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Adult mental health problems can impact on parents, and research highlights that their children are at higher risk of developing mental health problems. In extreme cases, mental health problems are associated with a risk of fatal child abuse. Despite this, there are few studies exploring clinical decision-making by adult mental health professionals. This study used qualitative methods to explore Community Mental Health Team (CMHT) workers' experiences of decision-making in the interface between mental health and child welfare. Workers were interviewed about their experiences of clinical decision-making regarding child welfare. Interviews and accounts were analysed using Interpretative Phenomenological Analysis. Influences on decision-making were explored and triangulated with the accounts of Named Nurses for Child Protection. The findings revealed that CMHT participants were aware of their responsibilities towards children, but a complex synthesis of factors impacted on their sense-making about risk and welfare. Three superordinate themes emerged: the tensions of working across systems; trying to balance the perceptions and feelings involved in sense-making; and the role that interpersonal dynamics play in the understanding and management of risk. This paper focuses in particular on perceptions and feelings. Copyright © 2011 John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]

Objectives The objectives of this paper were to explore the acceptability of components of a mobile phone/pedometer-based physical activity program and to understand motivators and barriers to increase physical activity in a diverse sample of sedentary women. Design and Sample Face-to-face semi-structured interviews were conducted following a 3-week pilot mobile phone/pedometer-based physical activity intervention. Forty-one sedentary women participated in the study. Measures Subjects were interviewed using a semi-structured interview guide. A qualitative description method was used to thematically analyze the interviews. Two investigators reviewed the transcripts independently and identified codes based on the main concerns in the interview questions. Results Three themes emerged from qualitative data shedding light on the perceived acceptability and usefulness of a mobile phone/pedometer-based intervention: (1) Monitor me: mobile phone/pedometer as self-monitoring tools, (2) Motivate me: cycle of feedback in goal setting and usefulness/uselessness of daily random messages, (3) Mobilize me: engaging and adapting physical activity to fit one's own lifestyle. Conclusion Mobile phone and pedometer-based physical activity programs might be helpful in keeping sedentary women engaged and motivated to increase their physical activity. A randomized controlled trial of this intervention is warranted. [ABSTRACT FROM AUTHOR]

Objective: The objective of this paper is to highlight, from within a broad study of recruitment/retention, findings that identify personal-professional boundaries as key challenges for rural child and youth mental health clinicians recruited from within the community. Design: Two mixed methods online questionnaires followed by semistructured telephone interviews with a small subset of respondents were administered to clinicians, team leaders, supervisors and managers whose practice responsibilities encompass rural settings in three regions of British Columbia, Canada. Participants: Forty-four clinicians and 27 team leaders/managers participated in the survey while eight clinicians and one team leader/manager participated in the semistructured interviews. Half the clinician respondents were recruited from within the community. Of those recruited from outside the community, half had prior experience living or working in a rural community. Main outcome measures: Levels of satisfaction with lifestyle, practice and preparation for practice were compared across categories of respondents identified earlier. Open-ended comments were coded by theme and also compared across categories of respondents. Results: While expressing their higher levels of satisfaction with rural lifestyle and professional practice, clinicians recruited from within rural communities report significant initial and ongoing stress related to personal-professional boundaries and dual relationships. They also report lower levels of satisfaction with orientation and preparation for practice relevant to dealing with these stressors. Conclusion: Prior attachment to rural communities, increasingly viewed as an effective recruitment and retention strategy, requires better preparation and ongoing supports to enable practitioners to deal with dual relationships and the personal-professional boundary issues that are a direct consequence of their attachments. [ABSTRACT FROM AUTHOR]

The paper tells of the social constructs surrounding young children with learning difficulties in their home, 'special' early education setting and 'inclusive' or mainstream early education setting in England. The exploratory study focused on how three- to four-year-old children made sense of their environments and how their identities were constructed by different parties in the different contexts. Ethnographic case studies were conducted using semi-structured and informal interviews with parents and practitioners, documentary analysis, fieldnotes, and live and video observations. Shared constructions across the contexts for each child were common, with constructions of them being happy and making progress pervasive across the children and settings. Differences in constructions across settings indicated that qualities could shine or negative constructions be tempered, thus showing the role of the environment and the culture of inclusion in socially constructing children with special needs. [ABSTRACT FROM AUTHOR]

In the first decade of the 21st century, British policing faced two new challenges in how it responded to social diversity: As well as instituting reforms in response to a highly publicized report describing the British police as 'institutionally racist' (Macpherson, ), they faced challenges associated with rapid increases in numbers of immigrants into the UK. Studying social representations at such times of change allows access into processes, themes and value systems that may otherwise remain hidden. This paper uses social representations theory to explore interview accounts provided by regular police officers of interactions with members of minority groups. Empirically, we focus on an area of diversity policing that has received relatively little previous attention: Police work in a rural context that has recently played host to large numbers of migrant workers. Our analysis shows that interviews operate as a site of resistance in which respondents attempt to rework hegemonic representations of the police as prejudiced and to re-present themselves and their work as able to respond appropriately to diversity. Fairness as a defining characteristic of good police practice is a central representational theme that links identity construction processes to police work with minority groups. Recent immigrant groups are represented as both needing and deserving help to assimilate into British culture: Their lack of acculturation and language difficulties provide additional challenges to police work and to how this is judged as 'fair'. We discuss the broader origins and implications of police officers' understandings of fairness and the use of social representations theory to study representational fields within organizational settings. Copyright © 2010 John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]

Everyday conversations among non-Indigenous Australians are a significant site in which racism towards Indigenous Australians is reproduced and maintained. This study explores the possibilities of everyday antiracism by asking how people negotiate racist discourses in interpersonal contexts. Twelve first year psychology students (10 female, 2 male, aged 18-50) who had completed a compulsory Indigenous studies course were recruited as participants. Semi-structured interviews were thematically analysed for the constraints and facilitators for responding to racism in everyday contexts. As constraints against speaking up, participants offered 'social expectations to fit in', 'fear of provoking aggression and conflict', assessments of 'the type of relationship', whether they 'could make a difference' and the 'type of racism'. As a facilitator for speaking up, participants reported they were confident in challenging erroneous statements when they felt well informed and authoritative about the facts. The research suggests that everyday antiracism requires a preparedness to deal with possible discomfort and 'bad feeling' which participants reported avoiding. The paper concludes with suggestions for stimulating critical thinking and intergroup dialogue in relation to everyday antiracism. Copyright © 2011 John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]

