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Portfolios are used in midwifery education to provide students with a central place to store their accumulative evidence of clinical experience for initial registration in Australia. Portfolio formats can be paper-based or electronic. Anecdotal discussion between midwifery students in Queensland debated the best format to document the requirements for the Australian Nursing and Midwifery Accreditation Council (ANMAC) standard 8.11. Midwifery students using paper-based portfolios envisioned that an ePortfolio would be streamline, simple, safe to use, and able to be used anywhere with WIFI, while some students using an ePortfolio expressed a desire to have a paper-based portfolio as a hard copy. This situation called for evidence of a comparison to resolve the debate. The aim of this study was to investigate midwifery students' experiences of the benefits and challenges between paper-based and ePortfolios when compiling evidence to meet the requirements for initial registration as a midwife in Australia (ANMAC, 2014). • Each type of portfolio had challenges and benefits. • Portfolio completion is time consuming, and stressful due to the need for verification of evidence. • Students require early and regular feedback on portfolio development. • National standards are required for consistency in documentation across universities. [ABSTRACT FROM AUTHOR]

The paper hand-held record (PHR) has been used extensively in general practice (GP) shared care management of pregnant women, and recently, the first Mater Shared Electronic Health Record (MSEHR) was introduced. The aim of this qualitative study was to examine women's experiences using the records and the contribution of the records to integrate care. At the 36-week antenatal visit in a maternity tertiary centre clinic, women were identified as a user of either the PHR or the MSEHR and organised into Phase 1 and Phase 2 studies respectively. Fifteen women were interviewed in Phase 1 and 12 women in Phase 2. Semi-structured interviews were used for data collection, and analysed using qualitative content analysis. Four main themes were identified: (1) purpose of the record, (2) perceptions of the record; (3) content of the record, and (4) sharing the record. Findings indicate that the PHR is a well-liked maternity tool. The findings also indicate there is under-usage of the MSEHR due to health-care providers failing to follow up and discuss the option of using the electronic health record option or if a woman has completed the log-in process. This paper adds to an already favourable body of knowledge about the use of the PHR. It is recommended that continued implementation of the MSEHR be undertaken to facilitate its use. [ABSTRACT FROM AUTHOR]

Background: The aim of the research is to shed light on the experiences of a group of nursing students enrolled in a yoga elective course who practiced yoga regularly for 14 weeks, regarding yoga and the phenomenon of doing yoga, with a qualitative approach. Methods: This qualitative study was conducted at a public university in Izmir, Turkey. The study sample consisted of 61 students enrolled in the 1st-year yoga course at the Department of Nursing, Faculty of Health Sciences. Except for two students, 59 of them participated in the study. Participants attended a face-to-face yoga course once a week for 1.5 h over a 14-week period. Each session comprised 30 min of theoretical instruction and 60 min of practice. In data collection, an interview form containing five questions was used to understand nursing students' experiences and thoughts about practicing yoga. In addition, A4 sized papers in different colors were presented to the participants. The participants were asked to draw and/or cut a shape by choosing the paper in the color that most evokes yoga. Then they were asked to explain why they chose this color and why they drew this shape. Participants were given one hour. After the data were collected, the pictures drawn by the participants and their descriptions of their drawings were transferred to the computer and included in the analysis. Qualitative data were hand-coded by the researchers. Within in-vivo coding, code names were formed from the participants' expressions. The findings analyzed by content analysis were interpreted with the literature under the themes by presenting quotations. Results: It was determined that the participants used nature figures (sun, cloud, tree, sky, flower) (f = 75), people doing yoga (f = 12), and sound, light and other figures (bird sound, wave sound, candle, light bulb, traffic light, heart, eye, left key, peace, swing, India, circle, etc.) (f = 29) in the shapes they drew and cut out on A4 sized papers in different colors to describe their experiences and thoughts about practicing yoga. The participants mostly chose blue-green-yellow colors (n = 41). With qualitative question analysis, a list of codes was created from the answers given by the students to the questions for the phenomenon of "doing yoga" (number of codes = 98). After the analysis of the data, four categories were reached. The category names and frequency numbers explaining the phenomenon of practicing yoga were distributed as "symbol of health and serenity (f = 345)", "the way to place goodness in your heart (f = 110)", "the most effective way to meet the self (f = 93)" and "no guarantee of relaxation (f = 71)", respectively. Conclusions: The results indicate that yoga is perceived by nursing students as a multifaceted practice that evokes a range of emotional and physical responses. Most participants associate yoga with symbols of health, serenity, and self-awareness, often using natural elements and blue-green-yellow the colors to represent these feelings. However, there is also recognition that yoga may not guarantee relaxation for everyone, as some students reported difficulties in meditation, physical discomfort, and challenges in focusing. The study highlights the variability in how individuals experience yoga, emphasizing both its positive effects on well-being and the potential challenges in practice. These findings suggest that while yoga is widely valued for its calming and health-promoting benefits, it may not be universally effective in achieving relaxation or mindfulness. [ABSTRACT FROM AUTHOR]

Workarounds are commonplace in healthcare settings. An increase in the use of electronic health records has led to an escalation of workarounds as healthcare professionals cope with systems which are inadequate for their needs. Closely related to this, the documentation of vital signs in electronic health records has been problematic. The accuracy and completeness of vital sign documentation has a direct impact on the recognition of deterioration in a patient’s condition. We examined workflow processes to identify workarounds related to vital signs in a 372-bed hospital in Sweden. In three clinical areas, a qualitative study was performed with data collected during observations and interviews and analysed through thematic content analysis. We identified paper workarounds in the form of handwritten notes and a total of eight pre-printed paper observation charts. Our results suggested that nurses created workarounds to allow a smooth workflow and ensure patients safety. [ABSTRACT FROM AUTHOR]

Background: The Partners in Recovery (PIR) program was implemented by the Australian Government Department of Health. Its overriding aim was to improve the coordination of services for people with severe and persistent mental illness, and who have complex needs that are not being met. The PIR capacity-building project (CBP) was funded to provide capacity building activities to the nationwide network of consortia that were set up in 2013 to deliver PIR over a 3-year period. The purpose of this paper is to describe the design and findings from an evaluation of the PIR CBP. Methods: The evaluation involved collecting feedback from consenting PIR staff via an online survey and follow-up semi-structured interviews. CBP activities included: state and national meetings; a web portal; teleconferences; webinars; a support facilitator mentor program; and tailored support from the CBP team. Results: The CBP made a positive contribution to the implementation and delivery of PIR. Staff highly valued activities that employed face-to-face interaction or provided informative knowledge exchange, and were appreciative of CBP staff being responsive and adaptable to their needs. Conclusions: From this evaluation, we recommend the following: identify relevant functions (e.g. prioritise networking), select the right mode of delivery (e.g. establish an online presence) and abide by key principles (e.g. be responsive to staff needs). This information is informing the mental health workforce capacity building activities that our team is currently undertaking. Capacity-building programs are necessary for advancing new public health initiatives, yet there remains limited evidence to inform best practices for delivering these in the context of mental health. This paper describes the design and findings of a capacity-building program developed to enhance the knowledge and skills of community-based mental health providers. From this evaluation, we recommend the following to ensure effective capacity-building programs: identify relevant functions (e.g. prioritise networking), select the right mode of delivery (e.g. establish an online presence) and abide by key principles (e.g. be responsive to staff needs). [ABSTRACT FROM AUTHOR]

Intersectoral collaborations are recommended as effective strategies to reduce health inequalities. People most affected by health inequalities, as are people living in poverty, remain generally absent from such intersectoral collaborations. Community-based participatory research (CBPR) projects can be leveraged to better understand how to involve people with lived experience to support both individual and community empowerment. In this paper, we offer a critical reflection on a CBPR project conducted in public housing in Québec, Canada, that aimed to develop intersectoral collaboration between tenants and senior executives from four sectors (housing, health, city and community organizations). This single qualitative case study design consisted of fieldwork documents, observations and semi-structured interviews. Using the Emancipatory Power Framework (EPF) and the Limiting Power Framework (LPF), we describe examples of types of power and resistance shown by the tenants, the intersectoral partners and the research team. The discussion presents lessons learned through the study, including the importance for research teams to reflect on their own power, especially when aiming to reduce health inequalities. The paper concludes by describing the limitations of the analyses conducted through the EPF–LPF frameworks and suggestions to increase the transformative power of future studies. [ABSTRACT FROM AUTHOR]

Background Study: Asynchronous online discussions are vital venues for collaborative knowledge construction. However, the lack of appropriate instruction designs poses challenges in promoting deep and substantive engagement with the core subject matter. This paper explores how to enhance adult students' knowledge construction in the context of asynchronous online discussions at an open university in Taiwan. Objectives: This study explores instructional designs aimed at promoting online knowledge construction among adult students and overcoming barriers to this process. Methods: This study used a convergent parallel mixed methods design to collect concurrently both quantitative data from the students' online discussion postings for content analysis and qualitative data from the focus group and individual interviews, the online open‐ended questionnaire, and the instructor's observation logs for thematic analysis. Then the results were merged in the interpretation stage. Results and Conclusion: The research highlights the significance of instructional designs in influencing students' level of knowledge construction during online discussions. The findings suggest that instructional designs that provide teacher‐led interim summaries, pose Socratic questions, and incorporate problem‐solving projects can promote higher‐level knowledge construction. However, time constraints, cultural influences, and unfamiliarity with peers negatively affected higher‐order knowledge construction. To address these challenges, culturally responsive and technologically inclusive instructional designs that take into account the specific challenges faced by adult learners are proposed to enhance learning outcomes through active participation. Limitation: The study's limited sample size warrants further research with a larger and more diverse cohort to validate the effectiveness of the proposed instructional designs. Another limitation is the lack of a robust theoretical base for the instructional strategies presented by the current action‐research study. Further examination and broader exploration in online education are needed to prop up proposed pedagogical approaches. Lay Description: What is currently known about this topic: Online discussions are essential for collaborative knowledge construction among adult students.Existing research primarily indicates that online knowledge construction often remains at a basic level, predominantly involving the sharing and comparing of information. What this paper adds: This study explores instructional designs aimed at elevating online knowledge construction among adult students at an open university in Taiwan.It identifies specific instructional strategies, such as teacher‐led interim summaries, the use of Socratic questioning, and the integration of problem‐solving projects, as effective in promoting higher‐level knowledge construction.The paper also sheds light on the challenges hindering higher‐order knowledge construction, including time constraints, cultural influences, and unfamiliarity among peers. Implications for practice and/or policy: The findings underscore the need for culturally responsive and technologically inclusive instructional designs. These should be tailored to the unique challenges faced by adult learners, particularly in asynchronous online environments.The paper suggests that such instructional designs can significantly improve learning outcomes by fostering more active and deeper participation in online discussions.It also highlights the importance of further research to validate these strategies, given the study's limited sample size and the need for a more robust theoretical foundation for the proposed instructional methods. [ABSTRACT FROM AUTHOR]

