Help-seeking Decisions Research Articles

The effects of maternal competence and situational stress level on children’s help-seeking expectations across 4 to 6 years of age

Help-seeking is a crucial problem-solving strategy for young children. However, it is not yet clear how children weigh different cues to make help-seeking decisions across preschool years, especially in caregiver–child interactions. The current study used a social expectation task to examine the effects of maternal competence and situational stress level on 4- to 6-year-old children’s help-seeking expectations from a third-party perspective. Children’s expectations of whether to seek help were measured. A total fo 135 Han Chinese children aged 4 to 6 years from an eastern city of China participated in this study. We found that 4- to 6-year-olds expected to seek more help from a competent mother than from an incompetent mother in low-stress conditions. When the stress level was high, however, they expected to seek help regardless of maternal competence levels. These results suggest that the interaction between the situational stress level and maternal competence determines young children’s help-seeking expectations across preschool years. They further suggest that young children seek help from mothers in an active and discriminatory way.

The Focal Concerns of Stalking Victims: Examining Victims’ Decisions to Engage Civil and Criminal Legal Systems

Few studies have explored the focal concerns theory as a framework for understanding crime victims’ decisions to adopt civil/criminal interventions. Using data from the 2019 National Crime Victimization Survey, the current study finds support for the theory, highlighting several factors influencing formal help-seeking decisions aligned with factors legal actors also consider in arrest and charging decisions. Indeed, stalking victims were more likely to apply for protection orders and/or contact the police after experiencing a repeated course of unwanted conduct (e.g., blameworthiness) by intimate partners (e.g., community protection) that caused victims to fear for themselves or others (e.g., community protection) and/or to access victim services (e.g., practical constraints). In addition, most victims believed they were targeted by stalkers who felt entitled, desired power and control, or felt rejected. The findings suggest implications for improving civil and criminal-legal responses to stalking complaints by outlining areas to probe during interviews for further corroboration.

ALASKA NATIVE DEMENTIA CAREGIVERS AND THE INCREASING NEED FOR CULTURALLY SAFE RESOURCES

Abstract With the rate of dementia increasing among Alaska Native people and the tribal health system ill-equipped to meet the challenges associated with dementia care, there is an urgent need to better understand cultural perspectives on dementia caregiving and what states and communities can do to support their caregivers. Despite the fact caring for others is a value and cultural practice for Indigenous communities, and caregivers tend to report fewer challenges and barriers related to care, they still experience barriers and challenges. Guided by Kleinman’s explanatory model of illness, a qualitative, the aim of this study was to gain insight on Alaska Native caregiver experiences in caring for someone living with dementia in communities across Alaska. 21 interviews with Alaska Native dementia caregivers in rural and urban communities were completed. Despite being innovative and resourceful in providing care, caregivers reported the high cost of care, inadequate training of health care providers, and the paucity of culturally safe caregiver training, education, and resources are especially concerning and need to be addressed in a timely fashion. Caregivers in this study recommended the development of basic educational materials to be aware of dementia, its stages, and the available supports, as well as caregiver support and respite services. The recommendations from this study focus on outreach and education for caregivers to improve their access to education, training, and support to reduce isolation, increase their dementia knowledge, expand their awareness of ancillary resources, and inform help-seeking decisions.

A Qualitative Thematic Analysis of First-Generation College Students’ Help-Seeking Attitudes, Decisions, and Behaviors

First-generation college students (FGCS) are significantly less likely to complete degrees compared to continuing-generation students. Among the multifaceted causes for this disparity, many FGCS possess limited social and cultural capital in academia, resulting in lower rates of help-seeking and resource utilization. In this study, we conducted an in-depth qualitative investigation to better understand FGCS's help-seeking attitudes, decisions, and behaviors. Twenty-five first-year FGCS at a 4-year, regional, public university participated in individual interviews. A faculty–student team analyzed interview data using reflective thematic analysis. Our findings demonstrate that FGCS were highly strategic about help-seeking, weighing potential costs and benefits. Though they valued self-sufficiency, FGCS sought support when they identified tangible problems and solutions, when potential providers were accessible and had clearly designated roles, and when helpers conveyed personal interest, empathy, and nonjudgment. These results support several recommendations for policy and practice, including critical consciousness, peer mentoring, and difference-education interventions.

