Improving post-traumatic growth of disaster survivors: An integrative literature review.

BACKGROUND: The psychological aspect is one of the important aspects of the affected disaster survivors. The change in the disaster management paradigm is one reason for the need to change interventions that previously only focused on handling posttraumatic distress syndrome into interventions to increase post-traumatic growth to prevent post-disaster psychological disorders. This review aims to synthesise recent research to develop further explanations regarding potential strategies to improve the post-traumatic growth of disaster survivors. METHOD: This is an integrative review of previous studies. Articles were identified via SCOPUS, EMBASE, JSTOR, PROQUEST, MEDLINE and grey literature (Google Scholar). All subject-relevant literature from 2000 to 2022 was identified. This review included quantitative and qualitative studies and literature reviews, with criteria: all types of interventions used to improve the post-traumatic growth of disaster survivors and potential influencing factors that may affect the implementation as well as other relevant outcomes. RESULT: From 400 initial search studies, 27 studies (24 quantitative. one qualitative, and two mixed methods) were eligible to be included in the review. Some factors promoting post-traumatic growth included religious coping, culture, social support, the severity of the trauma, coping strategies, education level and work satisfaction. CONCLUSION: By systematically exploring the factors that foster post-traumatic growth of disaster survival, this integrative review will give fundamental information to develop an intervention that prevents or minimises the psychological impacts of a disaster towards survivors.

An exploration of the Indonesian lay mental health workers' (cadres) experiences in performing their roles in community mental health services: a qualitative study.

BACKGROUND: Volunteers trained to support community mental health programs in Indonesia are known as 'mental health cadres.' These are lay people trained to provide basic support for people with mental illness in their local communities. The role of cadres in community mental health services is to provide health promotion activities and support for people with mental illness, such as home visits and family assistance. Their contribution can potentially address the challenges health services currently face in remote and resource-limited settings. However, little is currently known about implementing this form of the lay workforce and the experiences of mental health cadres in Indonesia in particular. This study aimed to explore the experience of cadres when performing their roles in community mental health services in Indonesia from the cadres' perspective. METHODS: The study employed a descriptive qualitative design. Purposive sampling was employed to recruit cadres with at least one year of experience handling those diagnosed with schizophrenia across four geographical areas in Java and Sumatra, Indonesia. Data were collected utilising focus groups undertaken between July and November 2020. Due to COVID-19 restrictions, eight focus group sessions for mental health cadres were carried out virtually via Zoom and non-virtual, facilitated by local moderators. Data were analysed using thematic analysis. RESULTS: The study involved 71 cadres in four regions: Aceh, Jakarta, West Java and East Java. The majority of participants were looking after their families with a minimum of high school-level qualifications. Four themes were interpreted from the data: (1) Motivation for volunteering, (2) The role of cadres in supporting mental health services, (3) Training and support needs in carrying out cadre roles, and (4) Barriers and facilitators to the implementation of cadre roles in local communities. CONCLUSIONS: Cadres reported a motivation to help people improve their mental health and reduce the stigma associated with mental illness. Cadres also contributed to secondary and primary prevention of mental illness with some limitations. This study's results are relevant to those wishing to understand and optimise the implementation of lay workforces in resource-limited settings.

Stakeholder perspectives of family interventions for schizophrenia in Indonesia: a qualitative study.

