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The purpose of this systematic literature review was to synthesize published phenomenologically informed studies situated in physical education with students with disabilities as the participants of the research. Keyword searches from different electronic databases were used to identify phenomenological studies from 2000 to 2022. A total of 16 articles were selected, and the findings were summarized and analyzed. Three thematic clusters surfaced from narrative analysis, which were: (a) the intersection of disability, gender, and athleticism; (b) social interactions in physical education; and (c) the role of the physical education teacher toward the lived experiences of students with disabilities. Findings support the need to engage through an intersectional lens considering multiple identities to better understand the experiences of children with disabilities in physical education. Appropriate modifications and accommodations that attend to all students' needs and promote meaningful social interactions among peers contributing to positive lived embodied experiences should be promoted. [ABSTRACT FROM AUTHOR]

ObjectivesTo explore the context in which older men navigate treatment for stress urinary incontinence (SUI) following prostate surgery by characterizing lived experience of men with symptomatic SUI.Subjects/patients and methodsMixed method study using surveys and semistructured interviews to examine a cohort of men who underwent evaluation for treatment of postprostatectomy SUI.ResultsThirty-six men were interviewed after consultation for SUI and 31 had complete quantitative clinical data. Twenty-six underwent surgery and 10 chose no surgical intervention. In qualitative interviews, respondents experienced substantial decline in quality of life due to incontinence citing concerns associated with use of pads and worrying about incontinence. Most patients reported "workarounds"-efforts to mitigate or manage incontinence including Kegels, physical therapy, and garments. Participants also reported lifestyle changes including less strenuous physical activity, less sexual activity, and/or fewer social gatherings. Patients then described a "breaking point" where incontinence workarounds were no longer sufficient. After seeking evaluation, men described challenges in exploring treatment for SUI, including access to care and provider knowledge of treatment options.ConclusionIn a novel study of patients living with SUI a predictable lived experience was observed that culminated in a desire for change or "breaking point." In all men, this led to treatment-seeking behaviors and for many it led to SUI intervention. Despite effective treatments, patients continue to meet barriers gaining access to SUI evaluation and treatment.

ABSTRACT Objective Method Results Discussion Long‐term recovery rates following eating disorders (EDs) treatment remain low. This might be partly due to a lack of agreement between key stakeholder groups, including people with lived experience, carers, clinicians, and researchers, regarding optimal therapeutic targets and strategies. We aimed to reach a consensus across these diverse groups on the most valued treatment targets and strategies for fostering ED recovery.We used the Delphi method with two phases: (i) Survey development and (ii) Expert rating. The survey development phase included the design of an initial set of items through scoping review and feedback from a committee of 14 experts. During the survey rating, we engaged a larger panel of 185 experts who comprised the stakeholder groups: Individuals with lived ED experience (n = 49), carers (n = 44), researchers (n = 46), and clinicians (n = 46).Thirty‐one targets and 29 strategies reached consensus (> 70% agreement over three rounds). Psychological‐emotional–social targets including quality of life, sense of purpose, and emotion regulation, along with ED behaviors, reached the highest agreement (> 90%). Strategies reflecting an individualized approach to treatment (i.e., considering diversity, assessing comorbidities, and enhancing rapport) achieved the highest agreement (> 90%). Responses across groups were similar, except researchers leaning more towards consideration of weight‐ and eating‐related targets.Holistic targets and individualized therapeutic strategies have consistent support from the different stakeholder groups involved in ED treatment. The agreed set of targets/strategies may be used, in triangulation with other sources of evidence, to design and evaluate coproduced and personalized interventions. [ABSTRACT FROM AUTHOR]

Introduction Objective Design Findings Discussion Conclusion Growing the mental health peer workforce holds promise for rural communities, but we currently lack an understanding of the guidance available to support the development, implementation and sustainability of this workforce in rural settings.Study aims are to: (1) determine the extent and nature of the literature that provides guidance for growing the peer workforce in rural mental health services; and (2) identify and explore any guidance relevant to rural peer work services dedicated to First Nations communities, including those promoting social and emotional well‐being within this body of literature.A scoping review method was employed to identify relevant peer‐reviewed and grey literature published between 2013 and 2022 across PsychInfo, Medline, Embase and CINAHL, Scopus and Informit HealthInfoNet databases, as well as targeted organisation websites and Google Advanced Search.A total of 26 unique studies/projects were included from the US, UK, Canada and Australia with public mental health, non‐government/for purpose and private sector service settings represented in the literature. Grey literature, such as reports of evaluations and frameworks, formed the majority of included texts. While there is a lesser volume of rurally focused literature relative to the general peer work literature, this is a rich body of knowledge, which includes guidance concerning services dedicated to First Nations communities. Via synthesis critical considerations were identified for the development, implementation and sustainability of peer work in rural mental health services across six domains: ‘Working with community members and stakeholders’, ‘Organisational culture and governance’, Working with others and in teams, Professional expertise and experience, Being part of and working in the community and ‘Local mental health services capacity’.While there are considerations relevant across a range of settings, the domains of: ‘working with community members and stakeholders’, ‘being part of and working in the community’ and ‘local mental health services capacity’, capture additional, distinct and nuanced challenges and opportunities for growing the peer work in rural services.The literature offers insights valuable for service planning, policy development and the allocation of resources to support rural peer workforce growth. [ABSTRACT FROM AUTHOR]

Background: Peer support workers provide support for people experiencing mental health conditions based on their own lived experience of mental health problems. Assessing fidelity to core ingredients of peer support is vital for successful implementation and intervention delivery. Modifications to its implementation are needed when scaling up to different socio-economic settings, raising further uncertainty about fidelity. As part of a large multi-centre study on peer support called Using Peer Support In Developing Empowering Mental Health Services (UPSIDES), we developed and evaluated the psychometric properties of the UPSIDES Fidelity Scale. Methods: We constructed the fidelity scale based on an initial item pool developed through international expert consultation and iterative feedback. Scale refinement involved site-level expert consultation and translation, resulting in a service user-rated 28-item version and a peer support worker-rated 21-item version assessing receipt, engagement, enactment, competence, communication and peer support-specific components. Both versions are available in six languages: English, German, Luganda, Kiswahili, Hebrew and Gujarati. The scale was then evaluated at six study sites across five countries, with peer support workers and their clients completing their respective ratings four and eight months after initial peer support worker contact. Psychometric evaluation included analysis of internal consistency, construct validity and criterion validity. Results: For the 315 participants, item statistics showed a skewed distribution of fidelity values but no restriction of range. Internal consistency was adequate (range α = 0.675 to 0.969) for total scores and all subscales in both versions. Confirmatory factor analysis indicated acceptable fit of the proposed factor structure for the service user version (χ2/df = 2.746; RMSEA = 0.084) and moderate fit for the peer support worker version (χ2/df = 3.087; RMSEA = 0.093). Both versions showed significant correlations with external criteria: number of peer support sessions; perceived recovery orientation of the intervention; and severity of illness. Conclusions: The scale demonstrates good reliability, construct and criterion validity, making it a pragmatic and psychometrically acceptable measure for assessing fidelity to a manualised peer support worker intervention. Recommendations for use, along with research and practical implications, are addressed. As validated, multi-lingual tool that adapts to diverse settings this scale is uniquely positioned for global application. Trial registration: ISRCTN, ISRCTN26008944. Registered on 30 October 2019. [ABSTRACT FROM AUTHOR]

\nKEY POINTSMale suicide is a significant public health concern, with devastating impacts on communities. Of the 3,144 deaths by suicide in Australia in 2021, three-quarters were males – a trend that has occurred for many years and across many countries. The pathway to suicide is highly individual and complex – influenced by social, systemic, and individual factors. This commentary explores the complex interplay of factors that contribute to the higher suicide rates among males, as well as the challenges in addressing this issue within the context of gender norms, mental health, social support, and life stressors. Collaboration with individuals with lived and living experience is crucial in developing gender-responsive services and systemic approaches that support males’ diverse and complex needs. Insights for responding to male suicide risk in clinical practice are provided. Psychologists can play a pivotal role in prevention efforts by: providing tailored support; delivering gender-sensitive programs; conducting research; and advocating for policy changes.What is already known about this topic:(1)  The suicide rate is higher among males in Australia and many other countries.(2)  Correlates of male suicide include mental health, substance use, relationship issues, social isolation, and alcohol use.What this topic adds:(1)  Suicide among men is influenced by a complex interplay between social, systemic and individual factors.(2)  Gender sensitive clinical and community approaches are needed that build collaborative relationships with males and people with lived experience, attend to the unique context of males’ lives, develop protective factors, and advocate for systemic change.(3)  Psychologists can play a critical role in prevention efforts by responding at both individual and community levels. [ABSTRACT FROM AUTHOR]

