Search

In recent years, with the acceleration of urbanization and the implementation of compulsory education, the pressure on students' study and life has increased, and the phenomenon of psychological and behavioral problems has become increasingly prominent. Therefore, the school has regarded students' mental health education as the top priority in teaching work. Effective expression classification can assist psychology researchers to study psychology and other disciplines and analyze children's psychological activities and mental states by classifying expressions, thereby reducing the occurrence of psychological behavior problems. Most of the current mainstream methods focus on the exploration of text explicit features and the optimization of representation models, and few works pay attention to deeper language expressions. Metaphors, as language expressions often used in daily life, are closely related to an individual's emotion, cognition, and psychological state. This paper studies children's smiling face recognition based on deep neural network. In order to obtain a better identification effect of mental health problems of children, this paper attempts to use multisource data, including consumption data, access control data, network logs, and grade data, and proposes a multisource data-based mental health problem identification algorithm. The main research focus is feature extraction, trying to use one-dimensional convolutional neural network (1D-CNN) to mine students' online patterns from online behavior sequences, calculate abnormal scores based on students' consumption data in the cafeteria, and describe the dietary differences among students. At the same time, this paper uses the students' psychological state data provided by the psychological center as a label to improve the deficiencies caused by the questionnaire. This paper uses the training set to train five common classification algorithms, evaluates them through the validation set, and selects the best classifier as our algorithm and uses it to identify students with mental health problems in the test set. The experimental results show that precision reaches 0.68, recall reaches 0.56, and F 1 -measure reaches 0.67. [ABSTRACT FROM AUTHOR]

This integrative review aims to evaluate the experiences of health and social care practitioners with regard to how they exercise professional curiosity in child protection practice. Professional curiosity gained significant currency following the Munro Review of Child Protection (2010) in England, as a means of seeking clarity on what is happening within a family. However, a recurrent finding from child safeguarding practice reviews is that practitioners continue to struggle to exercise curiosity. This is evident within both the United Kingdom and international literature, although descriptors for the concept may differ. This study attempted to identify facilitators and barriers to applying professional curiosity to provide a greater understanding of this theoretical concept. Title and abstract review of 1428 articles identified from databases and 11 from other sources resulted in 52 papers for full‐text review. The quality of each article was appraised using the Critical Appraisal Skills Programme tool for qualitative studies, the Mixed Methods Appraisal Tool (MMAT) for quantitative/mixed method studies and the Joanna Briggs framework for theoretical/opinion papers. Key findings were recorded in the Summary Table of Literature Reviewed. Data extracts were thematically analysed. Twenty‐four papers predominantly from the UK, but also from Australia, Italy, Sweden and USA formed the data set. Overarching themes that emerged from the thematic analysis included: noticing dissonance, emitting curiosity, constructing meaning, facilitators, individual professional challenges, organisational and macro‐level influences and conceptual development. This review demonstrated that professional curiosity is multifaceted and involves a whole system approach, from empowered, knowledgeable and competent frontline practitioners to creative, innovative and empathic organisations, that value staff contributions and place the child's best interests at the forefront of service development. Recommendations are made for practice and further research. [ABSTRACT FROM AUTHOR]

Background. Social and organisational changes in businesses have led to the appearance of "emergent risks" which affect workers but are less evident and hard to quantify such as psychosocial risks. Linked to psychosocial risks, issues such as work‐related stress and workplace violence are major challenges to occupational health and safety. This paper analyses the trends in the concerns expressed by wage‐earners in Spain regarding psychosocial factors that may affect them in the workplace. Methods. A causal analysis based on the application of binary logistic regression is presented, covering certain social and occupational characteristics of survey respondents and the psychosocial factors included in the Spanish National Surveys of Working Conditions for 2007 and for 2011‐2012. Binary logistic regression is a multivariate statistical tool that serves as a classification technique, identifying the variables that affect the probability of the event to be studied (dichotomous variable). This technique has the advantage that it does not require that the explanatory variables follow a normal distribution. The aim is to estimate the influence of the explanatory variables on the probability of the occurrence of the event under study, represented by the explained variable. Results. During the economic crisis of 2008, workers became more concerned about losing their jobs and about factors related to personnel cutbacks and decreases in investment in the prevention of occupational risks. Downsizing due to the crisis led to increased workloads for many of those still in work. Thus, in 2011, the likelihood of workers being concerned about working hours was greater, especially among respondents aged 25–34 and those working in commerce and transport. Workload was found to be a particular concern among respondents aged 25–34 and among workers in transport, communication, financial, professional, and administrative activities; health‐related activities; and industry. Conclusions. Policy should also be directed towards improving the structural aspects of psychosocial variations, in terms of work conditions, employment protection, and employment security to protect workers against income fluctuations as a result of job loss. [ABSTRACT FROM AUTHOR]

Parenting with a physical disability often brings with it a range of challenges. Occupational therapists are well positioned to support parents to address these challenges, yet occupational therapy research and practice around parenting is relatively scarce. This paper addresses the questions: (1) How should occupational therapists support parenting occupations for people with physical disability? (2) How do parents with physical disability experience occupational therapy? An anonymous survey of 62 parents, primarily mothers, with physical disability about their experiences with parenting challenges and occupational therapy was analysed using both quantitative and qualitative techniques. Parents experienced challenges in engaging in a range of parenting tasks with children over a range of age groups. Parents reported that support was often needed and indicated that occupational therapy could assist them directly with specific parenting goals as well as the more usual biomechanical goals that influence parenting. Yet less than half of participants who received occupational therapy services reported that parenting tasks were addressed, and only one‐fifth reported that their goals had been fully met. The data also indicated that the knowledge, skills, and attitudes of occupational therapists with regard to working with parents with disability can be improved. Findings suggest a need to better incorporate parenting occupations in standard occupational therapy training to increase occupational therapists' comfort and competence in working with clients on parenting issues. [ABSTRACT FROM AUTHOR]

Racism is a key modifiable determinant of health that contributes to health inequities in Aotearoa and elsewhere. Experiences of racism occur within the health sector for workers, patients and their whānau (extended family) every day. This paper uses stories of racism from nurses – reworked into vignettes – to examine the dynamics of racism to generate possible micro, meso and macro anti‐racism interventions. A critical qualitative design was utilised, informed by kaupapa Māori approaches. The five vignettes in this paper were sourced from a pair of caucused focus groups with nine senior Māori (Indigenous peoples of Aotearoa) and Tauiwi (non‐Māori) nurses held in Auckland Aotearoa in 2019. The vignettes were lightly edited and then critically analysed by both authors to identify sites of racism and generate ideas for anti‐racism interventions. The vignettes illustrate five key themes in relation to racism. These include (i) mono‐cultural practice, (ii) everyday micro‐aggressions; (iii) complexity and the costs of racism, (iv) Pākehā (white settler) privilege and (v) employment discrimination. From analysing these themes, a range of evidence‐based micro, meso and macro‐level anti‐racism interventions were derived. These ranged from engaging in reflective practice, education initiatives, monitoring, through to collective advocacy. Vignettes are a novel way to reveal sites of racism to create teachable moments and spark reflective practice and more active engagement in anti‐racism interventions. When systematically analysed vignettes can be utilised to inform and refine anti‐racist interventions. Being able to identify racism is essential to being able to effectively counter racism. [ABSTRACT FROM AUTHOR]

Reducing health inequities for migrants is a huge challenge shared globally. Based on big data of China Migrants Dynamic Survey in 2017, this paper applied Ordered Logit models and Logit models to examine the effect of health education on the health of migrants. Propensity score matching and instrumental variable were also employed to solve the endogenous problem. This paper found a significant health promotion effect of health education on the health of migrants, which remained significant after a series of robustness check. Further analysis showed that consultative health education is more effective than nonconsultative health education. Meanwhile, the positive association between health education and migrants' health behavior was identified which provided empirical evidence for knowledge, attitude, and practices theory. Heterogeneity analyses supported that health education has a stronger effect on migrants who were female, elderly, highly educated, and did not have chronic diseases than on those who were male, younger, less educated, and had chronic diseases. This paper demonstrates that health education is an important health promotion factor for migrants empirically and that the government should take actions to provide sufficient and targeted health education for migrants to promote their health. [ABSTRACT FROM AUTHOR]

