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Purpose: Drawing on survey data (N = 7,826) collected in the United Kingdom, Australia, and the United States, this paper examines whether sexual orientation is a differentiating factor in explaining relationship quality and maintenance. Previous research suggests that sexual orientation is not significant in determining relationship satisfaction; however, these analyses have used traditional variable driven approaches, which do not provide an holistic view of the relationship by considering the unique combination of characteristics. Method: In this study, latent profile analyses were used, which is a person-centered approach that allows for identification of different types of long-term relationships. Results: Data suggested that LGB individuals had marginally higher levels of relationship quality compared to their heterosexual counterparts, and sexual orientation was also associated with differing types of long-term relationships. Discussion: These findings are interrogated in more detail, in particular, how sexual orientation is associated with types of long-term relationships and how everyday practices are associated with relationship quality. [ABSTRACT FROM AUTHOR]

Aims This study aimed to compare the findings of the quality of nursing doctoral education survey across seven countries and discuss the strategic directions for improving quality. Background No comparative evaluation of global quality of nursing doctoral education has been reported to date despite the rapid increase in the number of nursing doctoral programmes. Design A descriptive, cross-country, comparative design was employed. Methods Data were collected from 2007-2010 from nursing schools in seven countries: Australia, Japan, Korea, South Africa, Thailand, UK and USA. An online questionnaire was used to evaluate quality of nursing doctoral education except for Japan, where a paper version was used. Korea and South Africa used e-mails quality of nursing doctoral education was evaluated using four domains: Programme, Faculty (referring to academic staff), Resource and Evaluation. Descriptive statistics, correlational and ordinal logistic regression were employed. Results A total of 105 deans/schools, 414 faculty and 1149 students/graduates participated. The perceptions of faculty and students/graduates about the quality of nursing doctoral education across the seven countries were mostly favourable on all four domains. The faculty domain score had the largest estimated coefficient for relative importance. As the overall quality level of doctoral education rose from fair to good, the resource domain showed an increased effect. Conclusions Both faculty and students/graduates groups rated the overall quality of nursing doctoral education favourably. The faculty domain had the greatest importance for quality, followed by the programme domain. However, the importance of the resource domain gained significance as the overall quality of nursing doctoral education increased, indicating the needs for more attention to resources if the quality of nursing doctoral education is to improve. [ABSTRACT FROM AUTHOR]

Purpose: To establish feasibility, acceptability, and preliminary efficacy of an adapted version of a commercially available, virtual-reality gaming system (the Personalised Stroke Therapy system) for upper-limb rehabilitation with community dwelling stroke-survivors. Method: Twelve stroke-survivors (nine females, mean age 58 years, [standard deviation 7.1], median stroke chronicity 42 months [interquartile range 34.7], Motricity index 14–25 for shoulder and elbow) were asked to complete nine, 40-min intervention sessions using two activities on the system over 3 weeks. Feasibility and acceptability were assessed through a semi-structured interview, recording of adverse effects, adherence, enjoyment (using an 11-point Likert scale), and perceived exertion (using the BORG scale). Assessments of impairment (Fugl–Meyer Assessment Upper extremity), activity (ABILHAND, Action Research Arm Test, Motor Activity Log-28), and participation (Subjective Index of Physical and Social Outcome) were completed at baseline, following intervention, and at 4-week follow-up. Data were analysed using Thematic Analysis of interview and intervention field-notes and Wilcoxon Signed Ranks. Side-by-side displays were used to integrate findings. Results: Participants received between 175 and 336 min of intervention. Thirteen non-serious adverse effects were reported by five participants. Participants reported a high level of enjoyment (8.1 and 6.8 out of 10) and rated exertion between 11.6 and 12.9 out of 20. Themes of improvements in impairments and increased spontaneous use in functional activities were identified and supported by improvements in all outcome measures between baseline and post-intervention (p < 0.05 for all measures). Conclusions: Integrated findings suggested that the system is feasible and acceptable for use with a group of community-dwelling stroke-survivors including those with moderately-severe disability. To ensure feasibility of use and maintenance of an appropriate level of challenge, gaming technologies for use in upper-limb stroke rehabilitation should be personalised, dependent on individual need. Through the use of hands-free systems and personalisation, stroke survivors with moderate and moderately-severe levels of upper-limb impairment following stroke are able to use gaming technologies as a means of delivering upper-limb rehabilitation. Future studies should address issues of acceptability, feasibility, and efficacy of personalised gaming technologies for delivery of upper-limb stroke rehabilitation in the home environment. Findings from this study can be used to develop future games and activities suitable for use in stroke rehabilitation. [ABSTRACT FROM AUTHOR]

