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Background: Festivals play an important role in improving death and grief literacy, enabling members of the public to engage with these often-sensitive topics. Good Grief Weston festival was co-designed and delivered with the community in Weston-super-Mare, a coastal town in South-West England with high levels of socioeconomic disadvantage but rich community assets. It was held in person over 8 days in May 2023. Objectives: To evaluate the reach and impact of Good Grief Weston festival and gather data to inform future festivals. Design: Mixed methods evaluation (survey and focus groups). Methods: Online and paper surveys assessing participants' characteristics and experiences were administrated during and after the festival. Survey participants who indicated their willingness to participate were invited to attend a focus group. Focus groups were recorded, transcribed and analysed using thematic analysis. Data were collected by trained community co-researchers. Results: Approximately 3000 people attended the festival. Of 204 completed surveys, 64.5% were from women, age range ⩽15 to ⩾75 years; 88.2% identified as White; 14.9% deaf, disabled/with a chronic condition; 18.9% neurodivergent; 9.0% gay, bisexual or queer. Festival participants were entertained (70.9%), inspired (68.5%), felt part of a like-minded community (54.3%), talked to someone new (49.2%), learnt about grief/bereavement (34.3%), shared or expressed experiences (30.3%) and found out about local support (19.7%). 71.3% reported that they felt more confident talking about grief after attending. Median experience rating was 5 (IQR 0; possible range 1 = poor to 5 = excellent). In free-text comments, participants expressed appreciation for the festival and described benefits in attending. Two focus groups were conducted (n = 8 participants, all women), lasting c.1.5 h. Focus groups added rich descriptions of the festival's value, and data to inform the next festival. Conclusion: Findings suggest festivals of this nature can play a central role in a public health approach. Plain language summary: What was the impact of Good Grief Weston festival? Why was the study done? Previous studies have shown that many people feel unsupported by their community after the death of a loved one. We designed a festival to improve knowledge and support for bereaved people. We did this study to assess how the festival affected the people who attended. What did the researchers do? The team included researchers and people and organisations from the local community. Together, we designed and ran a festival on the topic of death, grief and bereavement in Weston-super-Mare, a coastal town with areas of high deprivation. The festival took place over an eight-day period in May 2023 and included creative, interactive and educational events. The team collected feedback on attendees' experiences of the festival. We did this using online and paper feedback forms, postcards, and focus groups to collect as many opinions as possible. What did the researchers find? We found that a wide range of people attended the festival. Most people who took part in the research rated the festival as 'excellent'. They told us they learnt about grief and bereavement and found out about local support services. Attendees met new people, shared their experiences, and felt that the festival built community spirit. They also made suggestions to improve any future festivals. What do the findings mean? The findings show that in-person festivals can effectively engage the public on the topic of death, grief and bereavement. They can also help develop connections between people and organisations in communities. These connections and learning opportunities may help communities to support their members through bereavement. [ABSTRACT FROM AUTHOR]

Aim: This study aimed to determine the knowledge, attitudes, and practices of male nurses towards human papillomavirus (HPV) and HPV vaccination and to examine whether knowledge about the HPV vaccine affects attitudes and beliefs about HPV vaccines. Background: HPV is responsible for ≈5% of all cancers worldwide. Therefore, vaccination against HPV is recommended to prevent HPV infections and HPV‐related cancers in men and women. Methods: The study group included 383 male nurses who were asked to complete online questionnaires. The data were collected using the following tools: a sociodeomographical characteristics form, the Human Papillomavirus Knowledge Scale (HPVKS), and The Carolina HPV Immunization Attitudes and Beliefs Scale (CHIAS). Results: It was determined that the general HPV knowledge of the male nurses participating in the study was at a moderate level, but their knowledge of HPV screening test, HPV vaccination, and current HPV vaccination programmes were at a low level. Male nurses' HPV vaccination rates were relatively low, and most of them did not intend to be vaccinated. In addition, CHIAS Attitudes and Beliefs scores of the male nurses were at an average level and HPV knowledge affected the attitudes and beliefs of the nurses. Conclusion: These results demonstrate an opportunity to improve information and awareness about HPV and vaccines by nursing education. Summary statement: What is already known about the topic? Although HPV vaccination is recommended to prevent HPV infections and HPV‐related cancers in men and women, vaccination rates are far behind the target, especially for men. What this paper adds? Findings showed that male nurses' HPV vaccination rates were relatively low.Male nurses' knowledge about HPV and HPV vaccine was not sufficient.HPV knowledge affected the attitudes and beliefs of these male nurses. The implications of this paper: Nurses need to be aware of the HPV vaccine during their undergraduate education. [ABSTRACT FROM AUTHOR]

Objective. Health behavior research suggests that perceived social norms impact health decisions. This study aimed to (a) examine reasons for vaccine hesitancy among a sample of college students compared to a clinical sample (b) examine the accuracy of perceptions of others' receptivity and intention to seek out the COVID-19 vaccine, and (c) determine whether greater self-other normative discrepancies (SODs) were associated with increased likelihood to seek out the COVID-19 vaccine. Participants. Participants included 227 students at a Northeastern private college and 140 patients seeking medical care. Methods. College students completed an online, anonymous survey. Patients completed a paper-and-pencil survey distributed at appointment check-in. Results. Compared to their perceptions of others, participants had more positive beliefs about vaccines. The most common reason prompting individuals to seek out the vaccine was to return to "normal life." Conclusions. Future research might examine use of social norms interventions to decrease vaccine hesitancy. [ABSTRACT FROM AUTHOR]

BACKGROUND: It is unknown whether questionnaires measuring psychosocial constructs related to low back pain (LBP) that were originally designed for adults are suitable for adolescents, and if paper and web-versions have similar measurement properties. OBJECTIVES: To examine selected psychometric properties for the paper- and web-based Back-Beliefs Questionnaire (BBQ) and the Fear Avoidance Beliefs Questionnaire (FABQ-phys) among adults and adolescents in two diverse countries and to determine whether differences existed between countries and pain groups. METHODS: A sample of 156 adults (Hong Kong, n = 75; Australia, n = 81) and 96 adolescents (Hong Kong, n = 61; Australia, n = 35) participated in this cross-sectional study. RESULTS: Main effects for country and administration mode were observed in adult BBQ scores, where Australian adults reported significantly higher BBQ scores than Hong Kong adults (mean difference (MD); 95% CI: 2.85; 0.96-4.74) and significantly higher scores were recorded on the web mode compared to the paper mode (MD 0.74; 0.10-1.38). Similarly, Hong Kong adults and adolescents reported higher FABQ-phys scores than Australian adults and adolescents (MD; 95% CI: 3.40; 1.37-5.43 and 4.88; 0.53-9.23, respectively). Internal consistency values were mostly acceptable (α⩾0.7). CONCLUSION: Differences exist between cultures for LBP-related beliefs. The BBQ and FABQ-phys have acceptable measurement properties in both administration modes. [ABSTRACT FROM AUTHOR]

Purpose: This paper evaluated an electronic service-learning (e-SL) course utilizing regular and intensive delivery modes offered to undergraduate students in the 2020–2021 academic year. Methods: We collected pretest–posttest data (N = 130) and students' subjective evaluations of the course (N = 148) and the services they had provided (N = 160). Results: Students showed significant positive changes in both e-SL modes on positive youth development attributes, service leadership qualities, and life satisfaction, with greater changes among students taking the intensive mode. Students' views towards the e-SL course and the services they provided were positive, and students in the two e-SL modes did not differ significantly in their subjective evaluations. In addition, students' changes in outcome measures were positively associated with their subjective evaluations. Conclusions: The study provides additional support for the potential effectiveness of e-SL and suggests the promising application of intensive mode in implementing e-SL projects. [ABSTRACT FROM AUTHOR]

Introduction: The pandemic brought about changes in the operation of the nursing departments. Staffing problems arose that required immediate resolution but also effective communication problems due to personal protection measures. Purpose: The purpose of the present study was to investigate the functionality of the nursing team and possible communication barriers due to Personal Protection Measures. Additional objectives related to perceptions of vaccination and barriers to departmental functioning due to it. Material and Methods: The total sample consisted of 42 nurses and 36 nurses' assistants working in the Covid-19 wards at Alexandroupoli hospital. Data were collected from February to March 2022 by questionnaire, in paper form and in an online form. The statistical analysis was done with the SPSS program (IBM Corp. Released 2019, IBM SPSS Statistics for Windows, v.26.0, Armonk Results: The working group of nurses with permanent and auxiliary staff maintains good interpersonal relations, but the lack of training of the auxiliary staff does not inspire confidence in 57.1%. The work of the supervisors is recognized with positive opinions in a percentage of >90%, the mandatory vaccination and the suspension of work burdens the operation of the hospital, while a small percentage, 28.6% of the nurses have negative return attitudes towards non-vaccinated colleagues. 74% of nurses state that PPE causes difficulty in breathing and in their work in a percentage of 42.9%. Conclusions: The results of the study indicate that the use of PPE causes difficulties at the individual and work level. Hospitals in a period of health crisis need the existence of experienced staff, while good, effective communication and cooperation between permanent and auxiliary staff does not fully contribute for all nurses to the good operation of the nursing departments. [ABSTRACT FROM AUTHOR]

