Whether and how people reach care.
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226 to 250 of 2,047Delayed emergency healthcare seeking behaviour by Dutch emergency department visitors during the first COVID-19 wave: a mixed methods retrospective observational study.
Background: Emergency department (ED) visits due to non-coronavirus disease 2019 (COVID-19) conditions have drastically decreased since the outbreak of the COVID-19 pandemic. This study aimed to identify the magnitude, characteristics and underlying motivations of ED visitors with delayed healthcare seeking behaviour during the first wave of the pandemic.
Methods: Between March 9 and July 92,020, adults visiting the ED of an academic hospital in the East of the Netherlands received an online questionnaire to collect self-reported data on delay in seeking emergency care and subsequent motivations for this delay. Telephone interviews were held with a subsample of respondents to better understand the motivations for delay as described in the questionnaire. Quantitative data were analysed using descriptive statistics. Qualitative data were thematically analysed.
Results: One thousand three h…
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Understanding factors influencing care seeking for sick children in Ebonyi and Kogi States, Nigeria.
Background: Nigeria has one of the highest child mortality rates in the world, with an estimated 750,000 deaths annually among children under age five. The majority of these deaths are due to pneumonia, malaria, or diarrhea. Many parents do not seek sick-child care from trained, biomedical providers, contributing to this high rate of mortality.
Methods: This qualitative study explores factors enabling or preventing parents from seeking care for sick under-five children in Nigeria's Kogi and Ebonyi states, including gender-related roles and social norms. Interviews were conducted with parents of sick under-five children and service providers, and focus group discussions were held with community leaders to assess how care-seeking behavior was influenced by four modes from the Colvin et al. conceptual framework for household decision-making and pathways to care. These include (1) caregivers…
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The relationship between parent attitudes about childhood vaccines survey scores and future child immunization status: a validation study.
Importance: Acceptance of childhood vaccinations is waning, amplifying interest in developing and testing interventions that address parental barriers to immunization acceptance.
Objective: To determine the predictive validity and test-retest reliability of the Parent Attitudes About Childhood Vaccines survey (PACV), a recently developed measure of vaccine hesitancy.
Design, setting, and participants: Prospective cohort of English-speaking parents of children aged 2 months and born from July 10 through December 10, 2010, who belonged to an integrated health care delivery system based in Seattle and who returned a completed baseline PACV. Parents who completed a follow-up survey 8 weeks later were included in the reliability analysis. Parents who remained continuous members in the delivery system until their child was 19 months old were included in the validity analysis.
Exposure: The PAC…
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Perceptions of barriers to physical health care for people with serious mental illness: a review of the international literature.
Premature death and poorer access to quality care for physical health concerns is common for people diagnosed with serious mental illness (SMI). However, there is lack of clarity regarding the nature of barriers encountered at different points in the physical health care process, and the level of consistency of these barriers both among countries, and between consumers with SMI and health care staff. The current narrative review integrates views of consumers and health care staff on barriers to physical health care. It involved a search of CINAHL, Proquest, and Web of Science, for peer-reviewed papers published between 2005 and June 2012, for studies of perceptions of barriers to physical health care, published in English. Despite variations in health care systems among countries, there is agreement between consumers and health care staff that division between physical and mental health …
matched on Health Services Accessibility (mesh), Attitude to Health (mesh)
Cancer patients' desire for psychological support: prevalence and implications for screening patients' psychological needs.
Objectives: To investigate cancer patients' desire for psychological support and to identify patients' sociodemographic, disease-related and psychological factors associated with this desire.
Methods: The study is part of a multicenter, cross-sectional study assessing cancer patients' needs and desire for psychological support. Patients completed the Hospital Anxiety and Depression Scale, the Ways of Coping Checklist, the Cancer Rehabilitation Evaluation System and reported their desire for psychological support.
Results: Among the 381 included patients, women (26%) desired psychological support significantly more often than men (11%) (p<0.001). Patients' desire for psychological support was associated with being younger (OR=0.94; p<0.001 for women and OR=0.93; p=0.007 for men) and having a support-seeking coping (OR=1.10; p=0.010 for women and OR=1.36; p=0.003 for men). Other contextual…
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Mojtabai R (2010)cohort or longitudinalMEDLINE-indexed journal, not yet read by usSocial psychiatry and psychiatric epidemiology95 citations Mental illness stigma and willingness to seek mental health care in the European Union.
