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BACKGROUND: People with HIV/AIDS (PWHA) have 7-36 times greater risk for completed suicide associated with depression symptoms compared to general population. However, no study has sufficiently analyzed the mediating or moderating variables of the relationship between depression and suicidal ideation in Rwanda. OBJECTIVES: This study aimed to examine how complicated grief mediates and substance abuse moderates the effects of depression symptoms on suicidal ideation. METHODS: Data were collected from a convenient sample of 140 participants (M-age = 38.79 years, SD = 10.218) receiving antiretroviral therapy (ART) at Remera Health Center in a cross-sectional study. Multiple linear regression and Sobel test were used to examine the relationships between depression symptoms, complicated grief, suicidal ideation, and substance abuse. RESULTS: The results indicated that 29% of the sample had clinically significant symptoms of depression and 18% had suicidal ideation. The interaction between substance abuse and depression symptoms (ß = .468, t = 8.02, p = 0.000) was a significant predictor, explaining the 55.7% of variance in suicidal ideation. Furthermore, the Sobel test demonstrated that complicated grief mediated the effects of depression symptoms (t = 4.67, SE = 0.0101, p ≤ 0.001) on suicidal ideation. CONCLUSION: The results suggest that depression symptoms are associated with an increased risk of suicidal ideation, and this risk significantly amplified in the presence of complicated grief and substance abuse. These findings highlight the importance of integrating mental health services, particularly those addressing depression, complicated grief, and substance abuse, into HIV care programs to mitigate the risk of suicidal ideation among PWHA.
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Depresión , Pesar , Infecciones por VIH , Trastornos Relacionados con Sustancias , Ideación Suicida , Humanos , Masculino , Adulto , Femenino , Trastornos Relacionados con Sustancias/psicología , Trastornos Relacionados con Sustancias/epidemiología , Trastornos Relacionados con Sustancias/complicaciones , Infecciones por VIH/psicología , Infecciones por VIH/tratamiento farmacológico , Infecciones por VIH/complicaciones , Estudios Transversales , Depresión/epidemiología , Depresión/psicología , Persona de Mediana Edad , Rwanda/epidemiología , Factores de RiesgoRESUMEN
BACKGROUND: Most of the research on filicide mothers suggests that they experience negative feelings before they kill their child. However, little is known about whether these negative feelings can be expressed after one-year post-offense among incarcerated filicide mothers with no history of psychiatric problems. In this study, we aimed to conduct a qualitative analysis to (a) understand negative feelings evolving from negative emotions such as anger, guilt, shame, depression, and anxiety among filicide mothers incarcerated in Nyarugenge Prison in Rwanda, (b) identify the impact of experienced negative feelings on their personal wellbeing, and (c) explore their coping strategies. METHODS: This study adopted a phenomenology research design and face-to-face in-depth interviews to explore the problem among twenty filicide mothers selected from Nyarugenge prison. Data were audio recorded, transcribed verbatim, organized, and analysed by using ATLAS.ti 8 Windows. RESULTS: Anxious and depressed participants experienced both physical and emotional negative feelings. Social withdrawal and cognitive problems were expressed by anxious participants, while avoidance behaviours were particularly experienced by depressed participants. Intolerance created anger, while self-blame, regret, and acute stress created guilt. In addition, avoidance behaviours and poor self-judgment emerged from shame. Participants felt disconnected from their community and worried about a variety of issues because of their negative feelings. To cope with negative feelings, participants reported that they used abnormal defense, surrender and support from community resources. DISCUSSION: Our findings highlight the overall negative feelings of incarcerated filicide mothers, which can guide mental health professionals and different stakeholders to respond with appropriate interventions.
