Virtual voices: social support and stigma in postnatal mental illness Internet forums

Many women with postnatal mental illness do not get the treatment they need and this is often because stigma prevents disclosure. The purpose of this study was to explore online social support for postnatal mental illness, how women experience stigma and potential disadvantages of using Internet forums. Interviews were conducted with fifteen participants who had suffered postnatal mental illness and had used forums. Systematic thematic analysis identified common themes in relation to social support, stigma and disadvantages of using forums. Most women felt they benefited from visiting forums by developing a shared understanding and discourse about their illness. Findings suggest future research should investigate if women benefit from using online social support provided by forums, if use challenges stigma and further explore potential concerns about using forums

Diagnosing uncertainty, producing neonatal abstinence syndrome

The use of alcohol and other drugs during pregnancy is understood to be an important public health problem. One way in which this problem is expressed and responded to is via the identification and treatment of neonatal abstinence syndrome (NAS). In this article, we demonstrate how the processes of anticipating, identifying and responding to NAS are characterised by significant uncertainty among parents and health and social care practitioners. We draw on interviews with 16 parents who had recently had a baby at risk of NAS, and multidisciplinary focus groups with 27 health and social care professionals, held in Scotland, UK. NAS, and drug use in pregnancy, is a fraught and complex arena. Parents in the UK who use opioids risk losing custody of children, and must navigate a high degree of surveillance, governance and marginalisation. We suggest that considering NAS as a social diagnosis, further informed by Mol's political ontology of ‘multiple’ bodies/diseases, may help to produce clinical and social responses to uncertainty which avoid, rather than promote, further marginalisation of parents who use drugs. One such response is to develop a culture of relationship‐based care which empowers both service providers and service users to challenge existing practice and decision‐making.Output Status: Forthcoming/Available Onlin

A qualitative exploration of memory cuing by personal items in the home

© The Author(s) 2017. We are surrounded by personal items that can trigger memories, such as photos, souvenirs and heirlooms. Also during holidays, we collect items to remind us of the events, but not all bring back memories to the same extent. Therefore, we explored peoples’ responses to personal items related to a holiday, using the home tour interviewing method. In total, 63 accounts of cuing responses from nine home tours were analysed using thematic analysis. This resulted in four types of cuing responses: (a) ‘no-memory’ responses, (b) ‘know’ responses, (c) ‘memory evoked think or feel’ responses and (d) ‘remember’ responses. For each of these cuing response categories, we looked into the types of items and their characteristics. Furthermore, we found that some items can evoke multiple memories. The majority of the memories’ content refers to events close to the moment of acquiring the item

How patients and clinicians experience the utility of a personalized clinical feedback system in routine practice

The objective was to explore how a person-adaptive clinical feedback system (CFS) effects its users, and how meaning and relevance are negotiated. We conducted a 10-month case-study of the implementation and practice of Norse Feedback, a personalized CFS. The data material consisted of 12 patient interviews, 22 clinician interviews, 23 field notes, and 16 archival documents. We identified four main categories or themes: (i) patients' use of clinical feedback for enhanced awareness and insight; (ii) patients work to make clinical feedback a communication mode; (iii) patients and clinicians negotiate clinical feedback as a way to influence treatment; and (iv) clinical feedback requires an interactive sense-making effort. Patients and therapists produced the meaning and relevance of the CFS by interpreting the CFS measures to reflect the unique patient experience of the patient-therapist relationship. Patients regarded CFS as a tool to inform therapy with important issues. Patients became more self-aware and prepared for therapy. [Abstract copyright: © 2020 The Authors. Journal of Clinical Psychology published by Wiley Periodicals LLC.

Factors perceived to influence exercise adherence in women with breast cancer participating in an exercise programme during adjuvant chemotherapy: a focus group study

Aims and objectives. To explore factors influencing exercise adherence among women with breast cancer while following an exercise programme. Background. Earlier research shows that women with breast cancer decrease physical activity following the cancer diagnosis and that adhering to exercise interventions can be a challenge. Research is needed to identify motivational factors and barriers for exercise adherence among women during treatment for breast cancer. Design. This was a qualitative study to explore patient’s perceptions of the challenges to exercise adherence during a randomised, controlled trial. Methods. Twenty-seven women with early-stage breast cancer were purposively sampled for focus group interviews during 2011–2012 from their participation in the exercise intervention group during 2010–2012. Five focus groups were performed, and data analysis was completed using the systematic text condensation method. Results. During the focus group study, five main themes were identified, which described factors participants perceived to influence their adherence to exercise during chemotherapy: ‘side effects of breast cancer treatment as a barrier to exercise’, ‘restoring and maintaining normality in daily life motivates exercise’, ‘other valued activities compete with exercise’, ‘constructive support enhances exercise’ and ‘positive beliefs about efficacy and outcomes motivate exercise’. Conclusion. Adherence to exercise in women with breast cancer is challenged by internal and external conditions and may be improved by attention to the impact of treatment side effects and by supporting patient self-efficacy towards changing health behaviour. Relevance to clinical practice. Nurses should be aware that exercise adherence could be a challenge among women with breast cancer. They should help identify obstacles to exercise for women and ways to overcome them, as well as support them in their beliefs that they are capable of changing their health behaviou

The development and initial validation of a questionnaire to measure help-seeking behaviour in patients with new onset rheumatoid arthritis

Background: The early treatment of rheumatoid arthritis (RA) is vital. However, people often delay in seeking help at symptom onset. An assessment of the reasons behind patient delay is necessary to develop interventions to promote rapid consultation

Ranger perceptions of, and engagement with, monitoring of elephant poaching

Ranger‐based monitoring has enormous potential to inform conservation globally, with hundreds of thousands of rangers patrolling extensive areas and recording observations of illegal activities and biodiversity. Much quantitative research has demonstrated the pitfalls and potential of data collection by rangers, but little work has considered its human dimensions. Yet poor engagement with, and ownership of, monitoring by those undertaking it may compromise data quality and thereby limit evidence‐based conservation. We interviewed rangers and supervisors involved in a programme for monitoring and managing elephant poaching in the Zambezi Valley, Zimbabwe. We assess the importance that rangers ascribed to data collection within their broader occupation, and their level of engagement with data management and use. We found that rangers saw the collection of biodiversity data as a routine duty that helped guide patrol strategy. Reporting these data was perceived as a primary way of demonstrating fulfilled responsibilities to their supervisors. Rangers did not, however, engage actively with data management and use. Ranger sentiment was evenly divided between those who said feedback on how the data they collected were used would motivate more engaged data collection, and those who said they would continue collecting data regardless, out of duty. Three elements of the occupational culture of rangers at our site—a strong sense of duty, deference to authority and knowing their defined responsibilities within the organizational hierarchy—were identified as key drivers of their engagement with monitoring. Building on these findings, we develop a theory of change to develop more meaningful engagement of rangers with monitoring. We argue that more effective and sustainable monitoring can be achieved by building on existing ranger culture while also fostering rangers' appreciation of data collection and utilization. Addressing key challenges around ranger well‐being, and resource and capacity needs, is also essential