Search

Background: Spirituality and spiritual support for older people with intellectual disability are deemed important, however little is known about their specific needs. This paper reports for the first time on the religious and spiritual practices of older adults with intellectual disability. Methods: A national longitudinal study examined the prevalence of spiritual practices among older people with intellectual disability in the Republic of Ireland. Results: Older people with intellectual disability seek and receive solace from religious and spiritual practices, especially if they are lonely, in poor health, distressed or bereaved. There is likely a social benefit to spiritual and religious aspects of life that would be beneficial to explore further. Conclusions: Globally more research is required and efforts should be made to ensure greater opportunities for inclusion in societal spiritual and religious activities and to more clearly determine the spiritual needs of this population.

This paper on a strengths‐based approach (SBA) to practice is based on empirical research with stakeholders involved in an intensive support programme for young people at risk and their parents in Ireland. The Youth Advocate Programme (YAP) model provides wraparound support to respond to their needs by focusing on their competencies and their coping skills and building networks of community‐based supports. The model includes parents or carers in the suite of support offered by advocates. An SBA to practice has been discussed for some time in academic literature and practice guidance. However, it tends to be considered primarily in relation to social work practice, and there is ongoing ambiguity as to what it actually involves in day‐to‐day engagement with individual family members. Insightful, rich accounts of SBAs as part of routine practice provided by young people, parents and practitioners form the basis to this paper and detail how these approaches support the development of hope‐inspiring relationships and promote positive change. Relevant literature and research situates the debate on the experience of using SBA, the wider challenges faced by families, the impact of SBA in practice on those receiving the support service and its potential for use in the wider continuum of children and family services. [ABSTRACT FROM AUTHOR]

Background: This paper aims to explore the impact of recovery education on recovery knowledge, attitudes and the quality of life of students undertaking recovery education, contributing to the evidence base in relation to the impact of recovery education. It also explores the experiences of all stakeholders involved in the co-facilitation, delivery and participation in recovery education., Setting and Participants: This study evaluates the experiences of stakeholders involved in the co-facilitation, delivery and participation in recovery education across four recovery colleges in Ireland. Participants included students undertaking recovery education, peer educators, education facilitators, recovery college coordinators and practitioner/service providers., Discussion: Findings from the quantitative survey when compared with extant literature suggest that students had a good understanding of recovery education. The social aspect of empowerment for growth and wellbeing was identified through themes relating to co-production and facilitating student learning. Support for equitable access to recovery education, including co-production for both the public and staff, was identified as a challenge for the future., Conclusion: The findings from both the qualitative and quantitative components of the study show the positive impact of recovery education on stakeholders while acknowledging the need for ongoing support for people working in recovery education and the development of services. In particular, there was a high level of recovery knowledge found in students undertaking recovery education., Patient or Public Contribution: This study utilised a co-created study design. From inception a steering group comprising stakeholders (peer educators, recovery education facilitators including past recovery college students and nonpeer staff involved in the co-production of recovery education) directed the conduct of the evaluation. This steering group participated in an iterative process of information sharing, suggestions for evaluation process and language., (© 2023 The Authors. Health Expectations published by John Wiley & Sons Ltd.)

Objective: Although Ireland has one of the highest levels of well‐being in Europe, having a health condition has been found to have a direct negative impact. The aim of this study is to evaluate the current situation and the experiences of patients with epidermolysis bullosa (EB), a rare genetic skin disease, and their relatives living in Ireland, with a focus on burdens and helpful practices. Methods and Measures: In a mixed‐methods design, a series of standardised questionnaires were combined with open‐ended questions. Via an online survey, data from n = 59 EB patients and relatives of EB patients living in Ireland were collected. Results: EB affects both the patients and their relatives. Burdens were found in relation to the visibility of EB, the degree of severity, the current health status, reduced mobility, the financial impact of EB, the psychosocial impact and personal and social resources. The paper also analyses existing resources and highlights opportunities for support and needs of improvement. Conclusion: Quality of life with EB is influenced by somatic symptoms and the psychosocial burden. Individual helpful practices in dealing with this rare disease can be considered as mediators, but they need to be supported by structural and healthcare improvements. Patient or Public Contribution: The perspective of EB patients, their relatives and EB experts were taken into account in the development of the study design via two feedback loops with the EB patient organisations DEBRA Ireland and DEBRA Austria. The design was adapted accordingly. Additionally, by including open‐ended questions, patients and relatives could contribute their individual perspectives and add insights into their lives with EB that might not have been captured with the structured online survey alone. [ABSTRACT FROM AUTHOR]

