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Background: Groups at high risk of severe illness/death from COVID-19 (older people and those identified as clinically extremely vulnerable: CEV) experienced increased restrictions, poor mental health and loneliness during the first UK lockdown. Methods: Seventeen older adults, eight CEV adults, one parent of a CEV child, and two family carers of CEV adults, shared their experiences of the first UK lockdown through various media: written reflections, interviews, poetry, videos, photographs, and visual artwork. Results: Through a positive psychology lens, five themes were identified: experiencing loss; community and connection; finding joy, hope and optimism; adapting to change; and sense- and meaning-making. Conclusion: High-risk groups fostered wellbeing and flourishing and formed a sense of coherence in a time of great loss. Engagement with artistic, creative, and cultural activities facilitated this. The arts not only provided a creative means of collecting data but was also identified as a central thread in the findings. [ABSTRACT FROM AUTHOR]

Livestreaming and filming death rites and funeral ceremonies to enable remote engagement proliferated rapidly during the COVID-19 pandemic, and many expect these options to remain prevalent going forward. This paper draws on interviews with a diverse UK sample of 68 bereaved people, funeral directors, officiants and celebrants. It illustrates how, and explains why, people's experiences and evaluations of hybrid funerals can vary. In a context when in-person gatherings were limited, hybridisation played a valuable role in enabling more people to engage with funerals. However, virtual attendance was often considered less satisfying than in-person attendance because it did not enable people to participate well in the funeral activities that mattered to them or to participate with others as they would in person. Scope for participation was partly contingent on the functionality and use made of technology, including whether and which steps were taken to facilitate engagement and a sense of connection for those joining online. People's evaluations of hybrid funerals could also reflect their relationships to the deceased and their frames of reference – for example, whether they were comparing virtual attendance to attending in person, or to being unable to attend at all, or to an overwhelmingly large funeral. [ABSTRACT FROM AUTHOR]

Background: The COVID-19 pandemic placed a huge strain on healthcare services around the world, including community services. Students also faced substantial disturbance to educational programmes. Student district nurses are usually employed members of staff and can be recalled to the workforce, whereas pre-registration students cannot. Aims: This paper explores the feelings and experiences of student district nurses during the first UK national lockdown of the COVID-19 pandemic. An interpretative phenomenological approach was taken. Method: A semi structured 1:1 interview and focus group was held via zoom in July 2020. A total of eight student district nurses, who were all registered adult nurses, took part. Data was analysed using the Braun and Clarke model to identify themes. Results: The findings related to their experience of being a community adult registered nurse on the frontline, while also being a student district nurse. Three themes were identified from the analysis: anxiety and uncertainty, management of risk and teamwork. Conclusion: This study highlights the contribution that community nurses made in the clinical response to the COVID-19 pandemic. It adds to a paucity of literature available from this clinical setting and specifically from the viewpoint of a student district nurse. There is much written on the strains on hospital care, but it should be remembered that district nursing is the service that never shuts its doors because it has reached capacity. This study found that a lack of communication and uncertainty about their future as students contributed to heightened stress and anxiety. Teamwork and camaraderie are a vital aspect of any team and one that can support resilience in times of heightened stress. A lack of face-to-face interaction can lead to team members feeling isolated. Digital technology can be used to reduce this feeling when possible. [ABSTRACT FROM AUTHOR]

During the COVID-19 pandemic, many face-to-face group activities for new parents moved online. In this article, we share findings from 14 interviews conducted during the first lockdown in the United Kingdom with parents of babies under 12 months about their experiences of participating in online groups. Attendance at groups was treated as a survival mechanism or even a panacea for some parents, providing well-rounded entertainment and support for parents, their children and the parenting relationship. However, reviews of the online groups were mixed, with some deemed more adequate than others for online delivery. Parents expressed concerns about the lack of informal spaces in online contexts to share private conversations and the unnatural group conversations affected by the custom of taking turns to talk. These experiences highlighted what was important to parents: the need for the embodiment of connection. The peculiarity of the online setting saw the emergence of parenting display work; parental awareness of online impression management and self-presentation strategies. While online technologies are ubiquitous, online groups for parents are nascent, and these technologies require careful analysis and evaluation from users and facilitators. [ABSTRACT FROM AUTHOR]