Lived experience education occupies an increasingly important space in mental health education for social workers. Despite being plagued by practices that continue to be discriminating and exclusionary, the mental health policy and practice context demand robust attention to the meaningful inclusion of service users and their families to achieve genuine partnership, reciprocity, and equality in mental health service provision. For social work educators, lived experience education is now an indispensable component of a critically informed mental health curriculum and pedagogy. Framed within an appeal for epistemic justice, this article reports on qualitative survey data from social work students who experienced teaching from people with lived experience. Findings show that students greatly valued lived experience education, as it created opportunities for authentic and more diverse understandings of mental health that fostered critical reflection. A curriculum that supports epistemic equality and a social justice agenda would help scaffold lived experience expertise for student learning.IMPLICATIONS Mental health lived experience education positively impacts social work students’ values and attitudes towards mental health service users.Lived experience education supports social work students to expand their understandings of mental health and recovery beyond dominant biomedical perspectives.Genuine valuing of lived experience knowledge and expertise in social work education helps address epistemic injustice.Mental health lived experience education positively impacts social work students’ values and attitudes towards mental health service users.Lived experience education supports social work students to expand their understandings of mental health and recovery beyond dominant biomedical perspectives.Genuine valuing of lived experience knowledge and expertise in social work education helps address epistemic injustice. [ABSTRACT FROM AUTHOR]

ABSTRACT Countries around the world are experiencing both a growing need for mental health services and major gaps in the delivery of mental healthcare. The World Health Organisation's 2022 report on mental health emphasised co‐designed and systems‐level innovations responsive to the voice of those with lived experience. However, evidence for implementing such methodologies is sparse. Group model building (GMB), a participatory systems‐based approach, has been used in various fields, but its application is limited within mental healthcare settings. It is recognised as a valuable tool for engaging stakeholders, including those with lived experience, in understanding and redesigning health systems and services. The participatory approach aligns with the mental health sector's shift towards co‐design and person‐centred care. This study assessed the acceptability of GMB as a method for co‐design within mental healthcare, aiming to explore its potential for meaningful collaborative improvement and systems‐level insights. Participants from a regional Mental Health and Drug and Alcohol Service (MHDAS) engaged in GMB workshops and focus groups. Eighteen individuals, including lived experience workers and healthcare professionals, provided feedback that informed adjustments to the workshops' design, language, timing and facilitation techniques, enhancing GMB's relevance for mental health co‐design. The findings demonstrate the value and acceptability of the adapted GMB process in acute mental healthcare, marking a significant step towards evidence‐based, person‐centred service improvement. This study highlights the potential effectiveness of participatory methods in identifying and addressing systemic challenges, paving the way for future mental health reforms. Future work will focus on implementing and evaluating co‐designed interventions, aiming for more inclusive and effective mental healthcare and advancing innovation and reform in the field. [ABSTRACT FROM AUTHOR]

The Special Educational Needs and Disability (SEND) landscape in England is bleak. Since the COVID‐19 pandemic, the number of pupils with SEND has increased. There is a shortage of places available in specialist SEND provision, and many pupils with SEND are being educated in alternative provision settings which arguably do not meet their needs. Mainstream schools are struggling to meet the needs of pupils with increasingly complex needs and there has been a lack of financial investment in specialist support services, resulting in delays to assessments and interventions. Drawing on personal and lived experience, I argue that impairment can be painful and sometimes disabling. I argue that although social model has made a significant difference to the lives of disabled people, its ambition has not been fully realised. Disabled people still experience discrimination within education, housing, employment and in other areas. I argue that impairment is real, painful and disabling and can result in personal struggle. I therefore make the case that people with impairments require additional support as a ‘step up’ to guarantee equality of opportunity. Urgent investment is required in specialist SEND services to ensure that unnecessary struggle is avoided. [ABSTRACT FROM AUTHOR]

Introduction Methods Results Conclusion WHAT THIS PAPER ADDS What is already known on this subject What this paper adds to existing knowledge What are the potential or actual clinical implications of this work? Collaborative approaches in speech‐language pathology (SLP) aim to integrate the experience of clients and people important to them by including these stakeholders actively in decision making. This inclusion can lead to more effective, engaging, and safer SLP practice. A variety of collaborative approaches have evolved in response to sociocultural contexts, and as a result, there are many different approaches currently in use such as co‐design, co‐production, and co‐creation. However, despite widening acceptance and utilisation of collaborative approaches, the use and evidence for these in SLP literature have not been considered collectively. The current study aims to explore how collaborative approaches, used to develop products or services in SLP, are reported in literature.Using narrative review methodology, a systematic search of three databases and hand searching were conducted to explore how collaborative approaches, used to develop products or services, are reported in SLP. Search terms reflected the breadth of collaborative approaches and the diverse nature of SLP across clinical practice. Following screening of initial data, 59 articles were identified for data extraction and narrative synthesis. An internationally recognised reporting checklist for stakeholder involvement called the Guidance for Reporting Involvement of Patients and the Public, Version 2 (GRIPP2), informed the reviewing process in addition to qualitative description.Collaborative approaches across SLP practice were found to be diverse as were the terminology and tools used for collaboration. Two‐thirds of the studies were published after 2020. The timing and involvement of stakeholders in collaborative approaches varied greatly; however, most stakeholder involvement was found in the conducting of research activities, compared to other areas such as planning, analysis, and reporting. The GRIPP2 review indicated strengths and opportunities in reporting of stakeholder involvement. When stakeholder involvement was rigorously reported it could include reflection on how stakeholders contributed within their communication abilities and how this contribution benefited the study.Collaborative approaches reported in SLP focused on valuing and respecting people with living experience of communication and swallowing difficulties. This narrative review contributes to the resources available to support decision‐making and working together with stakeholders, encouraging SLPs to reflect, consider the context and respond. Future research could continue to strengthen consistency in terminology for collaborative approaches, use frameworks to plan and report stakeholder involvement and carefully consider involvement across the research continuum. There is an expectation that health services include stakeholders in development and evaluation of services. Collaborative approaches in speech‐language pathology (SLP) aim to integrate the lived experience of people with communication and swallowing difficulties and those important to them. These approaches, including but not limited to, co‐design, co‐production and participatory action research, have shared philosophies of being community‐driven, strengths based and inclusive (Loeffler & Bovaird, 2021). This study contributes information about current SLP practice when collaborative approaches have been employed to develop a product or service. The study maps diverse collaborative approaches and their frequency in the literature, as well as the various stakeholders involved, using the Guidance for Reporting Involvement of Patients and the Public, Version 2 (GRIPP2) checklists to guide the review of reporting stakeholder involvement. This synthesis of literature supports researchers and clinicians in making intentional decisions in implementation and reporting of collaborative approaches. This decision‐making can strengthen the implementation of collaborative approaches, which has implications for person‐centred care in SLP. [ABSTRACT FROM AUTHOR]

We explore an unsolved challenge in the era of evidence-based medicine (EBM): the recognition of the patient as an epistemic agent or ‘knower’. While patients are increasingly acknowledged as carriers of values and preferences, it seems more challenging to acknowledge them as carriers of important causal information. In contrast, the science of pharmacovigilance depends on patient testimonies as valuable sources of causal evidence. This incompatibility can give rise to cases of what has been called participatory epistemic injustice. We analyse the testimony of a chronic pain patient and co-author of this article, Christine. Christine gives an auto-ethnographic account of her interactions with healthcare professionals trying to find the right pharmacological treatment for her condition. Through the analysis of her own story, she identifies some relevant themes for the epistemic interaction between healthcare professionals and chronic pain patients. We argue that such epistemic interactions are increasingly shaped by EBM and its conception of causality, which devalues patient subjective testimonies and emphasises statistical evidence. We conclude that outlier patients face an inherent risk of being left vulnerable to participatory epistemic injustice, particularly regarding the discovery of novel, rare adverse effects of medicines. [ABSTRACT FROM AUTHOR]

The coronavirus disease 2019 (COVID-19) pandemic, and its associated mortality, morbidity, and deep social and economic impacts, was a global traumatic stressor that challenged population mental health and our de facto mental health care system in unprecedented ways. Yet, in many respects, this crisis is not new. Psychiatric epidemiologists have recognized for decades the need and unmet need of people in distress and the limits of the public mental health services in the United States. We argue that psychiatric epidemiologists have a critical role to play as we endeavor to address population mental health and draw attention to 3 areas of consideration: elevating population-based solutions; engaging equitably with lived experience; and interrogating recovery. Psychiatric epidemiology has a long history of both responding to and shaping our understanding of the relationships among psychiatric disorders and society through evolving methods and training, and the current sociohistorical moment again suggests that shifts in our practice can strengthen our field and its impact. This article is part of a Special Collection on Mental Health. [ABSTRACT FROM AUTHOR]

