1
|
Rankin L, Krouskop HG, Fisher ML. Mother-infant attachment from the perspective of young mothers: Does the data support a maternal instinct? Soc Sci Med 2024; 357:117172. [PMID: 39121564 DOI: 10.1016/j.socscimed.2024.117172] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2024] [Revised: 06/09/2024] [Accepted: 07/31/2024] [Indexed: 08/12/2024]
Abstract
Some conceptualizations of attachment imply an instinctual behavior that occurs naturally. Mothers who endorse this view are at greater risk for psychological stress, depression, and harsh parenting styles if they do not feel an immediate bond with their infant postpartum. The purpose of this study is to explore actual experiences of attachment from the perspective of young mothers (N = 75, Mage = 19.45 years) and based on these findings the extent to which there is empirical support for a maternal instinct. Mothers were interviewed at home three times (2 weeks, four months, and seven months postpartum), and interviews were thematically analyzed using an open coding method. Three broad themes and six sub-themes emerged: 1) experiences with the immediacy of attachment at birth are diverse (traumatic birth experience, sense of a maternal identity), 2) contextual factors on the bonding experience (physical touch-based caretaking, parenting stress and depression), and 3) time spent parenting influences attachment (reciprocity, parental confidence/knowledge). In conclusion, we could not find empirical evidence to support an innate maternal instinct. Despite diverse experiences with felt attachment at birth, all mothers perceived that the mother-infant connection was influenced by contextual factors after birth and was strengthened over time with more care-taking experience. This suggests that mothers likely developed a "maternal instinct" through repetitive interaction with their infant as the primary caretaker rather than a genetic predisposition to be superior nurturing parents.
Collapse
Affiliation(s)
- Lela Rankin
- School of Social Work, Arizona State University, 340 N. Commerce Park Loop, Suite 250, Tucson, AZ, 85745, USA.
| | - Haley G Krouskop
- Mel & Enid Zuckerman College of Public Health, University of Arizona, USA
| | | |
Collapse
|
2
|
Bina R, Uka A, Costa R, Tuval-Mashiach R. Seeking help for perinatal depression and anxiety: a systematic review of systematic reviews from an interdependent perspective. J Public Health (Oxf) 2024:fdae125. [PMID: 38981623 DOI: 10.1093/pubmed/fdae125] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2023] [Revised: 01/31/2024] [Accepted: 06/27/2024] [Indexed: 07/11/2024] Open
Abstract
BACKGROUND Seeking help for perinatal mood and anxiety disorders is crucial for women's mental health and babies' development, yet many women do not seek help for their condition and remain undiagnosed and untreated. This systematic review of systematic reviews aimed at summarizing and synthesizing findings from all systematic reviews on seeking help for PMAD in the context of interdependence theory, highlighting the interdependent relationship between women and healthcare providers and how it may impact women's seeking-help process. METHODS Four electronic databases were searched, and 18 studies published up to 2023 met inclusion criteria for review. RESULTS The capability, opportunity and motivation model of behavior was used as a framework for organizing and presenting the results. Results demonstrate that seeking help for PMAD is a function of the interdependent relationship between perinatal women's and healthcare providers' psychological and physical capabilities, social and physical opportunities, and their reflective and automatic motivation. CONCLUSIONS Unmet needs in perinatal mental healthcare is an important public health problem. This systematic review of systematic reviews highlights key factors for policymakers, researchers, and practitioners to consider to optimize healthcare systems and interventions in a way that enhances perinatal women's treatment whenever necessary.
