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Background: Moral distress is recognized as an international problem that contributes to decreased work productivity, job dissatisfaction and intent to leave for adult Critical Care nurses. Aim: To explore Critical Care nurses moral distress levels using the Moral Distress Scale Revised (MDS‐R) and its relationship with intention to stay. The study reported in this paper was part of a larger study that also investigated Critical Care nurses' work environment in Canada and the Midlands region of the UK. Study design: During January to August 2017 a cross‐sectional survey was distributed to adult Critical Care nurses in the Midlands region of the UK. Methods: Surveys were distributed to adult Critical Care Registered Nurses in the Midlands region of the UK examining moral distress levels and intention to stay in Critical Care, the organization (NHS Trust) and in the nursing profession. Results: Two hundred sixty‐six number of a potential sample of 1066 Critical Care nurses completed the survey (25% response rate). Age and moral distress were significantly positively correlated with intention to stay on their current unit (r = 0.16, P =.05), indicating older nurses were more likely to stay in the critical care unit. Moral distress was negatively correlated with intent to stay scores, showing critical care nurses with higher levels of moral distress were less likely to stay on their unit (r = −0.20, P =.02). Moral distress was also significantly negatively correlated with intention to stay with their current employer (r = −0.28, P <.001). Nurses that stated they had high rates of moral distress were more likely to consider leaving their current employer. Conclusion: Moral distress appears to be an issue among adult Critical Care nurses requiring further exploration and development of effective strategies to reduce this phenomenon and stabilize the workforce by reducing turnover. Relevance to clinical practice: By identifying the top causes of moral distress, tools and strategies can be developed to allow the Critical Care nurse to work within an ethically safe clinical environment and reduce the turnover of experienced adult Critical Care nurses. [ABSTRACT FROM AUTHOR]

Purpose: Recovery Colleges were developed to support the recovery of people with mental health difficulties through courses co-produced by professionals and people with lived experience. This study aims to examine the use of Recovery Colleges to support people with dementia. Design/methodology/approach: A survey was circulated to UK Recovery College and memory service staff, exploring provision, delivery and attendance of dementia courses. Open responses provided insight into participant views about recovery in post-diagnostic support and the practicalities of running dementia courses. Findings: A total of 51 Recovery College staff and 210 memory service staff completed the survey. Twelve Recovery College dementia courses were identified across the UK. Three categories emerged from the qualitative data: post-diagnostic support, recovery in the context of dementia, challenges and areas of innovation. Originality/value: This study highlights the benefits and practicalities of running Recovery College courses with people with dementia. Peer-to-peer learning was seen as valuable in post-diagnostic support but opinions were divided about the term recovery in dementia. [ABSTRACT FROM AUTHOR]

Why you should read this article: • To explore the use and uptake of video group consultations (VGCs) by UK general practice staff during the COVID-19 pandemic • To enhance your awareness of the potential use of VGCs in your clinical setting • To recognise that the use of VGCs is dependent on funding, organisational support, general practice priorities and understanding of the model. Background: Video group consultations (VGCs) are one approach to delivering care using a virtual platform for a group of patients with the same or similar health conditions. However, little is known about the use and uptake of VGCs in the UK. Aim: To describe the use and uptake of VGCs by UK general practice staff during the coronavirus disease 2019 pandemic. Method: A cross-sectional design using an online questionnaire. Data analysis adopted the principles of content analysis and demographic data were analysed descriptively. Findings: A total of 36 participants completed the questionnaire across nine UK regions and representing 36 general practices. A lack of standardisation regarding the use and uptake of VGCs across UK general practices was identified, hindering implementation, scale-up and delivery. Conclusion: While the VGC model looks promising, further research is needed to demonstrate its use and uptake, developing a more robust evidence base for implementation. [ABSTRACT FROM AUTHOR]

