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Background and Aims: Long‐acting injectable buprenorphine (LAIB) is a new treatment for opioid use disorder that is generating positive outcomes. Negative effects are typically mild and transient, but can occasionally be serious, resulting in treatment discontinuation/non‐adherence. This paper aims to analyse patients' accounts of how they felt during the first 72 h after initiating LAIB. Methods: Semi‐structured interviews were conducted (June 2021–March 2022) with 26 people (18 males and 8 females) who had started LAIB within the previous 72 h. Participants were recruited from treatment services in England and Wales and were interviewed by telephone using a topic guide. Interviews were audio‐recorded, transcribed and coded. The concepts of embodiment and embodied cognition framed the analyses. Data on participants' substance use, initiation onto LAIB and feelings were tabulated. Next, participants' accounts of how they felt were analysed following the stages of Iterative Categorization. Results: Participants reported complex combinations of changing negative and positive feelings. Bodily experiences included withdrawal symptoms, poor sleep, injection‐site pain/soreness, lethargy and heightened senses inducing nausea ('distressed bodies'), but also enhanced somatic wellbeing, improved sleep, better skin, increased appetite, reduced constipation and heightened senses inducing pleasure ('returning body functions'). Cognitive responses included anxiety, uncertainties and low mood/depression ('the mind in crisis') and improved mood, greater positivity and reduced craving ('feeling psychologically better'). Whereas most negative effects reported are widely recognized, the early benefits of treatment described are less well‐documented and may be an overlooked distinctive feature of LAIB. Conclusions: During the first 72 h after initiating long‐acting injectable buprenorphine, new patients report experiencing a range of interconnected positive and negative short‐term effects. Providing new patients with information about the range and nature of these effects can prepare them for what to expect and help them manage feelings and reduce anxiety. In turn, this may increase medication adherence. [ABSTRACT FROM AUTHOR]

Medical Education 2011: 45: 1251-1261 Objectives Professional status and working arrangements can inhibit doctors from acknowledging and seeking care for their own ill health. Research identifies that a culture of immunity to illness within the medical profession takes root during training. What happens when trainee doctors become unwell during their formative period of education and training? What support do they receive and how do they perceive that the experience of ill health affects their training trajectory? These research questions were developed by a multidisciplinary team of researchers and health professionals, who adopted a qualitative approach to investigate the experiences of personal illness among trainees in their Foundation Programme (FP) years. Methods Semi-structured interviews were conducted with eight FP trainees from the Severn Deanery in southwest England who had experienced significant illness. Interpretative phenomenological analysis was used to conduct and analyse the interviews, resulting in a comprehensive list of master themes. This paper reports an interpretative analysis of the themes of Support, Illness Experience, Crossing the Line, Medical Culture, Stigma and Disclosure. Results Ineffective communication within the medical education and employment system underpins many of the difficulties encountered by trainees who are unwell. Coping style plays a key role in predicting how trainees experience support during and after their illness, although this may be influenced by their particular diagnoses. The barriers to disclosure of their illnesses are discussed within the context of mobilising and maintaining support. Concern about the impact of missing training as a result of ill health appears to be significant in the transmitting of an ethos of invulnerability within the medical culture. Conclusions Suggestions to improve support procedures for trainees who are unwell include the provision of greater flexibility within the rotation system along with independent pastoral support. Promoting the importance of disclosing significant illness as early as possible might go some way towards challenging the culture of invulnerability to illness that prevails among doctors. [ABSTRACT FROM AUTHOR]

Background: It is widely acknowledged that inadequate handovers are associated with putting patients at risk in clinical settings; however, handover practices have received little attention in other 24‐hr settings such as long‐stay residential care facilities. Aim: This study aimed to explore the perceived purpose and organisational processes involved in the handover of information between shifts of staff caring for older residents in five care homes in England. Methods: The study took an ethnographic approach to fieldwork, undertaken between February and June 2016. It consisted of observations of handovers (n = 12) and interviews with managers, Registered Nurses (RNs) and care assistants (n = 27) working day and night shifts. Interview transcripts and observation notes were analysed within NVivo using a matrix approach. Results: Handovers were highly variable in all five care homes in relation to their timings, locations, content and participants. Managers and RNs highlighted handovers as an opportunity for risk assurance, supervision, team building, staff education and monitoring of residents' clinical status. In comparison, care assistants considered the purpose of handovers to be prepared for the responsibilities of working a shift. The discussion addresses implications of these findings, particularly consideration of how best use can be made of RN skills and knowledge in handovers. Conclusion: Research is needed to identify whether care home resident safety can be linked to handover practices and how the presence of RNs in handovers in care homes affects this. Implications for practice: Care home managers, RNs and care workers may find this research useful in practice when considering how best to organise handovers and deploy staff in care homes for older people. [ABSTRACT FROM AUTHOR]