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Madres , Prisioneros , Adaptación Psicológica , Niño , Emociones , Femenino , Humanos , Madres/psicología , Investigación Cualitativa , RwandaRESUMEN
BACKGROUND: Intimate partner violence (IPV) is reported to be a public health issue given its magnitude and long-lasting consequences. Men are generally thought to be perpetrators of IPV, but they can also be victims. In Rwanda, the experience of men as victims has not yet been described and characterized. The aim of this study is to examine the trends and correlates of IPV victimization for men and women in Rwanda. METHODS: The data for this study were extracted from the Rwanda Demographic and Health Survey (RDHS) in 2014/15 (female: n = 8292, male: n = 3470) and 2019/2020 (female = 8574, male: n = 3590). The survey had used a structured measure of IPV (i.e. physical, sexual, or emotional) and its related demographic characteristics to collect data in a nationally representative sample of ever-married women aged 15-49 years and men aged 15-59 years. Multiple logistic regression was applied to examine the association between demographic characteristics and IPV in both women and men. RESULT: The prevalence of IPV among women increased from 40% in 2015 to 46% in 2020, while it decreased from 21 to 18% in men during the same time period. The associated factors for women IPV victimization in 2015 were: uneducated husband (Adjusted Odds Ratios (AOR) = 5.570, 95% CI 1.29-24.02), woman from the poorest household (AOR = 2.834, 95% CI 1.9-93.12), husband aged from 30 to 39 years (AOR = 2.797, 95% CI 1.517-5.158), husband consuming alcohol (AOR = 3.021, 95% CI 1.517-5.158); women involved in decisions about their own earnings (AOR = 0.576, 95% CI 0.37-0.88); and purchases (AOR = 0.472, 95% CI 0.27-0.82). However, the factors such as uneducated husbands (AOR = 3.032, 95% CI 1.117-8.24); husbands consuming alcohol (AOR = 1.712, 95% CI 2.408-4.486); a woman's involvement in decisions on her personal health (AOR = 0.443, 95% CI 0.30-0.63) and visits from her family or relatives (AOR = 0.405, 95% = 0.41-0.22) were factors of IPV in 2020. On the other hand, the associated factors for men IPV victimization in 2015 were being from richer wealth index (AOR = 0.21, 95% CI 0.04-1.04), frequency of being hit in last 12 months by other than partner (AOR = 5.49, 95% CI 1.65-18.25), woman often consuming alcohol (AOR = 13.30, 95% CI 1.9-93.12); whereas its associated factor in 2020 were women consuming alcohol (3.91, 95% CI 0.55-9.87). CONCLUSION: The present study revealed a significant increase in IPV against women, and slight decrease of IPV against men in Rwanda from 2015 to 2020, as well as its associated risks and protective factors over time. This increase needs further exploration given that government and partners have invested in policies and strategies to mitigate the IPV with limited impact. Since there is a relationship between IPV prevalence and education, the existing laws on domestic violence need to be known by the citizens. Findings from this study evidenced also visits from extended families to be a protective factor and therefore suggesting the necessity of a family and community-based approach in managing IPV in Rwanda. Future studies to assess the effectiveness of community-based approach in preventing IPV.
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Víctimas de Crimen , Violencia de Pareja , Estudios Transversales , Composición Familiar , Femenino , Encuestas Epidemiológicas , Humanos , Masculino , Prevalencia , Factores de Riesgo , Rwanda/epidemiología , Parejas Sexuales/psicologíaRESUMEN
BACKGROUND: Although compelling evidence shows that exposure to intimate partner violence (IPV) during pregnancy is detrimental to both physical and mental health of the victims and their fetuses, studies on negative impact of IPV on antenatal care (ANC) services utilization are scarce. METHODS: The aim of the current study was to determine the impact of IPV exposure on ANC services utilization indicators such as (i) initiation of care within the first 3 months of pregnancy, (ii) receipt of at least four ANC visits and (iii) receipt of care from skilled providers among reproductive age women in Rwanda. This study used the data from the 2014-15 Rwanda Demographic and Health Survey. Multiple logistic regression was used to estimate the effects of physical and sexual IPV on the ANC services utilization indicators. RESULTS: Among married women living with their partners with at least one child aged 5 years or under (N = 5116), 17% of them reported physical violence, 22.8% reported psychological violence and 9.2% reported sexual violence. We found that there was a significant negative relationship between physical IPV and both early ANC and sufficient ANC. Women who had experienced physical violence by their partners during the preceding 12 months were less likely to receive more than four ANC visits, (O.R = 0.61, CI = 0.417-0.908) and they were less likely to attend the first ANC visits within the first 3 months (O.R = 0.656, CI = 0.445-0.967). CONCLUSION: In this study, the prevalence of IPV still remains high and there is evidence that it does have significant impact on ANC. Therefore, the results provide support for continued efforts to reduce intimate partner violence, through the improvement of screening for IPV during ANC visits.
