1
|
Fisher SD, Walsh T, Wongwai C. The importance of perinatal non-birthing parents' mental health and involvement for family health. Semin Perinatol 2024:151950. [PMID: 39069440 DOI: 10.1016/j.semperi.2024.151950] [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: 07/30/2024]
Abstract
Perinatal mental health research typically focuses on the birthing parent's experiences and their influence on birth/child outcomes, while not considering non-birthing parents in similar depth. Non-birthing parents are also at increased risk for mental illness during the perinatal period, and non-birthing parents' health and involvement affect the health of birthing people, fetuses, and newborns, necessitating greater understanding of non-birthing parents' contributions to family functioning. This review examines perinatal mental health disorders in non-birthing parents, their relationship quality with the birthing parent, and how the non-birthing parent's mental health and involvement affects the health outcomes of the birthing parent and the child. Recommendations are provided for healthcare professionals who work with perinatal patients and their families to engage non-birthing parents, learn about non-birthing parent health, and facilitate connections to care. By doing so, professionals working with perinatal patients can optimize health outcomes for their patients and the family as a whole.
Collapse
Affiliation(s)
- Sheehan D Fisher
- Department of Psychiatry & Behavioral Sciences, Northwestern University, 676 North Saint Clair Street Arkes Pavilion, Chicago, IL 60611, USA.
| | - Tova Walsh
- Sandra Rosenbaum School of Social Work, University of Wisconsin-Madison, 1350 University Ave, Madison, WI 53706 USA
| | - Clare Wongwai
- Department of Psychiatry & Behavioral Sciences, Northwestern University, 676 North Saint Clair Street Arkes Pavilion, Chicago, IL 60611, USA
| |
Collapse
|
2
|
Walsh TB, Garfield CF. Perinatal Mental Health: Father Inclusion At The Local, State, And National Levels. Health Aff (Millwood) 2024; 43:590-596. [PMID: 38560802 DOI: 10.1377/hlthaff.2023.01459] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/04/2024]
Abstract
Fathers occupy a dual role in the realm of perinatal mental health: partner and parent. In fathers' role as partners, their support for mothers during pregnancy and postpartum is associated with improved maternal mental health. In their role as parents, fathers themselves are vulnerable to perinatal mood and anxiety disorder. This article aims to advance awareness of paternal perinatal mental health issues and impacts on families. We first review the evidence on paternal perinatal mental health. This evidence includes the critical role played by fathers in maternal perinatal mental health, the prevalence of paternal perinatal mood and anxiety disorder, the impact of paternal mental health on child and family well-being, and screening and treatment approaches. Next, we offer recommendations for more inclusive approaches at the local, state, and national levels aimed at improving parental mental health and health outcomes for fathers, mothers, and babies.
Collapse
Affiliation(s)
- Tova B Walsh
- Tova B. Walsh , University of Wisconsin-Madison, Madison, Wisconsin
| | | |
Collapse
|
3
|
Watkins V, Kavanagh SA, Macdonald JA, Rasmussen B, Maindal HT, Hosking S, Wynter K. "I always felt like I wasn't supposed to be there". An international qualitative study of fathers' engagement in family healthcare during transition to fatherhood. Midwifery 2024; 130:103928. [PMID: 38290320 DOI: 10.1016/j.midw.2024.103928] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2023] [Revised: 12/20/2023] [Accepted: 01/16/2024] [Indexed: 02/01/2024]
Abstract
OBJECTIVE Engagement of fathers in family health services confers benefits for the health and wellbeing of the whole family. The childbirth continuum is traditionally considered a feminine event, however, commensurate with the changing paradigm of gender equity in family healthcare worldwide, the role of fathers is in transformation. The aim of the study is to explore father's perceptions and experiences of healthcare engagement during pregnancy and early infant care. DESIGN Qualitative free-text questions were embedded in a large multi-country, cross-sectional survey, to explored fathers' attendance, participation, and experience of health care during appointments with their pregnant partner and/or baby. SETTING AND PARTICIPANTS Expectant and new fathers were recruited through Prolific®, an international paid online survey platform. FINDINGS Qualitative responses (n=889) were provided by fathers from 28 countries, with experiences of a range of contexts and models of care; 46.8% of whose partners were pregnant and 53.2% had given birth since 2020. The findings suggest that although most fathers wanted to attend and participate in maternity and early parenting-related healthcare, multiple barriers were identified at the individual father, organisational context, and societal levels. Fathers reported negative social factors such as gender bias and restrictive gender norms as barriers to their healthcare engagement. In contrast, factors that enabled fathers to overcome barriers included the fathers' feelings of confidence in their partner's autonomy and decision-making skills, trusted professional relationships with clinicians, and clinicians with good interpersonal skills. KEY CONCLUSIONS Multiple barriers restrict the participation of fathers in healthcare for childbearing and early parenting. Knowledge of these barriers can inform healthcare redesign to include more successful engagement strategies for fathers, to benefit fathers, mothers, and infants alike. IMPLICATIONS FOR PRACTICE Health professionals consulting with the mother, father and infant triad are ideally placed to address the healthcare needs of both parents. Early engagement of fathers in family health care by use of inclusive interpersonal skills and the development of a trusted relationship has potential to improve paternal mental health, and may be associated with benefits for the health, wellbeing and safety of the whole family.