Caroline Hyland, an illustrator and former occupational therapist based in Dublin, Ireland, provided the cover art for the Winter 2023 edition of The Open Journal of Occupational Therapy (OJOT). "Can You See What I See?" is an acrylic painting on black textured paper. The piece was inspired by Caroline's grandmother Kathleen Duhig, her love of flowers, and the song "The Dutchman." Kathleen and three of her sisters lived with dementia. This painting, and several others, are featured in a book Caroline wrote to support living well with dementia. By combining her artistic talents and training as an occupational therapist, Caroline advocates for a society that sees people first, not the disease, dementia. [ABSTRACT FROM AUTHOR]

Introduction: Reminiscence therapy (RT), which engages individuals to evoke positive memories, has been shown to be effective in improving psychological well-being in older adults suffering from PTSD, depression, and anxiety. However, its impact on brain function has yet to be determined. This paper presents functional magnetic resonance imaging (fMRI) data to describe changes in autobiographical memory networks (AMN) in community-dwelling older adults. Methods: This pilot study used a within-subject design to measure changes in AMN activation in 11 older adults who underwent 6 weeks of RT. In the scanner, participants retrieved autobiographical memories which were either recent or remote, rehearsed or unrehearsed. Participants also underwent a clinical interview to assess changes in memory, quality of life, mental health, and affect. Findings: Compared to pretreatment, anxiety decreased (z = −2.014, p =.040) and activated significant areas within the AMN, including bilateral medial prefrontal cortex, left precuneus, right occipital cortex, and left anterior hippocampus. Conclusion: Although RT had subtle effects on psychological function in this sample with no evidence of impairments, including depression at baseline, the fMRI data support current thinking of the effect RT has on the AMN. Increased activation of right posterior hippocampus following RT is compatible with the Multiple Trace Theory Theory (Nadel & Moscovitch, 1997). [ABSTRACT FROM AUTHOR]

Aim: To design a digital template for form building, data collection and data management to assess the diet and oral health of elite athletes. Subject and methods: A web-based open-source platform, KoboToolbox (KBTB), was used to aid design and manufacture of a digital data collection form for use in oral health surveys. KBTB frontend form builder was used to create a customised questionnaire. Dental charting systems for the chosen indices were designed using XLSForms, converted to XForm and uploaded to the KBTB interface to create a single form for digital data input. This template was used to collect data for a cross-sectional study investigating the diet and oral health of a convenience sample of elite athletes in Ireland. Results: A digital data collection (DDC) form was designed for use in oral health surveys. The customised form was then used to collect data for a survey of 88 elite athletes on the KBTB platform. Dietary behaviours were recorded by the participants using KBTB. Following data collection, the dataset was downloaded from KBTB and cleaned for subsequent analysis. Conclusion: The design of a versatile form and oral health questionnaire template using digital tools customised for elite athletes was useful for efficient, comprehensive field data collection. DDC tools are convenient for data form design, collection, and storage. This template can be easily modified for use by other researchers planning oral health surveys. [ABSTRACT FROM AUTHOR]

Introduction: Befriending is one of the rehabilitative services embedded in the holistic approach adopted by Spirasi, the Irish National Centre for the Rehabilitation of Survivors of Torture. Their befriending programme offers survivors one-to-one companionship from trained volunteer befrienders. The literature suggests that befriending programmes can improve quality of life, provide emotional support and combat loneliness. However, there is little empirical research of the effectiveness of befriending programmes for torture survivors., Objective: The main objective was to explore, in complementary ways, the impact of the Spirasi befriending programme on befrienders and befriendees and to incorporate their voices into recommendations for optimising the service., Methods: The methodology consisted of five focus groups (two with befriendees, two with befrienders and one with both) and a portrait workshop facilitated by two community artists, where each befriending pair member created a portrait of their partner to express and visually explore the befriending relationship. Data comprised the focus group transcripts and written feedback on the portrait-creation process., Results: The themes identified in both data sets firmly ground the befriending programme in Spirasi's holistic approach to recovery. For the focus group participants, befriending promotes integration; models trusting, kind and reciprocal relationships; combats loneliness and protects against suicide. They also highlighted the importance of regular befriender training, increasing the programme's reach and developing a befriender community of practice. The portrait workshop was found to strengthen relationships and provide a context of normality, acceptance and shared humanity through compassionate and creative exchanges., Conclusions: This paper highlights the benefits of the befriending programme within Spirasi's holistic approach and the importance of collaborative expressive arts activities in building befriending relationships. It provides recommendations for good befriending practice which are relevant to all organisations working with survivors of torture as well as those working with people seeking international protection more broadly.

