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Objective: Childhood obesity is a public health challenge with health, economic and psychosocial consequences. The design of interventions addressing childhood obesity seldom considers children's perspectives on the topic. Weiner's causal attribution framework was used to explore children's perspectives on enablers of obesity. Methods and measures: Children (N = 277) responded to a vignette with an open-ended question. Data were analyzed using content analysis. Results: Children perceived internal, unstable and controllable causes (e.g. dietary intake, self-regulation and emotionality) as the main enablers (76.53%) of obesity, while some (11.91%) highlighted external, unstable and controllable causes (e.g. parent food restrictions). A focus on children with healthy body weight showed that they mentioned more internal, stable and controllable causes for obesity than children with unhealthy body weight/obesity did. The latter mentioned more external, unstable and controllable causes than their counterparts. Conclusions: Understanding children's causal attributions for obesity is expected to deepen our knowledge of obesity enablers and help design interventions matching children's perspectives. [ABSTRACT FROM AUTHOR]

Hypertension poses a critical threat to health in India, being the predominant risk factor for mortality and disability. With over 70% of outpatient care being provided by the private sector, our study investigated the practices and incentives of private health providers in screening, diagnosing, treating, monitoring, and counseling hypertension patients in rural and peri-urban India. Conducted from April 2020 to February 2021, the qualitative study involved 46 participants, including various healthcare professionals and patients in three Telangana state districts. Analysis revealed a lack of recognition of hypertension’s gravity among private providers in these areas, leading to inconsistent screening practices and varied diagnostic thresholds, particularly among rural medical practitioners. Both formal and informal providers lacked standardized protocols and follow-up mechanisms, with limited technical knowledge about hypertension observed, especially among rural practitioners who were often the first point of contact. Drug effectiveness, and incentives from pharmaceutical sales representatives influenced prescribing practices. Diagnostic labs also offered financial incentives for patient referrals. Thus, aligning providers’ objectives with patient preferences and public health goals is crucial. To encourage evidence-based hypertension care, the government and NGOs could implement strategies such as tailored incentives, financial rewards, tax benefits, accreditation, and recognition for private healthcare providers. Professional bodies in the private sector should establish programs emphasizing quality assurance and certifications. Future research should focus on designing and testing new models for private sector hypertension service delivery, coupled with targeted interventions to enhance care in rural and peri-urban settings. [ABSTRACT FROM AUTHOR]

Dental implant education is required to prepare students for independent general practice. This investigation aimed to assess students' perceptions of their educational experience and training in a preclinical dental implant introduction course, using reflective logs anonymously extracted from course portfolios. Methods: This study employed qualitative research methodology to analyze second-year dental students' reflections on their educational and development of psychomotor skills in a preclinical course focusing on dental implants at the University of Nevada, Las Vegas. These reflections served as the primary data source for qualitative analysis. The analysis was facilitated using NVivo software version 12 plus, which assisted in data coding and the organization of these codes into meaningful units, patterns, and themes. Results: Four themes emerged, which interrelated to each other and to the research question. Students reported positive course outcomes in dental implant learning, improvements in applying theoretical implant knowledge while developing practical skills, digitally scanning implant cases for the final restoration, and enhancement of their insight in evidence-based restoratively driven implant planning. They generally found the hands-on experience to have improved their understanding of the dental implant as an option for restoration. Although there were challenges, students viewed these as learning opportunities. For us, as educators, it provided invaluable feedback to understand students' perceptions of difficulties in knowledge acquisition and psychomotor skill development in placing and restoring dental implants. Conclusions: Within the limitation of this study, students expressed a positive perception of their learning experience in the introductory course on dental implants. [ABSTRACT FROM AUTHOR]

Abstract Hypertension poses a critical threat to health in India, being the predominant risk factor for mortality and disability. With over 70% of outpatient care being provided by the private sector, our study investigated the practices and incentives of private health providers in screening, diagnosing, treating, monitoring, and counseling hypertension patients in rural and peri-urban India. Conducted from April 2020 to February 2021, the qualitative study involved 46 participants, including various healthcare professionals and patients in three Telangana state districts. Analysis revealed a lack of recognition of hypertension’s gravity among private providers in these areas, leading to inconsistent screening practices and varied diagnostic thresholds, particularly among rural medical practitioners. Both formal and informal providers lacked standardized protocols and follow-up mechanisms, with limited technical knowledge about hypertension observed, especially among rural practitioners who were often the first point of contact. Drug effectiveness, and incentives from pharmaceutical sales representatives influenced prescribing practices. Diagnostic labs also offered financial incentives for patient referrals. Thus, aligning providers’ objectives with patient preferences and public health goals is crucial. To encourage evidence-based hypertension care, the government and NGOs could implement strategies such as tailored incentives, financial rewards, tax benefits, accreditation, and recognition for private healthcare providers. Professional bodies in the private sector should establish programs emphasizing quality assurance and certifications. Future research should focus on designing and testing new models for private sector hypertension service delivery, coupled with targeted interventions to enhance care in rural and peri-urban settings.

Ziyad F Al Nufaiei,1,2 Reem H Alluhibi,1,2 Mashael B Alsabiti,1,2 Haya Onaybisi,1,2 Lama M Alahmadi,1,2 Shatha A Jabal,1,2 Raid M Al Zhranei1,2 1Respiratory Therapy Department, College of Applied Medical Sciences, King Saud bin Abdulaziz University for Health Sciences, Jeddah, Saudi Arabia; 2King Abdullah International Medical Research Center, Jeddah, Saudi ArabiaCorrespondence: Ziyad F Al Nufaiei, Department of Respiratory Therapy College of Applied Medical Sciences-Jeddah King Saud bin Abdulaziz University for Health Sciences, P.O.Box.9515, Mail Code 6610, Jeddah, 21423, Saudi Arabia, Tel +966551600060 Ext 46125, Email nufaieiz@ksau-hs.edu.saBackground: Obstructive sleep apnea (OSA), if left untreated, can have major negative effects on health, such as an elevated risk of diabetes, heart disease, and stroke. Increasing people’s knowledge of this illness might lessen the stigma associated with sleep problems and motivate them to get treatment if they think they might have OSA.Aim of the Study: This study aims to assess the knowledge and awareness of OSA among patients’ families in Saudi Arabia.Methods: A phenomenological-oriented study with in-depth interviews was used to collect data from 28 participants.Results: Two themes and subthemes emerged from the interviews, revealing significant knowledge gaps, especially regarding the health risks and management of OSA. Only a few participants were aware of the serious health implications of untreated OSA. Furthermore, many did not know about effective management strategies for OSA.Conclusion: The level of awareness and knowledge among participants was poor, with participants’ lifestyles significantly affected by having relatives with OSA. They expressed concerns about challenges with CPAP adherence and recommended various coping techniques to support affected individuals.Keywords: obstructive sleep apnea, lifestyles, knowledge & awareness, qualitative design, snoring, health literacy

