Search

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]

In 2020–2021, a qualitative study was undertaken using an interpretive description methodology to identify what triggers grief in the first 2 years following the death of a beloved family member, and to gain other helpful insights about grief triggers from bereaved Canadian adult volunteers. In that study, a purposive sampling method was used to select 10 bereaved Canadian adult volunteers for in-depth, semi-structured interviews. This paper reports on the humor findings, as revealed to be a particularly complex grief trigger for many participants, as well as a periodic way for most to manage or live with their grief. Participant quotes and an extended discussion are included to illustrate the importance of these humor findings in relation to grief, and to inform bereaved people, bereavement service providers, and the general public about both helpful aspects and some cautionary considerations about humor. [ABSTRACT FROM AUTHOR]

Medical Assistance in Dying (MAID) legislation has evolved rapidly in Canada with significant impacts on nursing practice. The purpose of this paper is to describe evolving complexities in legislative context and practice standards that influence the experiences nurse practitioners and registered nurses have with MAID. Qualitative interviews were conducted with 25 registered nurses and 10 nurse practitioners from diverse contexts across Canada. Participants described their practices and considerations when discussing MAID as part of advance care planning; their use of, and challenges with, waivers of consent; their practice considerations in negotiating the complexities of clients for whom death is not reasonably foreseeable; and their moral wrestling with the inclusion of MAID for persons whose sole underlying medical condition is mental illness. Findings illustrate the moral complexities inherent in the evolving legislation and the importance of robust health and social care systems to the legal and ethical implementation of MAID in Canada. [ABSTRACT FROM AUTHOR]

While bystander intervention education has demonstrated promise as a strategy to reduce dating and sexual violence (DSV) on campus, little is known about whether survivors on whose behalf the interventions take place find these helpful. This paper uses qualitative, in-depth interviews with 33 DSV survivors to explore their perspectives on bystander intervention. Results indicate that while some interventions were identified as helpful, especially those that provided support to the survivor, many were not helpful enough or even harmful. Further work is needed to understand the consequences of bystander action. [ABSTRACT FROM AUTHOR]

Background: Empirical studies suggest that gratitude positively influence the quality of life of palliative patients and relatives. However, the literature is marked by a lack of conceptual clarity about what gratitude is and whether it can bring about individual and social benefits. Aim: This paper explores how palliative care patients and relatives understand gratitude, how discursive representations of gratitude may affect their positions, perceptions and relations, and how to conceptualise gratitude in the palliative context. Design: We examine 33 gratitude letters written by patients and relatives and 25 semi-structured interviews conducted as part of a pilot gratitude intervention study. We use a qualitative approach, thematic analysis, within a conceptual framework of discourse analysis. Settings/participants: Data were collected from 23 patients and 13 relatives recruited through three hospital palliative care services in French-speaking Switzerland. Results: Participants articulate gratitude in five ways: (1) appreciating others; (2) love; (3) need to reciprocate; (4) appreciating the little things; (5) solace amid serious illness. While some of these representations are sources of positive emotions and outlook, wellbeing and hope, others may confirm self-perceptions of powerlessness and burden. These results support a tridimensional conceptualisation of gratitude in palliative care as source of individual benefits, valuing closest relationships and moral obligation. Conclusion: Our study suggests that gratitude is a key to a good (end of) life, whilst highlighting potential negative effects. It could help healthcare professionals to better understand what gratitude means to patients and relatives, which may facilitate awareness and fostering of gratitude in palliative care. [ABSTRACT FROM AUTHOR]

This paper is an examination of the methodological and theoretical perspectives of a study with an inquiry focus on the experiences and perspectives of staff who worked at an injectable opiate assisted (iOAT) clinic. Twenty-two staff members, including nurses, social workers, and peer support workers, were interviewed. The goal of the study was to uncover how the clinic staff provided care to the clients who attend the clinic, their perspectives on how the clinic program impacted both them and their clients, and their experiences with the program itself. This interpretive descriptive study was underpinned by critical social theory. Thematic analysis was undertaken to identify recurring, converging, and contradictory patterns of interaction, key concepts and emerging themes. In this paper we examine and discuss how the relationship between critical social theory and interpretive description enhanced the study. Examples from the study are presented to provide insight into the relationship. [ABSTRACT FROM AUTHOR]

In a time of heightened bigotry and racialized violence, it is critical for social workers to engage in anti-racism practice. What leads White individuals to embrace this framework is less explored in scholarship. This paper presents data from an exploratory narrative inquiry with 10 White helping professionals in the Northeastern US who adopted an overtly anti-racism approach in their work. Narrative is a "cultural tool" through which individuals make sense of themselves and circumstances within context (Dauite et al., 2015: 48). Narrative inquiry involves uncovering the stories embedded within the overt stories told. With focus on pivotal childhood experiences, the themes taken up in this paper include the influence of family of origin values about race, exposure to racial difference, and experiences leading to the adoption of anti-racism tenets. The themes emerged as participants reflected on the self-discovery of racialization; initial exposure to racial inequity; and the impetus for them to become active in efforts to counter White supremacy. The paper aims to add to research on the engagement of White individuals in anti-racism efforts, an essential task for US social work as a predominantly White profession. [ABSTRACT FROM AUTHOR]

The use of vignettes in research and education is well documented. Documentation of how vignettes are developed and content validity is established, however, are rare. The purpose of this paper is to describe a method for development and establishing content validity of vignettes that can be used to assess student performance and research participant outcomes. This three-phase method was designed to validate seven vignettes for a future research project. Content validity index survey and expert panel interviews were used to inform improvements in validity. Findings showed that clinical vignettes were improved with respect to content relevance (from 0.93 to 0.96) and importance (from 0.68 to 0.93). Developing validated vignettes is essential when used to measure outcomes in education and in research. This three-phase method of vignette development and validation is feasible and effective in improving content validity of vignettes and can be used in other education and research projects. [ABSTRACT FROM AUTHOR]

This paper reports findings of a qualitative study examining the perceptions of 21 Australian women professionals who conduct home visiting with families experiencing intimate partner violence. There is scant evidence documenting how home visiting professionals adapted practice to address the safety concerns of women and their children within the context of the pandemic. Practitioners noted an increase in the risk level and complexity of intimate partner violence (IPV), including the ways that perpetrators weaponized the pandemic to exert power and control over women and children. Practitioners reported on their rapid adaptation of practices, to ensure the continuation of services which included moving to online delivery methods, wearing PPE, and negotiating practice from a distance. While responses to these changes were mixed, most reported their desire to continue to use online platforms post-pandemic, reporting increased safety, flexibility, and accessibility for the majority of clients. This research addresses a gap in respect of professionals' perceptions of the issues facing survivors of IPV and of their professional practice during the COVID-19 pandemic. As policies, practices, and protocols continue to adapt to the challenging environment posed by the pandemic the experiences of professionals and service users are critical to inform these changes. [ABSTRACT FROM AUTHOR]

