Therapeutic Support Research Articles

Enhancing Diabetic Foot Ulcer Healing: The Role of Channa striata Extract Nutrition in Accelerating Inflammatory, Proliferative, and Maturation Phases

Background: Diabetic foot ulcers pose a severe complication for individuals with diabetes mellitus, necessitating effective therapeutic support such as albumin nutrition throughout the wound healing process. Derived from Channa striata, a commonly consumed source of albumin in Indonesia, this extract can potentially expedite wound healing.Objective: This study aims to evaluate the efficacy of Channa striata extract nutrition in accelerating the inflammatory, proliferative, and maturation phases of diabetic foot ulcer healing.Methods: This quantitative study employed a pra-experimental design using a single-group pretest-posttest approach. The study involved 30 diabetic patients who were administered a daily dose of 550 grams of Channa striata extract over four weeks. The Bates Jensen Assessment Tool (BWAT) assessed wound progress.Results: Results revealed that the average participant age was 60.2 years, with an average diabetic history of seven years. The average wound duration was 8.7 weeks; 66.7% of the participants were female; 70% had Non-Insulin Dependent Diabetes Mellitus (NIDDM); and 56.7% were at stage IV. The study found a significant difference in BWAT scores before and after the administration of Channa striata extract in diabetic foot ulcer patients.Conclusion: This study supports the effectiveness of Channa striata extract as an adjunct therapy in expediting the wound-healing phases in diabetic foot ulcers.

Effective components of services for recurrent care experienced parents: A literature review of what works

Recurrent care services aim to reduce the number of repeat removals amongst birth parents who have already ‘lost’ a child through care proceedings. This literature review aimed to identify published evidence about effective components of services to support parents who have experienced repeat removals of their children to care.Searches identified 19 studies that included content relating to the components of service provision within recurrent care services. Across all studies, a range of perspectives were included: birth parents (n = 425); practitioners (n ≥ 151); other professionals (n = 109).The evidence reviewed indicates the importance of relationship-based practice, building a trusted relationship between parents and practitioners, continuity and tenacity in engaging with mothers and a non-judgemental approach. Services should be flexible, holistic and client led, with a long duration of support and a flexible end date. Services should: have a trauma-informed approach; recognise unresolved loss, complex grief and trauma experienced by mothers who have ‘lost’ their children through care proceedings; and provide emotional support, therapeutic support, practical support and advocacy. Services need to have a skilled and multi-disciplinary workforce with robust supervision and ongoing training.

Using Deep Learning to Suggest Treatment for Proximal Humerus Fractures.

Proximal humeral fractures are among the most common fractures seen in emergency departments. Accurately diagnosing and selecting the most appropriate treatment for these fractures can be challenging, and consultation with a senior orthopedic surgeon can be time-consuming for both the patient and the emergency unit. We developed a machine learning model for predicting the type of treatment based on injury radiographic images. The model distinguishes between nonoperative and operative treatment options, achieving an accuracy of 86% and an interobserver reliability (kappa) of 0.722 for test-dataset, which is more than the interobserver agreement between shoulder surgeons. This model has the potential to serve as a therapeutic decision support system for the practitioners in the emergency departments to expedite treatment decisions and to reduce patients' waiting time.

Fostering Development in Children With Congenital Heart Disease

Children with complex congenital heart defects often show delays and deficits in cognitive, language, motor, and social-emotional functioning. As such, the American Academy of Pediatrics and the American Heart Associated recommend ongoing monitoring and support of development. In conjunction with the formal therapeutic supports frequently recommended for young children with CHD, caregivers are instrumental in providing an enriching environment to enhance development in the hospital, at home, and in early childhood settings. In this article, we review the common developmental sequelae associated with CHD, underlying causes, and ways in which parents, family members, and professional caregivers can support development for children with CHD from birth to three years old.

Neuroticism Overestimated? Neuroticism Versus Hypertonia, Pain and Rehabilitation Outcomes in Post-Spinal Cord Injury Patients Rehabilitated Conventionally and with Robotic-Assisted Gait Training.