There are well-established rules and methods about sample size estimation in quantitative research approaches. However, qualitative research approaches justify very little about sample size estimation principles and largely depend on subjective judgements and arbitrariness. Contrarily, an adequate sample size is essential for a study to address the core elements of validity and credibility in qualitative research too such as rigor, trustworthiness, conformability and acceptance. Therefore, this review was carried out to explain the available methods to estimate sample size for qualitative studies. After conducting a thorough literature review, we discovered related articles that explore the estimation of sample size for qualitative studies. By examining these findings and integrating the information with our personal experience for estimation of sample size in the field of qualitative studies, we have produced an all-encompassing narrative review. After an in-depth literature search, four different approaches were described in this paper to answer the question of how to estimate sample size in qualitative studies. The four approaches described in this paper are (a) rules of thumb, (b) conceptual models, (c) concept of saturation and (d) statistics-based methods for sample size estimation in qualitative research. The paper presents four methods for estimating sample size in qualitative studies and simplifies the statistical approach for saturation calculation in qualitative studies. Yet, it is vital to responsibly integrate these methods, acknowledging their limitations and maintaining the importance of sample size estimation in qualitative studies.

The growing number of older individuals with complex needs and chronic illnesses is a major challenge to the health sector. This has led to a transfer of responsibilities from specialist to the primary healthcare sector. The aim of the study was to explore how healthcare professionals experience setting up and operating a municipal acute bed unit (MAU) in primary healthcare. Three focus groups of health professionals were recruited through purposeful sampling in 2019, and the 10 participants came from different professions. The study has a qualitative design with a hermeneutic approach. The findings identified three themes: (a) Strategic planning and coordinated services, (b) collaborative practice and learning and (c) flexible and family-centred care. The healthcare personnel experienced strengthened quality in the health services, improved work processes and increased safety for patients with relevant diagnoses. The interplay between internal and external factors seems to have been a successful innovation in planning and implementing an MAU in a medical facility in Mid-Norway. We assessed that being prepared for challenges is an important part of innovation in health services. The presence of an 'inherent capital' to meet unforeseen challenges in the future should be a prerequisite for innovation. [ABSTRACT FROM AUTHOR]

This study examines a science teacher's pedagogical content knowledge during instruction on the topics work and energy, simple machines, and friction force in a gifted class. The research adopts a single case study approach, employing qualitative methods. The participant is a middle school science teacher, and data collection tools include interviews, observations, card-sorting activities, and lesson plans. The study's data were analyzed in an in-depth analysis of explicit PCK. The main findings of the study are: (1) gifted students required additional science practice beyond the scope of the traditional curriculum, (2) the participating teacher encountered challenges when designing and implementing enrichment activities, (3) the characteristics of gifted students positively influenced the development of the teacher's pedagogical content knowledge, and (4) the presence of gifted students prompted a shift in the teacher's science teaching orientation from traditional methods to reform-based practices. Teachers need to have additional knowledge bases or pedagogical content knowledge components. Notably, the research underscores the relevance of the knowledge of enrichment curriculum and knowledge of characteristics of gifted students in the training of science teachers, along with the crucial role of STO in the education of gifted students, especially in the context of teaching physics. These findings offer significant implications for the curriculum designed for gifted students, particularly concerning the teaching and learning of physics topics. [ABSTRACT FROM AUTHOR]

Background: Advance care planning (ACP) is a process in which adults engage in an ongoing dialogue about future medical treatment and care. Though ACP is recommended to improve the quality of end-of-life care, the details of the dialogue experience in ACP are unknown. Objective: To explore participants' experiences of dialogue in an ACP educational program that encouraged them to discuss the value of a way of life. Research design: This qualitative descriptive study used the focus group interview method. Data were analyzed using qualitative content analysis. Participants and research context: A dialogue-based ACP educational program was conducted in four regions in Japan for local citizens to discuss the value of their way of life. A total of 66 individuals (mean age = 55.5 ± 17.2 years; 50 women and 16 men) participated in focus group interviews. Ethical considerations: This study was approved by the Ethical Review Committee of Tokyo Women's Medical University (no. 4723) and Kyoto University (no. R2099). Findings: Five main themes were extracted: discussing one's thoughts with others in a considerate manner, reflecting on one's way of life through others, feeling a sense of connection with others through storytelling, realizing the difficulties of talking about "what if" topics, and turning one's eyes toward the future through the dialogue. These themes were interrelated and illustrated the complexity of the experience of discussing values. Conclusions: The results suggest that dialogue in ACP is useful in clarifying values. They also indicated the need for dealing with the ethical challenges of discussing value and the importance of caring for the interlocutor to have a safe dialogue. In the ACP process, safety in dialogue may improve readiness in ACP, and health practitioners who support ACP need to address the ethical challenges entailing dialogue about values. [ABSTRACT FROM AUTHOR]

Copyright of Canadian Journal of Education / Revue Canadienne de l'Éducation is the property of Canadian Society for the Study of Education and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Abstract Background Care coordination is crucial to ensure the health of individuals with serious mental illness. The aim of this study was to describe and analyze an inclusive innovation process for coordinating municipal health and care services for individuals with serious mental illness. Methods We conducted café dialogues with professionals and service users with serious mental illness. The café dialogues engaged participants in conversation and knowledge exchange about care coordination, adressing topics of efficiency, challenges, and improvement. We used a responsible innovation framework to analyze the innovation process. Results Responsible coordination requires promoting service users’ health and ensuring communication and mutual awareness between professionals. Individual-level factors supporting responsible coordination included service users knowing their assigned professionals, personalized healthcare services, and access to meaningful activities. Provider-level factors included effective coordination routines, communication, information exchange, and professional familiarity. Results reflect professionals’ and service users’ perspectives on efficient care coordination, existing challenges, and measures to improve care coordination. Conclusion Café dialogues are an inclusive, participatory method that can produce insights into the responsible coordination of municipal health and care services for individuals with serious mental illness. The responsible innovation framework is helpful in identifying care coordination challenges and measures for responsible coordination.