Objective: It is often assumed that individual stigmatizing attitudes toward the mentally ill are linked to stigmatizing attitudes in the social milieu and that both, individual and social stigmatizing attitudes are major barriers to mental health treatment seeking. This study aims to examine these assumptions.
Method: Data from the 2005-2006 Eurobarometer general population survey (N = 29,248) are used to examine the association of social stigmatizing attitudes assessed in a random half of the sample with individual stigmatizing attitudes assessed in the other half of the sample, and to examine the association of both individual and social stigmatizing attitudes with willingness to seek professional help.
Results: Social stigmatizing attitudes are specifically and strongly associated with individual stigmatizing attitudes. Both social and individual stigmatizing attitudes are associated…
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The course of untreated anxiety and depression, and determinants of poor one-year outcome: a one-year cohort study.
Background: Little is known about the course and outcome of untreated anxiety and depression in patients with and without a self-perceived need for care. The aim of the present study was to examine the one-year course of untreated anxiety and depression, and to determine predictors of a poor outcome.
Method: Baseline and one-year follow-up data were used of 594 primary care patients with current anxiety or depressive disorders at baseline (established by the Composite Interview Diagnostic Instrument (CIDI)), from the Netherlands Study of Depression and Anxiety (NESDA). Receipt of and need for care were assessed by the Perceived Need for Care Questionnaire (PNCQ).
Results: In depression, treated and untreated patients with a perceived treatment need showed more rapid symptom decline but greater symptom severity at follow-up than untreated patients without a self-perceived mental problem o…
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The journey from self-care to GP care: a qualitative interview study of women presenting with symptoms of urinary tract infection.
Background: Urinary tract infection (UTI) is one of the commonest acute infections presenting to primary care. Little is known of women's experiences of UTI; self-care strategies and key triggers for their consulting behaviour are also little known.
Aim: To explore women's experiences of self-care and their journey to GP care, when faced with symptoms of a UTI.
Design of study: Qualitative semi-structured interview study with women recruited to a larger UK trial of different management strategies for UTI.
Setting: General practices across four counties in southern England.
Method: Twenty-one women were interviewed about the experiences they had prior to their GP visit, self-care strategies, and triggers for help seeking. Interviews were analysed thematically, using principles of analytic induction.
Results: Women reported a process of evaluation, monitoring, re-evaluation, and, finally, …
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Male involvement in antenatal HIV counseling and testing: exploring men's perceptions in rural Malawi.
Antenatal care can act as an excellent tool to improve access to HIV counseling and testing services. This paper investigates an issue that may weaken its potential, namely lack of male involvement. We explored married men's perceptions of HIV in pregnancy and male involvement in antenatal HIV testing and counseling in Southern Malawi through 11 focus group discussions and a cross-sectional survey (n=388). The main findings were that men were largely unaware of available antenatal HIV testing and counseling services, and perceived it overall problematic to attend female-oriented health care. Most men supported provision of antenatal HIV testing. They perceived husbands to participate in the process indirectly through spousal communication, being faithful during pregnancy, and supporting the wife if found HIV-positive. Involvement of husbands was compromised by men's reluctance to learn t…
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The association between perceived discrimination and underutilization of needed medical and mental health care in a multi-ethnic community sample.
This study examines the association between perceived discrimination and underutilization of needed medical and mental health care, in a representative, multi-ethnic community sample. Data were derived from a cross sectional survey of 10,098 White, U.S.-born Black, African-born Black, American Indian, Hispanic, and Southeast Asian adults in Hennepin County, Minnesota. Even after controlling for socio-demographic characteristics, health care access, and physical and mental health, perceived discrimination was associated with underutilization of medical care among Whites, U.S.-born Blacks, and American Indians and was associated with underutilization of mental health care among Whites, U.S.-born Blacks, Southeast Asians, and American Indians. Correlates of different types of discrimination (major, everyday, health care) on underutilization of care varied among ethnic groups. The higher pre…
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Azaiza F, Cohen M (2006)cohort or longitudinalMEDLINE-indexed journal, not yet read by usJournal of women's health (2002)90 citations Health beliefs and rates of breast cancer screening among Arab women.
