IntroductionBefore the 2014, Ebola epidemic in Sierra Leone, healthcare workers (HCWs) faced many challenges. Workload and personal risk of HCWs increased but their experiences of these have not been well explored. HCWs evaluation of their quality of life (QoL) and risk factors for developing work-based stress is important in helping to develop a strong and committed workforce in a resilient health system.MethodsCross-sectional study using World Health Organisation Quality of Life (WHOQOL)-BREF and Health and Safety Executive (HSE) Standards Tools in 13 Emergency Obstetric Care facilities to (1) understand the perceptions of HCWs regarding workplace risk factors for developing stress, (2) evaluate HCWs perceptions of QoL and links to risk factors for workplace stress and (3) assess changes in QoL and risk factors for stress after a stress management programme.Results222 completed the survey at baseline and 156 at follow-up. At baseline, QoL of HCWs was below international standards in all domains. There was a significant decrease in score for physical health and psychological well-being (mean decrease (95% CI); 2.3 (0.5–4.1) and 2.3 (0.4–4.1)). Lower cadres had significant decreases in scores for physical health and social relationships (13.0 (3.6–22.4) and 14.4 (2.6–26.2)). On HSE peer-support and role understanding scored highly (mean scores 4.0 and 3.7 on HSE), workplace demands were average or high-risk factors (mean score 3.0). There was a significant score reduction in the domains relationships and understanding of role (mean score reduction (95% CI) 0.16 (0.01–0.31) and 0.11 (0.01–0.21)), particularly among lower cadres (0.83 (0.3–1.4).ConclusionHCWs in low-resourced settings may have increased risk factors for developing workplace stress with low QoL indicators; further exploration of this is needed to support staff and develop their contribution to the development of resilient health systems.

This qualitative study aims to explore and analyse the experiences of women living with female genital mutilation (FGM) who have sought help from healthcare providers within the NHS. Nine women aged 20–46 years were recruited from support organisations in the north-west of England and interviewed about their experiences of NHS care and if any screening had taken place in relation to the consequences of living with FGM. The interviews were undertaken in English, audiotaped, transcribed and analysed using a framework analysis method. Eight of the women had given birth and the main contact with the NHS had been with midwifery, gynaecology and paediatric services. Three key themes emerged from the qualitative data: involvement with healthcare professionals; silent suffering; and compassionate communication. Findings highlight the importance of sensitive and culturally competent communication nurses require to support women and refer them to appropriate services.

No abstract

No abstract

This article aims to review the literature published in the UK, Australia and the US during the last 10 years on adult child–parent estrangement to increase awareness among health visitors of the complexity, frequency and consequences for new parents, especially mothers. Adult child–parent estrangement encompasses a deliberate distancing between the adult child and parent, resulting in an absence of communication. By increasing health visitors' awareness of the issues, it is hoped they may be able to reduce the distress, social isolation and potential consequences for new mothers and families in their care.