Personal assistance (PA) has long been a key support for Irish people with physical and sensory disabilities, but evidence shows that Ireland lacks national standards for allocation, provision and data collection. Addressing a particular gap in understanding the experiences of disabled people, this paper draws on a large-scale mixed-method study with PA service users which was conducted in summer 2021. Overall, the evidence shows satisfaction among many service users, but suggests that systemic shortfalls have a clearly detrimental effect on the functionings and capabilities valued by the participants in relation to their ability to participate in social and economic activities that many people take for granted. The findings of this study provide valuable insights into what good personal assistance means for disabled people's everyday lives and what Irish PA service users want to see change in the system. The findings are grounded in the Irish context, but they are useful to an international audience in clearly showing the value of PA and the importance of meaningfully including disabled people in its design and regulation. [ABSTRACT FROM AUTHOR]

Based on the rich extant research in the field of mental health in acculturation, it is calling to identify religion as one of the meditative variables of the relationship between acculturation and mental health. In addition, little knowledge exists about the detailed religious experience of Chinese migrants in Ireland. This research adopted classic grounded theory to guide data collection and analysis. The findings show that Christian faith plays a significant role as a mediator in the cross-cultural adaptation of the participants with two aspects of the mental impacts: helping to cope with mental stress and providing spiritual satisfaction. The results in this paper are part of the findings from an investigation of the religious experience of the participants during their cross-cultural adaptation in Ireland. [ABSTRACT FROM AUTHOR]

Background: Social prescribing link workers are non-health or social care professionals who connect people with psychosocial needs to non-clinical community supports. They are being implemented widely, but there is limited evidence for appropriate target populations or cost effectiveness. This study aimed to explore the feasibility, potential impact on health outcomes and cost effectiveness of practice-based link workers for people with multimorbidity living in deprived urban communities. Methods: A pragmatic exploratory randomised trial with wait-list usual care control and blinding at analysis was conducted during the COVID 19 pandemic (July 2020 to January 2021). Participants had two or more ongoing health conditions, attended a general practitioner (GP) serving a deprived urban community who felt they may benefit from a one-month practice-based social prescribing link worker intervention.. Feasibility measures were recruitment and retention of participants, practices and link workers, and completion of outcome data. Primary outcomes at one month were health-related quality of life (EQ-5D-5L) and mental health (HADS). Potential cost effectiveness from the health service perspective was evaluated using quality adjusted life years (QALYs), based on conversion of the EQ-5D-5L and ICECAP-A capability index to utility scoring. Results: From a target of 600, 251 patients were recruited across 13 general practices. Randomisation to intervention (n = 123) and control (n = 117) was after baseline data collection. Participant retention at one month was 80%. All practices and link workers (n = 10) were retained for the trial period. Data completion for primary outcomes was 75%. There were no significant differences identified using mixed effects regression analysis in EQ-5D-5L (MD 0.01, 95% CI -0.07 to 0.09) or HADS (MD 0.05, 95% CI -0.63 to 0.73), and no cost effectiveness advantages. A sensitivity analysis that considered link workers operating at full capacity in a non-pandemic setting, indicated the probability of effectiveness at the €45,000 ICER threshold value for Ireland was 0.787 using the ICECAP-A capability index. Conclusions: While the trial under-recruited participants mainly due to COVID-19 restrictions, it demonstrates that robust evaluations and cost utility analyses are possible. Further evaluations are required to establish cost effectiveness and should consider using the ICE-CAP-A wellbeing measure for cost utility analysis. Registration: This trial is registered on ISRCTN. Title: Use of link workers to provide social prescribing and health and social care coordination for people with complex multimorbidity in socially deprived areas. Trial ID: ISRCTN10287737. Date registered 10/12/2019. Link: https://www.isrctn.com/ISRCTN10287737 [ABSTRACT FROM AUTHOR]

Using data from The Irish Longitudinal Study on Ageing (TILDA), linked to administrative data on high-speed broadband availability from infrastructure maps, this study examines patterns of Internet uses and psychosocial outcomes for over 3500 people aged 50 plus across Ireland. High-speed broadband availability is associated with higher reported levels of home Internet access, greater frequency of Internet use and more engagement with Internet activities. Controlling for demographic and socio-economic circumstances, regression models show that quality of life is higher among daily users of the Internet. Little association is found with loneliness. Quality of life is higher among users of Internet-based communication applications such as email and video calls, and there is some evidence that loneliness may be less pronounced among users of these applications. The findings are consistent with the view that digital engagement can enhance the lives of older people and thus may be supportive of policies and interventions to address potential 'grey' digital divides. [ABSTRACT FROM AUTHOR]

