The need for improved emotional support: A pilot online survey of Australian women’s access to healthcare services and support at the time of miscarriage

ProblemWomen need improved emotional support from healthcare professionals following miscarriage.BackgroundSignificant psychological morbidity can result following miscarriage and may be exacerbated by poor support experiences. Women frequently report high levels of dissatisfaction with healthcare support at this time.AimThis study was developed to pilot a survey aimed at exploring women’s access to healthcare services and support at the time of miscarriage.MethodsWomen over 18 years, residing in Australia, who had experienced a miscarriage in the past two years completed a 29-item online survey.FindingsA total of 399 women completed the survey. Two key findings arose: 1) More than half of women (59%) were not offered any information about miscarriage or pregnancy loss support organisations or referral/access to counselling services at the time of miscarriage, despite almost all reporting they would have liked various forms of support from items listed 2) More than half (57%) did not receive follow up care, or emotional support at this time, beyond being asked how they were coping emotionally. Other findings showed 3) Women accessed various healthcare services at the time of miscarriage and 4) Women often saw a general practitioner at the time of miscarriage despite having a private obstetrician.ConclusionThere is clear mismatch between the support women want at the time of miscarriage and the care they receive from healthcare professionals. Despite considerable structural barriers, it seems likely there is scope within healthcare professionals’ usual practice for improved support care through simple measures such as increased acknowledgement, information provision and referral to existing support services.     

Smoking cessation care during pregnancy: A qualitative exploration of midwives’ challenging role

ProblemThe majority of South Australian pregnant women who smoke do not quit during pregnancy. Additionally, the prevalence of smoking is higher among pregnant women living in socially disadvantaged areas.BackgroundUnderstanding challenges in midwives’ provision of smoking cessation care can elucidate opportunities to facilitate women’s smoking cessation.AimWe aimed to understand midwives’ perspectives on current practices, perceived barriers and facilitators to delivery of smoking cessation care, and potential improvements to models of smoking cessation care.MethodsAn exploratory qualitative research methodology and thematic analysis was used to understand the perspectives of midwives in five focus groups.FindingsFour themes were generated from the data on how midwives perceived their ability to provide smoking cessation care: Tensions between providing smoking cessation care and maternal care; Organisational barriers in the delivery of smoking cessation care; Scepticism and doubt in the provision of smoking cessation care; and Opportunities to enable midwives’ ability to provide smoking cessation care.DiscussionA combination of interpersonal, organisational and individual barriers impeded on midwives’ capacities to approach, follow-up and prioritise smoking cessation care. Working with women living with disadvantage and high rates of smoking, the midwife’s role was challenging as it balanced delivering smoking cessation care without jeopardising antenatal care.ConclusionProviding midwives with resources and skills may alleviate the sense of futility that surrounds smoking cessation care. Provision of routine training and education could also improve understandings of the current practice guidelines.     

Capitalizing the Crisis? Explanatory Factors for the Design of Short‐time Work across Organisation for Economic Co‐operation and Development Countries

This article looks at the financial and economic crisis 2008–10 in 18 Organisation for Economic Co‐operation and Development states and seeks to investigate explanatory paths for the subsidization of further education within short‐time work programmes. Several hypotheses are put to the test: first, a classical partisan difference argument; second, a varieties of capitalism approach proposing a successful joint rallying of employers and employees for subsidization in coordinated market economies; and, lastly, the merged hypothesis that right‐wing parties in a coordinated economic context might subsidize feeling the pressure to overcompensate an ‘issue ownership’ of left parties in the field of employee‐friendly policies. We identify four explanatory paths: coordinated economies in the sample subsidized when they were economically closed or highly indebted. The results also support our combined hypothesis, that New Zealand – a left‐governed liberal market economy – and right‐governed coordinated market economies of the non‐Scandinavian type subsidized.     

