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Violence across Latin America is an increasingly important factor influencing migration to the US. A particular form of violence that is experienced by many Latinx migrants is extortion. This research analyzes the extortion experiences of Latinx immigrant adults arriving at the US southern border and the impact these experiences have on mental health. We find that on average, participants paid $804 in extortion during their migration. The most common perpetrators of extortion in our study were police followed by immigration officials throughout Latin America. Pregnant participants were less likely to experience extortion and adults traveling with children were more likely to be extorted. Participants who were extorted for money reported significantly greater severity of post-traumatic stress disorder (PTSD) symptoms compared to those who were not extorted. This research is the first of its kind to analyze extortion experiences among Latinx immigrants to the US, quantifying the prevalence, amounts paid, countries where extortion occurs, and perpetrators of extortion. In addition, extortion experiences are associated with negative effects on the mental health of newly arrived Latinx immigrants to the US. Based upon these findings, we recommend that extortion should be considered a significant stressor in the migrant experience, particularly for those adults traveling with children. [ABSTRACT FROM AUTHOR]

Summary: The COVID-19 pandemic and subsequent public health restrictions caused an unprecedented impact on long-term care services in the United Kingdom (UK). A qualitative study was conducted in the East Midlands, UK, to explore how home care provision was perceived and experienced, by those organizing, commissioning, or providing care, and those receiving care, during the pandemic. Fifteen semi-structured telephone interviews were conducted between September to December 2020 with people who organize, commission, or provide home care (n = 9), recipients of home care (n = 3), and their informal carers (n = 6). Findings: Three broad themes were constructed through a thematic analysis: (1) positive about home care; (2) fear of infection; and (3) social isolation. In addition to these overarching themes, specific group themes were identified amongst group one: those organizing, commissioning, or providing care, and group two: those in receipt of the care and informal carers. Those in group one spoke about the pandemic creating stressful working conditions, regardless of whether organizing, commissioning, or providing care. Despite working throughout the pandemic, they felt a forgotten part of the essential workforce, when compared to those employed in the National Health Service and institutional care. Those in group two experienced a loss of control with visits cancelled or frequently occurring outside of scheduled times. Dissatisfaction with the visits was directed at the management level, rather than at the staff visiting the homes. Applications: Awareness and understanding of the experiences of home care will provide useful knowledge when commissioning future services. [ABSTRACT FROM AUTHOR]

Pelvic Floor Muscle Training (PFMT) is the first primary solution to improve urinary incontinence (UI) symptoms, but many challenges stems from certain PFMT-related practices. Exploring PFMT experience will help to increase treatment satisfaction, enjoyment, and empowerment. Hence, the aim of this study was to investigate the experience of pelvic floor muscle training (PFMT) in Italian people with UI. A qualitative semi-structured interview study was conducted. The interviews' transcriptions were analysed using a constructionist epistemology lens and adopting the "Reflexive Thematic Analysis". Sixteen Italian participants (Women N = 10, Men = 6) with UI who experienced PFMT were interviewed. Four themes were generated: (1) 'Learn to Control the Unconscious Consciously' as participants learned to control continence through active exercises; (2) 'Starting PFMT, Changing Mind' as they realised they can have an active role in managing their condition; (3) 'Into the unknown intimacy', as they bridged the gap in their (mis)understanding of the pelvic floor area, overcoming the discomfort linked to intimacy; (4) The Importance of Not Being Alone in this Process', as the participants emphasised the paramount role of the physiotherapists in the healing process. To conclude, in people with UI, PFMT enhanced pelvic floor knowledge and understanding, fostering awareness, positive mindset, and symptom relief. The physiotherapist's pivotal role as an educator and empathetic guide in exercise programs, along with a preference for active exercises. Overall, our results proved that PFMT has positive consequences in people's beliefs and mindset about and in the management of UI. [ABSTRACT FROM AUTHOR]

Introduction: The experiences of living with Parkinson's disease (PD) from the perspective of newly diagnosed persons with PD (PwPD) have not been previously described. Aim: This study aimed to gain a better understanding of the impact of living with the early stages of PD. Methods: A qualitative interview study was conducted among nine persons, seven men and two women, from southern Sweden. Participants had a median age of 71 (min–max, 64–77) years and had been diagnosed with PD for a median of 5 (min–max, 2–12) months. Interviews were recorded and analysed using systematic text condensation. Results: The analysis resulted in one core category, Facing and dealing with emotional turbulence, and four categories with 2–3 subcategories each: Something is wrong (Vague signs of change; Losing control); The going gets tough (Recalling; Lack of motivation); Losing direction (Uncertainties; Frightened of disease progression) and Dealing with life (Avoiding social situations; Hope and despair; Ease worries). Conclusion: Newly diagnosed PwPD face emotional turbulence with increasing challenges in managing everyday basic needs. Impaired functioning affects self‐esteem and identity, which calls for strategies to overcome emotional reactions of embarrassment, frustration and worry. A sense of lost control and direction increased as the future became more uncertain. The participants' emotional burden and struggle to find a reason to go on or some solution to their new situation left them with both hope and despair. Our results suggest that a person‐centred needs‐based approach may help newly diagnosed PwPD deal with their new life situation. [ABSTRACT FROM AUTHOR]

Behavioral health professionals are at high risk for burnout and poor mental health. Our objective was to understand the impact of the Behavioral Health Providers Workforce Resiliency (BHPWR) ECHO Program on the resilience and burnout of participating behavioral health professionals. We assessed the first two years (March 2022 to March 2024) of the BHPWR ECHO, a national program operating from the University of New Mexico (N = 1585 attendees), using a mixed-methods design. We used a retrospective pre/post survey (n = 53 respondents) and focus interviews with 1–3 participants (n = 9 participants) to assess for changes in knowledge and confidence and assess changes in burnout and resilience. We found that participants increased their knowledge of how to respond when (1) their workload was more than they could manage, (2) they felt that they lacked control, (3) their work did not feel rewarding, and (4) they were experiencing compassion fatigue. They increased their confidence in (1) building a support system and (2) using the wellness tools taught in the course. Respondents were less burnt out (score: 26.0 versus 17.8, p < 0.01) and more resilient (29.9 versus 34.9, p < 0.01) compared to when they started attending the program. Tele-mentoring programs like the BHPWR ECHO Program may improve wellness among health care professionals. [ABSTRACT FROM AUTHOR]

As numerous nations transition into digital and aging societies, the digital divide has emerged as a significant impediment to older adults' autonomous engagement in the digital society. Enhancing the well-being of elderly individuals through remote medical technology represents a prevailing and prospective trend. Nevertheless, remote medical technology extends beyond the realm of healthcare, offering promise for narrowing the digital divide through the deployment of digital devices and provision of intergenerational support. Therefore, this study investigates the role of trust and expectations in the use of telemedicine, indicating potential pathways for how these products can improve older adults' daily living abilities. Through the construction of a theoretical model, we collected the relevant data of 661 elderly people who use telemedicine technology in China and analyzed the data with SmartPLS4 to obtain the research results. The study discovered that, among older people using telemedicine technology, (1) healthcare expectations promote the breadth of telemedicine product use; (2) trust in product safety increases the depth of telemedicine product use; (3) trust in the service provider promotes the breadth of telemedicine product use; and (4) when compared to the depth of product use, the breadth of telemedicine product use increases older adults' sense of control over their digital lives. The findings provide new empirical data to support growing beliefs about how expectations and trust can increase a sense of control over one's life. They also provide practical contributions on how to boost older adults' usage of telemedicine products, promote their digital literacy and competency, and enhance their sense of control over their digital lives. [ABSTRACT FROM AUTHOR]

