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The article focuses on a study in Scotland, United Kingdom of prioritizing protection of children from secondhand smoke exposure (SHSE) in a private space where smoke-free public places are enforced. It discusses the difficulty of political acceptability in enforcing the issue and the intervention over parental autonomy to smoke in their own home. The article also reports on the findings based on the study used called Reducing Families' Exposure to Secondhand Smoke (REFRESH) project.

Objective: To determine impact of undertaking an international educational program during a nurse's or midwife's pre-registration program on subsequent practice, focusing on how nurses and midwives were transformed personally through participation in such programs. Background: Participation in international educational programs has been reported to enhance nursing and midwifery students' personal and professional development, however long-term impacts remain unclear. This paper presents findings drawn from a larger grounded theory study. Study design and Methods: Charmaz's grounded theory methodology was used to elicit experiences from 13 general nurses, two mental health nurses, three midwives and four dual qualified nurse/midwives across eight different countries. Data analysis led to the creation of three categories, with this paper reporting on the category of Developing as a Person. Findings: Participation in international educational programs can be transformative for nurses and midwives with long-lasting impacts, contributing positively to their personal growth and development. Discussion: The study findings underscore significant long-term impacts of international educational programs for nurses and midwives. These outcomes highlight the importance of incorporating international experiences into healthcare education. Conclusion: By providing opportunities for healthcare professionals to engage with diverse settings and populations, organisations and educational institutions can foster the development of well-rounded and globally competent practitioners. Implications for research, policy, and practice: The study's findings hold significant implications for research, policy, and practice in healthcare education. To deepen our understandings, additional longitudinal research across diverse countries is warranted. Policymakers have an opportunity to acknowledge the positive impact of these programs on the personal growth and development of nurses and midwives, potentially leading to the integration of global competency requirements into licensure programs. In order to provide comprehensive education, educational institutions should consider the inclusion of study abroad opportunities, cultural exchanges, and global clinical placements within nursing and midwifery curricula. What is already known about the topic? • International educational programs are widely used as a way of developing nursing and midwifery students' cultural understandings. • Previous studies have reported on short-term impacts of international educational programs. What this paper adds: • Long-term impacts of participation in an international educational program on nurses and midwives are described. • Personal development and subsequent transformations occur for nurses and midwives as a result of participation in international educational programs. [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]

Islands are significantly on the agenda in Scotland. Media accounts – news, features, and other creative narratives – textually frame the representational terrains of island policy, agency and community. Such mediatization informs and responds to certain ideas and discourses of our island geographies. It typically includes what could be considered good islandness: that is, islands as good lifestyle havens, sites of social resilience and adaptive social renewal. During the COVID-19 pandemic, certain spaces and geographies were notably re-evaluated. Sites of 'isolation', 'remoteness' and places considered 'far from' occupied a heightened position of desirability and potential refuge. A purposive sample of stories and features is presented here to capture case exemplars of how Scotland's island space and place geographies were variously textually framed by media news across the initial lockdown and subsequent significant travel restriction phases (March 2020 to October 2020). The discussion explores how a short-view media framing of Scotland's island spaces specifically during the COVID-19 pandemic spoke to aspects of islandness as refuge and as resilience. The paper offers a longer-view perspective whereby the complexities and complicities of media framing of Scottish rural and island spaces as resilient is considered more broadly. [ABSTRACT FROM AUTHOR]

Purpose The purpose of this paper is to understand the perspectives of frontline health and social care professionals in relation to delays in discharge from community hospitals.Design/methodology/approach A qualitative approach was taken, using semi-structured interviews and non-participant observation, within three community hospitals in NHS Scotland. In total, 12 frontline health and social care professionals were interviewed and observation of the multi-disciplinary team meeting was completed. Thematic content analysis was used to analyse the data produced.Findings The key findings were delayed discharge as an issue, lack of resources and capacity, difficulties in the relationship between acute and community health staff, silo working between health and social care, conflicting pressures on staff, and influence over services and external factors. There were perceived different ways of working within acute health, community health and social work, which were suggested to reduce efficiency, cause tension and ultimately result in delays. All professionals perceived an inability to influence any of the factors causing delays in discharge.Practical implications The internal issues regarding inter-professional working could potentially damage integration, indicating a need to teach collaborative team skills as well as quality improvement training to support staff to challenge and change current ways of working.Originality/value The paper contributes to the evidence base of community hospitals. There are implications for both health and social care policy. [ABSTRACT FROM AUTHOR]

Creating a learning health system could help reduce variations in quality of care. Success is dependent on timely access to health data. To explore the barriers and facilitators to timely access to patients’ data, we conducted in-depth semi-structured interviews with 37 purposively sampled participants from government, the NHS and academia across Scotland. Interviews were analysed using the framework approach. Participants were of the view that Scotland could play a leading role in the exploitation of routine data to drive forward service improvements, but highlighted major impediments: (i) persistence of paper-based records and a variety of information systems; (ii) the need for a proportionate approach to managing information governance; and (iii) the need for support structures to facilitate accrual, processing, linking, analysis and timely use and reuse of data for patient benefit. There is a pressing need to digitise and integrate existing health information infrastructures, guided by a nationwide proportionate information governance approach and the need to enhance technological and human capabilities to support these efforts. [ABSTRACT FROM AUTHOR]

Citizenship is gaining currency in health and social care internationally as a way of making sense of the lived experiences of people with major life disruptions who face exclusion, marginalisation and discrimination, but the concept is often contested, poorly defined and understood. This paper charts the development of an empirical model of citizenship within Scotland, UK. A mixed‐method, community‐based participatory research approach using 10 focus groups (n = 77), concept‐mapping exercises (n = 45) and statement clarity and relevant ratings (n = 242) was used to develop a model of citizenship that is grounded in the lived experience of participants, which is absent from current conceptualisations of citizenship. Multidimensional scaling and hierarchical cluster analysis revealed five core domains emerging from our work: 'building relationships', 'autonomy and acceptance', 'access to services and supports', 'shared values and social roles' and 'civic rights and responsibilities' representing the personal meanings of citizenship for participants. We argue that the value of this model is that it is draws upon the personal understandings and experiences of participants who emphasised the 'banal ordinariness' of its core elements. We suggest that the model makes an original contribution by clearly illustrating the practical applicability of citizenship as a concept; thus, enhancing existing theories of citizenship. Our model highlights the interplay between the relational and structural aspects of citizenship and acknowledges the barriers that marginalised groups face in claiming their citizenship rights. It offers a call to action for policy makers and practitioners to set goals that contribute to the social inclusion of those who have experienced major life disruptions. [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]

