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Healthcare policies promote technology use as a means to modernise healthcare and support seamless, person-centred care. However, despite information technology (IT) use being common practice in clinical settings, its use in patients' homes is still developing. This study explored patients' perspectives on the use of IT and electronic health records (EHR) in their home environment. Semi structured interviews were conducted with housebound patients who received regular care from the district nursing team, and thematic data analysis was undertaken. Participants reported variable knowledge and experiences with mobile working and EHR. Most were positive and identified clear benefits for clinicians. However, few participants reported benefits to themselves. Contrary to popular belief, IT use is expected by older patients and, while barriers were identified, the overall opinion was positive. A digital divide was apparent, with some at risk of being disadvantaged by the increasing use of technology. [ABSTRACT FROM AUTHOR]

(1) To describe facilitators and barriers to the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) food shopping via electronic benefits transfer (eWIC) compared with paper vouchers. (2) To explore suggestions that WIC participants had for modifying the program to enhance their overall WIC experience. Qualitative, semistructured, in-depth interviews. WIC participants in East Tennessee. Twenty-four primary food shoppers of WIC-participating households aged at least 18 years were recruited using a purposive sampling strategy. Perceived facilitators and barriers to use of eWIC as compared with paper vouchers. Interview transcripts were analyzed using a grounded theory approach to identify emergent themes. Participants identified several ways eWIC has improved their food shopping experience, including ad hoc redemption of WIC benefits and a quicker, more discrete checkout. Participants' chief complaint about eWIC was transaction errors at checkout. Participants identified other barriers to shopping for WIC foods that cannot be addressed by the card alone, such as difficulty identifying WIC items in-store. Participants reported changes to their benefit tracking behaviors and provided suggestions to improve WIC further. The transition to eWIC was viewed favorably among WIC participants, although participants identified a need for additional support in addressing transaction errors. This finding presents an opportunity to modify messages delivered to WIC participants by WIC nutrition educators and enhance collaboration between WIC agencies, retailers, and e-commerce technology providers. [ABSTRACT FROM AUTHOR]

PURPOSE: To evaluate the effect of electronic and paper-based standardized nursing care plans (SNCPs) use on quality of nurses’ documentation. METHODS: Using quasi-experimental design, two wards were grouped into electronic and paper-based wards. Nurses were trained to use electronic- and paperbased SNCPs for care-planning and documentation. Data was collected before, 3, and 6 months postintervention and analyzed with SPSS version 20. FINDINGS: There was improvement in documentation quality in the two wards after introducing SNCPs with higher quality scores in the electronic ward postintervention. CONCLUSION: Providing SNCPs in electronic and paper formats is critical to improving nursing documentation. IMPLICATION FOR NURSING PRACTICE: Adequate training and support for nurses are needed for successful implementation of SNCPs in electronic health records (EHRs) in developing nations. [ABSTRACT FROM AUTHOR]

Background: Low- and middle-income countries (LMICs), including South Africa, are currently experiencing multiple epidemics: HIV and the rising burden of non-communicable diseases (NCDs), leading to different patterns of multimorbidity (the occurrence of two or more chronic conditions) than experienced in high income settings. These adversely affect health outcomes, increase patients' perceived burden of treatment, and impact the workload of self-management. This paper outlines the methods used in a qualitative study exploring burden of treatment among people living with HIV/NCD multimorbidity in South Africa. Methods: We undertook a comparative qualitative study to examine the interaction between individuals' treatment burden (self-management workload) and their capacity to take on this workload, using the dual lenses of Burden of Treatment Theory (BoTT) and Cumulative Complexity Model (CuCoM) to aid conceptualisation of the data. We interviewed 30 people with multimorbidity and 16 carers in rural Eastern Cape and urban Cape Town between February-April 2021. Data was analysed through framework analysis. Findings: This paper discusses the methodological procedures considered when conducting qualitative research among people with multimorbidity in low-income settings in South Africa. We highlight the decisions made when developing the research design, recruiting participants, and selecting field-sites. We also explore data analysis processes and reflect on the positionality of the research project and researchers. Conclusion: This paper illustrates the decision-making processes conducting this qualitative research and may be helpful in informing future research aiming to qualitatively investigate treatment burden among patients in LMICs. [ABSTRACT FROM AUTHOR]

Aim To report a pilot study for the development and validation of an instrument to measure quality in historical research papers. Background There are no set criteria to assess historical papers published in nursing journals. Design A three phase mixed method sequential confirmatory design. Methods In 2012, we used a three-phase approach to item generation and content evaluation. In phase 1, we consulted nursing historians using an online survey comprising three open-ended questions and revised the items. In phase 2, we evaluated the revised items for relevance with expert historians using a 4-point Likert scale and Content Validity Index calculation. In phase 3, we conducted reliability testing of the instrument using a 3-point Likert scale. Results In phase 1, 121 responses were generated via the online survey and revised to 40 interrogatively phrased items. In phase 2, five items with an Item Content Validity Index score of ≥0·7 remained. In phase 3, responses from historians resulted in 100% agreement to questions 1, 2 and 4 and 89% and 78%, respectively, to questions 3 and 5. Conclusion Items for the QSHRP have been identified, content validated and reliability tested. This scale improves on previous scales, which over-emphasized source criticism. However, a full-scale study is needed with nursing historians to increase its robustness. [ABSTRACT FROM AUTHOR]

The paper hand-held record (PHR) has been used extensively in general practice (GP) shared care management of pregnant women, and recently, the first Mater Shared Electronic Health Record (MSEHR) was introduced. The aim of this qualitative study was to examine women's experiences using the records and the contribution of the records to integrate care. At the 36-week antenatal visit in a maternity tertiary centre clinic, women were identified as a user of either the PHR or the MSEHR and organised into Phase 1 and Phase 2 studies respectively. Fifteen women were interviewed in Phase 1 and 12 women in Phase 2. Semi-structured interviews were used for data collection, and analysed using qualitative content analysis. Four main themes were identified: (1) purpose of the record, (2) perceptions of the record; (3) content of the record, and (4) sharing the record. Findings indicate that the PHR is a well-liked maternity tool. The findings also indicate there is under-usage of the MSEHR due to health-care providers failing to follow up and discuss the option of using the electronic health record option or if a woman has completed the log-in process. This paper adds to an already favourable body of knowledge about the use of the PHR. It is recommended that continued implementation of the MSEHR be undertaken to facilitate its use. [ABSTRACT FROM AUTHOR]

Article 6 of the Universal Declaration of Human Rights states that everyone has a right to identity as a person, and its importance cannot be overemphasized anywhere else than in the court of law. The wrinkles and grooves on labial mucosa called as sulci-labiorum forms a characteristic pattern and the study of these is referred to as cheiloscopy. These are unique to an individual just like the fingerprints hence, behold the potential for identification purpose and can be used to verify the presence of a person at the scene of crime. The aim of study was to compare the lip-prints taken on bond paper and cloth. The study was done in north Haryana from 2010-11 on 100 subjects. Purposive sampling was done and subjects were asked to produce lip prints on cloth as well as on bond paper. The data obtained using these two base materials were analyzed for any difference in results using Fischer's exact test. The difference in the result between the lip prints obtained using bond paper and cloth was found to be statistically non-significant. Hence, it can be concluded that lip prints present on the cloth of the accused as in crime scene can be compared with samples obtained on bond paper. [ABSTRACT FROM AUTHOR]

Background: One aspect of development in children is fine motor development. Delays in fine motor skills can make children have difficulty exploring the environment, barriers to learning, lazy writing, lack of creativity. This study aims to determine the effectiveness of playing Origami interventions to improve preschool children’s fine motor skills in PAUD Aisiyah VI Bengkulu City. Study Design:This research is a Quasi-Experimental study with a research design of “one group pretest and post-test without control group design”, a sample of 26 preschool children using purposive sampling. The intervention was given for two weeks as many as six meetings with 30 minutes per session. Data on children’s fine motor development were collected using the DDST II screening format. Results: Analysis using the Wilcoxon test obtained ρ value 0.000 (α 0.05). In conclusion, Origami play intervention is statistically effective in improving the fine motor skills of preschool children. Conclusion: Teachers and parents should pay more attention to and increase the stimulation of preschool children’s fine motor skills by facilitating children to play folding, sticking, and paper cutting more often. [ABSTRACT FROM AUTHOR]

