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Introduction: Although Jordan has made significant progress toward expanding the utilization of facility‐based intrapartum care, prior research highlights that poor service quality is still persistent. This study aimed to identify quality gaps between women's expectations and perceptions of the actual intrapartum care received, while exploring the contributing factors. Methods: Utilizing a pre–post design, quality gaps in intrapartum care were assessed among 959 women pre‐ and postchildbirth at a prominent tertiary hospital in northern Jordan. Data were gathered using the SERVQUAL scale, measuring service quality across reliability, responsiveness, tangibles, assurance, and empathy dimensions. Results: The overall mean gap score between women's expectations and perceptions of the quality of intrapartum care was −0.60 (±0.56). The lowest and highest mean gap scores were found to be related to tangibles and assurance dimensions, −0.24 (±0.39) and −0.88 (±0.35), respectively. Significant negative quality gaps were identified in the dimensions of assurance, empathy, and responsiveness, as well as overall service quality (p < 0.001). The MLR analyses highlighted education (β = 0.61), mode of birth (β = −0.60), admission timing (β = −0.41), continuity of midwifery care (β = −0.43), physician's gender (β = −0.62), active labour duration (β = 0.37), and pain management (β = −0.33) to be the key determinants of the overall quality gap in intrapartum care. Conclusion: Our findings underscore the importance of fostering a labour environment that prioritizes enhancing caregivers' empathetic, reassuring, and responsive skills to minimize service quality gaps and enhance the overall childbirth experience for women in Jordan. Patient or Public Contribution: This paper is a collaborative effort involving women with lived experiences of childbirth, midwives, and obstetrics and gynaecologist physicians. The original idea, conceptualization, data generation, and coproduction, including manuscript editing, were shaped by the valuable contributions of stakeholders with unique perspectives on intrapartum care in Jordan. [ABSTRACT FROM AUTHOR]

Objectives: Cardiac rehabilitation (CR) provides evidence-based secondary prevention for people with heart disease (HD) (clients). Despite HD being the leading cause of mortality and morbidity, CR is under-utilised in Australia. This research investigated healthcare systems required to improve access to CR in rural and remote areas of North Queensland (NQ). Methods: A qualitatively dominant case study series to review management systems for CR in rural and remote areas of NQ was undertaken. Data collection was via semi-structured interviews in four tertiary hospitals and four rural or remote communities. An audit of discharge planning and CR referral, plus a review of community-based health services, was completed. An iterative and co-design process including consultation with healthcare staff and community members culminated in a systems-based model for improving access to CR in rural and remote areas. Results: Poorly organised CR systems, poor client/staff understanding of discharge planning and low referral rates for secondary prevention, resulted in the majority of clients not accessing secondary prevention, despite resources being available. Revised health systems and management processes were recommended for the proposed Heart: Road to health model, and given common chronic diseases risk factors it was recommended to be broadened into Chronic disease: Road to health. Conclusion: A Chronic disease: Road to health model could provide effective and efficient secondary prevention for people with chronic diseases in rural and remote areas. It is proposed that this approach could reduce gaps and duplication in current healthcare services and provide flexible, client-centred, holistic, culturally responsive services, and improve client outcomes. What is known about the topic? Cardiac rehabilitation is known to improve health outcomes and reduce hospitalisations, but referrals and attendance are low (30%). What does this paper add? A revised systems-based model for improved access to secondary prevention for people with heart and related chronic diseases in rural and remote areas of North Queensland is proposed: Chronic disease: Road to health. What are the implications for practitioners? A functional system from hospitalisation to local healthcare services has been designed to improve access to secondary prevention. Staff require support and education to improve skills, better manage care and improve job satisfaction. [ABSTRACT FROM AUTHOR]

This paper advances the Future Ready Talent Framework (FRTF), a conceptual model of talents that are relevant to stakeholders of work-integrated learning (WIL) programs. The paper is organized into three sections. The first section provides background on the development of the FRTF, including a brief review of talent frameworks and the future of work literature as they relate to WIL. The second section presents the method through which the FRTF was extended and validated. This involved soliciting behavioral examples of talents from WIL stakeholders. The third section of the paper discusses implications of the FRTF for WIL, such as its application to student assessment. It also situates the FRTF in a broader discussion of WIL and the future of work. The goal of the paper is to position the FRTF as a tool that WIL stakeholders can use to create "common ground" as they communicate with each other about talent. [ABSTRACT FROM AUTHOR]

Background: Evidence‐based practice involves the synthesis of multiple forms of evidence to inform clinical decision‐making and treatment evaluation. Practice‐ and patient‐based evidence are two forms of evidence that are under‐represented in the stuttering literature. The collection of such knowledge is essential to support the design and delivery of effective stuttering interventions for adults. Aims: To build stakeholder consensus on the core components of intervention for adults who stutter, and to establish a guiding framework for the design and development of evidence‐based interventions for adults who stutter. Methods & Procedures: Adults who stutter and speech and language therapists (SLTs) with experience in providing stuttering intervention participated in the three‐round e‐Delphi Survey focused on: (1) identifying key stuttering intervention components, including principles, practices, and structural and contextual elements; and (2) obtaining group consensus on stuttering intervention components. Statements were categorized using the International Classification of Functioning, Disability and Health (ICF) model adapted to the study of stuttering. Outcomes & Results: A total of 48 individuals agreed to participate: 48/48 (100%) completed the Round 1 questionnaire, 40/48 (83%) responded to Round 2 and 36/40 (90%) participated in Round 3. Following content analysis of Round 1, 101 statements were developed, and consensus was achieved on 89 statements perceived as representing the core components of stuttering intervention for adults. Categorization of these statements reflected the key stuttering intervention components relating to personal reactions to stuttering, limitations in life participation and environmental factors. Conclusions & Implications: Consensus on the core components of stuttering intervention was reached through engagement with key stakeholders. The evidence‐based framework presented highlights the range of key intervention components a clinician should consider when designing interventions for adults who stutter. What this paper adds: What is already known on the subject: Evidence‐based practice endorses the synthesis of multiple knowledge forms including research, practice and patient evidence to support clinical decision‐making and treatment evaluation. The stuttering literature is characterized by an over‐representation of efficacy evidence, with significantly less practice and patient evidence to guide clinical practice. What this paper adds to existing knowledge: This study adds valuable practice‐ and patient‐based evidence for effective stuttering intervention components for adults who stutter. These relate to personal reactions to stuttering, limitations in life participation and environmental factors. What are the potential or actual clinical implications of this work?: This research presents a stakeholder‐informed framework for stuttering intervention to guide SLTs working with adults who stutter in designing evidence‐based interventions. The framework supports the adoption of a person‐centred approach to intervention to ensure each client's unique needs, preferences, values and desired outcomes are explored and integrated into therapy. [ABSTRACT FROM AUTHOR]