Accessible summary: What is known on the subject?: Nurses in mental health inpatient settings use a range of methods to try and help service users who self‐harmHarm‐reduction approaches are intended to help service users reduce the impact of their self‐harm rather than simply to prevent them self‐harmingHarm‐reduction techniques might be helpful for people who cut themselves because there are some clear ways harm can be minimized such as providing advice about cuttingNo one has previously tried to measure whether harm‐reduction techniques are more or less acceptable to mental health practitioners and service users than traditional methods. What the paper adds to existing knowledge?: The paper describes the development of the Attitudes to Self‐cutting Management scale. It met the criteria required of a good measurement tool.Each method of managing self‐cutting has a unique acceptability profileHarm‐reduction methods like advising on wound care and providing a first aid kit are endorsed by nurses and former service usersNurses providing sterile razors or remaining present during self‐cutting attract more divergent opinions but are preferred to seclusion and restraint. What are the implications for practice?: Nurses should talk through the approaches to management with service users and agree which techniques are preferred. Introduction: Harm‐reduction approaches for self‐harm in mental health settings have been under‐researched. Aim: To develop a measure of the acceptability of management approaches for self‐cutting in mental health inpatient settings. Methods: Stage one: scale items were generated from relevant literature and staff/service user consultation. Stage two: A cross‐sectional survey and statistical methods from classical test theory informed scale development. Results/Findings: At stage one, N = 27 staff and service users participated. At stage two, N = 215 people (n = 175 current mental health practitioners and n = 40 people with experience of self‐cutting as a UK mental health inpatient) completed surveys. Principal components analysis revealed a simple factor structure such that each method had a unique acceptability profile. Reliability, construct validity and internal consistency were acceptable. The harm‐reduction approaches "advising on wound care" and "providing a first aid kit" were broadly endorsed; "providing sterile razors" and "maintaining a supportive nursing presence during cutting" were less acceptable but more so than seclusion and restraint. Discussion: The Attitudes to Self‐cutting Management scale is a reliable and valid measure that could inform service design and development. Implications for practice: Nurses should discuss different options for management of self‐cutting with service users. Harm‐reduction approaches may be more acceptable than coercive measures. [ABSTRACT FROM AUTHOR]

Background Children's second-hand smoke (SHS) exposure in the home is highest in socio-economically disadvantaged areas. Personalized household air-quality measurements can promote changes in smoking that reduce SHS exposure. The 'First Steps 2 Smoke-free' (FS2SF) intervention is the first to trial this approach delivered as part of health professionals' routine work. This paper reports the findings of qualitative interviews with participants that explored their experiences of the intervention and why outcomes varied. Methods 120 women were recruited from the NHS First Steps Programme, which supports disadvantaged mothers. They received either personalized feedback on their home air quality and advice on reducing SHS or standard SHS advice. Qualitative interviews with 15 mothers were analyzed thematically using the Capability, Opportunity, Motivation, Behaviour (COM-B) model. Results The intervention increased women's capability to change home-smoking behaviour, through increasing awareness and salience of SHS risks to their children, and motivation to act. However, taking effective action was constrained by their limited social and environmental opportunities, including others' smoking in the home. Conclusions The FS2SF intervention was ineffective as it was unable to fully address the precarious, complex life circumstances that make creating a smoke-free home particularly difficult for women experiencing intersecting dimensions of disadvantage. [ABSTRACT FROM AUTHOR]

Aim and objective This paper aims to explore health visitors' accounts of assessment and judgement in health visiting in the context of policy change and an increased focus on risk, which is reshaping practice. Background Assessment and judgement underpin the targeting of support in health visiting practice. Existing literature suggests that needs assessment in health visiting is a complex process which draws on different types of knowledge. Methods The study, upon which this paper draws, was a qualitative exploration which aimed to explore the impact of policy change on health visiting practice and on families. The accounts of sixteen health visitors, who took part in semi-structured interviews, are reported. The interview data were analysed using thematic and narrative techniques. Results Health visitors' accounts of their observations of families' homes, relationships and practices, such as their references to 'dirt', harmful practices and appropriateness, illustrate ways in which assessment and judgement in health visiting practice are shaped by a discourse of risk and notions of ideal parenting. Health visitors problematise this discourse in relation to the potential stigmatising impacts for families. Although health visitors indicate ambivalence towards the use of assessment tools, the findings indicate that they feel the tools provide them with a safety-net at a time when their practice is being reshaped by a discourse of risk. Conclusion This paper identifies that assessment and judgement in contemporary health visiting are shaped by a discourse of risk. A discussion of the role of 'emotion in use' and collective emotions provides an appropriate theoretical lens to consider the impact that risk discourse has on health visiting practice and on families. Relevance to clinical practice This study highlights the need for assessment and judgement in health visiting practice to be highly reflexive, to support families in an era of risk. [ABSTRACT FROM AUTHOR]

Service users were interviewed as part of a multi-method evaluation of an alcohol and drug social work service in Scotland. This paper explores service user interviews that were conducted in the evaluation, addressing the following questions: What did the service users feel about the service itself? Leading on from this, what did they see as helpful in facilitating their recovery in general? The research will be contextualised in Scotland’s culture of problematic drug and alcohol use, Scottish drug and alcohol policy and the emerging recovery-orientated approach. The methodology of the evaluation will be explained and findings from the service user interviews will be outlined under the headings: therapeutic relationships, outreach, timeframe, and holistic approach and joint working. The paper demonstrates the importance of service user accounts not only for providing general feedback on social work services, but also for giving specific insight into what is helpful for individuals seeking to recover from substance use problems. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this paper is to report on the implementation of a physical activity (PA) scheme - Let's Motivate (LM) - within private care homes (CHs) in Dumfries and Galloway (D&G), Scotland; aiming to provide an insight into the different factors which might contribute to its success and further sustainability. Design/methodology/approach: A qualitative study is described in which one-to-one semi-structured interviews were carried out with eight key staff involved in implementing the project within two purposively sampled CHs; in order to explore their views and experiences of implementation. Findings: The paper provides an insight into the different factors which stand to both promote and impede the successful implementation of LM, within the two CHs involved. Originality/value: This paper explores a new and innovative PA initiative in CHs in D&G, Scotland. Studies exploring the factors which can both promote and impede implementation are important as they can help to usefully inform the implementation and sustainability of initiatives. [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]