Background: People with intellectual disabilities often present with unique challenges that make it more difficult to meet their palliative care needs. Aim: To define consensus norms for palliative care of people with intellectual disabilities in Europe. Design: Delphi study in four rounds: (1) a taskforce of 12 experts from seven European countries drafted the norms, based on available empirical knowledge and regional/national guidelines; (2) using an online survey, 34 experts from 18 European countries evaluated the draft norms, provided feedback and distributed the survey within their professional networks. Criteria for consensus were clearly defined; (3) modifications and recommendations were made by the taskforce; and (4) the European Association for Palliative Care reviewed and approved the final version. Setting and participants: Taskforce members: identified through international networking strategies. Expert panel: a purposive sample identified through taskforce members’ networks. Results: A total of 80 experts from 15 European countries evaluated 52 items within the following 13 norms: equity of access, communication, recognising the need for palliative care, assessment of total needs, symptom management, end-of-life decision making, involving those who matter, collaboration, support for family/carers, preparing for death, bereavement support, education/training and developing/managing services. None of the items scored less than 86% agreement, making a further round unnecessary. In light of respondents’ comments, several items were modified and one item was deleted. Conclusion: This White Paper presents the first guidance for clinical practice, policy and research related to palliative care for people with intellectual disabilities based on evidence and European consensus, setting a benchmark for changes in policy and practice. [ABSTRACT FROM AUTHOR]

Aim A discussion on how informatics knowledge and competencies can enable nursing to instantiate transition to integrated models of care. Background Costs of traditional models of care are no longer sustainable consequent to the spiralling incidence and costs of chronic illness. The international community looks towards technology-enabled solutions to support a shift towards integrated patient-centred models of care. Design Discussion paper. Data sources A search of the literature was performed dating from 2000-2015 and a purposeful data sample based on relevance to building the discussion was included. Discussion The holistic perspective of nursing knowledge can support and advance integrated healthcare models. Informatics skills are key for the profession to play a leadership role in design, implementation and operation of next generation health care. However, evidence suggests that nursing engagement with informatics strategic development for healthcare provision is currently variable. Implications for nursing A statistically significant need exists to progress health care towards integrated models of care. Strategic and tactical plans that are robustly pragmatic with nursing insights and expertise are an essential component to achieve effective healthcare provision. To avoid exclusion in the discourse dominated by management and technology experts, nursing leaders must develop and actively promote the advancement of nursing informatics skills. For knowledge in nursing practice to flourish in contemporary health care, nurse leaders will need to incorporate informatics for optimal translation and interpretation. Conclusion Defined nursing leadership roles informed by informatics are essential to generate concrete solutions sustaining nursing practice in integrated care models. [ABSTRACT FROM AUTHOR]

The increase in competition is felt by pastry producers. COK-KIS, established in 2016, needs to increase their sales by improving their products using the attributes that are preferred by potential consumers, in terms of flavor, nutritional value, and packaging. However, previous studies examining these attributes have been inconsistent. Hence, the aim of the study was to examine the combination of attributes to be used in COK-KIS products that are in line with the consumer’s preferences. The data was collected from 97 respondents through purposive sampling. The results were analyzed using conjoint analysis by SPSS. The study showed that the consumers’ preferred attribute was taste, the second was the nutritional value, and the third was the packaging. The most preferred combination of attributes was the low-calorie savory product, packed in a paper bag. [ABSTRACT FROM AUTHOR]

Background Electronic nicotine delivery systems (ENDS) are growing in awareness and use in the USA. They are currently unregulated as the Food and Drug Administration has yet to assert jurisdiction under its tobacco authority over these products, and a US Court of Appeals held they cannot be regulated as drugs/ delivery devices if they are not marketed for a therapeutic purpose. Observation of the current online marketplace suggests ENDS, like some nutraceutical products, are being promoted using affiliate marketing techniques using claims concerning purported health benefits. Objective This study performed a forensic analysis to characterise the relationships between online ENDS affiliate advertisements and ENDS sellers, and evaluated descriptive content on advertisements and websites to inform future policy and regulatory efforts. Methods A purposive sampling strategy was used to identify three forms of ENDS advertising. Web proxy software recorded identifiable objects and their ties to each other. Network analysis of these ties followed, as well as analysis of descriptive content on advertisements and websites identified. Results The forensic analysis included four ENDS advertisements, two linked affiliate websites, and two linked seller websites, and demonstrated a multilevel relationship between advertisements and sellers with multiple layers of redirection. Descriptive analysis indicated that advertisements and affiliates, but not linked sellers, included smoking cessation claims. Results suggest that ENDS sellers may be trying to distance marketing efforts containing unsubstantiated claims from sales. A separate descriptive analysis of 20 ENDS seller web pages indicated that the use of affiliate marketing by sellers may be widespread. Conclusions These findings support increased monitoring and regulation of ENDS marketing to prevent deceptive marketing tactics and ensure consumer safety. [ABSTRACT FROM AUTHOR]

The article focuses on a study in Scotland, United Kingdom of prioritizing protection of children from secondhand smoke exposure (SHSE) in a private space where smoke-free public places are enforced. It discusses the difficulty of political acceptability in enforcing the issue and the intervention over parental autonomy to smoke in their own home. The article also reports on the findings based on the study used called Reducing Families' Exposure to Secondhand Smoke (REFRESH) project.

Purpose: Most patient-reported outcome (PROs) used in thrombosis research and clinical practice are delivered using technology like online questionnaires. However, only few have undergone formal electronic adaptation from paper to digital versions, threatening the validity and reliability of the PROs. The present study aimed to perform an electronic adaption and cross-cultural translation of two PROs measuring health-related quality of life in a Danish cohort of patients with venous thrombosis (VTE), specifically the VEINES-QoL/Sym questionnaire and the PEmb-QoL questionnaire. Methods: The electronic adaption and cross-cultural translation processes followed the international guidelines recommended by ISPOR. The migration of the questionnaires from paper to electronic versions was conducted in the Research Electronic Data Capture (REDCap). Following approval of the electronically adapted and translated versions, a pretest of the questionnaires was performed by cognitive interviewing patients with VTE recruited from a hospital setting. Results: Nine men and ten women between the age of 19 and 73 years participated in cognitive interviews. The questionnaires were successfully adapted from paper to electronic versions, and during the migration process only a few modifications to the content and format were made. Most comments were related to technicalities, e.g. touch functions and checkboxes. The cross-cultural translation of both questionnaires was satisfactory, as only minor rephrasing was required. Conclusions: The original and Danish version of VEINES-QoL/Sym and PEmb-QoL were successfully adapted into electronic versions and are ready to share for REDCap users. Furthermore, the Danish versions of the two questionnaires have shown satisfactory face validity. [ABSTRACT FROM AUTHOR]

The aim of this study was to examine Turkish course exam questions in terms of originality, page layout, item types, item writing criteria and cognitive level. The research was conducted with the document analysis method, and to determine the data source, the maximum variation sampling method, one of the purposive sampling methods, was used. The data source of the research consisted of exam questions prepared by Turkish teachers employed in secondary schools in a medium-sized city in the Black Sea region. Exam questions from each of the school levels determined on the basis of High School Entrance Exam achievements, from each district within the provincial borders, and from each type of school at the secondary school level were included in the research. Within the scope of the research, 747 questions in 51 exam papers were analysed. Descriptive analysis was carried out for the research data, and the obtained findings were summarised using frequencies and percentages. When the research findings were examined, it was concluded that the exam papers had similarity rates ranging from 11% to 91%, and that several exam papers and questions were taken from different internet sources as they were without making any changes. Other obtained findings were that more than half of the Turkish course exam papers did not have the page layout features that should be found in an exam paper, that the most frequently used item type in the exam papers was the multiple-choice item type, and that teachers did not pay attention to the item writing criteria. Another striking finding of the study was that about four-fifths of the questions examined were prepared for the understand level and one-fifth for the remember and apply level, and that while very few questions were prepared for the analyze and create levels, no questions were prepared for the evaluate level. Moreover, it was concluded that the majority of the questions examined were prepared for the middle cognitive level, while higher-order questions were included only at a rate of eight per thousand. The obtained results are discussed within the scope of the literature and a number of recommendations have been made. [ABSTRACT FROM AUTHOR]