Background. Cancer diagnosis is a complex and multifaceted process that can be stressful and anxiety-provoking for patients. Evidence-based tools and information aids that can be used for guiding and supporting patients during cancer investigations and after diagnosis are limited. This paper presents a user-centred codesign project that aims to develop a cancer pathway support tool for patients, carers, and healthcare professionals. Method. A mixed-method codesign approach was used including prototype development (January–March 2022), three online codesign workshops (April–June 2022), one-to-one feedback, and beta testing informed by the standardised Theoretical Framework of Acceptability (TFA) questionnaire (July–October 2022). Nine individuals with lived experience of cancer contributed to the project and are referred to as codesigners. Results. The codesigners valued the potential importance of a tool that can be used by the patients and carers if they want specific information about cancer investigations, diagnosis, and treatment. The ability to select what they need as opposed to long leaflets and generating their own questions for the healthcare providers were highlighted as important aspects of improving patient care. The tool was collectively designed to provide clear definitions of the cancer care pathway and easily accessible links from trusted resources and includes practical information to minimise the burden that can be experienced from preparation for appointments and tests. Beta testing results with a small sample of potential users including patients, carers, and healthcare providers (n = 23) showed high acceptability of the guide (range = 7–35, mean = 28.52, and standard deviation = 3.88) based on the TFA questionnaire. Conclusion. A cancer pathway support tool called "Your Cancer Pathway Support Guide (YCPSG)" was developed as a result of an iterative codesign process aiming to improve patient experience and outcomes for people referred on a suspected cancer pathway or who have been diagnosed with cancer. The tool provides information and support in both digital and PDF formats. Further studies are needed to evaluate the potential impact of "Your Cancer Pathway Support Guide" on patient outcomes and experience and the wider system. [ABSTRACT FROM AUTHOR]

People who use alcohol and other drugs(hereafter "substances") and who are over the age of 40 are now more likely to die of a non‐drug related cause than people who use substances under the age of 40. This population will therefore potentially need greater access to palliative and end of life care services. Initially, the purpose of this rapid evidence assessment (REA), conducted August 2016–August 2017, was to explore the peer‐reviewed evidence base in relation to end of life care for people with problematic substance use. The following databases were searched using date parameters of 1 January 2004–1 August 2016: Amed, Psycharticles, Ovid, Ageinfo, Medline, Ebscohost, ASSIA, Social Care Online, Web of Knowledge, Web of Science, SSCI, Samsha, NIAAA. Data were extracted using a predefined protocol incorporating inclusion and exclusion criteria. Given the dearth of evidence emerging on interventions and practice responses to problematic substance use, the inclusion criteria were broadened to include any peer‐reviewed literature focussing on substance use specifically and end of life care. There were 60 papers that met the inclusion criteria. These were quality assessed. Using a textual thematic approach to categorise findings, papers fell into three broad groups (a) pain management, (b) homeless and marginalised groups, and (c) alcohol‐related papers. In general, this small and diverse literature lacked depth and quality. The papers suggest there are challenges for health and social care professionals in meeting the end of life needs of people who use substances. Addressing issues like safe prescribing for pain management becomes more challenging in the presence of substance use and requires flexible service provision from both alcohol/drug services and end of life care providers. Work is needed to develop models of good practice in working with co‐existing substance use and end of life conditions as well as prevalence studies to provide a wider context for policy development. [ABSTRACT FROM AUTHOR]

This study seeks to assess the health, social and economic outcomes associated with rough sleeping among women and compare those outcomes with those of (1) men sleeping rough, and (2) women experiencing other forms of homelessness (such as being housed in temporary supported accommodation due to family and domestic violence). The paper analyses survey data using the Vulnerability Index‐Service Prioritization Decision Analysis Tool (VI‐SPDAT) collected from 2735 women experiencing homelessness and 3124 men sleeping rough in Australian cities from 2010 to 2017. We find that women sleeping rough report poorer physical and mental health outcomes and greater problematic drug and or alcohol use relative to both men sleeping rough and women experiencing other types of homelessness (all p < 0.5). Women sleeping rough report significantly higher levels of crisis service utilisation (Β = 17.9, SE = 3.9, p < 0.001) and interactions with police in the previous 6 months (Β = 1.9, SE = 0.3, p < 0.001) than women experiencing homelessness not sleeping rough. Women sleeping rough also report greater healthcare utilisation, and, therefore, healthcare costs, than women experiencing homelessness not sleeping rough and men sleeping rough (all p < 0.05). From a policy perspective, the evidence presented in this paper supports a social determinants approach that moves from addressing symptoms of poor health outcomes associated with homelessness to preventing and ending homelessness with a particular focus on the life trajectories of women. Integrated services and homelessness strategies need to be developed through a gender lens, providing women sleeping rough with tailored permanent housing with wrap‐around supportive housing to address poor health outcomes. [ABSTRACT FROM AUTHOR]

Objectives. To review the prevalence of loneliness (during/after COVID-19) in older people. Design. Scoping review using Medline and PsycInfo for worldwide prevalence estimates (white published literature search) and Google for prevalence data inside the Euregio Meuse-Rhine (grey literature). Setting. Worldwide prevalence estimates and a focus on the Euregio Meuse-Rhine. Participants. Papers published between 2016 and 2022 and a mean age of minimum of 65 years. Measurements. Prevalence estimates for older people. Results. The white literature search yielded 37 articles. Before the onset of the COVID-19 pandemic, loneliness estimates were the highest in Nigeria (46%) and the lowest in Australia (5%) (mean prevalence was 25.6%). Loneliness was reported to be higher in specific populations, for example, people living in specific communities such as senior housing communities or with impairments, than in the general population, with a mean prevalence estimate of 47.8%. During COVID-19, the prevalence of loneliness was higher than that before the pandemic: we observed a mean prevalence of 39.4%, in comparison to 25.6 before COVID-19. The grey literature search showed that, compared to Belgium and the Netherlands (13.5% and 36.5%, respectively), loneliness estimates were the lowest in Germany, with a mean prevalence of 7.7%. Conclusion. Large international differences in the prevalence of loneliness were observed between countries and populations studied. Several hypotheses could explain such differences, including sociocultural or historical-political characteristics. Without surprise, the pandemic and associated measures were linked to a higher level of loneliness. Furthermore, recommendations for addressing loneliness, including interventions, are discussed. [ABSTRACT FROM AUTHOR]

Aim: To examine the experiences and support needs of homeless transgender people by synthesizing the existing evidence. Background: Transgender people face many challenges in society in terms of people's knowledge, understanding and acceptance of a person's gender identity. Evidence regarding the homelessness experiences and available supports to transgender people remains sparse. Methods: A systematic review was undertaken and included qualitative and quantitative studies. A total of twelve papers were included in the review, utilizing the PRISMA method. Methodological quality was evaluated using the Mixed Methods Assessment Tool (MMAT). Results: Following analysis, the themes that emerged were (a) pathways into homelessness, (b) experiences whilst homeless and (c) routes out of homelessness. Conclusion: It has become increasingly clear that the distinct needs of this group are complex and multifaceted. In order to adequately address the issues and concerns comprehensively, coordinated and effective collaborations need to be in place. Implications for nursing management: Clinical nurses need to recognize and respond to the distinct needs of trans homeless people. Nurse managers need to provide leadership to promote the needs of homeless trans people and ensure that policies and procedures are in place that are responsive to issues and concerns. [ABSTRACT FROM AUTHOR]

