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Heinonen N, Katainen A, Lallukka T, Nordquist H, Kouvonen A. Explanations for sickness absence due to common mental disorders: A narrative study of young health and social care workers. SOCIOLOGY OF HEALTH & ILLNESS 2024; 46:1083-1099. [PMID: 38289869 DOI: 10.1111/1467-9566.13754] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/09/2022] [Accepted: 01/09/2024] [Indexed: 02/01/2024]
Abstract
Over recent decades, sickness absence due to common mental disorders has increased among young workers. The phenomenon is mostly understood on the basis of epidemiological research, and knowledge regarding the viewpoints of young workers themselves is lacking. Our study explored the explanations for mental health-related sickness absence in the narrative accounts of young workers in high-risk health and social care occupations. Semi-structured narrative interviews were conducted with 23 Finnish young workers (aged 21-34), with self-reported sickness absence related to common mental disorders over the previous year. Our analysis identified three narrative explanations for the onset of mental health problems leading to sick leave: work as the sole cause, work as an additional cause and work as a trigger. These findings indicate that mental health-related sickness absences form a complex phenomenon related to various life and work-related circumstances. More comprehensive preventive measures are needed in the health and social care sector to help tackle mental health problems among young workers.
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Affiliation(s)
- Noora Heinonen
- The Faculty of Social Sciences, University of Helsinki, Helsinki, Finland
- Department of Public Health, Faculty of Medicine, University of Helsinki, Helsinki, Finland
| | - Anu Katainen
- The Faculty of Social Sciences, University of Helsinki, Helsinki, Finland
| | - Tea Lallukka
- Department of Public Health, Faculty of Medicine, University of Helsinki, Helsinki, Finland
| | - Hilla Nordquist
- The Faculty of Social Sciences, University of Helsinki, Helsinki, Finland
- Department of Public Health, Faculty of Medicine, University of Helsinki, Helsinki, Finland
- South-Eastern Finland University of Applied Sciences, Kotka, Finland
| | - Anne Kouvonen
- The Faculty of Social Sciences, University of Helsinki, Helsinki, Finland
- Centre for Public Health, Queen's University Belfast, Belfast, UK
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Haraldsson J, Johnsson L, Tindberg Y, Kristiansson P, Nordgren L. They are my worries, so it's me the doctor should listen to-adolescent males' experiences of consultations with general practitioners. BMC PRIMARY CARE 2024; 25:169. [PMID: 38760699 PMCID: PMC11102250 DOI: 10.1186/s12875-024-02431-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/10/2023] [Accepted: 05/13/2024] [Indexed: 05/19/2024]
Abstract
BACKGROUND Many adolescent males visit a general practitioner regularly, yet many report unmet health needs and negative experiences. This indicates a gap between provided healthcare and the needs of adolescent males. In order to improve adolescent males' possibilities to discuss their health concerns with general practitioners, the study's aim was to explore and describe how adolescent males understand and assign meaning to their experiences of consultations with general practitioners. METHODS This qualitative study was conducted at two healthcare centres in mid-Sweden in 2022. Nine males 15 to 19 years old described their experiences in semi-structured interviews immediately after consulting a general practitioner, regardless of reason for the consultation and whether or not accompanied by a parent. The analysis was guided by thematic analysis according to Braun & Clarke and reflective lifeworld theory's concepts of openness and sensitivity. RESULTS One overarching theme, To be listened to, and three themes were developed: To handle insecurity and uneasiness, To be understood and cared for, and To get parental support on his terms. In a good appointment, the general practitioner cares about him, listens attentively, and takes him seriously. More importantly, the general practitioner's understanding permeates the consultation, so that all aspects of it is adapted to him. The adolescent males doubted their ability to express themselves and to understand what would happen in the consultation, and therefore feared being dismissed without receiving any help. Such difficulties may be due to unfinished neurocognitive development and inexperience. They struggled with embarrassment, partly due to notions of masculinity, and strived to balance their needs of parental support, privacy, and being the one that the doctor listens to. CONCLUSIONS We argue that adolescent males are particularly vulnerable due to on-going neurocognitive and emotional development, inexperience, and notions of masculinity. However, good experiences can be generated through rather simple means. Adolescent males need individual adaptations demonstrating that they are cared for, understood and taken seriously. Furthermore, they need an unhurried pace to facilitate understanding, verbal affirmations to mitigate embarrassment, and help in navigating parental involvement.
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Affiliation(s)
- Johanna Haraldsson
- Department of Public Health and Caring Sciences/Family Medicine and Preventive Medicine, Uppsala University, Box 564, SE-751 22, Uppsala, Sweden.
- Centre for Clinical Research Sörmland / Uppsala University, Mälarsjukhuset, SE-631 88, Eskilstuna, Sweden.
| | - Linus Johnsson
- Centre for Clinical Research Sörmland / Uppsala University, Mälarsjukhuset, SE-631 88, Eskilstuna, Sweden
- Centre for Research Ethics & Bioethics, Uppsala University, Box 564, Uppsala, SE-751 22, Sweden
| | - Ylva Tindberg
- Centre for Clinical Research Sörmland / Uppsala University, Mälarsjukhuset, SE-631 88, Eskilstuna, Sweden
- Department of Women's and Children's Health, Uppsala University, Akademiska sjukhuset, SE-751 85, Uppsala, Sweden
| | - Per Kristiansson
- Department of Public Health and Caring Sciences/Family Medicine and Preventive Medicine, Uppsala University, Box 564, SE-751 22, Uppsala, Sweden
| | - Lena Nordgren
- Department of Public Health and Caring Sciences/Family Medicine and Preventive Medicine, Uppsala University, Box 564, SE-751 22, Uppsala, Sweden
- Centre for Clinical Research Sörmland / Uppsala University, Mälarsjukhuset, SE-631 88, Eskilstuna, Sweden
- Department of Public Health and Caring Sciences/Caring Sciences, Uppsala University, Box 564, SE-751 22, Uppsala, Sweden
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Alcalde E, Rouquette A, Wiernik E, Rigal L. Depressive symptomatology from a network perspective: Differences in the experience of symptoms involved in the self-recognition of depression and the diagnosis process by social position. Int J Soc Psychiatry 2024:207640241237714. [PMID: 38488236 DOI: 10.1177/00207640241237714] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/09/2024]
Abstract
BACKGROUND While social disparities in depression are well-documented, the symptom experience across social positions remains less studied. AIMS This study examines the connections between depressive symptoms and self-recognizing a depressive episode, on the one hand, and clinical diagnosis, on the other hand, by three social position indicators. METHODS We analyzed baseline data from a population-based cohort of adults living in France, grouping participants by three indicators: education, financial difficulties, and occupation, and stratifying by sex. Utilizing a psychometric network approach, we estimated 24 networks. Nodes corresponded to the 20 CES-D items and 1 external variable, either 'Limitations due to depression' or 'Clinical depression'. Comparisons between socially disadvantaged and advantaged groups across the three social indicators were made in terms of network structures, global strength, and edge weights involving symptoms and both external nodes. RESULTS The study included data from 201,952 participants. Individuals in lower social positions exhibited higher rates of depressive-related variables. Four depressive symptoms emerged as crucial, being linked both to 'Clinical depression' and 'Limitations' across all social positions. Socially disadvantaged groups had denser networks. Some of the tests comparing network structures according to social position were significant, suggesting differences in the symptom activation chains. Connections between each external node and 'Felt depressed' and 'Could not get going' were non-invariant in educational and financial-based networks. CONCLUSIONS Findings highlight four depressive symptoms, likely to play a key role in the experience of depression across all social positions. Other insights from specific symptoms could be used for improving depression care among disadvantaged populations.