This paper deals with the initial steps of the judicial process for persons with intellectual disabilities who are suspected of a minor offense; a stage where plaintiffs, police officers, and crown attorneys make a series of decisions that will have a significant impact on the course of the judicial process. The objective of this study was twofold: (i) to document the criteria that influence dispositions by police officers and crown attorneys about persons with intellectual disabilities in the criminal justice system (CJS), (ii) to report suggested improvements to better support them throughout the judicial process. Fourteen semi-structured interviews were conducted with key informants from the CJS and from service and community organisations working in the field of intellectual disabilities. The results of this qualitative study indicate that decisions made and dispositions taken rely on a series of implicit criteria that influence the course of the subsequent judicial procedures against persons with an intellectual disability. Suggestions for improvement pertain to developing the screening of intellectual disability procedures, the provision of information to key actors about intellectual disabilities, a preference for the use of summons to appear over other types of procedures, and drafting memorandums of understanding between various organisations and police services regarding persons with intellectual disabilities. In conclusion, an emphasis must be put on screening and diversion procedures for persons with intellectual disabilities when appropriate. [ABSTRACT FROM AUTHOR]

To investigate the foodservice, menu and meals in the aged-care residential setting to identify promoters and barriers to achieving optimum nutrition. An observational study conducted by the University of Otago Dietetic Training Programme. Rest home dietitians around New Zealand identified a final convenience sample of 50 facilities. Ten final-year student dietitians each spent two days in their designated rest homes, administering a 19-item questionnaire to ascertain practices relating to staffing, dining environment, menu, meals, snacks, feeding assistance, fluids, special diets, nutrition care, medications, nutrition policy and access to sunlight. Observations describing foodservice and meal-related activities only are reported in this paper. Most rest homes had the ability to provide for the needs of residents. Ninety per cent of facilities offered menu cycles of at least four weeks long. Potential barriers to meeting needs were inadequate amounts of protein-rich food for numbers served and lack of perceived choice in menus and meal service. Lack of foodservice staff training and poor uptake of training opportunities contributed to these barriers. This is the first such study conducted in New Zealand. Results should be of interest to the Ministry of Health and district health boards that are charged with the responsibility to ensure that meals in long-term care facilities meet the nutritional needs of this potentially vulnerable population. Shortcomings identified in the present study require a multidisciplinary approach that should include district health boards, auditing agencies, aged-care organisations, training providers and dietitians. [ABSTRACT FROM AUTHOR]

In this paper, we argue for a social psychological approach to citizenship which focuses on how social actors define competent and legitimate polity membership, together with the associated rights and responsibilities that this entails. A perspective based on the principles of rhetorical psychology is adopted in order to explore these issues in an analysis of a sample of young people's talk about issues of immigration to the UK. Analysis considers how matters of 'race', national identity and culture were oriented to and constructed during the interviews. We then explore how rights and responsibilities concerning cultural expression, interpersonal civility/courtesy and (implicitly acultural) legal frameworks were articulated as practical criteria for judgements about competent and legitimate polity membership. These findings are discussed in relation to existing social psychological work on issues such as racism and national identity, with a view to situating these matters within an overarching concern for the construction of polity membership. We conclude by briefly considering the implications of these findings for contemporary debates concerning citizenship education in the UK. Copyright © 2011 John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]

This paper explores the discursive construction of immigrants' criminality in interview accounts obtained by a sample of Greek people in Thessaloniki (Northern Greece). Analysis, which adopts a discursive approach to stereotypes and category construction, indicates that fear and insecurity on the part of Greek people are represented as a sine qua non consequence of immigration to Greece. Two different lines of argument are used to account for the arousal of fear. According to the first, fear constitutes a corollary of a widespread stereotypical representation of immigrants as criminals. The stereotype of immigrants' criminality is considered to be ill-warranted and it is attributed to the media or to other unspecified people. According to another, more regularly used, line of argument, however, fear is predicated upon the sordid living conditions of immigrants in Greece which make the probability of them being involved in illegal acts particularly high. In this case, fear is seen to derive from a 'rational estimate' of the probability of immigrant's involvement in criminal acts. Nested within the discourse of 'risk' the stereotypical image of immigrants' criminality is sustained and used to account for the need to protect the 'ingroup' from 'immigrant groups' through immigration control and surveillance. Copyright © 2011 John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]

To elicit patients' views on whether they could contribute to improvements in their care by carrying their own health information to clinician encounters; and to consider the implications for the development of a patient-held health file (PHF). Increasing rates of chronic disease lead to health care being delivered by multiple care providers often at distributed geographic locations. As a way of increasing the availability of patient information to care providers our project will trial a PHF. Patients carry these files to doctors' appointments where clinicians record data for other doctors or the patient. Increasing the availability of patient information is anticipated to enhance the safety and quality of care delivery and improve health outcomes. Qualitative semi-structured interviews were conducted with 10 patients. Participants were evenly distributed in terms of gender, aged 60 years or greater and visited at least two specialists and one general practitioner. In this exploratory study, patients who were currently active in decision making about their own health already recorded some health information. They were receptive to carrying their information and thought they should take some responsibility for their health. Patients who were more passive in making decisions about their health did not perceive a need to carry their own information and felt that their doctors communicated adequately. Patient-held health files provide an opportunity for patients to access their health information. Such files have the potential to improve health outcomes for patients who adopt both active and passive roles in relation to their own health and engaging with their health information. [ABSTRACT FROM AUTHOR]

Quality relationships form the backbone of social work with children and their families. They are particularly relevant in the close, intimate work with looked-after children who have identified how important it is to them that their relationship with their social worker is positive, warm and meaningful. It is accepted that in order to achieve and maintain successful and meaningful relationships, practitioners need to engage at an emotional as well as a professional level. All too often this requires a trade-off between organizational efficiency and the emotional work of caring for looked-after children. Therefore, it would appear the role of corporate parent is increasingly difficult, involving complex decisions about how practitioners might best spend their time, where their loyalties lie and the quality and direction of the final output. Using data from a series of interviews with practitioners, this paper explores the difficulties of maintaining active emotional engagement with children using the sociological concept of emotional labour. [ABSTRACT FROM AUTHOR]

This paper explores conceptions of commitment and styles of money management in heterosexual couples at two points in time: Just before the wedding (T1) and about a year later (T2). It also examines the potential effects of using FOCCUS as a form of marriage preparation (MP). Forty-two couples were recruited at T1 and randomly allocated to either A MP group and a group that would not be offered any marriage preparation - the Non-Marriage Preparation group (NMP). Individual, in-depth, semi-structured interviews were carried out at T1 and T2, recorded and fully transcribed. A thematic analysis (TA) yielded three themes or levels of commitment which were used to categorize couples at T1 and T2. Their money management styles were defined based on Pahl's (1989) typology. The results showed that conceptions of commitment had developed slightly overall by T2, and had been enhanced in the MP group. At T2, a more elaborated conception of commitment was associated with a greater tendency to treat money as a collective resource. Copyright © 2010 John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]