Objective To document tobacco advertising practices of a popular, high-grade, domestic cigarette in China across a broad spectrum of channels. Methods Media monitoring and direct observations were conducted to assess tobacco advertisements for Zhonghua cigarettes in Shanghai, China, through the following channels: newspapers, TV, internet, outdoor advertisements and point-of-sale advertisements. Results Consistent with the national ban, no direct tobacco advertisements were found in newspapers or on TV. However, statements about counterfeit 'Zhonghua' cigarettes indirectly promoted Zhonghua tobacco through newspapers. Although no tobacco advertisements were found in Shanghai mainstream websites or in channels of national mainstream sites, a great amount of information was communicated about Zhonghua cigarettes via websites, using patriotic themes and associations with Chinese culture. Large outdoor tobacco advertisements of 'Loving my China' were found in downtown Shanghai. Zhonghua tobacco advertisements were present in almost all of the points-of-sale observed (95%). Conclusions Zhonghua cigarettes are promoted directly and indirectly through a variety of channels. This study suggests there is an urgent need to establish comprehensive bans that prohibit all types of tobacco advertisements in China. [ABSTRACT FROM AUTHOR]

While on paper Zimbabwe has a comprehensive child protection legal framework, the occurrence of child sexual abuse (CSA) is high. Drawing from findings of a qualitative study, a case study design, and a research population consisting of a forum of organizations providing CSA interventions: the Victim Friendly System, this paper presents how some cultural myths, cultural practices, cultural rites, and religious practices may contribute to CSA in Zimbabwe. Purposive sampling was used to select 38 professional working in the VFS, 4 key informants, 17 VFS monthly meeting minutes, and 300 court files of tried and sentenced CSA cases from Harare and Gokwe. CSA is a gross child and human rights violation that places some religions, myths, beliefs, and cultural practices at crossroads with social work principles. Various social work interventions are suggested as ways to navigate the paradox: shaped by cultural, traditional, religious, and mythical factors contributing to CSA and legal frameworks to address CSA. [ABSTRACT FROM AUTHOR]

Beliefs form the fabric of every society. Likewise, there are socio-cultural beliefs that people hold as causes of climate risk. This paper sought to identify the socio-cultural beliefs on drought among crop farmers in Talensi, Ghana and how these provide insights for environmental management, social vulnerability, early warning systems and coping and adaptation. The selection of Talensi District was appropriate because it is one of the agrarian districts located in drought prone zone of Ghana. The study was designed following the case study approach. A total of 69 participants were selected through purposive sampling to participate in key informant interviews and focus group discussions conducted across nine (9) communities. The study found that manifestation of bad and/or indecent behavioural practices; performance and/or non-performance of traditional rites; presence and behaviour peculiar animals; and magical conjurations and incantations by spiritualists, diviners and soothsayers were the significant socio-cultural beliefs accounting for drought. The study concludes that the socio-cultural beliefs of the local people are their social-cultural capital and this asset is a useful gamut in explaining the social vulnerability; development of early warning drought systems; and selection of coping and adaptation strategies in Talensi District. A major recommendation is that individuals and institutions with expertise in technical and scientific early warning drought information should be circumspect in not adopting a judgmental approach when they are communicating and disseminating risk information, to the detriment of indigenous knowledge. [ABSTRACT FROM AUTHOR]

Aim: To explore the prospective acceptability of an implementation leadership training programme prototype for nurse managers in China to implement evidence‐based practices, from the perspectives of potential programme participants and deliverers. Design: A qualitative descriptive study was conducted in Spring 2022 at three tertiary hospitals in Hunan, China. Methods: We conducted individual semi‐structured interviews with unit‐level nurse managers (n = 14), including 12 potential participants, and two potential deliverers that have been involved in developing the programme prototype. Interview questions and thematic analysis were guided by the Theoretical Framework of Acceptability. Results: After reviewing the programme content, potential participants and deliverers reported that unit nurse managers would benefit from engaging in the programme, acknowledging that the programme fit with professional nursing values for implementing research evidence. They expressed positive views about being involved in producing academic papers through the training process, and interactive multi‐modal training activities such as group work, experience‐sharing and coaching. Seven participants were not very confident about being fully engaged in the training, as they could not navigate the English research literature. Both participants and deliverers highlighted factors that would influence their participation, including time constraints, the impact of the COVID‐19 pandemic, and support from senior organizational leadership. Conclusions: The training programme prototype was perceived to be useful and acceptable. The multimodal training activities were considered a strength and managers expressed an interest in writing academic papers about their implementation processes. Support from senior hospital leaders and programme deliverers was identified as critical to the training programme's success. Impact: The study helps understand nurse managers' perceptions and concerns of participating in an implementation leadership training programme and could inform the development and refinement of similar programmes in various nursing contexts globally. [ABSTRACT FROM AUTHOR]

Aims: This study aims to reveal the violent experiences of nurses working in the emergency department and the meanings they attribute to them. Methods: This research was conducted as narrative inquiry and interpretive phenomenology and recruited 15 nurses. Interviews with nurses actively working in the emergency department and who had been exposed to violence by patients or their relatives were conducted with a semi‐structured interview form. The consolidated criteria for reporting qualitative research (COREQ) checklist was used. Results: In the study, three themes were determined (1) Unpredictable event, (2) Interminable effects of violence, and (3) Like a bottomless pit. With seven sub‐themes. Conclusions: This study underlined that violence applied to nurses by patients or relatives of patients in the emergency department is an unexpected situation that causes negative emotions. Violence affects all aspects of life and limits communication with the patient. Coping with a violent situation is challenging for nurses, and they demand support from the management. Summary Statement: What is already known about this topic? Violence is most commonly reported as experienced by nurses in the emergency department.Violence affects nurses deeply and causes negative effects in daily life. What this paper adds: Nurses described the violence perpetrated by patients or by patients' relatives as a situation that causes negative feelings such as anger, worthlessness, and injustice.Nurses emphasized that violence affects their clinical environment and their daily lives. The implications of this paper: The multidimensional and destructive effects of violence on nurses have shown that it is important to make the necessary arrangements quickly to reduce violence in the emergency departmentThe study provides information about the experiences of nurses who have been exposed to violence by patients or their relatives in the emergency department. [ABSTRACT FROM AUTHOR]

Background: Cultural competence is considered one of the criteria for high‐quality nursing care. Aim: This study aimed to analyse cultural competence in nursing. Methods: This study was performed using the hybrid concept analysis approach in three phases. In the theoretical phase, literature was reviewed by searching Persian and English language databases, and 94 articles were included. In the second or fieldwork phase, 11 semi‐structured interviews were conducted with purposefully selected nurses. The results of both theoretical and fieldwork phases were analysed using conventional content analysis, and in the final analysis phase, the results of the previous phases were triangulated. Results: The attributes of cultural competence were obtained in the theoretical phase in six and the fieldwork phase in three categories. In the final phase, the categories obtained in both previous phases were triangulated: cultural competence in nursing is a continuous, developmental, flexible, extensive and complex process that is patient‐ and justice‐oriented and emerges through learning and skills acquisition, including cultural knowledge, attitudes and practices. Conclusion: Managers and planners of nursing education can use the results of this study to educate nursing students and nurses and evaluate outcomes as one of the criteria for quality care. Summary statement: What is already known about this topic? There is a concern in nursing that the profession needs a unified definition of cultural competence.What this paper adds? This study showed that cultural competence in nursing is a continuous, developmental, complex, and extensive process that is patient‐ and justice‐orientated and emerges through learning and skills acquisition, including cultural knowledge, attitudes, and practices.The implications of this paper: The findings help identify and present the definition of cultural competence in nursing and be used in the training of nursing students and the continuous education of nurses. [ABSTRACT FROM AUTHOR]

