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Background: Promoting options for aging in place (AIP) has broad appeal to policymakers and professionals providing services to persons living with dementia (PWD). However, the benefits or burdens of AIP likely vary among individuals and families. We sought to describe factors influencing decision‐making to age in place versus seek a higher level of residential care for PWD. Methods: A qualitative study was undertaken as part of a larger mixed‐methods study utilizing semi‐structured interviews with PWD, family care partners, and dementia clinicians. Interview transcripts were analyzed using qualitative content analysis with constant comparison. Sample size was determined by thematic saturation within subgroups. Results: We conducted 74 interviews among 14 PWD, 36 care partners, and 24 clinicians. Preferences for AIP were driven by (1) desire to preserve independence, (2) a sense that the "best care" is delivered by loved ones and in a familiar environment, (3) distrust and fear of care facilities, and (4) caregiver guilt. PWD and care partners frequently considered moving from home as a "last resort" and wanted to avoid planning for future care needs. Many decisions to move were reactive and triggered by patient safety events, physical dependency, or the loss of caregiver. Proactive decision‐making was facilitated by (1) prior experience witnessing the challenges of caring for a person with advanced dementia in the home; and (2) having substantial financial resources such that participants could seek major home adaptations or avoid "lower quality" institutions. Conclusions: Decisions regarding care setting for PWD frequently do not feel like a choice and are made under imperfect conditions. Programs using AIP as an outcome measure should recognize the various patient‐centered and non‐patient‐centered factors that influence such choices, and interventions should be designed to promote more informed and equitable decision‐making for care setting in dementia. [ABSTRACT FROM AUTHOR]

OBJECTIVES: Pediatric patients with life-limiting diagnoses frequently seek care in the pediatric emergency department (PED) during times of acute illness, or at end-of-life (EOL) . Although the population of patients with life-limiting diagnoses is heterogenous, clinician expertise in EOL communication is essential to providing family-centered care. In this study, we explored PED physician and nurse experiences with communication when eliciting EOL values, including factors specified to the PED environment, clinician perceptions of family supports and preferences, and clinicians' self-reflection of their skills and challenges in this sphere. METHODS: We performed a prospective qualitative study using semistructured interviews of PED physicians and nurses recruited from a quaternary care center. Thematic content analysis was performed on the transcribed interviews to identify codes and, ultimately, themes. RESULTS: We interviewed 17 emergency department clinicians, including 10 physicians and 7 nurses. Thematic content analysis revealed 6 salient themes. The first theme related to contextual factors of the emergency department environment. Two additional themes related to patient and family characteristics, including unique patient and family factors and clinician interpretation of parental/family needs. Lastly, we found 3 clinician-focused themes including knowledge gaps in EOL communication, communication styles and priorities in EOL conversations with families, and coping with ethical challenges. CONCLUSIONS: PED clinicians report communication-related challenges to providing optimal care for families and patients with life-limiting diagnoses. Participants self-identified gaps in communication skills in this area. Future studies should focus on clinician educational interventions on the basis of this needs assessment and include family perspectives to develop best practice. [ABSTRACT FROM AUTHOR]

Research on families with disabled children has highlighted how such families experience frustration in their encounters with health and welfare services. However, less attention has been given to how these encounters are linked to social class. This article explores whether levels of cultural capital and family resources influence communication with professionals among parents of disabled children. To this end, I draw upon a longitudinal qualitative dataset of fieldwork and interview data from families in Norway. The findings show that middle-class parents could utilize experts, keep communication smooth, and persist in trying to secure services for their children without any real sense of achievement to a higher degree than working-class parents. However, neither working-class nor middle-class parents thrived in navigating these bureaucracies. This study has clear implications for policy and professionals in acknowledging how levels of cultural capital and other family resources influence the ability to endure and navigate welfare institutions. Points of interest: To understand the situation of families with disabled children it is important to find out under which circumstances these families try to obtain public services for their children. The paper examines the significance of social class on how parents with disabled children manage welfare services for their children in Norway. The research uses interviews with parents and practitioners and observation of meetings. All parents fight for services for their children and find it frustrating. Working-class and middle-class parents differ in how they communicate with professionals and how they deal with frustration. [ABSTRACT FROM AUTHOR]

Background: Where available, Parkinson's Nurse Specialists (PNS) provide a range of care, support, guidance, and advocacy for people with Parkinson's (PwP), and, where appropriate, their care partners (CP). Parkinson's is a complex and progressive condition. Consequently, evaluating health outcomes is not a reliable method to understand the value and impact of PNS. Previous research has identified PNS can improve the subjective well-being of PwP in the community, also that barriers to care include heavy caseloads and a lack of time. Yet little is known about the value of the role of the PNS, particularly about the impact of pharmacological management and review. This research aims to close this research gap by providing explanatory theories of the impact and value of PNS to PwP, their CP, and other professionals. Methods: A social constructivist grounded theory approach was used. Semi-structured interviews were conducted with three groups, PNS, PwP, and CP. Interviews were analysed using NVivo for coding and categorising and Word for memo-writing. Data was analysed inductively and iteratively to identify contexts, social processes, actions, and behaviours, before final emergent theories were identified. Results: 46 semi-structured interviews (PNS 18, PwP 19, CP 9) led to four data categories and 13 sub-categories that delineated PNS value. (1) Expert Counsel; provision of emotional support, education, and lifestyle guidance; CP inclusion; provision from diagnosis; and across all stages of Parkinson's. (2) Conduit of Care; signposting, referral, and connection to PwP, CP, others; PNS barriers and facilitators; (3) Team/Partnership; continuity and partnership, 'working together'; (4) Pharmacological Support, PNS prescribing; concordance; speed of treatment. Where PNS were accessible they could offer personalised support and partnership, so providing person-centred care that improves health and well-being. Conclusion: Where a PNS is accessible due to service availability and manageable caseloads, to provide person-centred care, they deliver several benefits to PwP and CP which improve health and perceived well-being. Where PNS are not available, PwP and CP often struggle to manage their Parkinson's with negative impacts on health and well-being. [ABSTRACT FROM AUTHOR]

Background/Objectives: Empathy and emotional regulation (susceptibility and resistance) play an important role in a nurse's well-being and the provision of high-quality care. This phenomenon has not yet been studied in the context of nurses working in neuroscience. This study aimed to explore the perceptions related to empathy among nurses working in neuroscience contexts. Methods: Employing a mixed-methods approach, we conducted an online quantitative survey with 211 nurses working in various neuroscience settings using the Balanced Emotional Empathy Scale (BEES) and 15 online semistructured qualitative interviews to delve deeper into empathetic experiences. The mean and measures of dispersion, such as standard deviation, were used to analyze the quantitative data. Thematic analysis investigated qualitative data, and data triangulation was performed. Results: The quantitative findings revealed no significant differences in empathy or emotional regulation across the different neuroscience settings but highlighted an increase in susceptibility related to young age (under 29) and years of service (first 5 years). The interviews brought to light the challenges nurses face in highly emotional situations and the strategies they employ to manage empathy and maintain professional detachment, such as self-care strategies, awareness development, and team support. One hindering factor is managers. Conclusions: The findings of this study underscore the essential role of empathetic capability in nursing care in neuroscience. The experience of younger nurses and the first 5 years of employment are elements to be considered by managers for burnout risk. Nurses demonstrate susceptibility and resistance and maintain a balance in dealing with high-emotional-stress situations. The implications of these findings are significant and should guide future research and practice in the field of neuroscience nursing. [ABSTRACT FROM AUTHOR]