There are increased sector-wide efforts within health and social care systems to engage those with lived experience in service design, delivery, and monitoring – aiming to secure more equitable health outcomes. However, critical knowledge gaps persist around how national whole-system engagement strategies can account for the challenges experienced by populations that encounter exclusion within complex multi-layered systems. This includes a failure to delineate shared challenges across groups, and to develop transferable cross-group frameworks to assist sector-wide change. There is, therefore, a danger that those groups already least heard will be collectively left behind. With a view to informing a more inclusive engagement strategy in Ireland, this national study aims to investigate multi-level (policy and strategic, operational, on-the-ground services, individual) shared challenges impacting engagement for five populations who have been identified as underserved groups in a complex health and social care system, including: (1) those who misuse drugs and alcohol, (2) those who are experiencing homelessness, (3) those experiencing mental health, (4) migrants and those of minority ethnicies, and (5) Irish Travellers. Adopting a mixed-methods approach which draws on an evidence-informed multistakeholder perspective, this study employs data from: focus groups and life-course interviews with lived-experience populations (n=136), five focus groups (n=39) and a national on-line survey (n=320) with population-specific services providers; and national-level stakeholder interviews (n=9). Two cross-group participatory consultative forums with lived-experience and provider participants (n=28) were used to co-produce priority action areas based on study findings. This article presents findings on shared challenges in engaging these groups around leadership and commitment, implementation and action, population capacities, trust, and representation, stigma, and discrimination. Derived from these challenges, six development areas are presented to advance an inclusive equitable engagement approach in Ireland. These comprise: 1) balancing top-down prioritisation, and bottom-up direction; 2) sustaining multi-level, multi-form implementation; 3) measuring effectiveness and action; 4) embedding inclusive equitable engagement; 5) trust as a prerequisite, and outcome; and 6) an equalising, agency empowering agenda. [ABSTRACT FROM AUTHOR]

AbstractPurposeMaterials and methodsResultsConclusions\nImplications for rehabilitationTo identify factors that contribute to the enhanced life of people with spinal cord injury (SCI) in Sweden.This cross-sectional study combined workshops (n = 38) and survey data (n = 243) from people living with SCI and their relatives, health professionals, and personal care assistants working with people living with SCI. The data were first categorized using Bronfenbrenner’s bioecological model, followed by a conventional content analysis.The factors that contribute to an enhanced life for people living with SCI are similar to those of the general population, including relationships, leisure activities, and occupation within the mesosystem. However, the unique components of the exosystem and macrosystem are specifically associated with people living with SCI. The exosystem, particularly in healthcare, plays a major role for medical reasons but also tends to obtrude and minimize the mesosystem. The macrosystem is essential, as it sets the rules that govern the actors in the other layers, creating prerequisites for meeting the needs of the mesosystem and exosystem.The needs that contribute to an enhanced life are multifaceted and individualized. Therefore, these systems must be flexible throughout the lifespan of individuals with SCI.This paper reports needs that contribute to an enhanced life for people living with spinal cord injury in Sweden.The factors that contribute to an enhanced life are multifaceted and individual, and these must be considered throughout the entire life span, including getting help if secondary complications arise, aging and other life events.Individuals’ willingness to take ownership is strong but requires support from the surrounding systems that can accommodate individual’s unique needs.The exosystem (ea health care) plays a major role but risk to obtrude and minimize the mesosystem (individual’s immediate relations).Positive attitudes toward oneself, from family members and loved ones, from health care professionals and authorities are crucial for an enhanced life.This paper reports needs that contribute to an enhanced life for people living with spinal cord injury in Sweden.The factors that contribute to an enhanced life are multifaceted and individual, and these must be considered throughout the entire life span, including getting help if secondary complications arise, aging and other life events.Individuals’ willingness to take ownership is strong but requires support from the surrounding systems that can accommodate individual’s unique needs.The exosystem (ea health care) plays a major role but risk to obtrude and minimize the mesosystem (individual’s immediate relations).Positive attitudes toward oneself, from family members and loved ones, from health care professionals and authorities are crucial for an enhanced life. [ABSTRACT FROM AUTHOR]

ABSTRACT Aim Design Methods Results Conclusions Implications for the Profession and Patient Care Impact Reporting Method Patient or Public Contribution To explore the existential lived experiences of parents of children and young people with complex care needs.An explorative qualitative design.We conducted 16 in‐depth interviews with parents of children and young people with complex care needs across Norway from February to May 2022. Data collection and analysis were guided by the theoretical framework of van Manen's phenomenology of practice approach.Four distinct but interwoven themes reflecting the comprehensive and holistic nature of parents' existential lived experiences emerged: lived body: “I am forever changed”; lived space: Seeking sanctuary; lived time: “Time doesn't seem to exist”; and lived self‐other: Parents' changing relationships.Parents' ongoing efforts to manage fluctuations in their daily lives profoundly affect the existential aspects of their well‐being, suggesting that respectful and attentive nurse–parent relationships can nurture existential growth.There is a crucial need for a genuine nursing presence characterised by an attitude of open sensitivity and attentive listening to parents' existential experiences. Nurses should embrace the opportunity to engage in respectful and attentive dialogues with parents. Acknowledging that the insights emerging from these conversations can improve integrated and personalised nursing services worldwide.Parents of children and young people with complex care needs often experience suboptimal healthcare. Additionally, access to quality healthcare services, particularly in rural areas, is limited, creating inefficiencies and coordination challenges. This study provides nurses, other health care professionals, researchers, and decision‐makers with valuable perspectives on supporting parents' existential needs which may significantly impact their overall well‐being and coping abilities, contributing to a more compassionate approach to family care.Consolidated Criteria for Reporting Qualitative Research (COREQ).Parents of children and young people with complex care needs provided valuable feedback on the findings and implications of this work. [ABSTRACT FROM AUTHOR]

Purpose: To explore experiences of parenting a child with CP and pain. Method: Fourteen mothers and one father of children (9–16) with CP were included. All children had pain regularly, but the frequency and intensity of their pain experiences varied. Their motor function varied from GMFCS level I to V. Cognitive abilities varied from normal to moderate cognitive deficits. All children could express themselves verbally. Semi structured individual interviews were carried out, and results were developed using inductive thematic analysis. Results: The analysis resulted in the main theme "My child's pain is just one piece of a complex jigsaw puzzle". The main theme was developed by four mutually exclusive, but related themes: "My child's struggle burdens me", "Pain and CP direct our everyday life", "I want to be in control, but cannot always be" and "We are the only ones who understand the complexity". Conclusion: Parents of children with CP experience pain as one aspect of a bigger picture. They need help and support to cope with their child's pain, and professional helpers need to address the complexity pain is a part of. IMPLICATIONS FOR REHABILITATION: Parents of children with cerebral palsy (CP) experience their child's pain as one piece in a jigsaw puzzle, and counseling needs to address the complexity rather than the separate parts of the picture. Health professionals should support parents in evaluation and management of their child's pain, as a feeling of competence in pain management is important to reduce parental stress. Health professionals should inform themselves about the life situation of parents whose child with CP has pain, and encourage them to seek practical support and apply for relevant support schemes that can make their everyday life easier. Parents of children with CP should be encouraged to take part in a diagnosis-specific support group, where they can meet with others in a similar situation, in order to reduce their feeling of being alone with their challenges. [ABSTRACT FROM AUTHOR]

Purpose: To investigate the experience of working age adults living with chronic post-stroke pain in the United Kingdom (UK). Methods: Semi-structured interviews were conducted with eight working age (46–64 years) UK-based stroke survivors who experience chronic post-stroke pain (≥3 months). The interviews were analysed using interpretative phenomenological analysis. Results: The analysis led to three Group Experiential Themes: "The Solitude of the Pain Experience," "Unsatisfactory Healthcare and the Need for Self-Care" and "The Development of Pain Acceptance." Findings suggest that individuals see their post-stroke pain as an invisible disability, which is overlooked and misunderstood by others. Furthermore, in the absence of a differential post-stroke pain diagnosis, clear, accurate information and alternatives to pharmacological treatments, individuals with post-stroke pain invest their own resources in finding answers and a way to live with the pain. Conclusions: The findings suggest the need for further education on post-stroke pain for healthcare professionals, the consideration of pain in post-stroke assessments, the need for clear differential pain diagnoses and the provision of accurate information to patients. Research is needed to establish non-pharmacological evidence-based treatment approaches, such as pain management programmes, peer support and psychological interventions. IMPLICATIONS FOR REHABILITATION: Post-stroke pain is an invisible disability, difficult to describe to others and therefore often overlooked and misunderstood by others. Differential pain diagnoses should be given to patients with clear explanations of the underlying mechanism, characteristics and prognosis. Treatments other than pharmacology, such as a pain management programmes, peer support, family therapy and psychological interventions, should be considered and patients should be supported in finding a way to live a meaningful life despite the pain. Healthcare professionals, particularly in primary healthcare services would benefit from training on post-stroke pain. [ABSTRACT FROM AUTHOR]

