The present study aimed to explore the objective and subjective experiences of “mistreatment” in maternity care in a diverse cohort of women who gave birth in New York City hospitals to identify the prevalence and risk factors of mistreatment and measure the relationship between mistreatment and mental health (Bohren et al., 2015). The study utilized a mixed-methods cross-sectional approach. To collect the quantitative data, 109 participants <1 year postpartum completed an anonymous online survey comprising a self-report measure of demographic, health and mental health information, several mental health questionnaires and two measures of mistreatment in maternity care. 8 of these participants were interviewed about their childbirth experience. The quantitative data was analyzed utilizing linear regression, moderation analysis and path analysis, and the qualitative data was thematically coded then analyzed using Reflexive Thematic (RT) analysis. These data were then triangulated using a mixed-methods model of mistreatment. In total, 10-15% of the sample experienced mistreatment in the form of Low to Very Low respect and/or autonomy in decision making in their maternity care. Forms of mistreatment included unwanted procedures, provider pressure to undergo procedures, dismissal of women’s concerns, racial discrimination, abandonment, and medical neglect. Approximately 25% of respondents received an unwanted intervention; this was the most significant predictor of mistreatment. This relationship was moderated by race, parity and birth plan. Black, Latinx and Hispanic women experienced the lowest levels of respect in maternity care. Mistreatment in maternity care was correlated with increased risk for postpartum mental illness: decreased respect and autonomy in childbirth was associated with increased postpartum depression and PTSD symptoms. Eight themes were identified in the qualitative analysis: Discrimination and Unfair Treatment, Confusion and Abandonment, Disregard for Patient Autonomy, Hospital-Level Drivers of Mistreatment, Women Treated as Passive, Normalization of Mistreatment, Self-Advocacy and Vulnerability and, Reclaiming Power through Knowledge. Together, the triangulated mixed- methods data were fit to render a comprehensive “model of mistreatment” to illustrate direct and indirect relationships between mistreatment, mental health, race, trauma history, and childbirth preparation. These findings demonstrate that mistreatment is a multi-determined phenomenon that is interdependent with mental health and requires systematic measurement in healthcare treatment, the integration of anti-racist and patient-centered care and improved childbirth education for patients.

A qualitative, descriptive, explorative, and contextual research design was selected for this study. The purpose was to explore the phenomenon of mass hysteria among the Basotho in Lesotho and to develop guidelines which may facilitate early intervention and better management and control of mass hysteria outbreaks. The study area covered four of the ten districts in Lesotho. Four high schools where recent outbreaks of mass hysteria have been reported were included in the study. Semi-structured individual interviews and focus group interviews were conducted to collect the data. Purposive sampling was used to select young women in high schools who experienced mass hysteria; teachers who were present during mass hysteria episodes; a parent; and traditional healers and religious leaders who were involved in treating the affected.Thirteen individual interviews were held respectively with one victim of mass hysteria from a rural area, four school principals,a parent,five traditional healers, a priest and apastor. Three focus group interviews were conducted with thirty affected young women from three different high schools and two focus group interviews were held with twenty teachers from two different high schools.The data were transcribed verbatim and content analysis was done using open and axial coding. Four themes emerged from the findings, namely: manifestations of mass hysteria among the Basotho; interventions used by the Basotho to alleviate mass hysteria; Basotho’s views about the phenomenon of mass hysteria; and effects of mass hysteria onthe Basotho. The findings show that young