Objectives: To examine the relationship between health beliefs and participation in breast cancer screening among Arab women in Israel.
Methods: A random sample of 568 Arab women, aged 20-60, belonging to three religious groups, Muslim, Christian, and Druze, was recruited. Participants answered a telephone questionnaire regarding attendance for mammography screening and clinical breast examination (CBE) and health beliefs.
Results: Christian women had undergone more mammography screening and CBE than Druze and Muslim women. They perceived more benefits and fewer barriers to screening practices and had greater perception of the severity of breast cancer. Perception of susceptibility was similar across groups. The barriers that were significant for the Druze and Muslim women were feelings of discomfort and embarrassment, the belief that there was no cure in the case of a positive finding, …
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Psychological "resilience" and its correlates in chronic pain: findings from a national community sample.
The display of effective functioning despite exposure to stressful circumstances and/or internal distress is often termed 'resilience'. The study of resilience is believed to provide information about the nature of illness adaptation that is distinct from that obtained via the analysis of clinically impaired groups. In recent years, the concept of resilience has seen only limited exploration in the chronic pain literature. This article describes a multi-step procedure that first identifies resilience among chronic pain sufferers selected from a national sample of adults and then examines a set of its psychological correlates. Using the Profile of Chronic Pain:Screen (PCP:S), administered to a national sample of adults with chronic pain, a resilient subsample was identified on the basis of high scores on a Severity scale (at least 1 SD above the mean) combined with low scores (at least 1 …
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Barriers and facilitators affecting treatment uptake behaviours for patients with eating disorders: A systematic review synthesising patient, caregiver and clinician perspectives.
Objective: A significant treatment gap exists between persons affected by eating disorders (ED), and those engaging with treatment services. This systematic review aims to provide a thorough understanding of the barriers and facilitators affecting eating disorder treatment engagement, including a synthesis of the perspectives of patients, caregivers and healthcare professionals.
Method: This systematic review was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Studies were retrieved from three databases (PubMed, PsycInfo, Web of Science) and were screened and assessed independently by two raters. A thematic analysis was completed to determine the key barriers and facilitators reported by the included studies.
Results: A total of 73 studies were included. From these studies, 12 barriers and 13 facilitators were identified. Patients…
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Waiting-list interventions for children and young people using child and adolescent mental health services: a systematic review.
Question: Children and young people experience delays in assessment and/or treatment within mental health services. The objective of this systematic review, funded by the Emerging Minds Network, was to explore the current evidence base for mental health waiting list interventions to support children and young people.
Study selection and analysis: A literature search was conducted in MEDLINE, PsycINFO, Web of Science and the Cochrane databases from 2000 to 2023 (last searched October 2023). Included studies described interventions to support children and young people and/or their family while on a waiting list for child and adolescent mental health services. Titles and abstracts were screened independently by two reviewers, data were extracted by one reviewer, confirmed by a second and a narrative synthesis was provided.
Findings: Eighteen studies including 1253 children and young people …
matched on Mental Health Services (mesh)
Review: Can digital mental health interventions bridge the 'digital divide' for socioeconomically and digitally marginalised youth? A systematic review.
Background: Digital mental health interventions (DMHIs) have the potential to improve the efficiency, accessibility and effectiveness of mental health services for young people, with the potential to reach socioeconomically and digitally marginalised young people with mental health needs who would otherwise not seek help in person. This review aims to investigate the characteristics, acceptability and efficacy of DMHIs specifically developed for socioeconomically and digitally marginalised youth.
Method: Key databases were searched widely and systematically (EMBASE, MEDLINE, PsycINFO, OpenGrey). Final inclusion in this review required studies to evaluate DMHIs specifically targeting socioeconomically and digitally marginalised children and young people through a broad range of research designs.
Results: Ten studies, describing seven DHMIs, were included in this review. Studies varied in …
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How effective is group intervention in the treatment for unaccompanied and accompanied refugee minors with mental health difficulties: A systematic review.
Background: Unaccompanied refugee minors (URM) are at significantly higher risk of trauma exposure and mental illness. Research examining the most effective treatments for this population is limited.