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Utilización de Instalaciones y Servicios/estadística & datos numéricos , Violencia de Pareja/etnología , Aceptación de la Atención de Salud/etnología , Atención Prenatal/estadística & datos numéricos , Adolescente , Adulto , Estudios Transversales , Demografía , Femenino , Humanos , Persona de Mediana Edad , Embarazo , Prevalencia , Rwanda , Factores Sociodemográficos , Adulto JovenRESUMEN
The present study aimed to identify predictors and effects of problem gambling and examine the moderating role of family dysfunction between problem gambling and its effects. A sample of 104 gamblers (all were men, Mean = 26.2, SD = 6.8), was recruited from gambling venues in an urban area of Musanze district, Northern Province of Rwanda. Participants were aged above the legal age of 16 years. Data were collected using the Problem Gambling Severity Index (PGSI), the Brief Michigan Alcoholism Screening Test (Brief MAST), Drug Abuse Screening Test (DAST-10), the Psychopathy Checklist-Revised (PCL-R), the Big Five Inventory (BFI), the Insomnia Severity Index (ISI) and the Family Dysfunction Test. SPSS (version22) was used to carry out all statistical analyses. Results showed that personality traits predicted problem gambling. Additionally, problem gambling was associated with alcohol use, drug abuse, sleep deprivation, antisocial tendency and family dysfunction. Family dysfunction moderated the effects of problem gambling on drug abuse, alcohol use and sleep deprivation. Gambling is a complex but assessable phenomenon and future studies may explore further its correlates.
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Juego de Azar , Trastornos Relacionados con Sustancias , Adolescente , Anciano , Consumo de Bebidas Alcohólicas , Trastorno de Personalidad Antisocial , Estudios Transversales , Juego de Azar/psicología , Humanos , Masculino , Trastornos Relacionados con Sustancias/epidemiologíaRESUMEN
INTRODUCTION: Compelling evidence shows that the COVID-19 pandemic has detrimental effects on the mental health of university students. However, little is known about the psychological distress experienced by students from high schools during the pandemic. This study, therefore, sought to examine the prevalence of depression, anxiety and stress and their associated factors among students from high schools in Rwanda. METHODS AND MATERIALS: A retrospective, cross-sectional study was conducted on 384 students randomly selected from high schools. Data were collected using standardized measures of mental disorders and their associated factors. Bivariate and multivariate analyses based on the odds ratio were used to indicate the associated factors of anxiety, depression, and stress. RESULTS: The results indicated that slightly above half of the participants (51%, n = 195) had clinically significant symptoms of depression, 30.3% (n = 116) had stress and 67.3% (n = 259) had anxiety. Our analyses identified several key risk factors associated with increased odds of these mental disorders. These include exposure to domestic violence, COVID-19 symptoms like cough and myalgia, eating twice per day, having one of the three mental disorders, gender, with females showing higher susceptibility, and direct contact with the people who positively tested covid-19. Conversely, protective factors such as heightened awareness about Covid-19, positive mental health, social support, eating three times, belonging to the third Ubudehe category, and a high resilience emerged as significant elements mitigating the risks of these mental health challenges within our sample. Intriguingly, religious affiliation emerged as a notable factor, with students affiliated with the Witness of Jehovah and Adventist denominations exhibited lower risks for depression and anxiety. CONCLUSION: Our findings highlighted a high prevalence of depression, anxiety, and stress among students from secondary schools. Interestingly, this study also revealed the associated risk and protective factors of depression, anxiety, and stress in Rwandan students in high schools. Therefore, mental health interventions targeting the impact of COVID-19 on students, as young people are needed.
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Ansiedad , COVID-19 , Depresión , Estrés Psicológico , Estudiantes , Humanos , COVID-19/epidemiología , COVID-19/psicología , Rwanda/epidemiología , Femenino , Masculino , Estudiantes/psicología , Ansiedad/epidemiología , Adolescente , Depresión/epidemiología , Depresión/psicología , Estrés Psicológico/epidemiología , Prevalencia , Estudios Transversales , Estudios Retrospectivos , Factores de Riesgo , Factores Protectores , Pandemias , SARS-CoV-2 , Adulto JovenRESUMEN
Background: The alarming prevalence of teen mothers' exposure to perinatal intimate partner violence (IPV, 8.3-67%) and attachment disorders (ADs) among their children is a global concern, especially in sub-Saharan Africa with high teenage pregnancy rates. This study, therefore, aimed to examine the link between teen IPV and AD in their offspring. We sought also to explore the mediating roles of postpartum depression symptoms, maternal sensitivity, parenting stress, and perceived social support in the relationship between perinatal IPV and children's ADs.Method: This cross-sectional study selected a random sample of 309 teen mothers from Nyanza district. This sample size was determined using Yamane's formula, with random sampling. Various instruments were used for data collection, including questionnaires on intimate partner violence, social support, maternal sensitivity, postpartum depression symptoms and parenting stress and early trauma-related disorders. The data was analysed using SPSS, with mediation analyses performed using the PROCESS macro (version 4.1).Results: IPV was found to be significantly associated with attachment disorders. Simple mediation models showed that parenting stress completely mediated these relationships, while postpartum depression, perceived social support, and maternal sensitivity partially mediated the relationship between IPV and children's ADs. In parallel mediation model, the combined roles of all mediators fully mediated the associations between IPV and ADs.Conclusion: These findings offer valuable insights in designing or strengthening the appropriate interventions to prevent and mitigate the perinatal intimate partner violence and its detrimental impact on children's attachment disorders. Combating intimate partner violence in post-conflict situations is challenging in teen mothers, however, our results suggest that efforts to address maternal mental health and parenting practices may protect children from attachment disorders.
