Breastfeeding experiences and perspectives among women with postnatal depression: A qualitative evidence synthesis

BackgroundStudies show that postnatal depression affects around 10–16% of women globally. It is associated with earlier cessation of breast feeding, which can negatively impact infants’ long-term development. Mechanisms underpinning associations between mental health and women’s decision to commence and continue to breastfeed are complex and poorly understood.AimThe aim of this review was to investigate breastfeeding experiences, perspectives, and support needs of women with postnatal depression. No previous reviews were identified which had addressed this aim.MethodA systematic search was conducted of six databases to identify relevant qualitative studies. Six included studies were critically appraised and synthesised using thematic synthesis.FindingsFive themes were identified: (1) desire to breastfeed and be a ‘good mother’, (2) struggles with breastfeeding, (3) mixed experiences of support from healthcare professionals, (4) importance of practical and social support, (5) support for mental health and breastfeeding. Most women with postnatal depression expressed strong intentions to breastfeed, although some perceived ‘failure’ to breastfeed triggered their mental health problems. Practical and non-judgemental support for their mental health needs and for successful breastfeeding from healthcare professionals, family and friends are needed.ConclusionMost women with postnatal depression desired to breastfeed but experienced breastfeeding difficulties that could impact on their mental health. By offering women with postnatal depression tailored and timely support, healthcare professionals could help women minimize breastfeeding problems which could consequently impact on their mental well-being and ensure they and their infants have opportunity to benefit from the advantages that breastfeeding offers.     

Analyzing free-text survey responses: An accessible strategy for developing patient-centered programs and program evaluation

Despite widespread availability of yoga in the Veterans Health Administration (VA), it remains unclear how to best evaluate yoga programs. This is particularly problematic for programs aimed at veterans with mental health concerns, as evaluation typically focuses narrowly upon mental health symptom severity, even though program participants may have other health-related priorities. We analyzed responses to free-text questions on 237 surveys completed by veterans with mental health concerns enrolled in a yoga program at six VA clinics in Louisiana to characterize veteran participants’ experiences with yoga. Qualitative analysis resulted in 15 domains reflecting veterans’ individual health-related values and priorities. We use results to illustrate the potential for analysis of free-text responses to reveal valuable insights into patient experiences, demonstrating how these data can inform patient-centered program evaluation. The approach we present is more accessible to those responsible for decision-making about local programs than conventional methods of analyzing qualitive evaluation data.     

幽默言语认知心理机制的关联及整合

集中于幽默言语本质研究的诸多理论在阐释幽默产生和消解的底层认知运作机制时都表现出了一定的局限性,而两大认知理论——关联理论和概念整合理论给言语幽默解读的心理过程提供了较好的认知模型。关联理论认为对幽默言语理解的心理认知机制来自于寻求幽默的认知语境的最佳关联及最大关联性与最佳关联性之间的反差。概念整合理论从心理空间映射的角度解释了幽默言语的解读过程还牵涉到概念合成和层创结构。研究表明,两大理论具有互补性,二者的理论整合可以更好地揭示幽默效应的认知心理机制。     

基于心智模型的恐怖主义袭击扩展式演化博弈分析

政府反恐措施与恐怖分子袭击手段存在着相互观察、适应性演化的过程。本文首先构建了政府作为先行动者、恐怖分子作为后行动者的斯塔克伯格博弈模型,进一步建立了恐怖袭击问题的扩展式演化博弈模型。由于扩展式演化博弈的均衡分析需要考虑代际内和代际间不同层次的信念学习,造成了演化分析的复杂性。本文将"心智模型"概念引入到演化博弈,采取了心智模型演化解的分析方法,得出了简化后的演化均衡解。最后,结合新疆墨玉县6.28暴恐事件进行算例分析,比较怀特流形演化解和心智模型演化解的差异。心智模型演化解的结果表明,根据恐怖分子群体中选择袭击比例是否高于临界值,政府策略收敛到防御或者不防御。该求解方法通过将普遍接受的社会规范引入到演化过程分析,不仅简化了怀特流形的分析过程,而且均衡解展示了更为丰富的、更为切合实际管理问题的演化特征。     

Critical Reflection on the Ethics of Mindfulness

Mindfulness is a way to achieve mental wellbeing that has been widely adopted as part of counselling and mental health treatment. However, there is a distinct lack of critical reflection about the origins of this technique, how it is used, and the implications it has for the beliefs of clients. The purpose of this paper is to provide a carefully considered response to the use of humanistic mindfulness. Social workers need to explain why they recommend mindfulness, and explore culturally consistent and sensitive practice, so that they are abiding by the Australian Association of Social Workers Code of ethics.

