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Purpose: Sociometric studies and adult reports have established that children with Language Disorder (LD) are at risk of peer relationship difficulties. However, we have limited knowledge of how children with LD understand friendship, whom they deem as a good or bad friend, and what role their friendship concepts play in their relationships with peers. This exploratory study aimed to conduct a qualitative investigation into the friendship concepts that children with LD hold and to explore their strategies for making friends. Methods: We conducted multiple, art‐informed interviews on the topic of friendship with 14 children with LD at the age of 6–8 years. Participating children were based in the United Kingdom and Republic of Ireland. They attended enhanced provision, specific speech and language classes and mainstream classrooms. We used framework analysis to map children's responses to Selman's (1979) developmental model of interpersonal understanding, which espouses a theory of children's social development within the context of peer relationships. Results: The understanding of friendship formation in children with LD varied from physical presence to mutual support and sharing. Children's ideas about a good/bad friend represented the lowest developmental stage. Participants from the mainstream classroom demonstrated the highest stages of interpersonal understanding. Children with LD did not mention their language abilities as a barrier to making friends. Conclusion: There are limited studies exploring friendship directly from children with LD, and this study provides insights into this gap, by utilising art‐informed interviews. Children's immature understanding of a good/bad friend points towards a potential susceptibility to false friends, which we suggest needs further empirical validation. We also found that children with LD did not pay attention to their language difficulties when making friends, which raises questions about the ways diagnoses are shared with children. WHAT THIS PAPER ADDS: What is already known on the subject: Children with Language Disorder (LD) are at risk of peer relationship difficulties. Studies to date are based on sociometrics and adult reports. Only a few studies employ participatory approaches to research with children, directly engaging children with LD when exploring their friendships What this paper adds: This paper directly asks children with LD about their understanding of friendship and strategies for making friends.Physical proximity and play are important to children.s understanding of friendship especially in recognising good and bad friends. This indicates potential reasons for children with LD being susceptible to false friendsAdditionally, children with LD do not perceive language and communication as a barrier to making friends. What are the potential or actual clinical implications of this work?: Concepts around friendship and good/bad friends should be routinely assessed and targeted (if appropriate) in interventions. The study highlights the need to continue discussing practices around sharing diagnoses with children with LD. [ABSTRACT FROM AUTHOR]

Accessible Summary: What is known on the subject?: Nurses' observation of patients in seclusion is essential to ensure patient safety.Patient observation in seclusion assists nurses in adhering to the requirements of mental health legislation and hospital policy.Direct observation and video monitoring are widely used in observing patients in seclusion.Coercive practices may cause distress to patient‐staff relations. What the paper adds to existing knowledge?: We add detailed information on specific observation methods in seclusion and compare them from the perspective of patients.Nurses communicating with patients ensures relational contact and that quality care is provided to patients even in the most distressed phase of their illness.Providing prior information to patients on observation methods in seclusion and the need for engaging patients in meaningful activities, while in seclusion are emphasized.Observation via camera and nurses' presence near the seclusion room made patients feel safe and gave a sense of being cared for in seclusion.Pixellating the video camera would give a sense of privacy and dignity. What are the implications for practice?: The overarching goal is to prevent seclusion. However, when seclusion is used as a last resort to manage risk to others, it should be done in ways that recognize the human rights of the patient, in ways that are least harmful, and in ways that recognize and cater to patients' unique needs.A consistent approach to relational contact and communication is essential. A care plan must include patient's preferred approach for interacting while in seclusion to support individualized care provision.Viewing panels (small window on the seclusion door) are important in establishing two‐way communication with the patient. Educating nurses to utilize them correctly helps stimulate relational contact and communication during seclusion to benefit patients.Engaging patients in meaningful activities when in seclusion is essential to keep them connected to the outside world. Depending on the patient's presentation in the seclusion room and their preferences for interactions, reading newspapers, poems, stories, or a book chapter aloud to patients, via the viewing panel could help ensure such connectedness.More focus should be placed on providing communication training to nurses to strengthen their communication skills in caring for individuals in challenging care situations.Patient education is paramount. Providing prior information to patients using a co‐produced information leaflet might reduce their anxiety and make them feel safe in the room.When using cameras in the seclusion room, these should be pixelated to maintain patients' privacy. Introduction: A lack of research investigating the specific role that various observational techniques may have in shaping the therapeutic relations in mental health care during seclusion warranted this study. Aim: The aim of the study was to explore patients' experience of different methods of observation used while the patient was in seclusion. Method: A retrospective phenomenological approach, using semi‐structured interviews, ten patients' experiences of being observed in the seclusion room was investigated. Colaizzi's descriptive phenomenological method was followed to analyse the data. Results: Communicating and engaging patients in meaningful activities can be achieved via the viewing panel. The camera was considered essential in monitoring behaviour and promoting a sense of safety. Pixelating the camera may transform patient view on privacy in seclusion. Discussion: The mental health services must strive to prevent seclusion and every effort should be made to recognise the human rights of the patient. The study reveals numerous advantages when nurses actively engage in patient communication during the process of observation. Implications for Practice: Different observation methods yield different benefits; therefore, staff education in using these methods is paramount. Empowering the patient with prior information on seclusion, engaging them in meaningful activities and proper documentation on patient engagement, supports the provision of individualised care in seclusion. [ABSTRACT FROM AUTHOR]

Purpose: The concept of personal recovery is now a key pillar of service delivery. It aims to support individuals to flourish and establish a new identity following an acute episode or diagnosis. This view of recovery is unique to each person on that journey. However, there has been a significant focus on measuring these experiences. This paper aims to explore the influence of social constructionism on the concept of recovery within an Irish context, seeking to understand the influence of language, discourse and power on service users' experiences. Design/methodology/approach: A qualitative, interpretivist methodology was adopted for this case study design. Semi-structured interviews were conducted with 12 service users. Thematic analysis was chosen as the method of analysis. Findings: Personalising recovery did not always lead to the removal of biological symptoms, but with the appropriate supports, individual's recovery journey was greatly enhanced. On the contrary, personal recovery places overwhelmingly responsibility on the individual to succeed, largely driven by neoliberal discourse. This focus on individualism and the pressure to succeed was further experienced when people sought to re-integrate into society and participate in normalised social order. Ultimately, for many service users, they viewed personal recovery as an unfulfilled promise. Research limitations/implications: It is not a representative sample of service users within an Irish context. Originality/value: To the best of the authors' knowledge, this is the first study to explore influence of social constructionism on the concept of personal recovery within a mental health service context. [ABSTRACT FROM AUTHOR]

Background: People with Parkinson's disease (PD) do not always access specialist outpatient services in a timely manner in Ireland. The perspectives of people living with PD, relating to service access, are largely absent in the existing literature. Aim: To explore experiences of PD service access for people living with PD, using a qualitative approach. Methods: Purposive maximum variation sampling was used. Semi‐structured telephone interviews were conducted with 25 service users, including people with PD (n = 22) and supporting carers (n = 3). Informed consent was obtained from all participants. Interviews ranged in duration from 30 to 90 min. Data were managed in NVivo 12 and interpreted inductively using thematic analysis. The researchers were reflexive throughout the research process. The Consolidated Criteria for Reporting Qualitative Research checklist was employed to maximise transparency. Results: The findings highlight several key barriers to and facilitators of equitable and timely service access. Three key themes were identified comprising experiences of PD service access including 'geographical inequity', 'discriminatory practices', and 'public and private system deficits'. Together, these themes illustrate how a two‐tiered and under‐resourced health system lacks capacity, in terms of infrastructure and workforce, to meet PD needs for both public and private patients in Ireland. Conclusions: These findings point to problems for PD care, relating to (i) how the health system is structured, (ii) the under‐provision and under‐resourcing of specialist outpatient PD services, including medical, nursing, and multidisciplinary posts, and (iii) insufficient PD awareness education and training across health settings. The findings also show that telemedicine can provide opportunities for making access to certain aspects of PD care more flexible and equitable, but the feasibility and acceptability of technology‐enabled care must be assessed on an individual basis. Implications for policy, practice and research are discussed. Patient or Public Contribution: The design and conduct of this study were supported by an expert advisory group (EAG) of 10 co‐researchers living with PD. The EAG reviewed the interview schedule and the protocol for this study and provided detailed feedback from their perspective, to improve the methods, including the interview approach. The group also reviewed the findings of the study and contributed their insights on the meaning of the findings, which fed into this paper. [ABSTRACT FROM AUTHOR]

