scholarly journals Supporting perinatal anxiety in the digital age; A qualitative exploration of stressors and support strategies.

2020 ◽  
Author(s):  
Virginia Harrison ◽  
Donna Moore ◽  
Lisa Lazard
Keyword(s):  
Focus Groups ◽  
Help Seeking ◽  
Post Partum ◽  
Primary Source ◽  
Perinatal Period ◽  
Online Support ◽  
Perinatal Anxiety ◽  
Women's Experience ◽  
Realistic Information ◽  
Insight Into

Abstract Background: The period surrounding childbirth is one of profound change, which can often be experienced as stressful and overwhelming. Indeed, around 20% of women may experience significant levels of anxiety in the perinatal period. However, most women experiencing perinatal anxiety (PNA) go unrecognised and untreated. The Internet offers a potentially scalable solution to improve access to support, however a dearth of research is area means that work is needed to better understand women’s experience of PNA, so that potential targets for intervention can be identified, and possible barriers to support overcome. This study aimed to qualitatively explore women’s experience of anxiety triggers and support in the perinatal period; and gain insight into what online support is acceptable for women with PNA. Methods: Women who were either pregnant or within one year post-partum were invited to participate in focus groups across the UK. Focus groups were used to allow a diversity of perspectives to be heard, while simultaneously promoting the identification and prioritisation of important support needs and solutions. Interviews were transcribed and thematically analysed. Results: Five key themes emerged in relation to women’s experience with PNA: holding unrealistic expectations of birth and motherhood; stigma; the importance of peer support; uncertainty and poor maternal confidence; and a lack of mental health support and knowledge. Perinatal women felt under-supported and poorly prepared for motherhood. A mismatch between their expectations and the reality of their experience, alongside a pressure to be the ‘perfect mum’ was the primary source of their anxiety. Furthermore, stigma associated with PNA may have exacerbated these issues and led to help-seeking avoidance. Overall, women felt these issues could be addressed via online support, through the delivery of more realistic information, providing psychoeducation about PNA symptoms and management, and the inclusion of authentic peer experiences. Thus, delivering evidence-based information and interventions online may provide a solution that is acceptable to this cohort. Conclusions: This work provides unique insight into potential sources of anxiety for women in the PNA, while also offering potential internet-based support solutions that are likely to be acceptable and helpful for women with PNA.

scholarly journals Supporting perinatal anxiety in the digital age; A qualitative exploration of stressors and support strategies.

2020 ◽  
Author(s):  
Virginia Harrison ◽  
Donna Moore ◽  
Lisa Lazard
Keyword(s):  
Focus Groups ◽  
Help Seeking ◽  
Post Partum ◽  
Primary Source ◽  
Perinatal Period ◽  
Online Support ◽  
Perinatal Anxiety ◽  
Women's Experience ◽  
Realistic Information ◽  
Insight Into

Abstract Background: The period surrounding childbirth is one of profound change, which can often be experienced as stressful and overwhelming. Indeed, around 20% of women may experience significant levels of anxiety in the perinatal period. However, most women experiencing perinatal anxiety (PNA) go unrecognised and untreated. The Internet offers a potentially scalable solution to improve access to support, however a dearth of research in this area means that work is needed to better understand women’s experience of PNA, so that potential targets for intervention can be identified and possible barriers to support overcome. This study aimed to qualitatively explore women’s experience of anxiety triggers and support in the perinatal period; and gain insight into what online support is acceptable for women with PNA. Methods: Women who were either pregnant or within one-year post-partum were invited to participate in focus groups across the UK. Focus groups were used to allow a diversity of perspectives to be heard, while simultaneously promoting the identification and prioritisation of important support needs and solutions. Interviews were transcribed and thematically analysed.Results: Five key themes emerged in relation to women’s experience with PNA: holding unrealistic expectations of birth and motherhood; stigma; the importance of peer support; uncertainty and poor maternal confidence; and a lack of mental health support and knowledge. Perinatal women felt under-supported and poorly prepared for motherhood. A mismatch between their expectations and the reality of their experience, alongside a pressure to be the ‘perfect mum’ was the primary source of their anxiety. Furthermore, stigma associated with PNA may have exacerbated these issues and led to help-seeking avoidance. Overall, women felt these issues could be addressed via online support, through the delivery of more realistic information, providing psychoeducation about PNA symptoms and management, and the inclusion of authentic peer experiences. Thus, delivering evidence-based information and interventions online may provide a solution that is acceptable to this cohort. Conclusions: This work provides unique insight into potential sources of anxiety for women in the perinatal period, while also offering potential internet-based support solutions that are likely to be acceptable and helpful for women with PNA.

