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Objective: To establish the association of the mother's breastfeeding self-efficacy with infant feeding in the first six months of the child's life and identify the mothers' perception of their confidence to breastfeed. Background: Breastfeeding is a multi-determined process. Many factors contribute to a mother's ability to exclusively breastfeed until a child reaches six months of age. Among these factors is a mother's confidence in her abilities to breastfeed her baby, referred to as breastfeeding self-efficacy. Thus, self-efficacy for breastfeeding could be an essential predictor of reducing the risk of early weaning. Study design and methods: This is a mixed-method sequential explanatory study. The short form of the Breastfeeding Self-Efficacy Scale was used to determine the level of the mothers' confidence. 158 mothers were surveyed during their postpartum hospital stay, and 128 were included in a follow-up six months after delivery. Additionally, 22 participants were randomly selected for an in-depth interview (qualitative stage). Data were analysed using inferential statistics and thematic content analysis. Results: High levels of breastfeeding efficacy were identified during the hospitalisation and after discharge among all participants. Exclusive breastfeeding was practised among 45.31% of mothers six months after delivery. Return to work was a key factor contributing to early weaning. Family and health professional support during the breastfeeding process were associated as crucial for the duration of exclusive breastfeeding. Discussion: Exclusive breastfeeding for the first six months after delivery involves various factors, such as the mother's confidence in her breastfeeding skills and the specific circumstances she faces while breastfeeding. Thus, through the mixed qualitative and quantitative approaches, it was possible to identify the convergence of self-efficacy scores and the breastfeeding mothers' perception of their confidence and intention to maintain exclusive breastfeeding. Conclusion: High self-efficacy to breastfeed alone was not enough to maintain exclusive breastfeeding. It is necessary to combine self-efficacy and family or health service support and guidance to clarify the mother's doubts about potential difficulties that may appear throughout the breastfeeding process, the maintenance of lactation when she plans to return to work, and the breastfeeding technique. Implication for practice: Applying the Breastfeeding Self-Efficacy Scale associated with the breastfeeding mothers' interview during the prenatal and perinatal period facilitates early identification of mothers at risk for early weaning and helps nurses in planning interventions to support the breastfeeding mother and her child in favour of exclusive breastfeeding duration. What is already known about the topic? * Exclusive breastfeeding (EBF) is recommended for the first six months of a child's life; however, many mothers do not follow this recommendation due to multiple barriers such as mental health issues (i.e., postpartum depression or anxiety), educational gaps, physical discomfort like sore nipples, engorgement, return to work, and lack of support. * Breastfeeding self-efficacy has been associated with the duration of breastfeeding. What this paper adds * Breastfeeding mothers' self-efficacy is essential for stimulating maintenance. * Questions 3 (I always feed my baby without using powdered milk as a supplement) and 11 (I always breastfeed my baby on one breast and then switch to the other) of the Breastfeeding Self-Efficacy Scale (short form) predicted early weaning risk. * Planning nursing care intervention for breastfeeding mothers in their follow-up after birth should include assessing their breastfeeding self-efficacy and factors that could contribute to early weaning, such as returning to work and the lack of a support network. [ABSTRACT FROM AUTHOR]

Introduction/Objective: The objective of the study was to develop an understanding of the perceptions of people with Parkinson's disease and clinical academics on the implementation of a regional interdisciplinary model of care. Methods: A qualitative descriptive study was undertaken. A PD interdisciplinary clinic was conducted in an Australian regional location. As a novel variation, in this clinic, 4 clinical academics consulted simultaneously offering a long, 3-h appointment. Following the clinic, we conducted 2 focus groups with all clinical academics and 6 semi-structured interviews with people with PD and carers. Data were analyzed using Elo & Kyngäs' inductive content analysis approach. Results: An overarching main category namely, "interdisciplinary care proved valuable to regional people with PD and clinical academics," and 3 generic-categories including "identifying interdisciplinary care as a viable option in regional locations," "current care provision is disempowering and burdensome," and "regional residing people with PD and their carers seek locally accessible healthcare with PD skilled clinicians" were identified. Conclusion: Our findings suggest the implementation of interdisciplinary care to regional healthcare systems is valued by clinical academics and people with PD and carers. Further research is required to establish how interdisciplinary care can be implemented in regional Australia and its effects on practice changes, patient outcomes, and quality of life. [ABSTRACT FROM AUTHOR]

