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Food insecurity is widely documented among people living with HIV (PLWH) worldwide, and it presents significant challenges across the spectrum of HIV care and support. In North America, the prevalence of food insecurity among PLWH exceeds 50%. In the province of British Columbia (BC), it exceeds 65%. It comes as no surprise that food has become an essential tool in supporting and engaging with PLWH. Over the past decade, however, a shift has taken place, and food has become an incentive to boost uptake and outcomes of prevention, testing, treatment, and support. To explore this practice, we drew on a qualitative case study of incentives in the care and support of PLWH. This paper presents the findings of a targeted analysis of interviews (N = 25) that discuss food incentives and explores two main themes that shed light on this practice: (1) Using food to engage versus to incentivize and (2) Food is more beneficial and more ethical. Providers perceived food more positively than other incentives, despite the goal remaining somewhat the same. Incentives, such as cash or gift cards, were considered ethically problematic and less helpful (and potentially harmful), whereas food addressed a basic need and felt more ethical. [ABSTRACT FROM AUTHOR]

Family members of patients admitted to the intensive care unit (ICU) experience multidimensional distress. Many clinicians lack an understanding of spiritual health practitioners' role and approaches to providing spiritual support. Through semi-structured interviews and focus groups with 10 spiritual health practitioners, we explored how spiritual health practitioners support families of patients in the ICU to better understand their scope of practice and role within an interdisciplinary critical care team. Spiritual health practitioners' work was described through clinical roles (family support, clinician support, bridging family members and clinicians), activities (companioning, counseling, facilitating difficult conversations, addressing individual needs), tensions (within and between roles and activities, navigating between hope and anticipated clinical trajectory, balancing supportive care and workload) and foundational principles (holistic perspective, resilience). A more comprehensive understanding of these roles and skills may enable clinicians to better integrate spiritual health practitioners into the fabric of care for patients, families, and clinicians themselves. [ABSTRACT FROM AUTHOR]

Purpose: Systemic sclerosis or scleroderma is a chronic, rare connective tissue disease with negative physical and psychological implications. Coping strategies used by scleroderma patients have not been studied in-depth. The objective of the present study was to gain a greater understanding of the coping strategies employed by people living with scleroderma. Method: Three semi-structured focus group discussions were conducted with a total of 22 people with scleroderma. Interviews were recorded, transcribed, and analyzed using content analysis. Coping strategies discussed were analyzed through Lazarus and Folkman’s theoretical model of coping, including: (1) problem-focused, (2) emotion-focused, and (3) meaning-focused coping. Results: Participants reported using a combination of problem-focused (e.g., professional help; seeking disease-related information), emotion-focused (e.g., social support; adaptive distraction techniques), and meaning-focused coping strategies (e.g., benefit finding; goal reappraisal) to help them to cope with and manage their disease. However, many patients reported having difficulty in accessing support services. Conclusions: Scleroderma patients use similar coping strategies as patients with more common diseases, but they may not have access to the same level of support services. Accessible interventions, including self-management programs, aimed at improving problem- and emotion-focused coping are needed. Further, increased access to support groups may provide patients with opportunities to obtain social support and enhance coping. [ABSTRACT FROM AUTHOR]

Purpose:Theoretical and empirical research findings attest to the workplace being a social environment in which co-workers have a critical influence on the employment outcomes and return-to-work (RTW) success of other employees. However, co-workers do not have a formal role in RTW planning. The aim of this study was to explore how managers responsible for developing and implementing RTW procedures view the role of co-workers in this process. Method:An exploratory qualitative pilot study was conducted in Canada. Participants (1 male; 13 females; mean experience in RTW = 11.8 years) were workplace (n=8) or RTW managers (n=6) with direct oversight of RTW plans. The participants were recruited via invitation from a research institute and were drawn from three different provinces. Data were gathered via open-ended questions and were coded and subject to thematic analysis. Findings:Three key themes were identified: (1) Managers view RTW as having little relevance to co-workers but expect them to cooperate with the arrangements; (2) Formal procedures are inadequate when psychosocial barriers to work resumption are present, so managers use informal strategies to engage co-workers’ emotional and social support; and (3) Managers have difficulty integrating RTW procedures with other legal obligations, such as privacy and confidentiality requirements. Conclusion:Existing arrangements for the development and implementation of RTW are sufficient most of the time, but may be inadequate when an injured worker presents with psychosocial barriers to work resumption.Implications for RehabilitationStandard RTW arrangements can be inadequate when a RTW plan requires active co-worker support.Privacy and confidentiality provisions can result in managers using informal procedures for information exchange and to engage co-workers.The use of risk management strategies – assessment, consultation and communication – could be used to include co-workers when workplace issues threaten the success of a RTW plan. [ABSTRACT FROM PUBLISHER]