Objective: The study aimed to explore the perspective of healthcare workers on the resources they need to provide quality rehabilitation for people recovering from coronavirus disease 2019 (COVID-19) infection. Methods: A descriptive qualitative approach using reflexive thematic analysis was employed. Focus groups and interviews were performed with nine healthcare workers (one intensive care unit physiotherapist, one respiratory therapist and seven occupational therapists) with experience treating patients recovering from COVID-19 infection within hospital and in the community. Verbatim transcripts were coded and analysed for themes. Results: Healthcare workers perceive an urgent need for resources about recovery from COVID-19 infection to support quality care. They particularly want detailed guidance about potential trajectories of recovery, and what should be expected over time for people with long COVID. Many observed that this group of patients had higher oxygen requirement and experienced slower recovery than others with serious respiratory conditions. Supports for quality care do exist but were not perceived as sufficient by participants. They want any new resources developed to be accessible, quick to access and targeted to specific healthcare worker roles and services settings. Participants identified several barriers to accessing practice supports, including the time poor nature of health care and financial costs to both patients and healthcare workers. Conclusion: Healthcare workers perceive an urgent need for the development of resources to support quality rehabilitation for people recovering from COVID-19 infection, to support best outcomes for this group of patients. Any resources developed must consider identified barriers to their access and use to maximise their impact. What is known about the topic? Workforce development needs related to the management of people recovering from coronavirus disease 2019 (COVID-19) are relatively unknown, due to the novelty of the virus and sustained pressure on the healthcare system due to the pandemic. What does this paper add? The paper identifies resource gaps and potential improvements from the clinician perspective. It also emphasises the urgent need for tailored, multidisciplinary resources and workforce capacity building. What are the implications for practitioners? Access to accessible updated resources and continuing professional development is critical for allied health clinicians in the evolving field of COVID-19 rehabilitation. [ABSTRACT FROM AUTHOR]

Purpose: The aim of the study is to present the results and description of the direct study relating to changes that have occurred in the purchasing area as well as make out new solutions and good practices that were undertaken in the context of events with a destructive impact on the supply chain (Covid-19 pandemic, armed conflict in Ukraine, etc.) that occurred in the last years. Particular attention was paid to answering the question whether the events had an impact on the digital transformation in the purchasing area and what related changes were implemented. Design/methodology/approach: The answers to the research questions were obtained on the basis of the results of surveys conducted using the CAWI method based on the original questionnaire. A statistical method was used to verify the research hypothesis (Anova KruskalWallis test). The study covered the group of experts with a minimum of 8 years of professional experience in the field of purchasing and current position: Senior Purchasing Specialist or Purchasing Manager or Purchasing Director. Findings: The considerations and results of the research presented in the paper can be the basis for the characteristics of the changes taking place over the last years in purchasing and may constitute an indication and a model of good practices for organisations that have not yet implemented the improvements in the purchasing area which are proposed in the article. Research limitations/implications: The study provided confirmation that the respondents have a set of features directly related to the topic of the study, as well as the required work experience in the current company. Purposive sampling was used in the study. Future in-depth research may focus on identifying statistically significant relationships in the explored topic. Practical implications: The identified changes in purchasing area caused by events with a destructive impact on the supply chain and the list of good practices implemented in enterprises constitute valuable recommendations for management practice in the digitization process. Originality/value: The study proves that in the area of purchasing, numerous changes in the functioning of this process have been noticed over recent years, due to the events with a destructive impact on the functioning of the supply chain. The changes had an impact on the digital transformation which is related to the levels of purchasing maturity of enterprises. [ABSTRACT FROM AUTHOR]

This paper prioritizes the effective factors for fostering the culture of paying taxes in Iran's economic enterprises. The statistical population includes academic instructors and experts in the field of taxation selected by the purposive sampling method. Finally, 15 university instructors and experts answered structured interview questions. The inclusion criteria were at least 10 years of study, instructing, or working in the field of tax affairs. Sampling continued until the theoretical saturation stage. Also, the Intraclass Correlation Coefficient (ICC)coefficient value consistency and absolute agreement were confirmed to determine the measurement tool's reliability. Super Decision software and the ANP network analysis process were used to prioritize criteria. The results of prioritization showed that criterion V1, namely "electronic infrastructure" is the most important and as a result the most important sub-criteria in presenting the model of fostering the culture of tax payment in Iranian economic enterprises. After that, the V3 criterion, namely "financial incentives" was placed as the second priority. The management ability and attitude, and compliance with tax laws were ranked third and fourth. [ABSTRACT FROM AUTHOR]

A research gap exists in the understanding of multi-level governance for watersheds in Kenya under the current devolved framework. This paper uses the Migori River watershed as a case study to elaborate on the institutional arrangement in the management of the watershed and how it influences the nature and level of coordination among the actors involved. The data was collected through semi-structured interviews and content analysis of secondary data. The target institutions were selected based on existing policy and legal frameworks, press releases, and published administrative reports. Respondents for the semi-structured interviews were identified through purposive and snowball sampling techniques. The qualitative data was then analysed through content analysis. After analysis of the nature of coordination, a panel of experts rated each coordination dimension based on a comparison between the findings and the baseline indicators. The results on the structure and roles of institutions revealed adequate representation of the river basin management actors, but the associations among actors are weak due to overlapping mandates and gaps in the administration processes of river basin management programs. Coordination exists, but it is not all-encompassing; whereas efforts to collaborate were noted, they were inconsistent and tended to be on a per-need basis due to a lack of a common forum for stakeholder interactions and a common management plan for a clear vision and direction of actors' activities. There is an unclear delineation of roles in the institutional structure and thus causing institutional complexity, which further undermines coordination. To address the coordination gaps, the paper recommends the creation of a management council for the watershed to provide a central forum for the stakeholders' interaction, with a designated lead agency that organizes and facilitates meetings, oversees communications, and manages any emerging challenges, gaps and opportunities in collective actions. [ABSTRACT FROM AUTHOR]

Purpose: This paper aims to explore the perspectives of registered nurses towards communication with family members of older people with a tracheostomy. Design/methodology/approach: A qualitative design was used. Ten participants were recruited through purposive sampling. Face-to-face, semi-structured interviews were used in collecting data. Data were analysed by thematic analysis. Findings: The four themes identified were as follows: communication by considering time difference; considering factors related to effective communication, either family member–related factors or registered nurse–related factors; strategies of communicating to support family members, such as giving an opportunity to ask for accurate information, communicating to build self-confidence and communicating through cases; and using the art of communication by speaking slowly and clearly, using colloquialisms, being steady and calm, as well as using positive language. Practical implications: Having strategies and using the art of communication are important to help family members in obtaining accurate information and in building self-confidence in the care of older people. Originality/value: The paper indicates that registered nurses consider factors related to communication, and they gave more information to family members using effective strategies and the art of communication. Therefore, effective communication training to nursing teams should be performed to promote adherence to treatment and family members' satisfaction. [ABSTRACT FROM AUTHOR]

Bereavement and mourning are arguably one of the research interests of psychologists, psychoanalysts, and psychiatrists since Freud's publication of Mourning and Melancholia. This paper is a qualitative case study that sought to examine the mourning experience of the participant from childhood until his adolescence. For theoretical foundation, the four tasks of mourning primarily developed by James Worden was utilized for the proper direction of the research inquiry; namely: a.) accepting the reality of death; b.) experiencing the feeling of grief; c.) adjusting and creating new meanings in the post-loss world; and d.) reconfiguring the bond with the lost person. The paper finds that the participant's cognitive attitude, emotional experiences, and personal observations of the environment enable him to overcome actively (in an overlapping manner) the three tasks of mourning. However, the failure to find an enduring connection with his deceased parents is not a result of strong attachment but with the absence of personal belief about the meta-existence of God. [ABSTRACT FROM AUTHOR]

Purpose: This paper aims to argue that contextual safeguarding complements existing theoretical models and approaches. Its successful integration with dominant thinking and practice in safeguarding potentially offers new insights to improve system-wide practice. Design/methodology/approach: A theory synthesis design was used to purposively identify, summarise and compare selected safeguarding theoretical models and approaches to establish both convergence and divergence. Findings: The arguments provided in this paper suggest that synthesising theory offers a confluence of perspectives that promise to develop a more eclectic and holistic approach to safeguarding practice. The paper demonstrates how contextual safeguarding can be integrated with existing theoretical models and approaches. Research limitations/implications: This is a conceptual paper and therefore is not based on empirical data. Practical implications: This paper's conceptual insights include that integrating contextual safeguarding with existing theoretical models and approaches can broaden the knowledge base to whole system-wide safeguarding practice in the UK. The paper also confirms that the methodology used is feasible, although more work is required to test its efficacy on a larger scale. The conceptual paper argues for synthesis of contextual safeguarding and commonly used child safeguarding theoretical models and approaches to deal with both intra and extra familial forms of risk of harm to children effectively. Social implications: The neglect and abuse of children is a topical issue; hence, this paper has social implications regarding understanding of how the issue child abuse and neglect in the UK and globally should be dealt with. Originality/value: There is a dearth of studies that have gone beyond binary comparisons of contextual safeguarding and other theoretical models and approaches, which leaves a significant knowledge gap that has prompted the purpose of this paper. [ABSTRACT FROM AUTHOR]

