“I lost my happiness, I felt half dead and half alive” - a qualitative study of the long-term aftermath of obstetric near-miss in the urban district of Zanzibar, Tanzania

Abstract Background This study aims to explore the stories of three women from Zanzibar, Tanzania, who survived life-threatening obstetric complications. Their narratives will increase understanding of the individual and community-level burden masked behind the statistics of maternal morbidity and mortality in Tanzania. In line with a recent systematic review of women-centred, qualitative maternal morbidity research, this study will contribute to guidance of local and global maternal health agendas. Methods This two-phased qualitative study was conducted in July-August 2017 and July-August 2018, and involved three key informants, who were recruited from a maternal near-miss cohort in May 2017 in Mnazi Mmoja Hospital, Zanzibar. The used methods were participant observation, interviews (informal, unstructured and semi-structured), participatory methods and focus group discussions. Data analysis relied primarily on grounded theory, leading to a theoretical model, which was validated repeatedly by the informants and within the study team. The findings were then positioned in the existing literature. Approval was granted by Zanzibar’s Medical Ethical Research Committee (reference number: ZAMREC/0002/JUN/17). Results The impact of severe maternal morbidity was found to be multi-dimensional and to extend beyond hospital discharge and thus institutionalized care. Four key areas impacted by maternal morbidities emerged, namely (1) social, (2) sexual and reproductive, (3) psychological, and (4) economic well-being. Conclusions This study showed how three women’s lives and livelihoods were profoundly impacted by the severe obstetric complications they had survived, even up to 16 months later. These impacts took a toll on their physical, social, economic, sexual and psychological well-being, and affected family and community members alike. These findings advocate for a holistic, dignified, patient value-based approach to the necessary improvement of maternal health care in low-income settings. Furthermore, it emphasizes the need for strategies to be directed not only towards quality of care during pregnancy and delivery, but also towards support after obstetric complications.

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“You run out of hope:” An Exploration of Low-Income Parents’ Experiences with Food Insecurity using Photovoice

Public Health Nutrition ◽

10.1017/s1368980021002743 ◽

2021 ◽

pp. 1-21

Author(s):

Payge Lindow ◽

Irene H. Yen ◽

Mingyu Xiao ◽

Cindy W. Leung

Keyword(s):

Food Insecurity ◽

San Francisco ◽

Low Income ◽

Eating Behaviors ◽

Comparative Method ◽

Well Being ◽

Structured Interviews ◽

Unhealthy Eating ◽

Low Income Families ◽

The Impact

ABSTRACT Objective: Using an adaption of the Photovoice method, this study explored how food insecurity affected parents’ ability to provide food for their family, their strategies for managing household food insecurity, and the impact of food insecurity on their well-being. Design: Parents submitted photos around their families’ experiences with food insecurity. Afterwards, they completed in-depth, semi-structured interviews about their photos. The interviews were transcribed and analyzed for thematic content using the constant comparative method. Setting: San Francisco Bay Area, California, USA. Subjects: 17 parents (14 mothers and 3 fathers) were recruited from a broader qualitative study on understanding the experiences of food insecurity in low-income families. Results: Four themes were identified from the parents’ photos and interviews. First, parents described multiple aspects of their food environment that promoted unhealthy eating behaviors. Second, parents shared strategies they employed to acquire food with limited resources. Third, parents expressed feelings of shame, guilt, and distress resulting from their experience of food insecurity. And finally, parents described treating their children to special foods to cultivate a sense of normalcy. Conclusions: Parents highlighted the external contributors and internal struggles of their experiences of food insecurity. Additional research to understand the experiences of the food-insecure families may help to improve nutrition interventions targeting this structurally vulnerable population.