Background Falls in hospital remain a common and costly patient safety issue internationally. There is evidence that falls in hospitals can be prevented by multifactorial programs and by education for patients and staff, but these are often not routinely or effectively implemented in practice. Perspectives of multiple key stakeholder groups could inform implementation of fall prevention strategies. Methods Clinicians of different disciplines, patients and their families were recruited from wards at two acute public hospitals. Semi-structured interviews and focus groups were conducted to gain a broad understanding of participants' perspectives about implementing fall prevention programs. Data were analysed using an inductive thematic approach. Results Data from 50 participants revealed three key themes across the stakeholder groups shaping implementation of acute hospital fall prevention programs: (i) 'Fall prevention is a priority, but whose?' where participants agreed falls in hospital should be addressed but did not necessarily see themselves as responsible for this; (ii) 'Disempowered stakeholders' where participants expressed feeling frustrated and powerless with fall prevention in acute hospital settings; and (iii) 'Shared responsibility may be a solution' where participants were optimistic about the positive impact of collective action on effectively implementing fall prevention strategies. Conclusion Key stakeholder groups agree that hospital fall prevention is a priority, however, challenges related to role perception, competing priorities, workforce pressure and disempowerment mean fall prevention may often be neglected in practice. Improving shared responsibility for fall prevention implementation across disciplines, organisational levels and patients, family and staff may help overcome this. [ABSTRACT FROM AUTHOR]

Home visiting programs are an evidence-based approach to reducing adversity exposure and promoting well-being in children experiencing high-risk factors. Despite decades of research demonstrating the benefits of these programs, barriers continue to impact enrollment, engagement, and retention over time. The present qualitative study explored home visiting providers' perceptions of the behaviors they use to promote enrollment and engagement and reduced attrition for families. Twenty-one providers of three home visiting models (Nurse-Family Partnership, Parents as Teachers, and SafeCare) completed in-depth, semi-structured interviews to probe into provider behaviors that might improve program outcomes. Qualitative data analysis of interviews was conducted using NVivo software with a template approach used to identify broad themes. Findings indicated differences in provider behaviors across enrollment (provider approach and outreach), engagement (provider support and communication), and retention (provider sharing resources and setting goals). Across all three, providers emphasized the importance of building rapport. Implications suggest that workforce structure and training include behavioral strategies to improve enrollment, engagement, and retention in programs to promote program and familial success. Highlights: Provider approach and outreach are related to the promotion of enrollment in home visiting programs focused on families experiencing high-risk factors. Provider support and communication promote the engagement of families in home visiting programs. Sharing resources and setting goals with families were strategies reported by providers to promote the retention of families in home visiting programs. [ABSTRACT FROM AUTHOR]

Objective: The aim of this study was to explore parents' experiences of their relationships and interactions with healthcare professionals (HCPs) during care related to prenatal diagnosis and termination of pregnancy for foetal anomaly (TOPFA). Methods: A qualitative approach was used. Participants included 33 parents (23 women and 10 men) from Northern Ireland (n = 11) and Ireland (n = 22) who had a TOPFA. Data collection methods included semi‐structured interviews and written narrative accounts. Data were analysed using thematic analysis. Results: Findings confirmed that TOPFA was a traumatic, life‐altering experience for parents, impacting their health and well‐being. The actions, behaviours and words of HCPs impacted how parents perceived and interpreted their healthcare experiences and their access to services and supports. In relation to this, five themes are presented: (1) the importance of compassionate and non‐judgemental care, (2) the value of effective information and communication, (3) the desire for compassionate care for baby and facilitation of memory making, (4) the need for continuity of care and (5) parents' experiences of healthcare relationships during times of legislative change. Conclusion: This research reveals the important role HCPs play in helping parents cope with prenatal testing and TOPFA. Parents who had a positive relationship with an HCP, in which information was communicated effectively and compassionate and non‐judgmental care was provided, felt more supported and more able to accept and adapt to their loss. Patient and Public Contribution: An advisory group composed of parents who had experienced TOPFA and HCPs with experience in caring for such families were involved in the study from the outset, contributing to the design and development of data collection materials, interpretation of the findings and design of dissemination materials. [ABSTRACT FROM AUTHOR]

The purpose of this study is to understand institutional violence (IV) in the relationships between health professionals, hospitalized children, and family members. This is a qualitative study developed at the pediatric inpatient unit of a university hospital in the city of Salvador, Bahia, Brazil. The research participants consisted of 39 health professionals who specialized in pediatrics and 10 family members of hospitalized children. Semi‐structured interviews were the method used for data collection. Using discourse analysis as a basis and taking a Foucauldian perspective, the researchers observed that the expressions of IV could be traced to abusive power relations within the system. We found four discursive forms within the data set: communication problems as IV, violence through inattention and neglect, violence as an action and consequent materialization on the body, and psychological violence as a submission mechanism. Based on these findings, we argue that professionals, managers, the scientific community, and users might be able to better guarantee the safety of children by recognizing IV and effectively intervening in it. [ABSTRACT FROM AUTHOR]

Background: Patient and Public Involvement (PPI) is an important component of healthcare research. Conducting PPI within paediatric palliative care research requires specific ethical and practical considerations. Regular reviews of PPI activity are important. Aim: To evaluate a paediatric palliative care research centre's PPI activity to determine what went well, or less well; and how future activities can be improved. Design: Two stage evaluation: first a review of PPI study logs; second a qualitative exploration using a survey, structured interviews and a focus group. Data were analysed thematically. Settings/participants: Parents of children with life-limiting conditions, bereaved parents and researchers, all engaged in PPI activity within a paediatric palliative care research centre. Findings: The review of PPI logs for 15 studies highlighted the crucial role of funding in enabling PPI throughout the research. Eight parents completed the survey, 4 parents were interviewed and 12 researchers participated in a focus group. Three themes were developed: Clarity of processes and purpose; balanced relationships created a safe space; and mutual respect and value for PPI. These themes highlight what is working well within the Centre's approach to PPI and the opportunities to improve. Conclusions: To undertake meaningful PPI in paediatric palliative care research, adequate time and resources are required. Roles, processes and expectations must be explicitly agreed. Establishing relationships ensures trust and enables authenticity and vulnerability. In addition to improving research, PPI has personal benefits for researchers and parents. The evaluation led to the development of a 'route map' for establishing an impactful PPI group for paediatric palliative care research. [ABSTRACT FROM AUTHOR]

Background and Objectives: Previous studies have found that falls among community-dwelling older people with dementia negatively impact the health and well-being of their relative/friend care partners. Limited studies have explored the challenges care partners experience because of older people's falls (including fall incidents and fall risks). We sought to investigate care partners' experiences of these challenges and how care partners responded. Methods: We conducted an inductive thematic analysis of 48 dementia care partner interviews (age range: 33–86, mean: 61, 70.8% women; 58.3% adult children; 29.2% spouse; 62.5% completed college; 25% people of color), conducted after a health crisis of older people with dementia from three local university-affiliated hospitals in the United States. Findings: Care partners reported that falls in older people with dementia can intensify overall care demands and lead to self-sacrificing behaviors, dissatisfaction with healthcare providers, conflicts with care recipients, and intense emotions. Care partners described several adaptations to mitigate these impacts, including practicing acceptance, approaching falls as an opportunity for learning, facilitating collaborations within formal/informal care networks, collaborating with older people with dementia to balance autonomy and safety, and modifying the physical environment. Discussions and Implications: Falls among older people with dementia are a significant stressor and an important activation stimulus for their care partners. Our findings suggest that care partners are "second clients" and "competent collaborators." As they provide important insights about fall prevention, care partners should be engaged to co-design new multi-level interventions to facilitate collaborations among care networks, older people with dementia, and service providers. [ABSTRACT FROM AUTHOR]

Purpose: Little is known about how parents' transactions with health and educational professionals shape their experience of these systems, and impact on capacities to support their child with acquired brain injury (ABI). We explored experiences of specific transactions and perceptions of impact. Methods: A focus group and individual interviews were conducted with seven parents of children in the chronic phase of recovery following ABI. Thematic analysis was used to interpret the data. Results: Four superordinate themes were identified: "These Encounters Matter," "A Person not a Number—Interpersonal Skills that Count," "The Blind Leading the Blind," and "Becoming the Backbone." Findings highlighted that these transactions mattered to parents, promoting either distress or empowerment. Positive outcomes were characterized by transactions related to communication, empathy, trust, collaboration, and connection. However, there was a perception of the "blind leading the blind" and that ultimately parents needed to enter such transactions armed with knowledge and their own therapeutic goals. Conclusions: Our findings unpack contextual and transactional elements of parents' experiences with health and education professionals which empower or distress. Understanding and improving these processes is important, given the central role families play in child outcomes following ABI. Implications for clinical practice are discussed. IMPLICATIONS FOR REHABILITATION: Findings suggest encounters with health and education professionals impact parent functioning and enable, or undermine, them in supporting their child with acquired brain injury. Transactional processes between parents and professionals that led to empowering and positive, or disempowering and negative, outcomes were elucidated and professionals are invited to consider these. Training for health and education professionals related to knowledge of childhood acquired brain injury, but also attunement and interpersonal processes for consultations with parents, are highlighted as important. Findings suggest that helping parents develop effective advocacy skills for their child may also be indicated. [ABSTRACT FROM AUTHOR]