There has been a heavy emphasis in new product development (NPD) research on intrateam issues such as communication, trust, and conflict management. Interpersonal cohesiveness, however, has received scant attention. In addition, there are conflicting findings regarding the effects of close-knit teams, which seem to have a beneficial effect up to a point, after which the tight bond becomes a detriment. This paper addresses these issues by introducing an exploratory model of interpersonal cohesiveness→NPD performance that includes antecedents, consequences, and moderating factors. Antecedents of interpersonal cohesiveness include clan culture, formalization, integration, and political dominance of one department, while consequences are groupthink, superordinate identity, and, ultimately, external/internal new product (NP) performance. The relationships among interpersonal cohesiveness, groupthink, and superordinate identity appear to be influenced by two moderating factors: team norms and goal support. Additionally, product type is identified as a moderator on the effects of both groupthink and superordinate identity on external NP performance. The model is built from two sources: a synthesis of the literature in small group dynamics and NPD, and qualitative research conducted across 12 NPD teams. Individual team leaders were interviewed first, followed by interviews with two additional members on each team, for a total of 36 interviews. In keeping with the goals of qualitative research, the interviews and analysis were used to identify and define aspects of interpersonal cohesiveness rather than to test a preconceived model. Representation of different industries and product types was sought intentionally, and variance in NP innovativeness as well as in NP market success/profitability became key criteria in sample selection. The exploratory model and propositions developed in this study provide a framework for understanding the role of interpersonal cohesiveness in NPD teams and its direct and indirect effects on NP performance. Although a significant amount of research on cohesiveness has been conducted in previous studies of small groups, the narrow laboratory settings of that research have limited the generalizability of the findings. This study therefore serves as a useful starting point for future theory development involving interpersonal cohesiveness in NPD. It also provides a guide for managers in dealing with team cohesiveness. [ABSTRACT FROM AUTHOR]

AIMS AND OBJECTIVES: To explore service user and community mental health nurses views on responses to voice hearing experiences. BACKGROUND: People who hear distressing auditory hallucinations (voices) are often in contact with mental health services. Nursing responses to this experience have been limited, although emerging evidence suggests some utilitarian alternative interventions, such as discussing the content and meaning of the voices. DESIGN: Using exploratory interviews, this study investigated the response to voice hearing, with a purposive sample of community mental health nurses (n = 20) and service users (n = 20). This paper reports on a thematic content analysis of transcribed interviews, which highlighted differences in perspectives of voice hearers and the nurses supporting them. RESULTS: Voice hearers reported that interventions from community mental health nurses were limited to reviews of medication, access to the psychiatrist and non-directive counselling. They identified alternative needs, which involved talking more about the content and meaning of their voices. Conversely, community mental health nurses regarded their responses to voice hearing as being considered, titrated and demonstrating an awareness of the personal contexts of service users. These responses were however restricted by their perception of skill limitations. CONCLUSIONS: The contrasting views of nurses and users of services demonstrated in this study, reveal multiple social realities that represent a challenge to accepted professional responses in the provision of mental health care. RELEVANCE TO PRACTICE: People who hear voices express an interest in more helpful responses from community mental health nurses. The findings of this study indicate that nurses must begin to orientate themselves towards a more critical practice stance that encompasses available knowledge on the voice hearing experience. [ABSTRACT FROM AUTHOR]

This paper focuses on the management of R&D units established by foreign companies in China, investigating R&D missions, site build-up, integration with the parent organization, and overall performance measurement. The research is based on 37 qualitative expert interviews with local R&D directors and managers conducted between 2001 and 2004, using a semi-structured research questionnaire, and semi-quantitative research done on 199 foreign R&D labs in China. Cultural influences on R&D management, location advantages, expatriate involvement, and organizational evolution of local laboratories are discussed. We find that foreign R&D laboratories in China are not only important vehicles for local market development but also increasingly important sources of locally developed technology. [ABSTRACT FROM AUTHOR]

Mental health nurses have traditionally been discouraged from engaging with service users' experiences of hearing voices and to reinforce reality. However, this may not be a helpful way of intervening in what can be a very distressing symptom. There is little evidence of service users' experiences of community mental health nurses' (CMHNs) responses to their voices. This paper presents the findings of an exploratory interview study of a sample (n = 20) of service users to ascertain their perception of CMHN responses to their experience of hearing voices. Data are both quantitative and qualitative in nature. Content analysis of the qualitative elements of the study suggests responses can be conceptualized as facilitators, barriers and attributions. CMHNs are considered to be allies and the quality of the relationship is deemed important. The therapeutic repertoire of CMHNs, however, is seen as limited and rarely extends beyond facilitating access to the psychiatrist for review of medication. [ABSTRACT FROM AUTHOR]

BACKGROUND: Whilst research has been undertaken in relation to the lecturer practitioner role in nursing, there have been no cross-professional studies. There is an explicit political agenda in the United Kingdom on interprofessional education and enhancing the status of those who provide practice-based teaching. AIM: This paper reports a study to investigate the commonalities and differences between lecturer practitioners across professions and to generate hypotheses about the role, which follows different models of practice in the different professions. METHODS: An exploratory research design was adopted, using semi-structured interviews with a purposive sample of lecturer practitioners from six professions (architecture, clinical psychology, law, medicine, nursing and social work). A grounded theory approach was used. FINDINGS: All lecturer practitioners perceived a clear dichotomy between their professional practice role and their university role. All used similar strategies to adapt to and deal with combining two very differently perceived cultures. There were striking similarities in response to the consequences of serving 'two masters' in the areas of time management and role identity/definition. CONCLUSIONS: The role not only bridges theory and practice, but has to operate within very different organizational cultures. Further research is needed to test the generalizability of the findings. Relevance to clinical practice. This investigation aims to inform higher education and health service policy on lecturer practitioners, and also provide support for those undertaking this challenging role. The study poses challenging questions for policymakers in the current climate of interprofessional learning, which need to be addressed if future initiatives in this area are to be successful. [ABSTRACT FROM AUTHOR]

This paper examines the reactions to personnel selection methods in Spain and Portugal using a sample composed of 125 and 104 students, respectively. The results found are very similar in both countries. The best rated and most favorable methods are interviews, résumés and work sample tests, while contacts, integrity tests and graphology were the least favorable ones. With regard to the process dimensions used, face validity and opportunity to perform are the most important bases for considering personnel techniques favorably. The results show some similarities with the ones found by Steiner and Gilliland (1996) in French and American samples. The similarities among the countries are examined and directions for future research are discussed. [ABSTRACT FROM AUTHOR]