Background: With the growing integration of technology in education, the adoption of blended learning (b‐learning) has gained attention. B‐learning combines traditional classroom teaching with online components, holding potential to enhance student outcomes and educational efficiency. Yet, current research predominantly concentrates on higher education institutions in urban areas, creating a void in understanding its impact on K‐12 education, particularly in rural settings. Objectives: This qualitative study aims to propose recommendations for successful implementation of blended learning in rural K‐12 areas by addressing the key stakeholders influencing its adoption and identifying the main factors affecting its success. Methods: We performed a content analysis of grey literature documents detailing the implementation of b‐learning in K‐12 education. Additionally, interviews with crucial stakeholders such as teachers, principals, and experts in rural schools in South America provide insights into the challenges and prospects of b‐learning adoption in these contexts. Results and Conclusions: The study identifies pivotal stakeholders for effective b‐learning implementation, outlining their roles and addressing challenges inherent in rural settings. Recommendations for enhancing b‐learning's implementation in developing countries are also proposed. The research underscores the significance of involving diverse stakeholders such as governmental bodies, school leaders, educators, students, and families to ensure a holistic and efficient approach to blended learning. Lay Description: What is currently known about this topic: Blended Learning Definition and Benefits: Blended learning combines face‐to‐face and online instruction, enhancing student engagement and personalization by providing diverse learning pathways.Growth in K‐12 Implementation: Blended learning gained traction in K‐12 education, boosting academic outcomes, driven by recognition of learner diversity and potential in meeting students' needs.Contextual Challenges: Implementation challenges arise in low‐income households and rural areas, including limited access to technology and internet connectivity, impacting student engagement and success. What does this paper add: Focusing on Rural Dynamics: This study helps to fill a gap by investigating blended learning in rural K‐12 settings, spotlighting key players and success drivers in these unique contexts.Recommendations from Various Sources: By combining interviews and grey literature, this research generates comprehensive, practical recommendations grounded in both empirical insights and real‐world perspectives.Insights into Rural Hurdles: This paper extends the discussion on blended learning by addressing specific rural barriers, proposing family involvement, private sector partnerships for training, and tailored pedagogical strategies. Implications for practice or policy: Leadership and Collaboration: Effective school leadership and collaboration with local governments are pivotal for fruitful blended learning implementation, ensuring defined roles, responsibility, and accountability.Adaptable Curriculum Design: An adaptable, centralized curriculum aligns with recommendations, fostering efficient tracking of student progress and enabling customized learning.Engagement‐Centric Pedagogies: Recommendations spotlight interactive, student‐centered teaching methods, tailored to diverse student needs, nurturing active participation and elevated learning outcomes. [ABSTRACT FROM AUTHOR]

Accessible Summary: What is known on the subject?: Workplace violence is common in healthcare.Workplace violence remains a complex and serious occupational hazard in healthcare. What this paper adds to existing knowledge?: Since there is no study examining detailed explanations of experiences and perspectives of workplace violence among psychiatric nurses, this study will act as a guide for psychiatric nurses.This study provides information about how psychiatric nurses evaluate the concept of workplace violence from their perspective, what it means to them and the effects of workplace violence. What are the implications for practice?: Considering the effects of workplace violence, a preventive, systematic and holistic approach should be used in psychiatry and community mental health centres.Supportive interventions should be used to improve the health and safety of psychiatric nurses and patients. Introduction: Workplace violence is common in healthcare and remains a complex and serious occupational hazard. Aim: This research was conducted to assess the workplace violence experiences and perspectives of psychiatric nurses. Method: This study was a qualitative study conducted using a grounded theory approach method. The study was conducted between November 2022 and January 2023. The purposeful sampling method was used, and 11 psychiatric nurses were interviewed. Data were collected with an information form and a semi‐structured interview form. The data were analysed using content analysis, and themes were created. Findings: The ages of the psychiatric nurses ranged from 38 to 57 years. Themes and sub‐themes related to the workplace violence experiences and perspectives of psychiatric nurses included the way of violence (rising tension, eruption of the volcano, unintentional violence and turning to ash) and empowerment (ash cloud and ring of fire). Conclusion: Psychiatric nurses stated that they were exposed to verbal and physical violence for many reasons, that this situation seriously affected their physical, mental and social health and that in addition to the devastating effects of violence, they became stronger by developing various skills to protect against violence. Implications for Practice: Supportive interventions should be used to improve the health and safety of psychiatric nurses and patients. Strategies can be developed to include psychiatric nurses in occupational health nursing courses. [ABSTRACT FROM AUTHOR]

Objective: This study explored the experiences, concerns and perceptions of hospital clinical staff returning to work after parental leave during the COVID-19 pandemic. Methods: An exploratory mixed-methods study was performed. Eligible staff employed at a large metropolitan tertiary health service in Melbourne, Australia, completed an ethics-approved anonymous online cross-sectional survey and/or participated in an interview between February and June 2021. Results: Ninety-six staff completed a survey and four participated in an interview. Staff reported both positive and negative aspects of being on parental leave during the COVID-19 pandemic including disappointment their leave had not gone as planned; feeling isolated from family and friends; wanting greater communication from their health service; appreciating the increased opportunities for them and their partner to be at home and bond with their baby; and concerns about returning to work such as limited knowledge of COVID-19 workplace policies and potentially infecting their baby and family. Conclusions: The COVID-19 pandemic had a unique impact on the parental leave and return to work experiences of hospital clinical staff. The findings suggest that staff would benefit from formal return to work policies and programs including regular contact with their manager while on parental leave and workplace reorientation on their return, especially during events such as a pandemic. What is known about the topic? Healthcare workers often experience additional challenges and stressors returning to work after parental leave compared to other workers. What does this paper add? The COVID-19 pandemic had a unique impact on the parental leave and return to work experiences of healthcare workers who reported positive and negative aspects including isolation, limited workplace communication and increased opportunities for bonding with their baby. What are the implications for practitioners? Appropriate organisational initiatives may alleviate staff distress and support their return to work and could include formal return to work programs, regular managerial contact and workplace reorientation. [ABSTRACT FROM AUTHOR]

Objective: To explore the experiences and emotions of individuals with depression and physical comorbidity within the context of psychoeducational group interventions led by primary care nurses in Catalunya (Spain). Method: A psychoeducational group intervention was conducted in the first semester of 2019 with 13 primary care teams (rural/urban) and 95 participants with depression and physical comorbidity. The qualitative research and phenomenological perspective were based on 13 field diaries and 7 semi‐structured interviews carried out with the observer nurses. The interviews were recorded and transcribed. Codes were identified by segmenting the text into citations/verbatim accounts and emerging categories/subcategories by regrouping the codes. The results were triangulated among the researchers to identify and compare similarities and differences. Results: Four major themes were found: (a) gender differences; (b) coping strategies and changes observed during the intervention; (c) functions of the group as a therapeutic element; and (d) the nurses' perceptions of the group experience. Gender differences were identified in relation to experiences and emotions. Conclusions: As some patients acquired skills/behaviours during the intervention that helped them initiate changes and the nurses were satisfied with the intervention, it is important to include this information when planning effective interventions for patients with this profile. Summary statement: What is already known about this topic? There are gender differences in the prevalence of depression. What this paper adds? This study describes the experiences and emotions of women with depression and physical comorbidity within the context of psychoeducational group intervention. The implications of this paper: The study provides information about the experiences and emotions of women with depression. It will be important to include this qualitative information when planning effective interventions directed at patients with this profile. [ABSTRACT FROM AUTHOR]

Aims: To discuss the levels of structural empowerment (SE) and psychological empowerment (PE) and the factors that influence perceptions of empowerment among newly graduated nurses (NGNs). Design: Mixed methods study. Methods: The quantitative part of the study was conducted with 220 NGNs with <1 year of job experience. The study was conducted between February and May 2023. Focus group discussions were conducted with 30 NGNs. Data were collected by using the Conditions for Work Effectiveness Questionnaire (CWEQ‐II), the Psychological Empowerment Scale (PES) and a Semi‐Structured Interview Form. Quantitative data were analysed using stepwise regression analysis. Content analysis was used to analyse qualitative data. Results: CWEQ‐II and PES were moderate. The regression analysis showed that NGNs' SE scores increased in association with the following factors, including an increase in the total score on the PES, being married/having a partner, working a day shift, having career planning, increased satisfaction with the orientation programmes of the institution and increased satisfaction with the employing institution. As a result of the descriptive analysis of the focus group interviews conducted to determine the empowerment perceptions of NGNs, we identified three contexts along with the associated themes and subthemes. These three contexts were the 'concept of power', 'professional impression' and 'empowerment process'. Conclusion: The results of this study indicate that the SE and PE levels of NGNs are moderate, and their empowerment perceptions are influenced by many factors that can be individual, organizational and work environment relevant. Impact: This study's findings will guide policymakers, educators, researchers and administrators in empowering NGNs essential to the healthcare workforce. Reporting Method: The paper adheres to the COREQ checklist. Patient or Public Contribution: No patient or public contribution. [ABSTRACT FROM AUTHOR]

Adverse maternal and infant health outcomes among African Americans are increasingly recognized as indicators of a critical public health crisis in the United States. Research has found that stress is related to structural racism and the social determinants of health (SDOH) that cause avoidable, unfair inequities in resources, education, power, and opportunities across ethnic groups. This paper describes the SDOH needs and experiences of pregnant Black women from the perspective of doulas and Birthing Beautiful Communities (BBC) clients. The design was a qualitative description, using data collected over time (2017–2018, 2020–2021, and 2023). This study took place in Cleveland and Akron, Ohio and the sample included 58 clients, 26 doulas, and 2 resource intake specialist assistants (RISAs). Qualitative data included individual client interviews, three doula focus groups, and one interview with two BBC RISAs. Three coders used content analysis to deductively identify SDOHs and calculate the number of interviews that contained information about specific SDOHs. Although the sample reported issues with all SDOH, particular ones caused a cascade of SDOH effects. Transportation issues, for example, impeded women from being able to make it to work, doctor's appointments, and to purchase essential baby items (e.g., food, infant supplies). An inability to work—whether because of transportation challenges or pregnancy-related health complications—led to unstable housing and an inability to deal with transportation challenges. Many clients mentioned that housing was a major issue, with many clients experiencing housing instability. Implications include ensuring SDOH information is collected from a trusted source who can advocate and ensure access to a wide range of local resources, ensuring policies protect pregnant women from experiencing a cascade of SDOH that may contribute to continuing health disparate infant and maternal health outcomes in African American women. [ABSTRACT FROM AUTHOR]