Collapse
Affiliation(s)
- Rena Bina
- School of Social Work, Bar Ilan University, Ramat Gan 5290002, Israel
| | - Ana Uka
- Department of Nursing and Physiotherapy, Western Balkans University, Tirana, Albania
| | - Raquel Costa
- EPIUnit-Instituto de Saúde Pública, Universidade do Porto, 4050-600 Porto, Portugal
- Laboratório para a Investigação Integrativa e Translacional em Saúde Populacional (ITR), Universidade do Porto, 4050-600 Porto, Portugal
- Lusófona University, HEI-Lab: Digital Human-Environment Interaction Labs, Campo Grande 376, 1749-024 Lisboa, Portugal
| | | |
Collapse
|
3
|
Angus BM, Saling LL, Moffitt RL. Self-compassionate reflective writing for affect regulation in Australian perinatal women. Appl Psychol Health Well Being 2024; 16:745-764. [PMID: 38095265 DOI: 10.1111/aphw.12514] [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: 07/24/2023] [Accepted: 11/14/2023] [Indexed: 05/02/2024]
Abstract
The current study investigated the effect of a brief online self-compassionate reflective writing task on affect regulation in a sample of Australian perinatal women. Participants were 55 women (Mage = 35.47, SD = 3.79) who were pregnant (16.4%) and/or had an infant <24 months old (76.4%). State self-compassion, positive and negative affect, and future help-seeking behavior intentions were compared at pre- and post-intervention while controlling for trait self-compassion. Inductive thematic analysis was used to extract themes regarding why participants deemed the intervention helpful or unhelpful. As hypothesized, global state self-compassion and intention to engage in self-care behavior were higher, and negative affect was lower, immediately post-intervention relative to pre-intervention scores. Follow-up subscale analyses revealed that the mechanisms of the shift in state self-compassion scores were via reduced self-judgment and overidentification and increased common humanity. There was no significant change in positive affect or intention to engage in help-seeking behavior. Most participants (75%) indicated that the task was helpful with themes identified as written format, changed perspective, dedicating time to reflect, improved mood, and practicing self-kindness. Self-compassionate reflective writing may be a brief and accessible psychosocial approach with the potential to foster healthy emotion regulation and coping among perinatal women.
Collapse
Affiliation(s)
- Bronwyn M Angus
- Psychology, School of Health and Biomedical Sciences, RMIT University, Melbourne, Victoria, Australia
| | - Lauren L Saling
- Psychology, School of Health and Biomedical Sciences, RMIT University, Melbourne, Victoria, Australia
| | - Robyn L Moffitt
- School of Psychology, Deakin University, Geelong, Victoria, Australia
| |
Collapse
|
4
|
Seid J, Mohammed E, Cherie N, Yasin H, Addisu E. The magnitude of perinatal depression and associated factors among women in Kutaber woreda public health institution and Boru Meda general hospital, Ethiopia, 2022: a cross-sectional study. Front Psychiatry 2024; 14:1302168. [PMID: 38318482 PMCID: PMC10838999 DOI: 10.3389/fpsyt.2023.1302168] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/26/2023] [Accepted: 12/26/2023] [Indexed: 02/07/2024] Open
Abstract
Background Perinatal depression, characterized by the presence of depressive symptoms during pregnancy and/or within the first 12 months postpartum, poses a significant global public health concern. It contributes to a multitude of health risks for mothers, their infants, and their families. Understanding of perinatal depression and its associated factors is crucial for effective prevention and intervention strategies. However, there is a lack of comprehensive research on this topic in Ethiopia. Therefore, this study aims to determine the prevalence and factors contributing to perinatal depression among Ethiopian women. Methods An institutional-based cross-sectional study was conducted, involving 552 women receiving perinatal services at Kutaber district health institution and Boru Meda General Hospital. Study participants were selected through systematic random sampling techniques. Perinatal depression was assessed using the Depression, Anxiety, and Stress Scale-21 (DASS-21). The associations between various determinants and perinatal depression were examined using binary logistic regression, and factors with a p-value of less than 0.2 were included in the multiple logistic regression analysis. A p-value less than 0.05 was considered statistically significant. Results The prevalence of perinatal depression was found to be 32.2%. The prevalence of perinatal depression was found to be 32.2%. Factors significantly associated with perinatal depression included being a student [adjusted odds ratio (AOR) = 4.364, 95% confidence interval (CI): 1.386, 13.744], experiencing excessive pregnancy-related concerns (AOR = 1.886, 95% CI: 1.176, 3.041), past substance use (AOR = 2.203, 95% CI: 1.149, 4.225), the presence of anxiety symptoms (AOR = 3.671, 95% CI: 2.122, 6.352), experiencing stress symptoms (AOR = 6.397, 95% CI: 3.394-12.055), and daytime sleepiness (AOR = 2.593, 95% CI: 1.558, 4.316). Conclusion The findings of this study indicate a relatively high prevalence and valuable factors associated with perinatal depression. It highlights the need for a comprehensive approach to perinatal mental health that takes into account not only the biological aspects of pregnancy but also the psychological, social, and lifestyle factors that can impact a person's mental well-being during this critical period.
