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A smartphone application (app) from the company Monsenso was developed to monitor anxiety symptoms in the treatment of anxiety disorders as an alternative to paper registrations. The aim of the study was to explore patient and therapist experiences of using the app in conjunction with standard treatment for anxiety disorder in a developmental and implementation phase. The study design was qualitative. Semi-structured interviews were conducted with three therapists and seven patients from an outpatient clinic. The interviews were analysed using thematic analysis. Three main themes emerged for both patients and therapists. The patient themes were usability (it was easier to use the app and remember daily mood registrations), insight in own disorder (awareness of symptom progress), and support to use the app (support from the therapist was wanted). The therapist themes were therapeutic quality (app registrations made it easier to prepare sessions), the role of the therapist (enthusiasm and technical assistance affected the patient), and implementation challenges (time allocation is important). The anxiety monitoring app is recommended in standard treatment as an alternative to paper registrations. However, a successful development and implementation process include ready available technical support, time allocation, and therapist effort and enthusiasm. [ABSTRACT FROM AUTHOR]

Introduction. South Africa has an enabling legislative and policy framework that promotes the protection of adolescents and young people's sexual and reproductive health and rights. Much of the literature in this field has identified discriminatory and hostile attitudes from healthcare workers as a major underlying factor to negative sexual and reproductive health outcomes for this age cohort. Not as well understood is the role of structural violence although this type of violence, through its structures of injustice and inequalities, is closely associated with stigma and discrimination. Data and sources. To contribute to closing this research gap, this paper draws on the findings of a larger qualitative study, specifically focus group discussions with young people aged 15–24 years. Results. The consequences of these attitudes within the structural violence framework are illuminated as are recommendations for enhancing access to sexual and reproductive health and services by adolescents and young people. Discussion and conclusion. Key among the latter is that young people's sexual and reproductive health needs and wellbeing should be pursued through a multisectoral approach that encompasses stigma reduction interventions involving the young people, families, and communities collaborating with healthcare workers. [ABSTRACT FROM AUTHOR]

Purpose: Healthcare staff are on the frontline during disasters despite any personal adversity and vicarious trauma they may be experiencing. Wellness Warrior training is a post-disaster intervention developed in response to the 2019-2020 Australian bushfires to support staff in a rural hospital located on the South Coast of New South Wales, Australia. Method: This study explored the experiences and perspectives of 18 healthcare staff who were trained to provide emotional and peer support to their colleagues in the aftermath of a crisis. All the Wellness Warriors participated in semi-structured interviews between March and April 2020. Data were analysed using the reflexive thematic approach. Results: Healthcare staff reported developing interpersonal skills around deep listening and connecting with others which allowed for hearing the core of their colleagues' concerns. The training also helped staff to feel differently about work and restored their faith in healthcare leadership. Conclusion: Wellness Warrior training provided staff with knowledge and skills to support their colleagues in the aftermath of a natural disaster and later during the COVID-19 pandemic. As such, these findings suggest that peer support programs such as Wellness Warriors could be one way healthcare organisations can attempt to alleviate the psychological impact of natural disasters. [ABSTRACT FROM AUTHOR]

Purpose: Human movement is essential for health and well-being. Understanding human movement is pivotal in physiotherapy, but also an important element of physiotherapy education. This review identified, critically appraised, and synthesized the available evidence on learning and teaching human movement in physiotherapy as perceived by students, therapists, and instructors. Methods: The databases MEDLINE, CINAHL, ERIC, PsycINFO, MEDIC and FINNA, were searched. The search was conducted in March/April 2020 and updated in March 2022. The systematic review followed the JBI methodology for systematic reviews of qualitative evidence and was conducted in accordance with an a priori protocol. Results: The overall quality of the 17 included studies was scored low on ConQual but dependability and credibility were rated as moderate. Four synthesized findings aggregated from 17 categories and 147 findings described the perceived significance of 1) being present in movement, 2) movement quality, 3) movement transfer, and 4) contextual factors for the learning or teaching of human movement in physiotherapy. Conclusion: The synthesized findings indicate that the perceived significance of contextual factors, movement quality and transfer, and being present in movement should be considered in all learning and teaching of movement in physiotherapy. However, the evidence of the review findings was evaluated as low-level, which should be considered when applying these results to physiotherapy education or practice. [ABSTRACT FROM AUTHOR]

