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Though many initiatives and monetary benefits are incorporated under RNTCP/NTEP, many patients might incur some out-of-pocket expenditure (OOP) related to diagnosis, treatment, and hospitalization. Such costs lead to further poverty and default. This study estimated OOP costs. A cross-sectional mixed method study was conducted in 2020. Data were collected from two selected UHCs (both public and private sectors) from all eight administrative zones. A total of 278 newly registered drug-sensitive tuberculosis patients at different stages of treatment were enrolled, and 18 IDIs were done after obtaining the consent. Among 278, 231 (83%) were seeking the treatment from the public sector and 47 (17%) from the private sector. The average direct, indirect, and total costs were Rs. 8812, Rs. 4825, and Rs. 13,637, respectively. Extra food and supplements are the major field of expenditure for those enrolled in the public sector. Higher costs were incurred by the private sector patients. Longer distances, a long waiting time, belief systems, and unavailability of facilities or drugs were the common reasons for not visiting the public sector. IDI results also supported the cost heads. The majority of the expenses occurred at the private settings before diagnosis. IDIs suggested to changes in the programmatic approach toward migrants, industrial workers, and women. [ABSTRACT FROM AUTHOR]

Purpose: This study aims to conduct a process evaluation of Supporting Family Doctors to Address Elder Abuse (SAFE) intervention, a training program, and clinical guidelines developed to assist the family doctor in intervening in elder abuse (EA). Method: 160 family doctors answered pre-and post-training questionnaires on knowledge of EA, attitude, subjective norms, and the perceived behavioral control to intervene in EA, followed by semi-structured interviews post-intervention with a purposive sample of family doctors who participated in the SAFE intervention (N = 39). Results: There is a significant increase in mean scores of the knowledge, attitude, and subjective norms six months post-intervention (p < 0.001). The mean scores of perceived behavioral control of family doctors to intervene in EA decreased but were statistically insignificant (p > 0.05). Qualitative data explained the observed effect and process underlying the knowledge transfer and implementation of the SAFE intervention. Knowledge improvements due to awareness enhancement led to empowerment and confidence as the training program was effectual and comprehensive. Family doctors' self-reflection and empathy toward older adults contribute to attitude changes. Family doctors are better coordinated and receive support in intervening in EA. However, various roadblocks affect their perceived ability to intervene in EA and enhancement strategies necessary to assist family doctors to intervene in EA efficiently. Conclusion: The SAFE intervention was feasible and effective in improving family doctors' competency to intervene in EA. However, findings showed that doctors' capacities must go hand in hand with empowering older adults, creating awareness among community members, and pushing for law and policy reforms. [ABSTRACT FROM AUTHOR]

This study aims to examine the relationship among key factors including health care, mental health, attitude, social support, quality of life, life satisfaction and active aging to investigate factors that relate to active aging in the Thai elderly and to develop a new model of Thai active aging. Data for the quantitative research were collected using questionnaires and analyzed using descriptive statistics, explanatory factor analysis, and multiple regression analysis. The qualitative research sample consisted of thirty elders. The data were analyzed using content analysis. The results of this study indicate that all important factors related to the active aging of Thai elderly are at a high level such as previous active aging, quality of life, life satisfaction and adjusted active aging. From exploratory factor analysis, it was found that nine elements could be separated that reflect the adjusted active aging of Thai elderly people. In addition, the result indicated four variables that affect the adjusted active aging of the Thai elderly, health care, mental health, attitude and social support. This study creates a new model to serve as a guideline for the government or private sector to use in managing the Thai elderly. [ABSTRACT FROM AUTHOR]

During the COVID-19 pandemic, many organisations worldwide asked their employees to accept a temporary salary reduction to manage the financial consequences of the unprecedented event. In this paper, we use a CEO's salary reduction announcement to all employees and investigate whether a behaviour change intervention using five selected Behaviour Change Techniques (BCTs) increases expat employees' overall willingness to accept a temporary salary reduction. We use mixed qualitative and quantitative methods, including survey and experiment, to test our hypotheses and frame our results. The results show that, while the direction of impact was positive, respondents were overall not significantly more likely to accept a temporary salary reduction. However, a significant effect was found for the individual BCT 'Modelling'. Participants were significantly more likely to accept a pay cut if they knew their senior management took a larger cut than asked of participants. The outcomes of this study suggest that the availability of a financial buffer and the strength of the employer–employee relationship play a, possibly more important, role in employees' willingness to accept a pay reduction. In addition, leadership matters as this study shows that people are more willing to accept a salary reduction when senior management leads the way. [ABSTRACT FROM AUTHOR]

There is increasing interest in incorporating game design elements in workplace learning, known as instructional gamification. Despite initial positive indications, there is still a need for a deeper understanding of how organisational stakeholders play a role in implementing instructional gamification. This study employed an explanatory sequential mixed-methods approach to identify and understand stakeholders' instructional gamification design preferences and how these preferences might impact their endorsement of instructional gamification. A survey of 231 individuals at a software company was conducted to gather data on stakeholders' preferences for instructional gamification. This was followed by in-depth interviews with eight employees to further enhance the understanding of stakeholders' instructional gamification design preferences. The quantitative findings revealed four interrelated factors concerning the instructional gamification design preferences of the three stakeholder groups. However, the qualitative findings revealed that the stakeholder groups interpreted the items differently. By integrating the quantitative and qualitative findings, the study provides a comprehensive understanding of the factors that enable or hinder stakeholders' endorsement of instructional gamification in workplace learning. The study also presents four design propositions that facilitate stakeholder endorsement of gamified learning artifacts. The findings have both theoretical and practical implications for designing and implementing instructional gamification in workplace learning environments. [ABSTRACT FROM AUTHOR]

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This study investigates the communication skills expected of recent construction engineering graduates as portrayed in job ads and conveyed by employers. A content analysis of 100 job ads showed that teamwork, leadership, and interpersonal communication skills were the specific categories of communication skills listed most frequently. Subsequent interviews with 11 employers showed that although they considered the written communication skills of recent college graduates as sufficient, they found that many recent graduates had insufficient skills in assertiveness, email communication, relationship building, and audience adaptation, indicating that additional coursework or assignments in oral communication skills would benefit construction engineering majors. [ABSTRACT FROM AUTHOR]