Purpose: The disproportionate representation in juvenile justice systems of children who are, or have been, in the care of the state is a major cause of concern internationally. However, the experiences of this particular group are largely absent from both policy debates and the international research base. This paper aims to correct that deficit by exploring the lived experiences of residential care, justice-involved children. Design/methodology/approach: An interpretivist investigation of care experienced children's perceptions of their experiences, involving semi-structured interviews with a purposive sample of 19 children in England who were simultaneously in residential care and subject to youth justice supervision. Data were analysed using thematic content analysis. Findings: Care-experienced children described how their experiences of residential care environments and regimes have undermined their sense of how they see themselves, now and looking to the future. Against this background of disrupted identity, they also reported stigmatising interactions with staff that leave them feeling labelled both as a generic "looked-after child" and as a "bad kid". Research limitations/implications: The findings are based on the perceptions of a group of children in the criminal justice system, which, although reflecting the experiences of those with negative outcomes, may not be representative of all children in residential care. Practical implications: The findings have implications for those responsible for the care and development of care-experienced children, as well policymakers concerned with reducing the numbers of care-experienced children in youth justice. Those responsible for the care and development of care-experienced children should consider steps to reduce how factors outlined here disrupt a child's sense of self and introduce criminogenic labelling and stigma. Originality/value: Despite a number of studies seeking to understand why the number of care experienced children in the youth justice system is disproportionate, there is very little empirical work that seeks to understand the experiences and perceptions of children currently both in care and the criminal justice system. This paper seeks to correct this deficit, by detailing how children who are both in residential care and subject to youth justice supervision view their care experiences. The implications of this for policy, practice and further research are then explored. [ABSTRACT FROM AUTHOR]

Patient-centered care is recognized as a key element in recent healthcare management strategies. However, the integrated collection of patient feedback capturing the entire journey of patients with complex medical conditions remains understudied. Herein, we aimed to describe the development of an instrument prototype for the collection of PROMs and PREMs that would encompass a whole patient journey at a single time point. We further describe the process of its integration into a hospital's information system (HIS) and the results of a pilot feasibility study in adult patients with kidney and hematological diseases. We developed an instrument consisting of original PREM and generic EQ-5D-5L questionnaires. E-questionnaires were handled with REDCap software (version 12.5.14) and integrated into the HIS. Patients refusing to use e-questionnaires (48%) were offered paper administration and were older (64 vs. 50 years). The overall response rate for e-questionnaires was 57.1% with a median completion time of 2.0 and 3.7 min for PROM and PREM, respectively. Psychological and social services and primary care setting (diagnosis establishment and involvement in continuous care) were identified as most problematic. The majority of PREM dimensions encompassing different levels of care significantly correlated with PROM responses. Our data indicate the feasibility and potential relevance of the proposed approach, although wider-scale studies in diverse settings are needed. [ABSTRACT FROM AUTHOR]

Purpose: This paper aims to explore the use of lived experience research in peer work. Design/methodology/approach: A suite of user-friendly and engaging lived experience research resources was introduced to consumers by peer workers. In-depth interviews were conducted with 33 consumer participants and five peer workers about their experiences. The data were analysed using qualitative content analysis. Findings: The role of the peer workers appeared critical in ensuring that participants, despite their varied needs, preferences and backgrounds, derived optimum benefit from each resource. Features in resource delivery that promoted a positive experience included presenting the resources in the context of an existing relationship, providing clear explanations, going through resources together, encouraging reflection, taking enough time; and flexible delivery. Peer workers viewed the resources as potentially useful in their everyday peer work and as a valuable addition to their peer work toolkit. Practical implications: The benefit of lived experience research to consumers is likely to be optimised by supportive and thoughtful delivery of the resources. Peer workers have the skills and are in an ideal position to do this. Bringing lived experience research to consumers provides peer workers with a potentially unique and helpful approach for supporting and promoting recovery and is congruent with their overall practice. Originality/value: Lived experience research has the potential to benefit consumers directly but is rarely brought to their attention. This paper is the first to examine the potential role of peer workers in introducing learnings from lived experience research to consumers. [ABSTRACT FROM AUTHOR]

Background Working as a nurse in a war zone entails providing a unique form of care, and it is important to be well prepared before and during an international assignment. To improve organized preparations it is necessary to understand how nurses previously engaged in a military mission experienced their preparations. Objective The aim of this study is to describe military nurses' experiences of preparations for a mission, including factors that contribute to their being meaningful. Methodology The data comprises eight interviews with Swedish military nurses who served in Afghanistan. The results are analyzed using a qualitative content analysis. Meaning units are condensed into codes which, via subcategories, form categories. The categories are abstracted into an overall theme. Results The results highlight the importance of recognizing challenges and making informed choices. The overall theme shows that adequate preparation promotes an accepting attitude. Conclusions It is concluded that organized preparation for care in a combat environment should stimulate realistic reflection without entrapping one in negative thinking. [ABSTRACT FROM AUTHOR]

Background: Spoken discourse impairments post‐traumatic brain injury (TBI) are well‐documented and heterogeneous in nature. These impairments have chronic implications for adults in terms of employment, socializing and community involvement. Intervention delivered by a speech–language pathologist (SLP) is recommended for adults with discourse impairments post‐TBI, with an emphasis on context‐sensitive treatment. The developing evidence base indicates a wide array of treatment components for SLPs to evaluate and implement within their clinical practice. However, there is limited insight into how SLPs are currently treating discourse impairments and the rationales informing clinical practice. Aims: To explore the under‐researched area of clinical practice for spoken discourse interventions with adults post‐TBI, including treatment components and clinician rationales, and to contribute towards a shared knowledge base. Methods & Procedures: Participants were recruited via purposeful sampling strategies. Six SLPs participated from Australia, the United Kingdom (UK) and the United States (US). Semi‐structured interviews were conducted via Zoom. Interviews were manually transcribed, coded and analysed via a qualitative content analysis approach. Outcomes & Results: :Participants described discourse treatment practices across various settings and TBI recovery stages. Results indicated that SLPs used numerous treatment activities, resources and outcome measures. Intervention approaches primarily targeted social communication skills, strategy development/utilization and insight‐building. Clinical practice conformed to available guidelines where possible, reflected best practice and incorporated components of the research literature. Participants reported using individualized treatment activities aimed at addressing client‐specific factors and rationales prioritized tailored, context‐sensitive and goal‐directed treatment. Conclusions & Implications: This study provided insight into a previously under‐researched area. It highlighted a wide range of treatment activities and factors informing current SLPs' treatment of spoken discourse impairment post‐TBI. Overall, clinical practice and rationales discussed in this study were aligned with best practice and emphasized a contextualized, individualized approach to discourse treatment across service settings and stages of recovery. Participants identified areas requiring further support, including access to training, resources and research, and the challenge of finding suitable outcome measures. Further investigation into discourse management post‐TBI, from initial assessment to outcome measurement, may help inform clinical decision‐making and the transfer of research to practice. WHAT THIS PAPER ADDS: What is already known on the subject: Spoken discourse impairments occur in dialogic and monologic productions post‐TBI. Interventions targeting both genres are detailed within the research literature; however, studies exploring clinical practice and decision‐making for discourse interventions post‐TBI are limited. What this paper adds to existing knowledge: This study provides new insight into the current treatment targets, activities, resources and outcome measures employed by clinicians supporting adults with discourse impairment post‐TBI. It details the factors that influence clinical decision‐making for this caseload and identifies an emphasis on client priorities and the value of clinician experience. What are the potential or actual clinical implications of this work?: This study identifies the broad and complex considerations required to deliver context‐sensitive discourse intervention post‐TBI. It indicates the need for an in‐depth review from assessment to treatment outcomes to better understand and support this area of practice and to direct future research. This study also highlighted the role of clinician experience in discourse intervention and the value of sharing clinical knowledge and resources within and across the profession to support all levels of clinician experience. [ABSTRACT FROM AUTHOR]

Background: People with an acquired brain injury (ABI) find it challenging to use social media due to changes in their cognition and communication skills. Using social media can provide opportunities for positive connection, but there is a lack of interventions specifically designed to support safe and successful social media use after ABI. Aims: To investigate the outcomes of completing a social media skills intervention and identify barriers and facilitators for future implementation. Methods & Procedures: The study used a mixed‐methods, pre‐post‐intervention design. A total of 17 adults with an ABI were recruited. Participants completed an intervention that included a short self‐guided course about social media skills (social‐ABI‐lity course), and then participated in a private, moderated Facebook group over a 12‐week period (social‐ABI‐lity Facebook group). Data were collected over this period through observation of group activity and weekly surveys. They were also collected on social media use and quality of life at pre‐intervention, post‐intervention and after 3 months. Participants provided feedback on the experience of participating in the programme via a post‐intervention interview. Outcomes & Results: At post‐intervention, there were significant improvements in confidence in using Facebook (p = 0.002) and enjoyment of using Facebook to connect with others (p = 0.013). There was no significant change in reported quality of life, although participants described the multiple benefits of connection they perceived from involvement in the group. Observational data and feedback interviews were informative about the feasibility and acceptability of the intervention. Conclusions & Implications: This pilot study provided preliminary evidence that an intervention comprising a short, self‐guided training course and a private, moderated Facebook group improved outcomes for people with ABI. Key recommendations for future implementation include embedding active peer moderators within groups and taking an individualized approach to delivery of the intervention. WHAT THIS PAPER ADDS: What is already known on the subject: Research has documented the challenges that people with ABI experience in using social media, and the difficulty for rehabilitation clinicians in providing appropriate support in this field. What this paper adds to existing knowledge: This pilot study reports the outcomes of people with ABI completing a short, self‐guided social media skills course and participating in a private, moderated Facebook group. After the intervention, participants reported significantly increased confidence and enjoyment in using Facebook, described the benefits of connection found in the groups, and suggested potential improvements for future implementation. What are the potential or actual clinical implications of this work?: With the growing use of social media for connection and participation, there is a professional obligation to address social media communication skills in cognitive–communication rehabilitation for people with ABI. The findings of this study will inform interventions and future research to assist people with ABI to build their social media skills for communication, social support and a sense of connection. [ABSTRACT FROM AUTHOR]

