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Aim: To explore what characterises communication and collaboration within a patient and professional partnership in outpatient care settings garnered from the experiences of persons living with long-term conditions., Design: A qualitative descriptive study design., Methods: Semi-structured individual interviews were conducted with 15 persons with long-term condition/s who experienced outpatient treatment or follow-up care. Data were explored through inductive thematic analysis. The COREQ checklist was followed., Results: The analysis revealed five themes: adapting and self-managing in daily life, handling and carrying information, building trust and continuity, acting in a flexible and transparent dialogue and sharing the way forward. The participants described their personal and informal resources, and their actions to take control and manage health and well-being. A person-centred approach, sharing of knowledge and communication skills enabled the development of trust in the healthcare providers and their treatment and care. Communication was facilitated through availability, shared documentation, continuity and coordination of care. Collaboration was described as a flexible dialogue with mutual trust and transparency, shared learning and problem-solving. Sharing the way forward was a process, alongside and important to the life-changing process to cope with the illness., Conclusions: Prerequisites for the collaboration in outpatient settings were availability, continuity and a healthcare system that acknowledged, empowered and adapted to patients' health status, resources, everyday life and a patient's coping processes to manage their disease. For a co-created, person-centred outpatient care, it is important to acknowledge and/or collaborate with the patient's team of other healthcare providers and informal caregivers., Relevance to Clinical Practice: The study contributes to better understanding of patient preferences and prerequisites how to work in partnership and how to develop future services and person-centred care for persons living with long-term conditions., Patient and Public Contribution: Patients included in this study were participants during the data collection process., (© 2024 The Author(s). Nursing Open published by John Wiley & Sons Ltd.)

Background: Bereavement is a universal experience, yet little research has explored the lived experience of bereavement for people with learning disability (PWLD). Materials and methods: Four PWLD were interviewed about their experience of bereavement. Data were analysed using interpretative phenomenological analysis. Results: Four themes were identified: "Needing to know: Being included," "Struggling to say: The emotional experience," "Love after death: A continuing relationship" and "Missing their presence: The wider impact of death." Conclusions: PWLD should have the opportunity to make informed choices about their level of involvement and to develop their emotional experience. PWLD should be supported to develop a continued bond with the deceased and the wider impact of their loss recognised.

Professionalism is a core element of curricula in many disciplines but can be difficult to teach and learn. This study used audio-diary methodology to identify professionalism threshold concepts in a small group learning setting in undergraduate medicine and to understand factors that might facilitate students to "get" such concepts. Fifteen students and seven tutors kept audio-diaries over two terms. Data were analysed qualitatively for content. The key themes were then cross referenced to threshold concept criteria (e.g. where language indicated that learning was troublesome, integrative or transformative). Seven potential threshold concepts were identified which centred on students' developing professional identities including working with uncertainty, considering the bigger picture, not needing to know everything and professional culture. Reflection on workplace experiences within a small group helped students "get" these concepts. The study concludes that threshold concepts and audio-diaries are useful tools for understanding lived experiences of professionalism learning.

Background: Current treatments for people with obesity emphasise the need for person-centred approaches that consider complex biopsychosocial factors and value the lived experience of people when attempting to lose weight. Methods: Narrative interviews (n = 20) were conducted with people living with obesity to explore the causes of their weight gain and their expectations and engagement with treatment at a Weight Management Clinic. A mixed inductive and deductive qualitative analysis identified utterances that represented psychological constructs used to understand self-appraisal and health behaviour. A narrative analysis was used to situate these findings in the context of a participant's life story. Results: Locus of control was a dominant construct evidenced through a person's attributional style and self-efficacy. Transcripts represented a heightened sense of self-understanding and shifts in control, and styles of attribution and efficacy resulted in either stasis or self-actualisation. The Stages of Change model could be applied to narratives to ascertain a patient's motivation to access treatment. Importantly, narrative interviews also allowed for the consideration of how a person's systemic context influenced their weight. Conclusion: Narrative interaction supports both self- and shared understandings of the causes and consequences of obesity for individuals, in a non-blaming or shaming manner. It provides an opportunity to enhance engagement through tailored, person-centred treatments. [ABSTRACT FROM AUTHOR]

Background: Person‐centred care is a growing imperative in healthcare, but the documentation of person‐centred care is challenging. According to the Gothenburg Framework of Person‐centred Care, care should be documented in continuously revised care plans and based on patients' personally formulated goals and resources to secure a continuous partnership. Objectives: This study aimed to examine care plans produced within a randomised controlled trial that tested a person‐centred care intervention in older people with acute coronary syndrome. Nurses with training in the theory and practice of person‐centred care had written the care plans. Methods: We conducted a secondary analysis of care plans developed in a randomised controlled trial for assessing person‐centred care in patients with acute coronary syndrome (Myocardial Infarct [MI] or unstable angina pectoris). The study sample included 84 patients, with three care plans for each patient from inpatient (T1), outpatient (T2) and primary care (T3), that is, a total of 252 care plans. We conducted a descriptive quantitative content analysis of the care plans to examine the reported patients' life‐world and medical/health resources and goals. Results: The analysis illustrates the differences and overlaps between life‐world and medical/health goals and resources. The documented goals and resources change over time: life‐world goals and resources decreased with time as medical/health goals and resources documentation increased. Conclusions: This paper illustrates that in the setting of a randomised controlled trial, nurses with training in person‐centred care recorded fewer life‐world and more medical/health goals over time. Placing life‐world goals at the top of the goal hierarchy enables alignment with medical/health goals. Further research should explore whether the goals and resources documented in care plans accurately reflect patients' wishes as they transition along the care chain. Trial registration: Swedish registry, Researchweb.org, ID NR 65 791. [ABSTRACT FROM AUTHOR]