Aim: Individual experiences shape perceptions of illness. Post-Soviet migrants have different expectations of chronic disease treatment than German patients. This study aimed to delve into perceptions of diabetes mellitus, a topic of increasing importance in global migration. Design: Qualitative, semi-structured interviews were conducted with 26 post-Soviet migrants with diabetes and three Russian-speaking diabetes counselors, mainly recruited through a snowball system. Methods: The research data were analyzed using a hermeneutic approach. The categories of the common-sense self-regulation model and developed subcategories were scrutinized by means of content analysis, ensuring a comprehensive understanding of the data. Results: The perception of diabetes mellitus varied depending on the country where the diagnosis was made. This included the individual recording of symptoms, the expected time course, and the allocation of different competencies. Opportunities for access to the local healthcare system in the former Soviet Union influenced these expectations. Conclusion: The study’s findings underscore the importance of healthcare access in the country of origin and the patient’s knowledge of diabetes mellitus in shaping their perception and treatment. These factors, influenced by the social environment and the patient’s level of education, continue to play a role even after immigration to Germany. [ABSTRACT FROM AUTHOR]

Migraines are one of the most common and expensive neurological diseases worldwide. Non-pharmacological and digitally delivered treatment options have long been used in the treatment of migraines. For instance, migraine management tools, online migraine diagnosis or digitally networked patients have been used. Recently, applications of ChatGPT are used in fields of healthcare ranging from identifying potential research topics to assisting professionals in clinical diagnosis and helping patients in managing their health. Despite advances in migraine management, only a minority of patients are adequately informed and treated. It is important to provide these patients with information to help them manage the symptoms and their daily activities. The primary aim of this case study was to examine the appropriateness of ChatGPT to handle symptom descriptions responsibly, suggest supplementary assistance from credible sources, provide valuable perspectives on treatment options, and exhibit potential influences on daily life for patients with migraines. Using a deductive, qualitative study, ten interactions with ChatGPT on different migraine types were analyzed through semi-structured interviews. ChatGPT provided relevant information aligned with common scientific patient resources. Responses were generally intelligible and situationally appropriate, providing personalized insights despite occasional discrepancies in interaction. ChatGPT's empathetic tone and linguistic clarity encouraged user engagement. However, source citations were found to be inconsistent and, in some cases, not comprehensible, which affected the overall comprehensibility of the information. ChatGPT might be promising for patients seeking information on migraine conditions. Its user-specific responses demonstrate potential benefits over static web-based sources. However, reproducibility and accuracy issues highlight the need for digital health literacy. The findings underscore the necessity for continuously evaluating AI systems and their broader societal implications in health communication. [ABSTRACT FROM AUTHOR]