Aims: To study the available research evidence on outcomes from various group interventions in this population. The objective is to investigate if these can be used clinically in future interventions.
Methods: Systematic review was carried out for patient outcomes where group therapy was used as treatment in URM. Studies with ARM (Accompanied refugee minors) were included because of similarities between these groups and because many studies were mixed population.
Results: Seventeen papers met eligibility criteria with a total of N = 1,119 participants. About 80% studies with a quantitative component reported improvements, and 69% of the studies that carried out statistical analyses reported …
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Review: Unaccompanied refugee minors' perception of mental health services and professionals: a systematic review of qualitative studies.
Background: Unaccompanied refugee minors (URMs) are a population at risk of mental health problems and a population with whom the therapeutic alliance can be difficult to set up. The therapeutic alliance's quality can impact the result and effectiveness of psychotherapeutic interventions. The aim of the present study was to gather URMs' points of view about mental health services and mental health professionals (MHP) in the host country. A summary of interviews conducted with URMs will allow a better understanding of their perception and expectations.
Methods: Seven databases were searched with English and French keywords. In the end, nine studies were selected.
Results: The review of the interviews shows that URMs do not have a clear perception of MHP - it seems difficult for them to trust MHP, but also to understand the value of sharing past painful experiences to reduce current sympto…
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Digital health interventions for improving mental health outcomes and wellbeing for youth with type 1 diabetes: A systematic review.
Digital health interventions are a promising alternative to face-to-face psychosocial interventions that may improve psychological outcomes in youth with diabetes. Several reviews have explored the efficacy of digital health interventions for adults and youth with some chronic health conditions; however, their efficacy among youth with type 1 diabetes is not known. This systematic review aims to assess digital health interventions targeting both psychological and physical health outcomes in youth with type 1 diabetes as well as to evaluate study quality and efficacy, and provide directions for future research in this area. Relevant studies were identified through searches conducted in MEDLINE, Embase, APA PsycInfo, Scopus, Cochrane Central, and CINAHL Plus up until February 2021. Studies were included if they were randomized; reported at least one psychological outcome that was assessed …
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Implementation of peer support in mental health services: A systematic review of the literature.
Peer support within mental health services has a growing evidence base and aligns with current policies of recovery-oriented care. Despite these advantages, widespread implementation of peer support remains limited, likely due to various methodological and implementation issues. Researchers have noted the importance of utilizing an implementation framework to understand best practices for implementation. Therefore, the purpose of the current study was to synthesize the existing literature on the implementation of peer support interventions and identify barriers and facilitators using an implementation framework. The Consolidated Framework for Implementation Research (CFIR) was used to organize the literature obtained in the systematic search and synthesize best practices for implementation. The systematic search identified 19 published articles that were coded for relevant information in…
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Yue JL, Yan W, Sun YK, Yuan K, Su SZ, Han Y, Ravindran AV, Kosten T, Everall I, Davey CG, Bullmore E, Kawakami N, Barbui C, Thornicroft G, Lund C, Lin X, Liu L, Shi L, Shi J, Ran MS, Bao YP, Lu L (2020)systematic reviewMEDLINE-indexed journal, not yet read by usPsychological medicine45 citations Mental health services for infectious disease outbreaks including COVID-19: a rapid systematic review.
The upsurge in the number of people affected by the COVID-19 is likely to lead to increased rates of emotional trauma and mental illnesses. This article systematically reviewed the available data on the benefits of interventions to reduce adverse mental health sequelae of infectious disease outbreaks, and to offer guidance for mental health service responses to infectious disease pandemic. PubMed, Web of Science, Embase, PsycINFO, WHO Global Research Database on infectious disease, and the preprint server medRxiv were searched. Of 4278 reports identified, 32 were included in this review. Most articles of psychological interventions were implemented to address the impact of COVID-19 pandemic, followed by Ebola, SARS, and MERS for multiple vulnerable populations. Increasing mental health literacy of the public is vital to prevent the mental health crisis under the COVID-19 pandemic. Group-…
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Ibrahim N, Thompson D, Nixdorf R, Kalha J, Mpango R, Moran G, Mueller-Stierlin A, Ryan G, Mahlke C, Shamba D, Puschner B, Repper J, Slade M (2020)systematic reviewMEDLINE-indexed journal, not yet read by usSocial psychiatry and psychiatric epidemiology139 citations A systematic review of influences on implementation of peer support work for adults with mental health problems.