Evidence shows that during birth women frequently experience unconsented care, coercion, and a loss of autonomy. For many countries, this contradicts both the law and medical ethics guidelines, which emphasize that competent and fully informed women's autonomy must always be respected. To better understand this discordance, we empirically describe perinatal maternity care providers' and women's moral deliberation surrounding coercive measures during birth. Data were obtained from 1-on-1 interviews with providers (N = 15) and women (N = 14), and a survey of women (N = 118). Analyses focused on an in-depth exploration of responses to a question on the permissibility of coercion in birth whose wording was borrowed from a Swiss medical-ethical guideline. Reasons for and against a principle permissibility of coercive measures in birth were grouped into clusters of reasons to build a coherent explanatory framework. Factors considered morally relevant when deliberating on coercion included women's decisional capacity, beneficence/non-maleficence, authority through knowledge on the part of providers, flaws of the medical system, or the imperative to protect the most vulnerable. Also, we identified various misconceptions, such as the conviction that a pathological birth can justify coercion or that fetal rights can justifiably infringe on women's autonomy. Information and education on the issue of coercion in birth are urgently needed to enable women to fully exercise their reproductive autonomy, to prevent long-term adverse health outcomes of women and children, and to reconcile the medical vigilance which has lead to a reduction of perinatal morbidity and mortality with women's enfranchisement in their own care. [ABSTRACT FROM AUTHOR]

Objectives: Despite expanding knowledge about the internal and external resources that contribute to resilience among individuals who have experienced depression, the long-term accessibility and protectiveness of these resources across different stressors is unknown. We investigated whether and how the resilience resources of individuals who previously recovered from late-life depression remained protective during the COVID-19 pandemic. Methods: We used a sequential explanatory mixed methods design. Quantitative data were derived from two psychiatric case-control cohorts and included twelve repeated measures during the COVID-19 pandemic (n = 465, aged ≥ 60). Qualitative data included two sequential interviews held in 2020 (n = 25) and 2021 (n = 19). We used thematic analysis to determine the protective resources after depression and during the COVID-19 pandemic and linear mixed models to examine the effect of these resources on change in depressive symptoms during the COVID-19 pandemic. Results: While resources of 'Taking agency', 'Need for rest', 'Managing thought processes' and 'Learning from depression' remained accessible and protective during the pandemic, 'Social support' and 'Engaging in activities' did not. 'Negotiating with lockdown measures', 'changing social contact' and 'changing activities' were compensating strategies. Quantitative data confirmed the protectiveness of social contact, social cohesion, sense of mastery, physical activity, staying active and entertained and not following the media. Conclusion: Many of the resources that previously helped to recover from depression also helped to maintain good mental health during the COVID-19 pandemic. Where accessibility and protectiveness declined, compensatory strategies or new resources were used. Hence, the sustainability of resilience is enabled through adaptation and compensation processes. [ABSTRACT FROM AUTHOR]

Relatively little research has examined men's use of coercive controlling tactics against female partners after separation. This mixed-methods secondary analysis of 346 Canadian women documented coercive controlling tactics used by their ex-partners (86.4% identified at least one). The composite abuse scale emotional abuse subscale and women being older were associated with men using coercive control tactics post-separation. A secondary qualitative analysis of in-depth interviews with a sub-sample of 34 women provided additional examples. Abusive partners used numerous strategies to coercively control their ex-partners by stalking/harassing them, using financial abuse and discrediting the women to various authorities. Considerations for future research are presented. [ABSTRACT FROM AUTHOR]

The United Nations declares that the global degradation of ecosystems represents a danger to human health. Deterioration of forests is one of several threats against the natural systems. The aim of this exploratory study was to investigate people's experiences with clear-cutting and how it had affected their health and well-being. Qualitative data from six people who valued forest ecosystems were collected through semi-structured interviews and analyzed in accordance with Graneheim and Lundman's qualitative content analysis (Graneheim, U. H. and Lundman, B. (2004) Qualitative content analysis in nursing research: concepts, procedures and measures to achieve trustworthiness. Nurse Education Today, 24, 105–112). Clear-cutting was not regarded as an environment-friendly forestry method. The interviewees described emotional reactions such as grief and poor mental well-being when beloved forests were clear-felled. The grief was partly because of a personal loss of place and recreation area that was important for their physical and emotional well-being. Another part was grief on behalf of nature itself, that is, the loss of habitats of animals and plants and a worsening of the global climate. The interviewees held that emotions related to loss of nature were insufficiently communicated in public discourse. They felt powerless and unable to influence forestry because of what they experienced as an impenetrable industry. Clear-cutting of forests may result in poor well-being among people who value forest ecosystems. More focus on planetary health is needed, including healthy public policy promoting forest management that considers people's need for nature experiences and possible ecological grief when forests are totally and abruptly cleared. [ABSTRACT FROM AUTHOR]

Employment conditions are important social and commercial determinants of health. Informal employment—also known as 'cash-in-hand' and 'undeclared' work—is a discrete employment condition that has salience around the world. Fuelled by neoliberal ideology, informal employment has become increasingly common in high-income countries. Public health research concerning the health of informal workers comes largely from low- and middle-income countries, where the phenomenon is more visible. There has been little research on the health effects of informal employment in high-income countries including Australia. Twenty-nine workers aged 18 years and older, who were undertaking informal work activities, were recruited using social media and an online marketplace in Tarndanya (Adelaide-Kaurna Country), Australia. Qualitative narrative data, demographic profiles, and physical and mental health scores were collected. Most informal workers reported unfair and indecent employment conditions including job insecurity, low income, coercion, and lack of respect and dignity at work, and were often exposed to unsafe and unhealthy work environments. Workplace injuries and exposure to occupational hazards were common; and Physical and Mental Component Scores were poorer among informal workers when compared to the population of South Australia as a whole. With informal employment in Australia described as part of a 'significant, pervasive, damaging and growing' problem, there is a need for a health promotion lens over industrial relations policies in the interest of creating equitable access to fair and decent work. [ABSTRACT FROM AUTHOR]

Interest in voluntary assisted death (VAD) has been growing among researchers, policy makers and the public. This study aimed to explore older adults' perspectives on VAD in Australia. Using purposive sampling, 15 adults ≥65 years participated in in-depth semi-structured interviews. Interpretative phenomenological analysis identified four themes: cultural reflections; beliefs and worldviews; health aspects; and fabric of life. Participants expressed a desire to have control over end-of-life options, challenged by religious beliefs. Participants expressed concern that VAD legislation could leave people vulnerable to coercion and saw a need for safeguards. Reasons for and against supporting and utilising VAD were discussed. Physical illness was seen a more compelling reason for VAD than mental ill-health. Finally, connections to life and other were discussed, and being able to do the things one loved were named aspects of what it meant to live a good life. Implications are discussed along with future research directions. [ABSTRACT FROM AUTHOR]

Background: A high number of non-consensual sexual experiences happen in heavy drinking contexts, pointing to the importance of investigating how young people make meaning of their alcohol intoxicated sexual interactions. In analyzing that, researchers have used the concept of 'sexual agency', to describe how young people often draw on a neoliberal discourse, which emphasizes freedom, choice and individual responsibility to make meaning of their alcohol intoxicated sexual interactions. The aim of this paper is to argue for the applicability of a more situational understanding of sexual agency, such as Cahill's (2016), when investigating young people's alcohol intoxicated sexual experiences. Methods: 30 qualitative interviews were conducted with young Danes (aged 19-25) on their alcohol intoxicated sexual encounters. Results: A narrative analytical approach revealed that participants draw on three types of narratives on sexual encounters which emphasized: 1) The pleasurable experiences and a large degree of agency 2) The ambivalent experiences of agency and 3) The out-of-control sexual experiences. Conclusions: The results highlight the situational and varied nature of sexual agency in sexual encounters and that discourses on gender, sexuality and alcohol intoxication influence the participants' construction of agency. [ABSTRACT FROM AUTHOR]