Background: This study aims to describe the Libyan oral health care system in terms of its structure, function, workforce, funding, reimbursement and target groups. Methods: A single descriptive case study approach and multiple sources of data collection were used to provide an in-depth understanding of the Libyan oral health care system. A purposeful sample of the key informants (Managers of oral health centers, dentists of various specialties with experience in the field, dentists, nurses, dental technicians, and officials in the affairs of medical insurance) was recruited. The case and its boundaries were guided by the study's aim. Both qualitative and quantitative analyses were conducted. Descriptive statistics were used for quantitative data. Framework analysis, informed by the study objectives, was used to analyze interviews and documents. Results: The analysis showed that oral health services are integrated into medical services. The provision of dental care is mainly treatment-based, in the private sector. The oral health services in the public sector are mainly emergency care and exodontia. The dental workforce included in the study were mostly dentists (89% General Dental Practitioners (GDPs), 11% specialists), with a marked deficiency in dental technicians and nurses. Around 40% of dentists work in both the private and public sectors. The government provides the funding for the public sector, but the private sector is self-funded. No specific target group(s) nor clear policies were reported. However, the system is built around primary health care as an overarching policy. Dental caries is the most common oral problem among Libyan preschool children affecting around 70% and is the most common cause of tooth loss among adults. Conclusion: The oral health care system in Libya is mainly privatized. The public health services are poorly organized and malfunctioning. There is an urgent need to develop policies and plans to improve the oral health care system in Libya. [ABSTRACT FROM AUTHOR]

Background: In Germany, general practitioners play a pivotal role in palliative care provision. Caring for patients with palliative care needs can be a burden for general practitioners, highlighting the importance of self-care and mental health support. This study aimed to explore the role of palliative care in general practitioners' daily work, the stressors they experience, their coping mechanisms, and the potential benefits of Advance Care Planning in this context. Methods: An exploratory approach was employed, combining a short quantitative survey with qualitative interviews. The analysis was based on a structuring qualitative content analysis, following a deductive-inductive procedure and integrating the Stress-Strain Model and Lazarus' Transactional Model of Stress and Coping. We recruited eleven general practitioners to take part in the study. Results: General practitioners viewed palliative care as integral to their practice but faced challenges such as time constraints and perceived expertise gaps. Societal taboos often hindered conversations on the topic of death. Most general practitioners waited for their patients to initiate the topic. Some general practitioners viewed aspects of palliative care as potentially distressing. They used problem-focused (avoiding negative stressors, structuring their daily schedules) and emotion-focused (discussions with colleagues) coping strategies. Still, general practitioners indicated a desire for specific psychological support options. Advance Care Planning, though relatively unfamiliar, was acknowledged as valuable for end-of-life conversations. Conclusions: Palliative care can be associated with negative psychological stress for general practitioners, often coming from external factors. Despite individual coping strategies in place, it is advisable to explore concepts for professional psychological relief. Trial registration: Not registered. [ABSTRACT FROM AUTHOR]

(1) Background: The nursing profession has undergone a significant transformation not only in a formal context but also in terms of the increased educational competencies required of nurses and their preparedness to adapt to evolving roles and statuses. The aim of our study was to examine the experience of advanced practice nurses who conduct independent consultations on patients and to identify the main challenges they face in their practice. (2) Methods: We carried out 22 semi-structured interviews with nurses responsible for conducting independent consultations across three urban polyclinics located in Aktobe, Almaty, and Astana. All interviews were audio-recorded, transcribed verbatim, and subjected to qualitative content analysis. (3) Results: The content analysis revealed three main themes: "People awareness of the role of an independent nursing appointment", "Adaptation of the work environment", and "Confidence of nurses to provide independent services". (4) Conclusions: Limited competency among nurses and the absence of quality metrics for autonomous nursing consultations present substantial obstacles to assessing and enhancing the quality of care delivered by nurses in their independent roles. Developing and implementing quality indicators for independent nursing appointment, as well as additional training within the framework of interprofessional continuous education for nurses, are important steps toward enhancing the effectiveness, safety, and accessibility of nursing care. [ABSTRACT FROM AUTHOR]

