Exploring the phenomenon of suicidal behaviour (SB): An explanatory, mixed-method study in rural Pakistan

Background: Despite scientific literature and media reports of rising cases of suicide and attempted suicide in different parts of Pakistan, the extent of this problem remains unknown, particularly from outside the main urban centres of the country. Aims: To report data on Suicidal Behaviour (SB) from Malakand Division, a rural and marginalised part of Khyber Pakhtunkhwa (KPK) province, explore aetiological factors and propose preventive strategies. Methods: This study followed an explanatory, mixed-method study design. The first part quantitative [QUANT] comprised of police reports on suicidal behaviour, from 2001 till first 8 months of 2018. Detailed analysis of only data from 2013 was undertaken, as data prior to 2013 contained insufficient information. The second part that is, qualitative (QUAL) consisted of in-depth interviews with relevant stakeholders. A mixed method of inductive and deductive analytical approach was used. Results: From 2013 until the first quarter of 2018, the police recorded 1,645 attempts of both males and females of which 144 (8.75%) resulted in fatalities. Suicide attempts rose by 83.4% over the 5 years and 8 months. Approximately, 43.3% of the attempts were attributed to ‘depression’. Domestic abuse was reported in 49.6% of cases. Of the total victims, 1,049 (63.7%) were females, whereas 60.1% were married. Ingestion of the organophosphates poison (pesticide) was reported in 53.2% ( n = 999) of suicide attempts. In more than 90% of the non-fatal suicide attempts, victims were booked under punitive laws. Poor socio-economic status, inter-personal stressors, violence against women and mental illnesses were the major causes of suicidal behaviour in Malakand [QUAL]. Investment in human development, strengthening of the healthcare system, de-stigmatisation of mental illnesses and women empowerment could possibly prevent suicidal behaviour in Malakand [QUAL]. Conclusion: SB in Malakand Division is steadily increasing. The increase is more evident in vulnerable populations such as women and the younger population. ‘Psychosocial stressors’ and ‘depression’ were the main causes of suicidal behaviour. A broad-based, proactive, multi-sectorial approach is needed to prevent SB in the region.

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The educational research landscape on GIS integration and challenges – globally and in South Africa

Journal of Geography Education for Southern Africa ◽

10.46622/jogesa_5_2020_19-41 ◽

2020 ◽

Vol 5 ◽

pp. 19-41

Author(s):

Elfrieda Fleischmann ◽

◽

Christo van der Westhuizen ◽

Keyword(s):

Higher Education ◽

South Africa ◽

South African ◽

Mixed Method ◽

Basic Education ◽

Education Institution ◽

Mixed Method Study ◽

Global Trend ◽

Gis Integration ◽

Depth Interviews

As Geographic Information Systems (GIS) have only been included in the curriculum in the last decade, many educators globally struggle to integrate GIS practice into their teaching strategies. Following the global trend, South African educators might feel ill equipped as they did not receive formal GIS training in a higher education institution. This paper highlights key global and South African challenges regarding GIS integration. To compare the challenges that South Africa faces with those experienced elsewhere, this mixed method study gleaned data from student educators (n=78) who completed a questionnaire regarding their GIS FET Phase education, followed by in-depth interviews with FET Phase educators (n=10) and two provincial heads of Geography for the Department of Basic Education (DBE). Results from this study indicate a clear global and national pattern of barrier categories.

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Adolescents and Young Adults Knowledge, Adherence and Experiences While on Antiretroviral Therapy in a Tertiary Hospital in Lagos, Nigeria: A Mixed-Method Study

Journal of the International Association of Providers of AIDS Care (JIAPAC) ◽

10.1177/23259582211062754 ◽

2021 ◽

Vol 20 ◽

pp. 232595822110627

Author(s):

Roseline Iberi Aderemi-Williams ◽

Ayomikun Rofiat Razaq ◽

Isaac Okoh Abah ◽

Olabisi Oluranti Opanuga ◽

Alani Sulaimon Akanmu

Keyword(s):