Aims and objectives: To evaluate and explore mental health nurses' responses to and experience of an educational intervention to improve attitudes towards people with a diagnosis of borderline personality disorder (BPD). Report findings are concordant with relevant EQUATOR guidelines (STROBE and COREQ). Background: Attitudes towards people with a diagnosis of BPD are poorer than for people with other diagnoses. There is limited evidence about what might improve this situation. One intervention with reportedly good effect uses an underlying biosocial model of BPD. No previous intervention has been co‐produced with an expert by experience. We developed and delivered a 1‐day intervention comprising these elements. Design: A mixed‐methods design was used comprising prospective within‐subjects cohort intervention and qualitative elements. Participants were mental health nursing staff working in inpatient and community settings in one NHS Board in Scotland, UK. Methods: Measurement of cognitive and emotional attitudes to people with a diagnosis of BPD at pre‐ and postintervention (N = 28) and at 4‐month follow‐up. Focus groups were used to explore participants' experiences of the intervention (N = 11). Results: Quantitative evaluation revealed some sustained changes consistent with expected attitudinal gains in relation to the perceived treatment characteristics of this group, the perception of their suicidal tendencies and negative attitudes in general. Qualitative findings revealed some hostility towards the underpinning biosocial model and positive appreciation for the involvement of an expert by experience. Conclusions: Sustained benefits of an educational intervention for people working with people diagnosed with BPD in some but not all areas. Participants provided contrasting messages about what they think will be useful. Relevance to clinical practice: The study provides further evidence for incorporation of a biosocial model into staff training as well as the benefits of expert by experience co‐production. Mental health nurses, however, believe that more well‐resourced services are the key to improving care. [ABSTRACT FROM AUTHOR]

Aim The aim of this study was to assess pregnant women's Internet searching activity about medication safety, knowledge and perceptions of medication risk and willingness to take prescribed and non-prescribed medication or make online medication purchases. Background Online medication advice for pregnant women is complex. The quality and veracity of this data is increasingly important as more midwives report women are bringing retrieved online information to clinical appointments. Pregnant women's use of the Internet for seeking medication advice and purchasing medications has not yet been fully investigated. Design Online survey conducted from January - March 2013. Findings Of the 284 respondents, 39% were taking a medication when they became pregnant and 76% had searched the Internet for medication safety information. Analgesics were the most commonly searched category (41%). Health service sites were the most common online source and regarded as the most helpful and trusted. Regardless of age and education level, 90% of women agreed that if trying to become pregnant they would reconsider taking any medications because of the potential risk to their unborn baby. Forty-six percent of women with higher levels of education consider buying medication online as safe, a greater proportion than those of lower education. Five percent of women reported buying medication online. Conclusion The lack of specific recommendations for medication use during pregnancy is challenging for healthcare staff and pregnant women who need robust evidence to make informed treatment decisions. The Internet is a recognized, commonly accessed, source of medication information for pregnant women. [ABSTRACT FROM AUTHOR]

Aims and objectives To examine nursing home managers' knowledge, attitudes, beliefs and current practice regarding advance care planning for people with dementia in long-term care settings informed by the theory of planned behaviour. Background Internationally, advance care planning is advocated for people with dementia. However, evidence suggests that discussions with people with dementia are rare, particularly in long-term care settings. Whilst nursing home managers can be considered central to implementation in this setting, there is a dearth of research that has examined their perspective. This study reports on their role with regard to advance care planning and the perceived factors which influence this. Design A cross-sectional postal survey was carried out as part of a larger scale sequential explanatory mixed-methods study between January-March 2015. Setting and participants Nursing home managers in a region in the UK ( n = 178). Results A response rate of 66% ( n = 116) was achieved. Nursing home managers demonstrated a lack of knowledge of advance care planning, with negative attitudes underpinned by concerns regarding the capacity and lack of perceived benefits to the person with dementia. Currently, they do not view advance care planning as part of their role, with lack of ownership impacting upon current practice behaviours. Conclusions Whilst nursing home managers recognise the potential benefits of advance care planning, barriers and challenges create a reluctance to facilitate. Targeted training to address the knowledge deficit is required, with the wider components of advance care planning promoted. There is a need for greater role clarification to ensure nurses in long-term care settings identify with the process in the future. A gap between rhetoric and reality of implementation is evident; therefore, long-term care settings must critically examine system, organisational and individual factors for failure to implement advance care planning for people with dementia. Relevance to Clinical Practice Increased cognisance of the context in which advance care planning takes place is vital for improved implementation in this context. In addition strong nursing leadership is imperative to facilitate initiation, engagement and re-evaluation of the process of advance care planning. [ABSTRACT FROM AUTHOR]

There has been growing interest in religion and spirituality within social work literature. However, little empirical research has explored Islamic welfare organisations and especially their significance for service users. This article presents findings from an evaluation of a British Islamic social work organisation (Ihsaan Social Support Association (ISSA) Wales), drawing on qualitative interviews with Muslim service users (n = 8) and quantitative findings from the service user database (n = 495), a quality-of-life assessment (n = 42) and a satisfaction survey (n = 36). In discussing the qualitative findings, religious authority, authenticity, culture, gender and the role of mosques are considered in analysing why the organisation's services were perceived as beneficial to their Muslim service users. Over three-quarters of those responding to a satisfaction survey reported that the help from the organisation had improved their well-being, but quantitative data from assessment and review showed no evidence of either improvement or deterioration in quality of life over time, with the exception of social life, where there was a significant improvement. Overall, in exploring the experiences of these service users, the findings highlight the diversity within the category of the 'Muslim service user' and the potential contribution that Islamic social welfare organisations may make in meeting the needs of British Muslims. [ABSTRACT FROM AUTHOR]