Collapse
Affiliation(s)
- Vanessa Watkins
- Deakin University, Centre for Quality and Patient Safety Research, School of Nursing and Midwifery, Faculty of Health, Geelong, Victoria, Australia; Deakin University, Institute for Health Transformation, Faculty of Health, Geelong, Victoria, Australia.
| | - Shane A Kavanagh
- Deakin University, Institute for Health Transformation, Faculty of Health, Geelong, Victoria, Australia; Deakin University, School of Health and Social Development, Faculty of Health, Geelong, Victoria, Australia
| | - Jacqui A Macdonald
- Deakin University, Centre for Social and Early Emotional Development, School of Psychology, Faculty of Health; Geelong, Australia; Murdoch Children's Research Institute, Centre for Adolescent Health, Royal Children's Hospital, Parkville, Australia; University of Melbourne, Department of Paediatrics, Melbourne, Australia
| | - Bodil Rasmussen
- Deakin University, Centre for Quality and Patient Safety Research, School of Nursing and Midwifery, Faculty of Health, Geelong, Victoria, Australia; Deakin University, Institute for Health Transformation, Faculty of Health, Geelong, Victoria, Australia; Deakin University Centre for Quality and Patient Safety Research - Western Health Partnership, St Albans, Victoria, Australia; University of Copenhagen, Faculty of Health and Medical Sciences, Copenhagen, Denmark.; University of Southern Denmark, Faculty of Health Sciences and Steno Diabetes Center, Odense, Denmark; Aarhus University, Department of Public Health, Aarhus, Denmark
| | - Helle Terkildsen Maindal
- Deakin University, School of Health and Social Development, Faculty of Health, Geelong, Victoria, Australia; Aarhus University, Department of Public Health, Aarhus, Denmark; Health Promotion Research, Steno Diabetes Center Copenhagen, Gentofte, Denmark
| | - Sarah Hosking
- Deakin University, Institute for Health Transformation, Faculty of Health, Geelong, Victoria, Australia
| | - Karen Wynter
- Deakin University, Centre for Quality and Patient Safety Research, School of Nursing and Midwifery, Faculty of Health, Geelong, Victoria, Australia; Deakin University, Institute for Health Transformation, Faculty of Health, Geelong, Victoria, Australia; Deakin University Centre for Quality and Patient Safety Research - Western Health Partnership, St Albans, Victoria, Australia; Monash University, Department of Psychiatry, School of Clinical Sciences, Clayton, Victoria, Australia
| |
Collapse
|
4
|
Liverpool S, Eisenstadt M, Mulligan Smith A, Kozhevnikova S. An App to Support Fathers' Mental Health and Well-Being: User-Centered Development Study. JMIR Form Res 2023; 7:e47968. [PMID: 37578834 PMCID: PMC10463090 DOI: 10.2196/47968] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2023] [Revised: 05/30/2023] [Accepted: 06/22/2023] [Indexed: 08/15/2023] Open
Abstract
BACKGROUND Numerous studies describe the popularity and usefulness of parenting programs. In particular, parenting programs are generally viewed as effective for supporting parents' mental well-being during key transition periods. However, the evidence base for fathers is limited owing to their lack of involvement in parenting programs and scarcity of tailored support. OBJECTIVE This paper aimed to describe the co-design process for a universal digital intervention for fathers (fatherli) and the outline of a logic model with its expected outcomes. METHODS Following established guidelines for co-designing and developing complex interventions, we conducted a nonsystematic review of the available literature to gather key information, developed market surveys to assess fathers' needs and interests, consulted with key stakeholders to obtain expert opinions, and engaged in a rapid iterative prototyping process with app developers. Each step was summarized, and the information was collated and integrated to inform a logic model and the features of the resulting intervention. RESULTS The steps in the co-design process confirmed a need for and interest in a digital intervention for fathers. In response to this finding, fatherli was developed, consisting of 5 key features: a discussion forum for anyone to post information about various topics (the forum), a socializing platform for fathers to create and engage with others in small groups about topics or points of shared interest (dad hub), a tool for fathers to find other fathers with shared interests or within the same geographic location (dad finder), a resource for fathers to access up-to-date information about topics that interest them (dad wiki), and a portal to book sessions with coaches who specialize in different topics (dad coaching space). The evidence-based logic model proposes that if fatherli is successfully implemented, important outcomes such as increased parental efficacy and mental health help-seeking behaviors may be observed. CONCLUSIONS We documented the co-design and development process of fatherli, which confirmed that it is possible to use input from end users and experts, integrated with theory and research evidence, to create suitable digital well-being interventions for fathers. In general, the key findings suggest that an app that facilitates connection, communication, and psychoeducation may appeal to fathers. Further studies will now focus on acceptability, feasibility, and effectiveness. Feedback gathered during pilot-testing will inform any further developments in the app to increase its applicability to fathers and its usability.