Infants with Down syndrome are more likely to experience feeding problems and mothers are likely to require more feeding support than mothers of typically developing infants. During the COVID-19 pandemic, many feeding support services changed from face-to-face to online, which impacted some maternal feeding experiences negatively, but no studies to date have explored the impact for mothers of infants with Down syndrome. Thematic analysis was conducted on semi-structured interviews from thirteen new mothers of infants (aged 8–17 months) with Down syndrome in the UK. Three superordinate themes were generated: (1) Every baby with Down syndrome has a unique journey, (2) There's no point asking, they won't know, (3) Lack of in-person support. Many mothers expressed frustrations over health professionals' lack of Down syndrome specific knowledge resulting in unmet needs, further magnified due to the nature of the virtual support being offered. Moreover, mothers struggled with reduced social support from other mothers when encountering feeding problems. These results hold real-world implications for health professionals who could provide more specialised face-to-face feeding support to mothers of infants with Down syndrome. This should be prioritised for children's overall development and mothers' wellbeing. [ABSTRACT FROM AUTHOR]

When it became clear that the COVID-19 pandemic would require significant shifts in working practice, staff in the Adult Complex Needs department at the Tavistock clinic designed a study to explore the emotional impact of remote working on clinicians and patients, and to consider related clinical implications both individually and collectively. A set of semi-structured questions were designed to tap into experiences of working remotely, and clinicians were interviewed. The material arising from these interviews has been summarised into themes. The predominant theme was clinicians' awareness of the importance of their own emotional milieu in delivering psychoanalytic psychotherapy, especially at a time of crisis, in their initial emotional responses and as they gathered further remote experience. They raised challenges around maintaining an analytic frame amid therapeutic uncertainties, and in the context of the many physical losses of a remote frame: blurred clinical boundaries, altered emotional experiences and resonance, and important impacts on holding, patient attendance, and worsening distress and risks for patients who struggled remotely. Strategies to adapt were key, particularly remaining emotionally consistent and observant amidst uncertainty, and support was paramount to do so. These experiences assist in informing clinicians about the limitations and uses of remote clinical work. [ABSTRACT FROM AUTHOR]

Aim: To generate, test and refine programme theories that emerged from a rapid realist review investigating practising UK Nurses' and Midwives' experiences of effective leadership strategies during the COVID‐19 pandemic. Background: The realist review of literature generated six tentative theories of healthful leadership practices reflecting, working with people's beliefs and values; being facilitative; multiple means of communication and; practical support. The review yielded little insight into the actual impact of the leadership approaches advocated. Methods: A realist study, informed by person‐centredness using mixed‐methods. Online survey (n = 328) and semi‐structured interviews (n = 14) of nurses and midwives across the UK in different career positions/specialities. Quantitative data analysed using descriptive statistics and exploratory factor analysis. Framework analysis for qualitative data using context (C), mechanism (M), outcome (O) configurations of the tentative theories. Results: Three refined theories were identified concerning: Visibility and availability; embodying values and; knowing self. Healthful leadership practices are only achievable within organisational cultures that privilege well‐being. Conclusions: Leaders should intentionally adopt practices that promote well‐being. 'Knowing self' as a leader, coaching and mentoring practice development is important for leadership development. Implications for Clinical Practice: Nurses who feel valued, heard, cared for and safe are more likely to remain in clinical practice. Job satisfaction and being motivated to practice with confidence and competence will impact positively on patient outcomes. Impact: The study addresses the role of leadership in developing healthful workplace cultures. The main findings were six leadership practices that promote healthful cultures. The research will have an impact on strategic and clinical leaders, nurses and midwives. Reporting Method: This study used EQUATOR checklist, RAMASES II as reporting standards for realist evaluations. Patient or Public Contribution: No patient or public contribution. [ABSTRACT FROM AUTHOR]