women in Lesotho experience both physical and psychological symptoms during mass hysteria episodes and that it has a contagious effect. The interventions used by the Basotho to alleviate mass hysteria include traditional healing, herbal remedies, exorcism and prayer.The Basotho have different views about mass hysteria attributing it to either supernatural forces or natural illness. Episodes of mass hysteria have a negative impact on the victims,their families, and those who witnessed the episodes, causing confusion, fear and anxiety. Guidelines were compiled to assist teachersand health workers to improve the management and control of mass hysteria episodes in Lesotho. / Health Studies / D. Litt. et Phil. (Health Studies)

Thesis (MA (Psychology))--University of Stellenbosch, 2006. / This study aimed to determine whether low-income women residing in a rural community in South Africa experienced any significant difference in the prevalence rates of depressive symptoms postpartum as compared to depressive symptoms prepartum. Thirty women between the ages of 16 and 38 were recruited during pregnancy from the local community clinic in Kylemore, South Africa. The women where assessed for elevated levels of depressive symptomatology using the Beck Depression Inventory (BDI) during pregnancy and again at three and six months postpartum. It was found that 18 (60%) of the women reported elevated levels of depressive symptomatology during the prepartum assessment, with 11 (37.9%) and 12 (48%) women reporting elevated levels of depressive symptomatology at the three months and six month postpartum assessment respectively. It was further found that the sample from the current study did not experience any significant difference in the rate of depressive symptomatology from the prepartum assessment to either of the postpartum assessments. The results also suggests that a relationship exists between the levels of depressive symptomatology prepartum and the levels of depressive symptomatology postpartum, as those women who experienced high levels of depressive symptomatology during pregnancy continued to show high levels of depressive symptomatology at the postpartum assessments. The findings from the current study thus suggest that the classification of postpartum depression as a unique and separate entity, that differs from depression occurring in women at other times and from depression as experienced by men, may be misleading. The term suggests a depression that develops following childbirth, while in the current study it seemed that when depressive symptoms were reported postpartum, they were also already apparent during pregnancy. The findings from the current study therefore suggest that the existence of postpartum depression as a distinct diagnosis or illness is problematic – a suggestion that has frequently been suggested in the literature (Aderibigbe, Gureje, & Omigbodun, 1993; Chandran, Tharyan, Muliyil & Abraham, 2002; Cooper, Campbell, Day, Kennerly & Bond, 1988; Cox, Murray & Chapman, 1993; O’Hara, Zekoski, Phillips & Wright, 1990; Patel, Rodrigues, & DeSouza, 2002).

Thesis (MA)--Stellenbosch University, 2013. / ENGLISH ABSTRACT: The topic of perinatal depression (i.e. depression during and after pregnancy) remains a subject of continued research interest, as a broad literature body reports that a large proportion of women suffering from this mental disorder do not receive appropriate treatment. This is worrisome, firstly, because mental health treatment is often readily available to the public and at no cost. Secondly, untreated perinatal depression not only holds dangerous consequences for the mother but also for the infant and the rest of the family. It is therefore important to identify those factors that act as barriers to mental health care utilization for perinatal depression. Although this is a persistent problem within the South African context, to date, little is known about the barriers to the utilization of available mental health services experienced among pregnant South African women. For this reason, the Perinatal Mental Health Project (PMHP) aims to provide mental health services at the same location where women receive obstetric services. However, despite their efforts, the number of women who decline available treatment is still of great