As this review shows, using this multisystemic social-ecological theory of resilience can inform a deeper understanding of the processes that contribute to positive development under stress. It can also offer practitioners and policy makers a broader perspective on principles for the design and implementation of effective interventions.
Bronfenbrenner's ecological theory is appealing as a conceptual tool for guiding public mental health interventions. However, his theory underwent significant changes since its first inception during the late 1970s until his death in 2005, due to which the implications that can be drawn might differ depending on what concepts (i.e. early or later) of the theory is utilized. The aim of this paper was to examine how different concepts of Bronfenbrenner's theory have been utilized in (public) mental health research, and to analyse the value of these different uses for guiding public mental health policy and practice. A systematic search for articles that have utilized concepts of Bronfenbrenner's theory within the field of mental health resulted in a review of 16 published papers. We found that one set of papers (N = 10) used the early concepts of ecological systems without investigating interactions between these systems, while another set of papers used the concepts of ecological systems by also investigating interactions within and between these systems (N = 4). Another limited set of papers (N = 2) utilized the later concepts of proximal processes and the PPCT model. Our results show that studies using Bronfenbrenner's ecological system concepts by clearly considering interactions Electronic supplementary material The online version of this article (https://doi
The relationships between quality of life, psychopathological manifestations and coping related variables (coping resources, social support, sense of coherence) were examined among individuals who have perceived several severe traumata. One hundred Iranian refugees resettled in Sweden have been investigated by the Symptom Checklist (SCL-90-R), the Beck Depression Inventory (BDI), the Coping Resources Inventory (CRI), and the Interview Schedule for Social Interaction (ISSI), the Sense of Coherence Scale (SOC), and the WHOQoL-100 questionnaire in a cross-sectional study. Individuals, traumatized by combat experiences as a soldier during the war, with low BDI scores showed on average the significantly highest overall quality of life, the best physical health, the highest scores according to the sense of coherence most pronounced for "Meaningfulness," and the best availability of social integration compared to participants who did not had these experiences in combats and those with the experience but scored high in the BDI. Quality of life, coping resources, and social support were found closely related to psychopathological manifestations. Motivational orientations (highly developed Meaningfulness-SOC) and various coping competencies probably enable some traumatized individuals to resist against several traumata and to live in a good quality of life without psychopathological disturbances.
As explained by the World Health Organization (WHO) in 2000, the concept of health system responsiveness is one of the core goals of health systems. Since 2000, further efforts have been made to measure health system responsiveness and the factors affecting responsiveness, yet few studies have applied responsiveness concepts to the evaluation of mental health systems. The present study aims to measure responsiveness and its related domains in the mental health-care system of Tehran. Utilizing the same method used by the WHO for its responsiveness survey, responsiveness for outpatient mental health care was evaluated using a validated Farsi questionnaire. A sample of 500 public mental health service users in Tehran participated and subsequently completed the questionnaire. On average, 47% of participants reported experiencing poor responsiveness. Among responsiveness domains, confidentiality and dignity were the best performing factors while autonomy, access to care, and quality of basic amenities were the worst performing. Respondents who reported their social status as low were more likely to experience poor responsiveness overall. Attention and access to care were responsiveness dimensions that performed poorly but were considered to be highly important by study participants. In summary, the study suggests that measuring responsiveness could provide guidance for further development of mental health-care systems to become more patient orientated and provide patients with more respect.
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