Abstract Introduction: Postpartum psychosis is one of the severest psychiatric disorders to occur in the postpartum period. If it requires a woman’s admission, a psychiatric mother baby unit is recommended, where care will focus on the mother’s health, the mother-baby dyad, and their next of kin. To date, few studies have examined nursing interventions for patients with postpartum psychosis. Aim: Identifying nursing interventions used at a psychiatric mother baby unit, when a patient is hospitalized with postpartum psychosis. Method: A qualitative design using thematic analysis. Data was collected using semi-structured interviews (N=13) with expert nurses working at such a unit. Results: The analysis identified three themes: 1. Treatment of the mental disorder, which involves interventions to improve the mother’s mental and physical wellbeing; 2. Care for the mother-baby dyad, which involves interventions intended to promote safe interactions between mother and baby; and 3. Care for the partner, which involves interventions to improve the partner’s wellbeing. Discussion: Overall, within each of these themes, nurses described the urgency to tailor interventions to the needs of the patient, baby and partner. Implications to practice: Our comprehensive description of interventions can be used for the improvement of nursing care for patients hospitalized with postpartum psychosis.
DOCUMENT
WHAT IS KNOWN ON THE SUBJECT?: The combination of coping with their mental health problems and caring for children makes parents vulnerable. Family-centred practice can help to maintain and strengthen important family relationships, and to identify and enhance the strengths of a parent with a mental illness, all contributing to the recovery of the person with the mental illness. WHAT THIS PAPER ADDS TO THE EXISTING KNOWLEDGE?: Taking the strength and the opportunities formulated by parents themselves as a starting point is fairly new. Parents with severe mental illness find strength for parenting in several ways. They feel responsible, and this helps them to stay alert while parenting, whereas parenthood also offers a basis for social participation through school contacts and the child's friendships. Dedication to the parent role provides a focus; parents develop strengths and skills as they find a balance between attending to their own lives and caring for their children; and parenting prompts them to find adequate sources of social support. In this study these strategies were found to be the fundamentals of recovery related to parenting. WHAT ARE THE IMPLICATIONS FOR PRACTICE?: Nurses can support and coach patients who are identified as parents, and self-chosen parenting related goals are set and addressed. A family-focused approach by nurses can be used to prevent problems for children and their families, identify their strengths as well as vulnerabilities, and address the challenges to build resilience.ABSTRACT: Introduction Understanding of the problems of parents with mental illness is growing. Gaining insight into strategies for parenting, while taking the opportunities formulated by these parents themselves as a starting point is fairly new. Question What are the strategies of parents with a mental illness to be successful? Method Experiences of 19 mothers and eight fathers with a mental illness were explored with in-depth interviews. Data were content analysed, using qualitative methods. Results Next to feelings of inadequacy, interviewees also describe how children enrich and structure their lives and are not only a burden but serve as distraction from problems. Developing activities that interest both child and parent provides avenues for emerging strength. Mental illness constrains fathers, but also gives opportunities to develop a meaningful relation with their children. Discussion Strategies like being fully dedicated to the parental role, finding a balance between attention for one's own life and parenting and finding adequate sources of support are found to be fundamental for recovery in the parent role. Implications for practice Peer groups can be of valuable help and mental health workers can support parents to set self-chosen parenting related goals.
MULTIFILE
Divorce is a common and complex phenomenon with high social impact, especially when it involves pervasive conflict. This chapter discusses an analytic content-based framework for gaining an in-depth understanding of divorce. It considers seven inter- related dimensions: time, conflict, relationships, violence, systems, cooperation and communication. Each dimension can be further related to the exacerbating factors of addiction and psychiatric illness. This analytical method points the way to de- escalating domestic conflict and sometimes intimate violence after divorce by listen- ing to and properly interpreting the voices of children and parents. Partner violence and controlling behaviour before, during and after divorce can arise from the struggle of one partner to attack and diminish the other, or by both partners contending for power as the family breaks up. The resulting conflict can disrupt the parental partner- ship in ways that traumatize them and interfere with their children’s right to grow up in safe surroundings, nurtured and guided by both parents. Social professionals who respond effectively are able to look beyond stereotypes to sense the unique and subtle patterns underlying the intense and persistent discord characteristic of high-conflict divorce. Only when the particular aspects of those patterns are understood and prop- erly addressed can (co-) parenting be restored to assure the children of post-divorce safety and well-being.