Aim To review strategies for successful recruitment in small-scale, qualitative research in primary care by exploring those used in a variety of settings and providing a reflective analysis of the strategies used in one such study. Background Recruitment of participants in small-scale, qualitative research in primary care is problematic. Researchers need to be more aware of the issues involved, but there is little practical guidance available to help them devise efficient strategies for maximising recruitment. Data sources This paper draws on a study conducted in the Highlands of Scotland examining the emotional wellbeing of pregnant and non-pregnant women. This was a qualitative study using diaries and interviews over a period of nine months. Ten women were recruited over a period of more than two years. Review methods The author reviews the strategies for successful recruitment based on both a review of the available literature as well as the experience of one study. Discussion Recruitment of subjects to a study is one of the major elements of a research proposal and requires significant effort, yet there is little to guide researchers through this difficult process. The challenge of recruitment is seldom debated and studies rarely report problems encountered or outline approaches that proved particularly successful. The importance of successful recruitment is discussed and the arguably typical recruitment difficulties encountered by researchers conducting a study in the Highlands of Scotland are outlined. The elements that comprised successful recruitment in this and other studies are appraised. Conclusion Although focused specifically on recruitment in small-scale, qualitative studies in primary care, this paper raises broader issues about the recruitment of participants in all types of research. Recruitment has implications for the trustworthiness and dependability of the data and hence the findings of research. Despite this, there remains a lack of evidence about what enhances research recruitment, leaving researchers to rely on guesswork and anecdotes. In a climate of evidence-based practice, researchers should be encouraged to include a formal evaluation of recruitment strategies in their studies and to report their findings. Implications for practice/research As recruitment has implications for the trustworthiness and dependability of research, researchers need to consider a wide range of recruitment strategies and include a formal evaluation of their recruitment strategies when reporting on their research. [ABSTRACT FROM AUTHOR]

ABSTRACT This paper draws on the findings of a research study that examined the factors that influence local decision-making in cases where a child or young person is being considered by residential workers, social workers and senior managers for placement in a secure unit. After outlining the research problem and case study approach taken, the paper focuses on explicating the findings of the study that relate to the impact of group membership, goals, roles and norms on group performance in such cases. The paper illustrates how attending to these four areas, and the way in which power relations impact on them, may help those developing and managing groups to improve decision-making practice. [ABSTRACT FROM AUTHOR]

Aims and objectives This paper aims to explore student nurses' experiences of bioscience learning, teaching and application within the practice setting. It draws upon the social learning theory of communities of practice to consider the issues raised. Background The teaching of bioscience within many nursing curricula has shifted from traditional to more integrated approaches. Student nurses recognise bioscience as a valuable component of their studies, but many find it challenging. The focus of previous research in this area has often focussed on bioscience learning in theoretical rather than practice settings. Design A phenomenological study. Methods Data were collected via focus group or interview with a total of seven students across two campuses in a Scottish university. Participants were offered the opportunity to share their experiences at both the end of year one and year two of their studies. A thematic analysis was undertaken independently then jointly by the authors. Results The findings suggest that although participants recognise the value of bioscience within practice settings, they found that opportunities for learning were often limited. Bioscience-related learning, teaching and application was perceived to have been given less legitimacy by the practice setting than other aspects of placement activity. To enhance bioscience approaches participants expressed a desire for more structured and integrated approaches within both practice and university along with further peer learning opportunities. Conclusions Students recognise that bioscience knowledge is important in relation to the provision of safe and effective care. They request greater structure and consistency in relation to the learning, teaching and application of this topic during their placements. Relevance to clinical practice Those with a stake in educating nurses within clinical settings may find the views of student nurses on the topic of bioscience learning useful when planning and facilitating placement experiences. [ABSTRACT FROM AUTHOR]

The paper explores the views of social work practitioners regarding their ability to explore the emotional content of their practice in formalandin formal forums. The responses from a questionnaire- and interview-based study of a Scottish local authority reveal that supervision is subject to issues of ‘safety', permissions, manageria list approaches and individual relationships. Informal support from peers was valued due to its unrecorded, on-demand and supportive nature. The findings have implications for seeking improvements in supervision as suggested by the Social Work Task Force,and for securing of the validity and place of emotions in practice. [ABSTRACT FROM AUTHOR]

Background As quality improvement (QI) programmes have become progressively larger scale, the risks of implementation having unintended consequences are increasingly recognised. More routine use of balancing measures to monitor unintended consequences has been proposed to evaluate overall effectiveness, but in practice published improvement interventions hardly ever report identification or measurement of consequences other than intended goals of improvement. Methods We conducted 15 semistructured interviews and two focus groups with 24 improvement experts to explore the current understanding of balancing measures in QI and inform a more balanced accounting of the overall impact of improvement interventions. Data were analysed iteratively using the framework approach. Results Participants described the consequences of improvement in terms of desirability/undesirability and the extent to which they were expected/ unexpected when planning improvement. Four types of consequences were defined: expected desirable consequences (goals); expected undesirable consequences (trade-offs); unexpected undesirable consequences (unpleasant surprises); and unexpected desirable consequences (pleasant surprises). Unexpected consequences were considered important but rarely measured in existing programmes, and an improvement pause to take stock after implementation would allow these to be more actively identified and managed. A balanced accounting of all consequences of improvement interventions can facilitate staff engagement and reduce resistance to change, but has to be offset against the cost of additional data collection. Conclusion Improvement measurement is usually focused on measuring intended goals, with minimal use of balancing measures which when used, typically monitor trade-offs expected before implementation. This paper proposes that improvers and leaders should seek a balanced accounting of all consequences of improvement across the life of an improvement programme, including deliberately pausing after implementation to identify and quantitatively or qualitatively evaluate any pleasant or unpleasant surprises. [ABSTRACT FROM AUTHOR]

Introduction: In the United Kingdom, fractures of the cervical dens process in older and/or frail patients are usually managed nonsurgically in a hard collar. However, hard collars can lead to complications and this management approach is now being questioned, with growing interest in maximising patients' short‐term quality‐of‐life. It is vital that patients' perspectives are considered; yet, there is a dearth of literature examining the aspect. To help inform wider decision‐making about use of collar/no collar management of dens fractures in older/frail people, we explored older/frail people's experience of the two management approaches and how they affected their perceived quality‐of‐life. Methods: We interviewed older and/or frail adults with a recent dens fracture (aged ≥65 years or with a clinical frailty score of ≥5) or their caregiver. Participants were recruited from both arms of a clinical trial comparing management using a hard collar for 12 weeks (SM) with early removal of the collar (ERC) and were interviewed following randomisation and again, 12–16 weeks later. Data were analysed using a framework approach. Results: Both participant groups (SM/ERC) reported substantial, negative quality‐of‐life (QoL) experiences, with the fall itself and lack of access to care services and information being frequent major contributory factors. Many negative experiences cut across both participant groups, including pain, fatigue, diminished autonomy and reduced involvement in personally meaningful activities. However, we identified some subtle, yet discernible, ways in which using SM/ERC reinforced or alleviated (negative) QoL impacts, with the perceived benefits/burdens to using SM/ERC varying between different individuals. Conclusion: Study findings can be used to support informed decision‐making about SM/ERC management of dens fractures in older/frail patients. Patient or Public Contribution: Public and patient involvement contributors were involved in the study design, development of interview topic guides and interpretation of study findings. [ABSTRACT FROM AUTHOR]

