Mental health literacy

وَقَالُواْ يَٰٓأَيُّهَا ٱلَّذِي نُزِّلَ عَلَيۡهِ ٱلذِّكۡرُ إِنَّكَ لَمَجۡنُونࣱ‏

They say, ‘Receiver of this Quran! You are definitely mad

قَالَ إِنَّ رَسُولَكُمُ ٱلَّذِيٓ أُرۡسِلَ إِلَيۡكُمۡ لَمَجۡنُونࣱ‏

Pharaoh said, ‘This messenger who has been sent to you is truly possessed.’

وَيَقُولُونَ أَئِنَّا لَتَارِكُوٓاْ ءَالِهَتِنَا لِشَاعِرࣲ مَّجۡنُونِۭ

and said, ‘Are we to forsake our gods for a mad poet?’

ثُمَّ تَوَلَّوۡاْ عَنۡهُ وَقَالُواْ مُعَلَّمࣱ مَّجۡنُونٌ

they turned their backs on him, saying, ‘He is tutored! He is possessed!’

فَتَوَلَّىٰ بِرُكۡنِهِۦ وَقَالَ سَٰحِرٌ أَوۡ مَجۡنُونࣱ‏

Pharaoh turned away with his supporters, saying, ‘This is a sorcerer, or maybe a madman,’

كَذَٰلِكَ مَآ أَتَى ٱلَّذِينَ مِن قَبۡلِهِم مِّن رَّسُولٍ إِلَّا قَالُواْ سَاحِرٌ أَوۡ مَجۡنُونٌ

Every previous people to whom a messenger was sent also said, ‘A sor-cerer, or maybe a madman!’

And they that is the disbelievers of Mecca say to the Prophet s ‘O you to whom the Remembrance the Qur’ān — as you claim — has been revealed lo! you are indeed possessed!

He said ‘Verily this messenger of yours sent to you is a madman!’

and would say ‘Are we to abandon our gods for a mad poet?’ that is for the sake of what Muhammad (s) says? as regards the hamzas in a-innā ‘are we’ the same applies as mentioned above.

And they say: "O you (Muhammad) to whom the Dhikr (the Qur'an) has been revealed! Verily, you are a madman (6)"Why do you not bring angels to us if you are of the truthful? (7)We do not send the angels down except with the truth, and in that case, they (the disbelievers) would have no respite (8)Verily, We, it is We Who revealed the Dhikr (i.e. the Qur'an) and surely We will guard it (from corruption)(9) The Accusation that the Prophet (ﷺ) was a Madman and Demands for Him to bring down Angels Allah tells us about the disbelief, arrogance and stubbornness of the disbelievers as reflected in their words: يَا أَيُّهَا الَّذِي نُزِّلَ عَلَيْهِ الذِّكْرُ (O you (Muhammad) to whom the Dhikr (the Qur'an) has been revealed!) i.e., the one who claims to receive it. إِنَّكَ لَمَجْنُونٌ (Verily, you are a mad man!) i.e., by your invitation to us to follow you and leave the way of our forefath

Fir'awn said: "And what is the Lord of Al-'Alamin (23)(Musa) said: "The Lord of the heavens and the earth, and all that is between them, if you seek to be convinced with certainty. (24)(Fir'awn) said to those around: "Do you not hear (what he says)? (25)(Musa) said: "Your Lord and the Lord of your ancient fathers! (26)(Fir'awn) said: "Verily, your Messenger who has been sent to you is a madman! (27)(Musa) said: "Lord of the east and the west, and all that is between them, if you did but understand! (28) Allah tells us about the disbelief, rebellion, oppression and denial of Fir'awn, as He says: وَمَا رَبُّ الْعَالَمِينَ ((Fir'awn said:) "And what is the Lord of the 'Alamin") This is because he used to say to his people: مَا عَلِمْتُ لَكُم مِّنْ إِلَٰهٍ غَيْرِي (I know not that you have a god other than me.)(28:38) فَاسْتَخَفَّ قَوْمَهُ فَأَطَاعُوهُ (Thus he fooled his people, and