Background/aim The successful development and maintenance of professional identity is associated with professional development and retention in the health workforce. This paper explores students' perspectives on the ways pre-entry experiences and curricula content shape professional identity. Methods An online cross-sectional survey was sent to students enrolled in the final year of entry-level programmes in five countries. Descriptive statistical analyses of data were completed. Results The results reflect the perceptions of 319 respondents from five countries. Respondents identified professional education (98%) and professional socialisation during placement (92%) as curricula components with the greatest influence on professional identity formation. Discipline-specific knowledge such as, occupation-focussed models and occupational science were ranked lower than these aspects of practice. The students' length of programme and level of entry-level programme did not impact on these results. Conclusion When designing curricula educators need to be mindful that students perceive practice education and professional socialisation have the greatest affect on professional identity formation. The findings reinforce the need for curricula to provide students with a range of practice experiences, which allow the observation and application of occupation-based practices. It highlights a need for educators to provide university-based curricula activities, which better prepare students for a potential dissonance between explicit occupation-based curricula and observed practice education experiences. The study indicates the need for further research into the role curricula content, and in particular practice education, plays in the multidimensional formation of professional development within entry-level programmes. [ABSTRACT FROM AUTHOR]

Background: Globally, initiation of paediatric advance care planning discussions is advocated early in the illness trajectory; however, evidence suggests it occurs at crisis points or close to end of life. Few studies have been undertaken to ascertain the prevalence and determinants of behaviour related to initiation by the healthcare professional. Method: Underpinned by the Capability, Opportunity, Motivation–Behaviour (COM‐B) model for behaviour change, a cross‐sectional online survey was conducted in United Kingdom and Ireland using a purposive sample of health professionals. Descriptive and inferential statistics were applied and nonparametric statistical analysis used. Open‐ended questions were mapped and correlations between COM‐B and demographic profiles identified. Results: Responses (n = 140): Paediatric advance care planning was viewed positively; however, initiation practices were found to be influenced by wide ranging diagnoses and disease trajectories. Whilst some tools and protocols exist, they were not used in a systematic manner, and initiation behaviour was often not guided by them. Initiation was unstandardized, individually led, guided by intuition and experience and based on a range of prerequisites. Such behaviour, combined with inconsistencies in professional development, resulted in varying practice when managing clinical deterioration. Professionals who felt adequately trained initiated more conversations (capability). Those working in palliative care specialties, hospice settings and doctors initiated more discussions (opportunity). There was no difference in Motivation between professions, clinical settings or specialisms, although 25% (n = 35) of responses indicated discomfort discussing death and 34% (n = 49) worried about families' emotional reaction. Conclusion: Although advocated, paediatric advance care planning is a complex process, commonly triggered by the physical deterioration and rarely underpinned by support tools. The COM‐B framework was useful in identifying fundamental differences in initiation behaviour; however, further research is required to explore the complexity of initiation behaviour and the system within which the care is being delivered to identify influences on initiation. [ABSTRACT FROM AUTHOR]

Background: Analysis of the Psychiatric Morbidity Survey of Great Britain showed that the prevalence of common mental disorders was lower amongst men at or above Britain's state pension age of 65, relative to younger men. Retirees below this age had consistently higher rates of mental disorders than working men. In contrast, the low prevalence of mental disorders amongst retirees aged 65 and older was similar to that of their working peers. The aim of this analysis was to investigate this pattern of results in a national sample of Australian men, and the mediating role of socio-demographic factors.Method: Data were from the Household, Income and Labour Dynamics (HILDA) in Australia survey (2003). The analyses included men aged 45-74 years who were active in the labour force (n = 1309), or retired (n = 635). Mental health was assessed using the mental health scale from the Short-Form 36 Health Questionnaire.Results: Retirees were more likely to have mental health problems than their working peers, however this difference was progressively smaller across age groups. For retirees above, though not below, the age of 55 this difference was explained by poorer physical functioning. When age at retirement was considered it was found that early retirees who were now at or approaching the conventional retirement age did not display the substantially elevated rates of mental health problems seen in their younger counterparts. Further, men who had retired at age 60 or older did not display an initially elevated rate of mental health problems.Conclusions: The association between retirement and mental health varies across older adulthood. Retired British and Australian men below the conventional retirement age of 65 are more likely to have mental health problems relative to their working peers, and retirees above this age. However, poor mental health appears to be linked to being retired below this age rather than an enduring characteristic of those who retire early. [ABSTRACT FROM AUTHOR]