Aims: To investigate factors that influence the willingness of inactive nurses to return to nursing in a crisis situation and to identify aspects that need to be considered with regard to a possible deployment. Design: A deductive and inductive qualitative content analysis of semi-structured focus group interviews. Methods: Semi-structured focus group interviews with inactive or marginally employed nurses, nurses who have been inactive for some time and nursing home managers in October and November 2021. The participating inactive nurses had declared their willingness for a deployment during the COVID-19 pandemic or not. Data were analysed using qualitative content analysis. Results: Communication was seen as essential by the participants for an informed decision for or against a temporary return to nursing and to potential or actual deployments. To make them feel safe, inactive nurses need to know what to expect and what is expected of them, for example, regarding required training and responsibilities. Considering their current employment status, some flexibility in terms of deployment conditions is needed. A remaining attachment to care can trigger a sense of duty. Knowledge of (regular) working conditions in nursing can lead to both a desire to support former colleagues and a refusal to be exposed to these conditions again. Conclusion: Past working experiences and the current employment situation play a major role in the willingness of inactive nurses to return to nursing in a crisis situation. Unbureaucratic arrangements must be provided for those who are willing to return. Summary Statement: • What already is known - In crisis situations, not every inactive nurse is willing or able to return to nursing and therefore, the 'silent reserve' may not be as large as suspected. • What this paper adds - Inactive nurses need to know what to expect and what is expected of them for their decision regarding a return to active patient care during a crisis situation. • Implications for practice/policy -- Inactive nurses need to be informed and should be offered free training and refresher courses to ensure patient safety. Impact: This research shows that the group of inactive nurses are not a silent workforce which can be activated anytime. Those who are able and willing to return to direct patient care in crisis situations need the best possible support -- during and between crises. Reporting Method: This study adhered to COREQ guidelines. No Patient or Public Contribution: The involvement of patients or members of the public did not apply for the study, as the aim was to gain insight into the motivations and attitudes of the group of inactive nurses. [ABSTRACT FROM AUTHOR]

Background: Vicarious trauma can significantly affect the physical and mental health of nurses, as well as their ability to provide quality of care. However, the concept of vicarious trauma has received limited attention and remains controversial in the nursing context. Objective: The purpose of this study was to clarify and define the concept of vicarious trauma as it pertains to the nursing context. Methods: The Schwartz and Kim's three‐stage hybrid concept analysis method was used to define the concept. In the theoretical phase, PubMed, CINAHL, OVID, Medline, Embase, Web of Science, Scopus, ProQuest, PsycINFO, CNKI database, VIP database and Wanfang database were used using keywords "nurs*"and "vicarious trauma*", resulting in a total of 25 papers. In the fieldwork phase, we conducted participatory observations in three hospitals and semi‐structured in‐depth interviews with 18 clinical nurses from seven cities. In the analysis phase, the results of the previous two phases were integrated to develop a comprehensive concept of vicarious trauma in nursing. Results: Based on the results of the theoretical and field phases, we propose the concept of vicarious trauma in nursing as follows: vicarious trauma is a psychological trauma impacting nurses' cognitive schema which they may experience in clinical settings or on social media, resulting from deeply empathize with the physical or emotional trauma of patients, family, or colleagues, such as patients' physical injuries or death, family's grieving feelings and colleagues' received threats and attacks. Positively, vicarious trauma can transform into vicarious post‐trauma growth through repositioning and connection, nourishing nurses and promoting their personal and professional development. Conclusion: The concept of vicarious trauma in nursing is multidimensional and holistic. This study clarifies the concept of vicarious trauma in nursing using the hybrid concept analysis, providing a framework for future research and practice on vicarious trauma in the nursing field. Patient or Public Contribution: Nurses contributed to the conduct of the study by participating in the data collection via interviews. [ABSTRACT FROM AUTHOR]

Purpose: This paper aims to examine landlords' health support systems to tenants to control COVID-19 in selected informal settlement rental housing (ISRH) in Ghana, dwelling on landlords' views. Design/methodology/approach: The paper used the concurrent imbedded mixed-methods approach and grounded the findings in the socio-ecological theory. The authors collected both qualitative and quantitative data from 242 landlords in 13 informal settlements across Ghana using quotas. The authors undertook semi-structured face-to-face and telephone interviews. The authors conducted content and thematic qualitative data analysis and used simple descriptive statistical data analysis. Findings: The paper discovered that tenants had limited knowledge on the transmission of the pandemic, forcing landlords to regulate their building services usage, ventilation and thermal control, entertainment, common areas and rent advancement for tenants to control the pandemic. Also, tenants found it difficult to comply with the rules on ventilation for fear of criminal attacks, while high social connection and interaction among renters and inadequate enforcement caused the non-adherence by renters to social gathering. Again, landlords had difficulty in contract-tracing visitors suspected to be infected with the virus. Originality/value: The use of concurrent and imbedded mixed methods to investigate landlords' viewpoints on their support in health needs of their tenants to regulate COVID-19. The prescriptions from the study provide practical applications to formulate a mix of housing and health policies to formalize the support of landlords to their tenants in ISRH in Ghana. [ABSTRACT FROM AUTHOR]

Background: Nursing education starts in the classroom environment with a focus on the nurse educator-nursing student relationship. 'Presence' is defined as "a practice where the caregiver relates her/himself to the other in an attentive and dedicated way, by doing so learns to see what is at stake for the other; from desires to fear, and, in connection with this, come to understand what could be done in this particular situation and who she/he can be for the other". 'Presence' forms an integral part of the nursing profession and the value thereof should be facilitated during teaching and learning. Reflective practices may offer a teaching–learning strategy to facilitate presence in nursing students by nurse educators in large class settings. Having large classes presents challenges including from nurse educators' lack of knowledge about alternative teaching approaches; time demands for designing, implementing and testing new teaching methods; a lack of confidence in implementing new teaching approaches in the classroom; selecting and grading assessments; as well as feelings of discomfort and anxiety. A model to facilitate presence through reflective practices has already been developed and published by the present authors. The model relies on well-established steps in theory development covering concept analysis, model development and description (published in two papers by the present researchers) and model evaluation (the subject of this paper). The evaluation was carried out by a panel of experts and nursing participants. Methods: An explorative and descriptive qualitative design was followed. The developed model was evaluated and refined in two steps (covered in this paper). In Step 1, the model was evaluated by a panel of experts in model development, reflective practices and presence. The panel used critical reflection resulting in the refinement of the model. Step 2 involved an empirical phase where the model was evaluated by participants through participatory evaluation. Participants were selected through purposive sampling. Data collection methods included online semi-structured focus group interviews with nurse educators and virtual World Café sessions with nursing students. Content analysis was done through open coding. Results: Five themes emerged from the empirical phase, namely: Theme 1: understanding of the model; Theme 2: benefits of the model; Theme 3: limitations of the model; Theme 4: pre-existing conditions needed for successful implementation of the model; and Theme 5: recommendations for further development of the model. Conclusions: The results produced a refined model to be implemented into the curriculums of undergraduate, postgraduate and continuous professional development programmes across nursing education institutions. This model will significantly contribute to the body of knowledge and increase nurses' awareness of presence by transforming the way they feel, think, care and act in practice, which contributes to personal and professional development. [ABSTRACT FROM AUTHOR]

Sexual violence is a major problem on college campuses, and innovative solutions are needed. Our university created a semester-long, credit-bearing, academic course as a curricular intervention intended to reduce sexual violence on campus. In this article, we describe the multiple methods used to evaluate the course, including a pre–post online survey with a quasi-experimental design, a qualitative content analysis of student reflection papers, and semistructured interviews with previously enrolled students conducted by a peer interviewer 3 months after course completion. The synthesis of evaluation findings indicated that an academic course has the potential to positively affect campus climate around sexual violence. Furthermore, using multiple methods enabled us to create a theory of change that illustrates how key course components shaped students' knowledge, attitudes, and behaviors about sexual violence, thereby ideally generating campus change. Results have been used by various stakeholders for both practice-based and scholarly purposes. We provide lessons learned and implications for practice that are transferable to other multimethod curricular intervention evaluations regardless of topical focus, including the many ways in which using multiple methods added value to the study; the considerable investment of time and resources needed when using multiple methods; the challenges that can arise when integrating findings across methods; the major benefits of having a multidisciplinary research team consisting of faculty and students; and the need to engage in critical reflexivity. [ABSTRACT FROM AUTHOR]

Background: Dysphagia impacts negatively on quality of life, however there is little in‐depth qualitative research on these impacts from the perspective of people with dysphagia. Aims: To examine the lived experiences and views of people with lifelong or ongoing dysphagia on the impacts of dysphagia and its interventions on quality of life, and barriers and facilitators to improved quality of life related to mealtimes. Methods & Procedures: Nine adults with lifelong or acquired chronic dysphagia engaged in in‐depth interviews and a mealtime observation. The observations were recorded and scored using the Dysphagia Disorders Survey (DDS). Interviews were recorded, transcribed and de‐identified before content thematic and narrative analysis, and verification of researcher interpretations. Outcomes & Results: Participants presented with mild to severe dysphagia as assessed by the DDS. They viewed that dysphagia and its interventions reduced their quality of life and that they had 'paid a high price' in terms of having reduced physical safety, reduced choice and control, poor mealtime experiences, and poor social engagement. As part of their management of dysphagia, participants identified several barriers to and facilitators for improved quality of life including: being involved in the design of their meals, being adaptable, having ownership of swallowing difficulties, managing the perceptions of others and resisting changes to oral intake. Conclusions & Implications: This research improves understanding of the primary concerns of people with dysphagia about their mealtime experiences and factors impacting on their quality of life. Clinicians working with people with dysphagia need to consider how self‐determination, autonomy and freedom of choice could be improved through involvement in food design of texture‐modified foods. It is important that future research considers the views of health professionals on how these findings could impact on policy and practice particularly in ways to address the barriers and enhance facilitators to improved quality of life for people with dysphagia. What this paper adds: What is already known on the subject: Dysphagia impacts on quality of life, particularly as the severity of the dysphagia increases. Research to date has focused on people with dysphagia associated with an acquired health condition and has used quantitative assessment methods to measure quality of life. What this paper adds to existing knowledge: This study provides a qualitative examination of the impacts of dysphagia on quality of life from the perspective of people with lifelong or ongoing acquired dysphagia and their supporters. This study also provides qualitative insights into the barriers and facilitators of mealtime‐related quality of life. What are the potential or actual clinical implications of this work?: Health professionals should engage in open communication with their clients with dysphagia regarding the impacts of dysphagia on their lifestyle and quality of life. By considering these impacts, health professionals may be able to recommend interventions that are more acceptable to the person with the dysphagia which may have a positive impact on their mealtime experience. [ABSTRACT FROM AUTHOR]