Background: Global literature on medical travel focuses on patients from high-income countries traveling to middle-income countries reputed for providing high quality care at significantly lower costs. However, little is known about the movement of wealthy foreign patients to high-income countries such as the USA, the UK or Switzerland. Objective: In this paper, we focus on Swiss medical tourism stakeholders and their strategies to attract a niche of self-paying foreign patients to undergo medical treatment in Switzerland. We describes how they harness the label of 'Swiss quality' healthcare to promote Switzerland in global medical travel industry. Methods: We conducted semi-structured, in-depth interviews with 30 medical tourism stakeholders including 15 healthcare professionals (HCPs) treating self-paying foreign patients in publicly funded and privately owned hospitals in French- and German-speaking regions of Switzerland. The data were inductively coded using thematic analysis. Results: We present their views on 'Swiss quality' healthcare under three themes: health-related human resources, Swiss medical infrastructure, and foreign patients' perceived trust in the 'Swiss quality' label. Participants equated Switzerland's global image and 'Swiss quality' as a 'brand' and believed that foreign patients' trust in 'Swiss quality' is a unique selling point of Swiss healthcare system. Conclusion: By problematizing the use of 'Swiss quality' label to attract wealthy patients to Switzerland, we highlight a few ethical questions that deserve further scrutiny. [ABSTRACT FROM AUTHOR]

Introduction: Successful adoption of POCTs (Point-of-Care tests) for COVID-19 in care homes requires the identification of ideal use cases and a full understanding of the contextual and usability factors that affect test results and minimise biosafety risks. This paper presents a scoping-usability and test performance study of a microfluidic immunofluorescence assay for COVID-19 in care homes. Methods: A mixed-methods evaluation was conducted in four UK care homes to scope usability and to assess the agreement with qRT-PCR. A dry run with luminescent dye was conducted to explore biosafety issues. Results: The agreement analysis was conducted on 227 asymptomatic participants (159 staff and 68 residents) and 14 symptomatic participants (5 staff and 9 residents). Asymptomatic specimens showed 50% (95% CI:1.3%−98.7%) positive agreement and 96% (95% CI: 92.5%−98.1%) negative agreement with overall prevalence and bias-adjusted Kappa (PABAK) of 0.911 (95% CI: 0.857−0.965). Symptomatic specimens showed 83.3% (95% CI: 35.9%−99.6%) positive agreement and 100% (95% CI: 63.1%−100%) negative agreement with overall prevalence and bias-adjusted Kappa (PABAK) of 0.857 (95% CI: 0.549−1). The dry run highlighted four main sources of contamination that led to the modification of the standard operating procedures. Simulation post-modification showed no further evidence of contamination. Conclusion: Careful consideration of biosafety issues and contextual factors associated with care home are mandatory for safe use the POCT. Whilst POCT may have some utility for ruling out COVID-19, further diagnostic accuracy evaluations are needed to promote effective adoption. [ABSTRACT FROM AUTHOR]

Participatory research methodologies have expanded the opportunities for critical, emancipatory and democratic health and social work research. However, their practical application in research with vulnerable participants has historically been challenging due to ethical, practical and theoretical concerns. Individuals who are homeless are typically seen as 'hard-to-reach', transient, 'hidden' and even chaotic participant populations. Unsurprisingly, examples of the use of innovative participatory research techniques with those groups have been relatively scarce. This paper aimed to address this gap by discussing the application of one such technique – the mobile phone diary in research with multiply disadvantaged homeless adults. Diary methods are situated within the qualitative research on health, illness and social marginality, and the enhanced capabilities of the mobile phone diary are highlighted. The author illustrates the application of the mobile phone diary in his participatory research on the everyday life narratives of adults with serious mental illness (SMI) who were homeless. The process of designing the mobile phone diary is detailed. Following this, participant testimonies of their use of the mobile phone diary are presented. They demonstrate the participatory and inclusive nature, as well as the cathartic and empowering potential, of this technique. The methodological contributions and challenges and the theoretical generativity of the mobile phone diary method are discussed. The mobile phone diary is a feasible approach for eliciting evocative, contextualised and nuanced accounts of the lived experience of homelessness, social isolation, coping and recovery. [ABSTRACT FROM AUTHOR]

Home and belonging are emerging areas of social work research. Very few studies in the social work discipline critically examine how home is broadly experienced or understood. Whilst the notion of home is contested, social work researchers can explore meanings of home in their quest to understand how social workers can contribute to developing a sense of community and belonging. This article presents the findings of an intersectional qualitative study that explored meanings of home in a capital city of Australia, drawing implications for social work. A thematic analysis of 13 semi-structured interviews found that home was experienced as both a material and emotional place. Home was associated with (1) the material security of housing, including homeownership and the safety of suburbs and neighbourhoods; (2) a connection to multiple homes and the making of home in migration, such as when re-settling in a new country; (3) belonging to a family, including emotional connections to lost family members or acknowledging a supportive family and (4) religious, ethnic and cultural self-expression. This paper argues that researching meanings of home is relevant to social work as a discipline that espouses human rights and social justice because a sense of home is central to the politics of belonging to a safe community and society. [ABSTRACT FROM AUTHOR]

Objective: The majority of people with gambling problems contact helplines when they are in crisis, hampering their capacity to explore suitable treatment options. To date, there has been limited research identifying the best way to support individuals to reduce distress and maximise further treatment-seeking. In this paper, we describe the development and piloting of the resulting six-step brief intervention.Method: A six-step brief intervention was developed based on a literature review of existing interventions for crisis management, semi-structured interviews with 19 participants comprising gambling and crisis support counsellors and consumers, as well as experts in the addiction field.Results: The resulting six-step brief-intervention focusses on (1) acknowledging and measuring distress; (2) normalising and reducing distress; (3) optimising motivation for change; (4) providing a sense of hope; (5) re-measuring distress and, if reduced; (6) exploring options for treatment and support.Conclusion: Whilst developed primarily for helpline counsellors, the intervention has potential application for health practitioners working across telephone, online and face-to-face services. Further research is required to determine its effectiveness in improving treatment engagement amongst people with gambling problems. [ABSTRACT FROM AUTHOR]

