Information in mental health: qualitative study of mental health service users

BACKGROUND: Despite the widespread proliferation of consumer health information provision, little is known about information needs or information-seeking behaviour in mental health. A qualitative study was therefore undertaken to explore these issues for mental health service users. DESIGN: In-depth interview study with purposive sample of 36 men and women with experience of mental health problems. RESULTS: Four main themes were identified. A general lack of information was equated with a lack of respect. People undertook their own research into their condition, and recognized the challenge to professionals. Stigma was widespread and inhibited information seeking. There was a desire for an explanation of mental health problems in physical terms. People particularly valued hearing other people's experience of mental health problems, for reasons of universality, instillation of hope, and understanding and empathy. CONCLUSIONS: The findings provide support for a more equal partnership between patients and professionals. Information providers and health practitioners should take account of the value of other people's experience as an information source.     

Breaking down the barriers: a qualitative study to understand child oral health in refugee and migrant communities in Australia

Objective. Australia is an increasingly multicultural nation. Never before has the dental workforce been exposed to such language, cultural, religious and ethnic diversity. There is evidence that refugee and migrant children experience significantly poorer oral health than the nonmigrant population. However, little is known about the oral health knowledge, practices and beliefs of parents with young children from refugee and migrant backgrounds. The aim of this study was to identify the sociocultural influences on child oral health in these communities.

Design. Participatory and qualitative research methods were utilised. Partnerships were established with community agencies representing migrants from Iraq, Lebanon and Pakistan. Focus group discussions and semi-structured interviews were conducted with community members. Qualitative data were analysed thematically, combining focus group and interview data.

Results. Over 100 women participated in focus groups (n = 11) and semi-structured interviews (n = 7). Key findings included the knowledge, beliefs and practices concerning: caries risk factors, oral health practices and oral health literacy. Despite mothers' knowledge of the major causes of poor oral health – dietary changes, confusion about child oral hygiene practices and limited oral health literacy all influenced child oral health outcomes.

Conclusion. This culturally competent qualitative study explores the sociocultural factors influencing child oral health in refugee and migrant communities. Understanding and acknowledging these factors are a prerequisite to determining where and how to intervene to improve oral health. Furthermore, it has implications for both dental and non-dental health professionals working to reduce health inequalities within such communities.     

Ideology,obesity and the social determinants of health: a critical analysis of the obesity and health relationship

Based on a critical review of the obesity and health literature we provide five models of how the hypothesized obesity and health relationship is conceptualized. We then apply these models to make sense of how recent Canadian public health reports and clinical practice guidelines conceptualize the issue of obesity, its causes and health effects, and appropriate responses. We show how conformity to dominant models of the obesity and health relationship by health sciences researchers, public health workers, and the media lead to activities that rather than promoting health, actually threaten it. These dominant models – and the activities derived from them – do so by diverting attention from the far more important issues of the quality and distribution of the social determinants of health. These approaches also stigmatize heavy individuals, doing little to promote their health. For these reasons, we call for an end to seeing obesity as a significant health issue.     

Mental health support for youth offending teams: a qualitative study

The objective of the present study was to examine the views of professionals working in youth offending teams (YOTs) on a new model for providing mental health service support within the context of an interagency setting. Focus groups were used and data were analysed according to the constant comparative method. The setting consisted of two YOTs, one in an inner-city area and the other in a rural/semi-urban area, where primary mental health workers operate at the interface between YOTs and the specialist child and adolescent mental health services. Seventeen YOT professionals participated in four focus groups. Four themes were identified: previous experiences of specialist mental health services; issues of interagency working; the role of the primary mental health worker within the YOT; and recommendations for the future. Overall, the clinical component of the role (assessment and intervention), and the accessibility and responsiveness of the mental health staff were consistently valued, while there were mixed responses on role definitions within the team, consultation and training. It is concluded that mental health service provision through primary mental health workers is a useful model for interagency partnerships for high-risk client groups with multiple and complex mental health needs.     

