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Background: Utilization of video calls on hospital wards to facilitate involvement of and communication with family members is still limited. A deeper understanding of the needs and expectations of family members regarding video calls on hospital wards is necessary, to identify potential barriers and facilitate video calls in practice. Aim: The aim of this study was to explore the views, expectations and needs of a patient's family members regarding the use of video calls between family members, patients and healthcare professionals, during the patient's hospital admission. Methods: A qualitative study was carried out. Semi‐structured interviews with family members of patients admitted to two hospitals were conducted between February and May 2022. Family members of patients admitted to the surgical, internal medicine and gynaecological wards were recruited. Results: Twelve family members of patients participated. Family members stated that they perceive video calls as a supplemental option and prefer live visits during hospital admission. They expected video calls to initiate additional moments of contact with healthcare professionals, e.g. to join in medical rounds. When deploying video calls, family members mentioned that adequate instruction and technical support by nurses should be available. Conclusion: Family members considered video calls valuable when visiting is not possible or to participate in medical rounds or other contacts with healthcare professionals outside of visiting hours. Implications: Family members need to be supported in options and use of video calls on hospital wards. Additional knowledge about actual participation in care through video calls is needed as well as the effect on patient, family and healthcare professional outcomes. Impact: Using video calls on hospital wards can provide family members with flexible alternatives for contact and promote family involvement. Reporting Method: COREQ guidelines. Patient or Public Contribution: Family members of patients admitted to hospital have contributed by sharing their perspectives in interviews. What does this paper contribute to the wider global clinical community?: Family members perceive additional value from the use of video calls on hospital wards.For family, use of video calls needs to be facilitated with clear instruction materials and support. Trial and Protocol Registration: Amsterdam UMC Medical Ethics Review Committee (ref number W21_508 # 21.560). [ABSTRACT FROM AUTHOR]

Aims: To describe nurse managers' perceptions of interventions to support nurses as second victims of patient safety incidents and to describe the management of interventions and ways to improve them. Design: A qualitative study using interviews. Methods: A purposive sample of nurse managers (n = 16) recruited from three hospital districts in Finland was interviewed in 2021. The data were analysed using elements of inductive and deductive content analysis. Results: The study identified three main categories: (1) Management of second victim support, which contained three sub‐categories related to the nurse manager's role, support received by the nurse manager and challenges of support management; (2) interventions to support second victims included existing interventions and operating models; and (3) improving second victim support, based on the sub‐categories developing practices and developing an open and non‐blaming patient safety culture. Conclusion: Nurse managers play a crucial role in supporting nurses as second victims of patient safety incidents and coordinating additional support. Operating models for managing interventions could facilitate nurse managers' work and ensure adequate support for second victims. The support could be improved by increasing the awareness of the second victim phenomenon. Implications for the Profession and Patient Care: Mitigating the harmful effects of patient safety incidents can improve nurses' well‐being, reduce burden and attrition risks and positively impact patient safety. Impact: Increasing awareness of the second victim phenomenon and coherent operation models would provide equal support for the nurses and facilitate nurse managers' work. Reporting Method: COREQ checklist was used. What does this paper contribute to the wider global clinical community? Nurse managers' role is significant in supporting the second victims and coordinating additional support.Awareness of the second victim phenomenon and coherent operating models can secure adequate support for the nurses and facilitate nurse managers' work. [ABSTRACT FROM AUTHOR]

Aims: This study aimed to delineate the relationships between actors and contextual factors associated with the development of the advanced practice role in Catalonia. Methods: A complementary data analysis was conducted based on the social network analysis (SNA) method. The primary study design was qualitative, descriptive and explanatory. Participants from diverse perspectives of practice, organization and external environment were engaged to participate in semi‐structured focus groups. Data collection was conducted between March and May 2016 in Catalonia, Spain. Participants were asked to report on various dimensions of the role development context: understanding of the role, felt needs, perceived outcomes, barriers and facilitators. Results: Primary data analysis performed for 44 participants identified 71 related contextual factors associated with role development. Complementary network analysis revealed multiple relationships and agreements among participants and context‐related themes. Professional roles and disciplines clustered around topics show consensus and the significance of topics. Conclusion: Understanding the level of interactions and consensus among participants and contextual factors will ultimately allow better insight into how complex contexts influence the development of advanced practice nursing in healthcare organizations. Significant, consensual contextual factors should be used to influence further development and implementation of new roles that affect patient care and outcomes. Summary statement: What is already known about this topic? Comprehensive understanding of context at various levels should generate greater knowledge about what affects advanced practice role development locally and globally.What this paper adds? Findings could help organizations to make sense of the full dimension of context and to predict or act on development of advanced practice nursing roles.The implications of this paper: Significant, consensual contextual factors should be used to influence further development and implementation of new roles that affect patient care and outcomes. [ABSTRACT FROM AUTHOR]

Background: The COVID-19 (C19) pandemic shocked primary care systems around the world. Those systems responded by supporting patients in the community, and acute care facilities in crisis. In Canada, the Patient Medical Home (PMH) is a widely adopted care model that aims to operationalize the tenets and principles of Primary Health Care (PHC) as developed since the Alma-Ata Declaration. This paper describes how personnel working in and with Primary Care Networks (PCNs) in Alberta, Canada deployed the PMH model and its underlying PHC principles to frame and respond to the C19 shock. Methods: Using purposive and snowball sampling techniques, we interviewed 57 participants who worked in public health and primary care, including community-based family physicians. We used interpretive description to analyze the interviews. Results: PCN staff and physicians described how the PMH model was foundational to normal operations, and how C19 responses were framed by the patient-centric, team-delivered, and continuous care principles the model shares with PHC. Specifically, participants described ensuring access to care, addressing the social determinants of health, being patient centered, and redeploying and expanding PHC teams to accomplish these goals. Discussion: Delivering PHC through the PMH allowed physicians and allied health staff to deliver patient-centered, team-based, holistic bio-medical services to Albertans. In tailoring services to meet the specific social and health needs of the populations served by each PCN, healthcare providers were able to ensure relevant support remained available and accessible. [ABSTRACT FROM AUTHOR]

Background: Midwives can play a pivotal role in promoting natural-birth experiences. However, limited information is available about Jordanian laboring women’s experiences of natural childbirth guided by midwives. Understanding women’s experiences of natural birth can inform healthcare providers and policymakers to improve the care provided for laboring women. Purpose: This study aims to explore women's experiences of natural childbirth in a midwife-led care unit. Methods: A qualitative descriptive approach guided the study protocol. Data was collected through in-depth, semi-structured telephone interviews with 10 Jordanian women who experienced natural childbirth in a midwife-led care unit. Results: Two main themes emerged: “The journey of empowerment “and “being prepared for natural childbirth". The first theme consisted of two sub-themes: Making an informed decision, and being supported. The second theme consisted of three sub-themes: The power of the place, being satisfied with natural-childbirth practices, and feeling relieved. Conclusion: Women had positive childbirth experiences shaped by having autonomy in decision-making, perceived support, and being satisfied with the midwife-led care unit. Women’s positive experiences emphasize the need for social and political change to promote natural childbirth. Implications for Nursing: This paper provides evidence that supports the incorporation of midwife-led units to promote natural childbirth. New data will play a critical role in strengthening the responsibilities of nurses and midwives by raising public awareness and calling for policy changes to promote natural childbirth. [ABSTRACT FROM AUTHOR]

Aims: We aimed to investigate the perspective of primary care nurses on their role with patients who have chronic cardiovascular disease and to identify cultural elements shared by nurses caring for people with chronic cardiovascular disease. In primary care, the role of the nurse is essential to promote self‐efficacy in cardiovascular self‐care. Individuals with chronic cardiovascular disease need to integrate the disease into their life, together with the health recommendations for management and follow‐up. Methods: A qualitative, focused ethnographic study was conducted. Purposeful sampling was used to include nurses who were working in primary care during the study. Data collection took place between 20 January and 20 May 2014 and consisted of semi‐structured interviews. A thematic analysis was applied using the data. Results: Eleven participants were included. Cardiovascular care forces nurses to reflect on their identity and role in primary care. The relationship between the nurse and people with chronic cardiovascular disease is a complex process, which may cause nurses to feel a sense of failure and monotony in their work. Conclusions: Our findings may help to understand the role of the nurse and the care provided in patients with chronic cardiovascular disease. Summary statement: What is already known about this topic? Primary care nursing is necessary for the improvement of cardiovascular risk factors.Chronic cardiovascular patients need training in self‐care.The organizational culture confers different forms of care to patients. What this paper adds? The vision of the socio‐cultural role of the family and community nurse is shown regarding cardiovascular prevention.Information is provided on the differentiating approach to chronic cardiovascular patients in primary care.Our study reflects the influence of routine care in nursing consultations, and what it entails to provide improved nursing care in cardiovascular patients. The implications of this paper: These findings can be used to understand the need to change the focus of nursing care in cardiovascular prevention.The implementation of a follow‐up protocol for the care of cardiovascular patients can improve patients' self‐care and reduce monotony in the nursing consultation.Further training and research is necessary regarding comprehensive chronic cardiovascular care within primary care services. [ABSTRACT FROM AUTHOR]