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Measuring the Impact of a Full Service Grocery Store in a Food Desert

The International Journal of Community and Social Development ◽

10.1177/25166026211015488 ◽

2021 ◽

Vol 3 (2) ◽

pp. 161-176

Author(s):

Kellie Schneider ◽

Diana Cuy Castellanos ◽

Felix Fernando ◽

Jeanne A. Holcomb

Keyword(s):

Systems Engineering ◽

Low Income ◽

Social Impact ◽

Food Deserts ◽

Well Being ◽

Environmental Indicators ◽

Grocery Store ◽

The Impact ◽

Health And Well Being

Food deserts, areas in which it is difficult to obtain affordable, nutritious food, are especially problematic in low-income neighbourhoods. One model for addressing food hardship and unemployment issues within low-income food deserts is a cooperative grocery store. Through the cooperative model, the grocery store can serve as a cornerstone to address socio-economic marginalisation of low-income neighbourhoods and improve the health and well-being of its residents. It is important for communities and policymakers to be able to assess the effectiveness of these types of endeavours beyond traditional economic factors such as profitability. This article uses a systems engineering approach to develop a framework for measuring the holistic impact of a cooperative grocery store on community health and well-being. This framework encompasses values that characterise the relationship between food retail, economic viability and social equality. We develop a dashboard to display the key metrics for measuring the economic, social and environmental indicators that reflect a grocery store’s social impact. We demonstrate the usefulness of the framework through a case study of a full-service cooperative grocery store that is planned within the city of Dayton, OH.

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Psychological distress during COVID-19 pandemic in low-income and middle-income countries: a cross-sectional study of older persons in Thailand

BMJ Open ◽

10.1136/bmjopen-2020-047650 ◽

2021 ◽

Vol 11 (4) ◽

pp. e047650

Author(s):

Wiraporn Pothisiri ◽

Paolo Miguel Manalang Vicerra

Keyword(s):

Psychological Distress ◽

Low Income ◽

Older Persons ◽

Online Survey ◽

Well Being ◽

Secondary Outcome ◽

Ageing Society ◽

Psychological Well Being ◽

Middle Income ◽

The Impact

ObjectiveThe COVID-19 situation in Thailand was controlled with various social measures. Much of the information covered in the media and in studies focused on the public health and economic aspects of the pandemic. This study aimed to explore the psychological well-being of older people, which is important especially in an ageing society categorised as low income or middle income due to the limits of economic and healthcare resources.SettingThe impact of COVID-19 on older persons in Thailand, an online survey, taken across nine provinces within the five regions of the country.ParticipantsInformation was collected from 1230 adults aged at least 60 years old.If an older person was illiterate, unable to access the internet or had a disability preventing them from responding to the survey, an intermediary residing in the community conducted the survey interview.Primary and secondary outcome measuresThe analysis focused on the worries of older adults and the factors associated with psychological distress experienced during the pandemic using logistic regression analysis.ResultsThe majority of people aged at least 60 years old experienced psychological distress during COVID-19. Employment loss (OR 1.08, 95% CI 0.78 to 1.38), inadequate income (OR 1.77, 95% CI 1.28 to 2.44) and debt incursion (OR 2.74, 95% CI 1.57 to 4.80) were detrimental to psychological well-being. The negative changes in the perception of their health status (OR 1.92, 95% CI 1.23 to 2.99) and decreased life satisfaction (OR 1.49, 95% CI 0.45 to 1.87) also weighed on older Thais. The protective factors for psychological well-being were residing in rural areas (OR 0.46, 95% CI 0.35 to 0.61) and being married (OR 0.75, 95% CI 0.55 to 1.01).ConclusionObserving the concerns of the older population is important for introducing policies that can alleviate their precarious financial and health statuses.

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Psychosocial Consequences Among Nurses in the Affected Area of the Great East Japan Earthquake of 2011 and the Fukushima Complex Disaster: A Qualitative Study

Disaster Medicine and Public Health Preparedness ◽

10.1017/dmp.2018.100 ◽

2018 ◽

Vol 13 (03) ◽

pp. 519-526 ◽

Cited By ~ 1

Author(s):

Hideko Sato ◽

Teeranee Techasrivichien ◽

Atsuko Omori ◽

Masako Ono-Kihara ◽

Masahiro Kihara

Keyword(s):