The aim of the present study was to analyse the association between neuroticism (one of the Big Five personality traits) and the most common secondary sensorimotor complications occurring in patients after spinal cord injury (SCI), i.e., muscle spasticity (hypertonia) and pain, and to investigate the associations between neuroticism and the effects of conventional rehabilitation (dynamic parapodium) and those using robotic-assisted gait training (RAGT) in this group of patients. In addition, the association of neuroticism with self-efficacy, personal beliefs about pain control, and adopted coping strategies among SCI patients was analysed. These data can be used as a reference for designing effective forms of therapy and support dedicated to this group of patients. Quantitative analysis included 110 patients after SCI. The participants were divided by simple randomisation into a rehabilitation group with RAGT and a rehabilitation group with dynamic parapodium therapy (DPT). The following survey instruments were used for data collection: Revised NEO Personality Inventory (NEO-PI-R); Ashworth Scale; the Spinal Cord Independence Measure III (SCIM III); the Walking Index for Spinal Cord Injury II (WISCI-II); the American Spinal Injury Association Impairment Scale (AIS); the Pain Coping Strategies Questionnaire-CSQ; and the Beliefs about Pain Control Questionnaire-BPCQ. analyses showed a positive association between neuroticism and spastic tension (rho = 0.39; p < 0.001). the study showed that a high level of neuroticism correlates with a higher level of spasticity, but no such correlation was observed for pain. Additionally, the study did not show a significant correlation between neuroticism and rehabilitation outcome depending on the rehabilitation modality (RAGT vs. DPT). The results underline the importance of carrying out a psychological diagnosis of patients to provide therapeutic support in the rehabilitation process.

Utilization of early therapeutic supports by autistic preschoolers in Australia: A cross-sectional study following implementation of the National Disability Insurance Scheme.

There are many types of support for young autistic children and their families, but service use in this population is not well understood. In this study, primary caregivers of autistic preschoolers were surveyed (n = 95) and a selection were then interviewed (n = 19) to understand how early, therapeutic supports were accessed by families in Australia following the establishment of a National Disability Insurance Scheme (NDIS). This article presents the quantitative data from surveys and interviews. Families usually accessed at least two types of support. The most accessed supports were occupational therapy, speech pathology and psychology, with 43% of the sample accessing some other form of support. Multiple linear regression indicated that children's higher level of support need, living in less remote or less socio-economically disadvantaged areas, and high household income were associated with higher numbers of supports accessed. Services tended to follow an individual, clinic-based model and little use of alternative service delivery was reported. The findings indicate that Australian families are accessing a wider range of support types than before the NDIS and children with more substantial autism-related support needs are likely to access a greater number of types of supports. Socio-economic inequities continue to exist and should be addressed.

Evidence-based medicine: Indole-3-carbinol and resveratrol in human papillomavirus-associated conditions

Of all types of cancer in the female reproductive system, cervical cancer has the greatest social significance due to its impact on young patients, often even those who have not yet completed their reproductive function, and it is the third leading cause of cancer-related death. Considering the lack of etiological therapy for human papillomavirus and associated diseases, the high demand for effective methods of medical therapeutic support, and the absence of a gold standard treatment apart from destructive and excisional methods, it seems reasonable to consider the use of nutrients with anticancer effects in the treatment of low-grade cervical intraepithelial neoplasia both as an addition to the watchful waiting strategy and in the use of ablative treatment methods, as well as their adjuvant appointment in the case of obligatory precancer. Based on domestic and foreign literature sources from electronic databases such as PubMed, CyberLeninka, and Elibrary, this review presents data on the use of trans-resveratrol and indole-3-carbinol in HPV-associated diseases. The combination of two mutually complementary anticancer antioxidants – indole-3-carbinol, which primarily has antiproliferative effects, and trans-resveratrol, which restores cellular apoptosis mechanisms, comprehensively affects the pathogenetic mechanisms of the virus-induced pathological process: it has been proven to reduce the expression of oncogenes E6 and E7, increase the expression of tumor suppressor proteins – p53, pRb, PTEN, and decrease markers of proliferation PCNA and Ki-67. The combination of 200 mg of indole-3-carbinol and 60 mg of trans-resveratrol for the prevention of persistent papillomavirus infection and the treatment of cervical intraepithelial neoplasia has impressive potential; however, further research is needed to determine the most effective application schemes.

