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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.

This qualitative research highlighted the lived experiences of individuals transitioning from believers to atheists in the Philippines, a country deeply influenced by religious perspectives. The study employed a phenomenological approach and had six participants who were residents of Quezon City, Rizal, Cavite, Pasig City, Cavite, and Makati City. The study identified 10 superordinate Themes using Interpretative Phenomenological Analysis (IPA), highlighting the intricate nuances of the participants' experiences. These themes included: Religious Influences of Schooling, Family, and Personal Curiosity; Influence on Personal Morality and Skepticism; Experiencing Dissonant Texts, Actions, and Conversations; Inward Dilemmas due to Social Fear, Rationality, and Moral Ambiguity; Intersecting Influences from Local, Global, and Digital Environments; Sexuality, Hypocrisy, and Personal Beliefs; Contradictions in Religious Teachings Lead to Atheism; Shared Viewpoints Affirmed Personal Views; Disputations in Shared Circles Lead to Personal Discovery; Unfolding of Identity through Personal and Social Dynamics. The process of moving away from religious beliefs and embracing atheism was a multifaceted journey that involved numerous factors. One's upbringing in a particular religion, combined with personal exploration, societal pressures, and exposure to a variety of viewpoints, all played a role in shaping individual convictions. The study explored the process of how Filipino atheists converted from believers to atheism, and what factors influenced their journey towards atheism. The study emphasized the role of cognitive dissonance, interpersonal contacts, societal support, and social dynamics in shaping individuals' belief systems. The study also highlighted the challenges faced by Filipino atheists, including those related to sexuality and hypocrisy within religious contexts. Overall, the study shed light on the complexities of religious conversion and de-conversion and the importance of social support in shaping individuals' beliefs and identities. Ultimately, becoming an atheist required a thorough introspection that was shaped by internal and external variables, resulting in a redefinition of one's identity and a change in beliefs. [ABSTRACT FROM AUTHOR]

Mastering Mathematics can take a lot of effort but takes the proper skills and ongoing practice. Imparting knowledge to the students in mathematics subjects that are known to be difficult has been a challenge for math teachers. From modular to full face-to-face classes, there have been several adjustments and difficulties for teachers, which pushed the researchers, to come up with the study about the pedagogical modifications done by the teachers. In particular, the teachers' coping strategies and the milestones that they have achieved after classes will also be determined. Mathematics teachers at Badian National High School were chosen as ten participants in this qualitative study. Specifically, it utilized Heideggerian phenomenology and interpretative phenomenological analysis (IPA), anchored on the modified Van Kaam approach popularized by Moustakas. Hence, the following themes emerge: (1) The Adjustment, (2) The Struggle, (3) The Motivation, and (4) The Scheme. In conclusion, difficulties in online classes are the unstable internet connection and the need to focus on online discussions, while the adjustments in full face-toface classes are time management, financial problems, and the distance between the house and school. It is recommended to hear out the voices of the teachers in their difficult times, help address them, and might as well be given some benefits for all their efforts in teaching young minds. [ABSTRACT FROM AUTHOR]

ABSTRACT Introduction Aim Methods Findings Discussion In this text, the author’s lived experiences as a youth with anorexia nervosa, anxiety, and depression are explored. Experiences with accessing North American health services, both in specialized eating disorder (ED) and disordered eating (DE) settings, as well as in healthcare more broadly are shared.This work seeks to shed light on a patient perspective in mental health and to draw attention to some of the ways that the current framings of EDs and DE within the biomedical system might perpetuate harm.In this piece, a collection of the author’s lived‐experiences and interactions with the healthcare system are explored.The medical framing of EDs as a defect of both mind and body can jeopardize one’s autonomy and contribute to a sense of hopelessness. As mental health treatment increasingly prioritizes evidence‐based approaches and standardized practices, there is a growing concern that this shift risks undermining the autonomy of those it aims to support. The dualistic conceptualizations of mental and physical health in ED/DE treatment, at times, can cause harm, particularly for those who do not present with the physical manifestations of an ED/DE but remain largely affected in day‐to‐day life.The imposition of rigid treatment regimens can inadvertently diminish personal agency, overshadowing the nuanced, individualized needs and preferences of patients. Lived experience narratives encompass the personal, subjective insights of individuals navigating mental health challenges, in turn, providing invaluable insight that conventional methods may overlook. [ABSTRACT FROM AUTHOR]