The Revised National Tuberculosis Control Programme (RNTCP), which incorporated the WHO DOTS strategy was introduced in India in the mid-1990s. An operational research project was conducted between 1996 and 1998 to assess the needs and perspectives of patients and providers in two chest clinics in Delhi, Moti Nagar and Nehru Nagar, during the introduction of the new strategy. This paper reports on the findings of the project, concentrating on information collected from 40 in-depth interviews with patient defaulters and from non-participant observations in clinics and directly observed treatment centres. In Moti Nagar chest clinic, 117 of 1786 (6.5%) patients and 195 of 1890 (10%) patients in Nehru Nagar left care before their treatment was complete. It was argued that the reasons for default stem from a poor correlation between patient and programme needs and priorities, and from particular characteristics of the disease and its treatment. Patient needs that were not met by the health system included convenient clinic timings, arrangements for the provision for treatment in the event of a family emergency and provision for complicated cases like alcoholics. The problems facing the provider were poor interpersonal communication with the health staff, lack of attention and support at the clinic, difficulty for patients to re-enter the system if they missed treatment and, in certain areas, long distances to the clinic. Problems related to diseases were inability of the staff to deal with drug side-effects, and patients' conception of equating well-being with cure. Simple, practical measures could improve the provision of tuberculosis (TB) treatment: more flexible hours, allowances for poor patients to reach the clinics and training health care staff for respectful communication and monitoring drug side-effects. The findings indicate a need to rethink the label of 'defaulter' often given to the patients. The important areas for future operational research is also highlighted. [ABSTRACT FROM AUTHOR]

Abstract Recently the relevance of the philosophy of Martin Heidegger has been critiqued in nursing literature. However, this critique is based primarily upon an appropriation of Heidegger that does not reflect an understanding of meaning as grounded in temporality. Therefore, this paper aims to (1) explicate Heidegger's grounding of meaning, (2) briefly contrast Heidegger's and Husserl's notions of the origin of meaning, (3) describe how Heidegger was first introduced to nursing, and (4) illustrate through examples from a research study how the philosophy of Heidegger might inform the phenomenological researcher. [ABSTRACT FROM AUTHOR]

Introduction: Healthcare professionals, particularly nurses, have negative attitudes towards individuals with opioid use disorder (OUD) and these attitudes can contribute to suboptimal care. The aim of this study was to identify stigma, barriers and facilitators experienced by members of the OUD community when interacting with the healthcare system. Design: A qualitative exploratory design used semi‐structured focus group interviews to address the study aim. Methods: Following IRB approval, purposive sampling was used to recruit participants with a history of OUD, family caregivers of individuals with OUD, and support group leaders from regional recovery groups to provide a broad perspective of stigmatizing issues and barriers to care. Focus group discussions were conducted, and video recorded using web‐based conferencing software. Transcripts from the focus groups and field notes were analyzed and coded into themes. Results: Both structural and social determinants of health were identified by participants as stigmatizing and/or barriers to care. Thematic content analysis resulted in eight themes: stigmatizing language, being labeled, inequitable care, OUD as a chronic illness, insurance barriers, stigma associated with medications for OUD (MOUD), community resources, and nursing knowledge and care. Conclusion: Members of the OUD community are challenged by both internal and external stigma when seeking healthcare. Stigma negatively affects public support for allocation of resources to treat OUD. Interventions aimed at reducing stigma are critical to support effective OUD treatment and prevent barriers to OUD care. Clinical Relevance: Understanding the complex relationships between stigma and structural determinants of health will allow nursing science to develop educational interventions that provide the next generation of nurses with the knowledge, skills, and attitudes needed to advance health equity for individuals with OUD. [ABSTRACT FROM AUTHOR]

Aim: This study aims to explore the perception of nurses on the use of mobile phone SMS for managing diabetes in rural Ghana. Design: Exploratory Descriptive Qualitative Design. Methods: Purposive sampling was used to recruit (13) participants relative to data saturation after ethical clearance (REDACTED); using a semi‐structured interview guide. All interviews were transcribed verbatim and analysed using thematic content analysis. Results: Participants believe SMS was useful in facilitating interaction between nurses, clients, family and statistically significant others; improving medication adherence and supporting blood glucose monitoring. The use of infographics was preferred to traditional SMS among digitally literate patients and voice calls for those who were illiterate. Participants had limited knowledge of downloadable diabetic applications. Participants were willing to accept and use SMS for the management of diabetes mellitus. Patient or Public Contribution: Thirteen nurses actively participated in the study. [ABSTRACT FROM AUTHOR]

This study applied a fa'afaletui cultural lens to an exploratory qualitative study examining Samoan families' experiences and engagement with a person‐centred care model employed in specific mental health services in Aotearoa. Six semi‐structured talanoa group discussions with families who had been previously or currently engaged with mental health services. In addition, a local stakeholder group was recruited to guide stages of the fa'afaletui. A total of 13 individual participants from six families participated. Participants consisted of four mothers, two fathers, five sisters, one son, and one husband. Five themes were identified: (i) Fa'atuatua ile Atua; Spiritual faith in God; (ii) It is a hush hush topic; stigma of mental illness; (iii) We are in the dark with our communication and dealings with the services; (v) Practice what you preach; clinical service delivery misaligned with the model of care; and (vi) Alofa (love) and fa'aaloalo (respect); enablers of positive experience. The findings overall highlight spirituality and religion as core to a Samoan's faith to foster resilience and healing when facing adverse mental health events with their family members. In addition, the need to build up capacity for Pacific staffed specialist services and Pacific model to achieve equity and holistic care for Samoans and other Pacific populations at risk of adverse mental health outcomes are recommended. [ABSTRACT FROM AUTHOR]

Although the leadership literature has emphasized the importance of leader identity for leader behaviors and leader effectiveness, little is known about whether and how professionals, who are experts in their field and hold a formal leader role, construe a leader identity. To expand our understanding of leader identity construal, we explored how professors in German research universities interpreted their formal leader role and whether and how they saw themselves as leaders. Based on findings from an inductive interview study, we contribute to the literature in three ways: First, our findings imply that patterns of professional identity and leader identity dimensions likely predict when a leader role is rejected, accommodated, incorporated, or emphasized. Second, we explain why professionals with a formal leader role see themselves primarily as specialists, mentors, managers, or shapers. Third, we extend previous notions of the leader identity concept by elaborating on its dimensions. Our findings have practical implications on an individual and organizational level, and may help design more effective leadership development programs. [ABSTRACT FROM AUTHOR]