IMPLICATIONS

• The use of mindfulness in social work practice requires careful consideration as to its impact and relevance to clients’ needs.

• Mindfulness originates in philosophical traditions distinct from mental health treatment.

• In choosing to use mindfulness social workers require consistent and sensitive understanding of clients’ needs, world views, and culture.

     

Personal reflection and experience of a Fulbright Scholar: teaching a mental health course in Vietnam’s changing culture

This paper documents the experience of developing and teaching a course on mental health for undergraduate social worker students during a semester in Vietnam. Social work is a profession at the early stages of development in Vietnam, requiring much curriculum development. There are over 40 universities with undergraduate social work education programs, but few of the faculty have had training or experience in practicing social work. The paper will summarize the main reasons for developing such a course given the current state of mental health need and services in a changing culture, as well as the current state of professional social work education and the newly established profession of social work. The author describes the contexts underlying the course—the status of social work and social work education in Vietnam, the context of mental health and mental illness in Vietnam, and curriculum adaptation to the cultural context. From this experience, the lessons learned about the role of cross-cultural critical thinking, cultural knowledge, and other strategies will be discussed about teaching a subject like mental health internationally.     

Secularity,religiosity, and health: Physical and mental health differences between atheists,agnostics, and nonaffiliated theists compared to religiously affiliated individuals

Extensive literature in the social and medical sciences link religiosity to positive health outcomes. Conversely it is often assumed that secularity carries negative consequences for health; however, recent research outlining different types of secular individuals complicates this assumption. Using a national sample of American adults, we compare physical and mental health outcomes for atheists, agnostics, religiously nonaffiliated theists, and theistic members of organized religious traditions. Results indicate better physical health outcomes for atheists compared to other secular individuals and members of some religious traditions. Atheists also reported significantly lower levels of psychiatric symptoms (anxiety, paranoia, obsession, and compulsion) compared to both other seculars and members of most religious traditions. In contrast, physical and mental health were significantly worse for nonaffiliated theists compared to other seculars and religious affiliates on most outcomes. These findings highlight the necessity of distinguishing among different types of secular individuals in future research on health.     

What mental health professionals in Israel know and think about adolescent problem gambling

Mental health professionals are well versed in addressing multiple adolescent risky behaviours and play a primary role in the identification of and referral process and service provision for young people who engage in such behaviours. Given their ‘person-in-environment’ approach, training in multi-sectoral collaboration, and awareness of social policies, social workers are especially equipped to provide needed mental health services to young people. The aim of the current study was to examine Israeli mental health professionals’ awareness of and attitudes towards adolescent high-risk behaviours, including gambling. Child psychologists, social workers and school counsellors (N = 273) completed an online survey addressing concerns related to high-risk behaviours. Findings revealed that social workers perceived gambling as being among one of the least concerning adolescent mental health issues and reported feeling the least confident in their abilities to provide services to young people with gambling problems. The results suggest the importance of youth gambling addictions being incorporated into social work training curricula.     

青少年学业压力、父母支持与精神健康

追求学业上的成就,并由此实现社会流动、赢得尊敬和家庭的荣耀是中国文化的传统。但对教育成就的重视也导致儿童承受很大的压力,引发心理和身体的疾病。对上海685名学生学业压力与精神健康的调查证实,学业压力是加剧学生焦虑的风险因素,而父母的情感支持是促进儿童精神健康的保护性因素。因此促进父母对儿童的学习参与是重要的,但要注意时机,动态了解儿童的学习压力状况并提供及时的情感支持,这样有助于儿童的精神健康。