http://hdl.handle.net/1842/2204 2013-05-24T06:39:09Z 2013-05-24T06:39:09Z Strachan, Jennifer Claire http://hdl.handle.net/1842/6451 2012-09-26T14:44:44Z 2012-06-26T00:00:00Z

Title: ‘Facing choices’: a mixed-methods approach to patients’ experience of care and discharge in an inpatient mental health unit. Authors: Strachan, Jennifer Claire Abstract: Objectives: This thesis addresses patients’ conceptualising of the experience of admission to and discharge from an inpatient mental health unit, and the role of measurable psychosocial constructs in this conceptualisation. Design: An embedded mixed-methods design was employed. Themes developed using thematic analysis were compared and contrasted with standardised assessment ratings. Methods: Twelve adult patients of an acute mental health unit took part in two separate interviews about their experience of admission and discharge, and completed standardised measures of anxiety and depression, social support, attachment style and illness beliefs. Interview data were analysed using social constructionist thematic analysis. Relationships between participants’ contribution to constructed themes and their responses to standardised assessments were discussed in the context of extant literature. Results: A total of fourteen themes were constructed, organised around a central theme of choices, planning and decision making. Many themes were comparable to existing constructs in attachment theory and the literature addressing illness appraisal, including mentalisation, the safe haven, internal working models, self as illness and shame. Standardised assessments supported and enhanced these interpretations. Conclusions: Understanding of the process and adaptation to the inpatient experience can be enhanced by reference to the concepts of attachment theory and social cognition. Incorporation of these concepts into current care practices and future service development may improve the inpatient experience.

2012-06-26T00:00:00Z Masley, Samantha http://hdl.handle.net/1842/6444 2012-09-26T13:30:01Z 2012-06-26T00:00:00Z

Title: Exploring the relationship between schema modes, cognitive fusion and eating disorders Authors: Masley, Samantha Abstract: Aim: Schema therapy is becoming an increasingly popular psychological model for working with individuals who have a variety of mental health and personality difficulties. The aim of this review is to look at the current evidence base for schema therapy and highlight directions for further research. Method: A systematic search of the literature was conducted up until January 2011. All studies that had clinically tested the efficacy of schema therapy as described by Jeffrey Young (Young, 1994; Young et al., 2003) were considered. These studies underwent detailed quality assessments based on Scottish Intercollegiate Guidelines Network (SIGN-50) culminating in twelve studies being included in the review. Results: The culminative message (both from the popularity of this model and the medium to large effect sizes) is of a theory which has already demonstrated clinically effective outcomes in a small number of studies and which would benefit from ongoing research and development with complex client groups. Recommendations: It is imperative that psychological practice be guided by high quality research that demonstrates efficacious, evidence based interventions. It is therefore recommended that researchers and clinicians working with schema therapy seek to build on these positive outcomes and further demonstrate the clinical effectiveness of this model through ongoing research.

2012-06-26T00:00:00Z Wilson, Suzanne Elizabeth http://hdl.handle.net/1842/6387 2012-09-13T13:34:30Z 2012-06-26T00:00:00Z

Title: Mothers with a learning disability: their experiences of service provision during the postnatal period Authors: Wilson, Suzanne Elizabeth Abstract: Introduction: There is growing evidence that many parents with learning disabilities, when given adequate support, can parent successfully. Childbirth is a significant life event that marks a woman's transition to motherhood and is a time when parents first learn to nurture their children. Postnatal care aims to facilitate this learning experience as well as promote the emotional and physical well-being of both infant and mother. To date, no research has explored the support mothers with learning disabilities receive during the postnatal period. To fill this gap in the research and help inform service provision, this study aims to explore how mothers with learning disabilities experience postnatal care. Method: Semi-structured interviews were carried out with six mothers with learning disabilities. The data were collected and analysed using Interpretative Phenomenological Analysis. Results: Mothers experiences of postnatal care were conceptualised within four superordinate themes: challenges of providing support, how support was delivered , learning to cope and challenges to building trust. All of these had accompanying subthemes. Discussion: The results are discussed in the context of relevant literature. Consistent with previous research which has been carried out with parents with learning disabilities, participants were found to be highly dependent on informal support. The participants acknowledged the value of professional input and their perceptions of how this support was delivered had important implications. Learning how to cope with the demands of their new role raised issues not dissimilar to those of parents without learning disabilities. Challenges, however, were faced in establishing trusting relationships with professionals. The findings were found to have implications for clinical practice which are described and suggestions for future research made. Conclusion: The findings suggest that participant informal supports play a key role during the initial stages of parenthood particularly with providing practical support in areas which present challenges. Professional input was valued when delivered according to the typical pathway of care post-birth. It is recommended that consideration is given to how the support is delivered to participants. This should essentially seek to empower parents rather than undermine them as how support was perceived by parents impacted on their subsequent engagement with professionals.

2012-06-26T00:00:00Z Mills, Suzanne Barbara http://hdl.handle.net/1842/6385 2012-09-13T13:30:14Z 2012-06-26T00:00:00Z

Title: Maternal and infant factors influencing infant feeding – a longitudinal study Authors: Mills, Suzanne Barbara Abstract: Introduction: There has been a lack of longitudinal studies on maternal and infant factors associated with feeding difficulties. Feeding difficulties are common, cause much anxiety for parents, and are associated with a range of child health and behavioural outcomes. This study aims to gain an understanding of the prevalence and type of feeding difficulties found in a community sample, the prevalence of maternal mental ill-health and identify maternal and infant factors predictive of feeding difficulties. A final aim is to identify factors associated with successful and unsuccessful feeding experiences from a maternal perspective. Method: A short questionnaire with questions about support and help-seeking was compiled, and several standardised measures were included in the pack; a measure of maternal mood (DASS-21), social support (SOS-S), and eating disorder symptomatology (EAT-26). Questionnaires were given to mothers in pregnancy, and again when infants were around 3 and 7 months old. An adapted version of the Child Feeding Assessment Questionnaire, and the food fussiness subscale from the Children’s Eating Behaviour Questionnaire examined feeding behaviour and maternal response. The Infant Temperament Questionnaire examined maternal perception of infant temperament. Content analysis was used to identify themes in mother’s narrative about factors which help feeding and barriers to a successful feeding experience. A within subjects design was employed to examine predictors of infant feeding difficulties. Results: 23% of mothers of 3 to 5 month old infants, and 13% of mothers of 7 to 10 month olds reported their child as having one or more feeding difficulties. Levels of stress remained stable across the length of the study, but prevalence of maternal anxiety and depression reduced. 47% of those mothers who breast fed found breast feeding difficult or very difficult. Maternally identified barriers to successful feeding with feeding were child illness, and painful or difficult breastfeeding. Mothers wanted an improvement in support and knowledge of health professionals, and a reduction in pressure from health professionals in relation to feeding method. Maternal depression and stress were correlated with severity of food refusal in infants, as well as maternal anxiety and food fussiness, prior to post-hoc analyses. Following post-hoc analyses these relationships were no longer significant. Discussion: Relationships between infant behaviour, maternal health and feeding difficulties are explored. The low prevalence of feeding difficulties and reasons for negative findings in relation to predictors of feeding difficulties are discussed. Implications for health services are presented in the light of maternal views about support and barriers to successfully feeding their child.

2012-06-26T00:00:00Z