Living in the Margins: Assessing Police Engagement as a Form of Victim Help-Seeking Through Legal Estrangement

ABSTRACT This paper offers one attempt to move police reporting literature into help-seeking contexts. The current study uses the legal estrangement framework to examine complex victim help-seeking decisions, in the form of police engagement, for individuals living in impoverished neighborhoods with high violent crime rates in Philadelphia, Pennsylvania. A thematic analysis was applied to semi-structured interviews and found help-seeking is a dynamic process. Among victims of color, the legal estrangement framework contextualizes the landscape of help-seeking decisions, while other socio-ecological and situational characteristics simultaneously influence help-seeking behaviors. Concepts of procedural injustice, vicarious marginalization, and structural exclusion are reflected in both help-seekers and non-help-seekers.

‘It was Dangerous, Corrosive and Cruel but not Illegal’: Legal help-seeking Behaviours Amongst LGBTQA+ Domestic and Family Violence Victim-survivors Experiencing Coercive Control in Australia

Abstract Purpose There is an expanding body of research interrogating lesbian, gay, bisexual, transgender, queer, asexual and other gender and sexuality diverse (LGBTQA+) persons’ experiences of domestic and family violence (DFV). However, few studies have considered LGBTQA+ persons’ specific experiences of ‘coercive control’ and none have considered legal help-seeking behaviours and decisions within this context. This article addresses this gap, through an examination of LGBTQA+ Australians’ experiences of legal help-seeking behaviours when experiencing coercive control from an intimate partner and/or family member. Method The article draws on the qualitative responses of a sample of 137 LGBTQA+ victim-survivors who participated in a survey on Australians’ experiences of coercive control. The analysis considers the reasons why some participants did not report abuse to the police, and the impact of police reporting for those who did. Results The study found that many of the concerns about the impact of reporting held by those who did not report to the police, were actualized in the experiences of those who did. Further, the study found that LGBTQA+ persons experience similar barriers to help-seeking compared to heterosexual and cisgender women, in addition to barriers that speak specifically to LGBTQA+ communities. Conclusion The findings of this study highlight the shortcomings of the law’s response to domestic and family violence and the need for intersectional responses to coercive control in Australia and beyond. The emerging findings presented in this article reinforce the importance and further need for research that specifically examines LGBTQA+ experiences of coercive control.

Black Men's Intimate Partner Violence Victimization, Help-Seeking, and Barriers to Help-Seeking.

Guided by hegemonic masculinity and intersectionality theories, this descriptive, exploratory study examined Black men's intimate partner violence (IPV) victimization experiences, subsequent help-seeking decisions, and barriers to help-seeking. To begin exploring Black men's experiences, two research questions guided this study: (a) What are Black men's experiences of IPV-related help-seeking? (b) What barriers do Black men face when seeking IPV-related help and support? A total of 54 Black men participated in an online survey on their IPV experiences via the crowdsourcing platform Prolific. Overall, the men who participated in this study experienced relatively low levels of minor and severe physical and sexual violence victimization, as well as lower levels of coercive controlling violence in comparison to nationally representative data, suggesting this sample comprises men who experience situational couple versus coercive controlling violence. All but one participant utilized at least one help-seeking strategy. Informal strategies were most commonly utilized, whereas legal strategies were least commonly utilized. The degree to which participants perceived each strategy as helpful was quite variable, such that staying with friends or family was the most helpful strategy yet 47.8% found it unhelpful. The most common help-seeking barriers (e.g., wanting to solve the problem on their own) overlap with hegemonic masculinity and Black men's experiences with formal and legal systems, relating less to the internalized and anticipated stigma subscales created for women. Broadly, this study helps illustrate the need for researchers to focus on developing measures and interventions tailored to Black men and their experiences.