Collapse
Affiliation(s)
- Shaun Liverpool
- Faculty of Health, Social Care and Medicine, Edge Hill University, Ormskirk, United Kingdom
- Evidence Based Practice Unit, Anna Freud National Centre for Children and Families, University College London, London, United Kingdom
- fatherli Ltd, 103c Camley St, Kings Cross, N1C 4PF, London, United Kingdom
| | - Mia Eisenstadt
- Evidence Based Practice Unit, Anna Freud National Centre for Children and Families, University College London, London, United Kingdom
- fatherli Ltd, 103c Camley St, Kings Cross, N1C 4PF, London, United Kingdom
| | - Aoife Mulligan Smith
- fatherli Ltd, 103c Camley St, Kings Cross, N1C 4PF, London, United Kingdom
- Division of Psychology and Language Sciences, Faculty of Brain Sciences, University College London, London, United Kingdom
| | - Sofia Kozhevnikova
- fatherli Ltd, 103c Camley St, Kings Cross, N1C 4PF, London, United Kingdom
- School of Biosciences, University of Nottingham, Nottingham, United Kingdom
| |
Collapse
|
5
|
Hodgson S, Painter J, Kilby L, Hirst J. "Crying on the Bus": First Time Fathers' Experiences of Distress on Their Return to Work. Healthcare (Basel) 2023; 11:healthcare11091352. [PMID: 37174894 PMCID: PMC10178037 DOI: 10.3390/healthcare11091352] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2023] [Revised: 04/27/2023] [Accepted: 04/27/2023] [Indexed: 05/15/2023] Open
Abstract
There is increasing research interest in the experiences of new fathers taking paternity leave, but less insight into men's experiences of returning to work after the birth of their first baby. For many men in the UK context, this could take place immediately after the birth or after one or two weeks of paternity leave. This paper utilizes data from a UK-based study whilst also drawing on international literature and policy contexts. A constructivist grounded theory method was adopted to generate theory from the data gathered. Twelve new fathers shared their experiences in this study by participating in audio-recorded, semi-structured interviews. This paper focuses on fathers' experiences of negotiating the workplace as part of an overall theoretical framework related to broader transitions to fatherhood and sheds light on the distress, guilt and psychological challenges that the participants experienced when they initially returned to work. Whether fathers did or did not explicitly describe distress at this time, they all described a change in their worker identity, which for some participants led to uncertainty in the workplace. Men returning to work at this time in the postnatal period are vulnerable to experiencing distress. Flexibility and support in the workplace could be protective of their mental health. Finally, policy and practice developments are offered to support men's transitions to fatherhood in the workplace context.