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

Purpose: The reduction of the violence and child abuse requires the cooperation of national and international health-related organizations. The purpose of this paper is to investigate the role of NGOs in health and peace development through administrating supportive programs for child abuse and violence victims. Design/methodology/approach: The present research was a mixed method research, and the type of research was a descriptive-analytic study. To collect data, library and field methods were used. The research sample included 137 staff members of the NGOs supporting children in Tehran. Data analysis was performed using SPSS software. Findings: According to authorities and members of the NGOs supporting children, networking and affective factors played a significant role in the development of health and peace (P<0.01). This was feasible by controlling the factors affecting violence and child abuse. Practical implications: Given the fact that NGOs are contributing to the development and establishment of peace through effective participation and networking, trying to support the victims of child abuse and violence, the need for more attention from governments is recommended in order to support these organizations, especially legislative and financial support is needed to expand the activities of such organizations. Originality/value: This paper is original in its method, topic and findings. The first is mixed method research, which has studied the role of networking of NGOs for peace development through implementing support programs for victims of child abuse and violence. [ABSTRACT FROM AUTHOR]

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

Purpose This paper aims to focus on the role of hospital business models by examining the innovative business model of Moheb Hospitals, which have successfully achieved the goal of reducing costs and delivering high-quality health-care services in Iran by encouraging public–private partnership.Design/methodology/approach This paper is a single case study.Findings The study results illustrate the hospital's current business model and its underlying elements. After presenting the findings, this paper is concluded by presenting the standing issues that should also be addressed and how improvements and adjustments can be made.Originality/value This study offers new insight to identify and analyze the shortcomings of health-care sector in Iran and introduces new methods to efficiently use current competencies. [ABSTRACT FROM AUTHOR]

Continual course correction during implementation of nutrition programmes is critical to address factors that might limit coverage and potential for impact. Programme improvement requires rigorous scientific inquiry to identify and address implementation pathways and the factors that affect them. Under the auspices of 'The Micronutrient Powders Consultation: Lessons Learned for Operational Guidance,' 3 working groups were formed to summarize experiences and lessons across countries regarding micronutrient powder (MNP) interventions for young children. This paper focuses on how MNP interventions undertook key elements of programme improvement, specifically, the use of programme theory, monitoring, process evaluation, and supportive supervision. Methods included a review of published and grey literature, interviews with key informants, and deliberations throughout the consultation process. We found that although much has been written and published about the use of monitoring and process evaluation to inform MNP interventions at small scale, there has been little formal documentation of lessons for the transition from pilot to scaled implementation. Supervision processes and experiences are not documented, and to our knowledge, there is no evidence of whether they have been effective to improve implementation. Improving the efficiency and effectiveness of interventions requires identification of critical indicators for detecting implementation challenges and drivers of impact, integration with existing programmes and systems, strengthened technical capacity, and financing for implementation of effective monitoring systems. Our understanding of programme improvement for MNP interventions is still incomplete, especially outside of the pilot stage, and we propose a set of implementation research questions that require further investigation. [ABSTRACT FROM AUTHOR]

Perioperative nurses assist in organ procurement surgery; however, there is a dearth of information of how they encounter making conscientious objection requests or refusals to participate in organ procurement surgery. Organ procurement surgical procedures can present to the operating room ad hoc and can catch a nurse who may not desire to participate by surprise with little opportunity to refuse as a result of staffing, skill mix or organizational work demands. This paper that stems from a larger doctoral research study exploring the experiences of perioperative nurses participating in multi-organ procurement surgery used a grounded theory method to develop a substantive theory of the nurses' experiences. This current paper aimed to highlight the experiences of perioperative nurses when confronted with expressing a conscientious objection towards their participation in these procedures. A number of organizational and cultural barriers within the healthcare organization were seen to hamper their ability in expressing a conscience-based refusal, which lead to their reluctant participation. Perioperative nurses must feel safe to express a conscientious objection towards these types of surgical procedures and feel supported in doing so by their respective hospital organizations and not be forced to participate unwillingly. [ABSTRACT FROM AUTHOR]

Aims and objectives: To describe individuals' with type 2 diabetes mellitus sense‐making of blood glucose data and other influences impacting self‐management behaviour. Background: Type 2 diabetes mellitus prevalence is increasing globally. Adherence to effective diabetes self‐management regimens is an ongoing healthcare challenge. Examining individuals' sense‐making processes can advance staff knowledge of and improve diabetes self‐management behaviour. Design: A qualitative exploratory design examining how individuals make sense of blood glucose data and symptoms, and the influence on self‐management decisions. Methods: Sixteen one‐on‐one interviews with adults diagnosed with type 2 diabetes mellitus using a semi‐structured interview guide were conducted from March–May 2018. An inductive–deductive thematic analysis of data using the Sensemaking Framework for Chronic Disease Self‐Management was used. The consolidated criteria for reporting qualitative research (COREQ) checklist were used in completing this paper. Results: Three main themes described participants' type 2 diabetes mellitus sense‐making and influences on self‐management decisions: classifying blood glucose data, building mental models and making self‐management decisions. Participants classified glucose levels based on prior personal experiences. Participants learned about diabetes from classes, personal experience, health information technology and their social network. Seven participants expressed a need for periodic refreshing of diabetes knowledge. Conclusion: Individuals use self‐monitored glucose values and/or HbA1C values to evaluate glucose control. When using glucose values, they analyse the context in which the value was obtained through the lens of personal parameters and expectations. Understanding how individuals make sense of glycaemic data and influences on diabetes self‐management behaviour with periodic reassessment of this understanding can guide the healthcare team in optimising collaborative individualised care plans. Relevance to clinical practice: Nurses must assess sense‐making processes in self‐management decisions. Periodic "refresher" diabetes education may be needed for individuals with type 2 diabetes mellitus. [ABSTRACT FROM AUTHOR]

Purpose: Using the PRECEDE model, the purpose of this paper is to determine the predictors of mothers' performance in daily consumption of fruit and vegetables (FV) in rural preschoolers. Design/methodology/approach: This study was carried out on 350 mothers of preschool children who had health records in the rural health-care centers of Iran. To collect data, a researcher-made questionnaire based on the PRECEDE model was used. The data were analyzed using the SPSS 19 software. Findings: The results showed that 11.42 percent of the mothers observed the FV intake for their children recommended by WHO. The independent t-test showed a significant difference between the mean scores of predisposing, enabling and reinforcing factors. Originality/value: This study showed that the rate of FV intake by preschool children in rural areas was much lower than the recommended WHO rate. To promote behavior, attention to the predisposing, enabling and reinforcing factors seems to be necessary. [ABSTRACT FROM AUTHOR]

Probability judgment is a vital part of many aspects of everyday life. In the present paper, we present a new theory of the way in which individuals produce probability estimates for joint events: conjunctive and disjunctive. We propose that a majority of individuals produce conjunctive (disjunctive) estimates by making a quasi‐random adjustment, positive or negative, from the less (more) likely component probability with the other component playing no obvious role. In two studies, we produce evidence supporting propositions that follow from our theory. First, the component probabilities do appear to play the distinct roles we propose in determining the joint event probabilities. Second, contrary to probability theory and other accounts of probability judgment, we show that the conjunctive‐less likely probability difference is unrelated to the more likely disjunctive probability difference (in normative theory these quantities are identical). In conclusion, while violating the norms of probability judgment, we argue that estimates produced in the manner we propose will be close enough to the normative values especially given the changing nature of the external environment and the incomplete nature of available information. [ABSTRACT FROM AUTHOR]