High‐risk behaviours are sometimes encountered in Child and Adolescent inpatient mental health units and can prompt the use of coercive practices to maintain safety. Coercive practices may lead to re‐traumatisation of young people and deteriorating therapeutic relationships. Trauma‐informed practice (TIP) has successfully reduced coercive practices. While education is identified as foundational to implementation, evaluations of programmes remain minimal. The aim of this study was to explore mental health professionals' views and experiences of a trauma‐informed education programme and its likely impact on their approach to practice. Five mental health professionals agreed to participate, four contributed in a focus group and one in an individual interview. Data were analysed thematically using the Braun and Clarke Framework. Three main themes were identified. Firstly, shifting attitudes and perceptions of trauma‐informed practice. Participants believed they had developed more compassion towards clients and these attitudes were reflected in their clinical practice. Secondly, challenges associated with trauma‐informed practice educational intervention. Staffing issues and shift work made it difficult for participants to attend education sessions regularly. Participants identified barriers to practicing in a trauma‐informed manner in the current clinical environment. Finally, the need for interdisciplinary communication and support was identified. Participants saw the need for all professionals, not only nurses, to take responsibility for changing practice, and for stronger support at the organisational level. Trauma‐informed practice is crucial to recovery‐focused mental health nursing practice. These findings highlight the importance of TIP education and suggest areas for further improvement to enhance positive mental health outcomes for young people. [ABSTRACT FROM AUTHOR]

Medically compromised people with anorexia nervosa are cared for in inpatient settings where clinicians closely monitor health and safety. Clinicians are in a position of power, with the capacity to impose mandated weight gain to achieve medical stabilisation. Consumers are in a vulnerable position, compelled to temporarily relinquish autonomy and to accept coercive practices that often diminish the quality of the therapeutic relationship. Clinicians' position of power in mental healthcare has a dual potential for both healing and harm, and limited attention has been given to consumers' views of clinicians' power. The aim of this qualitative descriptive study was to investigate the consumer perspective of clinicians' power in the inpatient care of anorexia nervosa, establishing insight into the beneficence and maleficence of the power asymmetry. Ten women with anorexia nervosa in the community participated in semi‐structured interviews online. The COREQ checklist was used to ensure accuracy and completeness of reporting. Thematic analysis revealed that abuses of power were common in the course of inpatient AN care, however life‐saving measures were regarded as defensible. The perception of clinicians' power was determined by the strength of interpersonal relationships and clinicians' clinical competence. To mitigate the potential for harmful experiences, clinicians' use of power must be exercised with close consideration for consumer perspectives, with the integration of person‐centred care and trauma‐informed care principles. [ABSTRACT FROM AUTHOR]

In this article, we critically interrogate the concept of consent in relation to women's experiences of coerced and unwanted heterosexual anal sex. Among the 18 women we interviewed (all living in New Zealand), some clearly labelled their experiences of unwanted anal sex with men as nonconsensual. Many others, however, suggested that they had, in some way, consented. We identified two main discursive patterns in the ways that women discussed consent in these contexts: one that equated it with resignation, mostly associated with experiences of verbal pressure, and another that reduced consent to a lack of resistance to unwanted and unexpected anal penetration. Through these women's accounts, it was clear that consent and coercion are not mutually exclusive. Overall, consent in these cases was scripted within a gendered dynamic that was premised on men's sexual entitlement and women's traditional roles as sexual caretakers and gatekeepers. We argue that women's accounts and reflections on consent in this context illuminate structural fragilities in the very concept of sexual consent as a marker of ethical sex. Consent was substantively distinct from sexual enthusiasm and mutuality. We conclude that it fails in its promise to protect women against sex that is coercive and hurtful. [ABSTRACT FROM AUTHOR]

This paper uses critical realism to identify mechanisms that activate successful relationships. It draws data from a longitudinal, mixed‐methods study of youth who used multiple services. It examines functionality of four relational mechanisms: power, recognition, responsiveness and mutuality that lead to positive change and explores the implications of these for practice with youth with complex needs. [ABSTRACT FROM AUTHOR]

Functional movement disorders (FMD) have poor prognosis and high physical and psychological co-morbidity. Their pathogenesis remains unclear, clinicians often find them difficult to treat, and lack of agreement between healthcare providers and patients is common. This study aimed to explore the experiences of living with FMD to improve understanding of its impact and patients' needs. Ten participants across the UK were recruited online through a charity's social media platforms. Semi structured interviews were conducted via video calls and were audio recorded and verbatim transcripts were analysed using interpretative phenomenological analysis. Three superordinate themes were generated from the data, representing the three battles fought by the participants: (1) intrapersonal: the tug of war with the secret agent within- the power struggle with symptoms; (2) interpersonal: navigating stigma and self-preservation; (3) systemic: pursuing hope and treatments against helplessness and passivity. Loss of control, feelings of powerlessness and oppression by symptoms is often mirrored in participants' experiences of seeking healthcare and navigating societal stigma. Active efforts to regain influence, improve quality of life and maintain hope can be jeopardised by others' dismissive attitudes and lack of knowledge. Antonovsky's model of salutogenesis is proposed as a useful framework for facilitating empowerment in FMD service provision. [ABSTRACT FROM AUTHOR]

Purpose: Intimate partner violence (IPV) victim advocates are exposed daily to the traumas of their clients, including the potential exposure to an intimate partner homicide (IPH). While research has examined the effects of daily secondary exposure to IPV on victim advocates, little is known about the specific effect of IPH. This study examined how the IPH of a client affected advocates' perception of and approach to their work. Methods: Nine advocates were recruited from the northeastern U.S. and interviewed about their experience of the IPH of a client. Advocate interviews were analyzed using The Listening Guide Analysis which systematically isolates and listens to the different, and often contradictory, voices that a participant uses. Results: Exposure to IPH changed participants' perception of their role, how they defined client, and how they interacted with future clients. At a macro-level, the IPH of a client motivated advocates to advance changes in agency protocol, multisector responses, and state policy based on what they had learned from the IPH. Opportunities to translate shifts in their worldview into tangible changes to protocol and policy were critical to advocate adjustment after the IPH. Conclusions: In order to support advocates after IPH, organizations should acknowledge the potentially transformative effect of IPH and create opportunities for meaning making to assist in advocate adjustment. It is imperative for advocacy organizations to support their employees to prevent advocate burnout and the loss of experienced staff, and to continue to provide effective services to vulnerable members of their communities after IPH. [ABSTRACT FROM AUTHOR]