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Affiliation(s)
- Eugenia Alcalde
- Centre de Recherche en Epidémiologie et Santé des Populations (CESP), Institut National de la Santé et de la Recherche Médicale (INSERM) U1018, Villejuif, France
- IRIS, INSERM U997, Aubervilliers, France
| | - Alexandra Rouquette
- Centre de Recherche en Epidémiologie et Santé des Populations (CESP), Institut National de la Santé et de la Recherche Médicale (INSERM) U1018, Villejuif, France
- Public Health and Epidemiology Department, AP-HP Paris-Saclay University, Le Kremlin-Bicêtre, France
| | - Emmanuel Wiernik
- Université Paris Cité, Paris-Saclay University, Université de Versailles Saint-Quentin-en-Yvelines, INSERM, UMS011 Population-Based Cohorts Unit, France
| | - Laurent Rigal
- Centre de Recherche en Epidémiologie et Santé des Populations (CESP), Institut National de la Santé et de la Recherche Médicale (INSERM) U1018, Villejuif, France
- Public Health and Epidemiology Department, AP-HP Paris-Saclay University, Le Kremlin-Bicêtre, France
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Singer S, Wünsch A, Ihrig A, Bruns G, Holz F, Jakob J, Besseler M, Engesser D, Blettner M, König J, Bayer O. Men's Access to Outpatient Psychosocial Cancer Counseling. DEUTSCHES ARZTEBLATT INTERNATIONAL 2024; 121:121-127. [PMID: 38231700 PMCID: PMC11019762 DOI: 10.3238/arztebl.m2024.0005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/22/2023] [Revised: 01/10/2024] [Accepted: 01/10/2024] [Indexed: 01/19/2024]
Abstract
BACKGROUND Men make use of outpatient cancer counseling less commonly than women, even when they stand to benefit from it. METHODS In a cluster-randomized trial (registered under DRKS00032181), we studied whether measures on multiple levels (information for referring physicians, public information, structural changes, offerings specifically for male patients) over a period of 12 months would be able to increase the percentage of men among patients seeking outpatient cancer counseling (primary endpoint, initial contact; secondary endpoint, all contacts). The intervention effect was quantified by the fitting of generalized linear mixed models to obtain an odds ratio, which was adjusted for cluster structure and for the percentages of first contacts and of all contacts during the 12 months before the start of the intervention. RESULTS In 12 regions of Germany (6 each in the intervention arm and the control arm), 11 986 people had first contacts with outpatient cancer counseling, 6004 of them during the intervention phase. The percentage accounted for by men was 30.7% in the intervention arm and 25.7% in the control arm, corresponding to a statistically insignificant model-based adjusted odds ratio (OR) of 1.2 (95% confidence interval [1.0; 1.4], p = 0.08) for the primary endpoint. There were a total of 51 842 counseling sessions (both initial contacts and subsequent contacts), 26 651 of them in the intervention phase. The percentage of these that was accounted for by men was 27.6% in the intervention arm and 22.2% in the control arm; the adjusted OR for this secondary endpoint was 1.3 [1.1; 1.6], p = 0.01). CONCLUSION The targeted implementation of malespecific measures on multiple levels can increase, by a small amount, the percentage of men among persons seeking outpatient cancer counseling.
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Affiliation(s)
- Susanne Singer
- Division of Epidemiology and Health Services Research, Institute of Medical Biostatistics, Epidemiology and Informatics (IMBEI), University Hospital Mainz
- University Cancer Center Mainz (UCT), Johannes Gutenberg University of Mainz
| | - Alexander Wünsch
- Psycho-Oncological Service, Department of Medical Oncology, Inselspital, University Hospital Bern, University of Bern, Switzerland
- Freiburg Cancer Counseling Service, Comprehensive Cancer Center Freiburg (CCCF) in cooperation with the Department of Psychosomatic Medicine and Psychotherapy, University Hospital Freiburg, Medical Faculty, Albert Ludwigs University of Freiburg
| | - Andreas Ihrig
- North Baden Psychosocial Cancer Counseling Service, Department of General Internal Medicine and Psychosomatics, University Hospital Heidelberg
| | - Gudrun Bruns
- Tumor Network Cancer Counseling in the Münster Region, Münster
| | - Franziska Holz
- Cancer Counseling Service of the Hamburg Cancer Society, Hamburg
| | - Johannes Jakob
- Cancer Counseling Service of the phönikks Foundation, Hamburg
| | - Markus Besseler
- Munich Psychosocial Cancer Counseling Service of the Bavarian Cancer Society, Munich
| | - Deborah Engesser
- Division of Epidemiology and Health Services Research, Institute of Medical Biostatistics, Epidemiology and Informatics (IMBEI), University Hospital Mainz
| | - Maria Blettner
- Division of Epidemiology and Health Services Research, Institute of Medical Biostatistics, Epidemiology and Informatics (IMBEI), University Hospital Mainz
| | - Jochem König
- Division of Pediatric Epidemiology, Institute of Medical Biostatistics, Epidemiology and Informatics (IMBEI), University Hospital Mainz
| | - Oliver Bayer
- Division of Epidemiology and Health Services Research, Institute of Medical Biostatistics, Epidemiology and Informatics (IMBEI), University Hospital Mainz
- University Cancer Center Mainz (UCT), Johannes Gutenberg University of Mainz
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Viduani A, Arenas DL, Benetti S, Wahid SS, Kohrt BA, Kieling C. Systematic Review and Meta-Synthesis: How Is Depression Experienced by Adolescents? A Synthesis of the Qualitative Literature. J Am Acad Child Adolesc Psychiatry 2024:S0890-8567(24)00061-3. [PMID: 38340896 DOI: 10.1016/j.jaac.2023.11.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/01/2023] [Revised: 10/29/2023] [Accepted: 02/01/2024] [Indexed: 02/12/2024]
Abstract
