Search

Background: Understanding the motivations driving family members to continue caring for individuals with Alzheimer's disease is crucial for enhancing social support programs within community health systems. This study specifically explores the factors influencing Iranian family caregivers' ability to persist in their caregiving roles. Methods: This qualitative study was conducted using conventional content analysis with 22 participants in 2022 in Babol (a city in northern Iran). The inclusion criteria for the study included caregivers of Alzheimer's patients who had been the primary caregivers for at least one year for patients with a confirmed diagnosis of Alzheimer's disease. The sampling method was purposive, ensuring maximum variation in social position, demographic status, and stages of Alzheimer's disease after the onset of symptoms. In this research, data were collected from caregivers of Alzheimer's patients through semi-structured interviews and in-depth individual interviews. The data were analyzed using MAXQDA software. Results: One category and four subcategories were identified to explain the continuity of the caring role in family caregivers of Alzheimer's patients. The category was "on the Fence of the Caring Role." The subcategories included Commitment to Care (Being Determined, Being Indebted, Feeling Dutiful), Coercion to Care (Giving in to the Caring Role Due to Family Requirements, Patient Care Due to Financial Problems), Socio-Cultural Beliefs and Concerns (Spiritual and Religious Tendencies, Social Stigma and Social Fears), and Attachment and Love for the Patient (Feeling Pity, Feeling Nostalgia for Kinship). Conclusion: Family caregivers are deeply engaged in their roles, often feeling trapped by various pressures. Recognizing these dimensions can inform policymakers and health practitioners in developing targeted interventions, such as respite care programs, financial support, and community resources, aimed at alleviating caregiver burden and enhancing the quality of care for patients. By addressing the complexities of the caregiver experience, effective strategies can be implemented to support both patients and their caregivers, ultimately improving health outcomes within the community. [ABSTRACT FROM AUTHOR]

Background: Many palliative cancer patients require inpatient hospital treatment for medical reasons, which contrasts their frequent desire to be at home. Virtual reality (VR) could be a way of bringing the home environment closer to them. First observations have shown benefits from VR for inpatients in palliative care. The aim of this qualitative, descriptive study was to explore the expectations of in-patients suffering from incurable cancer and their relatives about VR, in particular individualized VR images of the patients' own home. Methods: Semi-structured interviews with inpatients suffering from incurable cancers and their relatives in three medical settings (palliative care, hematology, radiotherapy) of a German university hospital. Qualitative content analysis about expected benefits and concerns regarding VR-videos showing their private home; defining the main topics deductively and the subcategories inductively. We also assessed the patients' subjective perspective on their remaining time to live to estimate the impact of double awareness on the results. The Patient Advisory Board informed the study protocol and conduct. Results: We interviewed 15 patients (8 men; age M = 63.4, SD = 11.34; range 39–82) under palliative care, and four relatives. We organized the interview content in 6 themes (general interest, desired content, non-desired content, expected benefits, concerns, and irregularities) and 26 sub-themes. Most patients and relatives were interested in using VR during hospital treatment. They often preferred viewing nature or tourist sites over seeing their home or family. Reasons could be linked to privacy concerns and the general desire for distraction from the current situation that they specified with their expectation of well-being, a break from the patient-experience, the pursue of curiosity, and the VR evoking fond memories. Conclusion: VR seems to be of interest for palliative cancer patients, especially as distraction and relief from their illness. The desired content can be very different, so a choice from a selection of VR-content should be made available. If patients want to see videos of their own home, recordings by relatives instead of study or hospital staff seem to meet the need for privacy. Trial registration: Registered at Deutsches Register Klinischer Studien; registration number: DRKS00032172; registration date: 11/07/2023. https://drks.de/search/de/trial/DRKS00032172. [ABSTRACT FROM AUTHOR]

Background Aim Methods Results Conclusion In situations where a child's mental well‐being is threatened, the parents also need support. The available support has been perceived as insufficient by both parents and professionals.To explore the views of experts‐by‐experience of the support needed by parents when a child's mental well‐being is threatened.A qualitative study with a phenomenological approach was conducted in Finland. The data were collected in six focus group interviews during the autumn of 2022. The participants (n = 26) were adult experts‐by‐experience who had experienced either mental well‐being challenges in their own childhood (before the age of 18 years) or experienced the mental well‐being challenges of a child from the role of a parent. The data were analysed using inductive content analysis.The support needed by parents in situations where the mental well‐being of their child is at risk consists of support for parenting, support for sharing and support for surviving.Parents whose child's mental well‐being is at risk, need support both for their own well‐being and for their ability to support their child's well‐being. Support is needed not only from professionals but also from peers. [ABSTRACT FROM AUTHOR]

Objective: Mood assessment is challenging when people have cognitive and receptive communication impairments after severe brain injury. This study explored how UK-based medical and psychology professionals working with people with severe cognitive and communication impairments after brain injury assess mood in this population. Design: Following their participation in an online survey, professionals were invited to participate in individual semi-structured interviews. Interviews were analysed using thematic analysis to label explicit data (semantic themes) and implicit data (latent themes). Participants: Twenty-three clinical psychologists and nine medical professionals participated in online or in-person interviews. Results: Both groups explicitly reported using a combination of collateral information, history, observations, and patient interviews when assessing mood in this population. Medical professionals did not routinely use standardised measures and clinical psychologists often adjusted them when they used them. The respondents discussed difficulties conceptualising depression after brain injury, the experience needed by the assessor, and the need for an individualised approach for this population. Clinical psychologists discussed the pressures of working in healthcare systems and medical professionals discussed how symptoms may influence prescription choices. Seven latent themes were labelled which highlighted additional challenges and complexities experienced by those assessing mood, beyond the actual assessment process itself. Conclusions: No 'gold standard' approach to assessing mood in those with cognitive and communication difficulties after severe brain injury was identified. There was overlap in assessment approaches but no clear consensus. Interviewees felt that mood assessment must be approached differently in this population and that self-report measures are not useful. [ABSTRACT FROM AUTHOR]

Aim: This study was conducted to address the experiences of diabetic patients from a psychosocial perspective, examine the burden of disease, and determine their practices for symptom management. Materials and Methods: In this study, a phenomenological research design, a qualitative research design, was used. The study included 20 diabetic patients. Individual and face‐to‐face interviews were performed, and Colaizzi's phenomenological analysis method was used to analyze the data. Results: As a result of the data analysis, four categories (challenges with care and treatment, coping with the disease, effects, and healthy life behaviors) and eleven main themes (knowledge, application, symptoms, support resources, spiritual coping methods, physical coping methods, physical effects, spiritual effects, social effects, physical practices, and psychological practices) emerged. Conclusion: It was concluded that the disease burden of diabetic patients is intense and that the participants of the study were not effective in coping with the disease through symptom management and found spirituality important in coping. [ABSTRACT FROM AUTHOR]

Objective: To understand rural older farmers' perspectives and attitudes toward skin cancer risk and prevention. Design and sample: This study used a grounded theory approach and semi‐structured interviews with 12 rural older farmers (farm owners, farmworkers ages 50 years or older) in Washington. Participants' perspectives were explored relative to Health Belief Model constructs. Inductive and deductive analyses were used to generate relevant themes. COREQ guidelines were followed. Results: The findings fit well and extended the Health Belief Model, which was used to arrange key themes identified in relation to skin cancer risk and prevention, specifically participants' perceived barriers to accessing primary care and protection when outdoors, perceived benefits of sun‐protective behaviors, perceived hereditary susceptibility to skin cancer, perceived severity of the increased skin cancer risk, and cues to action for skin checks. A new construct of hope was identified to emphasize the importance of establishing emotional, instrumental, and informational support systems for promoting skin cancer prevention. Participants also indicated their hope of raising awareness of skin cancer prevention among all ages. Conclusions: Findings highlighted the importance of integrating skin cancer prevention services for rural older farmers and across the lifespan. Public health approaches are needed to enhance the awareness of and access to preventive care in these underserved populations. [ABSTRACT FROM AUTHOR]

Indigenous leaders in higher education are restive, disaffected, and dissatisfied with the slow gyrations of change. Using Interest Convergence Theory, this paper will unravel the constraints inherent in institutional reform that delimit the influence of Indigenous senior leaders in the sector. Positioned amidst the burgeoning impact of neoliberalism, an architecture of colonial governance models, and systemic resistance to change, Indigenous leaders are affecting reform. By providing examples of reform-driven agential actions shouldered by senior Indigenous leaders across Canada, Aotearoa, America and Australia, this paper, underpinned by relationality, details how Indigenous leaders are engaging with Indigenous Institutional work and Entrepreneurship, speaking back to interest-driven institutional policies and practices in the sector with a pronounced focus on nation building. Drawn from an international, comprehensive qualitative study, we investigate how Indigenous leaders in higher education are disrupting systemic racism to promote equity and justice within higher education amid macro-level resistance to change. [ABSTRACT FROM AUTHOR]