Background: Delivering serious news is usually challenging for healthcare professionals and the pandemic of COVID-19 and related restrictions brought additional challenges in this process. Aims: To explore the experience of bereaved relatives with receiving serious news from healthcare professionals during the pandemic COVID-19. Design: A qualitative study using thematic analysis and a codebook approach of data collected in semi-structured interviews with bereaved relatives. Setting/participants: Data were collected from July to August 2022 in person/via phone with bereaved relatives who lost their relatives during the pandemic (from March 2020 to March 2022). Participants were recruited using a convenience sample and snowball method through social media and through one university hospital palliative care unit that invited bereaved relatives of deceased patients treated at the unit to participate in this study. Results: A total of 22 participants, consisting of 4 men and 18 women, were interviewed for this study. Most of the participants were sons or daughters of individuals who had died (5 grandchildren, 14 sons/daughters, 2 spouses, 1 great-niece). Six themes were identified: Burden caused by visit ban, Fear of COVID-19, Inappropriate behaviour and communication of healthcare professionals, High need for emotional support, Need for detailed and honest communication, Tendency to make excuses for mistakes and lapses by healthcare professionals. Conclusions: Delivering serious news during a pandemic was negatively influenced by a lack of contact with patients and a lack of support and empathetic communication with staff. Overcoming these circumstances can be achieved by frequent communication using various communication tools (such as videoconferences or phone calls), and maintaining empathy and honesty in the communication process. Key message: This article describes results from a qualitative study with bereaved relatives focused on their experience with communication with physicians during the COVID-19 pandemic. Relatives lacked empathetic communication, they also experienced fear of getting infected and they tended to express understanding for the challenging circumstances faced by the healthcare staff. [ABSTRACT FROM AUTHOR]

Background: Short inter-pregnancy interval (IPI) is associated with adverse health outcomes for women and infants, and low-income women experience disproportionate rates of short IPI. An essential solution is providing postpartum (PP) women with timely contraceptive care. However, patient-centered approaches for facilitating care access are needed. Objective: To explore Community Health Center (CHC) staff and provider perspectives on the implementation of a clinical trial offering co-scheduled well-infant/maternal contraceptive care for women with infants 0 to 6 months at the Well-Baby Visit (WBV). Method: Eighteen participants (providers, staff, and administrators) representing 7 diverse CHC sites in 2 U.S. states completed semi-structured telephone interviews. Audio-recordings were transcribed and analyzed using hybrid thematic analysis. Results: Offering co-scheduled visits was perceived as beneficial for facilitating timely PP contraception, convenient care access, and encouraging family planning considerations during the PP period. However, provider and staff discomfort with initiating family planning and contraceptive care conversations at the WBV emerged as a salient barrier. Conclusion: Paired approaches to well-infant/maternal contraceptive care may promote increased access to timely contraception for PP women, possibly reducing unintended short IPI. Comprehensive training, ongoing support, and patient-centered implementation strategies tailored to context and developed with care team input are needed to ensure competency and comfortability with facilitating contraceptive care conversations at the WBV. [ABSTRACT FROM AUTHOR]

A cancer diagnosis in patients who are parents of minor children is uniquely stressful for both parents and children. Children need developmentally appropriate information and support to help reduce their fears and worries. Child life specialists (CLSs) are health professionals who work in pediatric environments to support children and families with the stress and uncertainty of illnesses. Increasingly, CLSs have been called upon to support children of patients in adult clinical environments. Our objective was to elucidate CLS caregiving narratives related to working with children of adult cancer patients. We used narrative inquiry to interview four CLSs working in adult oncology. Canadian CLSs who have experience providing care for children and families affected by parental cancer were recruited via convenience sampling. We used narrative analysis methods that included multiple close reads of the data, generating narrative themes, and noting conflicts or tensions in the data. CLSs' caregiving stories often highlighted the complexities of working in an adult oncology environment. Their narratives included challenges in providing optimal care to the children, including family-level barriers (such as parental wishes to withhold information from their children) and systemic barriers (such as late referrals and limited options for bereavement support). CLS participants identified several challenges of working with families in adult oncology. The CLSs highlighted a desire for additional institutional support for children of adult oncology patients and for themselves working in these environments in order to achieve what they believed to be optimal care. [ABSTRACT FROM AUTHOR]

The focus of this article is on exploring the rationales behind social workers' decision-making in everyday tasks that involve handling new referrals regarding children and families. Such decisions are made in a legal context, but at the same time require the use of discretionary space and reasoning based on sources of professional knowledge. Drawing on qualitative data compiled through an ethnographic approach, this study provides an insight into everyday practice, reasoning and decision-making. The study demonstrates that one of the important rationales for decision-making is derived from the social worker's direct experience of interacting with parents and children. A particular aspect of the interaction, parents' reactions to being referred, is scrutinized and serves as a form of validation for legal action. [ABSTRACT FROM AUTHOR]

Mental health carers are crucial in improving the physical health outcomes of people diagnosed with a mental illness (hereafter referred to as consumers). The long-term and multifaceted mental and physical health support carers provide to consumers can contribute to caregiver burden. Consequently, carers advocate for coordinated and integrated physical healthcare to improve the physical health outcomes of consumers and alleviate caregiver burden. The aim of this qualitative exploratory study is to explore carers' perceptions and experiences with the Physical Health Nurse Consultant role. Semi-structured interviews with nine carers nominated by consumers were conducted. Interviews were transcribed and reflexively thematically analysed. Three main themes were identified: (i) Therapeutic relationship s were a catalyst for health behaviour change; (ii) Overt and covert positive changes were observed by carer and (iii) Cares' involvement in integrated mental health and physical health care. Nine carers who were nominated by consumers to be involved in their physical healthcare planning, preferred to adopt a supporting role as this prevented or reduced caregiver burden. The findings support the adoption and continuation of the Physical Health Nurse Consultant role to facilitate positive physical health outcomes for consumers and a reduction in caregiving burden. The benefits of the Physical Health Nurse Consultant provide a compelling argument to embed the role in routine practice. Mental healthcare services should advocate for continued funding and career development for such positions to provide long term benefits for consumers and carers. Future research is required to explore carer and consumer involvement in co-producing future and localised iterations of the Physical Health Nurse Consultant role. This research should also measure the outputs and outcomes of co-production to clarify how the process worked in practice. [ABSTRACT FROM AUTHOR]

Background: Family‐centered care (FCC) approach in neonatal intensive care units (NICUs) has been shown to improve family satisfaction and quality of care. However, several contextual barriers influence its use in NICUs, and these barriers are understudied in Ghana. Aim: To describe FCC practice in Ghanaian NICUs in order to understand the contextual barriers. Study Design: The study employed a descriptive qualitative design. The researchers used a structured interview guide to collect the data in 24 interviews and 12 focus group discussions. We engaged families (n = 42), nurses and midwives (n = 33), and doctors (n = 9) to describe their perspectives on the barriers to FCC in two public tertiary hospital NICUs. The data were mapped, triangulated, and aggregated to inform the findings. Thematic analysis and MAXQDA qualitative software version 2020 were employed to analyse the data. This qualitative study followed the COREQ guidelines and checklist. Results: Perceived family barriers and perceived facility barriers to FCC were the two main themes. The perceived family barriers include family stress and anxiety, inadequate information sharing and education, culture and religion. The perceived facility barriers are inadequate space and logistics, workload and inadequate staff, restricted entry, and negative staff attitudes. Conclusion: The findings of this study shed light on the barriers to FCC practice in neonatal care in Ghanaian NICUs. Family stress and anxiety, a lack of information sharing, cultures and religious beliefs, NICU workload and staffing shortages, restrictions on family entry into NICUs, and staff attitudes towards families are all contextual barriers to FCC practice. Relevance to Clinical Practice: Health facility managers and NICU staff may consider addressing these barriers to implement FCC in the NICU in order to enhance family satisfaction and quality neonatal care. The design of future NICUs should consider family comfort zones and subunits to accommodate families and their sick infants for optimal health care outcomes. The development of communication models and guidelines for respectful NICU care may aid in integrating families into ICUs and promoting quality health care outcomes. [ABSTRACT FROM AUTHOR]