By providing a place in which children can be accessed, the school has long been a site for population-level health initiatives. Recent policy shifts towards health-promoting schools have however re-cast the school from passive host to active collaborator in public health. This paper examines secondary school teachers' views of their roles as partners in Scotland's human papilloma virus vaccination programme. Focus groups were held in seven schools across Scotland. Confusion was evident in relation to this role, with competing understandings of young women's sexuality, concerns about parental perceptions and uncertainty about professional responsibilities. Many teachers sought to distance themselves from the vaccination programme. Evidence was found of a ‘sedimentation of discourses’, as mass models of state-sanctioned health intervention persist alongside contemporary discourses of individual choice. [ABSTRACT FROM PUBLISHER]

Managing risk is a key component of mental health social work practice, with the literature detailing two unique approaches to risk management — the dominant risk minimisation strategies and the less favoured risk-taking approaches. Due to a lack of research it is unclear, however, whether this is a practice reality, how professionals reconcile the tension between the two approaches and practice dilemmas, and the impact of wider factors perceived to influence these decisions. This paper aims to address these questions by drawing on 2010 research that undertook qualitative semi-structured interviews with seven Mental Health Officers in a Scottish local authority. Whilst the study found risk was generally constructed as relating to harm and danger, in practice a more measured approach to risk management was identified, with both approaches being employed, and a new acceptance of risk as potentially positive by organisations and practitioners was recognised. Participants illustrated how decisions are reached, without feeling inhibited by the ‘blame culture’, but clarified that this involved dilemmas and was a fraught area of practice. The paper concludes that more scope for positive risk-taking is desirable and requires the support of the policy context, legislation and organisations. [ABSTRACT FROM AUTHOR]

This paper identifies key themes from research into programme fidelity of sexual abuse prevention programmes. It presents a detailed analysis of programme fidelity within a study of the Tweenees school-based abuse prevention programme (Barron and Topping, ). The paper reports how programme fidelity was addressed in a programme delivered to survivors of child sexual abuse by experienced survivor organisation workers. There was also study of programme fidelity in the delivery of the programme to grade-seven pupils through co-working between survivor organisation workers and teachers. Video was taken of all four sessions delivered to the survivors' group. To begin to explore programme fidelity when lessons were co-delivered by survivor organisation workers and a teacher, the first session of a grade-seven class was videoed. Survivor organisation workers achieved high levels of programme fidelity characterised by facilitative communicative behaviours (e.g. affirming responses, seeking clarification, checking understanding and summarising). The grade-seven teacher's communication was characterised by a behaviour management focus. Video analysis of interactions was a useful measure for programme fidelity and analysing appropriate communication underpinning delivery of the programme. Recommendations for future programme fidelity measures are provided for researchers and practitioners in the field. Copyright © 2010 John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]

Background:Deaths associated with alcohol and/or drugs belong to a category of ‘special’ deaths due to three characteristics: traumatic circumstances of the death, stigma directed to both the bereaved and the deceased, and resulting disenfranchised grief experienced by the bereaved. These factors can impede those who are bereaved in this way from both grieving and accessing support. In response to a lack of research in this area this paper reports on an interview study that has aimed to better understand the experiences and needs of this neglected group of bereaved people. Method:Interviews with 106 adults (parents, children, spouses, siblings, nieces and friends) bereaved through substance use in Scotland and England. Results:Five themes describe interviewee experiences: possibility of death, official processes, stigma, grief and support. These findings suggest what is dominant or unique in this group of bereaved people; namely, that living with substance use (including anticipatory grief), experiencing the subsequent death (often traumatic and stigmatised) and the responses of professionals and others (more likely negative than positive) can disenfranchise grief and negatively impact bereavement and seeking support. Conclusions:This article describes a large and unique sample, the largest in the world to be recruited from this population. Our study raises awareness of a hitherto largely ignored and marginalised group of bereaved people, highlighting what might be particular to their bereavement experience and how this may differ from other bereavements, thereby providing an evidence base for improving the availability, level and quality of support. [ABSTRACT FROM AUTHOR]

Background and aims Regulation of electronic cigarettes has moved to the top of the addiction policy agenda, as demonstrated by the recent focus across the United Kingdom on introducing age-of-sale restrictions. However, the views of those affected by such regulation remain largely unexplored. This paper presents the first detailed qualitative exploration of adolescents' perceptions of existing, and opinions about potential e-cigarette regulation. Methods Sixteen focus groups, including a total of 83 teenagers between the ages of 14 and 17 years, were conducted in deprived, mixed and affluent urban areas in Scotland and England between November 2014 and February 2015. Transcripts were imported into Nivivo 10, coded thematically and analysed. Results Participants critically considered existing evidence and competing interests in regulatory debates and demonstrated sophisticated understanding of the advantages and disadvantages of regulation. They overwhelmingly supported strong e-cigarette regulation and endorsed restrictions on sales to minors, marketing and e-cigarette use in public places. Concern about potential health harms of e-cigarette use and marketing increasing the acceptability of vaping and smoking led these adolescents to support regulation. Conclusions In focus group discussions, a sample of UK adolescents exposed to particular communications about e-cigarettes supported strict regulation of e-cigarettes, including banning sales to minors and use in indoor public areas. [ABSTRACT FROM AUTHOR]

Purpose: Despite the long-established importance of infant mental health, internationally this has not been mirrored in the provision of infant mental health services. Within Scotland in the UK, there has been significant recent government investment in developing infant mental health services. However, existing research identifies a massive knowledge and skills gap that could create barriers to implementation. This study aims to use qualitative methods to consider the views of relevant professional stakeholders on education and training within infant mental health. Design/methodology/approach: The authors completed semi-structured interviews with 14 professional stakeholders working in a health board in Scotland. This study used purposive sampling to include a broad range of professionals across health and social care services and analysed the resulting data using Braun and Clarke's (2006) methodology. This study adopted a reflexive stance throughout, including the research team interviewing each other as part of the process. Findings: Within the theme of education and training, we identified four sub-themes. These included roles for public health and societal education, training for parents, training for professionals and increasing professionals' experience of infant mental health. Originality/value: The issues identified are relevant in any area of the UK or internationally in considering the role of education and training in developing and maintaining new infant mental health services. Further research with families and with wider groups of professional stakeholders would be of further benefit. [ABSTRACT FROM AUTHOR]

This paper explores the extent to which students on a vocational postgraduate programme identify with characteristics and competences that define a professional career guidance and counselling practitioner. Literature suggests professionalism in careers work is characterised by a focus on the needs of the client with the practitioner in a facilitative role. Competences are often couched in developmental terms, with practitioners moving from inexperienced to experienced. Students identified the most valued characteristics as adherence to professional values and ethical standards with an emphasis on person-centred practice. They recognised that competence was a developmental process, characterising themselves as at an early stage on completion of their course. Supporting the client took precedence over issues such as advocating for the profession, supporting employers and social responsibility. Generally, students saw completing a programme of study either as a beginning to a process of development of professionalism or as part of their professional development. [ABSTRACT FROM AUTHOR]

