Abstract Background Maternal mental health remains a critical yet insufficiently addressed component of perinatal care in sub-Saharan Africa. In Southern Malawi, where cultural beliefs and traditional healing practices profoundly shape health-seeking behaviour, the intersection of traditional and clinical care presents both challenges and opportunities for improving maternal outcomes. Objective This study investigated the prevalence of perinatal mental health problems and explored the role of traditional healing practices alongside clinical care in supporting maternal mental health in Southern Malawi. Methods A convergent parallel mixed-methods design was employed. Quantitative data were collected from perinatal mothers (n = 330) using the Patient Health Questionnaire-9 (PHQ-9) and the Generalized Anxiety Disorder-7 (GAD-7) scale. Qualitative data were gathered through semi-structured interviews with perinatal mothers, healthcare providers (n = 10), and traditional healers (n = 10). Quantitative data were analysed with SPSS using descriptive statistics; qualitative data were analysed thematically. Results Approximately 35% of perinatal mothers reported moderate-to-severe depressive symptoms (mean PHQ-9 score: 10.5, SD = 4.3), while 30% exhibited moderate-to-severe anxiety (mean GAD-7 score: 9.2, SD = 3.9). Sixty percent of mothers relied on traditional healing methods for mental health concerns, citing cultural familiarity and trust. Forty percent faced barriers to clinical care, including stigma and limited awareness of available services. Qualitative data revealed that traditional healers provided essential emotional support and community cohesion, while healthcare workers reported inadequate training in perinatal mental health assessment. Conclusion The integration of traditional and clinical practices represents a promising strategy for enhancing maternal mental health outcomes in Southern Malawi. Findings highlight the urgent need for structured training of healthcare providers, community-sensitive interventions, and collaborative frameworks that leverage the complementary strengths of both healing systems. These insights are relevant to other low-resource settings across sub-Saharan Africa.
Due to societal developments, adolescents are exposed to stressors from external environments, family dynamics, and other sources, resulting in frequent mental health issues that have garnered widespread societal attention. Current research on Five-Senses Healing Landscape Design for adolescent mental health remains limited. This study aims to optimize Five-Senses Healing Landscape Design tailored to adolescents’ psychological needs, guided by the value orientation of prioritizing mental wellness and promoting well-rounded development. It endeavors to develop a holistic strategy that integrates therapeutic landscapes with mental health-enhancing elements, thereby creating a healing landscape that embodies multisensory experiences and natural ecology. The research seeks to provide supplementary psychological support for adolescent mental health, foster their holistic physical and mental development, and contribute to advancing the national Healthy China Initiative.
Nearly half (47%) of the Low-Income countries and one third (30%) of the Lower-Middle-Income Countries (LMICs) spend less than 1% of their health budget on mental health (1). There are 600 psychiatrists and an equal number of psychologists in Pakistan, serving a population of 250 million. This compares to some high-income countries, such as Canada, which has nearly 5,000 psychiatrists for a population of 41 million, and the United Kingdom, which has 13,000 psychiatrists for a population of 70 million. 80% of the world population living in LMICS has high rates of mental illness and has poor access to mental healthcare (2). So, where do people go to seek help for their emotional and mental health problems?
About two in five children and adolescents will meet the criteria for a mental disorder by age 18, and more than half of youth who are accessing mental health services receive them in an educational setting. Yet there is limited evidence on the effectiveness of school-based interventions on children’s mental health and education outcomes. We examine the effectiveness of two key United States' federally-funded interventions for expanding school-based capacities to improve children’s health and education outcomes—School-Based Health Centers (SBHCs) and Advancing Wellness and Resiliency in Education (AWARE) grants—in a mixed method, longitudinal study of low-income, Tennessee children.We linked health insurance claims data for children enrolled in Tennessee’s Medicaid program with administrative education records for students attending Tennessee public schools between 2006 and 2019. We also implemented a census of Tennessee school districts to determine which had SBHCs and AWARE grants and their start years, and we conducted semi-structured interviews with each treated district to assess their infrastructure, programs, staffing, partnerships, health services offered, and more. We estimated effects of SBHCs and AWARE grants on school-level rates of mental health conditions, behavioral health conditions, preventive health care visits, absences, chronic absences, and disciplinary incidents using a staggered adoption, difference-in-differences (DiD) approach.We found a statistically significant reduction in diagnosed mental health conditions among treated schools of 6 percent relative to their baseline prevalence, which our qualitative findings suggest might be related to increased health staffing in schools, earlier detection of mental health needs, and greater use of prevention strategies. We saw larger effects in some school districts with more extensive mental health infrastructure. We did not satisfy model assumptions for estimating causal effects on preventive health care visits, absences, chronic absences, and disciplinary incidents, although associations were in the expected direction.