A healthy lifestyle should be recommended to all patients with inflammatory arthritis due to the increased risk for cardiovascular diseases. Healthcare professionals (HPs) are essential in supporting patients to achieve healthy lifestyle habits and are expected to follow international and national lifestyle management guidelines. Despite this, few studies have studied HPs' perceptions of working on lifestyle management. Aim: To explore HPs' perceptions of working on lifestyle management for patients with early rheumatoid arthritis (RA). Methods: In this qualitative study, individual interviews were conducted with 20 HPs. Qualitative content analysis was used, and three categories and six subcategories were identified. Results: HPs' perceptions of working on lifestyle management for patients with early RA revealed a need for commitment from different levels. This included commitment from healthcare managers and organizations prioritizing work on lifestyle management and providing competence development for HPs. Commitment within the team regarding coordination of interdisciplinary teamwork and development of a structured lifestyle management approach, and commitment to involving patients in lifestyle management, by facilitating patient engagement and a person-centred approach. Conclusions: HPs' perceptions of working on lifestyle management for patients with early RA revealed that commitment from healthcare managers, organizations, and the interdisciplinary team was essential to facilitate collaboration, patient involvement, and a person-centred approach. [ABSTRACT FROM AUTHOR]

Purpose: The impact of a stroke is particularly evident during the transition home, with reported unmet needs. However, little is known about post-stroke adaptation in Portugal. This study aimed to understand how Portuguese people with stroke and their informal carers/family adapt over time, and how health professionals support their adaptation. Methods: A multi-perspective, longitudinal qualitative study was conducted using in-depth semi-structured interviews one and six months after inpatient discharge. A purposive sample of 24 participants (8 triads) participated. Thematic and narrative analysis strategies were used. Results: Three themes were identified: Managing change over time; Balancing support over time; Changing priorities. These suggest the importance of time and gradual adjustment of health professionals' approach throughout the rehabilitation process tailored to people with stroke' and carers' needs. Both valued positive thoughts and support from others to adjust life goals and find a balance between a mutual/bidirectional support and time for themselves. Conclusions: Findings show that the manner in which changes after a stroke are approached may be positively transformed to provide strength. As a result of the deeper understanding gained from this study, health professionals may be better placed to acknowledge the needs of people with stroke and carers and find effective ways of supporting them. [ABSTRACT FROM AUTHOR]

INTRODUCTION. The ongoing COVID-19 pandemic substantially affects health care workers from multiple disciplines, including nurses, physicians, therapists, and first responders. The aims of this study were to 1) explore and describe the experiences of health care workers and first responders working with individuals with COVID-19 infection, and 2) identify the support and strategies that were helpful during their experience.METHODS. A qualitative descriptive study was conducted via online video interviews of 29 health care workers and first responders who agreed to be contacted for an interview. Thematic analysis resulted in three themes and corresponding subthemes.RESULTS. The three overriding themes were 1) experiencing vulnerability, 2) suffering loss and grief, and 3) coping with vulnerability. A sense of vulnerability and high levels of stress were described and affected participants during their professional work as health care workers and first responders as well as their roles in their homes and communities.DISCUSSION AND CONCLUSION. The findings indicate the need for effective measures to assist health care workers and first responders to minimize the negative consequences of persistent and severe stress and vulnerability as they care for individuals with COVID-19 and their families. [ABSTRACT FROM AUTHOR]

