scholarly journals Infertility-related distress and clinical targets for psychotherapy: a qualitative study

BMJ Open ◽  
2021 ◽  
Vol 11 (11) ◽  
pp. e050373
Author(s):  
Loveness Dube ◽  
Nokuthula Nkosi-Mafutha ◽  
Ashley A Balsom ◽  
Jennifer L Gordon

ObjectivesAn estimated 30%–40% of women attending infertility tertiary care facilities experience clinically significant depression and anxiety. However, current psychological interventions for infertility are only modestly effective in this population. In this study, we aimed to identify the specific psychological components of infertility-related distress to assist in the development of a more targeted and effective therapeutic intervention. To our knowledge, this study is the first of its kind to include the views and opinions of mental health professionals who specialise in the field of infertility and the first to explore therapies currently used by mental health professionals.DesignA qualitative approach using semistructured individual interviews and focus group interviews with women who have experience with infertility and also mental health professionals specialising in the field of infertility. Thematic analysis was used to identify patterns and themes emerging from the data.ParticipantsTwenty-one women (aged 25–41 years) struggling to conceive for ≥12 months and 14 mental health professionals participated in semistructured interviews about the psychological challenges related to infertility.ResultsFive themes, each divided into subthemes, emerged from the data and these were developed into a model of infertility-related distress. These five themes are: (1) anxiety, (2) mood disturbance, (3) threat to self-esteem, identity and purpose, (4) deterioration of the couple and (5) weakened support network. In addition, therapeutic techniques used by mental health professionals were identified.ConclusionsThe results of this study suggest specific clinical targets that future interventions treating infertility-related distress should address.

2019 ◽  
Author(s):  
Veikko Pelto-Piri ◽  
Lars Kjellin ◽  
Ulrika Hylén ◽  
Emanuele Valenti ◽  
Stefan Priebe

Abstract Objectives The objective of the study was to investigate how mental health professionals describe and reflect upon different forms of informal coercion. Results In a deductive qualitative content analysis of focus group interviews, several examples of persuasion, interpersonal leverage, inducements, and threats were found. Persuasion was sometimes described as being more like a negotiation. Some participants worried about that the use of interpersonal leverage and inducements risked to pass into blackmail in some situations. In a following inductive analysis, three more categories of informal coercion was found: cheating, using a disciplinary style and referring to rules and routines. Participants also described situations of coercion from other stakeholders: relatives and other authorities than psychiatry. The results indicate that informal coercion includes forms that are not obviously arranged in a hierarchy, and that its use is complex with a variety of pathways between different forms before treatment is accepted by the patient or compulsion is imposed.


2019 ◽  
Vol 2 (02) ◽  
pp. 23-28
Author(s):  
Nishad P. M. A. ◽  
Dilshana N. B. ◽  
Anil Kakunje ◽  
Ravichandra K. ◽  
Kamran Chisty

BACKGROUND Mental and behavioral disorders are major health problems. Stigma can prevent the care and treatment of the mentally ill. There is a gross underestimation of psychiatric comorbidities among patients by non-mental health professionals. A positive attitude of these health professionals has a crucial role in the treatment of patients suffering from psychiatric illness. The primary objective of the study is to study the attitude of various nonmental health professionals towards mental illness. METHODS It is a crosssectional descriptive study, conducted in a private medical college in Mangalore, Karnataka in India. The study had 76 participants consisting of doctors and nurses. Instruments used were a semi-structured demographic proforma and Mental illness: Clinicians Attitude Scale - Version 4 (MICA-4). MICA-4 is a 16- item scale used for assessing attitude towards mental illness. RESULTS The total number of subjects included was 76 among which doctors constituted 57 and nurses 19. As the experience and age of the participants increased, a shift to the positive attitude towards psychiatric illness was noted. Specialist doctors had a higher positive attitude compared to non-specialist medical graduates and nurses. CONCLUSIONS It is essential to have structured training in psychiatry for all health care professionals.