Abstract Background Healthcare professionals (HCPs) are increasingly recommended to play an important role in supporting people with chronic disease in work participation. An intervention for HCPs to provide work-related support to their patients in clinical care was developed with intervention mapping (Maastricht Work-Related Support; Maastricht WRS). Action research proposes ‘combining research and practice’, which allows us to incorporate experiences of HCPs while implementing and to realize intervention’s full potential. Therefore, the aim of this study is to explore, by integrating action research into an intervention mapping approach, how experiences of HCPs with early implementation can be used to optimize the Maastricht WRS in clinical care. Methods Semi-structured interviews were held with nine HCPs (response rate 82%), involved in care for people with inflammatory arthritis, knee problems or inflammatory bowel disease. Some of them were not yet trained in the Maastricht WRS while others had received the training and were providing the Maastricht WRS. Results All participants regarded WRS an important part of clinical care. Untrained HCPs indicated a lack of knowledge and skills in providing the Maastricht WRS, and a need for tools. Trained HCPs were satisfied with the training and tools, but stressed that practical limitations hindered providing the Maastricht WRS. Action research showed that the intervention meets the needs of HCPs, but need some optimizations: (1) organizing ‘intervision’ for HCPs, (2) inform and activate patients to discuss work with their HCP, (3) update initial tools and (4) including patients’ work status in the electronic patient system. Conclusions Action research integrated into intervention mapping proved to improve the Maastricht WRS intervention. By involving HCPs, the intervention could be optimized to provide to support people with chronic diseases in clinical care in healthy and sustainable work participation.

Patient-reported experience measures (PREMs) evaluate children's and young people's (CYP) perceptions of care. An important PREM developed with and for children was created in London, UK. Given the absence of similar North American instruments, we aimed to adapt, translate, and linguistically validate this instrument for use in a Canadian pediatric outpatient setting. A qualitative design was used, involving CYP and their parents/caregivers. Phase 1 entailed the English survey adaptation using think-aloud testing, revision, and cognitive testing. Phase 2 involved translation into French, revision and back-translation, and cognitive testing. Phase 3 encompassed a cross-validation of the English and French versions of the adapted instrument. Fifty-five children in 3 age groups (8-11y, 12-13y, 14-16y) participated in creating the Canadian PREM. In Phases 1 and 2, 41 children participated in reviewing and updating specific questions in the instrument, resulting in adjustments and revisions based on their feedback. In Phase 3, 14 bilingual children linguistically validated the PREM instrument. This study reports the development of the first Canadian PREM specifically tailored to children. By incorporating the perspectives and preferences of CYP in clinical practice, this approach has the potential to amplify the delivery of patient-centered care for this vulnerable population and ensure that the needs and voices of CYP are acknowledged. V, Therapeutic. [ABSTRACT FROM AUTHOR]

Problem Statement: Despite the desire of disability sport players to be treated equally, they often embody resilience in the face of life-altering trauma. However, the specific contextual factors that influence their emotional experiences remain poorly elucidated, hindering our understanding of their coping mechanisms. Approach: This study uses a novel situational approach to emotional labor, which emphasizes the role of contextual elements - referred to as "emotional inducers" - in shaping emotional experiences in the sports field. Purpose: The aim of this study is to examine the emotional inducers contributing to both positive and negative emotions in an elite badminton player who sustained a skiing accident at the age of 26. Although he was left paraplegic by the accident, he experienced a "second life" in the sports field of elite para badminton. Results: based on a validated procedure of data collection and analysis, emotional inducers of the participant' emotional experience have been highlighted and categorized throughout his life course, allowing to identify: (1) four categories of positive inducers (e.g. Attractiveness of badminton) and three categories of negative inducers (e.g., Compete with other elite players) during the first life period; four categories of positive inducers (e.g. Quick understanding of the accident consequences) and three categories of negative inducers (e.g., Atmosphere of hopital) during the participant's interlife period; six categories of positive inducers (e.g. attractiveness of para badminton) and four categories of negative inducers (e.g., Learning of new physical possibilities) during the second life period. Discussion and conclusions: Highlighting the inducers of the participant's emotional experience throughout his life course from in-depth method allow to feed three highlights associated to three major recommendations for sport psychology practice: (1) Use past positive emotional inducers to strengthen players' resources; (2) Enable Players to Accept Negative Inducers; (3) Connect past and future inducers of positive experiences. [ABSTRACT FROM AUTHOR]

This study investigates how the perceptions of graduate students within a doctoral program in a midsized higher education institution in Southwest Florida evolved over a semester regarding multicultural education and impacted their careers and professional lives. A qualitative case study method was utilized with multiple data sources collected, including interviews, students' written papers, students' presentations, as well as online discussions and assignments that aimed to prepare educational leaders within culturally diverse topics while challenging and impacting their perceptions about diversity, race, cultural, and multicultural education experiences. The findings were that post-doctoral coursework in the area of multicultural education produced three significant themes: (1) false understanding of what multicultural education encompassed, (2) increased awareness of self-biases, lack of resources and training, and (3) finally, a feeling of helplessness where participants want to see transformation but are unable to affect change. [ABSTRACT FROM AUTHOR]

Pediatric burn injuries are a critical medical condition that triggers a series of ongoing multifactorial stressors that affect both children and their families. To inform healthcare research and clinical practice, this study aimed to understand and describe the perceptions and experiences of the parents of burn-injured children during hospital stay. Forty-six parents (thirty-eight mothers) of forty-six children (eighteen girls) with a mean age of 2.28 years (SD = 1.52) answered ten open-ended questions. This qualitative study was conducted in a referral hospital in the northern region of Portugal. Qualitative data were analyzed using an inductive content analysis. Five key themes emerged from the data analysis: diving into the crisis of the child burn injury, being together and in good hands, becoming aware of an uncertain future, enhancing supportive care and environment, and finding ways to guide parents. Qualitative findings underlined the pressing need for integrated care within this context. Parents were significantly burdened and distressed during the inpatient phase. These parents should be included in the integrated care plan starting from admission. Understanding and addressing parents' healthcare needs and psychosocial adjustment difficulties is paramount to the development of future intervention programs and the delivery of suitable integrated healthcare. [ABSTRACT FROM AUTHOR]