Purpose: In this paper, we present an exploratory, qualitative strand of a multiphase program evaluation of the Canadian-based SNAP® Youth Justice (SNAP YJ) model for males involved with the youth criminal justice system. SNAP YJ's therapeutic approach is founded on the evidence-based SNAP (Stop Now And Plan) model which focuses on strategies to enhance emotion regulation, self-control, and problem-solving for latency-aged children and their families. Integrating best practices from the literature, the SNAP YJ intervention uses technology (digital modules) to convey the manualized strategies and program sessions, engaging youth in an interactive manner. This systemic, cognitive behavioral intervention is designed to reduce further contact with the law and/or gang affiliation. The objectives of this study are to understand youth experiences of programing, enrich and contextualize preliminary outcome findings, and further develop programing through the inclusion of the youth perspective and feedback. Methods: A thematic analysis of 15 interviews with program participants from diverse backgrounds was conducted. Results: The results revealed a continuum of learning related to self-understanding and awareness of feelings; thinking and consequences; and prosocial skills and behavior. Discussion: Refinements to the program to target increased program effectiveness as a result of youth experiences are discussed. [ABSTRACT FROM AUTHOR]

This paper examines the ways in which older people's residential and nursing homes can constitute heteronormative environments – social spaces in which the same-sex attractions and desires of residents are disregarded in the provision of everyday care. The aim of this discussion is to examine the synergies and differences between older lesbian, gay and bisexual (LGB) adults' expectations for future care home provision and the expectations of care staff and managers in providing residential services to older people with diverse sexual backgrounds. We present qualitative evidence from research into the provision of care environments in Wales. In this paper, we present findings from two cohorts: first, from five focus groups with care and nursing staff and managers; and second, from 29 semi-structured interviews with older LGB adults (50–76 years) residing in urban and rural locations across Wales. We argue that residential care environments can constitute heterosexualised spaces in which LGB identities are neglected in comparison to the needs and preferences of other residents. To this extent, we discuss how care staff and managers can be more attentive and responsive to the sexual biographies of all residents and argue against the separation of care and sexual orientation in practice. [ABSTRACT FROM PUBLISHER]

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

Aim: Being front‐line healthcare professionals is associated with possible severe information anxiety during the COVID‐19 pandemic. Investigating signs of information anxiety is the first and key step of its targeted medical intervention. This study aims to explore the signs of front‐line healthcare professionals' information anxiety during the COVID‐19 pandemic. Design: This study is qualitative research. Grounded theory was used to classify information anxiety signs of front‐line healthcare professionals. Methods: Twenty‐four front‐line healthcare professionals from a general hospital with over 5000 beds in Wuhan were recruited to participate in semi‐structured interviews. According to the frequency and frequency variation of signs appearing in interviews, the trends of signs during the virus encounter, lockdown, flattening and second wave were compared. Based on the interviews, those signs that were conceptually related to each other were extracted to construct a conceptual model. Results: Psychological signs (emotion, worry, doubt, caution, hope), physical signs (insomnia, inattention, memory loss, appetite decreased) and behavioural signs (panic buying of goods, be at a loss, pay attention to relevant information, change habits) could be generalized from 13 subcategories of information anxiety signs. Psychological signs were the most in every period of the pandemic. Furthermore, psychological signs decreased significantly during lockdown, while behavioural and physical signs increased. Finally, severe psychological and behavioural signs were associated with physical signs. [ABSTRACT FROM AUTHOR]

Hispanic women who experience intimate partner violence (IPV) face unique disparities. They have poorer health outcomes and are less likely to seek help than their non-Hispanic counterparts. When women remain in relationships where IPV occurs and refuse to disclose or seek treatment, they may resort to self-silencing, which can also worsen health outcomes. The purpose of this study was to develop a theory that explains how self-silencing evolves among Hispanic women who experience IPV. Participants were recruited from two research studies focused on Hispanic women's health, and from snowball sampling, which involved referrals by previously registered participants. Data were collected via Zoom® and included individual interviews. A total of 25 women participated in this study. Analysis followed constructive grounded theory levels of analysis described by Charmaz and constant comparative methods described by Glaser and Strauss. A grounded theory entitled Bearing (Aguantando) With Intimate Partner Violence emerged from the data. The theory explains the main strategy Hispanic women use to deal with violence while remaining in a relationship where IPV occurs. The theory is constructed of four categories with subcategories. The results of this study provide an initial framework to understand the self-silencing process among Hispanic women who experience IPV. In addition, this study identifies different levels of interventions that can be useful for researchers and healthcare providers to promote Hispanic women's ability to become empowered, use their voices, and seek help. [ABSTRACT FROM AUTHOR]

Introduction: Mental health is a serious concern among novice school nurses in Japan. Numerous novice school nurses with various health problems experience high stress levels, affecting their mental health. They may be experiencing reality shock, a known risk factor for burnout and turnover, or its factor, the "reality gap." Objective: This study aimed to examine the hypothetical model by which the reality gap affects the mental health of novice school nurses. Methods: This cross-sectional study conducted a self-administered questionnaire survey, and responses were obtained from 102 novice school nurses. A path model was created based on a hypothetical model. Results: After several revisions on the hypothesis model, a modified path model was generated (CFI =.98, TLI =.93, RMSEA =.06). The path model showed that reality gaps negatively affected work engagement, work engagement positively affected intention to stay, and intention to stay positively affected mental health. Reality gap was also directly negatively associated with mental health. Having various support networks reduced the effects of reality gaps on mental health. Additionally, social support in the workplace boosted work engagement. Conclusion: Unique from other studies, this study contributed to understanding the effects of reality gaps on mental health. School managers and administrators should establish a support system that enables school nurses to receive various supports from within and outside the school. In addition, novice school nurses should take advantage of networks and support inside and outside school to reduce reality gaps and grow as professionals. [ABSTRACT FROM AUTHOR]

Purpose: Feedback is a tool that informs students about their learning process and facilitates necessary changes. It looks for the students' own perceptions of their performance and how to improve it, developing permanent learning skills vital for autonomous practice. It is useful for improving one's performance, clinical skills, communication and treatment of patients. If carried out improperly, it causes a lack of motivation and a collapse in the teacher–student relationship. The purpose of this paper is to analyze the perceptions and experiences of the residents and graduates of the psychiatry specialty at the Universidad of Concepción with respect to the feedback received on their performance during their training. Design/methodology/approach: The study was conducted using a qualitative approach of an exploratory, descriptive and interpretative nature that was also based on Grounded Theory. Ten in-depth voluntary interviews were conducted with residents-in-training and graduates from within the last two years of the Adult Psychiatry specialty at the Universidad of Concepción. Subsequently, the data were codified to create a theoretical model. Findings: The interpersonal teacher–resident relationship, when based on collaboration and an openness to dialogue, is fundamental in producing effective feedback. Research limitations/implications: The limitations of this study were based mainly on the qualitative methodology used, so it is not possible to generalize the results. Although the above limitation, this study seems to reaffirm the importance of feedback for residents in training, so it would be advisable to reproduce it in various training contexts and extend it to the perception of the teachers involved. On the other hand, to follow this research line, it is essential to create instruments that facilitate the use of quantitative research methodology, which allows the generalization and comparison of results in different areas. Social implications: This research opens a first line of research regarding subjective experience when receiving feedback, which will allow the creation of instruments to objectify how it is being developed in different educational contexts and to propose strategies to standardize its realization. Originality/value: There are no other studies of this type published. The originality of this research was that beyond the mention made about the known characteristics that a feedback must have to be effective, the participants gave special emphasis to the fact that it is a social relationship, which should be based on a horizontal interaction between two actors, in addition to promoting dialogue and mutual involvement in the task that brings them together. Thus it is an effective teaching strategy, fulfilling the objective of motivating the learning and autonomy of the resident. [ABSTRACT FROM AUTHOR]