Background and objective: Cancer-related fatigue (CRF) affects the quality of life after breast cancer. In a previous study, we developed a 72-item questionnaire that assesses CRF from a holistic point of view; named the Holistic Assessment of CRF (HA-CRF) questionnaire. The current study assessed the face and content validity of the HA-CRF questionnaire. Methods: Using a mixed-method approach, ten breast cancer survivors (BCS) did a cognitive walkthrough of the HA-CRF via an app followed by a semi-structured interview about relevancy and essentiality (qualitative). In addition, ten health care professionals (HCPs) assessed the relevancy, clarity, and essentiality of each item via a questionnaire (quantitative). Results: BCS indicated minor textual improvement for four items and six items were not completely clear. The app was considered easy to use and the HC-CRF was on average completed in 18 minutes. The HA-CRF questionnaire provided openness about fatigue and gave the feeling of being heard. The items were helpful and induced self-awareness. HCPs indicated 71% of items being very clear or minor revisions proposed by the minority, with 64% of items being essential and 92% considered relevant. Conclusions: The HA-CRF showed good face and excellent content validity. Further research is needed to assess its ability to monitor in daily life. [ABSTRACT FROM AUTHOR]

It has been almost 90 years since William Stephenson's 1935 letter to Nature that opened the door for Q methodology [Q]. Criticisms and excitement ensued and continue into the present within and outside of the Q research community. Yet, any research community contains researchers with different positionalities about the methodology's philosophical framework, and best practices regarding data collection and/or data analysis. A relatively recent Q study indicated differences of opinion among Q methodologists when it comes to data analysis and its philosophical framework. Twenty years ago, Hurd and Brown uncovered four divergent viewpoints about the Q community's view of the future of Q. Thus, especially with Q's growing popularity, it seemed time to repeat that study with some change to the subjective statements used within the data collection phase, as many changes have occurred especially regarding technological advances for data collection and data analysis. Two viewpoints were uncovered, Tradition and Community, with a focus on the theoretical framework provided by Stephenson and the welcoming nature of the Q community, and Unorthodox with Expansion of Q, with a yearning to expand Q both physically and theoretically including a willingness to move beyond Stephenson's vision. The discussion and conclusion focus on the implications of these perspectives and their shared consensus for the future of Q methodology as well as implications for other research methodologies. In other words, this study provides a demonstration of complementarity for understanding the behavior of all types of research communities. [ABSTRACT FROM AUTHOR]

According to the Dialogical Self Theory, there is a multiplicity of I-positions within the self in a dialogical relationship. Psychodrama refers to these positions as inner parts within the self. We propose an integration of both to create an intervention centered on unscripted intrapersonal role-playing of the I-positions for the purpose of meaning-making. We want less dominant or silenced I-positions to be heard and included in the dialogue. We illustrate this approach with a group of 24 adult participants who engaged in a reflective dialogue process to potentially change their attitudes and perspectives toward an exemplary topic of technological advancement. A mixed-method approach is applied to investigate the potential benefits of this intervention. In pre-and post-intervention, a questionnaire is used to gather self-reported attitudes with Likert-scale and open-ended questions to assess explicit attitudes and perspectives related to our exemplary case. We used a statistical test and thematic analysis to compare the results before and after the intervention. The qualitative results show a shift in perspectives. However, the quantitative results do not show statistical significance regarding attitude change. Furthermore, integrating quantitative and qualitative results shows a convergence of the findings in one group of participants while divergence in the other. Despite these results, the proposed interventional approach promises various potential applications. [ABSTRACT FROM AUTHOR]

Background: In Senegalese high-burden regions, the existing package of interventions is insufficient to reach the malaria elimination goal. Asymptomatic carriers of Plasmodium contribute significantly to malaria persistence and are not targeted by current interventions. The systematic treatment of all individuals in a community (mass drug administration, MDA) is a relevant intervention to tackle asymptomatic infections. The intervention can only be effective with a high participation of the population and, therefore, depends largely on its acceptability. This study aims to investigate the prospective acceptability of MDA in the Kedougou region to inform its potential use in a future strategy. Methods: Following a 7-construct theoretical framework, prospective acceptability of MDA implemented in the rainy season was studied. In four villages, a sequential mixed design, from qualitative to quantitative, was used. In November 2021, interviews with healthcare professionals and focus groups with villagers were conducted. Findings from thematic analysis informed the development of a questionnaire administered to individuals aged ≥ 15 years in March 2022. Based on the questionnaire, an acceptability score was constructed and associations with socio-demographic factors were investigated using a linear mixed model. Results: The 7 interviews, the 12 focus groups, and the questionnaire administered to 289 individuals demonstrated a good acceptability of MDA. Two potential barriers were identified: the contradiction of taking a medication without feeling sick and the occurrence of side effects; and four facilitators: the perception of malaria as a burden, a good understanding of MDA, a good perceived effectiveness, and the resulting economic benefits. The average acceptability score was 3.5 (range from -7 to + 7). Young adults aged 15 to 21 had a lower acceptability score compared to the other age groups, indicating an additional barrier to acceptability (β = -0.78 [-1.67;0.1]). Conclusion: MDA is a priori acceptable to communities of Kedougou region in Senegal. Sensitization campaigns co-constructed with the communities, especially targeting young adults, are essential to ensure good acceptability. [ABSTRACT FROM AUTHOR]

This research aims to explore the interaction between digital transformation and organizational culture in the Society 5.0 structuring in Turkey. The study's sample comprises business owners, senior managers from medium and large enterprises, academicians, and public employees, selected through purposeful sampling methods. Employing an explanatory-sequential design of mixed methods, data collection involved conducting surveys among these distinct sample groups. The quantitative analysis component of this study incorporates exploratory factor analysis, confirmatory factor analysis, correlation analysis, and Structural Equation Modeling (SEM). In the qualitative analysis section, the content analysis method was employed to pose semi-structured questions during interviews with 46 individuals. Code relationship analysis was applied to the data. All data were analyzed using SPSS 25, AMOS 24, and MAXQDA 20 software. According to the results of the quantitative study, digital transformation and organizational culture have a mutual influence. This influence is visible at all levels, with all dimensions and subdimensions influencing one another. On the other hand, the qualitative analysis demonstrated that Society 5.0 and its sub-dimensions influence both digital transformation and organizational culture, as well as their sub-dimensions. Furthermore, it was determined that understanding Society 5.0 necessitates digital transformation as well as a shift in organizational culture. Finally, organizations need to consider the developments within the scope of Society 5.0 and change their organizational structures accordingly. [ABSTRACT FROM AUTHOR]