Aim. This study aimed to (1) describe the perceived level of role transition from education to practice of new graduate nurses in Oman and (2) explore the barriers to and enablers of a successful transition. Background. The transition from a familiar academic environment to becoming a professional nurse is stressful and challenging. Exploring the transition barriers and enablers is instrumental in designing an effective experience. However, studies exploring the transition experience from academia to practice among new graduate nurses working in Oman are limited. Design. This study used a mixed method research design. Methods. Data were collected from nurses working for no longer than two years. Role transition was assessed using the Casey‐Fink Graduate Nurse Experience Survey. Barriers to and enablers of transition were explored through a focus group interview. Results. The total sample consists of 405 nurses working in 13 public hospitals. The majority (68.89%) of the participants had worked as a nurse for less than 6 months. The average score of the comfort and confidence subscale was 2.96 (SD = 0.38). Findings showed that the amount of workload and unclear role expectations were the most frequent difficulties new graduate nurses were experiencing in their transition from a student to a staff nurse. Findings from focus group interviews revealed a number of barriers and enablers that affected the transition experience of the new graduates. The barriers were fear, insufficient academic preparation, bridging the knowledge‐practice gap, and limited nurse‐physician interactions. The enablers were teamwork, organizational support, and the internship phase. Conclusion. The findings illustrate the need for healthcare organizations to design effective internship programs to ensure a successful transition experience. Providing staff with preceptorship training and enhancing nurse‐physician communication are important strategies for creating a comfortable work environment and ultimately ensuring a successful training experience for new nurses. [ABSTRACT FROM AUTHOR]

It is recommended that health promotion activities in the community focus on residents' strengths. Hence, this study explored the community strengths perceived by older adults living alone in a semi-mountainous rural region of Japan. A qualitative, descriptive approach was used. Content analysis was performed using data obtained through face-to-face interviews. Interview data were coded; codes were classified based on similarity to create subcategories and categories. The strengths within the community, as perceived by older adults living alone in a semi-mountainous rural region, were revealed in four categories related to ten subcategories: "loose connections with others", "active community participation", "close relationships with community professionals", and "familiarity with the living environment". Strengths within the community perceived by older adults living alone in a semi-mountainous rural region were cultivated in an environment formed by their past lives. Utilizing these resources may help support community-based societies in semi-mountainous rural regions where depopulation and aging are expected to continue in the future. This study was not registered. [ABSTRACT FROM AUTHOR]

This empirical research on children's poverty and the accompanying risk behavior was conducted in the Baktalórántháza micro-region, in one of the most disadvantaged micro-regions of Hungary. The study, completed in 2023, was conducted utilizing three methods, a questionnaire for families, interviews, and focus group interviews with social professionals working in the settlements. The region is one of the ten micro-regions with the highest poverty rate in the country. The majority of the population only has an elementary education, and the proportion of graduates is much lower than the national average. The proportion of households with three or more children is higher than the national average and the proportion of unemployed people in households with children is twice as high as the national average. Based on the experience of social workers working in the area, in addition to smoking and drinking alcohol, the consumption of psychoactive and psychotropic substances has increased among adolescents and young adults. Based on various indicators, children regularly consume illegal drugs. The origin and composition of these drugs are typically unknown. According to the reports by drug users, everyday life is easier, and they can escape from problems when under the influence of drugs. Based on the observations of experts, the consumption of various psychoactive substances has harmful effects on behavior, health, learning, and family life. School performance and the ability to think and learn decrease. Drug users are dissatisfied with their lives, have problems with social relationships, engage in partner violence, and may develop antisocial behavior in their lives. [ABSTRACT FROM AUTHOR]

