Quality assessment of the practice of focused antenatal care (FANC) in rural and urban primary health centres in Ekiti State

Objective: To ascertain that standard antenatal care (Focused antenatal care) is being received at the Primary Health Care level in urban and rural areas of Ekiti State and to determine the facilitating factors and challenges to the practice of FANC in urban and rural areas. Design: Cross sectional. Setting: Primary Health Centers Participants: Pregnant women and Heads of health facilities. Methods: Two hundred respondents each from urban and rural areas primary health centres were proportionately selected from 18 primary health centers using simple random sampling. Exit interviews were conducted using the antenatal care exit interview form of the Safe Motherhood Needs Assessment package. In-depth Interviews were conducted with the heads of selected facilities. Data was analysed using descriptive statistics and Chi square test and content analysis for indepth interview. Results: More respondents 58 (29.3%) from the urban areas had the minimum contents compared to 41 (20.7%) of the rural respondents (p < 0.05) and 178 (90.8%) of the urban were taught a range of health education topics compared to 177 (88.5%) (p = 0.45). Urban respondents were about 1.6 times more likely to receive the minimum contents than rural respondents. In-depth interview results explicated the facilitating factors and challenges to focused antenatal care in the study areas. Conclusion: The findings of this study is consistent with other studies establishing the fact that better health service is available to urban residents than rural residents;however, this study has succeeded in comparing the documented standard of antenatal care with what was being practiced in the selected PHCs of the state. The basic contents of focused antenatal care in Ekiti state were received by a small proportion of the respondents, suggesting that focused antenatal care had not fully translated into quality service;one major challenge to the delivery of standard antenatal care was inadequate number of skilled health workers especially in the rural areas. The gap between quality and utilisation of antenatal in urban and rural areas is gradually being closed up;this success should be improved upon and maintained.

Stalking of Healthcare Professionals by Their Clients: The Prevalence, Motivation, and Effect

It is proposed that healthcare professionals are prone to be stalked by their patients, but many feel ashamed to talk about it, believing that they might have done something to warrant the stalking. We undertook a rigorous review of the literature with the primitive goal of highlighting noteworthy issues on the stalking of healthcare professionals and psychologists by their patients. Databases such as PubMed and Google Scholar were searched to collate articles and studies on the topic with the keywords “stalker, stalking, assaults, aggression, and physicians”. From the review, the prevalence rate of stalking healthcare professionals ranged between 6% - 53%. This huge variation was largely due to the inconsistencies in the definition of what constituted stalking. The common motives of stalkers were largely due to erotomania or misguided expectation and a sense of resentment due to service dissatisfaction. Finally, it was apparently right to conclude that, medical doctors or healthcare professionals are at risk of being stalked on the grounds of service dissatisfaction, and mismanagement of treatment processes resulting in physical or perceived client injuries. Whereas psychologists and other psychiatrists are more prone to be stalked due to erotomaniac reasons.

Psychosocial Determinants of Postpartum Depression and Maternal Well-Being among Postnatal Women

Postpartum depression, a major depressive disorder, predisposes postnatal mothers to physical, social, and psychological malfunctioning. Purpose: The study aimed to identify the psychosocial determinants of postpartum depression and maternal well-being among mothers in the Accra metropolis. Materials and Method: A sample of 205 postnatal women between the ages of 15 - 39 years and are 4 - 12 weeks old postpartum was drawn from 37 Military Hospital, Accra. Employing a sequential explanatory approach, participants were administered the Depression, Anxiety and Stress Scale (DASS-21), Multidimensional Scale of Perceived Social Support (MSPSS), Marital Adjustment Test (MAT), and the Edinburgh Postnatal Depression Scale (EPDS). Findings: The study revealed that 14.1% of postnatal women in the Accra metropolis are at risk of developing PPD. A significant model emerged, [R2 = 0.488, F (7, 197) = 26.86, ρ < 0.05] and this was predicted by anxiety, stress and marital dissatisfaction among couples. On the other hand, results from Interpretive Phenomenological Analysis (IPA) of participants’ in-depth information revealed inadequate social support and dissatisfaction in marriage account for mothers’ at-risk behaviour of developing PPD;which impacts on maternal well-being. Conclusion: It is concluded that PPD is patent among postnatal women and psychosocial variables contribute a significant role in their experience of mental health problems following childbirth. This, in effect, requires attention from health professionals for holistic healthcare. The implications of these outcomes are discussed concerning mental healthcare delivery, the general public, and stakeholders in the health sector.

Stress Inoculation Training on Cognitive Emotional Regulation: The Effect on Vulnerable Married Female Adolescents

Married female adolescents are the most vulnerable people that culturally marry with their parents’ permission in Iran. This study aimed to investigate the effectiveness of stress inoculation training (SIT) on cognitive emotional regulation (CER) in these women. The method of this research was semi-experiment with pretest and posttest. The statistical society was the married adolescent female students from Qom high schools (80 people). First, they were assessed by cognitive emotional regulation questionnaire to find the subjects under the CER cut of point (55 people). Then 30 participants were randomly selected and were equally divided into experimental and control groups. The entry criteria for samples were female married students between 17 and 19 from low socioeconomic income. The experimental group received 8 sessions of SIT training while there was no intervention for control group. Results from MANCOVA analysis showed that there were significant differences between groups on cognitive emotional regulation in post-test. The data of pretest were the covariate factor. Finding suggests SIT is effective for cognitive emotional regulation in vulnerable married female adolescents. In addition, this training method elevates positive emotional strategies, which correlate with planning, focusing and organizing the emotions. In contrast, except self and the others blaming, negative emotional strategies differed slightly.

Group Therapy in Adults with Obsessive-Compulsive Disorder: A Review

In the treatment of OCD, several therapeutic approaches have been developed, including individual, group and/or pharmacological therapeutic methods. However, group therapy on OCD has received little research attention in comparison with other therapeutic methods and some studies demonstrated that OCD can be treated in group settings. In the literature, mentioned group therapies to treat OCD involve behavioral therapy, cognitive therapy, ERP (exposure and response prevention), cognitive behavioral therapy, ACT (acceptance and commitment therapy), supportive groups and individual therapy with family member involvement. In relation to their effectiveness, research indicated inconsistent findings. Therefore, the aim of this study was to address and to review whether group treatments on OCD are efficacious. This review focused on cognitive-behavioral group therapy (CBGT), ERP, and ACT.