Background: Cancer treatments have many adverse effects on patient's health leading to poor cardiorespiratory capacity, muscular- degeneration, fatigue, loss of strength and physical function, altered body-composition, compromised immune-function, peripheral neuropathy, and reduced quality of life (QOL). Exercise programs can significantly increase functional capacity when tailored to individual needs, thus improving health. Exercise interventions in cancer rehabilitation, when supported by appropriate nutrition can be effective in attaining a healthy weight and body-composition. The successful rehabilitation program should also include psycho-social education aimed to reduce anxiety and improve motivation. Methods: The current study aimed to collect information on the post-treatment needs of cancer patients including barriers and expectations facing them, their caregivers and their families through consultation in focus group interviews. Cancer survivors living in the Republic of Ireland were recruited from the University Hospital Galway, community-based cancer centres, cancer support groups and social media platforms to participate in the study and attend a focus group interview. The focus group discussions were designed to obtain information on the collective views of cancer survivors on relevant topics selected. The topics were developed in consultation with a patient and public involvement (PPI) group supporting the study. The topics list was circulated to all participants prior to the focus group. The interviews were audio recorded and transcribed verbatim. Focus group transcripts were analysed subjected to a thematic framework analysis using NVivo. Results: Thirty-six participants took part in 9 focus groups. Our analysis uncovered two main themes. The first theme 'cast adrift with no direction' was grouped into three sub-themes: everything revolves around treatment; panic and fear; and what exercise should I be doing? The second theme 'everybody is different' was clustered into two sub-themes: side effects get in the way; and personalised exercise program. Conclusion: The study highlighted the lack of information and support needed by patients living with and beyond cancer. The study also highlighted the need for a personalised exercise programme designed to target the individual patient symptoms that would be ideal for the mitigation of long term symptoms and in improving QOL. [ABSTRACT FROM AUTHOR]

This document is a collection of abstracts from the Proceedings of the 6th UK and Ireland implementation science research conference. The abstracts cover a range of topics, including interventions to promote interprofessional collaboration in healthcare for older people, the impact of After Action Review on safety culture in an Irish hospital, and the process evaluation of a community-based, digital approach to improving health during pregnancy. Other abstracts discuss the feasibility of implementing rapid-learning methodology in radiotherapy treatment and the need for a standard methodology for patient and public involvement in addressing health inequalities. These abstracts provide valuable information for improving healthcare practices and offer insights into various aspects of implementation science. [Extracted from the article]

Background: Cluain Mhuire is a secondary adult mental health service based in Ireland. The COVID-19 pandemic resulted in many services moving online, including our coping with depression group. A shortened, online version of the face-to-face group was piloted; however, analysis showed that it was not as effective as the longer face-to-face group. Thus, a 12-session, 2.5-hour online group CBT (gCBT) was subsequently run to directly compare the online therapy with the original face-to-face group. Aims: The primary objective of the study is to evaluate the effectiveness of a 12-week gCBT programme adapted to videoconferencing in reducing self-reported symptoms of depression and anxiety and enhancing quality of life (QoL). Results will be compared with the same group programme delivered face-to-face. Method: This is a between-groups, naturalistic treatment outcome study. Pre and post measures include the Beck Depression Inventory-II (BDI-II), Beck Anxiety Inventory (BAI), and the World Health Organisation Quality of Life Scale (WHOQoL-Bref). A mixed between-within subjects analysis of variance was performed to assess the impact of the three interventions (face-to-face, 8-session online and 12-session online) on participant scores; 112 participants (65 women, 47 men) were recruited (mean age=41.85, SD =13.08). Results: All three interventions significantly improved depression, anxiety and QoL scores. There was no significant difference between the treatment groups. Attendance was highest in the 12-session online group, followed by the 8-session online group and 12-session in-person group. Conclusions: These results add to the growing evidence supporting the effectiveness of internet-delivered gCBT in reducing depressive symptoms. [ABSTRACT FROM AUTHOR]