Purpose: Stigma reduction is an important public health challenge because of the large morbidity and mortality associated with some forms of substance use. Extreme stigma can lead to dehumanisation of target groups, who are ascribed with lesser humanity. The authors examined whether there was blatant and subtle dehumanisation of people who use heroin, and if these were associated with levels of support for non-discriminatory drug policy. Design/methodology/approach: A cross-sectional online study using a UK convenience sample (n = 307 [75.2% female, mean age 28.6 ± 12.2 years]) was conducted. Participants completed assessments of blatant (Ascent of Humans [AoH] scale) and subtle (an emotion attribution task) dehumanisation and a bespoke measure assessing support for non-discriminatory drug policies. Other measures controlled for stigma towards people who use drugs (PWUD) and moral disgust. Findings: There was greater blatant dehumanisation of people who used heroin compared to the general population and other potentially stigmatised reference groups, including people who use cannabis. The authors also found evidence of subtle dehumanisation, and people who used heroin were rated as being less likely to feel uniquely human emotions, less likely to feel positive emotions and more likely to feel negative emotions. Blatant dehumanisation was associated with significantly lower probability of support for non-discriminatory drug policy. Social implications: Dehumanisation may present significant challenges for stigma reduction initiatives and in fostering public support for drug policy and treatment. Denial of the humanity of this group could be used to justify discriminatory policies or relative deprioritisation of support services in funding decisions. Activities that seek to "rehumanise" PWUD, including social inclusion, and encouraging compassionate media representations that portray the lived experiences of substance use may be useful areas of future work. Originality/value: This is the first study to investigate blatant and subtle dehumanisation of people who use heroin, and how this relates to public support for drug policy. [ABSTRACT FROM AUTHOR]

Aims: To compare the acceptability, reliability and validity of five contemporary diabetes‐specific quality of life (QoL) scales among adults with type 1 diabetes in the United Kingdom and Australia. Methods: Adults with type 1 diabetes (UK = 1139, Australia = 439) completed a cross‐sectional, online survey including ADDQoL‐19, DCP, DIDP, DSQOLS and Diabetes QoL‐Q, presented in randomised order. After completing each scale, participants rated it for clarity, relevance, ease of completion, length and comprehensiveness. We examined scale acceptability (scale completion and user ratings), response patterns, structure (exploratory and confirmatory factor analyses) and validity (convergent, concurrent, divergent and known groups). To assess cross‐country reproducibility, analyses conducted on the UK dataset were replicated in the Australian dataset. Results: Findings were largely consistent between countries. All scales were acceptable to participants: ≥90% completing all items, and ≥80% positive user ratings, except for DSQOLS' length. Scale structure was not supported for the DCP. Overall, in terms of acceptability and psychometric evaluation, the DIDP was the strongest performing scale while the ADDQoL‐19 and Diabetes QoL‐Q scales also performed well. Conclusions: These findings suggest that the recently developed brief (7 items), neutrally worded DIDP scale is acceptable to adults with type 1 diabetes and has the strongest psychometric performance. However, questionnaire selection should always be considered in the context of the research aims, study design and population, as well as the wider published evidence regarding both the development and responsiveness of the scales. [ABSTRACT FROM AUTHOR]