concern. The present study offers a unique perspective on counselling for perinatal depression appointment-keeping barriers as it provides a holistic view of these barriers that exist not only within the women but also in their multi-levelled environments. Secondly, it addresses the problem of nonattendance to mental health care treatment offered by the PMHP and consequently also addresses the gap in South African research on the topic. The sample for this study was selected from PMHP files of those patients who failed to attend scheduled counselling appointments. The participants included in this study were selected by means of purposeful sampling to participate in face-to-face and telephonic semi-structured interviews. Participants were assured of confidentiality and anonymity. The semi-structured interviews were audio-recorded and transcribed after which transcriptions were entered into MS Word for textual analysis. Transcriptions were thematically analysed. The main themes that emerged from the present study included individual-related barriers, social-related barriers, institution-related barriers, community-related barriers and poverty-related barriers. The results of the present study reflect the motivations for depressive pregnant women to decline available and free mental health services provided by the PMHP, according to five main themes. These themes were then discussed according to Bronfenbrenner’s (1977; 1979) Ecological Systems Theory, which categorised the main themes identified according to the different systems operating within the patient’s environment, i.e. the individual-, micro-, meso-, exo-, and macrosystem. The individual system comprised the individual-related barriers, which included poor mental health, and ambivalent feelings toward the pregnancy. The microsystem comprised the social-related barriers, which included low social support and self-help strategies. Community-related barriers were considered within the mesosystem of the patient’s ecological environment, with stigma and pity as sub-barrier. The exosystem comprised the institution-related barriers, including referral protocol barriers, lack of information provided by the nurses, and nurses’ attitudes as experienced by participants. Lastly, poverty-related barriers were considered within the macrosystem, with financial life hardship, constant child-care demands, and transportation barriers as sub-barriers. The significance of this study lies in the original perspective offered on mental health care appointment-keeping behaviour within the South African context. Future research could, in addition to conducting interviews with hospital patients, include health care professionals and focus groups as this will allow for triangulation of the perspectives of all significant players. Also, having identified the problems and concerns with regards to attending counselling appointments, future research direction may be aimed at creating interventions designed to reduce the identified barriers to mental health care service use. / AFRIKAANSE OPSOMMING: Perinatale depressie (d.w.s. depressie voor en na swangerskap) bly ʼn onderwerp van voortdurende navorsings belang, aangesien ʼn breë navorsingsveld aandui dat ʼn groot proporsie van vroue wat aan hierdie geestesversteuring lei, nie die gepaste behandeling ontvang nie. Dit is kommerwekkend, eerstens, aangesien behandeling vir geestesgesondheid meestal openlik verkrygbaar is aan almal sonder enige koste. Tweedens, onbehandelde perinatale depressie hou nie slegs gevaarlike gevolge vir die moeder in nie, maar ook vir die baba en die res van die gesin. Dit is daarom belangrik om daardie faktore te identifiseer wat as hindernisse optree tot geestesgesondheid sorg diensgebruik vir perinatale depressie. Alhoewel dit ʼn voortdurende probleem binne die Suid-Afrikaanse konteks is, is daar tot op hede geen navorsing wat hindernisse tot gebruik van beskikbare geestesgesondheidsdienste bekend gemaak nie, veral wat ervaar word onder swanger Suid-Afrikaanse vroue nie. Vir hierdie rede, beoog die Perinatal Geestesgesondheid Projek (Perinatal Mental Health Project - PMHP) om geestesgesondheidsdienste te lewer by dieselfde plek waar vroue verloskundige dienste kan ontvang. Nietemin, ten spyte van hul pogings, is die getal vroue wat beskikbare behandeling