Aim Methods Results Conclusion This qualitative study explored the lived experiences of the patients with microphthalmia and anophthalmia and their parents, focusing on the healthcare, school settings and daily life challenges to improve patient management.In‐depth interviews were conducted in Stockholm, Sweden, from October 2022 to June 2023. Participants were recruited through the St Erik Eye Hospital database (2008–2022), and the data was analysed using reflexive thematic analysis.The study included 15 patients (9 female and 6 male), with a median age of 21 years (range 15–31), and 1 parent per patient. Five key themes were identified from the parental interviews and three from the patient interviews. Both groups emphasised the need for improvements in healthcare, including better physician continuity, emotional support, information provision and prosthesis functionality. Families of those with severe bilateral visual impairment highlighted the need for additional school and daily life support. While some parents had future concerns, most patients viewed their condition as a natural part of life.Patients and parents shared insights on the psychosocial impact and suggested improvements in the healthcare and school settings, providing valuable guidance for enhancing care and management for this patient group. [ABSTRACT FROM AUTHOR]

This paper works towards a social geography of eating disorders through the lens of the coronavirus pandemic in the UK. Through an empirical engagement with experience-centred knowledge, I couple nine in-depth interviews with autoethnographic material, drawing out the spatial (real and virtual) and temporal (habit, routine, anticipation, non-linearity) dimensions of eating disorder experience, management and recovery; highlighting principally how pandemic lockdown conditions intensified space-time, mind/body and social relations across various micro-domestic and macro-governmental scales. I engage 'lightly' with Foucauldian concepts of disciplinary and biopolitical power to draw out broad-brush themes around matters of containment, control and surveillance; taking feminist inspiration to think through Foucault critically as I explore a nexus of gendered pandemic power relations. In doing so, I contribute towards new feminist understandings of the disciplinary gaze, emphasizing the ongoingness of surveillance through both physical body-checking and what I term psychological 'guising'. Through such (in)voluntary disordered bodily practices, and an engagement with the feminist mind/body dualism, I emphasize the complexity of EDs as embodied mental illnesses, further complicating feminist understandings of control. I close by discussing the ethical-methodological importance of 'empathy' while emphasizing the overall imperative of critical qualitative inquiry for socio-cultural geographies and beyond. [ABSTRACT FROM AUTHOR]

Background: Research suggests that people with intellectual disabilities have a higher risk for cardiovascular disease than the general population. The aim of this study was to identify barriers for the prevention, diagnosis, and treatment of cardiovascular disease for people with intellectual disabilities. Method: We conducted individual interviews with relatives and general practitioners and focus group interviews with staff working at an assisted home facility, a cardiac ward, an obesity clinic and two rehabilitation centres (n = 33) in Norway. Inductive approach and thematic analysis were used to analyse the data. Results: We identified barriers on an individual and a structural level. The underlying reason for these barriers is that health problems, such as cardiovascular disease, are regularly overlooked as the condition of intellectual disability overshadows other possible diagnoses. Conclusion: This focus on intellectual disability rather than other explanations leads to shortcomings in the prevention, diagnoses, and treatment of cardiovascular disease in this group. [ABSTRACT FROM AUTHOR]

Objective: To investigate the needs of patients with SLE in terms of discharge planning, to outline the practical perspectives of clinical healthcare professionals regarding the enablers and impediments to SLE patients' discharge planning, and to establish a basis for the creation of SLE discharge plans for subsequently diagnosed patients. Methods: Descriptive qualitative research methodology was used in this study, with the researcher herself as the research instrument. Healthcare professionals formally employed in the rheumatology and immunology department, as well as SLE patients admitted to a tertiary-level hospital in Anhui Province between August and December 2023, were chosen for the study using a purposeful sample technique. In-person, semi-structured in-depth interviews were carried out, and used thematic analysis to analyze the interview data and distil themes. Result: A total of 17 patients and 13 healthcare professionals were interviewed. Five themes and sixteen sub-themes in all were extracted: ①the needs of SLE patients for discharge planning; ②the present state of discharge planning implementation; ③factors conducive to the implementation of discharge planning; ④factors hindering the implementation of discharge planning; ⑤recommendations for implementing of discharge planning. Conclusion: Planning for the discharge of SLE patients is essential, and in order to support patients' successful discharge, management should strengthen training, thoroughly evaluate the needs of SLE patients, and create customized discharge plans. [ABSTRACT FROM AUTHOR]

Background: Maintaining patients' dignity is a key ethical requirement in healthcare and is emphasized in nursing standards. This issue is particularly significant for patients with schizophrenia because they face unique challenges such as physical and psychological difficulties, dependence on others, and social isolation, making them more vulnerable. Organizational factors can either threaten or preserve their dignity. However, there is little knowledge in this domain within the sociocultural context of Iran. Research Objective: This study aimed to explore the role of the healthcare organization in the dignity of patients with schizophrenia, based on the opinions of patients, healthcare personnel, and family caregivers. Research Design: This qualitative study was conducted with 26 participants (16 patients, 4 family caregivers, 2 nurses, 3 psychologists, and 1 service worker) who were selected using a purposeful sampling method. The data were collected through semi-structured, in-depth face-to-face interviews until data saturation was reached. The data were analyzed via Graneheim and Lundman's method. Ethical Considerations: The study protocol was approved by the Research Ethics Committee of Urmia University of Medical Sciences (IR.UMSU.REC.1401.099). Findings: Based on data analysis, participants reported the three following challenges as organizational hidden threats to patients' dignity: "Lack of facilities," "premature management," and "ineffective communication." Conclusion: The study findings indicated that the healthcare organization does not support the dignity of patients. Management inefficiency and lack of facilities are evident in psychiatric hospitals, and healthcare centers are not monitored based on standard criteria. Limited interactions between healthcare personnel and patients were identified as the main reasons for the neglect of patients with schizophrenia and the violation of their dignity. The results of this study can help healthcare policymakers in designing and implementing effective programs to preserve the dignity of patients with schizophrenia. [ABSTRACT FROM AUTHOR]

This study identifies the stigma experienced by 12 bereaved parents 2 and 5 years after losing a child in the Sewol ferry disaster in South Korea. Using thematic analysis, we categorized the experience of stigma into two components based on Corrigan and Kosyluk's social cognitive model of stigma: public stigma and self-stigma, and each was analyzed into three types of stigma: stereotype, prejudice, and discrimination. We identified four additional factors related to stigma mitigation. The potential implications for characterizing the experiences of bereaved parents, particularly those facing stigma, are discussed in light of these findings in the longitudinal perspective. [ABSTRACT FROM AUTHOR]

Background: Newly graduated registered nurses face more challenges than their experienced counterparts, as they not only confront the high pressures of an increasingly complex medical environment but also need to quickly adapt to their jobs and role transitions. The emotional burden arising at this stage is referred to as transitional shock. Self‐depletion, as proposed by Baumeister, refers to the process by which individuals exhaust their internal psychological control resources when facing challenges, subsequently affecting cognition and emotion. The occurrence of transitional shock and the process of individual self‐depletion appear to be closely related. However, to our knowledge, there has been limited research exploring the occurrence of transitional shock from the perspective of self‐depletion theory. Aim: Investigating the emergence process of transition shock through the lens of self‐depletion theory entails an examination of the mechanisms by which individuals engage in self‐regulation when confronted with challenges and how transition shock manifests throughout this process. Designs: A descriptive qualitative study. Methods: Between August and November 2023, using maximum variation sampling and purposive sampling methods, 16 nurses were selected for semistructured interviews at a tertiary hospital in Suzhou, China. Results: Employing thematic analysis, three interconnected themes were identified, encompassing the entry‐level workforce challenges, the subsequent effects of energy depletion, and the sources and replenishment of energy. Conclusion: As new nurses adapt to their roles and environments, they encounter numerous pressures that markedly drain their psychological energy. This ongoing depletion of self‐regulation energy can lead to transitional shock, impulsive decision‐making, and missed nursing care. Implications for Nursing Management: Managers should implement comprehensive support strategies, including optimized work environments, enhanced training, and personal development, to help newly graduated nurses successfully transition and improve care quality and retention. [ABSTRACT FROM AUTHOR]