Evidence is emerging of the potential of person‐centred approaches to create partnerships between professionals and patients while also containing healthcare costs. This is important for enhancing outcomes in individuals with complex needs, who consistently report poor experiences with care. The shift towards person‐centred care (PCC) is, however, a radical departure from the norm, with increased expectations of both professional and patient. Although there have been studies on the ways in which health care professionals can modify practice to enhance PCC, not all patients welcome changes to their care delivery or understand the aim of the new approach. Without engagement and understanding from the patient, a PCC approach will fail to initiate. Few studies explore how, why and in what circumstances patients become more involved in their care and what professionals can do to enhance participation. We conducted a secondary analysis of qualitative data to examine this issue. Data were collected between 2014 and 2018 from primary care‐based PCC projects across the southwest of England. Supported by people with experience (practitioners and those receiving treatment), theory building workshops developed an explanatory framework that identified contextual factors and mechanisms likely to contribute to effective engagement. Our results show that engagement in a care partnership is achieved through trust and a patient's sense of candidacy. Shared understanding of purpose, clarity of expectations and power sharing were found to facilitate trusted relationships between professional and patient and encourage candidacy. Only then is it possible to develop goals that are meaningful to the patient. Our theory of engagement applies to professionals and patients alike but places the initial burden of responsibility on those who hold the most power: the professional and the system. This theory has the potential to explain patient engagement in PCC and a range of other service interventions, treatments and intervention research. [ABSTRACT FROM AUTHOR]

Objective Conduct a deep exploration of the outcomes that matter to people with a diagnosis of schizophrenia and understand from their perspective how these outcomes can be achieved. Sample and Methods In-depth qualitative interviews were conducted with 22 people with a diagnosis of schizophrenia. Interviews were analysed using thematic frameworks, and a realist informed theories of change approach. Results Our study revealed the potential causal relationships between the context of a person's life, short-term goals and long-term outcomes. We provide a nuanced and detailed exploration of outcomes that matter for people with schizophrenia in relation to self-defined well-being. Achieving life milestones, feeling safe and outcomes related to improved physical health along with employment, a positive sense of self and psychosocial outcomes, were highly valued. For short- and long-term outcomes to be achieved, individuals required medication with minimal side-effects, cognitive behavioural therapy, family/social support and meaningful activities in their lives. Well-being was influenced by life context and short- and long-term outcomes, but in a circular nature also framed what short-term goals could be achieved. Conclusions Working with people with a diagnosis of schizophrenia to identify and achieve better outcomes will necessitate a person-centred approach. This will require an appreciation of the relationship between the statutory and non-statutory resources that are available and a consideration of an individual's current well-being status. This approach acknowledges personal strengths and encourages ownership of goals and supports self-management. [ABSTRACT FROM AUTHOR]

Objectives: this study aims to explore how patient safety in community dementia services is understood by caregivers, and healthcare professionals. Methods: cross-sectional analysis of guided one-to-one interviews with 10 caregivers, and 10 healthcare professionals. Results: caregivers and healthcare professionals identified a range of issues including medication errors, mis-communication between professionals, unclear service pathways and the effects of stress on caregivers' behaviour. Caregivers and professionals differed in their attitudes to balancing safety with patient autonomy and who is responsible for managing safety. Conclusions: this article helps to define the nature of safety issues in the context of community care for people with dementia. In contrast to hospital medicine, where the ideal treatment world is safe with all risks managed or minimised, in dementia some risks are actively taken in the interests of promoting autonomy. Caregivers' views differ from those of health professionals but both parties see potential for collaborative working to manage risk in this context, balancing the promotion of autonomy with the minimisation of potential harm. [ABSTRACT FROM AUTHOR]

This study aimed to identify and describe the motivators for underage, curbside drinking leading to antisocial behavior and to use these insights to develop a suitable intervention to tackle this. A cross-sectional study was conducted with youths and key stakeholders. “Street drinking” was identified as the most common recreational activity for youths and was motivated by a lack of appropriate leisure services, peer pressure and behavior, and the local accessibility of alcohol. Antisocial behavior was a major theme associated with street drinking. Few studies have examined the root causes of youth drinking and antisocial behavior. Our findings show that deprivation, social bonds, and the symbolic capital attached to alcohol along with its relative cost and availability enhance its appeal to the young, and provide some illumination to the relationship between these related problems. [ABSTRACT FROM AUTHOR]