scholarly journals Original Paper Supporting perinatal anxiety in the digital age; A qualitative exploration of stressors and support strategies.

2019 ◽  
Author(s):  
Virginia Harrison ◽  
Donna Moore ◽  
Lisa Lazard
Keyword(s):  
Focus Groups ◽  
Help Seeking ◽  
Post Partum ◽  
Primary Source ◽  
Perinatal Period ◽  
Online Support ◽  
Perinatal Anxiety ◽  
Women's Experience ◽  
Realistic Information ◽  
Insight Into

Abstract Background: The period surrounding childbirth is one of profound change, which can often be experienced as stressful and overwhelming. Indeed, around 20% of women may experience significant levels of anxiety in the perinatal period. However, most women experiencing perinatal anxiety (PNA) go unrecognised and untreated. Barriers likely include: poor awareness of PNA, perceived stigma, and the reduced flexibility new mothers face. The Internet offers a potentially scalable solution to overcome these obstacles. Aims and Objectives: This study aimed to qualitatively explore women’s experience of anxiety triggers and support in the perinatal period; and gain insight into what online support is acceptable for women with PNA. Method: Women who were either pregnant or within one year post-partum were invited to participate in focus groups across the UK. Focus groups were used to allow a diversity of perspectives to be heard, while simultaneously promoting the identification and prioritisation of important support needs and solutions. Interviews were transcribed and thematically analysed. Results: Five key themes emerged in relation to women’s experience with PNA: holding unrealistic expectations of birth and motherhood; fear of judgement and pressure to be the ‘perfect mum’; the importance of peer support; poor maternal confidence; and a lack of mental health support and information. Perinatal women felt under-supported and poorly prepared for motherhood. A mismatch between their expectations, and the reality of their experience was the primary source of their anxiety. Furthermore, stigma associated with PNA may have exacerbated these issues and led to help-seeking avoidance. Overall, women felt these issues could be addressed via online support, through the delivery of more realistic information, providing psychoeducation about PNA symptoms and management, and the inclusion of authentic peer experiences. Thus, delivering evidence-based information and interventions online may provide a solution that is acceptable to this cohort. Conclusions: This work provides unique insight into potential sources of anxiety for women in the PNA, while also offering potential internet-based support solutions that are likely to be acceptable and helpful for women with PNA.

scholarly journals Adolescents’ Views on Seeking Help for Emotional and Behavioral Problems: A Focus Group Study

2019 ◽  
Vol 17 (1) ◽  
pp. 191
Author(s):  
Suzanne J. van den Toren ◽  
Amy van Grieken ◽  
Marjolein Lugtenberg ◽  
Mirte Boelens ◽  
Hein Raat
Keyword(s):  
Focus Groups ◽  
Behavioral Problems ◽  
Help Seeking ◽  
Psychosocial Problems ◽  
Emotional And Behavioral Problems ◽  
Focus Group Study ◽  
Healthy Adolescent ◽  
Seeking Help ◽  
Insight Into ◽  
Informal Help