Rationale, aims and objectives Internationally, health technology assessments ( HTAs) are ubiquitous drivers to health policy. Within Scotland, the Scottish Medicines Consortium undertakes the medicine review process. Input from clinical experts, involved in frontline care, is an integral component of the assessment process. This paper explores the relationship between the clinical experts and the HTA agency within Scotland to better understand what motivates expert clinicians to devote their time to the medicine review process with no remuneration. Methods Twenty-seven clinical experts from 16 different clinical specialties took part in one-to-one interviews at their place of work between October 2011 and March 2012. Data analysis was inductive and comprised the organization of data into a framework and a subsequent thematic analysis. Results Three distinct themes were identified: (1) recruitment, which identified two types of explanations for the experts' appointment: external justification (nominated by another) and internal justification (being recognized as an expert); (2) flexibility of the procedures, with experts able to determine their own response style and negotiate timelines; (3) health care systems, demonstrating that their affiliation to the health system underpinned the relationship and their motivation to be clinical experts. Conclusions The findings of this study provide insight into the elements important to clinicians who voluntarily contribute to HTA processes. Examination of these elements in the context of the organizational citizenship behavior literature provides a foundation on which to improve understanding of this relationship and sustain and improve clinical expert participation in an increasingly intensified clinical environment and within cash-limited HTA systems. [ABSTRACT FROM AUTHOR]

Purpose – Previously, diversion from the criminal justice system for people with learning disability (LD) and serious forensic needs in Scotland meant hospitalisation. More recently new legislation has meant that community-based rehabilitation is possible for this group. The purpose of this paper is to qualitatively explore the views of people with LD subject to these legal orders. This is both a chance to work in partnership to improve services and also to make the voices of this potentially vulnerable group heard. Design/methodology/approach – Semi-structured interviews were conducted with ten participants subject to a community-based order. All participants were male. Ages, index behaviour, and time spent on order varied. The data was transcribed and analysed using interpretative phenomenological analysis. Findings – The main themes which emerged from the data were a taste of freedom, not being in control, getting control back, loneliness, and feeling like a service user. Participants described positives about community-based rehabilitation but also a number of negatives. Practical implications – Participant accounts suggest that the current community rehabilitation model has some shortcomings which need to be addressed. Suggestions are made for improvements to the current model relating to: achieving clarity over the role of support staff and pathways out of the system; increasing opportunities for service users to voice concerns; empowering staff teams via extensive training and supervision; and directly addressing internalised stigma to promote community integration. Originality/value – This is the first piece of work evaluating compulsory community forensic care for people with LD from the perspective of service users. It highlights difficulties with the system which could lead to helpful ways to evolve this model. [ABSTRACT FROM AUTHOR]

Purpose -- The purpose of this paper is to explore the roles, motivations and experiences of volunteers who work to support asylum seekers (AS), refugees and refused asylum seekers (RAS) in Glasgow. Design/methodology/approach -- Qualitative semi-structured interviews were conducted with eight volunteer participants who worked to support migrants in Glasgow, two of which were AS. Purposeful and theoretical sampling was used and data were analysed using the framework approach. Findings -- The roles of participants were broad included providing "destitution relief" (providing shelter and food for destitute asylum seekers (DAS)) and acting as advocates for AS to help them access services. The most common reported motivation of participants was a humanitarian interest in the situation of migrants in Glasgow and the UK. In contrast, participants who were AS, volunteered because they could not work and it helped to improve their mental well-being. The complexity of the circumstances of some migrants was seen as the most challenging aspect of volunteering. Participants were involved first hand in the difficulties migrants had in accessing health and social services. Research limitations/implications -- This exploratory study confirmed the vital role voluntary organisations have in supporting migrants in Glasgow. It highlights the essential role volunteers have in supporting DAS and sets out some volunteer support needs. This has important implications for this context in Glasgow. Further work in other dispersal settings in the UK would help elucidate if this is replicable across the UK. Practical implications -- Volunteer's role as lay advocates should be recognised and then supported by statutory services such as primary care and social services. Social implications -- The overall view was that the system of claiming asylum poses numerous challenges for both migrants and the volunteers working to support them. AS can become completely reliant on the volunteers and the services they provide. Originality/value -- This is the first research study examining the roles, motivations and experiences of volunteers who support migrants. [ABSTRACT FROM AUTHOR]

Background: Paediatric palliative medicine (PPM) is a holistic approach to care for children and their families. Services are growing and developing worldwide but significant disparity in service provision remains. The Paediatric Supportive and Palliative Care Team (PSPCT) at the Royal Hospital for Children in Glasgow was established in 2019, but there is still no clear integrated role within the paediatric intensive care unit (PICU) at present. Through analysing the attitudes, meaning, knowledge and understanding of PPM in the PICU environment, we hoped to explore the experiences of those providing paediatric palliative care and to identify any barriers to or facilitators of integrated working to gain a better understanding of providing this care. Methods: This qualitative study used a survey composed of five open-ended and five closed questions. Sixteen out of a possible thirty-two responses (50%) were accrued from PICU healthcare professionals, including consultants (n = 19), advanced nurse practitioners (n = 4) and band-seven nurses (n = 9). The data were comprehensively studied and analysed by two coders using summative content analysis with assistance from data management software. Codes were further developed to form categories and subcategories. Results: Two categories were found: (1) the role of palliative care and (2) experiences of providing palliative care. A total of five subcategories were found, demonstrating that the PSPCT can enhance care in PICU through collaborative working. Barriers identified included staffing, funding and stigma around palliative care. Conclusions: This study shows that PICU professionals have a good understanding of the concepts of PPM and view it as an essential part of PICU work. Barriers related to resources and misperceptions of palliative care can be overcome through improved education, funding and staff retention, but this would require buy-in from policymakers. The perspective from our relatively small team increases generalizability to growing teams across the country. [ABSTRACT FROM AUTHOR]

Purpose - The purpose of this paper is to evaluate the organisational impact of the New to Forensic Mental Health education programme, developed for use across all forensic services in Scotland. To date, 267 have been trained as a trainer or mentor; 502 have completed the programme and 375 are yet to complete. The programme is designed to promote self-directed learning and is multi-disciplinary and multi-agency in approach. It includes case studies and problem-based learning relating to patients in a variety of settings, from the community to high secure care. Design/methodology/approach - As part of a larger longitudinal study to assess the value of this New to Forensic Mental Health education programme, organisational impact was assessed using semi-structured interviews with (n = 13) senior staff working in forensic services. Participants were purposively selected for interview. Findings - Transcripts were analysed using thematic analysis, which revealed three themes: "Acquiring knowledge: what you learn and how you learn", "Developing skills" and "Shift in attitudes and behaviour. The results demonstrate the positive impact the programme has had at an organisational level and what changes can occur when staff become more knowledgeable, skilful and confident. The implications for practice, along with the limitations of the study, are discussed. One of the weaknesses of this type of analysis is that it is always dependent on the analyst's interpretation, and is thus the product of that person's bias, filters or prejudices. Originality/value - This evaluation is one of the limited few that explore organisational impact of an education programme. [ABSTRACT FROM AUTHOR]