Dual Sensory Loss and learning disability is a historically neglected area of social work practice. This paper presents one element of a research study conducted with a health and social care provider in Northern Ireland. It explored staff experiences of assessing adults and children with a dual sensory loss and learning disability. Two sensory disability team managers, eight social workers and two rehabilitation officers were interviewed across sensory disability, learning disability and children with disability teams. Current levels of engagement and ways in which more inclusive services and practices could be developed were explored. Staff views indicate that there is minimal engagement between staff and service users with unique, complex needs. Staff use a range of tools, resources and skills in an attempt to promote inclusion and engagement. The paper concludes that to promote engagement staff need to develop their practice, making effective use of tools and resources. Staff skills and knowledge can be enhanced through training which is targeted, relevant and specific. There needs to be commitment to sharing good practice and cascading learning throughout teams. This will enable service users to have input into their own assessments which will form the cornerstone of all ongoing interventions. [ABSTRACT FROM AUTHOR]

Despite the benefits of utilising community‐based care services (CBS) for people with dementia and their caregiver being well established, people with dementia and caregivers use fewer services in comparison to other people in need of care. While societal, cultural and logistical factors effecting caregiver use of CBS are frequently studied, research of internal emotional barriers, mental limitations created by one's own self that prevents open communication of thoughts and feelings, and their effect on CBS use is limited. This paper explores internal emotional barriers on caregivers' use of CBS within the Irish Healthcare System. Professional Healthcare Providers were also interviewed as a preliminary indicator of their awareness of these internal emotional barriers and their impact on caregivers' use of CBS. Using interpretive description methodology, interviews with 20 caregivers and fourteen dementia professional healthcare providers were transcribed and a thematic analysis methodology applied to illuminate themes/patterns within participants' subjective perceptions of caregivers emotional barriers to using CBS. Four themes emerge: reluctance to question general practitioner (GP) authority; embarrassment during level of care requirement reviews; sense of obligation to provide all care; and fear of stigma. Caregivers interviewed were reluctant to communicate concerns with professional healthcare providers (PHPs), thereby reducing the PHP's awareness of these barriers and delaying/preventing use of CBS. As key gatekeepers within the care pathway, GPs should address the uneven power dynamic with the caregiver through user‐centred models of care, which actively encourage open dialogue, and receive training to identify the indicative behaviours of internal emotional barriers and empower the caregiver to communicate their feelings/concerns directly. [ABSTRACT FROM AUTHOR]

Mental health nursing in the forensic services is perceived as stressful as there is often a tension between therapeutic and custodial processes. Clinical supervision has been discussed as a support strategy for nurses. The aim of this paper is to explore forensic mental health nurses understanding of clinical supervision and their perception of its utility within their practice. A qualitative descriptive method was used and 10 mental health nurses were interviewed with the aid of an interview guide. Qualitative data was analysed using a thematic approach culminating in the emergence of three themes. Participants talked about the tension between caring and custodial roles within the forensic services which was stressful and created difficulties in the maintenance of a therapeutic relationship. Clinical supervision was seen as a necessary support to assist nurses working in the forensic services. The findings support the premise that there is a tension between therapeutic and custodial practices. Acknowledgement of the complexities of working within the forensic services and the provision of clinical supervision within a confidential, non-judgemental relationship may assist nurses in the provision of care and the maintenance of therapeutic relationships. [ABSTRACT FROM AUTHOR]

Purpose The purpose of this paper is to explore keyworkers’ experience and perceptions working with people experiencing homelessness and the use of psychologically informed approaches in an Irish context.Design/methodology/approach In this paper a qualitative descriptive methodology was employed and face-to-face in-depth semi-structured interviews were conducted. Data collected were analysed using a thematic framework and transcribed by the researcher.Findings It was the view of the keyworkers psychological approaches allowed them greater understanding of psychological trauma and its effects promotes safe physical and emotional environments builds rapport between staff and clients and enables keyworkers to work more effectively with people with complex needs. There was also convincing evidence staff are quite receptive to training.Originality/value Given there is no research exploring the use of psychologically informed approaches in homelessness service settings, this study researched an area that has not yet been explored in Ireland. This qualitative descriptive research provides a platform from which further research can be conducted. It is hoped that highlighting the psychological issues of homeless people, the data obtained will help improve Irish homeless services, and the findings extracted beneficial in terms of future service developments, professional training and education. [ABSTRACT FROM AUTHOR]

This paper provides an evaluation of the Heart of Living and Dying (HLD) Initiative. This initiative is a group process that attempts to bring Advance Care Planning (ACP) into the public domain. It encourages participants to consider what matters to them in their living along with their hopes, preferences, and wishes for their final years and end-of-life care. An inductive, interpretive, and naturalistic approach allowed the researcher to study these phenomena in their natural setting i.e., the community. This qualitative study used 5 focus groups with 17 people and employed thematic data analysis to identify key themes. All participants in the HLD speak from a personal perspective irrespective of any professional background. It transpired that 16 respondents worked in health and social care, which subsequently became noteworthy in the findings. Three key themes were identified: (a) feeling emotionally safe enough to have such sensitive conversations is vital; (b) participating in the HLD process increases the confidence of those participants who worked in health and social care, to undertake ACP conversations and (c) planning ahead is a complex, staged process rather than a single record-making event. The Covid-19 pandemic crisis reinforced the need to upstream ACP initiatives such as the HLD, as the norm for everyone, since all of us will one day die. It is recommended that the HLD be incorporated within ACP training given that the experiential nature of it and the use of groups was reported to build confidence in facilitating ACP conversations. A virtual HLD process needs to be developed to adapt to restrictions on gatherings due to Covid 19. [ABSTRACT FROM AUTHOR]

Purpose – The purpose of this paper is to present the unreported phenomenon of migrants with sight loss who experience unsupportive behaviour and attitudes from their own ethnic community due to their disability. In presenting specific case studies from a wider PhD study which investigated the previously undocumented experiences of migrants with sight loss in Ireland, the intention is to raise awareness among service providers of the additional vulnerability of this minority group. Design/methodology/approach – Migrants representing diverse ethnicities (Angolan, Algerian Nigerian, Zambian, Polish, Czech Republic, Malaysia Bangladeshi) described their experiences accessing disability services Ireland and discussed comparative attitudes towards disability in their home and host country. Service providers from the national organization working with people with sight loss were interviewed to gain an understanding of their attitudes and views on access and provision for migrants. By adopting a qualitative method following a constructivist grounded theory approach, migrants' own perceptions, beliefs, views and experiences of the sensitive subject of adjusting to sight loss while away from home were prioritised. Analysis of data was facilitated through qualitative software Atlas.ti and three core interrelated categories emerged most prominently: cultural perceptions of disability; support networks; and cultural barriers. The focus for this paper draws most significantly from the second category, support networks, most specifically the impact of absence or withdrawal of support for the migrant at the most vulnerable time of sight loss away from home. Findings – From grounded theory data analysis, three core interrelated categories emerged most prominently. They are: cultural perceptions of disability; support networks; and cultural barriers. This paper focuses most directly from findings related to support networks specifically highlighting two migrant case studies to report the impact of absence or withdrawal of support for migrant at the most vulnerable time of sight loss away from home. Service providers interviewed report inadequate information about migrants with sight loss. Evidence of stigma related to cultural perception of disability in the home community as trigger for discrimination from migrant's own network is reported by service providers. Findings are examined within an interdisciplinary theoretical framework, combining intercultural studies theories with disability models to facilitate a holistic understanding of the migrants' experience. Practical implications – The challenge of coping with disability for a migrant whose ethnic community network is absent, or withdraws its support owing to an individual's disability, have implications for alerting service providers to increased vulnerability of migrant service users. Consequently, this study has implications for programs and policies and can inform the development of culturally sensitive and appropriate services. Social implications – This study raises awareness of the compounded challenge for migrants with sight loss who are unsupported by their own ethnic group while living in a host country. Originality/value – This study reveals the previously unreported case of migrants who experience unsupportive behaviour from their own ethnic community following acquired disability. Evidence from migrants and their service providers demonstrates the impact of cultural perceptions of disability to influence the level of ethnic community support offered. [ABSTRACT FROM AUTHOR]

