• Irish general practitioners' view of perinatal mental health in general practice: a qualitative study.

      Noonan, Maria; Doody, Owen; O'Regan, Andrew; Jomeen, Julie; Galvin, Rose (BMC Family Practice, 2018-12-13)
      Identification of perinatal mental health problems and effective care for women who experience them are important considering the potentially serious impact that they may have on the wellbeing of the woman, her baby, family and wider society. General practitioners (GPs) play a central role in identifying and supporting women and this study aimed to explore GPs' experiences of caring for women with perinatal mental health problems in primary care. The results of this study may provide guidance to inform policy, practice, research and development of curriculum and continuous professional development resources. In-depth semi-structured interviews were undertaken between March and June 2017 with GPs (n = 10) affiliated with a University training programme for general practice in Ireland. Thematic data analysis was guided by Braun and Clarkes (2013) framework. Data were categorised into three themes with related subthemes: identification of perinatal mental health problems, decision making around perinatal mental health and preparation for a role in perinatal mental health. GPs described the multifaceted nature of their role in supporting women experiencing perinatal mental health issues and responding to complex psychological needs. Inbuilt tools on existing software programmes prompted GPs to ask questions relating to perinatal mental health. Limited access to referral options impacts on assessment and care of women. GPs desire further continuous professional development opportunities delivered in an online format and through monthly meetings and conference sessions. GPs require access to culturally sensitive; community based perinatal mental health services, translation services and evidence based perinatal psychological interventions. A standardised curriculum on perinatal mental health for trainee GPs needs to be established to ensure consistency across primary care and GP education should incorporate rotations in community and psychiatry placements.
    • It's not all about price: factors associated with roll-your-own tobacco use among young people - a qualitative study.

      Breslin, Elizabeth; Hanafin, Joan; Clancy, Luke; TobaccoFree Research Institute Ireland (TFRI), Focas Research Institute (BMC Public Health, 2018-08-08)
      Smoking prevalence in Ireland is falling in all age groups, but the prevalence of roll-your-own (RYO) tobacco use is rising among young people. This qualitative study aims to explore and understand the factors associated with young people's use of RYO products. Semi-structured individual and focus group interviews were conducted with young people aged 16-22 years. Participants were recruited from a higher education institution and youth organisations working with early school leavers across Dublin. In total, there were 62 participants in the study, consisting of 22 individual interviews and eight focus group interviews with 40 participants. Categoric and thematic data analysis was used to generate the findings. We identified two broad themes, incentivising and disincentivising factors. The lower cost of RYO products compared to pre-manufactured cigarettes was the most important incentive for users. However, other product characteristics, such as the artisanal factors associated with RYO products were also found. Social and environmental influences were apparent, in which certain groups and environments facilitated and normalised RYO practices. Amenities and facilities often provided smokers with normalised spaces which could be dedicated to the enactment of rolling practices and to the creation and maintenance of social bonds with other users. Disincentives included negative features related to the product itself, adverse health effects, and the effects of tobacco denormalisation. While the lower cost of RYO products is very important for young smokers, other product characteristics and influences also incentivise and disincentivise use. A more comprehensive understanding of the multi-dimensional appeal of these products will assist policymakers to target strategies to reduce the attractiveness to young smokers of these products.