A Home-Start peer support scheme for women with low mood following childbirth

Perinatal mental health problems vary in impact and severity, and can have long-lasting effects on maternal health and child psychological health and development. The evidence to support the effectiveness of postnatal peer and volunteer support schemes to improve the long-term health of women is mixed, with some studies highlighting positive effects in terms of reducing symptoms of depression. Using data from a peer support scheme designed to support women with low mood following childbirth, this paper provides insight into the initial support needs of women, alongside the challenges of using volunteer and peer support services. This paper provides health visitors and others working in community settings with an understanding of how volunteer befriending services may, or may not work in community settings. The data suggests that Home-Start does have a positive impact on the lives of some women, however more work is required in order to understand which aspects of the Home-Start intervention women find effective and why

An integrative review on women living with obstetric fistula and after treatment experiences

Aims and objectives. To review literature on the experiences of women with obstetric fistula, their lived experiences after treatment; and to provide evidence for future research. Background. Obstetric fistula is an injury most commonly resulting from a pro-longed labour. Long eradicated in developed countries, obstetric fistula remains a public health issue in sub-Saharan Africa and Asia. This is a highly stigmatised health condition, and an understanding of the women’s experience is required to inform holistic approaches for care and prevention. Design. An integrative review. Data sources. EBSCO host (Academic Search Premier, MEDLINE, PsychINFO, CINAHL), Web of Science; Grey literature and websites of international organisa-tions such as Women’s Dignity Project and EngenderHealth. Keywords, inclusion and exclusion criteria were defined and 25 articles published from 2004–January 2015 were identified. Review method. The review was guided by Whittemore and Knafl’s revised ana-lytical framework. All articles were assessed for methodological quality and criti-cally analysed to elicit emergent themes and subthemes. Results. Three broad themes were identified: challenges of living with fistula; treatment and care experiences; and reintegration experiences of women after fis-tula repair. Conclusions. Living with a fistula presents multidimensional consequences affect-ing women, families and communities. Accessing treatment is difficult, and there are no standardised treatment packages. Surgical repairs were variable in their success rate. Some authors claim women resume normal lives irrespective of their continence status, whilst others claim they face discrimination despite being conti-nent, thereby hindering reintegration. Quality of life is diminished for those remaining incontinent. Postrepair psychosocial support services are beneficial for reintegration, but research on programme benefits is limited. Therefore, further research is required to support its benefits and for policy development to meet care provision for women with fistula

A qualitative evaluation of home based contraceptive and sexual health care for teenage mothers

This paper reports on the findings from a qualitative study exploring the experiences of teenage mothers using a nurse-led, home-based contraceptive service designed to prevent repeat unplanned pregnancies. The aim was to understand if, and how the service was effective in equipping teenage mothers to make informed choices about contraception, thus preventing a second pregnancy. Unplanned teenage pregnancy remains a significant focus of health and social policy in the United Kingdom (UK). Despite the long-term pattern of declining conception rates, the UK continues to report higher rates than comparable countries elsewhere in Europe. Current estimates suggest that approximately one fifth of births amongst under 18’s are repeat pregnancies (Teenage Pregnancy Independent Advisory Group, 2009). Services that are designed to reduce second unplanned pregnancies are an important element in promoting teenage sexual health. However, there has been no UK research that explores this kind of service and the experiences of service users. We conducted a qualitative interview study. From 2013–2014 we interviewed 40 teenage mothers who had engaged with the nurse-led, home-based contraceptive service. The data demonstrates that the service was effective in preventing repeat pregnancies in a number of cases. Among the aspects of the service which were found to contribute to its effectiveness were privacy, convenience, flexibility, appropriately timed access, the non-judgemental attitude of staff and ongoing support