Purpose: To provide real-world data on patient perceptions and experiences with subcutaneous (SC) versus intravenous (IV) daratumumab. Patients and Methods: This was a cross-sectional, mixed-method (qualitative/quantitative) survey conducted in France, Germany, Spain and the United Kingdom involving multiple myeloma (MM) patients who switched from IV to SC daratumumab in the last 12 months (qualitative phase) or 24 months (quantitative phase [26 months in the UK]) prior to enrollment in the study. Results: Nine patients (mean age 65 years) participated in the qualitative phase and 113 patients (mean age 65.1 years) in the quantitative phase. Qualitative study results provided insights for the quantitative study and highlighted the benefits of switching from daratumumab IV to daratumumab SC as an improvement and a satisfactory change in patients' treatment journey. Quantitative survey showed that patients were significantly less anxious, stressed and nervous before SC injections than IV infusions (mean score: 1.3, 1.1, 1.4 versus 2.1, 2.0, 2.0 respectively, p< 0.001), and significantly more reassured, ready/well-prepared, usual self and relieved (mean score: 3.8, 4.3, 3.7, 3.6 versus 3.0, 3.6, 3.1, 3.0 respectively, p< 0.001). Immediately after SC first injection, 96.5% patients were feeling well or very well versus 77.9% immediately after IV first infusion (p< 0.001). 97.3% patients were satisfied with their SC treatment versus 89.4% for the IV injection (p< 0.001). Patients spent significantly less time in hospital for an SC injection of daratumumab than for an IV infusion, 1.5 hours and 5.0 hours respectively (p< 0.001). In the UK, the differences between the two administration forms were less visible, likely because of confounding factors including a longer time passed since the switch from the IV to the SC form and administration of the survey. Conclusion: In line with results from other studies, the SC form of daratumumab had less impact on patients' emotional burden than the IV form. [ABSTRACT FROM AUTHOR]

By utilizing a mixed-method approach that combines a quantitative analysis of 10,183 retrieved records of non-uploaded cases, and a qualitative in-depth interview of ten judges and five judge assistants, the current study investigated the pattern of selective uploading, and explored the possible reasons for non-disclosure. We found that the estimated upload rate based on the number of the uploaded and the non-uploaded cases for criminal cases is higher than that reported by previous studies. In addition, there are considerable variations across the type of crimes, the location of courts, and the year of adjudication regarding the patterns of non-disclosure. The in-depth interviews revealed that there are four common scenarios where a case can be assigned to the "Other" group for the reason of non-disclosure: (1) circumstances involving unconcluded cases; (2) cases containing sensitive information that can be used for illegal purposes; (3) cases that involve specially granted circumstances that lead to a mitigated punishment; or (4) simple technical difficulty. [ABSTRACT FROM AUTHOR]

This paper aimed to re-conceptualize teacher resilience, to develop the Teacher. Resilience Inventory, and to explore the impact of teacher resilience on job satisfaction and turnover intention using three sets of teacher samples from China. The validity of the Teacher Resilience Inventory was tested using content validity, construct validity, criterion validity, and cross validity. The results yielded the five dimensions of teacher resilience, namely, physical, emotional, psychological, social, and spiritual resilience, to re-conceptualize teacher resilience. The Teacher Resilience Inventory outlines a general picture of the resilience experience of teachers at work from a multidimensional perspective. Results also showed that teacher resilience significantly related to job satisfaction and turnover intention. This paper will advance the knowledge base on teacher resilience. It will also support teachers to negotiate and navigate demands and resources for desirable outcomes in their everyday life, during constant change and unprecedented uncertainties. [ABSTRACT FROM AUTHOR]

Many older adults are increasingly embracing digital technology in the Republic of Korea. This study investigated the relationship between the digital skills of Korean older adults and their perceived health status and digital technology application for health promotion. This mixed-method study comprised a community survey of 434 older adults aged ≥65 in two cities in South Korea, followed by focus group interviews. Five types of digital skills, 'operational internet skills', 'information navigation skills', 'social skills', 'creative skills', and 'mobile skills', were measured using the LSE digital skill measurement instrument. Multivariable analysis identified the influence of digital skills on health-related outcomes. Among them, 'social skills' associated positively with self-rated health (β 0.37, 95%CI 0.08, 0.65). 'Information navigation skills' contributed positively to the use of digital technology and the internet for a healthy lifestyle in terms of improving eating habits (β 0.43, 95%CI 0.09, 0.77), accessing healthcare (β 0.53, 95%CI 0.21, 0.85), and accessing long-term care services (β 0.45, 95%CI 0.11, 0.79). Thematic analysis revealed that the study participants use Korean language-based resources such as Naver and Kakao Talk for social connection to promote a healthy lifestyle. This study concludes that encouraging initial and sustained use of the internet and enhancing digital skills among Korean older adults can promote active and healthy aging. [ABSTRACT FROM AUTHOR]

This paper describes the development and validation of the multidimensional Teacher Well-being Inventory underlined by a rational-empirical approach using teacher samples from China. A 20-item multidimensional instrument on teacher well-being was established with good psychometric characteristics. The results yielded five dimensions, which comprises of physical, emotional/psychological, cognitive, social, and spiritual well-being. This concise measurement targets assessing the most salient well-being scenarios of teachers at work. This validated measurement can serve as a more robust gauge for promoting well-being literacy and functioning of individual teachers, students and schools in response to the OECD 2030 agenda of building the wellness society. [ABSTRACT FROM AUTHOR]

Background: Satisfaction is defined as the perceived fulfillment of patient or client needs and desires through the delivery of healthcare services. In developed countries, more than 60% of women have been screened for cervical cancer. However, only 12% of women in sub-Saharan Africa have been screened for precancerous cervical lesions. There is limited evidence on client satisfaction with cervical cancer screening services (CSCCSS) in Ethiopia, particularly, there is no study conducted by mixed method in the Amhara region. Objective: The study aimed to assess clients' satisfaction with cervical cancer screening services and influencing factors among women screened in Debre Markos town public health facilities in Northwest Ethiopia, 2022/23. Methods: A convergent parallel mixed methods design was conducted in Debre Markos town's public health facilities from October 10th, 2022 to January 10th, 2023. For the quantitative wing, a total of 401 cervical cancer screening service users were selected using a systematic random sampling technique. Data were collected using an interviewer-administered structured questionnaire. Clients were interviewed on exit in a private area far from the screening unit and the data were entered into Epi-data version 4.6.0.2, then exported to STATA version 14 for analysis. A binary logistic regression model was fitted to identify factors associated with client satisfaction with cervical cancer screening services. The qualitative data were collected through in-depth and key informant interviews using a semi-structured topic guide. The data were analyzed using a thematic analysis approach with Open code software (version 4.0.2.3). Result: The quantitative wing revealed that overall, 65% (95% CI: 60–69) of respondents were satisfied with the cervical cancer screening services they received. Gender of the provider (AOR: 6.11, 95% CI: 3.23–11.55, p-value = 0.000), waiting time (AOR: 4.77, 95% CI: 1.32–17.31, p-value = 0.017), clients' knowledge (AOR: 0.26, 95% CI: 0.12–0.59, p-value = 0.001), and clients' attitude (AOR: 6.43, 95% CI: 3.43–12.03, p-value = 0.000) were significantly associated with CSCCSS. Qualitative result: The thematic analysis revealed three themes. Theme 1: facility-related barriers (shortage of skilled manpower, shortage of infrastructure, providers' skill gap, unavailability of full service, leadership problem, long waiting time). Theme 2: client-related barriers (poor knowledge and attitude, gender preference). Theme 3: facility-related facilitators (free service, presence of supportive partners). Conclusion: According to the findings of this study, two-thirds of clients were satisfied with cervical cancer screening services, which was lower than the national target of 80%. Long waiting time, male gender of the service provider, unfavorable attitude, and good knowledge of clients were identified as significant factors negatively affecting client satisfaction with cervical cancer screening. [ABSTRACT FROM AUTHOR]