Reflecting global trends, migrant farm workers in South Africa experience challenges in accessing healthcare. On the commercial farms in Musina, a sub‐district bordering Zimbabwe, Medécins sans Frontières and the International Organization for Migration both implemented migration‐aware community‐based programmes that included the training of community‐based healthcare workers, to address these challenges. Using qualitative data, this paper explores the experiences that migrant farm workers, specifically those involved in the programmes, had of these interventions. A total of 79 semi‐structured interviews were completed with migrant farm workers, farm managers, NGO employees and civil servants between January 2017 and July 2018. These data were supplemented by a review of grey and published literature, as well as observation and field notes. Findings indicate that participants were primarily positive about the interventions. However, since the departure of both Medécins sans Frontières and the International Organization for Migration, community members have struggled to sustain the projects and the structural differences between the two programmes have created tensions. This paper highlights the ways in which local interventions that mobilise community members can improve the access that rural, migrant farming communities have to healthcare. However, it simultaneously points to the ways in which these interventions are unsustainable given the realities of non‐state interventions and the fragmented state approach to community‐based healthcare workers. The findings presented in this paper support global calls for the inclusion of migration and health in government policy making at all levels. However, findings also capture the limitations of community‐based interventions that do not recognise community‐based healthcare workers as social actors and fail to take into account their motivations, desires and need for continued supervision. As such, ensuring that the ways in which migration and health are included in policy making are sustainable emerges as a necessary element to be included in global calls. [ABSTRACT FROM AUTHOR]

Active citizen participation in research is important to generate societal impact of outcomes. Even so, many times, the community input in these processes is limited or non-existent, and co-creation processes are often not documented. This paper describes a structured and systematised protocol to co-create a nature-based social prescribing intervention addressed to face loneliness in urban deprived neighbourhoods. As a result, a nature-based social prescription menu was co-developed with stakeholders from health, social prescription, nature, associative, and research sectors. The menu consists of open spaces and nature activities and will be offered to the participants of a randomised controlled trial to test actions for social prescribing in natural spaces. [ABSTRACT FROM AUTHOR]

Background. Occupational stress is a phenomenon affecting people worldwide. Investigating occupational stress among immigrant worker populations will unravel some of the intricacies of this condition and its psychological effects on this population. Aim. This paper conceptually examined occupational stress within the context of immigrant workers' mental health and offer an operational definition to aid nurse researchers, educators, and practitioners in assessing and managing patients and developing culturally appropriate interventions for this population. Design. Walker and Avant's eight-step concept analysis is used as an organizing framework. Data Source. MEDLINE, CINAHL, OVID, PubMed, and APA Psych Info. Review Methods. Keywords job stress, immigrant work stress, occupational stress scale, immigrant work-related stress, and mental health were used. The search yielded 142 articles; 17 were selected based on the effect of work stress on mental health. Results. This analysis found that occupational stress can be attributed to communication problems, alienation, discrimination, and barriers to work-life balance can cause negative consequences among immigrants. An operational definition is also provided. Conclusion. There is a growing need to examine closely and differentiate between occupational and acculturative stress to navigate a more profound understanding of how these conditions negatively complement each other. [ABSTRACT FROM AUTHOR]

Current health and social care systems do not always meet the needs of the dying in our communities. As a result, patients and families are choosing to place their trust in those who can advocate for them or fill the gaps in care. Birth Doulas have been working with women during pregnancy and after birth for many years, and we are now seeing a new role, that of a Death Doula emerging in the end‐of‐life care space. How Death Doulas work within health and social care systems is not understood and we conducted a systematic review to explore the published literature to explore the role and potential implications for models of care delivery. Following the PRISMA recommendations, we searched the literature in January 2018 via bibliographic databases and the grey literature without search date parameters to capture all published literature. We looked for articles that describe the role/work of a death doula or a death midwife in the context of end‐of‐life care, or death and dying. Our search retrieved 162 unique records of which five papers were included. We analysed the papers in relation to relationship to health service, funding source, number and demand for services, training, licensing and ongoing support, and tasks undertaken. Death Doulas are working with people at the end of life in varied roles that are still little understood, and can be described as similar to that of "an eldest daughter" or to a role that has similarities to specialist palliative care nurses. Death doulas may represent a new direction for personalised care directly controlled by the dying person, an adjunct to existing services, or an unregulated form of care provision without governing oversight. [ABSTRACT FROM AUTHOR]

There has been a strong policy emphasis over the past decade on optimising patient‐centred care and reducing general practitioners' (GPs') workload by extending community pharmacy services and collaboration between pharmacists and GPs. Our aim was to review current evidence of pharmacists' and GPs' views of extended community pharmacy services and pharmacists' roles in the United Kingdom (UK). A systematic review was undertaken looking at UK studies investigating pharmacists' and/or GPs' views of community pharmacy services or roles from 2005 to 2017. A range of databases were searched including EMBASE, PubMed, Scopus, Web of Science, International Pharmaceutical Abstracts (IPA), PsycINFO, Science Direct and The Cumulative Index to Nursing and Allied Health Literature (CINAHL). In addition, reference lists of included studies were screened and grey literature was searched. Following the application of inclusion/exclusion criteria, the quality of papers was critically analysed, findings were extracted into a grid and subjected to narrative synthesis following thematic analysis. The search strategy yielded a total of 4,066 unique papers from which 60 were included. Forty‐seven papers covered pharmacists' views, nine combined both pharmacists' and GPs' views and four covered GPs' views. Study designs included interviews (n = 31, 52%), questionnaire surveys (n = 17, 28%) and focus groups (n = 7, 12%). Three main themes emerged from the data: "attitudes towards services/roles", "community pharmacy organisations" and "external influences". Pharmacists and GPs perceived a number of barriers to successful implementation and integration of pharmacy services. Moreover, collaboration between pharmacists and GPs remains poor despite the introduction of extended services. Overall, extending community pharmacy services require quality‐driven incentives and joint working between community pharmacists and GPs to achieve better integration within the patient's primary care pathway. [ABSTRACT FROM AUTHOR]

Introduction. Occupational therapists play a crucial role in the rehabilitation process, as they maximise patients' independence and participation in meaningful occupations by adopting creative solutions in their treatment plan. Recognizing the importance of creative work and incorporating it into daily activities can be a powerful technique for enhancing quality of life. As a result, OTs must comprehend the significance of using creativity on a daily basis with patients. Creativity has been implicit in occupational therapists' values and practices since the occupational therapy field's early days. In particular, OTs use meaningful activities to promote health, wellbeing, and independence, which have traditionally had a strong connection with creativity. Primarily, the OT uses practical exercise to create wellbeing and autonomy, which have had a healthy linkage with imagination. The OT has used creative exercise as a treatment technique since the beginning of the profession. Method. In this paper, a Narrative Review Checklist was used to carry out specific checks of manuscripts' structures and a careful selection of the articles which are included in the manuscript. In addition, articles referenced in review articles or guidelines were reviewed for inclusion. Findings. This review has shown that the primary motivation for implementing creative activities was to improve the patient performance, wellbeing, and self-esteem. The goal of implementing creative activities was to assist the client in self-expression as well as experience joy and desire. As a result, the necessity to investigate the influence of creative solutions in treatment from an OT standpoint has been identified. Conclusion. Future studies should focus on how it is important to consider the patient's intrinsic and extrinsic motivations when designing creative solutions, as well as how the disability affects their daily activities, occupations, and adherence to a treatment plan. [ABSTRACT FROM AUTHOR]

Objectives: This study aims to understand the current situation and multiple factors affecting the core competence specializing in the maternal, neonatal and under‐five nursing in China. Background: Highly skilled nurses and midwives are essential worldwide for achieving the Sustainable Development Goals, especially in low‐ and middle‐income countries like China, due to the overwhelming COVID‐19 crisis. Method: The 890 nurses and midwives from 12 hospitals were investigated in this cross‐sectional study, with two questionnaires: the sociodemographic information and competency inventory for the registered nurses. Results: The participants reported a mean total score of 193.78 (±42.19) out of 220 and lowest in critical thinking and research ability (3.01 ± 0.82). The professional title, level, marital status, relationship quality, highest qualification, experience in specialist nurse training, participation in scientific research projects and publishing papers were the influencing factors (P <.05). Conclusions: The respondents' core competence needs improvement, especially critical regarding thinking and research ability. In addition, marriage and good or excellent relationship quality are factors that can potentially improve competence. Implications for Nursing Management: Targeted interventions for higher core nursing competence need to be implemented, especially focusing on nurses' marital status and emotional support from partners. [ABSTRACT FROM AUTHOR]