Background: Voluntary medical male circumcision (VMMC) is a method for combination HIV prevention for adolescents > 15 years in settings with generalized epidemics. In Zimbabwe, policy currently allows VMMC in adolescents > 15 years old, but there is consideration to lower the threshold to 13 years old. There is a need to understand current practices in assent/consent, and parents' requirements for assent/consent to inform policy recommendations for the VMMC programme in lowering its age threshold. Methods: Cross-sectional surveys were conducted in September 2022 using convenience sampling among three respondent groups: uncircumcised adolescents/young men (AYM) aged 13–16 years (n = 881), circumcised AYM aged 13–20 years (n = 247), and parents of uncircumcised adolescents aged 13–16 years (n = 443). Surveys asked about VMMC knowledge, experiences with mobilisers, circumcised AYM's assent/consent experiences, and parents' preferences for assent/consent processes. Results: Knowledge of VMMC was significantly lower among younger adolescents aged 13–14 than their 15–16 year-old peers. 57% (142/247) of circumcised AYM had a one-to-one discussion with their provider before having the procedure, 32% (80/247) said they were not fully informed about VMMC prior to the procedure, and 54% (134/247) wanted more information about procedure-related pain. Over half (56%, 42/75) of circumcised AYM whose parents had not provided consent in-person for them to receive the procedure reported that their parents had never been contacted to verify consent. Conclusions: There are gaps in the current assent/consent process for VMMC in Zimbabwe. Providers should be trained to give balanced information on risks and benefits of the procedure, including potential for pain. One-on-one discussions between providers and adolescents prior to the procedure, age-appropriate counselling, and tools for providers to ascertain adolescents' understanding and ability to provide assent are essential processes, especially if the age threshold is lowered to include younger adolescents. it is also imperative to improve communication with parents, particularly to verify consent for their children has been given, per national guidelines. [ABSTRACT FROM AUTHOR]

We aimed to qualitatively explore factors influencing contraceptive use in women living with sickle cell disease (SCD). We conducted a semi-structured qualitative study using data from interviews with reproductive-aged women with SCD. The Theory of Planned Behavior, which describes an individual's attitudes, subjective norms, and perceived behavioral control as drivers of a health behavior, served as a framework for data collection and thematic analysis. We analyzed interviews from 20 participants. Attitudes toward contraception showed skepticism regarding hormonal contraception and concern about adverse effects of contraception related to SCD. The role of subjective norms in contraceptive choice depended on whether participants possessed trusted sources of information, such as health care providers, family, and friends, or whether they relied on themselves alone in their contraceptive decision-making. The influence of health care providers was complicated by inconsistent and sometimes conflicting counseling. Finally, with regard to participants' perceived control in their contraceptive choices, some were motivated to alleviate menstrual pain or prevent SCD-related pregnancy risks, but many reported feeling disempowered in contraceptive decision-making settings because of ways that healthcare providers exerted pressure or responded to participants' demographic characteristics. Women living with SCD are influenced by many factors similar to those documented for other populations when making decisions about contraception. However, SCD amplifies both the importance and risks of contraception and may also complicate individuals' autonomy and contraceptive access. Hematology and reproductive health providers should recognize the risk of coercion, maximize patients' reproductive agency, and coordinate reproductive health counseling for patients with SCD. [ABSTRACT FROM AUTHOR]

Objective: Deterioration rate among patients with bulimia‐spectrum eating disorders (BN‐EDs) after receiving enhanced cognitive‐behavioral therapy (CBT‐E) remains high. Previous studies identified body image concerns, environmental triggers, lack of social support, lack of resources, comorbidity, and discontinued skill use as predictors of deterioration. However, no studies have qualitatively explored patients' perceptions of how these factors influenced their skill use and led to deterioration after receiving outpatient CBT. Methods: This study aimed to qualitatively explore (1) what post‐treatment factors patients believe contributed to deterioration, and (2) whether patients continued to practice the CBT skills they learned from treatment and identify motivators and barriers to post‐treatment skill use. Twelve participants who had previously completed 16 sessions of CBT for their BN‐EDs and experienced at least modest treatment responses participated in the qualitative interviews. Results: Four themes were identified from the qualitative interviews. Post‐treatment deterioration was primarily driven by decreased skill use due to a perceived sudden loss of accountability and continued body dissatisfaction after treatment ended. Discontinued practice of binge analysis led to decreased awareness of the relationship between poor skill use and ED behaviors. Difficulty accessing resources impeded participants from receiving external help to address challenges in skill practice, thus also contributing to deterioration. Discussion: Findings suggested that outpatient treatment for BN‐EDs patients should emphasize more on body image concern, and deterioration prevention for outpatient CBT‐E should focus on building self‐accountability to keep practicing skills after treatment ends. Public significance: This study was the first to qualitatively explore post‐treatment factors influencing skill use and deterioration in patients with bulimia‐spectrum eating disorders after they completed outpatient CBT. Findings indicated that decreased skill use was a primary driver of post‐treatment deterioration, and that relapse prevention for outpatient CBT for BN‐EDs should focus on enhancing patients' self‐accountability to continue practicing therapeutic skills independently after treatment ended. [ABSTRACT FROM AUTHOR]

Scholarly works have extensively explored the marginalized positions of transgender individuals in Pakistan. However, there is a noticeable gap in literature concerning the profound impact of cis-heteropatriarchal parental control on young Khawaja Sara and Hijra individuals—members of the transgender community—particularly when they reside in their parental homes in Peshawar, Pakistan. Grounded in Foucault's panopticon concept, this study seeks to illuminate the pervasive surveillance experienced by young Khawaja Sara and Hijra within the confines of their familial environments. The study employed a qualitative methodology, which involved conducting face-to-face interviews with 10 members of the Khawaja Sara and Hijra communities in Peshawar. The findings demonstrate that trans identities are perceived as a breach of honor in the local Pashtun culture, leading to disrespect and disgrace for the family name. In this way, a meticulous monitoring through regular surveillance creates a neo-panoptic environment within their parental households. This pervasive surveillance not only obstructs their access to quality health services, educational facilities, and employment opportunities but also compels many transgender individuals to abandon their parental homes and migrate to urban areas in Peshawar for their security and protection. Despite grappling with societal pressures, encompassing corporal punishment, sexual abuse, and homelessness, the findings underscore the remarkable resilience and resistance displayed by young Khawaja Sara and Hijra members. Their resilience and resistance serve as a potent challenge against the entrenched cis-heteropatriarchal parental control in Peshawar, Pakistan. The study concludes on highlighting the harsh circumstances confronted by transgender individuals within their parental households in Peshawar, where their trans subjectivities label them as dishonorable. Despite enduring societal pressures, the resilience exhibited by young Khawaja Sara and Hijra emerges as a formidable challenge to the deeply entrenched cis-heteropatriarchal control. This describes the indomitable strength of the transgender community in overcoming systemic adversities in Peshawar. [ABSTRACT FROM AUTHOR]

Why you should read this article: • To recognise that many women who receive inpatient mental healthcare have negative experiences • To update your knowledge of the importance of gender-sensitive and trauma-informed inpatient mental health services for women • To understand women’s experiences of care and support in an NHS mental health rehabilitation service. The importance of providing women who experience mental health issues with gender-sensitive and trauma-informed care has been emphasised in research and policy. However, the literature highlights that many women who receive inpatient mental healthcare have negative experiences including restrictive interventions, feeling coerced to take medicines, lack of empathy and re-traumatisation. It is important to continue exploring women’s experiences in inpatient mental health services to determine to what extent the care offered is gender-sensitive and trauma-informed. This article reports on a service evaluation conducted in 2023 at one mental health rehabilitation service in England to explore the experiences of female service users. Six women were interviewed and the data obtained were analysed thematically. Most participants reported positive experiences of the service but there were areas where care could be improved. [ABSTRACT FROM AUTHOR]