François Gonon, Henri Gouraud, André Gillibert
et al.
Scientific institutions, including universities and research centers, occasionally engage in advocacy to gain financial support. However, this can be problematic if they selectively present scientific evidence. We describe a case involving a French semi-public foundation dedicated to clinical research on four adult psychiatric disorders: autism without intellectual disability, treatment-resistant depression, schizophrenia, and bipolar disorder. The foundation has claimed that an initial assessment at any of its Expert Centers led to a 50 % reduction in hospitalization days. We analyzed communication directed at the public in the French press, advocacy efforts towards members of the French Parliament (MFPs), evidence supporting this claim within those activities, and MFPs' initiatives that addressed the foundation's request. However, the reduction in hospitalization originated from a single study of bipolar disorder patients, which lacked a control group and had other methodological flaws. No scientific publications supported similar claims for the other three disorders. On May 2, 2024, 70 members of the French Parliament introduced a bill aimed at integrating these Expert Centers into the healthcare system. Justifications for the bill explicitly cited the 50 % reduction in hospitalization for all four conditions. This case highlights the need for policy makers and journalists to verify the robustness of scientific claims before these become policy. It also emphasizes the responsibility of scientists and journal editors to recognize and mitigate spin in research studies and opinion articles and to develop tools that help evaluate advocacy and lobbying claims in scientific contexts.
As the number of psychiatric hospitals are on the rise in China, this article examines how the psychiatric discourse as articulated by hospital staff interacts with local cultural understandings of madness/mental illness, as well as how such interactions impact patients and families’ reception of psychiatry. Data comes from 16 months of fieldwork in a psychiatric hospital in South China. We show that psychiatric professionals at the hospital attempted to establish their professional authority by discrediting other cultural epistemologies embraced by patients or families, such as religious and traditional Chinese medical understandings. Despite the quick effect of psychopharmaceuticals to control symptoms, the psychiatric perspective ultimately fell short in addressing the social and moral struggles faced by patients, such as patriarchy and gender-based violence. Moreover, as psychiatric professionals unreflexively used certain problematic local concepts to convey a biomedical and even genetically-determined account of mental illness to patients and families, they risked entrenching the stigma of mental illness and disempowering their clients. To improve the quality of mental healthcare, to make clients feel culturally safe and respected in clinical encounters, psychiatric professionals in China should develop a more holistic approach that takes into account the biological, psychological, and sociocultural aspects of mental illness, that recognizes the diverse sources of help clients may rely on. They should also develop a critical awareness of the language they use and of the power dynamics in which they and their clients are situated.
Objective Surgical complications may affect patients psychologically due to challenges such as prolonged recovery or long-lasting disability. Psychological distress could further delay patients’ recovery as stress delays wound healing and compromises immunity. This review investigates whether surgical complications adversely affect patients’ postoperative well-being and the duration of this impact. Methods The primary data sources were ‘PsychINFO’, ‘EMBASE’ and ‘MEDLINE’ through OvidSP (year 2000 to May 2012). The reference lists of eligible articles were also reviewed. Studies were eligible if they measured the association of complications after major surgery from 4 surgical specialties (ie, cardiac, thoracic, gastrointestinal and vascular) with adult patients’ postoperative psychosocial outcomes using validated tools or psychological assessment. 13 605 articles were identified. 2 researchers independently extracted information from the included articles on study aims, participants’ characteristics, study design, surgical procedures, surgical complications, psychosocial outcomes and findings. The studies were synthesised narratively (ie, using text). Supplementary meta-analyses of the impact of surgical complications on psychosocial outcomes were also conducted. Results 50 studies were included in the narrative synthesis. Two-thirds of the studies found that patients who suffered surgical complications had significantly worse postoperative psychosocial outcomes even after controlling for preoperative psychosocial outcomes, clinical and demographic factors. Half of the studies with significant findings reported significant adverse effects of complications on patient psychosocial outcomes at 12 months (or more) postsurgery. 3 supplementary meta-analyses were completed, 1 on anxiety (including 2 studies) and 2 on physical and mental quality of life (including 3 studies). The latter indicated statistically significantly lower physical and mental quality of life (p<0.001) for patients who suffered surgical complications. Conclusions Surgical complications appear to be a significant and often long-term predictor of patient postoperative psychosocial outcomes. The results highlight the importance of attending to patients’ psychological needs in the aftermath of surgical complications.
