Demonstrating cultural competence within health-visiting practice: working with refugee and asylum-seeking families

This qualitative study explored the experiences of health visitors working with refugee and asylumseeking families in central London, and assessed the dimensions of their cultural competency using Quickfall's model (Quickfall, 2004, 2010). In-depth interviews were conducted with 14 health visitors. Data were analysed using Framework, a thematicbased analytical method. The findings revealed that the health visitors demonstrated aspects of culturally competent care in relation to Quickfall's five-step model which was developed from the literature specifically for working with asylum applicants within a primary care setting. Shortcomings with regard to demonstrating cultural competence were related to working for an organisation whose work is governed by external factors such as national legislation and policy. In addition, the complexity of the needs of these vulnerable populations and limited resources sometimes compromised the cultural competence of the health visitors. However, they showed many positive xamples of how they provided equity, access and non-discriminatory services, health promotion and socially inclusive services

Factor structure and psychometric properties of the General Health Questionnaire (GHQ-12) among Ghanaian adolescents

Purpose: There is little information about the reliability and validity of the 12-item General Health Questionnaire (GHQ-12) in Ghana. This study sought to examine the reliability and factor structure of the GHQ-12 in Ghanaian adolescents. Method: sHigh school students (N = 770) completed the GHQ-12 and the Adolescent Stress Questionnaire (ASQ). Internal consistency, convergent validity and exploratory factor analysis were used. Results: A two factor structure, each with six items, was extracted. The total GHQ-12 had acceptable internal consistency and a generally high correlation with the ASQ subscales. Conclusion: The GHQ-12 can be used in Ghanaian samples, but more research is needed to confirm its factor structure

Routine testing for blood-borne viruses in prisons: a systematic review

Background: People in prison have a higher burden of blood-borne virus (BBV) infection than the general population, and prisons present an opportunity to test for BBVs in high-risk, underserved groups. Changes to the BBV testing policies in English prisons have recently been piloted. This review will enable existing evidence to inform policy revisions. We describe components of routine HIV, hepatitis B and C virus testing policies in prisons and quantify testing acceptance, coverage, result notification and diagnosis. Methods: We searched five databases for studies of both opt-in (testing offered to all and the individual chooses to have the test or not) and opt-out (the individual is informed the test will be performed unless they actively refuse) prison BBV testing policies. Results: Forty-four studies published between 1989 and 2013 met the inclusion criteria. Of these, 82% were conducted in the USA, 91% included HIV testing and most tested at the time of incarceration. HIV testing acceptance rates ranged from 22 to 98% and testing coverage from 3 to 90%. Mixed results were found for equity in uptake. Six studies reported reasons for declining a test including recent testing and fear. Conclusions: While the quality of evidence is mixed, this review suggests that reasonable rates of uptake can be achieved with opt-in and, even better, with opt-out HIV testing policies. Little evidence was found relating to hepatitis testing. Policies need to specify exclusion criteria and consider consent processes, type of test and timing of the testing offer to balance acceptability, competence and availability of individuals

Association between psychosomatic health symptoms and common mental illness in Ghanaian adolescents: Age and gender as potential moderators

Little is known about the role of age and gender in the association between psychosomatic symptoms and common mental illness in Ghanaian adolescents. This cross-sectional study examined age and gender as moderators between psychosomatic symptoms and common mental illness using data from a school-based survey ( N = 770). Males reported higher psychosomatic symptoms and common mental illness, while younger adolescents reported higher common mental illness only. Psychosomatic symptoms were positively associated with common mental illness, but age and gender did not moderate this association. Interventions aimed at reducing the prevalence rate in psychosomatic symptoms are crucial in decreasing common mental illness in Ghanaian adolescents. </jats:p

An Arabic Version of the Spiritual Well-Being Scale

This article reports on two studies to develop and validate an Arabic language version of the Spiritual Well-Being Scale (SWBS). The first study was a pilot study at a major government university in Jordan (N = 75, students). The second and main study was conducted in 5 large regional hospitals in Jordan (N = 63, patients). The SWBS was translated from English to Arabic and reviewed by an expert panel for language, cultural, and spiritual consistency. The Arabic version of the SWBS was revised after the results of the pilot study and further reviewed by an expert panel. The resulting data were subjected to descriptive and factor analysis. Results showed that the final version of the SWBS used in the main study had a two-factor structure consistent with previous studies. Descriptive data for a range of demographic variables are presented. Issues of inadequate translation and lack of variation in responses for some items are identified and the results discussed in light of dominant Islamic theological frameworks. © 2012 Taylor and Francis Group, LLC

Spiritual Well-Being, Depression, and Stress Among Hemodialysis Patients in Jordan