Purpose: Digital lean implementation can solve the dual problem of stagnating quality and rising costs in healthcare. Although technology adoption in healthcare has increased in the post-COVID world, value unlocking using technology needs a well-thought-out approach to achieve success. This paper provides a prescriptive framework for successfully implementing digital lean in healthcare. Design/methodology/approach: This study uses a mixed-method approach to achieve three research objectives. Whilst it uses a narrative review to identify the enablers, it uses qualitative thematic analysis techniques to categorise them into factors. The study utilises the delphi method for the thematic grouping of the enablers in the broader groups. The study used an advanced ordinal priority approach (OPA) to prioritise these factors. Finally, the study uses concordance analysis to assess the reliability of group decision-making. Findings: The study found that 20 identified enablers are rooted in practice factors, followed by human resource management (HRM) factors, customer factors, leadership factors and technology factors. These results further counter the myth that technology holds the utmost significance in implementing digital lean in healthcare and found the equal importance of factors related to people, customers, leadership and best practices such as benchmarking, continuous improvement and change management. Originality/value: The study is the first of its kind, providing the prescriptive framework for implementing digital lean in healthcare. The findings are useful for healthcare professionals and health policymakers. [ABSTRACT FROM AUTHOR]

Background: The COVID-19 pandemic has posed significant challenges to nations worldwide, affecting various sectors of society. Women's HIV harm reduction centers, which provide critical services, have also been affected by these difficulties. This study aimed to examine the challenges of the COVID-19 pandemic on the services offered by women's HIV harm reduction centers from the perspective of clients. Methods: A convergent mixed-method design was utilized to gain in-depth insights into the challenges of COVID-19 on the services provided by women's HIV harm reduction centers, counseling centers, and night shelters that cater to women at risk, such as drug users, sex workers, and the homeless population, in three provinces (Tehran, Khuzestan, and Kermanshah) in Iran. The study was conducted from January to May 2023. The quantitative aspect of the study employed a cross-sectional method with a sample size of 430 individuals. A researcher-developed questionnaire was used to assess a range of services. The qualitative part of the study involved traditional content analysis and included 32 individual interviews. The integration of qualitative and quantitative results was performed during the interpretation phase to provide a comprehensive understanding of the challenges of COVID-19 on women's HIV harm reduction centers. Results: In the quantitative phase, the mean age of women was 39.0 ± 10.2 years. 165 women reported a history of COVID-19, which accounts for 38.4% of the total. More than half of them (n = 102, 61.8%) recovering at home. The majority of women (n = 365, 84.9%) mentioned receiving the COVID-19 vaccine. COVID-19 diagnostic tests were conducted for 74.2% (n = 319) of women. Women expressed higher satisfaction with the services (HIV prevention services, and accommodation services) before the COVID-19 pandemic compared to the satisfaction during the pandemic. The qualitative analysis identified emerging challenges related to the COVID-19 pandemic in two categories: personal challenges and mismanagement of services, comprising nineteen subcategories. Conclusion: The findings of this study highlight the adverse impact of the COVID-19 pandemic on the services provided by women's HIV harm reduction centers, in contrast to the pre-pandemic period. To mitigate these negative effects, it is crucial to implement preventive measures and practical solutions. This may involve addressing the personal and management challenges of the centers. [ABSTRACT FROM AUTHOR]

Background: Electronic portfolios (e-portfolios) are valuable tools to scaffold workplace learning. Feedback is an essential element of the learning process, but it often lacks quality when incorporated in ePortfolios, while research on how to incorporate feedback into an ePortfolio design is scarce. Objectives: To compare the ease of use, usefulness and attitude among three feedback formats integrated in an ePortfolio: open-text feedback, structured-text feedback and speech-to-text feedback. Methods: In a mixed method designed experiment, we tested with 85 participants from different healthcare disciplines, three feedback formats in an ePortfolio prototype. Participants provided feedback on students' behaviour after observing video-recorded simulation scenarios. After this, participants completed a questionnaire derived from the Technology Acceptance Model (TAM). The experiment ended with a semi-structured interview. Results: Structured-text feedback received highest scores on perceived ease of use, usefulness, and attitude. This type of feedback was preferred above open-text feedback (currently the standard), and speech-to-text feedback. However, qualitative research results indicated that speech-to-text feedback is potentially valuable for feedback input on-premise. Respondents would use it to record short feedback immediately after an incident as a reminder for more expanded written feedback later or to record oral feedback to a student. Implications: Structured-text feedback was recommended over open-text feedback. The quality of the speech-to-text technology used in this experiment, was insufficient to use in a professional ePortfolio but holds the potential to improve the feedback process and should be considered when designing new versions of ePortfolios for healthcare education. [ABSTRACT FROM AUTHOR]

This study aims to identify the influence of Generation X and Generation Y on green buying behavior in the Indian context. Based on social cognitive theory and the generational cohort theory, the authors test the impact of Perceived Environmental Responsibility and Social Media Information Sharing on the relationship between Generation X and Y cohorts and their green buying behavior. This study uses the Quan-Qual approach to triangulate the results. A structured questionnaire was used to collect data from 427 respondents, and the hypotheses were tested with covariance-based structural equation modeling using AMOS software (AMOS 26 software). To probe further into the findings, in-depth interviews were conducted with 60 respondents from Gen X and Gen Y cohort groups, and the data were analyzed using NVIVO software. The findings reveal that the Gen X cohort seems to engage more in green buying behavior compared to the Gen Y cohort. Also, Social Media Information Sharing mediates the green buying behavior for Gen X and moderates it for Gen Y. Moreover, the qualitative inquiry confirms that the Perceived Environmental Responsibility of both Gen X and Gen Y cohorts does not significantly impact their green buying behavior. [ABSTRACT FROM AUTHOR]