E-formation d’un réseau de soins avec un dispositif numérique d’e-ETP, l’expérimentation du Centre Spécialisé Obésité des Hospices Civils de Lyon

ObjectiveSupporting patients living with obesity requires a consistent approach from healthcare professionals. Training in this therapeutic support is one of the missions of the Specialized Obesity Centers (CSO). A digital device was tested by the CSO of the Hospices Civils de Lyon (HCL) in order to assess its relevance for the training of its network of professionals between September and December 2022. Materials and methodsTwo e-courses were tested: “obesity nutrition” (38 workshops) and “bariatric surgery” (23 workshops) by volunteer healthcare professionals (n=282) and by a group of experts (n=8). Three main categories of data were collected for this experiment in order to assess the use, satisfaction and relevance of the platform using a Likert scale out of 10 and a list of words to choose from. ResultsThe completion rates for all courses for healthcare professionals are 32.8% (nutrition obesity) and 65.2% (bariatric surgery). More than 90% of users recommend the use of the tool for patients and healthcare professionals. The expert group assessed the interest of the tool in the context of training healthcare professionals at 9.3 ± 0.7 out of 10. ConclusionDigital technology now makes it possible to enrich care pathways with the use of digital devices provided that the latter maintain a consistency of approach and content. This experiment demonstrates here that this digital device, initially designed for the therapeutic education of patients, has its place in the future training pathways of caregivers.

Outcomes, unmet needs, and challenges in the management of patients who withdraw from anti-CGRP monoclonal antibodies: A prospective cohort study.

The anti-calcitonin gene-related peptide (CGRP), or its receptor (CGRP/R) monoclonal antibodies (mAbs), offer targeted, effective, and tolerated drugs for migraine. However, about 25% of patients fail to achieve a clinically meaningful response, usually leading to discontinuation. These patients often have a lengthy migraine history and multiple prior preventive treatment failures, resulting in limited therapeutic options. Herein, we describe the cause for and outcome of withdrawal of anti-CGRP/R mAb and evaluate the treatment course until discontinuation. We conducted a prospective analysis on migraine patients attending the Florence Headache Center in Italy, who discontinued treatment with anti-CGRP/R mAbs. The primary objectives were to describe the reasons for anti-CGRP mAbs discontinuation and the treatment course. Secondary objectives were the evaluation of the absolute change from baseline in monthly headache days, response rates, persistence in medication overuse, absolute change from baseline of the overall number and days of analgesics use per month, change of MIDAS and HIT-6 at three, six, and 12 months, and the last month of treatment. Among 472 patients, 136 (28.8%) discontinued mAb treatment after an average of 9.0 ± 6.1 (mean ± SD) months. The majority (96/136, 70.6%) discontinued due to ineffectiveness, followed by lost to follow-up during treatment (18/136, 13.1%) and adverse events (10/136, 7.3%). In total, 77.9% of the 136 patients ceased treatment within the first year. Following discontinuation, 48.5% initiated new pharmacological treatment, 39.7% were lost to follow-up, and 11.8% opted not to start another treatment. The majority of patients that started a new pharmacology treatment switched to another anti-CGRP/R (46/68, 67.6%). The second most-used treatment was onabotulinumtoxinA (7/68, 10.2%; all patients in this subgroup were naïve to this treatment), followed by an anticonvulsive medication (7/68, 10.2%). The response status (≥50% reduction in monthly headache days) was achieved by 30.5%, 34.6%, and 40.0% of patients at month 3, 6, and 12 of treatment, respectively. Considering only the comprehensive last month of treatment before withdrawn the percentage of responders was 16.9%. Although anti-CGRP/R mAbs have provided a substantial amelioration of migraine management, a relevant proportion of patients remains unresponsive and requires additional therapeutic support. Further research is required to identify non-responder features and address unmet needs in migraine treatment.

