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Aims: To elicit experiences of patients, family caregivers, and healthcare professionals in intermediate care units (IMCUs) in an academic medical centre in Baltimore, MD related to the challenges and intricacies of multimorbidity management to inform development of a multimorbidity symptom management toolkit. Design: Experience‐based co‐design. Methods: Between July and October 2021, patients aged 55 years and older with multimorbidity admitted to IMCUs at an academic medical centre in Baltimore, Maryland, USA were recruited and interviewed in person. Interdisciplinary healthcare professionals working in the IMCU were interviewed virtually. Participants were asked questions about their role in recognizing and treating symptoms, factors affecting the quality of life, symptom burden and trajectory over time, and strategies that have and have not worked for managing symptoms. An inductive thematic analysis approach was used for analysis. Results: Twenty‐three interviews were conducted: 9 patients, 2 family caregivers, and 12 healthcare professionals. Patients' mean age was 67.5 (±6.5) years, over half (n = 5) were Black or Hispanic, and the average number of comorbidities was 3.67. Five major themes that affect symptom management emerged: (1) the patient–provider relationship; (2) open and honest communication; (3) accessibility of resources during hospitalization and at discharge; (4) caregiver support, training, and education; and (5) care coordination and follow‐up care. Conclusion: Patients, caregivers, and healthcare professionals often have similar goals but different priorities for multimorbidity management. It is imperative to identify shared priorities and target holistic interventions that consider patient and caregiver experiences to improve outcomes. Implications for the Profession and/or Patient Care and Impact: This paper addresses the paucity of research related to the shared experience of disease trajectory and symptom management for people living with multimorbidity. We found that patients, caregivers, and healthcare professionals often have similar goals but different care and communication priorities. Understanding differing priorities will help better design interventions to support symptom management so people with multimorbidity can have the best possible quality of life. Reporting Method: We have adhered to the Consolidated Criteria for Reporting Qualitative Studies (COREQ) guidelines in our reporting. Patient or Public Contribution: This study has been designed and implemented with patient and public involvement throughout the process, including community advisory board engagement in the project proposal phase and interview guide development, and member checking in the data collection and analysis phases. The method we chose, experience‐based co‐design, emphasizes the importance of engaging members of a community to act as experts in their own life challenges. In the coming phases of the study, the public will be involved in developing and testing a new intervention, informed by these qualitative interviews and co‐design events, to support symptom management for people with multimorbidity. [ABSTRACT FROM AUTHOR]

To date, at least 2.41 billion people with Non-Communicable Diseases (NCDs) are in need of rehabilitation. Rehabilitation care through innovative technologies is the ideal candidate to reach all people with NCDs in need. To obtain these innovative solutions available in the public health system calls for a rigorous multidimensional evaluation that, with an articulated approach, is carried out through the Health Technology Assessment (HTA) methodology. In this context, the aim of the present paper is to illustrate how the Smart&TouchID (STID) model addresses the need to incorporate patients' evaluations into a multidimensional technology assessment framework by presenting a feasibility study of model application with regard to the rehabilitation experiences of people living with NCDs. After sketching out the STID model's vision and operational process, preliminary evidence on the experiences and attitudes of patients and citizens on rehabilitation care will be described and discussed, showing how they operate, enabling the co-design of technological solutions with a multi-stakeholder approach. Implications for public health are discussed including the view on the STID model as a tool to be integrated into public health governance strategies aimed at tuning the agenda-setting of innovation in rehabilitation care through a participatory methodology. [ABSTRACT FROM AUTHOR]

Background: Medicines are often suboptimally managed for heart failure patients across the transition from hospital to home, potentially leading to poor patient outcomes. The Improving the Safety and Continuity Of Medicines management at Transitions of care programme included: understanding the problems faced by patients and healthcare professionals; developing and co‐designing the Medicines at Transitions of care Intervention (MaTI); a cluster randomized controlled trial testing the effectiveness of a complex behavioural MaTI aimed at improving medicines management at the interface between hospitals discharge and community care for patients with heart failure; and a process evaluation. The MaTI included a patient‐held My Medicines Toolkit; enhanced communication between the hospital and the patient's community pharmacist and increased engagement of the community pharmacist postdischarge. This paper reports on the patients' experiences of the MaTI and its implementation from the process evaluation. Design: Twenty one‐to‐one semi‐structured patient interviews from six intervention sites were conducted between November 2018 and January 2020. Data were analysed using the Framework method, involving patients as co‐analysts. Interview data were triangulated with routine trial data, the Consolidated Framework for Implementation Research and a logic model. Results: Within the hospital setting patients engaged with the toolkit according to whether staff raised awareness of the My Medicines Toolkit's importance and the time and place of its introduction. Patients' engagement with community pharmacy depended on their awareness of the community pharmacist's role, support sources and perceptions of involvement in medicines management. The toolkit's impact on patients' medicines management at home included reassurance during gaps in care, increased knowledge of medicines, enhanced ability to monitor health and seek support and supporting sharing medicines management between formal and informal care networks. Conclusion: Many patients perceived that the MaTI offered them support in their medicines management when transitioning from hospital into the community. Importantly, it can be incorporated into and built upon patients' lived experiences of heart failure. Key to its successful implementation is the quality of engagement of healthcare professionals in introducing the intervention. Patient or Public Contribution: Patients were involved in the study design, as qualitative data co‐analysts and as co‐authors. [ABSTRACT FROM AUTHOR]