Background: Increasing attention is paid to the effectiveness of high‐intensity speech intervention in children with a cleft (lip and) palate (CP±L). It is, however, unknown if high‐intensity intervention is acceptable to the intervention recipients. Parents have an integral role in supporting their children with intervention highlighting the importance of intervention acceptability to parents. Aims: To compare the retrospective acceptability of high‐intensity speech intervention (10 1‐hr speech therapy sessions divided over 2 weeks) with the retrospective acceptability of low‐intensity speech intervention (10 1‐hr speech therapy sessions divided over 10 weeks) for children with a CP±L from the parents' point of view. Methods & Procedures: Twelve parents of 12 children, aged 6–0 years who received high‐intensity speech intervention (n = 6) or low‐intensity speech intervention (n = 6), were invited to participate in this study. Seven parents (n = 3 in the high‐intensity group and n = 4 in the low‐intensity group) agreed to participate (total response rate: 7/12, 58.33%). A qualitative study design using semi‐structured interviews was applied. To investigate the retrospective acceptability of the two intervention intensities, deductive coding according to the Theoretical Framework of Acceptability (TFA) was used. Outcomes & Results: With regard to the TFA construct 'affective attitude', results demonstrated that parents had positive feelings about the provided speech intervention regardless of the intensity. Parents of children who received high‐intensity speech intervention reported two specific benefits related to the high intervention intensity: (1) it improved their relationship with the speech‐language pathologist and (2) it improved their child's ability to make self‐corrections in his/her speech. Even though both high‐intensive and low‐intensity speech intervention were considered burdensome (TFA construct 'burden'), parents were less likely to drop out of high‐intensity intervention because the total intervention period was kept short. Conclusions & Implications: In conclusion, high‐intensity speech intervention seemed acceptable to parents. More positive codes were identified for some of the TFA constructs in the high‐intensity intervention group than in the low‐intensity intervention group. Considering that some parents doubted their self‐efficacy to participate in high‐intensity speech intervention, speech‐language pathologists need to counsel them so that they can adhere to the high intervention intensity. Future studies should investigate whether high‐intensity speech intervention is also acceptable to the children who receive the intervention and to the speech‐language pathologists who deliver the intervention. What this paper adds: What is already known on this subject: Increasing attention is paid to the effectiveness of high‐intensity speech intervention in children with a cleft (lip and) palate (CP±L). Different quantitative studies have shown positive speech outcomes after high‐intensity cleft speech intervention. Despite this increasing attention to high‐intensity speech intervention, it is unknown whether high‐intensity intervention is also acceptable to the intervention recipients. This study compared the retrospective acceptability of high‐intensity speech intervention (10 1‐hour speech therapy sessions divided over 2 weeks) with the retrospective acceptability of low‐intensity speech intervention (10 1‐hour speech therapy sessions divided over 10 weeks) in children with a CP±L from the parents' point of view. What this paper adds to existing knowledge: More positive codes were identified for some of the TFA constructs in the high‐intensity intervention group than in the low‐intensity intervention group. Nevertheless, some parents doubted their self‐efficacy to participate in high‐intensity speech intervention. What are the potential or actual clinical implications of this work?: The findings of this study forces us to reconsider the traditional cleft speech intervention delivery models which usually consist of low‐intensity intervention. Speech‐language pathologists need to counsel parents and so that they can adhere to the high intervention intensity. [ABSTRACT FROM AUTHOR]

Aim: This study aimed to explore and understand the barriers perceived by Italian nurses to adopting self‐monitoring for managing oral anticoagulation in real‐life settings. Background: Barriers to self‐monitoring implementation for managing oral anticoagulation have been poorly described. Design: The study had a qualitative descriptive and exploratory design with a hybrid approach. Methods: A literature review was conducted to identify a priori barriers (deductive approach), while a small and semi‐structured focus group discussion was performed to explore the contextual barriers experienced by Italian nurses (inductive approach). A classic content analysis technique was adopted. Data were collected in 2019. Findings Two main categories were identified. Organizational barriers referred to the lack of inter‐professional collaboration and health‐care system strategies to provide clinical pathways for self‐monitoring. Individual barriers encompassed professional characteristics (e.g. university background, professional knowledge, continuum education and accountability/responsibility) and patient characteristics (e.g. patient health literacy and knowledge, engagement/empowerment and educational programmes). Finally, unwarranted clinical variation in oral anticoagulation management arose as a barrier determined by organizational and individual elements. Conclusions: The results of this study pointed out an urgent public health issue in addressing barriers influencing self‐monitoring practice and in sustaining care models that might enhance the quality improvement of self‐monitoring for managing oral anticoagulation. Summary statement: What is already known about this topic? Anticoagulation therapy is one of the leading chronic treatments worldwide to prevent stroke in atrial fibrillation patients.Self‐monitoring is a valuable option to further improve the quality of anticoagulation surveillance and patient medication adherence compared to standard care models.Thus far, the barriers underpinning self‐monitoring implementation experienced by Italian nurses are mainly unexplored.What does this paper add? This study is the first Italian description regarding the main barriers perceived by Italian nurses to adopting SM in patients treated using oral anticoagulation therapy.Organizational barriers refer to the lack of inter‐professional collaboration and health‐care system strategies to provide clinical pathways for self‐monitoring.Individual barriers encompass professional characteristics and patient characteristics, and unwarranted clinical variation arose as a barrier determined by both organizational and individual barriers.The implications of this paper Description of the main barriers perceived by Italian nurses to adopt self‐monitoring of oral anticoagulation is required to prioritize policies and system‐level interventions.Health institutions, patient associations and scientific societies should develop policies that enhance the continuum of professional education of nurses regarding self‐monitoring for oral anticoagulation.Integrated care models where nurses have a leadership role in providing self‐monitoring practice are required to implement self‐monitoring widely. [ABSTRACT FROM AUTHOR]

Purpose: To identify the risk and protective factors affecting a salutogenic sense of health in adolescents with Moyamoya disease based on Antonovsky's salutogenesis theory. Methods: This study used a qualitative descriptive design. We interviewed adolescents diagnosed with Moyamoya disease and their parents and experts with experience in treating them from 4 July 2019 to 10 October 2019. Data analysis was performed according to the process of deductive content analysis based on Antonovsky's salutogenesis theory. Results: This study identified risk and protective factors affecting a salutogenic sense of health in adolescents with Moyamoya disease. Risk factors were closely related to problems with friends, parent relationships and academic work. Protective factors were identified as emotional support through interpersonal relationships, positive attitudes to the disease situation, ability to understand and predict patterns of symptoms, increasing strength to resolve the state of tension and developing available resources. Conclusion: The factors affecting a salutogenic sense of health in adolescents were identified reflecting on the characteristics of the developmental stage of adolescents and the symptoms and situations that are unique to adolescents. It is important for adolescents with Moyamoya disease to recognize available resources and use them appropriately to successfully manage the state of tension caused by stress. Summary statement: What is already known about this topic? Adolescence is an important developmental stage in which individuals experience rapid physical and cognitive changes; these developmental changes can be more stressful for adolescents with Moyamoya disease.Stressful situations increase the frequency and worsen the symptoms of transient cerebral ischaemic attacks, and these negative experiences lead to depression, anxiety, low self‐esteem, negative self‐concept formation and social maladjustment, which persist until adulthood. What this paper adds? The risk factors affecting the salutogenic sense of health in adolescents with Moyamoya disease were related to problems with interpersonal relationships and academic work.The families of adolescents with Moyamoya disease play a pivotal role in increasing their strength to resolve their state of tension.It is important for adolescents with Moyamoya disease to identify and understand the resources available to them and use them appropriately to manage the state of tension. The implications of this paper: This study is meaningful in that the factors affecting the salutogenic sense of health were identified by reflecting on the unique characteristics of the developmental stage of adolescents.The results of this study will guide clinical nurse and researchers in developing interventions to maintain and promote the health of adolescents with Moyamoya disease. [ABSTRACT FROM AUTHOR]

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Introduction: Maternal glycemia is associated with pregnancy outcomes. Thus, supporting the self-management experiences and preferences of pregnant women with type 1 and type 2 diabetes is crucial to optimize glucose control and perinatal outcomes. Research design and methods: This paper describes the mixed methods integration of a sequential comparative case study. The objectives are threefold, as we integrated the quantitative and qualitative data within the overall mixed methods design: (1) to determine the predictors of glycemic control during pregnancy; (2) to understand the experience and diabetes self-management support needs during pregnancy among women with pre-existing diabetes; (3) to assess how self-management and support experiences helpe to explain glycemic control among women with pre-existing diabetes in pregnancy. The purpose of the mixing was to integrate the quantitative and qualitative data to develop rich descriptive cases of how diabetes self-management and support experiences and preferences in women with type 1 and type 2 diabetes during pregnancy help explain glucose control. A narrative approach was used to weave together the statistics and themes and the quantitative results were integrated visually alongside the qualitative themes to display the data integration. Results: The quantitative results found that women achieved "at target" glucose control (mean A1C of the cohort by the third visit: 6.36% [95% Confidence Interval 6.11%, 6.60%]). The qualitative findings revealed that feelings of fear resulted in an isolating and mentally exhausting pregnancy. The quantitative data also indicated that women reported high levels of self-efficacy that increased throughout pregnancy. Qualitative data revealed that women who had worked hard to optimize glycemia during pregnancy were confident in their self-management. However, they lacked support from their healthcare team, particularly around self-management of diabetes during labour and delivery. Conclusions: The achievement of optimal glycemia during pregnancy was motivated by fear of pregnancy complications and came at a cost to women's mental health. Mental health support, allowing women autonomy, and the provision of peer support may improve the experience of diabetes self-management during pregnancy. Future work should focus on developing, evaluating and implementing interventions that support these preferences. [ABSTRACT FROM AUTHOR]

