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This study explored the experiences of lesbian, bisexual, and queer (LBQ) students' (N = 9, aged 19–24) of sexual harassment via semistructured interviews. Data were analysed using a thematic analysis. Three overarching themes emerged: (a) the paradox of men's unwanted sexual attention, (b) the negative impact on relationships, and (c) the LGBTQ* community as a refuge. The women reported enduring unwanted heteronormative sexual attention, and heterosexist and homophobic harassment which forced some to conceal their sexuality. Support for the LGBTQ* community was central in developing confidence to call-out harassment. The findings call for the inclusion of LBQ-specific messages in sexual violence awareness and prevention interventions. [ABSTRACT FROM AUTHOR]

Background: Cold water swimming is growing in popularity, especially among women. We have previously reported that women felt that cold water swimming helps with their menstrual and menopause symptoms. But little is known about the habits of women who cold water swim. Objectives: To determine the habits of women who cold water swim. Design: This was a mixed-methods study. Methods: An online survey asked women who cold water swim about their experience of swimming and how this affected their menstrual and menopause symptoms. The survey was advertised for 2 months on social media, with a focus on advertising in cold water swimming Facebook groups. In this article, only the questions on the women's swimming habits were analyzed. Results: The analysis of 1114 women, mainly from the United Kingdom, revealed that most had been swimming for 1–5 years (79.5%). Most swim in the sea (64.4%), and only 15.5% swim alone. The majority (89.0%) swim all year around, swimming for mainly 30–60 min in the summer and 5–15 min in the winter. The women mostly swim wearing swimming costumes (skins) throughout the year. The majority of the free-text responses showed women found mental and physical benefits from cold water swimming. Conclusion: It was not surprising to learn that women swim for longer in the summer than the winter, but hearing how they feel cold water swimming helps their physical and mental health is important. With the limitations on access and safety of many wild swimming sites in the United Kingdom, it is time to ensure that cold water swimming is safer and more supported. [ABSTRACT FROM AUTHOR]

Many young women turned to digital fitness technologies (DFT) to support their health and wellbeing during the covid-19 pandemic. The present study explores young student women's retrospective perceptions of their cumulative engagement with DFT, across periods of restriction and easing (March 2020–2021). Seventeen UK-based women (Age M = 20.29, SD = 1.72); Ethnicity White = 94.12% participated in one-on-one interviews using an adapted scroll-back technique. Data was analysed using narrative-informed reflexive thematic analysis. Three themes were developed: My lockdown #fitnesstransformation: DFT as information and inspiration, My unrealistic expectations: DFT as a source of comparison and concern and My new body positive and resilient self: DFT as a catalyst to self-development. Themes highlight how perceptions of DFT changed over time as a consequence of repeat engagement, sociocultural context and psychological meaning-making. Crucially, findings underscore the importance of examining the collective and cumulative effects of DFT engagement on health and wellbeing, both positive and negative. [ABSTRACT FROM AUTHOR]

Many people living with dementia have difficulties at mealtimes, which can result in serious complications for physical and mental health, leading to hospital admissions and even death. However, current training in mealtime care for staff working with this population has been found to be poorly reported, with variable effectiveness. It is essential that care home staff are able to provide good care at mealtimes. This study used ethnography to explore current practice in mealtime care for this population, identify good practice, and understand the factors influencing mealtime care. Approximately 28 h of mealtime observations were conducted in two UK care homes with diverse characteristics. Observations focused on interactions between care staff and residents living with dementia. Twenty-five semi-structured interviews were carried out with care home staff, family carers, and visiting health and social care professionals, to explore mealtime care from their perspectives. A constant comparative approach was taken, to probe emergent findings and explore topics in greater depth. Key thematic categories were identified, including: tensions in mealtime care; the symbolic nature of mealtime care; navigating tensions via a person-centred approach; contextual constraints on mealtime care; and teamwork in mealtime care. The findings indicated that a person-centred approach helps carers to find the right balance between apparently competing priorities, and teamwork is instrumental in overcoming contextual constraints. This evidence has contributed to development of a training intervention for care home staff. Future research should investigate the feasibility of mealtime care training in care homes. [ABSTRACT FROM AUTHOR]

Interviews with individuals experiencing homelessness can be challenging for various reasons, including mental and physical health issues, substance use, and negative experiences with authority figures. Researchers have used photos to facilitate communication and empower participants during data collection. We analyzed data from a previous study to explore the use of researcher-generated photos during interviews about health with 13 women experiencing homelessness. Conversation analysis revealed clear patterns regarding the use of the photos during the interviews. The photos were referred to 118 times over the total interview length, 6 hours and 23 minutes, with the interviewer making 62% of the referrals and the women accounting for 38%. Fifty-nine percent of the referrals occurred within the first 5 minutes of the interviews. The women used the photos to trigger associations and emotions, to describe photo content, or in a minor role during the interview. Interpretations from an advisory board of six women with lived experiences of homelessness suggested that the photos did not engage participants as intended, highlighting the importance of considering participants' perspectives when designing photo-elicitation methods. The feedback also provided valuable insights into interview locations and incentives in research that may have influenced the women's willingness to use the photos. This study emphasizes the importance of understanding the complexity of choosing researcher-generated photos in interviews with underserved, hard-to-reach populations. [ABSTRACT FROM AUTHOR]

The Sikh community may be more visible and vulnerable to racism than other religious groups, and previous research has documented the racism targeted at Sikh men and women in the United States. Relatively few studies have, however, addressed the racism experienced by Sikh communities in other countries, where racism may be less closely connected to the events of 9/11. The present study investigates the lived experience of racism in Sikh adults living in the United Kingdom. Six participants (5 male, 1 female) aged 19 to 30 years (M = 24.17, SD = 3.98) were recruited via advertisements placed on social media. Both Amritdhari Sikhs (n = 4) who had undertaken the Amrit Sanskar initiation ceremony or commitment and Sahajdhari Sikhs (n = 2) who had not undertaken the initiation participated. Semi-structured interviews were conducted (totaling 372 minutes of interview data), covering a range of subjects including personal experiences of racism and subsequent responses to the racist abuse. Interpretative Phenomenological Analysis of the interview transcripts identified five superordinate themes. These were (1) Appearance and Visibility; (2) Inevitability and Normalization; (3) Coping and Conformity (Religion as Support, Fitting In, Internalization); (4) Education and Understanding; and (5) Bystander Behavior (Experiences of Intervention, Religious Duty to Intervene, Consequences of Intervention). Findings highlight the extent to which racism occurs and the increased vulnerability of the Sikh community (e.g., appearance being the focus of racist abuse). Findings also highlight the importance of religion as a source of support and cultural pride and the significance of education and bystander behavior. Future research should further investigate these themes and introduce interventions to support the safety and well-being of members of the Sikh community experiencing racist abuse. [ABSTRACT FROM AUTHOR]

Sexual assault is a global problem, with the risk highest among university students. Bystander intervention preventing sexual assaults has primarily been researched using quantitative methods to understand what factors influence it. However, both sexual assault and bystander intervention are complex with many subtle and overlapping issues that, when analyzed qualitatively, can offer new insights. The current study aimed to explore and develop a nuanced and comprehensive understanding of students' perceptions of sexual assault and bystander intervention across two universities, one in the United Kingdom and one in Australia. Thirty-nine university students (19 in the United Kingdom; 20 in Australia) took part in one-to-one semistructured interviews. Using inductive thematic analysis, two overarching themes were identified: (a) navigating the complex dynamics of sexual assault; and (b) decisions to intervene or not to intervene. Findings suggest that the complexity and ambiguity around sexual assault can forestall bystander intervention. As such, increasing education, awareness, and discussions around sexual assault and bystander intervention is vital to increase awareness of the problem and mobilize action from bystanders to prevent sexual assault. [ABSTRACT FROM AUTHOR]