Purpose: To identify and examine subgroups of people with spinal cord injury (SCI) with different patterns of lived experience, and examine hidden impairments and disability among functionally independent and ambulant people. Materials and methods: Latent profile analysis of population-based data from the Australian arm of the International Spinal Cord Injury (InSCI) Community survey (n = 1579). Results: Latent subgroups reflected levels of functional independence and extent of problems with health, activity/participation, environmental barriers, and self-efficacy. Quality of life (QoL), psychological profiles, and activity/participation were often as good or better in participants who reported lower (vs. higher) functional independence alongside comparable burden of health problems and environmental barriers. QoL, mental health, and vitality reflected self-efficacy and problem burdens more closely than functional independence. Ambulant participants reported a substantial burden of underlying, potentially hidden impairments, with QoL and mental health similar to wheelchair users. Conclusion: Hidden disability among more independent and/or ambulant people with SCI can affect well-being substantially. Early and ongoing access to support, rehabilitation, and SCI specialist services is important irrespective of cause, type, severity of injury, and level of functional independence. Improved access to SCI expertise and equity of care would help to improve early recognition and management of hidden disability. Trial registration: Not applicable. IMPLICATIONS FOR REHABILITATION: Hidden disability can substantially affect the well-being and quality of life of people with spinal cord injury (SCI) who appear to be functioning well and independently. Early and ongoing access to rehabilitation and SCI specialist services is important for people with SCI of any cause, type, severity, and level of functional independence. The potential for and implications of hidden disability are key considerations for the broader community of health practitioners who manage people with SCI, to ensure that appropriate referrals to specialist SCI services occur. Hidden disability is a key consideration in the design and implementation of disability support systems. [ABSTRACT FROM AUTHOR]

Background: Weight stigma is pervasive within healthcare and negatively impacts both access to care and the patient‐practitioner relationship. There is limited evidence on weight stigma among registered dietitians, particularly in the United Kingdom, though data show weight‐related prejudice towards people living with obesity. The aim of this study was to examine both explicit and implicit weight stigma in practicing dietitians in the United Kingdom, as well as the lived experience of weight stigma among dietitians, both towards themselves and towards others. Methods: An online cross‐sectional survey was disseminated between February and May 2022 using snowball sampling. Inclusion criteria were that participants were UK registered dietitians aged 20–70 years. Results: Four hundred and two dietitians responded to the survey (female [94.1%], mean age 40.2 years [standard deviation (SD) 10.7]; White ethnicity [90%]; median 12 years [interquartile range (IQR) 6, 22] within dietetic practice). Mean self‐reported body mass index was 25.1 kg/m² (SD 8.7). Most dietitians reported experiencing weight stigma prior to (51%) and postregistration (59.7%), whereas nearly a quarter (21.1%) felt that weight influenced their ability as a dietitian. Weight stigma was experienced across the weight spectrum. Overall participants reported explicit weight bias attitudes, moderate beliefs that obesity is controllable and implicit antifat bias. Within open‐ended responses, dietitians reported three key themes related to their personal experiences of weight stigma: (1) experiences of stigma in dietetic practice, (2) impact of weight stigma and (3) perception of weight, appearance and job. Conclusion: This study shows that UK dietitians exhibit both explicit and implicit weight bias towards people living with obesity. Dietitians reported experiencing weight stigma, which impacted their career‐related decisions and their perception of their own ability to perform as dietitians. The study highlights the need to address weight stigma and its implications within the dietetic profession. Key points: Dietitians personally experience weight stigma prior to and post registration. Experiencing stigma impacts on career‐related decisions, the area of expertise dietitians choose and their confidence in their own abilities to practise as dietitians.Weight stigma is experienced across the weight spectrum.These data show that dietitians have both explicit and implicit bias towards people living with obesity.Our data highlight the need for weight stigma to be addressed within dietetic practice, both from a patient‐practitioner and professional point of view.There is a need for dietetic associations to address how weight stigma impacts the profession. [ABSTRACT FROM AUTHOR]

Objective: The limited research funding available needs to be directed towards stakeholder-identified priorities that will have the largest positive impacts on mental health. This study aimed to identify consensus mental health research priorities across lived experience and mental health professional panels. Method: A modified Delphi study with two panels (lived and professional experience in mental health) was used to identify priorities over three rounds. Priorities were rated on a 9-point scale from not important, important but not critical, to critical. Consensus (≥80% agreement on items rated ≥ 6 in importance across both panels) was analysed descriptively. Results: 1015 initial potential priorities and 18 additional priorities were rated by panel members (N = 120, 52 lived experience, 68 professionals), with 608 priorities achieving consensus across 23 mental health domains. Priority themes included: services; prevention, early intervention, detection and health promotion; intersectionality; determinants of mental health; translation; culture, spirituality and wellbeing (identity); suicide and self-harm; data and technology; capacity building; trauma; physical health; stigma and shame; help-seeking and coping; and co-design. Conclusions: There was high agreement across stakeholders on mental health research priorities, which may provide a basis for funding allocations for impactful research that would improve the mental health of the community. Key Points: What is already known about this topic: There is very limited funding for research in mental health. It is essential to identify what areas of mental health research would be most relevant and meaningful to the community. Co-design is important for authentic participation in priority-setting between different stakeholders in the community. What this paper adds: People with lived and/or professional experience identified research priorities across a broad array of mental health challenges, populations, and settings in the Australian community. The mental health research priorities can be used to guide policy, funding, and researchers in conducting future projects. Results pointed to the need for more research in a range of critical areas within the themes of services-based research; prevention, early intervention, detection and health promotion; and intersectionality. [ABSTRACT FROM AUTHOR]

Accessible summary: What Is Known on the Subject?: Service user involvement in mental health nursing education is beneficial in terms of attitudinal change to reduce stigma, clinical skill development and enhancing understandings of recovery‐oriented practice.Service users as experts by experience have not been embedded within pre‐registration nursing programs. Consequently, they remain limited in number, ad hoc and frequently tokenistic.Nurse academics responsible for the design and delivery of pre‐registration mental health nursing curricula have a potentially important role in facilitating expert by experience involvement in mental health nursing education. What this Paper Adds to Existing Knowledge: Nurse academics teaching mental health nursing have generally favourable views about the importance of expert by experience involvement.Nurse academics experience significant barriers in supporting the implementation of academic positions for experts by experience, particularly in obtaining funding.The experts by experience could contribute to mental health nursing education does not appear to be clearly understood by nurse academics. What Are the Implications for Practice?: Mental health services aspire to adopt a recovery‐oriented approach to practice. Involving experts by experience in mental health nursing education can facilitate increased understanding and appreciation of recovery‐oriented practice.Nurse academics could play an important role in supporting the implementation of experts by experience positions in nursing academia. To do so, they require an understanding of the benefits of EBE involvement in academia and the barriers that can be encountered when attempting to facilitate the implementation of such positions.Experts by experience contribute unique expertise, essential to the development of quality mental health services. Conveying this expertise through the educating the future nursing workforce in mental health is essential. Introduction: Involving service users in mental health nursing education is ad hoc and minimal, despite growing evidence of its benefits. Insights and experiences of nurse academics teaching mental health to pre‐registration students have been underrepresented in the research to date. Aim: To seek insights and experiences of nurse academics involved in designing and delivering pre‐registration mental health nursing education in Australian universities regarding involving service users in mental health nursing education. Methods: A descriptive qualitative study involving 19 nurse academics from 13 Australian universities, involved in pre‐registration mental health nursing education. Data were analysed thematically. Results: Participants reported minimal service user involvement. Most sought an increase and identified barriers. Data analysis resulted in five identified themes: (1) value‐rich, (2) resource‐poor, (3) imperfect processes, (4) 'part, but not all' and (5) unrecognised worth. Conclusions: Increasing meaningful involvement of service‐users in mental health nursing education requires support and investment from multiple stakeholders. Nurse academics are crucial stakeholders in understanding the unique expertise service users bring. Implications for Practice: Service users being central to all aspects of mental health services requires their active participation in the education of health professionals. Nurse academics have an important role in realising this goal. [ABSTRACT FROM AUTHOR]

Introduction: Professional identity is a multifaceted conceptual term combining behaviours, knowledge, skills, values, beliefs, contextual and socio-cultural factors with personal and group identity. The historical underpinning of occupational therapy is partly attributed to the difficulties occupational therapists face articulating their unique identity and the profession being misunderstood by others. Little is known about how occupational therapists working in community physical health settings experience their professional identity. Method: Interpretative phenomenological analysis was used to understand how five occupational therapists interpreted and made sense of their experiences of professional identity working in community UK physical health settings. Interviews were carried out following social media recruitment and analysed using interpretative phenomenological analysis guidance. Findings: Participants identified that their professional identity was forged through experiences over time developing skills, confidence and their inner understanding of who they were as an occupational therapists. Maintaining a secure professional identity was attributed to building their community of practice and creating a sense of belonging. Conclusion: Professional identity was forged through time and experience of 'doing', 'being' and 'becoming' occupational therapists. Building a community of practice and creating a sense of 'belonging' were key components of how these occupational therapists working in community physical health roles sustained their professional identity. [ABSTRACT FROM AUTHOR]