To investigate the experiences of healthcare staff in nursing homes during the COVID-19 pandemic. Individual interviews. Latent qualitative content analysis. Ten nursing homes in Sweden. Physicians, nurses and nurse assistants working in Swedish nursing homes. Participants' experiences of working in nursing homes during the COVID-19 pandemic. Four manifest categories were found, namely: Balancing restrictions and allocation of scarce resources with care needs; Prioritizing and acting against moral values in advance care planning; Distrust in cooperation and Leadership and staff turnover – a factor for moral distress. The latent theme Experiences of handling ethical challenges caused by the COVID-19 pandemic gave a deeper meaning to the categories. During the pandemic, nursing home staff encountered ethical challenges that caused moral distress. Moral distress stemmed from not being given adequate conditions to perform their work properly, and thus not being able to give the residents adequate care. Another aspect of moral distress originated from feeling forced to act against their moral values when a course of action was considered to cause discomfort or harm to a resident. Alerting employers and policymakers to the harm and inequality experienced by staff and the difficulty in delivering appropriate care is essential. Making proposals for improvements and developing guidelines together with staff to recognize their role and to develop better guidance for good care is vital in order to support and sustain the nursing home workforce. The COVID-19 pandemic has affected both patients and staff in nursing homes, in Sweden and worldwide. Our study highlights that during the COVID-19 pandemic, nursing home staff encountered several ethical challenges which caused moral distress. Moral distress stemmed from not being given adequate conditions to perform their work, thus not giving the residents appropriate care. Moral distress could also originate from nursing home staff's feeling of being forced to act against their moral values. [ABSTRACT FROM AUTHOR]

Background: A sustainable point-of-care (POC) diagnostic testing implementation in low-resourced facilities enhances quick diagnostic investigation and halts unnecessary referrals. This study identified the barriers impeding the implementation of POC diagnostic testing in health facilities without laboratories in the Bono Region of Ghana; as well as explored potential solutions that could enhance the accessibility and effectiveness of POC diagnostic testing, ultimately improving the quality of healthcare delivery. Methods: A total of twenty-eight participants were purposively selected from health facilities in low-resourced settings in the Bono Region for a descriptive qualitative study. Of the twenty-eight participants, seventeen including ten healthcare providers from CHPS facilities, six district health depot managers, and one regional depot manager were engaged in in-depth interviews. Additional eleven including nine healthcare providers and two district depot managers were also engaged in focus group discussions. NVivo version 12 software was employed for condensation, labelling, and grouping of themes. Data was analysed narratively. Results: Work overloads, limited POC testing services, stock-outs of POC tests at the facilities, and supply-related challenges of POC test kits were identified as major barriers to POC testing services. To solve these barriers, adequate funding, an effective delivery system, stakeholders' engagement and advocacy, and in-service and refresher training courses were suggested as potential solutions to POC diagnostic testing services implementation by the stakeholders. Conclusions: This study's findings emphasize the need to address the barriers hindering the implementation of POC diagnostic testing in health facilities without laboratories in the Bono Region of Ghana. The suggested solutions provide a roadmap for improving the accessibility and effectiveness of POC testing, which has the potential to enhance the quality of healthcare delivery, reduce unnecessary referrals, and ultimately improve patient health outcomes in underserved settings. [ABSTRACT FROM AUTHOR]

(1) Background: Patient safety culture (PSC) encompasses the values, attitudes, norms, beliefs, practices, perceptions, competencies, policies, and behaviours of professionals that determine organisational commitment to quality and patient safety. Few studies use mixed methods to analyse patient safety culture, and none offer the richness of using a mixed methodology to develop their theoretical model. This study aims to identify the factors nurses believe contextualise and influence PSC in relation to existing theoretical frameworks. (2) Methods: This study employed a sequential explanatory mixed-methods design combined with the Pillar Integration Process for data integration. (3) Results: In the final data integration process, 26 factors affecting nurses' PSC were identified. Factors nurses related to PSC not being assessed with the tool used in phase 1 were notification system, flow of patients, patient involvement, resources and infrastructure, and service characteristics. (4) Conclusions: This mixed-methods study provides an opportunity to identify the weaknesses and strengths of currently developed theoretical frameworks related to PSC and offers content for its improvement. Even though multiple studies aim to assess PSC using existing quantitative method tools, the development of this study offers a glimpse of some aspects relevant to nurses' PSC not included in the theoretical framework of the said tools, such as patient involvement, the flow of patients, and service infrastructure. [ABSTRACT FROM AUTHOR]