Background: A large number of deaths could be avoided by improving health behaviours. The degree to which people invest in their long-term health is influenced by how much they believe they can control their risk of death. Identifying causes of death believed to be uncontrollable, but likely to occur, may provide actionable targets for health interventions to increase control beliefs and encourage healthier behaviours. Method: We recruited a nationally representative online sample of 1500 participants in the UK. We assessed perceived control, perceived personal likelihood of death, certainty of risk estimation, and perceived knowledge for 20 causes of death. We also measured overall perceived uncontrollable mortality risk (PUMR) and perceived prevalence for each of the Office for National Statistics' categories of avoidable death. Findings: Risk of death due to cancer was considered highly likely to occur but largely beyond individual control. Cardiovascular disease was considered moderately controllable and a likely cause of death. Drugs and alcohol were perceived as risks both high in control and low in likelihood of death. However, perceptions of control over specific causes of death were found not to predict overall PUMR, with the exception of cardiovascular disease. Finally, our sample substantially overestimated the prevalence of drug and alcohol-related deaths in the UK. Conclusions: We suggest that more can be done by public health communicators to emphasise the lifestyle and behavioural changes that individuals can make to reduce their general cancer risk. More work is needed to understand the barriers to engaging with preventative behaviours and maintaining a healthy heart. Finally, we call for greater journalistic responsibility when reporting health risks to the public. [ABSTRACT FROM AUTHOR]

Bagwell-Gray et al. developed a taxonomy of intimate partner sexual violence (IPSV) focusing on type of force (physical or nonphysical) and type of sexual activity (penetration or no penetration). The current secondary descriptive qualitative analysis of interviews with 89 Canadian women IPV victims assessed IPSV that fit Bagwell-Gray's taxonomy. About half (46 or 51.7%) described sexual violence, most commonly sexual abuse (26 or 29.2%), sexual assaults (17 or 19%), and sexual coercion (16 or 17.9%), with overlap across categories. Forced sexual activity was seldom mentioned (3 or 3.4%). Implications for service providers and researchers are provided. [ABSTRACT FROM AUTHOR]

Purpose: Concerns about the likelihood, consequences, and meaning of losing control are commonplace across anxiety‐related disorders. However, several experimental studies have suggested that individuals without a diagnosis of a mental disorder also believe that they can and will lose control under the right circumstances. Understanding the range of beliefs about the nature and consequences of losing control can help us to better understand the continuum of negative beliefs about losing control. Methods: The present study used thematic analysis to identify common beliefs about losing control in an unselected sample. Twenty‐one participants, half of whom met criteria for at least one anxiety‐related disorder, were interviewed about their beliefs about losing control. Results: All 21 participants reported that losing control was possible. Losses of control were defined as multifaceted cognitive‐behavioural processes and were seen as negative considering the perceived consequences of the losses. Commonly described consequences were harm to oneself or others, powerlessness, and unpleasant emotions during (e.g., sadness, frustration, and anxiety) and following (e.g., regret, shame, and humiliation) a loss of control. Conclusions: These results suggest that perceived losses of control are common and that negative beliefs about losing may only become problematic when the losses are personally significant. Further, they offer important insight into what is common among clinical and non‐clinical beliefs about losing control and inform how these beliefs might be worth targeting in cognitive and behavioural interventions. [ABSTRACT FROM AUTHOR]

Aim: To explore the experiences primary care Advanced Nurse Practitioners have had in relation to deprescribing opioids in chronic non‐malignant pain. Design: A qualitative interview study. Methods: Primary care Advanced Nurse Practitioners were recruited from across the Northern Ireland GP Federations. Data collection for this study took place between April and June 2022. In total, 10 semi‐structured online interviews were conducted. Interviews were audio and visually recorded, transcribed verbatim and interpreted using a thematic analysis framework. The COREQ criteria were used to guide the reporting of this study. Results: The Advanced Nurse Practitioners experienced several challenges associated with opioid deprescribing and the implementation of current chronic pain guidelines. The main barriers identified were difficulties engaging patients in deprescribing discussions, a lack of availability of supportive therapies and poor access to secondary care services. The barriers identified directly impacted on their ability to deliver best practice which resulted in a sense of professional powerlessness. Conclusion: The experiences of the Advanced Nurse Practitioners demonstrate that opioid deprescribing in patients with chronic pain is challenging, and implementation of current chronic pain guidelines is difficult. Impact: This study contributes to existing literature on the topic of reducing opioid prescribing and as far as the authors are aware, is the first study to examine the experiences of primary care advanced nurse practitioners in this context. These findings will be of interest to other primary care practitioners, and prescribers involved in the management of chronic non‐malignant pain. Patient or Public Contribution: No patient or public contribution. [ABSTRACT FROM AUTHOR]

Accessible Summary: What is known on the subject: Most health professionals working in psychiatric care will experience adverse events (AE) such as service user suicide or violence, during their careerNorway lacks measures to capture potential iatrogenic injuries, such as risk assessment measures, to evaluate patient records for AEs in both inpatient and outpatient psychiatric clinics in hospitals What the paper adds to existing knowledge: We have described an approach to the validation of a research tool between different national contexts; a process that went beyond language translationWe have incorporated the understanding of health professionals and service users; to bring together the lifeworld of the patient with the professional definition of AEs, triggers and risk areas of AEs in a psychiatric context. The service users' experiences resulted in modifications to the tool. What are the implications for nurses: Applying the 'Global Trigger Tool—Psychiatry' in Norway and Sweden can help mental health nurses to prevent iatrogenic harm and reduce the occurrence of AEs through the identification of potential triggers.Implementing 'Global Trigger Tool—Psychiatry' might help mental health nurses to improve patient safety in Norway and Sweden. Introduction: There is little consensus on cross‐cultural and cross‐national adaptation of research instruments. Aim/Question: To translate and validate a Swedish research tool (GTT‐P) to detect iatrogenic adverse events in psychiatric health care by involving service users and health professionals in the process. Method: The GTT‐P, designed to identify events in patient records that were triggers for adverse events, was translated to Norwegian using a cross‐cultural adaptation approach. This involved two focus groups with clinical staff, one of which involved service users, and a joint discussion at a Dialogue Conference to generate consensus on the definition of the triggers of potential adverse events identifiable in patient records. Results: We highlight both the differences and commonalities in defining the nature of risks, the adverse events and the triggers of such events. The Dialogue Conference resulted in three modifications of the tool, based on service users' experiences. Service user involvement and co‐production was essential for both the translation and adaptation of the research instrument. Discussion: We have described an approach to the validation of a research tool between different national contexts; a process that went beyond language translation. This approach enables a more nuanced understanding of potential risks within a psychiatric context as it engages differences in the care delivery. Applying the GTT‐P in hospital‐based psychiatric care might help to identify processes that need to be changed in order to promote patient safety and a safer work environment for mental health nurses. Implications for practice: When translating and validating the GTT‐P from Swedish to Norwegian, we have considered the knowledge and experiences of both service users and health professionals. The application of the GTT‐P can promote greater patient safety in hospital settings. [ABSTRACT FROM AUTHOR]

Background and Aims: Retroactive jealousy is an unhealthy interest in a partner's romantic/sexual history that has a detrimental effect on sufferers and relationships. Significant numbers of people seek therapeutic help for retroactive jealousy each year, but no research has used their lived experiences to identify potential therapeutic interventions. That was the aim of this research. Methods: Seven adults (21–43 years) who had sought help for retroactive jealousy were interviewed about their experiences. Participants' accounts were analysed with reflexive thematic analysis, and findings were used to identify potential therapeutic interventions. Findings: Three main themes represented participants' experiences. Fears threaten hope and security involved negative self‐comparisons with past rivals, a sense of one's partner and the relationship losing value and of feeling wronged. Feeling compelled to know about the past involved one's mind as a creative generator of distress and feeling compelled to seek reassurance but making things worse. Feeling split and out of control involved feeling like a devil was on one's shoulder and having retroactive jealousy as a constant background to relational life. Implications: Therapeutic guidance for change and growth can be directed at participants' desires to forge a special romantic relationship, to achieve a more stable sense of self, and to act consistently with their underlying values and not in response to their visceral fears. We offer suggestions for psychoeducation regarding characteristics of healthy relationships, for working to move from insecure to secure responses, and for integrating cognitive defusion and implementation intentions to enhance agency. [ABSTRACT FROM AUTHOR]