On the historical determinants of third sector strength: A qualitative comparative analysis

This study proposes a theoretical explanation for the main causes of the third sector's strength. A Boolean comparative analysis based mainly on the theoretical frameworks of Rokkan and Esping-Andersen indicates that the combination of state-supported urban interests and Protestantism are necessary conditions. This result is very close to Max Weber's explanation of civil society which presupposes the facilitating role of the autonomous state. Thus, the empirical results are reinterpreted within the context of a Weberian explanatory framework. The implications of this endeavor within the historical context of developing countries are further explicated.     

The voice of troubled youth: Children's and adolescents' ideas on helpful elements of care

This article presents the findings of a qualitative study in a Flemish centre for children and adolescents with emotional and behavioural disorders. The aim of this study was twofold. First, we wanted to examine how youth reflect on their own behaviour and that of their peers'. Secondly, we wanted to know what, according to the youth, are the most significant helpful elements of treatment. Analysis shows a continuum of negative behaviour, ranging from relatively ‘normal’ disruptive behaviour such as arguing, up to serious disruptive behaviour such as physical aggression. This behaviour has a negative influence on the climate of the organization. ‘Availability of staff’, ‘nearness of staff’, ‘a clear set of rules and boundaries’, and ‘some time on my own/some alone time’ are perceived as helpful elements of treatment. ‘Strictness’, ‘not listening’, and ‘inappropriate staff attitudes and interventions’ are perceived as counterproductive elements of treatment. Results are discussed and recommendations both on the orthopedagogical as well as on the scientific level are formulated.     

Support for basic psychological needs in the context of HIV disclosure for older youth

Purpose

This study utilized Self-Determination Theory's sub-theory Basic Needs Theory (Deci & Ryan, 2000) to understand older youths' perceptions of support for their basic needs of autonomy, relatedness, and competence in the context of disclosing their HIV status.

Methods

Semi-structured interviews lasting 10–60 min each were conducted with nine youth aged 17–19 (4 women and 5 men) and two adult staff at a one-week residential program in a large southern city. Participant observations of disclosure-related conversations and experiences were conducted and recorded throughout the program. Reliability and validity assurances were met in multiple ways. Analysis of the content of interviews and observations indicated consistent themes that converged on the research questions.

Results

When participants perceived more support for their basic psychological needs for autonomy, relatedness, and competence, they reported more self-determined motivation to disclose their status and better satisfaction with their decisions. The results of this study indicate that Basic Needs Theory is useful for understanding how the basic psychological needs of autonomy, relatedness, and competence are satisfied or thwarted in the context of HIV disclosure for older youth.

Conclusions

Programs and people working with older youth with HIV/AIDS can use BNT to help youth identify, create, and adapt contexts to be supportive of their basic needs for autonomy, relatedness, and competence, and provide guidance and support accordingly. Providers can utilize this information to support youth in strategizing about their disclosure decisions and goals for their well-being.     

Engaging Students in Social Work Research Education

This article discusses existing issues in social work research education. It includes challenges to delivering research education at the MSW level such as student anxiety and disinterest, and incorporates an exploration of post graduation interest in research. The authors recommend that professors increase the emphasis on practical applications of research and encourage students to disseminate research results via publication. The article concludes with the implications of encouraging student research within the social work profession.     

Messages to Social Work Education: What Makes Social Workers Continue and Cope in Child Welfare?

This article examines the positive elements which make social workers continue their career with a focus on statutory child welfare. Such analysis is needed, as existing research tends to highlight stress, exhaustion and career break-up issues. The empirical data consist of focus groups of 28 social workers and a questionnaire addressed to 56 professionals in child welfare in two Finnish urban municipalities. The focus groups were targeted at novice, expert and veteran social workers. The analysis presents organisational, person-related and client-work-related positive elements from the point of view of social workers. The results highlight that social work in child welfare may be experienced as being rewarding and professionally challenging. The positive elements vary among novice, expert and veteran social workers, with the latter especially viewing their work as independent expert work with major opportunities to make a change in children's lives. Commitment to care of children is one of the key motivating factors. The study suggests that social work education should recognise that the subjective motivation to do social work may change during one's career and that social work may be simultaneously both stressful and rewarding. Students should learn how to balance these aspects of their work.