Purpose Health Sector Evolution Plan (HSEP) is known as the biggest and most comprehensive reform in Iran's health system. One of the goals of HSEP is to reduce inequity in the healthcare financing. The purpose of this paper is to demonstrate HSEP agenda setting from the perspective of equity in healthcare financing (EHCF) using the multiple streams model.Design/methodology/approach This qualitative study was conducted by 26 documents review and analysis, and 30 semi-structured interview with Iranian key informants in the field of HSEP that were selected based on purposeful and snowball sampling method. Data were collected using a researcher-made checklist based on the goals. All audio-taped interviews were transcribed and analyzed thematically. Data management and analysis were performed using the framework analysis in MAXQDA software.Findings The framework analysis identified 12 complementary sub-themes totally. Problem stream included four sub-themes (high share of Out Of Pocket, high index of catastrophic health expenditures, low EHCF index, and inappropriate economic state and sanctions). Focus on EHCF in general policies of the Iran World Health Organization's report in 2000, the Targeted Subsidies Law and emphasis on equalizing healthcare financing in the Fourth and Fifth Development Plan were considered as policy stream sub-themes. Finally, political stream showed four sub-themes including strong support from the Minister of Health for HSEP, mass media, the pressure of WHO and people's request to reduce health costs.Research limitations/implications The limitations of the present study included paying attention to one package (evolution in the treatment sector) of three health packages to assess EHCF, as well as the lack of similar national and international evidence in implementation framework.Practical implications The results of this study can be used to analyze other health sector reforms around the word and can help the formulation and implementation of most practical reforms, especially in field of health system financing.Social implications This study gives a holistic view about health system policy setting that can be used for understanding policy-making streams to population.Originality/value This is the first study that has examined HSEP (the biggest health sector reform in Iran) from the perspective of agenda setting. In addition, using the popular and well-known Kingdon's model to explain HSEP agenda setting is one of the strengths of this study. Furthermore, taking advantage of a wide range of related views by including highly informed people increased the strength of the results of the study. In addition, the short interval between the interview and reviewing the results on reforms reduced the recall bias of the participants in the study. [ABSTRACT FROM AUTHOR]

Purpose According to the great importance of community health as well as the ever-increasing development of health technologies, the importance of designing an interactive model of factors affecting health technology assessment (HTA) can be highlighted. The purpose of designing and implementing the framework of health information system assessment is to ensure that the required accurate data which are necessary to measure the main health indicators are available. The purpose of this paper is to design an interactive model of factors affecting HTA.Design/methodology/approach This is a cross-sectional, descriptive-analytic study conducted in the Iran Ministry of Health and Medical Education in the second half of 2017. A sample of 60 experts and professionals working in the field of health technologies are selected using purposive and snowball sampling methods. Two researcher-made questionnaires are used to collect the required data. The collected data are analyzed using decision-making trial and evaluation laboratory (DEMATEL) and MATLAB R2013a.Findings The results showed that “Legal dimension,” “safety,” “Effectiveness” and “Social dimension” were the affecting factors and net causes, and “Current application,” “Knowledge of technology,” “Ethical dimension,” “Costs” and “Organizational dimension” were the affected factors and net effects in the interactive model. Furthermore, “Legal dimension” with the coordinates C: [1.88, 1.27] and “Ethical dimension” with the coordinates C: [1.75, −75] were known as the most affecting and most affected factors in the interactive model, respectively.Originality/value The DEMATEL model is an appropriate tool for managers and policy makers to structure and prioritize factors influencing the HTA. Policy makers and decision makers can use this model for identifying relationships among factors and prioritize them. Because health policy makers and managers have a major role in formulating the regulations and guidelines related to the HTA, they should pay more attention to the legal considerations in their decisions and use the management tools to move the available resources toward implementing and enforcing rules and guidelines related to the HTA. [ABSTRACT FROM AUTHOR]

Consumer-directed care (CDC) is increasingly widespread among aged care service options in Organisation for Economic Co-operation and Development (OECD) countries. However, the evidence base regarding the programmatic and contextual factors that affect the outcome of CDC interventions is surprisingly small. This paper reports on a self-directed care approach for older Australians with complex care needs. A multimethods longitudinal comparative cohort study was employed comprising 4 survey tools and 56 semi-structured interviews. Participation rates were around 20%. A total of 185 (98 in the intervention and 87 in the control group) older people and carers were recruited at baseline. Eleven months later, 109 participants (59 in the intervention and 50 in the control group) completed the repeat measure. Attrition rates were around 40%. Data collection occurred between July 2010 and April 2012. The data suggest that intervention group participants were likely to be more satisfied with the way they were treated (P = 0.013), their care options (P = 0.014), the 'say' they had in their care (P < 0.001), the information they received regarding their care (P = 0.012), what they were achieving in life (P = 0.031), that the services changed their view on what could be achieved in life (P = 0.020) and with their standard of living (P = 0.008). The evaluation suggests that while only a very small segment of older people is interested in a voucher or cash option, a substantially larger group would like to have greater say over and more direct access to their care, without, however, assuming administrative and financial responsibilities. The paper concludes that a stepped capacity-building approach to CDC may improve the acceptability of CDC to older people and generate synergies that improve older people's care outcomes. [ABSTRACT FROM AUTHOR]

This introduction to the Special Issue Indigenous Youth Resilience in the Arctic reviews relevant resilience theory and research, with particular attention to Arctic Indigenous youth. Current perspectives on resilience, as well as the role of social determinants, and community resilience processes in understanding resilience in Indigenous circumpolar settings are reviewed. The distinctive role for qualitative inquiry in understanding these frameworks is emphasized, as is the uniquely informative lens youth narratives can offer in understanding Indigenous, cultural, and community resilience processes during times of social transition. We then describe key shared cross-site methodological elements of the Circumpolar Indigenous Pathways to Adulthood study, including sampling, research design, procedures, and analytic strategies. The site-specific papers further elaborate on methods, focusing on those elements unique to each site, and describe in considerable detail locally salient stressors and culturally patterned resilience strategies operating in each community. The concluding paper considers these across sites, exploring continuities and discontinuities, and the influence of cross-national social policies. [ABSTRACT FROM AUTHOR]