N26 Help-seeking experiences of patients with Inflammatory Bowel Disease from healthcare professionals: A qualitative descriptive study

Abstract Background Due to the chronic, relapsing and remitting disease course associated with Inflammatory Bowel Disease (IBD), self-management tools inclusive of conceptualising the problem, acknowledging the need for external help and knowing where to seek help from are essential for the management of IBD. Those living with IBD are challenged by physical symptoms and psychological and social issues that they are unable to self-solve. Help-seeking behaviour (HSB) is a relatively new concept to health services research (Cornally & McCarthy, 2011) and has been infrequently applied to the area of IBD. When IBD-related challenges are beyond self-resolution, patients require help and support from healthcare professionals (HCPs). This engagement must be facilitated at the point of issue recognition, as opposed to at crisis point. Given the dearth of research in this area, this study explored the help-seeking experiences of patients living with IBD for the challenges associated with IBD from HCPs, to enable us through understanding their experiences, how best to support help-seeking pathways and/or early interventions to assist those living with IBD to resolve issues that challenge their day-to-day lives. Methods A qualitative descriptive design (Sandelowski 2000; Neegaard et al., 2009; Sandelowski 2010) was employed as little is known regarding the help-seeking experiences of those living with IBD, their sources of help and preferred methods of seeking help. Participants were recruited purposefully from two public university hospitals in the Republic of Ireland that provide dedicated in- and out-patient care to those living with IBD. Data were collected via semi-structured one-to-one phone interviews (n=8). Results An overarching theme of ‘coming to terms with managing my IBD’ and four themes of ‘help-seeking trigger’, ‘help-seeking hesitancy’, ‘help-seeking decision pathway’ and ‘need for support’ emerged from the data by way of latent pattern content analysis. Conclusion Typically, help is sought for IBD related challenges by contacting their designated IBD nurse directly via text, the preferred method, or via phone. The majority of participants spoke of negative experiences of seeking help prior to the introduction of an IBD nurse. These may be categorised either by lack of service provision or by symptoms being dismissed or not understood by HCPs who lack expertise in the area of IBD. Triggers for seeking help are in line with the challenges identified in our earlier meta-synthesis of patients’ experiences of IBD (Byron et al. 2020) and tend to mainly be related to the physical symptoms associated with IBD as well as the medical treatments being delivered. The need for both formal and informal psychological support was identified by participants.

Customers’ help-seeking propensity and decisions in brands’ self-built live streaming E-Commerce: A mixed-methods and fsQCA investigation from a dual-process perspective

In the current competitive e-marketplaces, brands’ self-built live streaming e-commerce (BLSE), which features real-time visibility and synchronous interactivity, has become increasingly popular among enterprises. It has also become a major channel for customers to seek help during the purchasing process. Therefore, how firms can leverage platform-based information technology features to optimally transform customer help seeking into purchase behavior has become a pressing concern. This study contributes to existing research by examining the effects of customers’ help-seeking propensity on different information processing paths. We integrate the mixed-methods design with fuzzy-set qualitative comparative analysis, combining affordance theory and heuristic-systematic model. The results indicate that in BLSE, for customers with dependent help-seeking propensity, the heuristic processing mechanism has stronger effects than the systematic processing mechanism. However, for customers with autonomous help-seeking propensity, the effect of the systematic processing mechanism is stronger. Moreover, there are four coexisting combinations of platform elements that can result in high purchase intentions. Practical implications for future study are provided.

Medical decision-making for adolescents with depression: A bibliometric study and visualization analysis via CiteSpace.

This study focussed on evaluating the status of recent research on medical decision-making for adolescents with depression and identifying research hotspots and frontiers via CiteSpace. We extracted studies that were concerned with medical decision-making for adolescents with depression from the Web of Science Core Collection (WoSCC), covering the period from 1 January 1999 to 20 September 2022. We used CiteSpace to generate online maps of worldwide cooperation among countries, institutions, and authors. Hotspots and frontiers were systematically summarized. A total of 368 papers related to medical decision-making for adolescents with depression were obtained from WoSCC. The most prolific author was Nick Midgley (seven papers). The United States and University College London were the leading country and institution in this research area, with 177 and 17 papers, respectively. Countries, institutions, and authors all actively collaborated. Main recent research trends include the preference or attitude towards medical treatment in adolescents with depression; approaches for adolescents with depression to seeking medical help; and the key role of parent, family, and primary care in medical decision-making for adolescents. Thus, further attention should be paid to determining how to promote the role of parents, families, and primary care in the decision-making process and create appropriate online help-seeking tools and decision aids to facilitate shared decision-making in the future.

Factors influencing symptom appraisal and help-seeking of older adults with possible cancer: a mixed-methods systematic review.

