ABSTRACT
BACKGROUND: The social support offered to women in the perinatal period can buffer against depression and anxiety. The sources and types of support that reduce maternal levels of depression and anxiety are not well understood. AIMS: To investigate the effects of structural and functional support on depression and anxiety in women in the perinatal period, and to explore the experiences of women around support during the perinatal period. METHOD: A comprehensive search of six electronic databases was undertaken. Relevant studies published from January 2010 to April 2020 were included (PROSPERO reference number: CRD42020194228). Quantitative and qualitative studies were eligible if they reported the effects of, or had themes related to receiving functional or structural support in the perinatal period on women's levels of depression or anxiety. Qualitative data was synthesised using a thematic synthesis method. Quantitative data could not be pooled due to the lack of comparable RCTs or cohort studies and was thus presented in a narrative form. RESULTS: Fifty-one articles (41 quantitative and 10 qualitative studies) were included. Analysis of quantitative studies demonstrated that insufficient support from partner, friends and family was associated with greater risk of symptoms of depression and anxiety. Distance-delivered interventions (via internet or telephone) diminished levels of depression and anxiety. Qualitative data revealed three overarching themes: appreciating all forms of support in the perinatal period, recognising appropriate and inappropriate support from health professionals and services, and having barriers to mobilising functional and structural support. LIMITATIONS: Grey literature was not explored and search strategies only included English, Spanish and Portuguese language articles. The reviewed studies were heterogeneous and for this reason, quantitative assessments were not feasible. CONCLUSION: Support from specific sources such as family members, friends who are also mothers, health professionals, neighbours, supervisors, co-workers and online communities still need to be further investigated. Implications for health professionals involved in the care of women in the perinatal period are discussed.
Subject(s)
Anxiety , Depression , Female , Humans , Pregnancy , Anxiety/therapy , Anxiety Disorders , Depression/therapy , Mothers , Social SupportABSTRACT
Child and adolescent sexual abuse is considered to be a serious public health concern and a devastating form of violence with serious physical, mental, and behavioral consequences in the short and long term. This qualitative study aimed to identify maternal reactions to the disclosure of sexual violence and explore the comprehension regarding child and adolescent sexual abuse held by the mothers of child victims. Twelve mothers were interviewed, whose children had experienced a situation of sexual abuse and were receiving psychosocial care in a municipality in southern region of Brazil. The collected data were organized and analyzed using the principles of Grounded Theory with the Atlas.ti 7.5.7 software. From the analysis of the narratives, three main categories emerged: mothers with positive reactions, mothers with ambivalent reactions, and mothers with negative reactions. Mothers that presented positive reactions believed the report and supported their children, showing a comprehension that sexual abuse can occur in different ways and not only when there is penetration. The participants that had ambivalent reactions oscillated between maintaining or breaking off the relationship with the perpetrator of the violence, expressed initial disbelief regarding the report of the abused child, and had a comprehension that sexual abuse could be a form of affection. Mothers that had a negative reaction to the disclosure of abuse presented a contradictory narrative, minimizing the effects of the violence and placing the victims at fault regarding the abuse suffered. The importance of considering the possible relationships between the maternal comprehensions regarding child and adolescent sexual abuse and the reactions of these mothers during the professional intervention was demonstrated.
Subject(s)
Child Abuse, Sexual , Child Abuse , Adolescent , Child , Child Abuse, Sexual/psychology , Comprehension , Female , Humans , Mother-Child Relations , Mothers/psychology , ViolenceABSTRACT
O reconhecimento das estratégias utilizadas pelos cuidadores de crianças e adolescentes abusados sexualmente configura-se como um fator decisivo para o tratamento das vítimas. Este estudo qualitativo objetivou identificar estratégias de enfrentamento de mães que tiveram filhos abusados sexualmente e estavam em acompanhamento por serviços públicos de assistência social. Foram entrevistadas 12 mães que residiam em um município da região Sul do Brasil. Os dados foram organizados e analisados utilizando os princípios da Grounded Theory, com auxílio do software Atlas-ti 7.0. Observaram-se: (1) estratégias de enfrentamento interpessoais, com destaque para o apoio institucional da rede de suporte; (2) estratégias centradas na criança ou adolescente, como a interação cotidiana com os filhos e atendimento especializado fornecido pelas instituições; e (3) estratégias centradas na mãe, tais como crença religiosa, envolvimento laboral, cuidados com a saúde, isolamento, evitação e negação do fenômeno. Considera-se que este estudo contribui para profissionais compreenderem as singularidades das estratégias utilizadas pelas mães para auxiliar na intervenção com os envolvidos na situação de abuso sexual.
Recognizing the coping strategies employed by the carers of sexually abused children and adolescents is a crucial factor for the victims' treatment. This qualitative study aims to identify coping strategies of mothers who had children sexually abused while under the assistance of public welfare services. Twelve mothers in a city in the Southern region of Brazil were interviewed. Data obtained was organized and analyzed by Grounded Theory principles, with Atlas-ti 7.0 software help, resulting in three major categories: (1) interpersonal coping strategies, emphasizing institutional network support; (2) child/adolescent-centered coping strategies, such as daily interaction with children; and (3) mother-centered coping strategies, such as religious beliefs, labor involvement, health self-care, isolation, avoidance and denial of the violence. It is important for professionals to understand the particularities of mothers' coping strategies, so they can properly assist all involved in the sexual abuse situation.
El reconocimiento de las estrategias utilizadas por los cuidadores de niños y adolescentes abusados sexualmente se configura como un factor decisivo para el tratamiento de las víctimas. Este estudio cualitativo tuvo como objetivo identificar estrategias de afrontamiento de madres que tuvieron hijos abusados sexualmente y estaban siendo monitoreadas por servicios públicos de asistencia social. Se entrevistaron a 12 madres que residían en un municipio de la región Sur de Brasil. Los datos fueron organizados y analizados utilizando los principios de la Grounded Theory, con ayuda del software Atlas-ti 7.0. Se observaran: (1) estrategias afrontamiento interpersonal, con destaque al apoyo de la red institucional configurada; (2) estrategias centradas en el niño o adolescente, como la interacción cotidiana con los hijos y atención especializada proporcionada por las instituciones; y (3) estrategias centradas en la madre, tales como creencias religiosas, participación laboral, cuidados con la salud, aislamiento, evitación y negación del fenómeno. Se considera que este estudio contribuye a profesionales a comprender las singularidades de las estrategias utilizadas por las madres para auxiliar en la intervención con los involucrados en la situación de abuso sexual.
