Suchergebnisse

Background: There is growing recognition of the psychosocial burden of caregiving on relative caregivers of the mentally ill in low-and middle-income countries. Yet there remains limited formal research examining the challenges and psychosocial support needs of these relative caregivers, particularly with sensitivity to understanding caregiver experiences across diverse cultures and contexts. The purpose of this study was to study caregiver burden to inform potential intervention approaches among relative caregivers of treatment-engaged mentally ill patients in Cambodia. Methods: Participants were all relative caregivers identified through their connection to a non-governmental organization providing psychiatric care. Five focus group discussions were held with 37 participants to explore challenges experienced by relative caregivers. A total of 115 caregivers then completed a mental health assessment consisting of the Patient Health Questionnaire – 9 item scale, Generalized Anxiety Disorder – 7-item scale, and 21-item Depression, Anxiety, and Stress Scale. Internal consistencies ranged from α = .81 to .87 across scales. Results: Five themes emerged from the focus group discussions: financial burden, erratic behavior of patients, social alienation, somatic and emotional symptoms, and barriers to help-seeking. Assessment data indicated the sample was highly symptomatic. Women and those with no employment appeared to be at higher risk of distress, as were those caregivers with a biological relationship to the patient (parents, children, and siblings; relative to spouses or other relationships). Discussion: Findings suggest a need for regular screening and greater psychosocial support for relative caregivers. It is notable that the needs identified within the current study remain prominent even as this is a treatment-engaged sample.

BACKGROUND: Integrating evidence-based mental health services into primary care has been identified as one strategy for overcoming the treatment gap in low and middle-income countries, yet their uptake into standard practice remains poor. The purpose of this study was to understand stakeholder perspectives regarding barriers and facilitators to integration of mental health services into primary care settings in Northern Iraq. METHODS: Using a convergent mixed methods study design, quantitative and qualitative questionnaires assessed respondent perceptions of implementation factors under the domains of Autonomy, Acceptability, Appropriateness, Feasibility, Penetration/Accessibility, Sustainability, and Organizational Climate. We interviewed four types of stakeholders: clients, providers of mental health services, non-mental health (MH) staff working at the centers, and center directors. Interviews were conducted with clients at the completion of services, and with all other stakeholder groups in the latter half of the first year of program implementation, by Kurdish-speaking interviewer pairs. Qualitative and quantitative data were analyzed separately and merged using qualitative data transformation to quantify frequency of theme and integrate with quantitative findings through woven narrative. RESULTS: 123 clients, 26 providers, 40 non-MH staff, and 12 directors provided data. Positive perceptions of the program's acceptability, appropriateness, feasibility, and positive impacts were reported across all stakeholder levels. Providers reported that the program length (8–12 sessions) was a challenge. Clients described logistical challenges (e.g.: transportation, childcare, home duties); support from family and friends appeared to be critical. Lack of private space, insufficient staffing, and need for greater government support were also important issues. CONCLUSIONS: This mixed methods study is unique in its inclusion of non-MH staff and director perspectives on integration of mental health services in primary care ...

AbstractResearch on adolescence from the Majority World possesses major hidden potential in contributing to global adolescent research and developmental science more broadly. In this commentary, the authors (1) describe the background and the process through which this special issue came into fruition, (2) introduce the emic approaches to study the influences of macro‐contextual variations on developmental science and provide several pertinent examples on the contributions of Majority World research, (3) elaborate on challenges and barriers that Majority World scholars often face in conducting and disseminating their research, and (4) a few actionable steps and recommendations in promoting the representation and inclusion of Majority World research into global developmental science. Only when our field fully integrates findings from all regions of the world will we be able to develop a fundamental scientific representation and understanding of what it means to be an adolescent, how adolescents develop over time, and what tasks or phenomena in adolescent development are truly universal or specific to particular groups, regions, or areas.