As a dominant genre of academic writing, research papers can be considered as the locus of reproduction concerning asymmetrical power relations and dominance. Through a purposive sampling consisting of the analysis and evaluation of an argument, the purpose of this study was to divulge the power and ideology latent in the discussion section of the research articles to raise second language learners' awareness of the epistemological foundations and methodological goals and values of the ideologies behind the texts as social structures. By using a practical reasoning framework as an evaluative tool to analyze a text presented in the discussion part of arguments published in research articles, the analysis revealed that the scientific viewpoints exhibit themselves as the premises of these arguments. These world views maintain the dominance of the papers on global academic and social discourses. Understanding the ideological purpose of the article genre is crucial for promoting democratic and equitable education. This assertion highlights the importance of recognizing this function. [ABSTRACT FROM AUTHOR]

Reading comprehension is the ability to understand a text, decode and infer its meaning according to reader's level of comprehension. Similarly, reading is the ability to deduce, critique and construct the attributes of a text. Hence, reading and reading comprehension are intertwined and embedded as a skill to analyse the meaning of the text in general and synthesise the interpretation of your own understanding of a particular text. Despite this prerequisite skill, there are challenges that impede reading comprehension, and as a result, the paper intimates these challenges of reading comprehension using critical theory as a conceptual framework. It further employs participatory action research as a technique whereby co-researchers were purposively sampled and interviewed in a free attitudinal interview. Equally, the results are analysed using critical discourse analysis, where it is established that lack of collaborative learning, exposure to informational text, students' prior knowledge and punctuation marks are the core attributes of the challenges of reading comprehension. In brief, the paper contends that the use of fictional stories as a learning strategy can enhance the reading comprehension of first-year students. [ABSTRACT FROM AUTHOR]

Background: For adults with inflammatory bowel disease (IBD), they experience many challenges in dietary decision‐making. Thus, this study examined the perspective and experiences of adults with IBD in dietary decision‐making. Objective: This study aimed to explore the perception and consideration of people with IBD in their daily dietary decisions through monitoring, interpretation and action during the decision‐making process. Design: A qualitative study of individuals affected by IBD was conducted through semistructured interviews. Results: Twenty patients were recruited from four tertiary hospitals in Nanjing, China, and each participant completed a semistructured interview. The majority of participants reported on the process and experience of dietary decision‐making. Key themes were categorised into three stages: (1) assessing needs, preferences and food cues (monitor); (2) moving from experience to expertise (interpret) and (3) balancing expectations amidst limitations (act). The majority of participants reported that their decisions were shaped by assessing current disease status and food cues. Those interviewed with IBD were willing to make tradeoffs for bowel stability, but their decisions were also influenced by past dietary experiences and traditional Chinese beliefs. The lack of awareness of dietary guidelines was a significant barrier to healthy eating decisions. Positive or negative feelings accompanied dietary decisions. Conclusion: Although most people with IBD change their diet after diagnosis, the changes made are often inconsistent with existing dietary recommendations. Several factors can influence the dietary decision‐making process. This study will help assess the experiences of people with IBD in dietary decision‐making to encourage the formation of targeted dietary health and well‐being interventions. Knowledge of nutrition and diet should be provided in education and training programmes for IBD management. Patient or Public Contribution: The first three authors of this paper were the lead researchers in this study's design. These authors were mentored by patient researchers who also contributed to the manuscript, and the research process was co‐lead and directed by other patient participants and consultants. The results of this paper were directly obtained from patient participants. [ABSTRACT FROM AUTHOR]

Purpose: Meals on Wheels (MOW) support older people to live in their own homes and communities. The purpose of this paper is to explore MOW experiences from a multi-stakeholder level to inform and better equip this valuable service. Design/methodology/approach: A qualitative approach was undertaken utilising semi-structured interviews and focus groups with current, former and potential MOW service users and MOW stakeholders. Findings: Qualitative analysis explored MOW perspectives and experiences, highlighting a lack of MOW information and awareness, the importance of a client-centred approach the multiple roles of MOW and service transition. Originality/value: This research explores MOW from the perspective of different groups directly involved in this community service, offering unique multi-stakeholder insights to understand and guide the future of this service. [ABSTRACT FROM AUTHOR]

PURPOSE: This paper answered the research gap on entrepreneurial orientation with a sample of small and mediumsized enterprises' (SMEs) export performance and the mediating role of innovation capability and international networking accessibility that has not been tested in previous research. This study also tested the effect of entrepreneurial orientation on SMEs' export performance in the global market. The mediating role of international networking accessibility and innovation capability on SMEs' export performance also became another focus of this study. METHODOLOGY: This paper implemented a quantitative approach with 282 owners or managers of the SMEs brass industry cluster in Boyolali, Indonesia, who were examined using purposive sampling. FINDINGS: The findings of this study revealed that entrepreneurial orientation did not significantly affect SMEs' export performance but did significantly affect innovation capability and international networking accessibility. Another empirical test found that innovation capability had significantly affected SMEs' export performance and the international networking accessibility. International networking accessibility also significantly affected the performance of export SMEs. This study also found an important mediating role of international network accessibility and innovation capability in the relationship between entrepreneurial orientation and SMEs' export performance. IMPLICATIONS: This study contributes to research investigating the effect of entrepreneurial orientation on performance by conducting in-depth studies on innovation capabilities and international networking accessibility. Many studies have tested the mediating role of innovation capability and international networking accessibility. The practical implication of this study is that it can help managers or owners of SMEs better understand and find optimal solutions through enhancing innovation capability and international networking accessibility, which can be instilled in the characteristics of SME owners or managers to improve performance. ORIGINALITY AND VALUE: The results of this study indicate the mediating role of innovation capability and accessibility of international networking on SMEs' export performance. Therefore, the main contribution of the study is to determine the mediating role of innovation capability and international network accessibility in the relationship between entrepreneurial orientation and performance by integrating the theoretical perspective of the resource-based view (RBV). [ABSTRACT FROM AUTHOR]

One of the major impacts of hearing disability that hinders the individual's effective participation in society and full enjoyment of human rights and fundamental freedoms is his/her ability to communicate with others. Sign language is one of the main methods of communication used by people with hearing disability. Therefore, improving access to sign language services and increasing the availability of interpreters contribute to better inclusion and integration of people with hearing disability into society. This paper explores the experience of a Jordanian university that launched a pioneering initiative by offering a sign language course for its students. It reports the findings of a study that evaluated this initiative from the perspective of students. Feedback was recorded during unstructured interviews with 23 student participants who had taken the course. The paper concludes that universities can play a significant role in integrating people with disabilities into the education system and promoting their participation in society. [ABSTRACT FROM AUTHOR]

Background: Utilization of video calls on hospital wards to facilitate involvement of and communication with family members is still limited. A deeper understanding of the needs and expectations of family members regarding video calls on hospital wards is necessary, to identify potential barriers and facilitate video calls in practice. Aim: The aim of this study was to explore the views, expectations and needs of a patient's family members regarding the use of video calls between family members, patients and healthcare professionals, during the patient's hospital admission. Methods: A qualitative study was carried out. Semi‐structured interviews with family members of patients admitted to two hospitals were conducted between February and May 2022. Family members of patients admitted to the surgical, internal medicine and gynaecological wards were recruited. Results: Twelve family members of patients participated. Family members stated that they perceive video calls as a supplemental option and prefer live visits during hospital admission. They expected video calls to initiate additional moments of contact with healthcare professionals, e.g. to join in medical rounds. When deploying video calls, family members mentioned that adequate instruction and technical support by nurses should be available. Conclusion: Family members considered video calls valuable when visiting is not possible or to participate in medical rounds or other contacts with healthcare professionals outside of visiting hours. Implications: Family members need to be supported in options and use of video calls on hospital wards. Additional knowledge about actual participation in care through video calls is needed as well as the effect on patient, family and healthcare professional outcomes. Impact: Using video calls on hospital wards can provide family members with flexible alternatives for contact and promote family involvement. Reporting Method: COREQ guidelines. Patient or Public Contribution: Family members of patients admitted to hospital have contributed by sharing their perspectives in interviews. What does this paper contribute to the wider global clinical community?: Family members perceive additional value from the use of video calls on hospital wards.For family, use of video calls needs to be facilitated with clear instruction materials and support. Trial and Protocol Registration: Amsterdam UMC Medical Ethics Review Committee (ref number W21_508 # 21.560). [ABSTRACT FROM AUTHOR]