What matters for sustainable psychosocial interventions and who decides? Critical ethnography of a lay counselling program in Nepal

Lay counselling, or the delivery of talk-based therapeutic support by people without a clinical degree, is gaining popularity as a way of addressing global shortages of mental health professionals. In Nepal, lay counselors have made significant contributions to mental health and psychosocial care over the last two decades, particularly in the aftermath of major emergencies. However, research on the longer-term integration and sustainability of lay counselling interventions remains limited. This ethnographic study explored the meaning and importance of sustainability to different stakeholders in a lay counselling program implemented following Nepal's 2015 earthquake. We conducted participant observation in the everyday lives of five counsellors as well as four focus group discussions and 51 semi-structured interviews with counsellors and other key stakeholders. Our analysis revealed significant discrepancies in perceptions of sustainability; while organizations involved in implementing the program described it as a sustainability success due to continued government financing, counsellors emphasized their own and the government's failure to sustain high-quality service delivery in practice. Program-level barriers included inadequate budget and remuneration, lack of clinical supervision, and poor integration within existing systems. We also identified wider sociopolitical influences on sustainability, including the social positioning of counsellors, low understanding and acceptability of counselling, and a rapidly changing political landscape. These findings reveal the need for a critical approach to sustainability in global mental health, warning against superficial engagement that prioritizes continuity of government financing over quality of care and workers' rights. Advocating for an ecological orientation within sustainability research, we also discuss the importance of looking beyond program design factors to consider how local and national sociopolitical dynamics influence frontline service provision.

Fluctuating emotional states before and during child sexual abuse and rape: a file review analysis of males in mandated care in The Netherlands

Purpose The purpose of this study is to examine emotional states preceding and during sexual crimes in a Dutch sample of adult male patients who were admitted to mandated clinical care. Design/methodology/approach Emotional states preceding child sexual abuse (CSA) (n = 63) and rape against adults (n = 60) were compared using the Mode Observation Scale. Findings CSA and rape were equally preceded by feelings of vulnerability, undifferentiated anger and loneliness and characterised by callous unemotionality. Emotional manipulation was more dominant in the events leading up to CSA, whereas an exaggerated sense of self-worth was more dominant in the event preceding rape. Substance-related detachment was more common preceding rape but was equally common during both types of crimes. Controlled anger was more common in rape. Practical implications CSA and rape crimes are predominantly characterised by similar emotional states of persons who were admitted to mandated clinical care. This informs the development of more effective therapeutic interventions and support services tailored to the emotional profiles of patients, potentially improving rehabilitation or treatment outcomes. Scientifically, the results of this study provide a compelling foundation for further research into the psychological mechanisms underpinning sexual violence. Originality/value While previous research has often focused on these crimes in isolation, this study bridges a critical gap by examining the emotional commonalities between them. This study challenges the conventional understanding that treats these forms of sexual violence as entirely distinct, proposing instead that they may share underlying emotional dynamics.

Assessing the Efficacy of Cognitive-Behavioral Therapy on Body Image in Adolescent Scoliosis Patients Using Virtual Reality.

Background/Objectives: Adolescents with idiopathic scoliosis require emotional support to change their experience of their desired body shape and to feel optimistic about the cosmetic results of surgical treatment. Recently, the use of virtual reality in psychological assessment and treatment has given specialists a technology that appears particularly well-suited for addressing body image disorders. The study objectives were two-fold. Firstly, we aimed to evaluate changes within the body image of scoliosis patients pre- and postoperatively. Secondly, we aimed to investigate if differences in body image exist in scoliosis females after implementing cognitive-behavioral therapy. Methods: Thirty-six total scoliosis patients participated in the 1st and 2nd study phases. The psychotherapy took place before and after surgery and during the patient's stay in the hospital. Body image was assessed using a virtual reality-based application, "Avatar Scoliosis 3D". Results: Regarding body image dissatisfaction evaluated via virtual tasks, the difference between the desired by patients and actual (based on the radiographic parameters) body shape is significant preoperatively in both scoliosis samples: with and without therapy (p < 0.000001 and p < 0.000001, respectively). Conclusions: The results of the present study may have important implications for developing standards for body image disorder treatments in scoliosis patients. We revealed that irrespective of received therapeutic support, scoliosis patients accurately estimate their body shape pre- and postoperatively, and they feel dissatisfied with their body preoperatively but not postoperatively.