Background: The COVID-19 pandemic posed significant challenges for managers overseeing women's harm reduction centers. This study seeks to capture managers' perspectives on the service providing in women's harm reduction centers during the COVID-19 pandemic. Methods: This convergent mixed-method study conducted in three provinces of Iran: Tehran, Khuzestan, and Kermanshah. The study was carried out between January and May 2023. In the quantitative part, the researchers utilized reports from 10 center managers. A researcher-designed questionnaire was employed to collect data on a wide range of services and referrals provided by the centers. The qualitative part of the research involved conventional content analysis and included 12 individual interviews. Two directors from the Ministry of Health and ten managers of women's harm reduction centers participated in the interviews. During the interpretation phase, the researchers compared the quantitative and qualitative findings to obtain a comprehensive understanding of the topic. Results: During the quantitative stage of the study, it was observed that all the managers were women, with an average age of 40.7 ± 7 years. More than half of the managers had obtained a postgraduate education (n = 6, 60%), and a majority of them were married (n = 7, 70%). Additionally, 40% of the managers (n = 4) were working as contractors. During the non-COVID-19 period, there were higher coverage by centers and residents, more referrals of non-injecting drug users and sex workers, and a higher number of group counseling sessions in all three provinces compared to the COVID-19 period. The qualitative analysis revealed two primary themes: "challenges" and "capabilities." Conclusions: During the COVID-19 pandemic, providing some services and client referrals decreased in the centers, and center managers faced increased challenges. Many of these challenges were in the communication, executive, management, structure, education, financial, civilization, facilities, and socio-cultural sectors. Managers used their skills to manage and control these challenges. It is important to focus on these challenges and managerial capabilities to effectively handle future crises. [ABSTRACT FROM AUTHOR]

Background: We implemented a contextualized innovative mentorship program in the Clinical Master in Family Medicine (CMFM) program established in April 2020 at Arabian Gulf University. In this paper, we describe the process of this program and derive the major challenges faced by trainees and related corrective actions and their outcomes on high-risk trainees for optimal performance. Methods: We conducted a mixed-method longitudinal study of 80 trainees, analyzing information extracted from the Moodle learning platform about five key performance indicators as well as the contents (quantitative and qualitative) of mentoring meeting reports submitted through a validated online form between 2020 and 2022. We analyzed frequencies and themes of challenges and compared trainees' performance according to time and level of risk. Results: The follow-up of all 80 trainees in two cohorts (40 for each cohort) shows that most are female (93.75%) and the mean age is 30.00 ± 2.19 years with a ratio of mentors to mentees of 1 to 5. Meetings are conducted through phone calls, virtually, and face-to-face in 62%, 29%, and 8.3% respectively. The mean number and duration of meetings are 30.88 ± 2.31 and 20.08 ± 9.50 min respectively. Time management is the most reported challenge (41.3%), followed by health, social, and psychological-related issues in 7.6%, 4.6%, and 3% respectively. We extracted four main themes related to trainees, settings of training, e-Portfolio, and the COVID-19 pandemic. The mentorship program captured 12 trainees at high risk for low academic progress (12%) of whom six graduated on time and the remaining had to repeat a few courses the following terms. The performance of the program is stable over time (mean GPA of 3.30 (SE = 0.03), versus 3.34 (SE = 0.05) for cohorts 1 and 2 in the two years respectively, (P = 0.33). However, it is slightly lower among high-risk trainees compared to the remaining (GPA = 3.35 (SE = 0.03) versus 3.14 (SE = 0.08), P = 0.043) though above the minimum of the threshold of 3 out of 4, required for the master's degree. Conclusion: The mentorship program captured the struggling trainees and permitted to implement pertinent corrective actions timely, particularly in the context of a two-year intensive CMFM program during the COVID-19 pandemic. [ABSTRACT FROM AUTHOR]

While some food, agricultural, natural resources, and human science (FANRHS) experts participate in a variety of outreach opportunities, many face barriers to public interaction such as lack of incentive, knowledge, or confidence. This study examined scientists' and Extensionists' outreach experiences as guests on science podcasts. Results showed the guests had minimal formal science communication training yet were highly educated individuals and involved with informal education. Future research should examine how peer-modeling can be used to recruit more scientists to science communication opportunities and how institutions can improve training for outreach such as podcasts. [ABSTRACT FROM AUTHOR]

The main goal of the current research is to investigate and analyze the attitude of local residents towards the sustainable development of rural tourism to identify the opportunities and challenges of this type of tourism, which has been done with the case study of the villages of Alborz province. The research method is mixed, which uses the qualitative method of the research object in the first stage and the quantitative survey method in the second stage. The approach of the present research is sequential exploratory. The data collection tools are semi-structured interviews in the first stage and questionnaires in the second stage. According to the research findings in the qualitative phase, the experts and informants were selected using the purposeful sampling method, and finally, by aggregating 31 interviews, 134 raw propositions were extracted, which were extracted using the three-axis coding method in the form of open codes. They were classified as central and selective. Finally, among 134 raw propositions, 70 open codes, 21 core codes, and six selective codes were obtained. In the quantitative stage, analyzes were performed using SPSS26 and SmartPLS3 soft-ware. According to the quantitative findings of the obtained values, it was found that among the dimensions, the socio-cultural dimension has high values. According to the research results, the sus-tainable development of rural tourism will contribute to the qualitative development, organization, and management of rural tourism and attract investment in the tourism industry. [ABSTRACT FROM AUTHOR]

Purpose: This research addresses the professional logics of street-level managers (SLMs) and bureaucrats (SLBs) working in the Brazilian National Social Security Agency (INSS) through their perceptions of distributive justice and discretion. Since SLMs have the authority to influence SLBs' actions, we investigate whether these two groups hold similar viewpoints. Design/methodology/approach: We integrate the administrative data and survey responses (n = 678) with earlier thematic content analysis (n = 350) in three stages: mean-testing, regression analyses and complementary qualitative analysis, integrated through a mixed-methods matrix. Findings: Whilst no significant differences emerge in distributive justice ideas between groups, SLMs demand wider benefit-granting discretion, praising professionalism whilst adopting managerial posture and jargon. Research limitations/implications: The study adds to the theoretical discussions concerning SLM's influence on SLB's decision-making, suggesting that other factors outweigh it. The finding concerning the managers' demand for wider discretion asks for further in-depth approaches. Practical implications: Findings supply valuable insights for policymakers and managers steering administrative reforms, by questioning whether some roles SLMs play are limited to symbolic levels. Further, SLBs' heterogenous formations might be more relevant to policy divergence than managerial influence and perhaps an underutilised source of innovation. Originality/value: By approaching street-level management professional logics within a Global South welfare state through a mixed-methods approach, this study offers a holistic understanding of complex dynamics, providing novel insights for public sector management. [ABSTRACT FROM AUTHOR]