Background: Person‐centredness is important in delivering care for long‐term conditions. New models of care aim to co‐ordinate care through integration of health and social care which require new ways of working, often remotely from the patient. Objective: To describe how person‐centred care is enacted within multidisciplinary groups (MDGs) created as part of a new service, integrating health and social care for older people. Methods: We followed the implementation of eight neighbourhood MDGs, observing and interviewing staff from three MDGs at different phases of programme implementation using semi‐structured topic guides. Results: Thirty‐four MDG meetings were observed and 32 staff interviewed. Three core themes were identified which impacted on enactment of person‐centred care: the structural context of MDGs enabling person‐centred care; interaction of staff and knowledge sharing during the MDG meetings; and direct staff involvement of the person outside the MDG discussion. Conclusions: This study provides new insights into attempts to enact person‐centred care within a new model of service delivery. Teams did what they could to enact person‐centred care in the absence of the "real" patient within MDG meetings. They were successful in delivering and co‐ordinating some aspects of care (eg prompting medication reviews, referring to social worker, health improvement and arranging further multidisciplinary team meetings for complex cases). This "absence of patients" and time pressures within the MDGs led to reliance on the "virtual" record, enhanced by additional "soft" knowledge provided by staff, rather than ensuring the patient's voice was included. [ABSTRACT FROM AUTHOR]

The article presents a study which aims to explore the acceptability of antenatal enquiry for domestic abuse from the perspective of women using maternity services. The researchers detail the multimethod approach in data collection procedure and outcomes. It implies that women patients support and have positive views of antenatal enquiry for domestic abuse in healthcare settings.

Aim Osteoarthritis (OA) is one of the most common musculoskeletal conditions and a major cause of chronic pain and disability. Self-management of OA through education and exercise are recommended as core treatments. Current research has demonstrated the effectiveness of these approaches, but most trials tailor interventions for specific joints. The aim of the present study was to explore healthcare professionals' views on a group-based exercise intervention designed to facilitate the self-management of OA in the lower limbs and/or lower back. Methods Individual semi-structured interviews were conducted with 20 healthcare professionals (nine general practitioners, ten physiotherapists and one community-based rheumatologist). The interviews were audio-recorded, transcribed and analysed using thematic analysis. Results Three themes were identified: 1) Patient understanding of osteoarthritis; 2) Multiple-joint approach and 3) Practical aspects of the intervention. Healthcare professionals stated the usefulness of the intervention in improving patients' knowledge about their condition and self-management. They commented on including patients affected with OA in multiple or different lower limb sites in the intervention. They considered this a positive move, as they viewed self-management techniques as applicable to more than one affected joint in the lower body. Consideration of the practical aspects of the intervention included thoughts on an appropriate facilitator, the need to ensure accessibility to patients and ways to exercise once the intervention had ended. Conclusion Healthcare professionals saw the intervention as an acceptable and feasible approach to facilitate the self-management of OA. This study has implications for developing and implementing cost-effective interventions in primary care settings. Copyright © 2014 John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]

Objectives. Formulation is argued to be of central importance in most psychotherapeutic approaches, yet little is known about client's experience of this. This study sought to explore the client experience of receiving cognitive analytic therapy (CAT). It aims to gain a better understanding of the use of specific CAT tools (e.g., reformulation letters and diagrams) and how these tools relate to clients' understanding of change. Design. Grounded theory methodology utilizing a three-stage analysis process was used to explore client's retrospective accounts of change in CAT. Methods. Fifteen semi-structured interviews were conducted with nine participants who had received CAT. Data analysis involved initial coding of transcripts and further theoretical sampling and interviewing followed. This led to the production of a model that was then taken to three further participants for exploration in further interviews. An audit was conducted of the analysis process. Results. A core conceptual framework of 'doing with' the therapist emerged from the analysis and represented clients' experience of receiving CAT and participating in the reformulation process. This framework subsumed four interrelated themes; 'being with the therapist', 'keeping it real', 'understanding and feeling', and 'CAT tools'. Conclusions. CAT was seen as an active and emotional experience facilitated by a trusting and collaborative therapeutic relationship. The CAT reformulation was seen as important but only when embedded within this context. Whilst, this was a small study theoretical generalizations are discussed about the process of change and further clinical and research recommendations are presented. [ABSTRACT FROM AUTHOR]