Purpose: The spiritual dimension of a patient’s life is an important factor that may mediate detrimental impacts on mental health. The lack of research investigating spiritual well-being, religiosity, and mental health among Jordanian hemodialysis patients encouraged this research. This study explored levels of spiritual well-being and its associations with depression, anxiety, and stress. Design: A quantitative, cross-sectional correlational study. Method: A sample of 218 Jordanian Muslim hemodialysis patients completed a structured, self-administered questionnaire. The data were analyzed using descriptive statistics and linear multivariate regression models. Findings: The hemodialysis patients had, on average, relatively low levels of spiritual well-being, moderate depression, severe anxiety, and mild to moderate stress. The results of the regression models indicated that aspects of spiritual well-being were negatively associated with depression, anxiety, and stress, but only existential well-being consistently retained significant associations after controlling for religious well-being, religiosity, and sociodemographic variables. Conclusions: Greater spiritual and existential well-being of Jordanian hemodialysis patients were significantly associated with less depression, anxiety, and stress. It appears that these patients use religious and spiritual beliefs and practices as coping mechanisms to overcome their depression, anxiety, and stress. The implications for holistic clinical practice are explored

Housing Affordability, Tenure and Mental Health in Australia and the United Kingdom: A Comparative Panel Analysis

The paper contributes insights into the role of tenure in modifying the relationship between housing affordability and health, using a cross-national comparison of similar post-industrial nations ? Australia and the United Kingdom ? with different tenure structures. The paper utilises longitudinal data from the Household, Income and Labour Dynamics in Australia Survey (HILDA) and British Household Panel Survey (BHPS) to examine change in the mental health of individuals associated with housing becoming unaffordable and considers modification by tenure. We present evidence that the role of tenure in the relationship between housing and health is context dependent and should not be unthinkingly generalised across nations. These findings suggest that the UK housing context offers a greater level of protection to tenants living in unaffordable housing when compared with Australia, and this finds expression in the mental health of the two populations. We conclude that Australian governments could improve the mental health of their economically vulnerable populations through more supportive housing policies

Impact of Spiritual Well-Being, Spiritual Perspective, and Religiosity on the Self-Rated Health of Jordanian Arab Christians

The purpose of this study was to explore associations of spiritual well-being, spiritual perspective, and religiosity with self-rated health in a convenience sample of 340 adult Jordanian Arab Christians. Data were collected through church and community groups. Results indicated that spiritual well-being and religiosity were positively associated with self-rated health, but in the final regression model only spiritual well-being retained a significant association after controlling for the other spiritual and religious measures. In conclusion, spirituality and religiosity are important to Jordanian Arab Christians’ health and well-being, and the implications for nursing practice are explored

Social support, stress, health, and academic success in Ghanaian adolescents: A path analysis

The aim of this study is to gain a better understanding of the role psychosocial factors play in promoting the health and academic success of adolescents. A total of 770 adolescent boys and girls in Senior High Schools were randomly selected to complete a self-report questionnaire. School reported latest terminal examination grades were used as the measure of academic success. Structural equation modelling indicated a relatively good fit to the posteriori model with four of the hypothesised paths fully supported and two partially supported. Perceived social support was negatively related to stress and predictive of health and wellbeing but not academic success. Stress was predictive of health but not academic success. Finally, health and wellbeing was able to predict academic success. These findings have policy implications regarding efforts aimed at promoting the health and wellbeing as well as the academic success of adolescents in Ghana. © 2014 The Foundation for Professionals in Services for Adolescents

Psychosocial impact of the summer 2007 floods in England

Background The summer of 2007 was the wettest in the UK since records began in 1914 and resulted in severe flooding in several regions. We carried out a health impact assessment using population-based surveys to assess the prevalence of and risk factors for the psychosocial consequences of this flooding in the United Kingdom. Methods Surveys were conducted in two regions using postal, online, telephone questionnaires and face-to-face interviews. Exposure variables included the presence of flood water in the home, evacuation and disruption to essential services (incident management variables), perceived impact of the floods on finances, house values and perceived health concerns. Validated tools were used to assess psychosocial outcome (mental health symptoms): psychological distress (GHQ-12), anxiety (GAD-7), depression (PHQ-9) and probable post-traumatic stress disorder (PTSD checklist-shortform). Multivariable logistic regression was used to describe the association between water level in the home, psychological exposure variables and incident management variables, and each mental health symptom, adjusted for age, sex, presence of an existing medical condition, employment status, area and data collection method. Results The prevalence of all mental health symptoms was two to five-fold higher among individuals affected by flood water in the home. People who perceived negative impact on finances were more likely to report psychological distress (OR 2.5, 1.8-3.4), probable anxiety (OR 1.8, 1.3-2.7) probable depression (OR 2.0, 1.3-2.9) and probable PTSD (OR 3.2, 2.0-5.2). Disruption to essential services increased adverse psychological outcomes by two to three-fold. Evacuation was associated with some increase in psychological distress but not significantly for the other three measures. Conclusion The psychosocial and mental health impact of flooding is a growing public health concern and improved strategies for minimising disruption to essential services and financial worries need to be built in to emergency preparedness and response systems. Public Health Agencies should address the underlying predictors of adverse psychosocial and mental health when providing information and advice to people who are or are likely to be affected by flooding