And they will turn to one another and question one another (27)They will say: "It was you who used to come to us from the right side. (28)They will reply: "Nay, you yourselves were not believers. (29)"And we had no authority over you. Nay! But you were a transgressing people. (30)"So now the Word of our Lord has been justified against us, that we shall certainly taste (the torment). (31)"So we led you astray because we were ourselves astray. (32)Then verily, that Day, they will (all) share in the torment (33)Certainly, that is how We deal with the criminals (34)Truly, when it was said to them: "La ilaha illallah," they puffed themselves up with pride (35)And (they) said: "Are we going to abandon our gods for the sake of a mad poet? (36)Nay! he has come with the truth and he confirms the Messengers (37) The arguing of the Idolators on the Day of Resurrection Allah tells us that the disb

ولو كشف الغطاء لرأيت أكثر النفوس البشرية صرعى مع هذه الأرواح الخبيثة وهي في أسرها وقبضتها تسوقها حيث شاءت ولا يمكنها الامتناع عنها ولا مخالفتها وبها الصرع الأعظم الذي لا يفيق صاحبه إلا عند المفارقة والمعاينة فهناك يتحقق أنه كان هو المصروع حقيقة وبالله المستعان وعلاج هذا الصرع باقتران العقل الصحيح إلا الإيمان بما جاءت به الرسل وأن تكون الجنة والنار نصب عينه وقبلة قلبه ويستحرض أهل الدنيا وحلول المثولات والآفات بهم ووقوعها خلال ديارهم كمواقع القطر وهم صرعى لا يفيقون وما أشد أعداء هذا الصرع ولكن لما عمت البلية به بحيث ينظر الإنسان لا يرى إلا مصروعا لم يصر مستغربا ولا مستنكرا بل صار لكثرة المصروعين عين المستنكر المستغرب خلافة فإذا أراد الله بعبد حيرا أفاق من هذه الصرعة ونظر إلى أبناء الدنيا مصروعين حوله يمينا وشمالا على اختلاف طبقاتهم فمنهم من أطبق به الجنون ومنهم من يفيق أحيانا قليلة ويعود إلى جنونه ومنهم من يجن مرة ويفيق أخرى فإذا أفاق عمل عمل أهل الإفاقة والعقل ثم يعاوده الصرع فيقع في التخ

الثاني أن هذا باطل بصور كثيرة منها دخول الماء في العود والسحاب ودخول النار في الحديد ودخول الغذاء في جميع أجزاء البدن ودخول الجن في المصروع فالروح للطافتها لا يمتنع عليها مشابكة البدن والدخول في جميع أجزائه

فالعقل فن واحد وطريقه % أدرى فأرصد و الجنون فنون

هكذا ضعف الدين في قرون سالفة فكيف الظن بزمانك هذا وقد انتهى الأمر إلى أن مظهر الإنكار يستهدف لنسبته إلى الجنون فالأولى أن يشتغل الإنسان بنفسه ويسكت

وأما القسم الثاني، وهو المدح بسبب الجاه والمال، فالفرح بذلك، كالفرح بنبات الأرض الذي يصير عن قريب هشيما، ولا يفرح بذلك إلا من قل عقله، وإن كنت خاليا عن الصفة التي مدحت بها، ففرحك بالمدح غاية الجنون.

قالوا وكيف يمدح أمر يمنع القرار ويسلب المنام ويوله العقل ويحدث الجنون بل هو نفسه جنون كما قال بعض الحكماء الجنون فنون والعشق فن من فنونه كما قال بعض العشاق

The effectiveness of school mental health literacy programs to address knowledge, attitudes and help seeking among youth.: Aim: Conduct a systematic review for the effectiveness of school mental health literacy programs to enhance knowledge, reduce stigmatizing attitudes and improve help-seeking behaviours among youth (12-25 years of age). Methods: Reviewers independently searched PubMed, PsycINFO, Cochrane Library, CINAHL, ERIC, grey literature and reference lists of included studies. They reached a consensus on the included studies, and rated the risk of bias of each study. Studies that reported three outcomes: kn

Is It Possible to "Find Space for Mental Health" in Young People? Effectiveness of a School-Based Mental Health Literacy Promotion Program.: Lack of knowledge regarding, and the stigma associated with, mental disorders have been identified as major obstacles for the promotion of mental health and early intervention. The present study aimed to evaluate the effectiveness of a school-based intervention program focused on the promotion of mental health literacy (MHL) in young people (“Finding Space for Mental Health”). A sample of 543 students (22 classes), aged between 12 and 14 years old, participated in the study. Each class of studen