Second pregnancy prevention among teenagers

Practitioners’ perspectives were used to evaluate a sexual health service designed to prevent second unplanned teenage pregnancy. The service is called Preventing Second Pregnancy (P2P).According to the Family Planning Association (FPA), the UK has the highest teenage pregnancy rates in Western Europe (FPA, 2016). One fifth of births among under 18 year olds are repeat pregnancies (Teenage Pregnancy Independent Advisory Group (TPIAG), 2010; Aslam et al, 2015). The use of outreach contraception and sexual health services aimed at adolescents is one way in which easier access to support and advice on sex, relationships, contraception and sexually transmitted infections is facilitated (Hadley and Evans, 2013). The responsibility for the design and implementation of such programmes rests with local authorities, but little is known about what makes them a success or failure in preventing secondary pregnancies in teenagers (Hayter et al, 2016).Qualitative evaluation was conducted using three focus groups with nurses, midwives and health visitors involved in the referral to, and delivery of, the P2P sexual health service. Analysis was guided by Ritchie and Spencer (1994). This paper presents four characteristics emerging from the analysis that were perceived by health professionals to be important for the effectiveness of P2P.Key findings from previous research indicates that for some young mothers, outreach contraception and sexual health services have a role in the prevention of an unplanned second pregnancy (Hayter et al, 2016). Findings from this study indicate that aspects of the P2P service that practitioners felt contributed to its effectiveness were: flexibility and responsiveness, a commitment to breaking down barriers to accessing contraception, maintaining the initial impetus, and timely service provision

Exploring the Trajectory and Prevention of Alcohol Use Among Young People From the Perspective of Professional Youth Workers

Excessive alcohol use is a significant health issue. Underage drinking is one expression of excessive alcohol use. Researchers have identified a trajectory of alcohol involvement. Gaps exist in understanding the influences that delay and promote the trajectory of alcohol use among young people. The purpose of this study was to explore the contexts and influences that limited and contributed to the trajectory of alcohol use among young people. A qualitative descriptive design was used. Eight youth workers from a city in Northern England participated in individual audio-recorded semi-structured interviews. Transcriptions were coded. Data were analyzed within, and across, codes to identify themes. The theme “Alcohol is an Expected Part of Life” characterized a hypothetical trajectory of alcohol involvement. “Fostering Community in Youth Centers” characterized how participants’ perceptions informed their work. The results increase understanding of how contexts may influence initiation, promotion, and prevention of alcohol use among young people

A qualitative meta-synthesis of young peoples' experiences of ‘sexting’

Objective: To conduct a meta-synthesis of the qualitative research to explore young people's experiences and use of smart phones to send and receive sexually focused messages and images. Design: A qualitative meta-synthesis was conducted on the retrieved papers following a systematic search of PUBMED, Cumulative Index to Nursing and Allied Health Literature (CINAHL), COCHRANE, Embase, Medline and Psycinfo. The sample included five qualitative studies with a total sample size of 480 participants. Results: The meta-synthesis of the papers resulted in the development of four central themes: gender inequity, popularity with peers, relationship context, and costs and benefits. Conclusions: Drawing the qualitative work together highlights the manner in which ‘sexting’ is more nuanced than traditional ‘cyber-bullying’. The consensual sending of intimate images is a highly gendered activity. The gender issues require work with female students to explore the issue of ‘sexting’ and how it can be harmful. Work with male students around the issues of respect and gender harassment in relation to ‘sexting’ is also required and should contribute to sex and relationships education. The results indicate that school nurses working with young people need to build discussions about the use of technology within relationships into their work with young people

Identifying longitudinal sustainable hierarchies in activities of daily living

© 2017 Elsevier B.V. Activities of daily living serve as an indicator of progression in disability and rehabilitation. It is know that some of the measurement scales used show hierarchical properties indicating that activities of daily living are lost and gained in a consistent pattern. Few studies have investigated the extent to which these patterns are sustained across time and across a range of disability. The study aimed to investigate the hierarchical properties of the activity of daily living items in the ValGraf functional ability scale, to establish if there is a hierarchy of items in the scale and to study the sustainability of the hierarchy over time. Secondary analysis of a retrospective database from 13,113 people over 65 years in 105 nursing homes in northern Italy, between 2008 and 2013 was conducted. Data were gathered 6-monthly and analysed using Mokken scaling to identify a hierarchy of items in the scale and if this was sustainable over time. A sustainable hierarchy of items was observed running in difficulty from urinary incontinence to feeding. The hierarchical structure of the activities of daily living observed in the present study is stable over time meaning that changes in total score for these items can be compared meaningfully across time