Aims: We examined the predictive factors of COVID‐19 vaccine hesitancy among Jordanian older adults. Background: Vaccine hesitancy among older adults is influenced by several factors. Design: This study employed a cross‐sectional design. Methods: Online surveys were conducted between November 2021 and April 2022. The surveys included socio‐demographic variables, COVID‐19 vaccine‐related information, the Vaccine Attitude Examination Scale and the Fear of COVID‐19 Scale. Results: Participants were 350 older adults (aged 68.1 ± 7.21 years; 62.9% females). Linear regression analyses were performed to assess the impact of correlated variables on the explanation of anti‐vaccination attitudes. Participants reported a moderate level of fear of COVID‐19 and a moderate level of hesitancy towards receiving the COVID‐19 vaccine. The linear regression model revealed that several chronic illnesses, fear of COVID‐19 and number of family incidences of COVID‐19 explained vaccine hesitancy. Conclusions: Raising awareness among older adults about the desired effect of the COVID‐19 vaccine in terms of minimizing hospitalization, disease consequences and mortality rate is required. Well‐tailored interventions are essential to reduce vaccine hesitancy among older adults and reinforce the importance of receiving the vaccine for those with multi‐morbidities. Summary statement: What is already known about this topic? COVID‐19 vaccines are effective in minimizing the undesirable consequences of COVID‐19 and decreasing the mortality rate.Fear of COVID‐19 and misconceptions about the vaccination contribute to vaccine hesitancy.New COVID strains, new policies and new vaccine risk factors increase vaccine hesitancy. What this paper adds? There is a moderate level of COVID‐19 vaccine hesitancy among the Jordanian older adult population.Vaccine hesitancy among older adults is attributed to multi‐morbidities, negative attitudes towards the vaccine, fear of COVID‐19 and number of family incidences of COVID‐19.Factors that influence the attitudes of Jordanian older adults towards anti‐vaccination include having had COVID‐19, number of chronic illnesses, fear of COVID‐19 and number of family incidences. The implications of this paper: Health‐care providers should use evidence‐based strategies to motivate and encourage Jordanian older adults to get vaccinated by disseminating factual and transparent information about the efficacy and safety of COVID‐19 vaccines, thereby reducing associated fears and promoting trust among older adults.Health‐care providers should tailor educational campaigns and communication strategies that address the gap in health literacy levels among older adults to achieve the desired vaccination rate.The results inform policymakers and other stakeholders to commence proactive vaccination campaigns that use population‐specific strategies to increase vaccine uptake and acceptance. [ABSTRACT FROM AUTHOR]

This paper explores the effect of chatbot empathy and identity disclosure on willingness to donate (WTD) to a fundraising project and the psychological mechanism in the relationship. In a 3 (information-only vs. cognitive empathy vs. affective empathy) × 2 (chatbot vs. human identity) experiment, 496 US adults had a conversation about a fundraising event with one of six artificial intelligence-powered chatbots. The results revealed that neither chatbot empathy nor identity disclosure has a significant effect on WTD, rejecting the hypotheses. However, the data supported a significant interaction effect between chatbot empathy and identity disclosure on WTD. Moreover, the results suggested that the interaction effect between chatbot empathy and identity disclosure on WTD would be mediated through human likeness and social presence. This study suggests how empathy and human identity of chatbots should be applied with care to avoid the uncanny valley effect. [ABSTRACT FROM AUTHOR]

Assistive technologies have allowed people with disabilities to perform daily tasks with greater independence and autonomy, especially for visually impaired people. Using smart home solutions allows these users to control their homes with less cognitive and physical demand. However, making such applications accessible to meet the needs of visually impaired users, especially in developing countries, remains a challenge. This paper investigates the perceptions of these users about home automation technologies through semi-structured interviews. A total of 20 visually impaired people participated in the interviews. A thematic analysis revealed results concerning the following themes: (1) how people go about their lives at home and around, how people interact with current appliances, objects and environments, (3) how people perceive their attitude to technologies, (4) the Brazilian context of smart homes, (5) what people think smart homes should do and (6) envisaging ways of interacting with smart home systems. The results obtained provide significant insight into the needs of visually-impaired people in Brazil, with analysis of issues that are common with previous studies in more developed countries and specific issues that have important particularities and implications in Brazil and other developing countries. [ABSTRACT FROM AUTHOR]

Previous research has suggested that older trans and gender non-conforming (TGNC) people may face particular challenges related to stigma, social exclusion and discrimination in later life. However, direct data on social support and needs in older TGNC population both internationally and within the UK is limited due to the small, dispersed nature of this population, and the absence of specific data collection on aging TGNC populations. During the UK COVID-19 lockdown in summer 2020, older people and those with long-term health conditions were advised to adopt particular precautions. This study aimed to explore older TGNC people's social support networks, key concerns and unmet needs during the COVID-19 'lockdown'. A UK cross-sectional survey of LGBT + people aged 60+ (n = 375) was undertaken during the lockdown. This paper analyses responses from the subset (n = 38) of TGNC participants. The majority of TGNC respondents described diverse social networks, often centered around friends and non-kin social networks, although partners and adult children were also significant for some. In most cases, those with existing strong networks continued to maintain social connections during lockdown, albeit with some regrets about loss of activities and face-to-face connection. However, a minority of respondents had experienced greater challenges prior to lockdown, and may have been at increased vulnerability during the pandemic, for example indicating that they had no-one to call on for practical support in an emergency. When asked about unmet needs and challenges, social isolation was repeatedly raised as the most frequent concern. Several respondents also mentioned issues specifically affecting TGNC communities, including access to gender affirming care and a perceived rise in social intolerance. Health and social care providers should be aware of the diversity of support networks within TGNC communities. There may also be benefits in community sector interventions to help older TGNC build and maintain strong social networks. [ABSTRACT FROM AUTHOR]

Objectives: We investigated coronavirus disease 2019 (COVID-19) opinions, experiences, and willingness to accept COVID-19 vaccination during pregnancy at two prenatal clinics in early 2021 and early 2022. Materials and Methods: Paper questionnaires were distributed to pregnant women at prenatal care facilities in Virginia and Florida between January and April 2021 and January and April 2022. Questions regarding acceptance and opinions of the influenza vaccine served as a baseline to assess COVID-19 vaccine opinions. Associations between demographic parameters and vaccine opinions and acceptance were examined using Chi-square. A COVID-19 concern score was constructed by principal component analysis with differences between groups assessed by analysis of variance (ANOVA) and analysis of covariance (ANCOVA). Results: Many participants (40.6%) reported that the COVID pandemic had affected their pregnancy. Main themes were problems with social networks, increased stress/anxiety, and being more cautious. In 2021, 19.5% reported they would accept a COVID-19 vaccination during their pregnancy, which increased to 45.8% in 2022. Vaccine hesitancy did not vary by race or between sites, but educational attainment was significant (p < 0.001). Women with a higher concern score were more likely to report they would accept a COVID-19 vaccine. Women who would accept COVID vaccination had a positive opinion regarding the influenza vaccine. Main themes for refusing COVID-19 vaccination were concerns about side effects, lack of research/data, and mistrust of vaccines. Conclusions: The proportion of women willing to accept COVID-19 vaccination increased but remained below 50%. Willingness to accept vaccination during pregnancy was associated with higher education, higher concern about COVID-19, and a positive opinion of the influenza vaccine. [ABSTRACT FROM AUTHOR]

Evaluate the utility of brief online training for facilitating mental health professionals' perceived knowledge, confidence, and comfort in working with non-binary clients, and building positive attitudes. Baseline participants were 79 Australian registered mental health professionals, of whom 38 completed online training and a one-week follow-up assessment. Participants completed an assessment of attitudes, comfort, confidence, and perceived knowledge pertaining to non-binary people before and after completing online training. The training (30-minute average completion time) provided information on non-binary people's lives using text, images, embedded video, and links to optional resources. Follow-up measures completed one-week post-intervention indicated engagement in the training may lead to increased perceived knowledge, confidence and comfort. Attitudes were positive at baseline and were not significantly different at follow-up. Providing brief online training for working with non-binary people in mental health might improve practitioner perceived knowledge, confidence and competence at low cost and with easy access. Future research is required to account for limitations and build on current outcomes. Key Points What is already known on this topic: Little is known about the effects of brief online training regarding non-binary genders on mental health practitioner's attitudes, confidence, comfort, and perceived knowledge. Previous research has shown that brief training can increase positive attitudes for, knowledge of, behavioural intent, and cultural competence for working with sexual and gender minorities, though has not specifically focused on non-binary people. Previous literature has highlighted positive associations between practitioner knowledge and the well-being of non-binary people accessing health services. What this paper adds: This paper adds to the ongoing genesis of options for training mental health practitioners about non-binary people and relevant issues. Findings suggest beneficial outcomes from both prior professional training in this area and the brief training used in the study. The brief online training used in the study was associated with higher perceived knowledge, confidence, and comfort for working with non-binary clients, but further research is needed to understand reasons for change in these variables. [ABSTRACT FROM AUTHOR]

The study of authoritarianism has a long history in the field of psychology; however, much of this research focuses on Western countries, especially the United States. In effort to better understand authoritarianism cross‐culturally, we explore the current state of authoritarianism in an important cultural context: Russia. Thus, the current paper reports on large‐scale research of right‐wing authoritarianism and social dominance orientation in the modern Russian context. Six studies (total N = 1,358) included personality traits, basic human values, social beliefs, and intergroup attitudes that allowed us to comprehensively consider authoritarian attitudes in Russia. The results showed that personological profile and pattern of reaction to threat among Russian authoritarians is similar to Western authoritarians. However, economic views inherited from Soviet ideology make Russians differ in their view of economic conservatism from that supported by Western authoritarians. These data provide insight into the psychology of authoritarianism as well as explore novel aspects of Russian culture. [ABSTRACT FROM AUTHOR]