Background: In the Netherlands, all women aged 30–60 years are invited to participate in the national cervical cancer screening programme, which is aimed at early detection and treatment of precancerous lesions. One fourth of the Dutch population has a migration background, with Turkish and Moroccan immigrants being the largest immigrant populations. Turkish‐ and Moroccan‐Dutch women show lower screening participation rates and a higher incidence of cervical cancer, compared to native Dutch women. Since current information materials are not tailored to these women's needs, we developed a short culturally sensitive educational video to facilitate informed decision‐making for cervical cancer screening among Turkish‐ and Moroccan‐Dutch women. This article describes the development process of this video and the lessons learned. Methods: Using the Entertainment–Education communication strategy, we collaborated with an interdisciplinary team of Turkish‐ and Moroccan‐Dutch women, researchers, public health experts, and creative media professionals. We developed the video following the different stages of the Media Mapping model: Orientation, Crystallization, Design/Production, Implementation, and Dissemination. Each stage is described in the paper. Results: The video was developed in Moroccan‐Arabic, ‐Berber and Turkish, and emphasized three main themes: (1) more certainty about having cervical (pre)cancer and the possibility to prevent treatment, surgery, or premature death, and because of this, being there for the children, (2) according to the Islam, a woman should take good care of her health, and (3) anxiety, shame, and privacy. Conclusions: A short culturally sensitive educational video, delivered as part of a larger intervention together with the current information brochure, was developed based on theory and grounded in the needs of Turkish‐ and Moroccan‐Dutch women. The value and effectiveness of this intervention to facilitate informed cervical cancer screening decisions are evaluated in a randomised controlled trial. Patient or Public Contribution: We collaborated with Turkish‐ and Moroccan‐Dutch women during the development process of a short culturally sensitive educational video. Turkish‐ and Moroccan‐Dutch women were also invited to watch the raw footage to verify whether the content and presentation matched their needs and requirements. [ABSTRACT FROM AUTHOR]