Background: The unprecedented COVID-19 pandemic has become an endemic disease of global public health importance. Mass COVID-19 vaccination has been an essential global control strategy amidst challenges of limited acceptance. Because of globalization, COVID-19/similar diseases vaccination acceptance and the determinants in any particular setting are important global public health issues. Using a novel and pragmatic framework, this study explored determinants of COVID-19 vaccination acceptance among community members during the pandemic in Ebonyi state, Nigeria, and made policy-relevant recommendations on how to increase vaccination acceptance in subsequent outbreaks/pandemics. Methods: This qualitative study was based on the novel and pragmatic Individual Experiences and Perceptions and Complacency, Confidence, Convenience, and Compulsion (Four 'Cis') Determinants of Vaccination Acceptance Conceptual Framework – Omale INDEPT FORCIS Framework. On April 26 and 27, 2022, 20 semi-structured face-to-face focus group discussions were conducted in local language and pidgin English with 100 purposively selected consenting/assenting community members aged 15 years and above who had resided in the community for at least one year. Data was analysed using deductive (with some inductive) thematic analytic approach. Results: The many, diverse, and significant determinants of COVID-19 vaccination acceptance found were factors that were individual-related (individual experiences and perceptions and knowledge about COVID-19, COVID-19 vaccine/vaccination, and the vaccination process/system, sociodemographic, individual's condition (e.g. pregnancy)); COVID-19-related (factuality, transmissibility, frequency, severity, fatality); COVID-19 vaccine/vaccination-related (safety/side-effects, effectiveness, speedy production); COVID-19 vaccination process/system-related (real availability/accessibility); family, group, and other individual-related (experiences and perceptions and actions); and broader local, national, international, and global (LONING) context-related (socio-political, economic, historic, health system factors). The broader LONING contextual factors included the unprecedented disinformation/conspiracy theories, non-sustained COVID-19 risk/behaviour change communication, enforcement and non-enforcement or termination of peculiar control policies/measures (lockdowns, social/physical distancing, use of face mask etc.), mandatory COVID-19 vaccination policies, provision of incentives, past experiences regarding the Ebola viral disease outbreak, (un)trustworthiness of the Nigerian health system and her international/global partners, and the (un)trustworthiness of the governments in Nigeria and bad/good governance, inclusive of the failure of the Ebonyi state government to distribute the COVID-19 palliatives to the people during the lockdowns. Conclusion: The evidence illuminates complex and interrelated, specific underlying, and peculiar policy-relevant LONING determinants of COVID-19 vaccination acceptance and emphasizes the need for concerted and comprehensive LONING strategies (involving all the relevant LONING stakeholders/policy makers) in addressing these determinants to increase vaccination acceptance among community members in subsequent outbreaks/pandemics in Ebonyi state/Nigeria and similar settings. [ABSTRACT FROM AUTHOR]

AbstractPurposeMaterials and MethodsResultsConclusions\nIMPLICATIONS FOR REHABILITATIONDespite the substantial impact of pain in Parkinson’s, little attention has been given to understanding how individuals, especially those diagnosed at a younger age, perceive and manage their pain. This research aims to fill this gap by exploring the subjective experiences of pain in this population which is at a higher risk of experiencing pain.Interpretative Phenomenological Analysis (IPA) was used as a methodological framework. Non-directive, in-depth interviews were conducted with four French-speaking participants with Parkinson’s (diagnosed before 50 years old, with various pain profiles), and analyzed using IPA.Four major themes emerged: (1) the history of the disease, (2) adaptation to the disease, (3) losses related to pain and (4) strategies deployed to regain control over pain. Results highlight the participants’ processes of adaptation, despite the major identity disruption caused by the disease and pain. They also shed light on how the experience of pain is influenced by its relational dimension.Our results offer an understanding of the complexity and diversity of the experience of pain in this population. This complexity contributes to challenges in patients’ ability to articulate and represent their pain accurately, advocating personalized, multidisciplinary pain management approaches within this population.Individuals diagnosed with early-onset Parkinson’s disease face unique challenges, such as increased susceptibility to pain.However, current pain management often overlooks the specific needs of this population.Our findings highlight the complex connection between pain and the disease in early-onset individuals and how participants’ pain representations shape their adaptation to pain.This study outlines ways for health professionals to adopt a more targeted and individualized approach to managing pain in individuals diagnosed with early-onset Parkinson’s disease [ABSTRACT FROM AUTHOR]

Objectives: To describe the essential competencies required for patient engagement in their own safety. Method: We adopted a phenomenological approach in qualitative research to conduct semi-structured interviews with nurses (n = 14) and adult patients (n = 13) from different departments. By deeply exploring their experiences and feelings about patient engagement in patient safety, we sought to understand their views on the qualities that patients need to possess in order to participate in their own safety. Results: From the interviews, we identified six major themes, including competence of information sharing, competence of taking patient engagement as responsibility and right, competence of making equal communication, competence of maintaining trust relationship with health personnels, competence of accepting non-punitive safety culture, need of resource support, five of them showed essential competences for patients and one of them showed patients' need for promoting their engagement. Conclusion: The findings of this study show necessary competence and needs in patient engagement process of patient, offer a foundational reference for constructing a measurement tool for patient engagement in patient safety competence in the future, so that medical staff and patients can provide reference for the future targeted construction of patient competence improvement programs. At the same time, improving patient competence and engagement to better achieve safety goals requires the joint efforts of patients, medical staff, medical institutions, the government, and society. [ABSTRACT FROM AUTHOR]

AbstractObjectivesMetchodsResultsConclusion\nIMPLICATIONS FOR REHABILITATIONMaintenance hemodialysis patients’ psychology and physiology will have negative effects. Adherence to exercise can effectively enhance the physical function of maintenance hemodialysis patients and reduce the negative psychological emotions. In recent years, virtual reality technology has been gradually applied to the hemodialysis group, providing a new way for the rehabilitation training and healthy life of maintenance hemodialysis patients.To understand the real experience of maintenance hemodialysis patients participating in virtual reality rehabilitation training, and to make reference for the future clinical development of a more perfect virtual reality rehabilitation training program.Phenomenological research method was used to conduct semi-structured interviews with 10 maintenance hemodialysis patients, and the interview data were compiled and analyzed using Colaizzi’s seven-step analysis.Four themes were distilled: (1) Maintenance hemodialysis patients’ overall perceptual experience of the virtual reality rehabilitation system; (2) Physical and psychological improvement of maintenance hemodialysis patients with virtual reality rehabilitation system; (3) Individualized needs of maintenance hemodialysis patients during virtual reality rehabilitation training; (4) Future improvements and recommendations for the virtual reality rehabilitation system.The results of the study suggest that virtual reality improves patients’ motivation to recover and shows positive results and potential benefits in improving physical functioning and negative emotions in maintenance hemodialysis patients.Regular and continuous rehabilitation training is a very effective non-pharmacological treatment to improve the physical functioning and mental health of maintenance hemodialysis patients.Virtual reality technology can stimulate the underlying motivation of maintenance hemodialysis patients to undergo rehabilitation, thus, they are guided to adopt a healthy lifestyle.Virtual reality technology can be an effective aid in the rehabilitation of maintenance hemodialysis patients, thus reducing the workload of rehabilitation clinicians.Regular and continuous rehabilitation training is a very effective non-pharmacological treatment to improve the physical functioning and mental health of maintenance hemodialysis patients.Virtual reality technology can stimulate the underlying motivation of maintenance hemodialysis patients to undergo rehabilitation, thus, they are guided to adopt a healthy lifestyle.Virtual reality technology can be an effective aid in the rehabilitation of maintenance hemodialysis patients, thus reducing the workload of rehabilitation clinicians. [ABSTRACT FROM AUTHOR]

Background: Patients with Fabry disease (FD) consider their quality of life to be significantly affected. The majority of studies evaluate the quality of life using quantitative measures and standardised scales that offer relevant information about experience with the disease in multiple aspects. The main objective of the research was to examine in depth the quality of life and unmet needs of patients diagnosed with FD in relation to their disease and treatment. A qualitative and transversal study was carried out in two stages: (a) nine semi-structured qualitative interviews with patients and one representative of the patient association, conducted individually by phone; (b) a focus group was set up with three patients diagnosed with FD and one relative. A deductive, thematic analysis approach was used for data coding and analysis. Results: The analysis of the interviews revealed various relevant themes: experience with the disease, impact on daily activities, experience of the family and work environment, experience related to treatment and healthcare professionals, and unmet support needs. Diagnosis has a significant impact on both those suffering from the disease and on the family environment. The symptoms and evolution of the disease are highly variable among the patients interviewed and depend on the years diagnosed as well as the time taken to receive the diagnosis. The families of the interviewees have to go through an adjustment process in light of the significant psychological impact brought about by the disease. Patients show various unmet needs. The need mentioned most is to have more information, support, and understanding from people around them and society, improving empathy and raising awareness about the difficulties faced by people with FD while giving the disease visibility. A lack of social understanding is highlighted as one of the main challenges, as this does not only affect the emotional management of the disease but also has repercussions on working life and social relationships. Conclusions: It seems necessary to define possible strategies that help to improve the quality of life of patients and their experience with the disease. Some recommendations obtained from the study include: facilitate access to mental health professionals for patients and their families; improve training for specialists and coordination among them; and carry out actions to raise awareness of the disease that are aimed at the general public, the patients themselves, and the people around them. [ABSTRACT FROM AUTHOR]