Anxiety and Affective Symptoms Related to the Use of Classic Psychedelics: A Systematic Review.

There is a large and rapidly growing body of literature investigating the therapeutic effects of classic psychedelics in affective and anxiety disorders, but very few studies have examined the inverse of this, that is, the potential for psychedelics to inflict anxiety and affective symptoms. A systematic literature search was performed and 39 papers were included in the final review to qualitatively synthesize the current literature on anxiety and affective disorders related to the use of classic psychedelics. Persisting disorders were less frequent but generally occurred in individuals who presented with several risk factors (overdose, polydrug use, unstructured recreational setting, psychosocial stress, personal/familial psychiatric histories). When psychedelics were administered in clinical studies under the framework of psychedelic-assisted therapy, the incidence of enduring anxiety and affective symptoms was low. In most cases, acute transient anxiety emerged and resolved during the dosing session without the need for additional treatment interventions. The nuance of such cases is discussed, shedding light on the role of emotional catharsis in the therapeutic process. Several suggestions are proposed to enhance patient safety including strengthening the therapeutic alliance, ensuring adequate mental preparation, acclimating to high doses and providing on-going therapeutic support.

Innovative approaches: phyto-probiotics as a therapeutic support for managing obesity-linked psoriasis

Innovative approaches: phyto-probiotics as a therapeutic support for managing obesity-linked psoriasis

Client-Centered and Multidisciplinary Approaches in School-Based Occupational Therapy: Perceptions of Therapists and Parents

This study aimed to explore the perspectives of occupational therapists and parents who receive therapeutic support services for their children with special needs in school. We focused on school-based occupational therapy (SBOT) service goals, delineating how participants prioritize necessary services and perceive multidisciplinary collaboration. In this cross-sectional study, we employed an online survey methodology. We used a purposive sampling method to reach all school-based therapists registered in therapeutic support centers and a snowball sampling method to recruit parents. The final sample included responses from 29 therapists and 120 parents. We found that parents reported a greater need for service provision and multidisciplinary collaboration compared to school-based occupational therapists. Although therapists felt competent in their service provision, there is an urgent need to address the service needs expressed by parents. The participating therapists reported working with lower-functioning students and prioritized goals such as “providing task skills through Individualized Education Programs (IEPs)” and “enhancing student participation in educational activities.” In contrast, parents reported supporting higher-functioning children and prioritized goals such as “therapeutic activities within school environments” and “helping with important learning activities in natural environments.” This study underscores the need for ongoing research to develop integrative occupational therapy services in the school environment.

Impact of trauma and placement in residential or congregate care on the criminalisation of children in England/Wales and Australia

Children in residential care have the most complex needs of all children growing up in Out-of-Home care (OOHC), due to complex trauma from pre-care experiences of abuse and neglect, inadequate therapeutic supports while in care and significant placement instability. Some argue that residential care settings are intrinsically criminogenic, as evidenced by significant over-representation of this cohort in youth justice. However, little is known about how children’s experiences of trauma, including removal from family and placement in OOHC, is viewed by lawyers and decision-makers in criminal cases involving children in care. Criminal justice decisions can have long-term ramifications for children in care and custodial sentencing can often be a precursor to ongoing incarceration into adulthood. This qualitative, cross-national study explored the impacts of trauma and placement in residential or congregate care on the criminalisation of children in England/Wales and Australia. In-depth interviews were conducted with 28 legal, youth justice and judicial stakeholders in England, Wales (UK), New South Wales (NSW) and Victoria (Australia). While there are considerable differences in the operation of child protection and youth justice systems between these jurisdictions, thematic analysis using NVivo14 identified. confirmed ongoing systemic factors associated with criminalisation identified in previous literature persists despite attempts to address these through policy and practice reforms. These factors include an absence of therapeutic supports, unstable and unsafe residential care placements, over-reliance on police to respond to minor incidents, increasingly punitive police responses lacking awareness of the impacts of childhood trauma and inappropriate use of custody as an ‘alternative’ placement. These findings suggest the similar systemic processes across these jurisdictions are likely to reflect deeply entrenched ideologies about ‘care’ and ‘protection’ that function to criminalise trauma. The implications of these systemic factors when children are exposed to formal criminal justice decision-making are considered.