Genome sequencing (GS) has the potential to reduce the "diagnostic odyssey" that many parents of children with rare undiagnosed conditions experience. While much research has considered the impact of receiving a diagnostic result, research has rarely focused solely on the impact of receiving a "no primary finding" (NPF) result. This study aimed to investigate the experience of parents of children with rare and undiagnosed conditions following an NPF result from GS. Nine parents whose child had an NPF result from GS were recruited through the social media platform of the charity SWAN (Syndromes Without A Name) UK. Semi‐structured telephone interviews were conducted, transcribed verbatim, and analyzed using grounded theory. Analysis led to the emergence of two main themes. The first theme "Striving to Solve the Unsolved Puzzle" concerned the experience of striving to end the "diagnostic odyssey." The second theme "Navigating Hope, Lost then Found" plots the trajectory of hope raised by the promise of a new technology, dashed by the NPF, and the eventual return of small and distant hope for the future. Taken together, these themes allowed for a proposed theory: "The Disequilibrium of Hope," which highlights the dynamic and modifiable experience of hope participants experience in their GS journey. These results suggest GS can be an emotional rollercoaster for parents. While hope plays an important role in coping with the day‐to‐day life of living with a rare disease, careful management of expectations from GS is important during pre‐test counseling, and continued follow‐up and support are needed beyond result disclosure. An understanding of the disappointment and distress caused by an NPF result is valuable for healthcare professionals in this field to ensure counseling can be tailored. Further research should consider how to support parents after an NPF result. [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]

Background: The OPEN feasibility trial testing olanzapine in anorexia nervosa (AN) in young people (YP) was not successful due to poor recruitment. This study aims to understand clinicians' views and experiences of using olanzapine in AN and the challenges in implementing the trial in National Health Service (NHS) clinical settings. Methods: We conducted qualitative interviews with eating disorders (ED) clinicians involved with the study (n = 11). Framework analysis was applied to qualitative data to identify barriers and facilitators to recruitment and study implementation. A web-based semi-structured Qualtrics survey was administered to ED clinicians (n = 24). Findings from the survey were used to corroborate and expand on the information derived from qualitative interviews. Results: Qualitative analysis identified four main themes: (1) Acknowledging Service User (SU) / Family Concerns, (2) Prioritising person-centred care, (3) Limited Service Capacity and (4) Study eligibility criteria. Subthemes are outlined accordingly. Clinicians appeared confident addressing SU concerns around olanzapine in clinical discussions, but timing was critical, and olanzapine was considered one aspect of treatment that needed to align with their holistic approach. Service pressures restricted opportunities for recruitment and the ability to offer regular review. At the same time, some YP were ineligible for the trial, as they were already taking olanzapine, or needed to be prescribed it more promptly than the study procedures allowed. Survey findings underlined confidence in prescribing and informing on olanzapine, the various possible benefits of olanzapine besides weight gain, and the importance of therapeutic alliances and informed consent. Both data sets highlight the need for further evidence on long-term safety, side effects and efficacy of olanzapine use for AN. Where clinical service capacity is at a premium, research implementation is not prioritised, particularly in intensive clinical settings. Conclusions: Findings provide first-hand insight into individual and systemic challenges with research implementation in the NHS, which need to be considered when designing future clinical research studies. We emphasise a person-centred approach when discussing olanzapine to consider a holistic recovery from AN beyond weight-gain as an isolated outcome for improvement. Plain English summary: Although olanzapine, an atypical antipsychotic medication, is commonly used in eating disorder services across the world, it is not currently recommended by clinical guidelines in the United Kingdom. We interviewed clinicians working in eating disorder services that took part in a research study looking at olanzapine for young people with anorexia nervosa (AN), and published a survey asking clinicians about their experiences with and views on using olanzapine for AN. The lack of official long-term evidence concerned both clinicians and services users (SU)s. Many clinicians suggested that people with AN might be fearful of weight-gain as a side effect from olanzapine and therefore declined to take part in the study. Having a good relationship built on trust and consistency was deemed very important by clinicians to talk about medication and to provide good health care that focuses on the needs of SUs. Clinicians explained that it was a challenge to introduce the study to SUs in their day-to-day work, as mental health services are increasingly overburdened. Clinicians were also clear that SUs should only be prescribed olanzapine within the study if it was at the right time for them and fitted their treatment pathway. [ABSTRACT FROM AUTHOR]

AbstractPurposeMethodsResultsConclusion\nIMPLICATIONS FOR REHABILITATIONTo understand the breadth of sensory dysregulation on participation in daily tasks for young people with tic disorders, as research identified that sensory dysregulation experiences are broader than the symptoms being assessed.Eighteen semi-structured interviews were conducted with 16 families with children (5–16 years) with tic disorders. Interviews ranged from 45 to 120 min and were transcribed verbatim. Data collected from parents and young people were analysed and coded together. Thematic analysis using inductive and open coding methods was implemented using NVivo.The impact of sensory dysregulation on daily life may be understood through the higher-order theme: ‘‘sensory, emotions and tics; it’s a ticking time bomb’’, and three subthemes: (1) we sacrifice and adapt to get daily activities done in the home, (2) my child’s experience of the community environment hinders participation, and (3) sensory preferences impact our entire family.Sensory dysregulation experiences impact the entire family’s quality of life, yet patient-reported sensory measures do not adequately capture the impact on the family unit and breath of symptoms. A sensory-based measure for children with tics is needed to comprehensively assess sensory dysregulation sensitivities for this population, ensuring patients’ needs and effectiveness of therapy can be measured. This qualitative study provides health professionals with a greater understanding of the sensory dysregulation experiences of children and young people with tic disorders.This study highlights that the sensory dysregulation experiences of children and young people are broader than the symptoms assessed through standardised questionnaires.To comprehensively assess and treat sensory dysregulation in clients with tics, the impact on the family unit needs to be evaluated and understood.When comprehensively assessing sensory dysregulation, understanding the interplay of tics, sensory and emotional dysregulation aids in treatment planning.This qualitative study provides health professionals with a greater understanding of the sensory dysregulation experiences of children and young people with tic disorders.This study highlights that the sensory dysregulation experiences of children and young people are broader than the symptoms assessed through standardised questionnaires.To comprehensively assess and treat sensory dysregulation in clients with tics, the impact on the family unit needs to be evaluated and understood.When comprehensively assessing sensory dysregulation, understanding the interplay of tics, sensory and emotional dysregulation aids in treatment planning. [ABSTRACT FROM AUTHOR]

In this paper, we approach urban belonging as place-based affect to understand how it emerges and evolves in qualitatively different ways through everyday interactions with the city. Moving beyond a narrowly defined and fixed notion of urban belonging as feeling at home in place, we examine diverging feelings about Amsterdam during the early months of the COVID-19 pandemic. Confronted with the abrupt reconfiguration of everyday life, some residents felt a strong sense of contentment in relation to place, while others developed more ambivalent feelings. These ranged from anxious detachment, to disenchantment and even alienation and rejection, raising existential questions about their place in the city that reach beyond the pandemic. We demonstrate how these affective inequalities are grounded in everyday practices and evolve through social and material encounters in domestic and public space. Our findings draw attention to the processual and relational nature of urban belonging, highlighting the affective capacities of the city in everyday life. [ABSTRACT FROM AUTHOR]

ABSTRACT Introduction Aims Methods Results Discussion Implications Depression is a major public health issue, increasing the risk of comorbidities. Some people with depression experience cognitive dysfunction, which can persist even after symptomatic recovery. British South Asians are at greater risk of developing depression and are less likely to seek treatment. It is important to understand their experience of subjective cognitive dysfunction in depression and how best to support them.This study explored subjective experience of cognitive dysfunction during recurrent depression, in a sample of 12 British South Asians aged between 45 and 60 years.We conducted semi‐structured interviews to explore cognitive dysfunction during recurrent depression. We analysed the data using thematic analysis.Difficulties in attention and concentration resulted in lower quality of social relationships, including not feeling present and social isolation. Learning new information was difficult, thus impacting productivity. Participants found it difficult to engage in enjoyable activities that promoted brain health. The emotional, physical and spiritual impact negatively impacted on quality of life.Cognitive strategies used in therapies could improve brain health and functional recovery in people living with depression.Mental health nurses play a pivotal role in providing culturally appropriate information and strategies for managing cognitive dysfunction in recurrent depression. [ABSTRACT FROM AUTHOR]