Background: The single-child issue is a significant contributor to population decline, which adversely affects both parents and children. Despite government-approved incentives, the single-child problem remains a major population challenge. This study was conducted to explore the perceptions and experiences of single-child couples regarding childbearing incentives. Methods: This qualitative study used conventional content analysis and was performed on 21 single-child couples in Mashhad, North East Iran, selected through purposive sampling from urban health centers. Data were collected using semi-structured interviews until saturation was reached. The data were analyzed using the Elo and Kyngas (J Adv Nurs 62(1):107-15, 2008. 10.1111/j.1365-2648.2007.04569.x) method with MaxQDA10 software. Results: Two generic categories emerged from the data analysis including (1) "Advertising and providing information as an influencing factor to encourage childbearing", which included two subcategories of "Attention to the key lever of advertising" and "Necessity of adopting advertising policies and creating a culture of respecting maternal role", and (2) "Focusing on effective incentive policies", which consisted of three subcategories of "Adopting incentive policies to reduce people's financial problems", "Avoiding punitive policies" and "Need to adopt incentive policies for working women and elites". Conclusions: Incentive policies should focus on the culture building of the general public, implementing effective incentive policies, and addressing economic challenges, particularly for specific groups such as working women and higher education students. In addition, a public mobilization effort is needed to effectively implement population laws. Plain English summary: Single-child issue is a challenge, being a cause of population decline, and poses adverse effects on both parents and children. Various childbearing incentive policies exist, but single-child couples' perceptions regarding these incentives have been less explored. To encourage childbearing, it is crucial to implement effective advertising and information release among the target groups, based on respecting the maternal role and addressing conflicting attitudes towards the influence of employment and education on maternal role. Avoiding punitive policies, using financial incentive policies to reduce people's financial burdens and being ensured of their implementation, and adopting incentives to support working women and elites (female students in higher education), would be among the effective fertility incentives. [ABSTRACT FROM AUTHOR]

Purpose: To explore the experiences of patients with chronic low back pain (CLBP) plus comorbid depressive symptoms who received a remote synchronous videoconference group form of Acceptance and Commitment Therapy (ACT) or Behavioral Activation Treatment for Depression (BATD). Methods: A qualitative study (IMPACT-Q) was nested within a randomized controlled trial (RCT) designed to assess the efficacy and the cost-utility/cost-effectiveness of two therapies in the management of CLBP and depression. Fifty-five patients with CLBP plus depression were selected from the RCT. Twelve focus group sessions, each approximately 60–90 min long, were audio-recorded, transcribed verbatim, and analyzed by six coders through a thematic analysis (deductive and inductive) based on a descriptive phenomenological approach. Results: Patients perceived behavioral, affective, and cognitive improvements after completing group sessions. Overall, psychotherapy was perceived as a safe and non-judgmental place to express emotions and feel understood. The main barriers reported were lack of human contact and loss of social interaction. In contrast, ease of access, flexibility in the ability to connect from anywhere, avoidance of the need to travel, and savings in time and money were key facilitators to increase attendance and adherence to therapy. Conclusion: This study provided support for the acceptability of videoconference-delivered ACT or BATD in patients with CLBP plus comorbid depressive symptoms. IMPLICATIONS FOR REHABILITATION: Overall, patients reported behavioral, affective, and cognitive improvements after Acceptance and Commitment Therapy and Behavioral Activation Treatment for Depression group sessions. Acceptance and Commitment Therapy and Behavioral Activation Treatment for Depression delivered via videoconference platform were perceived as a facilitator for therapy attendance rather than a barrier. The findings indicate that group therapy on videoconferencing is perceived favorably as an alternative for managing patients with chronic pain and comorbid depression. Technical and social aspects of implementing videoconferencing therapies should be improved, as well as guidelines for adequate support for patients and therapists should also be provided. [ABSTRACT FROM AUTHOR]

Purpose: To describe the experiences of parents of children treated for corrosive esophageal ingestion. Methods: In-depth interviews were conducted with 17 parents (nine mothers and eight fathers) of children who had suffered a corrosive esophageal ingestion requiring hospitalization. Online interviews were also conducted with parents of children who were still undergoing treatment for corrosive esophageal ingestion. The interview guide explored the parents' overall experiences and included research questions that explored the participants' perceptions, thoughts, feelings and problems. The interviews were digitally recorded and transcribed verbatim. Inductive reflective thematic analysis was performed using MAXQDA. Results: Analysis of the interview transcripts generated three themes and nine sub-themes describing parents' experiences: emotional consequences, social consequences and facilitators. The results reveal that caregivers experienced anxiety and difficulties, prompting them to seek support from their family and social environment. Conclusion: These findings highlight the importance of identifying and understanding parental experiences. This understanding will also enable healthcare professionals to optimize the parental experience in caring for children with corrosive esophageal ingestion within a holistic clinical service. Understanding the experiences of children with corrosive esophageal ingestion from the parents' perspective identifies opportunities for systematic treatment and care. IMPLICATIONS FOR REHABILITATION: Corrosive esophageal ingestion in children is an injury that restricts and damages the quality of life for both children and their families. Due to the negative experiences of parents resulting from the gaps in treatment and care of corrosive esophageal ingestion, health professionals require training to deliver a holistic clinical service. The implementation of support group interventions is needed to address changes in the social and emotional consequences experienced by parents. [ABSTRACT FROM AUTHOR]

Background Aim Study Design Results Conclusion Relevance to Clinical Practice Surrogate decision–makers (SDMs) who make decisions for critically ill patients often face great challenges. Although shared decision‐making has been advocated, its implementation has been less than satisfactory.To explore the experience of the surrogate decision‐making process and determine how SDMs understand the values and preferences of critically ill patients.A constructivist qualitative study was used. The data were collected using semistructured interviews with four questions conducted between January and February 2023. The audio recordings were transcribed verbatim and analysed via thematic analysis. Fourteen SDMs (all family members) of 10 critically ill patients were recruited according to the inclusion criteria.We identified eight sub‐themes that were classified into three themes: (a) the unbalanced act: no respite for the surrogates, conflict between rationality and emotion, and sacrifice in surrogate decision‐making; (b) unclear values and preferences: ignored values, intentional silence and substituted values; and (c) unsatisfying surrogate decisions: decision regret and decreased surrogate decision‐making self‐efficacy.These findings underscore the urgent need for enhanced communication strategies and support systems to better assist SDMs in navigating their roles. Effective interventions could help clarify patients' values and preferences, thereby improving the decision‐making process and outcomes for both SDMs and patients.Misalignment between patient values and those of SDMs can potentially degrade the quality of decision‐making. Clinicians should be skilled in stimulating SDMs to think about patient values and preferences. [ABSTRACT FROM AUTHOR]

Background: Despite mandated insurance coverage since 2006 and robust health infrastructure in urban settings with high concentrations of minority patients, race‐based disparities in prostate cancer (PCa) treatment persist in Massachusetts. In this qualitative study, the authors sought to identify factors driving inequities in PCa treatment in Massachusetts. Methods: Four hospitals offering PCa treatment in Massachusetts were selected using a case‐mix approach. Purposive sampling was used to conduct semistructured interviews with hospital stakeholders. Additional interviews were conducted with representatives from grassroots organizations providing PCa education. Two study staff coded the interviews to identify major themes and recurrent patterns. Results: Of the 35 informants invited, 25 participated in the study. Although national disparities in PCa outcomes were readily discussed, one half of the informants were unaware that PCa disparities existed in Massachusetts. Informants and grassroots organization representatives acknowledged that patients with PCa are willing to face transportation barriers to receive treatment from trusted and accommodating institutions. Except for chief equity officers, most health care providers lacked knowledge on accessing or using metrics regarding racial disparities in cancer outcomes. Although community outreach was recognized as a potential strategy to reduce treatment disparities and engender trust, informants were often unable to provide a clear implementation plan. Conclusions: This statewide qualitative study builds on existing quantitative data on the nature and extent of disparities. It highlights knowledge gaps in recognizing and addressing racial disparities in PCa treatment in Massachusetts. Improved provider awareness, the use of disparity metrics, and strategic community engagement may ensure equitable access to PCa treatment. Plain Language Summary: Despite mandated insurance and urban health care access, racial disparities in prostate cancer treatment persist in Massachusetts.This qualitative study revealed that, although national disparities were acknowledged, awareness about local disparities are lacking.Stakeholders highlighted the importance of ancillary services, including translators, rideshares, and navigators, in the delivery of care.In addition, whereas hospital stakeholders were aware of collected equity outcomes, they were unsure whether and who is monitoring equity metrics.Furthermore, stakeholders agreed that community outreach showed promise in ensuring equitable access to prostate cancer treatment.Nevertheless, most interviewed stakeholders lacked clear implementation plans. To understand the drivers of racial disparities in prostate cancer treatment in Massachusetts, this statewide qualitative study was conducted through interviews with stakeholders at treating hospitals. Abstracted themes highlight the significance of provider awareness, the importance of overcoming transportation barriers, the accommodation of care through translators and navigators, and strategic community engagement for ensuring equitable access to care. [ABSTRACT FROM AUTHOR]