The research goals were to obtain an understanding of who the users of e‐books in the NHS are, what they are using e‐books for, and when and how they use them. This article presents the methodology used and the findings from the research. It also explores the outputs and next steps from the research, both for the individual countries and collectively. The Five Nations group, (library leads in England, Northern Ireland, Ireland, Scotland and Wales) commissioned research into healthcare staff use and non‐use of e‐books to understand the behaviours, needs and expectations of healthcare staff and to identify shared challenges around e‐books to inform policy and practice. [ABSTRACT FROM AUTHOR]

Physical inactivity levels are rising globally. In response, public health investigators have sought to design and implement effective interventions to raise levels of physical activity in populations, communities and individuals. Usually, such interventions are built around theories of behaviour change in which notions of motivation and incentivisation loom large. Drawing on focus group evidence derived in the context of a cluster RCT aimed at increasing levels of physical activity in the workplace, this paper offers a critical look at the factors that seemingly stimulate and sustain that activity. In particular, using novel methods of data analysis we illustrate how motives and motivation – often interpreted as a driving force 'in' individuals – can be more usefully seen as distributed; as a property of systems (incorporating technologies, organisational structures, and social interaction) rather than of persons. In our discussion, we outline various theoretical as well as empirical grounds for making such claims and conclude by drawing out the implications of our work for public health policy and research. [ABSTRACT FROM AUTHOR]

A plethora of government policies impacting older people in the United Kingdom (UK) have been strongly influenced by the rhetoric that service users should be actively involved in their social care; including decisions and delivery. User involvement is integral to the government's current drive to make service more "person‐centred" or "personalised" in adult social care. However, there has been little engagement with the broader Northern Ireland public on future adult social care policies. It has been suggested that knowing preferences for the type of future care and where and how it should be provided can be valuable for service users, providers and policy‐makers. Using a qualitative approach, this paper draws on data collected from three focus groups with people aged over 60 who are not in receipt of social care services. The focus groups took place between April 2016 and January 2017. The findings demonstrate that participants had limited knowledge and understanding of the current social care system in Northern Ireland. In addition, participants had not thought about their possible future care needs. The findings emphasise the importance of promoting and engaging the public in social care debates, particularly at a time when the need for reform of the health and social care system has been identified in Northern Ireland. [ABSTRACT FROM AUTHOR]

The aim of this paper is to inform the development of social work practice and policy by applying a practice-based evidence perspective to the experiential knowledge of social workers responsible for managing cases of elder abuse in Ireland. The study adopted a qualitative descriptive research design. Semi-structured interview data were collected from a purposive sample of eighteen senior case workers and inductive thematic analysis was undertaken. The findings are presented according to three themes: elder abuse case management, practice strategies for overcoming challenges and augmenting protective practice. By examining practice in the context of wider socio-political and legislative contexts, the paper provides learning in key areas for the protection of older people. The challenges to case management practice and the strategies employed to respond to these challenges are discussed in terms of adult protective service policy development and its relationship to practice. While recognising the imperative to respect a client's right to self-determination, increased statutory authority for the duty of the state to protect older people from abuse as well as the role of the case worker to act on behalf of the state to implement protective interventions is important for the future development of the service. [ABSTRACT FROM AUTHOR]

The contribution that social workers make to communities is integral to the principles and values of the profession but is often ‘hidden’ and unacknowledged. This paper is an exploration of social workers' engagement with community work approaches in a range of settings in the Republic of Ireland, where managerialism and a climate of austerity pose particular challenges for social work practice. By exploring the findings of qualitative interviews with social work practitioners, the paper examines themes and issues that emerge in the context of their practice settings and considers how community work ideas are enacted in contemporary social work practice. These ideas challenge dominant discourses and emphasise a process of active engagement with communities to counter inequality and injustice and seek change at both community and societal levels. The concept of ‘creative activism’ is developed to explore the idea of critical practice and the different forms of collective action that social workers undertake. The use of these ideas to strengthen the links between theory, research and practice on a postgraduate qualifying social work degree is discussed. The paper seeks to re-emphasise the place of community work within social work research, theory, practice and professional education. [ABSTRACT FROM AUTHOR]

Accessible summary What is known on the subject? Caring for people with dementia and responsive behaviours is challenging; however, little is known of nurses' experiences of responsive behaviours., What does this paper add to existing knowledge? To demonstrate understanding nurses need to be aware of their own actions, thoughts, attitudes and reactions., Time, education and management support are essential in enabling a person-centred approach., A decision regarding the place of care is difficult to come to, and given the drive to a person-centred approach, there is a need to consider the views of people with dementia., What are the implications for practice? Nursing staff supporting people with dementia should engage more frequently in reflective practice, ongoing education and decision-making., Service providers/managers need to have an understanding of the complexities of caring for a person with dementia and responsive behaviours and provide their staff with relevant supports and education that is accessible to all staff., Abstract Introduction Caring for people with dementia and responsive behaviours can challenge nurses, and little is known of their experiences. Aims To explore nurses' views of supporting people with dementia and responsive behaviours in long-stay facilities. Methods A qualitative descriptive study utilizing in-depth audio-recorded interviews of nine nurses, recruited from private and public care facilities. Qualitative content analyses conducted involving iterative comparisons of transcripts, summaries and memos, where coding, key quotes and tables were developed to determine themes. Results Four themes emerged: recognizing and understanding responsive behaviour, resources and interventions to support people with dementia and responsive behaviour, the impact of education on nursing practice and the care environment. Discussion Availability of staff, adequate time and financial restraints hinder nurses' ability to provide care. Access to ongoing education and being able to provide one-to-one care was valued as dementia-specific education changed nursing practice. Implications for practice Place of care was seen as dependent on the type of responsive behaviour in question, the duration of the behaviour and the impact of the behaviour on the person, other residents and staff. Dementia education needs to be accessible to all staff, and a collaborative approach is necessary in order to develop management guidelines and support strategies. [ABSTRACT FROM AUTHOR]

Previous research identifies the increased exposure of birth children of foster carers to experiences of separation, grief, and loss due to the transient nature of foster care, but little is known about how birth children manage this loss. This paper reports findings from a qualitative study that examined the retrospective experiences of 15 adult birth children of foster carers (aged between 18 and 28 years) in Ireland. Findings suggest that birth children experience grief and loss when foster children leave their families. They report experiencing a range of emotional responses such as guilt, blame, and sadness. A reluctance to discuss their emotional responses with either their parents or foster care professionals was also reported. Instead, birth children developed strategies to manage the loss, such as distancing themselves from the foster care process. The study highlights the importance of social workers and foster carers explaining to birth children why foster children are leaving and, where possible, maintaining contact between birth children and foster children. Additionally, findings indicate the need for birth children to have safe nonjudgmental spaces to discuss their emotional reactions to loss. [ABSTRACT FROM AUTHOR]

