Cross-cultural study of posttraumatic growth following childbirth

Posttraumatic growth describes positive changes following challenging events. Although such changes are well documented there remain a number of important areas for further research, some of which are addressed in this thesis. In particular, this thesis aimed to clarify the relationship between growth and adjustment following health events, explore growth in different cultures (UK and Africa), and examine growth following childbirth using a prospective design. First, two systematic reviews were carried out to examine (i) growth following health events and (ii) maternal wellbeing in African women. The first meta-analytic review found that growth following cancer and HIV/AIDS was associated with higher levels of positive mental health, higher subjective physical health, and lower levels of negative mental health. Moderating variables were time since the event, age, ethnicity, and type of negative mental health outcome. The second review found that maternal psychological problems in African women have a similar or slightly higher prevalence than reported in developed countries. Risk factors were broadly comparable although some culture-specific factors were also found. Three research studies were conducted. The first study qualitatively explored 55 Gambian women’s experiences of pregnancy, childbirth, and the postnatal period. Thematic analysis identified five themes: (1) transition to adulthood, (2) physical difficulties, (3) value of children in relation to others, (4) children as a strain, and (5) going through it alone. Prospective studies of growth following childbirth were then carried out in the UK (N=125) and The Gambia (N=101). Women completed questionnaires during their third trimester of pregnancy and up to 12 weeks after birth. A proportion of women in both countries reported growth following childbirth. In the UK, higher levels of growth were associated with caesarean sections and prenatal posttraumatic stress symptoms. In The Gambia, higher growth was associated with lower income, lower education, and higher postnatal social support

"A roller coaster of emotions": a qualitative study of parents very first experiences with their preterm baby

Objectives: To assess parents 19 first experiences of their very preterm babies and the neonatal intensive care unit (NICU). Design: Qualitative study using semistructured interviews. Participants: 32 mothers and 7 fathers of very preterm babies (<32 weeks gestation). Setting: Three neonatal units in tertiary care hospitals in South East England. Results: Five themes were identified. The first describes parents 19 blurred recall of the birth. The second shows the anticipation of seeing and touching their baby for the first time was characterised by contrasting emotions, with some parents feeling scared and others excited about the event. The third theme describes parents 19 first sight and touch of their babies and their 18rollercoaster 19 of emotions during this time. It also highlights the importance of touch to trigger and strengthen the parent 13baby bond. However, some parents were worried that touching or holding the baby might transmit infection or interfere with care. The fourth theme captures parents 19 impressions of NICU and how overwhelming this was particularly for parents who had not toured NICU beforehand or whose first sight of their baby was on NICU. The final theme captures unique experiences of fathers, in particular that many felt excluded and confused about their role. Conclusions: This study informs family-centred care by providing insight into the experiences of parents of very preterm infants at a time when they are most in need of support. Clinical implications include the importance of offering parents preparatory tours of the NICU and including fathers

Evaluation of the West Sussex Education, Training, and Employment (ETE) project: First interim report (September 2014-September 2015)

This report presents the findings from the second evaluation period of the ETVE project (September 2015-September 2016) drawing on primary data generated from qualitative interviews with a new cohort of service users who have accessed the service in the previous year, as well as data from interviews with key project stakeholders and external volunteers

“It’s changed my life not to have the continual worry of being warm” – health and wellbeing impacts of a local fuel poverty programme:a mixed-methods evaluation

BACKGROUND: Living in a cold home and being fuel poor can contribute to adverse physical and mental health. Energy efficiency interventions are considered the simplest ways of tackling fuel poverty and preventing associated negative health, wellbeing, and socio-economic consequences. The overall aim of the current study was to provide a greater understanding of the impact of a locally administered programme, which funded the installation of major heating/insulation measures in areas of high fuel poverty, on the health and wellbeing of beneficiaries of the programme. METHODS: A mixed-methods approach to explore the health and wellbeing impacts of a fuel poverty programme in East Sussex that took place between October 2016 and March 2018. Beneficiaries completed the Warwick-Edinburgh Mental Wellbeing Scale before and after any heating/insulation work had been completed in their home. Beneficiaries were also asked to retrospectively rate their health pre- and post-installation. Interviews with 23 beneficiaries of the programme were conducted to explore in-depth the impact of the programme on people’s health and wellbeing and the wider social determinants of health. RESULTS: A major heating/insulation measure was installed in 149 homes. The majority of measures installed were boilers (57.7%) and new central heating systems (32.2%). Self-rated health and wellbeing were significantly higher post-installation. Interviewees described clear examples of the positive impacts on physical health and wellbeing such as fewer chest infections, reduced pain, feeling less anxious and depressed, and generally feeling happier and more relaxed. Interviews also highlighted broader areas of impact such as reduced social isolation and increased use of domestic space. Many of the beneficiaries also reported a reduction in their energy bills since their new heating systems had been installed. CONCLUSIONS: The findings from the evaluation suggest that the installation of major heating or insulation measures such as new boilers have substantial benefits for the health and wellbeing of beneficiaries. The findings also suggest that the programme had a positive impact on wider determinants of health including reduction in stress and isolation that are likely to be part of the pathways between fuel poverty interventions and mental and physical health outcomes

Evaluation of the West Sussex Education, Training, Volunteering and Employment (ETVE) project: Third interim report (September 2016-September 2017), Brighton: University of Brighton

This report presents the findings from the third evaluation phase of the ETVE project (September 2016-September 2017) drawing on primary data generated from qualitative interviews with a new cohort of service users who have accessed the ETVE project in the previous year (n=6), an interview with a service user who participated in the first evaluation phase (n=1), and data from interviews with external volunteers (n=3)