The objective of this research was to explore how gay men use drugs in their sex lives, colloquially called "chemsex". This paper reports on a sub‐theme within the research about support, care and peer support. Longitudinal interviews were conducted with 20 gay and bi men between April 2017 and July 2019. Participants were recruited via geolocated dating apps (n = 17) and snowball sampling (n = 3). The main findings of this research are that medicalised forms of support for gay and bi men engaging in chemsex are often tardy in their responses to need, and whilst helpful for cessation of drug use, fail to address the holistic needs of the participants. A wide variety of peer support was practiced amongst the sample which often echoed previous forms of peer support practiced in the LGBT+ community. It was offered by both people who engaged in chemsex and those who did not and was highly beneficial to people who experienced problems with chemsex. However, peer support was also limited by factors such as shame and the instability of those offering support. In conclusion, we suggest that medicalised forms of chemsex support could benefit from more rigorous and rapid forms of assessment for problematic chemsex, and also provide infrastructure and training to peer support initiatives. We also suggest that medical services could learn from patients and their peers about what support needs remain unaddressed by professional services, and engage in collaborative approaches to practice development. [ABSTRACT FROM AUTHOR]

Although the provision of trauma‐informed psychoeducation for carers of adolescents who have experienced traumatic events has been shown to be a fundamental aspect of the recovery process, it is not routinely made available to the social care workers who look after unaccompanied asylum‐seeking adolescents living in residential care. Furthermore, the development of the content of trauma‐informed psychoeducation is rarely informed by those who have experienced trauma or the professionals who support them. This paper documents the process of ensuring that these voices inform the development and delivery of trauma‐informed psychoeducation for the social care workers working in this context. Four clinical reflection and three professional reflection composites were developed from the reflexive clinical journal data of the author's clinical practice as an expressive arts psychotherapist working with 28 unaccompanied minors during a 4‐year period. As well as drawing on clinical reflections from therapy sessions (one to two paragraphs per session), the composite material drew on notes on informal conversations between the author and the professionals involved in the lives of unaccompanied minors (one to two paragraphs weekly). The latter was often a response to different situations which arose with the unaccompanied minors in their care, thereby demonstrating the need for a more structured and formalised delivery of psychoeducation for these professionals. The composite material was complemented with a training needs assessment in the form of a vignette and accompanying open questions conducted with 30 social care workers looking after unaccompanied minors in residential care. Reflexive thematic analysis on combined data sets identified the following themes: Impact of trauma on everyday livesTrauma‐informed engagementHelping with difficult feelings and lossReducing the stigma of therapy The resulting training content was enhanced by the selection of tools and techniques developed by a number of clinicians–researchers with expertise in healing post‐traumatic stress. [ABSTRACT FROM AUTHOR]

Purpose: This paper aims to evaluate the validity and reliability of the Turkish version of the social cyberloafing (SC) scale as an important predictor of the mental health of healthcare employees. Methods: The data for this descriptive cross‐sectional study was obtained from 202 Turkish healthcare employees. We followed Dima's 6‐step protocol for validation. Findings: The one‐dimensional structure of the scale was found to be homogenous (H = 0.54) and reliable (α = 0.87). The CFA demonstrated that the 7‐item and one‐factor construct was a valid instrument to measure the SC (GFI = 0.98, CFI = 0.98, TLI = 0.95, SRMR = 0.03, RMSEA = 0.09). Practical Implications: These results demonstrated that the Turkish version of the SC scale is an accurate measurement tool. [ABSTRACT FROM AUTHOR]

There is a dearth of research on how negative religious attitudes towards LGBTQ people inform professional practice. This paper reports on a scoping review of 70 selected studies from 25 different countries. It explores key issues and knowledge gaps regarding the delivery of services to LGBTQ adults by religious healthcare, social care and social work organisations and/or practitioners with faith‐based objections to LGBTQ people and their lives. The review identified four main themes: (1) a close connection between religious affiliation and negative attitudes towards LGBTQ people, among both students and professionals; (2) a heightening effect of religiosity, particularly among Christian and Muslim practitioners/students; (3) educators' religious attitudes informing curriculum design and delivery, and some highly religious students resisting and/or feeling oppressed by LGBTQ‐inclusivity, if present; (4) examples of practice concerns raised by professionals and lay LGBTQ people. The article considers the ethical, practical, educational and professional standards implications, highlighting the need for further research in this area. [ABSTRACT FROM AUTHOR]

This study explores the experiences of professionals who worked with care home residents with impaired mental capacity in England and Wales during the COVID‐19 pandemic. It explores (i) how competing risks were balanced and (ii) how the Mental Capacity Act (MCA) functioned in care homes under pandemic conditions, with particular focus on its associated Deprivations of Liberty Safeguards (DoLS) and Independent Mental Capacity Advocacy (IMCA) systems. Between March and May 2021, we held an online survey and five focus groups aimed at professionals who worked in or with care homes during the pandemic. The study explored issues pertaining to residents with impaired mental capacity, alongside several other topics on which we report elsewhere. For this paper, we filtered data to only include responses from 'capacity professionals'. The resulting sample comprised 120 (out of 266) survey participants and 18 (out of 22) focus group participants. We performed manifest content analysis on the filtered data and found that (1) participants reported a 'massive discrepancy' between the ways different care homes balanced the risk of COVID‐19 infection with the risks associated with severe restrictions. (2) Some suggested this was due to vague guidance, as well as care home type and size. Participants told us the pandemic (3) obstructed smooth operation of statutory safeguards designed to protect residents' human rights and (4) resulted in confusion about the remit of the MCA during a public health crisis. Our findings raise concerns about the impact of pandemic‐related measures upon care home residents with impaired mental capacity. We urge further exploration and analysis of (a) the variability and inconsistency of restrictions applied at care homes, (b) the strain placed on key safeguards associated with the MCA, (c) uncertainty about the remit of the MCA during a public health crisis and (d) the human rights implications hereof. [ABSTRACT FROM AUTHOR]

Shortly after the COVID‐19 pandemic reached Aotearoa New Zealand, stringent lockdown measures lasting 7 weeks were introduced to manage community spread of the virus. This paper reports the findings of a qualitative study examining how lockdown measures impacted upon the lives of nurses, midwives and personal care assistants caring for community‐based patients during this time. The study involved nationwide surveys and in‐depth interviews with 15 registered nurses employed in community settings, two community midwives and five personal care assistants. During the lockdown, nurses, midwives and personal care assistants working in the community showed considerable courage in answering their 'call to duty' by taking on heightened care responsibilities and going 'the extra mile' to help others. They faced significant risks to personal and professional relationships when they were required to take on additional and complex responsibilities for community‐based patients. Despite the hypervigilant monitoring of their personal protective equipment (PPE), the need to safeguard family and community members generated considerable stress and anxiety. Many also faced personal isolation and loneliness as a result of lockdown restrictions. Moreover, the negative impacts of experiences during lockdown often continued to be felt once restrictions had been lifted, inflecting life during periods in which community transmission of COVID‐19 was not occurring. This article makes five core service delivery and policy recommendations for supporting community‐based nurses, midwives and personal care assistants in respiratory disease pandemics: acknowledging the crucial role played by community‐based carers and the associated stress and anxiety they endured by championing respect and compassion; demystifying the 'heroism' or 'self‐sacrifice' projected onto care workers; the timely provision of adequate protective equipment; improving remuneration, with adequate provision for time off; and regular counselling, peer support groups and education on work‐life balance delivered by support workers in recognition of stressors arising from these complex and isolated working conditions. [ABSTRACT FROM AUTHOR]