Background: Healthcare professionals (HCPs) are increasingly recommended to play an important role in supporting people with chronic disease in work participation. An intervention for HCPs to provide work-related support to their patients in clinical care was developed with intervention mapping (Maastricht Work-Related Support; Maastricht WRS). Action research proposes 'combining research and practice', which allows us to incorporate experiences of HCPs while implementing and to realize intervention's full potential. Therefore, the aim of this study is to explore, by integrating action research into an intervention mapping approach, how experiences of HCPs with early implementation can be used to optimize the Maastricht WRS in clinical care. Methods: Semi-structured interviews were held with nine HCPs (response rate 82%), involved in care for people with inflammatory arthritis, knee problems or inflammatory bowel disease. Some of them were not yet trained in the Maastricht WRS while others had received the training and were providing the Maastricht WRS. Results: All participants regarded WRS an important part of clinical care. Untrained HCPs indicated a lack of knowledge and skills in providing the Maastricht WRS, and a need for tools. Trained HCPs were satisfied with the training and tools, but stressed that practical limitations hindered providing the Maastricht WRS. Action research showed that the intervention meets the needs of HCPs, but need some optimizations: (1) organizing 'intervision' for HCPs, (2) inform and activate patients to discuss work with their HCP, (3) update initial tools and (4) including patients' work status in the electronic patient system. Conclusions: Action research integrated into intervention mapping proved to improve the Maastricht WRS intervention. By involving HCPs, the intervention could be optimized to provide to support people with chronic diseases in clinical care in healthy and sustainable work participation. [ABSTRACT FROM AUTHOR]

Physician-oriented online education could be a pathway to improve care for patients with heart failure, however, it is difficult to measure the impact of such education. Self-efficacy is a potential outcome measure. In this article, we develop a methodology for analyzing an educational intervention for general practitioners (GPs) using self-efficacy as a concept. This study was partly conducted within the setting of an observational study, IMPACT-B, where we developed online education for GPs. We designed and refined a 24-item questionnaire using item analysis, and exploratory and confirmatory factor analysis. Ninety-one GPs completed the questionnaire before and after the online education. Follow-up data after 6 months was available for 13 GPs. Item analysis revealed a high degree of internal consistency (coefficient alpha 0.95) and validity. Each additional year of experience was associated with an average baseline self-efficacy score of 0.50 points (95% CI [0.21-0.80]), and each additional patient in HF follow-up with an average score of 2.0 points (95% CI [0.48-3.5]). Items that differentiated most between GPs with high and low self-efficacy were the treatment of congestion as well as titrating medication and MRA in heart failure with reduced ejection fraction. Factor analysis reduced the number of questions to 14, mapping to three factors (diagnosis, treatment, and follow-up), and improved the model fit as measured by the goodness-of-fit indicator comparative-fit-index (from 0.83 to 0.91). We demonstrated a method to assess the impact of online education on general practitioners. This led to a questionnaire that was reliable, valid, and convenient to use in an implementation context. [ABSTRACT FROM AUTHOR]

Exercises performed at home are called Home-based Exercises. The suspension of classes exposed the learners to home-based exercises. The goal of this study is to explore the ideas and insights of learners on Home-based Exercise. The study utilized Basic Qualitative Research, specifically, Narrative Inquiry to gather the stories of learners. In a semi-structured interview, seven conversation partners participated. The seven conversation partners were chosen using inclusion criteria. The rigorous data analysis and data explication using Creswell's six-step data explication elicited four central themes: (1) The Obstacle: Hindrances in Performing Home-based Exercise, (2) The Push: A way to overcome the Hindrances, (3) The Goal: An Exercise Plan, and (4) The Drive: A motivation to keep going. The findings of this study provided a picture of how learners have coped with the challenges posed by exercising at home. This study carries meaningful data as a reference for future innovation in Home-based Exercise. [ABSTRACT FROM AUTHOR]

Background: The strengths-based approach (SBA) was initially developed for people living with mental health issues but may represent a promising support option for community participation of people living with a traumatic brain injury (TBI). A community-based organisation working with people living with TBI is in the process of adapting this approach to implement it in their organisation. No studies explored an SBA implementation with this population. This study explores the implementation of key components of the SBA in a community-based organisation dedicated to people living with TBI. Methods: A qualitative descriptive design using semi-structured interviews (n = 10) with community workers, before and during implementation, was used. Transcripts were analysed inductively and deductively. Deductive coding was informed by the SBA fidelity scale. Results: Group supervision and mobilisation of personal strengths are key SBA components that were reported as being integrated within practice. These changes led to improved team communication and cohesiveness in and across services, more structured interventions, and greater engagement of clients. No changes were reported regarding the mobilisation of environmental strengths and the provision of individual supervision. Conclusion: The implementation of the SBA had positive impacts on the community-based organisation. This suggests that it is valuable to implement an adaptation of the SBA for people living with TBI. This descriptive qualitative study explores the perceived changes within a community-based organisation following the implementation of a strength-based approach for people living with the sequela of a traumatic brain injury. Positive changes resulting from the implementation process were revealed through semi-structured interviews with community support workers of the organisation. [ABSTRACT FROM AUTHOR]

(1) Background: the scientific literature has shown that students' active involvement in the teaching–learning process significantly improves their learning outcomes. (2) Methods: this study shows the perceptions of seven researchers on the process of inquiring about the effects of the combined use of virtual reality (VR) and a practice teaching style in physical education in secondary educational institutions. (3) Results: the results obtained from the researchers' diaries and the focus group, through qualitative design, are arranged in the following categories: difficulties in data collection before, during, and after the intervention; perceived differences between VR interventions in laboratory situations and educational contexts; and the perceived transferability of the use of VR devices in the educational context. (4) Conclusions: more research is needed on the use of VR in the educational context, although the results obtained indicate that the teaching–learning process can be enriched by overcoming the difficulties inherent to the use of this technology in a variable context such as education. [ABSTRACT FROM AUTHOR]

BackgroundType 2 diabetes(T2DM) is a global health problem which is accompanied with multi-systemic complications, and associated with long-term health burden and economic burden. Effective health seeking behavior (HSB) refers to reasonably utilize health resources, effectively prevent and treat diseases, and maintain health. Effective health seeking behavior (HSB) is vital to mitigate the risk of T2DM complications. However, health seeking behavior for T2DM patients remains sub-optimal worldwide.ObjectiveThe study aimed to explore the internal logic of how health seeking behavior of T2DM patients develops and the influencing factors of health seeking behavior. With a view to provide a reference basis for improving the health seeking behavior situation of T2DM patients.MethodsThis study was conducted at an integrated tertiary hospital in China. People who were diagnosed with T2DM, capable of expressing clearly and had no mental illness, were approached based on a purposive sampling. The experience of T2DM and health seeking behavior were collected via in-depth interviews. A theory-driven thematic analysis based on Health Belief Model (HBM) was applied for data analysis. Inductive reasoning was used to identify emerging themes which were not included in HBM.Results26 patients with T2DM were included in the current study. Seven themes were identified, including: (1) T2DM diagnosis and severity; (2) T2DM treatment and management; (3) Perceived susceptibility of diabetes progression; (4) Perceived severity of diabetes progression; (5) Perceived benefits of health seeking behavior; (6) Perceived barriers of health seeking behavior; (7) Perception of behavioral cues. Generally, patients with T2DM lacked reliable sources of information, considered T2DM to be slow-progressing and without posing an immediate threat to life. Consequently, they did not fully grasp the long-term risks associated with T2DM or the protective effects of health seeking behavior.ConclusionThis study highlighted the challenges in health seeking behavior for patients with T2DM. It suggested that future interventions and strategies should involve multi-faceted approaches, targeting healthcare providers (HCPs), patients with T2DM, and their support networks. This comprehensive strategy can help patients better understand their condition and the importance of effective health seeking behavior. Ultimately, enhancing their capacity for adopting appropriate health-seeking practices.