Background: Intimate partner violence (IPV) is the most common form of violence against women. Postpartum IPV refers to any type of IPV that occurs up to one year after childbirth and has many adverse impacts on mothers and their children. Considering the lack of sufficient information on the prevalence and factors related to IPV after childbirth in Iran, this study aimed to evaluate the frequency and severity of IPV, its different forms, and psychosocial factors related to IPV, as well as to explore how IPV is perceived among mothers one year after childbirth. Methods: An explanatory sequential mixed-methods design was used to conduct this study in two phases. The first phase is a cross-sectional study that will be performed on postpartum mothers who have a one-year-old child referred to health care centers in the southern region of Tehran, Iran, with the aim of determining the prevalence of IPV and its related factors. The second phase is a qualitative conventional content analysis study with the purpose of exploring women's experiences and perceptions of IPV and its preventive or protective factors. Purposive sampling will be used. Based on the results of the quantitative phase, mothers who are at the two ends of the IPV spectrum (based on their total Conflict Tactics Scale (CTS-2) scores) will be selected, and in-depth and semistructured interviews will be conducted with them. Finally, the researchers will provide an interpretation of the quantitative results using qualitative data. Discussion: This is the first study that uses a mixed methods approach to explain different dimensions of IPV, its related factors, and mothers' perceptions of it. By providing a better understanding of this phenomenon, it is hoped that the results of this research will be used by policymakers and officials of educational and cultural systems to plan and provide effective interventions, enact laws, and present educational and cultural programs to prevent IPV after childbirth. Ethical code: IR.TUMS.FNM.REC1400.200. Plain English summary: Intimate partner violence is the most common form of violence against women, with a higher prevalence in Asian and Eastern Mediterranean countries, including Iran. The period after childbirth is a stressful and anxiety-provoking event due to the increased physical, psychological, social, and economic needs of parents, leading to intimate partner violence. Studies show that women who experience violence after childbirth face many physical, sexual, and emotional problems. Additionally, it will have a negative impact on their baby. Many factors can lead to intimate partner violence, among which psychological factors are among the most important. Therefore, we decided to perform a study in two phases with the aim of determining the prevalence and factors related to intimate partner violence. In the first phase, we will study Iranian women who have a one-year child living in southern Tehran city and ask them to complete questionnaires related to intimate partner violence. In the second phase, we will conduct an interview with women who have experienced violence after childbirth to obtain more information about the factors involved. [ABSTRACT FROM AUTHOR]

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

This mixed methods research study aimed to determine spiritual care competencies and death anxiety levels of nursing students practicing in intensive care. The quantitative part of this study included 33 students while the qualitative part included 17 students. Nursing students' spiritual care competence was detected to be above medium and their death anxiety was high. Two themes emerged from the qualitative data collected through in-depth interviews with 17 nursing students: (a) Views on spiritual care competencies and (b) Views on death. These findings are significant to reduce nursing students' death anxiety, increase spiritual care competencies and the quality of patients' end-of-life care. [ABSTRACT FROM AUTHOR]

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

Context: Despite the Weekly Iron folic acid supplementation (WIFS) program, the prevalence of anaemia among adolescent girls remains high. Phase 1 Indian Council of Medical Research (ICMR) task force study conducted in 2016 in Kallur showed that the IFA provision rate for adolescent girls was 72% but the consumption rate was only 15% in the Kallur area. The present study was done to identify the gaps for the difference between provision and consumption rate of weekly IFA tablets among adolescent girls using the WHO conceptual framework in home‑based settings. Materials and Methods: This crosssectional study with a mixedmethod design was conducted from October 2020 to December 2021. Quantitative data were collected from 972 adolescent girls and their parents using a structured pretested questionnaire, whereas qualitative exploration was done by focus group discussions. Descriptive analysis and bivariate analysis were used to analyse the quantitative data. Qualitative data were analysed and integrated with quantitative results. Results: The overall number of girls who were aware of Iron Folic acid therapy (IFAT) was 704 (72%). However, only 132 (13%) adolescent girls were found to be adherent to IFA therapy. Multivariable regression analysis revealed that side effects encountered on intake of IFAT (Odds ratio (OR) =0.5, P = 0.009) were associated with higher rates of nonadherence, whereas regular supply (OR = 13.6, P = 0.000), health education to parents (OR = 2.76, P = 0.002), and experiencing benefits (OR = 1.72, P = 0.006) were associated with higher rates of adherence. These were substantiated by qualitative findings. Conclusions: Ignorance on the impact of anaemia on adolescent health, fear of side effects, unpleasant effects experienced on intake of Iron folic acid (IFA), and inadequate counselling determines the adherence to weekly IFA supplements among adolescent girls. [ABSTRACT FROM AUTHOR]

We study the impact of providing consulting services and major capital infusions to small‐ and medium‐sized enterprises (SMEs) in the food sector in Kenya. We exploit a quasi‐experimental design that matches treated firms with comparable firms that applied for the same support but were just short of scoring sufficient points to receive this support. Using mixed methods, this quantitative analysis is supplemented by in‐depth qualitative interviews, which provide further insights into the workings of the program. The program helped SMEs launch new products and increased numbers of employees. Interviewees described higher sales resulting from the major capital infusions they received. [ABSTRACT FROM AUTHOR]

Young men from disadvantaged contexts are the least likely to attend university in Australia; furthermore, when they do attend, they are likely to struggle. This article draws on empirical data documenting the aspirations and resilience of first-in-family young men in Australian higher education, with the aim of nuancing their classed experience of university. Drawing on an exploratory longitudinal study (n = 42) and adopting a mixed method approach, we use the 25-item Connor-Davidson Resilience Scale (CD-RISC) and semi-structured interviews over a three-year period to explore changes in resilience of first-in-family men from the age of 17 to 20. The mixed-method approach employed in this study allows us to draw connections between the participants' subjective experience of resilience and the more objective measures of resilience as captured by the Connor-Davidson Resilience Scale, a psychometrically sound and validated instrument. Quantitative analyses of data enable us to document the trends in resilience over time for different groups of first-in-family men, while qualitative data provide insights structured around three key themes: independence and isolation; managing and adjusting; and using support structures. The article draws on analysis across these data to consider the participants' perceptions of their resilience, and how these perceptions change in reference to their experience, in order to paint a more nuanced picture of first-in-family men's classed experience of higher education. [ABSTRACT FROM AUTHOR]

This study investigates how tourists' Green Environmental Knowledge, Green Hotel Knowledge, and environment concern impact pro-environmental (PE) attitudes. Using mixed methods, it examines how PE attitudes influence the intention to stay at eco-friendly hotels, based on the theory of planned behavior. The study further explores the moderating role of the "Greta Effect" in connecting PE attitudes and hotel choice. This study utilizes a mixed-methods approach to enhance the comprehension of quantitative findings, on exploring the moderating impact of the "Greta Effect". The findings highlight the important role of environmental activism in inspiring action for green hotel choice. [ABSTRACT FROM AUTHOR]