Context: The motivational climate created by the athletic trainer in rehabilitation may be critical in influencing athletes’ intrinsic motivation and other psychosocial outcomes in the rehabilitation and the recovery processes. Objective: To examine intercollege athletes’ perceptions of the motivational climate in the rehabilitation setting. Specifically, examining if perceptions of the motivational climate can predict athletes’ levels of intrinsic motivation with rehabilitation as well as the relationship between perceptions of the motivational climate and athlete demographics (gender, starter status, athletic trainer gender, etc). Design: Cross-sectional, descriptive research. Setting: College sport team and athletic training center. Participants: National Collegiate Athletic Association Division II intercollege athletes from one institution (n = 187; 125 males and 62 females). Main Outcome Measures: Paper-based survey measuring mastery and performance perceptions of the motivational climate in rehabilitation, athletes’ goal orientation in sport, and athletes’ levels of motivation in rehabilitation. Results: Perceptions of a performance climate were positively related to intrinsic motivation effort–improvement (effect size = 25.34%). Perceptions of a mastery climate were positively related to interest–enjoyment and perceived competence and negatively related to tension–pressure (effect size = 39.03%). In general, female athletes, as well as athletes with a female athletic trainer, had significantly higher perceptions of mastery motivational climate effort–improvement than male athletes and athletes with male athletic trainers. While male athletes and athletes with male athletic trainers had higher perceptions of intrateam member rivalry in rehabilitation. Conclusions: The athlete’s gender and goal orientation, as well as the gender of the athletic trainer creating the motivational climate, can influence whether the environment is perceived as more mastery or performance. The recovering athletes’ perceptions of the climate in rehabilitation can, in turn, affect their intrinsic motivation toward the therapeutic interventions. [ABSTRACT FROM AUTHOR]

Objective: The COVID-19 pandemic has resulted in major disruption to economic, health, education, and social systems. Families with preschool children experienced extraordinary strain during this time. This paper describes a qualitative study examining the experience of parents of preschool children in Hawaii during the COVID-19 pandemic. Sample: Thirteen (N = 13) parents of preschool children living on the island of Oahu, Hawaii, participated in small group discussions occurring in February and March 2021, approximately 1 year after the start of the pandemic in the state. Discussion transcripts were coded and sorted into themes. Results: Four themes emerged: stressors due to the COVID-19 pandemic, family coping and resources, meaning of the COVID-19 crisis to the family, and family adaptation patterns. Themes mapped to the Family Adjustment and Adaptation Response model. Conclusion: Families relied on various resources to cope with stressors experienced due to the COVID-19 pandemic, and adopted new patterns related to seeking healthcare and household emergency preparedness. Findings may inform policies and interventions to support families during the ongoing COVID-19 pandemic and future public health emergencies. [ABSTRACT FROM AUTHOR]

Considering the popularity and particularity of basketball, the athletes face a potential "Sport Commitment Crisis" due to immense pressures from academics, training, employment, and college. To date, research in sports has demonstrated the relationship between coach trust and sport commitment; however, the relationship among teammates is yet to be explored. We examined whether teammate trust is related to commitment and if prosocial and antisocial behaviors mediate these relationships. Right before a game, the college basketball players (N = 570) were asked to complete a multi-section questionnaire measuring the aforementioned variables. Structural equation modeling (SEM) revealed that athletes' perceptions of their teammates' trust were positively related to their sport commitment, and these relationships were mediated by teammate prosocial behavior. In contrast, antisocial behavior did not affect their relationship. The findings suggest that teammate trust could facilitate sport commitment in athletes, which could occur via prosocial behavior. Current college athletes face multiple pressures such as academics, sports training, and future employment, which cause their continuous participation in sports training and competitions to be shaken, resulting in a decline in sport commitment. This study starts from the perspective of team atmosphere and peer behavior, and selects college basketball players on a large scale in China, because basketball is popular among Chinese college students and has brought greater social attention. In the process of playing basketball, the interaction between members is high, and the emotional factor with teammates is even more important. Therefore, the choice of research participants is also one of the advantages of this paper. [ABSTRACT FROM AUTHOR]

Aim: The aim of this study was to explore the effect of health‐care providers' attitudes towards the medical use of cannabis, subjective norms and perceived stigma towards medicinal cannabis users on health‐care providers' intention to recommend medicinal cannabis for patients with qualifying conditions. Methods: A cross‐sectional correlational study included 221 health‐care providers (mean age, 42.2 ± 11.2; 74.2% women and 76.5% nurses) who completed a questionnaire examining theory‐based variables and stigma towards medicinal cannabis users. Results: More positive attitudes towards the medical use of cannabis were associated with lower stigma towards medicinal cannabis users, which, in turn, was associated with a higher intention of recommending medicinal cannabis for patients with qualifying conditions. The relationship between attitudes towards the medical use of cannabis and the intention to recommend medicinal cannabis varies according to subjective norms. Conclusions: Among nurses and physicians, stigma towards medicinal cannabis users mediated the relationship between attitudes towards the medical use of cannabis and the intention to recommend medicinal cannabis for patients with qualifying conditions, whereas subjective norms moderated this relationship. Effective treatment with medicinal cannabis might be compromised by health‐care providers' negative attitudes, stigma and subjective norms. SUMMARY STATEMENT: What is already known about this topic? The use of medicinal cannabis (MC) is considered controversial by health‐care providers. Patients who use MC are still the target of social discrimination.What this paper adds? Stigma towards MC users mediated the relationship between attitudes towards the medical use of cannabis and the intention to recommend MC for patients with qualifying conditions, whereas subjective norms moderated this relationship.The implications of this paper: There is a clear need for educational programmes for health‐care providers on the use of MC and the legitimacy of MC use. [ABSTRACT FROM AUTHOR]

Background: Training conversation partners of people with aphasia who use facilitative communication strategies is one method that can improve access to healthcare for people with aphasia. However, the efficacy of communication partner training (CPT) has been investigated almost exclusively in the context of face‐to‐face (F2F) delivery. Online training may offer more cost‐effective and accessible options to a wider range of conversation partners, including student healthcare professionals. Aims: To conduct a pilot randomized controlled trial with student healthcare professionals comparing (1) an online aphasia CPT program, (2) a F2F CPT program and (3) no program (control group) on outcomes relating to attitudes and knowledge of aphasia. Methods & Procedures: A 45‐min introductory aphasia CPT program was developed using the theories and techniques of Supported Conversations for Adults with Aphasia (SCA)™. A total of 30 first‐year undergraduates studying occupational therapy at The University of Sydney were randomly allocated to one of three conditions: online CPT delivery, F2F delivery or delayed training control (no program). Outcomes measures included pre‐post‐testing with the Aphasia Attitudes, Strategies and Knowledge (AASK) survey. Outcomes & Results: A significant difference existed for the AASK survey pre‐post‐change scores between the online, F2F and control groups (χ2(2) = 20.038, p = 0.000). Post‐hoc analysis revealed that, compared with the control (Ctrl) group, participants in both the online and F2F groups had significantly higher knowledge of aphasia (Online versus Ctrl: p = 0.000; F2F versus control: p = 0.002), knowledge of facilitative strategies (Online versus Ctrl: p = 0.000; F2F versus Ctrl: p = 0.002), and positive attitudes towards aphasia (Online versus Ctrl: p = 0.031; F2F versus Ctrl: p = 0.032). No significant difference was observed between the online and F2F groups for the Total or any subtotals (p = 1.000). Conclusions and Implications: The results from this pilot randomized controlled trial indicate that online delivery of the 45‐min introductory CPT is equally as efficacious as F2F delivery, and thus may be a viable mode of delivery for future aphasia CPT programs. These pilot results pave the way for a larger study that will comprehensively evaluate the efficacy of an online aphasia CPT program for improving attitudes, knowledge and skills in a broad range of student healthcare professionals. What this paper addsWhat is already known on this subjectThe efficacy of F2F CPT for aphasia is well established. Online delivery of CPT programs may offer more cost‐effective and accessible services when compared with F2F approaches; however, there is a need to explore the efficacy of online programs.What this paper adds to existing knowledgeThe 45‐min online aphasia CPT program was found to be efficacious for improving student healthcare professionals' knowledge and attitudes towards aphasia and communication, and produced equally successful outcomes when compared with F2F delivery. This is the first study to report the efficacy of an online CPT program that is aligned with SCA for use with student healthcare professionals that also uses a self‐report outcome measure with validated psychometric properties.What are the potential or actual clinical implications of this work?Online CPT programs may be useful in both clinical and education contexts to support improved efficiency of services and to enhance communication environments for people with aphasia in healthcare contexts. [ABSTRACT FROM AUTHOR]

