How to ... be a reflective practitioner.

Aim: To produce a framework for the development of a qualitative semi-structured interview
guide.
Background: Rigorous data collection procedures fundamentally influence the results of
studies. The semi-structured interview is a common data collection method, but
methodological research on the development of a semi-structured interview guide is sparse.
Design: Systematic methodological review.
Data Sources: We searched PubMed, CINAHL, Scopus and Web of Science for
methodological papers on semi-structured interview guides from October 2004 - September
2014. Having examined 2,703 titles and abstracts and 21 full texts, we finally selected ten
papers.
Review methods: We analysed the data using the qualitative content analysis method.
Results: Our analysis resulted in new synthesized knowledge on the development of a semistructured
interview guide, including five phases: 1) identifying the prerequisites for using
semi-structured interviews; 2) retrieving and using previous knowledge; 3) formulating the preliminary semi-structured interview guide; 4) pilot testing the guide; and 5) presenting the
complete semi-structured interview guide.
Conclusion: Rigorous development of a qualitative semi-structured interview guide
contributes to the objectivity and trustworthiness of studies and makes the results more
plausible. Researchers should consider using this five-step process to develop a semistructured
interview guide and justify the decisions made during it.

/pdf/systematic-methodological-review-developing-a-framework-for-2zhocihiph.pdf

Systematic methodological review: developing a framework for a qualitative semi-structured interview guide

The upshot of these needs for change is both dismaying and exciting, both disturbing in the destruction of long-familiar patterns of dealing with human suffering, and paradoxically hopeful in raising the possibility that significant failures in our health care systems of the past — limited access to medical care and grossly inadequate public sector “non-systems”, for example — may now be addressed more successfully.

Administration and policy in mental health

Objective The postpartum period is recognized as a time of vulnerability to affective disorders, particularly postpartum depression. In contrast, the prevalence and clinical presentation of anxiety disorders during pregnancy and the postpartum period have received little research attention. In this article, we review the medical literature as it relates to the prevalence and clinical presentation of panic disorder, obsessive-compulsive disorder, posttraumatic stress disorder, and generalized anxiety disorder during pregnancy and the postpartum period. Data sources MEDLINE (1966 to July 2005 week 1) and PsycInfo (1840 to July 2005 week 1) were searched using combinations of the following search terms: pregnancy, childbirth, postpartum, panic disorder, phobia, obsessive-compulsive disorder, posttraumatic stress disorder, and generalized anxiety disorder. Study selection All relevant papers published in English and reporting original data related to perinatal anxiety disorders were included. Data extraction Studies were examined for data related to the prevalence, presentation, predictors/risk factors, new onset, course, and treatment of anxiety disorders during pregnancy and the postpartum period. Data synthesis Anxiety disorders are common during the perinatal period, with reported rates of obsessive-compulsive disorder and generalized anxiety disorder being higher in postpartum women than in the general population. The perinatal context of anxiety disorders presents unique issues for detection and management. Conclusions Future research is needed to estimate the prevalence of perinatal anxiety disorders more precisely, to identify potential implications of maternal anxiety disorders for maternal quality of life and child development, and to determine safe and effective treatment methods.

Anxiety disorders during pregnancy and the postpartum period: A systematic review.

Background: The increased acceptance of the prevalence of trauma in human experience as well as its psychological consequences has led to revisions of diagnostic criteria for the disorder. The three purposes of this study were to examine the rates at which women experienced psychological trauma in childbirth, to explore possible causal factors, and to examine possible factors in the development of the disorder.

Methods: One hundred and three women from childbirth education classes in the Atlanta metropolitan area completed a survey in late pregnancy and a follow-up interview approximately 4 weeks after the birth.

Results: The childbirth experience was reported as traumatic by 34 percent of participants. Two women (1.9%) developed all the symptoms needed to diagnose posttraumatic stress disorder, and 31 women (30.1%) were partially symptomatic. Regression analysis showed that antecedent factors (e.g., history of sexual trauma and social support) and event characteristics (e.g., pain in first stage of labor, feelings of powerlessness, expectations, medical intervention, and interaction with medical personnel) were significant predictors of perceptions of the childbirth as traumatic. The pain experienced during the birth, levels of social support, self-efficacy, internal locus of control, trait anxiety, and coping were significant predictors of the development of posttraumatic stress disorder symptoms after the birth.

Conclusions: These findings suggest several intervention points for health care practitioners, including careful prenatal screening of past trauma history, social support, and expectations about the birth; improved communication and pain management during the birth; and opportunities to discuss the birth postpartum. (BIRTH 30:1 March 2003)

Prevalence and predictors of women's experience of psychological trauma during childbirth.