Mental illnesses comprise the single largest source of health-related economic burden globally and low-and middle-income countries (LMICs) are disproportionately affected. Many individuals with schizophrenia do not receive evidence-based, psychosocial interventions as these are largely unavailable, undeveloped, and under-researched in LMICs. Involving service-users and carers in the design of interventions is crucial to ensure stakeholder needs are adequately addressed by the intervention and to aid successful implementation. We aimed to explore the views and perspectives of different stakeholder groups about the delivery, format, and content of family interventions for people living with schizophrenia in Indonesia as a first step towards developing evidence-based, acceptable family interventions. This study used a qualitative design comprising single stakeholder focus groups. Data were analysed separately using the framework approach incorporating deductive and inductive coding within an existing heuristic framework. 51 participants consented to take part in this study comprising six stakeholder consultation groups including service-users (n = 15), caregivers (n = 15) and healthcare professionals (n = 21). Service users were diagnosed with schizophrenia. Caregivers comprised parents (n = 10, 67%), brothers (n = 2, 13%), sister (n = 1, 7%) and husbands (n = 2, 13%). Healthcare professionals were working as nurses (n = 6, 29%), doctors (n = 5, 23%) or cadre's (n = 10, 48%). Caregiver and service-user respondents had limited knowledge or experience of structured family interventions. There was strong support for such interventions, however, for effective delivery a number of challenges exist in terms of widespread stigmatised views, low expectations for involvement in sharing decisions about care and treatment, views that healthcare professionals are expert and have the authority to delegate tasks to families such as responsibility for ensuring medication adherence and understanding the need to balance the needs of both service-users and families when there are conflicting agendas for treatment. These findings can support the development of evidence-based family interventions for families of those with schizophrenia in Indonesia, as user-informed interventions enhance engagement, satisfaction, and adherence to family interventions.

Lay community mental health workers (cadres) in Indonesian health services: A qualitative exploration of the views of people with mental health problems and their families.

INTRODUCTION: In community-based mental health services, lay workers recruited and trained to support mental health programs, known as mental health cadres, have an important role in supporting the care of families and people with mental disorders. This study aims to explore the experiences of people with mental disorders and their families about the role of mental health cadres in improving mental health and caring for people with mental disorders. METHODS: This study employed a qualitative descriptive design for data gathering. Focus groups were conducted between August 2020 and January 2021 with 19 people with mental health difficulties (people diagnosed with schizophrenia) and 25 family members who are the primary caregivers of people with mental disorders from three provinces in Indonesia: West Java, East Java, and Aceh. Participants were purposively sampled with inclusion and exclusion criteria used were people with mental disorders and their families who regularly interact with mental health cadres. Data were analyzed using inductive thematic analysis through six stages of coding and theme development. RESULTS: Several themes were identified. The most significant theme was emotional support provided by cadres in terms of reception from cadres about people with mental health problems (59.1%), tangible support in which cadres help people with mental disorders get treatment (52.27%), and cadre roles as duties/mandates (51.36%) was factors that facilitated the success. The finding of this study indicated that cadres were considered to provide a range of different support to people with mental health disorders and their families. In carrying out their role, there were factors that participants felt increased success in implementing the role of cadres. The cadre-patient/family relationship was influenced by perceived shame, trust relationship, and stigma. This research also revealed patient and family expectations about cadres' roles. CONCLUSIONS: Exploring the experiences of people with mental disorders and their families who received support from cadres could examine the factor that increases success in implementing cadre roles and barriers to mental health services by cadres, which are shame, mistrust, and stigma in the community. Therefore, paying attention to the expectations of people with mental health problems and their families about the cadre's roles in improving mental health services in the community is essential.

Disaster Training for Nurses in Indonesia: Balancing Physical, Psychological, and Managerial Competencies.

BACKGROUND: Indonesian nurses receive training for disasters when they take an undergraduate nursing program at the university, but there have been variations in the curriculum. Moreover, there is still limited informal training available specifically for disaster nursing. Therefore, needs assessments are necessary to identify the gap between Indonesian disaster nurses' existing and expected competencies. This study was conducted to identify competencies needed by disaster nurses. METHOD: A descriptive qualitative approach was used in this study. Data were collected from August to September 2019 from three areas in Indonesia: Yogyakarta, Lombok, and Jakarta. These areas frequently experience natural disasters, such as volcanic eruptions, earthquakes, and floods. Thirty-two nurses were interviewed. Data were analyzed with a descriptive qualitative approach. RESULTS: The study highlighted three main competencies needed by Indonesian nurses, which are physical, psychological, and managerial. CONCLUSION: Training for disaster nurses needs to balance the achievement of competencies related to physical, psychological, and managerial needs. [J Contin Educ Nurs. 2023;54(8):378-384.].

