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Objective: The aim of this study is to gain insight into the facilitators, barriers, and support needs of Dutch self-employed workers when returning to work (RTW) after sick leave. Methods: Three focus groups were conducted, involving 15 Dutch self-employed workers who were on sick leave due to health problems. The transcripts were analyzed through thematic content analysis. Results: Five main themes regarding barriers, facilitators, and needs of self-employed workers to RTW were identified: autonomy, social support, client management, financial security, and information on sick leave. Having autonomy was considered a facilitator for RTW. However, the participants expressed a need formore financial support, additional guidance from occupational health professionals, and tailored information regarding RTW. Conclusions: The results of this study emphasize a need for optimizing national policy and support for self-employed workers regarding sick leave and RTW. [ABSTRACT FROM AUTHOR]

Young-onset dementia (YOD) symptoms often first present in the workplace, resulting in work performance challenges and eventually loss of employment. This study aims to investigate the experiences, work values, and support needs of employees with YOD and their relatives. Semi-structured interviews were conducted to explore the experiences, work values, and support needs of (former) employees with YOD and their relatives. Subsequently, separate focus group discussions were conducted for employees and relatives to review and prioritize interview findings. Inductive thematic analysis was applied to both datasets. A total of 15 interviews (six employees; nine relatives) and four focus group discussions (ten employees; six relatives) were conducted. Six themes emerged, with five revolving around the central theme: desire to work. The other themes represent essential contributing factors, including importance of receiving a YOD diagnosis; knowledge, awareness, and understanding regarding YOD; open communication, joint decision making, and collaboration; work adjustments, involvement, and support; phasing out work and future perspectives. The findings highlight a strong desire to work post-YOD diagnosis, serving as a foundation for developing workplace support tools and guidance. This has the potential to help individuals with YOD preserve their self-confidence and identity while working within their capabilities. [ABSTRACT FROM AUTHOR]

Shy‐withdrawn behaviours place preschoolers at increased risk of experiencing adverse developmental outcomes. Positive teacher‐child relationships play a protective role against these negative socioemotional outcomes. This study aimed to understand, in‐depth, the beliefs, practices and support needs of preschool teachers toward shy‐withdrawn children. Thirty preschool teachers of children aged 3–5 years were interviewed, using a semistructured guide. The thematic analysis revealed that most preschool teachers were aware of the main manifestations, transactional influences and consequences of shy‐withdrawn behaviours, and of the empirically validated strategies that may be useful to modify them. However, a noteworthy proportion of participants reported misconceptions about the intentionality of shy‐withdrawn behaviours, negative emotions and inconsistent or less effective practices. Our findings highlight that strengthening pre‐service and in‐service training and providing coaching to the preschool staff may be helpful to restructure dysfunctional beliefs about shy‐withdrawn behaviours, translate developmental knowledge in evidence‐based classroom practices and enhance professionals' self‐awareness. Highlights: This study explored, in‐depth, the beliefs, practices and support needs of preschool teachers toward shy‐withdrawn children.Most of the 30 interviewed preschool teachers were aware of the main manifestations, transactional influences and consequences of shy‐withdrawn behaviours.Our findings highlight the need to strengthen teachers' training, bridging theoretical knowledge with professional development. [ABSTRACT FROM AUTHOR]

Up to 25% of people with type 2 diabetes (T2D) may binge eat which is almost 10 times as many as in the general population. Binge eating is associated with depression, anxiety, and social isolation. Moreover, binge eating may increase the risk of obesity and high blood glucose levels, both of which can accelerate the onset of complications to diabetes and death in people with T2D. Still, little is known about the experiences, needs, and preferences of people with T2D and binge eating that can inform and develop current and future treatment efforts. The aim of the study was therefore to gain in-depth insights into the experiences and biopsychosocial support needs of women and men with T2D and binge eating. Twenty semi-structured individual interviews (65% with females) were conducted and analyzed according to the methodology of Interpretive Description. Four themes were identified: (a) T2D and binge eating: Feeling trapped in a vicious circle; (b) Unwanted outcasts: Responding to continuous criticism; (c) Biomedical relief: Blaming and adjusting the body; and, (d) Silent struggles: Wanting to cease the secrecy. Pertinent to all themes were the guilt, shame, and worries about developing complications that the participants experienced when binge eating despite having T2D. Although binge eating triggered emotional distress, binge eating was at the same time a way of coping with such distress. Implications for treatment and future research are discussed, including the need to systematically assess and address binge eating in routine T2D care. [ABSTRACT FROM AUTHOR]