Objectives: The global coronavirus disease 2019 (COVID‐19) pandemic has not been well controlled, and vaccination could be an effective way to prevent this pandemic. By accommodating attribute nonattendance (ANA) in a discrete choice experiment (DCE), this paper aimed to examine Chinese public preferences and willingness to pay (WTP) for COVID‐19 vaccine attributes, especially the influence of ANA on the estimated results. Methods: A DCE was designed with four attributes: effectiveness, protection period, adverse reactions and price. A random parameter logit model with an error component (RPL‐EC) was used to analyse the heterogeneity of respondents' preferences for COVID‐19 vaccine attributes. Two equality constraint latent class (ECLC) models were used to consider the influence of ANA on the estimated results in which the ECLC‐homogeneity model considered only ANA and the ECLC‐heterogeneity model considered both ANA and preference heterogeneity. Results: Data from 1,576 samples were included in the analyses. Effectiveness had the highest relative importance, followed by adverse reactions and protection period, which were determined by the attributes and levels presented in this study. The ECLC‐heterogeneity model improved the goodness of fit of the model and obtained a lower probability of ANA. In the ECLC‐heterogeneity model, only a small number of respondents (29.09%) considered all attributes, and price was the most easily ignored attribute (64.23%). Compared with the RPL‐EC model, the ECLC‐homogeneity model obtained lower WTPs for COVID‐19 vaccine attributes, and the ECLC‐heterogeneity model obtained mixed WTP results. In the ECLC‐heterogeneity model, preference group 1 obtained higher WTPs, and preference groups 2 and 3 obtained lower WTPs. Conclusions: The RPL‐EC, ECLC‐homogeneity and ECLC‐heterogeneity models obtained inconsistent WTPs for COVID‐19 vaccine attributes. The study found that the results of the ECLC‐heterogeneity model considering both ANA and preference heterogeneity may be more plausible because ANA and low preference may be confused in the ECLC‐homogeneity model and the RPL‐EC model. The results showed that the probability of ANA was still high in the ECLC‐heterogeneity model, although it was lower than that in the ECLC‐homogeneity model. Therefore, in future research on DCE (such as the field of vaccines), ANA should be considered as an essential issue. Public Contribution: Chinese adults from 31 provinces in mainland China participated in the study. All participants completed the COVID‐19 vaccine choice questions generated through the DCE design. [ABSTRACT FROM AUTHOR]

Background: The prevalence of dementia is increasing with more healthcare workers being required to care for people living with this progressive neurological disorder. The knowledge level and attitude of healthcare workers caring for those living with dementia need to be assessed and resources targeted effectively to ensure best quality care is provided. Healthcare workers for the purpose of this paper include anyone employed to care for those living with dementia. Aim: To investigate the attitudes of healthcare workers towards people living with dementia. Methods: A survey of 110 healthcare workers was undertaken between October 2016 and December 2017, using the Dementia Attitude Scale to measure attitudes towards people living with dementia. Demographic data were collected by a survey to explore whether a person's age; cultural background; qualification level; or experience level had an impact on their attitude towards people living with dementia. Results: The full survey was completed by n = 85 healthcare workers with the majority having strongly positive views about people living with dementia, with an average score of 88.31/100. However, a large number reported being afraid of people living with dementia (n = 76, 89.4%) and would avoid people with dementia who were agitated (n = 51, 61.4%). While 100% (n = 85) agreed or strongly agreed that it was possible to enjoy interacting with people living with dementia, they were more ambivalent with n = 26 (31.6%) strongly agreeing with the statement that working with people living with dementia is rewarding. A significant difference in attitude was found using one-way analysis of variance within groups due to age (p <.000) and cultural background (p <.035). Conclusions: Healthcare workers within this study had mainly positive attitudes towards people with dementia as demonstrated by the high attitude scores. However, this paper has shown that healthcare workers may require further education to improve attitude and care towards those living with dementia. [ABSTRACT FROM AUTHOR]

This paper describes the integration of a pharmacist into a perioperative environment and the ensuing quality and economic benefits. Deficiencies were identified in medication management in operating theatres (OT) at a large tertiary hospital. A perioperative pharmacist was employed for a 6-month pilot period, with permanent funding dependent on demonstration of agreed economic benefits. A multidisciplinary committee set goals, drove strategic initiatives and was accountable for delivery of outcomes. Pharmaceutical expenditure was analysed and high expenditure items targeted. Cost savings and staff satisfaction were measured at 6 months. Savings of A$63 884 were achieved during the pilot period, resulting from optimised pharmaceutical unit pricing, OT medication stock on hand (imprest) review and redesigned medication management strategies. Improvements in medication management included better access to medications in the OT, rationalising available products to minimise wastage and implementation of guidelines and protocols for high-cost and high-risk medications. At 6 months, 97% of theatre staff supported continuation of the role; the project was extended with demonstrated cost savings of A$157 265 at 12 months. The integration of a perioperative pharmacist resulted in cost savings and medication management improvements in the OT setting. A permanent position was funded. What is known about the topic?: Medication use in OTs involves high volumes of high-risk and high-cost medications. Historically, there has been little pharmacist involvement in OTs, even though evidence has shown that hospital pharmacists can reduce medication errors, improve patient safety and reduce costs. What does this paper add?: This paper provides an overview of the process of establishing a perioperative pharmacist role in an adult tertiary hospital. It takes readers through the journey from pre-implementation audit to trial development, stakeholder consultation and specific medication and process targets. What are the implications for practitioners?: Hospitals and practitioners are faced with the challenge of improving service delivery within the constraints of a finite budget. This paper allows readers to learn from our experience and apply these learnings to their local hospital setting, ultimately improving both patient care and staff satisfaction through the development of a perioperative pharmacist service. [ABSTRACT FROM AUTHOR]

This paper explores the well-being ['well-being' and 'wellbeing' are used interchangeably in the literature. Well-being is used in this paper (except in the reference list where exact wording is maintained)] benefits of participation in a workplace choir for health service staff. A mixed method study, this project combines quantitative measures of work engagement, perceived stress, resilience levels and work absences with qualitative interviews with choir participants. It is the first study of workplace choirs in Ireland and one of very few studies internationally that research health service staff choirs. There is some preliminary evidence of benefits that choir attendance may increase positive perception of workers' mental health as well as effect depression rates. However, evidence is limited quantitatively and difficulties in measuring the health benefits of arts interventions are noted. Qualitative data, however, confirms previous study findings, namely that a workplace choir can promote social connectedness, enjoyment at work and staff engagement. Work place choir was also noted to appeal mainly to a limited demographic of work place staff and people with relatively positive health and well-being. Efforts must be made to engage staff from lower socio-economic backgrounds, diverse cultural backgrounds and male staff in work place health promotion activities, as these groups were found less likely to join a work place choir. Given the low cost and low risk of this activity, and the qualitative benefits reported, it is recommended to continue to develop and evaluate health service workplace choirs. [ABSTRACT FROM AUTHOR]

This formative research study was designed to collect opinion data from adolescents historically underrepresented in adolescent dating abuse (ADA) research measure development. Eight in-person focus groups and 7 telephone-based one-on-one interviews were conducted with U.S. youth aged from 11 to 20 years (N =48). We conducted two focus groups with Black, Multiracial, Latinx, Native American, and LGBTQ+ youth. Seven LGBTQ+ youth participated in one-on-one telephone-based interviews. Focus group participants and interview subjects were asked the same 11 questions from a semi-structured focus group question guide. Five questions were on the topic of dating behaviors in general. In addition, six questions were asked for reactions to a paper-based list of 75 abusive acts. Youth generated ideas for 10 new possible cyber-ADA items and 14 emotionally abusive items for inclusion on the ADA measurement instrument. They did not generate any new physical or sexual ADA items. Youth identified 14 acts that they felt should not be on the measure, either because the acts were not abusive and too common, because they could not understand the item, or because it seemed unrealistic as an act of ADA. The study faced several limitations and was a good first step toward enriching the cultural inclusivity of ADA measurement instrument. Continued attention to inclusionary research that seeks to understand the cultural milieux of diverse participants is essential for violence prevention scholarship and subsequent health programming and policy that derive from it. [ABSTRACT FROM AUTHOR]

Accessible summary: What is known on the subject?: In recent years, some have suggested that palliative care approaches be considered for patients diagnosed with severe, persistent mental illness.Palliative care aims to decrease the suffering related to illness rather than focusing on curing the illness.Palliative care approaches for patients diagnosed with severe, persistent mental illness are controversial: Some argue palliative care would improve quality of life while others argue it would negatively affect patients' well‐being.A recent survey found that psychiatrists from Switzerland tended to support the idea of palliative care approaches for those diagnosed with severe, persistent mental illness, but little is known about nurses' attitudes or beliefs regarding palliative psychiatry. What the paper adds to existing knowledge?: Participating nurses tended to agree that palliative care approaches may be appropriate and even important in caring for those diagnosed with severe, persistent mental illness.Participating nurses tended to prioritize quality of life and respect for patient autonomy.Participating nurses tended to agree palliative sedation may be an appropriate intervention. What the implications are for practice?: For those diagnosed with severe, persistent mental illness, care that aims to increase daily functioning and quality of life rather than care that looks to cure may be appropriate.Palliative psychiatry should be further explored and better defined. Introduction: In recent years, palliative care approaches for patients diagnosed with severe, persistent mental illness have been proposed, but remain controversial. Aim/Question: The central research question of the present study was whether nurses consider palliative psychiatry appropriate in general and for certain patient types in particular. This pilot study is designed to inform future research. Method: A quantitative survey that explored attitudes and beliefs regarding palliative care for those with severe, persistent mental illness. Results: The responding 38 nurses tended to agree that palliative care approaches are suitable (73%, n = 24) and even important (62%, n = 21) in treating patients diagnosed with severe, persistent mental illness, including interventions such as palliative sedation (73%, n = 24). Discussion: Widespread support among respondents regarding palliative care approaches for those diagnosed with severe, persistent mental illness might be an indication that palliative approaches are already implicitly understood and incorporated into patients' care. More research is needed to determine whether these findings represent nurses' views generally. Implications for practice: These finding suggest that palliative psychiatry should be further explored and developed. [ABSTRACT FROM AUTHOR]