AbstractChronic pain affects millions of Australians. Despite guidelines recommending non-pharmacological approaches as the first line treatment, opioid medications remain among the most common treatments. This study interviewed consumers and consumer representatives (i.e., representatives of peak pain advocacy organizations in Australia) to gain first-hand perspectives on chronic pain treatment in Australia. Individual semi-structured Key Informant Interviews (KIIs) with three consumers and three representatives were undertaken. Interviews were transcribed, and thematic analysis applied. Results showed that consumers and consumer representatives identified critical treatment access barriers. Another shared theme related to overarching principles of care, with sub-themes pertaining to the need for an interdisciplinary approach and pain education. A further shared theme focused on typical medical interventions, with one shared subtheme regarding the benefits and drawbacks of pain medications. Both groups highlighted the importance of a biopsychosocial approach with consideration of mental health, particularly related to perceived stigma and comorbidities. These findings highlight that chronic pain remains both undertreated and inadequately treated in Australia. There is a critical need to use novel approaches to overcome access barriers and stigma, and to advance precision medicine to match patients to the treatment most likely to be of benefit as early as possible in their journey. [ABSTRACT FROM AUTHOR]

Forced migrants are often presented in public and private discourse from a reductive perspective focusing solely on their vulnerability and their status as refugees, without acknowledging other aspects of their identity and life history. This article investigates how refugee-background participants in qualitative research interviews drew on the chronotopes of home to construct a narrative of origin that foregrounded diverse aspects of their identity and emphasised their lived experiences in a fuller sense. In their narratives, participants contested representations of their home countries and of historical events, as well as representations of themselves, to challenge reductive identity constructions. Further, the narratives suggested that while widely known, mass-mediated chronotopes may assist in initial orientation to a location and event or time period, these generally provide a limited, and sometimes a highly contestable, representation of reality. [ABSTRACT FROM AUTHOR]

PurposeMethodology/approachFindingsResearch implicationsPractical implicationsOriginalityExtensive research has been conducted on cross-cultural comparisons between Eastern and Western organizational cultures in major trading domains. However, there is a lack of examination of intra-comparative management nuances within Asian regions. This research paper focuses on the under-explored topic of the values, beliefs, and attitudes (VBAs) that influence the outcomes of East Asian (e.g. Japan) marketing strategies and operations when implemented in South Asian (e.g. India) markets and organizational contexts. The study aims to analyze the impact of VBAs on marketing effectiveness and provide insights for marketers in cross-cultural settings. The article analyzes the customer satisfaction orientation (CSO) of Japanese business executives and draws insights that offer lessons related to cultural VBAs for overall marketing strategy and foreign investors.The paper employs a social constructivist paradigm and gathers empirical research through multiple interviews. These facilitate novel and normally rare access and insights into Japanese business leaders’ lived experience of CSO in B2B Indian intercultural situations.Interpretivist data analysis reveals several push-pull factors that influence CSO practice. The research identifies shared values such as long-termism and harmony that have the potential to boost CSO as a marketing strategy in India.The paper develops a conceptualization of cultural VBAs that lead to successful CSO practice in India and is of relevance to foreign investors.This study suggests that East Asian marketers should carefully consider the impact of VBAs on their marketing strategies. Our research sheds light on the ongoing discussion on static versus evolving nature of culture and highlights the need to pay attention to cultural change, particularly congruence and confluence in workplace values.The intercultural study contributes to the literature on international marketing strategy by highlighting the nature and importance of understanding traditional and evolving cultural VBAs for appreciating receptivity to adoption and thereby efficacy of home country marketing strategy. [ABSTRACT FROM AUTHOR]

ABSTRACT Ketamine treatment has shown promising effects for different mental disorders. Yet, little is known on how people who receive ketamine for a psychiatric problem subjectively experience undergoing this intervention. We conducted a systematic literature search to identify relevant qualitative research on the first‐person experience of undergoing ketamine treatment in a psychiatric context. 24 eligible studies were identified and analysed using a thematic meta‐synthesis approach. Three main themes were identified. First, ‘The Ketamine treatment experience can be understood as a three‐stage journey with unique clinical features at each stage’. Second, ‘The subjective experience of acute ketamine treatment is multifaceted and complex’. Third, ‘Ketamine treatment can have different positive effects—but what happens if it does not work?’. In summary, the subjective experience of receiving ketamine treatment for a psychiatric problem can be understood as a journey whereby patients move towards, then undergo, and eventually depart from ketamine. Before treatment, the experiential focus lies on expectations, hopes, and feelings towards the drug. During treatment, the drug's multifaceted psychotropic effects and how they are emotionally appraised become central to experience. Once treatment is finished, the focus is on the presence or absence of clinically relevant effects. The conceptual framework we propose can guide further qualitative research on this topic and aid mental health professionals to better understand the experience of patients who undergo ketamine treatment for a psychiatric problem. [ABSTRACT FROM AUTHOR]

Emerging legal frameworks in Oregon and Colorado license facilitators to support adults receiving psychedelic services. The current legal frameworks are silent regarding facilitators’ personal experience with psychedelics. An e-Delphi process recruited 36 experts with at least 5 years’ experience facilitating psilocybin experiences in ceremonial settings, indigenous practices, or clinical trials. Respondents completed in-depth, semi-structured qualitative interviews via secure web links. Interviews were recorded, transcribed, and analyzed using Thematic Analysis. Experts with a mean of 15.2 (SD 13.1) years’ experience providing psilocybin services expressed the importance of first-hand experience with psychedelics as a qualification for the emerging workforce. One participant questioned the necessity of personal psychedelic experience. Experts suggested that personal experience may indirectly support high-quality care because it enhances facilitators’ personal wellbeing, and may help facilitators understand the complexity and nature of their clients’ psychedelic experiences. Novel state-legal psychedelic paradigms create a real-world opportunity to assess associations between facilitators’ personal psychedelic experience and the safety and outcomes of psychedelic services. [ABSTRACT FROM AUTHOR]

Purpose: Cognitive fatigue is commonly reported and described as disabling by patients recovering from neurological conditions including stroke. However, cognitive fatigue is usually underdiagnosed among stroke survivors which leads to a lack of specific treatments for this condition. Therefore, the aim of this study was to explore post-stroke cognitive fatigue as it is experienced by stroke survivors. Methods: This qualitative research followed the principles of descriptive phenomenology within a constructivist paradigm. Individual semi-structured interviews were conducted with stroke survivors experiencing post-stroke cognitive fatigue recruited through the Heart and Stroke Foundation, the Canadian Partnership for Stroke Recovery, and social media posts. Data were analyzed through inductive content analysis. Results: Eleven stroke survivors participated. The analysis revealed five themes illustrating the experience and descriptions of post-stroke cognitive fatigue: (1) characteristics, (2) aggravating factors, (3) management, (4) effect of cognitive fatigue on daily life, and (5) social awareness and support. Conclusion: This study highlights the complexity of post-stroke cognitive fatigue. Cognitive fatigue becomes more evident after discharge; therefore, clinicians should consistently screen for it and provide proper education to the patients and their carers. IMPLICATIONS FOR REHABILITATION: Cognitive fatigue is a complex phenomenon that can negatively affect the daily life of stroke survivors. Sensory-overloaded environments, emotional distress, poor sleep, and engaging in complex cognitive tasks can trigger post-stroke cognitive fatigue. More education on the concept of cognitive fatigue should be provided to healthcare providers to be able to identify and manage this symptom properly. [ABSTRACT FROM AUTHOR]

Background: Peer workers are people with personal experience of mental distress, employed within mental health services to support others with similar experiences. Research has identified a range of factors that might facilitate or hinder the introduction of new peer worker roles into mental health services. While there is mixed evidence for the effectiveness of peer worker delivered interventions, there are no studies exploring how implementation might be associated with effect. Methods: This was a qualitative comparative case study using data from interviews with 20 peer workers and their five supervisors. Peer workers delivered peer support for discharge from inpatient to community mental health care as part of a randomised controlled trial. In the trial, level of participant engagement with peer support was associated with better outcome (hospital readmission). Study sites with higher levels of engagement also had higher scores on a measure of fidelity to peer support principles. We compared data from sites with contrasting levels of engagement and fidelity using an analytical framework derived from implementation theory. Results: In high engagement-high fidelity sites, there was regular work with clinical teams preparing for working alongside peer workers, and a positive relationship between staff on inpatient wards and peer workers. The supervisor role was well resourced, and delivery of peer support was highly consistent with the intervention manual. In low engagement-low fidelity sites peer workers were employed in not-for-profit organisations to support people using public mental health services and in rural areas. Supervisors faced constrained resources and experienced barriers to joint working between organisations. In these sites, peer workers could experience challenging relationships with ward staff. Issues of geography and capacity limited opportunities for supervision and team-building, impacting consistency of delivery. Conclusions: This study provides clear indication that implementation can impact delivery of peer support, with implications for engagement and, potentially, outcomes of peer worker interventions. Resourcing issues can have knock-on effects on consistency of delivery, alongside challenges of access, authority and relationship with clinical teams, especially where peer workers were employed in not-for-profit organisations. Attention needs to be paid to the impact of geography on implementation. Trial registration: ISRCTN registry number ISRCTN10043328, registered 28 November 2016. [ABSTRACT FROM AUTHOR]

