Contemplating Help-Seeking in Perinatal Psychological Distress-A Meta-Ethnography

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.Peer reviewe

Lived experiences on help-seeking from the perspective of a mother with a dual diagnosis

Mothers with a co-occurring mental illness and substance abuse (dual diagnosis) use numerous different services. Help-seeking and engagement are complex processes which have not yet been sufficiently conceptualized. A descriptive phenomenological approach was used to explore these experiences from different service contexts and to describe the decisions in and structure of help-seeking over a 13-year period. Four in-depth interviews were conducted and data were analysed with a descriptive phenomenological method developed by Giorgi. The essential meaning structure is an inner conflict within the client, including a realization that change starts from within. The essential meaning structure combines the other meaning structures: disbelief of receiving help and admitting the need for help, keeping up the perfect façade and the risk of total collapse, being given and making own choices regarding care and being forced to use services and inner emptiness and search for contentment in life. It is possible that clients in the help-seeking process do not always recognize they have a need for care. If the client experiences inner powerlessness as emptiness and resistance to being helped, it is probably not possible to create relationships with care providers. Clients may have several ambiguous inner processes which prevent them from accepting the need for care. Theoretically and empirically a long-term approach is crucial, since the inner transformative processes take time. The services can contribute new experiences to the personal level of understanding and decision-making, if they consider the experiential level of their clients

Associating spatial patterns of zooplankton abundance with water temperature, depth, planktivorous fish and chlorophyll

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Preschool children’s coping and caregiver support in families with maternal substance misuse : A qualitative study

Maternal substance misuse affects caregiving, which influences children’s coping skills. However, little is known about how children of mothers with substance misuse describe their coping in stressful situations. We studied coping and caregiver support among 29 children 4 years of age recruited from a children’s health clinic serving families with maternal substance misuse in Finland. Children completed a revised Attachment Story Completion Task that we examined with qualitative content analysis. We identified children’s experiences with coping in stressful situations with optimal and non-optimal caregiver support. Experiences with optimal caregiver support included (a) empathy, (b) solicitude, (c) intimacy, (d) reassurance, (e) being a role model, (f) concrete help, and (g) shared joy. Ones with non-optimal caregiver support included (a) punishment, (b) abandonment, (c) unresponsiveness, (d) physical aggression, (e) aggressive protection, and (f) parentification. Children’s strategies for coping without caregiver involvement were (a) magic, (b) avoidance, (c) inappropriate laughing, (d) self-reliance, or (e) a lack of strategy. Our findings highlight that preschool children of mothers with substance misuse employ various coping strategies in stressful situations that either include caregiver support or indicate non-optimal support. Children also tended to use maladaptive coping strategies when a caregiver was not involved. Understanding children’s coping with stress in families with maternal substance misuse is essential to supporting their socioemotional development and providing adequate interventions.publishedVersionPeer reviewe

Katsaus suomalaiseen CAM-tutkimukseen

Tämä katsausartikkeli käsittelee suomalaista täydentävän ja vaihtoehtoisen lääkinnän tutkimusta. Käytämme siitä lyhennettä CAM-tutkimus (CAM eli Complementary and Alternative Medicine, täydentävä ja vaihtoehtoinen lääkintä). Artikkelin tavoitteena on selvittää, millaista CAM-tutkimusta Suomessa on tehty ja mihin tutkimus on kohdistunut. Tutkimusaineisto koostui CAM-hoitoja käsittelevistä 53 tutkimusartikkelista ja 12 väitöskirjasta ajanjaksolta 1980–2014. Aineisto haettiin kotimaisista ja ulkomaisista tietokannoista. Tutkimusmenetelmä oli sisällönanalyysi. CAM-tutkimusta tehtiin erityisesti 1990-luvulla ja 2000-luvun alussa. Useimmiten tutkimukset tehtiin yliopistossa tai yhteistyössä yliopistojen kanssa. Valtaosa aineistomme julkaisuista käsitteli CAM-hoitoja kokonaisuutena erittelemättä eri hoitomuotoja toisistaan. CAM-hoidoiksi tutkimuksissa luettiin erilaisia terveyden ylläpitoon tai sairauden hoitoon tarkoitettuja yrttejä, rohdoksia, homeopaattisia ja antroposofisia lääkkeitä, ruokavaliohoitoja sekä kehomielihoitoja, joista useimmin mainittiin henkiparannus, akupunktio ja vyöhyketerapia. Erittelemme artikkelissa suomalaisen CAM-tutkimuksen luokittelun kansainvälistä luokittelua mukaillen seuraavasti: 1) CAM-hoitojen vaikuttavuuden ja käytettävyyden tutkimus, 2) CAM-hoitojen historian ja kansanperinteen tutkimus, 3) CAM-hoitojen käytön yleisyyden ja käyttäjäryhmien tutkimus, 4) hoitohenkilökunnan asenteiden ja suhtautumisen tutkimus. Lisäksi hahmottelimme viidennen – tosin Suomen kontekstissa hyvin vähäisen – luokan: CAM-ammattien tutkimus, tieteentutkimus ja hoitonäkemysten tutkimus. Suurin osa tutkimuksista kohdistui CAM-hoitojen käyttöön ja käyttäjätyyppeihin. Tulosten mukaan vähintään kolmannes aikuisista oli käyttänyt tai kokeillut jotakin CAM-hoitoa. Muita tutkimuskohteita olivat CAM-hoitojenvaikutukset, terveydenhuoltohenkilökunnan asenteet ja hoitojen historia. Vaikutustutkimuksista suurin osa kohdistui jäsenkorjaukseen, jolla todettiin olevan myönteisiä vaikutuksia. Lääkärien ja sairaanhoitajien CAM-asenteet osoittautuivat jakautuneiksi

Amniotic Fluid Infection in Preterm Pregnancies with Intact Membranes

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