Collapse
Affiliation(s)
- Suzanne Hodgson
- Department of Nursing, Manukau Institute of Technology-Te Pūkenga, Manukau, Auckland 2104, New Zealand
| | - Jon Painter
- Department of Nursing and Midwifery, Sheffield Hallam University, Sheffield S10 2BP, UK
| | - Laura Kilby
- Centre for Behavioural Science and Applied Psychology, Sheffield Hallam University, Sheffield S10 2BP, UK
| | - Julia Hirst
- Department of Psychology, Sociology and Politics, Sheffield Hallam University, Sheffield S10 2BP, UK
| |
Collapse
|
6
|
The social predictors of paternal antenatal mental health and their associations with maternal mental health in the Queensland Family Cohort prospective study. Arch Womens Ment Health 2023; 26:107-116. [PMID: 35984501 PMCID: PMC9908725 DOI: 10.1007/s00737-022-01257-1] [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] [Received: 09/29/2021] [Accepted: 08/04/2022] [Indexed: 11/02/2022]
Abstract
Antenatal depression (AND) affects 1 in 10 fathers, potentially negatively impacting maternal mental health and well-being during and after the transition to parenthood. However, few studies have assessed the social predictors of paternal AND or their possible associations with maternal mental health. We analysed data from 180 couples participating in the Queensland Family Cohort longitudinal study. Both parents completed surveys measuring mental health, relationship quality, social support, and sleep quality at 24 weeks of pregnancy. Mothers also completed the same surveys 6 weeks' postpartum. Antenatal depression, stress, and anxiety were highest among fathers reporting lower social support and higher sleep impairment. Maternal AND, stress, and anxiety were higher among mothers reporting higher physical pain and poor sleep quality. Postnatally, mothers reporting lower social support also reported higher depression, anxiety, stress, and psycho-social well-being. While there were no significant associations between AND among fathers and maternal antenatal or postnatal depression, an exploratory analysis revealed that mothers whose partners reported lower antenatal social support also reported lower postnatal social support and higher postnatal depression. Our findings highlight the importance of including data among fathers to achieve a whole family approach to well-being during the transition to parenthood.
Collapse
|
7
|
Kakaşçı ÇG, Potur DC, Abbasoğlu DE, Karabulut Ö, Merih YD, Demirci N. Is participation in antenatal classes associated with fathers' mental health? A quasi-experimental and prospective study. Infant Ment Health J 2022; 43:938-950. [PMID: 36260029 DOI: 10.1002/imhj.22015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2020] [Accepted: 08/20/2022] [Indexed: 11/11/2022]
Abstract
BACKGROUND In comparison to those conducted with women, studies about the transition of men to parenthood are limited in numbers, especially in developing countries. Moreover, in Turkey, along with gender roles and sociocultural changes, the roles of fathers are also changing. This change highlights the need to understand early parenthood for fathers. METHODS A quasi-experimental, non-randomized prospective study with a pre- and post-training model was conducted in a hospital in Istanbul, Turkey. Men in the antenatal education group (EG = 55) and their pregnant wives participated in 6 weeks of training during pregnancy (24th-28th weeks gestation). Men in the care-as-usual group (CG = 55) attended routine check-ups and follow-ups with their wives. GHQ-28 (General Health Questionnaire-28) was administered three times in total at study enrolment, immediately following the 6-week intervention period, and at the 6th postpartum week. RESULTS There was no significant difference between the groups' GHQ-28 scores before and after the training. In the 6th week of postpartum follow-up, the GHQ-28 scores were significantly higher for the fathers who participated in the educational intervention. CONCLUSIONS Antenatal education classes were found to be associated with the mental health of fathers. Further research evaluating family-centered parenting support programs is warranted to better understand how to support fathers in the transition to parenthood, particularly in countries in which fathers' roles in pregnancy and early parenthood are changing.