This study aimed to get insight into adolescents’ views on help-seeking for emotional and behavioral problems. Fourteen focus groups were conducted. Two vignettes, depicting one healthy adolescent with few issues and one adolescent with severe psychosocial problems, were used to structure the focus groups. The focus groups were framed within a youth help-seeking model. Adolescents (mean age of 15.0 years) generally reported seeking help from friends or the internet for mild issues and from a person they trust like a parent or school mentor, for more severe problems. Adolescents correctly recognized the issues in vignette one as surmountable and the problems in vignette two as severe. A bond of trust with a help source was regarded as the main facilitator for the decision to seek help. Adolescents reported a preference for help sources who clearly displayed their expertise for the issue at hand and for informal help-sources, particularly friends.

scholarly journals Exploring women’s experiences of identifying, negotiating and managing perinatal anxiety: a qualitative study

BMJ Open ◽  
2020 ◽  
Vol 10 (12) ◽  
pp. e040731
Author(s):  
Soo Oh ◽  
Carolyn A Chew-Graham ◽  
Victoria Silverwood ◽  
Sirah Aksa Shaheen ◽  
Jacqualyn Walsh-House ◽  
...  
Keyword(s):  
Qualitative Study ◽  
Support Groups ◽  
Help Seeking ◽  
Perinatal Period ◽  
Future Research ◽  
Structured Interviews ◽  
North West ◽  
Women’S Experiences ◽  
Women's Experiences ◽  
Perinatal Anxiety

ObjectivesAnxiety affects around 15% of women during the perinatal period and can adversely impact both mother and child, with potential implications for long-term health; few studies have examined women’s experiences of perinatal anxiety (PNA). In the context of the National Institute for Health and Care Excellence prioritising PNA, this study aimed to explore women’s experiences of the identification and management of PNA and their engagement with healthcare professionals.DesignQualitative study with semi-structured interviews and applying thematic analysis.SettingRecruitment materials were shared widely through maternal support groups, children’s centres, libraries, National Health Service (NHS) providers (primary and secondary care) operating in the West Midlands or North West of England and through social media.ParticipantsSeventeen women (aged 25–42 years) with self-reported anxiety during pregnancy and/or up to 12 months postpartum. Interviews digitally recorded and transcribed with consent.ResultsThree main themes and corresponding sub-themes are described around a central concept of PNA as an individualised experience: barriers to disclosing PNA; help-seeking for PNA and establishing and engaging support networks. Disclosing, help-seeking and accessing systems of support were interconnected and contextualised by individualised experiences of PNA and pervaded by stigma.ConclusionsThis research provides new insights into PNA and calls for awareness to be improved to achieve parity alongside depression and avoid missed opportunities in the provision of care for women and families. Future research should seek to develop novel PNA-specific interventions aimed at prevention, management and/or combatting stigma to support more women to disclose mental health concerns and seek help early.

Investigation of the “alternative” effects of an online support group for mental health problems among Japanese adults: A cross-sectional study (Preprint)

2020 ◽  
Author(s):  
Osamu Kobori ◽  
Naoki Yoshinaga
Keyword(s):  
Mental Health ◽  
Support Groups ◽  
Support Group ◽  
Help Seeking ◽  
Mental Health Problems ◽  
Health Problems ◽  
Online Support ◽  
Online Support Groups ◽  
Online Support Group ◽  
Usage Frequency

BACKGROUND Owing to the rapid development of social networking services, online support groups vary widely both in goal and structure. Several studies have shown the potential effectiveness of online support groups, such as reducing psychological distress (eg depression) among individuals with mental health problems. However, online support groups often do not aim at effectiveness regarding distress-relief-related outcomes. OBJECTIVE The U2plus.jp (hereinafter U2plus) is an online support group for individuals with depression; in it, people support each other in structured ways while engaging in simple cognitive behavioral therapy (CBT) exercises. This study aimed to examine if usage frequency of the U2plus functions are associated with decreased stigma and increased consumer. METHODS In total, 355 U2plus users took part in an online survey. They were asked what therapy they had ever received, how often they logged into it and used each of its functions, and completed the following questionnaires: The Patient Health Questionnaire-9 (PHQ-9), the Perceived Devaluation Discrimination Scale, and the General Help Seeking Scale. RESULTS Regarding the therapy they received, 89.3% (n=308) had been on medication for mental health problems, and 67.5% (n=233) had received psychotherapy or mental health counselling. Regarding the usage frequency, approximately 20% of the participants signed in to U2plus and used its functions more than once a week. The usage frequency of U2plus functions was not associated with perceived stigma. However, usage frequency of some functions was correlated to help seeking intentions from formal sources (eg doctors and psychologists). Moreover, 90% of the participants had a history of medication for their mental health. Additionally, the more depressed participants were, the more frequently they used U2plus. CONCLUSIONS It was suggested that online support groups may serve as an alternative treatment option for those who are already undergoing pharmacological treatment and are willing to seek help from whatever source they deem helpful.