Background: This paper reports on a research study to inform the development of a specialist role to support front line public health nurses (PHNs) working with vulnerable families and at risk children in Ireland. Aims: This study aimed to investigate the position of a leading role and explore the implications of such change. Methods: Focus group and semi-structured individual interviews were conducted with ten purposively selected participants in public health nursing, social work and a nongovernmental children's organisation working in disadvantaged areas in Dublin. Results: Assistant directors of public health nursing are in a key position to inform decisions regarding the children's services. Conclusion: Access to support and appropriate supervision are fundamental resource requirements for PHNs who work with vulnerable families and at risk children. The introduction of a specialist-leading role to support these PHN's is essential to sustaining best practice. [ABSTRACT FROM AUTHOR]

Introduction: Increased awareness of testicular diseases can lead to early diagnosis. Evidence suggests that men's awareness of testicular diseases is low, with many expressing their willingness to delay help‐seeking for symptoms of concern. The risk of testicular diseases is higher in gender and sexual minority groups. In this study, we discuss the codesign, refinement and launch of 'On the Ball', an inclusive community‐based 'testicular awareness' campaign. Methods: The World Café participatory research methodology was used. Individuals from Lesbian, Gay, Bisexual, Transgender and Queer+ friendly organisations, testicular cancer survivors, policymakers, media/marketing experts and graphic designers were recruited. Participants were handed a brief for 'On the Ball', which was designed based on feedback from a previous World Café workshop. They were assigned to three tables. Participants rotated tables at random for three 20‐min rounds of conversations. Each table had a facilitator who focussed on one element of the campaign brief. Data were collected using audio recorders and in writing and were analysed thematically. Results: Thirteen individuals participated in the workshop. The following themes emerged from the data: (i) campaign identity, (ii) campaign delivery and (iii) campaign impact. Participants recommended enhancements to the campaign logo, slogan, social media posts and poster. They suggested delivering the campaign online via social media and offline using various print and broadcast media. Participants recommended targeting areas with a large number of men such as workplaces. To help measure the impact of the campaign, participants proposed capturing social media analytics and tracking statistics relating to testicular diseases. Recommendations were used to refine the 'On the Ball' campaign and launch it in a university. In total, 411 students engaged with the various elements of the campaign during the soft launch. Conclusions: 'On the Ball' campaign visuals ought to be inclusive. Online and offline campaign delivery is warranted to reach out to a wider cohort. Campaign impact can be captured using social media analytics as well as measuring clinical outcomes relating to testicular diseases. Future research is needed to implement the campaign online and offline, explore its impact and evaluate its feasibility, acceptability, cost and effect on promoting testicular awareness. Patient or Public Contribution: The 'On the Ball' campaign was codesigned and refined with members of Lesbian, Gay, Bisexual, Transgender and Queer+ friendly organisations, testicular cancer survivors, health policymakers, media and marketing experts and graphic designers using the World Café participatory research methodology. [ABSTRACT FROM AUTHOR]

Background: Research evidence suggests that a lack of engagement with palliative care and advance care planning could be attributed to a lack of knowledge, presence of misconceptions and stigma within the general public. However, the importance of how death, dying and bereavement are viewed and experienced has been highlighted as an important aspect in enabling public health approaches to palliative care. Therefore, research which explores the public views on strategies to facilitate engagement with palliative care and advance care planning is required. Methods: Exploratory, qualitative design, utilising purposive random sampling from a database of participants involved in a larger mixed methods study. Online semi-structured interviews were conducted (n = 28) and analysed using reflexive thematic analysis. Thematic findings were mapped to the social-ecological model framework to provide a holistic understanding of public behaviours in relation to palliative care and advance care planning engagement. Results: Three themes were generated from the data: "Visibility and relatability"; "Embedding opportunities for engagement into everyday life"; "Societal and cultural barriers to open discussion". Evidence of interaction across all five social ecological model levels was identified across the themes, suggesting a multi-level public health approach incorporating individual, social, structural and cultural aspects is required for effective public engagement. Conclusions: Public views around potential strategies for effective engagement in palliative care and advance care planning services were found to be multifaceted. Participants suggested an increase in visibility within the public domain to be a significant area of consideration. Additionally, enhancing opportunities for the public to engage in palliative care and advance care planning within everyday life, such as education within schools, is suggested to improve death literacy and reduce stigma. For effective communication, socio-cultural aspects need to be explored when developing strategies for engagement with all members of society. [ABSTRACT FROM AUTHOR]

This study analyses the experiences of youth workers in dealing with challenging behaviour among young people. The findings from a qualitative approach to the collection and analysis of data from 45 research participants are presented. The paper begins by briefly exploring the context of youth work in Ireland and outlining the research process. This is followed by a discussion of the nature of challenging behaviours experienced by youth workers including the emergent area of challenging behaviour involving new technology. Other significant themes arising from the research data are discussed. These include issues such as the audience factor, the importance of individual work, the significance of understanding background factors leading to difficult behaviour, and the need to support staff through challenging encounters. Particular attention is given to highlighting the practice implications of the research in developing effective practice in the area of challenging behaviour. [ABSTRACT FROM AUTHOR]

The supervision of undergraduate social work students on placement is fundamental to their development as 50% of the BSc (Hons) social work degree in the UK comprises practice learning, which is widely acknowledged as the signature pedagogy of the profession. In Northern Ireland practice learning opportunities are supervised by practice teachers. To ensure a consistent quality and supply of practice teachers a Master's programme offering approximately 35 places per year is delivered at Ulster University. The trainee practice teachers had to navigate working on the front line through the COVID 19 pandemic, post graduate study and the professional supervision and assessment of undergraduate social work students on placement. This article presents evidence from a small scale qualitative study evaluating the practice teaching programme conducted with 22 trainee practice teachers. Respondents were asked to complete a semi structured online survey. The evaluation sought their perceptions regarding the duality of their unique experience as a gatekeeper to the profession and student managing the unprecedented challenges of assessing the competence of social work students on placement. Several themes emerged including assessing competence, the student experience and support from the practice assessor. A further outcome was the creation of a Peer Learning Bubble Model. [ABSTRACT FROM AUTHOR]

Aim To explore nurses' use of the World Health Organization safety checklist in the perioperative setting. Background Promoting quality and safety in health care has received worldwide attention. The World Health Organization surgical safety checklist (2009) is promoted for reducing postoperative morbidity and mortality. The checklist has been introduced in Irish perioperative settings. Method(s) A descriptive, qualitative approach was utilised. A purposeful sample of ten nurses participated in individual, semi-structured interviews. Results Participants were committed to promoting safety in navigating challenges in introducing, complying and accepting the value of the World Health Organization surgical safety checklist in concordance with best practice. Participants moved from task completion to embracing the checklist as an effective surgical safety checking tool. Challenges were identified around roles and responsibilities in overseeing the completion of the checklist. Conclusion(s) The management of processes is critical when implementing any safety initiative. This paper highlights the complexity and challenges in implementing the World Health Organization surgical safety checklist, contributing to global discussions around translating policy into practice. Implications for nursing management The effective implementation of a checklist requires a coordinated management approach in collaboration with team members. These approaches will support learning experiences contributing to a shared understanding of the change being implemented by all team members. [ABSTRACT FROM AUTHOR]

The worldwide growth in formal youth mentoring programmes over the past two decades is partly a response to the perception that young people facing adversity do not have access to supportive relationships with adults and positive role models in their communities to the degree they once had. Formal mentoring programmes facilitate the development of a friendship or ‘match’ between an older volunteer and a young person, with the objective of supporting the young persons’ personal and social development. Drawing on 66 semi‐structured interviews with young people, parents, mentors and caseworkers associated with nine youth mentoring matches in the Big Brothers Big Sisters Programme in Ireland, this paper analyses the forms of social support evident in the mentor–mentee relationships and highlights how the mentoring relationship was perceived to have impacted on the well‐being of the young people participating. The findings reflect the consensus in the mentoring literature that close, well‐established mentoring relationships have the potential to bring about meaningful change in the lives of young people. [ABSTRACT FROM AUTHOR]