Abstract Background In advanced clinical learning labs on campus, high-fidelity simulation has become an essential educational approach in the Bachelor of Nursing Education programme. However, simulation while in clinical placement, in situ, is rarely used in Bachelor of Nursing Education. The aim of the present study was to explore how in situ simulation training at a surgical hospital ward, according to Bachelor of Nursing students, influenced their learning and development process. Methods A qualitative descriptive study was conducted. Data were collected through individual interviews with a sample of 21 s-year Bachelor of Nursing students who completed 40 in situ simulations during their eight-week clinical placement at a Norwegian University Hospital. Data were analysed using inductive content analysis. Results The data analysis generated six subcategories constituting two descriptive categories: building professional confidence and internalising nursing knowledge. Although the students found in situ simulation stressful and uncomfortable for being assessed by student peers, the teacher and preceptor, the process of managing clinical situations in simulation helped build professional confidence. What the students had learned in the simulation was directly transferable to real clinical situations because they were in the hospital setting. The simulation sessions enabled them to connect theoretical knowledge and clinical skills. They could test their skills in a safe environment, performing procedures that made them aware of how their knowledge could be used in real life. Conclusion According to the Bachelor of Nursing students’ own experiences, in situ simulation supported the students’ learning process, connected theory and practice and contributed to developing confidence in the performance of clinical skills. Including simulation in clinical practice could prove to be an effective way of teaching and learning clinical skills in nursing regarding resources and learning outcomes.

Dental implant education is required to prepare students for independent general practice. This investigation aimed to assess students’ perceptions of their educational experience and training in a preclinical dental implant introduction course, using reflective logs anonymously extracted from course portfolios. Methods: This study employed qualitative research methodology to analyze second-year dental students’ reflections on their educational and development of psychomotor skills in a preclinical course focusing on dental implants at the University of Nevada, Las Vegas. These reflections served as the primary data source for qualitative analysis. The analysis was facilitated using NVivo software version 12 plus, which assisted in data coding and the organization of these codes into meaningful units, patterns, and themes. Results: Four themes emerged, which interrelated to each other and to the research question. Students reported positive course outcomes in dental implant learning, improvements in applying theoretical implant knowledge while developing practical skills, digitally scanning implant cases for the final restoration, and enhancement of their insight in evidence-based restoratively driven implant planning. They generally found the hands-on experience to have improved their understanding of the dental implant as an option for restoration. Although there were challenges, students viewed these as learning opportunities. For us, as educators, it provided invaluable feedback to understand students’ perceptions of difficulties in knowledge acquisition and psychomotor skill development in placing and restoring dental implants. Conclusions: Within the limitation of this study, students expressed a positive perception of their learning experience in the introductory course on dental implants.

Background: In advanced clinical learning labs on campus, high-fidelity simulation has become an essential educational approach in the Bachelor of Nursing Education programme. However, simulation while in clinical placement, in situ, is rarely used in Bachelor of Nursing Education. The aim of the present study was to explore how in situ simulation training at a surgical hospital ward, according to Bachelor of Nursing students, influenced their learning and development process. Methods: A qualitative descriptive study was conducted. Data were collected through individual interviews with a sample of 21 s-year Bachelor of Nursing students who completed 40 in situ simulations during their eight-week clinical placement at a Norwegian University Hospital. Data were analysed using inductive content analysis. Results: The data analysis generated six subcategories constituting two descriptive categories: building professional confidence and internalising nursing knowledge. Although the students found in situ simulation stressful and uncomfortable for being assessed by student peers, the teacher and preceptor, the process of managing clinical situations in simulation helped build professional confidence. What the students had learned in the simulation was directly transferable to real clinical situations because they were in the hospital setting. The simulation sessions enabled them to connect theoretical knowledge and clinical skills. They could test their skills in a safe environment, performing procedures that made them aware of how their knowledge could be used in real life. Conclusion: According to the Bachelor of Nursing students' own experiences, in situ simulation supported the students' learning process, connected theory and practice and contributed to developing confidence in the performance of clinical skills. Including simulation in clinical practice could prove to be an effective way of teaching and learning clinical skills in nursing regarding resources and learning outcomes. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this study was to understand how spousal caregivers of people with amyotrophic lateral sclerosis and cognitive and/or behavioural impairments felt about the EMBRACE intervention. Materials and methods: A qualitative interpretive study, using individual semi-structured interviews pre- and post-participation in a palliative rehabilitation blended learning programme, was applied. In total, 13 spousal caregivers were interviewed pre-intervention and 10 of them post-intervention. Results: Three overarching themes were identified: Striving to Obtain Control in Everyday Life, Peer support Across the Illness Trajectory and The Complexity of Relations. Information provided in targeted videos and sharing experiences with peers in virtual group meetings were beneficial to comprehend, manage and find meaning in everyday challenges related to being a caregiver. Conclusion: The EMBRACE intervention helped spousal caregivers cope with everyday needs and challenges related to being a caregiver. EMBRACE was found to support and strengthen the participants in gaining more control in everyday life, creating a sense of coherence. Through targeted videos and discussions with peers, the participants felt prepared for the illness trajectory of their relative. Peer support promoted resilient functioning and reduced their feelings of loneliness. Clinical trial registration: This study was registered on clinicaltrials.gov under the name: A Complex Intervention Study on a Palliative Rehabilitation Blended Learning Programme to Support Relatives and Health Care Providers of People with ALS and Cognitive Impairments in Coping with Challenges. ID no. NCT04638608. URL: https://clinicaltrials.gov/ct2/results?cond=&term=NCT04638608&cntry=&state=&city=&dist=. [ABSTRACT FROM AUTHOR]