Background: Recent literature, largely from Africa, shows mixed effects of own-production on diet diversity. However, the role of own-production, relative to markets, in influencing food consumption becomes more pronounced as market integration increases.Objective: This paper investigates the relative importance of two factors - production diversity and household market integration - for the intake of a nutritious diet by women and households in rural India.Methods: Data analysis is based on primary data from an extensive agriculture-nutrition survey of 3600 Indian households that was collected in 2017. Dietary diversity scores are constructed for women and households is based on 24-hour and 7-day recall periods. Household market integration is measured as monthly household expenditure on key non-staple food groups. We measure production diversity in two ways - field-level and on-farm production diversity - in order to account for the cereal centric rice-wheat cropping system found in our study locations. The analysis is based on Ordinary Least Squares regressions where we control for a variety of village, household, and individual level covariates that affect food consumption, and village fixed effects. Robustness checks are done by way of using a Poisson regression specifications and 7-day recall period.Results: Conventional measures of field-level production diversity, like the number of crops or food groups grown, have no significant association with diet diversity. In contrast, it is on-farm production diversity (the field-level cultivation of pulses and on-farm livestock management, and kitchen gardens in the longer run) that is significantly associated with improved dietary diversity scores, thus suggesting the importance of non-staples in improving both individual and household dietary diversity. Furthermore, market purchases of non-staples like pulses and dairy products are associated with a significantly higher dietary diversity. Other significant determinants of dietary diversity include women's literacy and awareness of nutrition. These results mostly remain robust to changes in the recall period of the diet diversity measure and the nature of the empirical specification.Conclusions: This study contributes to the scarce empirical evidence related to diets in India. Additionally, our results indicate some key intervention areas - promoting livestock rearing, strengthening households' market integration (for purchase of non-staples) and increasing women's awareness about nutrition. These are more impactful than raising production diversity. [ABSTRACT FROM AUTHOR]

Lesbian, gay, and bisexual older adults are more likely than their heterosexual peers to experience health disparities, discrimination from healthcare providers based on sexual orientation, and rejection from their family of origin, all of which can complicate medical care and decision making, as well as end-of-life arrangements. Yet, relatively few studies of lesbian, gay, and bisexual seniors have looked at motivations for advance care and end-of-life planning, which are strategies that can help ensure that healthcare treatment and end-of-life wishes are enacted as desired. The present qualitative study investigated this topic with a purposive sample of nine lesbian, gay, and bisexual and same-gender-loving adults in a metropolitan region of the Southeastern United States. The study involved in-depth face-to-face interviews, followed by a brief pen-and-paper survey. Participants' ages ranged from 65 to 77; the sample included five men and four women. Six individuals were white/Caucasian, while three were African American/Black. We identified three themes related to motivations for advance care and end-of-life planning: wanting a sense of agency, learning from others, and reducing conflict and confusion for loved ones. We discuss the importance of these findings for social work practice with lesbian, gay, and bisexual older adults and for social work education, as well as implications for future research. [ABSTRACT FROM AUTHOR]

This paper reports findings from a study in England, which investigated the experiences of lesbian and gay parents in relation to homophobia in primary and secondary schools. The study was part of a larger European Union project investigating the impact of family and school alliances against homophobic and transphobic bullying in schools across six nation states. Qualitative in-depth semi-structured interviews with seven lesbian and gay parents from five families were conducted to explore their unique experience and perspectives on these issues. Discourse analysis was used to facilitate understanding of how lesbian and gay families negotiated the outsider/insider and public/private spheres of the school and communities of which they were a part. Parents identified a number of strategies to address their experiences of homophobia within schools. The findings have implications for how social work recognises and promotes diversity and equality when working with lesbian, gay, bisexual and transgender families, as social workers have a powerful role in supporting families. This involves recognising the strengths of lesbian, gay, bisexual and transgender families in their assessments. [ABSTRACT FROM AUTHOR]

Background: The growing burden of life-threatening illnesses and advancements in care interventions call for the intentional integration of palliative care services into existing care systems. The absence of active, functioning palliative care services in most hospitals in Ghana is a major concern. This study explored the factors influencing the integration of palliative care services in one of such institutions. Objectives: The aim of the study was to explore the institutional drivers of palliative care integration in a military health facility. Design: Exploratory qualitative study. Methods: We employed a qualitative exploratory study design situated within a constructivist paradigm. A purposive sampling method was used to select and interview 11 healthcare professionals. A semistructured interview was used to conduct face-to-face, in-depth interviews with participants between April and May 2022. A thematic data analysis was done based on the Braun and Clarke analysis process with the aid of QSR NVivo-12. Results: The six themes that describe the institutional driving factors for integrating palliative care services were cognitive restructuring, supportive logistics and infrastructure, staffing, healthcare professional skills, institutional policies and priorities, and utilization of focal persons. It was observed that a paradigm shift in the mindset of healthcare professionals and administrators was a major driver that would determine the integration of palliative care services. A cognitive restructuring will facilitate a more aggressive integration of palliative care services because logistics, staffing, and medication access will be prioritized. Conclusion: Institutions have the responsibility of aligning with the WHO policy on palliative care service access and must invest in training, staffing, prioritizing palliative care needs and policies, procurement of essential drugs, and the provision of logistics and supportive infrastructure to scale up the implementation of palliative care services. [ABSTRACT FROM AUTHOR]

Introduction: Mother-to-child transmission of hepatitis B infection is one of the major routes of hepatitis B virus (HBV) infection in Africa. Amusingly, Africa is the only region yet to meet the World Health Organization's target of reducing the prevalence of HBV infection to less than 1% among children under 5 years of age by 2020. In Ghana, little has been documented about midwives' views on the factors impacting the successful implementation of mother-to-child transmission via HBV prevention programs. Objective: This study explored midwives' views on the challenges associated with the prevention of mother-to-child transmission of HBV infection in the La-Nkwantanang municipality. Methods: The study adopted an exploratory descriptive qualitative design and involved 14 midwives who were purposively recruited from a primary-level health facility in the La-Nkwantanang Municipality, Accra. Individual face-to-face interviews were conducted using an in-depth interview guide. The data were content analyzed using the six steps recommended by Braun and Clark. Results: Three main themes, namely, health professional or midwife factors and patient and health facility factors, negatively impacted the prevention of maternal-to-child transmission program. The five subthemes identified in this study included lack of awareness, financial constraints, and unavailability of logistics and protocols. The study recognized that midwives face many challenges even though they have a strong desire to prevent vertical transmission of HBV. Conclusion: The implementation of a mother-to-child transmission program is negatively impacted by many intrinsic, client, and health facility factors. Midwives who act as major stakeholders need to be periodically trained on the components and protocols for managing pregnant women living with HBV. The necessary logistics and management protocols need to be urgently provided. The skills and education obtained from the training will empower midwives to be knowledgeable about how to deliver quality care and provide education and support for HBV-infected pregnant women. The provision of logistics needed for the successful implementation of the program could avert delays associated with the administration of the hepatitis B birth dose vaccine and immunoglobulin to exposed newborns. [ABSTRACT FROM AUTHOR]

