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Abstract: Background: Context-specific standardized psychometric instruments are essential for ensuring valid and reliable assessment of health outcomes across diverse populations to aid the advancement of research and health-related interventions. However, instruments measuring attitudes toward vaccinations are lacking in the extant literature. Therefore, we performed a cross-cultural adaptation of the Motors of COVID-19 Vaccination Acceptance Scale (MoVac-COVID19S) in Germany. Method: During the months of June and July 2022, 475 individuals aged 18 years and older from the general population of Germany participated in an online cross-sectional survey. Participants responded to five demographic questions, a measure of COVID-19 vaccine uptake willingness, and the MoVac-COVID19S. Confirmatory Factor Analysis (CFA) fit indices were used to evaluate the factor structures of the MoVac-COVID19S. Results: The CFA revealed that all examined factor structures of both the 9-item and 12-item versions of the MoVac-COVID19S were acceptable among the sample. Overall, CFI, GFI, and TLI values were higher than 0.95; RMSEA and SRMR values were all less than 0.08 for all the estimated models. The one-factor model of the 9-item version of the MoVac-COVID19S exhibited best fits indices compared to the one-factor and four-factor structures of the 12-item version of the scale. The bifactor model revealed that the general factor explained a higher percentage of the Explained Common Variance (ECV; ranging from 55% to 94%) in the majority of the items, compared to the specific factors. The scale was found to demonstrate convergent validity with related measures. Conclusion: The German version of the MoVac-COVID19S should be considered a unidimensional rather than a multidimensional measure. Although the 9-item version of the scale performed better among the sample compared to the 12-item version, the overall scores of both versions were found to be valid and reliable measures of attitudes toward COVID-19 vaccinations. The MoVac-COVID19S has the potential to be adapted for assessing attitudes toward any future vaccination programs. Limitations: While our study sampled only the general German population, the criticisms of CFA warrant further research using advanced methods, such as the Rasch model, and subgroups.

Abstract Background The World Health Organization recommends exclusive breastfeeding for the first 6 months of an infant’s life and continued breastfeeding for 2 years. The global rate of exclusive breastfeeding is low at 33%. Thus, it is important to identify philosophical and theory-based strategies that can promote exclusive breastfeeding. The aim of the study was to identify philosophical schools of thought and theories used in research on promoting the practice of exclusive breastfeeding. Methods A scoping review using Arksey and O'Malley's framework explored the phenomenon of exclusive breastfeeding practice promotion. Searches were conducted using CINAHL Plus full-text, PubMed, APA PsycInfo, and Academic Search Premier. Search terms included theory, philosophy, framework, model, exclusive breastfeeding, promotion, support, English, and publication between 2001—2022. Results The online search yielded 1,682 articles, however, only 44 met the inclusion criteria for the scoping review. The articles promoting exclusive breastfeeding used pragmatism (n = 1) or phenomenology (n = 2) philosophies and theories of self-efficacy (n = 10), theory of planned behaviour (n = 13), social cognitive theories (n = 18) and represented 16 countries. Theories of self-efficacy and planned behaviour were the most used theories. Conclusions This review suggests that theories and models are increasingly being used to promote exclusive breastfeeding. Orienting exclusive breastfeeding programmes within theoretical frameworks is a step in the right direction because theories can sensitize researchers and practitioners to contextually relevant factors and processes appropriate for effective exclusive breastfeeding strategies. Future research should examine the efficacy and effectiveness of theory-informed exclusive breastfeeding programmes over time. Such information is important for designing cost-effective EBF programmes.

Introduction Since the beginning of the COVID-19 pandemic, nurses have been on the frontline providing care for patients with COVID-19. Caring for patients with COVID-19 can be a rewarding experience for nurses, but research also suggests that nurses experience numerous challenges on the frontline. Objectives This study aims to explore the experiences of frontline nurses caring for patients with COVID-19 in Nigeria Methods Ten nurse volunteers working in a COVID-19 isolation center were purposively recruited. Data were collected with a semi-structured interview guide, and a template analysis approach was used to analyze the transcribed interviews. Results The participants volunteered at the isolation center for safety reasons, professional gain, and concern for humanity. Working at the isolation center was accompanied by changes in working hours, work dynamics, care context and care tools. These changes resulted in personal, professional, and work-related challenges for nurses. However, team spirit, positive patient outcomes, gratitude and family support helped the nurses cope with the challenges. Conclusions This research highlighted that working on the frontline of COVID-19 is associated with multiple and complex challenges that can impact nurses’ personal and professional life. Thus, a tailored approach to support is needed to address the challenges faced by frontline nurses.

Empathy is positively related to healthcare workers and patients’ wellbeing. There is, however, limited research on the effects of empathy education delivered in acute clinical settings and its impact on healthcare consumers. This research tests the feasibility and the potential efficacy outcomes of an immersive education programme developed by the research team in collaboration with clinical partners and a multidisciplinary advisory group. Healthcare worker participants in the intervention ward will receive an 8-week immersive empathy education. The primary outcome (feasibility) will be assessed by evaluating the acceptability of the intervention and the estimated resources. The secondary outcome (efficacy) will be assessed using a quasi-experimental study design. Non-parametric tests will be used to test healthcare worker participants’ empathy, burnout, and organisational satisfaction (within-group and across groups), and healthcare consumer participants’ satisfaction (between-group) over time. Despite growing interest in the importance of empathy in professional relationships, to our knowledge, the present pilot study is the first to explore the feasibility and efficacy of an immersive empathy education in New Zealand. Our findings will provide critical evidence to support the development of a randomised cluster trial and potentially provide preliminary evidence for the effectiveness of this type of empathy education.