Purpose: To investigate the longitudinal association between trajectories (incidence, remission) of generalized anxiety disorder (GAD), major depression (MD) and change in quality of life (QoL) in adults aged 50 + , and to assess the symmetry in these relationships using observational study data. Methods: Data were derived from two waves of The Irish Longitudinal Study on Aging (2014–2015, wave 3: n = 6400; 2016, wave 4: n = 5715), a nationally representative cohort of community-dwelling adults aged 50 +. GAD and MD were assessed by means of the short form of the Composite International Diagnostic Interview. QoL outcomes were assessed using the Control, Autonomy, Self-realization, and Pleasure scale (CASP-12 with two domains control/autonomy and self-realization/pleasure). Covariate-adjusted, asymmetric fixed effects panel regressions and post-estimation Wald tests were used for statistical analysis. Results: Regarding incident disorders, only incident MD was significantly associated with a reduction in QoL over time (control/autonomy domain: b = − 0.74, SE: 0.30). Regarding remission, both remission of MD (b = 0.61, SE: 0.20) and remission of GAD (b = 0.61, 0.26) were significantly associated with an increase in the self-realization/pleasure domain over time. Subsequent Wald tests of the estimates were not significant, indicating symmetric effects. Conclusion: Particularly the remission of GAD and MD was associated with a significant improvement in one of the QoL domains, indicating domain- and trajectory-specific differences. However, symmetric effects observed in this study indicate that gains and losses in QoL associated with remission and incidence of GAD and MD are of similar magnitude in adults aged 50 +. [ABSTRACT FROM AUTHOR]

Assistive technology (AT) enables and promotes inclusion and participation, especially for persons with a disability, ageing populations, and those with non-communicable diseases. AT is essential for generating collaborative learning environments, inclusive of students with a range of specific needs and required supports. However, many teachers lack the training, resources, and skills to use AT in the class. This study uses a systems thinking approach to consider teachers AT needs in the Irish classroom. Three hundred and five teachers completed an online survey, and 10 took part in semi-structured focus groups. The survey examined teachers experiences with AT, their training needs, and the context within which they need support. Teachers reported low levels of AT knowledge, skills, and confidence. Many described limited access to training and support for AT use. Results also reveal non-systems thinking, whereby there is no meaningful linking across the main strategic drivers of AT - policy, products, provision, and personnel, to support the people at the centre of the AT system – between these and the contextual factors that influence their effectiveness. An AT system which is easy to navigate, which has policies and provision that supports educators, and has expert personnel on hand to support teachers, is crucial if AT is to become embedded in Irish classrooms. This research shows that a comprehensive AT system in education should include policies, practices, personnel, and products that interact to support people to engage easily and successfully with AT in the classroom. Describes current trends in how teachers are engaging with Assistive Technology. Describes the current trends in disabilities in Irish classroom and teachers requirements for support. Understand the system challenges facing teachers attempting to use Assistive Technology. Support the development of Assistive Technology training for teachers which are informed by teachers needs. Inform the development and improving policies and processes for common situations. [ABSTRACT FROM AUTHOR]

The measurement of societal wellbeing has moved beyond gross domestic product and has emerged as an important factor within the paradigm of holistic sustainability assessment, including agricultural sustainability. At this juncture, knowledge gaps exist between agricultural policy priorities and data infrastructure to evaluate social sustainability issues, particularly regarding farmer sustainability. This study aims to address this gap through the development of a Farmer Sustainability Index (FSI), a composite index comprising three dimensions: farm continuity, community and social connections and farmer comfort. Socio‐demographic data were extracted from both core and supplementary EU Farm Accountancy Data Network data from the 2018 Teagasc National Farm Survey in Ireland. Statistical analysis was undertaken to compare the distribution of FSI and the individual dimension scores for farms across three socio‐demographic variables: farm system, farmer age cohort and region. The FSI results demonstrate that cattle farmers, farmers over 60 years of age and those residing in regions with poorer infrastructure experience lower levels of sustainability in comparison to other farmers, while the variation in FSI dimension scores identifies numerous sustainability risks to farms with differing socio‐demographic constructs. It is important for agricultural policy to be cognisant of these differences and the relational nature of these risks, to meaningfully address matters pertaining to sustainability, and the FSI provides an effective tool to assist policy in this regard. [ABSTRACT FROM AUTHOR]