Drawing on Elias's work on established-outsider figurations, stigmatisation and the civilising process, this study explores the narratives of women, who are mothers of children under the age of 18 years old, in one female prison in England, United Kingdom. We conducted 31 in-depth interviews as well as three focus groups with 26 different women, exploring their experiences of being an imprisoned mother as well as staying in contact with their children from prison. Moreover, we interviewed 15 members of staff. Our findings highlight the stigmatised 'outsider' nature that is ascribed to mothers in prison which is reinforced by the prison environment and figurations between mothers and prison staff. By highlighting the stigmatised and outsider positioning of mothers in prison, this research has significance for practice and policy. Improving support for imprisoned mothers and the development of non-stigmatising, more inclusive, compassionate institutions and compassionate responses are thus required. [ABSTRACT FROM AUTHOR]

Aims: This study aimed to examine whether the moderating role of social support on the negative association between school-age bullying victimization and life satisfaction in middle-age was different by age of victimization. Methods: A longitudinal study was conducted using data collected at the ages of 7, 11 and 50 years in the 1958 British birth cohort (N = 18,558). Frequency of bullying victimization (never, sometimes, or frequently) was assessed by parental interviews at ages seven and 11. A self-reported questionnaire assessed life satisfaction and perceived social support (instrumental and emotional) at age 50. To determine the moderating effect of social support on the association between bullying victimization and life satisfaction, hierarchical multiple linear regression analyses were conducted in which two interaction terms, victimization at age seven by social support and victimization at age 11 by social support, were simultaneously entered into the models. Results: Among 5304 respondents subjected to the statistical analysis, 34% had bullying victimization at age 7 years; 23% had bullying victimization at age 11 years. Instrumental support significantly buffered the effect of frequent victimization at age 11 (β = 0.03, p = 0.03) and significantly deteriorated the effect of frequent victimization at age 7 years (β = −0.04, p = 0.01), after adjusting for childhood confounders. No significant moderating effect was observed for emotional support. Conclusions: Instrumental support in middle-age may more effectively buffer the effect of late school-age victimization than of early school-age victimization, while both effect sizes were small and additional research is needed. [ABSTRACT FROM AUTHOR]

Those closest to people with lower-grade gliomas (LGGs) often assume the role of informal caregiver (IC). The additional responsibilities mean ICs of people with cancer can experience adverse impacts on their own lives. We explored the emotional impact of informal caregiving for people with LGGs. This was a descriptive qualitative study within the multi-method Ways Ahead project. We conducted semi-structured interviews with individuals from the United Kingdom, who currently, or in the past 5 years, informally cared for someone with an LGG. Interviews encompassed experiences of emotional impact as a consequence of caregiving for someone with an LGG. Inductive thematic analysis was undertaken. We interviewed 19 ICs (mean age 54.6 years; 14 females, 5 males). Participants reported substantial emotional impact. Four themes and associated subthemes were generated: Emotional responses to the illness (e.g. feeling helpless), Emotional responses to the unknown (e.g. anxiety about future uncertainty), Emotional consequences of care recipient changes (e.g. challenges of changed relationship dynamics), and Emotional weight of the responsibility (e.g. feeling burnout). Emotional impact in one area often exacerbated impact in another (e.g. future uncertainty impacted feelings of helplessness). Participants detailed the factors that helped them manage the emotional impact (e.g. being resilient). ICs of people with LGGs can experience wide-ranging emotional responses to and impacts of the illness, uncertain prognosis, care recipient changes, and the toll of caregiving. Adjustment and resilience are key protective factors, though further consideration of ways to identify and fulfil the emotional support needs of ICs of people with LGGs is required. [ABSTRACT FROM AUTHOR]

There is a lack of research concerning therapists' emotional responses to the suicide of clients and/or friends and family and yet, professionally, therapists commonly manage suicide risk of their clients and need to abide by relevant policies. Using a purposive sampling technique, twelve female clinical psychologists working in the UK were recruited via social media platforms. A qualitative method was adopted to offer an in-depth understanding into the lived experiences of losing a loved one and/or client to suicide. The semi-structured interviews took place via video-call or via telephone for up to one hour. Three themes were identified as follows: how talk is experienced as a way of making sense of suicide the messiness of being human,and an experience that helps psychologists face suicide. This study brings to light the dilemmas experienced by clinical psychologists who are both clinicians and survivors of suicide. The findings highlight the lack of conversation relating to bereavement by suicide within mental health services. This study offers insight into how clinical psychologists experience suicide bereavement, and discusses the clinical and UK policy implications. [ABSTRACT FROM AUTHOR]

Background: Immunological responses to metal ions can occur in people with metal implantable devices. Nevertheless, patients are not routinely asked about metal hypersensitivity nor tested for it prior to surgical procedures. Moreover, we have not identified any published literature on patients' experiences with this condition. We undertook this study to better understand the experiences of patients with metal hypersensitivity and to determine what information would help them make an informed decision about implantable medical devices with metal compositions. Methods: This is a patient-oriented research using an interpretative phenomenological methodology. We enrolled 16 people from five countries (Canada, New Zealand, Spain, the UK, and the USA) who experienced metal hypersensitivity following implantable medical device. We collected data from in-depth, semi-structured interviews focused on pre-procedural patient education and postoperative experiences to elucidate the barriers and opportunities related to metal hypersensitivity. We analyzed the data using interpretative phenomenological analysis. Results: The majority were white biological women between the ages of 34 and 65. None of the participants were informed about immunological responses to metals in implants during the consenting process. They encountered many challenges when symptoms of metal hypersensitivity occurred. The outcomes for the few who had the implants removed were mixed. Conclusion: Hypersensitivity reactions to metal need to be discussed as part of the consenting process, and additional strategies are needed to mitigate this issue in the health system. [ABSTRACT FROM AUTHOR]

Objective: To investigate how health and care leaders navigate the micro-politics of major system change (MSC) as manifest in the formulation and implementation of Sustainability and Transformation Partnerships (STPs) in the English National Health Service (NHS). Methods: A comparative qualitative case study of three STPs carried out between 2018–2021. Data collection comprised 72 semi-structured interviews with STP leaders and stakeholders; 49h of observations of STP executive meetings, management teams and thematic committees, and documentary sources. Interpretative analysis involved developing individual and cross case reports to understand the 'disagreements, 'people and interests' and the 'skills, behaviours and practice'. Findings: Three linked political fault-lines underpinned the micro-politics of formulating and implementing STPs: differences in meaning and value, perceptions of winners and losers, and structural differences in power and influence. In managing these issues, STP leaders engaged in a range of complementary strategies to understand and reconcile meanings, appraise and manage risks and benefits, and to redress longstanding power imbalances, as well as those related to their own ambiguous position. Conclusion: Given the lack of formal authority and breadth of system change, navigating the micro-politics of MSC requires political skills in listening and engagement, strategic appraisal of the political landscape and effective negotiation and consensus-building. [ABSTRACT FROM AUTHOR]