Ottawa to Bangkok: changing health promotion discourse

The discourse of the 2005 Bangkok Charter for Health Promotion in a Globalized World represents a radical departure from that of the Ottawa Charter that, in 1986, staked a place for the health promotion field in mainstream public health. Via a critical analysis of the discourse in these two Charters, this paper illustrates a shift from a 'new social movements' discourse of ecosocial justice in Ottawa to a 'new capitalist' discourse of law and economics in Bangkok. The Bangkok Charter's content may identify 'actions, commitments and pledges required to address the determinants of health in a globalized world through health promotion', but this paper shows how its discourse works to naturalize and perpetuate many of detrimental determinants associated with 'globalization'.     

The development and validation of a measure off parent-reported child health and morbidity: The Warwick Child Health and Morbidity Profile

Summary Objective: to validate a simple instrument for the measurement of parentreported health and morbidity in infancy and childhood suitable for research and service planning purposes and capable of measuring both cross-sectional and longitudinal health and morbidity experience in a child population. Setting: child health clinic (CIHC), child development unit (CDU) and paediatric outpatient department (OPD) in Coventry. Design: 3-phase field testing to establish testretest rellabllity, validity and inter-observer variation of the instrument. Field testing samples: phases 1 and 2; 188 parents of pre-school children attending one of the three health service settings — CHC, CDU or paediatric OPD; phase 3; 40 parents of pre-school children attending CHCs. Methods: test-retest reliability of each domain of the WCHMP was estimated using weighted Kappa; criterion validity was estimated for selected domains against health records; construct validity against medically plausible constructs was tested by comparing responses between domains; inter-observer variation was estimated using weighted Kappa. Results: the test-retest reliability of the WCHMIP varied from ‘moderate’ for behaviour, functional health and life quality status to ‘very good’ for acute significant Illness and hospital admission status; criterion and construct validity were high; weighted Kappas for all domains for inter-observer variation between the researcher and family health visitor were in the ‘good’ to ‘very good’ range and inter-observer variation remained unaffected by change in the order of administration of the WCHMP. Conclusions: the WCHMP is a simple measure of parent-reported health and Illness which, on Field-testing, has been shown to be reliable and valid with low inter-observer variation. After further development and validation including incorporation into the parent-held record, it should be suitable for use in infancy and early childhood to collect cross-sectional and longitudinal health and morbidity data for research and service planning purposes.     

Inoculating the electorate: a qualitative look at American corporatocracy and its influence on health communication

This research examines the profit-driven agendas, non-branded marketing strategies, and commercialized propaganda that influence citizen trust in health communication messages. Specifically focusing on Rick Perry’s 2007 human papilloma virus vaccination mandate, we highlight the role that corporate funding plays in legislation, regulation, and voter/consumer behavior. Emergent findings from in-depth interviews with Texas residents, in combination with US media reports, illustrate the questionable communications contaminating consumer trust and public health. Our critical analysis of health promotion reflects the commodification of health consciousness in the United States.     

Assessing the quality of preschool child health surveillance in primary care: a pilot study in one health district

OBJECTIVE: To develop a framework for measuring the quality of preschool child health surveillance acceptable to primary health care teams and measurable at individual primary health care team level. DESIGN: Published research evidence was identified and criteria developed by a local multidisciplinary expert group. The criteria were discussed with primary health care teams. How well they were achieved was assessed. SETTING: Twenty-eight general practices in one health authority area. METHODS: Data collection included observation of baby clinics, interviews with health visitors and general practitioners (GPs), questionnaires to parents, collation of child health surveillance reviews recorded in personal child health records and immunization rates. RESULTS: The criteria for assessing preschool child health surveillance were thought to be acceptable and achievable by primary health care teams. Fifteen of the 22 criteria used to assess baby clinics were met by over 90 of practices. Almost all practices completed child health surveillance reviews within a standard time and achieved 90 coverage for primary immunizations. At many practices, less than 90 of parents felt welcome at the baby clinic, usually had enough time to talk to their health visitor or had the purpose or results of the 6 to 8 week child health surveillance review explained to them. GPs were less likely than health visitors to discuss health promotion at child health surveillance reviews (chi(2) 11.52, P = 0.0007). Few practices had a call-up and recall system for all reviews. CONCLUSION: The framework that we developed for assessing preschool child health surveillance was acceptable and achievable by primary health care teams.     