Background: Despite news reports of morally distressing situations resulting from complex and demanding community-care delivery in Canada, there has been little research on the topic of ethical conflicts experienced by community-based health care professionals. Research aim: To identify ethical conflicts experienced by community nurses. Research design: Data were collected using semi-structured interviews and then relevant text was extracted and condensed using qualitative content analysis. This research was part of a larger grounded theory project examining how community nurses manage ethical conflict. Research context and participants: Community nurses, including 13 public health nurses and 11 home care nurses from two Canadian provinces, were interviewed. Ethical considerations: Study approval was granted by the Health Research Ethics Authority of Newfoundland and Labrador and by provincial health authorities. Findings: Seven ethical conflicts were identified and assigned to one of two groups. In the grouping categorized as challenges with obligations or risks, the ethical conflicts were: (1) screening for child developmental issues knowing there is a lack of timely early intervention services; (2) encountering inequities in the health care system; (3) not fulfilling principles, goals, and initiatives of primary and secondary prevention; and (4) feeling powerless to advocate for clients. The remaining ethical conflicts were categorized as challenges with process, risks, and consequences, and were: (5) jeopardizing therapeutic relationships while reporting signs of a child at risk; (6) managing confidentiality when neighbors are clients; and (7) supporting client autonomy and decision-making but uncertain of the consequences. Conclusions: Research investigation will continue to be important to raise awareness and mobilize ethics supports as health care services are steadily shifted from institutional to community settings. Moreover, with heightened potential for communicable disease outbreaks across international borders from global warming, community nurses around the world will continue to be required to address ethically-difficult care situations with competence and compassion. [ABSTRACT FROM AUTHOR]

Protecting the rights of people with psychosocial conditions is an important and controversial global aim, particularly in light of multiple calls for reduced coercion catalyzed by General Comment 1 of the United Nations Committee on the Rights of Persons with Disabilities, which stipulates the replacement of substituted care with supported care. Responding to this and other global calls for reduced coercion is complex globally but can entail particular challenges in developing countries, where resource shortages and environmental barriers are sometimes a significant factor in how people with mental conditions experience involuntary care and encounter limitations to their autonomy. To better understand these complexities, our study explored experiences of involuntary care among people with psychosocial conditions in South Africa. Participants described varying degrees of coercion within involuntary care and found that different approaches from professionals when they were in crisis significantly impacted their illness experience, including their ability to make decisions and feel dignified. Participants' reports include variable feelings and embodied experiences of coercion in different forms and degrees, ambivalence about compliance and resistance while being treated against their will, and gray areas between conventional separations of autonomy and paternalism. On the whole, our analysis troubles binaries about the use or disuse of involuntary care and illustrates the complexity of participants' experiences and views of coercive intervention, which could hold multiple possibilities for both care and autonomy. [ABSTRACT FROM AUTHOR]

Soul Injury is defined as a wound that separates a person from their real self, caused by unmourned loss and hurt, unforgiven guilt and shame, and fear of helplessness or loss of control. Tools and interventions have been developed to guide people impacted by Soul Injury. This study assessed the effectiveness of 12 tools and interventions provided during a 4-day Soul Injury Leadership Institute. This 2-part investigation included an online survey of participants who had attended a 4-day Institute training and a post-Institute narrative inquiry conducted as virtual structured interviews. Ninety-one professionals completed the online survey, which inquired about the impact of specific Soul Injury tools and interventions on the respondents' personal and professional life. The Anchor Your Heart tool was the most frequently used tool and had the most enduring utilization across time and settings. Qualitative data collected in virtual interviews with 15 volunteers demonstrated the power of the Write/Tell Your Story technique in which storied narratives permit an individual to integrate powerful experiences such as traumatic events, serious illness, and even death, providing further validation that Soul Injury is an important human phenomenon. [ABSTRACT FROM AUTHOR]

Intimate partner sexual violence (IPSV) is a common form of intimate partner violence (IPV). This study aimed to (a) identify a typology of intimate partner sexual victimization among French women victims of IPV on the basis of the frequency of various forms of sexual violence and (b) evaluate whether these profiles differ in several clinical characteristics. A total of 93 women consulting a specialized hospital service were recruited. Cluster analyses suggested four profiles: highly frequent rapes (5.4%), predominant sexual coercion (20.4%), medium frequency of all forms (20.4%), and low frequency of all forms (19.4%). Further person-centered research focusing on IPSV is warranted. [ABSTRACT FROM AUTHOR]

The use of shared decision-making (SDM) has recently attracted attention for building recovery-oriented therapeutic relationships with patients with severe mental illness (SMI). The purpose of this study was to describe a nursing process for SDM for psychiatric patients with SMI being treated via long-term coercive measures, such as seclusion and physical restraint, in the "seclusion room" of a psychiatric ward. The study used a modified grounded theory approach. The participants were 17 psychiatric nurses. Data were collected via semi-structured interviews. Concepts and categories were generated from verbatim transcripts, and their relationships were illustrated using a diagram and by generating a storyline. The nursing process for SDM was based on sensing the response to triggering stimuli, and the nurse-led preventive measures compensated for the patients' lack of coping skills. Because of the patients' persistent instability in response to certain stimuli, in our process, nurses are involved in creating opportunities for self-understanding and self-selection while also taking proactive preventative measures. Patients' reactions to surrounding stimuli were evaluated by nurses, who then determined whether they (or the patient) should take the lead in terms of decision-making. [ABSTRACT FROM AUTHOR]

This paper explores teenage girls' responses to general advice, and formal prevention messages, designed to reduce sexting-related risk and prevent harm. We conducted workshops with seven groups of girls (28 in total), aged 16–17 years, in a New Zealand city. Each group participated in a series of three workshop sessions. Drawing on a Freirean 'problem-posing' approach, we designed the workshops as spaces in which girls were invited to observe and critically discuss norms related to sharing nudes as well as harm prevention messages. Girls noticed the problematic gender and sexual politics that shape abstinence-based models that target girls (implicitly) to not send nudes, but which leave boys who distribute or otherwise misuse them out of the picture. Participants navigated a careful path between attending to risk and protection on the one hand, and endorsing their right to freedom of expression on the other. We argue for a subtle, but significant, shift away from a focus on sexting safety to a focus on the prevention of image-based sexual coercion, harassment and abuse. This reframing would help to direct prevention efforts to the gendered drivers and dynamics of harm perpetration, and the ways in which they are problematically socially ignored or condoned. [ABSTRACT FROM AUTHOR]

Individuals within organisations necessarily hold data including personal identifiable data, for individuals with a tendency to accumulate digital data and a reluctance to delete it, there is greater potential for data to be stored. Therefore, understanding why people engage in digital hoarding and how they respond to the mitigations put in place is important. Eleven people working in a large commercial organisation scoring highly on a digital hoarding questionnaire, took part in focus groups to understand the extent to which they kept digital data. The focus groups also explored employee compliance with policies and procedures including knowledge of GDPR. Thematic analysis led to three themes: (1) Organisational culture versus digital hoarding tendency, (2) Thinking about personal data, and (3) Responsibility and control. The findings highlight different motivations for data hoarding including anxiety driven by 'blame culture' as participants respond to workplace challenges and the need to be accountable. Participants were aware of policies including GDPR but often used workarounds to keep data longer than specified in their information retention policies. Technical approaches to data reduction were often counterproductive. Findings are discussed in relation to potential threats of digital data hoarding and technical and non-technical approaches to reducing digital data retention. [ABSTRACT FROM AUTHOR]