Background: Considerable evidence suggests that students' achievement emotions are important contributors to their learning and success online. It is, therefore, essential to understand and support students' emotional experiences to enhance online education, especially under the COVID‐19 context. However, to date, very few studies have investigated how students' achievement emotions might be affected by teaching and learning factors in online learning environments. Objectives: Based on Pekrun's (2006) control‐value theory of achievement emotions, this study examined the influence of students' perceived online teaching quality and appraisals of control and value on their achievement emotions in an online second language (L2) learning context instigated by the COVID‐19. Methods: Data were collected using an online survey of 1503 undergraduates from ten universities across different regions of China. Confirmatory factor analyses (CFA) were performed to test the validity of the instruments and structural equation modelling were conducted to examine the relations between L2 teaching and learning variables. Results and Conclusions: Results revealed that perceived teacher internet and communication technology competence had positive effects on enjoyment, but negative effects on anxiety and boredom, and these effects were fully mediated by perceived control and/or value. Perceived chaotic teaching structure (CTS) had reverse effects for the three emotions. Perceived CTS effects on enjoyment and anxiety were fully and partially mediated by perceived control, respectively. Takeaways: Online teaching quality is critical for students' appraisals and emotions towards L2 learning. Teachers should strive to improve online teaching quality and design interventions targeting students' perceived control and value to temper their affective experiences associated with the crisis‐prompted online teaching practices. Lay Description: What is already known about this topic: Teachers' internet and communication technology (ICT) competence and pedagogical design can enhance students' e‐learning efficacy, motivation and interests.Students' perceived control and value can influence their achievement emotions in online learning.Teacher's ICT competence and pedagogical design can impact students' emotions in online learning. What this paper adds: Perceived teacher ICT competence and chaotic teaching structures can have differential impact on students' perceived control and value for e‐learning.Perceived control and intrinsic value differently mediated the effects of the two teaching factors on students' emotions for e‐learning.Perceived teacher ICT competence and chaotic teaching structures can have both direct and indirect effects on students' e‐learning emotions via perceived control and value. Implications for practice and/or policy: Teacher training and development programs should prepare teachers for varying teaching formats including unplanned online teaching due to a forced switch to remote teaching.Teachers should acquaint themselves with using various online platforms and software to communicate the goals, expectations, structures and requirements of their language lessons to students' in a clear manner.Online language teaching interventions aiming to increase or decrease a specific emotion could directly target specific combinations of teaching characteristics and appraisals. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this paper is to investigate the clinical communication using Tamale Teaching Hospital as a case. Design/methodology/approach: The paper is based on the Reassure, Explain, Listen, Answer, Take Action and Express Appreciation (RELATE) model and the Four Habits models of Clinical Communication. Findings: The results of the study indicate that leadership conducted staff meetings with some of the components of the RELATE model. These include staff meetings, employee rounding and communication/notice boards. The results of the study also suggest that much as some parts of the Four Habits model was used in provider–patient communication, certain aspects of the model were absent. The study identified some communication challenges including poor dissemination, lack of unity among some health workers, poor attendance in meetings and, with respect to patients, language barrier, patients' reluctance to disclose their actual health problems to health providers, lack of privacy and lack of a friendly environment. Practical implications: Providers, especially physicians, should be given training on the local languages in areas where they perform their services. Health service providers should receive as part of their learning in-depth training on the Four Habits model of Clinical Communication, especially the Medical Officers. Originality/value: It is imperative to embrace evidence-based practices/models aimed at securing proper communication in all hospitals but most especially teaching hospitals. [ABSTRACT FROM AUTHOR]

The mental health care environment is a stressful environment, especially among student nurses. The purpose of the study was to develop a model of emotional support for student nurses working in the mental health care environment. The objectives were set in two phases: Phase one -- identification of concepts; Phase two -- development of a model of emotional support for student nurses. A theory-generating design, based on a qualitative, explorative and descriptive research approach, was used to meet the aim of the study. Data was purposively collected from 40 nursing students using (n=6) focus group discussions and eight educators and nine clinical staff by way of semi-structured interviews. Data was analysed by means of Tesch's method of data analysis. The model was developed by means of the four steps of which the first two are discussed in this paper as step three and four will be discussed elsewhere. Step one is the concept development consisting of concept identification and concept definition. A total of 22 concepts were identified, which were synthesised into six main concepts, namely, positive self-concept, positive work environment, academic and professional development, effective communication, formal and informal supportive interventions, and collaboration between the higher education institution and the mental health care setting. Step two is the model development during which the main concepts were placed in relation to one another, which formed an emotional support model for students working in mental health care settings. This paper gives an account of the methodological processes that were utilised to meet the aim and objectives of the study. [ABSTRACT FROM AUTHOR]

