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Background and objectives: People living with dementia have historically been excluded from qualitative research and their voices ignored due to the perception that a person with dementia is not able to express their opinions, preferences and feelings. Research institutions and organizations have contributed by adopting a paternalistic posture of overprotection. Furthermore, traditional research methods have proven to be exclusionary towards this group. The objective of this paper is to address the issue of inclusion of people with dementia in research and provide an evidence-based framework for dementia researchers based on the five principles of human rights: Participation, Accountability, Non-discrimination and equality, Empowerment and Legality (PANEL). Design: This paper adapts the PANEL principles to the research context, and uses evidence from the literature to create a framework for qualitative research in people with dementia. This new framework aims to guide dementia researchers in designing studies around the needs of people with dementia, to improve involvement and participation, facilitate research development and maximize research outcomes. Results: A checklist is presented with questions related to the five PANEL principles. These questions cover ethical, methodological and legal issues that researchers may need to consider while developing qualitative research for people with dementia. Conclusions: The proposed checklist offers a series of questions and considerations to facilitate the development of qualitative research in patients with dementia. It is inspired by current human rights work of recognized dementia researchers and organisations who have been directly involved in policy development. Future studies need to explore its utility in improving participation, facilitating ethics approvals and ensuring that outcomes are relevant to people with dementia.

Introduction. High-quality pre-registration student nurse training and development is integral to developing a sustainable and competent global nursing workforce. Internationally, student nurse recruitment rates have increased since the onset of the COVID-19 pandemic; however, attrition rates for student nurses are high. During the pandemic, many student nurses considered leaving the programme due to academic concerns, feeling overwhelmed, and doubting their clinical skills. Little was known about the extent to which nursing education prior to COVID-19 had prepared students for their role in managing the healthcare crisis or the impact on their resilience. Thus, this study aimed to explore how the COVID-19 pandemic impacted on the resilience levels of student nurses across the United Kingdom. Methods. Data were collected as part of a multi-site qualitative study named ‘COV-ED Nurse’ and involved pre-placement surveys, placement diaries, and post-placement interviews with nursing students. Student nurse participants were recruited from across the United Kingdom, from all years of study, and from all four nursing branches: children, adult, mental health, and learning disabilities. Participants were asked to complete a pre-placement survey that collected demographic details and information about their placement expectations. They were also asked to record a weekly audio-visual or written diary to describe their placement experiences, and, on completion of their placements, students were interviewed to explore their experiences of this time. Data were thematically analysed using the Framework Approach. Ethical approvals were obtained. Results. Two hundred and sixteen students took part in the wider study. The current study involved a subset of 59 students’ data. Four main themes were identified: ‘coping with increased levels of acuity’, ‘perceived risks of the pandemic’, ‘resilience when facing uncertainty and isolation’, and ‘the importance of coping mechanisms and sup

The responsiveness of professionals working with children and families is of key importance for child maltreatment early identification. However, this might be undermined when multifaceted circumstances, such as the COVID-19 pandemic, reduce interdisciplinary educational activities. Thanks to technological developments, digital platforms seem promising in dealing with new challenges for professionals’ training. We examined a digital approach to child maltreatment training through the ERICA project experience (Stopping Child Maltreatment through Pan-European Multiprofessional Training Programme). ERICA has been piloted during the pandemic in seven European centers involving interconnected sectors of professionals working with children and families. The training consisted of interactive modules embedded in a digital learning framework. Different aspects (technology, interaction, and organization) were evaluated and trainers’ feedback on digital features was sought. Technical issues were the main barrier, however, these did not significantly disrupt the training. The trainers perceived reduced interaction between participants, although distinct factors were uncovered as potential favorable mediators. Based on participants’ subjective experiences and perspectives, digital learning frameworks for professionals working with children and families (such as the ERICA model nested in its indispensable adaptation to an e-learning mode) can represent a novel interactive approach to empower trainers and trainees to tackle child maltreatment during critical times such as a pandemic, and as an alternative to more traditional learning frameworks.

Aim: To synthesise what is known from current international evidence about how parents are supported by significant others when they are faced with making decisions about their child's cancer care. Background: Parents are faced with making challenging decisions when their child has cancer and may benefit from support. Whilst previous research has comprehensively explored how healthcare professionals can offer support, little attention has been given to how support may be informally provided from a parent's network of significant others. Method: An integrative literature review was undertaken and reported following the ENTREQ framework. Literature was identified from comprehensive database searching across four relevant databases (CINAHL, PubMed, PsychINFO and British Nursing Database) and hand-searching reference lists of retrieved studies. Studies that met the inclusion criteria were critically appraised and then analysed using the Constant Comparative Analysis method. Results: Twenty-six articles were included in the review. Two overarching themes were identified. Theme 1— Dimensions of Decision-Making support— included three sub-themes: informational, emotional and instrumental mechanisms of support. Theme 2— Expectations of Decision-Making support— identified that parents’ expectations of their own role, and the role of their significant others, affected how decision-making was supported. Conclusions: Parents may seek and receive support from various significant members of their network, but there is a fine line between supportive and unsupportive behaviours. Relevance to clinical practice: Each family's unique personal, social and cultural context strongly impacts on their support needs, and nurses and other healthcare professionals should be mindful of how parents may access support from their significant others. Further indepth research around this area would contribute important knowledge around parents’ support needs.