OBJECTIVE To systematically investigate how youth with lived experience report their experience of depression in terms of features of depression and in relation to themselves and their environment. METHOD We conducted a systematic review of qualitative research around the world that explored the subjective experience of depression among youth (age range, 10-24 years) who had self-reported, screened positive for, or received a formal diagnosis of the disorder. We used multiple databases to search for relevant studies published in any language up until March 2023. Studies were coded regarding features of depression reported by adolescents. We also used thematic synthesis to extract and synthesize descriptions of the lived experience of depression, and to develop analytic themes. The study was registered with PROSPERO, CRD42021218300. RESULTS We identified a total of 23,424 unique records, and included 39 studies in the final review, representing the views of 884 adolescents with lived experience of depression. Most of the studies were conducted in high-income countries (72.8%), and the majority of participants were female (65%). The most frequently reported features of depression were sadness (present in 92.3% of the studies), social withdrawal (76.9%), and loneliness (69.2%). In addition, we constructed 3 themes that aimed to synthesize youths' accounts of their perceptions and experiences of depression: (1) making sense; (2) factoring in culture and contextual influences; and (3) accessing support and care. CONCLUSION Some of the more commonly reported features of depression among youth are not explicitly included in the DSM/ICD diagnostic criteria but are highly relevant and closely connected to the experiences of adolescents. Moreover, contextual interpretations of depression may be more sensitive to capture representations and narratives of depression among youth. Thus, incorporating features of depression reported by adolescents could potentially increase accuracy of detection, promote collaborative work, and enhance therapeutic and care outcomes. STUDY PREREGISTRATION INFORMATION The lived experience of depression in adolescence: a systematic review of the qualitative literature; https://www.crd.york.ac.uk/prospero/; CRD42021218300.
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Affiliation(s)
- Anna Viduani
- Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil, and Prodia - Child & Adolescent Depression Program, Hospital de Clínicas de Porto Alegre (HCPA), Porto Alegre, Brazil
| | - Daniel Luccas Arenas
- Hospital Materno-Infantil Presidente Vargas and Pontifícia Universidade Católica do Rio Grande do Sul, Porto Alegre, Brazil
| | - Silvia Benetti
- Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil, and Prodia - Child & Adolescent Depression Program, Hospital de Clínicas de Porto Alegre (HCPA), Porto Alegre, Brazil
| | | | | | - Christian Kieling
- Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil, and Prodia - Child & Adolescent Depression Program, Hospital de Clínicas de Porto Alegre (HCPA), Porto Alegre, Brazil.
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Fusar-Poli P, Estradé A, Stanghellini G, Esposito CM, Rosfort R, Mancini M, Norman P, Cullen J, Adesina M, Jimenez GB, da Cunha Lewin C, Drah EA, Julien M, Lamba M, Mutura EM, Prawira B, Sugianto A, Teressa J, White LA, Damiani S, Vasconcelos C, Bonoldi I, Politi P, Vieta E, Radden J, Fuchs T, Ratcliffe M, Maj M. The lived experience of depression: a bottom-up review co-written by experts by experience and academics. World Psychiatry 2023; 22:352-365. [PMID: 37713566 PMCID: PMC10503922 DOI: 10.1002/wps.21111] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 09/17/2023] Open
Abstract
We provide here the first bottom-up review of the lived experience of depression, co-written by experts by experience and academics. First-person accounts within and outside the medical field were screened and discussed in collaborative workshops involving numerous individuals with lived experience of depression, family members and carers, representing a global network of organizations. The material was enriched by phenomenologically informed perspectives and shared with all collaborators in a cloud-based system. The subjective world of depression was characterized by an altered experience of emotions and body (feeling overwhelmed by negative emotions, unable to experience positive emotions, stuck in a heavy aching body drained of energy, detached from the mind, the body and the world); an altered experience of the self (losing sense of purpose and existential hope, mismatch between the past and the depressed self, feeling painfully incarcerated, losing control over one's thoughts, losing the capacity to act on the world; feeling numb, empty, non-existent, dead, and dreaming of death as a possible escape route); and an altered experience of time (experiencing an alteration of vital biorhythms, an overwhelming past, a stagnation of the present, and the impossibility of the future). The experience of depression in the social and cultural context was characterized by altered interpersonal experiences (struggling with communication, feeling loneliness and estrangement, perceiving stigma and stereotypes), and varied across different cultures, ethnic or racial minorities, and genders. The subjective perception of recovery varied (feeling contrasting attitudes towards recovery, recognizing recovery as a journey, recognizing one's vulnerability and the need for professional help), as did the experience of receiving pharmacotherapy, psychotherapy, and social as well as physical health interventions. These findings can inform clinical practice, research and education. This journey in the lived experience of depression can also help us to understand the nature of our own emotions and feelings, what is to believe in something, what is to hope, and what is to be a living human being.