The study aimed to explore experiences of encounters with health care professionals among patients receiving palliative cancer care in specialist palliative care inpatient units. A qualitative explorative study design was conducted in a specialist palliative care inpatient setting. Data collection was implemented using semi-structured individual interviews (20 palliative care cancer patients) and analysed with inductive content analysis. Palliative care patients experienced both meaningful and disrespectful encounters with healthcare professionals. The meaningful encounters encompassed authentic and supportive experiences, while the disrespectful encounters included indifferent and inadequate experiences. Caring for a patient receiving palliative care requires care beyond tending to a patient's physical needs. Patients should be encountered holistically and as equal human beings without highlighting their roles as patients. The healthcare professionals and the organisations should also acknowledge the importance of time and effort spent for encounters and conversations with the patients instead of concentrating resources mainly on physical care. [ABSTRACT FROM AUTHOR]

Objectives: Normative beliefs around gender and sexuality place individuals in the Two Spirit, lesbian, gay, bisexual, trans, and queer (2SLGBTQ) community at risk for poorer health outcomes within the health care system compared with their heterosexual and cisgender counterparts, particularly within gendered areas of care including family planning and fertility intentions. The purpose of this research was to explore the effect that the normative beliefs of heteronormativity and cisnormativity had on the experiences of 2SLGBTQ people engaged in family planning, and to begin to understand how health care providers can provide appropriate, safe, and holistic care. Methods: We conducted a qualitative study using case study methodology and completing semi-structured interviews with 11 participants with diverse genders and sexualities. Findings: For members of the 2SLGBTQ community, family planning is greatly affected by ideals of normal, intersections of identities, health care systems, and community. They may face additional emotional labor and intentional decision-making when related to family planning. Heteronormativity and cisnormativity greatly impact the health care that is received. Conclusions: The findings contribute information in the limited field of research related to the 2SLGBTQ community and may support health care providers in providing holistic care. [ABSTRACT FROM AUTHOR]

Individuals with visual impairments encounter many obstacles with passenger vehicles. This study aimed to increase the understanding of challenges specifically related to vehicles including ingress, in-vehicle considerations, comfort, and acceptance of ridesharing and transportation options for individuals who are visually impaired. Ten participants who are visually impaired, with an average age of 57.5 years, completed a semi-structured interview. The interview took place over Zoom or over the phone and focused on their passenger vehicle preferences and challenges, as well as what they would want for them to look like in the future. All of the participants typically requested rides from family and friends for local transportation, while only two used rideshare services. Half of the participants described the most common challenge when getting into a vehicle as hitting one's head. All of the participants used their sense of touch to locate the seat belt, and most used touch and hearing to locate the vehicle and door they were getting into. When asked what they would like in the future for broader transportation needs, examples ranged from a talking cane, to an electronic guide dog, or to ear buds that could provide directions. Throughout the interviews, participants expressed the importance of transportation for them. This study increased the understanding of the challenges used when walking from an indoor environment to get to and into a vehicle. Understanding how individuals who are visually impaired currently get to and into a vehicle may aid engineers, new technology developers and O&M providers to create more processes and/or training that can help increase transportation options for those who are visually impaired. [ABSTRACT FROM AUTHOR]

This mixed-methods, exploratory study investigates the gambling activities of street youth in Mumbai, India. Data from surveys and brief interviews of 70 youth aged 12–24, two focus groups, and ethnographic observations offer descriptive snapshots of the gambling behavior of participants. The article includes details about games played, popular venues, initiation patterns, time spent gambling, and interactions with the police. Street youth gamble for social benefits, such as group membership and fun; it is also a leisure activity enabling time to go by quickly. Individual benefits include intermittent rewards and a high after winning or being referred to as a gambler. The inability to save, the lack of recreation options, living in groups, and the environment of the streets structure and sustain gambling. This study discusses the group and social dimension of gambling among street youth, and how this dimension makes their participation different from adolescent gambling in general and General Addictions Theory. It contributes to the literature by emphasizing that for street youth the social/group aspects of gambling predominate the psychological. The paper concludes with a discussion of the implications for practice, highlighting the need to develop recreational, income-saving, and educational awareness programs. [ABSTRACT FROM AUTHOR]

The article focuses on the use of video methods in study and research of human actions. Topics discussed includes use of video methods for research by occupational therapists and researchers, difference in video data and literature for understanding occupational behavior, advantages of using video data and challenges faced in employing use of video methods for research.

Objective: To identify barriers and facilitators to international implementation of a prospective system for standardized outcomes measurement in cleft care. Design: Cleft teams that have implemented the International Consortium for Health Outcomes Measurement Standard Set for cleft care were invited to participate in this 2-part qualitative study: (1) an exploratory survey among clinicians, health information technology professionals, and project coordinators, and (2) semistructured interviews of project leads. Thematic content analysis was performed, with organization of themes according to the dimensions of the reach, effectiveness, adoption, implementation and maintenance (RE-AIM) framework: reach, effectiveness, adoption, implementation, and maintenance. Results: Four cleft teams in Europe and North America participated in this study. Thirteen participants completed exploratory questionnaires and 5 interviewees participated in follow-up interviews. Survey responses and thematic content analysis revealed common facilitators and barriers to implementation at all sites. Teams reach patients either via email or during the clinic visit to capture patient-reported outcomes. Adopting routine data collection is enhanced by aligning priorities at the organizational and cleft team level. Streamlining workflows and developing an efficient data collection platform are necessary early on, followed by pilot testing or stepwise implementation. Regular meetings and financial resources are crucial for implementing, sustaining, analyzing collected data, and providing feedback to health care professionals and patients. Fostering patient-centered care was articulated as a positive outcome, whereas time presented challenges across all RE-AIM dimensions. Conclusions: Identified themes can inform ongoing implementation efforts. Intentionally investing time to lay a sound foundation early on will benefit every phase of implementation and help overcome barriers such as lack of support or motivation. [ABSTRACT FROM AUTHOR]

