Nurses’ implementation of perinatal mental healthcare in Irish primary care services for refugees and migrants: A Mixed Methods Study using Normalisation Process Theory (NPT)

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Project Area: Health policy and systems research

Project Summary

While Ireland has a long history of emigration, since the early 2000s the trend has changed, and more refugees and migrants are coming into Ireland than before. Refugee and migrant women are particularly susceptible to experiencing perinatal mental illness in resettlement countries. However, their perinatal mental healthcare needs are unmet, and this leads to negative and avoidable health outcomes i.e. health inequity. There are calls for integrating perinatal mental healthcare across all healthcare services, to increase accessibility to early screening, prompt treatment, and access to specialised services when required. As primary care services are often the first point of healthcare access for refugee and migrant women, primary care nurses play a critical role in the early identification of perinatal mental illness and timely treatment when needed. However, there is a dearth of evidence in this area. This participatory health research project will explore the levers and barriers to nurses’ implementation of perinatal mental healthcare for refugee and migrant women in Irish primary care services, using Normalisation Process Theory (NPT). The structure of this PhD is based on 3 Work Packages to address the following objectives:

  1. Review the international literature on facilitators and barriers to nurses’ implementation of perinatal mental healthcare for refugee and migrant women in primary care, from the perspective of service providers and service users (WP1 integrative literature review).
  2. Investigate the facilitators and barriers for nurses in implementing perinatal mental healthcare guidelines to refugee and migrant women, in Irish primary care services, using the NoMAD (NOrmalization MeAsure Development) tool (WP2 survey).
  3. Co-design recommendations for nurses’ implementation of perinatal mental healthcare guidelines that are responsive to the needs of refugee and migrant women in Irish primary care services (WP3 participatory world cafés).

This is the first participatory study of perinatal mental healthcare for refugee and migrant women in Irish primary care, that pays active attention to Public and Patient Involvement (PPI) with refugee and migrant women. It is also the first study of perinatal mental healthcare for refugee and migrant women through the lens of Normalisation Process Theory (NPT). Therefore, this project will build national evidence about micro, meso and macro level factors that require attention for normalising perinatal mental healthcare for refugee and migrant women in primary care services. This evidence will inform national and international practice and policy changes leading to more equitable and accessible perinatal mental healthcare in primary care services.

Skills Required

(If applying for this project you will be asked to outline how you meet the skills required below)

Essential Skills:

  1. Research Methodology skills:
    • Strong understanding of qualitative and quantitative research methods.
  2. Subject Matter Expertise:
    • Familiarity with the specific field of study.
  3. Communication Skills:
    • Minimum score of IELTS of 6.5 with no less than 6.0 in any component, for candidates whose first language is not English.
    • Excellent written and verbal communication skills for communicating and disseminating research findings.
    • Ability to engage with both academic and non-academic audiences.
  4. Analytical Skills:
    • Familiarity with data analysis software (e.g., NVivo, SPSS).
    • Strong critical thinking and problem-solving abilities.
  5. Project Management:
    • Ability to work independently and as part of a team.
    • Ability to meet deadlines.

Desirable Skills:

  1. Research Methodology skills:
    • Experience in conducting systematic literature reviews.
    • Familiarity with participatory health research.
  2. Subject Matter Expertise:
    • Registered nurse with the Nursing and Midwifery Board of Ireland.
    • Knowledge of the specific field of study.
    • Familiarity with existing guidelines and best practices for perinatal mental healthcare.
  3. Policy Analysis:
    • Understanding of healthcare policies affecting refugee and migrant populations.
    • Understanding of perinatal mental healthcare policies.
  4. Interdisciplinary Collaboration:
    • Experience of working in interdisciplinary teams.
    • Ability to integrate perspectives from different fields.
  5. Technical Skills:
    • Ability to use relevant software, tools and technologies (e.g., SPSS and NVivo).
    • Experience in managing research projects, including planning, execution, and reporting

Supervisory team:

Dr Kathleen Markey, PI/Primary Supervisor,
Associate Professor, Nursing and Midwifery, University of Limerick.

Dr Annmarie Grealish (Associate Professor, Nursing and Midwifery, UL)

Professor Anne MacFarlane (School of Medicine, UL)

This project is based in the University of Limerick.

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