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Research question How is men’s mental health affected within male professional football? Research methods Within this qualitative study, eighteen current first-team professional footballers were interviewed from across the English Football League (EFL) to explore how male professional footballers are affected by mental health. Braun and Clarke’s thematic analysis (2006) was applied along with “The Silences Framework” [Serrant-Green, L. (2010). The sound of “silence”: A framework for researching sensitive issues or marginalised perspectives in health. Journal of Research in Nursing, 16(4), 347–360] to allow the voices of this marginalised group to be heard. Results and findings The five key themes of social networks, environment, masking vulnerabilities, help-seeking and support, and mental health emerged from the data. The mental health theme is split into two sub-themes: impact on self and reaction of others. Implications This study makes an original contribution to the knowledge base as it is the first study to innovatively apply The Silences Framework to a sporting context. This study has applied The Silences Framework to show that professional footballers are affected by their mental health, and without appropriate access to support they continue to suffer in silence. This is likely to have negative consequences in their personal life, their football career, and their eventual transition away from being a professional footballer.

Background: The experiences of women who develop lymphoedema in the breast or trunk (BTL) after treatment for breast cancer have received little attention in either the academic or clinical setting. Consequently, women’s support needs remain unrecognized. Objective and Design: As this study sought to gain an understanding of women’s unheard experiences of a poorly understood condition, it was underpinned by The Silences FrameworkCitation1 which facilitates research into sensitive or marginalized issues. Sample and Methods: Fourteen women with BTL participated in individual, unstructured interviews, some using photographs or drawings to reflect their experiences. The data was analyzed using the Listening Guide.Citation2 Findings: Participants revealed that they were unprepared for the development of BTL; for many, the symptoms were unfamiliar and distressing. Furthermore, their concerns were often dismissed by healthcare professionals (HCPs), leading to long delays in obtaining an accurate diagnosis and treatment. For some women, the practical and emotional impact of developing BTL was profound. Practice Implications: Increased awareness and education about the risk of BTL as a potential side-effect of treatment for breast cancer is required for HCPs and patients. This will alleviate distress, better prepare patients, and ensure timely referral for treatment to manage this chronic condition.

Introduction. High-quality pre-registration student nurse training and development is integral to developing a sustainable and competent global nursing workforce. Internationally, student nurse recruitment rates have increased since the onset of the COVID-19 pandemic; however, attrition rates for student nurses are high. During the pandemic, many student nurses considered leaving the programme due to academic concerns, feeling overwhelmed, and doubting their clinical skills. Little was known about the extent to which nursing education prior to COVID-19 had prepared students for their role in managing the healthcare crisis or the impact on their resilience. Thus, this study aimed to explore how the COVID-19 pandemic impacted on the resilience levels of student nurses across the United Kingdom. Methods. Data were collected as part of a multi-site qualitative study named ‘COV-ED Nurse’ and involved pre-placement surveys, placement diaries, and post-placement interviews with nursing students. Student nurse participants were recruited from across the United Kingdom, from all years of study, and from all four nursing branches: children, adult, mental health, and learning disabilities. Participants were asked to complete a pre-placement survey that collected demographic details and information about their placement expectations. They were also asked to record a weekly audio-visual or written diary to describe their placement experiences, and, on completion of their placements, students were interviewed to explore their experiences of this time. Data were thematically analysed using the Framework Approach. Ethical approvals were obtained. Results. Two hundred and sixteen students took part in the wider study. The current study involved a subset of 59 students’ data. Four main themes were identified: ‘coping with increased levels of acuity’, ‘perceived risks of the pandemic’, ‘resilience when facing uncertainty and isolation’, and ‘the importance of coping mechanisms and sup

Objective To explore the role of transportation in seeking emergency obstetric care among women with obstetric complications. Methods A mixed-methods design. The study population comprised women aged 15–49 years who had experience direct obstetric complications and were attending the health facility for care at the time of this study. A total of 318 women completed the questionnaires, and in-depth interviews were held for six women who were purposively selected from the 318 respondents. Both questionnaire and semi-structured interviews were used in collecting data for this study. Quantitative data were analyzed using SPSS using both inferential and bivariate analysis, and a qualitative content analysis was carried out on the qualitative data. Results Of the 318 respondents, 290 (91.2%) accessed health facilities by motorized transport with 28 (8.8%) on foot. Mode of transportation was related to regularity at prenatal care (P = 0.003), with those who came on foot being regular attenders compared with those that came on motorized transport. Conclusion An efficient and suitable transport system as well as distance are key factors influencing women’s role in decision making to seek care.