van die hand wys steeds van groot kommer. Dié studie bied ʼn unieke perspektief op hindernisse tot berading vir perinatale depressie afspraak-ooreenkoms gedrag, aangesien dit ʼn algehele uitkyk bied op hindernisse wat nie slegs binne die vroue bestaan nie, maar ook in hul veelvlakkige omgewings bestaan. Tweedens, spreek dit die probleem van nie-bywoning van geestesgesondheidsbehandelingsdienste wat aangebied word deur die PMHP aan en gevolglik ook die gaping wat binne Suid-Afrikaanse navorsing rakende dié onderwerp bestaan. Die steekproef vir die studie was gekies van PMHP lêers van daardie pasiënte wat nie hul geskeduleerde terapie afsprake bygewoon het nie. Die deelnemers ingesluit in die studie is deur middel van doelgerigte-steekproefneming geselekteer om aan aangesig-tot-aangesig of telefoniese semi-gestruktureerde onderhoude deel te neem. Deelnemers is van hul vertroulikheid en anonimiteit van die proses verseker. Die semi-gestruktureerde onderhoude was oudio-opgeneem en transkripsies is daarvan gemaak, waarna die transkripsies in MS Word gelaai is vir tekstuele analise. Transkripsies is tematies geanaliseer. Die hooftemas wat na vore gekom het, sluit in individuele-verwante hindernisse, sosiale-verwante hindernisse, institusie-verwante hindernisse, gemeenskapsverwante hindernisse en armoede-verwante hindernisse. Resultate van dié studie reflekteer die motiverings van depressiewe swanger vroue om beskikbare en gratis geestesgesondheidsdienste wat verskaf is deur die PMHP van die hand te wys, volgens die vyf hooftemas. Hierdie temas is toe volgens Bronfenbrenner (1972) se Ekologiese Sisteemteorie verdeel in die verskillende sisteme teenwoording in die pasiënt se omgewing, naamlik die individuele-, mikro-, meso-, ekso-, en makrosisteem. Die individuele sisteem het die individuele-verwante hindernisse ingesluit, wat swak geestesgesondheid, en teenstrydige gevoelens teenoor die swangerskap omvat het. Die mikrosisteem het die sosiale-verwante hindernisse ingesluit, wat swak sosiale ondersteuning, en self-help strategieë omvat het. Gemeenskapsverwante hindernisse is binne die mesosisteem van die pasiënt se ekologiese omgewing beskou, en het stigma en jammerte as sub-hindernisse ingesluit. Die eksosisteem het die institusie-verwante hindernisse ingesluit, wat verwysing protokol hindernisse, gebrek aan inligting verskaf deur die verpleegsters, en verpleegsters se houdings soos ervaar deur die deelnemers omvat het. Laastens is die armoede-verwante hindernisse binne die makrosisteem beskou, en het finansiële lewens swaarkry, konstante kindersorg eise, en vervoer-verwante struikelblokke as sub-hindernisse ingesluit het. Die belang van dié studie lê in die oorspronklike perspektief van geestesgesondheidsbehandeling dienste afspraak-ooreenkoms gedrag binne die Suid-Afrikaanse konteks, wat aangebied is. Toekomstige navorsing kan, bykomend tot die voer van onderhoude met hospitaal pasiënte, fokus daarop om gesondheidsorg kenners en fokus groepe in te sluit, aangesien dit die triangulasie van perspektiewe moontlik maak van al die belangrike rolspelers. Ook, aangesien die probleem en bekommernisse rakende bywoning van terapie afsprake reeds geïdentifiseer is, mag toekomstige navorsing in die rigting beweeg met die doel om intervensies te omskep wat beoog om die geïdentifiseerde hindernisse tot geestesgesondheidsorg diensgebruik te verminder.

Assertive training was investigated to determine its usefulness in teaching mildly retarded women to become more assertive. The 10 subjects (ages 18-35, WAIS VIQ 50-75) were randomly assigned to either the assertive training or the control group. Experimental subjects received 5 weeks of daily assertive training sessions which employed modeling, behavior rehearsal, and focused instructions in a group setting. Specific components of assertive behavior were taught in the following order: (a) assertive refusals, (b) assertive requests, (c) posture, (d) eye contact, and (e) loudness, Results of a behavioral role-playing task administered to both groups before and after treatment revealed that assertaive training subjects made significantly greater improvement than controls in their assertive content, Additionally, these subjects manifested significantly more improvement than control subjects on a global assertiveness measure.