Objective: The present study was investigate parents' experiences of children with Epidermolysis bullosa. So, this descriptive phenomenological qualitative study was conducted on 17 parents of children with EB from five hospitals affiliated with the University of Medical Sciences, west of Iran. Data was collected through semi-structured interviews. COLAIZZI's method was also used to analyze the data. Results: Three main themes were extracted in this study: invasion of psychological crisis, alive but no living, and comprehensive support, including 10 categories. The parents of these children are the target of psychological crises that severely reduce their quality of life. In this regard, they need extensive support to improve their living conditions. Therefore, it is suggested to provide cultural and institutional contexts in which all components of the children's dignity are emphasized. [ABSTRACT FROM AUTHOR]

Forgiveness, a process of relinquishment of resentment, hostility, and anger toward an offender or self, is understudied among people living with HIV. This study examined the experience and process of forgiving the person who allegedly transmitted HIV, among people living with HIV. In-depth interviews were conducted with 14 people living with HIV aged 25 or older, diagnosed at least three years before the study. Three main themes emerged: “Anger is a poison”: between forgiveness and unforgiveness; “I gave up the drive to suffer”: the meaning of forgiveness; and “Forgiving is like building a building”: phases of the forgiveness process between forgiveness and unforgiveness. This study revealed cognitive and emotional processes and phases of forgiveness. Forgiveness-focused interventions for people living with HIV are suggested. [ABSTRACT FROM AUTHOR]

Background: Unintended teenage pregnancies are associated with greater health and socio-economic risks for teenage mothers and newborns. In Kenya, the government has declared a target for ending teenage pregnancy by 2030. However, the prevalence of teenage pregnancy has only decreased slightly, demonstrating the need for further efforts. Understanding teenage mothers' own experiences and perspectives is necessary to design appropriate interventions. Methods: A community-based qualitative study was conducted from March to May 2023. Two focus group discussions were conducted with community health volunteers and the mothers of teenage girls. Semi-structured interviews were conducted on the case histories of 19 teenage mothers and 18 key informants. Thematic analysis was subsequently performed using MAXQDA 2022. Findings: Four major reasons emerged for unintended teenage pregnancies: (1) lack of knowledge or awareness about the human reproductive system, (2) lack of knowledge about family planning (FP), (3) financial challenges, and (4) low access to FP. At the study site, cultural norms and stereotypes, such as "infertility caused by FP," "freedom of sex by promoting FP," and "cultural taboos on having sex before marriage and talking about sexuality," were observed as barriers in promoting FP to teenagers. In addition, teenagers from low socio-economic backgrounds were found to be more vulnerable because they can be easily exploited by men who can afford to provide for some of their basic needs. Regarding the influences of unintended teenage pregnancy on teenage mothers' lives, the 19 cases were classified into four categories: (1) dropping out of school, (2) financial challenges, (3) changing relationships with parents, and (4) no major influence. Crucially, unintended teenage pregnancies negatively influenced most study participants. Continuing education, supportive parental attitudes, positive perceptions of the relationship with the child's father, and having future perspectives were identified as factors mitigating the negative influences. Conclusions: Strengthening culturally appropriate comprehensive sexuality education and the school re-entry policy with a supportive environment may prevent unintended teenage pregnancy and mitigate its negative influences. As financial challenges can be both a reason for and a negative influence of unintended teenage pregnancy, economic empowerment interventions are necessary. Plain English summary: Teenage girls becoming pregnant unexpectedly face higher health and socio-economic risks, which can affect both the lives of teenage mothers and newborns. In Kenya, the government has targeted ending teenage pregnancies by 2030, but the decrease has been limited. Although understanding teenage mothers' experiences and perspectives is important for designing appropriate interventions, only a few studies have been conducted. This study focused on 19 teenage mothers and other key participants to gain a deeper understanding of their backgrounds. Four major reasons were identified for unintended teenage pregnancies: (1) lack of knowledge or awareness about the human reproductive system, (2) lack of knowledge about birth control methods, (3) financial challenges, and (4) low access to birth control methods. At the study site, cultural norms and stereotypes were observed as barriers in promoting the use of birth control methods to teenagers. In addition, teenagers from poor backgrounds were found to be more vulnerable because they can be easily taken advantage of by men who can afford to provide for some of their basic needs. Regarding the influences of unintended teenage pregnancy on teenage mothers' lives, the 19 cases were classified into four categories: (1) dropping out of school, (2) financial challenges, (3) changing relationships with parents, and (4) no major influence. In this study, unintended teenage pregnancies negatively influenced most participants. Continuing education, supportive parental attitudes, positive perceptions of the relationship with the child's father, and having future perspectives were identified as factors mitigating the negative influences. [ABSTRACT FROM AUTHOR]

Background: The global migration of health professionals in general and nurses in particular, has led to nursing shortages and socioeconomic impacts on health systems in both source and destination countries. Adding to the complexity of the situation is the fact that the nursing profession itself is evolving from a vocational to an academic one. Although nursing migration and academization have been studied from either an institutional or an individual perspective, there is a gap in the literature regarding how nursing teams experience these transitions. This study aims to explore how nursing teams navigate through the transitions of academization and internationalization of the current dynamic nursing landscape in Germany. Methods: Based on social constructivism epistemology this qualitative study involved face-to-face focus group discussions conducted at several hospital sites in Germany from September 2021 to May 2023. The focus group discussions were audio-recorded, transcribed, and analysed using content analysis; the four dimensions of transition theory according to Schlossberg's Four S (4 S) framework (self, situation, support, and strategy) were used as a priori items to construct the coding framework. Results: Nine focus group discussions were conducted with a total of 40 nurses from different educational and migrant backgrounds. The analysis showed that the transition experiences of the nursing teams were heterogeneous, with educational and national backgrounds playing an important role in how realistic their expectations of their professional roles and identities were. The dynamic situation characterized by a shortage of qualified nursing staff, increases the pressure on nursing teams and underscores the importance of employer-provided and peer support. Onboarding and communication are key strategies used depending on the duration of the employee turnover. Conclusion: This study provides insights into the challenges and coping strategies of nursing teams in the current dynamic scene of migration, academicization and professional socialisation in Germany. Extending the Schlossberg 4 S framework from the individual to the team perspective provides a comprehensive view of the transitional experiences of nursing teams. Within each domain of the framework, the experiences of nursing teams are remarkably diverse. Educational background (vocational or academic) and origin (German or foreign trained) play an important role in shaping the transitional experiences of nursing teams. [ABSTRACT FROM AUTHOR]

Background: The enhancement of nurses' disaster literacy is crucial for effective disaster emergency management, especially for clinical nurses with no prior experience in disaster rescue. This study aims to explore the perspectives of nurses who have been involved in disaster rescue operations on strategies to advance nurses' disaster literacy. Methods: A qualitative descriptive study, which follows unified qualitative study reporting guidelines. Thirty disaster rescue nurses were recruited to participate in this study, who came from 30 third-class hospitals in China. From October to December 2021, information was acquired by conducting semi-structured telephone interviews with participants. Qualitative content analysis was used to examine the data. Results: Six categories and eleven subcategories were created. Strengthening disaster education and training was the main focus, and its subcategories included continuing education, nursing curriculum development, and disaster rescue experience guide. The second focus, which included scene simulation, actual combat/military simulation, and virtual reality simulation, was strengthening disaster simulation and drill. The third focus was on providing psychosocial support, which included improving self-psychological adjustment, developing resilience, and engaging in active coping. The fourth category was to strengthen nurse/hospital managers roles and leadership, which included enhancing professional identity and policies/leadership support. The fifth category was disaster preparedness, and the sixth was enhancing knowledge transformation. Conclusions: Government agencies or healthcare organizations should actively promote the formation of nurses' disaster literacy from multiple viewpoints. Disaster education and training, simulation exercises, and psychosocial support should be prioritized. [ABSTRACT FROM AUTHOR]

Background: The demand for nursing professionals with advanced education and specialized knowledge is growing, which encourages nursing undergraduates to pursue postgraduate studies. Therefore, an in-depth investigation into the barriers and facilitators affecting the motivation of nursing undergraduates to take postgraduate entrance exams was necessary. This may provide more targeted recommendations for the formulation of relevant policies and the provision of student support. The purpose of this study is to explore the barriers and facilitators affecting the motivation of nursing undergraduates for postgraduate entrance examination. Methods: Data for this study were collected from in-depth semi-structured interviews with 15 nursing undergraduates from Nantong University between October and December 2023. Thematic analysis was employed to analyze the data. Results: Four barriers were identified, including study pressure and internship fatigue, self-doubt and fear of failure, employment pressure, and lack of information and resources. Four facilitators were also identified, including the desire to upgrade academic qualifications and professional skills, career development and transition, escaping clinical work and delaying employment, as well as the power of role models, and social support. Conclusions: The findings may help nursing undergraduates navigate the path to postgraduate entrance exams more effectively and ultimately succeed in their studies and future careers. The study underscores the importance of addressing these barriers and leveraging these facilitators to support the holistic development of nursing students. [ABSTRACT FROM AUTHOR]