Background: There is increasing interest in the assessment of health‐related quality of life (QoL) in the care of patients treated with home parenteral nutrition (HPN). However, it is not known whether healthcare professionals (HCPs) have embedded QoL assessment into routine clinical practice in line with current guidelines to favour a more holistic approach to HPN care. The aim of this study was to assess knowledge, current practice and the opinions of HCPs regarding QoL in care of patients on HPN. Methods: An online survey was distributed via email to HCPs working with HPN patients throughout England, Scotland, Wales and Northern Ireland. Participants were identified using a mailing list for the British Intestinal Failure Alliance, a specialist group within the British Association for Parenteral and Enteral Nutrition. Results: The survey was completed by 67 professionals comprising 24 dietitians, 17 nurses, 14 gastroenterologists, 6 pharmacists, 5 surgeons and 1 psychologist. Of these, 54 (80%) participants agreed that the measurement of QoL is useful. In contrast, 38 (57%) of all participants, including 27 (50%) of those participants who agreed that the measurement of QoL was useful, never measured QoL. Knowledge of QoL literature was rated as poor or very poor by 27 (40%) participants. Conclusions: Despite the perceived usefulness and importance of QoL assessment, very few HCPs embed it into clinical practice. Knowledge of QoL literature and QoL tools is variable, and there is significant variability in QoL practice. This is clear in terms of the frequency of QoL assessments and heterogeneity in methodology. In contrast, there was almost unanimous agreement that the complications associated with HPN contribute to poorer QoL. There is a need for specific, evidence‐based, clinical practice guidelines detailing how to define and measure QoL in this patient population. Key points: There is significant variability in quality‐of‐life (QoL) practice for patients treated with home parenteral nutrition (HPN).Our findings suggest that very few healthcare professionals are embedding QoL assessment into clinical practice.Evidently, there appears to be a need for specific, evidence‐based, clinical practice guidelines detailing how to define and measure QoL in HPN patients. [ABSTRACT FROM AUTHOR]

Background: Palliative medicine physicians may be at higher risk of burnout due to increased stressors and compromised resilience during the COVID-19 pandemic. Burnout prevalence and factors influencing this among UK and Irish palliative medicine physicians is unknown. Aim: To determine the prevalence of burnout and the degree of resilience among UK and Irish palliative medicine physicians during the COVID-19 pandemic, and associated factors. Design: Online survey using validated assessment scales assessed burnout and resilience: The Maslach Burnout Inventory Human Services Survey for Medical Personnel [MBI-HSS (MP)] and the Connor-Davidson Resilience Scale (CD-RISC). Additional tools assessed depressive symptoms, alcohol use, and quality of life. Setting/participants: Association of Palliative Medicine of UK and Ireland members actively practising in hospital, hospice or community settings. Results: There were 544 respondents from the 815 eligible participants (66.8%), 462 provided complete MBI-HSS (MP) data and were analysed. Of those 181/462 (39.2%) met burnout criteria, based on high emotional exhaustion or depersonalisation subscales of the MBI-HSS (MP). A reduced odds of burnout was observed among physicians who worked ⩽20 h/week (vs 31–40 h/week, adjusted odds ratio (aOR) 0.03, 95% confidence interval (CI) 0.002–0.56) and who had a greater perceived level of clinical support (aOR 0.70, 95% CI 0.62–0.80). Physicians with higher levels of depressive symptoms had higher odds of burnout (aOR 18.32, 95% CI 6.75–49.73). Resilience, mean (SD) CD-RISC score, was lower in physicians who met burnout criteria compared to those who did not (62.6 (11.1) vs 70.0 (11.3); p < 0.001). Conclusions: Over one-third of palliative medicine physicians meet burnout criteria. The provision of enhanced organisational and colleague support is paramount in both the current and future pandemics. [ABSTRACT FROM AUTHOR]

Increasing numbers of students with disabilities are accessing higher education each year, yet little is known about their assistive technology (AT) needs and its influence on relevant outcomes. The aim of this study was to examine met/unmet AT needs on educational engagement, academic self-efficacy and well-being and the impact of AT use in the areas of competence, adaptability and self-esteem for students with disabilities in higher education in Ireland. One hundred and eleven students with disabilities completed a cross-sectional online survey comprising the College Learning Effectiveness Inventory, the Student Course Engagement Questionnaire, the Self-Efficacy for Learning Form Abridged, the Psychosocial Impact of Assistive Devices Scale, and the Warwick-Edinburgh Mental Well-Being Scale. AT use was found to have a positive psychosocial impact in the areas of competence, adaptability and self-esteem. Those whose AT needs were fully met scored significantly higher on academic self-efficacy, well-being, and on 4 of the 10 educational engagement subscales compared to those who had unmet AT needs. Met/unmet AT needs were not predictive of educational engagement. These findings highlight the importance of AT from both educational engagement and psychosocial perspectives for students with a wide variety of disability diagnoses. The wide-reaching benefits of AT must be considered by governmental departments when making funding allocations to disability services within higher education institutions. Students with disabilities can face many additional challenges within the higher education environment. Findings from this research show that access to appropriate assistive technology can support students' educational engagement, increase well-being and academic self-efficacy and have a positive impact in the areas of competence, adaptability and self-esteem. Disability and Assistive Technology Officers in higher education should be cognizant of both the educational and psychological benefits of assistive technology across diverse students with various disability diagnoses. Policy makers should consider the wide-reaching benefits of assistive technology when making funding allocations to higher education institutions. [ABSTRACT FROM AUTHOR]

