Occupational therapist\u27s role in interventions for mothers with mental health disorders

Uvod: Materinstvo pri ženskah z motnjo v duševnem zdravju je poseben izziv, saj njihova naloga naenkrat ni več samo obvladovanje simptomov, temveč nenehno iskanje ravnovesja med usklajevanjem lastnih potreb in potreb otroka. Delovni terapevti lahko dajo tem materam priložnost, da razvijejo svoje naravne materinske instinkte in ustvarijo varno fizično ter emocionalno stabilno okolje, kar je ključno za optimalen razvoj otroka. Namen: Raziskati izkušnje in vlogo delovnih terapevtov pri obravnavi mater z motnjami v duševnem zdravju. Metode dela: S pregledom literature smo določili teoretični okvir, opredelili ključne besede in se odločili za kvalitativno raziskavo. Kot tehniko zbiranja podatkov smo uporabili polstrukturirani intervju. Vzorec, pridobljen po principu snežne kepe, je zajemal pet slovenskih delovnih terapevtov. Ti so imeli vsaj eno leto izkušenj z obravnavo mater z motnjo v duševnem zdravju in so do danes obravnavali vsaj eno mater z motnjo v duševnem zdravju, diagnosticirano pred zanositvijo. Izvedena je bila kvalitativna vsebinska analiza. Iz dobesednega prepisa intervjujev smo izbrali ključne podatke in jih povezali v hierarhične enote ter jih primerjali z obstoječo literaturo. Rezultati: Matere so bile obravnavane timsko, v domačem okolju, pristop je bil individualen, pomembno vlogo pri obravnavi so imeli delovni terapevti. Največkrat uporabljeni ocenjevalni inštrumenti so bili COPM, analiza aktivnosti in začetni intervju. Največ znanja za obravnavo mater so delovni terapevti pridobili od sodelavcev, uporabili pa so tudi znanja, pridobljena preko lastne izkušnje materinstva. Delovnoterapevtske obravnave so bile redko zastavljene po procesni metodi ali konceptualnih modelih. Razprava in zaključek: Obravnave, ki so jih najpogosteje izvajali, so bile povezane z vzpostavitvijo dnevnih rutin, vključevanjem v raznolike okupacije s področja dnevnih aktivnosti in sodelovanjem v družbi ter samostojnostjo pri izvedbi le-teh. Delovni terapevti so izpostavili pomembnost celostnega pristopa k obravnavi uporabnic in opolnomočenja za izvajanje okupacij matere. Kot izziv pri delu so izpostavili položaj njihove vloge v multidisciplinarnem timu in potrebo po večji širini znanja na področju duševnega zdravja. Smiselno bi bilo v prihodnosti vlogo delovne terapije pri obravnavi mater podpreti s konkretnimi smernicami za obravnavo in obravnavo bolj navezati na okupacije mater.Introduction: Motherhood is a challenging task per se. For woman with mental health disorders suddenly their job isn\u27t just managing their symptoms but searching for constant balance between her own and her child\u27s needs. Occupational therapists can provide opportunities for those mothers to develop their maternal instincts and create safe physical and emotionally stable environment, ensuring optimal child development. Purpose: To examine occupational therapists\u27 experiences and role within their interventions for mothers with mental health disorders. Methods: Firstly, we reviewed literature to form a theoretical overview and to determine key words. Then we conducted qualitative research, using semi-structured interview as a research method. We used snowball sampling which later on provided five Slovenian occupational therapists, who had at least one year of experience with treatment of mothers with mental health issues and have to this day treated at least one mother with mental health issues, diagonosed prenatally. Then followed thematic analysis and extraction with coding of data, which we then combined into hierarchic order. At last, we compared data with theoretical literature. Results: Occupational therapy interventions were mostly individual, in mothers\u27 home environments. In most cases multidisciplinary approach was used. Most used assessment tools were COPM, activity analysis and interviews for conducting occupational profile. Largest sources of knowledge for occupational therapists experiences from their co-workers and also experiences from their own motherhood. Their interventions were rarely based on process method or konceptual models. Discussion and conclusion: Most interventions were carried out to establish daily routines, including various activities of daily life and social participation as well as increasing mothers\u27 autonomy in those activities. Occupational therapists stressed the importance of holistic approach and empowering women for engaging in maternal occupations. As a challenge, occupational therapists indicated position of their role in multidisciplinary team and a necessity to gain more knowledge in relation to mental health. For future practice we strongly suggest establishing consistent occupational therapy guidelines for supporting mothers with mental health disorders and to bring more attention to maternal occupations