Background: Utilization of video calls on hospital wards to facilitate involvement of and communication with family members is still limited. A deeper understanding of the needs and expectations of family members regarding video calls on hospital wards is necessary, to identify potential barriers and facilitate video calls in practice. Aim: The aim of this study was to explore the views, expectations and needs of a patient's family members regarding the use of video calls between family members, patients and healthcare professionals, during the patient's hospital admission. Methods: A qualitative study was carried out. Semi‐structured interviews with family members of patients admitted to two hospitals were conducted between February and May 2022. Family members of patients admitted to the surgical, internal medicine and gynaecological wards were recruited. Results: Twelve family members of patients participated. Family members stated that they perceive video calls as a supplemental option and prefer live visits during hospital admission. They expected video calls to initiate additional moments of contact with healthcare professionals, e.g. to join in medical rounds. When deploying video calls, family members mentioned that adequate instruction and technical support by nurses should be available. Conclusion: Family members considered video calls valuable when visiting is not possible or to participate in medical rounds or other contacts with healthcare professionals outside of visiting hours. Implications: Family members need to be supported in options and use of video calls on hospital wards. Additional knowledge about actual participation in care through video calls is needed as well as the effect on patient, family and healthcare professional outcomes. Impact: Using video calls on hospital wards can provide family members with flexible alternatives for contact and promote family involvement. Reporting Method: COREQ guidelines. Patient or Public Contribution: Family members of patients admitted to hospital have contributed by sharing their perspectives in interviews. What does this paper contribute to the wider global clinical community?: Family members perceive additional value from the use of video calls on hospital wards.For family, use of video calls needs to be facilitated with clear instruction materials and support. Trial and Protocol Registration: Amsterdam UMC Medical Ethics Review Committee (ref number W21_508 # 21.560). [ABSTRACT FROM AUTHOR]

Background: The core of postnatal care is that midwives recognise the needs of women and new‐born babies and provide the highest possible quality of care and medical safety to optimise the health and well‐being of new families. The study aimed to describe midwives' experiences in providing postnatal care for families during the first week after the birth of their baby. Method s : An interview study included 18 midwives who interchangeably worked within the models of traditional hospital care, hotel‐based care, home‐based care, hospital‐based check‐ups, and specialist care at a breastfeeding clinic at one university hospital in Sweden. Data collected were analysed using thematic analysis according to Braun and Clarke. Findings: The main theme: 'Like a torch that enlightens new parents along a narrow and winding path into parenthood – a midwife's transitional support' was explored and comprised two themes: (1) Strengthening parents' self‐confidence in their parental role by handling over parental responsibility; and (2) Challenging to facilitate parents' understanding of their parental role. Conclusions: Midwives expressed that supporting parents in the parental transition was a delicate task and included balancing mothers', babies', and partners' needs. The midwives guided parents into parenthood during postnatal care in a strategic manner by strengthening parents in their parental role. Postnatal care delivered by midwives is crucial for new parents and their babies. [ABSTRACT FROM AUTHOR]

Purpose: Person-centred care is widely accepted as being central to high quality care, but little is known about how physiotherapists implement person centred rehabilitation in Intensive Care. This study explores the self-reported experiences and interpretations of physiotherapists delivering person-centred rehabilitation in this setting. Methods: A qualitative study using Interpretative Phenomenological Analysis explored the lived experiences of physiotherapists and students who have worked in Intensive Care. Three focus groups, with four participants in each, were conducted. Data were fully transcribed, analysed and managed using NVivo software. Results: Participants shared similar interpretations about the principles of person-centred care. Operationalising person-centred rehabilitation during early recovery was not easily achievable. As the person's clinical condition improved, participants moved away from routine physiotherapy and their practice became more person-centred through the development of a partnership. Participants connected as humans to understand the person and respond to their needs within a culture that valued person-centred care. Conclusions: Physiotherapists aspire to develop a partnership with their patients by connecting on a human level with them and addressing their biopsychosocial needs. Physiotherapists with experience of developing patient partnerships influence the culture of the Intensive Care team and are role-models to facilitate collaborative person-centred activity in others. IMPLICATIONS FOR REHABILITATION: Physiotherapists can move from a biomedical approach towards becoming partners with patients in an Intensive Care Unit (ICU) as they become cognitively aware. Physiotherapists become person-centred by connecting as humans to the patient and moving towards a biopsychosocial approach that addresses the physical, psychological and instrumental needs of the patient in ICU. When aiming towards a person-centred approach on ICU, physiotherapists contribute to a culture that nurtures the unique patient and works collaboratively with the family and the health care team. Experience working with patients in ICU, allows physiotherapists to identify opportunities to be person-centred and facilitate other team members in becoming so. [ABSTRACT FROM AUTHOR]

Background: The experience of loss and grief in patients' lives with life‐long treatment in haemodialysis, and in their families' lives is a major cause of mental health problems. In practice, nurses often describe a lack of time and limited knowledge of how to provide nursing care in situations of loss and grief, thus finding out from nurses' perspectives of what competencies they need to provide care would be useful for the development of nursing practice. Objectives: To develop knowledge in a nursing perspective of competencies to provide care for patients and their families, who experience grief linked to loss due to kidney failure, haemodialysis and/or death. Design: The study took a phenomenological‐hermeneutical approach. Semi‐structured interviews were conducted 12 nurses caring for patients receiving haemodialysis with no kidney transplantation option and family members. Ricoeur's interpretation theory involving naïve reading, structural analysis and critical interpretation and discussion was used for analysis. Results: Four themes emerged of nurse's experiences: (1) patient's loss and grief in everyday life, (2) dealing with supportive conversations when caring for patients, (3) families' losses are resulting in grief reactions and (4) importance of close relationships when caring for families. Conclusions: To nurses, patients on haemodialysis and their families have multiple loss and grief experiences. Nurses' working in kidney care need to develop competencies to support patients and families to cope with grief and loss. Further research is needed to develop these competencies and then to implement in education and practice. [ABSTRACT FROM AUTHOR]

Introduction: Transitional care of older adults can be highly stressful for informal carers (carers) particularly when they are not involved in preparation and planning with health practitioners. This study aimed to ascertain carer perspectives about the potential acceptability and usability of a tool entitled the TRANSITION tool to support preparation and planning for the transition of an older adult from hospital to home. Design: Exploratory qualitative. Methods: Semi‐structured interviews were undertaken between March 2020 and October 2021. A focus group was conducted in July 2022 to seek additional information and support data saturation. A total of 23 participants took part. Data were thematically analysed. Findings: Participants explained their perspectives about the tool in four themes: (1) the TRANSITION tool has value, but health practitioners ask the questions; (2) the TRANSITION tool would be useful and acceptable, but not for all carers; (3) interacting with health practitioners is a barrier to using the tool and to communication; and (4) recognising us as part of the care team. Conclusions: While the tool was found to have potential value and utility, it would only be expected to support carers when they are valued and respected by health practitioners. Leadership is required in healthcare organisations to support genuine care for older adults and their carers, and to enable health practitioners to have time for transitional care communication. Implications for Practice: The findings from the study suggest that the TRANSITION tool could support carers by prompting them about important areas of care to include in communication with health practitioners during discharge preparation. [ABSTRACT FROM AUTHOR]