Background: The improved survival rate for many cancers in high-income countries demands a coordinated multidisciplinary approach to survivorship care and service provision to ensure optimal patient outcomes and quality of life. This study assesses the feasibility of introducing a Women's Health Initiative cancer survivorship clinic in Ireland. Methods: The trial https://spcare.bmj.com/content/9/2/209.short comprises an intervention and control arm. Two hundred participants will be recruited. Key eligibility (1) women with early-stage hormone receptor-positive breast or gynecologic cancer (cervix or endometrial), within 12 months of completion of primary curative therapy, and (2) access to the Internet. The complex intervention comprises a nurse-led clinic targeting symptom management through a trigger alert system, utilizing electronic patient-reported outcome (ePRO) assessments at baseline, and 2, 4, 6, 8, 10, and 12 months. It also includes input from a dietitian monitoring diet and nutritional status. The control group will receive their usual care pathway standard of care and attend the cancer survivorship clinic and complete ePRO assessments at the start and end of the study. The primary endpoint (feasibility) includes the proportion of enrolled participants who complete baseline and follow-up ePRO surveys and partake in health professional consultations after ePRO data triggers. Secondary endpoints include changes in cancer-related symptom scores assessed by ePROs, health-related Quality of Life Questionnaire (QLQ) scores, Appraisal Self-Care Agency-R scores, and adjuvant endocrine therapy medication adherence. A process evaluation will capture the experiences of participation in the study, and the healthcare costs will be examined as part of the economic analysis. Ethical approval was granted in December 2020, with accrual commencing in March 2021. Discussion: This protocol describes the implementation of a parallel arm randomized controlled trial (RCT) which examines the feasibility of delivering a Cancer Survivorship Clinic. The ePRO is an innovative symptom monitoring system which detects the treatment-related effects and provides individualized support for cancer survivors. The findings will provide direction for the implementation of future survivorship care. Trial registration: ClinicalTrials.gov, NCT05035173. Retrospectively registered on September 5, 2021 [ABSTRACT FROM AUTHOR]

BreastCheck is Ireland's breast screening service which offers biennial mammograms to women aged 50–69. Practicing regular breast self-examination (BSE) enhances women's awareness and increases their perception of their susceptibility to the risk of breast cancer, possibly increasing their likelihood of attending a screening programme which reduces breast cancer mortality. Research is needed to identify the promotors and barriers to both attending breast cancer screening and practicing BSE. The aim of this study was to determine the promotors and barriers associated with attending breast cancer screening and practicing BSE in Irish women. Data from the participants of TILDA wave 3 (2014–2015) was used, the participant population included females only (≥50 years old), a total of 3575 women. Bivariate analysis was used to identify variables that were significantly associated with having had a mammogram since the last interview (wave 2) or regularly checking their breasts for lumps (BSE). Regression analysis was then used to determine the effect the significant variables had on predicting the likelihood of participants attending breast screening or practicing BSE. Over half (55%) of all women over the age of 50 had a mammogram since wave 2 was completed (2012) and two thirds reported practicing regular BSE. The factors associated with having attended for breast cancer screening were: having private health insurance (OR = 1.86, 95%CI = 1.45–2.380), and practicing BSE (OR = 1.683, 95%CI = 1.344–2.107). The factors found to be associated with practicing regular BSE were: higher quality of life (OR = 1.035, 95%CI = 1.015–1.057), higher BMI (OR = 1.118, 95%CI = 1.020–1.226), being married (OR = 1.436, 95%CI = 1.190–1.732) and attending mammogram screening (OR = 1.691, 95%CI = 1.353–2.114). Regular participation in mammography screening reduces breast cancer mortality. Women eligible for BreastCheck were significantly more likely to attend screening. BSE is associated with increased attendance at screening. Health-care professionals should encourage BSE in order to increase screening uptake. [ABSTRACT FROM AUTHOR]

Institutionalised cultures and imbalances of power have been identified within the literature as risk factors for the abuse of adults with intellectual disability living in residential services. Governments in the Republic of Ireland and internationally continue to support person‐centredness as a framework of care that can promote cultural change within disability services as a safeguard against abuse. However, there is limited research which seeks to explore if person‐centredness as a framework of care has had much impact on changing cultures within disability services as a protective factor against abuse. This study aims to explore how adults with intellectual disability living in residential services and staff experience the professional caring relationship and the framework of person‐centredness. The study was based on a phenomenological approach using thematic analysis which enabled six adults with intellectual disability and six staff to participate through one‐to‐one interviews. The thematic analysis resulted in three main themes: (1) Conflict within the relational dynamic between service users and staff. (2) Challenges to delivering person‐centred care. (3) Shared needs. Participants reported that there was conflict within the relationship between service users and staff influenced by relational and cultural issues. Participants also experienced challenges in delivering person‐centred care within the service. This study revealed that as a result of wider organisational and cultural influences, person‐centred cultures, which are vital to underpin changes in power imbalances, were often undermined. This research highlights that it is not enough to have a system of quality of care guided by the principles of person‐centredness alone to ensure a shift in culture and safeguard against abuse of adults with intellectual disability. Rather, consideration of the relational and cultural factors that impact their lives also needs to be built into the values and practices of services offered to adults with intellectual disability. [ABSTRACT FROM AUTHOR]