Collapse
Affiliation(s)
- Jemal Seid
- Department of Psychiatry, College of Medicine and Health Sciences, Wollo University, Dessie, Ethiopia
| | - Emam Mohammed
- School of Public Health, College of Medicine and Health Sciences, Wollo University, Dessie, Ethiopia
| | - Nigusie Cherie
- School of Public Health, College of Medicine and Health Sciences, Wollo University, Dessie, Ethiopia
| | - Husnia Yasin
- School of Public Health, College of Medicine and Health Sciences, Wollo University, Dessie, Ethiopia
| | - Elsabeth Addisu
- School of Public Health, College of Medicine and Health Sciences, Wollo University, Dessie, Ethiopia
| |
Collapse
|
5
|
Webb R, Ford E, Shakespeare J, Easter A, Alderdice F, Holly J, Coates R, Hogg S, Cheyne H, McMullen S, Gilbody S, Salmon D, Ayers S. Conceptual framework on barriers and facilitators to implementing perinatal mental health care and treatment for women: the MATRIx evidence synthesis. HEALTH AND SOCIAL CARE DELIVERY RESEARCH 2024; 12:1-187. [PMID: 38317290 DOI: 10.3310/kqfe0107] [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: 02/07/2024]
Abstract
Background Perinatal mental health difficulties can occur during pregnancy or after birth and mental illness is a leading cause of maternal death. It is therefore important to identify the barriers and facilitators to implementing and accessing perinatal mental health care. Objectives Our research objective was to develop a conceptual framework of barriers and facilitators to perinatal mental health care (defined as identification, assessment, care and treatment) to inform perinatal mental health services. Methods Two systematic reviews were conducted to synthesise the evidence on: Review 1 barriers and facilitators to implementing perinatal mental health care; and Review 2 barriers to women accessing perinatal mental health care. Results were used to develop a conceptual framework which was then refined through consultations with stakeholders. Data sources Pre-planned searches were conducted on MEDLINE, EMBASE, PsychInfo and CINAHL. Review 2 also included Scopus and the Cochrane Database of Systematic Reviews. Review methods In Review 1, studies were included if they examined barriers or facilitators to implementing perinatal mental health care. In Review 2, systematic reviews were included if they examined barriers and facilitators to women seeking help, accessing help and engaging in perinatal mental health care; and they used systematic search strategies. Only qualitative papers were identified from the searches. Results were analysed using thematic synthesis and themes were mapped on to a theoretically informed multi-level model then grouped to reflect different stages of the care pathway. Results Review 1 included 46 studies. Most were carried out in higher income countries and evaluated as good quality with low risk of bias. Review 2 included 32 systematic reviews. Most were carried out in higher income countries and evaluated as having low confidence in the results. Barriers and facilitators to perinatal mental health care were identified at seven levels: Individual (e.g. beliefs about mental illness); Health professional (e.g. confidence addressing perinatal mental illness); Interpersonal (e.g. relationship between women and health professionals); Organisational (e.g. continuity of carer); Commissioner (e.g. referral pathways); Political (e.g. women's economic status); and Societal (e.g. stigma). These factors impacted on perinatal mental health care at different stages of the care pathway. Results from reviews were synthesised to develop two MATRIx conceptual frameworks of the (1) barriers and (2) facilitators to perinatal mental health care. These provide pictorial representations of 66 barriers and 39 facilitators that intersect across the care pathway and at different levels. Limitations In Review 1 only 10% of abstracts were double screened and 10% of included papers methodologically appraised by two reviewers. The majority of reviews included in Review 2 were evaluated as having low (n = 14) or critically low (n = 5) confidence in their results. Both reviews only included papers published in academic journals and written in English. Conclusions The MATRIx frameworks highlight the complex interplay of individual and system level factors across different stages of the care pathway that influence women accessing perinatal mental health care and effective implementation of perinatal mental health services. Recommendations for health policy and practice These include using the conceptual frameworks to inform comprehensive, strategic and evidence-based approaches to perinatal mental health care; ensuring care is easy to access and flexible; providing culturally sensitive care; adequate funding of services; and quality training for health professionals with protected time to do it. Future work Further research is needed to examine access to perinatal mental health care for specific groups, such as fathers, immigrants or those in lower income countries. Trial registration This trial is registered as PROSPERO: (R1) CRD42019142854; (R2) CRD42020193107. Funding This award was funded by the National Institute for Health and Care Research (NIHR) Health and Social Care Delivery Research programme (NIHR award ref: NIHR 128068) and is published in full in Health and Social Care Delivery Research; Vol. 12, No. 2. See the NIHR Funding and Awards website for further award information.