Culturally adapted family intervention for people with schizophrenia in Indonesia (FUSION): a development and feasibility study protocol.

BACKGROUND: Mental illnesses comprise the single largest source of health-related economic burden globally, and low- and middle-income countries are disproportionately affected. The majority of people with schizophrenia who need treatment do not receive it and are often wholly reliant on family caregivers for daily care and support. Family interventions have an exceptionally robust evidence base for their efficacy in high-resource settings, but it is unknown whether they can produce equivalent effects in some low-resource settings where cultural beliefs, explanatory models of illness and contextual socio-economic issues differ. METHODS: This protocol describes the methods for a randomised controlled trial to determine the feasibility of testing culturally adapt and refine an evidence-based, family intervention for relatives and caregivers of people with schizophrenia in Indonesia. The feasibility and acceptability of implementing our adapted, co-produced intervention via task shifting in primary care settings will be evaluated using the Medical Research Council framework for complex interventions. We will recruit 60 carer-service-user dyads and randomise them in a 1:1 ratio either to receive our manualised intervention or continue to receive treatment as usual. Healthcare workers in primary care settings will be trained to deliver family interventions using our manualised intervention by a family intervention specialist. Participants will complete the ECI, IEQ, KAST and GHQ. Service-user symptom level and relapse status will be measured using the PANSS at baseline, post-intervention and 3 months later by trained researchers. Fidelity to the intervention model will be measured using the FIPAS. Qualitative evaluation will further assist with refining the intervention, evaluating trial processes and evaluating acceptability. DISCUSSION: National healthcare policy in Indonesia supports the delivery of mental health services in a complex network of primary care centres. This study will provide important information on the feasibility of delivering family interventions for people with schizophrenia via task shifting in primary care settings in Indonesia and allow further refinement of the intervention and trial processes.

Nursing Care on HIV/AIDS-Positive Men Who Have Sex with Men: A Qualitative Descriptive Study of Nurse's Perspective in Indonesia.

HIV/AIDS-positive men who have had sex with men (MSM) account for roughly one-third of new infections in the region, with numerous nations facing a high and rising prevalence. They often face stigmatization and discrimination from society, including nurses. This study aims to explore nurses' perspectives on caring for HIV/AIDS-infected MSM. A descriptive qualitative design was utilized. Fifteen nurses who cared for HIV/AIDS-positive MSM in the two hospitals in Jakarta, Indonesia, were recruited with purposive sampling techniques. A semi-structured and in-depth interview was conducted. Data were analyzed using thematic analysis. We emerged three superordinate and nine subordinate themes: (1) negative nurse perceptions in the early phase of treatment, (2) nurse attitudes contrasting with negative perceptions, and (3) nurses with knowledge of HIV/AIDS. The negative perceptions appeared only at the beginning of the treatment phase, and thereafter, they were followed by a positive attitude. Nurses appeared to develop a better understanding after interacting with their patients and receiving training on HIV/AIDS. Therefore, intensive training is expected to not only increase their knowledge but to encourage a positive attitude.

Children's psychosocial state after the 2018 Lombok earthquake.