Stigma of mental illness contributes to silence, denial and delayed help seeking. Existing stigma reduction strategies seldom consider gender and cultural contexts. The Strengths in Unity study was a multi-site Canadian study that engaged Asian men in three stigma reduction interventions (ACT, CEE, psychoeducation) and mobilized them as Community Mental Health Ambassadors. Our participants included both men living with or affected by mental illness (LWA) as well as community leaders (CL). This paper will: (1) describe the baseline characteristics of the Toronto participants including their sociodemographic information, mental illness stigma (CAMI and ISMI), attitudes towards social change (SJS), and intervention-related process variables (AAQ-II, VLQ, FMI, Empowerment); (2) compare the differences among these variables between LWA and CL; and (3) explore factors that may correlate with socio-economic status and mental health stigma. A total of 609 Asian men were recruited in Toronto, Canada. Both CL and LWA had similar scores on measures of external and internalized stigma and social change attitudes, except that LWA had more positive views about the acceptance and integration of those with mental illness into the community on the CAMI, while CL had a higher level of perceived behavioral control on the SJS. Group differences were also observed between LWA and CL in some process-related variables. Exploratory analysis suggests that younger and more educated participants had lower stigma. Our findings underscore the importance of engaging both community leaders and people with lived experience as mental health advocates to address stigma. [ABSTRACT FROM AUTHOR]

Background: There is increased recognition in clinical settings of the importance of documenting, understanding, and addressing patients' social determinants of health (SDOH) to improve health and address health inequities. This study evaluated a pilot of a standardized SDOH screening questionnaire and workflow in an ambulatory clinic within a large integrated health network in Northern California. Methods: The pilot screened for SDOH needs using an 11-question Epic-compatible paper questionnaire assessing eight SDOH and health behavior domains: financial resource, transportation, stress, depression, intimate partner violence, social connections, physical activity, and alcohol consumption. Eligible patients for the pilot receiving a Medicare wellness, adult annual, or new patient visits during a five-week period (February-March, 2020), and a comparison group from the same time period in 2019 were identified. Sociodemographic data (age, sex, race/ethnicity, and payment type), visit type, length of visit, and responses to SDOH questions were extracted from electronic health records, and a staff experience survey was administered. The evaluation was guided by the Reach, Effectiveness, Adoption, Implementation, and Maintenance (RE-AIM) framework. Results: Two-hundred eighty-nine patients were eligible for SDOH screening. Responsiveness by domain ranged from 55 to 67%, except for depression. Half of patients had at least one identified social need, the most common being stress (33%), physical activity (22%), alcohol (12%), and social connections (6%). Physical activity needs were identified more in females (81% vs. 19% in males, p <.01) and at new patient/transfer visits (48% vs. 13% at Medicare wellness and 38% at adult wellness visits, p <.05). Average length of visit was 39.8 min, which was 1.7 min longer than that in 2019. Visit lengths were longer among patients 65+ (43.4 min) and patients having public insurance (43.6 min). Most staff agreed that collecting SDOH data was relevant and accepted the SDOH questionnaire and workflow but highlighted opportunities for improvement in training and connecting patients to resources. Conclusion: Use of evidence-based SDOH screening questions and associated workflow was effective in gathering patient SDOH information and identifying social needs in an ambulatory setting. Future studies should use qualitative data to understand patient and staff experiences with collecting SDOH information in healthcare settings. [ABSTRACT FROM AUTHOR]

Many people overestimate the health risks associated with nicotine, mistakenly perceiving nicotine as the main carcinogen in cigarettes and a leading cause of smoking-related diseases. Health professionals have been calling for public education programs to correct nicotine misperceptions in the hope that a lower risk perception of nicotine could encourage the use of nicotine replacement therapy (NRT). However, a lower risk perception of nicotine could also lower perceived risk of electronic cigarettes (e-cigarettes). This paper evaluated the necessity of correcting nicotine misperceptions and explored possible intervention strategies to increase use of NRT and decrease use of e-cigarettes. In Study 1, smokers were surveyed about their perceptions of nicotine harm, and attitudes and intention toward using NRT and e-cigarettes. Results showed that overestimation of nicotine harm was associated with e-cigarette attitude and intention, but not with NRT. Informed by the survey results, three correction messages (a nicotine message, an NRT message, and an e-cigarette message) were developed and experimentally tested in Study 2 on both tobacco users and nontobacco users. The nicotine message lowered people's perception of nicotine harm but it did not change attitude and intention toward tobacco product use. The NRT message also failed to influence NRT attitudes and intentions. The e-cigarette message significantly lowered attitudes and intentions to use e-cigarette. [ABSTRACT FROM AUTHOR]

Family caregivers (FCGs) are an integral part of the healthcare system. Currently, FCGs provide 70%–90% of the care required by community‐dwelling children and adults living with complex chronic conditions and frailty. Despite FCG's contributions and the growing proportion of distressed caregivers, support for FCGs has not been a health system priority. Researchers have proposed training to enhance the competencies of health providers to work effectively with FCGs. In the absence of best practices for the competency indicators for caregiver‐centred care, we have developed a competency framework for training the health workforce to support FCGs. The objectives in this paper are fourfold: (a) a brief review of stakeholder engagement that led to the development of the competencies the health workforce needs to support FCGs, (b) a description of the process used to name the competency domains, (c) a report on the Modified Delphi process (conducted 2019) used to validate the domain indicators, and (d) a description of the competency framework. We adopted a caregiver and a multilevel interdisciplinary stakeholder codesign approach throughout the competency development process. The competency domains include: (a) Recognising the Caregiver Role, (b) Communicating with FCGs, (c) Partnering with FCGs, (d) Fostering Resilience in FCGs, (e) Navigating Health and Social Systems and Accessing Resources, and, (f) Enhancing the Culture and Context of Healthcare. Our Caregiver‐Centred Care Competencies for the health workforce are only a first step in supporting FCGs in their vital roles. There are few education and training resources to enable and empower health providers to support FCGs, there is an urgent need to develop training resources for the health workforce to recognise and support FCGs. [ABSTRACT FROM AUTHOR]

Background: The contemporary scientific literature documents a lack of attention toward the act of consoling put into practice by health care professionals (HCPs) in hospice services. Objective: To describe the act of consoling and its meaning for hospice-employed HCPs. Design: A multicenter observational survey study was performed through a paper-based questionnaire. Subjects: The study was sent to the directors of 10 hospices in Northern Italy and distributed to 232 HCPs. Results: A total of 218 HCPs responded (94%). The results showed that most HCPs consider the practice of consoling to be essential to their profession, but they also underscored the extreme complexity of the process. Conclusion: The act of consoling is not simply a professional duty defined in contractual clauses. Rather, it is a set of specific communicative practices and skills required of HCPs. [ABSTRACT FROM AUTHOR]

Background: The stigma of epilepsy still holds fast today, and consequently results in people with epilepsy not seeking the support they require. To date, little research has been conducted into seizure label preferences. This paper contributes new findings to this growing body of research. Methods: Participants with epilepsy completed an online survey stating their preferences for seizure labels: seizure; fit; attack; episode; s/he is having a seizure/fit; and s/he is fitting/seizing. Through a thematic linguistic analysis of the participants' comments, this paper investigates the influence of semantics and grammatical variation to assess how these linguistic features portray epilepsy. The semantic implications of individuals' personal seizure labels are also explored. Results: The consensus falls with seizure and s/he is having a seizure, as the alternative choices were comparatively less popular and illustrated many negative connotations. The participants' explanations their 'least preferable' rankings were categorized and thematically aligned. This proposed taxonomy offers insight into how different labels shape identity and contribute to the stigma. The grammatical variations of the phrases appear to contribute to (mis)representing seizure trajectory and imagery. The personalized seizure labels offered by a selection of participants may also be suggestive of the seizure experience itself. Conclusions: The consensus of these results can guide healthcare professionals and the media to opt, in the first instance, for the terms/ phrases that have been thought as the most preferable, and to avoid using those ranked by the majority as least preferable. [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: This paper investigates the palliative care competencies (knowledge, behaviours, attitudes) and education needs of nurses and healthcare assistants (HCAs) who provide supportive (Level 2) palliative care. Methods: A mixed-methods study using a sequential exploratory design was used, with findings integrated across sources. Qualitative focus groups were conducted in 2018 with a sample of staff (n=11, all female; nurses=4; HCAs=7) providing supportive palliative care in a single service setting. A quantitative survey, also conducted in 2018, explored the issue with a wider sample within the same setting (n=36; nurses=18; HCAs=18; female=32). Results: Qualitatively, communication was highlighted as an important domain of the competence framework, with many participants acknowledging that the ability to communicate effectively is essential. Quantitatively, participants scored in the lower range for competency variables. A significant difference was observed between HCAs and nurses on measures of knowledge (t= -2.718; df=30; p<.05) and behaviour (t=-3.576; df=30; p<.05), with HCAs scoring significantly higher than nurses. In relation to education, while some participants report being indecisive regarding engaging in education/training, others highlighted the benefit of education, especially its ability to impact on their current practice. Conclusion: This research contributes to understanding palliative care competencies among nurses and HCAs working in palliative care, and has important implications for the education and training of nurses and HCAs working in Level 2 palliative care in Ireland. [ABSTRACT FROM AUTHOR]

