scholarly journals Lived experiences of Ugandan women who had recovered from a clinical diagnosis of postpartum depression: a phenomenological study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Catherine Atuhaire ◽  
Godfrey Zari Rukundo ◽  
Laura Brennaman ◽  
Samuel Nambile Cumber ◽  
Grace Nambozi
Keyword(s):  
Suicidal Ideation ◽  
Postpartum Depression ◽  
Clinical Diagnosis ◽  
Lived Experiences ◽  
Phenomenological Study ◽  
Health Centre ◽  
Childbearing Age ◽  
Breast Milk Production ◽  
Self Harm ◽  
Southwestern Uganda

Abstract Background Postpartum depression affects a significant proportion of women of childbearing age. The birth of a newborn baby is normally considered a joyful event, inhibiting mothers from expressing their depressive feelings. If the condition is not well understood and managed, mothers with postpartum depression are likely to experience suicidal ideation or even commit suicide. This study explored lived experiences of women who had recovered from a clinical diagnosis of postpartum depression in southwestern Uganda. Methods This phenomenological study adopted the explorative approach through in-depth interviews as guided by the biopsychosocial model of depression. It was conducted in Mbarara Regional Referral Hospital, Bwizibwera Health Centre IV and Kinoni Health Centre IV located in Mbarara and Rwampara districts, southwestern Uganda. Data were collected from 30 postpartum mothers who were purposively selected, between 9th December 2019 and 25th September 2020. We analyzed this work using thematic data analysis and this was steered by the Colaizzi’s six-step phenomenological approach of inquiry. Results The findings were summarized into five major themes: 1) somatic experiences including insomnia and headache, breast pain, poor breast milk production, weight loss and lack of energy; 2) difficulties in home and family life including overwhelming domestic chores, lack of social support from other family members, fighting at home and financial constraints due to COVID-19 pandemic; 3) negative emotions including anger, self-blame, despondency and feelings of loneliness and regrets of conceiving or marriage; 4) feelings of suicide, homicide and self-harm including suicidal ideation and attempt, homicidal ideations and attempt and feelings of self-harm and 5) coping with postpartum depression including spirituality, termination of or attempt to leave their marital relationships, acceptance, counselling and seeking medical treatment, perseverance. Conclusion and recommendations Suicidal and homicidal thoughts are important parts of the postpartum depression experience, and these may put the lives of the mothers, their spouses and their babies at a great risk. Poor relationship quality, intimate partner violence and lack of financial resources contribute significantly to the negative emotional experiences of mothers with PPD.

scholarly journals Lived experiences of homelessness among elderly women: a phenomenological study

2021 ◽  
Vol 15 (8) ◽  
pp. 2413-2420
Author(s):  
Ebtesam Mo'awad El-Sayed Ebied ◽  
Naglaa El-Sayed Eldardery
Keyword(s):  
Suicidal Ideation ◽  
Lived Experiences ◽  
Phenomenological Study ◽  
Elderly Women ◽  
Self Care ◽  
Structured Interview ◽  
Health Problems ◽  
Human Needs ◽  
Basic Human Needs ◽  
Care Deficit

Background: Homelessness is a global issue that has a devastating impact on elderly women’s health. It is estimated that100 million people are considered homeless worldwide. Aim: to explore the lived experiences of homelessness among elderly women. Research question: What are the lived experiences of homelessness among elderly women? Sample: A purposive sample of 30 homless elderly women. Setting: a selected homelessness shelter. Tools: 1- A structured questionnaire of personal and medical data. 2- Semi-structured interview with open-ended questions. 3- Field notes. Results/Themes: five themes were represented; (1) Living without basic human needs (food, water, sleep &shelter), (2) Self-care deficit. (self-neglect, poor hygiene and bad odor). (3) Bio- psycho- social health problems (fear, aggressive behavior, depression, suicidal ideation, isolation, hopelessness, loss of family role, vision problems, diabetic foot and lack of acces to health care services), (4) Emotional distress (uncertainity, loss of interest, suicidal ideation, bad feeling, feeling lonely), (5) Strategies for resolution (religious and expression of feelings). Conclusion: Majority of homless elderly women experienced living without basic human needs, bio-psychsocial health problems, self-care deficit which predispose them to many devastating health consequences. Recommmendations: Employ urgent interventions to solve the unique and challenging health problems/needs of this vulnerable group; raising community awarness about the nature, and process of homelessness phenomena and conduct bio-psychosocial interventions studies of homeless elderly women. Key words: Lived experiences, homeless elderly women, phenomenological study.