Copyright of Global Qualitative Nursing Research is the property of Sage Publications Inc. 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: Childhood, adolescent and young-adult (AYA) cancer survivors often experience health problems due to late or long-term effects of their cancer or the treatment thereof. The general population gains health benefits from immersion in nature, and nature-based programmes seem to be an intervention that can promote health among childhood and AYA cancer survivors. Objective: To explore the impact of the WAYA wilderness programme on the health of childhood and AYA cancer survivors. Methods: The study had a qualitative approach, with data from individual interviews (n = 18) 3 months after completion of the WAYA programme. In addition, case report data was collected during follow-up talks (1, 2 and 12 months after the programme) (n = 19). The WAYA programme consisted of an 8-day expedition, followed 3 months later by a 4-day base camp. The programme included activities such as hiking, backpacking, kayaking, rock climbing, bushcraft and mindfulness. Data was analysed according to a qualitative content analysis. The consolidated criteria for reporting qualitative research (COREQ) were followed. Results: An overarching theme was identified: "Personal growth from challenges in nature supported by deep connections with others". In 4 additional themes, participants' experiences describe how deep personal connections arose, as they developed a feeling of being able and competent in nature. Nature provided a space that supported relaxation and respite from everyday challenges and stimuli, which also led to an experience of being more connected to nature. Conclusion: The WAYA programme was experienced as being of support to childhood and AYA cancer survivors. The programme provided them with skills and tools to be safe in nature. When connected to nature, the participants developed trust and self-confidence, personal growth, relaxation and recovery from stress. Their engagement in outdoor activities continued after completion of the programme, when they returned to everyday life at home. [ABSTRACT FROM AUTHOR]

Introduction: Breastfeeding has proven over the years to be one of the most effective means to ensure child survival. The advocators and myth busters of breastfeeding myths are supposed to be health professionals. However very little is known about myths surrounding breastfeeding as expressed by these health professionals (nurses and midwives). Hence this study. Objective: The study aimed at exploring the myths about breastfeeding as voiced by lactating nurses and midwives. Method: Qualitative exploratory descriptive design was used to investigate the subject matter. Twenty-five nurses and midwives were purposely selected to participate in the study after they had voluntarily opted to be part of the study. Data was audiotaped, transcribed verbatim and inductively analyzed. Results: It was evident that participants believed in myths about breastfeeding. The main themes discovered were breastfeeding myth beliefs and sociocultural myth influences. Six sub-themes identified were green stools/diarrhoea, childhood disease, teeth discoloration, child becoming stupid, culture and close relatives. Conclusion: Health professionals believe in unfounded myths about breastfeeding. Steps should be taken for them to get better lactation support. The outcomes of this study underscore the need for health professionals to address breastfeeding myths, understand the sociocultural context, and support evidence-based practice. Improving lactation support and education for nurses and midwives can lead to better clinical practice and, as a result, help to promote successful and healthy breastfeeding in Ghana. [ABSTRACT FROM AUTHOR]

Objective : To describe the process of developing a craniosynostosis decision aid. Design : We conducted a mixed-methods exploratory study between August 2019 and March 2020 to develop a decision aid about surgical treatment for single suture craniosynostosis. Setting : A single tertiary care academic children's hospital. Participants : The decision aid development team consisted of surgeons, research fellows, a clinical nurse practitioner, clinical researchers with expertise in decision science, and a university-affiliated design school. Qualitative interviews (N = 5) were performed with families, clinicians (N = 2), and a helmeting orthotist to provide feedback on decision aid content, format, and usability. Interventions : After cycles of revisions and iterations, 3 related decision aids were designed and approved by the marketing arm of our institution. Distinct booklets were created to enable focused discussion of treatment options for the 3 major types of single suture craniosynostosis (sagittal, metopic, unicoronal). Results : Three decision aids representing the 3 most common forms of single suture craniosynostosis were developed. Clinicians found the decision aids could help facilitate discussions about families' treatment preferences, goals, and concerns. Conclusions : We developed a customizable decision aid for single suture craniosynostosis treatment options. This tool lays the foundation for shared decision-making by assessing family preferences and providing clear, concise, and credible information regarding surgical treatment. Future research can evaluate this tool's impact on patient–clinician discussions about families' goals and preferences for treatment. [ABSTRACT FROM AUTHOR]

Informal employment has been identified as an important social determinant of health. This article addresses the processes through which informal employment affects workers' health in Chile. The study's methodological approach was based on qualitative interviews with 34 formal and informal workers. The findings show how workers perceive informal employment as negatively affecting their mental and physical health through different dimensions of their living and working conditions. Incorporating a gender perspective proves to be integral to the analysis of these processes. The article concludes by discussing how neoliberalism underlies such vulnerability processes and negatively impacts on the population's health. [ABSTRACT FROM AUTHOR]

Background: HIV is hyperendemic among fisherfolk in Sub-Saharan Africa, especially around Lake Victoria, Uganda. Purpose/Research Design: We conducted cross-sectional semi-structured interviews about oral pre-exposure prophylaxis (PrEP) implementation with 35 Ugandan fisherfolk (15 women, 20 men) and 10 key stakeholders (healthcare providers, policymakers, community leaders). We used a directed content analysis approach based on implementation science and social marketing frameworks. Results: Participants showed high acceptability for PrEP. Anticipated barriers among fisherfolk included stigma (due to similar medications/packaging as HIV treatment); misconceptions; mobility, competing needs, poverty, and partner conflict. Anticipated provider barriers included insufficient staffing and travel support. Recommendations included: change PrEP packaging; integrate PrEP with other services; decrease PrEP refill frequency; give transportation resources to providers; train more healthcare workers to provide PrEP to fisherfolk; and use positively framed messages to promote PrEP. Conclusions: Results can inform policymakers and healthcare organizations on how to overcome barriers to PrEP scale-up in most at-risk populations with poor healthcare access. [ABSTRACT FROM AUTHOR]

The production of data and numbers has become the key mechanism of both knowing and governing global public policy. And yet, processes of quantification are inherently paradoxical: from expectations of technocratic rationality and political usability of producing 'global' numbers that count for 'local' politics and needs to practical limitation of measurement and the necessity to work with 'good enough' data. This begs a question – how do these competing epistemic, political and value orders manifest themselves through the work that experts do? In this article, we explore the problem by focussing on reflexivity as a way for experts (primarily those working in key International Organisations) to make sense of and tame the tensions inherent in their work. Through rich qualitative exploration of over 80 semi-structured interviews with experts working in the areas of poverty, education and statistical capacity development, we contribute to debates in the social studies of quantification by arguing that reflexivity is not just a mental process that experts engage in but rather an important resource allowing them to make sense of the contradictions inherent in their work and to mobilise political and ethical considerations in the technocratic process of producing numbers. We identify three types of reflexivity: (1) epistemic reflexivity – regarding the quality of data and its epistemic status as reflecting the reality; (2) care-ful reflexivity – regarding values embedded in data and the duty of care to the populations affected by the measurement and (3) instrumental reflexivity – regarding political rationality and necessary trade-off required to realise political goals. Overall, the article argues that reflexivity becomes an increasingly central expert practice, allowing the transformation of the process of quantification into one of qualification enabling them to attach political attributes and values to data and measurement. [ABSTRACT FROM AUTHOR]