The purpose of this article is to examine the factors that influence fly-in and fly-out (FIFO) mental health service providers' experiences of vicarious trauma as they deliver services to communities in Inuit Nunangat through a constructivist self-development theory (CSDT) lens. Using a participatory action research methodology, we conducted eight semi-structured interviews with providers to understand their perspectives on the risk of developing vicarious trauma and potential mitigation strategies. We identified three themes through thematic analysis: 1) vicarious trauma is a risk associated with working in communities with high rates of trauma; 2) establishing individual and organizational strategies to reduce risk of vicarious trauma may improve FIFO providers' well-being and career longevity; and 3) FIFO models of care may offer protective benefits for mental health service providers against vicarious trauma. We conclude that FIFO models of care may help mental health service providers to manage the risk of vicarious trauma through reduced caseload and less time spent in community. [ABSTRACT FROM AUTHOR]

While there is growing evidence for resilience building programmes, to date research has not explored how professionals construct understanding of programme impact. RISE (resilience, integration, self-awareness, engagement), a 5-day yoga-based retreat programme, has been linked with positive wellness outcomes. This qualitative inquiry explores participants' reflection and experience 3 months after programme completion. Through a grounded constructivist lens, in-depth semi-structured phone interviews were conducted with 17 adult professionals in high-stress work environments who attended RISE. Initial hand-coding informed codebook development for systematic coding using directed content analysis using sensitizing structuring. Two integrated perceptions woven through five themes. Persistent threads of experiential learning and sense of permission provided structure for themes found. Five interrelated themes related to psychological health and workplace dynamics were (1) use of acquired behavioural skills and practices; (2) lived mindfulness; (3) resilience to stress and emotion regulation (4) self-care and self-compassion, and (5) sharing with others. Findings provide meaningful interpretation of previously reported programme efficacy by contextualizing perceived benefits within participants' constructed understanding of change. Specifically, environmental, social, and experiential considerations have suggested implications for resilience building programmes. Abbreviations: RISE (resilience, integration, self-awareness, engagement) [ABSTRACT FROM AUTHOR]

Role expectations of physicians providing health care for hunger strikers have been discussed in the context of prisons and detention centres. Ethical guidance for physicians in these situations is codified in the Declaration of Malta. In the last years, new forms of collective, public hunger strikes of asylum seekers have occurred. We have aimed at reconstructing the experiences of health-care personnel involved in one of such cases. Semi-structured interviews with nine participants (physicians and paramedics) that had been involved in a public collective hunger strike of asylum seekers in Germany were conducted. We identified three health-care provider groups: voluntary physicians, emergency service providers and medical consultants for the authorities. Role conflicts arising from multiple loyalty situations with obligations towards different stakeholders (e.g., strikers, employers, authorities) were perceived as the greatest challenge especially for voluntary doctor and emergency service provider participants. Such conflicts culminated in feeling instrumentalized for political goals. The results illustrate that professional challenges in the health care during a public collective hunger strike differ in various aspects from those described in the literature on custodial settings. We recommend expanding and adapting the medico-ethical guidance. [ABSTRACT FROM AUTHOR]

The birthing room is a major workplace for midwives but how it influences them in practice is not enough investigated. Purpose: This study aimed to explore midwives´ experiences of how the birthing room affects them in their work to promote a normal physiological birth. Methods: A phenomenological reflective lifeworld research approach was used and included individual interviews with 15 midwives working at four different hospitals in western Sweden, and of which two also assisted at homebirths. The analysis focused on the meanings of the study phenomenon. Results: A birthing room can by its design either support a normal physiological birth or support a risk approach to childbirth. Four opposing constituents complete the essential meaning of the birthing rooms, and to which the midwives need to relate in their roles as guardians for normal birth: i) a private or a public room; ii) a home-like or hospital-like room; iii) a room promoting activity or passivity; iv) a room promoting the midwife´s presence or absence. Conclusions: The birthing room mirrors a pathogenic-oriented care approach. A presupposition for the work to keep the birth bubble intact is to protect the mother from disturbing elements both inside and outside the room. [ABSTRACT FROM AUTHOR]