BackgroundThe cancer burden falls predominantly on older (≥65 years) adults. Prompt presentation to primary care with cancer symptoms could result in earlier diagnosis. However, patient symptom appraisal and help-seeking decisions involving cancer symptoms are complex and may be further complicated in older adults.AimTo explore the effect of older age on patients’ appraisal of possible cancer symptoms and their decision to seek help for these symptoms.Design and settingMixed-methods systematic review.MethodMEDLINE, EMBASE, CINAHL, PsycINFO, Cochrane Library, Web of Science Core Collection, ASSIA, the ISRCTN registry, and the National Institute for Health and Care Excellence were searched for studies on symptom appraisal and help-seeking decisions for cancer symptoms by adults aged ≥65 years. Studies were analysed using thematic synthesis and according to the Synthesis Without Meta-Analysis guidelines.ResultsEighty studies were included with a total of 32 995 participants. Studies suggested a possible association between increasing age and prolonged symptom appraisal interval. Reduced knowledge of cancer symptoms and differences in symptom interpretation may contribute to this prolonged interval. In contrast, in the current study a possible association was found between increasing age and prompt help-seeking. Themes affecting help-seeking in older adults included the influence of family and carers, competing priorities, fear, embarrassment, fatalism, comorbidities, a desire to avoid doctors, a perceived need to not waste doctors’ time, and patient self-management of symptoms.ConclusionThis review suggests that increasing age is associated with delayed cancer symptom appraisal. When symptoms are recognised as potentially serious, increasing age was associated with prompt help-seeking although other factors could prolong this. Policymakers, charities, and GPs should aim to ensure older adults are able to recognise potential symptoms of cancer and seek help promptly.

Help-seeking among college survivors of dating and sexual violence: a qualitative exploration of utilization of university-based victim services

Objective: Study uses qualitative data to examine help-seeking decisions as well as the drivers and barriers to utilization of university-based victim services through the accounts of survivors. Participants: The current study involves the analysis of 33 semi-structured interviews that were conducted with dating and sexual violence (DSV) survivors at a large, Mid-Atlantic University who both did and did not utilize university-based victim services. Methods: Data were analyzed using a thematic analysis approach. Results: Analysis shows that while survivors of DSV undergo a process of help-seeking that is similar to those described in previous help-seeking models, there are additional factors that contribute to a reluctancy to seek services at a university-based victim services center in particular that must be accounted for in the literature. Conclusions: The findings from the current study underscore the importance of understanding the specific drivers and barriers to utilization of university-based victim services.

\u201cA lot of medical students, their biggest fear is failing at being seen to be a functional human\u201d: disclosure and help-seeking decisions by medical students with health problems

BackgroundAlthough medical students have a duty to seek advice for their health conditions, they tend to avoid disclosure and help-seeking behaviours, therefore potentially posing a risk to themselves and their patients. The literature regarding their decisions to seek help or disclose health conditions is limited. The study’s purpose was to explore the factors that determine disclosure and help-seeking decision processes by medical students who have health conditions with or without disability.MethodsWe recruited by purposive sampling and conducted in-depth semi-structured interviews with 11 male and female medical students from a UK medical school, who had physical or mental health disorders. Thematic analysis was used to identify themes. A mix of inductive and deductive techniques was used while using an organising framework proposed by Llewellyn-Thomas (1995).ResultsThe impact of individuals’ features, such as personality traits on medical students’ disclosure and help-seeking decisions were identified. Different aspects of the condition, such as its type and severity were found to influence these decisions. Participants made an evaluation of the potential receiver of a disclosure, consisting of factors such as the receiver’s characteristics and attitudes. The culture of the medical environment, such as role models, had a major impact on their decisions. Finally, systemic factors, such as the lack of clarity of policies influenced students’ decisions.ConclusionMedical students’ disclosure and help-seeking decision processes are influenced by risk-benefit evaluations and factors in interlinked spheres of their lives. They tend to avoid or postpone disclosure and seeking help, especially when the university is involved, due to a perceived risk to their future. Future research should examine the role of personality traits and the medical culture. Medical schools should encourage earlier help-seeking and disclosure behaviours by clarifying procedures and building trust via online and confidential platforms; interpersonal channels and normalisation processes within the medical education and the profession as a whole.