Aim: To explore the interplay between the work of nurse managers and the support they receive and provide. Background: Support is the cornerstone of management practices and is pivotal in employees feeling committed to an organisation. Support for nurse managers is integral to effective health sector management; its characteristics merit more attention. Methods: The experiences of 15 nurse managers in rural health institutions in South Australia were explored using structured interviews, observation and document review. Results: Effective decision making requires adequate support, which influences the perceptions and performance of nurse managers, creating an environment in which they feel appreciated and valued. An ideal support system is proposed, the “sandwich support model,” to promote effective functioning and desirable patient outcomes via support “from above” and “from below.” Implications for Nursing Management: The need to support nurse managers effectively is crucial to how they function. The sandwich support model can improve management practices, more effectively assisting nurse managers. Organisations should revisit and strengthen support processes for nurse managers to maximize efficiencies. Conclusion: This paper contributes to understanding the importance of supporting nurse managers, identifying the processes used and the type of support offered. It highlights challenges and issues affecting support practices within the health sector. [ABSTRACT FROM AUTHOR]

Prenatal depression affects approximately 10% to 15% of women. Guidelines recommend supporting women to make informed treatment decisions; however, minimal evidence exists regarding this decision-making process. This study aimed to develop a constructivist grounded theory of prenatal antidepressant treatment decision-making. Semi-structured interviews were conducted with purposively sampled women from the community or specialty clinics (N = 31). Iterative data collection and analysis, theoretical sampling, and member checking supported model sufficiency. In the Creating Comfort in Choice theory that we developed, participants were highly conscious of societal stigma toward mental illness and prenatal medication use, so fear, anxiety, and guilt dominated decision-making. Participants navigated dynamically among three clusters of decision-making activities: seeking information, making sense of information, and self-soothing. "Seeking information" included internal and external processes. In "making sense of information," participants appraised available evidence. In "self-soothing," participants engaged in coping strategies to try to alleviate painful emotions. The Creating Comfort in Choice theory can support patient-oriented decision-making regarding prenatal mental healthcare. [ABSTRACT FROM AUTHOR]

This study adds to a small body of Canadian literature investigating the ways that newcomer women experience, and are impacted by, intimate partner violence (IPV). The study involved qualitative interviews with 15 newcomer women who migrated to Saskatchewan, Canada, from 12 different countries. These findings provide insight into participants' complex lived experiences and illustrate how women's status as newcomers intersected with their experiences of IPV. As well as abuse related to language ability and immigration status, participants in our study described their experiences of physical; sexual; emotional; psychological; economic; and legal abuse; as well as coercive control; isolation; surveillance, stalking, and harassment while in the relationship and after separation; challenges with shared parenting; and the imposition of patriarchal values. Perpetrators of IPV maintained control by intentionally isolating survivors, and participants were also isolated due to their status as a newcomer and their limited English-language ability and social connections. [ABSTRACT FROM AUTHOR]

Aims: To explore how emerging adult‐aged women self‐manage their sexual and reproductive health and to generate a grounded theory of these self‐management processes. Design: Grounded theory methods using a constructivist approach. Methods: Between September 2019 and September 2020, 18‑ to 25‐years‐old women (n = 13) were recruited from a 4‐year university, a 2‐year community college, and neighbourhoods surrounding the institutions of higher education. Individual interviews were transcribed verbatim and qualitatively analysed using a constant comparative method and inductive coding. Results: The theory purports that core processes of sexual and reproductive health self‐management used by the women in this study included both passive and (re)active processes. These processes expanded upon and/or maintained the women's accessible sexual and reproductive health knowledge, behaviour and beliefs, defined as the sexual and reproductive health repertoire. The processes appeared to be cyclical and were often initiated by a catalysing event or catalyst and resulted in conversations with confidantes, or trusted individuals. A catalyst was either resolved or normalized by expanding or maintaining the sexual and reproductive health repertoire. Conclusion: The resulting theory, EMeRGE Theory, offers insight into the complex and cyclical processes emerging adult‐aged women use to simultaneously develop and adapt their foundational sexual and reproductive health knowledge, behaviours and beliefs. Implications for the Profession and/or Patient Care: This explication of emerging adult‐aged women's sexual and reproductive health self‐management processes can be used by nurses and nurse researchers to better address this population's unique health needs. Impact: The EMeRGE Theory provides valuable guidance for future exploratory and intervention research aimed at improving the health and well‐being of emerging adult‐aged women. Reporting Method: The authors adhered to the Consolidated Criteria for Reporting Qualitative studies (COREQ) in preparation of this publication. Patient or Public Contribution: No patient or public contribution. [ABSTRACT FROM AUTHOR]

The purpose of this study was to investigate the effects of the concrete-representational-abstract–integrated (CRA-I) sequence on students with learning disabilities' performance when learning fraction and decimal concepts. Three elementary-level students in Grades 4 and 6 participated in a single-case multiple probe across behaviors study. The intervention involved explicit use of fraction blocks, coins, base ten blocks, number lines, pictures, and abstract symbols to teach unit fractions, fraction and decimal equivalence, addition of fractions with unlike denominators, and writing fractions as decimals. The researchers demonstrated a functional relation between CRA-I and three different behaviors related to fraction concepts: decreased error in estimating fraction magnitude, addition of unlike fractions, and writing fractions as decimals. The findings show promise in the use of CRA-I for teaching fraction concepts to students with learning disabilities. [ABSTRACT FROM AUTHOR]

A population consisting of women who have conceived before a time t ignores all women whose conception time exceeds t. Such a population is considered as a truncated population, and the samples are called truncated samples. Under the assumption that fecundability among women varies according to a Beta distribution (with parameters a and b), the distribution of conception times in a truncated population can be considered as truncated Type I geometric. This paper presents an algorithm to obtain the moment and maximum likelihood estimates of a and b from the truncated samples. Large sample properties of the estimators are also studied. Examples using the Hutterite and the Princeton Fertility Survey data are given. [ABSTRACT FROM AUTHOR]

Background: Increasing compliance with isolation precautions is important in reducing hospital-acquired infections and their consequences. It is not possible to achieve and maintain nurse compliance through supervision, control, pressure, or training. Therefore, nurses must personally demand compliance with isolation precautions. This study aimed to determine the relationship between compliance with isolation precautions and the moral sensitivity levels of nurses who have just started working. Methods: This study employed a descriptive and cross-sectional research design. The study population consisted of 456 new nurses recruited during the pandemic. All of the new nurses who volunteered to participate in the study and completed the questionnaires completely were included in the study and 398 nurses constituted the sample of the study. Data were collected from 398 out of 456 novice nurses who agreed to participate in the study. The population coverage rate was 87.28%. Participants were selected using convenience sampling method. The data collection tools included an Introductory Information Form, The Isolation Compliance Precautions Scale (TIPCS), and the Moral Sensitivity Questionnaire (MSQ). Descriptive statistics, correlation analyses, and regression models were used to analyze data. Findings: The mean score of the MSQ was high (mean ± SD = 90.49 ± 25.94; median (P25-P75) = 84 (range, 74–97), and the score for TIPCS was high (mean ± SD = 79.29 ± 7.68; median (P25-P75) = 82 (range, 76–85)). No correlation was found between MSQ and TIPCS (p > 0.05). According to the regression analysis, although the MSQ did not correlate with TIPCS, compliance with isolation measures was found to increase as the conflict subscale of moral sensitivity increased (β= -0.36, CI= -0.55 to -0.16; p < 0.001). Choosing the profession willingly had a positive correlation with compliance with isolation measures (β = 5.3, CI = 2.4 to 8.3; p < 0.001). In addition, starting the profession at an early age had a positive correlation with compliance with isolation measures (β= -0.49, CI= -0.8 to -0.17; p = 0.002). Conclusion: The conflict sub-dimension of moral sensitivity is an important factor in nurses' compliance with isolation measures, and conducting necessary training and other studies to improve nurses' moral sensitivity may increase their compliance with isolation measures. [ABSTRACT FROM AUTHOR]