This study used a mixed methods approach to understand the ways in which religion and quality of life (QoL) are associated in later life in Ireland. Longitudinal quantitative data from 2112 Christian women aged 57 and over at baseline (2009–10) participating in the Irish Longitudinal Study on Ageing (TILDA), as well as qualitative data from semi-structured interviews from 11 Christian women aged 65 and over in 2018, were used. The quantitative data showed an association between lower religiosity and lower QoL. Qualitative data supported an effect of religious involvement on QoL although certain aspects of being religious in Ireland were accompanied by distress. The data suggested that the relationship between religious attendance and higher QoL could be driven by multifactorial pathways, including psychological, social, and practical benefits. [ABSTRACT FROM AUTHOR]

Purpose: This study aims to explore the prevalence of CRC survivorship issues and their impact on survivors' quality of life (QoL). Methods: This study utilised a mixed methods sequential explanatory design. Adult CRC survivors between 6- and 60-months post-diagnosis (n = 304) were purposively recruited from three hospitals and twenty-one cancer support centres in Ireland. QoL was evaluated using the EuroQol and FACT-C questionnaires and results compared to population norms. 22 survey participants took part in semi-structured interviews exploring the impact of survivorship issues on their daily lives. Results: While CRC survivors reported QoL outcomes comparable to or better than normative populations, 54% were dissatisfied with their QoL. The most common survivorship issues reported included negative body image (74%), fatigue (68%), sexual dysfunction (66%) and sleep disturbance (59%). Thematic analysis of the qualitative data illustrated survivors' attempts to live with the impact of cancer and its treatment (loss, fear, impact) and striving to contextualise, reframe and understand the consequences of cancer and its treatment (control, vigilance, benefit). Within these themes, the cross-domain impact of less prevalent symptoms including bowel dysfunction (28–57%) and peripheral neuropathy (47%) were widely discussed. Conclusions: Although cancer survivors report positive QoL outcomes, many experience distressing physical, psychological and social effects. The findings suggest less common and difficult to manage symptoms are the greatest source of distress and unmet need. Support and information must be tailored to address survivors' individual needs and preferences for support, informed by holistic person-centred assessment. [ABSTRACT FROM AUTHOR]

The Allergy to Peanuts imPacting Emotions And Life study (APPEAL) explored the psychosocial burden of living with self-reported peanut allergy experienced by children, teenagers, adults and caregivers in the UK and Ireland. A two-stage (quantitative survey and qualitative interview [APPEAL-1]), cross-sectional study of the psychosocial burden of peanut allergy (APPEAL-2) was conducted. Quantitative data were evaluated using descriptive statistics and qualitative data were analysed using MAXQDA software. A conceptual model specific to UK and Ireland was developed using the concepts identified during the analysis. A total of 284 adults in the UK and Ireland completed the APPEAL-1 survey and 42 individuals participated in APPEAL-2. Respondents reported that peanut allergy restricts their choices in various situations, especially with regard to choosing food when eating out (87% moderately or severely restricted), choosing where to eat (82%), special occasions (76%) and when buying food from a shop (71%). Fifty-two percent of survey participants and 40% of interview participants reported being bullied because of PA. Psychological impact of peanut allergy included feeling at least moderate levels of frustration (70%), uncertainty (79%), and stress (71%). The qualitative analysis identified three different types of coping strategies (daily monitoring or vigilance, communication and planning) and four main areas of individuals' lives that are impacted by peanut allergy (social activities, relationships, emotions and work [adults and caregivers only]). The extent of the impact reported varied substantially between participants, with some reporting many negative consequences of living with peanut allergy and others feeling it has minimal impact on their health-related quality of life. This large survey and interview study highlight the psychosocial burden of peanut allergy for adults, teenagers, children and caregivers in the UK and Ireland. The analysis demonstrates the wide variation in level of impact of peanut allergy and the unmet need for those individuals who experience a substantial burden from living with peanut allergy. [ABSTRACT FROM AUTHOR]