use that intervention): PATIENT/CONSUMER, Intensive Therapy, PATIENT_CONSUMER, Psychoeducation, HOSPITAL, Hospital Laborist

Intervention Description: To compare the numbers of vaginal deliveries and delivery satisfaction among women with fear of childbirth randomised to either psychoeducation or conventional surveillance during pregnancy.

Intervention Results: Women randomised to the intervention group more often had spontaneous vaginal delivery (SVD) than did controls (63.4% versus 47.5%, P = 0.005) and fewer caesarean sections (CSs) (22.9% versus 32.5%, P = 0.05). SVD was more frequent and CSs were less frequent among those who actually participated in intervention (n = 90) compared with controls who had been referred to consultation (n = 106) (SVD: 65.6% versus 47.2%, P = 0.014; CS: 23.3% versus 38.7%, P = 0.031). Women in intervention more often had a very positive delivery experience (36.1% versus 22.8%, P = 0.04, n = 219).

Conclusion: To decrease the number of CSs, appropriate treatment for fear of childbirth is important. This study shows positive effects of psychoeducative group therapy in nulliparous women with severe fear of childbirth in terms of fewer CSs and more satisfactory delivery experiences relative to control women with a similar severe fear of childbirth.

Study Design: RCT

Setting: 1 maternity unit

Population of Focus: Nulliparous women with a measured fear of childbirth who gave birth after enrollment at antenatal clinics between October 2007 and August 20095

Data Source: Not specified

Sample Size: Total (n=371) Intervention (n=131) Control (n=240)

Age Range: Not Specified