Parenting stress was identified as a significant mediator, fully mediating the relationship between perinatal IPV and children's attachment disorders.Postpartum depression, perceived social support, and maternal sensitivity partially mediated the link between perinatal IPV and children's attachment disorders.The study underscores the necessity for multifaceted support programmes for adolescent mothers to address IPV, alleviate parenting stress, and enhance maternal mental health and social support, promoting better attachment outcomes for their children.
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Violencia de Pareja , Madres , Embarazo en Adolescencia , Humanos , Femenino , Violencia de Pareja/estadística & datos numéricos , Violencia de Pareja/psicología , Adolescente , Estudios Transversales , Embarazo en Adolescencia/psicología , Embarazo en Adolescencia/estadística & datos numéricos , Embarazo , Rwanda , Madres/psicología , Madres/estadística & datos numéricos , Depresión Posparto/epidemiología , Depresión Posparto/psicología , Apoyo Social , Encuestas y Cuestionarios , Apego a Objetos , Responsabilidad Parental/psicología , Relaciones Madre-Hijo/psicología , NiñoRESUMEN
BACKGROUND: There is little known about the family and community maltreatment of the offspring born of the genocidal rape and the offspring's self-perceptions and how they influence their recovery from mental health problems. This study aimed to examine how the mental health prognosis of these offspring could be influenced by the family or community perceptions and attitudes toward them and their self-perception and coping strategies. METHODS: Thirty-two semi-structured qualitative interviews were conducted on 16 dyads of mothers and their offspring who were selected from countrywide. The interviews were audio-recorded and transcribed verbatims that were analysed inductively using thematic analysis within the NVivo 12 software. RESULTS: Participants reported long-term psychological and psychosomatic consequences stemming from being born of genocidal rape. Notably, family and community maltreatment of the offspring and their self-perception exacerbated psychological distress and affected their capacity to recover. The majority of the offspring were using coping strategies such as sole collaboration with peers with the same history, efforts to hide their birth history, social Isolation (silence, untrusting, involvement in media etc), hardworking, reversed roles in the parental relationship, extreme involvement in praying, and harmful alcohol use. CONCLUSION: Given the documented detrimental effects of individual, family and community attitudes and perceptions on psychological, and psychosomatic symptoms as well as the offspring coping strategies, culturally relevant mental health interventions are required to support the well-being and social reintegration of individuals born of genocidal rape while minimizing stigma and their maladaptive coping strategies.
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Adaptación Psicológica , Salud Mental , Humanos , Femenino , Adulto , Masculino , Pronóstico , Violación/psicología , Persona de Mediana Edad , Adolescente , Niño , Adulto Joven , Autoimagen , Familia/psicologíaRESUMEN
INTRODUCTION: Involving parents of children with cerebral palsy (C-CP) in home exercise programmes (HEP) is globally practiced strategy closely linked to improved physical performance and functional outcomes for the child. Nevertheless, non-adherence to HEP is increasing at an alarming rate, and little is known about the factors influencing adherence to HEP (AHEP) especially in parents of C-CP. This systematic review aimed to identify the factors enhancing AHEP among parents of C-CP to reinforce the efficacy of rehabilitation practices proposed by health professionals, researchers, and educators. MATERIALS AND METHODS: We conducted searches in PubMed, Scopus, CINHAL, PsycINFO, and Embase for articles published up to March 2023, that investigated the factors influencing AHEP among parents of C-CP. A narrative synthesis was conducted using the search results and pertinent material from other sources. RESULTS: Overall, non-adherence rates to HEP were moderate to high, ranging from 34% to 79.2%. Strong evidence suggests that factors enhancing AHEP fall into three categories: child-related (such as younger age and better gross motor function [GMF]), the caregiver-related (including high self-efficacy and knowledge, strong social support, low levels of depression, anxiety and stress symptoms, and a low perception of barriers), and the physiotherapist-related. For the latter category, the parent's perception of a supportive and collaborative relationship with the therapist is one of the conditions most favourably influences AHEP. CONCLUSION: Our findings highlight that factors influencing AHEP are multifactorial. Some, such as GMF or the economic and social conditions of the family, are challenging to change. However, the relationship between therapist and parent is an aspect that can be strengthened. These results underscore the importance of substantial training and psychosocial support for therapists to enhance their awareness and competence in building supportive relationship with parents.