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

Copyright of Journal of Yüzüncü Yıl University, Faculty of Education is the property of Yuzuncu Yil University, Faculty of Education and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Croatian Review of Rehabilitation Research / Hrvatska Revija za Rehabilitacijska Istraživanja is the property of Croatian Review of Rehabilitation Research and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Aim: To define the missed care experiences of nurses exposed to verbal violence from patients. Background: Verbal violence takes the first place among the types of violence that nurses face in healthcare settings. This can cause negative emotional and physical responses in nurses and issues in patient and nurse interaction. As a result, it may lead to missed nursing care, defined as skipped, postponed or incomplete care during the patient's care. Methods: This is a phenomenological study. The study sample included 16 nurses working in inpatient clinics who reported experiencing verbal violence at least once in Turkey. The study was conducted between January and February 2022 with institutional permission and ethics committee approval (09/12/2021‐2021/357). A semi‐structured interview method was used to collect data. The information gathered from the interviews underwent thematic analysis using an inductive approach. The 'Consolidated Criteria for Reporting Qualitative Research (COREQ)' was used to report this qualitative study based on a comprehensive protocol. Results: The types of verbal violence most frequently faced by nurses were determined as swearing, insulting, shouting and threats. Study findings were classified into three main themes: (i) response to verbal violence, (ii) missed nursing care experiences and (iii) suggestions to cope with verbal violence. The most felt emotions in the face of verbal violence were feeling sad, unsafe and worthless. Nurses common behaviours, in response to verbal abuse were ignoring, getting used to, and wishing to get away. The examples of missed care included using non‐therapeutic communication, postponing care or withdrawing from care. Conclusion: Verbal violence caused negative emotional and behavioural responses in nurses, which, in turn, negatively affected the nurse–patient interaction. These findings mean that verbal violence may pave the way for missed nursing care. Implications for nursing policy: According to these findings, an uninterrupted nursing care process needs to focus on preventive measures against verbal violence and increase the administrative and legal support offered to nurses. [ABSTRACT FROM AUTHOR]

Objectives: Extensive research has shown voice hearing to be associated with symptoms of Post‐Traumatic Stress Disorder (PTSD) and dissociation. However, most studies have adopted a quantitative design, using cross‐sectional data sampling methods, precluding temporal relationships between variables from being defined. Design: Using a qualitative design, this study sought to identify potential symptom relationships by addressing the research question: what is the nature of the temporal relationship between voices, dissociation and PTSD symptoms? Methods: Seven voice hearers (aged 27 to 68 years) participated in a semi‐structured interview exploring voice hearing, PTSD symptoms, and dissociation. The interviews were analysed using Interpretative Phenomenological Analysis. Results: One superordinate theme was identified in the data. Voices were observed to occur in dynamic interrelationship with PTSD symptoms and dissociation, and were frequently experienced before and after PTSD symptoms and dissociative episodes. Conclusions: Implications for theoretical understandings of voice hearing and future research are discussed. [ABSTRACT FROM AUTHOR]

Aims and objectives: Oral care is an integrated part of everyday life. Within nursing, barriers related to providing oral care often lead to unmet caring needs. Poor oral care is associated with a risk of respiratory and cardiovascular complications during hospitalisation. Knowledge on patients' perspectives of maintaining or receiving oral care during admissions are limited. Following the Fundamentals of Care (FOC) framework, this study uses a person‐centred approach to explore patients' perceptions and experiences of receiving or performing oral care, including the nursing staff's clinical practices. Methodological design and justification: A focussed ethnographic approach was used to explore patients' perspectives and clinical practices during acute admissions in an Orthopaedic Department. Ethics issues and approval: The local Data Protection Agency and the Ethics Committee approved the study. Research methods, results and conclusions: Data were collected in an Orthopaedic ward at a Copenhagen University hospital, Hvidovre, and consisted of 14 days of field observations of clinical practices and 15 patient interviews. Data were analysed inductively using qualitative content analysis. Two themes were identified. The first, 'The purpose of oral care is defined by the eye of the beholder', describes the social implications for the patients and how patients reject the assumption of oral care being a transgressive act. The second, 'The unspoken need', focus on the lack of dialogue, including the limited provision of oral care and how the nursing staff assesses patients' ability to perform oral care (in)dependently without including the patients. Conclusion: Oral care is related to the patient's psychological and physical well‐being and affects social appearance. When oral care is provided respectfully, patients do not experience oral care as a transgressive act. Nursing staff's self‐assessments of the patients' (in)dependency to perform oral care risk leading to incorrect care. Developing and implementing interventions applicable to the clinical practice is needed. [ABSTRACT FROM AUTHOR]

Abstract Background Individuals with serious mental illness (SMI) are more likely to experience functional decline, low well-being, comorbidities, shorter lifespan, and diminished quality of life than the general population. This qualitative study explores determinants of health that individuals with SMI perceive as important to their health, well-being, and ability to live a meaningful life. Method We conducted interviews with 13 individuals with early detected first episode psychosis as part of a 20-year follow-up study of a larger cohort. Interview data were analyzed using qualitative content analysis. Results Analysis identified two themes comprising eight categories representing determinants of health. The first theme reflected management of mental and physical health. Categories in this theme were: access to mental healthcare adapted to individual needs, strategies during deterioration, use of psychotropic medication, maintenance of physical health and lifestyle. The second theme reflected social health determinants in coping with mental illness and comprised three categories: family and friends, engaging in meaningful hobbies and activities, and the influence of employment on mental health. Conclusions Individuals with SMI outlined mental, physical, and social determinants of health that were important for their health, well-being, and ability to live a meaningful life. In future clinical practice, coordinated care addressing the complexity of health determinants will be important.

Abstract Background Heart failure (HF) is an important health problem and guidelines recommend multidisciplinary management. The pharmacist is an important member of the multidisciplinary heart failure team, both in the hospital and community setting. This study aims to explore the perceptions of community pharmacists on their role in HF care. Methods We conducted a qualitative study based on face-to-face semi-structured interviews with 13 Belgian community pharmacists between September 2020 and December 2020. We used the Qualitative Analysis Guide of Leuven (QUAGOL) method as guidance for data analysis until data saturation was reached. We structured interview content into a thematic matrix. Results We identified two major themes: heart failure management and multidisciplinary management. Pharmacists feel responsible for the pharmacological and non-pharmacological management of heart failure, citing easy access and pharmacological expertise as important assets. Diagnostic uncertainty, lack of knowledge and time, disease complexity and difficulties in communication with patients and informal care providers are barriers to optimal management. General practitioners are the most important partners in multidisciplinary community heart failure management, although pharmacists perceive a lack of appreciation and cooperation and deplore communication difficulties. They feel intrinsically motivated to provide extended pharmaceutical care in HF but cite the lack of financial viability and information sharing structures as important barriers. Conclusion The importance of pharmacist involvement in multidisciplinary heart failure teams is undisputed by Belgian pharmacists, who cite easy access and pharmacological expertise as important assets. They point out several barriers impeding evidence-based pharmacist care for outpatients with heart failure: diagnostic uncertainty and disease complexity, lack of multidisciplinary information technology and insufficient resources. We recommend that future policy should focus on improved medical data exchanges between primary and secondary care electronic health records as well as the reinforcement of interprofessional relationships between locally affiliated pharmacists and general practitioners.

