Nurses' and physicians' assessment of mother-infant mental health at the first postnatal visits

Objective: To examine the degree to which physicians and nurses use their f irst postnatal contact with mothers and babies to learn about their psychos ocial strengths and problems. Method: Forty-two consecutively born infants and their mothers were observed during their initial postnatal visit with a public health nurse and their physician in Montreal. Both visits were audi otaped. Tapes were analyzed for the number of physical and psychosocial top ics discussed during the visits. Observers also rated the professionals' co mmunication skills. During a later home visit, mothers were given the Edinb urgh Postnatal Depression Scale, the Symptom Checklist-90-Revised, and the Working Model of the Child Interview (WMCI). Results: Nurses spent more tim e with families, discussed more psychosocial issues, and were rated to be m ore sensitive interviewers than physicians. They were also concerned about the psychological well-being and psychological difficulties of more mothers than were the physicians. In contrast, physicians were more sensitive to p regnancy complications in younger mothers. Mothers' satisfaction correlated with the number of psychosocial issues discussed by both professional grou ps. WMCI data suggest that recent non-Western immigrants are overrepresente d among insecurely attached mothers. Conclusions: Nurses and physicians obt ain different data from the same patients and should increase their collabo ration.