Background: Early childhood teachers (ECTs) play a significant role in equipping children with oral language and emergent literacy skills ahead of school entry. They are well positioned to play a vital role in ensuring preschool children receive a high‐quality preschool curriculum to prepare them for later literacy learning. Aims: The purpose of this study was to explore early career ECTs' views and confidence regarding their role in providing preschoolers with oral language and emergent literacy support and to examine their perceptions of their preservice preparation. Methods & Procedures: Nine Australian early career ECTs were recruited via purposive sampling for an in‐depth, semi‐structured interview. Data were analysed using an inductive thematic analysis approach. Outcomes & Results: Participants attached strong significance to their role in facilitating children's oral language growth and emergent literacy skills and reported a range of practices to support children's learning. However, they rarely referred to using established language facilitation strategies or using dialogic book reading prompts. Further, emergent literacy concepts such as phonological awareness and print awareness were not routinely described as features of participants' classroom activities. Participants did not consistently make a clear conceptual distinction between the constructs of oral language and emergent literacy and often used these terms interchangeably. Notably, participants indicated that they did not feel confident in their ability to identify preschool children who were not meeting developmental language milestones and reported that they felt poorly equipped to do so by their preservice training. Conclusions & Implications: ECTs' strong willingness to support preschool children's oral language and emergent literacy skills may be hindered by gaps in their knowledge; these may contribute to important and missed opportunities for identifying and supporting preschoolers' oral language and emergent literacy growth. What this paper adds: What is already known on this subject?: High‐quality learning experiences in preschool are important for maximising preschoolers' oral language and emergent literacy growth. Early childhood teachers can play an important role in facilitating this development and preparing children for later literacy learning. What this paper adds to existing knowledge?: The study findings provide insight into ECTs' perceptions of their role and support in developing children's oral language and emergent literacy skills. The results indicated ECTs did not feel confident with their knowledge of children's language milestones or identifying children with language difficulties. Participants reported that their preservice training left them underprepared in the area of oral language. What are the potential or actual clinical implications of this work?: ECTs demonstrated a strong willingness to support preschoolers' oral language and emergent literacy skills. However, their self‐reported knowledge gaps and low confidence may have implications for the early detection of children who are not reaching language developmental milestones in a timely way. [ABSTRACT FROM AUTHOR]

Buyer's clubs were first recognised during the HIV/AIDS pandemic in the 1980s and focussed on knowledge curation and distribution of treatments. In the past decade, there has been a resurgence of buyer's clubs, mostly focussed on hepatitis C treatment and PrEP. This paper aims to increase understanding of buyer's clubs and stimulate discussion on their role in achieving equitable access to medicines. Our proposed definition of a buyer's club is 'a community-led organisation or group which seeks to improve an individual's access to medication through knowledge sharing and/or distribution as its primary goal'. The logistical and relational infrastructures of buyer's clubs have been mapped out. Networks and communities are integral to buyer's clubs by facilitating practical aspects of buyer's clubs and creating a sense of community that serves as a foundation of trust. For a user to receive necessary medical support, doctors play a crucial role, yet, obtaining this support is difficult. Whilst buyer's clubs are estimated to have enabled thousands of people to access medicines, and they run the risk of perpetuating health inequities and injustices. They may have the potential to serve as a health activism tool to stimulate sustainable changes; however, this needs to be explored further. [ABSTRACT FROM AUTHOR]

This paper aims to establish strategies of coping with COVID-19 pandemic adopted by the clients of social assistance from the perspective of social workers. The qualitative research among Polish social workers and family assistants was conducted from September to November 2021. Based on 30 in-depth interviews with social work professionals, groups of social assistance clients' behaviours were identified and classified into the theoretical models of reactions to social change by Merton and Giddens. The following types of behaviour have been selected and categorized into four groups of reactions when dealing with social workers in a pandemic situation: coolheaded calculation, defiance, confusion, and adaptation. At the same time, reactions to the situation of social change were categorized into one of the strategies of active or passive behaviour: innovation, contestation, retreat, and acceptance. In addition, we discussed the impact of clients' coping strategies on social workers and established three attitudes of the surveyed social workers: adapting to the pandemic situation and customer behaviour, assuming the role of an emotional buffer and informant, and expecting support from superiors and coworkers. Knowing the behaviour of social assistance clients in a challenging situation makes it possible to adopt tailor-made measures. [ABSTRACT FROM AUTHOR]

Aims: This paper aimed to explore the views of employers at senior care businesses concerning the employment of retired nurses in Thailand. Design: A qualitative interview study was conducted. Methods: Face‐to‐face and online semi‐structured interviews with 78 senior care business employers were conducted. Results: Business employers had positive sentiments towards employing retired nurses to deliver care and supported them to remain in the profession. Business employers acknowledged that retired nurses have a high level of professional confidence with excellent knowledge and skills. Furthermore, retired nurses were often assigned to work in managerial roles. In addition, flexibility in terms of work hours, suitability of role and responsibilities, and reasonable compensation rates were important to nurses' decisions to remain in or return to the nursing profession. There is a need for the further development of recruitment, retention and reform policies to encourage retired nurses to continue or return to the nursing profession. Patient and Public Contributions: We thank all participants for their valuable input throughout the study. [ABSTRACT FROM AUTHOR]

Schizophrenia is a global concern, and, this paper, describes the caring roles of health professionals who are mothers of adult children with schizophrenia. A thematic analysis of data from a doctoral study identified a blending of expertise into an informed care model. Caring roles included: constant carer; coordinator carer; watchful bystander carer; and life coach carer. Previous research has not explored these dual roles. This paper elucidates their responsive approaches and contributions to mothering and caregiving roles. Informed by a fusion of professional and mothering knowledges, their insights into mental health care have been forged by their experiences and is an untapped resource. [ABSTRACT FROM AUTHOR]

Background: Aphasia, a common consequence of stroke, which affects both communication and social functioning, and in turn, quality of life, is on the rise due to increases in stroke prevalence and survival rate. The rehabilitation of post‐stroke aphasia primarily falls within the purview of speech‐language pathology and research supports the effectiveness of such services. However, provision of aphasia rehabilitation services in sub‐Saharan Africa is associated with challenges. Aims: This study aimed to examine rehabilitation services for individuals with post‐stroke aphasia in Ghana by exploring the roles of the stakeholder groups involved in the assessment and treatment of post‐stroke aphasia in Ghana, as well as the challenges they encounter in providing or identifying services. The stakeholder groups included educational institutions, interdisciplinary healthcare professionals, and family caregivers of individuals with post‐stroke aphasia. Methods & Procedures: A qualitative case study approach was used to collect and integrate from multiple sources data such as demographic information, interview responses and program syllabi to develop a holistic image. Fifteen respondents from the stroke and speech therapy units at Komfo Anokye and Korle‐Bu Teaching Hospitals, University of Ghana, and University of Health and Allied Sciences, Ghana were purposively sampled. Interview questions were developed and centred on aphasia education and training, knowledge of speech‐language pathology services, speech‐language pathology service delivery, access to speech‐language pathology services, challenges in both delivery and access to speech‐language pathology services and suggestions for improving speech‐language pathology services. In‐person and virtual interviews were conducted after demographic information was collected. Interviews were analysed thematically, and demographic information and program syllabi were triangulated with the interview data collected. Outcomes & Results: All stakeholder groups identified concerns with current aphasia services in Ghana. Issues raised included the insufficient number of speech‐language pathologists, lack of awareness of speech‐language pathology services for post‐stroke aphasia (among healthcare professionals and the public), absence of aphasia management information and clinical training in educational programming, lack of interest in speech‐language pathology training programs, financial challenges, spiritual and traditional beliefs and geographic barriers (i.e., speech‐language pathology services are currently available in only a few cities). Conclusions & Implications: These findings emphasised the need to improve post‐stroke aphasia rehabilitation in Ghana. The process of data collection itself educated respondents on the importance of post‐stroke aphasia rehabilitation, and by identifying barriers, strategies to improving services, such as designing standardised aphasia assessments for the Ghanaian context, can now be initiated. WHAT THIS PAPER ADDS: What is already known on the subject: To address post‐stroke aphasia, evidence‐based speech‐language pathology services are provided. However, there is a paucity of studies on post‐stroke aphasia services in Ghana, preventing an accurate report of services and practices in the country. What this study adds: This study provides an overview of the existing rehabilitation services for post‐stroke aphasia in Ghana. It highlights challenges facing the existing services and suggested strategies to improve post‐stroke aphasia services. What are the clinical implications of this work?: The study created awareness among healthcare professionals and general public (study participants) about the importance of rehabilitation services for post‐stroke aphasia. Based on the study findings, appropriate stakeholders such as policy makers, researchers, and healthcare professionals can further design assessments and interventions to improve rehabilitation, including speech‐language pathology services, for post‐stroke aphasia in Ghana. [ABSTRACT FROM AUTHOR]