Background: Human papillomavirus (HPV) self‐sampling has shown to be acceptable and feasible across cultures and effective in reaching women who do not participate in regular cervical cancer screening. However, most of these studies have included younger women. There is a lack of knowledge of how older women reason about HPV self‐sampling. Objective: The aim of this study was to describe how women (>60 years old) experience the offering of self‐sampling of HPV, compared to having a sample collected by a healthcare professional. Design and Participants: The study had a qualitative explorative design. Four focus group discussions were conducted with women 60–69 years old (n = 22). Data were analysed using principles of interpretive description. Results: Five themes were identified: self‐sampling—convenient and without pain, lack of knowledge, worries related to HPV self‐sampling, need for information and taking a societal perspective. Conclusion: Women aged >60 years found that HPV self‐sampling was convenient and easy to perform. Further, they stressed the importance of being able to remain in the screening programme in advanced age and that self‐sampling could be a possible solution. This study also revealed a lack of knowledge among women in this age group regarding HPV infection, how the disease is transmitted and its relation to cervical cancer. Public Contribution: Women who had performed HPV self‐sampling participated in the focus group discussion. [ABSTRACT FROM AUTHOR]

Aim: The aim of the study was to describe continuity from the perspective of working as an agency nurse (AN). Design: Qualitative design was applied using individual semi‐structured interviews. Method: Individual interviews with fifteen registered nurses working at agency companies were conducted in 2020. The interviews were analyzed with thematic analysis. The study followed the guidelines addressed in the COREQ (Consolidated Criteria for Reporting Qualitative Research) framework. Results: Thematic analysis yielded one theme ‐ standing strong and taking command ‐ and four categories: being competent and experienced, being prepared and at ease, ensuring an unbroken chain of care, and belonging on my own terms. The categories illustrated the engagement, professionalism, and natural leadership showed by the ANs to uphold quality and continuity. [ABSTRACT FROM AUTHOR]

Background: Children with autism spectrum disorders (ASD) face challenges in home oral care, accessing a dentist and accepting dental treatment. Aim: To determine the barriers to dental care for autistic children in Singapore through the experiences and opinions of their parents. Design: A qualitative exploratory approach comprising semistructured interviews and a focus group discussion was used. Audio recordings were transcribed and coded into themes using NVivo 12 software. Results: Participants were 23 parents of autistic children aged 3–12 years. The following barriers were identified: (1) Sensory, physical and parental knowledge issues are related to toothbrushing difficulties and use of nonoptimally fluoridated toothpaste in autistic children. (2) Accessing dental services was hindered by a lack of parental knowledge on the importance of an early dental home, parental apprehension about the child's acceptance of dental care, lack of information on specialised dentists and perceived high cost of dental visits. Parental suggestions for improvements included understanding the child's sensory profile, more information on finding a suitable dentist and subsidisation of costs for multiple acclimatisation visits. Conclusion: Caregivers' education, information about specialised dentists and the availability of specific dental care resources for autistic children in Singapore are needed for optimising their dental care. [ABSTRACT FROM AUTHOR]

Transracial adoption (TRA) represents the largest number of non‐disclosed adoptions in South Africa but remains under researched. This exploratory research investigates practices in the Western Cape, via semi‐structured interviews with adoption social workers and magistrates. Thematic analysis of data revealed the following themes: knowledge and attitudes towards the legal/policy framework of TRA; influences on placement decisions; preparation before and support offered after transracial placement; problems faced by adoption practitioners; and the Western Cape as supportive of TRA. A reluctance to engage with race and a de facto acceptance of TRA undermines a critical view of current practice. [ABSTRACT FROM AUTHOR]

Spontaneous imaginary companion (SIC) creation in childhood is a typical imaginative play behaviour associated with advanced sociocognitive skills; however, the direction of causality has not been established. To investigate this experimentally, researchers must determine whether children can create, on request, qualitatively equivalent imaginary companions (ICs) to those created spontaneously. We examined whether children could create ICs, and how these compared to SICs. Nine elementary school children were encouraged to create ICs in a 3‐month intervention. Accounts of elicited ICs were compared with an age‐matched sample of interviewees with SICs. Seven children maintained ICs for 6 months post intervention. Template analysis of IC interviews found four themes: Realistic Play, Multifaceted IC Mind, Utility of the IC, and Elicited IC Across Time. Analysis suggests elicited and SICs were similar in nature and utility, although intervention ICs tended to have animal rather than human appearances. Findings support the argument that children can be encouraged to create ICs similar to SICs. [ABSTRACT FROM AUTHOR]

This study explores the different manifestations and navigations of uncertainty in the practice of diagnostic next‐generation sequencing (NGS) testing. Drawing upon multi‐sited fieldwork conducted at a large Centre for Human Genetics in Belgium, we analyse how uncertainty takes shape and is managed in the different steps of the diagnostic process: starting from the testing offer, to the analysis in the lab, the multidisciplinary team meetings (MDTs) and ending with the consultation with the patient. Building on interviews with genetic healthcare professionals and their patients and observations in consultations and MDTs, our empirical work underlines the duality of uncertainty as both burdensome and productive. Building on the existing literature on uncertainty in medicine and NGS, our analysis shows the ontological politics at play in the everyday uncertainty work in this CHG. We show how the, at times, contrasting ways of dealing with uncertainty lead to friction but also result in constructive negotiation and collaboration between actors, making use of multiple types of evidence and expertise. By not only minimising but also sustaining or inviting uncertainty, genetic healthcare professionals are able to advance the practices around NGS in a way that matches their multidisciplinary understandings, considerations and more normative stances. [ABSTRACT FROM AUTHOR]

Aim: To describe how Swedish emergency nurses experience the preconditions of providing safe care during the COVID‐19 pandemic when collecting blood culture in the emergency department. Design: A qualitative exploratory design using content analysis with a manifest approach. Method: Semi‐structured interviews were conducted with 13 emergency nurses working in the emergency department. Results: The analysis resulted in one main category: unprecedented preconditions create extraordinary stress and jeopardize safe care when collecting blood culture. This main category includes four additional categories: organizational changes, challenges in the isolation room, heavy workload creates great stress, and continuous learning. Conclusion: The COVID‐19 outbreak has made the emergency department a workplace where constant changes of routines combined with new information and reorganization risk jeopardize safe care during blood culture sampling. Accordingly, high workload and stress have been identified as a reason for emergency nurses not following guidelines. It is therefore necessary to optimize the preconditions during blood culture sampling and identify situations where there are shortcomings. [ABSTRACT FROM AUTHOR]