Aim: To explore the effectiveness and acceptability of a pilot mentoring program for alcohol and other drug (AOD) nurse practitioners (also known globally as addiction nurse practitioners). Design: Mixed method evaluation. Methods: Two‐phase evaluation comprising survey (demographics, pre‐ and post‐program perceived competency and confidence) with 15 participants completing the pre survey and 10 participants completing the post survey, and qualitative interviews after the program with 10 participants. Results: The quantitative results indicate statistically significant increases in some domains of perceived competence and confidence in treatment. Qualitative findings indicate that participants valued peer support and mentoring from experienced nurse practitioners. Where formal residency or internship programs for nurse practitioners do not exist, informal mentoring programs may address issues inherent in nurse practitioner transition that may impact retention. We recommend further exploration of mentoring programs with larger sample sizes to determine if self‐reported clinical improvements are noted. Implications for Profession and/or Patient Care: Nurse practitioners are a vital part of the healthcare system; their advanced skills and knowledge place them in an ideal position to address prescriber shortages and access to care for populations underserved by healthcare. However, literature indicates that they are often underutilised, and transition to autonomous practice remains a challenge. Our exploration of a pilot mentoring program for nurse practitioners shows that their knowledge and perceived skills are high, yet peer assistance is valued in transitioning from advanced practice registered nurse to autonomous nurse practitioner. We recommend further trialling and evaluation of nurse practitioner mentoring programs to both increase supply of nurse practitioners and provide greater access to quality healthcare for underserved populations. Impact: What problem did the study address?: The ability of nurse practitioners to offer advanced practice interventions such as diagnosis and medication management potentially provides a solution to healthcare resource shortages. However, current literature indicates that advanced nurses transitioning to nurse practitioner roles suffer transition shock, leading to burnout and poor retention. What were the main findings?: Although this pilot mentoring program shows significant improvements in survey responses on confidence and capability, qualitative data shows that neophyte nurse practitioners value peer support and mentoring from more experienced practitioners. Participants described maintaining ongoing connections with both mentors and fellow mentees, which aided transition to the role of autonomous nurse practitioner. Where and on whom will the research have an impact?: The results of this pilot mentoring program indicate that there is benefit to these programs for neophyte nurse practitioners in many specialties. This paper indicates that mentoring programs for nurse practitioners may provide a community of practice and may have a positive impact on transition shock. Reporting Method: Good Reporting of a Mixed Methods Study (GRAMMS) checklist. Patient or Public Contribution: No patient or public contribution. [ABSTRACT FROM AUTHOR]

Objectives: Despite high levels of mental ill‐health amongst young people (aged 15–30), this group demonstrates low help‐seeking and high drop‐out from mental health services (MHS). Whilst shared decision‐making can assist people in receiving appropriate and effective health care, young people frequently report that they do not feel involved in treatment decisions. The current study focused on co‐design of a clinical education and participant information programme for the Brain and Mind Centre Youth Model of Care. This model, which articulates a youth‐focused form of highly personalised and measurement‐based care, is designed to promote shared decision‐making between young people and clinical service providers. Methods: We conducted workshops with 24 young people (16–31; MAge = 21.5) who had accessed mental health services. Participants were asked what advice they would give to young people entering services, before giving advice on existing materials. Workshops were conducted and transcripts were coded using thematic analysis by two lived experience researchers and a clinical researcher. Results: Young people found it empowering to be educated on transdiagnostic models of mental illness, namely clinical staging, which gives them a better understanding of why certain treatments may be inappropriate and ineffective, and thus reduce self‐blame. Similarly, young people had limited knowledge of links between mental health and other life domains and found it helpful to be educated on multidisciplinary treatment options. Measurement‐based care was seen as an important method of improving shared decision‐making between young people and health professionals; however, to facilitate shared decision‐making, young people also wanted better information on their rights in care and more support to share their expertise in their own needs, values and treatment preferences. Conclusions: These findings will inform the delivery of the further development and implementation of a youth‐specific clinical education and participant information programme for the BMC Youth Model. Patient or Public Contribution: Workshops were facilitated by researchers with lived expertise in mental ill‐health (A.H. and/or C.G.) and a clinical researcher (who has expertise as an academic and a clinical psychologist). A.H. and C.G. were also involved in conceptualisation, analysis, interpretation, review and editing of this paper. [ABSTRACT FROM AUTHOR]

Objective: In Australia, there is little evidence exploring why higher degrees by research (HDRs) are undertaken by surgeons. This study aims to describe the attitudes and experiences of surgical trainees and surgeons towards HDRs. Methods: A 23-question cross-sectional survey of surgical trainees and consultant surgeons from three Australian public hospitals was undertaken between August and December 2022. Data were analysed according to stage of career and HDR status and assessed using chi-squared test, with P < 0.05 considered significant. Results: Out of 270 participants, 72 (27%) completed the survey including 30 (42%) trainees and 42 (58%) consultants. Overall, 43 (60%) participants had completed or were undertaking a HDR, which was similar between trainees (n = 18) and consultants (N = 25; P = 0.968). A HDR was associated with more publications (P < 0.5). Respondents with a HDR were more likely to have a salaried academic position (50%) than those without (15%). There was no significant difference in academic appointments based on HDR attainment (P = 0.192). For surgical trainees, 93% rated the strengthening of resumes as the primary driver, compared with only 60% of consultants. For consultants, academic career aspirations and research interests were ranked the highest at 64% equally. Lack of time and competing nature of surgical training were equally ranked among all as the key barriers to completing a HDR. Conclusions: These results provide insight into the academic pursuits of surgeons with an understanding of the role HDRs play, including the different drivers for Masters and Doctorates. This is important for supporting future surgeons who seek to pursue research. What is known about the topic? The value of research is well-recognised as a crucial part of the surgical training pathway. Despite this, minimal contemporary evidence exists which explores the impact of higher degrees by research (HDR) on academic career pathways in the Australian context. What does this paper add? Contemporary evidence was obtained to understand why Australian surgeons undertake HDRs and how their completion impacts the surgical career pathway. What are the implications for practitioners? By understanding the role of HDRs in the surgical landscape, practitioners can ensure beneficial support for future academic surgeons is in place. [ABSTRACT FROM AUTHOR]

Aim: To identify barriers and facilitators impacting the implementation of a comprehensive transfer program aimed at parents of adolescents with chronic illness in clinical practice. Design: A real‐time, qualitative process evaluation. Methods: Individual interviews were conducted with 10 nurses and seven physicians from paediatric and adult outpatient clinics: Nephrology, hepatology, neurology, and rheumatology. Data were analysed through the lens of normalization process theory. Results: Themes were framed within the theory's four components. (1) Coherence: Healthcare professionals' views on their core tasks and on the parents' role influenced their perception of the program. (2) Cognitive participation: A named key worker, autonomy, and collaboration impacted healthcare professionals' involvement in the program. (3) Collective action: Department prioritization and understanding of the program's aim were key factors in its successful delivery. (4) Reflective monitoring: Participants experienced that the program helped parents during transfer but questioned if the program was needed by all families. Conclusion: We identified three barriers: Healthcare professionals' lack of understanding of the parental role during transfer, top‐down decisions among nurses, and physicians' uncertainty about their role in joint consultations. Facilitators: Healthcare professionals' understanding of the program's purpose and expected effect, the nurses' significant role as named keyworkers, and good collaboration across paediatric and adult departments. Implications for the Profession and/or Patient Care: Implementation strategies should be developed before implementing a transfer program in clinical practice. Impact: Implementing a parental transfer program in clinical practice can be challenging. Therefore, for successful implementation, it is crucial to identify barriers and facilitators.Barriers and facilitators exist at the personal, professional, and organizational levels, and it is important to understand them.The results of this qualitative study could support the implementation of transfer programs in other settings. Reporting Method: Consolidated criteria for reporting qualitative studies (COREQ). Patient or Public Contribution: No patient or public contribution. What does this paper contribute to the wider global clinical community?: Nurses' and physicians' experiences of ownership of the transfer program is essential for successful implementation.Clinics should appoint a named keyworker, preferably a nurse, as the driving force during the implementation of a transfer program.Nurses and physicians should receive training about the purpose, justification, and expected effect of a transfer program before implementation. [ABSTRACT FROM AUTHOR]