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BACKGROUND: People with intellectual disabilities experience persistent marginalization in relation to work and employment. The concept of work inclusion provides a way of generating a more specific understanding of the meaning of employment participation. Work inclusion of people with intellectual disabilities focuses not on mere presence, but instead emphasizes relational aspects and potential for meaningful participation. OBJECTIVE: In this paper we report on an empirical study into the experiences of people with intellectual disabilities of employment participation in the Icelandic labor market. We considered their experiences in relation to four key components of work inclusion, placing emphasis on how they perceived opportunities for inclusion related to social relations, belonging, valued contributions and trust. METHODS: This study used a qualitative research design. Data was collected with semi-structured interviews with 9 participants with intellectual disabilities who all had experience of being employed in the Icelandic labor market. RESULTS: Our findings show the role of the work environment in participants' experiences of opportunities for having good relations at work, having a sense of belonging to the organization, being able to make a contribution to the goals of the organization, and receiving trust in one's professional role and responsibility. When participants experienced opportunities in relation to these basic components of work inclusion, they felt more positively about their employment participation. Lack of opportunities was reported as a reason for segregation and withdrawal. CONCLUSION: This study shows the importance for work organizations and other actors in the labor market of paying attention to components of work inclusion and their relation with corporate culture. [ABSTRACT FROM AUTHOR]

Accessible Summary: What is known on the subject?: Advanced clinical practitioners (ACPs) are, typically, non‐medical healthcare professionals, who possess advanced clinical skills, a master's level qualification and evidence of leadership, management and research abilities.Most ACPs are nurses and new ACP roles are increasingly being established around the world.The views of senior staff towards new mental health nursing roles in organizations are likely to influence their introduction and sustainabilityResearch on mental health nursing ACP roles is sparse. What the paper adds to existing knowledge?: The paper uniquely provides specific information as to factors perceived by senior staff as affecting the implementation of ACP roles in mental health services.A wide range of mental health services were perceived as potentially benefiting from ACPs.Establishing role clarity for MHN ACPs is perceived as being as essential to successful introduction of the role, as has been found for other specialities. What are the implications for practice?: Participants identified a need for early engagement with service users and professions about new ACP roles and for processes that can evaluate ACP roles once they established.Some mental health nurses may require long‐term developmental pathways to help prepare them to take on a master's level course and then the ACP role. Introduction: Advanced clinical practice (ACP) roles are increasingly being developed internationally. Identifying factors perceived as affecting the development of ACP can support effective implementation. Aim: To understand the views of senior health service staff as to factors influencing the development of ACP roles in mental health services. Method: Focus group and semi‐structured interviews. Participants were directors of nursing (n = 10) and other senior staff from roles important to workforce development (n = 10). Results: Content analysis suggested seven categories: understanding the role and national guidelines, attitudes to the role, learning from implementing other roles, understanding prerequisites for development, challenges, opportunities and future support/actions. Prerequisites for success would include early engagement with stakeholders. Medical attitudes towards ACP roles were perceived as generally more positive than previously. Discussion: The study provides unique information regarding perspectives of senior staff regarding the implementation of ACP roles in mental health services. A wide range of mental health services were perceived as potentially benefiting from ACPs, with the importance of role clarity being highlighted and long‐term developmental pathways for staff. Implications for practice: Successful Implementation of ACP roles may require clear role definition, early engagement with stakeholders and processes to evaluate role outcomes. [ABSTRACT FROM AUTHOR]

Adolescents admitted to acute mental health inpatient units can experience episodes of distress for numerous reasons. Little is known about how they attempt to cope with this distress. This paper explores adolescent experiences of distress in an acute mental health inpatient unit. Fifty hours of non‐participant observations were conducted and documented using a critical incident technique (CIT) framework. An interpretive descriptive approach was used to analyse the observation data collected. Nineteen episodes of adolescent distress were observed and five themes emerged, of which two will be explored in this paper: clinical contexts and triggers, and coping or help‐seeking actions. The findings of this study will help mental health nurses working on acute adolescent units understand how adolescents attempt to cope with, and seek help for, episodes of distress, and enhance early responses to prevent escalation of distress. [ABSTRACT FROM AUTHOR]

Child abuse and neglect is a complex problem that needs to be addressed through a multidisciplinary approach. Nurses internationally have frequent contact with children and are ideally placed to respond to children experiencing abuse and neglect. Nurses' roles can include reporting abuse to child protection services (CPS). This paper reports on one aspect of the findings of a qualitative study exploring Australian nurses' perceptions and experiences of keeping children safe from abuse. Specifically, this paper reports on the theme relating to nurses' experiences of communicating their concerns to CPS and the family when reporting abuse and neglect. This qualitative study was underpinned by social constructionism, with data collected through semi‐structured interviews with 21 nurses working with children in Australia. Key findings reported are: (1) being heard; (2) [feeling] disappointed, discouraged and disenfranchised; and (3) managing tensions between engagement and reporting. Nurses at times perceived that they were not taken seriously by CPS and felt powerless to enact change for children. Nurses subsequently had to decide how, and if, to discuss their report with families to mitigate negative reactions and maintain engagement. This study highlights the need for more effective multidisciplinary collaboration between nurses and CPS to promote change for children affected by abuse in Australia. 'This paper reports on... nurses' experiences of communicating their concerns to CPS and the family' Key Practitioner Messages: Nurses often perceived that they were not taken seriously by CPS and felt powerless to make a difference for children.Nurses experienced a tension between openly discussing their intention to report with families and minimising negative reactions such as disengagement and mistrust.This study highlights the need for greater collaboration between CPS and nurses to promote shared understanding and effective action to promote the wellbeing of children experiencing abuse and neglect. [ABSTRACT FROM AUTHOR]

This paper explores how social workers integrate personal spirituality within nursing homes, where a highly regulated, stressful environment marginalizes professional identity and challenges retention. Researchers offer new evidence of how spirituality informs professional identity, ethical practice, and continuation in the role. Twenty BSW/MSW licensed nursing home social workers (NHSWs) reported how they daily navigate the personal spirituality-at-work opportunity and challenge. Qualitative analysis of in-depth interviews resulted in three primary codes and related subcodes: Spirituality-Integrated Professional Identity (Vocational Affirmation and Value Alignment), Spirituality-Informed Practice (Intervention Asset, Relational Affinity, and Ambiguous Boundaries), and Spiritually-Sustained Career Resilience. Respondents reported how spirituality animated professional identity, informed daily role enactment, and sustained role involvement. Recommendations are provided for normalizing ethical spirituality-at-work through social work education and practical guidance in navigating the spirituality and practice space. [ABSTRACT FROM AUTHOR]