We review methodological issues related to the quantitative assessment of thriving with interviews and paper-and-pencil scales. We emphasize two new paper-and-pencil measures of thriving, the Stress-Related Growth Scale (SRGS; Park. Cohen, & Murch, 1996) and the Posttraumatic Growth Inventory (PTGI: Tedeschi & Calhoun, 1996). These scales are designed to assess perceived benefits that result from a specific stressor, Research with the SRGS suggests a unidimensional structure of thriving, whereas research with the PTGI suggests a multidimensional structure. Two possible reasons for this inconsistent finding concern differences in the method of participant selection and in the recall period for the reporting of stressful events. In addition, we present a number of strategies to validate self-report measures of thriving, including corroboration from significant others and the use of control groups. We conclude with a brief discussion of the assessment of thriving at the group and community levels. [ABSTRACT FROM AUTHOR]

The recent emphasis on community care for those with mental illness has changed working patterns and modified inter-professional role boundaries within multi-disciplinary teams. Clients with serious mental illness are usually prescribed medications, which have a wide range of side effects. However, it is uncertain who is responsible for monitoring clients for the side effects of their medications, ensuring clients' and carers' understandings of their prescribed medications and optimizing compliance with medication. This paper discusses the findings of the first phase of an ongoing study designed to assess the role of community mental health nurses (CMHNs) in managing clients' medication and the provision of appropriate continuing professional education. Our respondents were 14 CMHNs, seven of whom were preparing to undertake a pharmacology module as part of a higher education diploma, and seven who were to act as comparators. Data from questionnaires, interviews and clinical observations were triangulated. All respondents felt that issues surrounding clients' medication were not accorded a sufficiently high profile and that it was, in part, their responsibility to expand their roles to meet these unmet needs of clients. Administering and managing clients' medications were considered to be the main area of 'occupational territory' which distinguished CMHNs from social workers. However, the nurses felt that their practice was limited by lack of appropriate educational preparation. [ABSTRACT FROM AUTHOR]

This study aims to identify different styles of personal digital information categorization based on the mindscape of the categorizers. To collect data, a questionnaire, a diary study, and 2 semistructured interviews were conducted with each of 18 participants. Then a content analysis was used to analyze the data. Based on the analysis of the data, this study identified 3 different types of categorizers: (i) rigid categorizers, (ii) fuzzy categorizers, and (iii) flexible categorizers. This study provides a unique way to understand personal information categorization by showing how it reflects the mindscapes of the categorizers. In particular, this study explains why people organize their personal information differently and have different tendencies in developing and maintaining their organizational structures. The findings provide insights on different ways of categorizing personal information and deepen our knowledge of categorization, personal information management, and information behavior. In practice, understanding different types of personal digital information categorization can make contributions to the development of systems, tools, and applications that support effective personal digital information categorization. [ABSTRACT FROM AUTHOR]

This paper examines the interactional underpinnings of social scientific research. Based on a detailed examination of a two-hour research interview it describes aspects of the conversational practices through which social scientific knowledge is generated. Put critiques of interview research have been somewhat unilateral in their focus, typically examining how researchers impose understandings on their subjects' reports. This paper moves beyond the unilateral focus to describe how researcher and subjects interact to mutually develop procedures for doing the actual research and collaboratively assemble their product. The analysis treats evaluative knowledge as a locally managed, interactional achievement. It stresses the practical, the situ character of how knowledge is co-produced. [ABSTRACT FROM AUTHOR]

In this paper I present a method for obtaining qualitatively rich discourse relatively inexpensively. The method consists in training informants in the use of a technique which requires them to imaginatively re-live events and to run a commentary on them in the present tense as though they are happening now. The selection of events and the construction of the commentary proceeds freely under the control of the subject and with the minimum of interference from the researcher. The aim is to make visible the skillful negotiations, perceptual strategies and understandings of subjects together with their occasioning contexts. The use of the method is set in the context of a discussion of the problems of interview research and illustrated with reference to data from two empirical studies, one with doctors and nurses in an abortion clinic and the other with managers of a financial services company. The paper also addresses the ethical issues involved in the use of such a method and the political problems that can arise in the handling of qualitatively rich data. [ABSTRACT FROM AUTHOR]

Within a framework which includes a review of the comparative strengths of questionnaire and interview based research and of the use of the telephone within both traditions, an account is given of an apparently innovative technique used to evaluate the trials of an educational database. As work had to be conducted quickly to a low budget and in respect of dispersed respondents, a postal questionnaire followed by telephone interview technique was devised and implemented. The paper concentrates on a critical review of the processes involved, and points to areas of future research development. [ABSTRACT FROM AUTHOR]

Moral certainty and uncertainty have a profound impact on nurses' ethical choices. In order to describe these concepts, the author examined long-term care nurses' convictions about the issue of withholding or withdrawing artificial nutrition and hydration from elders. A convenience sample of 25 BSN and MSN-prepared long-term care nurses were interviewed and asked to describe their experiences with this issue. A qualitative analysis utilizing Colaizzi's (1978) methodology was performed. Five categories of conviction emerged from the data. These five categories included absolute moral conviction, strong moral conviction, moderate moral conviction, moral uncertainty with conviction and moral uncertainty. Eighty-four per cent of the sample was convinced that tube feeding was not always in the resident's best interest. Sixteen per cent of the sample were uncertain, but were convinced that the resident should not suffer. A pattern emerged from the interview results and the answers to three additional questions. The pattern suggests that the more experience a nurse has with nontreatment the more likely she or he is to agree with it. In this paper. the five categories of conviction are compared and contrasted, the pattern of conviction described, and the implications of the findings for nursing discussed. [ABSTRACT FROM AUTHOR]

The ward sister role is increasingly coming understudy. This paper summarizes research into learning in the ward environment. The study being one of several on a similar theme, to have been published in the past 2 years. The research concentrated in particular on the behavioural characteristics of trained nurses perceived as good teachers. Attitudes and perceptions of teaching and teaming were investigated by interviewing trained and trainee nurses. The data concerning good teachers collected at interviews were developed into a questionnaire and the results factor analysed+ In the third phase of the study trained nurse-trainee verbal communications were observed and analysed to determine any relationship between verbal behaviours and effective teaching. The findings of the study led to the conclusion that on the job teaching of nurses is a complex global act in which the role model presented to the Learner has a powerful influence while it could nor be said conclusively that a link between effective teaching and verbal behaviour was identified, a trend towards a more participative mode of communication was noted in two identified good teachers. [ABSTRACT FROM AUTHOR]