DOCUMENT
De publicatielijst bevat alle publicaties waar Berno van Meijel aan bijgedragen heeft
DOCUMENT
Background: The most common reason for caesarean section (CS) is repeat CS following previous CS. Vaginal birth after caesarean section (VBAC) rates vary widely in different healthcare settings and countries. Obtaining deeper knowledge of clinicians’ views on VBAC can help in understanding the factors of importance for increasing VBAC rates. Interview studies with clinicians and women in three countries with high VBAC rates (Finland, Sweden and the Netherlands) and three countries with low VBAC rates (Ireland, Italy and Germany) are part of ‘OptiBIRTH’, an ongoing research project. The study reported here is based on interviews in high VBAC countries. The aim of the study was to investigate the views of clinicians working in countries with high VBAC rates on factors of importance for improving VBAC rates. Methods: Individual (face-to-face or telephone) interviews and focus group interviews with clinicians (in different maternity care settings) in three countries with high VBAC rates were conducted during 2012–2013. In total, 44 clinicians participated: 26 midwives and 18 obstetricians. Five central questions about VBAC were used and interviews were analysed using content analysis. The analysis was performed in each country in the native language and then translated into English. All data were then analysed together and final categories were validated in each country. Results: The findings are presented in four main categories with subcategories. First, a common approach is needed, including: feeling confident with VBAC, considering VBAC as the first alternative, communicating well, working in a team, working in accordance with a model and making agreements with the woman. Second, obstetricians need to make the final decision on the mode of delivery while involving women in counselling towards VBAC. Third, a woman who has a previous CS has a similar need for support as other labouring women, but with some extra precautions and additional recommendations for her care. Finally, clinicians should help strengthen women’s trust in VBAC, including building their trust in giving birth vaginally, recognising that giving birth naturally is an empowering experience for women, alleviating fear and offering extra visits to discuss the previous CS, and joining with the woman in a dialogue while leaving the decision about the mode of birth open. Conclusions: This study shows that, according to midwives and obstetricians from countries with high VBAC rates, the important factors for improving the VBAC rate are related to the structure of the maternity care system in the country, to the cooperation between midwives and obstetricians, and to the care offered during pregnancy and birth. More research on clinicians’ perspectives is needed from countries with low, as well as high, VBAC rates.
MULTIFILE
Chronic sorrow involves parents’ enduring grief due to their child’s disability. This stems not only from the recurring painful reality parents face, which differs from the life they had hoped for their children, families, and themselves but from also being confronted with societal and personal norms and expectations they cannot meet. There is a lack of research on the lived experiences of parents’ chronic sorrow. An Interpretative Phenomenological Analysis (IPA) study involving six parents with severely disabled children explored what it is like for parents to confront being ‘‘different.’’ Besides sorrow, the parents experienced intense ambiguity,guilt, and uncertainty while navigating societal expectations and their own perceptions of their children. Their ideas of parenthood and their self-identity as parents proved central to their strategies. This study provides insight into the intricacies of this particular aspect of chronic sorrow in parents, with relevance for research and practice.
DOCUMENT
This paper considers the partnership model, which is in the author’s view the best answer in the social policy creation in contemporary conditions. The author refers to changes and reforms in the development of welfare state in the world from 1980s onwards. He describes various approaches and models, paying particular attention to the welfare society model, and partnership as its central concept. Furthermore, he analyses the functioning of the partnership model based on the experience of the European Union, Great Britain and Hungary
DOCUMENT
The transition from adolescence to adulthood also has been described as a window of opportunity or vulnerability when developmental and contextual changes converge to support positive turnarounds and redirections (Masten, Long, Kuo, McCormick, & Desjardins, 2009; Masten, Obradović, & Burt, 2006). The transition years also are a criminological crossroads, as major changes in criminal careers often occur at these ages as well. For some who began their criminal careers during adolescence, offending continues and escalates; for others involvement in crime wanes; and yet others only begin serious involvement in crime at these ages. There are distinctive patterns of offending that emerge during the transition from adolescence to adulthood. One shows a rise of offending in adolescence and the persistence of high crime rates into adulthood; a second reflects the overall age-crime curve pattern of increasing offending in adolescence followed by decreases during the transition years; and the third group shows a late onset of offending relative to the age-crime curve. Developmental theories of offending ought to be able to explain these markedly different trajectories
DOCUMENT
Accessible Summary What is known on the subject? • Mentalizing is the capacity to understand both one‘s own and other people‘s behaviour in terms of mental states, such as, for example, desires, feelings and beliefs. • The mentalizing capacities of healthcare professionals help to establish effective therapeutic relationships and, in turn, lead to better patient outcomes. What this paper adds to existing knowledge? • The personal factors positively associated with the mentalizing capacities of healthcare professionals are being female, greater work experience and having a more secure attachment style. Psychosocial factors are having personal experience with psychotherapy, burnout, and in the case of female students, being able to identify with the female psychotherapist role model during training. There is limited evidence that training programmes can improve mentalizing capacities. • Although the mentalization field is gaining importance and research is expanding, the implications for mental health nursing have not been previously reviewed. Mental health nurses are underrepresented in research on the mentalizing capacities of healthcare professionals. This is significant given that mental health nurses work closest to patients and thus are more often confronted with patients‘ behaviour compared to other health care professionals, and constitute a large part of the workforce in mental healthcare for patients with mental illness. What are the implications for practice? • Given the importance of mentalizing capacity of both the patient and the nurse for a constructive working relationship, it is important that mental health nurses are trained in the basic principles of mentalization. Mental health nurses should be able to recognize situations where patients‘ lack of ability to mentalize creates difficulties in the interaction. They should also be able to recognize their own difficulties with mentalizing and be sensitive to the communicative implications this may have.
MULTIFILE
English version of the book 'Energieke Arbeid' published by the Centre of Applied Labour Market Research and Innovation (Dutch abbreviation: KCA) to celebrate the 10th anniversary of applied labour market research at Hanze University of Applied Sciences. After an introduction by drs. Marian van Os (vice-president of the Executive Board of Hanze University of Applied Sciences Groningen), the first chapter (by dr. Harm van Lieshout) takes a brief look back at the development of KCA over the past ten years. The second chapter (by dr. Louis Polstra) discusses the first of two lines of research of KCA: Healthy Ageing & Work. The third chapter (by dr. Harm van Lieshout) discusses the second line of research: The Labour Market in the EnergyPort Groningen Region. The book concludes with a brief epilogue by van Lieshout & Polstra.
DOCUMENT