Purpose The purpose of this paper is to report on a postdoctoral research study examining the importance of multi-level leadership and health governance for ensuring the implementation of national and provincial health sector strategies that aim to improve maternal and neonatal health (MNH) in low- and middle-income countries (LMICs).Design/methodology/approach A descriptive-interpretive qualitative, institutional approach was undertaken to explore the impact of provincial and district governance mechanisms on the delivery of MNH services in two districts in East New Britain Province (ENBP), Papua New Guinea (PNG). Data were collected from 12 key informants. Informants were selected on the basis of their direct involvement in health system management and deployment of health at provincial and district health governance levels.Findings The analysis revealed alignment between global strategies and national and provincial policy, suboptimal provincial government support related to implementation of policy, divergent data between districts and a disconnect between the local governance mechanisms and a donor-funded initiative for raising midwifery education.Research limitations/implications This qualitative study was limited by the small sample size and does not claim to be representative of ENBP or other provinces in PNG.Originality/value This paper contributes empirical evidence to the literature on health policy, leadership and governance for MNH, by recognising and exploring the formal and informal rules at play in a given context, and examining how they are made, changed, monitored and enforced. These insights are critical to understanding how the system actually functions (or not) to implement MNH strategies in LMICs. [ABSTRACT FROM AUTHOR]

Chronic health conditions represent a key challenge for contemporary public healthcare. Current policy promotes self-management support to reduce demands on health services and improve patients' health and wellbeing. Though there is emerging recognition that self-management is achieved in collaboration between health professionals and patients, how chronicity is managed in interaction remains relatively underexplored in research. In this paper we report on research examining how people are supported to self-manage their conditions through their healthcare encounters. We draw on observational data from consultations between people with multiple chronic health conditions and their healthcare professionals, and semi-structured interviews with both patients and professionals about these consultations. We illuminate points of disconnect between patients and health professionals and demonstrate how these disconnects unfold in self-management support interactions. We argue that self-management is temporally and socially situated, incorporating past, present and (anticipated) future experiences. However, there is a disjuncture between the temporal logics of self-management enacted by health professionals and the subjective temporalities of people's lived experience of chronicity. Health professionals focus on patients progressing toward optimistic futures but give less attention to the complexities of patient life histories that render self-management more difficult. For self-management support to be effective, we argue that health professionals need to consider the complexities of people's life histories and how these shape imagined futures. Policy guidelines, we argue, should attend to how relations between patients and professionals shape self-management support, and the historical and social factors that shape experiences of living with chronic conditions. [ABSTRACT FROM AUTHOR]

This exploratory study examined general practitioners' (GPs) perspectives on delivering end-of-life care in the New Zealand residential aged care context. A general inductive approach to the data collected from semi-structured interviews with 17 GPs from 15 different New Zealand general practices was taken. Findings examine: (1) GPs' life experience; (2) the GP relationship with the facilities and provision of end-of-life care; (3) the GP interaction with families of dying residents; and (4) GP relationship with hospice. The nature of the GP relationship with the facility influenced GP involvement in end-of-life care in aged care facilities, with GPs not always able to direct a facility's end-of-life care decisions for specific residents. GP participation in end-of-life care was constrained by GP time availability and the costs to the facilities for that time. GPs reported seldom using hospice services for residents, but did use the reputation (cachet) associated with hospice practices to provide an authoritative buffer for their end-of-life clinical decisions when talking with families and residents. GP training in end-of-life care, especially for those with dementia, was reported as ad hoc and done through informal mentoring between GPs. This paper is on a topic of increasing policy importance. With the aging of the population, the pressure on our aged care facilities will become intense. This paper highlights how GPs, the main source of clinical supervision in residential aged care, do their job and what the issues are that facilitate and impede their participation. [ABSTRACT FROM AUTHOR]

Dementia affects majority of older residents in nursing homes and physiotherapists are regularly involved with this population. However, little is known about the role of physiotherapists who treat residents with dementia in nursing homes. The aim of this paper was to report on an interpretivist qualitative exploration of the perceptions of both the providers of and referrers to domiciliary physiotherapy for residents with dementia in nursing homes in London. In 2015, we conducted semi‐structured interviews with 10 purposively sampled participants – two were providers of physiotherapy for residents with dementia in nursing homes, five were referrers to these providers and three occupied dual roles. A thematic analysis of the verbatim transcripts identified three main themes. First were perceptions of a multifaceted but unclear role, focused on both conventional 'physical' physiotherapy interventions and specialist care, the latter being reliant on knowledge and confidence that physiotherapists did not always feel they possessed. Second were the stated challenges to the role, including the focus and organisation of the nursing home setting, with perceived lack of emphasis on rehabilitation; the progressive and demanding nature of dementia itself; a lack of continuity of nursing home and visiting health professional staff with associated need to entrust physiotherapy intervention to multiple others and the final challenge was the difficulty measuring impact. Third, despite the challenges, enablers of the role were experienced, namely collaborative working and positive previous experiences of referrers. Joining these themes were underpinning concepts of complexity and uncertainty in relation to the physiotherapy role in this setting. This paper highlights a need for enhanced collaborative working in clinical practice, enabled at organisational level, to help address some of the uncertainties expressed around the physiotherapists' role with residents with dementia in nursing homes and thereby enable improvements to processes and outcomes of their interventions. [ABSTRACT FROM AUTHOR]

This paper concerns parenting assessments which are integral to child-safeguarding professional processes in England, and which involve Deaf parents whose primary language is British Sign Language (BSL). In an under-researched area of social work, the research aim was to contribute to the existing literature by eliciting the practice wisdom of specialist professionals. Specifically, it draws upon their linguistic and cultural knowledge of the Deaf community when they are involved in parenting assessments with Deaf parents who are subject to safeguarding concerns. Data about these professionals' actual experiences of navigating Deaf cultural-competency in contemporary child protection practices were collected through seven video-recorded, semi-structured interviews conducted in BSL. Using interpretive phenomenological analysis, data were analysed in their source language (BSL). This article focusses on one key theme, termed 'Professional Recognition', which incorporates a) the identification of specialist roles and b) the impact of referral processes and protocols on assessment outcomes. The findings highlight participants' perspectives on the benefits and disadvantages of their specialist role in this context. Although their brokerage skills, cultural competence, linguistic fluency and specialist knowledge of the Deaf community are highly regarded and valued by some colleagues, there is insufficient recognition of their existence by the majority. Secondly, participants are concerned by the inefficiency and inconsistency of the referral processes and protocols which they consider have adverse effects on assessment outcomes, and consequently the parents involved. [ABSTRACT FROM AUTHOR]

Objective: To investigate the perspectives of Australian nursing educators on the preparation of Bachelor of Nursing students for the care of older people's oral health. Background: The Australian population is ageing. Older people with poor oral health are at increased risk of worsening health and chronic disease conditions. Nurses can and need to take a leadership role in improving and maintaining older Australians' oral health in community, hospital, and residential care settings. Thus, it is important to investigate the perspectives of nursing educators on the preparation of nursing students for the care of older people's oral health. Study design and methods: Semi-structured interviews were conducted with 13 participants, including course coordinators, lecturers, directors, and researchers at 10 universities delivering accredited Bachelor of Nursing programs across seven different states in Australia. Data were analysed thematically. Results: Four themes were identified in nursing educators' perspectives: (1) the education of nursing students in providing oral healthcare is important, (2) there are notable gaps in nursing students' oral health education, (3) there are both internal and external barriers to strengthening oral health education across nursing programs, and (4) there is a need to develop and promote a shared oral health curriculum that includes interprofessional education and collaborative practice. Inherent in these themes was the need for a clear definition of the role of nurses in oral healthcare. Discussion and Conclusion: It is recommended that administrators and policymakers develop nursing accreditation standards that specify the role of nurses in oral health education, and the scope of this education including interprofessional and collaborative practice, for the oral healthcare of older people. Infusing such standards in nursing curricula will better educate and prepare nursing students for effective practice and leadership in gerontological care. What is already known about the topic? * Older people frequently have oral diseases that adversely affect chronic health conditions and increase the risk of poorer general health. * Even though oral healthcare is an essential part of nursing for older people, the provision of such care is implied rather than stated specifically in Australian Nursing and Midwifery Accreditation Council (ANMAC) standards. What this paper adds: * The education and preparation of students to provide oral healthcare appears to be expected rather than required in Australian nursing curricula. Based on the perspectives of nursing educators, this paper suggests that many nursing students may not be well prepared to provide evidence-based oral care and lead oral health initiatives. The paper identifies ways these issues can be addressed. * The paper discusses the importance of developing and promoting a clear oral health curriculum that includes interprofessional collaborative practice to strengthen nursing students' education and prepare them to provide effective oral healthcare for older people. * The paper outlines a needed definition of the role of nurses in providing oral healthcare. [ABSTRACT FROM AUTHOR]