Collapse
Affiliation(s)
- Çiğdem Gün Kakaşçı
- Faculty of Health Sciences, Division of Midwifery, Suleyman Demirel University, Isparta, Turkey
| | - Dilek Coşkuner Potur
- Faculty of Health Sciences, Department of Obstetrics and Gynecology Nursing, Division of Nursing, Marmara University, Istanbul, Turkey
| | | | - Özlem Karabulut
- Zeynep Kamil Women and Child Disease Training and Research Hospital, Istanbul, Turkey
| | - Yeliz Doğan Merih
- Faculty of Hamidiye, Division on Nursing, Department of Obstetrics Gynecology Nursing, Sağlık Bilimleri University, Istanbul, Turkey
| | - Nurdan Demirci
- Faculty of Health Sciences, Department of Obstetrics and Gynecology Nursing, Division of Nursing, Marmara University, Istanbul, Turkey
| |
Collapse
|
8
|
Pinar S, Bedford H, Ersser S, McMillan D. Women's experiences of perinatal depression: symptoms, barriers and enablers to disclosure, and effects on daily life and interaction within the family. Midwifery 2022; 112:103389. [DOI: 10.1016/j.midw.2022.103389] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2021] [Revised: 05/27/2022] [Accepted: 05/29/2022] [Indexed: 10/18/2022]
|
9
|
Leonard R, Linden M, Grant A. Personal and professional influences on health visitors' family focused practice for maternal mental illness: a cross sectional study. BMC Health Serv Res 2022; 22:113. [PMID: 35081961 PMCID: PMC8790840 DOI: 10.1186/s12913-022-07499-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2021] [Accepted: 01/14/2022] [Indexed: 01/13/2023] Open
Abstract
BACKGROUND Family focused practice (FFP) is an approach that recognises the inter-related needs of family members and recommends a continuum of activities to support families. While it is recognised that health visitors play a key role in supporting families when mothers have mental illness, there is limited understanding of health visitor's family focused practice (FFP) in this context and its relationships with factors, such as, workload, training, skill and knowledge, and personal and professional experience. This paper examined the effect of health visitors' interaction with the family, and personal and professional experience on their family focused practice. METHODS A cross sectional questionnaire (Family Focused Mental Health Practice Questionnaire) was distributed to 488 health visitors within community practice in Northern Ireland, with 230 choosing to take part. Independent t-tests and one-way analysis of variance were used to compare family focused practice scores. RESULTS Results found that health visitors who had face to face contact with partners and children (t(221) = 2.61, p = .01), and those that directly supported the partner (t(221) = 2.61, p = 0.01) had a significantly higher mean score of FFP, than those that did not. However, frequency of visits (daily, weekly, monthly or yearly) had no effect on family focused practice scores. Training also had a significant effect on family focused practice scores (F(2,221) = 4.841, p = 0.029). Analysis of variance revealed that personal experience of mental illness had a significant effect on scores (M = 97.58, p = 0.009), however variables such as, age, parental status, time since registration, and being in a specialist position had no effect. CONCLUSIONS In order for family focused practice to be effective, the quality, and content of visits and contact with family should be addressed, as opposed to a focus on the quantity of visits. However, in order for this to occur health visitors need to have appropriate support in their own right, with manageable caseloads and resources.
Collapse
Affiliation(s)
- Rachel Leonard
- Research Fellow, School of Nursing and Midwifery, Queen’s University, Medical Biology Centre, 97 Lisburn Road, Belfast, Northern Ireland BT9 7BL UK
| | - Mark Linden
- Research Fellow, School of Nursing and Midwifery, Queen’s University, Medical Biology Centre, 97 Lisburn Road, Belfast, Northern Ireland BT9 7BL UK
| | - Anne Grant
- Research Fellow, School of Nursing and Midwifery, Queen’s University, Medical Biology Centre, 97 Lisburn Road, Belfast, Northern Ireland BT9 7BL UK
| |
Collapse
|
10
|
Ssewanyana D, Zhang L, Martin MC, Proulx K, Malti T, Abubakar A, Angwenyi V, Kabue M, Marangu J, Odhiambo R, Njoroge E, Ombech E, Mokaya MM, Obulemire EK, Moran G, Marfo K, Lye S. Health seeking behaviors and childcare patterns in an informal settlement of Nairobi, Kenya: A cross-sectional study. PLOS GLOBAL PUBLIC HEALTH 2022; 2:e0000738. [PMID: 36962422 PMCID: PMC10021912 DOI: 10.1371/journal.pgph.0000738] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/19/2021] [Accepted: 06/16/2022] [Indexed: 11/19/2022]
Abstract
Children in urban informal settlements experience high risks for poor health and development. Understanding health seeking behaviors and childcare patterns of caregivers in urban informal settlements is important for devising effective interventions. This study describes household characteristics and aspects of nurturing care among caregivers of children aged 0-2 years in Dagoretti informal settlement, Nairobi-Kenya. In this cross sectional study, data were collected on household socio-demographic characteristics, antenatal care and child delivery practices, infant and young child feeding practices, activities that promote play, learning and school readiness, and on childcare and protection practices. Descriptive statistics of proportions and means were used to summarize the data. The study covers a total of 458 Kenyan and 118 immigrant households. Caregivers from immigrant households, with low education and from the younger age-group (less than 20 years) were vulnerable to sub-optimal caregiving and health seeking practices, including relatively lower rates of age-appropriate breastfeeding and poor dietary diversity. Seventy-five percent of expectant mothers attended less than four antenatal care visits. Households surveyed had limited possession of children's books (2% with three or more books), limited access to play materials (43% had two or more play materials), and low paternal involvement in child stimulation and early learning activities (14%). One-third and half of the children were left with inadequate care and disciplined using both violent and non-violent methods, respectively. Our findings highlight the urgent need for contextually appropriate and integrated interventions anchored in the WHO's nurturing care framework. These interventions can benefit from extensive involvement of caregivers, facility and community-based healthcare workers, policy makers, and other relevant stakeholders.