Collapse
Affiliation(s)
- Rebecca Webb
- Centre for Maternal and Child Health Research, School of Health Sciences, City, University of London, London, UK
| | - Elizabeth Ford
- Department of Primary Care and Public Health, Brighton & Sussex Medical School, Falmer, UK
| | | | - Abigail Easter
- Department of Women and Children's Health, School of Life Course Sciences, King's College London, London, UK
- Section of Women's Mental Health, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - Fiona Alderdice
- Oxford Population Health, National Perinatal Epidemiology Unit (NPEU), Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | | | - Rose Coates
- Centre for Maternal and Child Health Research, School of Health Sciences, City, University of London, London, UK
| | - Sally Hogg
- The Parent-Infant Foundation, London, UK
| | - Helen Cheyne
- Nursing, Midwifery and Allied Health Professions Research Unit, University of Stirling, Stirling, UK
| | | | - Simon Gilbody
- Mental Health and Addictions Research Group, University of York, York, UK
| | - Debra Salmon
- Centre for Maternal and Child Health Research, School of Health Sciences, City, University of London, London, UK
| | - Susan Ayers
- Centre for Maternal and Child Health Research, School of Health Sciences, City, University of London, London, UK
| |
Collapse
|
6
|
Valla L, Haga SM, Garthus-Niegel S, Drozd F. Dropout or Drop-In Experiences in an Internet-Delivered Intervention to Prevent Depression and Enhance Subjective Well-Being During the Perinatal Period: Qualitative Study. JMIR Pediatr Parent 2023; 6:e46982. [PMID: 38153796 PMCID: PMC10766164 DOI: 10.2196/46982] [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: 03/04/2023] [Revised: 10/24/2023] [Accepted: 11/06/2023] [Indexed: 12/30/2023] Open
Abstract
Background The perinatal period is a vulnerable time when women are at increased risk of depression. "Mamma Mia" is a universal preventive internet-delivered intervention offered to pregnant women, with the primary goals of preventing the onset or worsening of depression and enhancing subjective well-being during the perinatal period. However, treatment dropout from internet-delivered interventions is often reported. Objective The study aim was to acquire an understanding of the different experiences among participants who dropped out of the Mamma Mia intervention during pregnancy, compared to participants who dropped out during the postpartum follow-up phase. Methods A total of 16 women from a larger randomized controlled trial (Mamma Mia) participated in individual semistructured interviews following a strengths, weaknesses, opportunities, and threats format. Of the 16 participants included, 8 (50%) women dropped out early from the intervention during pregnancy (pregnancy group), whereas 8 (50%) women dropped out later, after giving birth (postpartum follow-up group). Data were analyzed using the framework approach. Results The results showed that there were differences between the groups. In general, more participants in the postpartum follow-up group reported that the program was user-friendly. They became more aware of their own thoughts and feelings and perceived that the program had provided them with more new knowledge and practical information than participants in the pregnancy group. Participants in both groups suggested several opportunities for improving the program. Conclusions There were differences between women who dropped out of the intervention during pregnancy and the postpartum follow-up phase. The reported differences between groups should be further examined.