Víctor Pedrero Castillo, Aracelis Calzadilla-Núñez, Claudia Moya-Ahumada
et al.
ABSTRACT Objective To evaluate the psychometric properties of the Jefferson Medical Empathy Scale, Spanish version (JSE-S), its factorial structure, reliability, and the presence of invariance between genders in the behavior of empathy levels among Chilean nursing students. Method Instrumental research design. The JSE-S was applied to 1,320 nursing students. A confirmatory factor analysis was used. An invariance study between genders was carried out. Descriptive statistics were estimated. Between genders, Student’s T distribution was applied alongside a homoscedasticity analysis. The level of significance was α ≤ 0.05. Results The confirmatory factor analysis determined the existence of three dimensions in the matrix. The statistical results of the invariance tests were significant, and allowed comparison between genders. Differences were found between mean empathy values, as well as in some of its dimensions between genders. Conclusion The factor structure of empathy data and its dimensions is in correspondence with the underlying three-dimensional model. There are differences in empathy levels and their dimensions between genders, with the exception of the compassionate care dimension, which was distributed similarly. Women were more empathetic than men.
Carla Patrícia de Almeida Santos Canuto, Luciane Paula Batista Araujo de Oliveira, Marília Rute de Souto Medeiros
et al.
RESUMO Objetivo Identificar o risco de quedas em idosos em um hospital da região do Trairi, no Rio Grande do Norte; descrever a relação entre risco de quedas e as características sociodemográficas dos participantes. Método Estudo descritivo, transversal, quantitativo, realizado em um hospital regional, respeitando os princípios éticos vigentes. Para a coleta, ocorrida em julho e agosto de 2018, foi adotada a Escala de Morse, adaptada com questões sociodemográficas. Realizada análise estatística descritiva e inferencial. Resultados O estudo teve 46 participantes, dos quais a maioria era formada por mulheres, com baixa escolaridade e os motivos de internação mais frequentes foram tratamento cirúrgico e doença pulmonar. Mais da metade apresentou risco alto de sofrer quedas (54,35%), seguido de moderado (32,61%) e baixo (13,04%). Houve associação entre risco alto de quedas, ter doença pulmonar como motivo de internação e diabetes como comorbidade. O risco alto de quedas foi menos frequente entre idosos internados para tratamento cirúrgico. Conclusão O risco alto para quedas foi encontrado em mais da metade dos idosos, o que variou de acordo com o motivo de internação e comorbidades, sendo mais frequentes naqueles internados por doença pulmonar e que apresentavam Diabetes.
Huana Carolina Cândido Morais, Nathalia Costa Gonzaga, Priscila de Souza Aquino
et al.
OBJECTIVE To analyze strategies for self-management support by patients with stroke in the light of the methodology of the five A's (ask, advice, assess, assist and arrange). METHODS Integrative review conducted at the following databases CINAHL, SCOPUS, PubMed, Cochrane and LILACS. RESULTS A total of 43 studies published between 2000 and 2013 comprised the study sample. All proposed actions in the five A's methodology and others were included. We highlight the Assist and Arrange, in which we added actions, especially with regard to the use of technological resources and joint monitoring between patients, families and professionals. No study included all five A's, which suggests that the actions of supported self-management are developed in a fragmented way. CONCLUSION The use of five A's strategy provides guidelines for better management of patients with stroke with lower cost and higher effectiveness.
Luciana Gomes Furtado Nogueira, Maria Miriam Lima da Nóbrega
OBJECTIVE To construct statements of nursing diagnoses related to nursing practice for individuals with diabetes in Specialized Care, on the basis of the Database of Nursing Practice Terms related to diabetes, in the International Classification for Nursing Practice (ICNP®) and in the Theory of Basic Human Needs and to validate them with specialist nurses in the area. METHOD Methodological research, structured into sequential stages of construction, cross-mapping, validation and categorization of nursing diagnoses. RESULTS A list was indicated of 115 statements of diagnostic, including positive, negative and improvement statements; 59 nursing diagnoses present in and 56 nursing diagnoses absent from the ICNP® Version 2011. 66 diagnoses with CVI ≥ 0.50 were validated, being categorized on the basis of human needs. CONCLUSION It was observed that the use of the ICNP® 2011 favored the specifications of the concepts of professional practice in care with individuals with diabetes.