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Affiliation(s)
- Paolo Fusar-Poli
- Early Psychosis: Interventions and Clinical-detection (EPIC) Lab, Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
- OASIS service, South London and Maudsley NHS Foundation Trust, London, UK
- Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy
- National Institute for Health Research, Maudsley Biomedical Research Centre, South London and Maudsley, London, UK
| | - Andrés Estradé
- Early Psychosis: Interventions and Clinical-detection (EPIC) Lab, Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - Giovanni Stanghellini
- Department of Health Sciences, University of Florence, Florence, Italy
- Diego Portales University, Santiago, Chile
| | - Cecilia Maria Esposito
- Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy
- Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy
| | - René Rosfort
- S. Kierkegaard Research Centre, University of Copenhagen, Copenhagen, Denmark
| | - Milena Mancini
- Department of Psychological Sciences, Health and Territory, University of Chieti and Pescara "G. d'Annunzio", Chieti, Italy
| | - Peter Norman
- Recovery College, South London and Maudsley NHS Foundation Trust, London, UK
- Mosaic Clubhouse Brixton, London, UK
| | | | - Miracle Adesina
- Global Mental Health Peer Network, Ibadan, Nigeria
- Slum and Rural Health Initiative, Ibadan, Nigeria
| | - Gema Benavides Jimenez
- Global Mental Health Peer Network, Madrid, Spain
- Utrecht University, Utrecht, The Netherlands
- Instituto Superior de Estudios Psicológicos, Madrid, Spain
| | - Caroline da Cunha Lewin
- Global Mental Health Peer Network, London, UK
- Patient and Public Involvement Team, NIHR Maudsley Biomedical Research Centre, South London and Maudsley NHS Foundation Trust and King's College London, London, UK
| | | | - Marc Julien
- Global Mental Health Peer Network, Douala, Cameroon
| | | | - Edwin M Mutura
- Global Mental Health Peer Network, Nairobi, Kenya
- Mentally Unsilenced, Nairobi, Kenya
- Psychiatric Disability Organization of Kenya, Nakuru, Kenya
| | - Benny Prawira
- Global Mental Health Peer Network, Jakarta, Indonesia
- Into The Light Indonesia, Jakarta, Indonesia
| | - Agus Sugianto
- Global Mental Health Peer Network, Jakarta, Indonesia
- Indonesian Community Care for Schizophrenia, Jakarta, Indonesia
- University of Manchester, Manchester, UK
| | - Jaleta Teressa
- Global Mental Health Peer Network, Nekemte, Ethiopia
- Nekemte Specialized Hospital, Nekemte, Ethiopia
| | - Lawrence A White
- Global Mental Health Peer Network, Yellowknife, Canada
- Centre for Learning & Teaching Innovation, Aurora College, Yellowknife, Canada
- Advanced Graduate Student, Unicaf University, Lusaka, Zambia
| | - Stefano Damiani
- Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy
| | - Candida Vasconcelos
- Early Psychosis: Interventions and Clinical-detection (EPIC) Lab, Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - Ilaria Bonoldi
- Early Psychosis: Interventions and Clinical-detection (EPIC) Lab, Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
- Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy
| | - Pierluigi Politi
- Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy
| | - Eduard Vieta
- Bipolar and Depressive Disorders Unit, Hospital Clinic, Institute of Neuroscience, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Catalonia, Spain
| | - Jennifer Radden
- Philosophy Department, University of Massachusetts, Boston, MA, USA
| | - Thomas Fuchs
- Department of General Psychiatry, Center for Psychosocial Medicine, University of Heidelberg, Heidelberg, Germany
| | | | - Mario Maj
- Department of Psychiatry, University of Campania "L. Vanvitelli", Naples, Italy
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Singer S, Blanck J, Maier L, Tischner CL. „Sie erscheint durch ihr Übergewicht keineswegs entstellt.“. FORUM DER PSYCHOANALYSE 2022. [DOI: 10.1007/s00451-022-00486-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
ZusammenfassungWie nehmen Psychoanalytiker*innen ihre männlichen bzw. weiblichen Patient*innen wahr? Anhand von Textanalysen der Berichte an den Gutachter aus Anträgen zur Kostenübernahme für Psychotherapien untersuchten wir, ob es hierbei geschlechtsspezifische Unterschiede gibt. Es wurden 20 Berichte von Patienten und 20 Berichte von Patientinnen qualitativ analysiert, resultierend in 399 kodierten Textsegmenten.Es zeigte sich, dass bei Frauen deutlich häufiger über deren Aussehen (Frisur, Körperbau, Augen, Kleidungsstil und so weiter) geschrieben wird. Auch in der Bewertung des Aussehens zeigten sich Unterschiede: Patientinnen wurden häufiger als hübsch/attraktiv oder als kindlich/jünger wirkend beschrieben, während diese Attribute fast nie bei Männern verwendet wurden. Diese wurden hingegen häufiger als überdurchschnittlich intelligent geschildert.In der Gegenübertragung zeigten sich bei Frauen häufiger Gefühle von Vorsichtig-sein-Müssen, aber auch von Mitgefühl und Sympathie, bei Männern hingegen häufiger der Wunsch, sie zu beschützen und ihnen zu helfen, der Wunsch, sie zu begrenzen, sowie Ärger/Wut.Diese Befunde legen nahe, dass Genderstereotype bei der Wahrnehmung von (und dem Schreiben über) Patient*innen eine wesentliche Rolle spielen.
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Fisher K, Seidler ZE, King K, Oliffe JL, Rice SM. Men's anxiety: A systematic review. J Affect Disord 2021; 295:688-702. [PMID: 34517242 DOI: 10.1016/j.jad.2021.08.136] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/14/2021] [Revised: 07/27/2021] [Accepted: 08/27/2021] [Indexed: 11/27/2022]
Abstract
AIM Anxiety disorders are amongst the most commonly diagnosed mental illnesses amongst men; however male-specific anxiety research is lacking. This review explores men's anxiety symptoms and disorders including help-seeking, coping and the role of masculinity. METHOD Four electronic database searches identified 8,333 citations, with 25 studies meeting inclusion criteria. Nineteen studies employed quantitative methods, five studies reported qualitative research, and one utilised mixed methods. RESULTS Unique profiles of anxiety, including psychosomatic symptoms, were identified and persisted over extended periods of time. Men commonly reported self-reliance over formal help-seeking, and typically managed anxiety symptoms through problem-based coping. Masculinity was related to anxiety in complex ways; adherence to norms of toughness could be protective against anxiety onset, while adherence to emotional restrictiveness and heterosexual presentation norms were positively associated with anxiety. The experience of, and help-seeking for anxiety transgressed many men's adherence to masculinity norms resulting in significant social and self-stigmas. LIMITATIONS The anxiety measurement scales utilised were inconsistent across included studies and there was limited scope of research into panic disorders, phobias and agoraphobia. CONCLUSION Findings demonstrate the enduring nature of anxiety for men and a potential under-reporting of symptoms, especially amongst younger men. To better tailor clinical care and public health resources to the needs of men with anxiety disorders, targeted research examining men's lived experiences of (and coping strategies for) anxiety is essential.
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Affiliation(s)
- Krista Fisher
- Orygen, Parkville, Victoria, Australia; Centre for Youth Mental Health, The University of Melbourne, Melbourne, Victoria, Australia.
| | - Zac E Seidler
- Orygen, Parkville, Victoria, Australia; Centre for Youth Mental Health, The University of Melbourne, Melbourne, Victoria, Australia.
| | - Kylie King
- Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, Victoria, Australia.
| | - John L Oliffe
- University of British Columbia, Vancouver, British Columbia, Canada; Melbourne School of Health Sciences, The University of Melbourne, Melbourne, Victoria, Australia.
| | - Simon M Rice
- Orygen, Parkville, Victoria, Australia; Centre for Youth Mental Health, The University of Melbourne, Melbourne, Victoria, Australia.