Collapse
Affiliation(s)
- Lisbeth Valla
- Regional Centre for Child and Adolescent Mental Health, Eastern and Southern Norway, Oslo, Norway
- Department of Nursing and Health Promotion, Faculty of Health Sciences, Oslo Metropolitan University, Oslo, Norway
| | - Silje Marie Haga
- Regional Centre for Child and Adolescent Mental Health, Eastern and Southern Norway, Oslo, Norway
| | - Susan Garthus-Niegel
- Institute and Policlinic of Occupational and Social Medicine, Faculty of Medicine, Technische Universität Dresden, Dresden, Germany
- Department of Childhood and Families, Norwegian Institute of Public Health, Oslo, Norway
- Institute for Systems Medicine and Faculty of Medicine, Medical School Hamburg, Hamburg, Germany
| | - Filip Drozd
- Regional Centre for Child and Adolescent Mental Health, Eastern and Southern Norway, Oslo, Norway
| |
Collapse
|
7
|
Li K, Lu J, Pang Y, Zheng X, Liu R, Ren M, Tu S. Maternal postpartum depression literacy subtypes: A latent profile analysis. Heliyon 2023; 9:e20957. [PMID: 37867796 PMCID: PMC10585387 DOI: 10.1016/j.heliyon.2023.e20957] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2023] [Revised: 10/09/2023] [Accepted: 10/12/2023] [Indexed: 10/24/2023] Open
Abstract
Aim To explore the potential categories and characteristic differences of maternal postpartum depression literacy. Design Cross-sectional survey. Methods From February 2023 to April 2023, convenience sampling was used to survey 278 women attending postnatal visits to three tertiary level A hospitals. The study included general demographic characteristics, postpartum depression literacy scale, and family caring index scale. Latent profile analysis was performed to identify the categories of maternal postpartum depression literacy, and multiple disordered logistic regression was used to analyze the influencing factors of different categories. Results Maternal postpartum depression literacy was divided into three categories: low literacy (41.0 %), moderate literacy (32.4 %), and high literacy (26.6 %). The results showed that work status, education level, whether the pregnancy was planned, whether or not they had participated in mental health-related courses, and family functioning status were factors influencing the category of maternal postpartum depression literacy (P < 0.05). Conclusion There was heterogeneity in postpartum depression literacy among mothers. Medical staff should implement targeted interventions according to potential category characteristics and influencing factors to improve the level of postpartum depression literacy.
Collapse
Affiliation(s)
- Kangfen Li
- School of Nursing, Southwest Medical University, Luzhou, Sichuan, China
| | - Jie Lu
- School of Nursing, Southwest Medical University, Luzhou, Sichuan, China
| | - Yan Pang
- Department of Nursing, Chengdu Women and Children's Central Hospital, University of Electronic Science and Technology of China, Chengdu, China
| | - Xinlie Zheng
- School of Nursing, Southwest Medical University, Luzhou, Sichuan, China
| | - Ran Liu
- School of Nursing, Southwest Medical University, Luzhou, Sichuan, China
| | - Min Ren
- Department of Obstetrics, Affiliated Hospital of Southwest Medical University, Luzhou, Sichuan, China
| | - Suhua Tu
- Nursing Department, Afliated Hospital of Southwest Medical University, Luzhou, Sichuan, China
| |
Collapse
|
8
|
Webb R, Uddin N, Constantinou G, Ford E, Easter A, Shakespeare J, Hann A, Roberts N, Alderdice F, Sinesi A, Coates R, Hogg S, Ayers S. Meta-review of the barriers and facilitators to women accessing perinatal mental healthcare. BMJ Open 2023; 13:e066703. [PMID: 37474171 PMCID: PMC10360426 DOI: 10.1136/bmjopen-2022-066703] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 07/22/2023] Open
Abstract
Perinatal mental health (PMH) problems are common and can have an adverse impact on women and their families. However, research suggests that a substantial proportion of women with PMH problems do not access care. OBJECTIVES To synthesise the results from previous systematic reviews of barriers and facilitators to women to seeking help, accessing help, and engaging in PMH care, and to suggest recommendations for clinical practice and policy. DESIGN A meta-review of systematic reviews. REVIEW METHODS Seven databases were searched and reviewed using a Preferred Reporting Items for Systematic Reviews and Meta Analyses search strategy. Studies that focused on the views of women seeking help and accessing PMH care were included. Data were analysed using thematic synthesis. Assessing the Methodological Quality of Systematic Reviews-2 was used to assess review methodology. To improve validity of results, a qualitative sensitivity