Background: Implementing an electronic system of service categorization and a referral system in healthcare is a strategic approach to improving overall health outcomes and optimizing resource use. This study aimed to investigate challenges experienced with the electronic patient referral system in Mashhad University of Medical Sciences (MUMS). Methods: In this qualitative research, data were collected using semi-structured interviews. Participants included physicians, experts, and stakeholders working in the Family Physician Program and the referral system, selected through purposive sampling. The data were analyzed using a thematic analysis framework, in which a thematic framework was developed, and key themes were identified. Data analysis was performed using Atlas.ti8 software. Results: According to the interviewees, the challenges of digitizing the referral system can be categorized into three main themes: structure, process, and outcomes. These themes include ten sub-themes, such as challenges related to Internet Infrastructure and the Sina System, Patients' Choice of Desired Specialists, Receiving Payment for Services, Appointment Scheduling, Interdepartmental Coordination, Recording Definitive Diagnosis Codes Before Referral, False Referrals, Dissatisfaction, Feedbacks, and Health Indicators. Conclusion: To improve the e-referral in Iran's health system, several strategies can be implemented. These include sustainable resource allocation, designing consequence mechanisms within the referral system to motivate collaboration and improving appointment scheduling systems. Furthermore, addressing these challenges requires a collaborative approach involving healthcare providers, IT professionals, and patient representatives to ensure that the system is efficient, user-friendly, and effectively meets the needs of all parties involved. Not paying enough attention to these issues cause reform failure while solving them requires multi-dimensional, systematic and coordinated interventions with a deep understanding of the obstacles and challenges. Disregarding these factors may result in apathy over time, ultimately impacting both the quantity and, more importantly, the quality of services. [ABSTRACT FROM AUTHOR]

Objectives: The main objective of the study was to explore the perspectives of healthcare professionals (HCPs) regarding artificial intelligence (AI) and to identify challenges in its incorporation in the healthcare sector of Pakistan. Methods: A qualitative exploratory study design was adopted. The study was conducted from January 15th to February 29th, 2024, and HCPs (doctors, pharmacists and nurses) from two tertiary care teaching hospitals in southern Punjab, Pakistan were taken as the study population. The interviews were conducted with the help of a semi structured interview schema. A thematic approach was adopted to analyse the data. Results: Out of 40 HCPs approached, 25 participated in the study with a response rate of 62%. The participants included in the study were doctors (14), pharmacists (6) and nurses (5). The participants had limited knowledge regarding AI and its basics. However, they showed positive perceptions about its incorporation. They believed that many of the problems faced by the healthcare sector of Pakistan can be minimized by AI incorporation. They believed that AI can boost up the efficiency of healthcare providers, reduce their workload, save time and minimize medical errors. Four main themes with multiple subthemes were identified: (1) Cognizance of AI, (2) Acceptability of AI among HCPs and training requirements for effective incorporation, (3) Merits and Demerits of AI, and (4) Challenges in incorporation of AI with proposed solutions. Conclusion: HCPs showed a willingness to embrace AI incorporation and believed that it may bring numerous benefits to the health system. Policymakers should take necessary steps to ensure AI incorporation in our healthcare sector. [ABSTRACT FROM AUTHOR]

Background: Transgender individuals often face stigma, discrimination, and various forms of abuse, which negatively impact their mental and physical health. They face a significantly greater risk of HIV, with a higher prevalence than the general population. Despite these challenges, transgender people have limited access to healthcare due to violence, legal barriers, and societal stigma, further exacerbated in countries like Uganda, where transgender identities are criminalized. Therefore, this study explored the lived experiences of HIV researchers working with gender minority populations in criminalizing contexts. Methods: This was an interpretative phenomenological analysis (IPA) qualitative study. Twelve (12) research team members at all levels were involved in the study. Participants had less than five years of involvement in HIV research among gender minority populations. Data were collected using field notes, reflective journals, documentation from daily team debriefing sessions, and semi-structured interviews. The analysis used NVivo software. Results: Positive experiences, barriers, and challenges were captured. The positive experiences were 'respecting cultural diversity', 'expanding networks', 'addressing misconceptions' and 'finding allies'. The barriers included 'experiencing stigma', 'lengthy research processes', 'feeling isolated', 'fearing for personal safety', 'unexpected logistical costs', and 'criminalization of sexual and gender minorities'. The key themes that emerged from the lessons learned were: 'dealing with gatekeepers', 'diversity and sensitivity training', 'leveraging networks', 'meaningful community engagement', 'reflexivity', 'ensuring safety', 'equal partnership', 'giving feedback' and 'awareness of legal implications'. Conclusions: This study highlights the importance of cultural sensitivity, community engagement, and reflexivity in research design and implementation. The findings emphasize the need for innovative strategies to navigate legal, social, and logistical barriers that researchers and participants face. Despite these challenges, the study demonstrates that meaningful collaboration with community members and building trust can significantly enhance the research process and outcomes. Future research should continue to explore these strategies while addressing ethical and safety concerns. [ABSTRACT FROM AUTHOR]

Introduction Methods Results Conclusion To investigate the perspectives of people accessing a general medical practitioner (GP)‐optometry model of collaborative care that was established to increase access to diabetes eye care.Qualitative study of patient barriers and facilitators to accessing primary diabetes eye care located in a metropolitan area in Australia. One‐on‐one interviews were recorded, transcribed and thematically analysed using a determinant framework on patient‐centred access to health care.Twenty‐four people with type 2 diabetes, including 15 males and 9 females, who accessed the service between September 2021 and June 2022 agreed to participate. Mean (SD) age of the participants was 52 (12) years and 50% had been diagnosed with diabetes for <2 years. Facilitators to accessing diabetes eye care included a referral from a GP or GP nurse, fee‐free consultations, availability of after‐hours appointments and short waiting times. Barriers to access included perceived out‐of‐pocket costs, competing responsibilities and lack of awareness of diabetic retinopathy screening recommendations.Considering diabetic retinopathy may present asymptomatically, primary health practitioners (optometrists and GPs) are well positioned to raise patient awareness of the importance of routine eye examinations. In Australia, access to routine screening could be facilitated by fee‐free eye checks and personalised text message reminders implemented at a health system level. [ABSTRACT FROM AUTHOR]

Nurses play a vital role in providing high-quality primary healthcare and health promotion services. The state of research highlights their often complex operational realities and shows the need for an evidence-based understanding of nurses' perspectives on health promotion practices, especially in low-resource settings. This study focuses on how community health nurses in rural primary healthcare centers in Nigeria perceive their health promotion role and the opportunities and challenges of, and potential entry points for strengthening, their practice. A sample of 10 nurses from eight rural primary healthcare centers in eight local government areas of Anambra state, Nigeria, was purposively selected. Data were collected via semistructured telephone and written interviews and analyzed by qualitative content analysis using a deductive–inductive approach. Nurses emphasized their commitment to supporting patients and communities to develop skills and take control of their own lives. Nurses described their role as facilitators of behavioral and environmental change, individual and community empowerment facilitators as well as social activists. Factors that enhance the health promotion practice of nurses include adequate skills, sufficient human and material resources and community support and participation. Inhibiting factors included insufficient funding, poor working conditions, staff shortages, high workload, lack of training opportunities and low participation of community members. Overcoming challenges and facilitating health promotion activities in rural communities require bolstering nurses by providing further training opportunities for enhancing their health promotion competencies and creating supportive environments. Future research should focus on how to strengthen nurses' health promotion efforts through interprofessional and intersectoral collaboration. [ABSTRACT FROM AUTHOR]

This study explores the role of family interpersonal relationships in coping with the effects of COVID-19 and examines factors that place Latinx adolescents at risk for adverse effects of COVID-19 and promote resilience. We used a qualitative inquiry to explore the impact of COVID-19 on Latinx New York City adolescents, using sensitizing concepts from the family stress and coping theory as a data organization and analysis strategy. Five focus groups with 26 students aged 13 to 17 years old were conducted, and emergent themes were identified from the data. Latinx student participants reported disruptions in their family structure and interaction patterns. Families of these adolescents faced income loss, death, and illness from COVID-19, which impacted parent-child relationships. The absence of needed community resources undermined family resilience. Yet, students used internal resources found in their families and within themselves to cope with the COVID-19 stressors. Participants reported challenges within the family, school, and youth's daily experiences. To lessen the pandemic's impact on Latinx students in the midst of the ever-changing COVID-19 pandemic requires an ecological approach in which family, school, community, and policy factors are considered, and partnerships at each of these levels are established. Efforts to enhance family-school collaboration, equitable access to mental health services, youth outreach, and strengthen existing internal and external resources in the lives of Latinx students are key to promoting their well-being. [ABSTRACT FROM AUTHOR]