Staying strong: Exploring experiences of managing emotional distress for African Caribbean women living in the UK

2021 ◽  
Vol 31 (1) ◽  
pp. 140-159 ◽  
Author(s):  
Rachel Graham ◽  
Victoria Clarke
Keyword(s):  
Focus Groups ◽  
Black Woman ◽  
Emotional Distress ◽  
Emotional Wellbeing ◽  
Strong Black Woman ◽  
Caribbean Women ◽  
African Heritage ◽  
Women's Experience ◽  
African Caribbean ◽  
The Uk

The “strong Black woman” (SBW) is a Western cultural stereotype that depicts African-heritage women as strong, self-reliant, independent, yet nurturing and self-sacrificing. US research indicates that this stereotype negatively impacts the emotional wellbeing of African-heritage women, while also allowing them to survive in a racist society. UK research has documented the significance of this stereotype in relation to African Caribbean women’s experience of depression around the time of childbirth and “attachment separation and loss”. However, research is yet to explore how UK African Caribbean women make sense of and negotiate the SBW stereotype in relation to their emotional wellbeing more broadly. Using five focus groups, with a total of 18 women, this research explored how these women experienced and managed emotional distress in relation to the SBW stereotype. The importance of “being strong” consistently underpinned the participants’ narratives. However, this requirement for strength often negatively impacted their ability to cope effectively with their distress, leading them to manage it in ways that did little to alleviate it and sometimes increased it. This study offers important implications for understanding the experiences of emotional distress for UK African Caribbean women.

scholarly journals Contemplating Help-Seeking in Perinatal Psychological Distress—A Meta-Ethnography

2021 ◽  
Vol 18 (10) ◽  
pp. 5226
Author(s):  
Minna Anneli Sorsa ◽  
Jari Kylmä ◽  
Terese Elisabet Bondas
Keyword(s):  
Psychological Distress ◽  
Help Seeking ◽  
Critical Appraisal ◽  
Service Providers ◽  
Perinatal Period ◽  
Linear Process ◽  
Small Children ◽  
Complex Process ◽  
Seeking Help ◽  
Critical Appraisal Skills

Perinatal psychological distress (PPD) may cause delays in help-seeking in the perinatal period, which is crucial for families with small children. Help-seeking theories focus on rational processes of behavior wherein ‘help-seeking’ is viewed as a decision-making process, in which action is preceded by recognizing a problem. We identified the phase prior to actual help-seeking actions as a life situation and a phenomenon through which to gain a deeper understanding from women’s own perspectives. The aim of this study was to integrate and synthesize knowledge of women’s experiences of contemplating seeking help for PPD. We chose interpretative meta-ethnography by Noblit and Hare (1988) and implemented eMERGe guidelines in reporting. The search was performed systematically, and the 14 included studies were evaluated with Critical Appraisal Skills Programme checklist (CASP). We identified seven themes and a metaphor in a lines-of-argument synthesis, showing that contemplating help-seeking is a multidimensional phenomenon. We did not observe a straightforward and linear process (as previous research suggests) but instead a complex process of contemplating help-seeking. A clinical implication is that service providers should work with outreach and develop their tools to connect with mothers with PPD. Another suggestion is to improve training in mental health literacy prior to or during pregnancy.

scholarly journals Tradition, taste and taboo: the gastroecology of maternal perinatal diet