Exclusive breastfeeding for at least 6 months provides numerous infant and maternal benefits. Yet mothers with risk factors, such as lower education, lower socioeconomic status, younger maternal age, planned cesarean birth, and anxiety and depression, are more likely to stop breastfeeding in the early postpartum period. Few studies have focused on perinatal depression as a risk factor for breastfeeding cessation. To tailor effective interventions, nurses must first understand the lived experience of breastfeeding for mothers at risk for perinatal depression. A descriptive phenomenological study was conducted to elucidate the experience of breastfeeding for mothers with perinatal depression. The study was grounded in Swanson’s middle-range theory of caring. After university Institutional Review Board approval, a purposive sample of 10 women was recruited from various organizations. Participants completed a demographic questionnaire and the Edinburgh Postnatal Depression Scale, and semistructured, audiorecorded face-to-face or telephonic interviews were conducted. The researcher transcribed the data which was transformed into constituents of the mothers’ lived experience by utilizing Giorgi’s descriptive phenomenological method. Five constituents emerged: choosing selflessness, harboring inadequacy, deliberate persevering, discerning meaning, and cherishing intimacy. The constituents embodied the essence of the mothers’ thoughts and feelings connected to breastfeeding. By daily choosing selflessness, mothers consciously decided to breastfeed despite physical or psychological struggles. They often were harboring inadequacy due to ongoing struggles which led to incessant thoughts of maternal incompetence. Yet they successfully breastfed for at least 2 weeks after birth by deliberate persevering. Through breastfeeding, they were discerning meaning to realize their value as mothers. Finally, they reveled in purposeful moments of togetherness with their babies through cherishing intimacy. The study findings inform recommendations for nursing education, practice, research, and policy. Nursing education must include basic breastfeeding and perinatal mental health knowledge in prelicensure curricula and up-to-date lactation management techniques and perinatal mental health awareness training in continuing education. Practicing maternal-child nurses must provide education and support to mothers about advantages and difficulties of breastfeeding throughout the perinatal period. Future research includes determination of support needs for women with perinatal depression with subsequent development and evaluation of therapeutic actions to promote breastfeeding success. / Includes bibliography. / Dissertation (Ph.D.)--Florida Atlantic University, 2017. / FAU Electronic Theses and Dissertations Collection

A growing body of research has explored the prevalence of eating disorder pathology within the ethnically and culturally diverse South African context. The purpose of this study was to examine the presence and severity of eating disorder symptoms within a multi-racial, female student sample. In addition to this, the pathogenic role of the family was considered and framed in terms of attachment theory. Thus, a secondary aim was to explore the relationship between disordered eating and participants' membership to an attachment style and /or dimension. A questionnaire survey was administered to a convenience sample of 127 first year, female, university students. The sample included 39 (30.71%) Black, 5 (3.94%) Coloured, 29 (22.83%) Indian and 54 (42.52%) White women. Levels of disordered eating were measured by the Eating Disorder Inventory 1 (EDI 1). Attachment styles were determined by means of the Close Relationship Questionnaire (CRQ) and attachment dimensions were calculated by means of the Adult Attachment Scale (AAS). It was found that Black students had higher mean scores on seven of the eight EDI 1 subscales than their Indian and White peers. There were significant differences noted on the EDI 1 sub-scales of Bulimia (p < .01), Perfectionism (p < .05), and Interpersonal Distrust (p < .05). White participants scored highest on the Body Dissatisfaction sub-scale. A negative relationship was indicated between the eight EDI 1 sub-scales and the secure attachment dimension (Close). A positive relationship was found between the eight EDI sub-scales and the two insecure attachment dimensions (Depend and Anxiety). Significant differences were found between the race groups in terms of the classification of participants into three attachment styles /dimensions. This research supports previous findings with regard to high levels of eating disordered pathology among Black women. Furthermore, support of a relationship between disordered eating and participants' attachment in close relationships was indicated. In particular, the psychological struggles implicated in disordered eating such as feelings of inadequacy and worthlessness, mistrust of others, and difficulty with emotions, were found to be significantly associated with unhealthy or insecure attachment patterns that reflected difficulty with trust and dependency in close relationships. / Thesis (M.A.)-University of KwaZulu-Natal, Pietermaritzburg, 2004.