Endometriosis is an incurable chronic condition associated with debilitating pain and subfertility, affecting 1 in 10 women. The current study aims to explore the perceptions and experiences of women with endometriosis regarding the diagnosis, support and treatment options available in Ireland. It will further determine whether additional supports or improvements are needed to care well and effectively for women with this disease in the Irish healthcare system. A qualitative study design was deemed most suitable. Twenty participants, women aged 18 and over with a diagnosis of endometriosis and experience of the Irish healthcare system, were recruited through purposeful sampling to complete semi-structured, one-to-one online interviews. Data was analysed using reflexive thematic analysis, and five themes were identified: 'dismissive attitudes normalising severe pain', 'inadequate health system', 'the impact of delayed diagnoses', 'lack of education and awareness' and 'navigating ignorance, taboo and societal views'. Insights into the experiences and needs of women diagnosed with endometriosis in Ireland were gained, and we discuss the implications of our findings for Irish healthcare services with reference to feminist health equity and recent national action plans. We propose a series of recommendations for patient-centred care models including increased access to training and education, as well as support for longer-term chronic pain management. [ABSTRACT FROM AUTHOR]

The method of photovoice has been previously used to effectively engage with socioeconomically disadvantaged groups and explore their eating behaviours. In this methodological article, we draw on our experiences from using photovoice through online interviews with families on low income about their food decisions. A purposive recruitment approach targeted parents of children 2–17 years old who lived on a tight budget across the island of Ireland. Participants provided demographic information and were invited to take photographs of food-related decisions and activities for 1 week during the COVID-19 lockdown. The photographs were then discussed through an online communication platform to generate qualitative data. A total of 28 parents participated in the photo-elicited interviews and shared a total of 642 photographs of factors that influenced their food decisions. Following the interviews, the researchers documented their reflections which focused on (1) participants' engagement with the online photo-elicitation and (2) practical aspects around participant consent and data safety. The participants in our study engaged well with the online photovoice method and shared a variety of photos which provided ample material to facilitate the conversations around their food environment and its impact on their food decisions. Our experiences can provide novel insights into using photovoice in a virtual environment and useful considerations around ethics and data collection for researchers who work with socioeconomically disadvantaged groups. Photo-elicited interviews offer an engaging and flexible data collection technique that can highlight issues informing future priorities of healthcare policy. [ABSTRACT FROM AUTHOR]

Background/Aims The extension of termination of pregnancy services in the Republic of Ireland represents a significant change to practice. As a result, education was provided to assist midwives and nurses to fulfil their expanded role. Using Kirkpatrick's framework, this study aimed to conduct an in-depth evaluation to ascertain if knowledge gained at a termination of pregnancy education programme was applied to clinical practice. Methods Semi-structured interviews were conducted with a purposeful sample of seven midwives and nurses, 3 months after attending a termination of pregnancy education programme. Results Attendance at the programme prompted reflection on practice, with participants providing examples of how they applied the knowledge gained to the care they provide. The complexities of providing a termination of pregnancy service were highlighted, along with additional educational requirements. Conclusions Knowledge gained from the education programme was applied to practice improving termination of pregnancy care. Additional education and training needs identified will guide the development of future programmes. [ABSTRACT FROM AUTHOR]

Objective: The study explores the attitudes of people with chronic health conditions towards the use of group-based telerehabilitation. Design: A qualitative research study. Setting: The setting involved semi-structured focus groups via videoconferencing software. Participants: A purposive sample of 18 people with chronic health conditions including cardiorespiratory, neurological and musculoskeletal conditions was recruited via national patient advocacy and support groups in Ireland and clinical contacts. The sample included both those who had, and had not, previously engaged in telerehabilitation programmes. Procedures: An online questionnaire collected demographic information and data regarding previous telerehabilitation participation and telerehabilitation preferences. Focus groups were conducted using videoconferencing software, in accordance with the Consolidated Criteria for Reporting Qualitative Research (COREQ) Checklist, and analysed using thematic analysis following Braun and Clarke's methodology. Findings were triangulated with quantitative questionnaire data. Results: Four focus groups were conducted including participants with chronic cardiorespiratory (n = 8), neurological (n = 6) and musculoskeletal (n = 4) conditions. Three themes were identified regarding telerehabilitation: (a) benefits and facilitators (including convenience, increased service accessibility, social connection and technological support), (b) challenges and barriers (including technological access and literacy, limited 'hands-on' therapy, safety concerns and social limitations), and (c) preferences (regarding mode of delivery, content, duration and generic programmes for mixed-condition groups). Conclusions: Telerehabilitation is convenient for people with chronic conditions; however, concerns exist regarding the use of technology and the limitations of this healthcare delivery method. The role of telerehabilitation is valued, and future programmes should acknowledge patient preferences including a hybrid model of care, exercise and educational content, social interaction and synchronous components. [ABSTRACT FROM AUTHOR]

Irish social workers historically took a central role in the development of bereavement services. In urban areas, recent research contributed to the development of new services. Less is known about the needs and experiences of patients and families accessing hospital-based services in rural parts of Ireland. Good practice initiatives developed in large urban hospitals may be harder to replicate in small rural hospitals, where physical conditions can be outdated, resources lacking and cultural factors variable. Despite a growing recognition of the psychological impact of pregnancy loss, it remains a significantly under-researched topic. This paper reports on a qualitative study of eight women's experience of care in a rural Irish hospital following pregnancy loss. Their accounts are salutary in identifying the extent to which, for some women, a sense of loss is persistent and painful. Hospital social workers can have a role to play in mediating the impact of pregnancy loss and minimising the risks of disenfranchised grief by developing tailored and appropriate responses—ones which are responsive to a spectrum of need. [ABSTRACT FROM AUTHOR]

Vocal load related to heavy voice use in particular professions increases the risk of occupational voice disorders. Research on professional voice use has primarily focused on educators, singers, and call-centre advisors. This paper describes the daily experiences of professional soccer managers' occupational voice use through qualitative methods. Four global themes were identified: 1) voice uses, 2) factors affecting voice change, 3) impact of voice use, and 4) the importance of voice in soccer management. All describe the nature of soccer managers' vocal demands. Risk factors for voice disorders include intense and prolonged voice use in environments with adverse acoustic properties for speakers and poor phonation methods. Research on vocal behaviours and early prevention programmes for this population group is warranted. [ABSTRACT FROM AUTHOR]

The positive deviance approach seeks to identify and learn from those that perform exceptionally well. Positive deviance as an approach to quality improvement is gaining traction in general practice. This study aimed to explore and compare stakeholders' perceptions of the factors that support the delivery of exceptional care in general practice and to refine a previously developed theoretical framework of factors associated with positively deviant care in general practice: the Identifying and Disseminating the Exceptional to Achieve Learning (IDEAL) framework. Semi-structured interviews were conducted with 33 purposively sampled patients, general practitioners, practice nurses, and practice managers in Irish general practice. Subsequently, a directed content analysis approach was employed to deductively analyse interview data using the IDEAL framework, and newly emerging factors were inductively analysed and abstracted into the framework. Several distinct strategies (e.g. patient activation and team collaboration), structures (e.g. facilities and staffing), and contextual factors (e.g. communication and rapport, and culture) were found to support the delivery of exceptional care, and differences in perceptions, values, and expectations emerged between patients and practice staff. Interview data largely supported the pre-determined factors posited by the IDEAL framework, and new factors were abstracted into the framework (e.g. facilities and infrastructure). Stakeholder engagement regarding the factors supporting exceptional care in general practice supported and extended the IDEAL framework, contributing to a more comprehensive understanding of how exceptional care is delivered in general practice. The refined framework will support researchers, policymakers, and teams looking to support, measure, and achieve exceptionally good patient care in general practice. [ABSTRACT FROM AUTHOR]

