Ana Rita Goes

Priorities for mental health promotion during pregnancy and infancy in primary health care

The perinatal period (shortly before and after birth) is a particularly significant stage, providing a sound base for healthy development. Primary health care should accompany the individual through the entire life cycle, and mental health problems constitute a public health threat that calls for the development of mental health promotion initiatives in primary health care. Responding, in 2004 our team initiated an action research project with the aim of reorganising primary health care during pregnancy and the first year of life. The aim is to enable health professionals to support families in the transition to parenthood, thereby promoting childrens mental health. In order to plan this reorganisation, we developed a two-step decision-making process: 1. assessment of antenatal health care; 2. joint reflection concerning the priorities for change. The study goal was to assess the particular characteristics and needs of families during the perinatal period as well as the kind of care they were actually receiving. We designed a cross-sectional quantitative—qualitative study that collected data from users and health professionals using questionnaires and semi-structured interviews. The reflection step took place during a workshop that aimed to analyse the results and discuss priorities. The study confirmed the need to search for mental health problems during pregnancy, particularly to prevent a disturbed mother/child bonding process, and the importance of emphasising issues such as communication, information provision and the adequate availability of health professionals for antenatal care. The findings led to the following conclusions: 1. risk and needs assessment regarding mental health and options for family support should be included in the protocols of antenatal care; 2. primary health care professionals should be enabled to undertake diagnostic work and problem solving related to mental health; 3. collaboration between different levels of health care and between health sector and community resources should be increased. The highly participative decision-making process used led to a selection of priorities and strategies that was meaningful to users and health professionals and should contribute to the implementation and sustainability of changes for mental health promotion. (Global Health Promotion, 2009; 1 (1): pp. 29—38)

Parental Involvement in Cognitive-Behavioral Intervention for Anxious Children: Parents’ In-Session and Out-Session Activities and Their Relationship with Treatment Outcome

Abstract The present study explored the role of parents’ in-session and out-session involvement in CBT for anxious children. Fifty 8- to 12-year-old children with a principal DSM-IV anxiety disorder participated in a group CBT program. Parental involvement in the therapy was assessed by the clinician and the children and parents completed a standardized anxiety scale as the main therapy outcome measure, at pre- and post-intervention. In addition, the parents completed questionnaires to evaluate a number of possible correlates of parental involvement, namely, child’s anxiety symptoms intensity and interference, parental beliefs about anxiety, expectancies regarding the efficacy of the intervention, and parental anxiety. The results indicated that the parents were moderately involved in the therapy and that socio-economic status and parental beliefs about anxiety were significant correlates of parental involvement. Finally, partial support was found for the idea that parents’ involvement in the therapy might have a positive impact on therapy outcome.

Preliminary Analysis of the Portuguese Version of the Child Anxiety Life Interference Scale

As perturbacoes de ansiedade sao altamente prevalentes entre criancas em idade escolar. Estas perturbacoes tendem a seguir um curso cronico e interferem significativamente no funcionamento diario dos jovens. O objetivo principal deste estudo foi examinar as propriedades psicometricas da versao Portuguesa da Escala de Interferencia da Ansiedade na Vida da Crianca - versoes para Pais e Criancas (CALIS-P e CALIS-C). Participaram 132 criancas, com idades entre os 7 e 12 anos, com diagnostico principal de ansiedade, e seus respetivos pais. A analise fatorial da CALIS-P revelou tres fatores que coincidem com as subescalas hipotetizadas: Interferencia Em Casa, Fora de Casa e na Vida da Familia. Para a CALIS-C, a analise fatorial revelou dois fatores que dizem respeito a Interferencia nas Relacoes Proximas e no Desempenho, que nao correspondem as subescalas da versao original. Os estudos psicometricos mostraram uma boa consistencia interna para as varias subescalas da CALIS e boas qualidades na validade convergente e divergente. Foi observada ainda uma correlacao significativa entre os resultados da CALIS e outra medida de interferencia. Estes resultados sugerem que a versao portuguesa da CALIS e uma medida confiavel e valida para a avaliacao do impacto da ansiedade na crianca e no funcionamento familiar.