Collapse
Affiliation(s)
- Derrick Ssewanyana
- Alliance for Human Development, Lunenfeld-Tanenbaum Research Institute, Toronto, ON, Canada
| | - Linlin Zhang
- Key Laboratory of Learning and Cognition, School of Psychology, Capital Normal University, Beijing, China
| | - Marie-Claude Martin
- Alliance for Human Development, Lunenfeld-Tanenbaum Research Institute, Toronto, ON, Canada
| | - Kerrie Proulx
- Alliance for Human Development, Lunenfeld-Tanenbaum Research Institute, Toronto, ON, Canada
| | - Tina Malti
- Centre for Child Development, Mental Health, and Policy, University of Toronto, Mississauga, Canada
| | - Amina Abubakar
- Institute for Human Development, Aga Khan University, Nairobi, Kenya
- Neuroassement group, KEMRI/Wellcome Trust Research Programme, Centre for Geographic Medicine Research, Kilifi, Kenya
| | - Vibian Angwenyi
- Institute for Human Development, Aga Khan University, Nairobi, Kenya
| | - Margaret Kabue
- Institute for Human Development, Aga Khan University, Nairobi, Kenya
| | - Joyce Marangu
- Institute for Human Development, Aga Khan University, Nairobi, Kenya
| | - Rachel Odhiambo
- Institute for Human Development, Aga Khan University, Nairobi, Kenya
| | - Eunice Njoroge
- Institute for Human Development, Aga Khan University, Nairobi, Kenya
| | - Eunice Ombech
- Institute for Human Development, Aga Khan University, Nairobi, Kenya
| | | | | | - Greg Moran
- Department of Psychology, Western University, London, ON, Canada
| | - Kofi Marfo
- Institute for Human Development, Aga Khan University, Nairobi, Kenya
| | - Stephen Lye
- Alliance for Human Development, Lunenfeld-Tanenbaum Research Institute, Toronto, ON, Canada
| |
Collapse
|
11
|
Mulligan C, Furlong M, McGarr S, O'Connor S, McGilloway S. The Family Talk Programme in Ireland: A Qualitative Analysis of the Experiences of Families With Parental Mental Illness. Front Psychiatry 2021; 12:783189. [PMID: 34867563 PMCID: PMC8634387 DOI: 10.3389/fpsyt.2021.783189] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/25/2021] [Accepted: 10/22/2021] [Indexed: 11/18/2022] Open
Abstract
Background: Parental mental illness is common, costly, can lead to children developing mental disorders and impaired lifetime outcomes, and places a substantial burden on caregiving partners. Family Talk (FT) is a widely implemented, 7-session, whole-family programme, with promising evidence of effectiveness in targeting the intergenerational transmission of mental illness. However, to date, very little qualitative research of family experiences of FT has been undertaken. The objectives of this study were to: (1) investigate the experiences of families attending FT; and (2) explore the key facilitators and barriers to engagement in mainstream mental health settings. Methods: This study was nested within a randomised controlled trial (RCT) of Family Talk [N = 86 families (139 parents, 221 children)] implemented in 15 adult, child and primary care mental health sites in Ireland. Semi-structured interviews were conducted with a purposive sample of 45 participants, including 23 parents with mental illness (PMI), 7 partners and 15 children/young people aged 9 to 18 years. Interview data were transcribed verbatim and analysed using constructivist grounded theory. Results: Over two thirds of families across sites reported substantial benefits from participation in FT, including reduced stigma, giving children and partners a voice, increased service-user confidence, and improved family communication/relationships. Key facilitators identified by families included: programme delivery by a competent, non-judgmental clinician; the whole-family approach; and family readiness to engage. Barriers to engagement included stigma, family crises/relapse, service constraints, impact of COVID-19, and a need for further child, family and follow-up sessions/supports. Conclusion: This study is the first qualitative analysis of family experiences of FT to be conducted within the context of an RCT and national programme to introduce family-focused practise for families with PMI. The findings illustrate that FT is beneficial across cultural/policy contexts, different mental disorders and can be implemented across adult and child mental health settings, including children with existing mental health challenges. Key barriers and facilitators to implementation were identified by families, all of which should help to inform the future implementation of FT, and other similar interventions, both in Ireland and elsewhere.