Background: The current earthquake disaster in Lombok, Indonesia, in July 2018 has caused 564 deaths, and 445.343 were evacuated to refugee camps, including children. Disasters have the potential in resulting short-and long-term effects on the psychological functioning, emotional adjustment, health, and developmental trajectory of children. Nurses play a significant role when a disaster occurs. One of the nurses' roles is to give a traumatic healing intervention to the victims. Objective: This study sought to assess children's psychosocial state after the 2018 Lombok earthquake. Methods: A total of 189 children from five regencies in Lombok were selected to participate in the study using accidental sampling. Data were collected using the Strengths and Difficulties Questionnaire (SDQ). Descriptive statistics and cross-tabulation were used for data analysis. Results: The participants consisted of 98 girls (51.9%) and 91 boys (48.1%), with the majority (n = 142 [75.1%]) being from school-aged children. The SDQ results showed that most of the children were at the abnormal stage for difficulties (n = 103 [54.5%]), and most of them were at a normal stage for strength (n = 97 [51.3%]). The cross-tabulation analysis revealed that gender might influence the SDQ score for the strength (p = 0.034), but not for difficulties (p = 0.482). However, age did not have a correlation with SDQ score, either for strength (p = 0.475) or difficulties (p = 0.836), respectively. Conclusion: The study found that children in Lombok generally displayed positive behavior and emotional progress after the earthquake. However, some children remained in distress and thus required more observation from parents or other social welfare agencies. This research may help nurses decide on their nursing care for children who experience disasters.

Nurses' perception about posttraumatic growth (PTG) after natural disasters.

BACKGROUND: Natural disasters have become the most common, profound, and universal type of catastrophes over decades. Natural disasters can lead to both negative and positive impacts on survivors. Nurses have an important role in fostering posttraumatic growth (PTG) as a positive psychological adjustment amongst the survivors. However, nurses may have different perceptions of their roles in PTG. Such differences may result in various approaches in supporting PTG as best as possible. Therefore, nurses' perception regarding PTG needs to be explored. METHOD: This study used a descriptive qualitative approach. A total of fourteen nurse participants were included across five different cities in Indonesia, including Jakarta, Bogor, Depok, Tangerang, and Bekasi. Data were collected through in-depth interviews and analyzed with a thematic method. RESULTS: The study revealed three themes, as follows (1) PTG is a new concept for nurses, (2) PTG is a condition that needs to be sought by volunteers, and (3) PTG means human-God and human-human positive relationships. CONCLUSION: The study highlights the importance of improving nurses' understanding regarding PTG so that they can deliver appropriate strategies or interventions to support survivors in gaining positive changes after experiencing a natural disaster. The study recommends that knowledge and skills related to PTG should be introduced in undergraduate nursing program.

Posttraumatic growth in adolescent survivors of earthquake, tsunami, and liquefaction in Palu Indonesia: a phenomenological study.

Exploration of posttraumatic growth (PTG) experiences in adolescent survivors of earthquakes, tsunamis, or liquefaction are needed by nurses to maximize the potential for recovery and growth of adolescents from trauma after natural disasters. The study used a qualitative method with a descriptive phenomenology approach. Data were collected through in-depth interviews with 16 adolescent survivors and were analyzed using the Colaizzi method. The results of this study have two main themes: trauma becoming the basis for realizing the meaning of life and escaping from disaster as a second chance to live better. PTG is a positive change that needs to be pursued. Escaping from disaster and realizing the meaning of life are the key points to get success in pursuing PTG to live a better life. In addition, support from mental health nurses through cognitive therapy (CT) and acceptance commitment therapy (ACT) are needed to increase the PTG.

Civic engagement and mental health system strengthening in Indonesia: a qualitative examination of the views of health professionals and national key stakeholders.