Child sleep is a common parental concern and there is an array of resources available to parents. However, an exploration of UK parents' help-seeking behaviours around child sleep is lacking. This study sought to identify the resources parents use to seek information and help for child sleep, as well as to explore what factors parents prefer about certain sources and their reservations about using other resources. Parents of 6-36 month old children residing in the United Kingdom (UK) completed an online questionnaire between October 2015 and October 2016 about their use, opinions and experiences regarding resources for child sleep. Quantitative data were descrip-tively analysed and thematic analysis was conducted on parents' open-ended text responses. Participants were 266 UK parents (97% mothers). Parents' ages ranged from 21 to 45 years (M= 33.49 years, SD= 4.71) and all resided in the United Kingdom (UK). General Internet searches were the most commonly reported source used by 47% of parents with a range of other informal resources also frequently consulted. Health Visitors (HVs) were the most accessed healthcare professional reportedly con-sulted by 38% of parents. Seven themes represented parental preferences for their resource use. Most strongly endorsed included a desire for information from other parents, particularly those with practical experience and accessing information that aligned with their parenting values. Parents preferred sources that provided support and reassurance, as well as those that afforded parents the ability to select relevant elements from a range of information. Seven themes represented parents' reserva-tions about resources. Most strongly endorsed were concerns about reliability, being judged and challenges associated with filtering vast amounts of information. Parents reported having reservations towards sources if they had a previous negative experi-ence with the source. Possible implications of the findings and specific suggestion

Aims. To explore what factors influence mothers' decisions to seek antibiotics for their young children. Design. Qualitative case study using postcode boundaries. Methods. Thematic analysis of qualitative data from mothers of children under 5, recruited via community playgroups within the case. Data were collected between October 2018 and May 2019, from six focus groups (n = 19) and one-to-one interviews (n = 14). Thematic analysis of the data consisted of six phases: data familiarization; generating initial codes; searching for themes; reviewing themes; defining and naming themes; and producing the report. Results. Mothers were influenced by their belief and trust in antibiotics. Antibiotics were identified as symbolic of recovery, healing and of providing protection and safety. Conclusion. By understanding the symbolic power of antibiotics on maternal decision making, all antibiotic prescribers may be able to offer and provide reassuring alternative and acceptable treatment options to mothers, rather than using antibiotics. Impact. This paper introduces the concept of antibiotics as powerful symbols which influence antibiotic seeking behaviour. This in turn may result in inappropriate use of antibiotics which contributes to the risk of antimicrobial resistance developing. Although the majority of antibiotics are still prescribed by doctors, the number of nurse prescribers has been increasing. Therefore, an increased awareness of antibiotic symbolism, in all prescribing clinicians, is important to enable future local and national strategies to be developed, to support maternal decision making and reduce antibiotic seeking behaviour.

The responsiveness of professionals working with children and families is of key importance for child maltreatment early identification. However, this might be undermined when multifaceted circumstances, such as the COVID-19 pandemic, reduce interdisciplinary educational activities. Thanks to technological developments, digital platforms seem promising in dealing with new challenges for professionals’ training. We examined a digital approach to child maltreatment training through the ERICA project experience (Stopping Child Maltreatment through Pan-European Multiprofessional Training Programme). ERICA has been piloted during the pandemic in seven European centers involving interconnected sectors of professionals working with children and families. The training consisted of interactive modules embedded in a digital learning framework. Different aspects (technology, interaction, and organization) were evaluated and trainers’ feedback on digital features was sought. Technical issues were the main barrier, however, these did not significantly disrupt the training. The trainers perceived reduced interaction between participants, although distinct factors were uncovered as potential favorable mediators. Based on participants’ subjective experiences and perspectives, digital learning frameworks for professionals working with children and families (such as the ERICA model nested in its indispensable adaptation to an e-learning mode) can represent a novel interactive approach to empower trainers and trainees to tackle child maltreatment during critical times such as a pandemic, and as an alternative to more traditional learning frameworks.

This chapter will briefly review some of the literature on self-harm, its prevalence, relevant national policies, and research with teachers, before reporting the findings of a qualitative study conducted in 2016 which investigated how prepared secondary-school teachers were dealing with young people who self-harm., This work was sponsored by the Florence Nightingale Foundation and Charlie Waller Memorial Trust Research Scholarship 2016-2017.

The organisation of health visitor work is an important part of service design, which can have an impact on when and where services are provided and who gains access. This article reports a 2018 survey of UK health visitors conducted to provide an overview of the range of ways in which health visitor cases and workloads are organised. The 584 respondents confirmed the operation of three broad types of health visitor service delivery models; namely, the individual case, the corporate case and the combination model. Themes that emerged from practitioners' experiences of working with the different models reflected concerns about continuity and staffing, accommodating different needs and different services in different places. Overall, the data indicated a lack of consistency in health visitor service across the UK. The advantages and disadvantages of each workload model are detailed and considered with respect to markers of a quality service, including achieving relationships with clients and sufficient communication within and across teams.

Background. Overuse of antibiotics and inappropriate prescribing has resulted in rapid development of antimicrobial resistance. Most antibiotics in the United Kingdom (71.4%) are prescribed in primary care by general practitioners, with about half prescribed for viral rather than bacterial illnesses. Aims. To explore antibiotic prescribing and factors which may influence maternal decision making to seek antibiotics for their young children. Methods. Data for children under five years was gathered using a mixed methods case study approach. Quantitative general practice antibiotic prescribing data (n= 697 children) was statistically analysed and these results were further explored in six focus groups with mothers (n=19) of children under five. The qualitative data was thematically analysed. Results. Quantitative data identified nearly half of children received antibiotics. Children under one were prescribed the fewest antibiotics. Qualitative focus group data showed mothers trusted their general practitioner to provide expert care for their child and often wanted convenient and timely access to advice and reassurance, rather than treatment. Conclusion. Antibiotics are frequently prescribed for young children in primary care. Healthcare professionals need to understand the maternal influences contributing to antibiotic use in children and consider strategies and interventions to reduce unnecessary antibiotic prescriptions.