Inter- and intragenerational relationships are known to be important in maintaining the wellbeing of older people. A key aspect of these relationships is the exchange of both emotional and instrumental social support. However, relatively little is known about how this exchange of support changes in the context of widespread disruption. The COVID-19 pandemic provides an opportunity to examine how older people's family relationships are impacted by such social change. The present qualitative study explores how older people in the United Kingdom experienced changes in inter- and intragenerational support during the COVID-19 pandemic. Participants (N = 33) were recruited through a large-scale nationally representative survey (https://www.sheffield.ac.uk/psychology-consortium-covid19). We asked how life had been pre-pandemic, how they experienced the first national lockdown and what the future might hold in store. The data were analysed using constructivist grounded theory. This paper focuses on the importance of family relationships and how they changed as a consequence of the pandemic. We found that the family support system had been interrupted, that there were changes in the methods of support and that feelings of belonging were challenged. We argue that families were brought into disequilibrium through changes in the exchange of inter- and intragenerational support. The important role of grandchildren for older adults was striking and challenged by the pandemic. The significance of social connectedness and support within the family had not changed during the pandemic, but it could no longer be lived in the same way. The desire to be close to family members and to support them conflicted with the risk of pandemic infection. Our study found support for the COVID-19 Social Connectivity Paradox: the need for social connectedness whilst maintaining social distance. This challenged family equilibrium, wellbeing and quality of life in older people. [ABSTRACT FROM AUTHOR]

To explore the experiences of children and young people (CYP) with attention deficit hyperactivity disorder during the COVID-19 pandemic and lock down restrictions. Semi-structured, online interviews were conducted with 17 children and young people from the UK, Northern Ireland, aged 10–14 years with ADHD. Over half the participants had a co-existing diagnosis, such as autism spectrum disorder. Interviews were recorded and transcribed verbatim before being subjected to thematic analysis. Four themes were identified; the emotional impact of the pandemic, adjustments to daily living, impact of remote learning and the effect on relationships. Many CYP citied feelings of sadness, loneliness and anxiety, others found the reduction in social demands favourable. As one of few studies to capture the experiences of children and young people with ADHD during the COVID-19 pandemic, this research highlights the potential negative long-term impact on emotional welfare, schooling and relationships. Health care professionals should be aware of the overall impact on health and well-being for children and young people with ADHD following the COVID-19 pandemic and lockdown restrictions to ensure that the effect of these are minimised and managed in the future. Educators and clinicians should be cognisant of the long term consequences of poor mental health during the COVID-19 pandemic and should put in place pro-active strategies to support children and young people with ADHD. Children and young people with ADHD may suffer greatly from reduced access to sports and leisure facilities. Policy makers should be conscious of the potential negative consequences of placing limitations on access to such facilities. [ABSTRACT FROM AUTHOR]

Background: Young carers are children or young people aged up to 25 years old who undertake unpaid caring responsibilities for a friend or family member. Young carers faced significant challenges brought on by the COVID-19 pandemic. We explored the impact of the pandemic and associated restrictions on mental health, wellbeing and access to support in young carers in the United Kingdom (UK) to understand how to improve services, as well as support this population in future health emergencies. Method: We conducted 22 qualitative semi-structured interviews from May to November 2021 with 14 young carers and eight staff working in organisations that supported them. Interviews took place remotely over video or telephone call and explored participant experiences of the pandemic and its impact on their health, wellbeing and caring responsibilities. We used reflexive thematic analysis to analyse interview transcripts. Results: We identified four overarching themes pertaining to the impact of the pandemic and associated restrictions on mental health, wellbeing and access to support in young carers in the UK: (1) challenges in protecting loved ones from the virus, (2) changes to and loss of routine, (3) reduced access to pre-pandemic informal and formal support structures and (4) better understanding of inner resilience and goals. Many participants struggled with their mental health and wellbeing as a result of pandemic related restrictions which impacted on support structures for themselves and the individual they cared for. However, positive impacts pertained to additional support provided by local authority and third sector organisations. Conclusions: Our findings highlight some of the changes that affected young carers during the COVID-19 pandemic. The impact of changes to routine and a reduction in pre-pandemic support were the greatest concerns reported by participants in this study. The additional support provided by local authority and third sector organisations during social restrictions suggests such organisations could play a greater role in supporting this population going forward and that schools and Governments may wish to put in additional strategies and provisions to protect young carers in the future. [ABSTRACT FROM AUTHOR]