Objective: We aimed to explore the experiences and perspectives of pregnant women, antenatal healthcare professionals, and system leaders to understand the impact of the implementation of remote provision of antenatal care during the COVID-19 pandemic and beyond. Methods: We conducted a qualitative study involving semi-structured interviews with 93 participants, including 45 individuals who had been pregnant during the study period, 34 health care professionals, and 14 managers and system-level stakeholders. Analysis was based on the constant comparative method and used the theoretical framework of candidacy. Results: We found that remote antenatal care had far-reaching effects on access when understood through the lens of candidacy. It altered women's own identification of themselves and their babies as eligible for antenatal care. Navigating services became more challenging, often requiring considerable digital literacy and sociocultural capital. Services became less permeable, meaning that they were more difficult to use and demanding of the personal and social resources of users. Remote consultations were seen as more transactional in character and were limited by lack of face-to-face contact and safe spaces, making it more difficult for women to make their needs – both clinical and social – known, and for professionals to assess them. Operational and institutional challenges, including problems in sharing of antenatal records, were consequential. There were suggestions that a shift to remote provision of antenatal care might increase risks of inequities in access to care in relation to every feature of candidacy we characterised. Conclusion: It is important to recognise the implications for access to antenatal care of a shift to remote delivery. It is not a simple swap: it restructures many aspects of candidacy for care in ways that pose risks of amplifying existing intersectional inequalities that lead to poorer outcomes. Addressing these challenges through policy and practice action is needed to tackle these risks. [ABSTRACT FROM AUTHOR]

Many people living with dementia are 'on the margins', not accessing services and support, despite policy and care advancements. The COVID-19 pandemic exacerbated this, with the closure of face-to-face support during lockdowns in the UK and globally. The aim of the 'Beyond the Margins' project was to develop, implement, and evaluate a face-face programme of support with, by and for people with direct experience of dementia who are on the margins of existing services and support. In March 2020 the project was interrupted by the outbreak of the COVID-19 pandemic and it changed to an online format. The three-phase participatory action research project included 40 people living with dementia, 26 care partners and 31 health and social care practitioners. A seven-week online personal development programme called Getting On with Life (GO) was developed, delivered, and evaluated. This paper focuses on the participatory approaches used to develop and implement the GO programme, and the resulting aspects of its approach to facilitation and content. Key features include the GO Programme's principles of providing a safe and a respectful space, and the programme's values of: Everyone who comes already knows things, can learn things and can teach things; Doing things 'with' each other, rather than 'for' or 'to' each other; Personalised goals—led by the needs of participants rather than an imposed agenda. A key finding was the importance of developing post-diagnostic programmes as a 'sandwich', providing a safe space for learning that is preceded by understanding pathways to access the programme and followed by explicit consideration of the next steps in increasing social engagement. [ABSTRACT FROM AUTHOR]

Introduction: Distance methods of supervision rapidly increased in use during the coronavirus disease 2019 (COVID-19) pandemic, and it is important to consider if these methods meet the needs of supervisees when deciding whether to retain these practices moving forward. Methods: An interpretative phenomenological approach was used to gain insight into the lived experience of distance supervision. Semi-structured interviews were completed with six occupational therapists who had experience receiving distance supervision as a supervisee, all of whom work in inpatient mental health units within a private healthcare company. Results: Interpretative phenomenological analysis revealed four superordinate themes of an altered interaction; the importance of a protected space; factors within the supervisory relationship and maximising the best of both worlds. Conclusion: Distance supervision methods afford increased access for supervisees and a reduction in the practical demands when supervised by an off-site supervisor. There are, however, clear differences in the nature of the experience which need to be considered to ensure that supervisee needs are met. This study provides insight into how distance supervision methods impact on the experience for supervisees and suggests areas for further consideration in moving forward with such approaches. [ABSTRACT FROM AUTHOR]

Background: Over the next two decades, the numbers of people who will need palliative care in the United Kingdom and Ireland is projected to increase. Hospices play a vital role supporting people who require specialist palliative care input through community-based and inpatient palliative care services. Evidence is needed to understand the role of these different services to inform future service development. Objectives: To describe the reasons for admission, and outcomes at the end of the stay, for patients admitted to two hospice inpatient units (IPUs). Design: This was a mixed-methods study using a convergent, parallel mixed-methods design. Methods: We reviewed the case notes of all patients admitted to two hospice inpatient units from July to November 2019; conducted semi-structured interviews with patients and families; as well as brief structured interviews with inpatient unit staff. Results: Two hundred fifty-nine patients were admitted to a hospice IPU, accounting for 276 admissions in total. Overall, 53% were female; median age was 71 years (range: 26–95 years). Most patients (95%) were White British or Scottish, and 95% had a cancer diagnosis. Most patients were admitted from the community, under one-third were admitted from hospital. Most (85%) had previous palliative care involvement. Nearly, half had district nurse support (48%). Worry and anxiety was frequently reported as a reason for admission, alongside physical concerns. Median length of stay was 12 days, and 68% died during their stay. Hospice was recorded as the preferred place of care for 56% of those who died there. Conclusions: Sustained efforts to promote the hospice as place of care for people with conditions other than cancer are needed alongside greater clarity regarding of the role of the hospice IPU, and who would benefit most from IPU support. [ABSTRACT FROM AUTHOR]

Objective: Breast cancer incidence is rising among Pakistani women in the United Kingdom. However, uptake of breast screening remains low. This study aimed to improve access to breast screening for British-Pakistani women by exploring their knowledge of breast cancer and the role of primary care and community networks to support screening access amongst British-Pakistani women. Methods: We undertook a secondary qualitative analysis of 18 semi-structured interviews with British-Pakistani women from East Lancashire in the United Kingdom. Anonymized transcripts of the interviews were used for a thematic analysis. Results: Three themes were identified in the interviewees' responses: (i) 'Women's knowledge of breasts and breast cancer', which described how a cultural taboo exists around Pakistani women's bodies and around breast cancer; (ii) 'Role of primary care', which detailed how General Practitioners can support informed decisions and offer a trusted and valued information source; (iii) 'Community engagement', which described the potential to disseminate breast-screening information through the whole community, including primary care providers, all family members and mosques. Conclusions: Our analysis suggested three main targets for future interventions to improve access to breast screening for British-Pakistani women: (i) co-produced strategies to increase knowledge of breasts and breast screening; (ii) greater collaboration with local General Practitioners to support women to make informed choices about screening; and (iii) community engagement involving General Practitioners and community leaders, to inform everyone – not just screening-age women – about breast cancer and screening. [ABSTRACT FROM AUTHOR]

Background: Voluntary and community sector bereavement services are central to bereavement support in the UK. Aim: To determine service providers' perspectives on access to their support before and during the COVID-19 pandemic. Design: Mixed methods study using an explanatory sequential design: (1) Cross-sectional online survey of UK bereavement services; (2) Qualitative interviews with staff and volunteers at selected services. Settings/participants: 147 services participated in the survey; 24 interviews were conducted across 14 services. Results: 67.3% of services reported there were groups with unmet needs not accessing their services before the pandemic; most frequently people from minoritised ethnic communities (49%), sexual minority groups (26.5%), deprived areas (24.5%) and men (23.8%). Compared with before the pandemic, 3.4% of services were seeing more people from minoritised ethnic groups, while 6.1% were seeing fewer. 25.2% of services did not collect ethnicity data. Qualitative findings demonstrated the disproportionate impact of the pandemic on minoritised ethnic communities, including disruption to care/mourning practices, and the need for culturally appropriate support. During the pandemic outreach activities were sometimes deprioritised; however, increased collaboration was also reported. Online provision improved access but excluded some. Positive interventions to increase equity included collecting client demographic data; improving outreach, language accessibility and staff representation; supporting other professionals to provide bereavement support; local collaboration and co-production. Conclusions: Service providers report inequities in access to bereavement support. Attention needs to be paid to identifying, assessing and meeting unmet needs for appropriate bereavement support. Identified positive interventions can inform service provision and research. [ABSTRACT FROM AUTHOR]