Drawing on Sen's conceptual refinements of agency, in particular the distinction between agency freedom and agency achievement, this article highlights the existence of a feedback loop between agency and the capability to aspire. To explore this loop, the author uses John Dewey's praxeological approach, bringing institutions into the "Capability Approach" along with situated agency. Against this background, she develops an agentive model of the capability to aspire, where the latter is nurtured by the longitudinal and lateral dimensions of experience. While the longitudinal dimension involves temporal processes driven by creative continuity (between past, present and future), the lateral dimension involves relational processes driven by social interactions (between a person and her environment). Institutions are an important part of that environment. By propagating social norms that define roles and behaviours in society, they provide a matrix for individual and collective aspirations, especially for people with fewer individual resources. But as Sen has pointed out, the moral ideals pursued by institutions do not necessarily translate into concrete achievements. This is why Dewey invites us to subject them to an ongoing critical inquiry that confronts their goals to their effective role in people's lived experience, with the aim to transform them if necessary. The article concludes by discussing the implications of such a transformative inquiry and its potentially empowering effect in voicing aspirations and articulating new ones. [ABSTRACT FROM AUTHOR]

Critical physiotherapy has been a rapidly expanding field over the last decade and could now justifiably be called a professional sub-discipline. In this paper we define three different but somewhat interconnected critical positions that have emerged over the last decade that share a critique of physiotherapy's historical approach to health and illness, while also diverging in the possibilities for new forms of practice and thinking. These three positions broadly align with three distinctive philosophies: approaches that emphasize lived experience, social theory, and a range of philosophies increasingly referred to as the "posts". In this paper we discuss the origins of these approaches, exploring the ways they critique contemporary physiotherapy thinking and practice. We offer an overview of the key principles of each approach and, for each in turn, suggest readings from key authors. We conclude each section by discussing the limits of these various approaches, but also indicate ways in which they might inform future thinking and practice. We end the paper by arguing that the various approaches that now fall under the rubric of critical physiotherapy represent some of the most exciting and opportune ways we might (re)think the future for the physiotherapy profession and the physical therapies more generally. [ABSTRACT FROM AUTHOR]

Aim: To qualitatively explore the experiences of individuals with Gestational Diabetes Mellitus (GDM) in Australia, and to recognise opportunities for leveraging digital health to enhance the support of GDM management. Method: A cross sectional online survey assessed the experiences of individuals with GDM, the healthcare system and their digital health usage. Respondents (recruited via a national diabetes registry or social media) were adults receiving GDM care within Australia in the last 5 years, who responded to any of three open‐ended questions (n = 815) exploring positive, negative and other GDM experiences. Thematic analysis was utilised, and themes were mapped to the socio‐ecological systems framework. Results: At a system level, themes related to (1) accessibility of care including the value of digital health and the inflexible or inconsistent perception of the (2) implementation of guidelines. At an interpersonal level, themes covered the need for adequate (3) health information provision, and (4) supportive care, as well as highlighting (5) experiences of stigma including a desire for greater awareness of GDM. Individual‐level themes included: (6) differential barriers to accessing care; (7) negative emotional burden; (8) internalisation of stigma; (9) dietary freedom and social impact and (10) opportunity for change derived from having GDM. Conclusion: Findings suggest a demand for more supportive, person‐centred GDM care, improved information provision and individualised implementation of clinical guidelines. Such mechanisms may support reduced barriers to accessing care or negative psychosocial impacts of GDM. Though not central to the identified experiences, digital health tools may help address the need for optimised GDM care. [ABSTRACT FROM AUTHOR]

Bariatric surgery is becoming a more commonly used treatment for the management of obesity; however, measures of effectiveness have tended to rely heavily on the short‐term physical health indicators of success, whilst largely neglecting psychological and social factors. The understandings achieved through listening to the lived experiences of countless individuals as they steered their way through the complex journey of bariatric surgery, this commentary deliberates on some of the unique lived experiences of patients who have undergone bariatric surgery and the overriding and under‐supported long‐term social and psychological aftermath. [ABSTRACT FROM AUTHOR]