Objective: To explore how the parents of children with atopic dermatitis and allergic diseases such as food allergy, allergic rhinoconjunctivitis, and asthma experience interactions with the Danish healthcare system over time. Design and methods: A qualitative design with individual in-depth interviews. The analysis was inspired by Systematic Text Condensation. Subjects: Eleven parents of children with atopic dermatitis and allergic diseases who received treatment at hospitals in the Capital Region of Denmark. The families had experiences of cross-sectoral patient care. Results: Despite having the same diseases, the children's care pathways were very different. Mapping demonstrated the intricacy of care pathways for this group of children. We identified three aspects that impacted interaction with healthcare: responsibility, tasks, and roles. The families experienced care when the distribution of tasks and responsibilities associated with treatment and system navigation were consistent with both their expectations and their actual experiences. At the same time, families frequently experienced limited collaboration between healthcare professionals resulting in perceived fragmented care and an extended role for parents as care coordinators. Families felt cared for when healthcare professionals knew both their biomedical and biographical circumstances, and adjusted the level of support and care in accordance with the families' particular needs, expectations, and evolving competences. Conclusion: We suggest that a possible pathway to improve care may be through a partnership approach as part of family-centered care, with general practitioners having a key role in helping to articulate the individual needs and expectations of each family. [ABSTRACT FROM AUTHOR]

We describe the gap between parents' special education needs and pediatric primary care providers' (PCPs) ability to address those needs from a mixed-methods study at a safety-net hospital. We conducted qualitative interviews with English- and Spanish-speaking parents (n = 25) and PCPs (n = 11) about special education knowledge and experience and interactions with a primary care–embedded special education clinic. PCPs also answered survey questions on these topics. Parents reported four challenges: (1) knowing where to start and how to advocate for their youth, (2) being heard or having a say, (3) using the "right" language, and (4) gathering information on special education resources. Primary care providers disclosed three barriers: (1) training, (2) knowledge to assess the appropriateness of supports, and (3) time to address concerns. The gap between PCPs and parents was bridged by the special education clinic. Systematic interventions can ensure that PCPs help parents address the special education needs of their patients. [ABSTRACT FROM AUTHOR]

This study explores care experiences while utilising palliative care services of non-western migrant families from the perspectives of patients, family caregivers, and healthcare professionals in Denmark. Twenty-three semi-structured individual and group interviews were conducted among eight patients with a life-threatening disease, 11 family caregivers, and ten healthcare professionals. Thematic analysis revealed three themes: 1) Communication between families and healthcare professionals; 2) Building and lack of trusting relations, and feeling safe, and 3) Access to information and navigating in the healthcare system. Moreover, "language and culture" emerged as transaction themes that are not mutually exclusive, however, interconnect across the mentioned three themes. Non-western migrant families can be supported by healthcare professionals' cultural competency training, negotiating on providing services concerning information, patient preferences, family involvement, and palliative care setting. This study findings urge inter-sectoral collaboration to ensure needs-oriented and linguistically and culturally appropriate palliative care services for non-western migrant families in Denmark. [ABSTRACT FROM AUTHOR]

The study's aim is to explore the experiences of nursing home residents and their next of kin related to interacting with volunteers in daily life and when the resident's death is imminent. Qualitative data consisted of 130 hours of participant observations in three nursing homes and 13 interviews with five residents and eight next of kin. A thematic analysis identified three themes: (1) Social everyday activities - a frame for responsiveness and meaningful everydayness - reflecting the existential dimension of these activities; (2) Time - contrasting volunteers' time for care activities and bedside support to dying residents with professionals' time for similar activities; and (3) Valuable relief when death is imminent - inherent ethical dilemmas - reflecting potential tension between the valuable relief volunteers provide and the preferences of residents and their next of kin. Volunteers can promote and improve a holistic palliative care approach for residents in nursing homes. [ABSTRACT FROM AUTHOR]

Given the limited information on physicians' practices at the time of pronouncing a patient's death, this study aimed to learn about the prevalence and purpose of internal medicine residents' practices, the obstacles to performing them and how they can be overcome. Responses to a questionnaire were analyzed using logistic regression, to compare respondents who did and did not have a ritual. Twenty-one interview transcripts were thematically analyzed. A total of 151 physicians responded to the questionnaire; 35 (22.3%) reported performing a private ritual at the time of patient death. Religious participants were 2.97 times more likely {CI: 1.18–7.41} to perform a ritual following a patient's death. Three main themes were found, indicating residents' need to pause and perform a practice to honor the patient, express their humanity, and cope with the overflow of emotions. Senior staff should support opportunities for residents to honor the moment of death. [ABSTRACT FROM AUTHOR]

Background: Within the NICU, there is a delicate equilibrium between providing assistance to parents by nurses and prioritising family-centred care (FCC). The FCC assumes the role of a mediator, effectively conveying compassion. The intricate dynamics between FCC, parental nurse support, and parental stress in neonatal intensive care units (NICUs) necessitate comprehensive investigation. Objective: This study examines the mediating effect of FCC on the relationship between parental nurse support and parental stress in NICUs. Methods: This cross-sectional observational study used convenience sampling to select 223 parents (202 mothers) from Mansoura City hospitals in Egypt. Data were collected using the Nurse Parent Support Tool (NPST), Family-Centered Care Self-Assessment Tool (FCCS-NICU), and the Parental Stressor Scale: NICU (PSS: NICU). Mediation analysis was used to examine the relationships between variables. Results: Nurse support was positively associated with FCC (β = 0.81, p < 0.001) and negatively related to parental stress (β=-1.156, p < 0.001). FCC was found to reduce parental stress (β=-0.18, p < 0.001). Mediation analysis confirmed that FCC partially mediated the relationship between nurse support and parental stress (indirect effect β = 0.145, 95% CI: 0.055–1.007). Conclusions: This study highlights a significant association in the mediating role of FCC between nurse support and parental stress. Strengthening FCC practices can be an effective strategy for nurses to support parents and alleviate their stress in NICU settings. Implications to practice: NICUs should implement FCC-oriented training for nurses, foster a culture that supports FCC principles, and develop policies to establish FCC as a cornerstone of neonatal care. [ABSTRACT FROM AUTHOR]

Purpose: To explore how health professionals provide information to informal carers during inpatient stroke rehabilitation and whether these practices align with adult learning principles. Methods: Informal carers and survivors of stroke who had completed inpatient rehabilitation, and health professionals working in inpatient stroke rehabilitation were interviewed. Directed qualitative content analysis was conducted using an adult learning model, to determine how closely reported practices aligned to adult learning principles. Results: 14 carers, 6 survivors of stroke and 17 health professionals participated. Carers (79% female, 57% spouse/partner) reported having incomplete knowledge during rehabilitation, lacking information about mechanisms of stroke recovery, rehabilitation processes, long-term effects of stroke, and navigating post-discharge services. Health professionals supported carers to address their learning needs related to safety of caring for stroke survivors. Carers indicated they were responsible for their own non-safety related learning. Health professionals tended not to check carers' understanding of information provided nor offer learning opportunities beyond written or verbal information. Conclusions: Health professionals consistently provide certain information to carers during inpatient rehabilitation, but adult learning principles are not routinely applied when information is provided. Fostering adult learning among informal carers may improve preparedness of carers to support stroke survivors after discharge from inpatient rehabilitation. IMPLICATIONS FOR REHABILITATION: Carers reported often being in a state of shock in the early post-stroke period, and may need extra support to remember, understand, and apply information. Carers are often highly motivated to acquire immediate and relevant information tailored to their situation. Interactions between health professionals and carers are learning opportunities that can assist the carer to commence their unexpected and significant learning journey. Health professionals should apply adult learning principles when communicating with carers on all topics, not just topics important to the healthcare team such as patient safety and requirements for discharge. [ABSTRACT FROM AUTHOR]