O final do século XIX, com a inserção maciça da mulher no mercado de trabalho, se deu início a um processo de fusão e, mútua ocupação, do espaço doméstico (privado) e do público. Nesse cenário, percebe-se mudanças significativas, nas suas trajetórias econômica, profissional e familiar. Tomando essa cartografia como contexto, este trabalho consistiu analisar, as múltiplas atividades desenvolvidas pela mulher (nos âmbitos domésticos e profissionais) e as possíveis ressonâncias sobre a saúde. Participaram desse estudo, sete mulheres residentes na Região Metropolitana do Recife, e com rotina diária, de duas ou mais, jornadas de trabalho. Suas idades, variaram entre 30 e 49 anos. No que se refere à profissão, uma era taxista; duas professoras do estado, locadas em área de risco; duas policiais militares; e uma segurança armada. Realizamos entrevistas semidirigidas, no local de melhor conveniência das participantes. Posteriormente, elegeu-se como procedimento de organização, descrição e análise das falas das entrevistadas, a análise temática de conteúdo. Identificaram-se três unidades de sentido, a saber: sobrecarga das múltiplas atividades; identificação com a profissão; e repercussões sobre a saúde e estratégias de enfrentamento. Neste contexto, identificamos a presença de uma grande satisfação e realização nas tarefas e nos compromissos assumidos por essas mulheres, contudo, alguns impactos negativos foram notados. O preço pelo alto desempenho e, elevadas cobranças, culminaram em diversas formas de sofrimento e sobrecarrega emocional. Entre os quais, destacamos: presença de alguns sintomas depressivos e de ansiedade, assim como, pressão alta, insônia, excesso de peso, estresse e dores de cabeça. A busca por redes de apoio familiar e social, se configurou como o mais importante fator de proteção ao risco e manutenção da saúde no grupo estudado. Essas parcerias assumiram lugar fundamental, na tessitura das estratégias de enfrentamento para o grupo estudado. O estudo da interação, entre as múltiplas atividades desenvolvidas pela mulher e, as ressonâncias sobre a saúde permitiram fornecer informações e recursos para o desenvolvimento de intervenções clínicas, como também, de subsídios para o fortalecimento de políticas públicas, que visem o atendimento e proteção das necessidades da mulher no exercício de suas variadas funções / The Final of the XIX century, with the massif (salid) insercion of woman into the market of work, has given origin to a process of fusion and mutual occupation of the domestic (private) space and of the public one. In this scenery, we can perceive meaninful changes in her economical, profissional and familiar trajectories. Using, employing this cartography as a certain context, this work has consisted os analysing the multiple activities developed by woman (in her domestic and profissional fields of action) and the possible resonanges upon her healthiness. Seven women from the Metropolitan Region of Recife, having in their daily work routine, two or more days labor. Their ages varied from 30 to 49 years old . Relating to profession, one of them was a taxical driver; two of them were teachers from state of pernambucos official schools, locates in risking areas; two of them from women military police, and one from armed-weaponed safety. We had perfomed, accomplished semidirect interviews in the participants better convenience place. Later on, we have elected, chosen, as the inverviwed persons speeches organization, description and analysis proceeding, content thematic analysis. We have identified meaning three units of senses, multiple activities overload; identification with profession and resonanges upon healthiness and confronting strategies-fieds a great satisfaction presence and fruition in their tasks and in the commitments assumed by these women. However, notwith-standing, we have found out some negative impacts. Price for high fulfillment and high changes, exigences on demands have reached their clímax, their highest point in suffering several ways and emotional overload wchich we can emphasize: some depressive syntoms and anxiety syntoms presence, as well as high pressure, sleeplesness, height excess, stress and headaches. The supporting nets search -the familiar and social ones - has taken shape has (configurated itself) as the most important factor of protection to healthiness risk and maintenance in this studied group. These partnerships have assumed, have developed a fundamental locus- place in these women confronting strategies texture. The interaction study among the multiples activities accomplished, developed by women and their resonance upon their healthiness has allowed, permitted providing (informations and ressonances for clinical interventions development, as well as subsidies for public politics furnishing that aim at the women needs attendances and protection in their several and varied functions exercise