Objective: To examine the effects of exposure to conflicting nutritional information (CNI) through different forms of media on nutrition-related confusion and backlash among consumers in the UK.Design: Cross-sectional survey administered via Qualtrics among 18-75-year-old participants in the UK. The sample was stratified by age and gender with quotas defined according to the 2011 UK census distribution.Setting: Qualtrics' Online panel of respondents in the UK.Participants: 676 participants comprising nearly an equal number of females (n 341) and males (n 335) and a majority (58·6 %) from households whose income was <£30 000.Results: Our findings showed that nearly 40 % of respondents were exposed to some or a lot of CNI. We found that while exposure to CNI from TV and online news increased nutrition confusion, CNI from health professionals increased backlash. Exposure to CNI from social media and health websites was associated with reduced backlash. We also found that nutrition confusion and backlash were negatively associated with exercise behaviour and fruit and vegetable consumption, respectively.Conclusions: Our study supports the theoretical pathways that explain the influence of CNI exposure on nutrition-related cognitive and behavioural outcomes. Additionally, different types of online information sources are associated with these outcomes to varying degrees. In the context of obesity and diabetes rates in the UK, our findings call for (a) further experimental research into the effects of CNI on consumers' diet-related cognitions and behaviours and (b) multi-stakeholder, interdisciplinary approaches to address this problem. [ABSTRACT FROM AUTHOR]

Background The adequacy of personal protective equipment (PPE) and infection prevention and control (IPC) training in UK medical students and interim Foundation Year 1 (FiY1) doctors during the COVID-19 pandemic is unknown, as is its impact on COVID-19-related anxiety. Methods Cross-sectional, multi-centre study analysing self-reported adequacy of PPE and IPC training and correlation to a modified pandemic anxiety scale. Participants were current medical students and FiY1 doctors in the UK. Data were collected by an online survey. Results Participants reported that they received insufficient PPE information (43%) and IPC training (56%). Significantly, fewer participants identifying as women or BAME/mixed ethnicity reported receiving sufficient PPE information, compared with those identifying as men and White British/White Other, respectively. COVID-19-related anxiety was significantly higher in those without sufficient reported PPE or IPC training, in women compared with men, and in FiY1 doctors compared with medical students. Conclusions With medical students currently volunteering in and imminently returning to hospitals in an educational capacity, levels of self-reported PPE and IPC training are sub-optimal. Better training is paramount to avoid harm to patients and healthcare professionals and to reduce COVID-19-related anxiety among medical students and FiY1 doctors. [ABSTRACT FROM AUTHOR]

Introduction: Higher levels of anxiety and depression have been found to be associated with greater difficulty in stopping smoking. This raises the question as to whether mood disturbance may be associated with exposure to, and use of, quitting support. Aims: This study examined whether General Practitioner (GP) advice and/or offer of support, or stop-smoking service use differed between smokers reporting or not reporting depression/anxiety. Methods: Data came from the Smoking Toolkit Study. Participants were 1,162 English adults who reported currently smoking or having stopped within the past 12 months, aged 40+ years, surveyed between April and September 2012. Anxiety/depression was assessed by the mood disturbance item of the EuroQol five dimensions questionnaire (EQ-5D). This was compared to recall of GP quit advice and/or support, and stop-smoking aid use adjusting for age, gender, and social grade. Results/Findings: Smokers reporting depression/anxiety were more likely to recall being offered advice and support to stop smoking by their GP (OR = 1.50, 95% C.I. = 1.05–2.13). However, there were no significant differences in use of stop-smoking aids during the past year. Conclusions: Smokers reporting depression/anxiety are more likely to be offered stop-smoking support by their GPs, but this does not appear to translate into stop-smoking aid use, despite high motivation to quit. Given higher nicotine dependence in this group, mental health specific support may need to be offered, and more needs to be done to make this offer of aid attractive. [ABSTRACT FROM AUTHOR]

The article looks at cross sectional studies and their importance in the health and social care sector. It offers a description of cross sectional studies, along with their use in the establishment of the prevalence of a health outcome or cause of disease. The use of cross sectional studies in collecting simple waiting time data is also noted, with an emphasis on its advantages and disadvantages.