Background: Despite progress made over the past twenty years, child mortality remains high, with 5.3 million children under five years having died in 2018 globally. Pneumonia, diarrhoea, and malaria remain among the commonest causes of under-five mortality; contributing 15%, 8%, and 5% of global mortality respectively. Recent evidence shows that integrated community case management (iCCM) of pneumonia, diarrhoea, and malaria can reduce under-five mortality. However, despite growing evidence of the effectiveness of iCCM, there are implementation challenges, especially stock out of iCCM commodities and inadequate supportive supervision of community health workers (CHWs). This study aimed to address these two key challenges to successful iCCM implementation by using mobile health (mHealth) technology.Methods: This cluster randomised controlled trial compared health centre catchment areas (clusters) where CHWs and their supervisors implemented mHealth-enhanced iCCM supportive supervision and supply chain management vs clusters implementing iCCM as per current Zambian guidelines. CHWs in intervention clusters used community DHIS2 platform on mobile phones to report on a weekly basis children with iCCM conditions and make requisitions for iCCM commodities. Their supervisors received electronic reports on disease caseloads and monthly automated supervision reminders. The supervisors on receipt of requisitions, organized the medical supplies and notified CHWs for collection. Intention-to-treat analysis on the primary outcome, the percentage of children aged 2-59 months receiving appropriate treatment for malaria, pneumonia, or diarrhoea from an iCCM trained CHW, was performed using a generalized linear model. Prevalence ratios and 95% confidence intervals comparing the prevalence of appropriate treatment in the intervention and control groups were calculated using log binomial regression with an exchangeable correlation matrix, adjusted for clustering by health facility.Results: In the intervention clusters, 61.3% (98/160) of expected monthly supervision visits took place vs 52.0% (78/150) in the controls. A total of 3690 children 2-59 months old presented with malaria, diarrhoea, or pneumonia. In the intervention group, 65.9% (1,252/1,899) of children received appropriate care for iCCM conditions, compared to 63.3% (1,134/1,791) in the control group. The mHealth intervention was associated with 18.0% improvement in supportive supervision and 21.0% increase in appropriate treatment for pneumonia; these changes were not statistically significant. There was a 2-3-fold increase in the proportion of CHWs receiving supplies ordered: prevalence ratios ranged from 2.82 (confidence interval (CI) = 1.50, 5.30) to 3.01 (95% CI = 1.29, 7.00) depending on the particular commodity.Conclusion: This study was unable to determine whether using mHealth technology would strengthen supervision and supply chain management of iCCM commodities for community-level workers. There was no statistically significant effect of mHealth enhanced iCCM on appropriate diagnosis and treatment for children with malaria, pneumonia, and diarrhoea in rural Zambia. Longer term longitudinal studies are required to determine the impact of mHealth enhanced iCCM on health outputs and outcomes.Trial Registration: ClinicalTrials.gov, NCT02866097. [ABSTRACT FROM AUTHOR]

Pervasive social networking sites (SNSs) access has forced people to pay continuous attention to the overwhelming volume of information which ultimately increases their usage. The extensive use of SNSs has contributed to the overuse of technology and that can lead to overload which may produce negative behavioural consequences. This study used cognitive load theory as foundation of the model to examine the effect of overloads and discontinuous intentions incorporating SNS addiction, social media self-efficacy and SNS fatigue. To test the proposed model and hypothesis, a total of 371 Chinese university students participated in the study. Findings reveal that information and communication overload exert a direct impact on SNS addiction, and the relationship between SNS addiction and discontinuous intentions amongst users is negatively significant. The moderated mediation analysis result indicates that social media self-efficacy moderates the mediating effect of SNS addiction between overloads (information and communication) and discontinuous intentions. Moreover, the relationship between SNS addiction and discontinuous intentions is partially mediated by SNS fatigue. Implications emphasise that SNS providers should effectively prevent the negative behavioural response of SNS users by providing training on the effective use of SNSs. [ABSTRACT FROM AUTHOR]

With the rising popularity of SNS games, virtual goods are expected to generate revenue for game providers. However, previous findings may be at odds with changes in this new virtual environment, while some social platforms lack understanding of what motivates users to purchase virtual goods in SNS games either. Considering the social nature of SNS games, this study adopted the self-presentation theory to explore these factors. A conceptual model was proposed and subsequently empirically tested with 302 samples collected from the questionnaire survey. The results show that the desire for online self-presentation is significantly influenced by SNS games involvement, online self-presentation norms, interactivity, and perceived usability. The results also indicate that the effect of the desire for online self-presentation on intention to purchase virtual goods is significant. In addition, the moderated role of perceived usability on the relationship between interactivity and the desire for online self-presentation is established as well. Our findings contribute to the literature on SNS games as well as self-presentation. It also lends insights into how SNS providers can tap this source of revenue. [ABSTRACT FROM AUTHOR]

In this study, the constructive communication process of anti-vaccination advocates is explored to provide insight into the challenges of communicating with an engaged, educated public that is distrustful of mainstream medical and governmental organizations. Using the circuit of culture as a theoretical and methodological model, this article examines how anti-vaccination advocates use social media to construct and reinforce a belief system that counters dominate understandings of health. Findings show that, through online communication, anti-vaccination advocates create shared cultural constructs embracing the identity of health information crusader, critic, and expert. This community consumes, produces, and distributes information that reframes mainstream health information and reinforces shared values. The purposes of this study are to better understand the culture of anti-vaccination advocates, identify communication barriers, and offer practical implications for health care professionals. [ABSTRACT FROM AUTHOR]