analysis was conducted to assess whether themes remained consistent across all reviews, regardless of their quality rating. RESULTS A total of 32 reviews were included. A wide range of barriers and facilitators to women accessing PMH care were identified. These mapped across a multilevel model of influential factors (individual, healthcare professional, interpersonal, organisational, political and societal) and across the care pathway (from decision to consult to receiving care). Evidence-based recommendations to support the design and delivery of PMH care were produced based on identified barriers and facilitators. CONCLUSION The identified barriers and facilitators point to a complex interplay of many factors, highlighting the need for an international effort to increase awareness of PMH problems, reduce mental health stigma, and provide woman-centred, flexible care, delivered by well trained and culturally sensitive primary care, maternity, and psychiatric health professionals. PROSPERO REGISTRATION NUMBER CRD42019142854.
Collapse
Affiliation(s)
- Rebecca Webb
- Centre for Maternal and Child Health Research, City University, London, UK
| | - Nazihah Uddin
- Centre for Maternal and Child Health Research, City University, London, UK
| | | | - Elizabeth Ford
- Department of Primary Care and Public Health, Brighton and Sussex Medical School, Brighton, UK
| | - Abigail Easter
- Department of Women and Children's Health, School of Life Course Sciences, King's College London, London, UK
- Section of Women's Mental Health, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | | | | | - Nia Roberts
- Bodleian Health Care Libraries, University of Oxford, Oxford, UK
| | - Fiona Alderdice
- Nuffield Department of Population Health, National Perinatal Epidemiology Unit, Oxford, UK
| | - Andrea Sinesi
- Nursing, Midwifery and Allied Health Professions Research Unit (NMAHP RU), University of Stirling, Stirling, UK
| | - Rose Coates
- Centre for Maternal and Child Health Research, City University, London, UK
| | - Sally Hogg
- Faculty of Education, University of Cambridge, Cambridge, UK
| | - Susan Ayers
- Centre for Maternal and Child Health Research, City University, London, UK
| |
Collapse
|
9
|
Sorsa M, Hohenthal M, Pikulinsky M, Sellergren H, Puura K. Qualitative description of outreach and engagement in perinatal substance treatment in Finland. Subst Abuse Treat Prev Policy 2023; 18:6. [PMID: 36681846 PMCID: PMC9862241 DOI: 10.1186/s13011-022-00513-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2022] [Accepted: 12/29/2022] [Indexed: 01/22/2023] Open
Abstract
BACKGROUND Women with perinatal substance problems experience a multitude of barriers to care. They have specific early intervention needs, they endure societal stigma, and both substances and mental health issues influence the way they navigate within support and treatment systems. Early interventions for women with perinatal substance problems are underresearched contexts. The aim of the study is to describe building relationships and engagement within an outreach and low threshold service encounter tailored for pregnant women with SUD (substance use disorder). METHODS The data consist of online written narratives from 11 workers involved in the program and feedback from 504 families in the recovery process comprising 228 open-ended answers. The data were analyzed with a thematic analysis. RESULTS The programs are characterized by flexibility and the implementation of inclusive ways to approach families. The themes for enhancing relationships and engagement within outreach and low threshold programs are Acceptance and attitude: a sensitive approach of approval; flexibility within strictness to allow for diversity and individuality; availability and space to ensure a trustful atmosphere; negotiating via doing to build connections; and everyday life changes: imagining recovery. The themes represent the need of being available, focusing on the worker's attitudes and building connections by doing together, and visioning recovery together. CONCLUSIONS The study results can add to the understanding of SUD outreach and low threshold work during pregnancy. The elements described in this study need further theoretical development, research and critical assessment. Building relationships during pregnancy were characterized by connecting within everyday life situations and supporting the development of an attachment relationship between the baby and the parents. To promote recovery, a comprehensive approach in which substance-related issues and mental health conditions are interconnected can be favored. Engaging early on during pregnancy might enhance success during future rehabilitation.