Background: Despite worldwide concern about the poor physical health of patients with schizophrenia spectrum disorders (SSD), physical health screening rates are low. This study reports nurses' and patients' experiences of physical health screening among people with SSD using the Finnish Health Improvement Profile (HIP-F) and their ideas for implementation improvements. Methods: A qualitative exploratory study design with five group interviews with nurses (n = 15) and individual interviews with patients with SSD (n = 8) who had experience using the HIP-F in psychiatric outpatient clinics. Inductive content analysis was conducted. Results: Two main categories were identified. First, the characteristics of the HIP-F were divided into the subcategories of comprehensive nature, facilitating engagement, interpretation and rating of some items and duration of screening. Second, suggestions for the implementation of physical health screening consisted of two subcategories: improvements in screening and ideas for practice. Physical health screening was felt to increase the discussion and awareness of physical health and supported health promotion. The HIP-F was found to be a structured, comprehensive screening tool that included several items that were not otherwise assessed in clinical practice. The HIP-F was also considered to facilitate engagement by promoting collaboration in an interactive way. Despite this, most of the nurses found the HIP-F to be arduous and too time consuming, while patients found the HIP-F easy to use. Nurses found some items unclear and infeasible, while patients found all items feasible. Based on the nurses' experiences, screening should be clear and easy to interpret, and condensation and revision of the HIP-F tool were suggested. The patients did not think that any improvements to the HIP-F were needed for implementation in clinical settings. Conclusions: Patients with schizophrenia spectrum disorders are willing to participate in physical health screening. Physical health screening should be clear, easy to use and relatively quick. With this detailed knowledge of perceptions of screening, further research is needed to understand what factors affect the fidelity of implementing physical health screening in clinical mental health practice and to gain an overall understanding on how to improve such implementation. [ABSTRACT FROM AUTHOR]

Objective: No fatigue‐specific programs exist for people with systemic sclerosis (SSc) despite the burden of fatigue and negative impact on daily activities. This study used a convergent parallel mixed methods design to evaluate the impact of an adapted virtual intervention, Fatigue and Activity Management Education in Systemic Sclerosis (FAME‐iSS), in the United States. Methods: Eighteen people with SSc participated in three separate six‐week FAME‐iSS programs. Participants completed the modified Fatigue Impact Scale (m‐FIS), the Self‐Efficacy for Performing Energy Conservation Strategies Assessment (SEPESCA), the Patient‐Reported Outcomes Measurement Information System (PROMIS) Self‐Efficacy for Managing Symptoms, and the Hospital Anxiety and Depression Scale (HADS) before, immediately after, and three months post intervention. Data were analyzed using descriptive and nonparametric inferential statistics. Participants' perceptions of the program and their use of fatigue management strategies were qualitatively analyzed using content analysis. Results: Eighty‐nine percent of participants were women with a mean ± SD age of 52.0 ± 11.6 years and a mean ± SD disease duration of 13.7 ± 14.5 years, and more than 70% had a college degree. Significant improvements were observed for self‐efficacy on the PROMIS Self‐Efficacy for Managing Symptoms (P = 0.002) and SEPESCA (P = 0.016) immediately post intervention, which continued to significantly improve up to the three‐month follow‐up (P = 0.006 and 0.035, respectively). Significant improvements were also observed for the m‐FIS between baseline and the three‐month follow‐up (P = 0.029). Participants reported a deeper understanding of fatigue and that they liked sharing strategies and experiences with each other along with the facilitator, citing that "there was a power in our group because we had a common condition." Conclusion: FAME‐iSS resulted in improvements in the impact of fatigue and self‐efficacy for managing symptoms and performing energy conservation strategies. Feedback was positive, and the virtual format allowed for greater accessibility and sharing of strategies. [ABSTRACT FROM AUTHOR]