This is an exploratory study to document the demographic characteristics, backgrounds, and services provided by trained and certified INELDA end-of-life doulas. Like birth doulas, end-of-life doulas represent a divergent, yet complementary form of care for dying persons. The purpose of end-of-life care is to facilitate comfort of the dying person and their closest family members. Surveys were completed by 618 end-of-life doulas regarding their demographic characteristics, employment backgrounds, services, and their experiences providing end of life care to dying persons and their closest family members. Follow-up qualitative interviews were also conducted with a subset of 39 respondents who completed the original survey. Results show that trained doulas are largely white (91.4%), female (90.4%), hold a Bachelor's (32.3%) or Masters (32.4%) degree, and are employed outside of their EOLD work (70.1%). Qualitative data details services provided to dying persons and family members in addition to the benefits and challenges of working with traditional healthcare settings. [ABSTRACT FROM AUTHOR]

Background: Healthcare usage patterns change for people with life limiting illness as death approaches, with increasing use of out-of-hours services. How best to provide care out of hours is unclear. Aim: To evaluate the effectiveness and effect of enhancements to 7-day specialist palliative care services, and to explore a range of perspectives on these enhanced services. Design: An exploratory longitudinal mixed-methods convergent design. This incorporated a quasi-experimental uncontrolled pre-post study using routine data, followed by semi-structured interviews with patients, family carers and health care professionals. Setting/participants: Data were collected within specialist palliative care services across two UK localities between 2018 and 2020. Routine data from 5601 unique individuals were analysed, with post-intervention interview data from patients (n = 19), family carers (n = 23) and health care professionals (n = 33; n = 33 time 1, n = 20 time 2). Results: The mean age of people receiving care was 73 years, predominantly white (90%) and with cancer (42%). There were trends for those in the intervention (enhanced care) period to stay in hospital 0.16 days fewer, but be hospitalised 2.67 more times. Females stayed almost 3.5 more days in the hospital, but were admitted 2.48 fewer times. People with cancer had shorter hospitalisations (4 days fewer), and had two fewer admission episodes. Themes from the qualitative data included responsiveness (of the service); reassurance; relationships; reciprocity (between patients, family carers and staff) and retention (of service staff). Conclusions: Enhanced seven-day services provide high quality integrated palliative care, with positive experiences for patients, carers and staff. [ABSTRACT FROM AUTHOR]

Identifying and recruiting key informants is a widely used sampling strategy in applied qualitative health research. Key informants were first conceptualized within ethnography, but there is little methodological guidance about how to use this technique outside of that research tradition. The objective of this article is to offer practical suggestions about how existing methods for data collection with key informants could be translated to methodologies commonly used in applied qualitative health research. This article delineates how key informants could be conceptualized and sampled and how data sufficiency can be approached. The article prompts deeper consideration of the politics of representation and epistemic power that are inherent to the use of key informants in applied qualitative health research. [ABSTRACT FROM AUTHOR]

Introduction: Opioid overdose deaths continue to climb in the United States. Administering naloxone to an overdose victim can save their life, but rapid access to naloxone remains a barrier. Delivering naloxone to a bystander using a drone has potential to increase naloxone availability but there are still many uncertainties about this mode of delivery. Can an untrained bystander to an opioid overdose successfully administer drone delivered naloxone after viewing video instructions on the drone and how long does it take? Methods: This mixed-methods observational study, conducted in a controlled outdoor environment, simulated an opioid overdose using a mannequin (overdose victim) and panicked bystander. Untrained and medically naïve participants were instructed to call for help, move the drone from the landing spot to the mannequin, and follow the instructions provided by the drone to administer naloxone. Data was collected using video recordings, interviews, and an online survey. Time stamp data was extracted from the video for 2 time points: time for removing the naloxone from the drone and time to administer the naloxone. Interviews were audio recorded and analyzed using an inductive concept analysis approach. One interview question was coded as a binary response of anxiety/no anxiety and added to the demographic data. Results: The average time to remove and administer naloxone was 62 seconds. Anxiety during the activity was reported by 59% of the participants but there was no correlation between anxiety and time. The design of our drone and instructional video can be improved. Conclusions: We have established baseline times for completing steps in administering naloxone delivered by drone. We were able to successfully induce anxiety and have a baseline measure for what percentage of untrained bystanders may experience anxiety when involved with an emergency situation. Design of instructional materials and drone construction can contribute to anxiety and successful administration of naloxone. [ABSTRACT FROM AUTHOR]

Transitional care to cardiac rehabilitation during the pandemic was a complex process for older adults, with additional challenges for decision-making and participation. This study aimed to explore the perspectives of older adults and health providers on transitional care from the hospital to cardiac rehabilitation, focusing on patient participation in decision-making. A qualitative exploratory design was used. Semi-structured interviews were conducted with 15 older adults and 6 healthcare providers. Document analysis and reflexive journaling were used to support triangulation of findings. Six themes emerged from the data, related to insufficient follow-up from providers, the importance of patients' emotional and psychological health and the support provided by family members, the need for information tailored to patients' needs and spaces for participation in decision-making, as well as challenges during COVID-19, including delayed medical procedures, rushed discharge and isolating hospital stays. The findings of this study indicated a number of potential gaps in the provision of transitional care services as reported by older adults who had a cardiovascular event, often during the first few weeks post hospital discharge. [ABSTRACT FROM AUTHOR]

Introduction: The purpose of this study was to obtain baseline data on bone mass density for Native Hawaiian women and to better understand the socio-cultural context for assessing bone health and risk of osteoporosis for this underserved population. Method: A sequential mixed-method design guided by Leininger's Culture Care Theory of Diversity and Universality consisted of two phases: (a) an initial exploratory focus group and (b) dual-energy X-ray absorptiometry (DEXA) scans and individual interviews. Data were analyzed using descriptive statistics and thematic analysis. Results: Phase a (n = 12) suggested that Native Hawaiian women have limited knowledge of bone health, but recognize traditional and cultural ways of health. Phase b (n = 50) showed that Native Hawaiian women have healthy bones, according to the T -score results. The interviews suggested that perspectives of bone health are culturally anchored. Discussion: Understanding cultural values and practices are vital for care. Preliminary recommendations for health professionals are included. [ABSTRACT FROM AUTHOR]