(1) Background: Patient safety culture (PSC) encompasses the values, attitudes, norms, beliefs, practices, perceptions, competencies, policies, and behaviours of professionals that determine organisational commitment to quality and patient safety. Few studies use mixed methods to analyse patient safety culture, and none offer the richness of using a mixed methodology to develop their theoretical model. This study aims to identify the factors nurses believe contextualise and influence PSC in relation to existing theoretical frameworks. (2) Methods: This study employed a sequential explanatory mixed-methods design combined with the Pillar Integration Process for data integration. (3) Results: In the final data integration process, 26 factors affecting nurses' PSC were identified. Factors nurses related to PSC not being assessed with the tool used in phase 1 were notification system, flow of patients, patient involvement, resources and infrastructure, and service characteristics. (4) Conclusions: This mixed-methods study provides an opportunity to identify the weaknesses and strengths of currently developed theoretical frameworks related to PSC and offers content for its improvement. Even though multiple studies aim to assess PSC using existing quantitative method tools, the development of this study offers a glimpse of some aspects relevant to nurses' PSC not included in the theoretical framework of the said tools, such as patient involvement, the flow of patients, and service infrastructure. [ABSTRACT FROM AUTHOR]

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

This study assessed the quality of perioperative nursing (PON) care in selected hospitals in Osun State, Nigeria. This study adopted a concurrent mixed method design to assess the quality of perioperative nursing care in selected hospitals. The study adopted multiple sampling select surgical patients and perioperative nurses for quantitative and qualitative data. observational checklist and interview guide were used for data collection. for analysis using SPSS version 25 for quantitative data while descriptive and inferential statistical techniques were employed for quantitative data at significant level of 0.05while content and thematic analysis were used for qualitative data. Results from quantitative data showed that 52.8% of pre-operative nursing care was of good, quality, 53.2% of intra-operative nursing care was of good, 47.9%, of post-operative nursing care was of poor quality while 49.9% of overall perioperative nursing care was of good, quality. There was statistically significant difference between the level of quality of care across the three health facilities (p = 0.01). Results from the qualitative findings showed that nurses rated the quality of perioperative care as moderate while many of the patients spoke glowingly about the quality of care they receive and that perioperative nurses are doing their best. This study concluded that there is good quality of pre and intra- operative nursing but poor quality of post-operative and overall quality of perioperative nursing care. Hence, there is need for perioperative nurses to make their voices and care more visible in the care of surgical patients. Public Contribution: Perioperative nurses were involved at the data collection stage. They were the subjects for the study. [ABSTRACT FROM AUTHOR]

Purpose: The study examined the relationship between e-learning usage, creativity, e-learning utility and academic performance among undergraduate (UG) and postgraduate (PG) students at Banaras Hindu University (BHU), India. Design/methodology/approach: The data from 480 students were collected using a cross-sectional survey design. Pearson correlation analysis was performed in order to investigate the association between the variables. Findings: The results revealed a significant positive correlation between time of use and academic performance (r = 0.294, p < 0.01). However, there was no significant correlation between time of use and the usability of e-learning in the attainment of learning outcomes. Furthermore, there was a negative correlation between time of use and creativity (r = −0.170, p < 0.01). Practical implications: The results indicate that educators ought to promote consistent utilization of e-learning platforms to enhance scholarly achievements. However, learners should exercise prudence in their usage, as an over-reliance on these platforms may impede their creativity. Originality/value: This study contributes to the existing body of knowledge regarding the impacts of e-learning on students' academic performance and creativity. Additionally, it offers instructing professionals and students who make use of e-learning platforms information that might be helpful to them. [ABSTRACT FROM AUTHOR]

A barrier to meeting the goal of universal health coverage in India is the inequality in utilisation of health services between indigenous and non-indigenous people. This study aimed to explore the determinants of utilisation, or non-utilisation, of public healthcare services among the Santals, an indigenous community living in West Bengal, India. The study holistically explored the utilisation of public healthcare facilities using a framework that conceptualised service coverage to be dependent on a set of determinants – viz. the nature and severity of the ailment, availability, accessibility (geographical and financial), and acceptability of the healthcare options and decision-making around these further depends on background characteristics of the individual or their family/household. This cross-sectional study adopts ethnographic approach for detailed insight into the issue and interviewed 422 adult members of Santals living in both rural (Bankura) and urban (Howrah) areas of West Bengal for demographic, socio-economic characteristics and healthcare utilisation behaviour using pre-tested data collection schedule. The findings revealed that utilisation of the public healthcare facilities was low, especially in urban areas. Residence in urban areas, being female, having higher education, engaging in salaried occupation and having availability of private allopathic and homoeopathic doctors in the locality had higher odds of not utilising public healthcare services. Issues like misbehaviour from the health personnel, unavailability of medicine, poor quality of care, and high patient load were reported as the major reasons for non-utilisation of public health services. The finding highlights the importance of improving the availability and quality of care of healthcare services for marginalised populations because these communities live in geographically isolated places and have low affordability of private healthcare. The health programme needs to address these issues to improve the utilisation and reduce the inequality in healthcare utilisation, which would be beneficial for all segments of Indian population. [ABSTRACT FROM AUTHOR]

The aim of the study is to examine the role of childhood experiences and achievement motivation in high school students' hope levels. The quantitative (N = 686, 43.9% females and 56.1% males, aged between 13 and 19; Mage = 16.02, standard deviation = 1.23) and qualitative data of the study, in which enriched design was used, were collected from high school students studying in the Southeast of Turkey. Hierarchical regression was used in the quantitative part of the study and content analysis was carried out in the qualitative part. It is seen that the results in the qualitative analysis part largely coincide with the results in the quantitative part. The results denote that high school students have high hope levels. Also, according to the results, there is a negative, low‐level, and significant relationship between childhood experiences and hope, and a positive and moderately significant relationship between hope and achievement motivation. Although childhood experiences and achievement motivation significantly predict the level of hope, it is concluded that achievement motivation contributes more to the hope‐related variance which is explained. The findings reveal the value of achievement motivation and childhood experiences in understanding adolescents' hope multidimensionally. Practitioner Points: Childhood experiences and achievement motivation significantly predict adolescents' hope.It has been concluded that negative experiences do not affect the level of hope in adolescents who predominantly remember these experiences from childhood.Hope in adolescents is more related to achievement motivation, which is a goal‐oriented and individual trait, than to childhood experiences. [ABSTRACT FROM AUTHOR]

In the current educational context, international institutions are being called to rethink education and declining new strategies that aim to teach sustainable behaviors. From this perspective, the present study aims to investigate the attitudes towards the sustainability of trainee teachers, verifying their connection with psycho-social variables, such as environmental identity and sense of community responsibility, and exploring their most common dispositions. In total, 126 Italian preservice teachers were involved in a mixed method study where they were asked to complete a questionnaire and participated in focus groups. The use of a combination of quantitative–qualitative methodologies has allowed us to obtain in-depth information about sustainability education. Quantitative data showed a virtuous circular relationship between environmental identity, attitudes towards education for sustainability, and the sense of community responsibility. Qualitative data showed the high frequency of two key action verbs, avoid and respect, but no specific reference to the educational field. After creating the target concept 'to teach', we observed a worrying absence of lemmas related to emotional dimension, and that the communication perspective is set on adults' point of view, rather than on pupils. Limitations, strengths, and practical implications have been extensively discussed, especially in relation to the field of teacher education. [ABSTRACT FROM AUTHOR]