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Singer S, Kojima E, Deppisch L, Taylor K, Wickert M, Riedel P, Alt J, Heß G, Hechtner M, Bayer O. What is the best time for psychosocial counselling from the perspective of cancer patients and their relatives? A multi‐centre qualitative study. COUNSELLING & PSYCHOTHERAPY RESEARCH 2021. [DOI: 10.1002/capr.12488] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Affiliation(s)
- Susanne Singer
- Division of Epidemiology and Health Services Research Institute of Medical Biostatistics, Epidemiology and Informatics (IMBEI) University Medical Centre of Johannes Gutenberg University Mainz Germany
- University Cancer Centre Mainz (UCT) Mainz Germany
| | - Erika Kojima
- Division of Epidemiology and Health Services Research Institute of Medical Biostatistics, Epidemiology and Informatics (IMBEI) University Medical Centre of Johannes Gutenberg University Mainz Germany
- University Cancer Centre Mainz (UCT) Mainz Germany
| | - Larissa Deppisch
- Division of Epidemiology and Health Services Research Institute of Medical Biostatistics, Epidemiology and Informatics (IMBEI) University Medical Centre of Johannes Gutenberg University Mainz Germany
- University Cancer Centre Mainz (UCT) Mainz Germany
| | - Katherine Taylor
- Division of Epidemiology and Health Services Research Institute of Medical Biostatistics, Epidemiology and Informatics (IMBEI) University Medical Centre of Johannes Gutenberg University Mainz Germany
- University Cancer Centre Mainz (UCT) Mainz Germany
| | | | | | - Jürgen Alt
- University Cancer Centre Mainz (UCT) Mainz Germany
| | - Georg Heß
- University Cancer Centre Mainz (UCT) Mainz Germany
| | - Marlene Hechtner
- Division of Epidemiology and Health Services Research Institute of Medical Biostatistics, Epidemiology and Informatics (IMBEI) University Medical Centre of Johannes Gutenberg University Mainz Germany
- University Cancer Centre Mainz (UCT) Mainz Germany
| | - Oliver Bayer
- Division of Epidemiology and Health Services Research Institute of Medical Biostatistics, Epidemiology and Informatics (IMBEI) University Medical Centre of Johannes Gutenberg University Mainz Germany
- University Cancer Centre Mainz (UCT) Mainz Germany
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Shi P, Yang A, Zhao Q, Chen Z, Ren X, Dai Q. A Hypothesis of Gender Differences in Self-Reporting Symptom of Depression: Implications to Solve Under-Diagnosis and Under-Treatment of Depression in Males. Front Psychiatry 2021; 12:589687. [PMID: 34759845 PMCID: PMC8572815 DOI: 10.3389/fpsyt.2021.589687] [Citation(s) in RCA: 61] [Impact Index Per Article: 20.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/31/2020] [Accepted: 09/23/2021] [Indexed: 11/13/2022] Open
Abstract
The phenomenon of female preponderance in depression has been well-reported, which has been challenged by higher rates of suicide and addictive behaviors in males, and a longer life-span in females. We thus propose an alternative hypothesis "Gender differences in self-reporting symptom of depression," suggesting mild-moderate depression tends to be reported more often by females, and severe depression and suicide tend to be reported more often by males. Potential mechanisms that account for this difference may include three aspects: covariation between estrogen levels and the incidence peak of female depression, gender differences in coping style (e.g., comparative emotional inexpressiveness and non-help-seeking in males), and gender differences in symptom phenotypes (e.g., atypical symptoms in male depression). Our newly presented hypothesis implied the overlooked under-diagnosis and under-treatment of depression in males. For effective diagnoses and timely treatment of male depression, it is critical to incorporate symptoms of depression in males into the relevant diagnostic criteria, encourage males to express negative emotions, and increase awareness of suicidal behavior in males.
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Affiliation(s)
- Peixia Shi
- Department of Nursing Psychology, Army Medical University, Chongqing, China
| | - Aigang Yang
- Department of Nursing Psychology, Army Medical University, Chongqing, China
| | - Qing Zhao
- CAS Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences (CAS), Beijing, China.,Department of Psychology, University of Chinese Academy of Sciences, Beijing, China
| | - Zhaohua Chen
- Department of Nursing Psychology, Army Medical University, Chongqing, China
| | - Xiaomei Ren
- Department of Nursing Psychology, Army Medical University, Chongqing, China
| | - Qin Dai
- Department of Nursing Psychology, Army Medical University, Chongqing, China
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Lundvall M, Hörberg U, Palmér L, Carlsson G, Lindberg E. Young men's experiences of living with existential concerns: "living close to a bottomless darkness". Int J Qual Stud Health Well-being 2020; 15:1810947. [PMID: 32854600 PMCID: PMC7482899 DOI: 10.1080/17482631.2020.1810947] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/10/2023] Open
Abstract
Introduction Young men may struggle in life with challenges of various concerns about their identity and who they want to be in life. Many health issues arise from social norms and wider societal determinations and for today’s young men, following such norms poses a risk of losing oneself. An essential part of health are connected to the existential dimensions in life and concerns who you are, and how well you know and understand yourself. However; little is known about what it means for young men to live a life with existential concerns. Purpose and method The purpose of this phenomenological study, based on reflective lifeworld research (RLR), is to describe young men’s experiences of living with existential concerns for which they have sought support. Eight lifeworld interviews were conducted. Results The results essentially show that young men living with existential concerns describe their situations as living close to a bottomless darkness. This is further described according to four constituents: enduring everyday life, striving for a solution, hearing an inner self-critical voice, and wearing a hard shell. Conclusion We conclude that strengthening young men’s health processes requires healthcare professionals to create an atmosphere where young men feel safe talking about existential concerns without feeling exposed and vulnerable.
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Affiliation(s)
- Maria Lundvall
- Faculty of Caring Science, Work Life and Social Welfare, University of Borås , Borås, Sweden
| | - Ulrica Hörberg
- Department of Health and Caring Sciences, Linnaeus University , Växjö, Sweden
| | - Lina Palmér
- Faculty of Caring Science, Work Life and Social Welfare, University of Borås , Borås, Sweden
| | - Gunilla Carlsson
- Faculty of Caring Science, Work Life and Social Welfare, University of Borås , Borås, Sweden
| | - Elisabeth Lindberg
- Faculty of Caring Science, Work Life and Social Welfare, University of Borås , Borås, Sweden
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12
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Wills C, Gibson K, Cartwright C, Read J. Young Women's Selfhood on Antidepressants: "Not Fully Myself". QUALITATIVE HEALTH RESEARCH 2020; 30:268-278. [PMID: 31585513 DOI: 10.1177/1049732319877175] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
The impact of antidepressants on selfhood is well recognized but little is known about what this means for young women who take antidepressants during a key period for identity development. We analyzed interviews with 16 young women to explore the way that antidepressant use might shape selfhood. Thematic analysis was used to identify a range of potential self-related themes in the participants' narratives including a "diagnosed self," "an ill self," "a normal self," "a stigmatized self," "an uncertain self," and a "powerless self." Themes highlighted the complex influence of antidepressants on young women's selfhood. Antidepressants not only offered legitimacy for distress and the opportunity to have a more "normal" self but also left the young women challenged by some of the negative associations with antidepressant use and uncertainty about their identity. Prescribers should be mindful of the impact of antidepressants on young women's developing selfhood.