Background: Patient-centered care aims to prevent disease and promote well-being by actively involving patients in treatment and decision-making that is based on respecting the patients and their families. However, no scales have been developed to assess patient-centered care from the nurse's perspective. This study aimed to develop a scale to measure nurses' level of patient-centered communication and confirm its validity and reliability. Methods: A methodological cross-sectional study was adopted to develop and validate the Patient-Centered Communication Scale (PCCS). The items were developed through a literature review and online interviews with nurses. Content validity was assessed by experts and the content validity index was calculated. A pretest of the questionnaire was conducted with 10 clinical nurses. To evaluate the factor structure and internal consistency reliability, the PCCS was administered online to 325 nurses in South Korea. Data were analyzed using descriptive statistics, explanatory factor analysis (EFA), and confirmatory factor analysis (CFA). Results: The final instrument consisted of 12 items and three factors: (1) information sharing, (2) patient-as-person, and (3) therapeutic alliance. EFA revealed a distinct three-factor structure, explaining 59.0% of the total variance. CFA confirmed the adequacy of the model fit and validated the inclusion of the final items. The Cronbach's alpha values ranged from 0.60 to 0.77, indicating acceptable internal consistency. Convergent validity was evidenced by the correlation between the PCCS and a measure of interpersonal communication competence. Conclusions: The 12-item PCCS showed good reliability, construct validity, and convergent validity. The scale has utility for measuring the level of patient-centered communication skills in nurses. [ABSTRACT FROM AUTHOR]

Background and objective Children with medical complexity (CMC) have chronic and severe conditions leading to medical fragility. CMC represent less than 1% of children but account for one-third of paediatric healthcare expenditures. Enrollment to a complex care program (CCP) decreases health care resource utilization while improving parental satisfaction. An in-depth understanding of how these changes operate in real-world setting is needed to further support CMC and their families. This study aimed at assessing the possible reasons for a decrease in emergency department (ED) visits and hospitalization length of stay related to enrollment to a CCP, based on parental perspectives. Study design Using a qualitative approach, data were collected using in-depth, semi-structured interviews with parents of CMC enrolled in a CCP from a university hospital centre in Montreal, Canada. The interview guide was co-constructed by an interdisciplinary team, including a parent partner and a clinical nurse coordinator. Themes have been identified inductively, using thematic analysis. Results Parents identified personalized care , family empowerment and guidance as enablers arising from the CCP that contributed to the decrease in hospital-delivered care utilization. Improvement in medical baseline condition was also identified as a contributing factor, while not necessarily related to program's support. Conclusions In this study, we identified personalized care, parental empowerment, and guidance as three strategies for a CCP to potentially decrease ED visits and hospital length of stay, from the parents' perspective. Parents identified the clinical nurse coordinator as playing a central role in supporting the implementation of these strategies. [ABSTRACT FROM AUTHOR]

Background: The interaction of health personnel with relatives is linked to the quality of care results in nursing homes. However, there is limited knowledge of how relatives perceive being an integral part of the nursing home context. This secondary analysis has its starting point in an ethical concern about relatives' experiences in a previous study. Aim: To critically discuss relatives' experiences of suffering when their next of kin live in a nursing home in a rural arctic context. Research Design, Participants and Context: The critical hermeneutic stance is informed by Habermas. The secondary analysis is conducted on original data from five semi-structured focus groups with 18 relatives of residents of two nursing homes in a rural part of Norway. The theoretical framework concerning dignity, well-being, and suffering, as developed by Galvin and Todres, contrasts the analysis. Ethical Considerations: The study followed the principles of the Helsinki Declaration. It was approved by the Norwegian Center for Research Data (NSD) (reg. no. 993360). Findings: The main theme of this study is: suffering while resigning to an unacceptable violation of dignity. This theme is deepened by two subthemes: (a) suffering while adapting to a relationship of dependence and (b) suffering while accepting the unacceptable. Conclusions: Relatives experience suffering as a cross-pressure in their struggle to interact responsibly with health personnel in nursing homes. This may have a negative outcome, where relatives end up adapting to being silent witnesses to missed care and a violation of dignity. [ABSTRACT FROM AUTHOR]

Mobile health (mHealth) screening tools for autism are gaining in prevalence, and have benefits such as video content and direct resources linkage. However, it is unclear whether such tools will ameliorate autism inequities or will help only those already advantaged in autism care. To investigate this issue, we conducted semi-structured qualitative interviews with 18 primary care and Early Intervention/Early Childhood Special Education providers in six US states. Providers were given hypothetical scenarios in which a family presents to care with results from one of 9 mHealth autism screening tools. Providers discussed their clinical approach and assessed the tool's fit with their patient/client population. Each transcript was audio-recorded, transcribed, and coded; a phenomenological approach was used to develop key themes. 4 themes and 18 subthemes emerged. These included Clinical and business factors (e.g. scope of practice concerns and clinical efficiency), Validity and trustworthiness (e.g. familiarity, data privacy/security), Family interaction quality (e.g. supporting family advocacy, provision of information, affecting family anxiety, and emotional support), and Accessibility (e.g. English proficiency/language issues, cultural inclusivity, and literacy/educational level). Providers suggested modifications to enhance equity, such as portraying diverse families, reducing the reading level of text, and making tools shorter to better fit clinical context. Families may find information about autism online, and health care and education providers may use online tools to screen for autism. However, we do not know if online autism screening tools are easily used by families and providers. We interviewed primary care and educational providers, asking them to review results from online tools that screen for autism. Providers had concerns about how usable and accessible these tools are for diverse families and suggested changes to make tools easier to use. [ABSTRACT FROM AUTHOR]

Social workers often fail to engage fathers in child protection investigations (CPIs), especially when they involve domestic abuse (DA) by fathers. The aim of this study is to examine the strategies used by social workers to achieve cooperation with fathers in CPIs that involve the father being suspected of DA against the child's mother. With the use of qualitative methods, we conducted 31 semi‐structured interviews with 15 social workers during their work on 12 CPI cases. Through thematic analysis, two main strategies for achieving cooperation were created: (1) Securing an Initial Bond, which involved reducing the tension in CPI proceedings and affirming the father; (2) Maintaining the Bond while addressing the father's abusive behaviour, which involved negotiating with fathers about the DA and helping them shift their perspective on how their behaviour has impacted the victims. This analysis is rooted in the framework of shame, guilt and social bonds. However, there is a risk that these strategies may lead to the DA being minimized or overlooked. Striking a balance between building a bond and addressing abuse is crucial, and the timing of addressing DA plays a central role. [ABSTRACT FROM AUTHOR]

Background: Though prior literature has demonstrated that communication in the Neonatal Intensive Care Unit (NICU) needs to be improved, in-depth descriptions of parents' views of NICU communication are lacking. Purpose: We sought (1) to explore parent perceptions of communication in the NICU and (2) to understand parents' communication needs and preferences. Methods: We conducted in-depth semi-structured cognitive interviews utilizing concurrent probes with parents of 10 patients in our urban level IV Neonatal Intensive Care Unit over a period of 4 months (July 2021-October 2021). Interview questions were derived from the Quality of Communication scale. We conducted thematic analysis of interview transcripts modeled after work by Braun and Clarke. Results: Four overarching themes were identified: Strengths, Challenges, People, and Coping Strategies. Parents reported a range of communication quality in the NICU. Results revealed that the first 48 hours of NICU hospitalization represent a period of vulnerability and uncertainty for parents. Parents value clear yet hopeful communication about a baby's clinical status and expected course. Implications for Practice and Research: We hope that the concrete findings from this study can both inform practice in the NICU now and influence practice guidelines to include such components as emphasis on the first 48 hours, desire for proactive information sharing, and the importance of including hope. [ABSTRACT FROM AUTHOR]

Copyright of Journal of Academic Research in Nursing (JAREN) is the property of Hemsirelikte Egitim ve Arastirma Dergisi and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Background: The wounded healer concept refers to healthcare providers who, in the past, have had similar experiences to those of their clients and now draw on these challenging experiences to assist their clients. This study explored the positive traits of nurses with chronic cardiovascular diseases who transitioned to wounded healers. Methods: A qualitative content analysis study was conducted within hospitals in Tehran, Iran, between November 2023 and March 2024. Sampling was conducted using a purposive sampling method in accordance with the study objectives and inclusion criteria. The data were collected through semi-structured face-to-face interviews. Twenty-three participants, comprising 16 females and 7 males, participated in the interviews. Data analysis was conducted by employing a qualitative content analysis approach, including creating codes, subcategories, generic categories, and main categories. MAXQDA v20 software was utilized to facilitate the analysis process. Results: The data analysis revealed one main category that aligned with the research question: the positive traits of a wounded healer nurse, consisting of three generic categories: (1) traits related to interpersonal and professional relationships; (2) traits related to the professional dimension; and (3) traits related to the personal dimension. wounded healer nurses demonstrate positive traits that enhance patient care. Conclusions: The findings of this study have important implications for nursing practice and education. By identifying the positive traits exhibited by nurses as wounded healers affected by chronic cardiovascular diseases, nursing programs can emphasize and strengthen these qualities to convert challenges into opportunities and bridge the theory-practice gap. [ABSTRACT FROM AUTHOR]