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Parálisis Cerebral , Padres , Humanos , Parálisis Cerebral/rehabilitación , Parálisis Cerebral/psicología , Padres/psicología , Niño , Terapia por Ejercicio/métodos , Apoyo Social , Cuidadores/psicología , Servicios de Atención de Salud a Domicilio , Cooperación del Paciente/psicologíaRESUMEN
Background: Birth through genocidal rape has a detrimental impact on the health of the offspring; however, there is scarce literature that focuses on efforts to support and reintegrate people born of this crime due to the lack of needs assessments that can inform policies and interventions. Objective: This study sought to explore perceptions of the intervention utility and effectiveness in supporting and reintegrating offspring born of the 1994 genocidal rape against the Tutsi in Rwanda. Methods: A purposive sample of 16 dyads of non-partnered mothers raped in the 1994 genocide against the Tutsi and their offspring participated in semi-structured qualitative interviews. The transcribed interview verbatims were uploaded to NVivo 12 and analyzed inductively using thematic analysis. Results: The analysis resulted in several subthemes that were grouped into four main themes based on research questions. These themes included the reconstruction of a positive image (ie, hardworking, contribution to the community, supporting vulnerable people, etc.), the benefits of collaborating with peers in a similar situation (ie, a sense of belonging, self-acceptance, relieving distress and emotional pain, etc.), the support obtained from Survivors Fund Rwanda (ie, psychosocial support, financial support for school fees, support to get a job), and the intervention and strategies needed (ie, continuous psychosocial support, catch-up learning programs, accompaniment support, advocacy to get a job, supporting the parents, etc.). Conclusion: Our results highlight how the youth born of genocidal rape are reconstructing a positive image and self-advocacy, their perception of obtained support, and the recommended intervention. These findings will help in initiating or strengthening interventions targeting this population, especially strategies to support and reintegrate them.
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BACKGROUND AND OBJECTIVE: Although narrative therapy (NT) is globally practiced for alleviating psychological disorders, studies of its efficacy for vulnerable children are still scarce, especially in African post-conflict settings. Thus, this study was aimed at assessing the efficacy of NT for Rwandan Orphans and abandoned children (OAC) with ADHD and anxiety disorders. METHOD: This study was a parallel randomized controlled trial in which participants (n = 72) were recruited from SOS Children's Villages. A half of participants (n = 36) were randomly allocated to either the NT group or the waitlist control group (WCG). Outcomes were collected at baseline before randomization and 10 weeks post-randomization. RESULTS: ANOVA results indicated a significant main effect of time for anxiety disorders (p < .001, ηp2= 0.176), and the main effects of group were significant for anxiety disorders (p < .001, ηp2= 0.254) and ADHD disorders (p < .001, ηp2= 0.260). There was a significant time by group interaction effect for anxiety disorders (p < .001, ηp2= 0.328) and for ADHD (p < .001, ηp2= 0.193). Between group analyses showed that the difference in symptoms was significant for anxiety disorders (p < .001, Cohen's d = 1.28) and for ADHD (p < .001, Cohen's d = 1.6) during the posttest, and the effect sizes were large. LIMITATION: The long-term effects of the intervention for the current sample were not assessed in this study. CONCLUSION: Despite its limitations, this study provides initial support for the safety, efficacy, and usefulness of NT among Rwandan OAC with ADHD and anxiety disorders. Health professionals must implement the new intervention as an everyday tool.