Summary Central disorders of hypersomnolence (CDH) are chronic diseases that significantly impact the lives of affected individuals. We aimed to explore the perspectives of individuals with narcolepsy type 1 (NT1), narcolepsy type 2 (NT2), and idiopathic hypersomnia (IH), and the challenges they encounter in their daily lives and within the healthcare systems in the Nordics. Interviews with patients (N = 41) and healthcare professionals (n = 14) and a patient survey (n = 70) were conducted in 2022 in Denmark, Sweden, Finland, and Norway to develop a patient journey map that visualises the patient with CDH journey and provides insights into the difficulties faced by these individuals. The patient journey mapping approach was chosen to focus on the processes and experiences of patients, highlighting the challenges they confront. Our findings revealed that the process of receiving a CDH diagnosis, as well as subsequent misdiagnoses and treatment, can be protracted and burdensome. CDH diagnoses remain poorly understood by neurologists, general practitioners, and the public, resulting in adverse consequences, with patients reporting a mean (standard deviation [SD]) time from symptom onset to diagnosis of 8.4 (5.11) years and a mean (SD) of 5.5 (4.17) productive hours lost/day. The available non‐pharmaceutical support for patients with CDH, encompassing medical, psychological, educational, and professional assistance, was insufficient. The generalisability of the findings to one specific diagnosis is limited due to the collective analysis of the CDH. These findings are invaluable for identifying disruptions in the patient with CDH journeys and for designing improved pathways for those with NT1, NT2, and IH in the future. [ABSTRACT FROM AUTHOR]

Plain English Summary: Eating disorders (EDs) are common and can be deadly, yet treatment approaches are not currently meeting the needs of individuals in Canada requiring care. As noted in the existing literature, ED treatment is largely inaccessible in Canada and can be ineffective in facilitating long-term recovery. Recent research has suggested that improvement to publicly funded, hospital-based ED treatment for adults is necessary and that those in Canada with lived experience should be involved in the process of doing so. This paper is based on a study that set out to explore ED treatment and gather potential recommendations from eleven individuals in Canada with lived experience. Several recommendations were identified to improve ED treatment in Canada, while simultaneously addressing harmful stigma about people with lived experience with EDs. These recommendations included providing interim support, ensuring individualized care, offering dignified treatment, increasing resources, and directly targeting stigma. From this study, it is suggested that current ED treatment methods must change to improve health outcomes and reduce stigma, and exploring the perspectives of those with lived experience is a promising method for doing so. Background: Eating disorders (EDs) are increasingly common, affecting over one million individuals in Canada. Canadian adults (i.e., age 18+) requiring medical stabilization for their eating disorder (ED) may be referred to adult inpatient (IP) ED treatment for care. Recent Canadian publications have brought attention to the need for improved approaches to Canadian ED treatment; urging researchers to seek perspectives of people with lived experience to determine how to best do so. This study explored the perspectives of a sample of individuals in Canada with lived experience to identify recommendations for improvement of adult IP ED treatment programs and processes. Methods: Employing a transformative philosophical view and feminist standpoint theory, this study utilizes a qualitative hermeneutic phenomenological approach to fulfill the objectives. Eleven participants with lived adult IP ED treatment experiences from across Canada were interviewed individually, to discuss their experiences and recommendations regarding referral, transitions into and out of care, and treatment itself using an online video conference platform. Data were analyzed using interpretative phenomenological analysis. A comprehensive list of recommendations was drafted and brought back to participants for feedback. The feedback was implemented to create the final list of recommendations. Results: Several limitations of referral, transitions, and treatment, facilitated and exacerbated by stigma at individual and societal levels, were identified by participants. These included guilt and shame upon referral, lack of respect and trust from healthcare providers during transitions, and lack of consideration of social determinants of health during treatment. Participant-informed recommendations, which can be categorized as interim support, individualized care, dignified treatment, resources, and stigma, were identified to ameliorate the experiences of those in Canada with EDs while also combatting stigma. Conclusions: Adult IP ED treatment in Canada is in urgent need of significant change to meet the needs of those requiring care and to address harmful stigma. Implementing participant-informed recommendations may aid in achieving this goal. The meaningful inclusion of those with lived experience, particularly marginalized populations, will be paramount to the development of an approach to adult IP ED treatment that properly serves individuals in Canada who need it. [ABSTRACT FROM AUTHOR]

Increasing evidence highlights the benefits and importance of discussing End-of-Life (EoL), yet many people struggle to talk openly about death and dying. This practice-based report details the development of Dying Matters, an applied theatre performance designed to encourage EoL conversations with loved ones. The combination of lived experience monologues and reflection activities appeared to provide an inspiring and supportive experience. The team observed many attendees actively taking moments during the performance to ponder and write their response to EoL preferences prompts. Further application of this work is recommended to engage a broader community and to enhance healthcare professional training. [ABSTRACT FROM AUTHOR]