Although the historical impact of racial segregation and ongoing health and economic inequities between older Black and White adults is well documented, little is known about the relationships among race, individual- and neighborhood-resources, and formal volunteering in later life. This study explores this intersection. Individual-level data from 268 respondents aged 55+ were collected in the St. Louis metropolitan area through paper-based mail surveys. Objective neighborhood data were obtained at the zip code level from secondary sources and matched with respondents. Using exploratory factor analysis, we constructed a 14-item environmental scale with 3 neighborhood dimensions (economic, social, and built environment). Older Black adults had lower levels of education; had fewer financial assets; lived in neighborhoods with less economic resources and lower built environment scores; and fewer formally volunteered when compared to older White adults. Individual resources (financial assets, health) and neighborhood resources (social and built environment) were positively associated with formal volunteering among older Black adults. Only individual resources (age, marital status, financial assets, health) were associated with formal volunteering among older White adults. A coherent set of policies that bolsters individual and environmental capacities may increase the rate of volunteerism among older black adults. [ABSTRACT FROM AUTHOR]

Previous studies show that certain minority and ethnic communities experience low human papillomavirus (HPV) vaccination rates despite a higher cervical cancer burden. HPV is known to be responsible for almost all cervical cancer cases. Hmong Americans, a growing Asian American population, appear to be at increased risk. The cervical cancer incidence rate among Hmong American women is three times higher than other Asian/Pacific Islanders and more than four times higher than Non-Hispanic Whites. Despite such alarming statistics, there is limited research focusing on HPV literacy and its associated factors in the Hmong American community. This study's objectives are to investigate: (1) the level of HPV knowledge among Hmong Americans; (2) HPV vaccination initiation and completion rates of Hmong Americans; and (3) factors associated with HPV literacy in the Hmong American community. Andersen's Behavioral Model of Health Services Use was used as the study's theoretical framework. A self-administered paper and online health survey was completed by192 Hmong Americans living in a major metropolitan area in Minnesota. Results revealed a mean score of 4.76 (SD 1.67) for the 7-item questionnaire measuring HPV knowledge. The HPV vaccination initiation rate was 46.3 % (n = 56), with 32.7 % completing the recommended three doses. Multiple regression analysis found that participants' level of education, number of doctor visits, and cervical cancer screening literacy were significantly associated with HPV knowledge. This study's results indicate the important role of health providers in educating Hmong Americans patients about HPV and cervical cancer prevention to decrease the cervical cancer burden in this high-risk population. [ABSTRACT FROM AUTHOR]

Aim This paper presents an evaluation of a career development policy in South Australia which increased the number of senior staff nurse positions and provided senior registered nurses with time away from clinical duties to undertake agreed projects. We use Kanter's model of structural power and commitment theory to understand the dimensions of this policy. Background Development strategies for experienced staff who wish to remain at the bedside are needed, especially in smaller health services with limited opportunities for horizontal or vertical mobility. Methods Face-to-face semistructured interviews were conducted with 54 senior staff nurses who participated in the career structure arrangements. Results The policy enhanced the structure of opportunity in three ways: by increasing the number of senior staff nurse positions, the ladder steps were improved; undertaking strategic projects developed new skills; and the job enrichment approach facilitated time out from the immediate pressures of ward work and challenged nurses in a different way. Conclusions Through job enrichment, South Australia has found a novel way of providing meaningful career development opportunities for experienced nurses. Implications for nursing management Methods of job enrichment need to be considered as part of career development policy, especially where movement between clinical facilities is limited and staff wish to remain at the bedside. [ABSTRACT FROM AUTHOR]

The COVID-19 pandemic, on a global scale, has prompted multifaceted challenges, including a notable psychological toll on the general population. This study uses mixed-method approach for a nuanced exploration of these experiences. Using a phenomenological strategy, qualitative responses from 999 participants were analyzed regarding their pandemic-induced anxiety and the influence of quarantine measures on their lives. Quantitative measures, including the revised Impact of Event Scale (IES-R), patient health questionnaire-9 (PHQ-9), the seven-item generalized anxiety disorder assessment (GAD-7), and Insomnia Severity Index (ISI), were used to quantify trauma, depression, anxiety, and insomnia attributed to COVID-19. Partial least squares structural equation modeling (PLS-SEM) was utilized for quantitative data analysis. The anxiety-related responses were mainly clustered into four themes: life threats, support shortage, economic consequences, and disruptions to family and social life. Subthemes that addressed the perceived effects encapsulated disruptions to academic and professional lives, familial and social relationships, psychopathological stress, and movement limitations. The findings from quantitative analysis revealed the significant associations between COVID-19-related trauma and symptoms of anxiety, depression, and insomnia, as indicated by coefficients exceeding 0.10 (all z-values > 1.96; p-values < 0.05). In conclusion, the findings underscore COVID-19's role in escalating anxiety, influenced by various factors, and its disruptive effects on daily life due to quarantine measures. The strong associations between the pandemic and the symptoms of depression, anxiety, and insomnia underscore the urgency of comprehensive psychological and public health interventions to alleviate these impacts. [ABSTRACT FROM AUTHOR]

The purpose of this paper is to present the content validation, including a pilot test, of the Home Assessment of the Person-Environment Interaction (HoPE). The HoPE fills a gap for evaluating issues related to home adaptation. Using qualitative methods, a two-phase study was conducted: an expert consultation and a pilot test. The expert consultation was conducted via focus groups with occupational therapists ( n = 20), and individual interviews with adults who had undergone home adaptation ( n = 5). The pilot test was undertaken using a multiple case study design of four adults awaiting home adaptation. Data were audio-recorded, transcribed, and analyzed using NUD.IST software. In phase 1, experts agreed with the content of HoPE and suggested minor changes. In phase 2, HoPE enabled occupational therapists to identify handicap-creating situations. After both phases, the final version of HoPE is more comprehensive than other current tools and addresses the complex experiences of clients with whom occupational therapists work which suggests a new approach for practice regarding home adaptation. [ABSTRACT FROM AUTHOR]