There is a global recognition that the homeless in different clusters are isolated social groups. They are highly susceptible to loneliness and related psycho‐physical health outcomes owing to their less supportive and fragmented social networks. The conditions are worse in the case of chronic or lifetime homelessness. Beyond this popular notion, other critical perspectives are also there. This paper attempts to analyse the differences in inter‐personal social networks between the chronic and the non‐chronic homeless groups at a railway junction in India. The data have been collected through structured and semi‐structured questionnaires from 28 homeless people (15 chronically and 13 non‐chronically homeless) of Burdwan Railway Junction – a vital railway junction of West Bengal, India. The chronically homeless group displays more supportive and compact inter‐personal networks in this study than the non‐chronic homeless group. Living in the station area for a long time, they have formed a society of their own. Barring some psychological stress and social abuse, the livelihood scenario of these people is relatively stress‐free and social networks relations are more intensive and supportive. Considering the outcomes, instead of the housing‐first approach of rehabilitation, we favour the development of community shelters with minimum basic amenities close to their present location. [ABSTRACT FROM AUTHOR]

UK South Asian women are less likely to engage with cancer screening than the general population and present later with more advanced disease. Tailored interventions are needed to address barriers to these women accessing screening services. 'Wise up to cancer' is a community‐based health intervention designed to increase cancer screening uptake. It has been implemented within the general population and a study was undertaken to implement it within a South Asian female community. This paper explores one workstream of the wider 'Wise up to Cancer' study which involved working out how best to adapt the baseline questionnaire (the first part of the intervention) for South Asian women in an inner‐city location in Northern England. The aim of this workstream was to evaluate what worked well when implementing the adapted 'Wise up to Cancer' with South Asian women. In 2018, we conducted qualitative semi‐structured interviews and focus group with 14 key stakeholders; women who had received the intervention, health champions and community workers to explore their perspectives on how the adapted intervention worked within a South Asian female community. The interviews were audio recorded or (notes taken), data were transcribed verbatim and the dataset was thematically analysed. We found that training peers as community health champions to deliver the intervention to address language and cultural barriers increased participant engagement, was beneficial for the peers and supported participants who revealed difficult social issues they may not have otherwise discussed. Accessing women in established community groups, following planned activities such as English language classes worked but flexibility was needed to meet individual women's needs. Further research is needed to explore the impact of adapting 'Wise up to Cancer' for this community in terms of engaging with cancer screening. [ABSTRACT FROM AUTHOR]

This paper presents an in-depth study and analysis of the correlation between satisfaction with rural residents' income and mental health well-being in the context of industrial structure upgrading. Most of the studies on residents' subjective well-being from the perspective of relative income or income inequality have started from the happiness of rural residents and the satisfaction of rural residents' life, and few scholars have focused on the psychological health of rural residents. Subjective well-being is significantly related to external and internal goals in desire. Life satisfaction is significantly and positively correlated with external and internal goals, as well as the six dimensions of desire, except for social identity; positive emotions are significantly and positively correlated with internal goals; negative emotions are only negatively correlated with self-acceptance, and there is a significant positive correlation between income level and desire. In vertical income, there is also a process of judging whether the expected income is achieved. If the expected income growth level is achieved, the income satisfaction will increase. Desire mediates the effect of income level on subjective well-being. Income level influences subjective well-being through internal goals; income level influences life satisfaction and positive emotions through external goals. The relationship between income inequality and mental health is influenced by the characteristics of the population, with women and middle-aged people being the most negatively affected. This relationship is also influenced by income level, with the effect of income inequality on mental health showing a negative effect in the lower and middle-income groups but a positive effect in the higher income groups. Income inequality affects residents' mental health through the mediating effects of a sense of social justice, life stress, and trust in government. Inequality in household wealth can exacerbate the negative effects of income inequality on mental health. [ABSTRACT FROM AUTHOR]

Introduction: Prevalence rates of human papillomavirus positive (HPV+) head and neck cancers (HNC) have increased over the last decades. Communicating about HPV is an increasingly relevant part of HNC patient care. This systematic review was conducted to explore healthcare professionals' (HCP) views and experiences of discussing HPV with HNC patients. It also examined perceptions among different HCP groups of their professional roles in HPV discussions. Methods: A narrative synthesis of qualitative research was conducted. Three databases—Embase, PsycINFO and CINAHL+—were searched from January 2007 to August 2018. Relevant data were extracted and synthesised thematically. Results: Five studies were identified: four were qualitative and one used mixed methods. HCPs varied in their experience and views of discussing HPV. HCPs who engaged in these discussions believed they were beneficial for patients. All HCPs described the need to address their HPV knowledge deficits in order to provide clear HPV information. Changes in professional roles which were linked to HPV communication for HCPs involved in HNC patient care were also evident. Conclusions: Effective HPV discussions are an important part of patient‐provider interactions. Evidence‐based interventions and professional development activities which support HCPs in their HPV discussions with patients would be valuable. [ABSTRACT FROM AUTHOR]

Aim: To explore the information‐seeking patterns of care aides who work in nursing homes. Background: Under the direction and supervision of nursing professionals, care aides provide the majority of direct care to nursing home residents. Understanding how, why, when and where they seek information to perform their duties is important for managers, policymakers and stakeholders. Method: Semi‐structured interviews with eight care aides employed in three Canadian nursing homes were analysed using the Braun and Clarke method of thematic analysis. Results: Five prominent information‐seeking patterns emerged as themes. Conclusions: Care aides were motivated to seek information for personal and job‐based reasons that included wanting to avoid mistakes and preparing physically, mentally and emotionally for the work ahead. They described depending on a social hierarchy of verbal information and using personal time (before/after work) to seek the information they needed. Due to time constraints, they relied on established patterns, accessed online information once a day at most and preferred paper‐based sources. Implications for Nursing Management: Programs to enhance care aide communication skills to include the importance of information‐seeking are warranted. Time for formal information‐seeking during working hours should be provided and encouraged. When care aides initiate information‐seeking to improve care this should be recognized and respected by others on the team. Programs to enhance care aide communication skills to include the importance of information‐seeking are warranted. Time for formal information‐seeking during working hours should be provided and encouraged. When care aides initiate information‐seeking to improve care this should be recognized and respected by others on the team. [ABSTRACT FROM AUTHOR]

This paper contributes to scholarship on the medicalisation of mental health support for young people through a case study of a multidisciplinary mental health service in rural Australia. All staff (n = 13) working at the service participated in semi‐structured, individual interviews. Transcripts of interview data were read and selectively coded and interpreted in relation to the overarching question of how participants view and experience mental health care provision to a diverse range of young people. Following analytical reflection, codes pertaining to engagement, accessibility and care provision were re‐examined using the concept of medicalisation to understand the biomedical underpinning of mental healthcare and how this plays out in the experiences and perceived challenges participants talked about in responding to the mental health concerns of diverse young people. The resulting analysis is presented under five theme headings: (a) privileging clinical expertise and priorities within service provision, which was an important source of conflict for some participants; (b) 'multidisciplinary' teams—a 'difficult kind of culture at times'; (c) articulations of where cultural barriers lie; (d) the tracks along which young people are directed to 'engage' with 'mental health'; and (e) a clinical 'feel' to space. We suggest that service and system investment needs to be given to alternative ways of thinking about and approaching mental health and care provision that are cognisant of, and engage with, the inherent connections between individual circumstance and social, place, cultural, economic and political contexts. This is particularly relevant to the provision of care in rural contexts because of limited service options and the complexities of access and providing care to a diverse range of young people living in isolated environments. Interdisciplinary frameworks need to be enacted and services must acknowledge their own cultural positions for alternative ways of working to become possibilities. [ABSTRACT FROM AUTHOR]

The aim of this paper was to understand the needs of family caregivers and professionals supporting people living with dementia with eating and drinking difficulties towards the end of life and the strategies they use to overcome them. A total of 41 semi‐structured interviews with family caregivers (n = 21) and professionals (n = 20) were conducted in London and surrounding areas of England. Interviews were audio‐recorded and transcribed verbatim. Four themes were identified: caregivers accessing and seeking help, perceived priorities of care, professionals' supportiveness and educational role, and strategies. Caregivers often struggle as they are not aware of the eating and drinking difficulties associated with dementia's progression. Care can change over time with families prioritising a person's comfort towards the end of life rather than ensuring a particular level of nutrition. Mutual support is required by both professionals and caregivers to enhance the care of the person living with dementia. Cognitive difficulties are often behind initial eating and drinking challenges in dementia, whereas physical challenges take over towards the later stages. Flexibility and creativity are key to adapting to changing needs. There is a need to raise awareness of the eating and drinking challenges associated with the progression of dementia. Professionals can help caregivers embark on the transition towards focussing on comfort and enjoyment of eating and drinking near the end of life rather than nutrition. This is particularly relevant for those caring for a relative living at home. Caregivers' input is needed to tailor professionals' recommendations. [ABSTRACT FROM AUTHOR]