Parental well-being has implications for child outcomes and child well-being. The COVID-19 pandemic has placed substantial psychological distress on parents especially those from under-resourced backgrounds who also have young children. Most of the available studies have used surveys to understand the impact of COVID-19 on parents' well-being with only a few of those studies looking at parents with children below five years from under-resourced backgrounds. We explored the impact of the COVID-19 pandemic on the well-being of 118 parents from under-resourced communities using qualitative methods. Through thematic analysis, we identified eight themes related to the impact of COVID-19: (1) Losing child care and taking teaching/care responsibility, (2) new rules and routines, (3) loss of basic needs, (4) fear of the virus, (5) loss of social support, (6) loss of jobs, (7) deeper connections, and (8) enhanced hygiene. We also identified four themes related to how parents coped with the impacts of the pandemic: (i) engaging in hobbies; (ii) making plans; (iii) accepting, and (iv) avoiding arguments. Implications include supporting parents' autonomy and providing flexibility at work, developing and tailoring mindfulness and stress reduction interventions to support parents' self-compassion and psychological flexibility skills, preparing lesson samples and helping parents role play to support their self-efficacy in teaching children, and prioritizing keeping child care settings open. Highlights: Loss of child care significantly contributed to parents' psychological distress. Parents experienced low self-efficacy in teaching their children. Parents lost jobs and their partners took more hours to compensate for the lost income which affected their relationships with children. Parents coped by participating in hobbies, accepting, engaging in proactive coping mechanism, and avoiding arguments. [ABSTRACT FROM AUTHOR]

Objective: This study aimed to explore perceptions regarding the sustainability of exercise following participation in a pre- and post-colorectal surgery exercise intervention trial (PREPARE-ABC). Design: Qualitative interview study. Data were analysed using framework analysis and independently coded by two researchers. Setting: Six United Kingdom National Health Service Trusts. Participants: Eighteen interviews (hospital-based exercise n = 9, home-based exercise n = 3, standard care n = 6) were conducted with patients 12–15 months after being randomised in the trial, after their 12 month appointment. Intervention: Individuals who participated in one of two exercise intervention groups (hospital-supervised or home-supported exercise) or a standard care control group of the PREPARE-ABC trial were invited to interview. Results: The exercise interventions were reported to influence participants' recovery and future sustainability of exercise behaviour change. Several participants continued to engage in exercise over a year after their surgery. Reasons for this included being engaged with exercise prior to diagnosis, psychological benefits of exercise and wanting to be engaged with something to help recovery. Perceptions about the sustainability of active lifestyles were influenced by confidence to engage in structured exercise or physical activity and beliefs about its potential to promote future wellness. Conclusions: Sustainability varies among individuals and early assessment of physical activity engagement could be beneficial. Physical activity interventions immediately following surgery may be important for future engagement. [ABSTRACT FROM AUTHOR]

Background/Objectives: Physiotherapists face significant challenges in managing chronic pain; a complex condition best addressed through a biopsychosocial (BPS) approach. Although substantial evidence exists globally, research specific to Spain remains limited. This study explores the experiences and challenges Spanish physiotherapists encounter in integrating BPS elements across public and private healthcare settings. Methods: Semi-structured interviews with 12 experienced physiotherapists were conducted, using a qualitative approach with purposive sampling and reflexive thematic analysis. The analysis, grounded in a constructivist/interpretivist framework, allowed themes to emerge naturally from the data, supported by relevant quotes. Results: Three primary themes were identified: (1) challenges in implementing the BPS approach, including patient resistance and limited training; (2) facilitators for adopting the BPS model, such as multidisciplinary support and positive patient outcomes; and (3) emotional and psychological aspects of the physiotherapists. The findings highlight the complexities of chronic pain management in physiotherapy, emphasizing the need for enhanced psychological training, integrated multidisciplinary care, early diagnosis, and effective family involvement. These insights are critical for improving both patient care and physiotherapist well-being. Conclusions: This study provides valuable guidance for future strategies, focusing on educational enhancements, multidisciplinary collaboration, healthcare policy reform, and emotional support for physiotherapists within the Spanish healthcare context. [ABSTRACT FROM AUTHOR]

Cultural competence (CC) in the refugee context remains under-addressed in the literature. This study explores the perceptions of asylum seekers and refugees (N = 25) concerning the CC of healthcare providers. This study was conducted in 2019, on the island of Lesvos in Greece. A major finding is that, for the participants, CC means the provision of equal and human treatment and not the knowledge of culture-specific information from healthcare providers. Moreover, our findings highlight the necessity of rethinking CC in the refugee context and integrating relevant components to enhance the provision of equal treatment and ultimately end perceived or existing discrimination. [ABSTRACT FROM AUTHOR]

Introduction: Electronic cigarettes, or e‐cigarettes, are rapidly gaining popularity throughout the globe as safer alternatives to traditional cigarette smoking. There are significant public health concerns due to the uncertainty of long‐term health consequences. This study aims to examine the experiences, attitudes and social dynamics of e‐cigarette users to provide guidance for public health policies and interventions. Methods: In this qualitative descriptive study, semi‐structured interviews were conducted. Fifteen e‐cigarette users were recruited using a snowball sampling strategy, where initial participants referred other suitable users. All participants had at least 6 months of regular e‐cigarette use. Data were collected through face‐to‐face interviews with open‐ended questions. The interviews were transcribed verbatim and reviewed by the researchers. This review identified four main themes and eight sub‐themes. Results: The four main themes identified as a result of the analysis are as follows: (1) initiation and usage experiences; (2) perceptions of health effects; (3) social and environmental factors and (4) addiction and future plans. Participants primarily began using e‐cigarettes out of curiosity, due to the appealing fragrance and the belief that they were less harmful than traditional cigarettes. Usage patterns varied among participants, with some reporting minimal cravings in the early morning hours. Opinions on the long‐term health effects of e‐cigarettes were diverse, with many participants acknowledging uncertainty. Peers and family members perceived e‐cigarettes as more socially acceptable than traditional smoking, resulting in fewer negative reactions. Finally, participants' levels of addiction and intentions to quit varied, with some expressing a desire to reduce or cease usage due to health concerns. Conclusion: The findings of this study indicate that the adoption of e‐cigarettes is influenced by a confluence of factors, including curiosity, the perception of reduced damage in comparison to conventional cigarettes and social acceptance. Notwithstanding these claimed advantages, users have a diverse array of beliefs and understandings concerning the enduring health consequences of e‐cigarettes. The presence of varying levels of addiction and the corresponding aspirations to cease the behaviour highlight the necessity for focused public health interventions. Patient or Public Contribution: E‐cigarette users were actively involved in this study, providing essential insights and feedback throughout. Their first‐hand experiences shaped the interview guide and contributed to the identification of key themes. Participants also reviewed and confirmed the accuracy of the interview transcripts, ensuring the reliability of the data. [ABSTRACT FROM AUTHOR]

Background and Objective: Mental health treatment for psychosexual problems is effective, but treatment rates are low. Metaverse‐based therapy offers one solution to increase overall treatment rates. Understanding attitudes towards this novel approach could lead to wider adoption of metaverse‐based therapy, resulting in higher treatment rates for psychosexual problems. Methods: Twenty‐one participants across three focus groups of different ages shared their perceptions and attitudes about metaverse‐based therapy broadly and for treating sexual disorders. A content analysis of the transcribed text from the focus groups using qualitative data analysis software was conducted. Results: Participants identified several perceived benefits of metaverse‐based intervention, including avoiding the perceived embarrassment of going to a clinic and accessing patients (a) with diverse physical or mental functionality, (b) living in remote areas and/or (c) balancing different family/work obligations or duties. The two main concerns with metaverse‐based therapy were the fear of online therapy being less personal than traditional therapy and the technological fluency needed. Clarifying their acceptance of the therapy, participants reported that they would be more likely to engage in metaverse‐based therapy if they trusted their therapist. Also, although it might be effective for mild and moderate disorders, participants were more reluctant about its use for severe mental illness. Conclusions: Results suggest that attitudes towards metaverse‐based intervention are mainly positive, since it removes some barriers that hinder access to psychological treatment in general and, specifically, for problems of a sexual nature. Patient and Public Contribution: During the design stage, a person with sexual difficulties was consulted to understand the patient's perspective. Members of the public advised the implementation of the focus groups. Three potential service users were involved in the coding of the text during the content analysis. [ABSTRACT FROM AUTHOR]