The present paper extends the needs-based model of reconciliation to contexts marked by status inequalities rather than by overt intergroup aggression. Specifically, we investigated whether and when members of high-status versus low-status groups experience divergent socio-emotional needs vis-à-vis members of the respective other status group. Building on research informed by social identity theory, we hypothesized that the groups' different positions in the social hierarchy only translate into divergent needs when the status differences are perceived as illegitimate. In Study 1 (N = 130), we tested this prediction by manipulating status and perceived legitimacy of status differences in a setting with artificially created groups. Results confirmed that the need to be socially accepted by members of the other status group was stronger in high-status compared with low-status group members but, as expected, only when the status differences were perceived to be illegitimate. Also as predicted, the need to be empowered by the other status group was stronger in low-status compared with high-status group members, again only under conditions of illegitimate status differences. Study 2 (N = 169) further corroborated our perspective by replicating these findings in a naturalistic intergroup context. Implications for the role of legitimacy perceptions in determining differential socio-emotional needs and for the promotion of sustainable social change are discussed. Copyright © 2013 John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]

Many facilities for people with dementia have been built with little translation of the substantial body of evidence available to inform design. Knowledge translation has been described as a four-stage process: awareness, agreement, adoption and adherence. This paper identifies where knowledge translation fails in the design of aged care facilities for people with dementia. Ten aged care facilities were audited using the Environmental Audit Tool. Senior managers and architects involved in the facility design were then interviewed to ascertain their knowledge of evidence-based principles of dementia design, their agreement with the principles and the nature of the obstacles they had encountered in their implementation. All architects claimed at least partial awareness of the design principles. Five facility managers claimed full awareness. Those facilities designed with the input of managers who were fully aware of the principles were of significantly higher design quality. There was little agreement on the significance of other obstacles. Once aged care providers are aware of the principles, they appear to find ways to implement them. If the next generation of residential aged care facilities is to be suitable for people with dementia, the facility managers must be made aware of the available design principles, architects encouraged to be more active in sharing their knowledge and ways found to improve the exchange of knowledge between the parties. [ABSTRACT FROM AUTHOR]

The reporting of suspected child abuse and neglect is a mandated role of medical doctors, nurses, police and teachers in Victoria, Australia. This paper reports on a research study that sought to explicate how mandated professionals working in rural Victorian contexts identify a child/ren at risk and the decisions they make subsequently. [ABSTRACT FROM AUTHOR]

o'leary d.f. & ni mhaolrúnaigh s. (2012) Information-seeking behaviour of nurses: where is information sought and what processes are followed? Journal of Advanced Nursing 68(2), 379-390. Abstract Aim. This paper is a report of a study on how nurses inform their decision-making in the workplace. Background. Despite the growing availability of research evidence, nurses have been slow to adopt it into their daily decision-making. Method. The study was undertaken in Ireland between 2006 and 2007 using a sequential mixed methods approach. In phase 1, the views of a quota sample of 29 nurses were explored using semi-structured interviews incorporating vignettes. Phase 2 involved the design and dissemination of a survey to a disproportionate stratified random sample of 1356 nurses. The response rate was 29%. Findings. In decision-making, nurses accessed other people, especially nursing colleagues, the most frequently. Sources that provided prepackaged information such as guidelines were favoured over sources that provided access to original research. The process of information-seeking for routine and non-routine decisions was different. Nurses making routine decisions relied mostly on their experience and an assessment of the patient. In non-routine decision-making, participants experienced more uncertainty about their decisions. Accordingly, sources of information used were more varied and the information-seeking process more extensive. The study highlighted the complexities of establishing whether information used in decision-making is research based or not. Conclusion. Routine practices should be reviewed and updated regularly through organizational mandates, as nurses do not generally question them. Research information to inform non-routine decision-making must be easily available to nurses in their workplace, as information searches generally prioritize finding enough, rather than the best, information to make a decision. [ABSTRACT FROM AUTHOR]

Aim. This paper is a report of the development and testing of the Self-Efficacy for Preventing Falls Nurse and Assistant scales. Background. Patient falls and fall-related injuries are traumatic ordeals for patients, family members and providers, and carry a toll for hospitals. Self-efficacy is an important factor in determining actions persons take and levels of performance they achieve. Performance of individual caregivers is linked to the overall performance of hospitals. Scales to assess nurses and certified nursing assistants. self-efficacy to prevent patients from falling would allow for targeting resources to increase SE, resulting in improved individual performance and ultimately decreased numbers of patient falls. Method. Four phases of instrument development were carried out to (1) generate individual items from eight focus groups (four each nurse and assistant conducted in October 2007), (2) develop prototype scales, (3) determine content validity during a second series of four nurse and assistant focus groups (January 2008) and (4) conduct item analysis, paired t-tests, Student's t-tests and internal consistency reliability to refine and confirm the scales. Data were collected during February--December, 2008. Results. The 11-item Self-Efficacy for Preventing Falls Nurse had an alpha of 0.89 with all items in the range criterion of 0.3-0.7 for item total correlation. The 8-item Self-Efficacy for Preventing Falls Assistant had an alpha of 0.74 and all items had item total correlations in the 0.3-0.7 range. Conclusions. The Self-Efficacy for Preventing Falls Nurse and Self-Efficacy for Preventing Falls Assistant scales demonstrated psychometric adequacy and are recommended to measure bedside staff's self-efficacy beliefs in preventing patient falls. [ABSTRACT FROM AUTHOR]

Aim. This paper is a report of a study conducted to test a model linking new graduate nurses' perceptions of structural empowerment to their experiences of workplace bullying and burnout in Canadian hospital work settings using Kanter's work empowerment theory. Background. There are numerous anecdotal reports of bullying of new graduates in healthcare settings, which is linked to serious health effects and negative organizational effects. Methods. We tested the model using data from the first wave of a 2009 longitudinal study of 415 newly graduated nurses (<3 years of experience) in acute care hospitals across Ontario, Canada. Variables were measured using the Conditions of Work Effectiveness Questionnaire, Negative Acts Questionnaire-Revised and Maslach Burnout Inventory-General Survey. Results. The final model fit statistics revealed a reasonably adequate fit (χ² = 14.9, d.f. = 37, IFI = 0.98, CFI = 0.98, RMSEA = 0.09). Structural empowerment was statistically significantly and negatively related to workplace bullying exposure (β = -0.37), which in turn, was statistically significantly related to all three components of burnout (Emotional exhaustion: β = 0.41, Cynicism: β = 0.28, Efficacy: β = -0.17). Emotional exhaustion had a direct effect on cynicism (β = 0.51), which in turn, had a direct effect on efficacy (β = -0.34). Conclusion. The results suggest that new graduate nurses' exposure to bullying may be less when their work environments provide access to empowering work structures, and that these conditions promote nurses' health and wellbeing. [ABSTRACT FROM AUTHOR]