Despite a growing burden of stroke in low‐middle‐income countries, research on patient's experiences and access to rehabilitation services remains limited. This study explores the experiences of stroke patients in relation to access and use of stroke rehabilitation services, coping strategies and strategies to improve care in Ghana. A cross‐sectional study was conducted. A total of 136 adult stroke patients hospitalised and subsequently discharged in three major referral hospitals in Ghana participated in the study. A paper‐based questionnaire was used to collect data. Data were inputted into STATA version 12, cleaned and analysed using descriptive statistics and Chi‐Square tests. Findings showed that stroke patients experience stroke differently. Early detection (awareness) of stroke symptoms at onset was low (29.4%). Hypertension was the major (58.1%) predisposing risk factor for stroke, followed by diabetes (14.7%). Multiple barriers impede access to outpatient rehabilitation services: high cost of medications (43.4%), transportation constraints (10.3%), long waiting time (6.6%), forgetfulness about appointment (4.4%), limited education on rehabilitation (20.6%), lack of community support (12.5%) and ineffective communication with healthcare providers (5.2%). Recommended strategies to improve access to rehabilitation care included public education on stroke and its associated risk, reduction in the cost of drugs and increased stroke rehabilitation funding by the NHIS, especially for physiotherapy consultation and training support to caregivers on patient care. Given the difference in stroke experience and barriers in accessing rehabilitation care, multi‐level health policy and service delivery reforms are needed to improve access to rehabilitation care, including national public awareness campaigns on early signs of stroke and subsidised cost of stroke rehabilitation. [ABSTRACT FROM AUTHOR]

Background: Little is known directly about the experiences of health professionals with cancer. Current studies mainly employ pathographies as the information source and focus on doctors experiences only.Objective: This paper aims to build upon our understanding of healthcare professionals who have cancer and considers practical management of barriers and gaps in care.Method: It uses conductive research to analyse and critique available studies, highlighting the experiences of health professionals throughout their diagnosis and treatment. It additionally presents thematic clinical observations, reflecting additional experiences noted by the author during her own therapeutic practice.Results: The findings reflect a disparity between treatment of healthcare professionals suffering from cancer as compared to the general patient population.Conclusions: A number of recommendations are made to support healthcare colleagues to facilitate the care offered to this group of patients. [ABSTRACT FROM AUTHOR]

Community environments have the potential to alleviate loneliness and social isolation as they offer opportunity for sociality and to expand personal social network connections. Implementing a social network intervention in community environments to connect people to who are at risk of loneliness or social isolation could help alleviate these concerns. However, implementing interventions in community environments is made difficult by the interplay between the community context and intervention. Thus, to support implementation a detailed understanding of the types of community contexts is required. To examine the optimal factors that promote the implementation of a social network designed to alleviate loneliness and social isolation intervention in the community observations, interviews and documentary analysis were conducted. The Consolidated Framework for Implementation Research and a typology of community contexts were used to inform the data analysis and interpret the findings. Key factors were found to affect the implementation of the intervention in the different community contexts. These inter‐related factors operated across three domains. Service User Needs affected intervention take up as its suitability varied. The stability of the workforce and nature of everyday work also impacted on implementation. Finally, the fluctuating capacity of organisations and the organisational culture were also influential. No single community environment was found to have all of the optimal factors required for implementation and sustainably. The UK policy agenda of austerity had negatively affected community environments' capacity to deliver such intervention through increasing service user needs and reducing available resources. Trial registration: ISRCTN19193075. [ABSTRACT FROM AUTHOR]

This study investigated the treatment methods used by physical and occupational therapists for poststroke paretic upper limbs and the factors influencing their decision‐making processes. For the treatment methods of poststroke paretic upper limbs, the respondents were asked to select the most clinically used treatment according to the severity of the patient's condition. For the factors influencing their decision‐making processes, the respondents were asked to indicate each determinant using a 5‐point Likert scale (1 = no influence at all to 5 = very strong influence). Six hundred thirty‐eight therapists participated in this study. Exploratory factor analysis was used to assess the validity of the questionnaire. The findings indicated task‐specific training (N = 333, 52%) as the most popular for mild cases, followed by repetitive facilitative exercise (n = 143, 22.3%) for moderate cases and electrical stimulation (n = 246, 38.4%) for severe cases. This study revealed that evidence about treatment (very strong: n = 171 (27.0%), and strong: n = 287 (45.0%)) and patient preferences (very strong: n = 203 (31.8%), and strong: n = 251 (39.3%)) affected decision‐making significantly regarding treatment methods for the poststroke paretic upper limb. [ABSTRACT FROM AUTHOR]

This study employs a qualitative methodology to investigate the implications of Romanian women's migration to Italy for employment in the domestic care sector. The research is based on in‐depth interviews conducted face to face with 20 Romanian women who have resided in Italy for over a decade, with the aim of capturing the details of their long‐term integration processes. These interviews, conducted in 2022, specifically focus on the participants' lived experiences of migration and adaptation within the Italian context. Findings reveal that economic motivations are a primary driver intertwined with aspirations for personal and familial advancement. However, the research also highlights the challenges faced by these women, including precarious employment conditions, emotional strain due to family separation, and complexities of integration within the host society. Social networks and transnational ties emerge as crucial factors influencing both the decision to migrate and the subsequent adaptation process. The analysis underscores the duality inherent in care work migration: While it bolsters the Italian care economy and offers economic opportunities for the migrants, it simultaneously exposes them to vulnerabilities such as job insecurity and potential exploitation. By investigating this migration of care workers, the research contributes to the field of welfare economics by clarifying the economic ramifications of gendered occupational segregation and migration status. Furthermore, it advocates for implementing inclusive labour market practices and policies that prioritize the well‐being of migrant care workers and facilitate their successful integration into host societies. [ABSTRACT FROM AUTHOR]

A pervasive barrier to preventing, reducing, and ending homelessness is the stigmatization of and discrimination towards persons experiencing homelessness (PEH), termed "homeism." To date, there has been no systematic review of the experiences and outcomes of stigmatization and discrimination among PEH or interventions to reduce this discrimination. To fill this gap in the literature, we conducted a scoping review to identify the ways in which PEH have been stigmatized and discriminated against, the results of these experiences, and interventions that have been used to reduce stigma and discrimination. We reviewed results from 12 databases with no date restrictions; 205 studies met our inclusion criteria. Thematic data analyses resulted in the identification of 12 categories. Using community consultation, the scoping review themes were reviewed and validated with 25 PEH or service providers in the homelessness sector and their feedback integrated into our results. Thematic categories included discrimination and stigmatization in healthcare, social services, workplaces and employment, and public spaces by the general public; discrimination and stigmatization from landlords, police and security guards, informal social networks, and by PEH toward PEH; discrimination and stigmatization linked to intersectional domains; PEH feelings about discrimination and stigmatization; outcomes of discrimination and stigmatization for PEH; and interventions to reduce stigma, discrimination, and prejudice towards PEH. Based on findings from this review, we argue that homeism serves as a social determinant of health as PEH confront multiple barriers to housing, income security, and healthcare due to interpersonal, institutional, structural, and intrapersonal stigmatization and discrimination. [ABSTRACT FROM AUTHOR]