Performance management systems are intended to positively influence employee behaviour but do they also motivate significant gaming? This concern is increasingly noted in the literature yet research into gaming and how it arises has been very limited. Using data collected from 65 semi-structured interviews with academics working in 13 research intensive business schools/schools of management in the United Kingdom, this article demonstrates how performance management systems can encourage employees to engage in a range of behaviours termed gaming in order to navigate performance management systems. It categorises gaming behaviours into five types: gratuitous proliferation, hoarding performance, collusive alliances, playing safe and cooking the books. The article then examines the distinctive features of each type and illustrates how it arises as a response to performance management systems. Given the widespread use of performance management systems and the close similarities in the way they are implemented in different public and private sector organisations, the derived categories are relevant to contexts beyond the university setting. [ABSTRACT FROM AUTHOR]

Objectives: This study aimed to explore carers' experiences of supporting a family member or friend with dementia through COVID-19 and experiences of hope and resilience during this time. Methods: Qualitative longitudinal research was undertaken in the UK, with 13 unpaid carers of people living with dementia who took part in two semi-structured interviews 8 weeks apart between June and October 2020. All transcripts were analysed using reflexive thematic analysis. Findings: Four themes were developed and included: COVID-19 impacted negatively upon everyday living; carer resilience: adapting to COVID-19; analysis of risk: safeguarding the person living with dementia; and thinking about the future with COVID-19. Conclusions: The results illustrated how the sudden changes which occurred during the pandemic negatively impacted on carers and people living with dementia in several ways, including additional responsibilities and taking away hope. The importance of continued formal and informal support for carers and people living with dementia during COVID-19 were highlighted. Formal services, care homes, and organisations need to be supported to implement procedures to ensure a safe environment during future lockdowns or periods of social restrictions. This will enable carers to remain visiting their family members and increase their confidence in accessing services and allowing paid carers to support their family member with dementia. These results have also illustrated the resilience of carers, who adapted to sudden changes which impacted negatively on their wellbeing and the wellbeing of the person living with dementia. [ABSTRACT FROM AUTHOR]

Language disorder (LD) is a common childhood condition affecting language development, which can in turn impact children's peer relationships. Although most children with LD are included in mainstream classrooms, there is limited knowledge about the way friendships support or hinder the learning experiences of children with LD in inclusive settings. Typically developing (TD) peers' views tend to get overlooked when considering inclusion but they need to be heard as they too adapt to inclusive classrooms. In this small-scale study, we explored the perspectives of peers on their friendship quality with children with LD. We conducted friendship interviews with classroom friends (n = 9) of 6–8-year-old children with LD (n = 9), who attended the enhanced provision and mainstream classrooms in the United Kingdom and the Republic of Ireland. We used sociometric nomination methods to identify the reciprocal friends of children with LD. We then interviewed these friends using art-based methods and analysed our interview data using thematic framework. Friends of children with LD attending the enhanced provision showed an inclusive mindset and revealed their own strategies for overcoming potential communication barriers. In contrast, friends in full-time mainstream classrooms did not report experiencing communication difficulties when interacting with a peer with LD. We conclude that educational practice should build on those inclusion strategies that children find natural and consider the importance of teaching all children about adjustments that can support inclusion of those with communication difficulties. [ABSTRACT FROM AUTHOR]

Background: The Cleft Lip Education with Augmented Reality (CLEAR) project centers around the use of augmented reality (AR) in patient leaflets, as a visual means to overcome the "health literacy" gap. This trial followed Virtual Reality (VR CORE) guidelines for VR Phase 2 (Pilot) trials. Methods: Participants included families of children treated for Cleft Lip and Palate at the Royal Hospital for Children, Glasgow. Interventions were AR leaflet or Traditional Leaflet. Objectives were to calculate sample sizes, assess outcome instruments, trial design, and acceptability to patients. Primary outcome measure was Mental Effort Rating Scale, and secondary outcomes were Patient Satisfaction (Visual Analogue Scale), Usefulness Scale for Patient Information Material (USE) scale, and Instructional Materials Motivation Survey (IMMS). Randomization was by block randomization. The trial was single blinded with assessors blinded to group assignment. Results: 12 Participants were randomized, with crossover design permitting analysis of 12 per group. Primary outcome with Mental Effort Rating Scale indicated higher mental effort with Traditional compared to AR Leaflet (4.75 vs 2.00, P =.0003). Secondary outcomes for Satisfaction were Traditional 54.50 versus AR 93.50 (P =.0001); USE scale 49.42 versus 74.08 (P =.0011); and IMMS 112.50 versus 161.75 (P =.0003). Subjective interviews noted overwhelmingly positive patient comments regarding the AR leaflet. Outcome instruments and trial design were acceptable to participants. No harms were recorded. Conclusions: The CLEAR pilot trial provides early evidence of clinical efficacy of AR leaflets in patient education. It is hoped that this will provide a future paradigm shift in the way patient education is delivered. [ABSTRACT FROM AUTHOR]

Background: The current emphasis among addiction treatment providers is to use person-first language, such as "a person with a substance use disorder," as a way to reduce stigma around addiction and resulting barriers to treatment. This study considers how individuals recovering from substance use feel about the terms "alcoholic" and "addict," particularly how they self-identify and whether they believe the terms carry stigma. Method: Thirty-five individuals were interviewed, recruited primarily, but not exclusively, from 12-step meetings (Alcoholics Anonymous, Narcotics Anonymous), from 3 locations throughout a rural New England state. Interviews were transcribed and coded in Atlas Ti qualitative analysis software, and a content analysis of text coded with "stigma" was conducted. Results: Some comments reflected a belief that the terms "addict" and "alcoholic" carry a stigma. However, more comments rejected the notion of these being stigmatized terms; or acknowledged the stigma but reflected the subject's lack of internalizing of any stigma. Comments reflected other themes including a sense of pride, identity and ownership when self-identifying as an addict or alcoholic. Several comments suggested that person-first language is part of a larger movement to "soften everything," without changing the underlying condition (addiction). The findings may reflect the fact that subjects were recruited from 12-step programs, where the convention is to self-identity using the terms "alcoholic" and/or "addict." Conclusions: Some individuals seeking treatment for addiction may prefer self-identifying using old-school terminology (addict, alcoholic) rather than person-first language, for a variety of reasons (eg, they do not internalize the stigma of such terms). [ABSTRACT FROM AUTHOR]

Objectives: Previous literature finds that having a child with a cleft lip and/or palate (CL/P) may pose social and emotional challenges for parents. For parents of children born during the Covid-19 pandemic, such challenges may be heightened. Further, novel demands brought about by the pandemic could have caused additional hardships. The aim of this study was to describe the impact of the pandemic on new parents through qualitative exploration of their experiences. Design: Semi-structured interviews were conducted with 14 parents of children born in the United Kingdom with CL/P between January and June 2020, around the start of the pandemic. Data were analysed using inductive thematic analysis. Results: Three themes, with sub-themes, were identified. The first theme, " Changes to Healthcare: The Impact of Restrictions and Reduced Contact", discussed the impact of the pandemic on perinatal care, the care received from the specialist CL/P teams, and parents' experiences of virtual consultations. The second theme, "Family Functioning During the Pandemic", covered parental anxiety, fathers' experiences, and social support. The third theme, " Surgical Prioritisation: Delays and Uncertainty", addressed changes to surgical protocols, coping with uncertainty, complications associated with delayed surgery, and how parents created positive meaning from this period. Conclusions: A range of increased and additional psychosocial impacts for parents were identified, along with several coping strategies, utilization of social support, and the positive aspects of their experiences. As the pandemic continues, close monitoring of families affected by CL/P remains imperative, particularly for those at risk of emotional distress. [ABSTRACT FROM AUTHOR]