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Trastorno por Déficit de Atención con Hiperactividad , Terapia Narrativa , Niño , Humanos , Trastorno por Déficit de Atención con Hiperactividad/diagnóstico , Rwanda , Niño Abandonado , Trastornos de Ansiedad/psicología , Ansiedad/psicologíaRESUMEN
Despite the abundance of literature highlighting poor sleep quality among medical students and its detrimental impact on their mental well-being and academic performance, no study has been conducted to investigate the sleep quality of undergraduate medical students in Rwanda to date. Therefore, this study sought to determine the magnitude of sleep quality of undergraduate medical students in Rwanda and to compare the scores of seven components of sleep quality across classes. This cross-sectional study was conducted among 290 undergraduate medical students aged 18-35 years (mean = 24, SD = 2.9) randomly recruited countrywide from 1st November 2021 to 1st March 2022. The questionnaire was self-administered with 2 sections: characteristics of medical students, and Pittsburgh Sleep Quality Index (PSQI). The Pearson Chi-square test was used to test whether the categories of seven components of sleep quality differ between classes, then ANOVA followed by the post hoc test was used to test if the seven components and global score of Pittsburgh Sleep Quality Index differ between classes. The results revealed that the global PSQI mean score was 7.73 (SD = 2.83), with fifth-year medical students reporting the highest PSQI mean score (M = 8.44, SD = 2.77), followed by first-year (M = 8.15, SD = 3.31). One-way ANOVA showed that the global PSQI score (F = 2.76, p = 0.028), subjective sleep quality (F = 3.35, p = 0.011), habitual sleep efficiency (F = 10.20, p < 0.001), and daytime dysfunction (F = 3.60, p = 0.007) were significantly different across classes. Notably, the post hoc test revealed significant scores differences in the global PSQI score between class II and V (p = 0.026), in subjective sleep quality between class I and II (p = 0.043), and between class I and IV (p = 0.016); habitual sleep efficiency between class V and all other classes (p < 0.001); and daytime dysfunction between class III and IV (p = 0.023). This paper concludes by arguing that poor sleep quality is highly prevalent among medical students in Rwanda, with final and first-year students reporting the poorest sleep quality. There were significant differences across classes in the global PSQI, subjective sleep quality, habitual sleep efficiency, and daytime dysfunction. Intervention approaches such as sleep education, behavioral changes, and relaxing techniques are recommended to address contributing factors and ultimately maximize the academic goals of Rwandan medical students.
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Trastornos del Inicio y del Mantenimiento del Sueño , Trastornos del Sueño-Vigilia , Estudiantes de Medicina , Humanos , Calidad del Sueño , Rwanda/epidemiología , Estudios Transversales , Sueño , Encuestas y Cuestionarios , Trastornos del Sueño-Vigilia/epidemiologíaRESUMEN
Despite the tremendous evidence of the harmful effects of maternal filicide on the lives of offenders, there is a scarcity on studies of their negative emotions and personal wellbeing especially in sub-Saharan Africa. Thus, this study was primarily aimed at assessing the prevalence of negative emotions experienced by filicide mothers and how they were associated with personal wellbeing in Rwanda. With an institutional-based cross-sectional study design, we measured the symptoms of anxiety, anger, shame, guilt, depression and personal well-being in a convenient sample of 55 filicidal mothers (mean age = 26.69; SD = 6.88) who were incarcerated in Nyarugenge prison. SPSS (version 24) was used to compute descriptive, Pearson correlation, independent t-test and regression analyses. The results indicated that the rates of shame were (100%), guilt (98.2%), anxiety (92.7%), depression (92.7%), low happiness and satisfaction with life (81.8%), and anger was (76.4%) in the current sample. Based on age category, there was no significant difference in anger scores, depression, guilt, shame and personal well-being scores between young and adult filicide mothers (p>.05). Young filicide mothers (M = 14.55, SD = 4.03), on the other hand, had higher anxiety scores than adult filicide mothers (M = 11.57, SD = 4.72), t = 2.52, p = .015. Finally, anxiety (ß = -.507, t = -3.478, p = .001) and age (ß = -.335, t = -2.685, p < .001) were negatively associated with personal well-being. The results emerged from this study highlight that filicide mothers experience substantial negative emotions and poor personal wellbeing regardless of their age category. However, poor personal wellbeing was associated with anxiety and age. Based on these results, mental health professionals should examine their mental state with respect to negative emotions and initiate programs that decrease the emotions as well as increase personal well-being.
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Satisfacción Personal , Prisioneros , Adulto , Estudios Transversales , Emociones , Femenino , Culpa , Humanos , Madres/psicología , Rwanda , VergüenzaRESUMEN
Despite mounting evidence indicating an increased risk of long-term mental disorders in Rwanda's general population, little is still known about the national prevalence of mental disorders among victims of intimate partner violence (IPV) in a post-conflict setting. The aim of this study was to compare the prevalence of mental disorders among IPV exposed and non-exposed individuals in Rwanda. This was a cross-sectional study based on secondary data from the 2018 Rwanda Mental Health Survey. The sample consisted 20,381 participants selected nationwide, from 7,124 households (age range: 14-65 years), of which 3,759 Rwandans were exposed to IPV (18.4%) and 16,622 were non-exposed to IPV (81.6%). Participants were screened for IPV exposure and common mental disorders, and data was analyzed using the SPSS version 25 software. The results showed that the rate of any mental disorder was substantially higher in the group exposed to IPV than the non-exposed, at 32.4% and 11.7% respectively. These results highlight that among Rwandans diagnosed with severe mental disorders, participants with a history of IPV exposure present with increased odds of mental disorders prevalence and severity. Therefore, people seeking mental health care should also be screened for their IPV exposure and offered appropriate interventions.