Dental hygienist is the main provider of preventive oral care to promote and improve the oral health of individuals, families, and groups in society. However, the participation of dental hygienists in community outreach and public health programmes in Lithuania is limited, mainly due to the lack of institutional support and the unavailability of positions in public health initiatives, and the country's population has insufficient access to cost‐effective oral health promotion services. This exploratory study aimed to analyse dental hygienists' perception of their profession–to evaluate the scope of practice and professional challenges faced by dental hygienists in Lithuania, focusing on their provision of preventive dental care and educational roles. This study is one part of a prospective study which was conducted in 2021. By using the qualitative approach, with a semistructured interview, the dental hygienists' experience, towards understanding their duties and concept of profession, was collected. Interviews were conducted with seven dental hygienists. A thematic analysis of data from the interview was performed. Three themes were extracted from the contents: (1) concept of dental hygienist's profession, (2) personal qualities, and (3) practical activities carried out by dental hygienists. The study results showed dental hygienists in Lithuania have a broad role focusing on patient care, educational activities, and preventive methods in line with European standards. Key attributes such as communication skills, diligence, and empathy are essential for effective practice, ensuring quality patient care and professional standards. Despite fulfilling nationally defined roles, dental hygienists seek expanded competencies and greater involvement in clinical and preventive care. [ABSTRACT FROM AUTHOR]

Study Objective: The present study is aimed at providing an assessment of the changes in burnout, job strain, isostrain, sleepiness, and fatigue levels over time and identifying factors associated with these symptoms among healthcare workers in French emergency departments (EDs). Method: We conducted a prospective, multicenter study in four EDs and an emergency medical service. Participants completed questionnaires at inclusion and at 90 days to assess burnout, job strain, isostrain, sleepiness, and fatigue. Results: A total of 211 respondents (43.5%) completed the questionnaires at inclusion. At the beginning of the study, 84 (40.8%) participants presented symptoms of burnout, 86 (43.2%) had symptoms of job strain, and 58 (29.4%) of isostrain. Forty‐two (20.1%) healthcare workers presented symptoms of sleepiness, and 8 (3.8%) had symptoms of fatigue. We found that symptoms of burnout were more frequent for healthcare workers with a previous psychiatric history (55.3% vs. 39.1%, p = 0.02) and were lower among participants who had at least one dependent child (33.1% vs. 48.3%, p = 0.013). Symptoms of job strain were higher among administrative staff compared to physicians (55.6% vs. 28.7%, p = 0.01) and among healthcare workers with managerial responsibilities compared to those without (45.6% vs. 28.8%, p = 0.015). Symptoms of isostrain were higher among administrative staff (42.3%) compared to paramedics (34.1%) and physicians (19.8%, p = 0.026). Conclusion: We identified that potential factors associated with the emergence of symptoms of burnout and job strain are suggested, underlining several areas of improvement for the prevention against mental health disorders in the specific population of ED healthcare workers. Trial Registration: ClinicalTrials.gov identifier: NCT04383886. [ABSTRACT FROM AUTHOR]

Background. Severe challenges in recruiting and retaining healthcare workers exist on a global level and are especially noticeable in elderly care services. Previous studies have not assessed how the attractiveness of a job is related to wellbeing at work among licensed practical nurses (LPNs) even though these professionals are vital in providing care to the elderly. Objective. The purpose of this study is to define factors that affect LPNs' attractiveness of work and wellbeing at work. Design. A cross‐sectional survey study. Participants. A large‐scale nationwide sample of 10 848 licensed practical nurses (LPNs) working in Finland. Methods. An online survey for LPNs working in Finland was conducted. Criteria for a good workplace (CFGW), measuring the attractiveness of work and wellbeing at work, were utilized. Descriptive and comparative analyses were performed. Cronbach's alpha values were tested to assess internal consistency (α = 0.739–0.915). An ANOVA or t‐test result which indicated a statistically significant between‐group difference (which was in line with difference ≥0.1) was considered as both statistically significant and significant in practice. Results. The core group, LPNs' wellbeing at work (m = 4.36), is extremely important factor of attractiveness of work. Regarding the subgroups high quality of care (m = 4.61), reconciling of work and private life (m = 4.59) and well‐functioning practices (m = 4.55) were most important. Well‐functioning practices associated with several background variables, e.g., with working for full‐time (p ≤ 0.001, mean = 3.10) and age (p < 0.001). LPNs over 56 years old, especially, regard well‐functioning practices important (p = 3.17). LPNs' who were 56 years old or older (m = 3.12) and those who had work experience 1 year or less (m = 3.19) stated rewarding work most important. Conclusions. The core group, wellbeing, is an exceptionally important for the LPNs attractiveness of work. The LPNs' wellbeing at work is supported by the quality of care and reconciliation of work and private life. [ABSTRACT FROM AUTHOR]

Increasing frailty or a medical crisis threatens older people's autonomy. Further threats may arise from adult children if such changes or events are perceived as permitting or signalling a need to assume greater control over their parent's life. In the context of reablement—a time‐limited intervention seeking to help older people regain their confidence and ability to live as independently as possible—this is observed in cases where adult children resist, or seek to sabotage, reablement. This runs counter to the notion of family being a valuable resource and partner to reablement services in achieving the desired outcomes. Notions of autonomy and legitimate authority, which often co‐occur in care relationships, provide a useful lens to understand this phenomenon. The aims of this study were to explore reablement staff's accounts of the ways adult children seek to assume control over their parents' reablement, and how they manage such situations. We undertook a secondary analysis of a qualitative dataset comprising transcripts of 11 focus groups with staff (n = 78) in five reablement services in England and Wales conducted for the purposes of a study investigating the factors affecting older people's engagement with reablement. Staff's accounts included descriptions of the different ways adult children can seek to exert control over the reablement process. Staff believed that, when aware this was happening, older people ceded control to their child(ren) because preserving the relationship with their child(ren) was a greater priority than maximising their independence. Staff's descriptions of the different strategies they used to protect family relationships whilst supporting the older person's autonomy shed light on the skills reablement staff require. Findings support person‐centred approaches to reablement which understand and respond to the wider family context. They also point to possible limitations or gaps in workforce training and supervision. [ABSTRACT FROM AUTHOR]

Aim: To explore nurse leaders' resilience and their role in supporting nurses' resilience during the COVID‐19 pandemic. Background: The COVID‐19 pandemic has challenged health care systems on a global level. Nurse leaders are tasked with ensuring high‐quality care, even during crises, which requires active problem‐solving and confidence in the future—resilience from leaders. Method: A scoping review was conducted using inductive thematic analysis and the PCC (Participants, Concept, Context) framework. The PubMed, Scopus, CINAHL, and PsycINFO databases, as well additional studies and grey literature, were searched from December 2019 to June 2021. Results: The review included 12 studies. Nurse leaders' self‐awareness, self‐reflection, and coping strategies described their resilience during the pandemic. A relational leadership style, supportive and safe work environment, and adequate communication were found to support nurses' resilience. Conclusions: There is scarce research concerning nurse leaders' resilience during the COVID‐19 pandemic. Future research needs to address nurse leaders' personal resilience due to the link with nurses' resilience. Implications for Nursing Management: A healthy work environment is essential for nurses' resilience. During crises, nurse leaders should adopt relational leadership styles and actively interact with nursing staff. [ABSTRACT FROM AUTHOR]

Loneliness research has tended to focus on mainstream and older populations despite evidence that non‐mainstream groups, like those experiencing homelessness, may experience loneliness differently. Limited existing research indicates that (a) people who have been homeless experience loneliness as multidimensional (as a pluralistic, non‐unidimensional emotion, experienced specific to lacked relationships) and (b) mainstream loneliness scales may be inappropriate for this group. The current study piloted and appraised the feasibility the short version of the Social and Emotional Loneliness Scale for Adults (SELSA‐S) among 129 Australian adults with a lived experience of homelessness. Exploratory Factor Analysis and an observational questionnaire appraisal were used to assess factorial and content validity and showed the measure did not fit this sample as well as in mainstream samples. Removal of items that participants found difficult to comprehend/answer improved the factorial fit of the scale. In conclusion, the SELSA‐S may be inappropriate for measuring loneliness among people who have experienced homelessness. Further research needs to explore the potentially different structure of loneliness among marginalised groups so that a better understanding of loneliness can be reached. [ABSTRACT FROM AUTHOR]