Facilitators and Barriers for Advance Care Planning Among Ethnic and Racial Minorities in the U.S.: A Systematic Review of the Current Literature.: Growing evidence suggests a low engagement in advance care planning (ACP) among ethnic minorities in the U.S. The purpose of this study was to synthesize findings from prior research about ACP among ethnic minorities. An extensive literature search was conducted using multiple electronic databases. After applying inclusion criteria, 26 studies were included. Four categories of facilitators and barriers to ACP were identified: (1) Socio-demographic factors, (2) health status, literacy and experie

Adolescent health literacy and health behaviors: A systematic review.: Objectives: To systematically review and synthesize literature on the relationship between health literacy and health behaviors in adolescents. Methods: Searches in PsychInfo, PUBMED/MEDLINE, and Educational Resources Information Center (ERIC) were conducted. Studies were included if they reported original data on the relationship between health literacy and a health behavior in adolescents, were written in English, and the population did not have a chronic illness or disability. Results: Sevent

The effect of a community-based self-help multimodal behavioral intervention in Korean American seniors with high blood pressure.: Background: Great strides have been made in improving heart health in the United States during the last 2 decades, yet these strides have not encompassed many ethnic minority populations. There are significant health disparity gaps stemming from both a paucity of valid research and a lack of culturally sensitive interventions. In particular, many Korean Americans with chronic illnesses encounter difficulty navigating the healthcare system because of limited health literacy. Methods: The effect o

Workplace Interventions Targeting Mental Health Literacy, Stigma, Help-Seeking, and Help-Offering in Male-Dominated Industries: A Systematic Review.: Mental ill-health and suicide represent a significant proportion of the burden of global disease among men. Connell's relational theory of masculinities provides a useful framework to explore how mental health literacy, mental health stigma, and delayed help-seeking and help-offering behaviors are associated with mental ill-health among men, particularly within male-dominated industries. To address the high incidences of mental ill-health in male-dominated industries, several workplace intervent

Desire for motherhood: exploring HIV-positive women's desires, intentions and decision-making in attaining motherhood.

With access to prevention of parent-to-child transmission (PPTCT) and antiretroviral therapy (ARV), people living with HIV/AIDS are better able to consider childbearing and parenthood. However, there is limited understanding of the reproductive healthcare needs and the impact of infection on the fertility desires of women living with HIV/AIDS. Research on the relationship between fertility and HIV/AIDS has been largely clinical, focusing on the ability of women living with HIV/AIDS (WLHA) to conceive or their pregnancy outcomes. This paper describes the findings of a qualitative study undertaken in Namakkal district, Tamil Nadu, India that aimed to explore fertility desires, intentions and fertility decision-making in WLHA and the barriers they face in fulfilling these desires. In-depth interviews were held with selected 43 currently married WLHA aged 18-35 years and 10 key informants. T…

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Incorporating Crisis Intervention Team (CIT) knowledge and skills into the daily work of police officers: a focus group study.

This qualitative focus group study was conducted to evaluate the effectiveness of Crisis Intervention Team (CIT) training for police officers. Thematic analysis of transcripts of focus group discussions revealed that officers report increased knowledge of mental illnesses (which manifests as an improved ability to recognize and respond, reduced stereotyping/stigmatization, greater empathy toward consumers and their caregivers, more patience when dealing with consumers, and fewer arrests/more redirection toward treatment), as well as practical application of learned skills (evidenced by an ability to put individuals with mental illnesses at ease, reduced unpredictability of the crisis situation, and reduced risk of injury). Results highlight the potential for collaboration between law enforcement (and other public safety/criminal justice professions) and the mental health professions in t…

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Developing a measure of communicative and critical health literacy: a pilot study of Japanese office workers.

With the increase in media reports and rapid diffusion of the Internet, the skills in finding and utilizing health information (health literacy; HL) are becoming important in maintaining and promoting health. This study aimed to examine the psychometric properties of a brief measure to assess major components of communicative and critical HL among Japanese office workers, in order to consider its applicability to health promotion at workplace. The participants were 190 male office workers at a Japanese company. A self-administered questionnaire was distributed at the annual health checkup, in which HL, health-related behaviors and coping with job stress were asked. Also, the number of somatic symptoms reported by the worker was counted out of the eight symptoms in the health checkup questionnaire. The higher HL group was more likely to have regular eating patterns and exercise weekly, an…

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Safe babies: a qualitative analysis of the determinants of postpartum smoke-free and relapse states.