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Violencia de Pareja , Trastornos Mentales , Adolescente , Adulto , Anciano , Estudios Transversales , Humanos , Violencia de Pareja/psicología , Trastornos Mentales/epidemiología , Trastornos Mentales/psicología , Persona de Mediana Edad , Prevalencia , Factores de Riesgo , Rwanda/epidemiología , Adulto JovenRESUMEN
BACKGROUND: Community-Based Sociotherapy (CBS) is an approach that was introduced in Rwanda in 2005, with the aim of improving psychosocial well-being among its participants and facilitating reconciliation processes. Over the years, CBS has been adapted contextually and the effectiveness of the approach has been measured in different ways, using qualitative and quantitative study designs. This study specifically assesses the effectiveness of CBS in terms of fostering the social dignity of participants as the primary outcome. METHODS/DESIGN: A cluster randomized controlled trial design with person-level outcomes whereas the CBS treatment is delivered at the cluster level. A total of 1200 eligible participants will be randomly assigned to two groups in a 1:1 ratio. Participants in the intervention group will receive the CBS intervention, while the control group will be waitlisted. The primary outcome measure is a self-designed and psychometrically validated Social Dignity Scale. The secondary outcome measures will be the WHO (Five) Well-Being Index (WHO-5), the Multidimensional Scale of Perceived Social Support (MSPSS), the Posttraumatic Stress Disorder Checklist for DSM-5 (PCL-5), the Self-reporting Questionnaire (SRQ-20), and the perceived parental self-efficacy scale. The primary analysis will be performed following an intention to treat analysis, using generalized estimating equation modeling. DISCUSSION: We expect this cluster randomized controlled trial to provide insight into the effectiveness of CBS on social dignity and secondary psychosocial outcomes among its group participants, who have different socio-historical backgrounds including genocide survivors, perpetrators, bystanders and their descendants, people in conflicts (family/community), and local leaders. This study will inform CBS implementers, policymakers, practitioners, and other stakeholders on the role of social dignity in interventions that focus on psychosocial healing. TRIAL REGISTRATION: ISRCTN ISRCTN11199072. It was registered on 2 April 2022.
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Genocidio , Respeto , Humanos , Rwanda , Proyectos de Investigación , Encuestas y Cuestionarios , Ensayos Clínicos Controlados Aleatorios como AsuntoRESUMEN
Background: Narrative Therapy is an efficacious treatment approach widely practiced for various psychological conditions. However, few studies have examined its effectiveness on resilience, a robust determinant of one's mental health, and there has been no randomized controlled trial in sub-Saharan Africa.Objective: This study sought to evaluate the efficacy of narrative therapy for the resilience of orphaned and abandoned children in Rwanda.Method: This study was a 'parallel randomized controlled trial' in which participants (n = 72) were recruited from SOS Children's Village. Half of the participants (n = 36) were randomly allocated to the intervention group and the rest to the delayed narrative therapy group. For the intervention group, children attended ten sessions (55â min each) over 2.5 months. Data were collected using the Child and Youth Resilience Measure (CYRM) and analyzed using mixed ANOVA within SPSS version 28.Result: The results from ANOVA indicated a significant main effect of time and group for resilience total scores. Of interest, there was a significant time by group interaction effect for resilience. Pairwise comparison analyses within-group showed a significant increase in resilience in the intervention group, and the effect size was relatively large in this group.Conclusion: Our findings highlight the notable efficacy of narrative therapy for children's resilience in the intervention group. Therefore, health professionals and organizations working with orphaned and abandoned children will apply narrative therapy to strengthen their resilience and improve mental health.Trial registration: Pan African Clinical Trial Registry identifier: PACTR202107499406828..
The effect size of narrative therapy for resilience was relatively large in the intervention group.Narrative therapy is an efficacious approach for resilience elevation in orphaned and abandoned children.Close attention should be paid to the implementation of narrative therapy for strengthening children's resilience as an everyday tool in foster care.