Introduction: Following traumatic injury, occupational therapists (OTs) are pivotal in supporting people to return-to-work (RTW) and regain independence. Aim: to identify priorities for RTW after traumatic injury and highlight barriers hindering the process. Method: We recruited 17 participants with direct (i.e. trauma survivor [ n = 11]; OT trauma survivor [ n = 2]) or indirect (i.e. OT [ n = 4]) experience of returning to work following traumatic injury. Online consultations, lasting 60 min, were guided by a semi-structured script ensuring relevant topics were covered. An inductive approach was used for coding themes using thematic analysis. Findings: Sense of purpose, identity and social interaction were greater priorities for RTW, than financial stability. Major barriers were: pain and fatigue; adapting to physical changes; impacts on mental health; and lack of support (healthcare and the workplace). Participants (public and healthcare professionals) reported a lack of vocational rehabilitation in supporting trauma survivors RTW, but advocated occupational therapy for psychological recovery; purposeful engagement in occupations; and community support. Conclusion: Restoring an individual's self-identity and social connections, whilst helping control pain and fatigue, should be prioritised when planning occupational therapy for those returning to work after traumatic injury. This study was limited to 'returners', but can inform occupational therapy interventions for RTW. [ABSTRACT FROM AUTHOR]

Background: Research has highlighted a need for more theoretical work in arts interventions, including the role of the dyad. This study aimed to test theories from a literature review on the impact of including carers in museum programmes for people with dementia, and develop a model which can be used in other programmes to consider the impact of including carers more broadly. Methods: Using a realist evaluation approach, theory was developed through interviews and participant-observation at six museums in the UK. Findings: The impacts of including carers fell into seven broad areas – caring responsibility, session function, controlling access, preventing engagement, comparisons and losses, long-term impact of in-the-moment activities, and reducing social isolation and opening up the museum. Conclusions: Including carers may have both unanticipated benefits and negative consequences, and greater attention is needed on how both carers and people with dementia can be supported in shared sessions. Carers should be viewed as participants of programmes, and can even be the main beneficiaries, even where the programme is ostensibly 'for' the person with dementia – it's not simply that carers are the enablers of, or barriers to, the impacts on the person with dementia. [ABSTRACT FROM AUTHOR]

Public narratives around dementia have historically been negative, and have not been shaped by people with dementia themselves, but stories of living with dementia are becoming more common in the public domain. This qualitative study explored the motivations and experiences of bloggers by conducting interviews with six bloggers with dementia in the UK. Thematic analysis suggested that the asynchronous nature of blogging offered a valuable, personalised space for people with dementia to tell their own stories in their own way. Blogging as a format posed some practical challenges, but bloggers developed strategies to overcome these. Motivations for blogging were on three levels: the personal (as a journal, and as a 'room of one's own'); community (as solidarity for other people with dementia, and as comfort for families and friends) and society (as an educational and campaigning tool). Whilst the study is small, and there are many voices of people with dementia missing from the blogging community, this research demonstrates the potential for blogging by people with dementia to change public narratives and perceptions of dementia. [ABSTRACT FROM AUTHOR]

Background: People with dementia and their caregivers often lack equitable access to hospice care which is a concern internationally. Domains of best practice in palliative care for this population exist and hospices are urged to become dementia friendly. Aim: This study aimed to evaluate the model of 'Hospice Enabled Dementia Partnership' mapped to international domains of best practice. Design: Three-phased monitoring, group interview and individual interview study using a formative evaluation framework. Setting / Participants: The partnership model was a collaboration between a large specialist palliative care hospice, a dementia charity and a Health Care Trust in the United Kingdom. Service documents were subjected to documentary review of monitoring activity and key indicators of service success. Group interviews and individual interviews took place with family carers (n = 12), health care professionals involved in delivering the service (n = 32) and senior professionals (n = 5) responsible for service commissioning in palliative or dementia care. Results: One hundred people with dementia were referred to the service between May 2016 and December 2017. Thirty-eight of the 42 people who died, achieved their preferred place of care and died at home. Four themes were derived from the data 'Impact of Dementia', 'Value of the Service', 'Information and Learning Needs' and 'Working in Partnership'. Conclusions: Positive outcomes resulted from this best practice model; achievement of preferred place of care and death at home, dual benefits of therapies for patients and families and partnership in cross working and learning between services. Replication of this model should be considered internationally. [ABSTRACT FROM AUTHOR]

Non-violent resistance (NVR) therapy is a parenting intervention increasingly used for violent and/or controlling behaviour by adopted children. However, little is known about adoptive parents' experiences of using it. In this study, semi-structured interviews with 10 mothers were analysed using interpretative phenomenological analysis. Four superordinate themes were identified: (1) The importance of values: experiences of NVR are underpinned by the fit between personal values and those of NVR; (2) NVR is hard work; (3) Providing hope for change; (4) A spectrum of success. Results indicated that if the NVR approach is aligned with mothers' values, it is experienced as an effective intervention for child–to–parent violence (CPV). In addition, while considerable effort is required to 'do' NVR, it becomes easier as it is unconsciously incorporated into practice. These findings add to the emerging evidence-base for NVR, complementing empirical studies that have shown it to successfully reduce CPV. These findings may also help clinicians prepare adoptive parents for the challenge of using it. [ABSTRACT FROM AUTHOR]

Background: Prescribing clinicians have to negotiate ambiguities around information provision and consent for medications on a daily basis, despite the availability of professional guidance. Aim: This study aims to explore some of the many factors prescribing clinicians in the United Kingdom take into account when deciding what information to give to patients about medication choices, and when. Design: In depth face-to-face interviews, utilising both a hypothetical scenario and semi-structured prompts, were conducted in order to elicit extended reflections on how clinicians individually work through such dilemmas and make decisions. Setting/participants: Ten prescribing clinicians (doctors and nurses) from a large combined team of National Health Service (NHS) secondary and community palliative care providers in England. Results: Palliative care staff regularly face choices about information provision in prescribing discussions, in particular when considering whether information might increase distress. Participants presented three overlapping framings that helped them assess the range of factors that could potentially be taken into account; (1) assessing the individual patient, (2) tailoring the provision of information and (3) jointly forming a plan. Conclusions: Information provision about medication choices and effects is a demanding, ongoing process, requiring nuanced judgements that constitute an unacknowledged yet significant aspect of clinical workload. Although current medical guidelines allow clinical discretion about information provision, this can leave individual clinicians feeling vulnerable. Further evolution of guidelines needs to establish a more sophisticated way to acknowledge professional and legal requirements, whilst also promoting professional autonomy and judgement. [ABSTRACT FROM AUTHOR]

Background: Access to affordable, appropriate housing is one of the key social determinants of health, affecting well-being across the lifecourse. However, beyond a recognition that housing quality is linked to place of death, little is known about the ways in which housing status impacts social, emotional, and practical aspects of dying and bereavement. Method: The Checking Out project is a qualitative study aiming to explore the ways in which socio-economic status impacts people's experiences of, and attitudes towards, death, dying, and bereavement in the United Kingdom. Qualitative interviews were carried out with 14 bereaved individuals with experience of poverty at end of life or in bereavement, and 15 professionals supporting individuals in low-income communities. Interviews were conducted via phone/video call, and data include experiences of end of life and bereavement both before and during the pandemic. Transcripts were examined using thematic analysis. Results: Housing emerged as an important factor affecting people's experiences, with 7 of the 14 bereaved individuals and all except 1 of the professionals discussing housing-related issues. Participants described ways in which unsuitable housing and housing insecurity impacted practical aspects of dying but also emotional and social well-being at end of life. Housing-related issues affected both patients and their families, though families found it difficult to air these concerns when their relative was dying. Conclusion: The paper demonstrates how trusted professionals are able to advocate or address the issues faced by bereaved individuals and suggests implications for policy and practice. A greater awareness of the potential impact of housing status across public services, including healthcare practitioners, welfare support, and housing providers, could better support patients and practitioners to address these issues proactively. Housing providers and policy-makers should be included as key partners in collaborative public health approaches to palliative care. [ABSTRACT FROM AUTHOR]