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Background: Empathy and emotional expression, as important psychological elements, significantly impact couples' marital satisfaction. Premarital counseling models are designed to increase positive couples' communication behaviors and emotional style. Accordingly, this study compared the effects of marriage preparation based on Satir's communication model and narrative therapy on empathy and emotional expression in single young adults. Methods: This quasi-experimental study employed a pre-test, post-test and a control group design. The research population included all girls and boys on the age of marriage who were referred to Vesta Counseling Clinic in Kashan City, Iran, from March 20th, to September 22nd, 2019. The study participants were 45 individuals who were selected by convenience sampling method. Then, they were randomly assigned to three groups (narrative therapy intervention, Satir intervention, and controls) of 15 clients. The research participants in the two intervention groups attended 11 sessions of narrative therapy and Satir communication therapy; however, the controls received no intervention. The data collection instruments were the Emotion Expression Scale (EES), and the Questionnaire Measure of Emotional Empathy (QMEE). The research hypotheses were tested using the Multivariate Analysis of Covariance (MANCOVA) by SPSS. Results: The present study results suggested that narrative therapy (F=53.97, P=0.0001) was more effective than Satir's communication model (F=33.82, P=0.0001) in terms of emotional expression. Both intervention groups obtained higher mean scores on emotional expression, compared to the controls (F=29.005, P=0.0001). Besides, the narrative therapy group gained a higher Post-test mean score for empathy (F=101.12, P=0.0001), compared to the Satir group (F=84.93, P=0.0001). Besides, both interventions were more effective in the test groups, compared to the controls (F=68.27, P=0.0001). Conclusion: Narrative therapy was more effective for improving emotional expression and empathy, compared to Satir's communication model. Family and marriage counselors are recommended to apply these premarital models for young single adults in counseling centers. [ABSTRACT FROM AUTHOR]

While there is a growing body of research on information behavior during nonroutine events such as natural disasters, the research has largely neglected older persons as a specific group despite their identification as a demographic that suffers disproportionately during disasters. To address this gap, this article reports on the study of the information behavior and related activities of older persons during natural disasters. Based on a qualitative study, we draw on the theory of information worlds to study the key activities of preparing, responding, and recovering from disasters. The article contributes to the information behavior literature by developing a more informed understanding of both the interrelationship between the information worlds and activities of older persons, and how older persons seek and share information during disasters. [ABSTRACT FROM AUTHOR]

The primary purpose of online dating sites, a specialised form of social media, is to aid their users in finding love and making friends. However, while such sites are very popular, only limited research has been conducted to investigate the experiences of female dating site users. Moreover, the factors underlying the popularity of online dating sites have also yet to be fully clarified. Therefore, the current study utilised netnography and online interviews to explore the experiences of female dating site users, while also observing the physical travel paths of such users within the field. More specifically, the particular situational context of online dating was investigated through an approach that included the following three stages: the observation and collection of online data, participation in an active manner, and emergent design. The study's key theoretical contribution is its establishment of a netnography model along with eight associated propositions. Overall, the study's findings substantially illuminate the online dating site experiences of female site users. [ABSTRACT FROM AUTHOR]

Although it is recognised that face-to-face interactions are important for sharing interests and (new) knowledge, it remains unknown how and where students and university employees interact in academic buildings. Therefore, the aim of this study is to analyse the location choice for face-to-face interactions in an academic building, including several personal- and interaction characteristics. An Experience Sampling Method (ESM) was used to collect data on 643 face-to-face interactions during two weeks in the Flux building at Eindhoven University of Technology, the Netherlands. In general, students more often interacted in meeting rooms than teaching staff, and support staff interacted less in eat/drink areas and the hallways than other users. Unexpectedly, some of the lectures took place outside of traditional project-/lecture space. Real estate managers of university campuses could use these results to create better interactive work environments that stimulate face-to-face interactions among employees and students of different departments. Practitioner Summary: Based on longitudinal data of ftf interactions among students and employees in an academic building, results showed that ftf interaction characteristics, compared to personal characteristics, are most important for explaining the location choice of interactions. These insights could help to design academic work environments that optimise the support of interactions. Abbreviation: ABO: activity-based office; ANOVA: analyses of variance; ESM: experience sampling method; FTF: face-to-face; HR: human resources; MMNL: mixed multinomial logit model; NewWoW: new ways of working [ABSTRACT FROM AUTHOR]

Life expectancy is increasing for people with intellectual disability, many of whom live with family. While there has been research about aging and future planning, there is limited evidence about the characteristics of the caregiving relationship. The aim of this study was to examine perspectives of caregiving for older people with intellectual disability and their family. A constructivist grounded theory approach was used, and 19 people with intellectual disability and 28 family members were interviewed. Caregiving was informed by transitions across the life course. Three interrelated concepts, Riding the Waves, Shifting Sands—Changing Tides, and Uncovering Horizons comprise the core components of the theoretical model— Navigating Ever-Changing Seas. This model informs complex, trans-generational relationships that impact decision-making for people with a long-term condition. Applications within health care indicate a need for systems to include individuals and their networks of care in policy, practice, research, and service delivery across the lifespan. [ABSTRACT FROM AUTHOR]