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Background: Moral distress is a multifactorial and complex phenomenon influenced by various individual, cultural, and systemic factors. This study aimed to investigate the frequency and intensity of nurses' moral distress, explore their experiences, and develop the conceptual model of risk factors of moral distress in surgical units and operating rooms. Method: This is a sequential mixed-method study conducted at four teaching hospitals affiliated with the Qom University of Medical Sciences. In the first step, the moral distress of nurses in surgical units and operating rooms was investigated by a survey. The participants included nurses who worked in the operating room and surgical units. (n = 180). The data was collected by a Moral Distress Scale-Revised (MDS-R) questionnaire. In the second step, the experiences of nurses regarding risk factors of moral distress were explored using semi-structured interviews and analyzed using the conventional content analysis by Graneheim and Lundman's approach. Results: One hundred eighty nurses participated in this study. The mean total moral distress scores ranged from 12 to 221, with a mean (SD) of 116.8 (42.73). The causes of moral distress cited with the highest frequency and intensity related to the 'role of healthcare providers'. The experiences of the participants in the theme 'Inductive process of moral distress development' were categorized into three categories: 'Melting into the faulty system', 'Power and the system as distress promotors', and 'Perceived unpleasant consequences'. Conclusion: The results indicated that the frequency of moral distress in operating rooms and surgical units was at a moderate level and the distress intensity of nurses was at a moderately high level. The results indicated that in the investigated system, the "inductive moral process of distress development" was continuously understood by the participants. This process was influenced by systemic and individual factors. Weak assertiveness, conservative compromise, and desensitization to unprofessionalism as individual factors were effective in causing distress. Risk factors at the systemic level led nurses to melt into the faulty system and created adverse outcomes at the individual level. The lack of systemic support and the stabilization of mobbing by powerful system members had a negative impact on the individual factors of distress development. Also, these factors directly cause negative consequences. [ABSTRACT FROM AUTHOR]

Aim: The purpose of the study was to describe the preparation of children for day surgery from the parent's viewpoint. Design: Empirical Research Mixed Method. Methods: The research applied a mixed‐methods study design. The study was conducted at the Paediatric Day Surgical Department of one REDACTED between 2018 and 2020 at the same time as an associated randomised controlled conduct trial. Parents of 41 children (ages 2–6 years) completed measures assessing their preparation for day surgery and satisfaction with the procedure. Semi‐structured interviews were conducted with 15 parents to better understand their experiences. Results: According to the results, most of the parents (95%) told their children about the upcoming day surgery procedure. The child was prepared for the surgery with cognitive and sensory information, and the preparation usually started at home well before the surgery. The parents' experiences with the most critical aspects of preparing their child included three main categories: (1) usability of the preparation method; (2) content and timing of the preparation method and (3) consideration of the family perspective. [ABSTRACT FROM AUTHOR]

Objectives: Autism spectrum disorder (ASD) is a neurodevelopmental disorder that includes abnormal communication, repetitive and limiting interests, and social dysfunction. This study aimed to identify the experiences of parents in raising children with ADS in Iran. Methods: A total of 18 parents of children with ASD were selected by purposive and convenient... [ABSTRACT FROM AUTHOR]