Introduction: Globally, perinatal death presents a profound challenge for healthcare and healthcare professionals, requiring enormous clinical expertise and mental fortitude. The complexity involved in balancing professionalism, empathy, and the human face pose significant emotional challenges for nurses and midwives. Perinatal deaths in Ghana remain high and have adversely impacted the achievement of Sustainable Development Goal 3. Nurses and midwives play a central role in the Ghanaian healthcare system, and understanding their experiences in providing care to grieving mothers can provide valuable data for enhancing bereavement support as well as promoting quality improvement in clinical care. Objective: To explore the experiences of nurses and midwives who support bereaved parents during perinatal deaths in Ghana. Methodology: A descriptive-phenomenological approach was used to explore the lived experiences of the participants. Twelve participants were purposively recruited from the neonatal and intensive care unit of a District Hospital in northern Ghana. Interviews were conducted using a semi-structured interview guide. The data was analyzed iteratively using the thematic analysis approach. Findings: Six themes emerged from the interviews with the study participants. The six themes were personal experience of perinatal death, emotional impact on the nurses and midwives, parental reactions and coping, blame and guilt, the impact on work, and long-lasting psychological impact. The themes reflect the emotional and practical experiences encountered by the nurses and midwives when supporting bereaved parents and the impact of such experiences on their well-being. Conclusion: Perinatal bereavement support is a core responsibility of the nurses and midwives who work in maternal and neonatal units. Despite an improvement in perinatal death globally, the rates are still of great concern in Sub-Saharan Africa. Ironically, the experiences of nurses and midwives who support parents in times of perinatal death are lacking in Sub-Saharan Africa. This study sheds light on the experiences of nurses and midwives who support parents during perinatal death in a Ghanaian context, highlighting the importance of supporting these healthcare professionals. [ABSTRACT FROM AUTHOR]

Background: Children and young people (CYP) with complex neurodisability experience multiple physical, communication, educational and social challenges, which require complex packages of multidisciplinary care. Part of the holistic care required includes supporting the families and parents/caregivers. The aim of the wider study was to introduce a new programme ('Ubuntu') to parents/caregivers and healthcare professionals (HCPs) in order to test the feasibility and acceptability of the concept and content, with the goal of potential adaptation for the UK in mind. Data collection and analysis uncovered rich data on caregiving journeys, navigation of health services, and perceived service gaps. This paper focuses solely on these topics. Further papers will report on the feasibility and adaptation data. Methods: Two rounds of semi‐structured interviews were conducted with 12 caregivers of CYP with complex neurodisability and six HCPs from a variety of disciplines, recruited from a community child health service in London Borough of Newham, UK in 2020. The interviews included open‐ended questions to explore caregiving journeys, experiences of navigating health services and perceived service gaps. Transcripts were analysed using a data‐driven inductive thematic analysis. Results: Three themes were identified that related to the aim of understanding caregivers' experiences and unmet needs relating to current service provision. These were (1) Caregiver Mental Health, (2) The Information Gap and (3) The Need for Holistic Support. Mental health difficulties were reported, particularly around the period of diagnosis. Priority needs included the provision of clear information about the diagnosis and services offered, opportunities to forge peer support networks and for services across the community to collaborate. Conclusions: The delivery of health services for CYP with neurodisability should encompass the broad needs of the family as well as meeting the clinical needs of the CYP. [ABSTRACT FROM AUTHOR]

Background: The Special Supplemental Nutrition Program for Women, Infants, and Children, also known as WIC, is associated with improved health outcomes for participants. The role of WIC Peer Counselors was created to support breastfeeding among WIC participants. Objective: This Naturalistic Inquiry study explored the perceptions and experiences of 9 WIC Peer Counselors located in Southeast Texas. Methods: The WIC Peer Counselors were recruited via purposive and snowball sampling and participated in semi-structured face-to-face interviews. Data collection, analysis, and trustworthiness adhered to established guidelines. Results: Study findings revealed the novel approaches the WIC Peer Counselors used to encourage, initiate, support, and sustain WIC participants' breastfeeding, including using tools of their craft, involving and educating family members, making themselves accessible 24/7, and identifying the need for equipment and supplies. Conclusions: The WIC Peer Counselors' understanding of the breastfeeding culture of their WIC clients and their unique ability to establish and maintain rapport with them make WIC Peer Counselors ideally suited resources to meet the WIC goal of increasing breastfeeding and thereby improving the health of the nation. Health care providers should recognize the valuable, yet unrecognized and underutilized, contributions of WIC Peer Counselors and consider referring pregnant and postpartum dyads to WIC for breastfeeding education and support. [ABSTRACT FROM AUTHOR]

Background: Using extracorporeal membrane oxygenation (ECMO) in paediatric and neonatal intensive care units (PICU/NICU) creates ethical challenges and carries a high risk for moral distress, burn out and team conflicts. Aim: The study aimed to gain a more comprehensive understanding of the underlying factors affecting moral distress when using ECMO for infants and children by examining the attitudes of ECMO nurses. Methods: Four focus groups discussions were conducted with 21 critical care nurses working in a Swiss University Children's Hospital. Purposive sampling was adopted to identify research participants. The data were analysed using reflexive thematic analysis. Results: Unlike "miracle machine" stories in online media reports, specialized nurses working in PICU/NICU expressed both their hopes and fears towards this technology. Their accounts also contained references to events and factors that triggered experiences of moral distress: the unspeakable nature of the death of a child or infant; the seemingly lack of honest and transparent communication with parents; the apparent loss of situational awareness among doctors; the perceived lack of recognition for the role of nurses and the variability in end-of-life decision-making; the length of time it takes doctors to take important treatment decisions; and the resource intensity of an ECMO treatment. Conclusion: The creation of a multidisciplinary moral community with transparent information among all involved health care professionals and the definition of clear treatment goals as well as the implementation of paediatric palliative care for all paediatric ECMO patients should become a priority if we want to alleviate situations of moral distress. Relevance for Clinical Practice: The creation of a multidisciplinary moral community, clear treatment goals and the implementation of palliative care for all paediatric ECMO patients are crucial to alleviate situations of moral distress for nurses, and thus to improve provider well-being and the quality of patient care in PICU/NICU. [ABSTRACT FROM AUTHOR]

Purpose: Childhood immunizations have proven to be one of the most beneficial interventions to promote public health and prevent childhood deaths due to disease. However, global coverage of childhood immunization has decreased throughout the world due to guardians' growing hesitancy towards immunizations. This study aims to describe how specialist nurses promote legal guardians to adhere to national childhood immunization programmes. Design and Methods: This study had a qualitative design. Semistructured interviews with 11 specialist nurses, who were paediatric primary care nurses or nurse practitioners, were conducted. Data were analysed using qualitative content analysis. Results: The findings, with four main categories including four subcategories, showed nurses using both local guidelines and national guidelines to promote guardians to adhere to the childhood immunization programme. The main intervention the nurses did to promote childhood immunization coverage was giving legal guardians general information about the programme. With hesitant guardians, adopting a person‐centred approach towards the legal guardian improved adherence. Practice Implications: Further research should focus on how specialist nurses can respond to guardians who decline immunization for their children, as this study identified difficulties in this area. Furthermore, research on guardians' perspectives towards childhood immunization may also help generate further effective guidance on how to promote immunization coverage among children. [ABSTRACT FROM AUTHOR]