A questão que permeou este trabalho de tese consistiu em interrogar em que medida os grupos terapêuticos Projetos de Vida, oferecido às mulheres em sofrimento psíquico, dão suporte à sua (re) inserção social, sobretudo no que diz respeito à vida laborativa. Os referenciais teóricos adotados para a contextualização desta temática abrangeram as determinações do Ministério da Saúde quanto à perspectiva psicossocial dos atendimentos aos usuários dos CAPS e as elaborações teóricas de Hannah Arendt sobre ação humana no contexto da vida ativa. Este trabalho teve como objetivo compreender como as usuárias dos CAPS de transtorno mental de Recife-PE experienciam os grupos terapêuticos Projetos de Vida e de que modo tais experiências repercutem no seu viver cotidiano. Teve como objetivos específicos: descrever o trabalho realizado no grupo; contextualizar o ambiente sociofamiliar e laborativo vivenciado pelas usuárias participantes da pesquisa; descrever a experiência prática cotidiana das usuárias a partir das vivências nesse grupo e a repercussão no seu cotidiano. Trata-se de uma pesquisa qualitativa, cujas narrativas foram realizadas através de entrevista aberta, questionário sociodemográfico e consulta a documentos (prontuários e livro de registro de grupos). Para a compreensão das entrevistas, utilizou-se o Interpretativismo de Wilhelm Dilthey, buscando-se compreender os sentidos dados a estes grupos terapêuticos em suas vidas laborativas. No processo de desvelamento, os relatos obtidos abrangeram aspectos comportamentais e emocionais, com destaque a: melhor preparação e conscientização para a convivência sociofamiliar; melhorias no âmbito pessoal de bem-estar e sentimentos de acolhimento, valorização e oportunização de conforto e segurança emocional no convívio interpessoal. Houve, também, relatos de que as vivências contribuíram para o retorno à vida laborativa profissional e para o fornecimento do resgate da reabilitação e reinserção social. As narrativas indicam, ainda, que a maioria dos processos interventivos realizados nos referidos grupos é voltada para o estímulo e incentivo a outros aspectos da vida, que não o laborativo, com destaque para o enfrentamento ao estigma da doença mental e a autoconfiança para a reinserção social. Os relatos sobre as abordagens terapêuticas mencionam um razoável espectro de recursos técnicos para o alcance do que se propõe: discussões temáticas sobre saúde e doença mental; reflexões sobre comportamento; passeios terapêuticos e emprego de artes. Os desejos manifestos se voltam para pretensões de retomada de atividades e aquisição de novos projetos, o que reflete a mudança no papel social da mulher na contemporaneidade. Sobretudo, as narrativas apresentadas corroboram a importância do cuidado às pessoas em sofrimento psíquico, bem como reafirmam o pressuposto de Hannah Arendt sobre vida ativa, qual seja, a ação humana torna-se sem sentido se não for voltada para alguma forma de realização. / The question that pervaded this thesis was to examine to what extent the therapeutic groups Life Projects, offered to women in psychological distress, give support to their social (re) integration, particularly with regard to the working lives. The theoretical framework adopted to the contextualization of this thematic covered the determinations of the Ministry of Health regarding the psychosocial perspective of care to users of CAPS and the Hannah Arendt theoretical elaborations on human action in the context of active life. This study aimed to understand how users of mental disorder CAPS in Recife-PE experience the therapeutic groups Life Project and how such experiences impacting their daily lives. The project has as specific objectives: to describe the work realized in the group; contextualize the social-family and occupational environment experienced by the women participating users of research; describe the everyday practical experience of users from the experiences in this group and how it impacted on their daily lives. This is a qualitative research, whose narratives were made through open interview, sociodemographic questionnaire and consultation documents (records and group record book). For understanding the interviews, it was used the Wilhelm Dilthey interpretivism, seeking to understand the meanings given to these therapeutic groups in their occupational lives. In the process of unveiling, the obtained reports covered behavioral and emotional aspects, especially to: better preparation and awareness of the social-family conviviality; improvements in the personal level of welfare and feelings of acceptance, appreciation and facilitation of comfort and emotional security in interpersonal living. There were also reports that the experiences contributed to the return to professional working lives and for the supply of the rescue of rehabilitation and social reintegration. The narratives also show that most interventional procedures performed in these groups is aimed at stimulating and encouraging other aspects of life, excluding the working lives, especially to face the stigma of mental illness and the self-confidence for the social reintegration. The reports on the therapeutic approaches mention a reasonable range of technical resources for the achievement of what is proposed: thematic discussions on health and mental illness; reflections on behavior; therapeutic riding and arts application. The manifested desires turn to intending of the recovery of activities and acquisition of new projects, which reflects the change in women's social role in contemporary society. Above all, the narratives presented corroborate the importance of caring for people in psychological distress and reaffirm the Hannah Arendt assumption on active life, namely, human action becomes meaningless if it is not directed to any embodiment.