Purpose: Sensory modulation intervention involves using calming and grounding sensory stimuli to support coping with distress and intense emotions. Evaluating the impact of sensory modulation is challenging in inpatient settings due to the numerous variables influencing outcomes in ward environments. This study aims to determine the impact of sensory modulation across all organisational levels including service users, staff confidence and attitudes, ward climate and seclusion events. Design/methodology/approach: Organisational case studies were conducted in two Aotearoa New Zealand inpatient mental health services, using qualitative and quantitative data to explore the effects of a sensory modulation programme. Findings: Results showed that sensory modulation enhanced staff knowledge and confidence in fostering therapeutic relationships and reducing restrictive practices, positively impacted ward climate and provided service users with sensory strategies to use in everyday life. Practical implications: The findings captured the complexity of implementation and impact of sensory modulation programmes at individual, group and organisational levels. It is important to recognise the influencing factors and impact of sensory modulation across all levels of service delivery. Originality/value: Organisational case study methodology offered a unique approach to evaluating the impact of sensory modulation within inpatient mental health services. Data analysis suggests that in addition to managing acute service user distress, sensory modulation impacts broader staff, team and service level outcomes. [ABSTRACT FROM AUTHOR]

This paper constructs two conforming finite element grad grad and elasticity complexes on the cuboid meshes. For the finite element grad grad complex, an H 2 conforming finite element space, an H (curl ; S) conforming finite element space, an H (div ; T) conforming finite element space and an L 2 finite element space are constructed. Further, a finite element complex with reduced regularity is also constructed, whose degrees of freedom for the three diagonal components are coupled. For the finite element elasticity complex, a vector-valued H 1 conforming space and an H (curl curl T ; S) conforming space are constructed. Combining with an existing H (div ; S) ∩ H (div div ; S) element and an H (div ; S) element, respectively, these finite element spaces form two finite element elasticity complexes. The exactness of all the finite element complexes is proved. [ABSTRACT FROM AUTHOR]

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

Background: Patient Reported Outcomes Measures (PROMs) are being used increasingly to measure health problems in stroke clinical practice. However, the implementation of these PROMs in routine stroke care is still in its infancy. To understand the value of PROMs used in ischemic stroke care, we explored the patients' experience with PROMs and with the consultation at routine post-discharge follow-up after stroke. Methods: In this prospective mixed methods study, patients with ischemic stroke completed an evaluation questionnaire about the use of PROMs and about their consultation in two Dutch hospitals. Additionally, telephone interviews were held to gain in-depth information about their experience with PROMs. Results: In total, 63 patients completed the evaluation questionnaire of which 10 patients were also interviewed. Most patients (82.2–96.6%) found completing the PROMs to be feasible and relevant. Half the patients (49.2–51.6%) considered the PROMs useful for the consultation and most patients (87.3–96.8%) reported the consultation as a positive experience. Completing the PROMs provided 51.6% of the patients with insight into their stroke-related problems. Almost 75% of the patients found the PROMs useful in giving the healthcare provider greater insight, and 60% reported discussing the PROM results during the consultation. Interviewed patients reported the added value of PROMs, particularly when arranging further care, in gaining a broader insight into the problems, and in ensuring all important topics were discussed during the consultation. Conclusions: Completing PROMs appears to be feasible for patients with stroke attending post-discharge consultation; the vast majority of patients experienced added value for themselves or the healthcare provider. We recommend that healthcare providers discuss the PROM results with their patients to improve the value of PROMs for the patient. This could also improve the willingness to complete PROMs in the future. [ABSTRACT FROM AUTHOR]

Background: Patients with a stroke often cannot care for themselves after hospital discharge. Assessment of their self-care ability is the first step in planning post-discharge home care. This study aimed to design and validate a measure of perceived self-care ability (PSCA) in stroke patients. Methods: A sequential-exploratory mixed method was conducted in Tehran, Iran, in 2020–2021. The qualitative phase involved in-depth semi-structured interviews with 12 participants. Transcripts were content analyzed. The results guided the development of 81 items. psychometric properties such as face validity (Impact Score > 1.5), content validity ratio (CVR > 0.63), content validity index (Item Content Validity Index: ICVI > 0.78, Scale Content Validity Index/Average: SCVI/Ave > 0.8) and Kappa value (Kappa > 0.7), internal consistency (Cronbach's alpha > 0.7), relative reliability (ICC: inter class correlation coefficient), absolute reliability (Standard Error of Measurement: SEM and Minimal Detectable Changes: MDC), convergent validity (Correlation Coefficient between 0.4–0.7), interpretability, responsiveness, feasibility, and ceiling and floor effects were assessed. Results: Content analysis of the qualitative interviews yielded 5 major categories and 9 subcategories that reflected "Perceptual stability", "Cognitive fluctuations", "Sensory, Motor and Physical health"," The subjective nature" and "The dynamic nature" of PSCA. Results of face and content validity reduced the number of items to 32, capturing three dimensions of PSCA in chronic stroke patients; these dimensions included perceptual ability, threatened health status, and sensory, motor, and cognitive ability. The findings supported the reliability and validity of the measure. Conclusions: The PSCA questionnaire was developed and validated within the Iranian culture. It is useful in assessing the self-care of patients with stroke and in informing practice. [ABSTRACT FROM AUTHOR]

Just like in many countries around the world, there is a multicultural society in Northern Cyprus. As migrations to the island continue to increase, the phenomenon of multiculturalism has begun to be discussed in the education system. This research was conducted with the aim of determining the attitudes and views of primary school teachers in Northern Cyprus towards multicultural education. Mixed methods strategy was used in this research. In the research, the concurrent triangulation strategy from mixed methods strategies was used. Data collection tools the Teacher Multicultural Education Attitude Scale and developed interview form were used. In the quantitative part of the research, the Teacher Multiculturalism Attitude Scale was applied to 111 randomly selected teachers. According to the survey results, no significant difference was detected depending on the variables of gender, nationality, professional seniority, branch, graduation degree and graduated school. However, significant differences were identified in the multiculturalism scores age and based on the region where the teachers were employed. In the qualitative part of the research, interviews were conducted with 12 participant teachers. According to the qualitative findings, teachers perceived multiculturalism as diversity in terms of nationality, ethnic background, language, and religion. Further, teachers indicated that education in Northern Cyprus does not cater to a multicultural structure, leading to various problems experienced by students and parents, primarily related to communication. The teachers attributed this situation to the unpreparedness of the Ministry of Education (MEB) and the reluctance to change education policies due to an exclusive society. Subsequently, teachers expressed that they did not consider themselves competent in multicultural education and expressed a willingness to participate in in-service training programs if provided. [ABSTRACT FROM AUTHOR]