Collapse
|
12
|
The Experiences of First-Time Fathers in Perinatal Services: Present but Invisible. Healthcare (Basel) 2021; 9:healthcare9020161. [PMID: 33546202 PMCID: PMC7913323 DOI: 10.3390/healthcare9020161] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2020] [Revised: 01/16/2021] [Accepted: 01/21/2021] [Indexed: 11/21/2022] Open
Abstract
Fathers in the UK are becoming more involved in the care of their infants and children. A constructivist grounded theory approach was adopted to explore men’s transition to fatherhood. This paper reports on one of the sub-categories derived from the data. First-time fathers with a child under two were recruited predominantly via social media. Audio-recorded semi-structured interviews were undertaken with an opening question asking men to tell their story of becoming a father. Interviews were transcribed and analysed using constructivist grounded theory methods. This paper reports one core aspect of the research findings which has particular relevance for healthcare professionals. The men in this study were highly appreciative of the care their partner and baby received but consistently reported a lack of father-specific support throughout their journey to fatherhood. This ranged from generally poor communication with healthcare professionals to being ignored and side-lined in maternity settings where they continued to be treated as visitors before, during and after the birth of their baby. Despite similar findings being reported over the last 30 to 40 years and policy directives emphasising the importance of working with fathers, change within healthcare services remains slow. Currently, fathers’ needs are not being adequately met by perinatal services.
Collapse
|
13
|
Shatte ABR, Hutchinson DM, Fuller-Tyszkiewicz M, Teague SJ. Social Media Markers to Identify Fathers at Risk of Postpartum Depression: A Machine Learning Approach. CYBERPSYCHOLOGY BEHAVIOR AND SOCIAL NETWORKING 2020; 23:611-618. [PMID: 32915660 DOI: 10.1089/cyber.2019.0746] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
Postpartum depression (PPD) is a significant mental health issue in mothers and fathers alike; yet at-risk fathers often come to the attention of health care professionals late due to low awareness of symptoms and reluctance to seek help. This study aimed to examine whether passive social media markers are effective for identifying fathers at risk of PPD. We collected 67,796 Reddit posts from 365 fathers, spanning a 6-month period around the birth of their child. A list of "at-risk" words was developed in collaboration with a perinatal mental health expert. PPD was assessed by evaluating the change in fathers' use of words indicating depressive symptomatology after childbirth. Predictive models were developed as a series of support vector machine classifiers using behavior, emotion, linguistic style, and discussion topics as features. The performance of these classifiers indicates that fathers at risk of PPD can be predicted from their prepartum data alone. Overall, the best performing model used discussion topic features only with a recall score of 0.82. These findings could assist in the development of support and intervention tools for fathers during the prepartum period, with specific applicability to personalized and preventative support tools for at-risk fathers.
Collapse
Affiliation(s)
- Adrian B R Shatte
- School of Science, Engineering & Information Technology, Federation University, Melbourne, Australia
| | - Delyse M Hutchinson
- Centre for Social and Early Emotional Development, School of Psychology, Deakin University, Geelong, Australia
- Murdoch Children's Research Institute, Centre for Adolescent Health, Royal Children's Hospital, Melbourne, Australia
- Department of Paediatrics, University of Melbourne, Royal Children's Hospital, Melbourne, Australia
- University of New South Wales, National Drug and Alcohol Research Centre, Sydney, Australia
| | - Matthew Fuller-Tyszkiewicz
- Centre for Social and Early Emotional Development, School of Psychology, Deakin University, Geelong, Australia
| | - Samantha J Teague
- Centre for Social and Early Emotional Development, School of Psychology, Deakin University, Geelong, Australia
| |
Collapse
|
14
|
Leonard R, Linden M, Grant A. Predictors of family focused practice among health visitors: A mixed methods study. J Adv Nurs 2020; 76:1255-1265. [PMID: 32012334 DOI: 10.1111/jan.14310] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2019] [Revised: 11/19/2019] [Accepted: 01/21/2020] [Indexed: 01/18/2023]
Abstract
AIMS To determine what predicts health visitors' family-focused practice with mothers who have mental illness. To explore health visitors' experiences of family-focused practice and what factors, if any, enable and/or hinder it. DESIGN A sequential mixed-methods design was employed. METHODS In Phase 1, a total of 230 health visitors, in five Health and Social Care Trusts in the UK were recruited using convenience sampling and completed the Family Focused Mental Health Practice Questionnaire. Three multiple regression models were developed to test whether workload (Model I), professional knowledge (Model II) and health visitors' professional and personal experience (Model III) predicted their family-focused practice. In Phase 2, 10 health visitors, who completed the questionnaire, participated in semi-structured interviews to describe their experiences of family-focused practice. The data collection of the two phases was conducted from September 2017 - September 2018. RESULTS Model III was significant. While personal experience of parenting was positively associated with family-focused practice, length registered as a health visitor and personal experience of mental illness was negatively associated. Qualitative findings suggested that increasing years of professional experience and personal experience of mental illness enabled health visitors to support mothers and their children, but not other adult family members, including partners. Limited skills and knowledge to support mothers with severe mental illness (i.e. schizophrenia) hindered family-focused practice. CONCLUSION This study advances understanding of how health visitors' professional and personal experiences can influence their family-focused practice and highlights the importance of organizations promoting their capacity to support mothers with severe mental illness and to include mothers' partners. IMPACT A clear understanding of factors affecting health visitors' capacity to engage in family-focused practice will help to inform policy, education and practice in health visiting; with potential to improve outcomes for the whole family.