Social participation in out-of-home activities is important for people living with dementia, yet little is known about such participation. The aim of this study was to explore and compare out-of-home participation among people living with dementia in four countries by assessing different types of places of participation visited or no longer visited. A cross-sectional design was used to gather self-reported experiences concerning out-of-home participation among people with mild stage dementia living in Canada (n = 29), Sweden (n = 35), Switzerland (n = 35) and the UK (n = 64). Interviews were conducted using the Participation in ACTivities and places OUTside the Home for older adults (ACT-OUT) instrument. Participants still visited 16 (Median) places out of a possible total of 24, and they had abandoned 5 (Median) places. Neighbourhood was the place most participants still visited, whereas 50% of them had stopped going to a Sports facility, with no significant differences between country samples regarding how many participants had abandoned that place (Fisher's exact test, p > 0.01). There were significant differences between country samples in the frequency of present participation and abandonment of the Hospital, Dentist's office, Cemetery, Garden, and Forest (Fisher's exact test, all p < 0.01). Although the participants still visited a variety of places, they had stopped going to places previously visited, which indicates reductions in participation, posing an inherent risk to well-being. The similarities and differences across samples from the four countries suggest that healthcare services and access to public transport may contribute to the complex interactional process of out-of-home participation for people living with dementia. The findings highlight the need for initiatives targeting specific types of places to support continued participation in society, especially places at a higher risk of abandonment such as places for recreation and physical activity. [ABSTRACT FROM AUTHOR]

Background: Dementia is a life-limiting illness, but the trajectory of dying can be difficult to establish and care at end of life can be variable and problematic. Methods: This UK study was carried out to explore the end-of-life-care experiences of people with dementia from the perspective of their family carers. In-depth interviews were conducted with 40 bereaved family carers of people with dementia. Results: Forty family carers (male n = 9, female n = 31) age range: 18–86 years were interviewed. Issues with poor communication were common. The hard work of caring and issues regarding unpredictability of living and dying with dementia were also commonplace within the study. Only three patients were referred for specialist palliative care support at the end of life, all of whom had a dual diagnosis of dementia and cancer. Conclusion: This qualitative study has identified that there are several gaps in the end-of-life care of people with dementia, and frequently, there is poor communication during the last year of life. The need for high-quality integrated care for people dying with dementia with appropriate support during the last year of life is identified. COVID-19 has disproportionately affected people with dementia, and in the post-pandemic era, there is an urgent need to ensure every person dying with dementia is supported to die in their preferred place and that family members are supported and enabled to be treated as the 'expert' in terms of their knowledge of their relatives' care and preferences. [ABSTRACT FROM AUTHOR]

Objectives: The cultural beliefs, practices and experiences of ethnic minority groups, alongside structural inequalities and the political economy play a critical, but overlooked role in health promotion. This study aimed to understand how ethnic minority groups in the United Kingdom conceptualised COVID-19 and how this influenced engagement in testing. Method: Black (African and Caribbean) and South Asian (Indian, Pakistani and Bangladeshi) community members were purposefully recruited from across the UK. Fifty-seven semi-structured interviews were conducted and analysed using principles of grounded theory. Results: We found that people of Black and South Asian ethnicity conceptualised COVID-19 as a disease that makes them visible to others outside their community and was seen as having more severe risk and suffering worse consequences, resulting in fear, stigmatisation and alienation. Views about COVID-19 were embedded in cultural beliefs, relating to culturally specific ideas around disease, such as ill-health being God's will. Challenges brought about by the pandemic were conceptualised as one of many struggles, with the saliency of the virus contextualised against life experiences. These themes and others influenced engagement with COVID-19 testing. Testing was less about accessing timely and effective treatment for themselves and more about acting to protect the family and community. Testing symbolised a loss of income, anxiety and isolation, accentuated by issues of mistrust of the system and not being valued, or being treated unfairly. Conclusion: Health communications should focus on counterbalancing the mistrust, alienation and stigmatisation that act as barriers to testing, with trust built using local credible sources. [ABSTRACT FROM AUTHOR]

Introduction: Occupational therapists have an integral role in the treatment of people with functional neurological disorder, yet there is evidence of variable implementation of occupational therapy in community settings. This study explored the barriers and enablers to delivering community-based occupational therapy to people with functional neurological disorder in the United Kingdom. Methods: Community-based neurological occupational therapists (n = 10) with experience in functional neurological disorder were invited to complete semi-structured qualitative interviews. The interview schedule and analysis were based on the Theoretical Domains Framework, a behavioural science tool for investigating barriers and enablers to clinical practice. Data were analysed using a combined content and framework analysis approach. Findings: Important barriers to treatment included limited published information to guide practice, lack of professional role clarity and restricted multidisciplinary team working. Enablers included occupational therapists' dual training in physical and mental health and focus on activity engagement. Service provision, quality and access varied across geographical locations. Conclusion: Occupational therapists are uniquely placed to help people with functional neurological disorder; however, findings suggest that existing community service structures in many regions in the United Kingdom are inadequate and limit the quality of treatment that can be provided. Additional resources are required to support occupational therapy service provision in community settings. [ABSTRACT FROM AUTHOR]

Background: Despite the extensive research and intense debate on coercion in psychiatry we have seen in recent years, little is still known about formally voluntarily admitted patients, who experience high levels of perceived coercion during their admission to a psychiatric hospital. Aims: The purpose of the present research was to explore forms of treatment pressure put on patients, not only by clinicians, but also by patients' relatives, during admission to psychiatric hospitals in Italy, Poland and the United Kingdom. Methods: Data were obtained via in-depth, semi-structured interviews with patients (N = 108) diagnosed with various mental disorders (ICD-10: F20–F49) hospitalised in psychiatric inpatient wards. Maximum variation sampling was applied to ensure the inclusion of patients with different socio-demographic and clinical characteristics. The study applied a common methodology to secure comparability and consistency across participating countries. The qualitative data from each country were transcribed verbatim, coded and subjected to theoretical thematic analysis. Results: The results of the analysis confirm that the legal classifications of involuntary and voluntary hospitalisation do not capture the fundamental distinctions between patients who are and are not coerced into treatment. Our findings show that the level of perceived coercion in voluntary patients ranges from 'persuasion' and 'interpersonal leverage' (categorised as treatment pressures) to 'threat', 'someone else's decisions' and 'violence' (categorised as informal coercion). Conclusion: We suggest that the term 'treatment pressures' be applied to techniques for convincing patients to follow a suggested course of treatment by offering advice and support in getting professional help, as well as using emotional arguments based on the personal relationship with the patient. In turn, we propose to reserve the term 'informal coercion' to describe practices for pressuring patients into treatment by threatening them, by making them believe that they have no choice, and by taking away their power to make autonomous decisions. [ABSTRACT FROM AUTHOR]