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OBJECTIVE: To identify the factors of postpartum depression among teen mothers. METHOD: A convenient sample of 120 teen mothers who were aged 15 to 19 years (M = 18.02, SD = 1.16) were recruited. Depression and its related factors were assessed with Edinburgh Postnatal Depression Scale, Eating Disorder Inventory (Body Dissatisfaction and Drive for Thinness subscales), Parental stress index (Parental distress and Parental-child dysfunctional interaction subscales), Frost Multidimensional Perfectionism Scale (parental criticism of parenting subscale) and Multidimensional Scale of Perceived Social Support. Both descriptive and analytical analyses were performed using Statistical Package for the Social Sciences (SPSS version 22). RESULTS: Results showed that 48% of sample had clinically high levels of depressive symptoms. Its associated factors were parental distress (ß = .297, t = 3.378, p = .001), weight/shape disturbances (ß = .217, t = 2.42, p = .017), economic income (ß = -.210, t = -2.32, p = .022) and parental-child dysfunctional interaction (ß = .20, t = 2.08, p = .03) among seven factors considered. CONCLUSION: Regression analyses showed that parental distress, weight/shape disturbances, economic income and parental-child dysfunctional interaction predicted unique variance associated with depression level. These findings are discussed in light of future work and the persistent need to inform prevention and treatment programs for teen mothers.
Asunto(s)
Depresión Posparto , Adolescente , Madres Adolescentes , Depresión/epidemiología , Depresión Posparto/epidemiología , Femenino , Humanos , Madres , Responsabilidad Parental , Rwanda/epidemiologíaRESUMEN
Background: There is an abundance of evidence suggesting that interpersonal violence commonly co-occurs with mental disorders and substance abuse. Interpersonal violence is one of the most well-documented and salient factors of mental disorders and substance abuse; however, there are no studies investigating the moderating role of interpersonal violence in post-conflict Rwanda. Objective: The aim of the present study was to explore the relationship between mental disorders and substance abuse among Rwandan university students, and whether the role of interpersonal violence is a moderating factor. Method: A purposive sample of 143 undergraduate university students (mean age = 22.4 years, SD = 2.6) from University of Rwanda-Remera Campus were selected for participation in this cross-sectional study. We used linear regression analysis to examine the relationships between mental disorders, substance abuse and interpersonal violence. Results: Substance abuse was significantly associated with post-traumatic stress disorder (PTSD), anxiety, depression and interpersonal violence. Interpersonal violence was a significant moderator of the associations between PTSD symptoms (ß = 0.43, p < 0.001), anxiety symptoms (ß = 0.47, p < 0.001), depressive symptoms (ß = 0.48, p < 0.001) and substance use. Conclusion: The results imply that PTSD, depression and anxiety symptoms are associated with increased risk of substance abuse, and this risk appears to become substantially more elevated when there are also current or historic reports of interpersonal violence.
Antecedentes: Existe una gran cantidad de evidencia que sugiere que la violencia interpersonal comúnmente coexiste con los trastornos mentales y el abuso de sustancias. La violencia interpersonal es uno de los factores relativos a los trastornos mentales y el abuso de sustancias más destacado y mejor documentado; sin embargo, no hay estudios que investiguen el papel moderador de la violencia interpersonal posterior al conflicto de Ruanda.Objetivos: El objetivo del presente estudio fue explorar la relación entre los trastornos mentales y el abuso de sustancias entre los estudiantes universitarios ruandeses, y si el papel de la violencia interpersonal es un factor moderador.Métodos: Se seleccionó una muestra intencional de 143 estudiantes universitarios de pregrado (edad media = 22,4, DE = 2,6) del Campus de la Universidad de Ruanda-Remera para participar en este estudio transversal. Utilizamos el análisis de regresión lineal para examinar las relaciones entre los trastornos mentales, el abuso de sustancias y la violencia interpersonal.Resultados: El abuso de sustancias se asoció significativamente con TEPT, ansiedad, depresión y violencia interpersonal. La violencia interpersonal fue un moderador significativo de las asociaciones entre los síntomas de TEPT (ß=.43, p<0.001), síntomas de ansiedad (ß=.47, p<0.001), síntomas depresivos (ß=.48, p<0.001 y abuso de sustancias.Conclusión: Los resultados implican que los síntomas de TEPT, depresión y ansiedad están asociados con un mayor riesgo de abuso de sustancias, y estos riesgos parecen ser sustancialmente más elevados cuando también hay reportes actuales o históricos de violencia interpersonal.