Objective: To develop a participatory approach in the evaluation of 3D printed patient-specific models of congenital heart disease (CHD) with different stakeholders who would potentially benefit from the technology (patients, parents, clinicians and nurses). Methods: Workshops, focus groups and teaching sessions were organised, targeting different stakeholders. Sessions involved displaying and discussing different 3D models of CHD. Model evaluation involved response counts from questionnaires and thematic analysis of audio-recorded discussions and written feedback. Results: Stakeholders' responses indicated the scope and potential for clinical translation of 3D models. As tangible, three-dimensional artefacts, these can have a role in communicative processes. Their patient-specific quality is also important in relation to individual characteristics of CHD. Patients indicated that 3D models can help them visualise 'what's going on inside'. Parents agreed that models can spark curiosity in young people. Clinicians indicated that teaching might be the most relevant application. Nurses agreed that 3D models improved their learning experience during a CHD course. Conclusion: Engagement of different stakeholders to evaluate 3D printing technology for CHD identified the potential of the models for improving patient- doctor communication, patient empowerment and training. Practice Implications: A participatory approach could benefit the clinical evaluation and translation of 3D printing technology. [ABSTRACT FROM AUTHOR]

Objective: To study midwives’ knowledge, practice and opinions regarding advice about fetal alcohol syndrome (FAS), fetal alcohol spectrum disorders (FASDs) and alcohol intake in pregnancy. Design: A postal questionnaire was sent to 1862 midwives employed in 13 NHS Trusts in East Anglia, incorporating city and rural areas. Results: The authors received responses from 33.5% of the midwives contacted (n=624), of which 98% stated that alcohol abstinence in pregnancy would be their preferred advice, and 38% had seen an infant with FAS. Less than 2% indicated that they were ‘very prepared’ to deal with the subject. Only 10% identified all four classic features of FAS. Conclusions: More than a third of midwives had seen an infant with FAS. The advice given to pregnant mothers by participants varied. The midwives stated that they would like more information and support. Implications for practice: Expansion of midwives’ knowledge should improve the quality of antenatal advice, leading to better prevention, intervention and recognition of FASD in children. [ABSTRACT FROM AUTHOR]

Aim To develop and validate a bronchiolitis severity scoring instrument for use by nurses and other healthcare professions. Background Bronchiolitis is a viral lower respiratory tract infection of infancy. In industrialized countries, admission rates have increased over the last decade with up to 3% of all infants born being admitted to hospital. A small number of these hospitalized infants will require admission to critical care for either invasive or non-invasive ventilation. During the seasonal epidemic, the number of unplanned admissions to critical care with bronchiolitis substantially increases. Design We will use a mixed methods study design. Methods We will use scale development and psychometric methods to develop a scoring instrument and to test the instrument for content, construct and criterion validity and reliability in several different clinical locations. This study protocol has been reviewed and approved by the NHS National Research Ethics Service, January 2011. Discussion There is an urgent need to develop a valid and reliable severity scoring instrument sensitive to clinical changes in the infant, to facilitate clinical decision-making and help standardize patient care. Furthermore, a valid and reliable scoring instrument could also be used as a proxy patient-reported outcome measure to evaluate the efficacy of clinical interventions in randomized controlled trials. [ABSTRACT FROM AUTHOR]

Medical Education 2012: 46: 711-721 Context Although medical students receive varied feedback throughout their training programmes, research demonstrates that they frequently perceive it as insufficient. However, supervisors tend to perceive that it is adequate. Students' responses to, and use of, feedback are not clearly understood. The purposes of this study were to investigate how medical students recognise, respond to and utilise feedback, and to determine whether there are maturational differences in understandings of the role of feedback across academic years in medical school. Methods This was a mixed-methods study collecting qualitative (focus group and open-ended questionnaire items) and quantitative (questionnaire) data across the 5 years of an undergraduate programme. Results A total of 68 students participated in 10 focus groups. The questionnaire response rate was 46% (564/1233). Data analysis investigated the students' perceptions of feedback and explored patterns of responses across the continuum of undergraduate medical school stages. Maturational differences among the year cohorts within the programme emerged in three general areas: (i) student perceptions of the purpose of feedback; (ii) student recognition of feedback, and (iii) student perceptions regarding the credibility of feedback providers. Conclusions Junior students generally perceived the receiving of feedback as a passive activity and preferred positive feedback that confirmed their progress and provided reassurance. More senior students viewed feedback as informing their specific learning needs and personal development. They valued immediate informal verbal feedback and feedback from peers and others, as well as that from senior teachers. Exploring students' progressive degrees of engagement with feedback and its relationship with self-esteem are subjects for further study. [ABSTRACT FROM AUTHOR]