Accessible summary: What is known on the subject?: Readiness to change has been documented as a factor affecting alcohol treatment attendance, engagement and outcome.Knowledge regarding readiness to change and its influencing factors in patients with alcoholic liver diseases will inform the development of relevant interventions to help these patients to successfully stop drinking. What this paper adds to existing knowledge?: The scores in all three dimensions of readiness, recognition, ambivalence and taking steps, were low.For the recognition stage, age, drinking severity and stigma are important factors to be considered.For the ambivalence stage, age and drinking severity are important influencing factors.For the taking steps stage, drinking refusal self‐efficacy and depression should be the focus.Instead of negative associations, we found that age and drinking severity, self‐stigma and depression were positively associated with readiness to change.Patients who are younger and have higher drinking severity, higher self‐stigma, higher self‐efficacy and severe depression are more likely to change alcohol use. What are the implications for practice?: Age, drinking severity, self‐stigma, drinking refusal self‐efficacy and depression are important factors to be considered when mental health nurses try to increase psychological preparedness for changing alcohol use in patients with alcoholic liver diseases.Different factors must be considered for patients in different stages of readiness to change.Different alcohol treatments are needed for different patient populations. Introduction: Readiness to change (RC) refers to the willingness or psychological preparedness for changing alcohol use. Knowledge regarding factors influencing RC is crucial for developing alcohol treatment plans. Aims: The study's purpose was to investigate RC and its influencing factors in patients with alcoholic liver disease (ALD). The factors explored include demographics, disease characteristics, drinking severity, self‐stigma, depression, social support and self‐efficacy. Method: This is a cross‐sectional study using self‐reported questionnaires. Results: Eighty‐seven patients with ALD were recruited. Their scores in all three dimensions of readiness, recognition, ambivalence and taking steps, were low. Self‐stigma, age and drinking severity explained 32.3% variation in recognition. Drinking severity and age explained 21.5% variation in ambivalence. Self‐efficacy, depression and age explained 19.3% variation in taking steps. Discussion: Instead of negative associations, we found that age, drinking severity, self‐stigma and depression were positively associated with RC. Younger patients with higher drinking severity, higher self‐stigma, higher self‐efficacy and severe depression are more likely to change alcohol use. Implications for practice: Mental health nurses should consider factors such as age, drinking severity, self‐stigma, self‐efficacy and depression, while trying to increase patients' RC. More specifically, strategies to increase self‐efficacy and interventions to support coping are needed. Relevance statement: Many ALD patients needing treatment for problematic alcohol use can be effectively managed in primary care with appropriate specialist support. An experienced specialist mental health nurse can play this role. Mental health nurses are important members of alcohol addiction treatment teams. Traditionally, most nurses working in alcohol therapy services have been mental health specialists and work in a partnership model with physicians and other healthcare professionals. The influencing factors found in this study can further inform mental health nurses to recognize and work more effectively with ALD patients' alcohol problems. [ABSTRACT FROM AUTHOR]

Objective: To describe the perceptions of healthcare workers employed at a metropolitan public health service, with respect to how they identify, manage and care for refugee patients. Methods: This study surveyed healthcare workers using a cross-sectional, mixed methods descriptive design, which partially replicates a previous Australian study. A total of 215 responses to a brief online survey were received (n = 48 medical, n = 100 nursing and midwifery, n = 50 allied health, n = 4 other). Results: Nurses and allied health respondents were more likely to record working with refugees rarely or never (P = 0.00). Most respondents (70.3%) identified no negative effects from working with refugees, and perceived this patient group enhanced (71.3%) their work. Insufficient identification, interpreter availability, education, healthcare worker capacity and providing culturally specific treatment were all identified as potential service barriers. Allied health respondents were more likely to report low confidence about working with refugees in general (P = 0.04). Respondents with more than 10 years' experience with refugees (P = 0.02), and those with good self-perceived awareness of community services (P = 0.01), were more confident in their ability to manage social issues. Conclusions: This study suggests that contextual factors influence the perceptions of healthcare workers who provide care to refugee patients; however, communication, health literacy and healthcare worker capacity were consistently raised as key issues when working with refugees. What is known about the topic?: Refugee and asylum seeker patients may present with complex health needs to any part of the Australian health system. The majority of previous research has occurred in primary care settings. What does this paper add?: This study adds an acute and subacute perspective to the evidence base, and also includes medical respondents for the first time. Compared to previous research, respondents of this study saw refugee patients more frequently in their practice, and also reported fewer negative effects from working with them. Most demographic characteristics had no significant effect on worker-reported confidence in this study; however, greater experience of working with refugees and good self-perceived awareness of community services were both identified as positive influences. What are the implications for practitioners?: Practitioners should prioritise remedying barriers that are consistently identified as affecting the service provided to refugee patients (communication, health literacy and healthcare worker capacity) as part of their quality and service improvement efforts. [ABSTRACT FROM AUTHOR]

OBJECTIVE: The aim of this study was to examine the factors influencing job satisfaction of nurses, physicians, and advanced practice providers in ambulatory oncology settings. BACKGROUND: Job satisfaction is essential to clinician well-being and quality of care. METHODS: In 2017, clinicians from 29 ambulatory medical oncology practices completed anonymous paper questionnaires that examined job satisfaction, clinician-to-clinician communication, and perceptions of patient safety. Linear regression, adjusted for clustered observations, examined the relationship between job satisfaction, clinician communication, and patient safety perceptions. RESULTS: Of 280 respondents (response rate of 68%), 85% reported that they were satisfied or very satisfied with their current position. Patient safety and accuracy of clinician communication were positively and significantly associated with job satisfaction. CONCLUSIONS: Although most surveyed clinicians were satisfied, 15% were dissatisfied and reported communication and safety concerns. Leadership efforts to strengthen clinician communication actions and develop positive safety cultures are promising strategies to promote clinician well-being and high-quality cancer care. [ABSTRACT FROM AUTHOR]

India is more challenged than developed nations in reducing the Covid-19 cases and lowering death rates due to the huge population and unprepared health care system. As intention to vaccinate is contextual and its availability does not translate into their de facto adoption., this paper examines the factors that determine intention to vaccinate against COVID-19 in India. A research model was tested using 222 responses was tested using structural equation modeling. Findings suggested that credibility and awareness positively impacted whereas vaccine hesitancy and perceived risk negatively influenced intention to vaccinate. The fear of side effects did not impact the intention to vaccinate. [ABSTRACT FROM AUTHOR]

Accessible summary: What is known on the subject?: Coercive interventions (CI) in emergency psychiatry face increasing criticism, as they can be an emotional, even traumatic event for all persons involved. They are thus considered the last resort.The use of coercive interventions differs widely with regard to type and frequency of measures across different countries and institutions.Individual staff characteristics, such as attitudes towards coercion, may play a vital role in the management of aggression.Little is known about the influence of emotions of staff members on CI, but they are likely to play an important role. What the paper adds to existing knowledge?: Most staff members surveyed had a rather critical view of coercion and considered it a "necessary evil."Staff members with the most work experience had a more critical view of coercion in comparison with less experienced staff. Nurses rated coercion more positively than did psychiatrists or psychologists.Emotions play an important role in decision‐making processes. The current study systematically asked for accompanying emotions during the application of CI and looked for individual differences. A majority of the participants experienced compassion; about half felt helplessness, grief or anxiety. Almost 20% stated that they felt a sense of power. Older staff members more often felt anger or guilt; women felt less power than men did. Nurses felt more desperation than other occupational groups.Staff members consider reflective interventions, such as team supervisions or post‐seclusion/restraint debriefings with the patient, as important. Nevertheless, only half reported that these interventions are carried out routinely.Staff members believe that certain risk factors (including stress, low staffing, a fully occupied ward and the presence of particular staff members) enhance the probability of CI. What are the implications for practice?: To reduce the use of coercive interventions, we recommend that psychiatric teams include highly experienced staff members as work experience has a positive effect on the attitudes towards coercive interventions.Structured post‐seclusion/restraint debriefings and team supervisions are considered helpful by staff members and are relatively easy to implement on acute wards. Enhancing staff members' ability to reflect on their own attitudes, emotions and actions is likely to reduce coercive interventions. Introduction: Little is known about staff attitudes towards coercive interventions (CI) and emotions accompanying these measures. Aim: The current study assessed attitudes, views on reflective interventions and accompanying emotions of different occupational groups towards CI, as well as factors, that increase the probability of CI. Method: Staff members (N = 138) of a large psychiatric hospital in Germany were assessed using the Staff Attitude to Coercion Scale (SACS) and newly developed items assessing staff members' emotions and views on coercion. Results: Experienced staff members were most critical of coercion. Nurses rated coercion significantly more positively than other staff. A majority experienced compassion; about half felt helplessness, grief or anxiety. Almost 20% felt a sense of power. Nurses felt the most desperation. Participants strongly desired reflective measures such as post‐seclusion/restraint debriefings with patients. According to staff members, stress on the wards and low staffing increases the probability of CI. Discussion: The study assessed accompanying emotions during the application of CI. Attitudes towards coercion and emotions are associated with individual staff characteristics (e.g. profession, work experience). Implications: The presence of experienced staff members may help prevent CI. Staff consider reflective interventions helpful in reducing CI. [ABSTRACT FROM AUTHOR]

