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A structural equation modelling of the buffering effect of social support on the report of common mental disorders in Zimbabwean women in the postnatal period.

ABSTRACT: OBJECTIVE:Globally, 13-20% of women experience a common mental disorder (CMD) postnatally. Unfortunately, the burden of CMDs is disproportionally substantial in women from low-income countries. Nevertheless, there is a growing recognition of the buffering effect of social support (SS) on psychiatric morbidity and the need for mental well-being support services/interventions. This study evaluated the relationship between psychiatric morbidity and SS levels, and factors influencing the mental health functioning of Zimbabwean women postnatally. Data were collected from 340 mothers and were analysed through structural equation modelling. RESULTS:The mothers' mean age was 26.6 (SD 5.6) years. The mean Multidimensional Scale of Perceived Social Support score was 42.7 (SD 10.8), denoting high levels of SS. Additionally, 29.1% of the population reported excessive psychiatric morbidity, the median Shona Symptoms Questionnaire score was 5 (IQR: 2-8). The structural equation model demonstrated the buffering effects of SS on psychiatric morbidity (r?=?-?0.585, p?=?0.01), and accounted for 70% of the variance. Being unmarried, increased maternal age, lower educational and income levels were associated with poorer maternal mental health. There is a need for routine; surveillance and treatment of CMDs in women in the postnatal period, including integration of low-cost, evidenced-based and task-shifting SS interventions.

SUBMITTER: Kaseke T

PROVIDER: S-EPMC6394011 | biostudies-literature | 2019 Feb

REPOSITORIES: biostudies-literature

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A structural equation modelling of the buffering effect of social support on the report of common mental disorders in Zimbabwean women in the postnatal period.

Kaseke Tanaka T January James J Tadyanemhandu Catherine C Chiwaridzo Matthew M Dambi Jermaine M JM

BMC research notes 20190228 1

<h4>Objective</h4>Globally, 13-20% of women experience a common mental disorder (CMD) postnatally. Unfortunately, the burden of CMDs is disproportionally substantial in women from low-income countries. Nevertheless, there is a growing recognition of the buffering effect of social support (SS) on psychiatric morbidity and the need for mental well-being support services/interventions. This study evaluated the relationship between psychiatric morbidity and SS levels, and factors influencing the men ...[more]

PMID: 30819242

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Project description:BackgroundCommon mental health disorders (CMDs) are leading causes of disability globally. The ongoing COVID-19 pandemic has further exacerbated the burden of CMDs. COVID-19 containment measures, including lockdowns, have disrupted access to in-person mental health care. It is therefore imperative to explore the utility of digital mental health interventions to bridge the treatment gap. Mobile health technologies are effective tools for increasing access to treatment at a lower cost. This study explores the utility of Inuka, a chat-based app hinged on the Friendship Bench problem-solving therapy intervention. The Inuka app offers double anonymity, and clients can book or cancel a session at their convenience. Inuka services can be accessed either through a mobile app or the web.ObjectiveWe aimed to explore the feasibility of conducting a future clinical trial. Additionally, we evaluated the feasibility, acceptability, appropriateness, scalability, and preliminary effectiveness of Inuka.MethodsData were collected using concurrent mixed methods. We used a pragmatic quasiexperimental design to compare the feasibility, acceptability, and preliminary clinical effectiveness of Inuka (experimental group) and WhatsApp chat-based counseling (control). Participants received 6 problem-solving therapy sessions delivered by lay counselors. A reduction in CMDs was the primary clinical outcome. The secondary outcomes were health-related quality of life (HRQoL), disability and functioning, and social support. Quantitative outcomes were analyzed using descriptive and bivariate statistics. Finally, we used administrative data and semistructured interviews to gather data on acceptability and feasibility; this was analyzed using thematic analysis.ResultsAltogether, 258 participants were screened over 6 months, with 202 assessed for eligibility, and 176 participants were included in the study (recruitment ratio of 29 participants/month). The participants' mean age was 24.4 (SD 5.3) years, and most participants were female and had tertiary education. The mean daily smartphone usage was 8 (SD 3.5) hours. Eighty-three users signed up and completed at least one session. The average completion rate was 3 out of 4 sessions. Inuka was deemed feasible and acceptable in the local context, with connectivity challenges, app instability, expensive mobile data, and power outages cited as potential barriers to scale up. Generally, there was a decline in CMDs (F2,73=2.63; P=.08), depression (F2,73=7.67; P<.001), and anxiety (F2,73=2.95; P=.06) and a corresponding increase in HRQoL (F2,73=7.287; P<.001) in both groups.ConclusionsStudy outcomes showed that it is feasible to run a future large-scale randomized clinical trial (RCT) and lend support to the feasibility and acceptability of Inuka, including evidence of preliminary effectiveness. The app's double anonymity and structured support were the most salient features. There is a great need for iterative app updates before scaling up. Finally, a large-scale hybrid RCT with a longer follow-up to evaluate the clinical implementation and cost-effectiveness of the app is needed.

Dataset Information

A structural equation modelling of the buffering effect of social support on the report of common mental disorders in Zimbabwean women in the postnatal period.

Publications

A structural equation modelling of the buffering effect of social support on the report of common mental disorders in Zimbabwean women in the postnatal period.

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