Previous research has established that leaders in information and communication technology (ICT) are crucial for establishing a user-centred systems design perspective in ICT for work-related tasks. This paper therefore describes the perspectives of 18 ICT leaders in three kinds of leadership roles (managers, project leaders and specialists) in order to understand their views of user-centred systems design concerning ICT. It uses the concept of technological frames of reference to analyse three domains: technology-in-use, technology strategy and nature of technology. The results show that many specialists see user involvement as a critical factor in successfully establishing new information and communication technologies, but that these systems are currently built around the needs of management rather than end users. Looking forward, all three relevant social groups are optimistic about how ICT will become more user-centred and more strategically aligned in the future. However, changes in ICT are described as extremely energy-consuming and difficult – akin to 'walking in the jungle with a machete'. Finally, we discuss the relevance of technological frames and present some implications for the successful establishment of user-centred system design as a perspective in organisations. [ABSTRACT FROM AUTHOR]

Objective: Allied health structures and leadership positions vary throughout Australia and New Zealand in their design and implementation. It is not clear which organisational factors support allied health leaders and professionals to enhance clinical outcomes. The aim of this project was to identify key organisational contexts and corresponding mechanisms that influenced effective outcomes for allied health professionals. Methods: A qualitative realist evaluation was chosen to describe key aspects of allied health organisational structures, identify positive outcomes and describe how context and processes are operationalised to influence outcomes for the allied health workforce and the populations they serve. Results: A purposive sample of nine allied health leaders, five executives and 49 allied health professionals were interviewed individually and in focus groups, representing nine Queensland Health services. Marked differences exist in the title and focus of senior allied health leaders' roles. The use of a qualitative realist evaluation methodology enabled identification of the mechanisms that work to achieve effective and efficient outcomes, within specific contexts. Conclusions: The initial middle range theory of allied health organisational structures in Queensland was supported and extended to better understand which contexts were important and which key mechanisms were activated to achieve effective outcomes. Executive allied health leadership roles enable allied health leaders to use their influence in organisational planning and decision-making to ensure allied health professionals deliver successful patient care services. Professional governance systems embed the management and support of the clinical workforce most efficiently within professional disciplines. With consistent data management systems, allied health professional staff can be integrated within clinical teams that provide high-quality care. Interprofessional learning opportunities can enhance collaborative teamwork and, when allied health professionals are supported to understand and use research, they can deliver positive patient and business outcomes for the health service. What is known about the topic?: A collective allied health organisational structure encourages engagement of allied health professionals within healthcare organisations. Organisational structures commonly include management and leadership strategies and service delivery models. Allied health leaders in Queensland work across a range of senior management levels to ensure adequate resources for sufficient suitably skilled professional staff to meet patient needs. What does this paper add?: Literature to date has described how allied health professionals operate within organisational structures. This paper examines key aspects of allied health management, governance and leadership, together with mechanisms that support allied health professionals to deliver effective clinical and business outcomes for their local community. What are the implications for practitioners?: Health service executives and allied health leaders should consider supporting executive allied health leadership roles to influence strategic planning and decision-making, as well as to deliver outcomes that are important to the health service. When allied health leaders implement integrated professional and operational governance systems, executives described allied health professionals as influential in supporting team-based models of care that add value to the business and improve outcomes for patients. When allied health leaders use consistent data management, executives reinforced the benefit of aligning activity data with financial costs to monitor, recognise and reimburse appropriate clinical interventions for patients. When allied health leaders support allied health workforce capability through educational and research opportunities, clinicians can use research to inform their clinical practice. [ABSTRACT FROM AUTHOR]

The purpose of this paper is to explore Congolese refugees and asylum seekers' survival strategies in South Africa, the focus of this paper will be on the role of the social worker. The paper is part of the study that was conducted on Congolese refugees and asylum seekers in South Africa post-war or conflicts. The study employed a qualitative research method and a descriptive case study of 10 female Congolese refugees living in Yeoville, Johannesburg South Africa. The participants have lived in South African for less than five years and there were 30–40 years of age. Data were collected by means of one-on-one in-depth interviews in the form of semi-structured interviews. Purposive sampling and snowball sampling techniques were used in the selection of participants. Thematic content analysis was used in analyzing the data collected. The paper provides recommendations on what role can social workers play can in mental wellbeing interventions. This study also contributes to a better understanding of mental wellbeing issues of Congolese refugees and asylum seekers. Ethical approval for this research study was obtained from the Department of Social Work Human Research Ethics Committee (Non-medical) of the University of Witwatersrand. [ABSTRACT FROM AUTHOR]

The peer workforce has increased significantly in recent years; however, structured development and support for the roles are lacking. This paper explores the role of executive and senior management understanding in the employment of peer roles. In‐depth, semi‐structured interviews and one focus group were conducted with 29 participants from a range of nongovernment and public mental health services within Queensland, Australia. Findings of this study suggest management exposure to and understanding of peer work are essential to the development of an effective peer workforce. Exposure and understanding of peer roles reportedly led to greater acceptance and commitment from management. This commitment inspired action in the form of; enhanced support including advocacy/championing, increased development of roles and influenced culture within the organization to be more accepting of peer work. There was a perception that developing an 'accepting' organizational culture supported the integrity and expansion of peer roles including designated 'peer management' positions. Development of peer management positions is suggested as an effective means of improving the impact of peer perspectives, advocating for peer work and providing ongoing and timely supervision. Recommendations include the need for training and information for management on the unique function, purpose and value of peer roles; and the development of networks, including mentoring opportunities, for organizations with limited experience to gain support and advice from those with greater experience developing peer roles. [ABSTRACT FROM AUTHOR]

Scotland is faced with pernicious health inequalities, which stem from inequalities in living conditions and the societal structures that create them. While action is needed to address the wider structural causes of health inequalities, the role of general practitioners (GPs) merits attention due to health care's potential to mitigate or exacerbate health inequalities. Minimal research, however, has explored how GPs understand the fundamental causes of health inequalities nor how they conceptualise their role in mitigating these. This paper aims to fill this gap using in-depth qualitative interviews with 24 GPs working in some of Scotland's most socio-economically disadvantaged, urban areas. Using Raphael's SDH discourse framework, this paper found clear linkages between GPs' perceptions of their patients, how they defined the 'problem' of health inequalities, and what they thought could be done to tackle them in disadvantaged areas. In general, there was convergence on how interviewees viewed their role in mitigating health inequalities through their work with individual patients. However, greater variation was found when describing the boundaries of their role and how far these extended beyond individual encounters. Specifically, only those GPs fluent in discussing structural causes of health inequalities discussed obligations to change local systems via strengthening community linkages and to influence higher level policies related to the SDH. This suggests that while there is a degree of what Metzl and Hansen deem 'structural competency' amongst some GPs working in disadvantaged areas, the scope remains to deepen this competency more broadly. [ABSTRACT FROM AUTHOR]

This paper explores the role of the General Practitioner Liaison Nurse (GPLN) in improving integration and coordination of services within Primary Health Care. This position can play a major role in care coordination and cultural change. The GPLN within HealthOne Mt Druitt (HOMD) identifies patients' needs and facilitates communication, case conferencing and care coordination between health and other providers. The priority areas of children and their families at risk or with significant unmet needs, and chronic aged and complex care, were identified as target areas. This paper focuses on the GPLN within the chronic aged and complex care service model. The GPLN within HOMD was able to improve coordination and integration of services for patients of the facility. Activities included organising multidisciplinary services and addressing psychosocial issues. Patients and community health staff identified the importance of the role for improving coordination and integration of services. Decision and policy makers saw the position as vital to the implementation, operation and sustainability of HOMD. [ABSTRACT FROM AUTHOR]