This qualitative study explores smoking cessation during pregnancy and the factors that contribute to remaining smoke-free and relapsing. Ninety-four women attending prenatal clinics in central North Carolina who had quit smoking before 30 weeks gestation were enrolled in an observational study that included a face-to-face interview at 4 months postpartum. Results were analyzed for common themes in the two groups: those who remained smoke-free and those who had relapsed. Fetal health motivated pregnant women to quit smoking, while stress, socializing with smokers, cravings, and easy access to cigarettes tempted women to smoke. Women who remained smoke-free postpartum overcame temptations by continuing to acknowledge the health benefits of not smoking and having a strong internal belief system, significant social support, negative experiences with renewed exposure to cigarettes, and concr…

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Pacific Islanders' perspectives on heart failure management.

Objective: To identify the health beliefs, attitudes, practices, and social and family relations important in heart failure treatment among Pacific Islanders. Methods: Four focus groups were convened with 36 Native Hawaiians and Samoans with heart failure and their family caregivers. Thematic data analysis was used to categorize data into four domains: health beliefs and attitudes, preferred health practices, social support systems, and barriers to heart failure care. Results: Common coping styles and emotional experiences of heart failure in this population included avoidance or denial of illness, hopelessness and despair, and reliance on spiritual/religious beliefs as a means of support. Among study participants, more Samoans preferred to be treated by physicians whereas more Native Hawaiians preferred traditional Hawaiian methods of healing. Two types of social support (informational …

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Relationships between young drivers' personality characteristics, risk perceptions, and driving behaviour.

Research has shown that inexperienced drivers underestimate the risks associated with a range of driving situations. In addition, personality factors are an important influence on both risk perceptions and driving behaviour. The study investigated the strength of relationship between personality factors, risk perceptions, and driving behaviour among young, mainly inexperienced drivers. One-hundred and fifty-nine students aged between 17 and 20 completed an online questionnaire assessing five facets of personality, four components of risk perceptions, and one measure of driving behaviour. Using structural equation modeling as a means of assessing the overall fit of each model, 39% of the variance in young drivers' speeding was accounted for by Excitement-Seeking, Altruism, their Aversion to Risk Taking, and their own likelihood of having an accident, with Altruism and Aversion to Risk Tak…

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Is social capital associated with HIV risk in rural South Africa?

The role of social capital in promoting health is now widely debated within international public health. In relation to HIV, the results of previous observational and cross-sectional studies have been mixed. In some settings it has been suggested that high levels of social capital and community cohesion might be protective and facilitate more effective collective responses to the epidemic. In others, group membership has been a risk factor for HIV infection. There have been few attempts to strengthen social capital, particularly in developing countries, and examine its effect on vulnerability to HIV. Employing data from an intervention study, we examined associations between social capital and HIV risk among 1063 14 to 35-year-old male and female residents of 750 poor households from 8 villages in rural Limpopo province, South Africa. We assessed cognitive social capital (CSC) and struct…

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HIV/AIDS-related stigma and discrimination: accounts of HIV-positive Caribbean people in the United Kingdom.

This paper explores the effects of HIV/AIDS-related stigma and discrimination (HASD) on HIV-positive Caribbean people in the Caribbean and the UK. In-depth, semi-structured interviews were held with a purposively selected group of 25 HIV-positive people of Caribbean origin, using primary selection criteria of sex, age, sexuality and country of birth. Interviews with respondents revealed that they are keenly aware of the stigma surrounding HIV/AIDS, which some attribute to a particularly Caribbean combination of fear of contamination, homophobia, and ignorance, reinforced by religious beliefs. In fact, religion serves a double role: underpinning stigma and assisting in coping with HIV. HASD has usually occurred where respondents have lost or do not have control over disclosure. Compared to UK-born respondents, the accounts of Caribbean-born respondents, most of whom were born in Jamaica, …

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Helping themselves to get pregnant: a qualitative longitudinal study on the information-seeking behaviour of infertile couples.