肥胖和正常体重初中生自我概念与心理健康的比较研究

目的 探讨肥胖与正常体重初中生在自我概念与心理健康方面的差异以及自我概念与心理健康之间的关系.方法 采用田纳西自我概念量表、临床症状自评量表(SCL-90)对初一至初三的学生进行调查.结果 肥胖初中生的自我概念水平低于正常体重的初中生(t=-13.416,P＜0.01);但是肥胖初中生的心理健康得分高于正常体重的初中生(t=4.014,P＜0.05);相关分析表明,自我概念量表的大多数因子与心理健康量表的总分呈显著的负相关(r=-0.142 ～0.301);回归分析显示,生理自我、心理自我和自我认同对肥胖初中生的心理健康有显著的预测作用.结论 自我概念对肥胖初中生的心理健康影响较大.     

儿童肥胖对健康的影响

超重肥胖已成为影响我国儿童青少年身心健康的重要公共卫生问题,相关研究表明肥胖会影响儿童的各个方面,包括高血压、2型糖尿病、非酒精性脂肪性肝病(NAFLD)、阻塞性睡眠呼吸暂停(OSA)、血脂异常,还与哮喘和多种肿瘤如结直肠癌、乳腺癌有关,肥胖儿童的焦虑和抑郁发生率也较高。本文就儿童青少年肥胖产生的健康危害进行综述,提高人们对儿童肥胖防控的重视。     

定性调查在妇幼保健服务研究中的应用与评价

1993年2～3月,对河北省1990年1月1日～1992年12月31日3年中孕产妇死亡率最高的4个项目县的妇幼保健服务调查资料中的定性调查部分,重点对产前检查和住院分娩的资料进行了分析,探讨了“专题小组讨论”定性调查方法在妇幼保健应用科研中的具体做法,评价了该方法在其中的重要作用。文中还对调研地区产前检查和住院分娩的现状及改进措施进行了讨论。     

一站式儿童保健服务模式与儿童保健质量的探讨

目的 观察一站式儿童保健服务模式对促进儿童保健质量的效果。方法 从2010年1月至2013年1月山东省青岛市城阳区人民医院儿童保健区接收的儿童中抽取160例作为研究对象,随机分为干预组和对照组,每组各80例。对干预组儿童实施一站式儿童保健服务模式,对照组儿童实施常规儿童保健服务模式,对比6个月后两组儿童的保健质量。结果 儿童保健情况：干预组儿童保健系统管理率为82．51％,保健时平均等待时间为32．3±4．8min;对照组儿童保健系统管理率为63．87％,保健时平均等待时间为54．1±7．6min;干预组儿童保健的系统管理率及平均等待时间均优于对照组,差异有统计学意义（χ^2=4．713,t＝4．681,均P＜0．05）。儿童家属满意度：干预组儿童家属满意率为95％,对照组儿童家属满意率为75％,前者高于后者,差异有统计学意义（χ^2=4．619,P＜0．05）。结论 开展一站式儿童保健服务能明显提高儿童保健质量,值得进一步的普及和推广。     

Day care, maternal mental health and child development: evidence from a longitudinal study

Data from a long-term follow-up study of 632 born in Calgary in 1980 are reported, with particular reference to the experience of day care and its association with parental factors and the children's adjustment when they were, on average 6#lb7 years old. The sample was specially selected to include a high proportion of children with serious disabilities, and data for these children have been considered separately. Children with several years of day care behind them did not display attachment problems when they entered elementary schooling. They were however more active and aggressive than children without day care experience. This activity pattern is associated with Type A behaviour, which represents busy, active, competitive children. These traits probably reflect parental ambitions and activity patterns. Mothers who stayed home to look after several children were much more likely to be seriously depressed than mothers who returned to the external labour force in their child's preschool years. Maternal depression was associated with neurosis and depression in the child. This study gives support to the idea that high quality, affordable and universally available day care would be supportive of parental child care roles. Several sub-types of adaptation and day care experience have been identified, and hypotheses for exploration in a longer term study are suggested.     

