Technology-assisted nursing for postpartum support: A randomized controlled trial.
Deborah E McCarter, Eugene Demidenko, Tauna S Sisco and 1 others
PMID 31222789WHAT IT FOUND
Postpartum electronic nurse messages did not improve mothers' depression or parenting stress compared with usual care.
The optional nurse call was linked to higher satisfaction than messages alone, and safety alerts prompted contacts.
Key findings
01The electronic nursing intervention did not significantly change postpartum depression scores or parenting stress compared with usual care.
02Safety alerts led to 62 nurse-initiated calls to 50 participants, each averaging 13 minutes, and 12 participants were referred for treatment.
03Women offered the optional nurse call reported higher satisfaction than women receiving messages alone (mean 3.94 versus 3.69; difference 0.244, p=.025).
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
The trial was open-label, so participants knew whether they could request a nurse call, which can affect satisfaction. Attrition was high and uneven: 39% of married women and 64% of women living with partners left before 6 months, and non-married women using the hospital clinic had 80% attrition. The sample came from one urban hospital in the Northeast United States and was described as predominantly white and well educated. It may not apply to more diverse populations. Participants were not selected for high depression risk, so the study may have had insufficient power to detect a preventative effect. The technology was repurposed appointment-reminder software with limited functionality, which may have diluted the intervention effect. Women who declined participation said they were too busy or did not anticipate depression, which may have introduced self-selection bias. The authors noted that the EPDS and PSI-SF may not be sensitive enough to capture small benefits from simple nursing support.
The easy way to misread this
Do not conclude that technology-assisted nursing prevents or treats postpartum depression. The main mood and stress outcomes were null, and the positive satisfaction and safety-call findings do not show that the intervention changed clinical outcomes.