Collapse
Affiliation(s)
- Minna Sorsa
- Child Psychiatry, Tampere University Hospital, Pirkanmaa Hospital District, Tampere, Finland
- Nursing Science, Faculty of Social Sciences, Tampere University, Biokatu 12, FM 5 (4-306), SF-33520 Tampere, Finland
| | - Maria Hohenthal
- The Federation of Mother and Child Homes and Shelters, Helsinki, Finland
| | - Miia Pikulinsky
- The Federation of Mother and Child Homes and Shelters, Helsinki, Finland
| | - Hanna Sellergren
- The Federation of Mother and Child Homes and Shelters, Helsinki, Finland
| | - Kaija Puura
- Child Psychiatry, Tampere University Hospital, Pirkanmaa Hospital District, Tampere, Finland
- Faculty of Medicine and Health Technology, TamCAM Research Centre, Tampere University, Tampere, Finland
| |
Collapse
|
10
|
Daehn D, Rudolf S, Pawils S, Renneberg B. Perinatal mental health literacy: knowledge, attitudes, and help-seeking among perinatal women and the public - a systematic review. BMC Pregnancy Childbirth 2022; 22:574. [PMID: 35854232 PMCID: PMC9295513 DOI: 10.1186/s12884-022-04865-y] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2021] [Accepted: 06/23/2022] [Indexed: 11/16/2022] Open
Abstract
Background The perinatal period is a time of increased vulnerability to mental health problems, however, only a small proportion of women seek help. Poor mental health literacy (MHL) is a major barrier to seeking help for mental health problems. This study aimed to collect the existing evidence of MHL associated with perinatal mental health problems (PMHP) among perinatal women and the public. This review analysed which tools were used to assess perinatal MHL as well as the findings concerning individual components of perinatal MHL. Methods Four electronic databases (PubMed, PsycINFO, Web of Science, and CINAHL) were analysed from their inception until September 1, 2020. Not only quantitative studies reporting on components of MHL (knowledge, attitudes, and help-seeking), but also studies reporting overall levels of MHL relating to PMHP were taken into account. Two independent reviewers were involved in the screening and extraction process and data were analysed descriptively. Results Thirty-eight of the 13,676 retrieved articles satisfied the inclusion criteria. The majority of selected studies examined MHL related to PMHP in perinatal women (N = 28). The most frequently examined component of MHL in the selected data set was help-seeking. A lack of uniformity in assessing MHL components was found. The most common focus of these studies was postpartum depression. It was found that the ability to recognize PMHP and to identify relevant symptoms was lacking among both perinatal women and the public. Perinatal women had low intentions of seeking help for PMHP and preferred seeking help from informal sources while reporting a variety of structural and personal barriers to seeking help. Stigmatizing attitudes associated with PMHP were found among the public. Conclusions There is a need for educational campaigns and interventions to improve perinatal MHL in perinatal women and the public as a whole. Supplementary Information The online version contains supplementary material available at 10.1186/s12884-022-04865-y.
Collapse
Affiliation(s)
- Daria Daehn
- Department of Clinical Psychology and Psychotherapy, Freie Universitaet Berlin, Habelschwerdter Allee 45, 14195, Berlin, Germany.
| | - Sophie Rudolf
- Department of Clinical Psychology and Psychotherapy, Freie Universitaet Berlin, Habelschwerdter Allee 45, 14195, Berlin, Germany
| | - Silke Pawils
- Department of Medical Psychology, University Hospital Hamburg-Eppendorf, Hamburg, Germany
| | - Babette Renneberg
- Department of Clinical Psychology and Psychotherapy, Freie Universitaet Berlin, Habelschwerdter Allee 45, 14195, Berlin, Germany
| |
Collapse
|