Objectives: The study investigated how senior residential aged care staff perceived the purpose, function, impact and challenges of implementing a new role in their organisation for an unregistered care worker with a Bachelor of Dementia Care: the Dementia Care Support Worker. The role was piloted over two years in an Australian organisation with three aged care facilities to examine its potential to address gaps in service provision for people with dementia. Background: The residential aged care workforce is under pressure to care for residents with increasingly complex health conditions and where most care is provided by care workers. Presently no formal leadership role exists for care workers with specialised dementia knowledge in the aged care setting. Study design and methods: A qualitative descriptive approach was taken to explore senior staff members' perceptions of the role at two time points. Twenty-three semi-structured interviews held in July-August 2017 (n = 12), soon after role commencement, and in February-March 2019 (n = 11) were thematically analysed. Results: Three themes reflected senior staff members' expectations of the role: enhancing staff and management knowledge about dementia and dementia care practices; facilitating changes to improve care for residents living with dementia; and educating and supporting residents' families. Eighteen months later, participants felt the role was helping meet the need for improved care of residents with dementia, and staff understanding of dementia. They suggested communication and support structures to improve role effectiveness. Discussion: Staff were receptive to the establishment of the Dementia Care Support Worker role and felt it resulted in improvement in dementia care. Success was contingent on strong organisational support and resourcing. Conclusion: Improving dementia knowledge of care staff is an essential first step in driving care quality improvements. The Dementia Care Support Worker role for care workers has the potential to address knowledge needs and support improved care practices. Implications for research, policy, and practice: This research models how a new role might be configured for unregistered care workers with specialist dementia knowledge. Further research is needed to explore the establishment of such a role more widely in other organisations, to investigate whether it could provide a new career development pathway for care workers and improve the skills and capacity of the aged care workforce. Substantial policy changes would also be required to support role viability, such as around increased salary. Research which examines the impact of such roles on care outcomes would complement the findings. What is already known about the topic? • While dementia is common in residential aged care, knowledge of dementia is typically low among the care staff. • Consequently, care staff are not equipped to meet the complex needs of residents with dementia and their families. • New roles for unregistered care workers with specialised dementia knowledge have been proposed, but not tested. What this paper adds • This research models how a new role might be configured for care workers with specialist dementia knowledge. • Aged care facility leaders support a role for care workers with formal specialist dementia knowledge and skills, and perceive the role helps improve the quality of resident care and develop stakeholders' dementia knowledge. • Appropriate communication and support structures are required for the effective establishment of the role. [ABSTRACT FROM AUTHOR]

While many evidence-based tools and measures exist to support child protection practice, in the United Kingdom, there is little evidence of their routine use in casework. This paper reports on a qualitative study exploring the use of such tools with children and families receiving statutory social care services. Fifteen social workers working in child safeguarding teams in two local authorities in Southeast England agreed to incorporate the use of outcome measures into their casework over a 6-month period. Qualitative data were collected through monthly action learning workshops held separately in each local authority. The results showed how the impact of using the measures was shaped by a combination of institutional factors, practice context and the dynamics of casework. Outcome measures were found to have benefits as well as limitations with respect to partnership working, assessment and decision-making and overall social work practice. Implications are discussed for the prospects of enhancing the use of evidence-based tools in statutory social work with children and families. [ABSTRACT FROM AUTHOR]

The purpose of this paper is threefold: firstly, to provide a brief overview of current practice in workplace mental health and introduce an emerging role for occupational therapy in this field (i.e., practicing at the organizational level where "clients" are workplaces or organizations, and not individual workers); secondly, to present the findings from a small qualitative study which describes this emerging role from the perspectives of occupational therapists who have worked in this area; and thirdly, to provide suggestions for future work which could advance this emerging role for occupational therapy world-wide. Previous research suggests that there is an increasing interest among employers to address workplace mental health through organizational initiatives and that occupational therapists are beginning to consult on the topic. Occupational therapists in our small qualitative study described their role in organizational workplace mental health as one which involves adopting a business lens, practicing in an organization-centred manner, and focusing on population health promotion. Suggestions for future work to advance this emerging role include identifying the fundamental elements of the business lens, investigating models and frameworks to guide organization-centred practice, evaluating the short-, medium-, and long-term outcomes of interventions, exploring the fit between an occupational perspective and workplace mental health, and examining the impact of COVID-19 on current practice. [ABSTRACT FROM AUTHOR]

Accessible Summary What is known on the subject? Primary care and, in particular, general practice ( GP) are often first point of access to health care. International evidence suggests that healthcare systems oriented towards primary care may produce better outcomes, at lower costs and with higher user satisfaction. Despite this, there are noted deficiencies and variations in the quality of care in primary care for patients with mental health problems., What this paper adds to existing knowledge? Emerging models of providing mental health services in primary care are poorly understood. This paper evaluates a mental health nurse-led Primary Care Liaison Service ( PCLS), developed in 2011 in inner London., The findings suggest that this type of service can improve the quality of care for people presenting with mental health problems within primary care, specifically due to improved integration, clinical effectiveness, patient-centred care, access and efficiency. The study also highlighted challenges such as staff retention within this new role and setting appropriate referral criteria., What are the implications for practice? This is a relatively new service, and the cost-effectiveness is not yet fully understood; however, commissioners may want to consider the potential benefits of a similar service in their area. The extent to which the findings are transferable will depend on service configuration and local demographics which can vary., Further research within this area could give more detail on the impact of such teams on health outcomes, recovery rates, secondary care referrals and accident and emergency attendances, and its cost-effectiveness., Abstract Aims/Question General practice is typically the first point of access to healthcare. This study explores what value a Primary Care Liaison Nurse ( PCLN) service, established in 2011, can bring to people with mental health problems in primary care. Method Semi-structured interviews were used to elicit participants' experiences and perspectives on the value of a PCLN service. Participants included ten interviews with seven general practitioners and three senior practitioners working in primary care mental health services. Thematic analysis, based on a 6-phase approach, was used to describe and explore the data collected. Results Five main themes were derived from the thematic analysis of the interviews relating to: integration; clinical effectiveness; patient centred care; access; and efficiency. Discussion The study suggests that the PCLN service can improve the quality of care and is generally highly valued by its stakeholders. The study identifies particularly valued elements of the service, including having a duty worker, as well as aspects which could be improved, such as patient criteria. Implications for practice This is a relatively new service and the cost-effectiveness is not yet fully understood; however, commissioners may want to consider the potential benefits of a similar service in their area. [ABSTRACT FROM AUTHOR]

Background Clinical commissioning groups (CCGs) were in early development when fieldwork took place. Public Health (PH) was moving into the local authority, and new ways of working were being established. Methods Three qualitative case studies in the North of England were undertaken using three different data collection methods: observations, interviews and the collection of documents that were related to the project. Comprehensive field notes were taken during observations, analysed alongside interview transcriptions and collected documentation using the software programme Atlas.ti. Results The relationship between the CCG and their local PH team was in development at the time of data collection. Three different PH roles could be discerned from the data: 'co-owner', 'service provider' and 'critical friend'. These roles impacted on the utilization of PH by CCGs and the wider relationship between the CCG and PH. Conclusions These models are 'ideal types', and in reality the CCG-PH relationship in most areas will contain elements of all three models. However, to think of them as set out in this paper is instructive for both CCGs and PH. It is important that CCGs and their PH colleagues to think clearly about what they are trying to achieve and how that can most effectively work together. [ABSTRACT FROM AUTHOR]

ABSTRACT From the findings of a study examining the perspective of parents using Intensive Family Support Service based in northern England, this paper examines the constituent elements required for effective relationship-based practice. Although the study is based in a single site in England, the findings are more broadly relevant, given both national and international interests in relationship-based practice in child protection. The participants in this study - parents whose children had been assessed as being 'at the edge of care'- were asked to comment on the intervention they had received. Analysis of parents' interviews suggests that the service user-worker relationship was critical to their positive experience of the service. The paper provides an analysis of parents' descriptions of 'positive relationships' and identifies the key themes. It then considers these findings in the context of contemporary children and families' social work practice. Engaging with current debates, the paper makes reference to the impact of modernization, which has served to erode effective face-to-face work with families, given excessive 'backroom' demands of administration and audit. Discussion engages with an emerging emphasis on effective relationship-based practice following reports from Munro and the Social Work Reform Board. In this context, the paper concludes that the views of these families whose children are on the 'edge of care' offers insights into the skills required for relationship-based practice. [ABSTRACT FROM AUTHOR]

Professional identities are important in defining workers' roles, and are concerned with attributes relating to those roles and how they are performed. Evidence shows mental health nurses undertake many different roles as part of their work. Yet, the roles of mental health nurses are insufficiently understood by healthcare staff, service users, and nurses themselves. Mental health nursing work has been deemed invisible and lacking in role clarity. Poor understandings about professional identity of mental health nurses result in difficulties recruiting to the profession, nurses lacking confidence articulating the value of their work, with misunderstandings apparent with service users about the specific role of mental health nursing in their care. The primary focus of this study, conducted in Wales, United Kingdom, was to examine how talk about mental health nursing was handled by participants from multiple perspectives. Data consisted of 17 individual interview transcripts with mental health nurses and 13 interview transcripts from mental health service users, and three focus groups with nursing students. Participants' talk was analysed using thematic analysis. This paper reports how participants described mental health nursing work to have significant role overlap with other multidisciplinary team members. Participants highlighted that mental health nurses often have an 'in the middle' label because the complexity of their work can be hard to describe. The implications are pertinent for nurses because if they are considered to be in a liminal position, they risk being perceived as neither one role nor another, resulting in nurses struggling with professional identities and role confidence. [ABSTRACT FROM AUTHOR]