A small, local-level communication initiative aimed to bring about social change and development in communities affected by sustained conflict in Mindanao, Philippines. A realist evaluation involved a secondary analysis of existing data sets that revealed previously undetected mechanisms and 13 outcomes for improving dialogue, livelihood, and participatory communication. This article describes the method developed for the realist evaluation and constructs Context-Mechanism-Outcome configurations from the existing data sets. The realist evaluation represents what took place in a context characterized by conflict, disadvantage and disempowerment through 2 key mechanisms, community-centered radio and community radio volunteers. Both mechanisms became voices for the voiceless. The community-centered radio program supported community volunteers to mobilize communities to participate in radio segments, offering opportunities for their voices to be heard on local issues resulting in discussion, provision of services not previously offered, community leaders more responsive to community needs, and coordinated community action that resolved needs. [ABSTRACT FROM AUTHOR]

The objectives of this study were (1) to describe home health care (HHC) nurses’ perception of and care processes related to geriatric depression and frailty, and (2) to identify barriers to care delivery for older persons with these two conditions. Ten semi-structured interviews were conducted with HHC nurses, and 16 HHC nursing visits to 16 older patients (≥65 years) were observed. Mixed method analysis showed that HHC nurses did not routinely assess for frailty and depression. Major barriers to care delivery included insufficient training, documentation burden, limited reimbursement, and high caseload. Addressing these barriers would facilitate HHC nursing care for frail, depressed elders. [ABSTRACT FROM AUTHOR]

Abstract: Background: To meet the challenge of multimorbidity in decision making, a switch from a disease‐oriented to a goal‐oriented approach could be beneficial for patients and clinicians. More insight about the concept and the implementation of this approach in clinical practice is needed. Objective: This study aimed to develop conceptual descriptions of goal‐oriented care by examining the perspectives of general practitioners (GPs) and clinical geriatricians (CGs), and how the concept relates to collaborative communication and shared decision making with elderly patients with multimorbidity. Method: Qualitative interviews with GPs and CGs were conducted and analyzed using thematic analysis. Results: Clinicians distinguished disease‐ or symptom‐specific goals, functional goals and a new type of goals, which we labelled as fundamental goals. “Fundamental goals” are goals specifying patient's priorities in life, related to their values and core relationships. These fundamental goals can be considered implicitly or explicitly in decision making or can be ignored. Reasons to explicate goals are the potential mismatch between medical standards and patient preferences and the need to know individual patient values in case of multimorbidity, including the management in acute situations. Conclusion: Based on the perspectives of clinicians, we expanded the concept of goal‐oriented care by identifying a three‐level goal hierarchy. This model could facilitate collaborative goal‐setting for patients with multiple long‐term conditions in clinical practice. Future research is needed to refine and validate this model and to provide specific guidance for medical training and practice. [ABSTRACT FROM AUTHOR]

Elucidating mechanisms of how high quality clinical encounters with providers may alleviate depressive symptoms in young adults are critical to reduce psychological morbidity and disability. Guided by Street's Model of Health Communication (SMHC), this study explores the predictive relationships of the clinical encounter, which includes communication functions (patient-provider communication and patient self-appraisal of communication skills with provider) and proximal outcomes (patient activation; PA) to improve health outcomes (depressive symptoms) in young adults. This study of young adults (n = 60) employed path analysis to examine the overall model fit and direct and indirect effects of each variable on depressive symptoms. The final SMHC had excellent model fit (X2= 2.26,p=.32, TLI =.99, CFI = 1.00, RMSEA =.05). Patient-provider communication and self-appraised communication skills with providers had indirect effects on depressive symptoms and a direct effect on PA; PA had a direct effect on depressive symptoms (R2=.30,p<.01). Findings elucidate potential novel targets, amenable to behavioral intervention, to improve depressive symptoms within the clinical encounter, and provide a foundation for hypothesis-driven model testing among young adults with depressive symptoms. [ABSTRACT FROM AUTHOR]