Purpose: The COVID-19 pandemic has affected many industries, and reports indicate that this includes the illicit drug market. Recent research suggests that the homeless are particularly vulnerable during the pandemic, and the UK Government has acted to house rough sleepers. Research is scarce regarding homeless people's experiences of the illicit drug market. This study aims to explore homeless people's experiences of the drug supply in the UK during COVID-19. Design/methodology/approach: Eight homeless people who use illicit drugs, residing in hostels for homeless people in Southampton, participated in semi-structured one-on-one telephone-based interviews. Findings: A thematic analysis revealed five themes: availability of drugs, presence of dealers, quality of drugs, finances and personal experiences. Participants reported varying experiences of the drug supply, with lockdown measures expressed as the main reason for reduced supplies, as users found it difficult to find dealers and generate income for purchasing drugs. Research limitations/implications: The results may lack generalisability to the wider population, such as rough sleepers and drug dealers, suggesting a need for further research into people's experiences of the drug supply during COVID-19. Research on this topic could be more in-depth through the use of research methods that are convenient for the homeless population. Practical implications: Services should invest in harm reduction services and encourage homeless people who use drugs to engage in substitution treatment. Homeless services should provide psychological support for homeless people who use drugs. Social implications: The changes in homeless people's behaviour following the pandemic may have implications for their interactions with the rest of society (e.g. begging in town centres may reduce). These changes in behaviour may also change the way society can best support homeless people. Originality/value: The results are partially consistent with other research findings about the illicit drug supply; however, they also suggest that some individuals experienced minimal change in the illicit drug supply. [ABSTRACT FROM AUTHOR]

Aims and Objectives: To explore the experiences of nursing students in England who had worked through the first wave and transitioned to qualification in the ongoing pandemic. Background: Experiences of health professionals and student nurses during the pandemic are now well documented, but the transition of students to qualification is less well understood. In Summer 2020, we interviewed 16 student nurses who had worked as health care assistants on paid extended placements as part of the COVID‐19 response in the East of England, finding surprisingly positive experiences, including perceived heightened preparedness for qualification. A year later, we re‐interviewed 12 participants from the original study to hear about transitioning to qualification during the ongoing pandemic. This study provides novel insights into their experiences. Design: A qualitative study design was used. Methods: Twelve newly qualified nurses who had participated in the original study took part in qualitative, online interviews where they shared their experiences of working and transitioning to qualification during the ongoing pandemic since we spoke to them a year earlier. The data was analysed using thematic analysis. COREQ guidelines were used in developing and reporting this study. Results: Three themes were identified. Constant change: in the clinical environment and arising out of the transition to newly qualified nurse, mental health and well‐being and reflecting on the past to learn for the future. Conclusions: Participants experienced a unique transition to qualification. The perceived heightened preparedness for qualification that participants who had worked as students during the first wave of the pandemic had become a reality, ameliorating some of the known effects of transition. However, increased expectations and added responsibilities in extremely busy, fluctuating clinical environments with minimal support add weight to calls for mandatory preceptorship programmes. While heightened resilience was evident, provision of ongoing mental health and well‐being support is strongly recommended. Relevance to Clinical Practice: We need a partnership approach with nurse educators and practice colleagues which ensures preparation for qualified practice is appropriate. If we do not effectively prepare students for qualified nurse posts, patient care will almost certainly be compromised. [ABSTRACT FROM AUTHOR]