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British employers, under increasing competitive pressures, and applying new technology and work organization, have sought to reduce labour costs, resulting in work intensification and precarity. Older employees as a result are exposed to work demands that conflict with expectations of favourable treatment in late career. National survey data for Britain in the years 1992, 2001, 2006 and 2012 demonstrate a decline in overall job attitude among older employees following the changed conditions of the 1990s and across the major recession that began in 2008. To assess whether this decline is unequally distributed, decomposition by socio-economic class is carried out. This shows that older employees in the ‘service class’ of managerial and professional employees are affected at least as much as older employees in intermediate and less-skilled classes, thus underlining the age effect and showing that ‘service-class’ employees are not invulnerable to a changing economic environment. [ABSTRACT FROM AUTHOR]

Background: Obesity is increasing worldwide and weight-control strategies, including the consumption of plant food supplements (PFS), are proliferating. This article identifies the herbal ingredients in PFS consumed for weight control and by overweight/obese dieters in six European countries, and explores the relationship between their consumption and their self-reported BMI. Methods: Data used were a subset from the PlantLIBRA PFS Consumer Survey 2011-2012, a retrospective survey of 2359 PFS consumers. The survey used a bespoke frequency-of-PFS-usage questionnaire. Analyses were performed in two consumer subsamples of 1) respondents taking the products for "body weight reasons", and 2) "dieters for overweight/obesity", to identify the herbal ingredients consumed for these reasons. The relationship between the 5 most consumed herbal ingredients and self-reported BMI in groups 1 and 2 is explored by comparing BMI proportions of consumers vs. non-consumers (using Chi-squared test). Results: 252 PFS (8.8 %) were consumed for "body weight reasons" (by 240 PFS consumers); 112 PFS consumers (4.8 %) were "dieting for overweight/obesity". Spain is the country where consuming herbal ingredients for body weight control and dieting were most popular. Artichoke was the most consumed herbal ingredient. Considering only the 5 top products consumed by those who responded "body weight", when using the total survey sample, a greater proportion of BMI ≥ 25 was observed among consumers of PFS containing artichoke and green tea as compared to non-consumers (58.4 % vs. 49.1 % and 63.2 % vs. 49.7 % respectively). Considering only the 5 top products consumed by "dieters" and using only the "dieters" sample, a lower proportion of BMI ≥ 25 was observed among pineapple-containing PFS consumers (38.5 % vs. 81.5 %); however, when using the entire survey sample, a greater proportion of BMI ≥ 25 was observed among artichoke-containing PFS consumers (58.4 % vs. 49.1 %). Conclusions: A comparison of results among the scarce publications evaluating the use of weight-loss supplements at the population level is limited. Nevertheless every hint is important in finding out which are the self-treatment strategies used by overweight/obese individuals in European countries. Although limited by a small sample size, our study represents a first attempt at analysing such data in six EU countries. Our findings should encourage the conduction of further studies on this topic, long-term and large sample-sized studies, ideally conducted in the general population. [ABSTRACT FROM AUTHOR]

There is evidence that variable access to training, support mechanisms and resources limits social work research capacity. A survey circulated to UK social work academics in 2008 was completed by 249 respondents (response rate 33 percent). A sub-sample of twenty-nine respondents was selected for follow-up telephone interview. Both interview and survey data revealed respondents' enthusiasm for undertaking research but highlighted the practical difficulties they faced in terms of relief from teaching responsibilities; access to research funding; and a comparatively limited infrastructure for social work research. Suggestions for improvements included assistance with developing and submitting bids, mentoring, and greater access to research and practice networks. [ABSTRACT FROM AUTHOR]

Aim To examine nurse employees' and employers' views about responsibilities for managing nurses' careers. Background Career management policies are associated with cost savings, in terms of workforce recruitment and retention and an increase in job and career satisfaction. In nursing, responsibility for career management remains relatively unexplored. Design A multicenter, cross-sectional questionnaire survey. Methods Data were collected from 871 nurse employees and employers in the British National Health Service. The study was conducted in 2008, a period when policy reforms aimed at modernizing the healthcare workforce in England. In the current discussions in Europe and the USA about the future of nursing, these data reveal insights not previously reported. Exploratory analyses were undertaken using descriptive and inferential statistics. Results The analysis indicated a temporal dimension to career management responsibilities. Short-term responsibilities for securing funding and time for development lay more with employers. Medium-term responsibilities for assessing nurses' strengths and weakness, determining job-related knowledge and skills and identifying education and training needs appeared to be shared. Long-term responsibilities for developing individual careers and future development plans lay primarily with employees. Conclusion New ways of managing nurses' career development that lead to greater independence for employees and greater flexibility for employers, while retaining a high-calibre and competent workforce, are needed. Ultimately, career management responsibilities should not tilt to either side but rather be shared to benefit both parties. Clarifying employers' and employees' responsibilities for career management may help both parties to develop a common understanding of each other's role and to meet their obligations in a constructive dialogue. [ABSTRACT FROM AUTHOR]