ABSTRACT Objective Method Results Discussion We examine the small amount of research to date that describes and/or evaluates waitlist interventions as a precursor to treatment for an eating disorder (ED) with the intent to provide recommendations for future research that can further test the efficacy and effectiveness of waitlist interventions.A review of published studies showed the standard of proof about the usefulness of waitlist interventions to be slight, with important gaps in our knowledge. One such gap was whether recovered people with lived experience could provide support to adults waiting for treatment. We briefly present new research evaluating this approach (N = 40), where people waiting for treatment were randomized to waitlist as usual or guided self‐help with a trainee psychologist or a person with lived experience.Eight published studies across 10 different programs are described; N = 7 addressed waitlists for children and adolescents, and only three were randomized controlled trials. Our new research did not support the involvement of people with lived experience at this stage of the treatment journey.The results suggest some promise of waitlist interventions. Parents waiting for family‐based treatment were able to improve weight and nutritional health in their children and experienced improved self‐efficacy with respect to managing the ED. Provision of a waitlist intervention to adults may increase the probability of later engagement in treatment. It is still not possible to conclude whether waitlist interventions improve outcomes over treatment compared to those who did not receive such an intervention. We make five recommendations for future research. [ABSTRACT FROM AUTHOR]

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]

Background: Despite increasing recognition of long COVID, the psychosocial impacts of the lived experience on individuals remain underexplored. This systematic review sought to fill this gap by identifying key themes that describe the psychosocial dimensions of long COVID. Objective: The aim of this study is to identify key themes illustrating the psychosocial aspects of individuals' lived experience of long COVID. Search Strategy: Searches were conducted in multiple databases and grey literature sources for qualitative studies published between November 2019 and June 2024. Inclusion Criteria: Eligible studies involved adult participants self‐reporting long COVID. The studies needed to provide qualitative data that could be synthesised thematically. Data Extraction and Synthesis: Data extraction and thematic synthesis were conducted by at least two independent reviewers at each stage. Quality appraisal was performed using the Critical Appraisal Skills Programme tool. Results: The review included 34 studies. Thematic synthesis yielded five themes: 'Debilitation', 'Uncertainty', 'Sources of Support', 'Meaning Making: Adjusting to a New Normal' and 'Experiences with Healthcare Services'. Individuals with long COVID reported experiencing physical, economic, and social challenges. Uncertainty and scepticism from others caused anxiety. Support from healthcare services, friends and online groups played an important role. Acceptance and gratitude were found to be meaningful in adjusting to the new normal. Experiences with healthcare services varied. Discussion and Conclusions: This review provides valuable insights into the psychosocial impact of long COVID, highlighting the profound changes and challenges that individuals face. Healthcare services should adopt a holistic approach to integrate psychosocial support within their management strategies, to improve overall patient outcomes. [ABSTRACT FROM AUTHOR]

Introduction: People with dementia of all ages have a human right to equal access to quality health care. Despite evidence regarding its effectiveness, many people living with dementia are unable to access rehabilitation for promoting function and quality of life. Conducted in Australia, this study was designed to (1) explore barriers to access to dementia rehabilitation and (2) identify solutions that improve access to rehabilitation. Methods: People living with dementia (n = 5) and care partners (n = 8) and health professionals (n = 13) were recruited nationally. Experience‐based codesign across three virtual workshops was used to understand barriers and design solutions to improve access to rehabilitation treatments. Socio‐ecological analyses, using the Levesque Access to Health care framework, were applied to findings regarding barriers and to aid selection of solutions. Results: There was high attendance (92.3%) across the three workshops. Barriers were identified at a user level (including lack of knowledge, transport, cost and difficulty navigating the health, aged care and disability sectors) and health service level (including health professional low dementia knowledge and negative attitudes, inequitable funding models and non‐existent or fragmented services). Solutions focused on widespread dementia education and training, including ensuring that people with dementia and their care partners know about rehabilitation therapies and that health professionals, aged care and disability co‐ordinators know how to refer to and deliver rehabilitation interventions. Dementia care navigators, changes to Australia's public funding models and specific dementia rehabilitation programmes were also recommended. Conclusions: Barriers to accessing rehabilitation for people with dementia exist at multiple levels and will require a whole‐community and systems approach to ensure change. Patient or Public Contribution: People with living experience (preferred term by those involved) were involved at two levels within this research. A Chief Investigator living with dementia was involved in the design of the study and writing of the manuscript. People with living experience, care partners and service providers were participants in the codesign process to identify barriers and design potential solutions. [ABSTRACT FROM AUTHOR]