Qualitative Study ◽

Interpersonal Relationships ◽

Acute Stress ◽

Positive Impact ◽

Well Being ◽

Great East Japan Earthquake ◽

Family Responsibilities ◽

Psychosocial Consequences ◽

Mutual Care ◽

The Impact

AbstractObjectiveThe goal of this study was to assess the psychosocial consequences among nurses affected by the Great East Japan Earthquake in order to identify their coping strategies and explore possible countermeasures against complex disasters.MethodsIn 2012, we conducted a qualitative study and screened participants for posttraumatic stress disorder (PTSD).ResultsThirty-eight nurses participated in this study. The result showed a relatively high proportion of probable PTSD (39%). Thirty-two conceptual codes emerged from the data and were grouped into 8 categories: “initial acute stress,” “acute stress turning chronic,” “chronic physical and mental fatigue,” “occupational stress,” “fear of the impact of radiation on children’s health,” “occupational satisfaction,” “positive influences of the disaster experiences,” and “impact of mutual care through interpersonal cognition.”ConclusionsThe study reveals that mutual care may have a positive impact in assisting recovery and enhancing the psychological well-being of nurses. We suggest that disaster management should take into consideration the conflict between professional and family responsibilities. In the light of the chronic impact of the nuclear crisis, enhanced support for interpersonal relationships and human resources, as well as appropriate safety precautions, is urgently needed to help affected nurses. (Disaster Med Public Health Preparedness. 2019;13:519-526)

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Interactions between human behaviour and the built environment in terms of facility management

Facilities ◽

10.1108/f-03-2017-0040 ◽

2018 ◽

Vol 36 (1/2) ◽

pp. 2-12 ◽

Cited By ~ 2

Author(s):

Darja Kobal Grum

Keyword(s):

Built Environment ◽

Low Income ◽

Well Being ◽

Human Behaviour ◽

Natural Environments ◽

Psychological Well Being ◽

Content Type ◽

Sustainable Solutions ◽

Wide Range ◽

The Impact

Purpose In comparison with the relations between the human and natural environments that have been the central focus of environmental psychology for many years, the interactions between the psychological processes underlying human behaviour and the built environment have only recently regained the interest of researchers. In this paper, the author first discusses the reasons for the slower development of human – built environment relations. Afterwards, the author systematically examines the impact that the research of environmental stress, namely, poor housing and poor neighbourhood quality, had on the contemporary understanding of human – built environment relations. Design/methodology/approach The author focuses on social, biophilic and evidence-based design. The author proposes deeper psychological engagement in correlation with human behaviour, psychological well-being and society. The author highlights the inclusion of psychologists in interdisciplinary research teams addressing the development of sustainable solutions to the issues of residential environments. Findings It has been shown that substandard house quality, high noise, lack of natural light in houses, poorer physical quality of urban neighbourhoods, living in a low-income neighbourhood, etc. are linked to elevated physiological and psychological stress. Despite this evidence, there is still a gap between building designers and building users in modern industrialised societies, which could deepen tenants’ dissatisfaction due to specific behavioural needs and consequently lower their psychological well-being and health risk behaviour. Research limitations/implications These are potential risks of error arising from the use of assumptions, limited samples size and data from the secondary resources. Originality/value The major contributions of this paper are as follows. If the environment is understood as a dynamic, constantly changing and complex system of a wide range of players, the author can discern in this environment a dynamic that is otherwise characteristic of emotional dynamics. Expressed participants’ high satisfaction with residential status does not necessarily generate high expectations regarding real estate factors.

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The impact of sleep disturbances on care home residents with dementia: the SIESTA qualitative study

International Psychogeriatrics ◽

10.1017/s1041610220000642 ◽

2020 ◽

Vol 32 (7) ◽

pp. 839-847

Author(s):

Lucy Webster ◽

Kingsley Powell ◽

Sergi G. Costafreda ◽

Gill Livingston

Keyword(s):

Qualitative Study ◽

Sleep Disturbance ◽

Sleep Disturbances ◽

Care Home ◽

Well Being ◽

Structured Interviews ◽

Topic Guide ◽

Disturbed Sleep ◽

Risk Of Falls ◽

The Impact

ABSTRACTObjectives:Nearly 40% of care home residents who are living with dementia also have symptoms of disturbed sleep. However, the impact of these disturbances is relatively unknown and is needed to indicate whether interventions are warranted; therefore, we aimed to investigate the impact.Design:One-to-one semi-structured interviews.Settings:Four UK care homes.Participants:We interviewed 18 nurses and care assistants about residents with sleep disturbances.Measurements:We used a topic guide to explore staff experience of sleep disturbance in residents with dementia. The interviews were audio recorded and transcribed and then analyzed thematically by two researchers independently.Results:Staff described that sleep disturbances in most, but not all, residents impacted negatively on the resident, other residents, staff, and relatives. Residents became more irritable or agitated if they had slept badly. They slept in the daytime after a bad night, which then increased their chances of being awake the following night. For some, being sleepy in the day led to falls, missing medication, drinks, and meals. Staff perceived hypnotics as having low efficacy, but increasing the risk of falls and drowsiness. Other residents were disturbed by noise, and staff described stress when several residents had sleep disturbance. Some of the strategies reported by staff to deal with sleep disturbances such as feeding or providing caffeinated tea at night might be counterproductive.Conclusions:Sleep disturbances in care home residents living with dementia negatively affect their physical and psychological well-being. These disturbances also disturb other residents and increase stress in staff.