Copyright of Community & Physician / Toplum ve Hekim is the property of Turk Tabipleri Birligi / Turkish Medical Association and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Background and Purpose: Research on the childcare experiences of visually impaired mothers and their expectations from nurses in this context is relatively scarce. This study aims to explore the experiences of visually impaired mothers in caring for their children, as well as their expectations from nurses during this process. The goal is to provide strategic recommendations for nurses based on these expectations. Methods: The study utilized a phenomenological design and employed a qualitative methodology. Data for this study were collected in six different provinces of Turkey between March 2019 and May 2020. The study group consisted of 25 visually impaired mothers with nondisabled children aged 0–18 years. Results: The analysis yielded four themes: "Postpartum Emotions and Care at 0–1 Years," "Hygienic Care of the Child," "Experiences in the Child's Illness," and "Nursing Support: Expectations of Visually Impaired Mothers." While the first three themes are associated with childcare, the fourth theme encompasses both the expectations from nurses and recommendations for visually impaired mothers. The study found that visually impaired mothers had unique experiences and either received assistance or developed childcare strategies. However, it was observed that nurses struggled to empathize with visually impaired mothers, and efforts to address their specific needs were limited. Implications for Practice: Pediatric nurses should develop methods to facilitate childcare for visually impaired mothers. Successful outcomes in this field depend on nurses collaborating with visually impaired mothers and providing them with ongoing support. [ABSTRACT FROM AUTHOR]

Background: Interpersonal communication is a crucial component of the cancer experience that can contribute to managing cancer care and improving cancer survivors' and caregivers' quality of life. Cultural and contextual factors may impact Hispanic childhood cancer survivor (CCS) and parent caregiver relationships and communication. This study sought to describe the healthcare communication experiences of Hispanic parents with CCS, families, and medical providers. Methods: We conducted 15 semi-structured interviews with Hispanic caregivers from a safety-net hospital in Los Angeles County. Interviews were conducted in English and Spanish, audio-recorded and professionally transcribed, and analyzed using a thematic approach. Results: Caregivers shared the importance and impact of medical communication when exploring the "first big talk" of the diagnosis, uncertainty about treatment, navigating multiple providers, therapeutic communication (i.e., providing emotional reassurance), and current and lingering effects of cancer. All caregivers shared "good communication" experiences, while others shared various barriers to communication, including a lack of understanding of the cancer diagnosis and caregiver experience, psychological challenges impacting communication, cultural and language differences, physical factors that limit communication, and young age of child impacting communication with caregivers. Conclusions: Our findings suggest that a strong interpersonal communication skill set for clinicians can contribute to managing cancer care and improving caregivers' psychological adjustment. [ABSTRACT FROM AUTHOR]

Autism Spectrum Disorder (ASD) is a developmental disorder that affects an individual's ability to communicate, create social relationships, and regulate sensory input and repetitive behaviors. An uncommon intervention used in ASD treatment is farm animal-assisted therapy (AAT). AAT interventions focus on the use of animals in adjunct to achieve goals and outcomes. Farm AAT is defined as the use of farm animals such as cows, sheep, goats, horses, and pigs in AAT interventions. There is a lack of evidence on the use of farm animals and their benefits within the scope of AAT and in recreational therapy. The purpose of this study was to provide evidence, from the perspective of parents, of the potential benefits of farm AAT as a recreational therapy intervention for individuals with ASD. Data collection using a semi-structured interview guide was conducted over the phone with parents who participated in family session programs at the study location. Five participants were selected who matched the inclusion criteria for this study. The findings from this study reported that there were increases in social behaviors, regulation of behaviors, and a sense of normalcy for the children. The findings from this study provide a foundation for future research related to farm AAT such as evidenced-based curriculums and practices. The data provide therapists and parents with an understanding of the potential benefits that are gained from participation in farm AAT interventions. [ABSTRACT FROM AUTHOR]

Background: A holistic approach to emergency care treatment planning is needed to ensure that patients’ preferences are considered should their clinical condition deteriorate. To address this, emergency care and treatment plans (ECTPs) have been introduced. Little is known about their use in general practice. Aim: To find out GPs’ experiences of, and views on, using ECTPs. Design & setting: Online survey of GPs practising in England. Method: A total of 841 GPs were surveyed using the monthly online survey provided by medeConnect, a market research company. Results: Forty-one per cent of responders' practices used Recommended Summary Plan for Emergency Care and Treatment (ReSPECT) plans for ECTP, 8% used other ECTPs, and 51% used Do Not Attempt Cardiopulmonary Resuscitation (DNACPR) forms. GPs were the predominant professional group completing ECTPs in the community. There was broad support for a wider range of community)based health and social care professionals being able to complete ECTPs. There was no system for reviewing ECTPs in 20% of responders’ practices. When compared with using a DNACPR form, GPs using a ReSPECT form for ECTP were more comfortable having conversations about emergency care treatment with patients (odds ratio [OR] = 1.72, 95% confidence interval [CI] = 1.1 to 2.69) and family members (OR =1.85, 95% CI = 1.19 to 2.87). Conclusion: The potential benefits and challenges of widening the pool of health and social care professionals initiating and/or completing the ECTP process needs consideration. ReSPECT plans appear to make GPs more comfortable with ECTP discussions, supporting their implementation. Practice-based systems for reviewing ECTP decisions should be strengthened. [ABSTRACT FROM AUTHOR]

BACKGROUND: Moderately preterm infants (MPTI) comprise a large proportion of NICU admissions and are an understudied population. The unique experience of families with MPTIs has yet to be examined in the literature. Describing MPTI parent needs and preferences may inform interventions to improve care and outcomes for this population. METHODS: Semistructured qualitative interviews were performed with English-speaking birth parents of infants born between 32 and 34 weeks gestation to describe their NICU experience and identify areas for improvement specifically surrounding care team inclusion, education, discharge, and communication. Interviews were recorded, transcribed, and analyzed using directed content analysis. Enrollment ceased when the data reached thematic saturation. RESULTS: Sixteen birth parents participated. Four themes emerged around parent-medical team connectedness, parental confusion, discharge readiness, and the desire for a use of a mix of in-person and electronic communication methods (e-mail, texting, apps, etc) for communication. MPTI parents valued a strong connection with the medical team; owever, they described a lack of knowledge regarding the reasons for admission and ongoing management. Near discharge, parents desired more information regarding feeding, reflux, and breathing patterns. Parents preferred in-person discussions but described a role for electronic methods to improve their understanding of their infant and discharge readiness. CONCLUSIONS: From the MPTI parent perspective, clinicians can focus improvement efforts on communication, specifically around reasons for admission, discharge planning, and anticipatory guidance. These results may serve as a foundation for initiatives to improve the MPTI parent experience and potentially parent and MPTI outcomes. [ABSTRACT FROM AUTHOR]

Background: Caring for parents continuing pregnancy after learning about a severe life-limiting condition in their unborn is challenging. Most existing studies focus on affected families, whereas research on the subjective experience of care professionals is scarce. Aim: We aimed to (1) explore experiences and needs of involved care professionals, (2) obtain information about existing care structures, and (3) identify requirements for a structured perinatal palliative care program. Design: Grounded Theory study using theoretical sampling. Data was collected by semi-structured interviews and analyzed following the principles of grounded theory coding and situational analysis. Setting: A total of 18 professionals from 12 different services in Munich and surroundings participated in the study: 8 physicians, 3 midwives, 2 nurses, 1 each pregnancy counselor, grief counselor, chaplain, clinical psychologist, and undertaker. Results: Several organizations provide support for affected parents, but inter-institutional communication is scarce. Due to the lack of a dedicated perinatal palliative care program, professionals make immense and partly unpaid efforts to support concerned parents. Providers experience "collateral beauty" in their work despite all the suffering and grief. This includes the development of a humble attitude and feelings of gratitude toward life, the feeling of having a meaningful task and professional as well as personal growth. Requirements for a structured perinatal palliative care program include: fostering peer support, ensuring regular supervision, and enhancing interdisciplinary exchange. Conclusions: Perinatal palliative care demands a high level of personal engagement but is experienced as highly rewarding by care professionals. [ABSTRACT FROM AUTHOR]