Accessible Summary: What is known on the subject?: Parenting experiences are a great challenge but also a meaningful achievement for mothers diagnosed with schizophrenia (MDWSs).Most previous studies focused on the parenting experiences of Chinese mothers diagnosed with depression rather than those diagnosed with schizophrenia, who usually experience psychiatric symptoms. What this paper adds to existing knowledge?: Unlike in Western society, Chinese society is characterised by a family‐centred culture. This study insightfully explores MDWSs' parenting and family life experiences addressing their intrapersonal mindsets, interpersonal connections with family members across generations and extrapersonal roles such as traditional social expectations as a mother, wife and daughter‐in‐law.While Western studies have mainly focused on MDWSs' personal resilience, this study insightfully explored MDWSs' resilient dimensions including their personal, familial and cultural issues within the Chinese society. What are the implications for practice?: This study develops a comprehensive and professional understanding of the parenting experiences and family interactions of MDWSs who struggle to achieve their motherly role and re‐establish connections with intimate family members.The findings highlight the following important considerations when offering family‐based nursing cares: (1) assess power relationships, familial dynamics and cultural influences between MDWSs and their family members; (2) extend family members' involvement, such as parents‐in‐law, while offering psychoeducation to MDWSs and their family members. Introduction: In Chinese culture, raising the next generation is recognised as a crucial family matter involving intergenerational participation. Mothers diagnosed with schizophrenia (MDWSs) usually experience high stress due to psychiatric symptoms, different parenting values across generations and traditional expectations associated with motherly roles. MDWSs need urgent professional assistance. Aim: To explore MDWSs' parenting experiences and family life in Chinese cultural contexts. Method: In‐depth interviews were conducted with 20 MDWSs. Data were analysed using interpretative phenomenological analyses. Results: The superordinate theme was identified as 'You are not a qualified mother'. Three major themes were elicited: experiencing crises in parenting, family life and self‐stability; striving to be a good mother and wife under humiliation; and developing wisdom and courage to move forward. Discussion: A dehumanised attitude of family members in a paternalistic culture was found. While Western society focuses on personal resilience and family‐based nursing care for nuclear families, Chinese society intensively focuses on MDWSs' relationship with nuclear family members as well as extended family members such as parents‐in‐law. Implications for Practice: The results highlighted the significance of culturally sensitive nursing care for MDWSs and family‐centred psychoeducation that clarifies familial dynamics and improves effective communication between MDWSs and their family members. [ABSTRACT FROM AUTHOR]

Accessible summary: What is known on the subject?: Stigma associated with care homes has been found to influence residents' lives, and it is a known risk factor for depression among older adults worldwide.Older residents in Asia and particularly, in Thai care homes commonly experience stigma due to being strongly influenced by a traditional cultural paradigm of filial piety.The understanding of how residents perceive and experience the stigma associated with residing in care homes, as well as its link to the development of depression, remains very limited. What does the paper add to existing knowledge?: This research explains the dynamics of the process of the stigma associated with living care homes among Thai older residents.This research highlights the various ways in which stigma impacts residents, their families and care home staff.This study identifies mitigating stigma factors, including social support, coping strategies (karma, mindfulness and religious devotions) and activities that may mitigate perceived stigma associated with care home residency. What are the implications for practice?: There is a compelling need to improve the well‐being of older people living in care homes and to combat the cultural stigma associated with living in care homes through promoting positive attitudes and educational interventions in society, communities and care homes themselves and involving residents' families in the planning and delivery of care for residents. We advocate that the government promotes security and sustainable life for all Thai older adults. Introduction: Stigma associated with living in care homes is a known risk factor for depression among care home residents in Asia, including Thailand. However, little is understood about how such stigma is experienced among residents and care home staff. Aims: To examine older adults' perceptions of stigma and to understand how stigma associated with living in care homes causes or exacerbates depressive symptoms. Methods: A qualitative case study approach was used to gain an in‐depth view of stigma, from two public care homes in northeast Thailand. Data were collected by in‐depth interviews with 50 participants (30 older residents and 20 care home staff), and non‐participant observation was conducted over 1 month. Thematic analysis was used to analyse the data. Results: The study identified three major themes of stigma, comprising the causes of stigma, reactions toward stigma, and mitigating factors. Discussion: Negative beliefs about care homes and residents, contribute to stigma. Residents exhibited negative emotions and behaviours, including depressive symptoms. Residents reported using particular coping strategies that helped them cope with their perceptions of stigma. Implications for Practice: Future research should focus on strategies or research to combat stigma in order to prevent depression and reduce perceptions of stigma. [ABSTRACT FROM AUTHOR]

Accessible Summary: What is known on the subject?: Safewards was developed for acute mental health units, and while could be effective in forensic mental health services, there are some gaps in the model for such services, where factors including offending behaviour and longer term care can have an influence. What this paper adds to existing knowledge?: The importance of acknowledging and addressing responses related to offending behaviour in forensic mental health settings, while also understanding the vulnerability of the consumer group and responsibilities to the maintenance of professional boundaries.Enhancing collaboration with consumers/families/carers/supporters is important in a forensic mental health setting, and an important element of Safewards Secure. What are the implications for practice?: This study completes the development of Safewards Secure, designed to foster collaboration, address issues pertinent to forensic mental health settings to enhance implementation and acceptance of the model and reduce conflict and containment. Introduction: Safewards is a model developed for acute mental health settings designed to reduce conflict and containment; however, it requires adaptation to forensic mental health settings. Aim: To develop the Safewards Secure model, a model to assist forensic mental health services to reduce conflict and containment. Method: A literature review was conducted to elicit possible modifiers and adjustments to the interventions. A Nominal Group Technique was then used to engage forensic mental health experts who had experience implementing Safewards (n = 12) to seek feedback about the suggestions and reach consensus on the Safewards Secure model and interventions. Data were thematically analysed. Results: Experts reached consensus on all suggestions, however, did recommend minor additions and modifications. Two themes were also interpreted: Safewards Secure is just as much for staff as it is for consumers, and the proposed additions encourage more meaningful staff to consumer collaboration. Discussion: This study identified key challenges experienced by nurses working in forensic mental health settings, however, these challenges were not seen as insurmountable. The Safewards Secure model offers prompts and suggestions to encourage reflection, collaboration and a humanistic approach to care in forensic mental health settings. Implications for Practice: Addressing reactions to offending behaviour and encouraging more collaboration might assist in ensuring a more person‐centred approach to forensic mental health nursing care. [ABSTRACT FROM AUTHOR]

Accessible Summary: What is known on the subject?: Workplace violence is common in healthcare.Workplace violence remains a complex and serious occupational hazard in healthcare. What this paper adds to existing knowledge?: Since there is no study examining detailed explanations of experiences and perspectives of workplace violence among psychiatric nurses, this study will act as a guide for psychiatric nurses.This study provides information about how psychiatric nurses evaluate the concept of workplace violence from their perspective, what it means to them and the effects of workplace violence. What are the implications for practice?: Considering the effects of workplace violence, a preventive, systematic and holistic approach should be used in psychiatry and community mental health centres.Supportive interventions should be used to improve the health and safety of psychiatric nurses and patients. Introduction: Workplace violence is common in healthcare and remains a complex and serious occupational hazard. Aim: This research was conducted to assess the workplace violence experiences and perspectives of psychiatric nurses. Method: This study was a qualitative study conducted using a grounded theory approach method. The study was conducted between November 2022 and January 2023. The purposeful sampling method was used, and 11 psychiatric nurses were interviewed. Data were collected with an information form and a semi‐structured interview form. The data were analysed using content analysis, and themes were created. Findings: The ages of the psychiatric nurses ranged from 38 to 57 years. Themes and sub‐themes related to the workplace violence experiences and perspectives of psychiatric nurses included the way of violence (rising tension, eruption of the volcano, unintentional violence and turning to ash) and empowerment (ash cloud and ring of fire). Conclusion: Psychiatric nurses stated that they were exposed to verbal and physical violence for many reasons, that this situation seriously affected their physical, mental and social health and that in addition to the devastating effects of violence, they became stronger by developing various skills to protect against violence. Implications for Practice: Supportive interventions should be used to improve the health and safety of psychiatric nurses and patients. Strategies can be developed to include psychiatric nurses in occupational health nursing courses. [ABSTRACT FROM AUTHOR]