Introduction: There remains a dearth of knowledge concerning the phenomenology of suicidal thoughts, with research focusing on reasons for feeling suicidal rather than their mental expression. While clinical interviews remain the standard phenomenological approach, such exploration of lived experiences may prove challenging for this sensitive topic. As a complementary alternative, the use of naturally-occurring online data is opportune for capturing elaborations on tabooed phenomena. Methods: In this phenomenological study, we present a thematic analysis on lived experiences of suicidal thoughts as spontaneously reported by nonidentified users of a Reddit online board (r/Depression), collecting 668 posts using the search terms "suicidal ideation," "suicidal thoughts," and "suicide." Codes were grouped into descriptive categories summarizing the properties of thoughts, their effects, and their relation to suicide. Then, an interpretative synthesis yielded global themes connecting salient meanings on the experience of suicidal thoughts. Results: With a long-term and recurring nature, thoughts of suicide appear in the form of vivid imagery and daydreaming's, initially bringing relief to adverse feelings but eventually becoming conditioned and all-consuming. Rather than a wonderment, they are experienced as intrusive thoughts by people struggling to make meaning of their occurrence. When conciliating the presence of unwanted thoughts, users express intricate relations to wishing or not to die, as well as varying perceptions of control over actions or fear of suicidal behavior. Discussion: With an innovative application of big qualitative data into phenomenological analysis, this study contributes to an initial characterization of suicidal thoughts, uncovering findings that are not contemplated into current conceptualizations of suicidality. The analysis is limited by a restricted context of posts and unknown demographics, and further research with clinical interviews is warranted for in-depth exploration of suicidal thoughts. [ABSTRACT FROM AUTHOR]

Decisions about the treatment of eating disorders do not occur in a socio-political vacuum. They are shaped by power relations that produce categories of risk and determine who is worthy of care. This impacts who gets access to care and recognition of rights in mental health services. Globally, there are calls for more human rights-based approaches in mental health services to reduce coercion, improve collaborative decision making and enhance community care. Treating individuals with longstanding, Severe and Enduring Eating Disorders (SEED) or Severe and Enduring Anorexia Nervosa (SE-AN) can be particularly problematic when it involves highly controversial issues such as treatment withdrawal and end-of-life decisions and, where legally permissible, medically assisted dying. In this article, we argue that the socio-political context in which clinical decision making occurs must be accounted for in these ethical considerations. This encompasses considerations of how power and resources are distributed, who controls these decisions, who benefits and who is harmed by these decisions, who is excluded from services, and who is marginalised in decision making processes. The article also presents tools for critically reflective practice and collaborative decision-making that can support clinicians in considering power factors in their practice and assisting individuals with longstanding eating disorders, SEED and SE-AN to attain their rights in mental health services. Plain English Summary: Navigating the ethical issues involved in the treatment of longstanding eating disorders, Severe and Enduring Eating Disorders (SEED), and Severe and Enduring Anorexia Nervosa (SE-AN) can be difficult for many clinicians. These include highly controversial issues such as treatment withdrawal, end of life issues, and medically assisted dying. In this article, we argue that the socio-political context in which clinical decision making occurs must be accounted for in these ethical considerations. This encompasses considerations of how power and resources are distributed, who controls these decisions, who benefits and who is harmed by these decisions, who is excluded from services, and who is marginalised in decision making processes. The article also presents tools for critically reflective practice and collaborative decision-making that can support clinicians in considering power factors in their practice and assisting individuals with longstanding eating disorders, SEED and SE-AN to attain their rights in health services. [ABSTRACT FROM AUTHOR]

Research into the risk of anorexia nervosa (AN) has examined twin pairs to further the understanding of the contributions of genetics, trait inheritance, and environmental factors to eating disorder (ED) development. Investigations of twin experiences of EDs have been biologically-based and have not considered the qualitative, phenomenological aspects of twin experiences. A gap in the literature exists regarding understanding of discordant twins with EDs. This research was developed in response, with the aim to deepen understanding of AN in discordant twins and to create novel ideas for further research and testing. The case studies presented in this article provide lived experience insights of two identical discordant twin pairs: one twin pair discordant for longstanding AN and one twin pair discordant for 'atypical' AN (the twin with AN has recovered). The perspectives and experiences of each co-twin (one with AN and one without) explore a number of factors that may have contributed to twin discordance in these cases, and how each twin has responded to the impact of AN in their lives. Through use of first-person accounts in case study presentation, this article centres social justice values of lived experience leadership and involvement in research. This article aims to extend current knowledge and understanding of EDs in discordant twins, particularly regarding risk for ED development, ED duration, diagnosis and treatment, and recovery processes. [ABSTRACT FROM AUTHOR]

ABSTRACT Borderline personality disorder (BPD) is often perceived as being more common in females, since women are more likely to seek help and be diagnosed. However, epidemiological studies have reported no sex differences in community prevalence. The purpose of this study was to learn from the narrative journeys of men who have received a diagnosis of BPD. Eight men participated, mean age 45.9 years (range 27–73 years). Recruitment was through clinician referrals at the study site and via social media and website advertising. Participants consented to a 60–90‐min semi‐structured interview via an audio‐visual digital platform. Audio recordings were transcribed and analysed using Interpretative Phenomenological Analysis (IPA). Three themes were identified: (i) The Emergence of Symptoms, (ii) Reaching Crisis Point and (iii) Receiving a Diagnosis. Participants reported many adverse experiences during childhood and adolescence. Early symptoms were often exacerbated by emotionally invalidating caregiving. Participants reported seeking mental health support only after reaching a crisis point, which often arose following an employment‐related stressor. Participants typically initiated help‐seeking by consulting a General Practitioner. Long delays were reported from initial help‐seeking to being diagnosed with BPD; all expressed relief upon diagnosis. The findings highlight the deleterious consequences of emotional invalidation in participants' mental health and their capacity to access timely support. General Practitioners play a critical role in identifying probable symptoms of BPD in men and are the gateway to referral to psychiatrists and psychologists. It is vital that education is provided to assist their important work. [ABSTRACT FROM AUTHOR]

Introduction: A growing number of children have developmental delay (DD) or intellectual and developmental disabilities (IDD), and early intervention (EI) can improve their developmental trajectory. However, access to EI is fraught with disparities. This article describes the development of Parent Navigator (PN) program that placed three parents with lived experience in a pediatric medical home to serve as community health workers to provide support to families with a child with DD or IDD to access EI and other needed resources. Method: We used a mixed-methods approach to program evaluation that included (a) documenting the number of referrals to the EI programs made by the PNs; (b) documenting referral outcomes; (c) conducting a physician satisfaction survey; and (d) interviewing the PNs to reflect on their experiences assisting families. Results: From July 2018 to September 2020, our PNs facilitated 623 referrals to EI due to significant developmental concerns found during a pediatric visit. Rates of successful connection to EI were 71%. Survey results indicated that pediatricians felt the PNs were a valuable part of the healthcare team and helped reduce their own job stress. The PNs provided multiple examples of their methods of addressing barriers to EI access by relating to families with their own lived experience and by "meeting families where they are at." Discussion: The PN program might be a successful approach to addressing disparities in EI access for families in need by using an innovative method of employing individuals with lived experience in the pediatric primary care setting. Public Significance Statement: This study discusses a Parent Navigator program that was implemented in a pediatric primary care clinic to help connect families of children with developmental delays or disabilities to early intervention and other needed services. The Parent Navigators contributed their lived experience of having a children with a developmental disability and played an important roll in improving access to services for children with developmental concerns. This could be a useful model to replicate in other settings. [ABSTRACT FROM AUTHOR]

Background: Psychosis is a condition which often starts early in life and leaves a significant mark on a young person's life. It is usually regarded and discussed from a professional point of view. This study sheds light on the lived experiences of young adults who go through a process of developing their first episode of psychosis. Methods: Interviews were carried out with 10 young adults, aged 19–32 years, 3–12 months after contact with an early detection team for psychosis and were diagnosed as having had a first episode of psychosis. Through a reflexive team-based method, data were put through a preliminary analysis and analyzed line-by-line. Results: We developed three main themes: 1) "A stressful life situation", which refers to the period before the psychotic experience. 2) "A peculiar feeling" to describe the psychotic experience, and 3) "Redefining the meaning of psychosis", which points to how developing psychosis was understood in hindsight. Discussion: We discuss how early labeling and stigma may impact the young adults' meaning-making processes. Moreover, we question the conventional psycho-educational approach and call for a more open and dialogical way to interact with young adults who experience and try to make sense of their first episode of psychosis. [ABSTRACT FROM AUTHOR]