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Impact of Universal Credit in North East England: a qualitative study of claimants and support staff

BMJ Open ◽

10.1136/bmjopen-2019-029611 ◽

2019 ◽

Vol 9 (7) ◽

pp. e029611 ◽

Cited By ~ 10

Author(s):

Mandy Cheetham ◽

Suzanne Moffatt ◽

Michelle Addison ◽

Alice Wiseman

Keyword(s):

Mental Health ◽

Local Government ◽

Qualitative Study ◽

Low Income ◽

Welfare Benefits ◽

North East ◽

The Uk ◽

The Impact ◽

Community Sector ◽

Roll Out

ObjectivesTo understand the impact of the roll-out of Universal Credit (UC) from the perspectives of claimants and staff supporting them in North East England.DesignQualitative study comprising interviews and focus groups.SettingGateshead and Newcastle, two localities in North East England characterised by high levels of socioeconomic deprivation, where the roll-out of UC started in 2017 as a new way to deliver welfare benefits for the UK working age population.Participants33 UC claimants with complex needs, disabilities and health conditions and 37 staff from local government, housing, voluntary and community sector organisations.ResultsParticipants’ accounts of the UC claims process and the consequences of managing on UC are reported; UC negatively impacts on material wellbeing, physical and mental health, social and family lives. UC claimants described the digital claims process as complicated, disorientating, impersonal, hostile and demeaning. Claimants reported being pushed into debt, rent arrears, housing insecurity, fuel and food poverty through UC. System failures, indifference and delays in receipt of UC entitlements exacerbated the difficulties of managing on a low income. The threat of punitive sanctions for failing to meet the enhanced conditionality requirements under UC added to claimant’s vulnerabilities and distress. Staff reported concerns for claimants and additional pressures on health services, local government and voluntary and community sector organisations as a result of UC.ConclusionsThe findings add considerable detail to emerging evidence of the deleterious effects of UC on vulnerable claimants’ health and wellbeing. Our evidence suggests that UC is undermining vulnerable claimants’ mental health, increasing the risk of poverty, hardship, destitution and suicidality. Major, evidence-informed revisions are required to improve the design and implementation of UC to prevent further adverse effects before large numbers of people move on to UC, as planned by the UK government.

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Older People, Mobility and Transport in Low- and Middle-Income Countries: A Review of the Research

Sustainability ◽

10.3390/su11216157 ◽

2019 ◽

Vol 11 (21) ◽

pp. 6157 ◽

Cited By ~ 4

Author(s):

Mark Gorman ◽

Sion Jones ◽

Jeffrey Turner

Keyword(s):

Older People ◽

Low Income ◽

Well Being ◽

The State ◽

Small Scale ◽

Knowledge Gaps ◽

Middle Income ◽

Middle Income Countries ◽

The Impact ◽

Low And Middle Income

Older populations are rising globally, which in high-income countries has helped to generate a growing literature on the impact of ageing on travel requirements and transport policy. This article aims to provide an initial assessment of the state of knowledge on the impact on transportation policy and usage of the increasing numbers of older people in low- and middle-income countries (LAMICs), through a review of the literature relating to older people and transportation. As both the academic and policy/practice-related literature specifically addressing ageing and transport in LAMICs is limited, the study looks beyond transportation to assess the state of knowledge regarding the ways in which older people’s mobility is affected by issues, such as health, well-being, social (dis)engagement and gender. We find significant knowledge gaps, resulting in an evidence base to support the implementation of policy is lacking. Most research in low-income countries (LICs) is either broad quantitative analysis based on national survey data or small-scale qualitative studies. We conclude that, although study of the differing contexts of ageing in LAMICs as they relate to older people’s mobilities and transport use has barely begun, institutions which both make and influence policymaking recognise the existence of significant knowledge gaps. This should provide the context in which research agendas can be established.