The military lifestyle can be defined by a triad of unique stressors: frequent relocation, parental absence, and risk of injury, illness and/or death of a serving member. Research has suggested that this unique triad of stressors can impact the mental health of children and youth living in military families. However, research focusing on the mental health of children and youth living in military families overwhelmingly focuses on the American context. Due to key contextual differences, it is unclear to what extent the American findings are representative of military-connected children and youth living in other geographical contexts, such as Canada. A large qualitative study was conducted to explore the mental health of military-connected children in Canada from three perspectives: child, parent, and service provider. This paper reports on the service provider findings. Using individual semi-structured interviews, data were collected from 11 service providers. Data analysis was guided by qualitative content analysis. Two main themes emerged: (1) the mental health of children living in military families may be impacted by the military lifestyle stressors, and (2) the mental health of children living in military families can be impacted by the accessibility and availability of mental health services. While this qualitative study builds upon recent Canadian work that has considered the service provider perspective, additional research is needed to better understand the experiences of service providers who support military-connected children and youth. Highlights: American research shows that the military lifestyle factors can impact the mental health of military-connected children. The mental health of military-connected children has yet to be extensively explored in Canada. The mental health of children living in Canadian military families may be impacted by the military lifestyle stressors. The mental health of Canadian military-connected children can be impacted by the accessibility and availability of mental health services. Our findings can help build capacity and knowledge for service providers who support Canadian military-connected children. [ABSTRACT FROM AUTHOR]

Caregiving in the South Asian context is often assumed by family automatically for the person with cancer (PWC). In this paper, we applied the disclosure decision-making model (DD-MM) to understand the motives behind cancer prognosis disclosure (or not) by caregivers to the PWC. Fifty caregivers participated in semi-structured interviews; and data were analyzed using Framework Approach. For the disclosing caregivers, some of the themes that emerged were consistent with the DD-MM framework while others were not. In particular, the theme "recipient assessment" was part of the DD-MM framework, while others such as unmet communication needs, caregiver self-reflection, and family support were outside of the framework. In contrast, for the non-disclosing caregivers, the reasons for nondisclosure fit very concisely into the DD-MM framework, particularly with information assessment, recipient assessment, and (non) disclosure efficacy. This study has significant implications for development of communication skills trainings around holding family meetings in India. [ABSTRACT FROM AUTHOR]

Goal: Recent efforts to push hospitals to provide high-value care have relied on payment incentives. However, evidence indicates that 70% to 90% of performance improvement projects do not achieve their desired goals. Therefore, in addition to managing external industry pressures, hospitals need to develop performance improvement (PI) capabilities that enable them to capitalize on improvement opportunities, effectively develop and adopt solutions, and ensure the sustainability of improvements over time. While operational capabilities enable hospitals to produce and deliver services, more is needed to attain and sustain superior performance. Dynamic capabilities drive changes in operational capabilities to meet environmental demands. Dynamic capabilities also enable hospitals to renew and reconfigure their resources to optimize performance. This paper proposes the dynamic-capabilities framework as an appropriate way to develop and manage PI capabilities in hospitals, and it discusses the implications of shifting to a strategy that is driven by dynamic-capabilities PI. Methods: The research team designed a semi-structured interview based on a review of the literature to understand whether hospitals were engaging in the activities outlined in the dynamic-capabilities framework. Nine study participants were recruited from a convenience sample of hospital PI staff at hospitals in Massachusetts and New Hampshire. De-identified transcripts were entered into NVivo12 qualitative data analysis software, and data were thematically indexed and coded following the principles of content analysis. Principal Findings: PI structures, improvement methodologies, and weaknesses did not vary significantly among hospitals. Most hospitals had a PI department and were more likely to adopt PI projects initiated by top management. While PI staff were trained in improvement methodologies, no programs were in place that required the rest of the hospital staff to become familiar with PI methods. Common areas of weakness were PI project selection, communication, coordination, learning from current and former PI projects, and systematic approaches to sustain improvements. Practical Applications: Dynamic PI capabilities provide an opportunity to systematically identify improvement opportunities, seize on and learn from those opportunities, and renew and reconfigure resources to optimize performance. Ad hoc PI projects are insufficient to enable a hospital to sustain superior performance. Internal and external pressures to deliver high-value patient care and services require hospitals to exceed their current PI efforts. By developing dynamic PI capabilities, hospitals will adopt a more systematic and effective approach to PI, which will likely result in superior performance. [ABSTRACT FROM AUTHOR]

Background: The COVID‐19 pandemic has brought about disruptions in healthcare for adults with intellectual and developmental disabilities. There is a need to explore ways to promote proactive healthcare and better prepare individuals for healthcare encounters. Methods: A co‐designed tool, the COVID Check‐in Tool, was introduced as part of a virtual health education programme to encourage proactive healthcare. Implementation of this Health Check‐in was evaluated with 36 adults with intellectual and developmental disabilities and 96 family caregivers who completed the programme using surveys, structured interviews and focus groups. Findings: Forty‐four percent of participants engaged in the Health Check‐in process, resulting in many reported benefits for those who participated. However, there were also barriers to initiating the Check‐in, along with challenges using the COVID Check‐in Tool, according to both the adults with disabilities who were interviewed and the family caregivers. Conclusions: The study underscores the importance of considering ways to integrate tools into routine healthcare practices, to facilitate improved healthcare delivery for people with intellectual and developmental disabilities during pandemic recovery efforts. As well, involving people with lived experience in the development and implementation of healthcare resources is critical. Accessible Summary: Our team worked together to make a tool that would help people with intellectual and developmental disabilities talk to their doctor about health problems after not seeing them a lot because of the pandemic. We called this tool the 'COVID Check‐in'.Then people from our team taught online health courses about how to use the COVID Check‐in Tool and other health topics.After the courses were over, we asked 36 adults with intellectual and developmental disabilities and 96 family caregivers if they had a Health Check‐in with their doctor and how it went, or what problems they had with it.Almost half of the people who took the courses had a Health Check‐in and most of the people thought it was helpful. Some people did not do it or did it but had problems with it.We end the paper with some ideas of how to make it easier to check in with the doctor and why it is important to include people with disabilities and family caregivers when making healthcare tools. [ABSTRACT FROM AUTHOR]

Background: Speech and language therapists (SLTs) use videofluoroscopic swallow study (VFSS) results to manage dysphagia. Yet, in some services only doctors can directly request a VFSS, potentially creating workflow inefficiencies and delaying patient access to VFSS. An alternative model, where SLTs directly refer patients for VFSS, is used in many services in the UK and Australia. However, processes for implementing and sustaining this model have not been reported. Aims: To evaluate the implementation of an SLT‐led inpatient VFSS referring model using the Consolidated Framework for Implementation Research (CFIR) to ascertain implementation barriers, facilitators and critical sustainability factors. Methods & Procedures: This implementation evaluation examined stakeholder perceptions of implementing the SLT‐led VFSS referring model via interviews of (1) SLTs who treat and refer inpatients for VFSS; (2) doctors who manage and refer inpatients for VFSS; (3) radiologists; and (4) trained VFSS referring SLTs. The CFIR was used to prospectively guide implementation planning, evaluation and outcome reporting, regarding barriers, facilitators and sustainability factors. Outcomes & Results: Implementation facilitators were (1) the advantage of SLT‐led VFSS referring over the standard model (doctors referring), in promoting high‐quality VFSS referrals; (2) compatibility of the model with the SLT skill set; (3) supportive communication networks between staff groups; and (4) engaging stakeholders throughout implementation. Adequate availability of trained VFSS referring SLTs was both a barrier and a facilitator of implementation. It was also a critical sustainability factor, along with ongoing staff education and outcome monitoring. Conclusions & Implications: The CFIR supported systematic evaluation of implementation facilitators and barriers, and adjustment of factors critical for implementing and sustaining the new model. Findings may assist other organizations to establish the SLT‐led VFSS referring model. What this paper adds: What is already known on the subject: Models where SLTs directly refer patients for VFSS have been described in the literature, with evidence of appropriate referrals and adherence to radiation safety standards. However, the process for establishing and sustaining this referring model has not been published. What this paper adds to existing knowledge: This study describes the process and outcomes of implementing an SLT‐led VFSS referring model, using the CFIR. A key advantage of the new model that facilitated implementation was the improved quality of VFSS referrals compared with the standard referring model. Important facilitating factors in the environment were the compatibility of the model with SLTs' skillset and supportive communication network between doctors and SLTs. Initially, an implementation barrier was the inadequate availability of trained SLT referrers. Using proactive implementation strategies, more referrers were trained (which was a facilitating factor for implementing and sustaining the model). What are the potential or actual clinical implications of this work?: This study highlights that successful implementation requires more than just an effective model. Features of the environment require consideration to minimize barriers and optimize facilitating factors, supported by proactive implementation strategies. Planning and evaluating implementation processes and outcomes using a standardized implementation framework such as CFIR aided understanding of barriers and facilitators for introducing the SLT‐led VFSS referring model. This process may assist other services to implement the model. [ABSTRACT FROM AUTHOR]

Aims and objectives. To examine the effect of the introduction of an electronic nursing documentation system on the efficiency of documentation in a residential aged care facility. Background. Modern technology has the potential to free caregivers in residential aged care facilities from their burden of paper documentation and allow them more time to care for residents. To date, there is inadequate evidence to verify this assumption. Design. Longitudinal cohort study with work sampling method for data collection. Methods. This study was conducted between 2009-2011; two months before and 3, 6, 12 and 23 months after implementation of an electronic documentation system. A work classification tool was used by an observer to record documentation activities being performed on paper or on a computer by the caregivers. Results. When compared with the proportion of time caregivers spent on documentation in the preimplementation period, personal carers' proportion reduced at three months after implementation. The proportion increased from six months and then dropped at 23 months. Recreational activity officers' proportion increased at three months after implementation. It stabilised at six months and increased again at 12 months. At 23 months, the proportion returned to the preimplementation level. Less than half of the caregivers' time on documentation after implementation was associated with computer-related tasks. Conclusions. Introduction of an electronic documentation system may not necessarily lead to efficiency in documentation for the caregivers. Charting some information items on paper and others on a computer may hinder realization of documentation efficiency. Relevance to clinical practice. To optimise the efficiency benefit of electronic documentation in a residential aged care facility, it is not only necessary to automate all nursing forms but also to ensure that the system is aligned with caregivers' documentation practice. Continuous education and mentor support is essential to ensure caregivers' effective usage of the electronic system. [ABSTRACT FROM AUTHOR]