Background Globally, there is an increased need to provide patient-centred care for people diagnosed with type 2 diabetes mellitus. In Nigeria, a poorly financed health system has worsened the difficulties associated with managing type 2 diabetes mellitus in clinical settings, causing a detrimental effect on patient-centred care. Aims We aimed to develop a conceptual model to promote patient-centred type 2 diabetes mellitus care in clinical settings. We explored nurses’ contextual perceptions of clinical practices and operations in light of type 2 diabetes mellitus management across public hospitals in Lagos, Nigeria. Identifying a nurse-led intervention is critical to care optimisation for people diagnosed with type 2 diabetes mellitus. Methods We adopted a qualitative approach. Using the constant comparison method and semi-structured questions and interviewed practice nurses, with over one year’s experience and who were working in public hospitals across Lagos, Nigeria. The framework method was used to analyse the data obtained. Results Nurses provided insight into four areas of patient-centred type 2 diabetes mellitus management in clinical settings: empowering collaboration; empowering flexibility; empowering approach; and empowering practice. Nurses discussed an empowering pathway through which health settings could provide patient-centred care to individuals diagnosed with type 2 diabetes mellitus. The pathway entailed the integration of macro, meso and micro levels for patient management. Nurses’ accounts have informed the development of a conceptual model for the optimisation of patient care. Conclusions The model developed from this research sits within the patient-centred care model of healthcare delivery. The research sits within the patient-centred care model of healthcare delivery. inform patient-centred care, not only in countries with poorly financed healthcare systems, but in developed countries with comparatively better healthcare.

Background: Patients have a right to be treated with dignity. However, reports have continually identified concerns regarding the quality of care and dignity in hospitals. Undignified care can have unfavourable impact on the patient’s recovery such as leading to depression and loss of will to live. The aim of this study was to explore dignity as perceived by patients and nurses within hospital and community environments. Methods: An integrative review methodological approach was adopted. Nine databases including Medline, CINAHL plus with full text, Web of Science, Embase, Pubmed, Psycinfo, Scopus, Nursing and Allied Health Source, and Science Direct were systematically searched for relevant articles using a predetermined set of inclusion criteria. Articles were included if they were primary empirical studies, peer reviewed, published between 2008–2019, assessing patients’ or nurses’ perception of dignity outside the end-of-life context, conducted in one of the European countries and written in English. Included papers were analysed using constant comparative analysis. The preferred reporting system for systematic review and meta-analysis (Prisma) flow diagram was used for quality appraisal and review.

Whistleblowing is a procedure where an existing or past participant of an establishment reveals actions and practices believed to be illegal, immoral, or corrupt, by individuals who can influence change. Whistleblowing is an important means of recognising quality and safety matters in the healthcare system. The aim of this study was to undergo a literature review exploring perceived barriers of whistleblowing in healthcare among healthcare professionals of all grades and the possible influences on the whistle-blower. An integrative review of both quantitative and qualitative studies published between 2000 and 2018 was undertaken using the following databases. CINAHL Plus, Embase, Google Scholar, Medline, and Scopus. The primary search terms were ‘whistleblowing’ and ‘barriers to whistleblowing’. The quality of the included studies was appraised using the Critical Appraisal Skills Programme criteria. Prisma flow diagram for quality appraisal and review was utilised. Ten peer-reviewed articles were included. Included papers were analysed using constant comparative analysis. The review identified three broad themes (cultural, Organisational, and individual) factors as having a significant influence on whistleblowing reporting among healthcare professionals This study points out that fear is predominantly an existing barrier causing individuals to hesitate to report wrongdoing in care and further highlights the significance of increasing ethos of trust and honesty within healthcare to uphold the human rights of patients

The COVID-19 lockdown approach in sub-Saharan Africa countries may not be as beneficial as intended due to the current employment, housing and health infrastructure challenges. Hence other infection prevention and control might need to be considered.