Purpose -- This article seeks to explore the difference that adult support and protection legislation may have made to work with adults at risk of harm in Scotland. Design/methodology/approach -- The article is based upon findings of a joint academic and practitioner qualitative research project that interviewed 29 social service practitioners across three local authorities. Findings -- The legislation was seen as positive, giving greater attention to adults at risk. Views about the actual difference it made to the practitioners' practice varied, and were more likely in new rather than ongoing work. Three differences were noted: duties of investigation, protection orders and improved shared responsibility within the local authority and across other agencies, but to a lesser extent NHS staff. Overall it gave effective responses, more quickly for the adults at risk. Whilst the law brought greater clarity of role, there were tensions for practitioners in balancing an adult's right to autonomy with practitioners' safeguarding responsibilities. Originality/value -- The paper demonstrates that a dedicated law can improve safeguarding practice by clarifying the role of social work practitioners and the responsibilities of other agencies. The right to request access to records and banning orders were seen as valuable new measures in safeguarding adults at risk. As such the study from the first UK country to use dedicated adult safeguarding law offers a valuable insight for policy makers, professionals and campaign groups from other countries, which might be considering similar action. [ABSTRACT FROM AUTHOR]

Purpose – The purpose of this paper is to report results of a research project which investigated how two UK National libraries categorise their core business purpose together with an assessment of the role and relevance of additional (or value-added) services in their strategic thinking, future planning and performance measurement. Design/methodology/approach – This is a qualitative interpretive study, using a collective case study methodology, with the National Libraries of Wales and Scotland as the core cases. Semi-structured interviews were conducted with senior managers in both institutions, together with focus groups with librarians and library assistants, selected using purposive sampling. All instruments were piloted; data from the respondents were recorded, coded, classified and cross-checked to ensure validity and rigour, using themed interview schedules to facilitate analysis. Findings – It is difficult to be definitive as to core and additional services as individuals have differing interpretations of the terms. Changing customer demands and expectations, technological developments and the impact of a dynamic and complex economic environment suggest it is more meaningful to reconceptualise services according to the extent to which they contribute to achieving basic business purpose at any one time. Originality/value – Libraries must demonstrate efficiency and effectiveness in service provision, and in relation to achieving primary purpose and resource priorities in order to survive. Examining the relevance of defining and distinguishing core and added-value services in relation to performance assessment and strategic vision addresses a gap in existing knowledge. [ABSTRACT FROM AUTHOR]

law j., mccann d. & o'may f. (2011) Managing change in the care of children with complex needs: healthcare providers' perspectives. Journal of Advanced Nursing 67(12), 2551-2560. Abstract Aim. This paper is a report of a descriptive qualitative study of the role and activities of nursing and allied health professionals caring for children with complex needs in a community setting. Background. Health care is changing in terms of service provision and delivery, with an increased focus on person-centred care, prevention and community-based services. The role of nursing and allied health professionals is central to these changes but is not well described in terms of capacity, or the knowledge and skills required to meet increasing demand. Method. Within four Health Boards, semi-structured telephone interviews were conducted in 2007 with three nursing and four allied health managers, followed by four focus groups with 15 nursing and 11 allied health practitioners; in addition, three nurses and one speech therapist were interviewed by telephone. Results. Respondents identified challenges related to communication and information systems, equity of service provision, family-centred care and partnership working. Generic and specialized knowledge and skills are needed, although providing the right skills in the right place can often prove problematic with potential implications for service provision. Conclusion. Findings support the adoption of integrated partnership working, going beyond the identification of key professionals, to developing a set of criteria against which future service provision could be judged. Research priorities were identified; comparative evaluation of services, better understanding of the transition process and a clearer sense of the individual's response to the increasing customization of services. [ABSTRACT FROM AUTHOR]

St Columba's Hospice, Edinburgh, is a busy specialist palliative care unit with 30 inpatient beds. A previous publication reported the first strand of a qualitative exploratory study evaluating the impact of open visiting on patients at the hospice. This paper reports on the second strand, which sought to elicit the views of the hospice staff through focus group interviews. The main themes identified were valuing the family and friends as visitors, involving the family as part of the care team, patient powerlessness over visiting, shared rooms and their impact on visitors and patients, and the staff role as advocates or gatekeepers. Several strategies for developing a flexible and 'patient-controlled' visiting policy were identified, including quiet times without visitors, restriction of visitor numbers in shared rooms, and encouraging breaks from visiting. Since the study was completed, the hospice's visiting policy has been modified to ensure that it is patient-centred and meets the needs of patients and families. [ABSTRACT FROM AUTHOR]

Abstract: Teenage parenthood is problematised in the UK. Attention is increasingly falling on the potential or actual father yet we still know relatively little about young men’s experiences and attitudes in this area. This paper focuses on the experiences of, and attitudes towards, pregnancy and fatherhood amongst a sample of men incarcerated in a Scottish Young Offender Institute. In-depth interviews were conducted with 40 inmates, aged 16–20, purposively sampled using answers from a questionnaire administered to 67 inmates. Twelve men reported eighteen pregnancies for which they were, definitely or possibly, responsible. All but one of the pregnancies were unplanned. Five of the men were fathers: two were still in a relationship with the mother of their child and were in close contact with her and the child while incarcerated, three, all of whom had separated from their partner before the birth, had had patchy contact with mother and child before and/or during their sentence. All five of the men expressed a strong desire to be ‘a good father’. Amongst the interview sample as a whole, most said they did not feel ready to become fathers. The main reason given was being unable to fulfil what they regarded as the key role of financial provider. Most of the men had given little or no thought to the possibility of a sexual partner becoming pregnant. Contraceptive use was high, however, amongst the minority who reported thinking about this possibility. The paper concludes by considering the cultural context of the men’s attitudes and the potential for intervention development for incarcerated male young offenders in the areas of Sex and Relationships Education and parenting. [Copyright &y& Elsevier]

This paper reports the findings of a research project which explored the care factors that influence the educational achievement of looked-after children. The project was innovative because it focused on children looked after at home and away from home. A mixed-methods strategy was adopted to analyse data from two large Scottish local authorities. The project developed, what is to date, the largest dataset which includes variables for one-fifth of children discharged from care in Scotland over a 5-year period. The qualitative element of the project collected in-depth data on the care and education experiences of looked-after children and care leavers. The overall finding was that looked-after children perform less well academically than their counterparts in the general school population. The empirical data indicated that factors such as placement type, reason for becoming looked after and age on becoming looked after were significant in determining educational achievement. Empirical results further indicated that looked-after children suffered from discrimination and social exclusion in many areas of their lives, including school and where they lived. [ABSTRACT FROM AUTHOR]