Today's business environment is becoming increasingly dynamic, and the concept of agility is gaining attention in the corporate world and in academia. The objective of our research is to explain how talent management (TM) can shape talents as key human resources, according to company‐specific agility needs, and thus contribute to gaining competitive advantage in dynamic firm environments. We approach this task by viewing it from the perspective of dynamic capabilities. A total of 24 semistructured interviews were conducted with senior TM professionals working in German companies differing in terms of size, age, structure, industry, and ownership. As a result, we identified three different types of dynamic TM capabilities promoting organizational agility to various extents. By rooting our qualitative study in the research fields of TM and agility in the under‐researched theoretical realm of dynamic capabilities, we contribute to the theoretical as well as the empirical discussion by addressing the specific challenges of an increasingly dynamic environment. As a result, we provide a contextualized viewpoint from which to explain the process inherent in dynamic TM capabilities that continuously shape talent and organizational agility. [ABSTRACT FROM AUTHOR]

In the article, the author explains the meaning of popular science. He states that the building of science is a more chaotic process. The author is concerned with the individual acts of generating a new idea that sum up into the body of scientific information. To do research is to be in a special state of grace. He maintains that American archival journals suffer for not recording more of the raw experience. He proposes a sort of interview in which good scientists and engineers talk in a very personal way about how they do science and what it means to them.

Children placed in residential care are significantly over‐represented in youth justice systems. Drawing on interviews and focus groups with service providers, this exploratory study examines practice factors that impact on the criminalization of this group of children across multiple services and systems, including in the residential care environment, police, lawyers, courts and youth justice systems, as well as multi‐systems practice with this group in one Australian state. Positive outcomes were observed for children in residential care where well‐functioning care teams existed, as well as for children in therapeutic residential care settings. However, clear limitations were identified across all phases of children's youth justice system involvement, including placement with offending peers, the criminalization of behaviours of concern, greater use of remand and detention, limited support to navigate legal and youth justice processes, challenges to service collaboration, and limited applicability of sentencing considerations. The findings indicate a pervasive level of systemic disadvantage for this group of children, and imply that a holistic strategy underpinned by affirmative action across several systems will be necessary to address the ongoing criminalization of children in residential care. [ABSTRACT FROM AUTHOR]

Introduction: While expert clinical practice requires a flexible approach to problem solving, evidence shows that medical clerks tend to focus on knowledge acquisition as the key to expertise. It is not until residency training that learners shift their understanding of expertise towards developing adaptive approaches to clinical problems. This raises the possibility that adaptive expertise is a threshold concept and that authentic clinical experiences involving complex problem solving are required to create the liminal state that enables transformation to an adaptive expertise mindset. With this possibility in mind, the current study examined the conceptualisations of expertise held by recently graduated physical therapists using the framework of threshold concepts as a sensitising lens. Methods: An exploratory qualitative study in the Constructivist Grounded Theory tradition was conducted, utilising 14 one‐on‐one semi‐structured interviews with recently graduated physical therapists. Results: Most participants were in a transitional state regarding their conceptualisation of expertise, sometimes focusing on the acquisition of knowledge and routinisation of practice as their hallmark of expertise and at other times acknowledging the need for developing more dynamic and adaptive problem‐solving approaches to patient care. These mixed responses were expressed not only in their framing of patient management but also in their reasons for valuing colleagues and in their approach to continuing professional development. Notably, many participants suggested that the interview itself was a key impetus to their reflecting on these issues. Conclusion: Our findings suggest that participants were only beginning to transition into an adaptive expertise mindset upon entering practice, reinforcing the possibility that authentic practice may be an important impetus for recognising the limits of routine expertise. However, spontaneous comments from participants suggest that this transition might be better supported though active guided reflection in addition to meaningful clinical engagement with patients and colleagues. After interviewing physical therapy students, the authors suggest that adaptive expertise is a threshold concept that requires the "troublesome" discovery of the limits of "knowing all the answers." [ABSTRACT FROM AUTHOR]

Perceived stress, a known risk factor for poor health, has been extensively assessed in adult populations. Yet an equivalent assessment tool for measurement of global perceived stress in children is lacking. This study aimed to develop and provide initial validation of a scale to measure perceived stress in children aged 7–11 years. Using a two‐phase design, we conducted semi‐structured interviews with thirteen child‐parent dyads for development of items. In a sample of 123 children (age range 7–11 years, Mage = 9 years 7 months, 54.5% male) we administered the resulting Perceived Stress Scale for Kids (PeSSKi). Exploratory factor analysis of the 10‐item PeSSKi yielded support for both a one‐factor and a two‐factor solution (negative, positive item wording). The PeSSKi was associated positively with the Penn‐State Worry Questionnaire for Children (r = 0.748, p < 0.001) and negatively with the Students' Life Satisfaction Scale (r = 0.381, p < 0.001) indicating strong convergent/divergent validity respectively. Girls showed higher scores on the PeSSKi than boys with no effects observed by age. Initial psychometrics suggest the PeSSKi provides a robust scale for assessment of perceived stress in children. Further validation is needed across different child populations, over time and with physical measures of stress and health outcomes. [ABSTRACT FROM AUTHOR]

Introduction: Antimicrobial resistance is one of the biggest threats facing global humanity. In 2014, Public Health England (now the UK Health Security Agency) launched the Antibiotic Guardian (AG) campaign as a national health promotion initiative to increase public and health professionals' commitment to reducing the threat of antibiotic resistance (ABR). The aim of this research study was to gain a snapshot of public AG attitudes towards antibiotic use, the AG campaign and illness postpledge. Methodology: This research used an exploratory study design using thematic and framework analysis of semistructured, in‐depth interviews. A purposive convenience sampling strategy was used to recruit 10 participants; adults in the general population who had registered with and chosen an AG pledge via the AG online platform during November 2020 were eligible for inclusion. Interviews were conducted via Zoom. Results: Six main themes were identified: campaign awareness, motivators to pledge (uncertainty about the future of ABR, personal gratification, personal responsibility, moral obligation and COVID‐19), perceptions of personal responsibility (and patient perspectives of moral obligation in clinicians), the impact of the campaign and campaign promotion. Pledging appeared to solidify existing perceptions AGs held. Behavioural motivations for responsible antibiotic behaviours stemmed from perceptions of personal responsibility, moral obligation and concerns about ABR. AGs attributed responsibility to variable patterns in overprescribing. Perceptions towards COVID‐19, coinciding with the previously established study period, appeared mixed. AGs were keen to promote responsible perceptions in relation to antibiotics, resistance and the AG campaign. However, poor social acceptability of ABR concern was raised as a barrier to campaign promotion. Discussion: The AGs' longstanding commitment to antimicrobial resistance demonstrates the importance of a pre‐existing interest in the public's self‐reported judicious behaviours and decision to pledge to an ABR‐focused campaign. Presenting the local and global threat to human mortality and morbidity in a more relatable format in public messaging should be considered in future strategies promoting ABR awareness and shifts in public perceptions. More frequent messaging to existing AGs is further recommended to propagate positive behaviour change among a wider audience. Patient or Public Contribution: This study was based on interviews with adult members of the public who had pledged to be AGs via the website www.AntibioticGuardian.com. Interviews were based on the public's perceptions of the AG campaign, antibiotic use and ABR. [ABSTRACT FROM AUTHOR]