BACKGROUND: Mental health services in Indonesia are developing rapidly in response to national and global health policy to support people living with psychosis. This presents a unique opportunity for civic engagement, the active involvement of patients, carers and communities in mental health care, to shape emergent services. In-depth explorations of the views of professionals and other key stakeholders in mental health care on the use of civic engagement in Indonesia are lacking which contributes to a limited understanding of its potential in this regard. The study aimed to explore contemporary professionals' and other key stakeholders' perspectives on the current use of and potential for civic engagement to strengthen mental health systems in Indonesia. METHODS: Qualitative interviews were undertaken and analysed using thematic analysis underpinned by a critical realist approach. Eighteen multi-disciplinary professionals and lay health workers involved in mental health care in Jakarta and Bogor and 10 national key stakeholders were recruited. RESULTS: Despite high levels of awareness of and support for civic engagement amongst mental health professionals and policy makers combined with a nascent grass roots movement, analysis revealed unstructured and insufficient mechanisms for civic engagement which resulted in ad-hoc and mostly superficial levels of involvement activity. Civic engagement was thought to require a marked shift in existing practices as well as organisational and societal cultures. Challenging stigma is a key feature of civic engagement and our analysis highlights the relevance of social contact methods which are locally and culturally contextualised in this regard. Our findings point to a need to expand current definitions of civic engagement which focus on indivdiual enablement to ones that also encompass environmental and organisational enablement to optimise the future use of civic engagement in mental health settings. CONCLUSIONS: Key mental health stakeholders have identified that central aspects of Indonesian culture are well aligned to the ethos of civic engagement which has the potential to facilitate the enactment of recent global health policy. However, full realisation is likely to be impeded by prevailing paternalistic cultures in mental health services and high levels of stigma and discrimination towards those with mental illness in Indonesia without intervention.

Implementing civic engagement within mental health services in South East Asia: a systematic review and realist synthesis of current evidence.

INTRODUCTION: Civic engagement (CE) has the potential to transform mental health services and could be particularly important for low and middle-income countries (LMICs), which are rapidly developing to respond to the burden of poor mental health. Research from high income countries has found many challenges associated with the meaningful implementation of CE in practice, but this has been underexplored in LIMCS and in South East Asia (SEA) in particular. METHODS: We completed a realist synthesis and systematic review of peer reviewed publications and grey literature to identify the context and actions which promote successful implementation of CE approaches in SEA. We used a theory-driven approach-realist synthesis-to analyse data and develop context-mechanism-outcome configurations that can be used to explain how civic engagement approaches operate in South East Asian contexts. We worked closely with patient and public representatives to guide the review from the outset. RESULTS: Fifty-seven published and unpublished articles were included, 24 were evaluations of CE, including two Randomized Controlled Trials. The majority of CE interventions featured uptake or adaptation of Western models of care. We identified important cultural differences in the enactment of civic engagement in SEA contexts and four mechanisms which, alongside their contextual barriers and facilitators, can be used to explain how civic engagement produces a range of outcomes for people experiencing mental health problems, their families and communities. Our review illustrates how CE interventions can be successfully implemented in SEA, however Western models should be adapted to fit with local cultures and values to promote successful implementation. Barriers to implementation included distrust of services/outside agencies, stigma, paternalistic cultures, limited resource and infrastructure. CONCLUSION: Our findings provide guidance for the implementation of CE approaches within SEA contexts and identify areas for further research. Due to the collectivist nature of many SEA cultures, and the impact of shared traumas on community mental health, CE might best be implemented at community level, with a focus on relational decision making.Registration This review is registered on PROSPERO: CRD42018087841.

Exploring the potential use of patient and public involvement to strengthen Indonesian mental health care for people with psychosis: A qualitative exploration of the views of service users and carers.

BACKGROUND: Patient and public involvement (PPI) has the potential to strengthen mental health systems in Indonesia and improve care for people living with psychosis. Current evidence from other parts of the world demonstrates the need to understand the contexts in which PPI is to be enacted to ensure optimal implementation. OBJECTIVE: To understand service users' and carers' views on the current use and potential applicability of PPI within Indonesian mental health services. DESIGN: Qualitative study incorporating focus groups analysed using thematic analysis. SETTING AND PARTICIPANTS: Participants included 22 service users and 21 carers recruited from two study sites in Indonesia (Jakarta and Bogor). All participants had experience of psychosis either as a service user or carer. RESULTS: Despite the value attributed to PPI in relation to improving services and promoting recovery, current use of such activities in Indonesian mental health services was limited. Participants expressed a desire for greater levels of involvement and more holistic care but felt community organizations were best placed to deliver this because PPI was considered more congruent with the ethos of third-sector organizations. Additional barriers to PPI included stigma and low levels of mental health literacy in both health services and communities. DISCUSSION AND CONCLUSION: Participants felt that there was potential value in the use of PPI within Indonesian mental health services with careful consideration of individual contexts. Future aspirations of involvement enactment should ensure a central design and delivery role for third-sector organizations. Facilitators to global collaborative research in the context of the current study are also discussed.