2021 ◽  
pp. bmjnph-2021-000252
Author(s):  
Hannah G Lunkenheimer ◽  
Oskar Burger ◽  
Santosh Akhauri ◽  
Indrajit Chaudhuri ◽  
Lisa Dibbell ◽  
...  
Keyword(s):  
Community Health ◽  
Community Health Workers ◽  
Food Choice ◽  
Health Workers ◽  
Post Partum ◽  
Perinatal Period ◽  
Mortality Rates ◽  
Food Group ◽  
Maternal Malnutrition ◽  
Health Promoting

BackgroundMaternal malnutrition is a major source of regional health inequity and contributes to maternal and infant morbidity and mortality. Bihar, a state in eastern India adjacent to Jharkhand and West Bengal, has relatively high neonatal mortality rates because a large portion of infants are born to young mothers. Bihar has the second-highest proportion of underweight children under 3 in India, with infant mortality rates of 48 per 1000 live births. Maternal malnutrition remains a major threat to perinatal health in Bihar, where 58.3% of pregnant women are anaemic.MethodsWe examined dietary beliefs and practices among mothers, mothers-in-law and community members, including Accredited Social Health Activists (ASHAs), using focus group discussions (n=40 groups, 213 participants), key informant interviews (n=50 participants) and quantitative surveys (n=1200 recent mothers and 400 community health workers). We report foods that are added/avoided during the perinatal period, along with stated reasons underlying food choice. We summarise the content of the diet based on responses to the quantitative survey and identify influencers of food choice and stated explanations for adding and avoiding foods.Key findingsAnalyses for all methodologies included gathering frequency counts and running descriptive statistics by food item, recommendation to eat or avoid, pregnancy or post partum, food group and health promoting or risk avoiding. During pregnancy, commonly added foods were generally nutritious (milk, pulses) with explanations for consuming these foods related to promoting health. Commonly avoided foods during pregnancy were also nutritious (wood apples, eggplant) with explanations for avoiding these foods related to miscarriage, newborn appearance and issues with digestion. Post partum, commonly added foods included sweets because they ease digestion whereas commonly avoided foods included eggplants and oily or spicy foods. Family, friends, relatives or neighbours influenced food choice for both mothers and ASHAs more than ASHAs and other health workers.Perinatal dietary beliefs and behaviours are shaped by local gastroecologies or systems of knowledge and practice that surround and inform dietary choices, as well as how those choices are explained and influenced. Our data provide novel insight into how health influencers operating within traditional and biomedical health systems shape the perinatal dietary beliefs of both mothers and community health workers.

scholarly journals Identifying Corporate Sustainability Issues by Analyzing Shareholder Resolutions: A Machine-Learning Text Analytics Approach

2020 ◽  
Vol 12 (11) ◽  
pp. 4753
Author(s):  
Viju Raghupathi ◽  
Jie Ren ◽  
Wullianallur Raghupathi
Keyword(s):  
Machine Learning ◽  
Corporate Sustainability ◽  
Primary Source ◽  
Text Analytics ◽  
Useful Knowledge ◽  
Word Cloud ◽  
Textual Data ◽  
Shareholder Resolution ◽  
The Impact ◽  
Insight Into

Corporations have embraced the idea of corporate environmental, social, and governance (ESG) under the general framework of sustainability. Studies have measured and analyzed the impact of internal sustainability efforts on the performance of individual companies, policies, and projects. This exploratory study attempts to extract useful insight from shareholder sustainability resolutions using machine learning-based text analytics. Prior research has studied corporate sustainability disclosures from public reports. By studying shareholder resolutions, we gain insight into the shareholders’ perspectives and objectives. The primary source for this study is the Ceres sustainability shareholder resolution database, with 1737 records spanning 2009–2019. The study utilizes a combination of text analytic approaches (i.e., word cloud, co-occurrence, row-similarities, clustering, classification, etc.) to extract insights. These are novel methods of transforming textual data into useful knowledge about corporate sustainability endeavors. This study demonstrates that stakeholders, such as shareholders, can influence corporate sustainability via resolutions. The incorporation of text analytic techniques offers insight to researchers who study vast collections of unstructured bodies of text, improving the understanding of shareholder resolutions and reaching a wider audience.