Hermeneutic phenomenology's aim is to bring forth that which needs to be thought about. It is an invitation to think. To articulate thinking, one needs to listen in the corners and the shadows of the lived experience(s) of the phenomenon being investigated. The method simultaneously holds numerous perspectives and adopts an embodied approach to embracing experiential knowledge. This paper explores the power of hermeneutical phenomenology, as a methodological approach for understanding what it means to be intersex. Intersex people have bodies that are born different to typical male-female ones. Intersex is an umbrella term that includes more than thirty ways the human body may differ according to its sex characteristics (i.e., genitalia, hormones, chromosomes, sex organs). From interviews with intersex people, we confirm that employing a hermeneutic phenomenological approach did not just answer our research questions, but also became a powerful and empowering means through which some participants were effectively able to navigate, share and 'own' their personal story. Indeed, the method's person-centred and ethical underpinnings permitted some to engage in the research in ways that became empowering and transformational. [ABSTRACT FROM AUTHOR]

In the Western context of delayed motherhood and declining fertility, an array of fertility enhancements have emerged. While bioethical debates and literature on the technological prowess of these enhancements proliferate, it is useful to explore the lived experience of women undergoing them. This article uses Tabitha Moses' artwork Investment, a series of embroidered hospital gowns, as a vehicle to explore lived experience of women engaging with fertility enhancements, including in vitro fertilisation. This analysis challenges dominant biomedical and corporate discourses framing fertility enhancements as benign. Using constructs of patriarchy, biopower, biopolitics (Foucault), and technobiopower (Haraway), we identify how power over women's bodies is extended through fertility enhancements. Haraway's notion of figuration supports the analysis. Understood as a tropic melding of semiotic and material, the figuration of The Infertile Woman offers a way to explore discursive operations of power and amid them the creation of a new form of reproductive labour. [ABSTRACT FROM AUTHOR]

Working from home (WFH) is a new reality and norm in today's work culture. COVID-induced lockdown introduced the concept of WFH for many people. Blurring home and workplace boundaries was a prominent cause of disorientation in people's lives. Hence, WFH becomes a significant phenomenon to explore as it raises the fundamental question of body and space in shaping people's experiences. To study this, the researchers designed a phenomenological inquiry and examined the lived phenomenon of WFH during the COVID lockdown. Borrowing theoretical concepts from philosophers Martin Heidegger and Merleau-Ponty, they aimed to understand human experiences from an embodied perspective. They interviewed a few adults (age group 27–50) in three urban Indian cities during the first phase of the COVID-19 lockdown. The participants' experiences were transcribed, and Interpretative Phenomenological Analysis (IPA) was conducted. The IPA themes highlighted their varied lived experiences and lifeworld, such as distractions in working from home, their changed routines, habits, and social interaction. The findings are discussed through phenomenological psychology concepts such as embodied cognition, body memory, extended self, shared empathy, intersubjectivity and pre-reflective bodily intelligence in coping. The study's contribution is that it advances a methodological understanding by interpreting people's experiences from a phenomenological view of being-in-the-world in which the individual is not an isolated entity but is in the world/placed in the world with other people and the environment. [ABSTRACT FROM AUTHOR]

Objectives: This study aimed to explore the experiences of women with moderate‐to‐severe mental health difficulties during pregnancy, with a focus on establishing their psychological needs. Psychological distress caused by mental health difficulties during pregnancy is common and can significantly impact women and their babies. However, women's subjective experiences of difficulties with their mental health throughout pregnancy, alongside their experiences of staff, services and treatments are less well understood. Design: In this qualitative study, an Interpretive Phenomenological Analysis (IPA) approach was used. Methods: Semi‐structured interviews were conducted with participants recruited via a regional Perinatal Mental Health Service. Interviews were transcribed and analysed following the IPA methodology. Results: Five superordinate themes were identified which represented the lived experiences of the 11 participants on their journey through pregnancy whilst living with mental health difficulties and subsequent psychological distress: (i) Feeling the 'wrong' feelings, (ii) Societal pressures and a desire for greater acceptance, (iii) Searching for answers despite a lack of resources, (iv) What made a difference and (v) Experiences and expectations of service provision. Within these themes, 13 subordinate themes were also identified. Conclusions: These themes highlight the need for greater awareness and acceptance of mental health difficulties during pregnancy as well as postnatally. While perinatal mental health services are evolving, there is still an urgent requirement for services to continue to develop to meet women's needs, as well as to develop the role of clinicians as facilitators of engagement with needs‐matched care. [ABSTRACT FROM AUTHOR]

This article investigates teachers' lived experiences of an online professional development (OPD) course in Denmark – that is, Teknosofikum – through a hermeneutic phenomenological perspective, and it relies on the interpretive analysis of 15 semi‐structured interviews. The article's contribution focuses on the theme of 'time' and highlights it as a multifaceted construct that plays a relevant role in learning. By relying on the ideas of temporal structuring and multiple temporalities, the article shows that OPD courses and HE teachers' engagement nest themselves into pre‐existing and complex nexus of commitments and duties, each of which has its own temporality and rhythm, along with longer‐term aspirations for pedagogical development. As time emerged as a relevant aspect characterizing OPD course design and HE teachers' experiences, the article provides simple recommendations for 'time‐aware' OPD courses. [ABSTRACT FROM AUTHOR]

In education, there is a risk that joy in learning is counteracted by allowing a performance culture to dominate. Research shows that emotions are of great importance for results, motivation and well‐being. This study aims to add knowledge about the essential meanings of joy in learning based on students' lived experiences and thereby implications for the learning environment. The essence of the phenomenon of joy in learning has been formulated through descriptive phenomenological analysis. Qualitative data consists of 25 narratives from students engaged in voluntary forms of education. The study shows that joy in learning emerges throughout the learning process, when students discover that they gain knowledge, understand and can control their learning process and achieve something with their knowledge. The implications for teaching involve awareness of the learning process providing a balance between structure, support, challenge and personal choice which was valued along with relationships that contribute to autonomy. [ABSTRACT FROM AUTHOR]

Literature regarding trans and gender diverse (TGD) prisoners' experiences of prison custody is limited. Reviewing international literature enables a better understanding of these experiences and how effectively TGD policies are implemented. This systematic review employed PRISMA and ENTREQ guidelines to enhance transparency in reporting the synthesis of qualitative and mixed‐methods research. Seventeen papers were included and through meta‐ethnographic synthesis three overarching themes emerged: structural, interpersonal and intrapersonal. Recommendations include reducing reliance on survival strategies by TGD prisoners through implementation of policies which meet TGD prisoners' needs and to enabling better informed decision making regarding housing. Further research into lived experiences would allow for a better understanding of what currently works, how services could be improved, and identify potential training needs. [ABSTRACT FROM AUTHOR]

Background: Documented inequalities in access to eye care for people with learning disabilities and/or autism are caused by poor uptake of primary eye care services, poor identification of eye problems, lack of signposting and reasonable adjustments of existing services, concerns about costs of care and the low priority historically given to these issues in eye care policy at a regional and national level. In 2019, the charity SeeAbility employed four eye care champions (ECCs) with lived experience of learning disability and/or autism to work in local communities in London and the Northwest of England. They provided peer‐to‐peer support on understanding the need for good eye health and engaged with policy makers, and learning disability, autism and eye care professionals at the local, regional and national levels to influence both the clinical practice of individual practitioners (within existing service/pathway models) and more widely to influence the commissioning of the Easy Eye Care pathway. This study explores the experiences of these ECCs. Methods: The study was conducted in April and May 2023. A case study approach was used to describe the experiences of the ECCs from March 2019 to March 2023. Data from structured interviews with the four ECCs and workload analysis were triangulated to provide a multifaceted understanding of this novel health promotion project. Findings: The ECCs found the role useful and reported that confidence in their practice and impact grew with time but they required ongoing support in the role. A good understanding of the promotional messages was reported. Developing a good network of contacts at an early stage, both people with learning disabilities and healthcare professionals, was key. Relationships with professionals were supportive and positive and a positive emotive response to their lived experience was reported in these interactions. Conclusions: From the perspective of the ECCs, the role is useful and beneficial. The work suggests some key recommendations for future development which include planning to build networks, support in presentation and communications skills and defining key messages and knowledge. Confidence of the ECCs builds with time in the role but also needs support the emotive impact of their lived experiences on audiences is highlighted. There is a need to evaluate how the programme is perceived by those who interact with it and how it changes behaviours which leads to better health outcomes. Accessible Summaries: People with learning disabilities are 10 times more likely than other people to have a problem with their eyes but less likely to get the eye care they need.This paper explains how people with a learning disability and/or autism are employed to tell other people with learning disabilities and/or autism, their supporters, health and care professionals and people who plan services about how important it is to get regular eye care. This job is an 'Eye Care Champion'.We share what the eye care champions did in their role, what worked well and what did not.We discuss how what we have learnt can help other people with learning disabilities and/or autism work as eye care champions and perhaps as champions for other areas of healthcare. [ABSTRACT FROM AUTHOR]