Feminisms have had a significant impact on social work discussions in Latin America in recent decades. However, the gap between academic discussions and professional practice remains wide. Based on a qualitative study that included 69 semi-structured interviews with social workers in Chile, in this article, we focus the analysis on the experiences of women social workers implementing mental health programmes. These are women – professionals facing extremely precarious working conditions – who work with other women who, while below the poverty line, are users of state health policy. The findings suggest that in these highly precarious spaces, the division between professional and the user is blurred, producing what feminist philosopher María Lugones calls 'liminal space'. Professionals and users establish alliances and practices of resistance from that liminal space to challenge the oppressions they experience. Drawing upon a decolonial feminist perspective, we identify challenges for social work such as problematising professional bonds, incorporating structural readings of precariousness and feminised resistance, and repositioning the value of frontline social workers' and users' knowledge. We can learn from these women's experiences that question the deepest foundations of colonial and patriarchal capitalism still present in training and professional practice. [ABSTRACT FROM AUTHOR]

Social work scholarship concerned with mixed-race and queer identities is growing and ever-changing, yet often treats race and sexuality as separate experiences independent from context and environment. In addition, in studies of mixed-race people, the legacy of the Black-White/US-based multiracial paradigm and the history of such research using race as the only or primary analytic has left a dearth of studies that seek to understand mixed-race experiences within geographical, transnational and intersectional contexts. In this paper, we extend previous work focused on situational and contextual multiracial identities through an interview-based study of a sample of 12 queer and mixed-race individuals. We employ a narrative analysis to explore how emergent themes of geography and migration are salient to self-making processes of participants. Findings include: (1) diverse geographic and migration histories among participants; (2) interviewees’ use of discursive strategies that draw upon experiences of geography and migration within the narrative structure; and (3) the critical role of geography and migration in expanding and changing participants’ identity discourses and in shaping individuals’ identity and sense of community. Ultimately, this work serves as a call for on-going attention to how geography and migration, as well as intersectional and transnational perspectives, add depth and texture to studies of queer-mixed people while also offering specificity to social work’s broader commitment to context and environment. [ABSTRACT FROM AUTHOR]

A clinical nutritionist (CN) is a university-educated professional trained to perform preventive and recovery functions in the health of patients. The actions of these professionals, both worldwide and in Latin America, may face barriers and opportunities that require careful identification and examination. The main objective of this study is to identify the most important barriers and opportunities for the clinical nutritionist in 13 Latin American countries. A qualitative study was carried out; the initial phase involved conducting in-depth individual interviews with 89 informants, experienced CNs from 13 Latin American countries. After calculating the mean and standard deviation, we ranked the top 10 most frequently reported barriers by assigning a score ranging from 1 to 10. Additionally, 3 opportunities were identified with a lower score from 1 to 3. Means and standard deviation were calculated to sort the responses. Results: the most important barrier was the absence of public policies that regulate and/or monitor compliance with the staffing of CNs according to the number of hospital beds, while the most important opportunity was the advances in technology such as software, body analysis equipment and other tools used in Nutritional Care. The identified barriers can interfere with the professional performance of CNs and, moreover, make it difficult to monitor the good nutritional status of patients. It is recommended to consider the barriers identified in this study, as well as the opportunities, with a view to improving the quality of hospital services with an adequate supply of nutritionists. [ABSTRACT FROM AUTHOR]

Introduction: Managing a patient on mechanical ventilation is a vital aspect of clinical scope in intensive and critical care units. In addition, it is a highly technical, intricate, dynamic task requiring extensive knowledge and skills. Little is known about critical care nurses' experiences caring for patients on mechanical ventilation in contexts where resources are constrained, creating an empirical gap in the available body of knowledge. Objective: This study explored critical care nurses' experiences caring for patients on mechanical ventilators at an intermediate hospital in northeastern Namibia. Method: The study followed qualitative descriptive and explorative designs. The purposive sample included 13 critical care nurses who had cared for patients on mechanical ventilation for more than 6 months. Data were collected via individual unstructured interviews and analyzed using a reflexive thematic analysis approach. Results: Four themes and eight subthemes emerged. Varied personal feelings, such as feeling proud, competent, exhausted, traumatized, overwhelmed, and concerns for patients' well-being were experienced by critical care nurses. Participants described learning from colleagues in the unit and expressed concerns about not having postbasic training in critical care nursing. Negative experiences included concerns about community members' misconceptions about critical care units and mechanical ventilators, and challenges with resources, personnel, and admission procedures. Conclusion: Critical care nurses in resource-constrained settings have positive and negative experiences caring for patients on mechanical ventilators. The findings have implications for the development of support systems for critical care nurses, including induction programs, competence enhancement, psychological support, the development of guiding documents for admission, patient preparation and sensitization of community members. There is a need for this study to be replicated in other resource-constrained contexts where specialized critical care nurses are available. [ABSTRACT FROM AUTHOR]

Patient-led recording occurs when a patient records a clinical encounter with their smart device. Understanding patient-led recording is important in ensuring a safe and patient-centered response to this behavior. This exploratory study provides insight into the patient perspective of patient-led recordings. We conducted 20 semistructured interviews with hospital and health service patients. The interview data was analyzed using thematic analysis. We identified three themes relating to patient-led recordings, including patient engagement, psychosocial, and health service. Findings suggest that health services move beyond querying the permissibility of recording and consider how to maximize the benefits of recording while reducing the risk of harm. Patients and clinicians need to be made aware of the potential broader psychosocial benefits of recording a clinical encounter during hospital admission. These results point to an urgent need for health services to develop policies and resources that support clinicians to work within a culture of recording. [ABSTRACT FROM AUTHOR]

Aim: The study aimed to explore the perceptions of intensive care unit staff deployed to other clinical areas. It also aimed to identify challenges that the staff face during their redeployment. Design: A mixed method study. Method: 40 participants (nurses and healthcare assistants) completed an anonymous online questionnaire, and five participants (nurses) participated in one-to-one semi-structured interviews. Participants were recruited through purposive sampling from the selected ICU/HDU. Results: Content analysis of the data revealed three major themes: "Negative feelings of redeployment", "Positive feelings of redeployment" and "Visible and Structured leadership interventions". Results indicate that ICU nursing management needs to make some additional efforts and implement the study recommendations to improve the overall perception and experience of ICU/HDU staff redeployment. Public Contribution: This research will create insight into the redeployment of intensive care unit staff to other clinical areas. Furthermore, it will add value to patient safety and improve institutional healthcare policies. [ABSTRACT FROM AUTHOR]

This exploratory study examined the intersections of Middle Eastern and North African (MENA) American cultural identity and attitudes towards mental health and mental health services. Fifteen in-depth narrative interviews with participants of MENA descent in the United States were analyzed using qualitative thematic content analysis, revealing five primary themes within these data: denial, lack of awareness, stigma/shame, collective identity, and resistance. These results indicate cultural identity plays a unique and significant role in how this population understands and responds to mental health and substance use challenges, in a way that often creates barriers to social service provision and success. Implications and suggestions for how these findings might be used to develop more culturally competent and effective social work interventions for MENA communities are discussed. [ABSTRACT FROM AUTHOR]