Adverse childhood experiences (ACEs) have been associated with negative mental and physical health consequences. Neighbourhood police officers (NPOs) are thought to be well placed to identify and support children experiencing ACEs. Within this paper, we describe a qualitative exploration of an initiative deployed by a large UK police force which aimed to aid early identification of young people with ACEs using police data and provide subsequent support given by NPOs. A thematic analysis was conducted using transcripts from three focus groups of NPOs, supplemented by questionnaires. Key themes identified in both sets of data offer reflections for policing and other public service provision seeking to target on the basis of ACEs, including: limitations in the usefulness of police data to identify childhood adversity; challenges using the ACEs framework as a means to target such 'early intervention'; and debates regarding the appropriate role of the police in supporting young people in adversity. Prior to replication of this intervention elsewhere, there are several points to consider: whether police data alone are sufficient in identifying ACEs; ensuring clarity regarding the role of the public sector agencies in such intervention; and determining an apt measure of success for the scheme. Key practitioner messages: Modelling using only police data can provide insight into the population of children who may have suffered from ACEs but may not provide significant opportunities for early interventionThere is a clear need for defining the role of UK police forces in the delivery of early interventionIt is evident that multi‐agency working/data sharing is crucial to preventing the duplication of referrals and interventions conducted with young people who have experienced ACEs 'There is a clear need for defining the role of UK police forces in the delivery of early intervention' [ABSTRACT FROM AUTHOR]

Background: The Living Lab in Ageing and Long-Term Care (Netherlands) and Nurturing Innovation in Care Homes Excellence in Leeds (NICHE-Leeds; UK) represent partnerships between science and care. The Scientific Linking Pin (SLP), a senior researcher employed by a university, works one day per week in a long-term care (LTC) organisation, and has a pivotal role in the partnership. Objective: To explore the nature of the SLP role. Methods: A qualitative approach was used. Fifteen researchers with at least one year's experience as a SLP in either the Living Lab or NICHE-Leeds participated in a semistructured interview. Data were thematically analysed. Findings: Participants described how the SLP role provided insights into what matters to care organisations, and how it enabled them to impact LTC practice. Participants perceived the role to be multifaceted. Goals and activities performed by SLPs included developing relationships, raising awareness of the partnership, identifying (research) priorities, generating research questions, building committees, brokering knowledge, developing research studies, generating academic outputs, building links and connections, and assisting with internal projects. Challenges faced were mistrust from care staff and poor engagement, working with staff from different professional backgrounds, research not being a priority for care organisations, multiple and rapidly changing priorities, and differences in expectations. SLPs addressed these challenges through relationship-building, creating a "safe" space for care staff, building engagement, and managing expectations. Implications: Partnership-working in the care sector is gaining international recognition and adoption, and therefore, it is useful to capture and share learning about successful implementation of this approach. [ABSTRACT FROM AUTHOR]

This paper reports on a qualitative study of child protection in the UK. The research involved children's practitioners from a range of agencies, including social care, education, health and youth offending, who were asked about working together on complex child protection cases. The aim was to explore how participants talked about complexity in these cases, in order to deconstruct influential perspectives on interprofessional working. Interview transcripts were analysed using critical discourse analysis, a qualitative method that examines patterns of language use in relation to social structures of power and control. The findings identified three overall perspectives: clinical, expert system and relation‐centred approaches, which practitioners combined in various ways. These perspectives have a bearing on how the ‘team around the child’ is conceptualized in discourse about child protection. The paper links these findings to the assumptions of predictability and control currently embedded in policy and practice guidance, and explores their implications for social workers and other children's practitioners. [ABSTRACT FROM AUTHOR]

Background: General hospitals in China have been establishing General Practice Departments (GPD). Although General Practice Nurses (GPNs) are an important part of this medical system, their training has not been synchronised. This study explored the working status of nurses in GPDs in general hospitals in Beijing to provide a theoretical basis for the training and development of GPNs in China. Methods: We conducted in-depth, individual interviews with outpatient nurses at 19 hospitals in Beijing between March and April 2021. We employed a qualitative analysis to interpret participant narratives and used a codebook thematic analysis to analyse the interview data and extract themes. Results: The analysis revealed four themes: (i) a lack of full-time GPNs in GPDs of most tertiary hospitals, (ii) the inability of GPNs to fully express their potential and skills owing to their limited roles, (iii) insufficient standardised patient education provided by nurses in GPDs, and (iv) a lack of systematic and relevant training for nurses working in general practice settings. Conclusions: To promote the development of GPNs, GPDs in general hospitals in China should hire full-time GPNs, define their job duties in alignment with their values, and provide standardised training to strengthen their core competencies. [ABSTRACT FROM AUTHOR]

Background: In patient safety accidents, nurse managers are indirectly victimized by the pressures from many aspects and become the second victim. This study delves into the experiences of nurse managers in China, aiming to uncover their cognition and provide reference for relevant managers. Methods: A descriptive phenomenological approach was used to gain insight into the inner reality of nurse leaders' experiences and management perceptions of experiencing patient safety incidents. The data of 15 nurse leaders who experienced patient safety incidents in Bethune Hospital, Shanxi Province, China, were collected via face‒to‒face semi-structured interviews, and the data were analyzed via the 7-step analysis method of Colaizzi. Results: On the basis of the content of the interviews, three themes were identified, the emotional experience of experiencing patient safety events, role dilemmas, the obstruction and conceptual reshaping of nursing management. Eight subthemes as follows: physical and mental health-related symptoms due to passive coping and life and work disorder, self-relief, playing multiple roles with lack of role adjustment ability, blurred role positioning and initial signs of job burnout, event replay is impeded, Inaccurate analysis of safety incidents, subversion and remolding of the nursing management concept. Finally, it can be abstracted as "forced growth in patient safety events". Conclusion: Patient safety incidents can lead to negative impacts, role dilemmas, and management confusion for head nurses, but they also promote purposeful rumination, meditation, and growth. Medical institutions should pay attention to special groups that are second victims of head nurses and construct a safety event support system for nurse leaders to improve the post-training and education system for nurse leaders, help them better adapt to their roles, break through their role dilemmas, improve their post-competence, and construct an effective safety event management system. [ABSTRACT FROM AUTHOR]

Background: The existence of various ethical challenges, the inability to resolve ethical conflicts, and, as a result, the low quality of care and the occurrence of dissatisfaction in patients and nurses have been discussed for years. By creating new ethical challenges, the Covid-19pandemic has played an important role in making the process of care for these patients more difficult and complicated. This study was conducted with the aim of designing a prescriptive model to help provide ethical-care and resolve ethical conflicts during the Covid-19pandemic. Methods: In this two-stage qualitative study, a grounded theory research method was used in the first stage, and data were collected through semi-structured interviews. Sampling started purposefully and continued theoretically. In the second step, the appropriate model was designed using the three-step method proposed by Walker and Avant. Results: The core concept was "behavior based on faith in God", based on which the grounded theory of "faithful nursing" and then "model of solving ethical challenges with nursing based on faith in God" were presented. The strategies of the model in three parts are strengthening the beliefs of nurse, strengthening environmental facilitators to help nurse, and strengthening situational analysis in duty diagnosis in nurse were presented. Conclusions: According to this model, nurses' beliefs play a key role, and the strengthening of environmental factors play a secondary role in ethical-care. [ABSTRACT FROM AUTHOR]