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Affiliation(s)
- Celine Wills
- The University of Auckland, Auckland, New Zealand
| | - Kerry Gibson
- The University of Auckland, Auckland, New Zealand
| | | | - John Read
- University of East London, London, United Kingdom
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Green RM, Travers AM, Howe Y, McDougle CJ. Women and Autism Spectrum Disorder: Diagnosis and Implications for Treatment of Adolescents and Adults. Curr Psychiatry Rep 2019; 21:22. [PMID: 30852705 DOI: 10.1007/s11920-019-1006-3] [Citation(s) in RCA: 54] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
PURPOSE OF REVIEW We review the recent literature regarding the implications of gender on the diagnosis and treatment of autism spectrum disorder (ASD) in women and adolescent females. We also discuss important clinical observations in treating this population. RECENT FINDINGS Growing research supports gender specificity in ASD symptom presentation. Differing phenotypes, psychiatric co-morbidities, and level of "camouflaging" (behavioral coping strategies to conceal symptoms for use in social situations) are thought to further contribute to the discrepancy in prevalence rates and resulting misdiagnosis or delayed diagnosis in adolescent females and women. Both nosological and cultural factors appear to be contributing to differences in the diagnosis of ASD in women. These differences in presentation have important implications for late diagnosis, treatment of ASD, and the quality of life for women with autism.
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Affiliation(s)
- Renée M Green
- Lurie Center for Autism, Massachusetts General Hospital, 1 Maguire Road, Lexington, MA, 02421, USA. .,Harvard Medical School, Boston, MA, USA.
| | - Alyssa M Travers
- Lurie Center for Autism, Massachusetts General Hospital, 1 Maguire Road, Lexington, MA, 02421, USA.,Harvard Medical School, Boston, MA, USA
| | - Yamini Howe
- Lurie Center for Autism, Massachusetts General Hospital, 1 Maguire Road, Lexington, MA, 02421, USA.,Harvard Medical School, Boston, MA, USA
| | - Christopher J McDougle
- Lurie Center for Autism, Massachusetts General Hospital, 1 Maguire Road, Lexington, MA, 02421, USA.,Harvard Medical School, Boston, MA, USA
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Martin D, Atkinson C. What narratives do young people use to communicate depression? A systematic review of the literature. EMOTIONAL AND BEHAVIOURAL DIFFICULTIES 2018. [DOI: 10.1080/13632752.2018.1460527] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Affiliation(s)
- Dorota Martin
- Kirklees Educational Psychology Service, Dewsbury, UK
| | - Cathy Atkinson
- Manchester Institute of Education, University of Manchester, Manchester, UK
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15
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Athanasiadis C, Gough B, Robertson S. What do counsellors need to know about male depression? BRITISH JOURNAL OF GUIDANCE & COUNSELLING 2017. [DOI: 10.1080/03069885.2017.1346232] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- Chrysostomos Athanasiadis
- Division of Counselling and Psychological Therapies, School of Community Health and Midwifery, University of Central Lancashire, Preston, UK
| | - Brendan Gough
- School of Social Sciences, Leeds Beckett University, Leeds, UK
| | - Steve Robertson
- School of Health and Community Studies, Leeds Beckett University, Leeds, UK
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16
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Hjeltnes A, Moltu C, Schanche E, Binder PE. What Brings You Here? Exploring Why Young Adults Seek Help for Social Anxiety. QUALITATIVE HEALTH RESEARCH 2016; 26:1705-1720. [PMID: 26193889 DOI: 10.1177/1049732315596151] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
Social anxiety disorder typically manifests in young adulthood, but there is an absence of qualitative research on the actual experiences of young adults suffering with this disorder. The aim of the present study was to investigate the lived experiences of 29 Norwegian university students who were seeking professional help for symptoms of social anxiety. We conducted in-depth interviews prior to a clinical trial. The interviews were transcribed and analyzed using a team-based thematic analysis method based on a hermeneutic-phenomenological epistemology. We identified five themes: (a) from being shy to interpreting anxiety as a mental health problem, (b) experiencing emotions as threatening and uncontrollable, (c) encountering loneliness as relationships fall away, (d) hiding the vulnerable self from others, and (e) deciding to face social fears in the future. We relate our findings to existing theory and research, discuss our process of reflexivity, highlight study limitations, and suggest implications for future research.
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Sarı S, Gençöz F. Shame Experiences Underlying Depression of Adult Turkish Women. QUALITATIVE HEALTH RESEARCH 2016; 26:1102-1113. [PMID: 25823845 DOI: 10.1177/1049732315579177] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
Shame is a major component of many mental health problems and affects symptoms, coping styles, remission, and therapeutic ruptures. There are few qualitative studies aimed at understanding shame and its role for patients diagnosed with depression. In this research, we explored the origins of shame, and the coping strategies that patients diagnosed with depression employ to cope with shame. This qualitative research aimed at an in-depth analysis of shame experiences of adult women who had been diagnosed with depression and treated with cognitive behavioral psychotherapy in a Women Health Center in Turkey. Purposive sampling yielded nine high shame prone adult women who were married and had children. Four semi-structured interviews were conducted with each of the nine participants, and 36 semi-structured interviews were analyzed by Interpretative Phenomenological Analysis. According to the results of the analysis, four themes emerged. These were "substitution of rage for the feeling of shame and unworthiness," "perfection struggle to overcompensate the belief of being inadequate," "feeling shame for their own body and sexual acts," and "need for individuation." The results were interpreted by considering the social context and culture of Turkey, and the clinical implications were discussed.