Background: The World Health Organization recommends the use of donated human milk (HM) as the second-best option for mothers who are temporarily unable to provide sufficient breast milk to meet the needs of their infants. However, HM donation is yet to become an accepted practice in Uganda. We assessed the level of, and factors associated with acceptability to donate HM among postnatal mothers at St. Francis Hospital Nsambya (SFHN). Methods: A cross-sectional sequential explanatory mixed method study was conducted between October 2018 and March 2019. A questionnaire on sociodemography, awareness and likely acceptability to donate HM was administered to 410 postnatal mothers at SFHN. Multivariate logistic regression analysis was undertaken to determine factors associated with acceptance of HM donation. Focus Group Discussions (4) and Key Informants Interviews (4) were used to explore factors influencing behaviours to donate human milk. Qualitative data were analysed using a content thematic approach. Results: Overall acceptance of donating the HM was 77.6%, and the significant factors were: willingness to express the HM (AOR 7.5; 95% CI 3.01, 18.68); wet-nursing knowledge (AOR 2.3; 95% CI 1.1, 5.0) and visit to under-5 years' clinic (AOR 21.3; 95% CI 2.3, 196.9). The major themes in relation to accepting to donate HM were wet nursing experience, and confidence in donating the HM, and its perceived effectiveness. There were concerns about the safety and adequacy of HM and fear of transmitting criminal behaviours and mental illness through human milk. Conclusions: Acceptance to donate HM among postnatal mothers at St. Francis Hospital Nsambya was very high. Willingness to express and store human milk, prior knowledge about wet nursing and a visit to an under-five outpatient clinic were associated with acceptance. Thus, establishing a human milk bank is feasible in the study setting. [ABSTRACT FROM AUTHOR]

Background: Different mental disorders may be associated with many work-related factors to which primary health care workers (PHCWs) are exposed. The current research aims to measure the rates of depression, anxiety, and stress among PHCWs, and their associated causes in primary health care (PHC) settings. Methods: An explanatory sequential mixed methods design was employed in this research from January 2021 to January 2022 in Tabriz, Iran's PHC centers. First, this study followed an online-based cross-sectional survey using a self-reported questionnaire. The Depression, Anxiety and Stress Scale-21 Items (DASS-21) and questions on demographic and work-related characteristics were completed by 303 frontline PHCWs during the quantitative phase. In the qualitative phase, a semi-structured interview was held with 12 PHCWs who had the highest level of depression, anxiety, and stress to identify the reasons and sources of mental health prevalence. Quantitative data were analyzed using descriptive statistics via SPSS-26. A content analysis was performed to analyze qualitative data. Results: The results showed that self-reported stress, anxiety, and depression had a prevalence of 40.3%, 42.9%, and 42.6%, respectively. Symptoms of at least one mental disorder were experienced by 54% of respondents, while 28% had all three. Major sources of stress, anxiety, and depression among PHCWs were working environment conditions, organizational policies, job-related reasons, and interpersonal relations. Conclusions: The results of current study indicated that PHCWs experienced high levels of depression, anxiety, and stress. The main factors and reasons that contributed to these mental health issues among PHCWs were work environment conditions, organizational policies, job-related reasons and interpersonal relations. Therefore, interventions should be implemented to promote mental health of PHCWs. This can include measures such as psychological screening, supportive care, workload management, flexible scheduling, and access to mental health resources. Additionally, training programs can be implemented to enhance resilience and coping skills among healthcare professionals. [ABSTRACT FROM AUTHOR]

The aim of this research is to explore nurses' experiences in caring for migrants, regular and non-regular, within outpatient clinics in Italy. Materials and Methods: Thirteen nurses have been interviewed through online semi-structured interviews, conducted with the support of a questionnaire, made by researchers, consisting of open-ended questions on legislative issues, cultural issues, and regarding best practices. Purposive sampling has been used, along with phone and email recruitment. The audio recordings of the interviews were verbatim transcribed, then examined. This study is a qualitative descriptive fundamental research project. Results: Interviewees highlight migrants' difficulties in accessing care, critical points of legislation, transcultural skills crucial to nurses, and good practices. A total of 105 labels were developed and grouped into 23 categories under 7 themes (Italian legislation and migrants; structural difficulties in assistance; the influence of politics; the work of NGOs and associations; nursing care; winning strategies; and the role of the Family and Community Nurse). Conclusion: The research highlights how access to care for migrants is hindered by legislative, structural, and cultural barriers, with consequences on the NHS (improper accesses to the emergency room, increased workload, and economic expenditure). For the full realization of the right to health, as enshrined by Art. 32 of the Constitution, changes are needed with respect to regulations and professionals' training. [ABSTRACT FROM AUTHOR]