Aim: To explore spouses' experiences of living with a partner suffering from non‐cardiac chest pain (NCPP). Design: An inductive qualitative study. Methods: Individual interviews (n = 10) were performed with spouses of partners having NCCP and cardiac anxiety. The analysis was performed according to Patton's guide for content analysis of qualitative data. Results: Three categories and seven subcategories were identified. First, 'a feeling of being neglected', where spouses felt ignored by healthcare professionals and excluded by their partners. Secondly, 'a tension between hope and despair' encompassed feelings of faith, support, unpreparedness for chest pain and situational frustration. Lastly, in 'a threat to ordinary life', spouses noted chest pain‐induced changes impacting daily life, finances, leisure and relationships. To conclude, NCCP in partners significantly affects their spouses emotionally and practically. Spouses felt neglected and isolated, oscillating between hope and despair and experiencing faith, powerlessness and frustration. They also faced challenges in daily life and relationships. [ABSTRACT FROM AUTHOR]

Reproductive coercion (RC) is a type of intimate partner violence that includes birth control sabotage (BCS). We explored the perceived intent behind BCS to refine RC measurement, using a mixed-methods design with a clinic-based sample of Latina women (13 interviews; 482 surveys). Women perceived partners used BCS for reasons beyond pregnancy promotion. Specifically, 16.8% of participants reported any past-year RC; this decreased to 9.5% when asked if their partner used BCS with the sole intent of getting them pregnant. RC measures and assessment should separate behavior from intent in BCS questions to not underestimate the prevalence and to guide clinical response. [ABSTRACT FROM AUTHOR]

Reducing and eliminating seclusion and restraint in inpatient settings has been a key area of focus in mental health policy and research for many years. To address this issue, numerous programmes aimed at minimising the use of these practices have been developed over the past two decades, with varying degrees of success. This article reports on research focused on the implementation of a localised, multilevel complex intervention that targeted both organisational and individual factors related to the use of seclusion and restraint. The researchers followed the impact of the intervention by interviewing medical, nursing and allied health staff who worked within the service (N = 12) and analysing the rates of seclusion and restraint over an 18‐month period. Post‐adoption, participants identified that there were clear changes in practice culture. Seclusion clearly became a practice of last resort and other options became prominent in staff's practice. Participants identified that there was a sense of shared purpose across the multidisciplinary team. The clinical environment was viewed as being more therapeutic for service users and less frightening for staff. There was a significant difference in the total number of seclusion events between pre‐ (Mean = 6.22, SD = 5.82) and post‐implementation (Mean = 2.55, SD = 2.44, p = 0.002, d = 0.94), demonstrating a significantly lower number of seclusions was observed after the intervention. Similarly, a significant difference in restraint events between pre‐ (Mean = 5.50, SD = 3.77) and post‐implementations (Mean = 3.38, SD = 3.21, p = 0.037, d = 0.62) was observed. [ABSTRACT FROM AUTHOR]

For those who have suffered from trauma and are struggling with PTSD, finding healing through spiritual means can be a meaningful experience for trauma survivors, caregivers, and their loved ones. While much of the current research on PTSD recovery focuses on psychological, physiological, social, and cognitive factors, the spiritual dimension is often overlooked despite its increasing recognition in recent years. This study explores the experiences of individuals who attribute their recovery from PTSD to spirituality, with participants from diverse backgrounds of religion, culture, nationality, and level of faith who have experienced various traumas and recovery methods. The study identifies four stages of recovery: disappointment and disconnection, rock bottom, a leap into spirituality, and mutual forgiveness leading to reconnection. The role of powerlessness in the recovery process is also examined, and a model for a spiritually-based approach to recovery containing the four phases and three turning points is proposed. [ABSTRACT FROM AUTHOR]

Aim: To explore the priorities of women mothering children in the context of intimate partner violence and to understand what shapes those priorities. Design: A qualitative study using interpretive description, informed by Feminist Intersectionality adhering to the COREQ guidelines. Methods: Thematic analysis was used to analyse the data. Data Sources: Dialogic, semi‐structured interviews were conducted with a community sample of 20 adult Canadian women who were mothering dependent children (under 18 years) in the context of recent intimate partner violence from a current or former partner. Results: Women's main priorities focused on their own and their children's well‐being and creating stability related to housing and finances. Three themes identified: it's all about the kids; my safety...totally disregarded; and I have to take care of him. Multiple external factors (coercive control, structural inequities, assumptions about mothering) shape priorities and the tensions arising from competing priorities women felt compelled to address simultaneously. Conclusion: Priorities of women mothering in the context of intimate partner violence are complex, shaped not only by what they want but by the limited options available to them given constraints such as income, employment, housing and service responses. Coercive control, structural inequities and assumptions about mothering are important factors influencing mothers' priorities and experiences. Better understanding mothers' priorities can support better tailored policies, services and nursing practice. Implications for Nursing: Structural inequities that negatively impact health and well‐being by limiting access to resources and the supports needed to enhance health can be better recognized and addressed through a trauma and violence informed care approach. Impact: This study addressed understanding the priorities of women mothering in the context of intimate partner violence. This research will impact women mothering in the context of intimate partner violence who receive care from nurses and other providers as well as those who provide care. Reporting Method: This study adhered to relevant EQUATOR guidelines (the COREQ checklist). No Patient or Public Contribution: The women who took part in the interviews for this study did not participate in the study design, analysis or manuscript preparation. [ABSTRACT FROM AUTHOR]

Doxycycline postexposure prophylaxis (doxy-PEP) reduces sexually transmitted infections (STIs) in men who have sex with men (MSM) and transgender women (TGW). In a clinical trial of doxy-PEP, we sought to assess acceptability, impact, and meaning of doxy-PEP use among MSM/TGW. We conducted semistructured, in-depth 1:1 interviews with MSM and TGW enrolled in the intervention arm of the Doxy-PEP study. We queried motivations for and meaning of use, attitudes, beliefs, adherence, effect on sexual behaviors, and partner, community, and structural factors related to use. We coded interview transcripts into content areas, followed by thematic analysis. We interviewed 44 participants (median age 38), 2% were TGW, 17% Black, 61% White, 30% Hispanic, and 45% persons with HIV. We identified three overarching themes. First, participants found doxy-PEP acceptable, and believed it was effective based on their history of STIs, easy to adhere to, and acceptable to sex partners. Second, doxy-PEP benefited their quality of life and mental health, offering "peace of mind" by reducing their anxiety about acquisition or unwitting transmission of STIs. Participants reported feeling more "in control" of preventing STIs, and positive about supporting their personal, partner, and community health. Third, impact on sexual behavior was variable, with most reporting no change or a brief initial change. Participants in a multi-site clinical trial of doxycycline for STI prevention perceived it to be efficacious, and that it provided quality-of-life benefits, including reduced anxiety and sense of control over sexual health. Doxy-PEP had limited impact on sexual behavior. Clinicaltrials.gov: NCT03980223. [ABSTRACT FROM AUTHOR]

This is an autoethnographic note on conducting fieldwork with the purpose of documenting; first, outside academia––doing documentary photography; and second doing ethnography and autoethnography within academia. It explores different ways to conduct fieldwork (alone or in groups, ethnographically or autoethnographically) and different traditional and innovative ideas about how the "field" was interpreted commonsensically in the past and could be interpreted now, using the analytical dimension of the hybrid field. It is written both autoethnographically and creatively and includes a short methodological "novel." The research note concludes with a reflection on a particular field-work experience, tackling its limitation and imagining different ways to perform it. [ABSTRACT FROM AUTHOR]