OBJECTIVE To evaluate the efficacy of Calendula officinalis in relation to Essential Fatty Acids for the prevention and treatment of radiodermatitis. METHOD This is a randomized double-blind controlled clinical trial with 51 patients with head and neck cancer in radiotherapy treatment divided into two groups: control (27) and experimental (24). RESULTS There is statistically significant evidence (p-value = 0.0120) that the proportion of radiodermatitis grade 2 in Essential Fatty Acids group is higher than Calendula group. Through the Kaplan-Meier survival curve we observed that Essential Fatty Acids group has always remained below the Calendula group survival curve, due to the lower risk of developing radiodermatitis grade 1, which makes the usage of Calendula more effective, with statistical significance (p-value = 0.00402). CONCLUSION Calendula showed better therapeutic response than the Essential Fatty Acids in the prevention and treatment of radiodermatitis. Brazilian Registry of Clinical Trials: RBR-237v4b.
PurposePatient‐defined spiritual aspects of mental health care are an understudied and potentially important aspect to non‐pharmaceutical treatments. A review of this area will lead to improved rigorous research and better patient outcomes. The purpose of this paper is to examine the public health implications of spiritual healing practice, in conditions such as depression.Design/methodology/approachThe current research into spiritual healing was reviewed, and in particular its use in depression. Scientific and anecdotal evidence was considered, and areas of improvement were identified.FindingsThe attitudes of physicians and patients may affect the efficacy of patient‐defined spiritual healing, which is currently lacking in rigorous academic research. A better scientific understanding may aid in a cost‐benefit analysis of such treatments in the future.Originality/valueThis paper should aid those involved in public health‐care planning or who practice psychotherapeutic methods to ensure they utilise all possible methods, whilst working within a rigorous evidence‐based framework.
Daiane Porto Gautério, Silvana Sidney Costa Santos, Marlene Teda Pelzer
et al.
Os objetivos deste estudo foram caracterizar os idosos residentes em uma Instituição de Longa Permanência quanto ao uso de medicamentos e verificar a existência de polifarmácia. Trata-se de estudo descritivo e quantitativo, realizado por meio de dados de um banco originado da pesquisa Perfil de idosos residentes numa Instituição de Longa Permanência para Idosos (ILPIs): proposta de ação de enfermagem/saúde. Foram selecionados 39 idosos que faziam uso de medicação. Os achados evidenciaram predominância de mulheres, com idade entre 80 e 89 anos, que sabem ler e são viúvas. As doenças do aparelho circulatório foram as mais frequentes. Os idosos usavam em média 3,7 medicamentos e 30,8% deles utilizavam polifarmácia. Os medicamentos mais usados foram para as intercorrências do sistema cardiovascular. Verificou-se a presença de medicamentos considerados impróprios para idosos. Espera-se sensibilizar os profissionais de saúde a promoverem o uso racional e cuidadoso de medicamentos para os idosos institucionalizados.
Suely Itsuko Ciosak, Elizabeth Braz, Maria Fernanda Baeta Neves A. Costa
et al.
A senescência e a senilidade são temas cada vez mais explorados, considerando o crescente aumento da população idosa no mundo, principalmente no Brasil. A assistência ao idoso deve prezar pela manutenção da qualidade de vida, considerando o processo de perdas próprias do envelhecimento e as possibilidades de prevenção, manutenção e reabilitação do seu estado de saúde. Conhecer o cotidiano dos idosos tem sido um desafio para os profissionais de saúde para implementar programas e ações que visem alcançar a manutenção do equilíbrio no processo saúde-doença, e é nessa busca que temos envidado esforços para contribuir, de forma efetiva, nas estratégias de fortalecimento dos idosos e seus familiares, de forma a tornar possível o desencadeamento de ações na promoção da saúde, principalmente considerando que o desafio para este milênio é construir uma consciência coletiva para alcançar uma sociedade para todas as idades, com justiça e garantia plena de direitos.