Purpose: Efficient delivery of integrated healthcare requires solid alliances and collaboration with stakeholders on a regular basis. Due to coronavirus disease 2019 (COVID-19), it has become necessary to explore new ways of delivering integrated healthcare, and virtual clinics have offered one solution and are likely to continue due to the uncertainty with COVID-19. This study aims to explore clinicians' experiences of how efficient virtual elective knee clinics (VEKC) are in an orthopaedic setting in comparison to traditional face-to-face clinics. Design/methodology/approach: The study utilised a mixed-methods study to obtain qualitative and quantitative data. This involved an anonymous online survey in addition to in-depth qualitative interviews conducted with a purposive sample of multidisciplinary colleagues who work with the VEKC in an acute hospital. Findings: Three overarching themes and nine sub-themes emerged in the qualitative analysis. Overall, clinicians in both the quantitative and qualitative aspects of the study highlighted several ways that virtual clinics are efficient from both the patient and health service perspective. However, participants also highlighted barriers in relation to virtual clinics not being suitable for certain cohorts of patients and pathologies. Originality/value: This is the first study in Ireland to provide valuable insights into the experiences of multidisciplinary clinicians using VEKC and their efficiency compared to traditional face-to-face clinics. [ABSTRACT FROM AUTHOR]

Objective. To explore the experiences of bereaved mothers as they suppress lactation following late miscarriage (>20 weeks), stillbirth or neonatal death. Method. A qualitative, focused ethnographic approach was used involving in-depth interviews with 15 bereaved mothers, who attended a maternity hospital in Dublin. Data were collected from January to August 2012. Findings. Three key themes were identified: (1) suppression of lactation following the loss of a baby: silent tears; (2) mothering; (3) supportive care needs and the bereaved mother's experience. This paper focuses on the first global theme. The majority of bereaved mothers found engorgement and leaking milk particularly challenging both physically and emotionally following the loss of their baby; especially as their baby's funeral or wake took place during this period. The study highlights a number of areas where women could be better prepared for this experience. Conclusion. The findings highlight that the majority of bereaved mothers will require improved guidance and support with their breast care needs following the loss of their baby with awareness and sensitivity to their shortened motherhood. [ABSTRACT FROM AUTHOR]

Background: Problem alcohol use is common and associated with considerable adverse outcomes among patients who attend primary care in Ireland and other European countries for opiate substitution treatment. This paper aims to describe patients' experience of, and attitude towards, screening and therapeutic interventions for problem alcohol use in primary care. Methods: This qualitative study recruited problem drug users (N = 28) from primary care based methadone programmes in the Ireland's Eastern region, using a stratified sampling matrix to include size of general practice and geographical area. Semi-structured interviews were conducted and analysed using thematic analysis, and audited by a third reviewer. Results: We identified three overarching themes relevant to the purpose of this paper: (1) patients' experience of, and (2) attitude towards, screening and treatment for problem alcohol use in primary care, as well as their (3) views on service improvement. While most patients reported being screened for problem alcohol use at initial assessment, few recalled routine screening or treatment. Among the barriers and enablers to screening and treatment, patients highlighted the importance of the practitioner-patient relationship in helping them address the issue. Nevertheless, patients felt that healthcare professionals should be more proactive in the management of problem alcohol use at a primary care level and that primary care can play an important role in their treatment. Conclusions: Problem alcohol use is an important challenge in the care of problem drug users. While primary care is well placed to address this issue, little data has reported on this topic. The development of interventions which promote screening and brief interventions in practice are likely to benefit this at-risk group and further research and education, that help achieve this goal, are a priority. Strategies such as dissemination of clinical guidelines, educational videos, academic detailing and practice visits, should be explored. [ABSTRACT FROM AUTHOR]

Contemporary health policy increasingly positions responsibility for the management of health with the individual which reflects newer neo-liberal discourses of health. Such an approach can be seen as problematic in the context of men's health, with men tending to be seen as largely 'irresponsible' towards their own health. This paper addresses this question by drawing on qualitative data on how men conceptualise responsibility for health. Whilst the desire to be responsible for health was borne by most of the men in the study, this was not always reflected in practice. There was also evidence of strategies that men adopted for either divesting themselves of responsibility for health or for legitimising lack of responsibility. In some instances, acting 'irresponsibly' was what defined participants as 'real men'. The implications of these findings for men's health policy are discussed with specific reference to the recent publication of Ireland's National Men's Health Policy. [ABSTRACT FROM AUTHOR]

The objective of our research is to analyse career dissatisfaction through the psychoanalytical lens of Jacques Lacan. Taking a multiple-case study approach, semi-structured interviews were conducted with seven male, senior managers working in the highly competitive technology industry. We found that respondents are defining satisfaction against a socially constructed career system that obliterates the concept of an agentic self. By grounding our qualitative investigation in the research fields of career and career dissatisfaction in the under-researched realm of Lacanian theory, we extend career theory to include a psychodynamic lens. We also contribute to practice by providing an alternative approach to career counselling that encourages the client to co-construct a sense of liberation and empowerment. [ABSTRACT FROM AUTHOR]

Developing age-friendly communities is a significant global policy issue. The World Health Organization's (WHO) age-friendly cities and communities initiative significantly influenced the development of Ireland's Age-friendly Programme. This article critically examines the utilisation of the WHO age-friendly planning framework in the context of Ireland. It explores older adults' experience of living in a county which is currently implementing an age-friendly programme, and uses this analysis to assess how the age-friendly programme addresses older residents' needs, and to illustrate how the WHO conceptual and planning framework has worked in Ireland. The article reports on a qualitative case study which used constructivist grounded theory to explore the lived experience of older adults. The research identifies salient social and cultural dimensions of the day-to-day lived experience of older people which, although they impact on the age-friendliness of the places in which they live, are downplayed or neglected in the WHO framework. In critically analysing the transfer and relevance of the WHO age-friendly model in light of broader issues such as diversity of place, the dynamic nature of person–place relations, and the interplay between age-friendly policy and other age-related public policy, the article suggests ways in which the use of the WHO framework can be modified to accommodate better the diverse experience of older adults in Ireland, but also in other geographic and cultural contexts. [ABSTRACT FROM AUTHOR]

Introduction: Maternity services underwent much change during the COVID‐19 pandemic. Research on the impact on miscarriage care and experiences during this time is sparse. Within a national evaluation of recurrent miscarriage care, we qualitatively explored stakeholder views and experiences of recurrent miscarriage services in Ireland. This study describes the impact of the COVID‐19 pandemic on those experiences and perceptions of care. Methods: People with professional and lived experience of recurrent miscarriage and service engagement were actively involved in this qualitative study from idea generation to analysis and reporting. We recruited women and men with two or more consecutive first‐trimester miscarriages, and people involved in the management/delivery of recurrent miscarriage services and supports. We used purposive sampling to ensure that perspectives across disciplinary or lived experience, geographical, and health service administrative areas, were included. We conducted semi‐structured interviews, virtually all due to COVID‐19 restrictions, between June 2020 and February 2021. These were audio‐recorded, and data were transcribed, and subsequently analyzed using reflexive thematic analysis. Results: We interviewed 42 service providers and 13 women and 7 men with experience of recurrent miscarriage. We actively generated two central themes during data analysis. The first—'Disconnected'—describes how many women navigated miscarriage diagnosis and management and care in subsequent pregnancies alone; many felt that this resulted in increased trauma. At the same time, men struggled with not being present to support their partners and described feeling disconnected. The second theme highlighted 'The perceived dispensability of recurrent miscarriage services and supports'. Some service providers felt that service reduction and redeployment demonstrated a lack of value in the service. Virtual clinics facilitated access to services, but a preference for in‐person care was highlighted. Conclusion: Our analysis provides rich insights into the significant impacts that the COVID‐19 pandemic has had on the way recurrent miscarriage care is provided and experienced, with important implications for early pregnancy, miscarriage and recurrent miscarriage care. Services have undergone significant changes and, while these may be temporary, how services should be delivered in the future requires consideration, particularly given the deficits in care and care experiences highlighted prepandemic. Patient or Public Contribution: Members of the multidisciplinary RE:CURRENT Project Research Advisory Group (including four parent advocates, two of whom are co‐authors on this article) were actively involved throughout the study, including the generation of topic guides and the refining of themes. [ABSTRACT FROM AUTHOR]