Communication campaigns often include components that have been designed for a specific population, a strategy referred to as targeting. Targeted narratives are story-based components of a campaign that feature a character or situation relevant to the intended audience. Though commonplace, few studies have explicated the underlying mechanisms by which targeted narratives exert influence. In a message evaluation study, 316 women aged 40–75 (Mage = 51.19,SD = 8.11) were exposed to one of two targeted narratives and asked to complete measures of model admiration, narrative memorability, and intentions to receive a mammography. Targeting was based upon affiliation with the Mormon church. The results revealed that the relationship between the targeted narratives and screening intentions was especially strong for women from the target population who admired the depicted models and found the stories memorable. [ABSTRACT FROM PUBLISHER]

Aim The aim of this study was to gain insight into the process of patient enablement in general practice nursing consultations. Background Enhanced roles for general practice nurses may benefit patients through a range of mechanisms, one of which may be increasing patient enablement. In studies with general practitioners enhanced patient enablement has been associated with increases in self-efficacy and skill development. Design This study used a constructivist grounded theory design. Methods In-depth interviews were conducted with 16 general practice nurses and 23 patients from 21 general practices between September 2013 - March 2014. Data generation and analysis were conducted concurrently using constant comparative analysis and theoretical sampling focussing on the process and outcomes of patient enablement. Use of the storyline technique supported theoretical coding and integration of the data into a theoretical model. Findings A clearly defined social process that fostered and optimised patient enablement was constructed. The theory of 'developing enabling healthcare partnerships between nurses and patients in general practice' incorporates three stages: triggering enabling healthcare partnerships, tailoring care and the manifestation of patient enablement. Patient enablement was evidenced through: 1. Patients' understanding of their unique healthcare requirements informing their health seeking behaviours and choices; 2. Patients taking an increased lead in their partnership with a nurse and seeking choices in their care and 3. Patients getting health care that reflected their needs, preferences and goals. Conclusions This theoretical model is in line with a patient-centred model of health care and is particularly suited to patients with chronic disease. [ABSTRACT FROM AUTHOR]

Aims and objectives To assess the acceptability and usability of a standardised communication tool for nurses. Background and significance Communication is key in health care. On a daily, if not hourly, basis, nursing staff is inundated with new information regarding tools and resources, practice changes and the work environment. However, there is currently no standardised messaging or delivery method to effectively communicate new information. Even with a plethora of communication tools such as flyers, posters, emails, unit huddles and unit meetings, there is no means to guarantee attendance to crucial information. Design Descriptive, cross-sectional online survey, implemented at a nonacademic, suburban hospital with 280 nurses. Methods The Clinical Chatter, an online tool developed by nursing leadership to standardise messages regarding the organisation, new tools and resources, professional development, recognition and unit updates, was delivered to each nurse on a weekly basis followed by administration of Acceptability and Usability scales. Results The Clinical Chatter tool has adequate acceptability and usability as a method of communication among nurses in a hospital organisation. Sociodemographic variables of age and years of experience had no statistically significant association with perceived acceptance and usefulness of the tool. Conclusion The findings indicate that the Clinical Chatter tool can be used as a standardised communication tool to deliver key information among nurses working in a hospital organisation. Nursing leadership must establish and support a clear communication system to enhance patient care and outcomes and improve nursing job satisfaction. Relevance to clinical practice Communication is vital to advancing health care. Lack of communication among nursing has been linked to unsafe patient care: medication errors, unhealthy work environments and decreased nurse retention rates. Clinical Chatter is an effective communication tool for presentation of institutional information to nursing personnel. [ABSTRACT FROM AUTHOR]

The article presents an overview of the leadership role of advanced practice registered nurses (APRNs) with the implementation and evaluation of a pediatric diabetes telemedicine program for a rural community with limited access to pediatric diabetes specialists. Topics include implementation of the innovative model of care, limitations and future quality improvement metrics, and benefits and challenges of telemedicine program.

Aim This study aimed to establish and describe the level of communication satisfaction that professional nurses experience in selected public hospitals in the City of Johannesburg, South Africa. Background The success of any organisation depends on the effectiveness of its communication systems and the interaction between staff members. Method Data were collected by means of questionnaires, based on the Communication Satisfaction Questionnaire ( CSQ), from a sample of 265 professional nurses from different categories, chosen using a disproportionate random stratified sampling method. Results The results indicated poor personal feedback between nurse managers (operational managers) and professional nurses, as well as dissatisfaction among nurse managers and professional nurses with regard to informal communication channels. A lack of information pertaining to policies, change, financial standing and achievements of hospitals was identified. Conclusion Nurse managers should play a leadership role in bringing staff of different departments together by creating interactive communication forums for the sharing of ideas. Implications for nursing management The results emphasise the need for nurse managers to improve communication satisfaction at all levels of the hospital services in order to enhance staff satisfaction and create a positive working environment for staff members. [ABSTRACT FROM AUTHOR]