Collapse
Affiliation(s)
- Rachel Leonard
- School of Nursing and Midwifery, Queens University Belfast, Belfast, UK
| | - Mark Linden
- School of Nursing and Midwifery, Queens University Belfast, Belfast, UK
| | - Anne Grant
- School of Nursing and Midwifery, Queens University Belfast, Belfast, UK
| |
Collapse
|
15
|
Teague SJ, Shatte AB. Exploring the Transition to Fatherhood: Feasibility Study Using Social Media and Machine Learning. JMIR Pediatr Parent 2018; 1:e12371. [PMID: 31518298 PMCID: PMC6715057 DOI: 10.2196/12371] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/30/2018] [Revised: 11/06/2018] [Accepted: 11/09/2018] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Fathers' experiences across the transition to parenthood are underreported in the literature. Social media offers the potential to capture fathers' experiences in real time and at scale while also removing the barriers that fathers typically face in participating in research and clinical care. OBJECTIVE This study aimed to assess the feasibility of using social media data to map the discussion topics of fathers across the fatherhood transition. METHODS Discussion threads from two Web-based parenting communities, r/Daddit and r/PreDaddit from the social media platform Reddit, were collected over a 2-week period, resulting in 1980 discussion threads contributed to by 5853 unique users. An unsupervised machine learning algorithm was then implemented to group discussion threads into topics within each community and across a combined collection of all discussion threads. RESULTS Results demonstrated that men use Web-based communities to share the joys and challenges of the fatherhood experience. Minimal overlap in discussions was found between the 2 communities, indicating that distinct conversations are held on each forum. A range of social support techniques was demonstrated, with conversations characterized by encouragement, humor, and experience-based advice. CONCLUSIONS This study demonstrates that rich data on fathers' experiences can be sourced from social media and analyzed rapidly using automated techniques, providing an additional tool for researchers exploring fatherhood.
Collapse
Affiliation(s)
- Samantha J Teague
- Centre for Social and Early Emotional Development, School of Psychology, Deakin University, Burwood, Australia
| | - Adrian Br Shatte
- Centre for Social and Early Emotional Development, School of Psychology, Deakin University, Burwood, Australia.,School of Science, Engineering and Information Technology, Federation University, Berwick, Australia
| |
Collapse
|
16
|
Leonard RA, Linden M, Grant A. Family-Focused Practice for Families Affected by Maternal Mental Illness and Substance Misuse in Home Visiting: A Qualitative Systematic Review. JOURNAL OF FAMILY NURSING 2018; 24:128-155. [PMID: 29683021 DOI: 10.1177/1074840718770612] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
Maternal mental illness is a major public health issue and can adversely affect the whole family. Increasingly, research and policy are recognizing the benefits of a family-focused approach to practice, an approach that emphasizes the family as the unit of care. This review was conducted with the aim of systematically analyzing the qualitative literature surrounding health visitors' family-focused practice with mothers who have mental illness and/or substance misuse. Through the synthesis, we developed three main findings: (a) parents' needs regarding health visitors' family-focused practice, (b) the ambiguity of mental illness in health visiting, and (c) the challenges of family-focused practice in health visiting. Above all, health visitors, families, and mothers with mental illness experience many challenges in family-focused practice, even though it is both desirable and beneficial. This calls for a deeper understanding of how family-focused practice can be effectively practiced in health visiting.
Collapse
|