Author(s):  
Nishad P. M. A. ◽  
Dilshana N. B. ◽  
Anil Kakunje ◽  
Ravichandra K. ◽  
Kamran Chisty

BACKGROUND Mental and behavioral disorders are major health problems. Stigma can prevent the care and treatment of the mentally ill. There is a gross underestimation of psychiatric comorbidities among patients by non-mental health professionals. A positive attitude of these health professionals has a crucial role in the treatment of patients suffering from psychiatric illness. The primary objective of the study is to study the attitude of various nonmental health professionals towards mental illness. METHODS It is a crosssectional descriptive study, conducted in a private medical college in Mangalore, Karnataka in India. The study had 76 participants consisting of doctors and nurses. Instruments used were a semi-structured demographic proforma and Mental illness: Clinicians Attitude Scale - Version 4 (MICA-4). MICA-4 is a 16- item scale used for assessing attitude towards mental illness. RESULTS The total number of subjects included was 76 among which doctors constituted 57 and nurses 19. As the experience and age of the participants increased, a shift to the positive attitude towards psychiatric illness was noted. Specialist doctors had a higher positive attitude compared to non-specialist medical graduates and nurses. CONCLUSIONS It is essential to have structured training in psychiatry for all health care professionals.


2021 ◽  
Vol 0 (0) ◽  
Author(s):  
Bart Cusveller ◽  
Maarten van Garderen ◽  
Joan Roozemond-Kroon

Abstract Aim: To explore how mental health professionals address spiritual care for outpatients in weekly multidisciplinary care meetings (MDM), and to explore the barriers and facilitators in the ways health professionals address spiritual care in those meetings. Method: Two teams of mental health professionals providing care for psychiatric outpatients are included. Qualitative data were collected from audio recordings of multidisciplinary meetings and from focus-group interviews afterwards. Data were analysed using ‘open coding’. Results: Spiritual care was not frequently addressed mostly due to the requirements of the health insurance reimbursement system. Aspects of spirituality addressed in these meetings pertained mainly to meaningful daily activities. Addressing spiritual care was facilitated, on the other hand, by a holistic focus on health and recovery-oriented care. Conclusion: In ambulatory mental healthcare spirituality is sparsely addressed and, when addressed, few aspects of spirituality come into view. Facilitating healthcare professionals’ awareness of their clinical perspective is an essential step to improve spiritual care for psychiatric outpatients.


2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Paolo Corsico

Abstract Background The convergence of neuroscience, genomics, and data science holds promise to unveil the neurobiology of psychosis and to produce new ways of preventing, diagnosing, and treating psychotic illness. Yet, moral challenges arise in neurobiological research and in the clinical translation of research findings. This article investigates the views of relevant actors in mental health on the moral challenges of accessing neurobiological information in the context of psychosis. Methods Semi-structured individual interviews with two groups: researchers employed in the National Health Service (NHS) or a university in England (n = 14), and mental health professionals employed in NHS mental health services (n = 14). This article compares results in the two groups (total n = 28). Results This article presents findings around three conceptual areas: (1) research ethics as mostly unproblematic, (2) psychosis, neurobiological information, and mental health care, and (3) identity, relationships, and the future. These areas are drawn from the themes and topics that emerged in the interviews across the two groups of participants. Researchers and health professionals provided similar accounts of the moral challenges of accessing—which includes acquisition, communication, and use of—neurobiological information in the context of psychosis. Acquiring neurobiological information was perceived as mostly unproblematic, provided ethical safeguards are put in place. Conversely, participants argued that substantive moral challenges arise from how neurobiological information is delivered—that is, communicated and used—in research and in clinical care. Neurobiological information was seen as a powerful tool in the process through which individuals define their identity and establish personal and clinical goals. The pervasiveness of this narrative tool may influence researchers and health professionals’ perception of ethical principles and moral obligations. Conclusions This study suggests that the moral challenges that arise from accessing neurobiological information in the context of psychosis go beyond traditional research and clinical ethics concerns. Reflecting on how accessing neurobiological information can influence individual self-narratives will be vital to ensure the ethical translation of neuroscience and genomics into mental health. Trial registration The study did not involve a health care intervention on human participants. It was retrospectively registered on 11 July 2018, registration number: researchregistry4255.


Author(s):  
Jade Gourret Baumgart ◽  
Hélène Kane ◽  
Wissam El-Hage ◽  
Jocelyn Deloyer ◽  
Christine Maes ◽  
...  