M.Sc. (Research Psychology) / Mental health is known to be adversely affected by gender inequality and poverty. The World Health Organization (WHO) reported that psychological disorders affect half the global population (WHO, 2010) and South African estimates posited that 16.5% of the population presented with common mental disorders in 2007 (Williams et al., 2008). Depression and anxiety disorders in women, specifically, are posing a major public health concern in developing countries due to inadequate treatment (Aidoo & Harpham, 2001). Protective factors, namely intrapersonal, interpersonal, community and cultural factors, were identified by Ungar (2008) as a mechanism that promotes resilience and alleviates the effects of adversity. In order to develop knowledge geared toward intervention strategies to promote mental health in socio-economically disadvantaged women in urban communities, this study employed an explanatory mixed methods research design (which included both quantitative surveys and qualitative interviews) to establish an incidence of depressive symptoms, and levels of ego-resilience, among women in Doornkop, Soweto. This was done in order to explore, first, the relationships between selected socio-demographic variables and depression and ego-resilience, and second, to investigate if there was a relationship between depression and ego-resilience. Finally, the study aimed to gain an understanding of how women perceived the role of protective resources in their lives which might promote positive mental health outcomes. The statistical component of the study found a weak negative correlation between the two constructs of depression and ego-resilience. Symptoms of depression appeared to be related by exposure to a high number of difficult life experiences, and particularly in instances of having been a victim of crime or violence. While ego-resilience seemed to be related to increased participation in community groups, it also correlated with adversity, namely, unemployment. This led the researcher to the conclusion that for this sample, depression and ego-resilience were independent constructs, and although they were divergent concepts, both were shaped by exposure to adversity. The interview data further explored exogenous sources of resilience as set out by Ungar (2008). These findings highlighted the importance of interpersonal relations on feelings of well-being. While the protective factors varied in the sources from which they arose (from children, romantic partners, parents, peers and community groups to music and television, and faith in God), they all provided a sense of purpose, belonging and self -worth, which enabled positive feelings. The main recommendation that arose from the research was the need for community education about mental illness, the services available to communities, and the importance of developing and maintaining family and community systems of support. These measures may go some way toward enhancing resilience in women and reducing vulnerability to mental disorders arising from experiences of adversity. Furthermore, a focus on community-based interventions, such as education and life skills, is vital in shifting the focus of interventions from mental illness to the promotion of mental health. Ongoing research is fundamental to developing our existing knowledge of both psychopathology and the promotion of mental well-being in women in socio-economically deprived communities. Research, in light of the challenges facing community mental health services in poor areas, could include foci on the beliefs of professionals including the knowledge and skills required to deliver effective mental health services. Knowledge of this nature should serve to enhance our understanding of the complexities of mental health and inform the development of innovative and appropriate treatment modalities that are oriented to the particular needs of women in resource-poor communities.