Divorce has long been described as one of the most stressful life experiences. A review of the literature identified numerous studies that have identified detrimental effects of parental divorce on children and adolescents and few that have emphasized possible optimal implications or effective coping with this event. The focus of this study subsequently fell on how young adults had coped with the divorce of their parents during their childhood or adolescent years. Semistructured retrospective interviews were conducted with 15 participants selected by means of snowball sampling in the completion of this study. Findings revealed a set of themes and subthemes relating to adults’ coping with parental divorce during childhood or adolescence as well as a set of factors that could potentially hinder such coping. Effective communication in relationships was highlighted as a particularly valuable coping method. It is hoped that these insights will enable those involved with assisting families during divorce to cope more effectively with this event. [ABSTRACT FROM PUBLISHER]

Aims and objectives To explore how communication failures occur in documents and documentations across the perioperative pathway in nurses' interactions with other nurses, surgeons and anaesthetists. Background Documents and documentation are used to communicate vital patient and procedural information among nurses, and in nurses' interactions with surgeons and anaesthetists, across the perioperative pathway. Previous research indicates that communication failure regularly occurs in the perioperative setting. Design A qualitative study was undertaken. Methods The study was conducted over three hospitals in Melbourne, Australia. One hundred and twenty-five healthcare professionals from the disciplines of surgery, anaesthesia and nursing participated in the study. Data collection commenced in January 2010 and concluded in October 2010. Data were generated through 350 hours of observation, two focus groups and 20 semi-structured interviews. A detailed thematic analysis was undertaken. Results Communication failure occurred owing to a reliance on documents and documentation to transfer information at patient transition points, poor quality documents and documentation, and problematic access to information. Institutional ruling practices of professional practice, efficiency and productivity, and fiscal constraint dominated the coordination of nurses', surgeons' and anaesthetists' communication through documents and documentation. These governing practices configured communication to be incongruous with reliably meeting safety and quality objectives. Conclusions Communication failure occurred because important information was sometimes buried in documents, insufficient, inaccurate, out-of-date or not verbally reinforced. Furthermore, busy nurses were not always able to access information they required in a timely manner. Patient safety was affected, which led to delays in treatment and at times inadequate care. Relevance to clinical practice Organisational support needs to be provided to nurses, surgeons and anaesthetists so they have sufficient time to complete, locate, and read documents and documentation. Infrastructure supporting communication technologies should be implemented to enable the rapid retrieval, entry, and dispersion of information. [ABSTRACT FROM AUTHOR]

The purpose of this pilot study was to design, implement, and evaluate a Family Empowerment Program (FEP), guided by the Illness Beliefs Model. Participants included 25 Thai family members who were the primary caregivers of a child with thalassemia. In Phase I, data were collected from participants using individual in-depth interviews and focus groups before involvement in the FEP. In Phase II, 12 hr of FEP sessions were offered to groups of participants. Content analysis of the audiotaped FEP sessions is reported in this article. Family caregivers reported that the FEP helped them share beliefs and experiences related to caring for their child with thalassemia, make decisions related to families’ problems/needs and beliefs, provide each other mutual social support, and develop increased ability to manage care for their chronically ill child through sharing information and learning from other family caregivers about family functioning, family management, and family relationships. Future research is needed to examine the FEP intervention under more controlled conditions with measures that include family functioning and child health outcomes. [ABSTRACT FROM AUTHOR]

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Information communication technologies ( ICT) are an integral part of contemporary family life, though the existing research about its impact is scarce, less than definitive, and individually based, as well as failing to attend to cross-cultural and cross-national dimensions. This study investigates how family clinicians construe the impact of ICT in the clinical context. A survey directed at family clinicians ( N = 258) in four countries ( Canada, Mexico, Spain and the USA) was designed to gather data on their beliefs about the impact of the emerging ICT on families and on their own clinical practice. The study found differences in the use of ICT across countries and correlation analyses showed there were more positive attitudes about the impact of emerging ICT on family dynamics among the clinicians whose use them the most. Practitioner points A constructive attitude towards emerging technology may enhance the effective use of technology in family therapy., The use of technology for personal and professional purposes by therapists may elicit appreciative conversations with families about its impact on family processes., Emerging digital technologies may enable clinicians to involve family members in virtual exercises and participation. [ABSTRACT FROM AUTHOR]