A high prevalence of smoking has been reported among people receiving care within inpatient and forensic mental health services. An Irish inpatient mental health service introduced a "smoke free campus" policy in 2018. Six semi-structured interviews were completed with patients within this setting in 2019. Using thematic analysis, five themes were identified: Experience of stakeholder support, routine, experience of being an inpatient, the meaning of smoking, and the experience and perception of the smoking policy and governing bodies. The findings have implications for staff who work in mental health inpatient settings or who develop policies regarding smoking on hospital sites. [ABSTRACT FROM AUTHOR]

Purpose Return to work is a complex and challenging process which takes various forms in different contexts. The aim of this study is to explore and compare cross-country differences in stakeholders' experiences and views on actors, policies and practices relevant for return to work after long-term sickness absence. The comparative exploration is done in six countries with various legislative backgrounds, welfare and social dialogue systems. Methods Using a purposive sample, six multidisciplinary stakeholders group discussions were conducted in six countries: Belgium, Estonia, Ireland, Italy, Romania and Slovakia. A total of 51 individuals comprised of social partners, policymakers or representatives of public bodies and patient associations participated. An interpretative phenomenological analysis was employed to derive the most important themes in the discussions. Results Five major themes emerged from the group discussions. A graphic model is proposed to emphasize the variety of frameworks and processes across countries. Conclusions The core part of the return to work process is the dynamic relation between legislation, stakeholders and practices, which is influenced by broader national and societal factors. The cross-country variation in legislations, stakeholders and practices can be understood as a continuum, from low to high structuring, development and comprehensiveness. Although social dialogue appears to have a role in return to work process with variation across countries, it is not always on top of the agenda of social partners. [ABSTRACT FROM AUTHOR]

Background: Modifiable factors such as substance use, lack of attendance at antenatal care, overweight or obesity and sleeping position are associated with a higher risk of stillbirth. This qualitative study aimed to explore women's experiences of modifiable factors during pregnancy and their awareness of stillbirth. Methods: Purposive sampling was implemented by hospital staff in a large tertiary maternity hospital in Ireland between November 2020 and March 2021. Women were approached during their stay in the hospital and were invited to participate in a semistructured interview 3–5 months later. Eligible women were primiparous, >18 years of age and had an uncomplicated pregnancy and delivery. Eighteen women who consented to be followed up were interviewed at 3–5 months postpartum. Thematic analysis was used to analyse the data. Results: Four themes were identified: attitudes towards behaviour change, awareness regarding stillbirth and risk factors, the silence around stillbirth and risks, and attitudes towards receiving information about stillbirth. Women spoke about behaviour change in terms of outcomes, and most changes (e.g., ceasing alcohol consumption) were perceived as easy to manage. Awareness of stillbirth was limited among the women interviewed, and the association between risk behaviours and stillbirth was not known by any woman. Results suggest that there is a silence around stillbirth, including in antenatal care, which hinders information provision. However, most women highlighted the value of receiving information and extra education about modifiable risk factors and stillbirth. Conclusion: There is a general lack of understanding of the link between behavioural risk factors and potential pregnancy outcomes such as stillbirth. Providing further information to women about stillbirth and providing additional support with behaviour change might contribute to enhancing preventive efforts. Patient or Public Contribution: Patients were involved in this study by providing their experiences of antenatal care which were used as primary data. [ABSTRACT FROM AUTHOR]

Aim: Nurse leaders influence workplace culture; however, little is known about ethnic cultural influences on nurse leader development. This research aims to identify personal strategies promoting effective leadership by nurse leaders from European small island countries. Design: Descriptive qualitative study. Methods: In 2017, nineteen semi‐structured interviews with nurse leaders from England, Greece, Republic of Ireland and Malta explored leadership journeys, strategies employed to support their growth and development, and how cultural identity played a role. Transcripts were analysed using reflexive thematic analysis. Results: Four main themes and 12 subthemes captured the strategies and approaches of the nurse leaders: (1) Influences, (2) Communication, (3) Process and (4) Relationships. These findings reflect and validate the five transformational leadership practices of the Exemplary Leadership Model. While cultural island identity was discussed, there was a shared cultural identity within the role of "nurse leader" that spanned all islands. Patient or Public Contributions: Nineteen nurse leaders contributed to this study. [ABSTRACT FROM AUTHOR]

This research reports on qualitative interviews with 31 participants who are Irish parents, identify as lesbian, gay, bisexual, queer (LGBQ), and who expressed difficulty in the process of obtaining birth certificates for their children. Our aim was to use personal information management (PIM) and personal digital archiving (PDA) as a lens to explore the invisible work that the Irish government requires of a sexual minority parent group to obtain "equal" treatment in the birth registration and birth certificate process. Our findings suggest overlap with existing information behavior research (IB) that explore invisible information work, IB as a burden, information marginalization, information vulnerability, and information overload, and the everyday in IB. We propose a new framework: personal information burden (PIM‐B) which is characterized by additional PIM activities, negative affect, lack of identity self extension to the personal information, and additional information seeking. We propose that a PIM‐B may be used as an indicator of inequality in future research. [ABSTRACT FROM AUTHOR]

Older men are less likely than women to meet in social groups and have greater difficulty developing social relationships beyond paid work. Yet they are joining Men's Sheds in ever greater numbers, often with the support of women, as wives, partners and daughters. Little is known about women's perspectives of Men's Sheds and what women get from men's participation in Sheds. Informed by social role theory, the present study explored narratives from 26 significant women of male Shedders in Ireland and Australia. The narratives reveal how gender roles and unspoken rules shape people's lives, with three overarching themes emerging. These include (1) older men being vulnerable, with subthemes men's masculine persona, and women's vigilance, (2) gendered spaces for older men, with subthemes companionship: men mending men and healing in the Shed and (3) the spill over effects of Men's Sheds. Retirement, whether planned or prompted by ill‐health, ushers in a new stage of life, requiring new routines and social contacts. For men who lived their life according to gender social roles, which perceive men as masculine, independent and assertive and not inclined to open display of emotion and affection, adjusting to certain aspects of retirement may be difficult, particularly the lack of purposeful activity. Conversely, for women social role identity may be a source of strength for recognising and accepting vulnerability, and for seeking help. Our findings suggest women are central in encouraging older men to join Men's Sheds. In turn, women may experience an alleviation of stress when men participate in Sheds because they are not under the same pressure of their traditional social roles as carers and nurturers. [ABSTRACT FROM AUTHOR]

