Midwives' perceived barriers in communicating about depression with ethnic minority clients.

OBJECTIVE: This study aimed to assess the most influential barriers midwives perceive in communicating about depression-related symptoms with ethnic minority clients. METHODS: In-depth interviews were held with midwives (N = 8) and Moroccan-Dutch women (N = 6) suffering from perinatal depression to identify the most salient communication barriers. Subsequently, an online survey among midwives (N = 60) assessing their perceived barriers and the occurrence of these barriers in practice was administered. Composite scores using the QUOTE methodology were calculated to determine influential barriers. RESULTS: Three types of barriers emerged from the interviews. Educational-related barriers, client-related barriers and midwife-related barriers. Results of the survey showed that the most influential barriers were educational-related barriers (e.g. lack of culturally sensitive depression screening instruments) and client-related barriers (e.g. cultural taboo about talking about depression). CONCLUSION: Culturally sensitive screening instruments for depression and patient education materials should be developed to mitigate the educational-related barriers to communicating about depression. Patient education materials should also target the clients' social environment (e.g. husbands) to help break the cultural taboo about depression. PRACTICE IMPLICATIONS: Based on this study's results, communication strategies to empower both midwives and ethnic minority clients with depression can be developed in a collaborative approach.