Background: Chronic conditions may limit older peoples' social engagement and wellbeing. Reduced social connections can result in loneliness and social isolation. This study aimed to explore the experience of social connection in older people living with chronic conditions, and the factors influencing their social participation. Methods: A purposive sample of 19 community-dwelling older Australians (mean age 75.5 years) with one or more chronic conditions participated in a qualitative descriptive study. Semi-structured interviews explored participants' perceptions of their social connections and the potential impact of their chronic conditions. Views about the role of general practice in supporting older persons' wellbeing were discussed. Data were analysed inductively using thematic analysis. Results: Five themes were identified: (1) the experience of loneliness, (2) managing diminishing social contacts, (3) living with chronic conditions, (4) barriers to social connection, and (5) facilitators of social connection. Participants felt that ageing with chronic conditions contributed to loss of function and independence, which limited social connections, and increased loneliness and social isolation. Barriers to social connections included issues with mobility, transport and forming new networks. Families were a primary support, with continued community engagement and general practice support crucial to staying well and socially connected. Conclusions: Understanding older peoples' experiences, and the barriers and facilitators of social connections can guide clinicians' interventions. General practice is a promising intervention point because of its high use by those with chronic conditions to stay well. General practice nurses are well-placed to collaboratively address the barriers older people face in maintaining social connections. Chronic conditions may limit older peoples' social engagement, with diminished social connections leading to loneliness, social isolation and other serious health consequences. This study explored the experience of social connection in older people living with chronic conditions and factors influencing their social participation. Older people identified the importance of family, community engagement and staying well through primary care support. Understanding the barriers and facilitators of social connections for older people can guide the general practice team in developing appropriate interventions. [ABSTRACT FROM AUTHOR]

Background: Social inequities in the healthcare system threaten global health. Efforts to establish equity in healthcare is a key goal of healthcare systems worldwide. Social justice is a basic value of the nursing profession that always merits attention. Objective: This study aimed to identify and explain the processes of the nursing profession's participation in establishing social justice in healthcare system. Research design and methods: This qualitative study was conducted using the grounded theory method. Participants and research context: Data were collected through in-depth, semi-structured, individual interviews with 26 participants, 23 of whom were members of the nursing profession. Sampling started purposefully and, then, continued with theoretical sampling. Field notes were also taken for data collection. Data analysis was performed using Corbin and Strauss' 2015 method. Ethical considerations: The research was approved by the Ethics Committee of Urmia University of Medical Sciences in Iran. Findings: The "Professional Dynamics in the Path of Justice" was the study's core category. This theory is the result of nine main categories: "inefficient professional authority," "social justice, a neglected component in education," "clinical concerns, barriers to nurses' presence in society," "individual input reserves to facilitate social justice," "inadequate maturity of the profession in the path of equity in health," "promoting justice in clinical practice," "a tendency to community-oriented profession," "use of personal approaches for justice promotion," and "emerging justice-expanding nursing." These categories cover the underlying factors, strategies, and outcomes of the nursing profession's participation in establishing social justice process in healthcare. Conclusion: The theory of professional dynamics in the path of justice can be used as a practical guide to describe the role of nurses in establishing social justice. Further studies with a quantitative approach to applying this theory are recommended. [ABSTRACT FROM AUTHOR]

Aims and objectives: This qualitative study explored the experiences of neonatal nurses with facilitating closeness between parents and babies with congenital abnormalities in the neonatal intensive care unit (NICU). Background: Babies with congenital abnormalities often require admission to the neonatal intensive care unit. Parents may experience emotional distancing from their baby, due to their response to their baby's congenital abnormality, as well as physical separation due to their baby's hospitalisation in the NICU. NICU nurses can help facilitate the development of closeness between babies and parents in the NICU. Method: This qualitative interpretive description study involved face‐to‐face, semi‐structured interviews with twelve neonatal nurses following which the data collected were thematically analysed. The consolidated criteria for reporting qualitative research (COREQ) checklist were used in preparing this paper. Results: Three major themes emerged from the analysis—"Everyone copes differently," "You have to focus on what is the normal thing" and "It's very much an individualised approach." Participants often felt unprepared to care for babies with congenital abnormalities and implemented coping mechanisms to overcome the emotional labour they experienced. Skin‐to‐skin cuddles were considered the most beneficial strategy for parents to develop closeness with their baby. Participants recognised that they sometimes "pushed" parents into engaging with their baby. Participants highlighted the importance of individualised, supportive care for these parents. Conclusions: Neonatal nurses require increased education about congenital abnormalities and individualised care to support them in caring for babies with congenital abnormalities. Relevance to clinical practice: Further research is needed on parental experience of developing closeness with a baby with a congenital abnormality in the NICU. [ABSTRACT FROM AUTHOR]

The enactment of the Mental Health Act (MHA) 2007 introduced the role of the multidisciplinary Approved Mental Health Professional (AMHP) in England and Wales by amending The MHA 1983. The role can now be performed by a range of professionals including a psychologist, an occupational-therapist, a social worker or a mental-health/learning difficulties nurse. This amendment amongst other legal provisions replaced the earlier Approved Social Worker role. This is an exploratory qualitative research that aimed to identify if the decision-making relating to management and assessment of risk varied according to the professional background of the AMHP. The decision-making of 10 social work and 10 nursing AMHPs were examined through the use of an experimental vignette containing audio-visual and written materials in order for participants to reach a decision about whether or not to detain. Proposed detention rates between social work and nurse AMHPs were identical although variation was found across the whole sample in terms of the risks that were identified in the vignette. The paper concludes by arguing that these results suggest that differences in the way AMHPs reach decisions may well relate to a variety of individual differences rather than reflecting initial professional identity and training as so often argued in the literature. [ABSTRACT FROM AUTHOR]

Objective To explore service availability and accessibility for people with advanced chronic obstructive pulmonary disease (COPD) and their carers and strategies for improvement, including the potential role of a COPD care co-ordinator in ensuring best-practice care in the Australian context. Methods This qualitative study used focus groups and interviews with health professionals, carers and consumers to explore gaps and restrictions in services, barriers to access and the functioning of services. Data were analysed deductively. Results Key themes arising from the data included difficulties around access to care, lack of continuity of care, poor care co-ordination, the need for active disease management as well as supportive care, and poor communication. A COPD care co-ordinator was suggested as an effective strategy for ensuring best-practice care. Conclusions People with advanced COPD often have difficulty navigating the acute, primary and community care systems to deal with the multiple services that they may require. Lack of communication between health professionals and services is frequently a significant issue. A COPD care co-ordinator, encompassing advanced nursing skills, could ensure that care is centred on the needs of the person and their carer and that they receive continuing, appropriate and accessible care as they approach the end of their life. What is known about the topic? The importance of care co-ordination as a quality care indicator in chronic disease is growing, and the care co-ordinator role as a facilitator of quality care is increasingly being recognised in the UK and US. There is currently little information in the Australian context about how a COPD care co-ordinator role could be implemented, where it could be situated and the level of skill required. What does this paper add? This paper explores the specific issues in developing a COPD care co-ordinator role and provides a detailed model of care for the introduction of care co-ordinators into the Australian setting. What are the implications for practitioners? The proposed COPD care co-ordinator role has the potential to improve quality, continuing care for people with advanced COPD. It could facilitate the linkage of multidisciplinary teams across acute, primary and community care settings and promote timely and effective communication. The role would provide a clear point of contact for all practitioners and the opportunity for nurses to develop an advanced practice role in COPD care co-ordination, combining a palliative care approach with a chronic disease management framework. [ABSTRACT FROM AUTHOR]

This paper describes a mixed method survey that was administered to a group of Australian palliative care social workers (n = 27). Specifically, it aimed to investigate the ways that social workers understood and worked with clients who were estranged from family at the end of life. Respondents suggested that estrangement potentially impacted clients emotionally, practically, and existentially. They were challenged to make clear assessments, provide emotional support, encourage news ways of thinking about estrangement, to manage practical issues, work with the client’s family, and monitor their own professional role. Theories and models of intervention and levels of training are also discussed. [ABSTRACT FROM AUTHOR]

Universities, industry and professional bodies advocate work-integrated learning (WIL) as a valuable way to prepare graduates to meet the challenges of contemporary society. When organizations preference particular students over others to host on placement, the full individual and collective potential of WIL is not realized. This paper reports findings from a qualitative study focused on the role played by Human Resource (HR) professionals in influencing student access to WIL placements in Australian organizations. Findings suggest being in a HR role may influence why and how an individual acts as a WIL gatekeeper however, there is an interplay between forces at three distinct levels: organizational, occupational/job and personal, which affect the intentions and actions of the HR professional. Furthermore, the study suggests several conditions are required for an inclusive approach to WIL to be enacted. This study contributes to the underexplored topic of equity and access in WIL. [ABSTRACT FROM AUTHOR]