(1) Background: While in many countries, the psychiatric and mental health sectors had been in crisis for years, the onset of a novel coronavirus pandemic impacted their structures, organizations, and professionals worldwide. (2) Methods: To document the early impacts of the COVID-19 health crisis on psychiatry and mental health sectors, a systematic review of the international literature published in 2020 was conducted in PubMed (MEDLINE), Cairn.info, and SantéPsy (Ascodocpsy) databases. (3) Results: After applying inclusion and exclusion criteria, 72 articles from scientific journals were selected, including papers documenting the early impact of the COVID-19 pandemic on the organization of psychiatric care delivery, work processes in psychiatry and mental health units, and personal experiences of mental health professionals. This review identified the contributions aimed at preventing the onset of mental disorders in the early stages of the health crisis. It lists the organizational changes that have been implemented in the first place to ensure continuity of psychiatric care while reducing the risk of SARS-CoV-2 transmission. It questions the evolution of the rights and duties of mental health professionals in the first months of the pandemic. (4) Discussion and conclusions: Although this literature review exclusively documented the early impacts of the COVID-19 health crisis, it is of significant interest, as it pictures the unprecedent situation in which psychiatry and mental health care professionals found themselves in the first stages of the pandemic. This work is a preliminary step of a study to be conducted with mental health professionals on an international scale—the Psy-GIPO2C project—based on more than 15 group interviews, 30 individual interviews, and 2000 questionnaires. The final aim of this study is to formulate concrete recommendations for decision-makers to improve work in psychiatry and mental health.


2019 ◽  
Author(s):  
Veikko Pelto-Piri ◽  
Lars Kjellin ◽  
Ulrika Hylén ◽  
Emanuele Valenti ◽  
Stefan Priebe

Abstract Objectives The objective of the study was to investigate how mental health professionals describe and reflect upon different forms of informal coercion. Results In a deductive qualitative content analysis of focus group interviews, several examples of persuasion, interpersonal leverage, inducements, and threats were found. Persuasion was sometimes described as being more like a negotiation. Some participants worried about that the use of interpersonal leverage and inducements risked to pass into blackmail in some situations. In a following inductive analysis, three more categories of informal coercion was found: cheating, using a disciplinary style and referring to rules and routines. Participants also described situations of coercion from other stakeholders: relatives and other authorities than psychiatry. The results indicate that informal coercion includes forms that are not obviously arranged in a hierarchy, and that its use is complex with a variety of pathways between different forms before treatment is accepted by the patient or compulsion is imposed.


2019 ◽  
Vol 12 (1) ◽  
Author(s):  
Veikko Pelto-Piri ◽  
Lars Kjellin ◽  
Ulrika Hylén ◽  
Emanuele Valenti ◽  
Stefan Priebe

Abstract Objectives The objective of the study was to investigate how mental health professionals describe and reflect upon different forms of informal coercion. Results In a deductive qualitative content analysis of focus group interviews, several examples of persuasion, interpersonal leverage, inducements, and threats were found. Persuasion was sometimes described as being more like a negotiation. Some participants worried about that the use of interpersonal leverage and inducements risked to pass into blackmail in some situations. In a following inductive analysis, three more categories of informal coercion was found: cheating, using a disciplinary style and referring to rules and routines. Participants also described situations of coercion from other stakeholders: relatives and other authorities than psychiatry. The results indicate that informal coercion includes forms that are not obviously arranged in a hierarchy, and that its use is complex with a variety of pathways between different forms before treatment is accepted by the patient or compulsion is imposed.


Author(s):  
Pihla Markkanen ◽  
Minna Anttila ◽  
Maritta Välimäki

It is not uncommon for teachers to face challenging behavioral issues in their classrooms, including disruptive, aggressive, or insulting behavior toward peers or adults. In this paper, we describe what knowledge, skills, and support is needed among teaching personnel to manage challenging situations with pupils. This study was carried out in one comprehensive school in Southwest Finland. Two focus group interviews were conducted with teaching personnel (schoolteachers and classroom assistants, N = 16). The participants also wrote short texts about challenging situations they had experienced. The qualitative data were analyzed with inductive content analysis. According to the results, the teaching personnel needed better knowledge about the factors affecting pupils’ behavior and about good practices to apply with pupils in challenging situations. Moreover, the personnel lacked the skills needed to anticipate and recognize pupils’ moods and signs of mental distress, and expressed the desire for support from mental health professionals. Teachers with adequate knowledge about the factors linked to behavioral issues are more capable of promoting environments conducive to positive interactions with their pupils, thereby limiting challenging situations. When developing education and support for teaching personnel, collaboration between education and mental health professionals is essential.


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