Background: Despite the increasing burden of breast cancer in the developing world, there is a misunderstanding of the complex and multifaceted relationship between culture and cancer, particularly breast cancer. Hence, a dichotomy of illness narratives exists due to differential meaning making concerning breast cancer. While clinicians always recommend biomedical treatment, women with breast cancer often seek alternative treatment pathways. Aims: To explore the experiences of women with breast cancer and clinicians in Nigeria on the dichotomy in the illness narratives. Methods: This qualitative study used in‐depth interviews and focus group discussion to explore the experiences of 22 women with breast cancer and 7 clinicians in Nigeria on the dichotomy in the illness narratives using grounded theory method analysis. Results: This study revealed that many women living with breast cancer (WLBC) hold health beliefs that are contradictory to the biomedical norm. They mostly sought treatment based on the perceived aetiology of breast cancer. The treatment pathway follows faith and traditional healing as alternatives or sometimes in combination with biomedicine. WLBC reported a constant fear of biomedical treatment, perceived to be harmful to women's sexuality, fertility and body image. Hence, after perceived treatment failure from alternative care, biomedical care becomes the last resort, usually at an advanced stage of breast cancer, often responsible for poor prognosis. Conclusion: There is a dichotomy of illness construction between sufferers and health practitioners. To guide women with breast cancer on the path of care, modern care practitioners should consider some cultural norms and practices without compromising professional ethos. [ABSTRACT FROM AUTHOR]

Objectives: Recently, a set of consensus criteria and near‐consensus criteria for the evaluation of chronic rhinosinusitis (CRS) disease control was identified by an international multidisciplinary panel of key stakeholders. The objective of this study is to evaluate patient perspectives on these disease control criteria. Methods: This is a qualitative phenomenological study using constant comparative methodology. Twenty‐one one‐on‐one interviews, ranging from 6 to 15 min and based on a standardized semi‐structured script, with CRS patients from diverse backgrounds were performed. The authors analyzed transcripts of the interviews to identify recurrent themes in patient responses. Conclusions were drawn based on these themes. Results: All participants agreed with the consensus criteria (overall symptom severity, nasal obstruction severity, patients' self‐assessed CRS control, and need for CRS‐related oral corticosteroids), and most participants agreed with near‐consensus criteria (nasal endoscopy, smell loss and nasal drainage severities, impairment of day‐to‐day activities, and overall quality of life) identified by the international multidisciplinary panel. Some patients disagreed with inclusion of smell loss due to common etiologies—such as post‐viral or iatrogenic causes—that would not necessarily be an indicator of active sinonasal inflammation. One theme that emerged was the need for a facial pain/pressure criterion to be added. Conclusions: CRS patients overwhelmingly affirmed recently described consensus and near‐consensus criteria for CRS disease control with the caveat that a question asking about facial pain/pressure should be included as well. Recently, identified consensus criteria for CRS disease control should be interpreted within the context of patient perspectives. [ABSTRACT FROM AUTHOR]

Facing crises, life problems, and illnesses, many people turn to religion, spirituality, and faith as a psychosocial adjustment approach. This qualitative study assessed the spiritual needs of fourteen Iranian patients who recovered from COVID-19. Qualitative content analysis resulted in three themes, including "composure" with three categories of "prayer", "hope", and "connection"; "meaning in the life" comprising two categories of "a new prospect of life" and "the power of nature"; and "global responsibility" involving one category of "the relationships between individuals, communities, and the world". This study highlighted that patients relied on spirituality to cope with COVID-19 disease. [ABSTRACT FROM AUTHOR]

Borderline personality disorder (BPD) is frequently understood as a diagnosis applicable mainly to women, despite population studies suggesting similar prevalence between men and women. The scarce available information suggests that compared to women, men may face additional gender-related barriers to diagnosis and treatment when attempting to engage with support and treatment for BPD-related difficulties. The current study presents a qualitative in-depth exploration of the help-seeking and diagnosis experiences of four men with BPD. Using Interpretive Phenomenological Analysis, three themes were generated: (1) "There's just no help out there": barriers to treatment; (2) self-understanding and insight; and (3) the importance of emotional and psychological connection with health care professionals and close family and friends. Having a greater understanding of male-specific experiences of BPD could improve the helpseeking journeys of men with BPD through early identification, accurate and timely diagnosis, to relevant and effective treatment and support. [ABSTRACT FROM AUTHOR]

Backgroud: Cancer‐related cognitive impairment is one of the common complications in children with cancer, but our understanding of their experience with cognitive deficits remains limited. From the perspective of parents, this study aimed to explore the distress and demands faced by children with cancer‐related cognitive impairment, to provide references for developing targeted intervention strategies for cancer children. Methods: We used a purposeful sampling method to conduct semi‐structured interviews with the parents of 18 children with cancer‐related cognitive impairment. The transcripts were analyzed using Colaizzi's method. Results: Three categories and 11 subcategories were obtained from the data analysis, including diverse levels of cognitive impairment in children (speech communication difficulties, impaired executive function, attention deficit, and intellectual disability), persistent negative emotions (anxiety and worry, complaints and resentment, negative avoidance and positive experiences after psychological adjustment), multiple needs (need for disease information, need for professional management, and an urgent need for more external support). Conclusion: Parents of children with cancer‐related cognitive impairment face a significant psychological burden, coupled with confusion and numerous inquiries regarding the symptoms and management of their children's cognitive impairment. It is imperative for medical professionals to strengthen the dissemination of information related to cancer‐associated cognitive impairments, while promptly recognizing and intervening in related symptoms. Rational allocation of resources, establishment of targeted support systems, and enhancement of social acceptance may be the key points that policymakers could consider. These efforts hold immense significance, as they play a pivotal role in elevating cognitive capabilities and enhancing the overall quality of life for children with cancer. [ABSTRACT FROM AUTHOR]

Background: Every advanced cancer diagnosis brings enormous challenges to patients and their relatives on numerous levels: be it physical, practical, social challenges, or on a more personal level. While specific aspects have been researched before, an overarching approach is lacking. Aim: To understand the lived experiences of people with advanced cancer, to identify gaps along the cancer care continuum, to identify potential opportunities for meaningful interventions and to develop a theoretical framework for practitioners and researchers. Design: A qualitative study using in-depth interviews with patients, relatives, and care professionals. Interviews were transcribed verbatim and analysed using a conventional content analysis. Setting/participants: Fifty-four interviews with 17 patients from a university oncology department and palliative care service, 15 relatives and 22 care professionals from physicians to funeral directors. All interviewees were recruited by a German university hospital. Results: We developed a novel model describing the diagnosis with advanced cancer as a highly disruptive experience that threatens to challenge the integrity of personhood in cancer patients through four areas: communication, knowledge, relationships, and confidence. We were able to identify factors leading to disintegration in these areas and factors supporting a restoration of integrity of personhood. Conclusions: The developed model provides a more thorough understanding of patients lived experiences. It can help to develop new interventions along the cancer care continuum to support patients in the complex challenges they face. These interventions should focus on supporting the integrity of personhood. [ABSTRACT FROM AUTHOR]

Background: Significantly fewer individuals with migration backgrounds than native-born individuals undertake advance care planning. Older adults with Turkish and Moroccan backgrounds represent one of the largest ageing non-Western minority groups in Europe. Their relatives could play important roles in facilitating or hindering advance care planning, but their views remain underexplored. Aim: To explore advance care planning knowledge, experience, views, facilitators and barriers among older Turkish and Moroccan adults' relatives in Belgium. Design: Qualitative thematic analysis of semi-structured interview data. Setting/participants: Twenty-two relatives of older Turkish and Moroccan adults in Brussels, Mechelen and Antwerp, recruited via general practitioners. Results: Participants had limited advance care planning knowledge and had not discussed it with healthcare professionals. Some found discussing end-of-life preferences with relatives beneficial; others opposed the discussion of specific topics or felt discussions were unnecessary, as they felt responsible for caregiving and trusted by their relatives to make future decisions. Barriers included personal and relational characteristics, emotional difficulty and perceived non-urgency. Facilitators included information in older adults' native languages, general practitioners' cautious initiation and the involvement of several family members. Conclusions: Relatives of older people with Turkish and Moroccan backgrounds are unfamiliar with advance care planning and have highly variable views on it. People should be given opportunities to discuss advance care planning in a culturally appropriate manner, and the diversity of perspectives regarding whether and how to engage in such planning should be recognised. ClinicalTrials.gov no. NCT05241301. [ABSTRACT FROM AUTHOR]

Sri Lankan Tamil refugees (SLTRs) have lived in the United Kingdom in substantial numbers for about three decades. However, they remain under‐represented in academic and public discourse, and little is known about their migration experiences. This study examined first‐hand accounts of such experiences, with special attention paid to identity and acculturation. Data were collected through four semi‐structured interviews and analysed using interpretative phenomenological analysis (IPA). The results suggest that SLTRs' experience of conflict as an imposed life disruption continues to shape their adaptation, identity, and meaning‐making ("Afflicted life"). Changing social identities mediate protection from, as well as risk of, trauma. SLTRs try to remedy the socio‐economic and emotional losses suffered in the conflict, but achieve only a partial compensation. Consequently their repair efforts are a source not only of positive emotions but also of dissatisfaction ("Living past"). Finally, participants' sense of belonging and quest for home represent a challenging socio‐emotional process in which they continue to engage even decades after migration ("Continuing quest for home"). This nuanced analysis of how the past continues to shape lived experience, contributes to the under‐developed literature on qualitative psychological investigations of acculturation, research on forced migration, and the establishment of IPA in social psychology. [ABSTRACT FROM AUTHOR]