Risk factors for paternal perinatal depression and anxiety: A systematic review and meta-analysis
- Authors: Chhabra, Jasleen , McDermott, Brett , Li, Wendy
- Date: 2020
- Type: Text , Journal article
- Relation: Psychology of men & masculinity Vol. 21, no. 4 (2020), p. 593-611
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- Description: This article aims to identify the risk factors associated with paternal perinatal depression and anxiety. Studies published between January 1950 and December 2017 that report paternal depression and anxiety in the perinatal period were obtained from 5 different databases. In total, 84 studies were included in the systematic review, and 31,310 participants from 45 studies were included in the final meta-analysis. Risk factors obtained were classified based on the frequency of distribution of factors. Maternal depression is an important risk factor for fathers in the postnatal period (odds ratio [OR] = 3.34, 95% confidence interval [CI 2.51, 4.46]). Marital distress was also linked to a twofold increase in the likelihood of paternal depression in the postnatal period (OR = 2.16, 95% CI [1.47, 3.19]). Parenting stress as a risk factor was strongly and significantly associated with paternal anxiety in perinatal period (OR = 14.38, 95% CI [7.39, 27.97]). The findings suggest that maternal depression, marital distress, and parental stress are important risk factors for fathers' mental health in the perinatal period. The current meta-analysis also identifies gender role stress, domestic violence, and mismatched expectancies from pregnancy and childbirth as the risk factors that are unique to fathers only in the perinatal period. Future intervention programs should screen and target fathers with no previous children, or a depressed partner, and aim to enhance relationship satisfaction. Public Significance Statement Like women, men also show signs and symptoms of depression and anxiety in the perinatal period. Meta-analysis revealed that partner's depression, marital distress, and parenting stress are significant risk factors to fathers' mental health in perinatal period. Counteracting these risk factors may reduce the risk of depression and anxiety in fathers in the perinatal period.
Predictive factors for depression and anxiety in men during the perinatal period: A mixed methods study
- Authors: Chhabra, Jasleen , Li, Wendy , McDermott, Brett
- Date: 2022
- Type: Text , Journal article
- Relation: American Journal of Men's Health Vol. 16, no. 1 (2022), p. 15579883221079489-15579883221079489
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- Description: The purpose of this study was to identify the risk factors associated with paternal perinatal mental distress in a sample of Australian men. A mixed-methods design was used. The qualitative component (N = 13) using thematic analysis identified maternal depression, marital distress, masculine gender role stress, unplanned pregnancy, work–family conflict, and sleep disturbance as risk factors for paternal perinatal mental distress. The quantitative component (N = 525) expanded on the qualitative findings and examined the associations between the identified risk factors and mental distress of fathers in the perinatal period measured by Edinburgh postnatal depression scale. Hierarchical multiple regression analysis revealed six significant predictors of paternal perinatal mental distress with masculine gender role stress being the most significant risk factor for paternal perinatal mental distress. The results from this study provide an insight into how masculine gender role may affect the expression and experience of mental distress in fathers within the perinatal period. Implications of research findings are discussed.
Palliative care education and its effectiveness: a systematic review
- Authors: Li, Wendy , Chhabra, Jasleen , Singh, Smita.
- Date: 2021
- Type: Text , Journal article
- Relation: Public Health Vol. 194, no. (2021), p. 96-108
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- Description: Palliative care education (PCE) is an important public health approach to palliative care and is crucial to improving its utilisation. The present study aims to develop a comprehensive understanding of PCE and its effectiveness. A systematic review approach, including narrative synthesis, was used to review qualitative and quantitative studies published in the English language between January 1969 and January 2019, focussing on PCE programs. Thirty-nine research studies were included in the systematic review. The target audience of the included studies were mostly healthcare professionals, followed by family caregivers. Definitions of death and palliative care, symptom management and communication were leading themes in the reviewed PCE programs. The educational resources used in PCE programs were mainly self-developed teaching materials, with some programs utilising eLearning resources. The included PCE programs were effective in improving knowledge, attitude and confidence in palliative care and the satisfaction of participant learning experience. PCE is a useful tool to improve knowledge of, confidence in and attitudes towards palliative care amongst healthcare professionals and carers. To make palliative care a public health issue, PCE should be expanded to the public and policy-makers.
Evaluation of rural general practice experiences for pre-vocational medical graduates
- Authors: McGrail, Matthew , Chhabra, Jasleen , Hays, Richard
- Date: 2023
- Type: Text , Journal article
- Relation: Rural and Remote Health Vol. 23, no. 1 (2023), p.
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- Description: Introduction: Despite substantial investment in rural workforce support, sustaining the necessary recruitment and retention of general practitioners (GPs) in rural areas remains a challenge. Insufficient medical graduates are choosing a general/rural practice career. Medical training at postgraduate level, particularly for those ‘between’ undergraduate medical education and specialty training, remains strongly reliant on hospital experience in larger hospitals, potentially diverting interest away from general/rural practice. The Rural Junior Doctor Training Innovation Fund (RJDTIF) program offered junior hospital doctors (interns) an experience of 10 weeks in a rural general practice, aiming to increase their consideration of general/rural practice careers This study aimed to evaluate the educational and potential workforce impact of the RJDTIF program. Methods: Up to 110 places were established during 2019–2020 for Queensland’s interns to undertake an 8–12-week rotation (depending on individual hospital rosters) out of regional hospitals to work in a rural general practice. Participants were surveyed before and after the placement, although only 86 were invited due to the disruption caused by the COVID-19 pandemic. Descriptive quantitative statistics were applied to the survey data. Four semistructured interviews were conducted to further explore the experiences post-placement, with audio-recordings transcribed verbatim. Semi-structured interview data were analysed using inductive, reflexive thematic analysis. Results: In total, 60 interns completed either survey, although only 25 were matched as completing both surveys. About half (48%) indicated they had preferenced the rural GP term and 48% indicated strong enthusiasm for the experience. General practice was indicated as the most likely career option for 50%, other general specialty 28% and subspecialty 22%. Likelihood to be working in a regional/rural location in 10 years was indicated as ‘likely’ or ‘very likely’ for 40%, ‘unlikely’ for 24% and ‘unsure’ for 36%. The two most common reasons for preferencing a rural GP term were experiencing training in a primary care setting (50%) and gaining more clinical skills through increased patient exposure (22%). The overall impact on pursuing a primary care career was self-assessed as much more likely by 41%, but much less by 15%. Interest in a rural location was less influenced. Those rating the term poor or average had low pre-placement enthusiasm for the term. The qualitative analysis of interview data produced two themes: importance of the rural GP term for interns (hands-on learning, skills improvement, influence on future career choice and engagement with the local community), and potential improvements to rural intern GP rotations. Conclusion: Most participants reported a positive experience from their rural GP rotation, which was recognised as a sound learning experience at an important time with respect to choosing a specialty. Despite the challenges posed by the pandemic, this evidence supports the investment in programs that provide opportunities for junior doctors to experience rural general practice in these formative postgraduate years to stimulate interest in this much-needed career pathway. Focusing resources on those who have at least some interest and enthusiasm may improve its workforce impact © 2023, Rural and Remote Health.All Rights Reserved.