The aim of this study was to explore the lived experience of interstitial cystitis (IC)/painful bladder syndrome (PBS). A phenomenological approach with emphasis on reflection and openness was adopted. Twenty women diagnosed with IC an average of nine years prior to data collection produced a written account of their experiences. The textual data was analyzed using thematic analysis. Four themes were derived from data analysis: diagnostic uncertainty; restrictions and limitations on life; self-management; and interpersonal relationships and social support. Women reported issues in receiving a diagnosis of IC, undergoing numerous diagnostic tests, and experiencing multiple referrals. Having undergone numerous treatments with limited success, women sought information and management strategies outside of standard medical care and reported a negative impact on sexual and social relationships. The findings illustrate the complex nature of women's experiences and the physical and psychological impacts and effects of IC/PBS on women's daily lives. [ABSTRACT FROM AUTHOR]

Objective: Virtual Consultations may reduce the need for face-to-face outpatient appointments, thereby potentially reducing the cost and time involved in delivering health care. This study reports a discrete choice experiment (DCE) that identifies factors that influence patient preferences for virtual consultations in an orthopaedic rehabilitation setting. Methods: Previous research from the CONNECT (Care in Orthopaedics, burdeN of treatmeNt and the Effect of Communication Technology) Project and best practice guidance informed the development of our DCE. An efficient fractional factorial design with 16 choice scenarios was created that identified all main effects and partial two-way interactions. The design was divided into two blocks of eight scenarios each, to reduce the impact of cognitive fatigue. Data analysis were conducted using binary logit regression models. Results: Sixty-one paired response sets (122 subjects) were available for analysis. DCE factors (whether the therapist is known to the patient, duration of appointment, time of day) and demographic factors (patient qualifications, access to equipment, difficulty with activities, multiple health issues, travel costs) were significant predictors of preference. We estimate that a patient is less than 1% likely to prefer a virtual consultation if the patient has a degree, is without access to the equipment and software to undertake a virtual consultation, does not have difficulties with day-to-day activities, is undergoing rehabilitation for one problem area, has to pay less than £5 to travel, is having a consultation with a therapist not known to them, in 1 weeks' time, lasting 60 minutes, at 2 pm. We have developed a simple conceptual model to explain how these factors interact to inform preference, including patients' access to resources, context for the consultation and the requirements of the consultation. Conclusions: This conceptual model provides the framework to focus attention towards factors that might influence patient preference for virtual consultations. Our model can inform the development of future technologies, trials, and qualitative work to further explore the mechanisms that influence preference. [ABSTRACT FROM AUTHOR]

Introduction: Successful adoption of POCTs (Point-of-Care tests) for COVID-19 in care homes requires the identification of ideal use cases and a full understanding of the contextual and usability factors that affect test results and minimise biosafety risks. This paper presents a scoping-usability and test performance study of a microfluidic immunofluorescence assay for COVID-19 in care homes. Methods: A mixed-methods evaluation was conducted in four UK care homes to scope usability and to assess the agreement with qRT-PCR. A dry run with luminescent dye was conducted to explore biosafety issues. Results: The agreement analysis was conducted on 227 asymptomatic participants (159 staff and 68 residents) and 14 symptomatic participants (5 staff and 9 residents). Asymptomatic specimens showed 50% (95% CI:1.3%−98.7%) positive agreement and 96% (95% CI: 92.5%−98.1%) negative agreement with overall prevalence and bias-adjusted Kappa (PABAK) of 0.911 (95% CI: 0.857−0.965). Symptomatic specimens showed 83.3% (95% CI: 35.9%−99.6%) positive agreement and 100% (95% CI: 63.1%−100%) negative agreement with overall prevalence and bias-adjusted Kappa (PABAK) of 0.857 (95% CI: 0.549−1). The dry run highlighted four main sources of contamination that led to the modification of the standard operating procedures. Simulation post-modification showed no further evidence of contamination. Conclusion: Careful consideration of biosafety issues and contextual factors associated with care home are mandatory for safe use the POCT. Whilst POCT may have some utility for ruling out COVID-19, further diagnostic accuracy evaluations are needed to promote effective adoption. [ABSTRACT FROM AUTHOR]

Aphasia, a language disability, can profoundly affect a person's mood and identity. The experiences of participants who received Solution-Focused Brief Therapy, a psychological intervention, were explored in the Solution-Focused brief therapy In poststroke Aphasia (SOFIA) Trial. Thirty participants with chronic aphasia, 14 with severe aphasia, participated in in-depth interviews that were analyzed using framework analysis. Two overarching themes emerged: valued therapy components (exploring hopes, noticing achievements, companionship, sharing feelings, and relationship with therapist) and perceptions of progress (mood, identity, communication, relationships, and independence). Participants were categorized into four groups: (a) "changed," where therapy had a meaningful impact on a person's life; (b) "connected," where therapy was valued primarily for companionship; (c) "complemental," where therapy complemented a participant's upward trajectory; and (d) "discordant," where therapy misaligned with participants' preference for impairment-based language work. This study suggests that it is feasible to adapt a psychological therapy for people with aphasia, who perceive it as valuable. [ABSTRACT FROM AUTHOR]

Summary: UK social workers are exposed to chronically poor working conditions and experience extremely high levels of sickness absence. The aim of this study was to gain an in-depth understanding of working conditions and wellbeing of social workers. Seven UK social work employers sent a survey of working conditions, wellbeing, and turnover intentions to all child and family social workers, followed by a series of individual semi-structured interviews with respondents. Data were collected between January and May 2019. Six hundred and seventy-six (41% response rate) completed surveys were returned and 19 interviews undertaken. Findings: Quantitative findings demonstrated that working conditions scored better than previous studies, with positive scores on autonomy, peer, and managerial support. However, the four remaining conditions (demands, relationships, role, and change) each scored worse than 75–90% of respondents in UK-wide benchmarks of individuals from various occupations. Regression outcomes demonstrated that demands, control, change, relationships, and peer support each significantly impacted employee wellbeing. Furthermore, over 20% of respondents suggested that they were frequently exposed to poor service user behaviour. Thematic analysis of interviews suggested that workload (demands), relationships with peers, management, and services users, and the way in which change was communicated were the main difficulties cited. Applications: It is clear that work is needed to support social worker stress and wellbeing at work. Management should support individuals in terms of developing peer and managerial support, and adopting best practice in reflective supervision. Furthermore, a more robust system of caseload allocation would support and improve significant workload pressures. [ABSTRACT FROM AUTHOR]

This article describes a pilot qualitative research study, exploring the impact of bereavement experiences, on pre-qualifying social work students in two UK Universities with diverse demographics. The research study took place in the context of general concern about the mental health of UK University students and suggests that social work students may be at particular risk of developing emotional wellbeing issues linked to bereavement. Interviews followed a free association narrative technique, with analysis of the data highlighting four main themes. Firstly, bereavement is associated with practical problems which may trigger wellbeing issues. Secondly, there is an increased need for specific bereavement training and support to be embedded within social work programmes, alongside skills and knowledge of cultural diversity and the part this plays in the bereavement process. Lastly, the study demonstrated that bereavement experiences are not isolated but linked to other losses and therefore students may need effective support to process these before they can effectively support others. The study appears to be distinctive in its focus on the impacts of bereavement on social work students and has significant implications for the ways in which students are supported by social work education programmes, as well as paving the way for further research in this area. [ABSTRACT FROM AUTHOR]

Introduction: The clinical benefits of 24-hour postural management are widely recognised by occupational therapists, but little is known about its impact on service users and carers or whether clinical practice is consistent across regions. The aim of this research was to investigate the use of 24-hour postural management by occupational therapists and to explore its impact on service users with neurodisability and their carers. Methods: Quantitative and qualitative methods were employed in two phases: (a) online survey with 96 occupational therapists across one UK region, with data analysed by descriptive statistics and correlations; (b) focus groups with service users and/or carers (n = 9), with data analysed by thematic analysis. Results: Findings showed moderate positive correlation between frequency of use and (a) all key intervention skills and (b) knowledge of night-time positioning (p < 0.001). Moderate positive correlations were found between level of training and (a) assessment skills and (b) knowledge of night-time positioning (p < 0.001). The overarching theme from focus groups was 'reliance on individualised equipment', with overwhelming frustration from lack of support, loss of identity, equipment cost, insufficient focus on preventative strategies and accessibility issues. Conclusion: A clinical practice guideline, including training, is crucial to direct practice. Providers must engage with service users and carers to address their frustrations. [ABSTRACT FROM AUTHOR]