To address the lack of research on the information needs of spinal cord injured (SCI) patients and family members in acute care, in order to inform the provision of appropriate information supports. Semi-structured interviews were conducted with seven traumatic SCI patients and six family members. Reflexive thematic analysis was used to analyse and interpret the data. Five themes were generated: (1) "You were lying in limbo and you knew nothing" describes how being situated in non-specialist acute care limited participants' access to information; (2) "You'll never walk again" is not enough describes the need for information about the effects of SCI and the management of secondary conditions; (3) "The delivery was awful" demonstrates the importance of information being explained clearly and empathically; (4) "It was going in one ear and out the other" highlights the need for ongoing conversations with healthcare professionals, as retaining information provided in the early stages post-injury is often difficult; and (5) "Hope" not "false hope" discusses the importance of giving patients and family members hope while simultaneously being realistic about potential recovery. SCI patients and family members had significant unmet information needs in acute care. SCI patients and family members had significant unmet information needs while in acute care. Being in non-specialist acute care significantly limited most participants' access to information. During the acute phase of care, most patients and family members would like to know the patient's recovery prognosis, the impact of SCI on the patient's functional independence, how to manage secondary complications, and what to expect in rehabilitation. As patients and family members often had difficulty absorbing information in the early stages post-injury, information should be continuously repeated, reinforced and clarified. HCPs should promote realistic hope for SCI patients and family members even in the absence of neurological recovery, by focusing on what the patient is still capable of while being honest about their prognosis. [ABSTRACT FROM AUTHOR]

Adult safeguarding is characterised by competing debates related to core concepts including policy and legislative frameworks. In some countries, to reconcile the dualism of agency and structure, conflict and ambiguity are legislated for through the introduction of adult safeguarding legislation (ASL). This study set out to explore how the absence of ASL in the Irish context impacts safeguarding processes. A qualitative approach involving semi-structured interviews (N  = 14) and focus groups (N  = 2) with social workers, explored variables from adult safeguarding cases that contribute to positive outcomes in the absence of ASL, and where legislation could have helped, using a critical incident technique. Four themes emerged: practices and processes; coercive control and undue influence; information sharing and multiagency cooperation; and inability to access services. Whilst in the majority of cases existing policy and legislation achieved successful outcomes, legislative powers such as a duty to cooperate, to share information and powers of entry were deemed necessary. This study suggests limits to safeguards and protections within current policy. It illustrates the dualism that often exists between the agency of social workers to act to safeguard adults at risk and the structural rules, relationships and resources that can restrict the context of action in absence of legislation. [ABSTRACT FROM AUTHOR]

Aim: To explore the experience of people with idiopathic pulmonary fibrosis living through the COVID‐19 pandemic. Design A qualitative descriptive design using semi‐structured interviews. Method: Purposive sampling was employed to recruit 13 participants with idiopathic pulmonary fibrosis attending the respiratory department of a large urban teaching hospital in Limerick, Ireland. Data were collected between January 2021 and February 2021 through semi‐structured interviews, using an online platform. Reflective thematic analysis was used for data analysis. Results: Four key themes were identified from participant's experience of living through the COVID‐19 pandemic: (1) fear of contracting COVID‐19 disease, (2) living with reduced social interaction, (3) the adjustment in the relationship with healthcare professionals (HCP) and (4) navigating an altered landscape. Conclusion: Healthcare professionals have a key role in protecting the physical and psychological health of the person with idiopathic pulmonary fibrosis during this time and into the future. Through being cognisant of the additional supportive care needs of people with idiopathic pulmonary fibrosis, HCP can focus on developing targeted interventions aimed to enhance care provision. Impact This study considers people with idiopathic pulmonary fibrosis as a particularly vulnerable group whose experiences of living through the COVID‐19 pandemic warrant specific attention. Participants felt compelled to self‐isolate due to fear and anxiety of contracting COVID‐19 disease. Participants reported increased social isolation with some experiencing anger and resentment at loss of precious time with loved ones. Participants felt an increased responsibility for self‐monitoring their condition and had concerns about differentiating symptoms of COVID‐19 disease from an exacerbation. A variety of strategies that helped them cope through the pandemic were identified and also the important role these played. The results from this study can be used to inform HCP' understanding of challenges experienced by people with idiopathic pulmonary fibrosis during enforced restrictions related to the COVID‐19 pandemic. [ABSTRACT FROM AUTHOR]

This qualitative study explored healthcare professionals' views in relation to the potential expansion of cardiac rehabilitation services to include stroke patients, thereby becoming a cardiovascular rehabilitation model. 23 semi-structured interviews were completed with hospital and community-based stroke and cardiac rehabilitation professionals in Switzerland (n = 7) and Ireland (n = 19). The sample comprised physiotherapists, occupational therapists, speech and language therapists, stroke physicians, cardiologists, psychologists, dieticians and nurses. Interviews were audio-recorded and the transcripts were analysed in NVivo using inductive Thematic Analysis. Barriers and facilitators to cardiovascular rehabilitation were captured under four broad themes; (i) Cardiac rehabilitation as "low-hanging fruit," (ii) Cognitive impairment ("the elephant in the room"), (iii) Adapted cardiac rehabilitation for mild stroke, and (iv) Resistance to change. Hybrid cardiac rehabilitation programmes could be tailored to deliver stroke-specific education, exercises and multidisciplinary expertise. Post-stroke cognitive impairment was identified as a key barrier to participation in cardiac rehabilitation. A cognitive rehabilitation intervention could potentially be delivered as part of cardiac rehabilitation, to address the cognitive needs of stroke and cardiac patients. The cardiac rehabilitation model has the potential to be expanded to include mild stroke patients given the commonality of secondary prevention needs. Up to half of stroke survivors are affected by post-stroke cognitive impairment, consequently mild stroke patients may not be such an "easy fit" for cardiac rehabilitation. A cardiovascular programme which includes common rehabilitation modules, in addition to stroke- and cardiac-specific content is recommended. A cognitive rehabilitation module could potentially be added as part of the cardiac rehabilitation programme to address the cognitive needs of stroke and cardiac patients. [ABSTRACT FROM AUTHOR]

The Coronavirus disease 2019 (COVID‐19) pandemic public health and social protective measures imposed globally resulted in partial or full closure of key services and supports for services and supports for people with a disability, chronic illness or age‐related dependency. This caused huge disruption to care provision and family carers were relied upon to assume this care at home. Many family carers, including those in employment, found themselves navigating additional care responsibilities without 'usual levels' of support from family, friends, work, school, day care services, homecare and community services. The purpose of this study was to examine the impact of the COVID‐19 pandemic on family carers, their employment and care‐giving responsibilities, through the lens of the Conservation of Resources (COR) theory (Hobfoll, 1989). Adopting a qualitative research approach, 16 family carers (14 females, 2 males) who were in employment prior to the onset of or during the pandemic, participated in an in‐depth, semi‐structured telephone or online video interview between June and September 2020. Interviews lasted between 45 and 100 min, were audio‐recorded and transcribed verbatim. A thematic analysis of the interview data identified four main themes: colliding worlds; navigating unchartered waters alone; opportunity despite adversity and the relentless unknowing. Findings indicate that the onset of the pandemic resulted in the sudden loss of valued resources, which disrupted routines and caused care and work life domains to become intrinsically intertwined. Consistent with the main principles of the COR theory, adapting and transitioning to different ways of working and caring with depleted resources and supports, generated considerable stress for family carers and impacted their well‐being. The implications for employers, healthcare providers, policy makers and other key stakeholders are considered, to enable family carers to successfully reconcile work with care and protect their well‐being, as the pandemic continues to unfold and in the event of future societal crises. [ABSTRACT FROM AUTHOR]

This qualitative study explored the digital communication skills assistance provided by young adults in the age range 18 to 25 years to older family members during the period of the first COVID-19 pandemic lockdown in Ireland in 2020. Data were collected from a sample of young adults (n = 248) using an online survey instrument to explore their learnings from the intergenerational exchange. The study found that young adults who assisted their older family members considered the learning experience to be successful and were rewarded with reciprocal benefits. This study contributes to the field of intergenerational research by exploring the perspectives of young adults involved in an intergenerational exchange to support the digital skills of their older adult family members in Ireland. [ABSTRACT FROM AUTHOR]