In South African communities, both faith leaders and health care workers play a vital role in supporting the health of community members and people living with HIV in particular. This study describes HIV stigma when faith leaders and health care workers engaged in discourse. The study used a descriptive qualitative inquiry design. Data were gathered between 2015 and 2016 in the areas of Masiphumelele and Gugulethu in Cape Town, South Africa. Three themes emerged: (1) participants identified influences that can increase HIV stigma; (2) participants shared the challenges that they face to reduce HIV stigma; and (3) participants suggested solutions to reduce HIV stigma. Themes discussed include ground-level problems and practical solutions to address HIV stigma in faith communities. Collaboration between faith leaders and health care workers are vital resources in the fight against HIV stigma. Future research and interventions should aim to promote organised collaboration between faith communities and health care structures. [ABSTRACT FROM AUTHOR]

Background: Individuals with serious mental illness (SMI) are more likely to experience functional decline, low well-being, comorbidities, shorter lifespan, and diminished quality of life than the general population. This qualitative study explores determinants of health that individuals with SMI perceive as important to their health, well-being, and ability to live a meaningful life. Method: We conducted interviews with 13 individuals with early detected first episode psychosis as part of a 20-year follow-up study of a larger cohort. Interview data were analyzed using qualitative content analysis. Results: Analysis identified two themes comprising eight categories representing determinants of health. The first theme reflected management of mental and physical health. Categories in this theme were: access to mental healthcare adapted to individual needs, strategies during deterioration, use of psychotropic medication, maintenance of physical health and lifestyle. The second theme reflected social health determinants in coping with mental illness and comprised three categories: family and friends, engaging in meaningful hobbies and activities, and the influence of employment on mental health. Conclusions: Individuals with SMI outlined mental, physical, and social determinants of health that were important for their health, well-being, and ability to live a meaningful life. In future clinical practice, coordinated care addressing the complexity of health determinants will be important. [ABSTRACT FROM AUTHOR]

Aim: To explore the challenges and opportunities facing executive nurse directors in the UK and identify factors to strengthen their role and support more effective nurse leadership. Design: A qualitative descriptive study using reflexive thematic analysis. Methods: Semi‐structured, telephone interviews were carried out with 15 nurse directors and 9 nominated colleagues. Results: Participants described a uniquely complex role with a broader scope than any other executive board member. Seven themes were identified: preparation for the role, length of time in role, role expectations, managing complexity, status, being political and influencing. Strengthening factors included successful working relationships with other board colleagues, development of political skills and personal status, coaching and mentoring, working within a supportive team culture and having strong professional networks. Conclusion: Executive nurse leaders are key to the transmission of nursing values and the delivery of safety and quality in healthcare settings. To strengthen this role, the limiting factors and the recommended shared learning identified here should be recognized and addressed at an individual, organizational and professional level. Implications for the profession and patient care: Given the pressure on all health systems to retain nurses, the role of executive nurse leaders needs to be seen as an important source of professional leadership and their value in actioning health policy into practice recognized. Impact: New insights have been provided into the executive nurse director role across the UK. Findings have demonstrated challenges and opportunities to strengthen the executive nurse director role. These include recognition of the need for support, preparation, networking and more realistic expectations of this unique nursing role. Reporting method: The study adhered to the Consolidated Criteria for Reporting Qualitative Research. Patient or public contribution: There was no patient or public contribution. [ABSTRACT FROM AUTHOR]

Aim: Swedish Child Health Services provide regular health surveillance of children 0–5 years and support to parents, with the aim to contribute to equitable child healthcare and to promote physical, emotional, and social health for children. Individual conversations with the child health nurse, including screening for postnatal depression, have been recommended and well implemented for mothers, whereas routines for a visit specifically for the nonbirthing parent vary and are not well studied. The aim of this study was therefore to explore how nonbirthing parents experienced individual conversations with their child health nurse, held 3 months after the birth of their child. Design: Qualitative interview study. Methods: Semistructured interviews were conducted with 16 fathers who had participated in individual conversations with a nurse at their child health centre, 3 months post‐partum. Data were analysed with qualitative content analysis. The study adhered to the COREQ checklist for qualitative studies. Results: The findings are presented in three categories: 'Being invited into a supportive context', 'Talking about what was important' and 'Taking it home', each of them including three subcategories. The individual conversations, without the mother present, made the fathers feel important and allowed for a different type of content, tailored to their own needs. The conversations were validating and led to changes in daily routines with their child for some fathers. [ABSTRACT FROM AUTHOR]

Abstract Aim The aim of the study was to describe continuity from the perspective of working as an agency nurse (AN). Design Qualitative design was applied using individual semi‐structured interviews. Method Individual interviews with fifteen registered nurses working at agency companies were conducted in 2020. The interviews were analyzed with thematic analysis. The study followed the guidelines addressed in the COREQ (Consolidated Criteria for Reporting Qualitative Research) framework. Results Thematic analysis yielded one theme ‐ standing strong and taking command ‐ and four categories: being competent and experienced, being prepared and at ease, ensuring an unbroken chain of care, and belonging on my own terms. The categories illustrated the engagement, professionalism, and natural leadership showed by the ANs to uphold quality and continuity.

(1) Background: the scientific literature has shown that students’ active involvement in the teaching–learning process significantly improves their learning outcomes. (2) Methods: this study shows the perceptions of seven researchers on the process of inquiring about the effects of the combined use of virtual reality (VR) and a practice teaching style in physical education in secondary educational institutions. (3) Results: the results obtained from the researchers’ diaries and the focus group, through qualitative design, are arranged in the following categories: difficulties in data collection before, during, and after the intervention; perceived differences between VR interventions in laboratory situations and educational contexts; and the perceived transferability of the use of VR devices in the educational context. (4) Conclusions: more research is needed on the use of VR in the educational context, although the results obtained indicate that the teaching–learning process can be enriched by overcoming the difficulties inherent to the use of this technology in a variable context such as education.