Background: During infectious epidemics, healthcare workers are required to deliver traditional care while facing new pressures. Time and resource restrictions, a focus on saving lives and new safety measures can lead to traditional aspects of care delivery being neglected. Aim: Identify barriers to delivering end-of-life care, describe attempts to deliver care during the COVID-19 pandemic, and understand the impact this had on staff. Design: A rapid appraisal was conducted incorporating a rapid review of policies from the United Kingdom, semi-structured telephone interviews with healthcare workers, and a review of mass print media news stories and social media posts describing healthcare worker's experiences of delivering care during the pandemic. Data were coded and analysed using framework analysis. Setting/Participants: From a larger ongoing study, 22 interviews which mentioned death or caring for patients at end-of-life, eight government and National Health Service policies affecting end-of-life care delivery, eight international news media stories and 3440 publicly available social media posts were identified. The social media analysis centred around 274 original tweets with the highest reach, engagement and relevance. Incorporating multiple workstreams provided a broad perspective of end-of-life care during the COVID-19 pandemic in the United Kingdom. Results: Three themes were developed: (1) restrictions to traditional care, (2) striving for new forms of care and (3) establishing identity and resilience. Conclusions: The COVID-19 pandemic prohibited the delivery of traditional care as practical barriers restricted human connections. Staff prioritised communication and comfort orientated tasks to re-establish compassion at end-of-life and displayed resilience by adjusting their goals. [ABSTRACT FROM AUTHOR]

Introduction: Children and young people with developmental coordination disorder experience multiple occupational performance and participation challenges across environments. Research to date has not fully explored occupational therapy practice with children with developmental coordination disorder and their families. This study aims to describe current occupational therapy practice with children with developmental coordination disorder. Method: This study used a cross-sectional, online qualitative vignette survey methodology. International occupational therapists who were working with or had worked with children with developmental coordination disorder within the previous 5 years were invited to participate. Following a case vignette, clinicians were asked questions prompting them to describe their practice based upon the vignette. The data were analysed thematically. The Consolidated Criteria for Reporting Qualitative Research and Checklist for Reporting Results of Internet E-Surveys reporting guidelines were adhered to. Findings: Fifty-three valid responses were analysed. Analysis identified three themes describing occupational therapy practice with children with developmental coordination disorder: (a) a collaborative approach to establish occupation-focused goals; (b) occupation-focused assessment to guide therapy and diagnose developmental coordination disorder; and (c) the use of occupation-based interventions incorporating multiple strategies to enhance occupational engagement. Conclusion: This study suggests that current occupational therapy practice with children with developmental coordination disorder is collaborative, occupation-focused, and multi-component. Findings highlight a gap between the complexity of practice and the nature of interventions evaluated in research to date. [ABSTRACT FROM AUTHOR]

Background: The death of a child is acutely distressing. Evidence on the benefits and value to parents of spending time with their dead child have now been integrated into routine practice and is regarded as a bereavement support intervention. UK children's hospices have a tradition of using 'cooling facilities' (cold bedrooms, cooled blanket/mattress) to extend this period of time by slowing deterioration of the body. Aims: To describe: (1) type and use of cooling facilities in UK children's hospices, policies and practices regarding their use, and any changes over time. (2) Director of care's views on the purpose of cooling facilities and the rationale for hospice-specific practices. Methods: An explanatory mixed-methods design consisting two phases: a crosssectional survey of directors of care of UK children's hospices (n = 52) followed by semi-structured telephone interviews with a sub-sample of respondents. Survey data were analysed using descriptive statistics and interview data using directed content analysis. Results: 41/52 hospices completed the survey and 13 directors of care were interviewed. All hospices had cooling facilities. Some offered use of portable cooling facilities at home, though take-up appears low. Hospices differed in approaches to managing care and duration of use. Views on whether parents should observe deterioration informed the latter. Directors of care believed they provide families with time to say 'goodbye' and process their loss. Challenges for staff were reported. [ABSTRACT FROM AUTHOR]

This study sought to understand how individuals bereaved through homicide (murder or manslaughter) describe their postevent experiences to inform clinical needs and promote mechanisms for change. A total of 21 participants (18 females) between the ages of 29 and 66 (M age = 47.81 years, SD = 8.99) took part in this study. They were all participating in a residential program for homicidally bereaved individuals and were all residents in the United Kingdom. The sample comprised of 12 parents, five siblings, one partner, one daughter, one friend, and one grandmother of the deceased. The length of time since the bereavement varied from 12 months to 18 years (M = 2.48, SD = 1.80). Thematic analysis was used to analyze the narratives collected. Three central themes emerged, namely (a) uniqueness of the experience, (b) changed self and world, and (c) mixed experiences of support. The uniqueness of the individuals' experiences was associated with the nature of the homicide event and the consequences that are unlikely to occur in "normal" deaths (e.g., judiciary). A sense of a changed self (e.g., ongoing emotional/mental and physical responses, coping) and world (e.g., changed beliefs regarding safety and criminal activity) seemed to be contributing to different shades of (mal)adjustment. Adaptive and protective strategies were identified. The current study with a large qualitative sample generated a unique, rich description/integration about individuals' journeys following an experience of homicidal bereavement. Findings are likely to inform policy and clinical practice by considering individuals' voices. [ABSTRACT FROM AUTHOR]

Psychological problems are common among people with inflammatory bowel disease (IBD) following stoma surgery. However, the ways in which stoma-related psychological needs are identified and addressed in health care settings remain unexplored. In this study, we investigated the perspectives of young people with a stoma and health care professionals about access to psychological support. Semi-structured interviews were conducted with young people with an IBD stoma (18–29 years, n = 13) and health care professionals (n = 15), including colorectal surgeons, gastroenterologists, specialist nurses in IBD and stoma care, and general practitioners in England. Data collection and analysis were informed by constructivist grounded theory. Three analytic categories were developed: "initiating support-seeking," "affirming psychological needs," and "mobilizing psychological support," which capture young peoples' trajectory to access psychological support. Based on the findings, we highlight the need for both patients and health care professionals to assign greater priority to the identification of psychological symptoms post-stoma surgery. More effective care pathways, which include responsive psychological services, would enhance access to psychological support for young people with a stoma. [ABSTRACT FROM AUTHOR]

Little is known about what recovery means to those with chronic fatigue syndrome/myalgic encephalomyelitis, a poorly understood, disabling chronic health condition. To explore this issue, semi-structured interviews were conducted with patients reporting improvement (n = 9) and deterioration (n = 10) after a guided self-help intervention, and analyzed via "constant comparison." The meaning of recovery differed between participants—expectations for improvement and deployment of the sick role (and associated stigma) were key influences. While some saw recovery as complete freedom from symptoms, many defined it as freedom from the "sick role," with functionality prioritized. Others redefined recovery, reluctant to return to the lifestyle that may have contributed to their illness, or rejected the concept as unhelpful. Recovery is not always about eliminating all symptoms. Rather, it is a nexus between the reality of limited opportunities for full recovery, yet a strong desire to leave the illness behind and regain a sense of "normality." [ABSTRACT FROM AUTHOR]