Funded PhD Opportunity Developing and testing an EMDR Early intervention to improve mothers’ cognitive processing of trauma associated memories embedded during an unexpected caesarean birth

Subject: Nursing and Health

Summary

Background

The RQIA (2017) reported NI as having the highest CS rates in the UK with rates of 25- 35% with with costs substantially higher than vaginal births (£3,781 vs £1,985).   However, following one CS, about 75% of women with an uncomplicated pregnancy who go into spontaneous labour can give birth vaginally (RCOG, 2016) and NICE (2012) states that women who request a CS due to fear and anxiety should be referred to mental health support services.  Increasing the rates of normal vaginal deliveries by reducing CS and encouraging uptake of Vaginal birth after CS (VBAC) is a public health priority: reducing FoC or Postpartum PTSD, due to traumatic birth is an important factor. Reducing FoC is proposed to reduce CS rates and increase VBAC and serves the common goal of promoting normal birth and woman-centred care, reducing rates of costly interventions.

Study Aim

This study aims to develop and test an Early EMDR intervention for prevention of the longer term effects associated with a traumatic birth

EMDR

Eye Movement Desensitization and Reprocessing (EMDR) is a psychotherapeutic approach that has been shown to be effective in the treatment of PTSD in several large randomized controlled trials (RCT). The therapy consists of a standard protocol which includes eight phases and Alternating Bilateral Sstimulation (ABS) to desensitize traumatic memories.  The effectiveness of EMDR therapy in treating PTSD has undergone the scrutiny of several meta-analyses looking at its effectiveness resulting in the World Health Organization (2013/15) identifying it as a psychotherapy of choice in the treatment of PTSD in children, teenagers, and adults.  To date, however, few studies have explored the potential of EMDR to address trauma arising from obstetrical emergencies occurring in pregnancy and childbirth such as an emergency caesarean birth.

Method

The study design is action research and the approach selected is the PDSA cyle (The Plan-Do-Study-Act cycle) as this is clinically relevant for a HSC project designed to bring about change http://www.academy.solent.nhs.uk/media/37336/guide-to-pdsa-cycles.pdf

Sample

The sample will be mothers who have had an emergency CS and they will be recruited from one or more HSC Trusts in Northern Ireland.

Relevant references

PDSA cycles http://www.academy.solent.nhs.uk/media/37336/guide-to-pdsa-cycles.pdf (Accessed 04/09/2018)

National Institute for Health and Care Excellence (2012).  Caesarean section Clinical guideline [CG132].  Available at:  https://www.nice.org.uk/guidance/cg132/chapter/1-guidance  (Accessed 04/09/2018)

National Institute for Health and Care Excellence (2014) Clinical guideline [CG192] Antenatal and postnatal mental health: clinical management and service guidance. Available at: https://www.nice.org.uk/guidance/cg192 (Accessed 04/09/2018)

National Institute for Health and Care Excellence (2016) Caesarean Section Costing Report. Available at: https://www.nice.org.uk/guidance/cg132/resources/costing-report-184766797 (Accessed 04/09/2018)

NHS 2018 https://improvement.nhs.uk/documents/2142/plan-do-study-act.pdf (Accessed 04/09/2018)

RQIA 2017 https://www.rqia.org.uk/  (Accessed 04/09/2018)

World Health Organization, Human Reproduction Programme (2015) Statement on caesarean section rates.  Available at: http://www.who.int/reproductivehealth/publications/maternal_perinatal_health/cs-statement/en/ (Accessed 04/09/2018)

Essential Criteria

  • Upper Second Class Honours (2:1) Degree from a UK institution (or overseas award deemed equivalent via UK NARIC)
  • Experience using research methods or other approaches relevant to the subject domain

Funding

    DFE

    The scholarship will cover tuition fees at the Home rate and a maintenance allowance of £ 14,777 per annum for three years. EU applicants will only be eligible for the fees component of the studentship (no maintenance award is provided).  For Non EU nationals the candidate must be "settled" in the UK.

Candidates should have ordinary UK residence to be eligible for both fees and maintenance (£14,777). Non UK residents who hold ordinary EU residence may also apply but if successful will receive fees only.

Other information

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Key Dates

Submission Deadline
Friday 26 October 2018
Interview Date
6 November 2018

Contact Supervisor

Professor Marlene Sinclair

Other Supervisors

Apply online

Visit https://www.ulster.ac.uk/applyonline and quote reference number #314754 when applying for this PhD opportunity