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Yes, But

Psychology of Women Quarterly ◽

10.1177/0361684316653902 ◽

2016 ◽

Vol 40 (4) ◽

pp. 504-517 ◽

Cited By ~ 11

Author(s):

Laina Y. Bay-Cheng ◽

Anne E. Bruns

Keyword(s):

Young Women ◽

Low Income ◽

Well Being ◽

Gender Inequalities ◽

Sexual Experiences ◽

Unwanted Sex ◽

Unwanted Sexual Experiences ◽

Wide Range ◽

Almost All ◽

The Impact

Reflecting the wide range of consensual unwanted sexual experiences, researchers often have contrasting views of the impact of these incidents on young women. Some scholars support a normalizing view of these as fairly harmless and ordinary aspects of relationships, akin to other forms of willing compromises between partners. Other researchers problematize unwanted sexual experiences, framing them in terms of gender inequalities and detrimental effects. In the current study, we were interested in how young women themselves characterized their unwanted sexual experiences and whether these accounts varied according to a woman’s social location. We interviewed 41 young women (18–22 years old) from three groups: affluent undergraduates, low-income undergraduates, and low-income nonstudents. Almost all of the affluent undergraduates framed their unwanted sexual experiences in normalizing terms, representing such events as relatively harmless incidents and outgrowths of developmental experimentation. In contrast, the low-income students and nonstudents both articulated more ambivalent positions and were more inclined to link their experience to sources of vulnerability, including personal adversity (e.g., trauma, social, and material insecurity) and social norms and stigma. Participants’ sexual histories, life circumstances, and standpoints at the intersection of gender and class were reflected in their experiences of unwanted sex, reinforcing that contextualized analyses and interventions are essential to advancing women’s sexual rights and well-being. Online slides for instructors who want to use this article for teaching are available on PWQ 's website at http://pwq.sagepub.com/supplemental

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COVID-19 and mental health: Anxiety disorders among immigrants due to COVID-19 outbreak in South Korea

The International Journal of Psychiatry in Medicine ◽

10.1177/00912174211042695 ◽

2021 ◽

pp. 009121742110426

Author(s):

Shiva Raj Acharya ◽

Deog Hwan Moon ◽

Jin Ho Chun ◽

Yong Chul Shin

Keyword(s):

Mental Health ◽

Anxiety Disorder ◽

Anxiety Disorders ◽

South Korea ◽

Low Income ◽

Well Being ◽

Cross Sectional ◽

The Government ◽

The Impact ◽

Severe Anxiety

Background The COVID-19 pandemic has affected various facets of health. While mental health became a major concern during the COVID-19 outbreak, the impact on the migrants’ mental health has still been neglected. The purpose of this study was to examine the COVID-19 outbreak's impact on the mental health of immigrants in South Korea. Methods A total number of 386 immigrants in South Korea participated in this quantitative cross-sectional study. The standardized e-questionnaire, including the General Anxiety Disorder (GAD-7) scale, was used to measure the anxiety level. Logistic regression analysis was performed to find out the determinants of anxiety disorders among immigrants. Results The prevalence of severe anxiety among immigrants was found to be 47.2%. Female immigrants (28.6%) had a lower anxiety disorder than males (71.4%). Immigrants who were married, living alone, had a low income, had a history of health problems were suffered from moderate to severe anxiety. Immigrants who were unemployed (OR 2.302, 95% CI = 1.353–3.917) and lost their jobs due to the COVID-19 outbreak (OR 2.197, 95% CI = 1.312–3.678) have a higher anxiety disorder. Immigrants aged over 30 years were found to suffer from a high level of anxiety (OR 2.285, 95% CI = 1.184–4.410). Relief support from the government was significantly associated with anxiety disorder among immigrants (p < 0.01, OR = 3.151, 95% CI = 1.962–5.061). Conclusion With very limited studies on immigrants’ mental health during the COVID-19 pandemic, this paper provides scientific research evidence of the COVID-19 outbreak's impact on the mental health of migrants. Our study has consequences for implementing integrated psychological interventions and health promotion strategies for the well-being of immigrants’ mental health.

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