Background: Healthcare assistants working in hospice at home settings have a pivotal role in supporting people dying at home and their family caregivers. Some healthcare assistants are working alone in patients' homes, which magnifies some of the issues reported for those working closely with other team members. There is a dearth of evidence in terms of education, training and support needs for healthcare assistants when working alone. Aim: To explore the role of newly employed lone working healthcare assistants delivering palliative care in the community, and their support and educational needs. Design: Qualitative exploratory study using semi-structured interviews. Setting/participants: Healthcare assistants (n = 16) employed less than 12 months by a national non-profit hospice and palliative care provider located across the UK. Results: Analysis of interviews identified three main themes: (1) Healthcare assistants have a unique and complex role catering for holistic needs of patients and their family caregivers in the home environment; (2) preparation for the complex role requires focus on experiential learning and specific training to support holistic care provision; (3) lone workers experience loneliness and isolation and identify peer support as a key intervention to support their wellbeing. Conclusions: Given the complexities of their role within community palliative care teams, there are key learning points in relation to healthcare assistant preparation. Education and support networks should be prioritised to reduce isolation and support ongoing learning and development of newly employed healthcare assistants; all of which is vital to ensure safety and quality of care for the growing number of people they support in the community. [ABSTRACT FROM AUTHOR]

Objective: To develop a measure of the needs injured children and their families' needs throughout recovery; The MAnchester Needs Tool for Injured Children (MANTIC). Design: Tool development, psychometric testing. Setting: Five children's major trauma centres in England. Participants: Children aged 2 to 16 years with any type of moderate/severe injury(ies) treated in a major trauma centre within 12 months of injury, plus their parents. Methods: Stage 1a (Item generation) : Interviews with injured children and their parents to generate draft items. Stage 1b (Co-production) : Feedback about item clarity, relevance and appropriate response options was provided by parents and the patient and public involvement group. Stage 2 (Psychometric development) : Completion of the prototype MANTIC by injured children and their parents with restructuring (as necessary) to establish construct validity. Concurrent validity was assessed by correlation with quality of life (EQ-5D-Y). MANTICs were repeated 2 weeks later to assess test–retest reliability. Results: Stages 1a,b : Interviews (13 injured children, 19 parents) generated 64 items with semantic differential four-point response scale (strongly disagree, disagree, agree, strongly agree). Stage 2 : One hundred and forty-four participants completed MANTIC questionnaires (mean age 9.8 years, SD 3.8; 68.1% male). Item responses were strong requiring only minor changes to establish construct validity. Concurrent validity with quality of life was moderate (r = 0.55, P < 0.01) as was test–retest reliability (ICC = 0.46 and 0.59, P < 0.001). Uni-dimensionality was strong (Cronbach's α > 0.7) Conclusion: The MANTIC is a feasible, acceptable, valid self-report measure of the needs of injured children and their families, freely available for clinical or research purposes. [ABSTRACT FROM AUTHOR]

While health services are expected to have public involvement in service (re)design, there is a dearth of evaluation of outcomes to inform policy and practice. There are major gaps in understanding why outcome evaluation is under-utilised. The aims of this interpretive descriptive study were to explore researcher participants' experiences of and/or attitudes towards evaluating health service outcomes from public involvement in health service design in high-income countries. Additionally, the aims were to explore barriers and enablers of evaluation, and reasons for the use of evaluation tools or frameworks. Semi-structured interviews (n = 13) were conducted with researchers of published studies where the public was involved in designing health services. Using framework analysis, four themes were developed that captured participants' experiences: Public involvement is hard – evaluation is harder; power, a diversity of agendas, and the invisible public; practical and methodological challenges; and genuineness and authenticity matter. Evaluation is driven by stakeholder requirements, including decision-makers, funding bodies, researchers, and academics, and evaluation tools are rarely used. The public is largely absent from the outcome evaluation agenda. There is a lack of commitment and clarity of purpose of public involvement and its evaluation. Outcome evaluation must be multi-layered and localised and reflect the purpose of public involvement, what constitutes success (and to whom), and use the most appropriate methods. Multi-level supports should include increased resources, such as funding, time, and expertise. Without improved evaluation, outcomes of investment in public involvement in health service design/redesign remain unknown. [ABSTRACT FROM AUTHOR]

Background: Mapping out actual supportive care needs assists nurses in providing holistic individualized care. This study aimed to explore the care needs of parents of children with cancer in the Philippines. Method: Guided by the Supportive Care Needs Framework (SCNF), this study used an embedded mixed-method design with the quantitative revised Cancer Patient Needs Questionnaire and qualitative semistructured interviews to describe parents' care needs and priorities. Results: Filipino parents (N = 156) of children with cancer have various care needs which could be classified along the SCNF categories—practical, informational, spiritual, physical, emotional, and physical needs as ranked from highest to lowest. A number of variables were significantly associated with care needs. Solid tumor diagnosis was associated with greater practical, emotional, and psychosocial care needs; having a child who had undergone surgery was associated with more practical and spiritual care needs; and being within one year of the child's diagnosis was associated with practical, psychosocial, and spiritual care needs. Parent priority needs included (a) addressing financial needs; (b) access to temporary housing to minimize treatment-related costs; (c) support groups among parents of children with cancer as a source of information; (d) financial and social support between members of family and partners of parents of children with cancer; and (e) using prayer to facilitate acceptance. Conclusions: Supportive care needs of parents of children with cancer are important components of care that should be given recognition to enhance holistic individualized care throughout the childhood cancer experience. [ABSTRACT FROM AUTHOR]

This study explored the potential role of victim advocacy in Native American missing person cases. Interviews with 25 tribal and non-tribal victim/social service providers were conducted to assess their perspectives on the factors which make Native Americans vulnerable to going missing, the barriers and challenges regarding reporting and investigating missing persons, as well as how victim/social service providers might better support the families of missing persons. Findings suggest that advocates perceive that responding to and offering services for Native families who experience a missing loved one will be extremely difficult because of the intersection of isolation, poverty, and jurisdictional complexities among tribal lands, combined with social service providers and law enforcement officers' lack of resources and training regarding cultural sensitivity. At the same time, advocates suggest that additional training and resources could help overcome many of these barriers and see a role for victim service providers in responding to missing and murdered Native American persons. Implications and suggestions for practice are discussed. [ABSTRACT FROM AUTHOR]