Aim To explore associations among breastfeeding duration, maternal personality and maternal attitudes and experiences of breastfeeding. Background Understanding influences on breastfeeding initiation and duration is critical to increasing breastfeeding rates and supporting new mothers. Maternal characteristics such as self-efficacy, knowledge and confidence are known to enable women to breastfeed, but little is known about the influence of maternal trait personality on breastfeeding. Design An exploratory cross-sectional survey. Method A total of 602 mothers with an infant aged 6-12 months old completed a self-report questionnaire examining maternal trait personality, breastfeeding duration and attitudes and experiences of breastfeeding. Data were collected between March-June 2009. Results Mothers who reported high levels of extraversion, emotional stability and conscientiousness were significantly more likely to initiate and continue breastfeeding for a longer duration. Attitudes and experiences significantly associated with these personality traits such as perceived difficulties and lack of support may explain these patterns. For example, characteristics associated with introversion and anxiety may prevent women from seeking support or challenging negative attitudes of others at this critical time. Conclusion Understanding the influence of maternal personality may thus be a useful tool in antenatal support to recognize women who may need extra, directed support while facilitating discussion of potential barriers to breastfeeding. [ABSTRACT FROM AUTHOR]

To estimate the proportion of nurses in Hungary who intend to change their profession or want to migrate abroad; to compare the proportion of nurses who intend to leave nursing in Hungary and in selected European countries; and to describe factors that predict nurses' intent to work in their current job another year. An exploratory research design with subsequent comparison was used, and a cross-sectional mail survey was implemented. Measures of intent to leave, to work another year as well as indicators of push and pull factors were identified and adopted from a literature review. One thousand nurses were randomly selected and mailed a questionnaire. Comparison was made with the results from the NEXT study. For statistical analyses, linear and logistic regression was used to predict nurses' intention to leave and proportional z-test for making comparisons. Nurses ( n = 754) responded the questionnaire. Approximately half of the sample did not consider changing to another health care job or leaving the profession. Compared with Hungary, the proportion of nurses who intended to leave nursing was significantly lower in Belgium and the Netherlands but was greater or the same in the rest of the European countries. Speaking a foreign language was the most significant predictor of working abroad for Hungarian nurses. Number of shifts, satisfaction with flexible scheduling and managerial support were all relevant predictors of working another year as a nurse. Both the intent to leave nursing and migrating abroad were prevalent issues in Hungary. Working conditions and social/managerial support were key factors identified as strong predictors of stay in the same job for another year. Compared with other European countries, Hungary was not in a worse position in the proportion of nurses wanting to leave nursing. All hospital managers and head nurses should be aware of their role in keeping nurses in the clinical practice and avoid staff nurses migration from the Hungarian health care system. [ABSTRACT FROM AUTHOR]

A cross sectional UK-wide survey assessed current levels of dissemination and implementation of Evidence-Based Practice in social care and social work agencies. A structured questionnaire was e-mailed to 357 agencies of which 155 (43.4%) completed and returned it. Although the results show that Evidence-Based Practice in this area is still in its early stages, most respondents reported a good knowledge of Evidence-Based Practice as well as the view that professional decisions should be informed by-but not only-research evidence. The lack of time, resources, information, and training are identified as the main barriers to be overcome for an effective implementation of Evidence-Based Practice in the social services. [ABSTRACT FROM AUTHOR]