Purpose: This paper describes a project to assess the feasibility of a brief healthy lifestyle health education group (HE) program and its effects on patient outcomes. Design and Methods: Forty adult inpatients were enrolled in the HE program, which featured a one‐group, pretest or posttest design deployed in an adult psychiatric unit. Outcomes comprised (1) feasibility and acceptability of the program and (2) changes in patient knowledge and weight. Findings: The HE program demonstrates not only feasibility, but also improvement in patient outcomes related to maintaining a healthy lifestyle. Practice Implications: Requisite changes in practice are necessary for the success of the HE program deployed in a typical, inpatient psychiatric unit. [ABSTRACT FROM AUTHOR]

This study explores the impact of mental capacity in relation to breast screening for women with intellectual disabilities in the UK. Participation in breast screening is considerably lower for women with intellectual disabilities compared to the general population. Barriers to screening include poor mobility and behavioural difficulties. There is currently no research which primarily explores the relationship between mental capacity and breast screening for this group of individuals. This paper presents the results of a cross‐sectional survey of 131 women with intellectual disabilities supported by eight Social Care Providers within England and Wales. The data were collected between January 2017 and July 2017. The current research explores the decision‐making process surrounding breast screening, considering the impact of associated risk factors during this process. Participants completed a specifically created survey addressing the aforementioned issues. The results indicated that women who lacked capacity, were less likely to engage in breast screening. It was also demonstrated that the process outlined in the Mental Capacity Act (MCA; 2005) was not always followed; women were not routinely assessed if there were doubts regarding their decision‐making ability around breast screening and best interest meetings (BIM) were not always held if the person lacked capacity. In order to be able to generalise the current findings, further research is needed to gain a broader understanding of how professionals make decisions around breast screening for women with intellectual disabilities in case the individuals are unable to decide this independently. [ABSTRACT FROM AUTHOR]

Ageing does not reduce people's need to connect with family members, friends, and acquaintances, and neither does migration. For those older migrants living in a foreign land, connectedness with others plays a particularly important role in achieving a sense of belonging and sustaining their health and well‐being. This paper explores the issues of social isolation and loneliness among older Asian migrants in New Zealand. Data were collected from in‐depth semi‐structured interviews with Chinese‐ or Korean‐speaking migrants aged between 75 and 84 years (n = 10: all females), and from three focus groups consisting of Chinese‐ and Korean‐speaking migrants (n = 10: 7 females, 3 males) and Chinese professionals (n = 5: 3 females, 2 males) between June 2016 and December 2016. The qualitative data obtained were analysed applying a thematic analysis approach using NVivo software for group analysis by a multidisciplinary research team. The findings from the study show that older Asian migrants experienced high levels of isolation and loneliness at least at some points in their migrant lives. Most participants in this study were living alone or with only their spouse, and this living arrangement was likely to provide fertile ground for isolation and loneliness to grow in the context of later‐life migration. It was also observed that their lonely ageing ironically resulted from their efforts to preserve family relationships through avoiding being a burden, while allowing them a sort of space to maintain now barely connected lives. The participants revealed multiple ways of coping with lonely and isolated experiences in their limited social network, and these individual strategies allow us to make suggestions about how best to reduce older migrants' social isolation and loneliness in the New Zealand context and beyond. [ABSTRACT FROM AUTHOR]

An introduction is presented in which the editor discusses various reports within the issue on topics including the correlation between obesity and lack of activity in children, psychosocial factors that affect the level of exercise in children, and exercise in children with chronic illnesses.

Summary: What is known and objective: Deprescribing is the process of discontinuing or reducing the dosage of medications that are no longer appropriate or aligned with goals of care, which is paramount in elderly patients with multiple comorbidities and polypharmacy. The objective of this study was to assess the perceptions of primary care physicians on deprescribing for elderly patients and potential barriers to deprescribing that physicians experience in the Local Health Authority (LHA) of Parma, Emilia‐Romagna, Italy. Methods: One hundred and sixty physicians (57% of the total number of primary care physicians in Parma) attended an educational session related to deprescribing and were asked to anonymously complete a paper survey. Participants were asked to assess their level of agreement on nine questions about their perception of deprescribing and potential factors affecting the deprescribing process using a seven‐point Likert‐type scale. A correlation coefficient was calculated to assess the association between physicians’ confidence in deprescribing and attitudes or barriers associated with deprescribing. Results and discussion: Many physicians (72%) reported general confidence in their ability to deprescribe. Most respondents (78%) reported they were comfortable deprescribing preventive medications, yet only half (53%) were comfortable deprescribing guideline‐recommended therapies. Lack of evidence on discontinuing preventive medicines and concern about withdrawal side effects were reported to impede deprescribing by more than one‐third of physicians. When medications were initially prescribed by another physician, 40% of physicians reported hesitance in deprescribing them. About half of physicians (45%) did not feel comfortable deprescribing when patients/caregivers believed that continuation of the medication was needed. Lack of time and difficulty engaging patients/caregivers in the deprescribing process were cited as barriers by about one in four physicians. There was no strong correlation between physicians’ confidence and attitudes or barriers associated with deprescribing. What is new and conclusion: The study results show that physicians believe they are generally comfortable with deprescribing, although there are still several factors that hamper their ability to engage in the process. An improved understanding of physicians’ views on deprescribing may help guide further research, and policies to help patients remain healthy while streamlining their medication regimen. [ABSTRACT FROM AUTHOR]

Social prescribing link workers are recently introduced roles in English primary care. One of their intended functions is to support patients with conditions influenced by the wider, social determinants of health. Their main purpose is to connect people to community resources to meet their nonmedical needs. However, our research reveals that link workers provide not only connections but also what we have described as "holding" for individuals with complex needs, who lack informal networks of support or who are waiting to access services. We explore the concept of holding, its meaning and significance in this context, and consider its consequences. As part of a realist evaluation, we observed seven link workers in GP practices in England during focussed ethnographies over a 3‐week period. We took field notes and interviewed 61 patients and 93 healthcare and voluntary sector professionals. Nine to twelve months later, we carried out follow‐up interviews with forty‐one patients, seven link workers, and a link worker manager. We identified four functions of holding: supporting patients waiting for services, sustaining patients as they prepare for change, reducing the emotional burden of primary healthcare professionals, and bearing witness to patients' distress. Holding appears to be a vital but often overlooked aspect of social prescribing. Patients benefit from having a reliable and consistent person to support their emotional needs. However, similar to the impact of holding on other primary care professionals, there are unintended consequences: some link workers exceed their capacity, become overburdened, experience burnout, and leave their job. Recognizing the importance of holding and understanding its role in link workers' primary care responsibilities are critical. If holding work is accepted as a role for link workers, providing training and support to them should be prioritised to ensure successful implementation and positive outcomes for patients, link workers, and primary healthcare staff. [ABSTRACT FROM AUTHOR]

Internationally, community healthcare is provided by personal health budgets or personalised schemes as part of a consumer-directed care emphasis. Although the introduction of a personalised scheme in Australia has improved the lives of many, people with psychosocial disability (PSD) and their families have experienced many challenges with service integration. Six focus groups with 17 National Disability Insurance Scheme (NDIS) support workers were conducted between June and November 2022. Participants were asked semistructured questions about their engagement with emergency department (ED) clinicians when presenting with a person with PSD and NDIS plan. They were also asked how they contribute to service integration to improve communication practices between the two services. A qualitative, descriptive thematic analysis approach was used. Results indicate there is a need for improved service integration pathways between the ED and NDIS services. The thematic analyses identified five main themes: the ED is harmful and not safe, but nowhere else to go; make the ED safe; further training for ED staff; improving communication across services; and alternatives to the ED. This study reports NDIS support worker's experience when supporting a person they are caring for in the ED. NDIS support workers have an understanding of the needs of the people they care for;their wisdom can contribute greatly to ED clinical responses in crisis care. Recommendations are offered to assist with service integration between the two systems. [ABSTRACT FROM AUTHOR]