Study protocol of a randomized control trial on the effectiveness of improvisational music therapy for autistic children

BackgroundMusic therapy is the clinical use of musical interventions to improve mental and physical health across multiple domains, including social communication. Autistic children, who have difficulties in social communication and often increased anxiety, tend to show a strong preference for music, because it can be structured and systematic, and therefore more predictable than social interaction. This makes music therapy a promising medium for therapeutic support and intervention. Previous clinical trials of music therapy compared to traditional therapy for autistic children have shown encouraging but nevertheless mixed results.Key aimsThe primary aim is to conduct a randomised controlled trial (RCT) of improvisational music therapy for autistic children and test its effectiveness in at improving social communication and wellbeing, and to reduce anxiety.Research planThe RCT will be conducted with 200 autistic children in the UK aged 7 to 11 years old. Participants will be randomly assigned to either improvisational music therapy or support as usual. The trial will be an assessor-blind, pragmatic two-arm cluster RCT comparing the impact of 12-weeks of improvisational music therapy in addition to support as usual, vs. support as usual for autistic children.MethodsResearchers who are blind to which arm the children are in will conduct assessments and obtain data via caregiver reports. The primary outcome will be the absolute change in the total score of the Brief Observation of Social Communication Change (BOSCC) assessed at baseline, T1 (13 weeks) and T2 (39 weeks) follow-ups. The BOSCC consists of specific items that were developed to identify changes in social-communication behaviours. Secondary outcome measures include: (1) Parent reported anxiety scale for youth with ASD (Note that we do not use the term ‘ASD’ or Autism Spectrum Disorder, because many autistic people feel it is stigmatising. Instead, we use the term ‘autism’) (PRAS-ASD) (2) Young Child Outcome Rating Scale, for wellbeing (YCORS), (3) Strengths and Difficulties Questionnaire (SDQ); and (4) Vineland Adaptive Behaviour Scale (VABS). (5) The Children’s Communication Checklist-2 (CCC-2) will be completed to evaluate pragmatic speech with fluent speakers only; (6) The Music Engagement Scale (MES); and (7) Assessment of the Quality of Relationship (AQR) will be used to evaluate the child-therapist relationships using video-analysis of music therapy sessions. Additional data will be collected by administering the Wechsler Abbreviated Scale of Intelligence (WASI-II), Music at Home Questionnaire (M@H), and children’s versions of the Empathy Quotient (EQ) and Systemizing Quotient (SQ). Audio and video data from the therapy sessions will be collected and analysed (using both human and computer-based feature-coding, e.g., machine learning and AI-driven methods) to identify how music and non-musical interactions foster change throughout the therapy.DiscussionThis study aims to observe if the interactions, engagement, and therapeutic modalities fostered during music therapy sessions can translate to non-musical contexts and improve autistic children’s social communication skills, identifying possible mediating factors contributing to the effectiveness of music therapy, potentially informing policy making and governance.Trial registrationThis randomised control trial is registered with the NIH U.S. National Library of Medicine: https://clinicaltrials.gov/search?term=NCT06016621, clinicalTrials.gov Identifier: NCT0601662, Registration Date 19th August 2023.

Analysis of Trends in the Use of Artificial Intelligence in Diagnosis and Treatment

AI in healthcare has improved, making diagnostics more accurate and increasing the effectiveness of treatments. The present study discusses the AI trends in diagnostic and therapeutic applications and focuses on the presented practical applications and their effects on patient care. The purpose of this particular review is to focus on the current developments in the implementation of AI in the field of health care, present main use cases and successes, as well as discuss about the issues and concerns in the topic at hand. Previous studies on AI in healthcare with specific consideration of diagnostic image analysis and interpretation, histology and molecular pathology, whole-genome sequencing, and therapeutic decision support are discussed. The selection criteria included papers with data gathered from real-life AI cases and quantitative findings. Study materials were obtained from e-journals, conference papers, and established online sources with descriptive analysis being done on the data collected. A summary of the findings revealed a number of highly impactful subcategories focused on the use of artificial intelligence diagnostic imaging, especially in radiology, pathology, and genomics. The AI applications used in the fields of operations and drug discovery revealed the ability to accurately predict clinical trial outcomes and to create effective treatments. First of all, AI can become a game changer in healthcare by enhancing diagnostics accuracy and treatment outcomes. The future research questions include further developing the methods that explain the AI models’ decisions, protecting the privacy of patient information, and reducing algorithmic bias for better fair healthcare for all. Therefore, better interactions between creators of AI and clinicians and regulatory authorities are pertinent to make sure that the full advantages of AI are realized in clinical practice to advance patient care.