Understanding help-seeking decisions in people with subjective cognitive decline: A systematic review of qualitative studies

ObjectiveTo synthesize the findings of qualitative research on help-seeking in people with subjective cognitive decline. MethodsRelevant qualitative studies were identified by searching the PubMed, CINAHL, Ovid Medline, PsycInfo, Embase, and Web of Science databases. Studies that investigated help-seeking behavior in older adults with subjective cognitive decline were retrieved. The systematic review was conducted in line with JBI methodology for systematic reviews of qualitative evidence. Results11 studies were included and three themes related to the process of help-seeking for cognitive problems emerged. These themes included: detected changes, challenges in identifying the need for help and decision to seek professional help. ConclusionMaking decisions to seek help for people with subjective cognitive decline is a multi-stage process. A better understanding of the complex psychological responses to subjective cognitive decline among older adults may help health care professionals to develop strategies to improve help-seeking in clinical practice.

A Behavioral Economic Model of Help-Seeking for Depression.

Findings from the clinical psychology literature indicate that many who experience depression do not seek treatment when needed. This may be due to help-seeking models and interventions failing to account for the behavioral characteristics of depression that affect decision making (e.g., altered sensitivity to punishment and reward). Behavioral economics can provide a framework for studying help-seeking among individuals with depression that explicitly considers such characteristics. In particular, the authors propose that depression influences help-seeking by altering sensitivity to treatment-related gains and losses and to the delays, effort, probabilities, and social distance associated with those gains and losses. Additional biases in decision making (e.g., sunk-cost bias, default bias) are also proposed to be relevant to help-seeking decisions among individuals with depression. Strengths, limitations, and future directions for research using this theoretical framework are discussed. Taken together, a behavioral economic model of help-seeking for depression could assist in identifying those who are at greatest risk of going untreated and in creating more effective help-seeking interventions.

From their own perspectives: a qualitative study exploring the perceptions of traditional health practitioners in northern Uganda regarding cancers, their causes and treatments

BackgroundMany cancer patients in the low- and middle-income countries seek care with traditional health practitioners (THPs) and use traditional and complementary medicines (T&CMs) for treatment of cancers. Little is known about the perceptions and influence of THPs on cancer patients’ help-seeking and treatment decisions. We aimed to explore perceptions of THPs regarding cancers, cancer causes, and preferred treatments for cancers, in order to identify aspects that can inform interventions to improve cancer outcomes in Uganda.MethodsWe conducted this ethnographic study in northern Uganda. In-depth interviews were conducted at the respondents’ homes in quiet, open places, and in the absence of none- respondents. Interviews were audio-recorded and transcribed verbatim within a week of the interviews. Thematic qualitative analysis approaches were used to identify themes and subthemes.ResultsWe included 21 respondents in the study; most were male (16/21), married, with median age of 59 years (range 39 – 80). Most respondents perceived cancer as a new and challenging disease, while one respondent thought of cancer as a result of an imbalance within the body. Most confessed unawareness of the causes of cancers, but believed that cancer could result from the interplay of a number of factors including poor diets, ingestions of chemical agents, and assaults by the spirits of the dead. Some reported that cancers (especially of women’s genital tracts) were sexually transmitted, or caused by accumulation of dirt. Only few healers treated cancers. Most respondents reported that they referred cancer patients to biomedical facilities, sometimes after they have first used their medicines. Most respondents hoped that collaborative research with scientists could help them identify potent T&CMs that cure cancers.ConclusionTraditional health practitioners require training on cancer causes, symptoms and signs, and the necessity for prompt initiation of effective treatments in order to improve cancer outcomes. The predisposition of the majority of respondents to refer cancer patients to biomedical services sets a fertile ground for meaningful cooperation between biomedical and traditional health practices. The national health system in the low- and middle-income countries could formally recognize traditional health practices as a component of the national healthcare system, and encourage the two to practice side by side.