Improving prevention in Dutch child health care in schools: Development of a short questionnaire for early detection of psychosocial and related child rearing problems

Background: The focus of Dutch child health care among schoolchildrenhas shifted from preventing somatic diseases to early diagnosisof psychosocial problems. Studying psychosocial problems oftenrequires the use of extensive questionnaires. The LSPPK is ashort questionnaire developed for the purpose of school doctorsexamining five year olds. Methods: A study was carried out comprisingdata from 2,528 children visiting school doctors. Answers fromthe children's parents who filled in the LSPPK questionnairewere compared to those of a health care professional (schooldoctor). Results: One or more problems were mentioned by 50%of the parents, while 5% indicated severe problems. Internalconsistency of the questionnaire was good; Cronbach's s were0.66 and 0.71 respectively for parent's and professional's answers.Furthermore, 75% of the school doctors indicated that the LSPPKprovides a dialogue-oriented interaction between health careprofessionals and parents, because it helps parents to expresstheir worries. Conclusion: The LSPPK invites parents to raisetheir worries about the behavioural and emotional problems oftheir children. In Dutch child health care the LSPPK is a usefulinstrument for indicating psychosocial problems among childrenas experienced by their parents and confirmed by school doctors.This article discusses the usefulness of the LSPPK for childhealth care in schools in European countries.     

家庭环境和妇幼保健服务对学龄前儿童健康的影响

以城市和农村交接混合区住宅的父母为对象 ,进行了有关家庭环境和妇幼保健服务的现状调查。结果表明 ,主要影响母亲的保健行动的因素有民族、学历、职业、年收入、家庭形态、健康信息等因素。还被提示的问题有 ,作为婴幼儿喂养必须的信息来源的保健书籍之中 ,发现朝鲜文的保健书籍很缺少 ,因此考虑很有必要开发朝鲜文的育儿书籍。关于新生儿访问 ,当提供保健服务和健康信息时有必要考虑因民族的不同所造成的育儿观念的差异。笔者考虑有必要重新探讨有关提高母子保健手册的有效利用的新体系的调整以及妇幼保健服务管理体制的最佳模式。     

我国地市级妇幼保健机构儿童保健服务能力基础调查

目的 对我国地市级妇幼保健机构儿童保健人员及设备投入水平、服务开展状况和管理情况历史数据进行分析,为比较我国儿童保健发展变化水平提供基础数据。方法 对2013年5-7月的历史调查数据进行收集分析。采用容量比例概率抽样方法,在有全国代表性的13个省中随机抽取1/3的地市,对地市级妇幼保健机构的儿童保健服务情况进行问卷调查。结果 实际调查的51所地市级妇幼保健机构中,每万名儿童有1.64名地市级妇幼保健机构儿保人员。机构平均开展9项儿童保健服务,生长发育服务的开展比例最高(98.0%),其次是营养咨询指导(94.1%)、耳及听力保健(92.2%)和心理行为发育测验(90.2%)。儿童康复服务的开展比例最低(62.7%)。平均设置儿童保健门诊6个。70%以上的机构设置了生长发育、心理行为发育测验、眼保健、听力保健门诊,高危儿随访门诊、口腔保健、儿童康复和早期发展指导门诊设置率均低于60%。2012年平均为下级医疗卫生机构举办培训班4次,举办托幼机构卫生保健人员培训班3次。结论 我国东、中、西部地区地市级妇幼保健机构儿童保健服务能力差异逐步缩小,但儿童保健服务设备与人员投入仍不足,科室设置和相关服务的开展需进一步提高。     

Healthcare financing in Syria: satisfaction with the current system and the role of national health insurance--a qualitative study of householders' views

This study aims to identify the satisfaction with the current public health system and health benefit schemes, examine willingness to participate in national health insurance and review expectations and preferences of national health insurance. To this end, qualitative semi-structured interviews were carried out with 19 Syrian householders. Our results show that a need for health reform exists and that Syrian people are willing to support a national health insurance scheme if some key issues are properly addressed. Funding of the scheme is a major concern and should take into account the ability to pay and help the poor. In addition, waiting times should be shortened and sufficient coverage guaranteed. On the whole, the people would support a national health insurance with national pooling and purchasing under a public set-up, but important concerns of such a system regarding corruption and inefficiency were voiced too. Installing a quasi non-governmental organisation as manager of the insurance system under the stewardship of the Ministry of Health could provide a compromise acceptable to the people.