There has been little research on social workers' views and experiences of managing contact for children in public care, and none focused in Scotland, where different institutional and legal features provide contrast with the rest of the UK. This study explored the views of 19 social work practitioners and managers and three Reporters to the Children's Hearing system regarding the management of contact for children in non-permanent placements, using semi-structured interviews and a focus group. The paper focuses on the themes of the supervision and assessment of contact, risks associated with contact and contact via ICT-e-mail and the internet. It suggests improvements in assessing contact are needed and concludes that while there are strengths in practitioners' current awareness of risks, a risk-based conception of contact, as exemplified by most respondents' views about the use of new technology, is in tension with the thrust of current legislation; conceptions of contact need to be flexible enough to embrace the variety of purposes contact might serve. Copyright © 2010 John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]

Supported self-management (SSM) is an important part of adapting to life after stroke however it is a complex concept. It is unclear what SSM in stroke consists of or how stroke survivors, families, and clinicians can most effectively work together to support person-centred self-management. In this study, we aimed to explore what was most important in making SSM work in community stroke rehabilitation. We conducted a Q-methodology study with stroke survivors (n = 20), community-based stroke clinicians (n = 20), and team managers (n = 8) across four health boards in Scotland, United Kingdom. Participants ranked 32 statements according to their importance in making SSM work. Factor analysis was used to identify shared viewpoints. We identified four viewpoints: (i) A person-centred approach to build self-confidence and self-worth; (ii) Feeling heard, understood, and supported by everybody; (iii) Preparation of appropriate resources; and (iv) Right thing, right place, right time for the individual. Important across all viewpoints were: a trusting supportive relationship; working in partnership; focusing on meaningful goals; and building self-confidence. Differing views exist on what is most important in SSM. These views could be used to inform quality improvement strategies to support the delivery of SSM that considers the preferences of stroke survivors. Clinicians should be aware of their own viewpoint of supported self-management and consider how their perspective may differ from stroke survivors' and colleagues' perspectives of what's important to support self-management. Working in partnership with stroke survivors plus developing a trusting and supportive relationship with them are core components of supporting self-management in the longer term after stroke. Building a sense of self-worth and self-confidence, a focus on meaningful goals, training and support for staff, and tailoring support to people's needs at the right time are important considerations for supporting longer-term engagement in self-management. [ABSTRACT FROM AUTHOR]

The involvement of citizens in the production and creation of public services has become a central tenet for administrations internationally. In Scotland, co-production has underpinned the integration of health and social care via the Public Bodies (Joint Working) (Scotland) Act 2014. We report on a qualitative study that examined the experiences and perspectives of local and national leaders in Scotland on undertaking and sustaining co-production in public services. By adopting a meso and macro perspective, we interviewed senior planning officers from eight health and social care partnership areas in Scotland and key actors in national agencies. The findings suggest that an overly complex Scottish governance landscape undermines the sustainability of co-production efforts. As part of a COVID-19 recovery, both the implementation of meaningful co-production and coordinated leadership for health and social care in Scotland need to be addressed, as should the development of evaluation capacities of those working across health and social care boundaries so that co-production can be evaluated and report to inform the future of the integration agenda. [ABSTRACT FROM AUTHOR]

Introduction: The COVID‐19 pandemic had an unprecedented effect on those living and working in care‐homes for older people, as residents were particularly vulnerable to contracting the SARS‐CoV‐2 virus, associated with high morbidity and mortality. Often undervalued, care‐home nurses (RNs) are leaders, managing complex care while working in isolation from their professional peers. The pandemic made this more apparent, when care and treatments for COVID‐19 were initially unknown, isolation increased due to withdrawal of many professional health services, accompanied by staff shortages. Objective: To explore RNs' experiences of working in older people's care‐homes during the COVID‐19 pandemic. Design: Qualitative interview study. Setting: Care‐homes for older people in England and Scotland, UK. Methods: Recruitment via direct contact with care‐homes, social media, and links provided by national partners, then purposive sampling for age, gender, type of care‐home, and location. Data collected through one‐to‐one online interviews using topic guide developed collaboratively with care‐home nurses, focusing on how COVID‐19 impacted on nurses' resilience and mental wellbeing. Data analyzed thematically using Tronto's ethics of care framework to guide development of interpretative themes. Results: Eighteen nurses (16 female; 16 adult, and two mental health nurses) were interviewed March–June 2021; majority aged 46–55 years; mean time registered with Nursing and Midwifery Council: 19 years; 17 had nursed residents with COVID‐19. RNs' experiences resonated with Tronto's five tenets of ethical care: attentiveness, responsibility, competence, responsiveness, and solidarity. All nurses described being attentive to needs of others, but were less attentive to their own needs, which came at personal cost. RNs were aware of their professional and leadership responsibilities, being as responsive as they could be to resident needs, processing and sharing rapidly changing guidance and implementing appropriate infection control measures, but felt that relatives and regulatory bodies were not always appreciative. RNs developed enhanced clinical skills, increasing their professional standing, but reported having to compromise care, leading to moral distress. Broadly, participants reported a sense of solidarity across care‐home staff and working together to cope with the crisis. Conclusion: Care‐home nurses felt unprepared for managing the COVID‐19 pandemic, many experienced moral distress. Supporting care‐home nurses to recover from the pandemic is essential to maintain a healthy, stable workforce and needs to be specific to care‐home RNs, recognizing their unique pandemic experiences. Support for RNs will likely benefit other care‐home workers either directly through wider roll‐out, or indirectly through improved wellbeing of nurse leaders. Clinical relevance: The COVID‐19 pandemic, an international public health emergency, created many challenges for Registered Nurses (RNs) working in long‐term care facilities for older people, as residents were particularly vulnerable to the impact of the SARS‐CoV‐2 virus. Care‐home RNs faced challenges distinct from their hospital‐based nursing peers and non‐nursing social care colleagues due to their isolation, leadership roles, professional legal obligations, and ethical responsibilities, leading to psychological distress on the one hand, but also a newly found confidence in their existing and newly developed skills, and increased recognition by the wider health community of their specialisms. [ABSTRACT FROM AUTHOR]

We examine how asylum seekers and refugees living in Glasgow use various tactics to survive and navigate everyday challenges within the restrictive UK immigration system. Thirty interviews were conducted with asylum seekers and refugees of various nationalities and personal backgrounds (ethnicity, class, education and migratory circumstances). Twenty state and third sector organisation staff were also interviewed. Participant observation within third sector organisations was also undertaken. While asylum seekers and refugees feel uncertainties and challenges, we found that they actively use various tactics to navigate the often-lengthy UK asylum process. 'Agency in waiting' encompasses the negative impact of a long stagnation period endured while awaiting confirmation of refugee status and the tactics developed despite the difficulties that asylum seekers and refugees face. We consider three ways that tactics are used: to gain familiarity, to engage in meaningful activities, and to establish social connections. [ABSTRACT FROM AUTHOR]