Expectations of survivors towards disaster nurses in Indonesia: A qualitative study.

OBJECTIVE: This study aims to explore the expectations of survivors towards disaster nurses. METHODS: The study used qualitative content analysis. Data were collected in 2017 through three focus group discussions with 21 survivors and in-depth interviews with three community leaders; the respondents had experienced one of the following events: a) an earthquake in Padang 2009, b) a volcanic eruption in Yogyakarta 2010, and c) flooding in Jakarta 2014. RESULTS: Four themes represented survivors' expectations of what nurses can do in responding to a disaster, including: a) provision of direct nursing care, b) provision of information of health service access, c) provision of resources through cross-sector coordination, and d) disaster preparedness activities for the community. CONCLUSIONS: This study suggests the importance of disaster nurses having the competency to update information regarding healthcare access, particularly the utilization of health insurance and providing culturally competent care to the survivors. Disaster nurses are also expected to be able to train the community and families about preparedness-related activities. Besides, these disaster nurses should improve their competency in disaster risk reduction. More broadly, such nurses should have the ability to advocate and coordinate with the local government and other stakeholders regarding access to healthcare services and continuous rapid assessment, so that survivors receive immediate and appropriate treatment.

Evaluating the acceptability of a co-produced and co-delivered mental health public engagement festival: Mental Health Matters, Jakarta, Indonesia.

BACKGROUND: Public engagement events are an important early strategy in developing a meaningful research agenda, which is more impactful and beneficial to the population. Evidence indicates the potential of such activities to promote mental health literacy. However, this has not yet been explored in Indonesia. AIM: This paper describes a mental health public engagement festival carried out in Indonesia in November 2018 and uses evaluation data to consider the acceptability and use of such activities in Indonesia in the future. METHOD: Evaluation data was collected from 324 of the 737 people who attended a six-day mental health festival comprising 18 events including public lectures, film screenings, arts activities, exercise classes and panel discussions. Attendees were asked to evaluate the festival in terms of its quality, benefits and areas for improvement. Descriptive statistics were used to analyse the evaluation data. 87 service users, carers, academics and professionals also engaged in a research prioritisation exercise to collaboratively determine mental health research priorities for Indonesia. RESULTS: Participants evaluated the festival extremely positively with a significant majority (92%) rating the quality of the festival as good or excellent. Attendees reported an increase in their understanding of mental health issues and identified intended behaviour change including an increased propensity for future engagement with mental health research. Key strengths of the festival included the central role of patients, carers and the local community in the design and delivery of the festival which promoted emotional engagement and development of shared understanding and the use of international experts which in attendees' opinion further enhanced the credibility of festival activities. CONCLUSION: This manuscript indicates that a co-produced mental health public engagement festival is a potentially acceptable way to increase awareness of mental health in Indonesian populations. Future festivals should be larger in scope and target men, older people and the general public to maximise benefit and incorporate rigorous evaluation of effectiveness.

Cognitive behaviour therapy for anxiety in adolescent with early prodromal of psychosis at boarding school.

