Making the Most of Bed Rest: Weekly Support Group and Education for Hospitalized Antepartum Patients
Title: Making the Most of Bed Rest: Weekly Support Group and Education for Hospitalized Antepartum Patients
- Identify two positive outcomes of an inpatient Antepartum support group.
- Identify three psychological sequelae associated with pregnancy bed rest.
- Identify three commonly requested educational topics of Antepartum bed rest patients.
Psychological sequelae associated with pregnancy bed rest have been well documented with hospitalized women’s reactions being more pronounced. Women quickly develop feelings of separation and isolation from their normal routines and usual connections with others. As a result, anxiety, loneliness, boredom, powerlessness, stress, dysphoria and depression may complicate an already high-risk pregnancy. Hospitalization provides an opportunity to offer support as well as pregnancy-related education to these women. At this community hospital with a large high-risk obstetrical population and over 3500 deliveries a year, a support group for hospitalized antepartum patients is being used for socialization, to lessen anxiety and improve mood, and provide patient education.
Proposed change:
Develop and initiate weekly support group sessions on an 18 bed antepartum unit to address commonly identified concerns with evidence-based education and support.
Develop a data collection tool identifying successful group topics and patient’s moods prior to and after group participation.
Implementation, outcomes and evaluation:
The perinatal clinical nurse specialist (CNS) identifies antepartum patients able to attend group, requests a physician’s order, and then invites patients to attend. A multidisciplinary team within perinatal services is utilized to provide education for each 1 hour “Mom’s In Waiting” group session, where the CNS or the perinatal social worker is also present. A structured activity or discussion occurs for part of the hour, with time being specifically left for socialization among the group members. At the end of group a short likert scale survey is administered to each participant.
Survey results for the first eighteen months provide an overwhelmingly positive response to group by attendees with 98 percent noting enhanced mood perception after attending group and 100 percent stating they looked forward to attending group. Group participants frequently dress and apply make-up prior to group and conversation in the sessions flows easily. Popular session topics, chosen by participant suggestions include breastfeeding, infant massage, guided imagery and neonatal intensive care (NICU) preparation. The post-group survey is currently being amended to include additional markers for improved mood.
Implications for nursing practice:
Survey documentation should promote development of support groups in other antepartum settings. Currently at this hospital antepartum patients, as well as postpartum NICU mothers, are screened with the Edinburgh Postnatal Depression Scale (EPDS). As perinatal mood disorders have been shown to correlate with poor maternal and neonatal outcomes, long-term goals include evaluating EPDS scores and mood disorders related to group attendance.
Keywords: depression, socialization, education