Background: Couples seeking infertility treatment are generally hungry for information about available therapeutic options and how to help themselves achieve pregnancy. This study examined couples' perceptions of the information available from various sources in the context of achieved pregnancy or continuing treatment. Methods: A 3 year prospective interview study started in April 2004, following couples undergoing infertility treatment at a tertiary fertility clinic at Aberdeen Maternity Hospital. Fifty-four couples were invited to participate. Up to three semi-structured interviews took place, and were analysed thematically using a variation of grounded theory. Results: Twenty-seven couples agreed to participate and of the 25 couples followed up, 11 were diagnosed with unexplained infertility. The age range of the women was 22-41 years. All hoped to be given information on helping the…

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Public knowledge and assessment of child mental health problems: findings from the National Stigma Study-Children.

Objective: Child and adolescent psychiatry confronts help-seeking delays and low treatment use and adherence. Although lack of knowledge has been cited as an underlying reason, we aim to provide data on public recognition of, and beliefs about, problems and sources of help. Method: The National Stigma Study-Children is the first nationally representative study of public response to child mental health problems. A face-to-face survey of 1,393 adults (response rate 70.1%, margin of error +/-3.5%) used vignettes consistent with diagnoses of attention-deficit/hyperactivity disorder (ADHD) and depression. Descriptive and multivariate analyses provide estimates of the levels and correlates of recognition, labeling, and treatment recommendations. Results: Respondents do differentiate "daily troubles" from mental health problems. For the cases that meet diagnostic criteria, 58.5% correctly ident…

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How people decide to seek health care: a qualitative study.

Background: There is considerable variation in service use, with overuse in conditions such as upper respiratory tract infections and high levels of unmet need in older patients with embarrassing conditions such as incontinence. The reasons for this situation are varied but to facilitate appropriate accessing of services the decision processes involved in help-seeking require greater understanding. Objectives: This study aimed to describe the decision making process for help-seeking in middle and older aged people with urinary storage symptoms. Methods: In-depth qualitative interviews were carried out with 33 men and women who had sought medical care for urinary symptoms. Respondents were recruited from an epidemiological study of the prevalence of urinary symptoms in community dwelling adults aged 40 years and over. Questions were directed at help-seeking for urinary symptoms as well as…

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"Getting me back on track": the role of outreach interventions in engaging and retaining people living with HIV/AIDS in medical care.

This qualitative study investigated the process of engagement in HIV medical care from the perspective of people living with HIV/AIDS (PLWHA). In-depth interviews were conducted with 76 participants in six cities. All participants were considered underserved because of histories of substance use, mental illness, incarceration, homelessness, or cultural barriers to the traditional health care system. A semistructured interview guide elicited narratives related to health care and the role of program interventions in facilitating access to care. Data analysis revealed that participants cycled in and out of care, a process that was influenced by (1) their level of acceptance of being diagnosed with HIV, (2) their ability to cope with substance use, mental illness, and stigma, (3) their health care provider relationships, (4) the presence of external support systems, and (5) their ability to …

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Use of complementary and alternative therapies in community-dwelling older adults.

Objectives: Although complementary and alternative medicine (CAM) use is becoming increasingly prevalent in the United States, knowledge regarding complementary and alternative therapy use in older adults is limited. The purposes of this study were to (1) assess the prevalence and patterns of CAM use in a probability-based sample of older adults; (2) describe the characteristics of older CAM users; and (3) identify factors associated with complementary and alternative medicine use/nonuse. Methods: A cross-sectional survey design was used. An age-stratified sample of community-dwelling adults ages>or=65 (N=1200) was randomly selected from the Minnesota Driver's License/Identification Tape using names from the Twin Cities seven-county metropolitan area. The mailed questionnaire included items on demographics, health status, health care utilization, CAM modality use, reasons for use, costs,…

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Guilt and shame: experiences of parents of self-harming adolescents.

This paper reports the findings of a qualitative study that used a hermeneutic phenomenological methodology to develop insights into the experience of parents of young people who engage in self-harming behaviour. Six mothers (and one father who accompanied his wife) participated in the study. Findings reveal that mothers experienced guilt and shame, and that these feelings shaped their reactions and responses. These mothers described experiencing emotional dilemmas, such as the degree to which they could be responsible, uncertainty about how to understand self harm, and the best course of action to take with their child. They also encountered difficulties in combating the negative emotional effects for themselves and other family members. Findings provide insights that can help nurses and family health workers to understand and assist parents with greater effectiveness; by maintaining a …

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Frequency of complementary and alternative medicine utilization in hypertensive patients attending an urban tertiary care centre in Nigeria.