Dublin Anti-Bullying Self-Efficacy Scales aim to measure the effectiveness of school anti-bullying programs in promoting five steps that victims and bystanders take against online and offline bullying behaviors. These steps are anti-bullying self-efficacy beliefs to recognize bullying behaviors, comprehend emergency, take responsibility, know what to do, and intervene. However, when an anti-bullying program is very effective for the majority of participants who give high scores, a considerable number of participants who give low scores are very likely to be detected as outliers. This raises two measurement issues. First, high scores create highly negatively skewed data and lead to measuring a unidimensional rather than multidimensional construct. This could be one reason why recent research has been unclear about the extent to which the scales measure a unidimensional, multidimensional, or bifactor construct. Second, should outliers be removed or be considered as participants for whom the program was ineffective? If the scales had measurement invariance across the group of outliers and non-outliers or low and high self-efficacy, it could be concluded that the anti-bullying program was ineffective for some participants. The current research aims to address these issues by testing both measurement invariance as well as unidimensional and bifactor models of anti-bullying self-efficacy. Results of Pure Exploratory Bifactor (PEBI) Analyses and Item Response Theory (IRT) with Two-Parameter-Logistic (2PL) Models of data from a convenience sample of 14-year-old students in Ireland (N = 1,222) indicated sufficient psychometric properties of both unidimensional and multidimensional scales for victim offline, victim online, bystander offline, and bystander online. Further research can use these scales for measuring the bifactor model of anti-bullying self-efficacy as well as the cut-off score for distinguishing between low and high anti-bullying self-efficacy. [ABSTRACT FROM AUTHOR]

Introduction: Illness perception and self-efficacy in patients with coronary artery disease (CAD) may affect medication adherence, which is one of the most important challenges in disease management in this group of patients. Objective: The present study aimed to investigate the factors influencing medication adherence in CAD patients, especially the effect of illness perception and self-efficacy. Methods: This study was cross-sectional and conducted from April to September 2021. A total of 259 patients with confirmed CAD were selected by convenience sampling method based on inclusion criteria. Illness perception, self-efficacy, and medication adherence were investigated using Brief IPQ, SCSES, and MARS_10 questionnaires, respectively. The data were analyzed using the STATA software (version 14) and the regression path analysis method. Results: Patients had moderate illness perception and high self-efficacy, and 61.8 of them adhered to their medication regimen. Greater illness perception, better self-efficacy, and higher education had a positive effect on medication adherence, and increasing age had a negative effect on it. The final path model shows a good fit of the data in the model (χ2: 0.37, df: 274, χ2/df: 0.36, CFI: 1, IFI: 0.95, TLI: 1.07, and RMSEA: 0.00). Conclusion: The results of the present study suggest that patients' illness perception can play an important role in predicting self-efficacy in disease management and the level of medication adherence in patients with CAD. To improve self-efficacy and medication adherence, future intervention studies should focus on the patient's illness perceptions and their improvement. [ABSTRACT FROM AUTHOR]

This interpretive research study explores U.S. adults' lived experiences during the beginning months of the COVID-19 global pandemic. Participants (N= 44), recruited from a convenience sample of U.S. adults, engaged in in-depth semi-structured interviews or focus groups. Through an iterative analysis of participants' experiences and the theoretical model of communal coping (TMCC), the authors identified three convergent stressors (i.e., isolation, uncertainty, conflict) and several coping strategies related to participants' stressor appraisal (i.e., individual or joint) and action orientation (i.e., individual or joint). Based on these findings, this study offers the novel theoretical concept of Discursive coping and proposes a model for how this perspective might be integrated with current theorizing about individual and communal coping. Implications for communal coping and discursive theory are discussed as well as practical recommendations for public health messaging. [ABSTRACT FROM AUTHOR]

This paper compares several methods of generating confidence intervals for forecasts of population size. Two rest on a demographic model for age-structured populations with stochastic fluctuations in vital rates. Two rest on empirical analyses of past forecasts of population sizes of Sweden at five-year intervals from 1780 to 1980 inclusive. Confidence intervals produced by the different methods vary substantially. The relative sizes differ in the various historical periods. The narrowest intervals offer a lower bound on uncertainty about the future. Procedures for estimating a range of confidence intervals are tentatively recommended. A major lesson is that finitely many observations of the past and incomplete theoretical understanding of the present and future can justify at best a range of confidence intervals for population projections. Uncertainty attaches not only to the point forecasts of future population, but also to the estimates of those forecasts' uncertainty. [ABSTRACT FROM AUTHOR]

Objective: Indigenous Australians are nearly three times more likely to have diabetes than non‐Indigenous Australians. The prevalence of diabetes‐related vision impairment for Indigenous Australians is 5.5% compared to 1.5% for non‐Indigenous Australians, and treatment rates are lower for Indigenous Australians. Despite this situation, there is limited evidence on effective service delivery models for diabetic retinopathy care and treatment. This study seeks to identify best‐practice features of diabetic retinopathy care that could be used to inform current and future service delivery models for Indigenous Australians with diabetic retinopathy. Setting: All states, territories and geographic remoteness categories in Australia. Participants: Eight ophthalmologists engaged in providing eye healthcare to Indigenous Australians. Design: Semi‐structured interviews were conducted. The Framework Approach was used to conduct a thematic analysis of the interviews to facilitate identification of key themes and issues that emerged from these discussions. Results: Seven best‐practice features for service delivery of diabetic retinopathy treatment for Indigenous Australians were identified. These were: cultural safety, affordability and accessibility, partnerships with key stakeholders, timeliness, integration with primary care, clarity of guidelines, and clinician attitude and motivation. Conclusion: The findings from this study identified seven best‐practice features for diabetic retinopathy treatment. These have the potential to inform and influence how care is delivered to Indigenous Australians. Although further research is warranted to capture other service provider inputs and Indigenous end‐user perspectives, these features in the meantime can begin to inform the decisions of the Indigenous eyecare sector on policy reforms and best‐practice diabetic retinopathy treatment approaches. [ABSTRACT FROM AUTHOR]

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Treatment burden contributes to suboptimal adherence and lower health-related quality of life among people diagnosed with chronic conditions, but little is known about how the psychological process of emotional dysregulation influences treatment burden. To explore this relationship, we conducted a descriptive, cross-sectional study comprised of 149 men and women diagnosed with one or more Centers for Medicare and Medicaid Systems defined chronic conditions recruited from a single primary care setting. Multivariate analyses demonstrated emotional dysregulation as an independent factor contributing to total (p <.001), medication (p =.007), and dietary (p <.001) treatment burden, with model effect sizes ranging from large (.43) to moderate (.21), controlling for other known antecedent factors of treatment burden. Emotional dysregulation was not a factor contributing to exercise related treatment burden. Our findings indicated emotional dysregulation as an important factor contributing to higher levels of total, medication, and dietary treatment burden associated with daily self-management regimens. [ABSTRACT FROM AUTHOR]

In times of shrinking resources and fragmented societies, partnership is a value-driven social structure that should be theorized in order to be considered for implementation, effectively and sustainably. Recognizing the scarce theoretical perspectives on partnership, this article addresses the lack of an integrated universal model. It delineates the theoretical field through extensive literature review, reaffirming the critical gap in knowledge. Original qualitative research utilized an international case-study of a social partnership, and a historic investigation since its inception three decades ago. A Grounded Theory Methodology guided the systemic analysis of the empirical data, culminating in a proposed universal partnership model. The study finds mutuality to be the heart of a partnership and a differentiating criterion from other social structures. Three pillars that are grounded in mutuality sustain a partnership, and include a common ground, connection, and commitment. Further research is needed to test the proposed model on other diverse partnerships. [ABSTRACT FROM AUTHOR]