Background: Little is known about the relationship between women's birthing experiences and the development of trauma symptoms. This study aimed to determine the incidence of acute trauma symptoms and posttraumatic stress disorder in women as a result of their labor and birth experiences, and to identify factors that contributed to the women's psychological distress. Method: Using a prospective, longitudinal design, women in their last trimester of pregnancy were recruited from four public hospital antenatal clinics. Telephone interviews with 499 participants were conducted at 4 to 6 weeks postpartum to explore the medical and midwifery management of the birth, perceptions of intrapartum care, and the presence of trauma symptoms. Results: One in three women (33%) identified a traumatic birthing event and reported the presence of at least three trauma symptoms. Twenty-eight women (5.6%) met DSM-IV criteria for acute posttraumatic stress disorder. Antenatal variables did not contribute to the development of acute or chronic trauma symptoms. The level of obstetric intervention experienced during childbirth (β= 0.351, p < 0.0001)and the perception of inadequate intrapartum care (β= 0.319, p < 0.0001) during labor were consistently associated with the development of acute trauma symptoms. Conclusions: Posttraumatic stress disorder after childbirth is a poorly recognized phenomenon. Women who experienced both a high level of obstetric intervention and dissatisfaction with their intrapartum care were more likely to develop trauma symptoms than women who received a high level of obstetric intervention or women who perceived their care to be inadequate. These findings should prompt a serious review of intrusive obstetric intervention during labor and delivery, and the care provided to birthing women.

Childbirth and the development of acute trauma symptoms: incidence and contributing factors.

Background: 
Little is known about the relationship between women's birthing experiences and the development of trauma symptoms This study aimed to determine the incidence of acute trauma symptoms and posttraumatic stress disorder in women as a result of their labor and birth experiences, and to identify factors that contributed to the women's psychological distress 

Method: Using a prospective, longitudinal design, women in their last trimester of pregnancy were recruited from four public hospital antenatal clinics Telephone interviews with 499 participants were conducted at 4 to 6 weeks postpartum to explore the medical and midwifery management of the birth, perceptions of intrapartum care, and the presence of trauma symptoms 

Results: One in three women (33%) identified a traumatic birthing event and reported the presence of at least three trauma symptoms Twenty-eight women (56%) met DSM-IV criteria for acute posttraumatic stress disorder Antenatal variables did not contribute to the development of acute or chronic trauma symptoms The level of obstetric intervention experienced during childbirth (β= 0351, p < 00001)and the perception of inadequate intrapartum care (β= 0319, p < 00001) during labor were consistently associated with the development of acute trauma symptoms 

Conclusions: Posttraumatic stress disorder after childbirth is a poorly recognized phenomenon Women who experienced both a high level of obstetric intervention and dissatisfaction with their intrapartum care were more likely to develop trauma symptoms than women who received a high level of obstetric intervention or women who perceived their care to be inadequate These findings should prompt a serious review of intrusive obstetric intervention during labor and delivery, and the care provided to birthing women

Childbirth and the development of acute trauma symptoms : incidence and contributing factors

https://onlinelibrary.wiley.com/doi/pdf/10.1111/jan.12163

Data collection and sampling in qualitative research: does size matter?

Considerable research documents the health consequences of psychosis and co-occurring substance use disorders. Results of randomized controlled trials assessing the effectiveness of psychosocial interventions for persons with dual diagnoses are equivocal but encouraging. Many studies are hampered by small, heterogeneous samples, high attrition rates, short follow-up periods, and unclear description of treatment components. The treatments available for this group of patients (which can be tailored to individual needs) include motivational interviewing, cognitive-behavioral therapy, contingency management, relapse prevention, case management, and skills training. Regardless of whether services follow integrated or parallel models, they should be well coordinated, take a team approach, be multidisciplinary, have specialist-trained personnel (including 24-hour access), include a range of program types, and provide for long-term follow-up. Interventions for substance reduction may need to be further developed and adapted for people with serious mental illnesses. Further quality trials in this area will contribute to the growing body of data of effective interventions.

https://sites.bu.edu/sswhrsaseminar/files/2013/09/Psychosocial-Treatments-for-People-with-Co-occurring-Severe-Mental-Illnesses-and-Substance-Use-Disorders-Dual-Diagnosis-A-Review-of-Empirical-Evidence.pdf

Psychosocial Treatments for People with Co-occurring Severe Mental Illnesses and Substance Use Disorders (Dual Diagnosis): A Review of Empirical Evidence

Stigmatising attitudes are not uncommon among mental health professionals who may be less than optimistic about outcomes for people with long-term mental health problems. These perceptions are probably related to the professionals' experiences, such as those working in the public sector dealing with clients in the most disturbed phases of mental illness. We provide an overview of stigma and some contemporary stigma conceptualisations and then explore some stigma-reducing strategies for mental health professionals. The way that mental health professionals work with patients can have an important effect on their recovery.

Jan Horsfall

Papers

Childbirth and the development of acute trauma symptoms: incidence and contributing factors.

Childbirth and the development of acute trauma symptoms : incidence and contributing factors

Data collection and sampling in qualitative research: does size matter?

Psychosocial Treatments for People with Co-occurring Severe Mental Illnesses and Substance Use Disorders (Dual Diagnosis): A Review of Empirical Evidence

Stigma in Mental Health: Clients and Professionals