Background: Approximately 4.4 million people in England (8% of the total population) are living with a long‐term neurological condition. Within this group of vulnerable individuals, there will be individuals living with severe spasticity that requires regular outpatient treatment with botulinum toxin injection. The closure of outpatient spasticity services during the pandemic impacted individuals who required spasticity treatment and their carers, as well as the specialist clinicians responsible for service delivery. Objectives: We aimed to gain insight into the experiences of individuals living with spasticity, their carers and a clinical spasticity service lead during the pandemic, and to reflect on potential learning for the future. Methods: A qualitative study was designed using semi‐structured interviews conducted by telephone. Participants comprised patients living with a long‐term neurological condition who attended outpatient spasticity clinics before the start of the pandemic in England, primary carers who accompanied patients attending these clinics and a clinical spasticity service lead. Data were audio recorded, transcribed, anonymised and coded. Data analysis utilised the One Sheet of Paper thematic approach to identify themes, which were discussed and analysed by the interdisciplinary research team and two patient and carer participants. Results: Out of the 11 participants recruited, aged 36–77 years, seven comprised people living with spasticity related to a long‐term neurological condition, three were carers and one was a clinical spasticity service lead. Six participants were male and five were female. Among the participants, four were stroke survivors, two were living with spinal cord injury and one was living with multiple sclerosis. Analysis revealed six major themes: experience of living with spasticity during the pandemic; impact of the pandemic on patient, carer and clinician health; access to and experience of outpatient clinic appointments; coping strategies during the pandemic; system improvements; and learning from the pandemic period. Conclusion: These findings contribute research knowledge to a very limited research knowledge base and suggest that there is scope for improving system and service delivery through the allocation of research funding to senior clinicians working in this specialist area. [ABSTRACT FROM AUTHOR]

Introduction: Although living kidney donation is generally considered a safe procedure, it is ethically critical that prospective donors are fully informed before consent. However, prospective donors lack a deep understanding of the donation experience, making the postdonation aftermath feel unanticipated. We sought to gain in‐depth qualitative descriptions of the short‐ and long‐term risks and benefits associated with kidney donation among an ethnically diverse group of donors to offer a balanced view of the positive and negative experiences that may occur postdonation. Methods: We conducted individual narrative in‐depth interviews (September 2020–March 2021) using the DIPEx (database of individual patient experiences) method with former living kidney donors primarily via Zoom. Results: Fourteen donors (10 women; 8 White, 5 Hispanic, and 1 Native American) completed interviews. Interactions with healthcare providers leading up to donation were largely positive; however, lack of clarity regarding postdonation laboratory values among primary care providers led three participants to be erroneously told they developed kidney disease. Most experienced unanticipated outcomes, including postsurgical complications (e.g., hernia), long‐term fatigue (i.e., ≥12 weeks), emotional distress (e.g., depression), hypertension, and gout. Difficulty obtaining life insurance following donation was an unexpected challenge. Despite these issues, participants were unanimously enthusiastic about living kidney donation and reported no regrets. Conclusions: Enthusiasm for living kidney donation remained high among all participants despite most experiencing negative outcomes. These findings suggest that greater transparency regarding postdonation experiences may not preclude the decision to move forward with living kidney donation. These narratives will be utilized for an online module of lived experiences of donation. [ABSTRACT FROM AUTHOR]

Borderline personality disorder (BPD) is frequently understood as a diagnosis applicable mainly to women, despite population studies suggesting similar prevalence between men and women. The scarce available information suggests that compared to women, men may face additional gender-related barriers to diagnosis and treatment when attempting to engage with support and treatment for BPD-related difficulties. The current study presents a qualitative in-depth exploration of the help-seeking and diagnosis experiences of four men with BPD. Using Interpretive Phenomenological Analysis, three themes were generated: (1) "There's just no help out there": barriers to treatment; (2) self-understanding and insight; and (3) the importance of emotional and psychological connection with health care professionals and close family and friends. Having a greater understanding of male-specific experiences of BPD could improve the helpseeking journeys of men with BPD through early identification, accurate and timely diagnosis, to relevant and effective treatment and support. [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]

The findings presented here are from a qualitative research study, adopting creative research methods with seven children to provide an in-depth understanding of their lived experience of living with Parental substance misuse (PSM). The children's data were analysed using interpretive phenomenological analysis. The research also included focus groups with twenty-two professionals which added further understanding to the children's experiences. Bronfenbrenner's ecological theory was adopted as a framework to structure the research data from the micro to the macrosystem. Key messages identified the need for children living with PSM to be seen and heard and offered specialist support in their own right. The children experienced multiple risk factors, which were often enduring, and did not reduce as they grew older. This research provided an understanding of the complex needs of children and the risk factors which reach beyond their immediate home environment. This article argues for change, including improved training for front line practitioners, specialist service provision for children not reliant on their parents' engagement, and for policy change and financial resources for their implementation. It is proposed that this would bridge the gap between research and practice and lead to improved outcomes for children living with PSM. [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]