scholarly journals Drivers of ‘clinically unnecessary’ use of emergency and urgent care: the DEUCE mixed-methods study

2020 ◽  
Vol 8 (15) ◽  
pp. 1-256
Author(s):  
Alicia O’Cathain ◽  
Emma Knowles ◽  
Jaqui Long ◽  
Janice Connell ◽  
Lindsey Bishop-Edwards ◽  
...  
Keyword(s):  
General Practice ◽  
Mixed Methods ◽  
General Practitioner ◽  
Health Service ◽  
Health Services ◽  
Focus Groups ◽  
Emergency Departments ◽  
Help Seeking ◽  
Mixed Methods Study ◽  
Coping Capacity

Background There is widespread concern about the pressure on emergency and urgent services in the UK, particularly emergency ambulances, emergency departments and same-day general practitioner appointments. A mismatch between supply and demand has led to interest in what can be termed ‘clinically unnecessary’ use of services. This is defined by the research team in this study as ‘patients attending services with problems that are classified as suitable for treatment by a lower urgency service or self-care’. This is a challenging issue to consider because patients may face difficulties when deciding the best action to take, and different staff may make different judgements about what constitutes a legitimate reason for service use. Objectives To identify the drivers of ‘clinically unnecessary’ use of emergency ambulances, emergency departments and same-day general practitioner appointments from patient and population perspectives. Design This was a sequential mixed-methods study with three components: a realist review; qualitative interviews (n = 48) and focus groups (n = 3) with patients considered ‘clinically unnecessary’ users of these services, focusing on parents of young children, young adults and people in areas of social deprivation; and a population survey (n = 2906) to explore attitudes towards seeking care for unexpected, non-life-threatening health problems and to identify the characteristics of someone with a tendency for ‘clinically unnecessary’ help-seeking. Results From the results of the three study components, we found that multiple, interacting drivers influenced individuals’ decision-making. Drivers could be grouped into symptom related, patient related and health service related. Symptom-related drivers were anxiety or need for reassurance, which were caused by uncertainty about the meaning or seriousness of symptoms; concern about the impact of symptoms on daily activities/functioning; and a need for immediate relief of intolerable symptoms, particularly pain. Patient-related drivers were reduced coping capacity as a result of illness, stress or limited resources; fear of consequences when responsible for another person’s health, particularly a child; and the influence of social networks. Health service-related drivers were perceptions or previous experiences of services, particularly the attractions of emergency departments; a lack of timely access to an appropriate general practitioner appointment; and compliance with health service staff’s advice. Limitations Difficulty recruiting patients who had used the ambulance service to the interviews and focus groups meant that we were not able to add as much as we had anticipated to the limited evidence base regarding this service. Conclusions Patients use emergency ambulances, emergency departments and same-day general practitioner appointments when they may not need the level of clinical care provided by these services for a multitude of inter-related reasons that sometimes differ by population subgroup. Some of these reasons relate to health services, in terms of difficulty accessing general practice leading to use of emergency departments, and to population-learnt behaviour concerning the positive attributes of emergency departments, rather than to patient characteristics. Social circumstances, such as complex and stressful lives, influence help-seeking for all three services. Demand may be ‘clinically unnecessary’ but completely understandable when service accessibility and patients’ social circumstances are considered. Future work There is a need to evaluate interventions, including changing service configuration, strengthening general practice and addressing the stressors that have an impact on people’s coping capacity. Different subgroups may require different interventions. Study registration This study is registered as PROSPERO CRD42017056273. Funding This project was funded by the National Institute for Health Research (NIHR) Health Services and Delivery Research programme and will be published in full in Health Services and Delivery Research; Vol. 8, No. 15. See the NIHR Journals Library website for further project information.

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