Social support, coping, resilience and mental health in Malaysian unwed young pregnant women and young mothers : Their experiences while living in a shelter home

Sammanfattning: This thesis is based on four articles. In the first article, questionnaire data from a follow-upstudy (Article I) that aimed to explore social support, coping and resilience as predictors ofmental health in unwed young pregnant women and young mothers during placement in ashelter home were analysed. Nine shelter homes were invited to participate in the study (n ofpre-assessment = 250; n of post-assessment = 79). Percentages, paired sample t-tests, multipleanalyses of variance (MANOVA), and multiple regression analysis were used to analyse thedata. There were no significant changes in social support, coping or resilience between thepre- and post-assessment. The variability in the mental health scores from the follow-upassessment could be explained by the variability in coping, social support and resilience forbetween 14% of the variance in the BDI score and 36% in the GHQ sum-score. However,about 32% of the unwed young pregnant women and young mothers had a BDI score above26 suggesting the occurrence of a depressive disorder at the second assessment. Thequalitative part of the study (Articles II and III) attempted to investigate the reactions receivedfrom their significant others, and how these reactions influenced their pregnancy experience.Furthermore, their daily life experience during their placement in a shelter home is described.Seventeen unwed young pregnant women and young mothers aged from 12 to 18 wereinterviewed. Qualitative content analysis and thematic analysis were used to analyse thetranscriptions of the interviews. Significant others were often perceived as reacting to theunwed young pregnant women and young mothers with secrecy, repression and rejection. Theresponse of the unwed young pregnant women and young mothers to the significant others inrespect of their pregnancy was to feel detached, trapped, unworthy and ambiguous. Theresults of the thematic analysis (Article III) led to three themes: rules and regulations, therelationship with the staff, and the relationship with the other girls in the shelter home. Theresults indicated that the participating shelter homes were often not fulfilling the standards ofshelter homes according to the Malaysian national laws and the United Nations Conventionon the Rights of the Child. In addition, a mixed methods approach (Article IV) was applied toinvestigate the associations between the experiences of the unwed young pregnant women andyoung mothers in the shelter home and their social support, coping, resilience, and mentalhealth. Because of the nominal data, the findings from the qualitative analyses were quantifiedand jointly analysed with the questionnaire data using Spearman Rank coefficient. The analyses were done based on the interviews and survey with 17 unwed young pregnantwomen and young mothers aged 12 to 18 years. The mixed methods study emphasized thatthe unwed young pregnant women and young mothers have poor availability and adequacy ofsocial support and were at risk of developing mental health problems if untreated.