Purpose: The evidence base for peer support work in mental health is established, yet implementation remains a challenge. The aim of this systematic review was to identify influences which facilitate or are barriers to implementation of mental health peer support work.
Methods: Data sources comprised online databases (n = 11), journal table of contents (n = 2), conference proceedings (n = 18), peer support websites (n = 2), expert consultation (n = 38) and forward and backward citation tracking. Publications were included if they reported on implementation facilitators or barriers for formal face-to-face peer support work with adults with a mental health problem, and were available in English, French, German, Hebrew, Luganda, Spanish or Swahili. Data were analysed using narrative synthesis. A six-site international survey [Germany (2 sites), India, Israel, Tanzania, Uganda] using a measu…
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The effectiveness of interventions for reducing subjective and objective social isolation among people with mental health problems: a systematic review.
Purpose: Subjective and objective social isolation are important factors contributing to both physical and mental health problems, including premature mortality and depression. This systematic review evaluated the current evidence for the effectiveness of interventions to improve subjective and/or objective social isolation for people with mental health problems. Primary outcomes of interest included loneliness, perceived social support, and objective social isolation.
Methods: Three databases were searched for relevant randomised controlled trials (RCTs). Studies were included if they evaluated interventions for people with mental health problems and had objective and/or subjective social isolation (including loneliness) as their primary outcome, or as one of a number of outcomes with none identified as primary.
Results: In total, 30 RCTs met the review's inclusion criteria: 15 included…
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Mitra R, Hodes M (2019)systematic reviewMEDLINE-indexed journal, not yet read by usChild: care, health and development32 citations Prevention of psychological distress and promotion of resilience amongst unaccompanied refugee minors in resettlement countries.
Aim: As increasing numbers of unaccompanied refugee minors (URMs) are arriving in Europe, there is a need to investigate which factors promote psychological resilience and improve their mental health. This review aims to identify preventive post settlement influences, including living arrangements, access to mental health services, and effective treatments that may improve mental health outcomes.
Methods: A systematic literature review was conducted of published papers in any language for children (<18 years) entering a host country, unaccompanied and seeking asylum. Specific studies were eligible if they examined any treatment or nontreatment influences on mental health or psychological resilience for the URM. Thirteen published quantitative studies were identified.
Results: URMs in more supportive living arrangements including foster care had lower risk of PTSD and lower depressive sym…
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Interventions delivered by nurses in adult outpatient psychiatric care: An integrative review.
WHAT IS KNOWN ON THE SUBJECT?: In many countries, the majority of psychiatric care is being delivered in an outpatient setting and the proportion of outpatients is increasing on a global level. Nurses are the largest workforce in psychiatric care, but their role has been said to be difficult to define. According to our knowledge, there are no previous reviews focusing on nurse-delivered interventions in the adult psychiatric outpatient setting. WHAT THIS PAPER ADDS TO EXISTING KNOWLEDGE?: This review summarizes nurse-delivered interventions identified in the research literature and describes these systematically. Analysing all the identified interventions using the Nursing Interventions Classification, we conclude that the emphasis of nurse-delivered interventions in psychiatric outpatient care is on interventions aiming at improving the functioning of both patients and their family memb…
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Mental Health Interventions for Parent Carers of Children with Autistic Spectrum Disorder: Practice Guidelines from a Critical Interpretive Synthesis (CIS) Systematic Review.
Parent carers of children with Autism Spectrum Disorder (ASD) often report increased levels of stress, depression, and anxiety. Unmet parent carer mental health needs pose a significant risk to the psychological, physical, and social well-being of the parents of the child affected by ASD and jeopardize the adaptive functioning of the family as well as the potential of the child affected by ASD. This systematic review identifies key qualities of interventions supporting the mental health of parent carers and proposes practitioner-parent carer support guidelines. A search of four databases (Medline, PubMed, PsycINFO, and Social Science Data) was conducted to identify studies that met the following criteria: (1) an intervention was delivered to parent carers of a child with ASD under the age of 18 years; (2) the research design allowed for a comparison on outcomes across groups; and (3) out…
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