Young Adults ◽

Mixed Method ◽

Knowledge Score ◽

Tertiary Hospital ◽

Adolescents And Young Adults ◽

University Teaching ◽

Mixed Method Study ◽

Social Support Systems ◽

Depth Interviews ◽

Optimal Adherence

In Nigeria, there is a paucity of data on knowledge and experiences of adolescents and young adults (AYAs) with HIV and ART, as well as their challenges maintaining optimal adherence. A mixed-method study was carried out between August and September 2018 among AYAs attending Lagos University Teaching Hospital, Nigeria. Data collection was via AYAs' hospital records, standardized questionnaires, and in-depth interviews (IDIs). The 4-day ACTG tool was used to measure adherence. Collected data were analyzed descriptively. Assessment of 34 AYAs comprising 18 (52.9%) males with 28 (82.4%) students revealed an overall knowledge score about ART and its effect of 73.6%. Twenty-five (73.5%) had poor knowledge of the development of resistant strains of HIV due to non-adherence recorded. Optimal adherence (≥95%) was recorded in 20 (58.8%) AYAs. IDI produced 4 themes: (i) reasons for non-adherence, (ii) ensuring optimal adherence, (iii) Social support systems and disclosure, and (iv) stigmatization. Our study provided formative data and revealed areas for intervention to improve knowledge and adherence to ART.

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The educational research landscape on GIS integration and challenges – globally and in South Africa

The Journal of Geography Education in Africa ◽

10.46622/jogea.v3i.2549 ◽

2020 ◽

Vol 3 (1) ◽

pp. 63-80

Author(s):

Elfrieda M-L Fleischmann ◽

Christo P. van der Westhuizen

Keyword(s):

Higher Education ◽

South Africa ◽

South African ◽

Mixed Method ◽

Basic Education ◽

Education Institution ◽

Mixed Method Study ◽

Global Trend ◽

Gis Integration ◽

Depth Interviews

As Geographic Information Systems (GIS) have only been included in the curriculum in the last decade, many educators globally struggle to integrate GIS practice into their teaching strategies. Following the global trend, South African educators might feel ill-equipped as they did not receive formal GIS training in a higher education institution. This paper highlights key global and South African challenges regarding GIS integration. To compare the challenges that South Africa faces with those experienced elsewhere, this mixed-method study gleaned data from student educators (n=78) who completed a questionnaire regarding their GIS FET Phase education, followed by in-depth interviews with FET Phase educators (n=10) and two provincial heads of Geography for the Department of Basic Education (DBE). Results from this study indicate a clear global and national pattern of barrier categories.

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Mixed method survey to assess the problems and propose solutions for implementation of CME/CPD in Sindh, Pakistan

Pakistan Journal of Medical Sciences ◽

10.12669/pjms.35.2.243 ◽

2019 ◽

Vol 35 (2) ◽

Author(s):

Nighat Ali Shah ◽

Marium Soomro ◽

Mehjabeen Musharraf ◽

Shiraz Shaikh

Keyword(s):

Mixed Method ◽

Original Work ◽

Career Progression ◽

Perceived Barriers ◽

Mixed Method Study ◽

Successful Implementation ◽

Creative Commons ◽

Qualitative Component ◽

Depth Interviews ◽

Open Access Article

Objectives: To determine the type of CME/CPD sessions attended by doctors, identify the problems with implementation of CME/CPD program and propose possible solutions for successful implementation of CME/CPD Program. Methods: This was a concurrent triangulation mixed method study. Quantitative questionnaires were filled by faculty and physicians from different specialties. The qualitative component had both focus groups and in depth interviews conducted with different professional bodies (PMA), faculty JSMU, College of Family Physicians. This study was done in 2016-2017. Results: More than half of the participants (53.6%) reported that CPD/CME should be mandatory. Doctors who had graduated from outside Karachi were significantly less likely to report CPD/CME to be mandatory as compared to graduates from Karachi (p=0.004).Top three factors which influenced HCP’s to attend CPD/CME included career progression (65.1%), interest (54.7%) and knowledge gap (50.5%). The most common perceived barriers were lack of study leave, cost and work-life imbalance. The implementation issues expressed by different stakeholders included lack of doctor’s interest, busy clinical schedule and poor accessibility. Conclusion: Mostly medical practioners believe that CPD program is an important step toward enabling physicians to demonstrate their competency and professionalism to themselves and others. The PM&DC has to take practical steps to evaluate the cognitive, clinical, and humanistic attributes of certified doctors. How to cite this:Shah N, Soomro M, Musharraf M, Shaikh S. Mixed method survey to assess the problems and propose solutions for implementation of CME/CPD in Sindh, Pakistan. Pak J Med Sci. 2019;35(2):555-560. doi: https://doi.org/10.12669/pjms.35.2.243 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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How the persistence of patriarchy undermines the financial empowerment of women microfinance borrowers? Evidence from a southern sub-district of Bangladesh