Background: To study the frequency and pattern of use of complementary and alternative medicine (CAM) in patients with essential hypertension attending a tertiary hypertension clinic. Methods: Two hundred and twenty-five consecutive hypertensive patients attending the hypertension clinic of the Lagos University Teaching Hospital over a 3-month period were interviewed. Socio-demographic data, duration of hypertension, clinic attendance, current blood pressure, and compliance to conventional medications was documented. CAM utilization was explored using both structured and open-ended questions. Results: There were 90 (40%) male and 135 (60%) female patients with mean age +/- SD overall was 55.1 +/- 12.4 years. 88 (39.1%) of the respondents used CAM. Herbal products were the most commonly used CAM type. Amongst the CAM users, the most common herbal product used was garlic (69.3%). Others we…

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Barriers to self-management and quality-of-life outcomes in seniors with multimorbidities.

Purpose: Persons with multiple chronic diseases must integrate self-management tasks for potentially interacting conditions to attain desired clinical outcomes. Our goal was to identify barriers to self-management that were associated with lower perceived health status and, secondarily, with lower reported physical functioning for a population of seniors with multimorbidities. Methods: We conducted a cross-sectional telephone survey of 352 health maintenance organization members aged 65 years or older with, at a minimum, coexisting diagnoses of diabetes, depression, and osteoarthritis. Validated questions were based on previous qualitative interviews that had elicited potential barriers to the self-management process for persons with multimorbidities. We analyzed associations between morbidity burden, potential barriers to self-management, and the 2 outcomes using multivariate linear reg…

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Impact of a statewide home visiting program on parenting and on child health and development.

Objectives: To assess the impact of a voluntary, paraprofessional home visiting program on promoting child health and development and maternal parenting knowledge, attitudes, and behaviors. Methods: This collaborative, experimental study of 6 Healthy Families Alaska (HFAK) programs enrolled 325 families from 1/00 to 7/01, randomly assigned them to HFAK and control groups, interviewed mothers at baseline, and followed families until children were 2 years old (85% follow-up). Child outcomes included health care use, development and behavior. Parent outcomes included knowledge of infant development, parenting attitudes, quality of the home environment, and parent-child interaction. HFAK records were reviewed to measure home visiting services. Home visitors were surveyed to measure knowledge, perceived effectiveness and perceived training adequacy. Results: There was no overall impact on chi…

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The pain experience of Hispanic patients with cancer in the United States.

Purpose/objectives: To explore Hispanic patients' cancer pain experience from a feminist perspective to find explanations for inadequate pain management. Design: A qualitative online forum study. Setting: Internet and community settings. Sample: 15 Hispanic patients with cancer recruited using a convenience sampling method. Methods: A six-month online forum was conducted using nine discussion topics, and the data were processed using a thematic analysis. Main research variables: Cancer pain experience. Findings: Four major themes emerged related to the following findings. The first was a lack of communication with healthcare providers regarding undermedication. The second was that women and men were enduring pain because of traditional gender roles guiding their behaviors. Third, participants placed the highest priority on family during the diagnosis and treatment process, thus setting a…

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Mobbing in the workplace by peers and managers: mobbing experienced by nurses working in healthcare facilities in Turkey and its effect on nurses.

Aim: This research was conducted as a descriptive and cross-sectional study with the purpose of determining the mobbing experienced by nurses who work in healthcare facilities in Turkey, its emotional, social and physiological effects on the nurses and the actions that the individuals take to escape from the mobbing. Background: The term 'mobbing', which includes workplace terrorizing, pressure, frightening, belittling and psycho-terror, is defined as the presence of systematic, directed, unethical communication and antagonistic behaviour by one or more individuals. These actions that occur frequently and continue for a long time are the most serious and effective causes of workplace stress. The person who is the target of the mobbing is left without help, without protection and alone in the workplace. Individuals who are exposed to psychological abuse experience physiological, psycholog…

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The influence of culture on immigrant women's mental health care experiences from the perspectives of health care providers.