Attachment Organization in Suicide Prevention Research

Crisis ◽  
2014 ◽  
Vol 35 (1) ◽  
pp. 60-66 ◽  
Author(s):  
Amanda Venta ◽  
Carla Sharp
Keyword(s):  
Risk Factors ◽  
Suicidal Ideation ◽  
Suicide Attempt ◽  
Interpersonal Relationships ◽  
Suicide Ideation ◽  
Suicide Attempts ◽  
Critical Role ◽  
Self Report ◽  
Future Research ◽  
Self Harm

Background: Identifying risk factors for suicide-related thoughts and behaviors (SRTB) is essential among adolescents in whom SRTB remain a leading cause of death. Although many risk factors have already been identified, influential theories now suggest that the domain of interpersonal relationships may play a critical role in the emergence of SRTB. Because attachment has long been seen as the foundation of interpersonal functioning, we suggest that attachment insecurity warrants attention as a risk factor for SRTB. Aims: This study sought to explore relations between attachment organization and suicidal ideation, suicide attempts, and self-harm in an inpatient adolescent sample, controlling for demographic and psychopathological covariates. Method: We recruited 194 adolescents from an inpatient unit and assigned them to one of four attachment groups (secure, preoccupied, dismissing, or disorganized attachment). Interview and self-report measures were used to create four variables reflecting the presence or absence of suicidal ideation in the last year, single lifetime suicide attempt, multiple lifetime suicide attempts, and lifetime self-harm. Results: Chi-square and regression analyses did not reveal significant relations between attachment organization and SRTB, although findings did confirm previously established relations between psychopathology and SRTB, such that internalizing disorder was associated with increased self-harm, suicide ideation, and suicide attempt and externalizing disorder was associated with increased self-harm. Conclusion: The severity of this sample and methodological differences from previous studies may explain the nonsignificant findings. Nonsignificant findings may indicate that the relation between attachment organization and SRTB is moderated by other factors that should be explored in future research.

The Role of Perfectionism and Autobiographical Memory in a Sample of Parasuicide Patients

Crisis ◽  
2008 ◽  
Vol 29 (2) ◽  
pp. 64-72 ◽  
Author(s):  
Susan A. Rasmussen ◽  
Rory C. O’Connor ◽  
Dallas Brodie
Keyword(s):  
Suicidal Ideation ◽  
Autobiographical Memory ◽  
Memory Task ◽  
Self Report ◽  
Hierarchical Regression ◽  
Overgeneral Autobiographical Memory ◽  
Socially Prescribed Perfectionism ◽  
Hopelessness Depression ◽  
Self Harm ◽  
First Time

The main objective of this study was to investigate the relationship between social perfectionism, overgeneral autobiographical memory recall, and psychological distress (hopelessness, depression/anxiety, and suicidal ideation) in a sample of parasuicide patients. Forty patients who had been admitted to a Scottish hospital following an episode of deliberate self-harm participated in the study. The participants completed the autobiographical memory task and a battery of self-report measures (multidimensional perfectionism, hopelessness, depression/anxiety, and suicidal ideation). The results showed that repetitive self-harmers were more overgeneral in their recall of positive autobiographical memories than were first-time self-harmers. Hierarchical regression analyses showed that socially prescribed perfectionism interacted with overgeneral recall of both positive and negative memories to predict suicidal ideation/depression. The findings are discussed in relation to previous research.

scholarly journals Efficacy of dialectical behavior therapy for adolescent self-harm and suicidal ideation: a systematic review and meta-analysis

2021 ◽  
pp. 1-11
Author(s):  
Oswald D. Kothgassner ◽  
Andreas Goreis ◽  
Kealagh Robinson ◽  
Mercedes M. Huscsava ◽  
Christian Schmahl ◽  
...  
Keyword(s):  
Systematic Review ◽  
Clinical Trials ◽  
Suicidal Ideation ◽  
Dialectical Behavior Therapy ◽  
Meta Analysis ◽  
Adolescent Psychopathology ◽  
Cochrane Library ◽  
Behaviour Therapy ◽  
Clinical Consequences ◽  
Self Harm