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Affiliation(s)
- Sevda Sarı
- Middle East Technical University, Ankara, Turkey
| | - Faruk Gençöz
- Middle East Technical University, Ankara, Turkey
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18
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Strömbäck M, Wiklund M, Salander Renberg E, Malmgren-Olsson EB. Gender-sensitive and youth-friendly physiotherapy: Steps toward a stress management intervention for girls and young women. Physiother Theory Pract 2016; 32:20-33. [DOI: 10.3109/09593985.2015.1075639] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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19
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Michniewicz KS, Bosson JK, Lenes JG, Chen JI. Gender-Atypical Mental Illness as Male Gender Threat. Am J Mens Health 2015; 10:306-17. [DOI: 10.1177/1557988314567224] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
The present study examined whether men view gender-atypical (i.e., feminine) psychological disorders as threats to their gender status. Men and women ( N = 355) rated their expectations of gender status loss, feelings of distress, and help-seeking intentions in response to 10 different stereotypically masculine and feminine psychological disorders. Men as compared to women expected greater gender status loss for, and reported more distress to, gender-atypical versus gender-typical disorders. Expectations of gender status loss partially mediated the link between participant gender and distress at the thought of gender-atypical disorders. These findings suggest that feminine disorders pose more powerful gender status threats for men than masculine disorders do and that men’s expectations of gender status loss for feminine disorders drive their negative reactions to these mental illnesses. The discussion emphasizes the importance of considering the gender-typicality of disorders, and the implications of these findings for clinical interventions.
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Affiliation(s)
| | | | - Joshua G. Lenes
- Department of Psychology, University of South Florida, Tampa, FL, USA
| | - Jason I. Chen
- Department of Psychology, University of South Florida, Tampa, FL, USA
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20
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Nakimuli-Mpungu E, Wamala K, Okello J, Alderman S, Odokonyero R, Musisi S, Mojtabai R. Developing a culturally sensitive group support intervention for depression among HIV infected and non-infected Ugandan adults: a qualitative study. J Affect Disord 2014; 163:10-7. [PMID: 24836082 DOI: 10.1016/j.jad.2014.03.042] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/16/2013] [Revised: 03/22/2014] [Accepted: 03/24/2014] [Indexed: 11/27/2022]
Abstract
BACKGROUND Depression is ranked first among neuropsychiatric diseases that contribute to the burden of disease in low- and middle-income countries. However, access to antidepressants is limited and there is a dearth of locally developed psychotherapeutic interventions targeted to treat depression. AIM We aimed to obtain information on the cultural understanding of depression symptoms, complications and treatment methods used in post-conflict communities in northern Uganda in order to inform the development of an indigenous group support intervention to treat depression. METHODS Focus group discussions (FGDs) were conducted with a total of 110 men and women aged 19-68 years. FDGs took place in a private space, lasted about 2-3h and were conducted in the local language for patients and their caregivers and in English for health workers. Interview transcripts from the FGDs were reviewed for accuracy, translated into English and transcribed. QRS Nvivo 10 qualitative data analysis software was used for coding and thematic analysis. RESULTS Our study revealed community misperceptions about etiology, presentation and treatment of depression. Regardless of HIV status, most FGD participants who were not health workers linked depression symptoms to HIV infection. Although there were concerns about confidentiality of issues disclosed, many FGD participants were supportive of a group support intervention, tailored to their gender and age, that would not only focus on treating depression but also provided them with skills to improve their livelihoods. Simple CBT techniques were deemed culturally appropriate and acceptable. LIMITATION Generalizability of study findings may be limited given that the sample was primarily of Luo ethnicity yet there are different ethnic populations in the region. CONCLUSION Local communities can directly inform intervention content. The participants׳ preferences confirmed the need for a gender-specific intervention for depression that extends beyond medications and empowers them emotionally, socially and economically.
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Affiliation(s)
- Etheldreda Nakimuli-Mpungu
- Makerere University, College of Health Sciences, Kampala, Uganda; Peter C. Alderman Foundation, NewYork, USA.
| | - Kizito Wamala
- African Center for Tortured Victims, Kampala, Uganda
| | - James Okello
- Peter C. Alderman Foundation, NewYork, USA; Gulu University, Department of Psychiatry, Gulu, Uganda
| | | | - Raymond Odokonyero
- Makerere University, College of Health Sciences, Kampala, Uganda; Peter C. Alderman Foundation, NewYork, USA
| | - Seggane Musisi
- Makerere University, College of Health Sciences, Kampala, Uganda; Peter C. Alderman Foundation, NewYork, USA
| | - Ramin Mojtabai
- Johns Hopkins School of Public Health, Department of Mental Health, Baltimore, United States
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Fletcher G. Of baby ducklings and clay pots: method and metaphor in HIV prevention. QUALITATIVE HEALTH RESEARCH 2013; 23:1551-1562. [PMID: 24122519 DOI: 10.1177/1049732313508012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
In this article, I report on my decision to undertake a process of elicitation, development, and examination of metaphors for experiences of HIV prevention work in Burma/Myanmar. I cover the theoretical basis to that decision, my rationale for using metaphor elicitation as method when researching the rhetoric and practice of HIV prevention in Burma/Myanmar, the process I used, and some of the resultant metaphors. I also demonstrate that this process resulted in the opening up of a space for talking about HIV prevention that avoided recourse to standard prevention rhetoric, thereby enabling a new and deeper understanding of the gap between this rhetoric and people's actual practice or experience.
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Strömbäck M, Malmgren-Olsson EB, Wiklund M. 'Girls need to strengthen each other as a group': experiences from a gender-sensitive stress management intervention by youth-friendly Swedish health services--a qualitative study. BMC Public Health 2013; 13:907. [PMID: 24083344 PMCID: PMC3850732 DOI: 10.1186/1471-2458-13-907] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2013] [Accepted: 09/30/2013] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Mental health problems among young people, and girls and young women in particular, are a well-known health problem. Such gendered mental health patterns are also seen in conjunction with stress-related problems, such as anxiety and depression and psychosomatic complaints. Thus, intervention models tailored to the health care situation experienced by young women within a gendered and sociocultural context are needed. This qualitative study aims to illuminate young women's experiences of participating in a body-based, gender-sensitive stress management group intervention by youth-friendly health services in northern Sweden. METHODS A physiotherapeutic body-based, health-promoting, gender-sensitive stress management intervention was created by youth-friendly Swedish health services. The stress management courses (n = 7) consisted of eight sessions, each lasting about two hours, and were led by the physiotherapist at the youth centre. The content in the intervention had a gender-sensitive approach, combining reflective discussions; short general lectures on, for example, stress and pressures related to body ideals; and physiotherapeutic methods, including body awareness and relaxation. Follow-up interviews were carried out with 32 young women (17-25 years of age) after they had completed the intervention. The data were analysed with qualitative content analysis. RESULTS The overall results of our interview analysis suggest that the stress management course we evaluated facilitated 'a space for gendered and embodied empowerment in a hectic life', implying that it both contributed to a sense of individual growth and allowed participants to unburden themselves of stress problems within a trustful and supportive context. Participants' narrated experiences of 'finding a social oasis to challenge gendered expectations', 'being bodily empowered', and 'altering gendered positions and stance to life' point to empowering processes of change that allowed them to cope with distress, despite sometimes continuously stressful life situations. This intervention also decreased stress-related symptoms such as anxiousness, restlessness, muscle tension, aches and pains, fatigue, and impaired sleep. CONCLUSIONS The participants' experiences of the intervention as a safe and exploratory space for gendered collective understanding and embodied empowerment further indicates the need to develop gender-sensitive interventions to reduce individualisation of health problems and instead encourage spaces for collective support, action, and change.