BACKGROUND: Early prodromal of psychosis starts in adolescent indicated by non specific symptoms which may result in the changes of behaviour, role, function, and social interaction. Cognitive behaviour therapy is a strategic intervention in reducing anxiety symptom. The purpose of this research is to find out the effects of cognitive behaviour therapy for anxiety in adolescent with early prodromal of psychosis. METHOD: The design of this research was Quasi experimental design: pre-post test with control group. Samples were selected after the screening on adolescents in boarding school with the Prodromal Questionnaire (PQ16). Subjects were 78 respondents consisting of 39 each groups, obtained by random sampling technique. Nursing intervention was provided to intervention group 1, while cognitive behaviour therapy was provided to intervention group 2. The measurement of anxiety in adolescents is by using the Hamilton Anxiety Rating Scale for Anxiety (HARS). The analysis was performed by Repeated Anova and Independent t-test. RESULT: The result of the research shows that anxiety level decrease significantly on those two groups, whilst the decrease of anxiety and early prodromal of psychosis in the intervention group 2 indicates more decrease than intervention group 1. CONCLUSION: Cognitive behaviour therapy is recommended to reduce anxiety in adolescent with early prodromal of psychosis.

Family experience in facilitating adolescents during self-identity development in ex-localization in Indonesia.

BACKGROUND: Self-identity is a personal reflection that is consistent and covers various individual aspects, such as job/career, spirituality, relations, intellectuality, sexuality, culture, interests, personality, and physical identity. The increasing level of juvenile delinquency worldwide, including in Indonesia, is a manifestation of unsuccessful identity development in adolescents. Self-identity development is inseparable from family influence. This study aimed to explore the experiences of families in facilitating their adolescents during self-identity development while living in ex-localization. METHODS: This study used a descriptive qualitative design and involved 12 participants. Data were collected through in-depth interviews and analyzed using thematic analysis. RESULTS: This study resulted in five themes: the identity achievement of adolescents living in ex-localization is similar to that of adolescents in general; the domination of external barriers during identity achievement; ex-localization as a stressor; families' efforts to facilitate their adolescents during identity achievement; and family expectations for the future. CONCLUCIONS: This study highlights the importance of improving family awareness of adolescents' identity achievement when living in ex-localization with the help of nursing mental health professionals.

What does the literature suggest about what carers need from mental health services for their own wellbeing? A Systematic Review

Objective: The aim of this study was to examine prior studies relating to carers' needs from mental health services for their own wellbeing. Method: A systematic approach was adopted for the literature review. The databases searched included MEDLINE, PSycINFO, EMBASE, and CINAHL, involving the use of search terms such as carers, mental health, and needs. The search was conducted in April 2012 and updated in December 2015. In total, 40 published papers were included in the review and were subsequently assessed for quality. For the data synthesis, a thematic analysis approach was employed to integrate the quantitative and qualitative evidence relating to carers' needs. Results: Twenty-five of the reviewed studies were qualitative, 12 were quantitative, and 3 were mixed. Four major carer needs emerged from the synthesis: (1) holistic wellbeing of service users, (2) holistic wellbeing of carers, (3) supportive attitudes of professionals, and (4) carer involvement. All four of these needs, in fact, revolved around the carers' ill relatives. Conclusions: The studies reviewed suggest that while carers of people suffering from mental illness have a range of needs, they generally fail to offer straightforward information about their own needs

No disponible

The influence of assertiveness training on depression level of high school students in Bengkulu, Indonesia

Objective: The research identified the influence of assertiveness training against teenage depression in high scholars in Kepahiang Regency, Bengkulu, Indonesia. Method: This study used a quasi-experiment approach with pre-test and post-test design and a control group. Eighty students were engaged through simple random sampling. Results: The study found the frequency of depression in teenagers and considered the effect of assertiveness training. 14.10 teens were counted as depressed before assertiveness training provision, while the post-training average was 7.98 (p = .000). Assertiveness training had a significant effect on the prevalence of depression in the intervention group. Conclusions: The study recommends schools to cooperate with health services to increase mental health programs such as building peer groups, delivering assertiveness training, and teaching stress management to prevent depression in teenagers

No disponible