If we build it, they will come: Caregiver decision to use an accessible outpatient psychiatric service for children and adolescents in Nigeria

ObjectiveIf child and adolescent psychiatric (CAP) services were accessible in lower-middle-income countries (LMIC) such as Nigeria, what individual and socio-cultural factors would influence caregivers’ willingness to use these services when they are needed? MethodsTo address this question, we conducted structured interviews with a stratified random sampling of 442 adult caregivers of children aged 5 to 19-years who lived within 10 km of an established CAP outpatient service in Ibadan, Nigeria. ResultsBased on structural equation modeling, our cross-sectional findings indicated that caregivers were generally willing to use the accessible outpatient CAP service for a narrow range of overtly disruptive and developmentally atypical child behavior. However, their decisions were not influenced by their recognition of child and adolescent mental health (CAMH) conditions, competing life stressors, caregiver wellness, nor stigma as we had initially hypothesized. Rather caregivers pragmatically considered a range of approaches to address CAMH concerns. Post-hoc hypotheses confirmed that caregivers’ beliefs about etiology and treatment effectiveness for CAMH conditions shaped their help-seeking decisions and stigmatization of CAP services. Specifically, caregivers who attributed CAMH conditions to physical causes regarded biomedical interventions as the most effective treatment while spiritual interventions were deemed to be the least effective. ConclusionsTaken together our results suggested that caregivers were receptive and willing to use outpatient psychiatric services for their children. However, their beliefs about the etiology and treatment effectiveness of CAMH conditions shaped how they intended to engage the services. These findings underscored the importance of scaling up a broader spectrum of accessible complementary CAMH intervention and prevention services in Nigeria that extend beyond indigenous or biomedical models. In doing so caregivers will come.

Migrant Women's Help-Seeking Decisions and Use of Support Resources for Intimate Partner Violence in China.

In China, women who domestically relocate from rural or less developed regions to major cities are at a higher risk for intimate partner violence (IPV) than their non-migrant counterparts. Few studies have focused on Chinese domestic migrant women’s help-seeking for IPV and their use of different sources of support. The present study aimed to identify factors that influence migrant women’s help-seeking decisions. In addition, we also examined factors that contribute to migrant women’s use of diverse sources of support for IPV. A sample of 280 migrant women victimized by IPV in the past year at the time of the survey was drawn from a larger cross-sectional study conducted in four major urban cities in China, including Beijing, Shanghai, Guangzhou, and Shenzhen. Using a multinomial logistic regression model and a zero-inflated Poisson model, we found that factors influencing migrant women’s help-seeking decisions and their use of diverse sources of support included socioeconomic factors, IPV type, relationship-related factors, knowledge of China’s first anti-Domestic Violence Law, and perception of the effectiveness of current policies. We discuss implications for future research and interventions.

Attitudes of relatives of patients with schizophrenia

IntroductionInvestigating family member’s attitudesabout schizophrenia is an important step in its management. They likely influence the family’s help-seeking decisions and affect both adherence with biomedical interventionsand social integration of the patients.ObjectivesDescribe families’ beliefs about the symptoms and the treatments of schizophrenia.MethodsWe led a transversal study including 32 relatives of patients with schizophrenia (DSM 5). We collected data for both patients andrelatives. We asked relatives to respond by “yes/no/I am not certain” to the questionnaireincluding items dealing with symptoms and optimal cures forschizophrenia.ResultsThe mean age of the relatives was 60.8 years; 71.9% were parents; 37.5% were illiterate; 46.9% reported having another family member with a mental disorder (MD) and 15.5% of relatives were able to label the term “schizophrenia”. Nine participants (28%) believed that the patient makes shame to the family’s member and 72% of them was convinced that patient is dangerous.The majority of participants (90.6%) provedthe need for drugs and 65.6% attested the utility of psychotherapies.However, they believed innon-medical practices such as reading Holy Koran verses (87.5%), charity and exorcism (62.5%). Family history of MD was correlated to traditional practices (p=0.038). The belief that patient is dangerous and that he makes shame were associated with advanced age of relatives (p=0.000 and 0.037 respectively). Significant correlationwas found betweennon medical practices and erratic follow-up (p=0.043).ConclusionsThis study points outthe need to improve the psychoeducation of family members of persons with schizophrenia.

Psychosocial influences on help-seeking behaviour for cancer in low-income and lower middle-income countries: a mixed-methods systematic review

IntroductionStarting cancer treatment early can improve outcomes. Psychosocial factors influencing patients’ medical help-seeking decisions may be particularly important in low and lower middle-income countries (LMIC) where cancer outcomes are poor....