Introduction: Covid‐19 expanded the use of remote working to engage with public contributors in health and social care research. These changes have the potential to limit the ability to participate in patient and public involvement and engagement (PPIE) for some public contributors. It is therefore important to understand public contributors' preferences, so that remote working can be organized in an optimal way to encourage rather than discourage participation. Methods: We use an economic preference elicitation tool, a discrete choice experiment (DCE), via an online survey, to estimate public contributors' preferences for and trade‐offs between different features of remote meetings. The features were informed by previous research to include aspects of remote meetings that were relevant to public contributors and amenable to change by PPIE organizers. Results: We found that public contributors are more likely to participate in a PPIE project involving remote meetings if they are given feedback about participation; allowed to switch their camera off during meetings and step away if/when needed; were under 2.5 h long; organized during working hours, and are chaired by a moderator who can ensure that everyone contributes. Different combinations of these features can cause estimated project participation to range from 23% to 94%. When planning PPIE and engaging public contributors, we suggest that resources are focused on training moderators and ensuring public contributors receive meeting feedback. Discussion and Conclusion: Project resources should be allocated to maximize project participation. We provide recommendations for those who work in public involvement and organize meetings on how resources, such as time and financial support, should be allocated. These are based on the preferences of existing public contributors who have been involved in health and social care research. Patient or Public Contribution: We had a public contributor (Naheed Tahir) as a funded coapplicant on the UKRI ESRC application and involved members of the North West Coast Applied Research Collaboration (NWC ARC) Public Advisor Forum at every stage of the project. The survey design was informed from three focus groups held with NWC ARC public contributors. The survey was further edited and improved based on the results of six one‐to‐one meetings with public contributors. [ABSTRACT FROM AUTHOR]

Rationale, Aims, and Objectives: While paediatric clinician‐scientists are ideally positioned to generate clinically relevant research and translate research evidence into practice, they face challenges in this dual role. The authors sought to explore the unique contributions, opportunities, and challenges of paediatric clinician‐scientists, including issues related to training and ongoing support needs to ensure their success. Method: The authors used a qualitative descriptive approach with thematic analysis to explore the experiences of clinician‐scientist stakeholders in child health (n = 39). Semi‐structured interviews (60 min) were conducted virtually and recorded. Thematic analysis was conducted according to the phases outlined by Braun and Clarke (2006). Results: The analysis resulted in the creation of three themes: (1) "Walking on both sides of the fence": unique positioning of clinician‐scientists for advancing clinical practice and research; (2) the clinician‐scientist: a specialized role with significant challenges; and (3) beyond the basics of clinical and research training programmes: essential skill sets and knowledge for future clinician‐scientists. Conclusions: While clinician‐scientists can make unique contributions to the advancement of evidence‐based practice, they face significant barriers straddling their dual roles including divergent institutional cultures in healthcare and academia and a lack of infrastructure to effectively support clinician‐scientist positions. Training programmes can play an important role in mentoring and supporting early‐career clinician‐scientists. [ABSTRACT FROM AUTHOR]

Rationale, Aims and Objectives: Nasogastric feeding is becoming commonly used to support patients with medically compromised eating disorders. Previous research has demonstrated the safety of this approach, however there is limited evidence as to how adult patients and staff perceive this feeding method. This study aimed to describe the acceptability of a nasogastric refeeding protocol with adult patients with medically unstable eating disorders and the staff involved in their treatment. Method: This was a qualitative exploratory study using semi‐structured interviews conducted in acute medical wards of a tertiary hospital where nasogastric nutrition is the sole source of nutrition for the first 7 days of the eating disorder admission. Data were analysed using the Framework method. Results: Eight patients (100% female, median: 22 years old, n = 6 diagnosed with anorexia nervosa) and 12 staff members (medical n = 5, nursing n = 5, dietitians n = 2; median: 8.5 years clinical experience) were interviewed. Patients reported that nasogastric feeding was tolerable, however concerns were raised regarding communication and the desire for concurrent oral feeding. Acceptability from staff was influenced by perceived competence, confidence, tensions around patient‐centred care, and working with stigma and ambivalence. Conclusions: Consideration needs to be given as to whether a 'nil by mouth' status during nasogastric feeding further impacts recommencing an oral diet to progress treatment. Improvements are required within the current service, including improved communication, additional educational resources for patients, and allowing patients to partake in decision‐making as able. [ABSTRACT FROM AUTHOR]

Background: Health care providers (HCPs) in the emergency department (ED) frequently must decide whether to conduct or forego confidential conversations with adolescent patients about sensitive topics, such as those related to mental health, substance use, and sexual and reproductive health. The objective of this multicenter qualitative analysis was to identify factors that influence the conduct of confidential conversations with adolescent patients in the ED. Methods: In this qualitative study, we conducted semistructured interviews of ED HCPs from five academic, pediatric EDs in distinct geographic regions. We purposively sampled HCPs across gender, professional title, and professional experience. We used the Theoretical Domains Framework (TDF) to develop an interview guide to assess individual and system‐level factors affecting HCP behavior regarding the conduct of confidential conversations with adolescents. Enrollment continued until we reached saturation. Interviews were recorded, transcribed, and coded by three investigators based on thematic analysis. We used the coded transcripts to collaboratively generate belief statements, which are first‐person statements that reflect shared perspectives. Results: We conducted 38 interviews (18 physicians, 11 registered nurses, five nurse practitioners, and four physician assistants). We generated 17 belief statements across nine TDF domains. Predominant influences on having confidential conversations included self‐efficacy in speaking with adolescents alone, wanting to address sexual health complaints, maintaining patient flow, experiencing parental resistance and limited space, and having inadequate resources to address patient concerns and personal preconceptions about patients. Perspectives divided between wanting to provide focused medical care related only to their chief complaint versus self‐identifying as a holistic medical HCP. Conclusions: The factors influencing the conduct of confidential conversations included multiple TDF domains, elucidating how numerous intersecting factors influence whether ED HCPs address sensitive adolescent health needs. These data suggest methods to enhance and facilitate confidential conversations when deemed appropriate in the care of adolescents in the ED. [ABSTRACT FROM AUTHOR]