It is well documented that serious mental health problems such as depression, schizophrenia, and post migration stress disorders exist among immigrant women. Informed by Kleinman's explanatory model, this qualitative exploratory study was conducted with seven health care providers who provided mental health services to immigrant women. Analysis of the data revealed that (a) immigrant women face many difficulties when accessing mental health care services due to cultural differences, social stigma, and unfamiliarity with Western biomedicine, (b) spiritual beliefs and practices that influence immigrant women's mental health care practices, and (c) the health care provider-client relationship, which exerts great influence on how immigrant women seek mental health care. The study also revealed that cultural background exerts both positive and negative influences on how immigrant women seek m…

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Factors affecting home delivery in rural Tanzania.

Background: Studies of factors affecting place of delivery have rarely considered the influence of gender roles and relations within the household. This study combines an understanding of gender issues relating to health and help-seeking behaviour with epidemiological knowledge concerning place of delivery. Methods: In-depth interviews, focus group discussions and participant observation were used to explore determinants of home delivery in southern Tanzania. Quantitative data were collected in a cross-sectional survey of 21,600 randomly chosen households. Results: Issues of risk and vulnerability, such as lack of money, lack of transport, sudden onset of labour, short labour, staff attitudes, lack of privacy, tradition and cultures and the pattern of decision-making power within the household were perceived as key determinants of the place of delivery. More than 9000 women were intervie…

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A theory of planned behavior study of college students' intention to register as organ donors in Japan, Korea, and the United States.

This study investigated willingness of Americans, Koreans, and Japanese to register as organ donors using the theory of planned behavior. Although previous research showed that attitude toward donation and communication with family predicted organ donation behaviors for respondents in the United States, these variables were also significant for respondents in Japan and Korea. Perceived behavioral control predicted intention to register for Japanese participants whereas knowledge about organ donation was associated with reluctance to register for Koreans. Spiritual connection and concern were shown to be causal factors underlying attitude in all 3 countries. In spite of positive attitudes toward organ donation and comparable knowledge with Americans and Japanese, most Korean participants declined to take an application to register as a donor. Implications of these findings for future rese…

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Seeking serenity: living with HIV/AIDS in rural Western Canada.

Introduction: The purpose of this naturalistic inquiry was to describe the experience of living with HIV infection in rural Alberta, Canada. Although the urban HIV epidemic has been well researched, the virus continues its spread into more remote populations where there is a need to understand and address its impact. Affected rural residents form a diverse and marginalized group that includes women, Aboriginal peoples, immigrants, injecting drug users, and men who have sex with men, yet there are few data available to inform appropriate health and social services and practice. A number of factors, such as stigma, invisibility, isolation, confidentiality, poverty, and risk behaviours, contribute to the rural experience, but have not been clearly explicated in the literature. This study was conducted in order to better understand the perceptions of health in a rural setting, the processes …

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Health service utilization for eating disorders: findings from a community-based study.

Background: Prior use of health services was examined in a community sample of women with bulimic-type eating disorders. Method: Participants (n = 159) completed a structured interview for the assessment of eating disorder psychopathology as well as questions concerning treatment-seeking and type of treatment received. Results: Whereas a minority (40.3%) of participants had received treatment for an eating problem, most had received treatment for a general mental health problem (74.2%) and/or weight loss (72.8%), and all had used one or more self-help treatments. Where treatment was received for an eating or general mental health problem, this was from a primary care practitioner in the vast majority of cases. Only half of those participants who reported marked impairment associated with an eating problem had ever received treatment for such a problem and less than one in five had receiv…

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Implementing a clinical and research registry in obstetrics: overcoming the barriers.

Objective: This study aimed to describe the obstacles and solutions in developing and implementing a prospective obstetric database registry that collects biopsychosocial data on women during pregnancy and postpartum. The clinical goals of the registry were to improve both diagnosis of mental health and substance use problems and access to mental health care during pregnancy. The research goals were to examine the impact of psychiatric illness and substance use on birth outcomes. Study setting and registry design: A questionnaire that contained validated instruments for mental health, substance use and psychosocial stressors was developed and administered to all pregnant women in an academic medical center obstetric clinic. Results were incorporated with reminder and decision support systems to ensure active follow-up of patients with mental health needs. Automated medical record informa…

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