PLoS ONE ◽

10.1371/journal.pone.0250000 ◽

2021 ◽

Vol 16 (4) ◽

pp. e0250000

Author(s):

Tunvir Ahamed Shohel ◽

Sara Niner ◽

Samanthi Gunawardana

Keyword(s):

Decision Making ◽

Mixed Method ◽

Gender Norms ◽

Division Of Labour ◽

Gender Performance ◽

Mixed Method Study ◽

Economic Decision Making ◽

And Gender ◽

The Relationship ◽

Depth Interviews

A significant body of multi-disciplinary research supports the proposition that women may experience empowerment from microfinance programs. This is based on the assumption that an increase in women’s financial contribution to the household helps to transform gender norms and relations which increases their decision-making power. However, the relationship between the strength and persistence of patriarchal gender norms within the household and women’s financial empowerment needs further exploration. This paper presents the findings of a mixed-method study comprising 331 surveys and 33 in-depth interviews with women receiving microfinance and their husbands in a southern sub-district of Bangladesh; it draws upon gender socialisation and gender performance theory to understand how patriarchal gender norms influence women’s financial empowerment in households receiving microfinance. Findings demonstrate that participation in microfinance programs has not shifted gender norms, nor financially empowered women. Women’s loans were largely controlled by men as prescribed by underlying, unchanged patriarchal gender norms. The inter-generational reproduction of patriarchal gender relations continued to reproduce a strict gendered division of labour that reinforced restrictions on women’s behaviour, mobility, and decision-making domains, and men’s dominance in household and economic decision-making.

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Physical Activity Among Foreign-Born Older Adults in Canada: A Mixed-Method Study Conducted in Five Languages

Journal of Aging and Physical Activity ◽

10.1123/japa.2017-0105 ◽

2018 ◽

Vol 26 (3) ◽

pp. 396-406 ◽

Cited By ~ 3

Author(s):

Catherine E. Tong ◽

Joanie Sims Gould ◽

Heather A. McKay

Keyword(s):

Physical Activity ◽

Older Adults ◽

South Asian ◽

Mixed Method ◽

Mixed Method Study ◽

Foreign Born ◽

Daily Step Count ◽

Health Transitions ◽

Depth Interviews

Foreign-born older adults (FBOAs) are at risk for negative health transitions in Canada. Physical activity (PA) enhances health, yet we know very little about the PA habits of FBOAs in Canada. We conducted a mixed-method study in English, Cantonese, Mandarin, Punjabi, and Hindi, with 49 South Asian and Chinese FBOAs in Vancouver, Canada. In total, 49 participants completed surveys; of these 49, 46 wore accelerometers and 18 completed in-depth interviews. Participants’ mean daily step count was 7,876 (women: 8,172, men: 7,164, Chinese: 8,291, and South Asian: 7,196). The bulk of their time is spent in light and sedentary activities. PA is principally acquired through walking for errands and work performed in and around the home. This study challenges the assumption that FBOAs are less active than their nonimmigrant peers and confirms the key role of “nonexercise” and low activity, rather than moderate to vigorous, in older adults’ PA acquisition.

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Meaning in Life in Patients with Chronic Pain and Suicidal Ideation: A Mixed-Method Study. (Preprint)

10.2196/preprints.29365 ◽

2021 ◽

Author(s):

Alessandra Costanza ◽

Vasileios Chytas ◽

Valérie Piguet ◽

Christophe Luthy ◽

Viridiana Mazzola ◽

...