Nowadays, patients' safety is the top priority for medical services around the world. However, it is believed that many of the adverse events in hospitals are preventable. Type and screen (T&S) procedures require intense practical training by each medical practitioner in each hospital. This study applied an interactive Virtual Reality (VR) technology to supplement the traditional approach to facilitate procedural training. The VR system made use of the Unity3D for application development. To investigate the reliability and validity of the conceptual medical training model, a survey was conducted to measure the content, motivation and enhanced readiness of practitioners. The partial least squares (PLS) modelling was carried out to investigate the correlation between each pair of measured variables. The study results indicated that the learning model has good reliability for each measurement factor and validates the survey study. The PLS modelling also indicated a significant correlation between each pair of measured variables. The project developed a VR training program for training in T&S procedures. The study provides important implications on the development of a practical VR training program for medical practitioners, as well as valuable insights for the development of similar VR training programs in the future. Lay Description: What is already known about this topic: Patients' safety is the cornerstone of high‐quality medical services around the worldPractical skill training no matter whether a student in a medical degree programme at university or as a medical intern is very importantType and screen (T&S) is an essential protocol and diagnostic procedure for patients, and it requires intense practical training by each medical practitioner, and is essential to doctors, nurses, and medical interns in all hospitalsVR offers benefits to the learners, as well as educators. It is cost‐effective, and provides safe, repeatable, standardized and interactive training to medical practitioners. What this paper adds: An interactive Virtual Reality (VR) training program is developed to supplement the traditional approach to facilitate procedural training for medical practitionersA conceptual model to investigate the relationship between content (C), motivation (M), and enhanced readiness (E) for medical practitioners under VR trainingThe PLS modelling has indicated a significant correlation between content, motivation, and enhanced readiness. Implications for practice and/or policy: In the training of medical practitioners, besides considering the gaming elements in the training program, more emphasis should be put on the design of the content to enhance their motivation for learningThe motivation of medical practitioners has positive impact to their readiness for participating the VR trainingThe study has important indication in the design of similar practical VR training programs in the future. [ABSTRACT FROM AUTHOR]

Home telemonitoring has been used as a solution to support the care of individuals living with chronic disease. While effectiveness of telemonitoring have been widely studied, more research is needed to understand the perceptions among patients and clinicians in incorporating telemonitoring into their daily routine and practices. This paper presents an investigation of patients’ and clinicians’ experiences in a care augmenting telemonitoring service, their perceived impact delivered through the service, and clinicians’ perceptions on how the service was introduced in their organizations. This work was embedded in a large multi-site trial of home telemonitoring using a mixed method approach for evaluation. Interviews with clinicians involved in the study were conducted at multiple time points during the trial. Questionnaires were administered to clinicians and patients at the end of the trial. Results showed that both patients and clinicians recognized the benefits of patient empowerment through telemonitoring, and patient-clinician interactions. Results identified the needs of a dedicated telemonitoring clinical care coordinator role, guidelines that translate telemonitoring services into clinical pathways and engagement of different healthcare providers, especially general practitioners, to support the integration of telemonitoring into chronic disease management programs and long-term organizational strategic plans. [ABSTRACT FROM AUTHOR]

Background. Despite substantial progress in the treatment of hepatitis C through the use of direct-acting antivirals which have been shown to cure the disease, complementary and alternative medicines (CAM) are popular among patients as a substitute or complement of allopathic medicines. This study aimed to explore the perspectives of patients and CAM practitioners on the use of CAM for the treatment of hepatitis C in Pakistan. Methods. A cross-sectional design was adopted. Participants (CAM practitioners and patients) were recruited from the capital and two provinces: Khyber Pakhtunkhwa and Punjab of Pakistan. A survey using paper-based questionnaires, each specific for patients and CAM practitioners, was conducted to gather information pertaining to demography, disease status, treatment history, and participants' perspectives (about the disease, reasons to switch to CAM, and referring source). Results. A total of 417 respondents (n = 284 patients, n = 133 practitioners) were recruited. Of the total patients, 170 (59.9%) had started CAM during the previous three months. There were 168 (59.2%) of the total patients who had used allopathic treatments for hepatitis C prior to their use of CAM. The confidence in CAM (24.6%), high cost (19%), and unbearable side effects (52.1%) of allopathic medicines were the main reasons to switch to CAM treatment. Majority (49.3%) of the patients were referred to CAM on the recommendations of relatives or care givers (17.3%) whereas only 9.5% were referred by health care professionals. Out of 133 practitioners, 48 (36.1%) were practicing herbal medicines. From practitioners' perspectives, club-moss (Lycopodium clavatum) was the best treatment option for hepatitis C. The majority, 73 (54.9%), of the patients had chosen to use CAM because of the side effects of allopathic medicines. Patients who had previous "good experience" with CAM were the most common referral source (56.4%) for CAM use in hepatitis C. Conclusions. Patients' beliefs in CAM, side effects of allopathic therapy, high cost of allopathic medicines, and referrals from previous CAM users are key factors in the switching of hepatitis C patients to CAM. [ABSTRACT FROM AUTHOR]

Accessible summary: What is known on the subject?: AHDs in mental health are fundamental tools in advance care planning processes. It is an important method for involving mental healthcare users in clinical decisions and in providing effective healthcare based around user preferences.AHDs can be applied in situations in which the person may forfeit their legal capacity, according to the Convention on the Rights of Persons with Disabilities.However, the use of AHDs as described above is not yet a reality in Spain. What the paper adds to existing knowledge?: The present study surveys the knowledge and attitudes of mental healthcare providers towards AHDs in clinical practice.Although providers had a moderate–low level of knowledge about AHDs, they presented positive attitudes towards them. What are the implications for practice?: The use of AHDs in mental healthcare practice poses challenges to the Spanish mental healthcare system. Acquiring up‐to‐date data on the knowledge and attitudes of providers towards AHDs allows organizations to address aspects of their service that require reinforcement. This data could also be used by other countries just starting to use AHDs, as an initial step towards supporting the implementation of a multistage intervention process.More in‐depth training for providers would help improve their competence to implement or honour the statements set out in AHDs, the related legal and ethical issues, and liability issues related to their implementation.The Spanish mental healthcare system requires structural changes so that providers can embrace new ways of relating to users and to organize partnerships and a continuity of care centred on user preferences. Introduction: Advance healthcare directives (AHDs) in mental health offer important information regarding service users' preferences. However, whether AHDs are truly understood by providers is questionable. Aim: To survey the knowledge and attitudes of mental health professionals towards AHDs and examine any associations with sociodemographic and occupational variables. Method: We cross‐sectionally surveyed the knowledge and attitudes of 113 mental health professionals by using two validated questionnaires. Results: Participants showed very positive attitudes and high levels of knowledge about the conceptual definition and application of AHDs in clinical practice but their knowledge of the legalities, procedure and registration of AHDs was poor. Working in a community, having a career specializing in mental health or having personally signed an AHD was associated with enhanced knowledge about them. Moreover, female sex or employment as an auxiliary nursing‐care technician was associated with stronger positive attitudes. Discussion: Legal and structural changes will be needed to implement AHDs in Spain and to promote competence among healthcare providers in order to include AHDs in everyday practice. Implications for practice: The Spanish mental healthcare system requires legal and structural changes and must improve healthcare providers' competence in AHDs before they are implemented. [ABSTRACT FROM AUTHOR]

Optimal primary care sector performance is vital for ensuring the delivery of quality health services and effective clinical management of populations. The Primary Care Practice Improvement Tool (PC-PIT) incorporates subjective staff input and objective indicators to measure 13 elements of organisational performance. This study aimed to measure change in organisational performance for general practices using the PC-PIT with Primary Health Network (PHN) support. A pre-post design was used for changes in PC-PIT subjective and objective scores. Practices used results with PHN support to complete two Plan Do Study Act initiatives and were reassessed 9-months later. PC-PIT scales were dichotomised into lower and higher scores, with odds ratios used to determine effect size. Staff survey response rates were 55.4% at baseline and 50.1% at follow up. There were modest increases in the likelihood of staff rating several elements higher at follow up. When implemented with PHN support staff, the PC-PIT has the potential for effective, focussed and sustained quality improvement, with capacity to support Health Care Home model transition and implementation. Optimising primary care practice performance presents an important national challenge. This paper demonstrates the positive effect of the Primary Care Practice Improvement Tool (PC-PIT), supported by a Primary Health Network practice support team, in building practice quality and performance. [ABSTRACT FROM AUTHOR]

This paper examines the role of service climate (SC) in the link connecting human resource management practices (HRMP) to commitment to service quality (CSQ). Data were collected from 1236 hospital staff working in different private hospitals in India. The model linking HRMP to CSQ with the moderation of SC was tested using Hayes PROCESS. Results revealed that human resource management practices found to be influencing CSQ and with the interaction of SC the effect is further augmented. The interacting role service climate has been found to be significant at mean and high levels. [ABSTRACT FROM AUTHOR]

Aim: To assess the perception of the nursing profession in Armenia from the perspective of multiple stakeholders, including nurses and the general public. Background: Nurses' role perception is a complex phenomenon defined by multiple stakeholders. Methods: The assessment used a convergent parallel mixed‐methods design, with a dominant qualitative status. We conducted the qualitative phase through focus group discussions and in‐depth interviews with 235 people and collected quantitative data in a cross‐sectional telephone survey with 389 participants. Results: The nursing profession has been influenced by medical hierarchy and subordination, and none of the participants recognized nursing as an autonomous health care profession. The quantitative survey findings were largely consistent with the qualitative results. Our findings highlighted empathy and compassion as inherent qualities of nurses in Armenia. Conclusion: To change opinions about the nursing profession and highlight nurses' meaningful contribution to the provision of health care services, it is important to develop a national definition of nursing and introduce higher educational opportunities for nurses in Armenia. Implications for nursing management: The paper highlights the importance of quality education for preparing highly competent nurse managers who can become role models in promoting nurses' roles in health care systems and improving the professional and public image of nursing. [ABSTRACT FROM AUTHOR]