Introduction: Online child sexual abuse (OCSA) affects considerable numbers of children globally and is associated with a variety of mental health problems. Existing practitioner studies suggest that young people are infrequently asked about online abuse and practitioners have a fragmented understanding of the problems experienced or how they might approach them. There are very few evidence-based interventions that guide clinical assessment or practice. Digital Health Interventions (DHIs) have the potential to be an effective option where children and young people's services are challenged, including accessibility and anonymity. The aim of this study was to explore mental health practitioners' views of how DHIs may play a role in supporting young people who have experienced OCSA, and the role they can play in healthcare delivery. Method: In-depth qualitative interviews and one focus group were conducted with 25 child mental health professionals across two sites (Manchester and Edinburgh). Data was analyzed using reflexive thematic analysis. Results: Three overarching themes and 9 sub-themes were identified: (1) feeling a little bit lost; (2) seeing potential problems; and (3) knowing what works. Practitioners expressed interest in a DHI to support this client group and saw it as a way of managing waiting lists and complementing existing therapies. They felt that many young people would see this as a preferred medium to inperson therapy, would be empowering, and offers new ways of learning how to stay safe online. However, there were concerns about how much time would be needed by staff to deliver a DHI, anxieties about safety issues in relation to content and data protection, some of which may be unique to this population of young people, and concerns about the absence of a therapeutic relationship with vulnerable children. Discussion: Our findings indicated that practitioners were uncertain about working with children subjected to OCSA but were receptive to the possibility of using a DHI to support their practice and to reduce waiting lists. Concerns were expressed about the time needed for staff training and support as well as concerns over patient safety and the lack of evidence about the effectiveness of an unsupported DHI. [ABSTRACT FROM AUTHOR]

Aim: The aim of this study was to: (1) use cognitive task analysis to describe final year nursing students situation awareness in recognising, responding and escalating care of deteriorating patients in ward settings; and (2) make recommendations for training and practice. Design: A mixed methods cognitive task analysis with a convergent triangulation design. Method: Data collection involved observations of 33 final year nursing students in simulated deteriorating patient scenarios and retrospective cognitive interviews. A process tracing technique was applied to identify the cues to deterioration participants perceived; how cue perception altered as situational demands increased; the extent that participants made connections between perceived cues and reached a situational understanding; and the factors that influenced and constrained participants situation awareness. Qualitative and quantitative findings are woven together and presented using descriptive statistics, illustrative quotations and timeline extractions. Results: The median cue perception was 65.4% and 57.6% in the medical and surgical scenarios, respectively. Perception was negatively influenced by incomplete vital sign monitoring as situations escalated; limited physical assessments; passive scanning behaviours; poor task automaticity; and excessive cognitive demands. Incomplete perception, poor cue integration and underdeveloped mental models influenced situational understanding. Escalation calls did not always accurately reflect situations and a reporting mindset was evident. Clinical exposure to deteriorating patients was described as variable and opportunistic. Reporting Method: The study is reported in accordance with the Good Reporting of a Mixed Methods Study (GRAMMS) checklist. Patient or Public Contribution: Patients and public were not involved in this research. [ABSTRACT FROM AUTHOR]

Background: Current policies to reduce the use of involuntary admissions are largely oriented towards specialist mental health care and have had limited success. We co-created, with stakeholders in five Norwegian municipalities, the 'Reducing Coercion in Norway' (ReCoN) intervention that aims to reduce involuntary admissions by improving the way in which primary mental health services work and collaborate. The intervention was implemented in five municipalities and is being tested in a cluster randomized control trial, which is yet to be published. The present study evaluates the implementation process in the five intervention municipalities. To assess how the intervention was executed, we report on how its different elements were implemented, and what helped or hindered implementation. Methods: We assessed the process using qualitative methods. Data included detailed notes from quarterly progress interviews with (i) intervention coordinators and representatives from (ii) user organisations and (iii) carer organisations. Finally, an end-of-intervention evaluation seminar included participants from across the sites. Results: The majority of intervention actions were implemented. We believe this was enabled by the co-creating process, which ensured ownership and a good fit for the local setting. The analysis of facilitators and barriers showed a high degree of interconnectedness between different parts of the intervention so that success (or lack thereof) in one area affected the success in others. Future implementation should pay attention to enhanced planning and training, clarify the role and contribution of service user and carer involvement, and pay close attention to the need for implementation support and whether this should be external or internal to services. Conclusions: It is feasible to implement a complex intervention designed to reduce the use of involuntary admissions in general support services, such as the Norwegian primary mental health services. This could have implications for national and international policy aimed at reducing the use of involuntary care. [ABSTRACT FROM AUTHOR]

This study tests a theoretically informed model to understand why women who use opioids (WWUO) are at risk of rape while using drugs. Structured interviews were conducted with 168 WWUO. Three domains were hypothesized to increase risk: the sexually coercive context of drug use, women's social vulnerability, and drug use severity. Logistic regression examined the odds of being raped by domain. One-third of WWUO had been raped while using drugs. The sexually coercive context and social vulnerability domains significantly increased women's odds of being raped. Prevention efforts should target social and contextual factors. [ABSTRACT FROM AUTHOR]

Aim: To explore push, pull and retention factors affecting indonesian nurses decision to stay in the nursing profession. Introduction: Identifying influencing factors that determine Indonesian nurses' decisions to remain working in Indonesia gives a better understanding of nurses' migration and therefore are necessry to explore. Background: Studies examining nurse migration's push and pull factors have been carried out extensively. A study exploring factors that make nurses stay in their home countries, such as Indonesia needs to be conducted to provide different insights for related parties. Methods: A qualitative descriptive study was conducted with 52 managers and 181 nurses from hospitals and community health centres across four different regions in Indonesia, including DKI Jakarta, Lampung, South Kalimantan and West Nusa Tenggara. A purposive sampling method was used. The data were collected online (via Zoom) and offline through semi‐structured interviews and focus group discussions. A content analysis was performed. The Consolidated Criteria for Reporting Qualitative Research (COREQ) was followed. Results: Five categories were developed: non‐financial support, sense of togetherness, following the husband, social image and powerlessness. Discussion: Socio‐cultural factors influence Indonesian nurses to stay working in their country despite their economic and career development difficulties. Conclusion: Socio‐cultural circumstances have become powerful factors affecting Indonesian nurses to stay working in Indonesia. Implications for nursing practice and policy: There is a need for harmonisation of policies related to nursing migration between recipient and source countries. Moreover, policies should go beyond education, competency and credentialing regulations and include addressing social costs and needs, such as the possibility of migrating nurses' families to the recipient countries. [ABSTRACT FROM AUTHOR]

Some people receiving mental healthcare experience distress related to voice hearing and the available support. Some practitioners lack knowledge and confidence in providing this support. Furthermore, coercion in mental healthcare can negatively affect voice hearer-practitioner relationships. Previous research investigating mental health distress, including voice hearing, has largely emphasised an individual-centric perspective. Less is known about voice hearers' and practitioners' relational experiences within mental healthcare contexts and how this might influence voice hearing. This was a qualitative study that utilised a constructivist Grounded Theory methodology to explore the experiences of voice hearers (n = 15), through semi-structured interviews, and practitioners (n = 18) through focus group discussions (n = 3). A tripartite relationship theory situates experiences of voice hearing within a mental healthcare context, mediated through a tripartite voice hearer – voice – practitioner relationship. This consists of five themes: Level of agency; Interpersonal dynamic; Who's making sense; Medication: helping or hindering; and Personal bully. This paper presents a novel theory, grounded in voice hearers' and practitioners' experiences. This expands on current knowledge about voice hearing by situating voice hearing experiences within relational and clinical contexts. [ABSTRACT FROM AUTHOR]