Keyword(s):

Chronic Pain ◽

Suicidal Ideation ◽

Interpersonal Relationships ◽

Mixed Method ◽

Meaning In Life ◽

Suicide Attempts ◽

Study Data ◽

Mixed Method Study ◽

University Hospitals ◽

The Impact

BACKGROUND Patients suffering from chronic pain are at elevated risk of suicidal ideation (SI) and behavior (SB), including suicide attempts and completed suicides. In most studies associations between chronic pain and SI/SB are robust even after adjusting for the effect of socio-demographics and psychiatric comorbidity. However, to refine the risk profile of these patients, further exploration of other possible risk and protective factors is necessary. OBJECTIVE There is a common clinical observation that experiencing chronic pain often requires a revision of life goals and expectations and hence it impacts the existential domain including one’s perception of the Meaning in Life (MiL). The aim of this study was to characterize the main domains that constitute the personal MiL, including the ‘presence of’ and ‘search for’ constructs, in a group of patients with chronic pain and SI. METHODS Participants (N=70) were enlisted by ongoing recruitment through a larger project anchored in daily clinical practice at the Multidisciplinary Pain Center of the Geneva University Hospitals. It was an observational mixed-method study: data was recorded through both validated quantitative questionnaires and and qualitative open-ended questions. RESULTS Responses to questionnaires showed the presence of a depressive episode in 68 patients (97.1%) as well as the presence of anxious disorders in 25 patients (35.7%). With a threshold for positive MiL scoring of 24, the score (mean±SD) for the ‘presence of’ construct was 20.13±8.23 and about two-thirds (63%) of respondents presented with a score <24. The scores for the ‘search for’ MiL were lower (18.14±8.64 and 70% of respondents <24). The ‘presence of’ and ‘search for’ constructs were significantly and positively associated (Chi2=0.402; p=0.001). An open question addressed the ‘presence of’ construct by inviting the respondent to cite domains that they consider as providing meaning in their life at the present time. The 3 main dimensions that emerged from content analysis of this qualitative section were: the domain of relationships; the domain of personal activities; and pain and its consequences on MiL. CONCLUSIONS The results of this study provide insights into patients with chronic pain and SI including the domains that provide them with meaning in their lives and the impact of pain on these domains with regard to SI. Main clinical implications concern both prevention and supportive/psychotherapeutic interventions. They are based on a narrative approach aiming to explore with the patients the contents of their suffering and the MiL domains that they could identify to mitigate it, in order to restructure/reinforce these domains and thus possibly reduce SI. Specifically, as resulting from our study, a focus addressed on maintaining the domains of interpersonal relationships and personal activities can allow the patients to ultimately escape the bio-psycho-social vicious cycle of chronic pain-induced deep moral suffering.

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New mothers and social support: A mixed-method study of young mothers in Australia

Journal of Sociology ◽

10.1177/1440783320978706 ◽

2020 ◽

pp. 144078332097870

Author(s):

Heidi Hoffmann ◽

Rebecca E Olson ◽

Francisco Perales ◽

Janeen Baxter

Keyword(s):

Social Support ◽

Family Relationships ◽

Mixed Method ◽

Adverse Outcomes ◽

Mixed Method Study ◽

Young Mothers ◽

Cross Sectional ◽

Early Entry ◽

Sources Of Support ◽

Depth Interviews

Motherhood can bring joy and enrichment but may also be associated with stress leading to poor health outcomes and low life satisfaction. Young mothers are a group particularly at risk of adverse outcomes, including increased social, economic, and health disadvantage following early entry to motherhood. This article reports results from a mixed-method study examining variations in levels of social support reported by mothers. Cross-sectional analyses of survey data from the Longitudinal Study of Australian Children showed that young mothers (aged less than 25 years when their child was born) generally reported higher levels of social support, but poorer family relationships than older mothers. In-depth interviews with nine young mothers provided insights into how they perceived support under these circumstances. Our research shows that young mothers often experienced difficult childhoods and strained relationships with parents, but many reconnected with their mothers after pregnancy and saw them as important sources of support.

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