Persuasive system features have been widely adopted to encourage attitude and behaviour change. Recently, most social networking sites (SNS) adopt some form of persuasive system features that leverage social influence to deliberately induce prescribed behaviours in their users. However, studies on how these features can be used to promote knowledge sharing are inadequate; particularly, regarding how SNS that have been developed solely for academic purposes can adopt these features to promote knowledge sharing. To address this knowledge gap, this study integrates constructs from the social capital theory and persuasive systems design model to investigate the impact of persuasive social features on knowledge sharing among students of tertiary institutions on academic social networking sites. Data are quantitatively gathered from 218 respondents from tertiary institutions and statistically analyzed. The results suggest that perceived dialogue support and perceived social support have strong influences on knowledge sharing behaviour. Lay Description: What is already known about this topic: Researchers' use of Academic Social Networking Sites has been prevalent.Knowledge sharing is essential in research.Users are predominant information consumers rather than sharers.Encouraging knowledge sharing continues to be a problem. What this paper adds: Persuasive system features are effective for inducing attitude and behaviour change.Persuasion features that leverage on social activities influences knowledge sharing behaviour. Implications for practice and/or policy: Developers of Academic Social Networking Sites are encouraged to develop algorithms that connect users with similar understanding and values.Improving dialogue and social support features on these sites can also improve knowledge sharing. For instance, users who actively contribute to discussions could receive open recognition, encouragement and motivation. [ABSTRACT FROM AUTHOR]

Objective: The aim of this study was to identify the hepatitis C treatment intentions of Aboriginal people living with hepatitis C virus (HCV) in Western Australia. Methods: This study used a mixed-methods design. In the cross-sectional survey, 123 Aboriginal people who inject drugs and self-report as living with hepatitis C completed a purpose-designed questionnaire. In the qualitative phase, 10 participants were interviewed about the factors influencing their future intentions to undertake hepatitis C treatment. Results: Analysis of the survey data revealed significant associations between an intention to undertake hepatitis C treatment and support, community attachment, stable housing and stigma. In addition, there was a high overall level of expressed intention to undertake HCV treatment, with 54% of participants responding positively. Analysis of the qualitative data supported quantitative findings, revealing concerns about stigma, lack of social support and unstable housing as factors affecting the intention to undertake hepatitis C treatment. Conclusion: This mixed methods study with Aboriginal people living with self-reported HCV indicates interventions focused on reducing stigma and unstable housing could positively affect hepatitis C treatment intentions. These findings have implications for developing holistic programs to promote and support people on hepatitis C treatment. What is known about the topic?: Substantial knowledge gaps need to be resolved if HCV elimination among Aboriginal Australians is to be achieved. Current research has prioritised non-Aboriginal communities. What does this paper add?: This study found that stigma and unstable housing require attention if Aboriginal Australians are to obtain the full benefits of direct acting antiviral (DAA) hepatitis C treatment. What are the implications for practitioners?: Reducing stigma (in the primary healthcare setting) and providing access to stable housing are vital components of supportive, non-judgemental and culturally appropriate care for Aboriginal people. This study highlights the importance of education for nurses and other primary care providers to increase engagement in the hepatitis cascade of care. To achieve this, scaling-up of HCV treatment engagement, trained Aboriginal community healthcare workers and HCV treatment advocates must mobilise and support Aboriginal people to avoid the negative effects of stigma, build positive and enabling relationships and reinforce positive attitudes towards DAA hepatitis C treatment. [ABSTRACT FROM AUTHOR]

Accessible Summary: In the past 30 years, many people with (intellectual) learning disabilities have been moved out of large "institutions" and into their own home in their local communityThese people are now often between 30 and 50 years oldWe asked people with learning disabilities aged between 30 and 50 and who are living in their local community what things, including work, that they enjoyed doingWe asked people with learning disabilities aged between 30 and 50 and who are living in their local community whether they felt that they could make decisions about their lifeWe found out the things that make their life good, and also what might stop people enjoying their lifeWe learnt that people with learning disabilities should receive more support to assist them before they retireWe learnt that people with learning disabilities still need more support and choice around who they live with Background: This study investigated perceived quality of life (QoL) of community‐dwelling middle‐aged adults (30–50 years) with an intellectual disability and/or developmental disability living in rural or urban areas in New South Wales and Queensland, Australia. The specific aim of the current paper was to provide a descriptive evidence base of QoL and its specific domains by various key demographic characteristics of middle‐aged individuals. This cohort is likely to have either experienced or reached adulthood during and after large‐scale deinstitutionalisation in Australia. Methods and procedures: A cross‐sectional design was utilised, based on the QoL‐Q survey, testing domains of satisfaction; Competence/Productivity; Empowerment/Independence; and social belonging/community integration. The survey included demographic questions and was distributed to participants through disability support agencies across two states. The final sample included 291 respondents. Results: The overall QoL‐Q scores ranged from 3.0 to 29.5 (Mean = 20.4, SD, 4.1), with considerable variation in mean scores both across and within domains. The two demographic areas that showed greatest predictive value for QoL were work status and accommodation issues. The loss of agency and control in choice of co‐residents influenced perceived QoL for empowerment and independence domain of QoL‐Q. Conclusions: The findings highlight QoL issues associated with policy decisions and support programmes for middle‐aged adults. The two key recommendations arising from the project are that future planning for post‐retirement or reduced working hours needs to commence at a much younger age than currently expected, and more attention needs to focus on facilitating individual decision‐making and choice within shared accommodation options. [ABSTRACT FROM AUTHOR]

Objectives: HealthPathways, pioneered in Canterbury, New Zealand, in 2008, is a web-based tool designed to promote health care integration and patient management in primary care and to reduce fragmentation in the delivery of health services. This cross-sectional study evaluated the utilisation and perceptions of this tool among health professionals in Australia and New Zealand. Methods: A cross-sectional survey was administered online through Research Electronic Data Capture (REDCap) to general practitioners (GPs), practice nurses and managers, nurse practitioners, specialist and community nurses, hospital clinicians, nurses, managers, and allied health professionals between April and September 2018. The frequency of HealthPathways use in the previous month was modelled as an ordered response using an ordered logistic regression model after adjusting for the possible effects of sex, age, years in clinical practice, location and time spent in practice. Results: Health professionals perceived HealthPathways to be useful in primary care management and referral, as well as in the prereferral treatment of patients. GPs in New Zealand, New South Wales and Victoria were 73%, 47% and 27% more likely to have used HealthPathways ≥10 times in the previous month respectively. Conclusion: The results suggest that HealthPathways is having a positive effect on healthcare systems in New Zealand and Australia. However, differences in uptake suggests the need for focused implementation, integration into eReferral software and expanding the tool to medical students, registrars, allied health professionals and potentially patients to encourage behavioural change. What is known about the topic?: Early evaluations suggest that HealthPathways is a useful tool for health professionals, although uptake and utilisation may be limited. However, there is no comparative evidence regarding uptake and implementation of the tool. What does the paper add?: This study is among the first to provide a comparative narrative of the literature assessing the implementation and uptake of HealthPathways across Australia and New Zealand. It is also among the first to compare the perceptions of allied health professionals in the use of HealthPathways across Australia and New Zealand. What are the implications for practitioners?: The results of this study suggest the need for focused implementation, integration into eReferral software and expanding the tool to medical students, registrars, allied health professionals and potentially patients to encourage behavioural change. [ABSTRACT FROM AUTHOR]

Objective: The objective of this study is to determine whether physiotherapy and counselling students, who represent a future generation of two health professions, have differing views about complementary and alternative medicine (CAM). Methods: In order to determine physiotherapy and counselling students' self‐rated knowledge and beliefs about CAM and the factors which influence that understanding, a modified 10‐item CAM Health Belief Questionnaire was administered across all year groups to physiotherapy students and counselling students at two universities in Perth, Western Australia. The self‐rated paper‐based survey measured knowledge of CAM among physiotherapy and counselling students, evaluation of their beliefs regarding the use of CAM, factors that influence their knowledge and beliefs, and their likelihood of recommending CAM to future patients. Results: A response rate of 96.8% was achieved, with 387 physiotherapy students and 88 counselling students. Moderately positive beliefs about CAM were confirmed in both groups, with mean scores of 42.8/70 for physiotherapy students and 43.3/70 for counselling students. There were no significant differences between the student groups in overall self‐rated knowledge of CAM. The main factors that influenced the students' responses were personal experience for counselling students and scientific evidence for physiotherapy students. Other factors included university training, attitudes of lecturers, tutors and fellow students, cultural background, and opinions of external practitioners. Counselling students were more likely than physiotherapy students to recommend CAM therapies to their future patients. Conclusion: The results from this study demonstrate minimal self‐rated knowledge but moderately positive attitudes towards CAM by both physiotherapy and counselling students. [ABSTRACT FROM AUTHOR]

Health workers are prone to burnout, which can have an adverse effect on their person and the patients to whom care is offered. The goal of this paper was to assess the levels of burnout experienced by healthcare workers in Accra, Ghana. The study was conducted using the cross-sectional study design. Questionnaires were used to obtain data from 365 respondents who worked in 12 major healthcare facilities. Data obtained were analyzed with SPSS version 23. Majority of the respondents were females (56.7%) as against males (43.3%). The total score for all burnout variables among health worker groups ranged from good (71.50%), alarming (12.60%), acute crisis (6.02%), and burnout (9.90%). Among the health worker groups, nurses had the highest percentage score values for all burnout variables. There was an association between burnout and these sociodemographic characteristics: age (p < 0.001), gender (p = 0.003), educational qualification (p < 0.001), occupation (p < 0.001), years of work experience (p < 0.001), marital status (p < 0.001), and parenthood (having children) (p < 0.001). It is recommended that measures should be put in place in Ghanaian hospitals to assess stress and burnout levels to ensure people who are going through such situations are properly cared and supported. [ABSTRACT FROM AUTHOR]