Aim: To evaluate Advanced Nurse Practitioner (ANP) role implementation in primary care across Scotland in contributing to primary care transformation, and establish what works, for whom, why and in what context. Design: A realist evaluation using multiple case studies. Methods: Two phases, conducted March 2017 to May 2018: (1) multiple case studies of ANP implementation in 15 health boards across Scotland, deductive thematic analysis of interviews, documentary analysis; (2) in‐depth case studies of five health boards, framework analysis of interviews and focus groups. Results: Sixty‐eight informants were interviewed, and 72 documents were reviewed across both phases. ANP roles involved substitution for elements of the GP role for minor illness and injuries, across all ages. In rural areas ANPs undertook multiple nursing roles, were more autonomous and managed greater complexity. Mechanisms that facilitated implementation included: the national ANP definition; GP, primary care team and public engagement; funding for ANP education; and experienced GP supervisors. Contexts that affected mechanisms were national and local leadership; remote, rural and island communities; and workload challenges. Small‐scale evaluations indicated that ANPs: make appropriate decisions; improve patient access and experience. Conclusions: At the time of the evaluation, the implementation of ANP roles in primary care in Scotland was in early stages. Capacity to train ANPs in a service already under pressure was challenging. Shifting elements of GPs workload to ANPs freed up GPs but did little to transform primary care. Local evaluations provided some evidence that ANPs were delivering high‐quality primary care services and enhanced primary care services to nursing homes or home visits. Impact ANP roles can be implemented with greater success and have more potential to transform primary care when the mechanisms include leadership at all levels, ANP roles that value advanced nursing knowledge, and appropriate education programmes delivered in the context of multidisciplinary collaboration. [ABSTRACT FROM AUTHOR]

The proposition that teaching is a reflective profession is prominent within educational discourse. Theories that underpin reflection are a critical component of initial teacher education (ITE) programmes. This study aims to assess the reliability of the modified Reflective Practice Questionnaire (RPQ) in a population of ITE students; and to compare the study findings to other studies using the RPQ in other professions. This study reports cross-sectional findings for reflective capacity in ITE students undertaking three different ITE programmes, the Bachelor of Arts (Hons) (BA) Education [n=91], Professional Graduate Diploma in Education (PGDE) Primary [n=209] and Secondary [n=167], in one Scottish university. Findings show that the modified RPQ reliably assesses reflective capacity (Cronbach's alpha 0.82), which differs depending on the programme of study followed. BA students' reflective capacity is higher than that of PGDE (P) but is not different to PGDE (S) students. PGDE (P) students differing from BA students in terms of Reflection-in-Action (RiA), Self-Appraisal (SA), Confidence (general) (CG), and Confidence (communication) (CC), whereas PGDE (S) and BA students differ in terms of SA, CG CC and Stress interacting with Pupils (SiP). This study indicates student teachers' reflective capacity is higher than those found in studies of other professions. [ABSTRACT FROM AUTHOR]

Health visitors in Scotland gift 'play@home', a book-based early intervention programme, to parents as part of the universal health visiting service. The provision of health improvement information to parents is recognised as a core function of health visiting and yet evidence shows that not every family receives the play@home resources. This paper discusses the perceived facilitators and barriers to implementing this programme through exploring the views of ten health visitors and four health visiting managers in two health board areas in Scotland. The findings conclude that increasingly vulnerable families, supported by fewer qualified health visitors, present challenges to the health visiting service. The play@home programme is valued by health visitors as a flexible tool with which to engage with families. Collaborative working with other services enhances provision and play@home does become embedded in practice over time. Strategic policy links to raise the profile of play@home are improving. [ABSTRACT FROM AUTHOR]

In the UK, transformation of the nursing workforce, including development of the role of the advanced nurse practitioner within general practice, is essential to meet healthcare demands. This article presents the results of a small, qualitative study conducted among students at one university in Scotland, describing their experiences of participation in advanced practice education. Data were collected through semi-structured interviews to generate in-depth descriptions and to identify the facilitators and barriers to learning. The study identified that a shared responsibility for patient care creates opportunities for learning. The facilitators to learning were identified as foundation level education in history taking and clinical examination, finance, having a supportive network and mentorship. Barriers included pressure of work and a lack of clarity about roles and training needs. Given the key role that these nurses will have in future healthcare models, there is a requirement for a national education standard. It is recommended that the Nursing and Midwifery Council leads on defining advanced nurse practitioner in general practice programme learning outcomes. The overall aim of such courses is to enhance the experience for future nurses to encourage recruitment and transform the nursing workforce. [ABSTRACT FROM AUTHOR]

Aim: Melanoma is one of the most common human malignancies; yet, it is often thought of as a disease of adulthood rather than one affecting adolescents and young adults. This study sought to understand the experiences of adolescents, young adults and their family living with malignant melanoma. Design: A qualitative study using Interpretive Phenomenological Analysis, through a multi‐perspective design. Methods: Data collection was conducted between January and August 2018 in each participant's Primary Care Centre when they were attending for an outpatient appointment. Each young person and a nominated family member were interviewed (n = 10) either individually (n = 4) or as a dyad (n = 6) according to their personal choice. In‐depth semi‐structured interviews were conducted and audio‐recorded with the participant's consent. Interview data were transcribed verbatim and analysed. Findings: The metanarrative 'Life Interrupted' was the core conceptual thread woven throughout the findings. It represents the interconnections and interrelationships between the adolescent or young adult and their family. Being able to recognize the disease and seek support was challenging with often limited physical, emotional or social support resulting in feelings of fear and isolation. Four super‐ordinate themes were identified: (a) 'Is it Serious', (b) 'Too Much too Young', (c) 'Not the Same' and (d) 'Time to Live'. Conclusions: With the rising incidence of MM in the adolescents and young adults population globally, there are demands to improve healthcare professionals and nurse's knowledge and understanding of MM. As young people with MM experience their journey outside specialist cancer services, the care delivery for this patient group and their families require stronger links between services. Impact: This study will inform the improvement of care delivery for MM in order that this patient group is provided with the same access to service delivery as other adolescents and young adults with cancer. [ABSTRACT FROM AUTHOR]

Much has been written over the past thirty years within the international social work literature on Family Group Conferencing as a process of decision making. Yet, the theories that frame our understanding of how Family Group Conferencing contributes towards family outcomes are less distinct. This article makes an original contribution to this literature by proposing the use of recognition theory as a beneficial lens for understanding the Family Group Conferencing process. The recognition theory contends that social relations acknowledge and validate personal existence and are pivotal to identify formation; a just society is therefore one where everyone gets due recognition. A retrospective qualitative study will be used to exemplify how Family Group Conferencing can create the conditions within which participants can experience different forms of recognition: care; respect; solidarity and, as such, experience a level of social justice (or not). It is argued that recognition within the Family Group Conferencing process can influence the identity and relationships of those involved in social work services. This article has significance beyond those with an interest in Family Group Conferencing as the recognition theory can shed light on the nature of relationships in social work practice more generally. [ABSTRACT FROM AUTHOR]