Accessible Summary: What is known on the subject?: Coercive measures represent an ethical conflict because they limit the person's freedom, compromising their personal autonomy, self‐determination and fundamental rights.The reduction of the use of coercive measures implies not only regulations and mental health systems, but also cultural aspects, such as societal beliefs, attitudes, and values.There is evidence about the professionals' views on coercion in acute mental health care units and community settings, but they remain unexplored in inpatient rehabilitation units. What the paper adds to existing knowledge?: The knowledge about coercion varied from not knowing at all the meaning of the word, to a proper description of the phenomenon.Coercive measures are considered a necessary evil or normalized in mental health care and considered implicit to daily practice. What are the implications for practice?: The perceptions and attitudes towards coercion might be influenced by the knowledge about the phenomenon. Training of mental health nursing staff in non‐coercive practice could help professionals to detect, be conscious towards, and question coercive measures, thus orienting them to the effective implementation of interventions or programmes with evidenced effectiveness to reduce them. Introduction: Creating a therapeutic and safe milieu with the minimum coercive measures requires knowing professionals' perceptions and attitudes towards coercion, but they remain unexplored in medium and long‐stay inpatient psychiatric rehabilitation units. Aim: To explore the knowledge, perception and experience of coercion among nursing staff at a rehabilitation medium‐stay mental health unit (MSMHU) in Eastern Spain. Method: Qualitative phenomenological study including 28 face‐to‐face, semi‐structured interviews based on a script. Data were analysed using content analysis. Results: Two main themes were found: (1) therapeutic relationship and treatment in the MSMHU, which included three subthemes: qualities of the professionals for building the therapeutic relationship; perceptions about the persons admitted to the MSMHU; views of the therapeutic relationship and treatment in the MSMHU; (2) Coercion at the MSMHU, comprising five subthemes: professional knowledge; general aspects; emotional impact of coercion; opinions; alternatives. Discussion: Coercive measures are often normalized in mental health care and considered implicit to daily practice. A proportion of participants who did not know what coercion is. Implications for Practice: Knowledge about coercion might influence attitudes towards coercion. Mental health nursing staff could benefit from formal training in non‐coercive practice, facilitating the operative implementation of effective interventions or programmes. [ABSTRACT FROM AUTHOR]

Introduction: Osteoporosis remains unrecognised and untreated in patients with fragility fractures, which leads to higher mortality rate, increasing social and economic burden related to subsequent fractures. However, the presence of a coordinated and centralised care pathway for fragility fractures is lacking. The purpose of this paper is to explore the perspectives of health professionals regarding the current management for distal radius fragility fractures, how the care pathway can be optimised for patients with distal radius fragility fractures, and where occupational therapists can contribute. Methods: This paper uses a phenomenological qualitative methodology with selective and purposeful sampling, consisting of health professionals from an Australian Health Service (N = 20). Online surveys (N = 18) and semi-structured interviews (N = 16) were conducted. Content analysis was applied, followed by thematic analysis to identify emerging themes. Results: Eighteen health professionals participated in the presurvey of which 16 were interviewed. The identified themes presented the gaps in the knowledge and awareness of fragility fractures and osteoporosis, as well as a lack of coordination in the system, especially the referral process. Discussion: These findings are consistent with previous studies which also highlight the importance of communication, coordination, collaboration, cooperation, responsibility, and a population approach in achieving integrated care. This study contributes to the global call for a centralised and coordinated care pathway for fragility fractures. The study explores personal experiences of health professionals who expressed interest in fragility fractures management. Exploring patients' perspectives on their journey of fragility fractures management provides opportunity for future research. [ABSTRACT FROM AUTHOR]

Background: Developmental language disorder (DLD) is a condition which affects an individual's ability to use and understand language. Terminological confusion, and the use of non‐evidence‐based diagnostic criteria has impacted access to services for this population for several decades. Changes in terminology and diagnosis were proposed as part of a UK‐based consensus study, Criteria and Terminology Applied to Language Impairments (CATALISE), in 2016 and 2017. Since the publication of the recommendations, there have been active efforts across several English‐speaking countries to support uptake of these recommendations into policy and practice. Aims: The aim of the study was to explore the experiences of individuals who have been leading the dissemination of the CATALISE recommendations since their publication in 2017. The study was undertaken to inform future implementation efforts aimed at facilitating the adoption of the recommendations into policy and practice. Methods & Procedures: Researchers, practitioners and parents from nine countries were recruited to the study (n = 27). Online focus groups and semi‐structured interviews were conducted using topic guides informed by the Consolidated Framework for Implementation Research. Inductive thematic analysis was undertaken. Preliminary findings were member‐checked prior to completion of the analysis. Outcomes & Results: CATALISE recommendations were described as partially adopted by participants. Dissemination strategies included building a coalition, conducting educational meetings, and developing educational materials. Common barriers to implementation related to the complexity and compatibility of the recommendations, and practitioner confidence. Four themes were identified across the data set to guide future implementation efforts: (a) ride the wave, craft the narrative (b) reach across the divide, be brave (c) create space for multiple voices and, (d) support for speech and language therapistss on the front line. Conclusions & Implications: Individuals with DLD and their families should be included in future implementation planning. Engaged leadership is essential to address issues of complexity, compatibility, sustainability and practitioner confidence if CATALISE recommendations are to be integrated into service workflow and processes. Implementation science can provide a useful lens to progress future research in this area. WHAT THIS PAPER ADDS: What is already known on this subject: Dissemination efforts have been undertaken to facilitate the uptake of recommendations from a UK‐based consensus study (CATALISE) in relation to developmental language disorder since publication across several countries. What this study adds to existing knowledge: The required changes in diagnostic practice are complex to implement. A lack of compatibility with healthcare processes and low practitioner self‐efficacy were also identified as a challenge to implementation. What are the potential or actual clinical observations of this work?: Parents and individuals with developmental language disorder need to be engaged as partners in future implementation planning. Organisational leaders need to facilitate the contextual integration of the changes within service systems. Speech and language therapists require ongoing case‐based opportunities to enhance their confidence and clinical reasoning skills to implement CATALISE recommendations successfully in their everyday practice. [ABSTRACT FROM AUTHOR]

Introduction: Educating patients and families about self-care is one of the important roles of nurses in Nurse-led clinics (NLCs). NLCs need standards for guiding the practice of nurses. A standard is an authoritative statement that sets out the legal and professional basis of nursing practice. This paper seeks to report the development of practice standards for patient and family education in NLCs. Methods: This project used a Sequential-Exploratory mixed methods design. Before the study, we conducted a literature review to identify gaps. Directed content analysis was used in phase 1. The second phase involved two focus groups. The third phase involves two rounds of modified Delphi. Results: Twenty-nine participants were interviewed, and 1816 preliminary codes were formed in phase 1. 95 standards were grouped into three main categories (structure, process, and outcome). In the first focus group, experts eliminate 32 standards. Experts eliminate 8 standards after the second stage of the focus group. After two rounds of Delphi, the final version of the standard consists of 46 standards (13 structure, 28 process and 5 outcome). Conclusions: Nurses and institutions could benefit from practice standards for patient education in the NLCs, which consist of 46 statements in three domains, as a guide for clinical activities and a tool to gauge the quality of patient education in NLCs. The developed standards in this study can guide new and existing NLCs and help them evaluate ongoing activities. Providing patient education in NLCs based on standards can improve patients' outcomes and promote their health. Highlights: • Existence of practice standards for patient education in NLCs is necessary. • Structure standards necessary for the establishment of NLCs. • Process standards guide practice in NLCs. • Outcome standards used for evaluation of NLCs performance. [ABSTRACT FROM AUTHOR]

Accessible Summary: What is known on the subject?: Problematic internet use (PIU) negatively affects adolescents' lives biopsychosocially.There is limited qualitative research examining the problem of PIU in adolescents. These studies focused more on the non‐clinical population. Adolescents' perceptions of the internet, their thoughts, feelings and behaviours in situations where they can and cannot access the internet have rarely been examined. What does the paper add to existing knowledge?: This research provides an in‐depth look at the experiences of adolescents with PIU in a clinical population.Unlike previous studies, adolescents mentioned that they turned to the internet for reasons such as lack of activity, their need to spend time with their friends and better getting along with people they met on the internet. They also described a world without internet as apocalypse, desert and grave.In this study, a holistic emphasis was placed on the thoughts, feelings and behaviours of adolescents in situations where they could and could not access the internet. This may contribute especially to mental health nurses working in clinics in terms of understanding the thought‐emotion and behaviour patterns of adolescents with PIU.Adolescents also stated that their lives were affected positively and negatively as a result of PIU. What are the implications for practice?: Mental health nurses can use activity therapy, behaviour modification: social skills, coping enhancement, parent education: adolescent, self‐awareness enhancement, cognitive restructuring, emotion and behaviour management interventions to reduce the risk of PIU and the problems it causes for adolescents. What are the implications for practice?: Mental health nurses can use activity therapy, behaviour modification: social skills, coping enhancement, parent education: adolescent, self‐awareness enhancement, cognitive restructuring, emotion and behaviour management interventions to reduce the risk of PIU and the problems it causes for adolescents. Introduction: Studies on problematic internet use (PIU) are mostly on the non‐clinical population. Understanding the experiences of adolescents with PIU is critical in shaping nursing interventions and improving the quality of care. Aims: A comprehensive description of the experiences of adolescents with PIU. Methods: In the study, descriptive phenomenology design, one of the qualitative research methods, was used. Data were collected using a personal information form and a semi‐structured interview form and analysed using Giorgi's phenomenological method (n = 11). Results: As a result of the content analysis, five main themes were identified: reasons of PIU, internet‐related perceptions, experiences in accessing the internet, experiences in not being able to access the internet and consequences of internet use. Discussion: Different from previous studies, adolescents stated that they use the internet because of their lack of activity and their need to spend time with their friends. They stated that when they could not access the internet, they thought they could never live without the internet and started quarrel. [ABSTRACT FROM AUTHOR]

Research on Black/African American males' depressive experiences and expressions is still developing. While research has shown that men are less likely to be diagnosed with depression when compared to women, the experiences of Black/African Americans are often ignored at a far greater level. This study aimed to highlight how Black/African American men understood, discussed, and dealt with their depression. Interviews of N = 4 Black/African American men were analyzed from a larger qualitative study that examined depression among Blacks/African Americans. Qualitative content analysis techniques, which included open coding, were used to identify themes within the interviews that identified similarities across participant's experiences. The themes highlighted within this report included: (a) depressive episodes as responses to traumatic life events; (b) family and paternal significance for Black/African American men; (c) substance use and sleeping as coping/treatment; and (d) stigma as the greatest impediment to help-seeking and service use. Blacks/African Americans experienced depression within the classical contextualization of the DSM-V. However, they quickly learned to adapt to their experiences, push through the pain, and identify their experiences as normal parts of everyday living. The paper ends with some recommended practice implications for service providers who are interested in working with Black/African American men. [ABSTRACT FROM AUTHOR]