Perceived Control, Marital Satisfaction, Social Support and Infertility Related Stress: A Mediated Moderation

Infertility can be a significant source of stress, affecting not only individuals but also their relationships and overall well-being. This study examines the relationship between perceived control, marital satisfaction, social support and infertility-related Stress in women seeking fertility treatment. A correlational research design with a non-probability purposive sampling strategy was used. One hundred ten diagnosed infertile women were recruited at age 35 years and above. The Urdu version of all scales was administered for pilot testing to 10 diagnosed infertile women taken from Government hospitals in Lahore. For statistical analysis, SPSS version 26 was used to analyze the data by applying mediated moderation by process macro and independent sample t-test. A total of 110 responses were received. The overall perceived control score was found to be 12.10 ± 6.53, marital satisfaction score of 10.40 ±5.24, social support score of 10.92 ±4.62 and infertility related Stress score of 55.91 ±7.90. Perceived control has a significant impact on infertility-related Stress (β=-.81***). The overall difference in perceived control score (p&lt;0.05) marital satisfaction score(p&lt;0.05) and infertility-related Stress score (p&lt;0.05) in employed and unemployed women was also significant. Overall, perceived control has a direct relationship with marital satisfaction and with infertility-related Stress. The interaction between marital satisfaction and social support (MS*SS) is also significant. Significant employment differences in perceived control, marital satisfaction, and infertility-related Stress were found. Implications for therapeutic interventions and support programs for women facing infertility are discussed, highlighting the need for a holistic approach to mental health and relational well-being in this context.

Experiences and impacts of psychological support following adverse neonatal experiences or perinatal loss: a qualitative analysis

BackgroundPoor parental mental health in the perinatal period has detrimental impacts on the lives and relationships of parents and their babies. Parents whose babies are born premature and/or sick and require neonatal care or those who experience perinatal loss are at increased risk of adverse mental health outcomes. In 2021 a North-West charity received funding to offer psychological support to service users of infants admitted to neonatal care or those who had experienced perinatal loss, named the Family Well-being Service (FWS). The FWS offered three different types of support – ad hoc support at the neonatal units or specialist clinics; one-to-one person-centred therapy; or group counselling. Here we report the qualitative findings from an independent evaluation of the FWS.MethodsThirty-seven interviews took place online or over the phone with 16 service users (of whom two took part in a follow-up interview), eight FWS providers and 11 healthcare professionals. Interviews were coded and analysed using thematic analysis.ResultsThe analysis revealed two themes. ‘Creating time and space for support’ detailed the informational, contextual, and relational basis of the service. This theme describes the importance of tailoring communications and having a flexible and proactive approach to service user engagement. Service users valued being listened to without judgement and having the space to discuss their own needs with a therapist who was independent of healthcare. Communication, access, and service delivery barriers are also highlighted. The second theme - ‘making a difference’ - describes the cognitive, emotional, and interpersonal benefits for service users. These included service users being provided with tools for positive coping, and how the support had led to enhanced well-being, improved relationships, and confidence in returning to work.ConclusionThe findings complement and extend the existing literature by offering new insights into therapeutic support for service users experiencing adverse neonatal experiences or perinatal loss. Key mechanisms of effective support, irrespective of whether it is provided on a one-to-one or group basis were identified. These mechanisms include clear information, flexibility (in access or delivery), being independent of statutory provision, focused on individual needs, active listening, the use of therapeutic tools, and positive relationships with the therapist. Further opportunities to engage with those less willing to take up mental health support should be developed.