Edinburgh Napier University

  Objective: to explore midwives' behavioural intentions and the determinants of these intentions with regard to the management of antenatal care of women with maternal distress.

Design: an exploratory survey using a questionnaire. Descriptive statistics calculated expanded TPB constructs, demographic information, personal characteristics and work related details. Multiple linear regression analyses were used to examine which factors influence midwives' intention to provide antenatal care of maternal distress.

Setting: midwives working in Dutch primary care.

Participants: 112 midwives completed the survey.

Results: midwives did not report a clear intention to screen for maternal distress (3.4671.8). On average, midwives expressed a positive intention to support women with maternal distress (4.6371.57) and to collaborate with other health-care professionals (4.6371.57). Finding maternal distress an interesting topic was a positive predictor for the intention to screen (B¼0.383; p¼0.005), to support (B¼0.637; p= <0.000) and to collaborate (B=0.455; p=0.002). Other positive predictors for the intention to screen for maternal distress were years of work experience (B=0.035; p=0.028), attitude about the value of screening (B=0.326; p=0.002), and self-efficacy (B=0.248; p=0.004). A positive attitude toward support for women with maternal distress (B=0.523; p=0.017) predicted the intention to support these women. Number of years of work experience (B=0.042; p¼0.017) was a positive predictor for the intention to collaborate with other health-care professionals.

Key conclusions: the intention to screen for maternal distress was less evident than the intention to support women with maternal distress and the intention to collaborate with other health-care
professionals. Important factors predicting the midwife's intention to screen, support and collaborate were finding maternal distress an interesting topic, years of work experience, attitude about the value of screening and support and self-efficacy about screening.

Implications for practice: to provide care involving all three components of antenatal management of maternal distress implies efforts to influence the factors that predict the intention to screen, to support women with maternal distress and the intention to collaborate with other health-care professionals.