Schools provide different contexts for pre-service teachers who are learning to teach under the guidance of mentor teachers as part of work-integrated learning (WIL). As a result, universities and teachers' colleges offer guidance to schools and classroom practitioners to ensure that pre-service teachers are provided with similar opportunities during WIL field experiences. This qualitative paper used semi-structured interviews, observations and document analysis to examine mentoring contexts in different classes, to gain a deep understanding of the mentoring practices, by using the socio-cultural-theory lens. The mentoring pair was used as the unit of analysis. The study analyzed three cases from Zimbabwean secondary schools with different mentoring contexts. Findings indicate that the contexts of WIL for pre-service teachers could be more conducive but are limited by the multiple roles of mentors and limited mentoring infrastructure and facilities. The paper recommends that pre-service teachers practice in different school contexts. [ABSTRACT FROM AUTHOR]

This paper reports on the design of a study to examine the policy landscape relevant to sugar-sweetened beverage taxation in seven sub-Saharan African countries. The study responds to the need for strong policy to address the rising burden of non-communicable diseases in the region. Sugar-sweetened beverage taxation has been widely recommended as a key component of a comprehensive policy approach to NCD prevention. However, it has proved a contentious policy intervention, with industry strongly opposing the introduction of such taxes. The aim was to identify opportunities to strengthen sugar-sweetened beverage taxation-related policy for the prevention of nutrition-related NCDs in a subset of Eastern and Southern African countries: Kenya, Tanzania, Botswana, Rwanda, Namibia, Zambia, Uganda. The study was conducted as a collaboration by researchers from nine institutions; including the seven study countries, South Africa, and Australia. The research protocol was collabora-tively developed, drawing on theories of the policy process to examine the existing availability of evidence, policy context, and stakeholder interests and influence. This paper describes the development of a method for a policy landscape analysis to strengthen policies relevant to NCD prevention, and specifically sugar-sweetened beverage taxation. This takes the form of a prospective policy analysis, based on systematic documentary analysis supplemented by consultations with policy actors, that is feasible in low-resource settings. Data were collected from policy documents, government and industry reports, survey documentation, webpages, and academic literature. Consultations were conducted to verify the completeness of the policy-relevant data collection. We analysed the frames and beliefs regarding the policy 'problems', the existing policy context and understandings of sugar-sweetened beverage taxation as a potential policy intervention, and the political context across relevant sectors, including industry interests and influence in the policy process. This study design will provide insights to inform public health action to support sugar-sweetened beverage taxation in the region. [ABSTRACT FROM AUTHOR]

During 2001–2002, the National Institute for Occupational Safety and Health (NIOSH), at the United States Centers for Disease Control and Prevention, collaborated with the Bureau of Labor Statistics (BLS) at the United States Department of Labor to conduct a voluntary survey of U.S. employers regarding the use of respiratory protective devices. In 2003, the survey results were jointly published by NIOSH and BLS. This study highlights and evaluates the scientific impact of the 2001–2002 survey by using the Science Impact Framework which provides a historical tracking method with five domains of influence. The authors conducted interviews with original project management as well as a thorough document review and qualitative content analysis of published papers, books, presentations, and other relevant print media. A semi-structured and cross-vetted coding was applied across the five domains: Disseminating Science, Creating Awareness, Catalyzing Action, Effecting Change, and Shaping the Future. The 2001–2002 survey findings greatly enhanced understanding and awareness of respirator use in occupational settings within the United States. It also led to similar surveys in other countries, regulatory initiatives by the Occupational Safety and Health Administration and Mine Safety and Health Administration, and ultimately to a renewed partnership between NIOSH and BLS to collect contemporary estimates of respirator use in the workplace within the United States. [ABSTRACT FROM AUTHOR]

Background: Continuous monitoring using wireless wearable sensors is a promising solution for use in clinical practice and in the home setting. It is important to involve nurses to ensure successful implementation. This paper aims to provide an overview of 1) factors affecting implementation of continuous monitoring using wireless wearable sensors by evaluating nurses' experiences with its use on the nursing ward, and 2) nurses' expectations for use in the home setting. Methods: Semi-structured interviews were conducted with 16 nurses from three teaching hospitals in the Netherlands, covering constructs from the Consolidated Framework for Implementation Research (CFIR). A deductive approach of directed content analysis was applied. One additional factor was added using the Unified Theory for Acceptance of Technology (UTAUT). The quotes and domains were rated on valence (positive, neutral, negative) and strength (strong: − 2, + 2, neutral 0, and weak: − 1, + 1). Results: Data was collected on 27 CFIR constructs and 1 UTAUT construct. In the experience of at least 8 nurses, five constructs had a strong positive influence on implementation on the nursing ward, including relative advantage (e.g., early detection of deterioration), patient needs and resources (e.g. feeling safe), networks and communications (e.g. execute tasks together), personal attributes (e.g. experience with intervention), and implementation leaders (e.g., project leader). Five constructs had a strong negative influence: evidence strength and quality (e.g. lack of evidence from practical experience), complexity (e.g. number of process steps), design quality and packaging (e.g., bad sensor quality), compatibility (e.g, change in work) and facilitating conditions (e.g, Wi-Fi connection). Nurses expected continuous monitoring in the home setting to be hindered by compatibility with work processes and to be facilitated by staff's access to information. Technical facilitating conditions (e.g. interoperability) were suggested to be beneficial for further development. Conclusions: This paper provides an overview, of factors influencing implementation of continuous monitoring including relative importance, based on nurses' experiences with use on nursing wards, and their perspectives for use in the home setting. Implementation of continuous monitoring is affected by a wide range of factors. This overview may be used as a guideline for future implementations. [ABSTRACT FROM AUTHOR]

As policymakers globally recognize aging in place as the preferred option for most adults, there is a growing need to supplement family or informal caregiving for frail older adults with formal homecare services, particularly for those who require 24/7 care due to significant physical and/or cognitive impairment. The core objective of this qualitative study was to explore family members' experiences in employing live-in care workers, particularly the nature of their engagement and the quality of their relationships with these care workers. Our analysis of semi-structured interviews with 35 family caregivers revealed four themes: 1) challenges in acquiring support and developing dependency; 2) negotiation of roles, responsibilities, and moral dilemmas; 3) shifting emotions between trust and suspicion; and 4) role confusion, expectations, and disappointments. The study suggests that families might benefit from formal guidance regarding fostering and maintaining positive relationships in the homecare environment. This paper provides nuanced knowledge that may inform the development of such interventions. [ABSTRACT FROM AUTHOR]

Background: Evidence supports the effectiveness of shared book reading for promoting language and literacy development, but it is known that families experiencing vulnerability may have reduced access to books and are less likely to share books regularly at home. Community hubs often provide support to families experiencing vulnerability and may provide an opportunity to create environments that support families to engage in shared book reading, especially if families are invited into the creation of these environments through co‐design. However, there is currently little evidence regarding the impact of co‐designing shared book reading environments with families in community settings. Aims: The current study is part of a broader project which used co‐design to develop a shared book reading environment in collaboration with stakeholders in a community hub. This small‐scale study aimed to provide a preliminary evaluation of the impact of this co‐designed shared book reading environment at the community hub on (1) the frequency of shared book reading at the hub; (2) participants' confidence and enjoyment of reading with children at the hub; and (3) participants' experiences of shared book reading at the hub. Method & Procedures: The co‐design project was carried out in four phases with families, staff and community partners at the community hub. A convergent mixed‐methods approach was used to collect and analyse quantitative and qualitative data in the first and last phase of the project to evaluate project outcomes. Quantitative data (environmental observations of reading at the hub and participant ratings of confidence and enjoyment of reading with children at the hub) were analysed using descriptive statistics and nonparametric statistical tests. Qualitative data (participants' responses regarding their experiences of changes implemented in the community hub) were analysed using inductive content analysis. Outcome & Results: An increased frequency of shared book reading was observed within the community hub after changes were implemented, and positive changes in enjoyment of book reading were recorded. Qualitative responses from participants following conclusion of the project were organised into three main categories, which showed that (1) children and families were reading more and enjoying reading activities that were happening; (2) children and families were borrowing more books; and (3) families had changed the way they were reading at home with their children. Conclusions & Implications: A co‐designed shared book reading environment within a community hub had a positive impact on shared book reading experiences for families in areas with high levels of vulnerability. WHAT THIS PAPER ADDS: What is already known on this subject: Community hubs provide a unique opportunity to support early language and literacy development in partnership with families in areas of vulnerability; however, there is limited literature investigating the impacts of these supports. A previous study utilised co‐design to develop a shared book reading environment with stakeholders at a community hub in an area where a high proportion of children are considered to be 'vulnerable' in terms of language and literacy development. It was found that co‐design enabled the development of collaborative changes to support shared book reading that were valued and owned by families, staff and community partners at the community hub. What this study adds: The current study focused on evaluating the impact of a co‐design project on the frequency of shared book reading at the hub and participants' experiences, confidence and enjoyment of reading with children at the hub. Analysis of pre‐ and post‐data provide preliminary evidence that a co‐designed shared book reading environment in a community hub can have a positive impact on increasing families' awareness and engagement with book borrowing, engagement in shared book reading activities in the community and at home, and participants' confidence and enjoyment of reading with children. What are the clinical implications of this work?: Speech pathologists have an important role to play in prevention and promotion. This study has shown that collaboration with families experiencing vulnerability can support the implementation of strategies to promote shared reading in a community hub and demonstrate increased quality and frequency of shared book reading. The utilisation of a community hub also highlights the opportunities for the speech pathology profession to deliver community‐based promotion and prevention initiatives as a strategy to address equitable language outcomes. [ABSTRACT FROM AUTHOR]

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

Summary: Results of our previous research indicated that older adults believe that there's a lack of sufficient social support from informal sources available to them in difficult situations they face. In follow-up research, we found that older adults defined limitation in their self-sufficiency in daily activities to be the most significant difficult situation for them. This paper disseminates the results of the research seeking to answer the research question: According to older adults, can family be a source of social support in a difficult situation of limitation of self-sufficiency in daily activities? Social support theory is the used theoretical basis. Using the method of qualitative content analysis we analysed 23 semi-structured interviews with older adults. Findings: We found that if two conditions, that is, geographic proximity to individual family members and the quality of relationships with family members, are ensured, family can function as one of the informal sources of social support according to older adults. In case that older adults prefer a formal source of social support, they consider their family as a source of social support only in an extreme situation of limited self-sufficiency. Applications: This study provides social workers with a better understanding of the difficult situations of older adults and what kind of social support older adults prefer. This study also provides an argumentation about the importance of gerontological social work. [ABSTRACT FROM AUTHOR]