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Affiliation(s)
- Maria Strömbäck
- Community Medicine and Rehabilitation, Physiotherapy, Umeå University, Umeå, Sweden.
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Vaingankar JA, Rekhi G, Subramaniam M, Abdin E, Chong SA. Age of onset of life-time mental disorders and treatment contact. Soc Psychiatry Psychiatr Epidemiol 2013; 48:835-43. [PMID: 23076588 DOI: 10.1007/s00127-012-0601-y] [Citation(s) in RCA: 59] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/29/2012] [Accepted: 09/25/2012] [Indexed: 11/30/2022]
Abstract
BACKGROUND Early onset of mental disorders is a major social and public health concern as it affects individuals in their most formative years. The impact is more pronounced when early onset is also associated with treatment delay. Little is known about the age of onset (AOO) for mental disorders and its predictors in Singapore. METHOD A national mental health survey was conducted among adult residents aged 18 years and above in Singapore. The composite international diagnostic interview (CIDI 3.0) was used to establish the life-time diagnosis of major depressive disorder (MDD), dysthymia, bipolar disorder, generalized anxiety disorder (GAD), obsessive compulsive disorder (OCD) and alcohol abuse and dependence, and the age of onset as well as any subsequent treatment contact. RESULTS A total of 6,616 respondents (mean age of 43.9 years) participated in the survey giving a response rate of 75.9 %. The median AOO for having any one of the mental disorders was 22 years with variation among the different disorders. Predictors for AOO varied across the mental disorders. Only 8 % had sought any treatment in the first year after onset. Males, those belonging to Malay and Indian ethnicities and 50+ age cohorts were less likely to have made treatment contact in the year of onset. CONCLUSION Nearly half of the respondents with any life-time mental disorder would have its onset by age of 22 years, and very few had sought treatment within the first year from onset. The study also identified socio-demographic predictors associated with AOO for mental disorders and delayed treatment contact, thus highlighting a vulnerable subpopulation that can be targeted for outreach and early interventions.
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Affiliation(s)
- Janhavi Ajit Vaingankar
- Research Division, Institute of Mental Health, Buangkok Green Medical Park, 10 Buangkok View, Singapore 539747, Singapore.
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Alex L, Lehti A. Experiences of well-being among Sami and Roma women in a Swedish context. Health Care Women Int 2013; 34:707-26. [PMID: 23570318 DOI: 10.1080/07399332.2012.740110] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Our aim was to explore the experiences of well-being and lack of well-being among middle-aged and older women belonging to two national minority groups in Sweden. Interviews from nine older Sami women and four middle-aged Roma women were analyzed using grounded theory with the following categories identified: contributing to well-being (with the subcategories belonging to a healthy family, being spiritual, cultural norms as health promoting, and having had a life of one's own); and contributing to lack of well-being (with the subcategories living subordinate to the dominant society, living in a hierarchical family, and living in the shadow of tuberculosis.).
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Affiliation(s)
- Lena Alex
- Department of Nursing, Umeå University, Umeå, Sweden.
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26
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Røseth I, Binder PE, Malt UF. Engulfed by an Alienated and Threatening Emotional Body: The Essential Meaning Structure of Depression in Women. ACTA ACUST UNITED AC 2013. [DOI: 10.1163/15691624-12341254] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Abstract
Women are twice as likely to be diagnosed with a depressive disorder as men. Before trying to explain this difference, we must first understand how women experience depression. We explore the phenomenon of depression through women’s experiences, using Giorgi’s descriptive phenomenological method. An essential meaning structure describes the development of depression: The women find themselves entrapped in a personal mission which had backfired. Motivated by shame and guilt from the past, they overinvest in work or others’ emotions to relieve internal pain. They feel deeply sensitive to, and responsible for, other persons’ distress while ignoring their own feelings and needs. Gradually their emotional body grows awry and acts in increasingly alienating and threatening ways. Ultimately they feel forced to submerge in their emotional body; they succumb to depression. We reflect on this structure on the basis of Minkowski, Scheler, Sartre and Merleau-Ponty, and in relation to contemporary research on depression.
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Carlson E. Precepting and symbolic interactionism--a theoretical look at preceptorship during clinical practice. J Adv Nurs 2012; 69:457-64. [PMID: 22670850 DOI: 10.1111/j.1365-2648.2012.06047.x] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
AIM To present a discussion of precepting through the use of symbolic interactionism as exemplified by findings from an ethnographic study. BACKGROUND It is a well-known fact that clinical practice, where students are supervised by precepting nurses, is an important part of nursing education. Several previous studies have stressed the vital role preceptors have for the development of student nurses' clinical competence. Despite this, few of these findings are discussed from a theoretical standpoint to further explain and illustrate the complexity of preceptorship. DATA SOURCES This article builds on findings from an ethnographic study undertaken between November 2006-May 2007 and again between March-September 2009. Full details of the empirical findings have been reported elsewhere. DISCUSSION Precepting can be understood as a trusting relationship between preceptor and student interacting and sharing nursing activities. The participants' actions will influence and shape the meaning and understanding of these activities. IMPLICATIONS FOR NURSING Precepting is a complex and advanced role for nurses that they need to be properly prepared for. Thus, preceptor preparation needs to be organized in collaboration between healthcare organizations and universities. It is suggested that preceptor preparation programmes should focus on reflection, critical thinking and communication skills. CONCLUSION Symbolic interactionism can serve as a potential theory that will expand the understanding of and give new perspectives of nursing practice. It would therefore be encouraging to see further testing of suitable theories to interpret empirical findings and create opportunities for practice improvement.
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Affiliation(s)
- Elisabeth Carlson
- Malmö University Department of Care Science, Faculty of Health and Society, Skåne University Hospital, Malmö, Sweden.
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