Abstract Background Given the widespread nature and clinical consequences of self-harm and suicidal ideation among adolescents, establishing the efficacy of developmentally appropriate treatments that reduce both self-harm and suicidal ideation in the context of broader adolescent psychopathology is critical. Methods We conducted a systematic review and meta-analysis of the Dialectical Behaviour Therapy for Adolescents (DBT-A) literature on treating self-injury in adolescents (12–19 years). We searched for eligible trials and treatment evaluations published prior to July 2020 in MEDLINE/PubMed, Scopus, Google Scholar, EMBASE, and the Cochrane Library databases for clinical trials. Twenty-one studies were identified [five randomized-controlled trials (RCTs), three controlled clinical trials (CCTs), and 13 pre-post evaluations]. We extracted data for predefined primary (self-harm, suicidal ideation) and secondary outcomes (borderline personality symptoms; BPD) and calculated treatment effects for RCTs/CCTs and pre-post evaluations. This meta-analysis was pre-registered with OSF: osf.io/v83e7. Results Overall, the studies comprised 1673 adolescents. Compared to control groups, DBT-A showed small to moderate effects for reducing self-harm (g = −0.44; 95% CI −0.81 to −0.07) and suicidal ideation (g = −0.31, 95% CI −0.52 to −0.09). Pre-post evaluations suggested large effects for all outcomes (self-harm: g = −0.98, 95% CI −1.15 to −0.81; suicidal ideation: g = −1.16, 95% CI −1.51 to −0.80; BPD symptoms: g = −0.97, 95% CI −1.31 to −0.63). Conclusions DBT-A appears to be a valuable treatment in reducing both adolescent self-harm and suicidal ideation. However, evidence that DBT-A reduces BPD symptoms was only found in pre-post evaluations.

scholarly journals Clinical diagnosis in paediatric patients at urban primary health care facilities in southern Malawi: a longitudinal observational study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Mtisunge Joshua Gondwe ◽  
Marc Y. R. Henrion ◽  
Thomasena O’Byrne ◽  
Clemens Masesa ◽  
Norman Lufesi ◽  
...  
Keyword(s):  
Clinical Diagnosis ◽  
Health Workers ◽  
Health Centre ◽  
Treatment Algorithm ◽  
Secondary Level ◽  
Support Staff ◽  
Health Care Facilities ◽  
Severe Illness ◽  
Primary Health ◽  
Sick Children

Abstract Background Despite health centres being the first point of contact of care, there are challenges faced in providing care to patients at this level. In Malawi, service provision barriers reported at this level included long waiting times, high numbers of patients and erratic consultation systems which lead to mis-diagnosis and delayed referrals. Proper case management at this level of care is critical to prevent severe disease and deaths in children. We aimed to adopt Emergency, Triage, Assessment and Treatment algorithm (ETAT) to improve ability to identify severe illness in children at primary health centre (PHC) through comparison with secondary level diagnoses. Methods We implemented ETAT mobile Health (mHealth) at eight urban PHCs in Blantyre, Malawi between April 2017 and September 2018. Health workers and support staff were trained in mHealth ETAT. Stabilisation rooms were established and equipped with emergency equipment. All PHCs used an electronic tracking system to triage and track sick children on referral to secondary care, facilitated by a unique barcode. Support staff at PHC triaged sick children using ETAT Emergency (E), Priority (P) and Queue (Q) symptoms and clinician gave clinical diagnosis. The secondary level diagnosis was considered as a gold standard. We used statistical computing software R (v3.5.1) and used exact 95% binomial confidence intervals when estimating diagnosis agreement proportions. Results Eight-five percentage of all cases where assigned to E (9.0%) and P (75.5%) groups. Pneumonia was the most common PHC level diagnosis across all three triage groups (E, P, Q). The PHC level diagnosis of trauma was the most commonly confirmed diagnosis at secondary level facility (85.0%), while a PHC diagnosis of pneumonia was least likely to be confirmed at secondary level (39.6%). The secondary level diagnosis least likely to have been identified at PHC level was bronchiolitis 3 (5.2%). The majority of bronchiolitis cases (n = 50; (86.2%) were classified as pneumonia at the PHC level facility. Conclusions Implementing a sustainable and consistent ETAT approach with stabilisation and treatment capacity at PHC level reinforce staff capacity to diagnose and has the potential to reduce other health system costs through fewer, timely and appropriate referrals.

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