Background: Community health worker programmes have the potential to contribute critically towards universal health coverage. However, CHWs globally have often continued to operate on the periphery of the health care system, viewed as a non-essential cadre. This results in a workforce that often remains disempowered and under-supported. This paper presents evidence from a study conducted in a rural part of South Africa, to better understand issues of CHW prioritisation, integration, and empowerment. Methods: We applied an analytical lens based on empowerment theory and conducted a secondary analysis of qualitative data emerging from a sub-study of a cRCT evaluating the effectiveness of supportive supervision for CHWs within a large-scale national CHW programme. The cRCT was conducted between 2017 and 2022, and 39 CHWs were included in the study. Results: We organised our findings across the four domains of structural empowerment; information, resources, support, and opportunity, and mapped these domains against the domains of psychological empowerment. Our findings show how CHWs are still working in the periphery of the healthcare system. Without sufficient prioritisation, high level-support from national and district governments, and sufficient investments in programmatic domains—such as training, equipment, and supportive supervision—it is likely that the CHW cadre will continue to be seen as informal health care workers. Conclusions: CHW empowerment could be a lever to potentially transform the current health system towards universal coverage; however, this process can only happen with sufficient high-level prioritization and investment. [ABSTRACT FROM AUTHOR]

Reporting adverse drug reactions (ADRs) is fundamental in improving medication safety. Community pharmacists (CPs) being the first point of contact for individuals seeking healthcare in a community, play a significant role in ADR reporting. However, this has been poorly implemented in many countries including Nigeria. This paper aims to explore stakeholders' perspectives on current reporting practices and suggest ways to enhance ADR reporting among CPs in Nigeria. This qualitative study employed a purposive sampling approach to identify key informants. Key informant interviews (KIIs) were conducted with 25 carefully selected pharmacists, using a semi-structured interview guide between July 2023 and August 2023. The interview transcripts were analyzed using a thematic content approach. While a low ADR reporting trend was observed among all participating pharmacists, it was notably higher among those with less than five years of experience. The main barriers to ADR reporting, as identified by the interviewed community pharmacists were lack of awareness and knowledge, absence of motivation, and insufficient feedback from National Agency for Food Drug Administration and Control (NAFDAC). Training and awareness campaigns were the most frequently suggested methods for improving ADR reporting. Other proposed strategies included providing motivation, regular feedback, establishing mandatory reporting, and simplifying the reporting process. The study has highlighted the suboptimal ADR reporting practices among CPs in Anambra state. It underscores the significance of training, sensitization, advocacy, and other related interventions as pivotal means to enhance ADR reporting in this group. Furthermore, there is a pressing need for intervention-based studies to delve into and implement these approaches effectively. [ABSTRACT FROM AUTHOR]

Informal healthcare providers (IHPs) often serve as the first point of contact for healthcare services for non-communicable diseases in urban slums and their ability to identify risk factors and symptoms of the diseases is crucial for early detection and management. This paper assesses level of knowledge of hypertension and diabetes mellitus (DM) among IHPs. A cross-sectional survey was conducted in eight slums in Enugu and Onitsha cities in south-eastern Nigeria. Data was collected from 238 IHPs including patent medicine vendors, traditional birth attendants, traditional bonesetters, and herbalists. Knowledge scores were computed for each respondent. Adequate knowledge was set at ≥ 50% score and inadequate knowledge at < 50%. Binary logistic regression analysis was used to identify factors/independent variables associated with adequate knowledge among IHPs. Independent variables in the regression model were seven items that describe the profile of IHPs and can influence their access to information on non-communicable diseases. Knowledge of risk factors and symptoms of hypertension and DM among IHPs was low since only 21 (8.82%) and 19 (7.98%) of them had adequate knowledge of hypertension and DM, respectively. In regression analysis, IHPs who had received formal training in the past demonstrated significantly higher levels of knowledge, with odds of adequate knowledge in hypertension being 14.62 times greater for trained providers, and the odds of adequate knowledge of both non-communicable diseases being 21.34 times greater for trained providers. Training of IHPs is needed to address the critical knowledge deficit of risk factors and symptoms of hypertension and DM. This would contribute to better health outcomes and reduced disease burden in urban slums. [ABSTRACT FROM AUTHOR]

Purpose: Sociometric studies and adult reports have established that children with Language Disorder (LD) are at risk of peer relationship difficulties. However, we have limited knowledge of how children with LD understand friendship, whom they deem as a good or bad friend, and what role their friendship concepts play in their relationships with peers. This exploratory study aimed to conduct a qualitative investigation into the friendship concepts that children with LD hold and to explore their strategies for making friends. Methods: We conducted multiple, art‐informed interviews on the topic of friendship with 14 children with LD at the age of 6–8 years. Participating children were based in the United Kingdom and Republic of Ireland. They attended enhanced provision, specific speech and language classes and mainstream classrooms. We used framework analysis to map children's responses to Selman's (1979) developmental model of interpersonal understanding, which espouses a theory of children's social development within the context of peer relationships. Results: The understanding of friendship formation in children with LD varied from physical presence to mutual support and sharing. Children's ideas about a good/bad friend represented the lowest developmental stage. Participants from the mainstream classroom demonstrated the highest stages of interpersonal understanding. Children with LD did not mention their language abilities as a barrier to making friends. Conclusion: There are limited studies exploring friendship directly from children with LD, and this study provides insights into this gap, by utilising art‐informed interviews. Children's immature understanding of a good/bad friend points towards a potential susceptibility to false friends, which we suggest needs further empirical validation. We also found that children with LD did not pay attention to their language difficulties when making friends, which raises questions about the ways diagnoses are shared with children. WHAT THIS PAPER ADDS: What is already known on the subject: Children with Language Disorder (LD) are at risk of peer relationship difficulties. Studies to date are based on sociometrics and adult reports. Only a few studies employ participatory approaches to research with children, directly engaging children with LD when exploring their friendships What this paper adds: This paper directly asks children with LD about their understanding of friendship and strategies for making friends.Physical proximity and play are important to children.s understanding of friendship especially in recognising good and bad friends. This indicates potential reasons for children with LD being susceptible to false friendsAdditionally, children with LD do not perceive language and communication as a barrier to making friends. What are the potential or actual clinical implications of this work?: Concepts around friendship and good/bad friends should be routinely assessed and targeted (if appropriate) in interventions. The study highlights the need to continue discussing practices around sharing diagnoses with children with LD. [ABSTRACT FROM AUTHOR]

Internally displaced persons (IDPs) seek refuge in territories that are considered safer, including outside officially designated camps. This development raises security concerns for host communications, thus increasing the likelihood of conflict. This paper set out to unveil the presence of IDPs in non-camp settings (NCS) in Kwara State, examine the security implications associated with their covert existence within host communities, and evaluate the strategies put in place by the State Government to address them. The study adopted a mixed method approach, in which 200 copies of a questionnaire were distributed to local participants in selected towns, out of which 188 copies were retrieved. A snowball technique was used to identify unregistered IDPs while a purposive sampling technique was useful in the selection of key informants for interviews. The study found that the security implications of hosting IDPs were numerous: feelings of insecurity, a threat to physical and mental health, a threat to life, vulnerability to harassment; increasing demographic imbalance, and condescending attitude of the host population among others. The study concluded that a high level of impoverishment in NCS threatens human security for both the host population and the IDPs. The study recommended that the Kwara State Government should synergize with relevant stakeholders and the local communities, to identify and profile all victims of internal displacement for an effective response to security challenges. [ABSTRACT FROM AUTHOR]

Gender is socially constructed beliefs perceived or ascribed to the sex identity of the person. Thus, this study explored, described, and interpreted the social experiences of LGBTQIA+ college students in a Catholic School. This study employed a descriptive qualitative research design. Hence, it helped to obtain a rich narrative concerning the social experiences of this group of students studying in a private Catholic school. Moreover, this paper came up with six participants determined through purposive sampling and set inclusion criteria. It employed the semi-structured in-depth interview. Also, this study utilized Lichtman’s 3Cs in analyzing the narratives of the participants. This study revealed that LGBTQIA+ college students experienced bullying and discrimination during their basic education years when they were trying to come out as who they were. Alongside the experience of coming out, they felt that they were not accepted by their father as members of the social group since they would be vulnerable to any form of humiliation. However, being a student in a Catholic school, they felt that they were accepted and welcomed. Likewise, they never experienced what happened during their high school years. Hence, the findings may serve as an eye-opener for many about the social experiences of this minority to elicit the practice of gender sensitivity and equality. [ABSTRACT FROM AUTHOR]