The study aimed to investigate relational outcomes of Italian emancipated foster youth across open-ended reflections about their perceptions of their relationships with the biological and foster family, with partner and peers. A total of 26 Italian emancipated foster youth (19–25 years old) recruited by social services completed a single in-depth interview. A qualitative thematic analysis was selected for this study. The results revealed two major themes of foster care experience that emerged often simultaneously from the participants’ narration: (1) Positive Relational Outcomes including “Feeling supported,” “Sense of belonging,” “Good memories,” “Relationship with family of choice,” and “Staying in touch”; and (2) Negative Relational Outcomes referring “Devaluation,” “Refuse,” “Bad memories,” and “Isolation.” Foster care experience leads to complex relational perceptions in emerging adulthood according to different relational outcomes and ways of processing foster care experience. Professionals could work on relational outcomes and memories, especially during a critical transition like emerging adulthood, to support youth in making sense of their past experiences. [ABSTRACT FROM AUTHOR]

Background: Heart failure (HF) is an important health problem and guidelines recommend multidisciplinary management. The pharmacist is an important member of the multidisciplinary heart failure team, both in the hospital and community setting. This study aims to explore the perceptions of community pharmacists on their role in HF care. Methods: We conducted a qualitative study based on face-to-face semi-structured interviews with 13 Belgian community pharmacists between September 2020 and December 2020. We used the Qualitative Analysis Guide of Leuven (QUAGOL) method as guidance for data analysis until data saturation was reached. We structured interview content into a thematic matrix. Results: We identified two major themes: heart failure management and multidisciplinary management. Pharmacists feel responsible for the pharmacological and non-pharmacological management of heart failure, citing easy access and pharmacological expertise as important assets. Diagnostic uncertainty, lack of knowledge and time, disease complexity and difficulties in communication with patients and informal care providers are barriers to optimal management. General practitioners are the most important partners in multidisciplinary community heart failure management, although pharmacists perceive a lack of appreciation and cooperation and deplore communication difficulties. They feel intrinsically motivated to provide extended pharmaceutical care in HF but cite the lack of financial viability and information sharing structures as important barriers. Conclusion: The importance of pharmacist involvement in multidisciplinary heart failure teams is undisputed by Belgian pharmacists, who cite easy access and pharmacological expertise as important assets. They point out several barriers impeding evidence-based pharmacist care for outpatients with heart failure: diagnostic uncertainty and disease complexity, lack of multidisciplinary information technology and insufficient resources. We recommend that future policy should focus on improved medical data exchanges between primary and secondary care electronic health records as well as the reinforcement of interprofessional relationships between locally affiliated pharmacists and general practitioners. [ABSTRACT FROM AUTHOR]

Background Screening of colorectal cancer (CRC) can reduce incidence and mortality. First-degree relatives (FDRs) of patients with CRC or advanced adenoma before the age of 65 (index patients) are at increased risk of CRC; however, the guidelines for screening of FDRs by colonoscopy are poorly followed.Objectives The present study, conducted in the context of the COLOR3 interventional study project, aimed to explore the positioning of general practitioners (GPs) in familial CRC screening in France.Methods From February 2020 to April 2021, 35 semi-structured interviews with GPs of index patients and/or their FDRs were conducted by telephone. The full-data transcribed corpus was subjected to horizontal thematic analysis.Results Knowledge and compliance with the guidelines vary greatly between GPs. Although initiating the diagnostic process, GPs do not consider themselves as actors in the flow of information concerning familial risk. Their accompaniment of index patients in this role varies. GPs should overcome barriers to implementing colonoscopic screening for FDRs. They underline the importance of exploring family history, but they lack the time and doubt the reliability of the information given by FDRs.Conclusion Challenges include circumventing gaps in knowledge, adherence to guidelines and improving family history updates. The GPs interviewed suggested personalised guidelines in specialists' reports to initiate information campaigns raising awareness of familial risk, and to enhance coordination between organised screening and familial screening.

This qualitative study aims to investigate the sources of burnout from Iranian EFL teachers’ perspectives. To this end, thirty-four Iranian male and female EFL teachers participated in the semi-structured interview to comment on the burnout sources and then rank them in terms of priority. Also, one hundred teachers responded to an online open-ended questionnaire. The coding scheme revealed two external and internal nodes, five themes, and fifteen subthemes. Under the external node lay financial, organizational, and teacher training problems. The internal node involved teachers’ psycho-affective traits and personal life affairs. The results showed that external sources outweighed the internal ones. Among the external sources, teachers’ low pay, the supervisor’s maltreatment, and workload, and among the internal ones, teachers’ low problem-solving abilities, low motivation and self-efficacy held high ranks. No one attributed burnout to teachers’ gender and age, and almost all participants unanimously criticized the educational administration system of Iran for not providing teachers with the necessary means of burnout recognition and prevention. The study has implications for educational policymakers and practitioners.

Tinnitus is a multifactorial phenomenon and psychological, audiological, or medical factors can facilitate its onset or maintenance. A growing body of research investigates individuals' perceptions, associations, and experiences of living with tinnitus. This body of research examines tinnitus as a condition rather than a symptom. We examine a sample of chronic tinnitus patients in terms of associations that are induced by neutral sounds. In particular, we investigate how patients with chronic tinnitus ascribe meaning to those neutral sounds. The present study uses Mayring's content analysis to explore the content of psychological associations underlying valence ratings of everyday neutral sounds. Nine tinnitus patients completed a hearing exercise, during which they listened to seven neutral sounds, following which we examined their sound-induced associations using semi-structured interviews. Three groups of factors influenced patients' associations and valence ratings of neutral sounds: affect, episodic memory, and 'other'. The former two factors further comprised two subcategories. In line with previous psychoaudiological research designs, our findings suggest that neutral, everyday auditory stimuli evoke strong affective reactions—possibly through serving as retrieval cues for episodic memories. Based on these findings, we discuss our results in the context of previous psychoaudiological findings and propose further research concerning psychological associations that may specifically underlie the tinnitus sound. [ABSTRACT FROM AUTHOR]

Aim: The aim of the study was to describe continuity from the perspective of working as an agency nurse (AN). Design: Qualitative design was applied using individual semi‐structured interviews. Method: Individual interviews with fifteen registered nurses working at agency companies were conducted in 2020. The interviews were analyzed with thematic analysis. The study followed the guidelines addressed in the COREQ (Consolidated Criteria for Reporting Qualitative Research) framework. Results: Thematic analysis yielded one theme ‐ standing strong and taking command ‐ and four categories: being competent and experienced, being prepared and at ease, ensuring an unbroken chain of care, and belonging on my own terms. The categories illustrated the engagement, professionalism, and natural leadership showed by the ANs to uphold quality and continuity. [ABSTRACT FROM AUTHOR]