Introduction: The efforts of relatives in providing palliative care (PC) at home are important. Relatives take great responsibility, face many challenges and are at increased risk of poor physical and mental health. Support for these relatives is important, but they often do not receive the support they need. When PC is provided at home, the support for relatives before and after a patient's death must be improved. This study aimed to describe relatives' suggestions to improve the support from health professionals (HPs) before and after a patient's death in general PC at home. Methods: This study had a qualitative descriptive design based on the data from open‐ended questions in a survey collected from the Swedish Register of Palliative Care. The respondents were adult relatives involved in general PC at home across Sweden. The textual data were analysed using thematic analysis. Results: The analysis identified four themes: (1) seeking increased access to HPs, (2) needing enhanced information, (3) desiring improved communication and (4) requesting individual support. Conclusions: It is important to understand and address how the support to relatives may be improved to reduce the unmet needs of relatives. The findings of this study offer some concrete suggestions for improvement on ways to support relatives. Further research should focus on tailored support interventions so that HPs can provide optimal support for relatives before and after a patient's death when PC is provided at home. [ABSTRACT FROM AUTHOR]

Caregivers of children with neurodiverse needs are known to experience challenges and hardship due to the increased needs of the child and the lack of support available. This study aimed to explore the support needs and well-being of caregivers of children with neurodiverse needs in Australia. Sixty-six caregivers participated in an online survey asking questions about support needs. The results highlighted five main themes that caregivers commonly experienced including: barriers to community engagement, impact on close relationships, negative impact on mental health and identity, financial hardship, and identified support needs. Findings identified multiple unmet needs existing amongst caregivers and further emphasises the importance of addressing these needs to improve the quality of life of caregivers of children with neurodiverse needs. [ABSTRACT FROM AUTHOR]

Adulthood autism diagnosis has become increasingly common, but little is known about post-diagnosis support experiences and needs. We interviewed 19 autistic adults and 4 support persons on experiences of formal and informal post-diagnosis support. Reflexive thematic analysis was used to identify themes. Participants reported difficulties accessing suitable formal support, especially regarding education and employment. Informal support was helpful but created challenges in the relationships between autistic adults and support persons. For autistic adults, support from autistic peers fostered belonging and self-acceptance. We also identified complex interactions between adults' post-diagnosis identity development and support experiences as they resolved the dilemma between self-acceptance and a desire to change. Findings have important implications for services working with autistic adults and their families. [ABSTRACT FROM AUTHOR]

When families transition out of the Australian Defence Force, they can experience a range of challenges that pose risks to their mental health and wellbeing. These may be further complicated by a lack of access to services and low uptake of existing support. While some research has investigated the experiences of previously serving men and women, the support needs of their children have received little empirical attention. This article reports on a qualitative study that explored the experiences of young people who are now adults, when their parents left the Australian Defence Force. Themes developed included gaps in defence and civilian support, inadequate school support, military stigma and receptiveness to support, and ideas for improving strategies and support. Findings were analysed using a thematic approach, and then a socioecological lens was applied, highlighting the multilevel support needs as well as the significant service gaps experienced by young people during the military–civilian transition. IMPLICATIONS Understanding young people's experiences when their parents leave the Australian Defence Force can help social workers and other disciplines appropriately address their support needs through research and practice. Engagement and service provision efforts should consider the multilevel systems that protect young people from experiencing critical or long-term impacts. They should recognise the role of young people's agency, acknowledging that experiences during the military–civilian transition are not homogenous. [ABSTRACT FROM AUTHOR]

People with disability face heightened vulnerability during disasters due to functional limitations and inadequate support. This study explores disaster preparedness, capabilities, and support needs among Australians with disability. A cross-sectional survey was conducted, aligned with the Person-Centred Emergency Preparedness (P-CEP) framework: a co-designed and tested framework that helps people with disability assess their capabilities, identify their needs, communicate with others, and plan for different emergency scenarios. Data collection involved self-administered online surveys and interviewer-administered telephone surveys through convenience sampling. Descriptive statistics and regression modelling were employed for data analysis. Of the 138 respondents, most were female (68.1%) and aged 60–69 (23.9%). While 60.3% had emergency plans, motivators included enhancing survival chances (36.7%) and past disaster experiences (22.7%). Barriers included uncertainty about preparation (22.0%) and difficulty obtaining information (11.3%). Those perceiving bushfire risk were more likely to have a plan (p = 0.004), while individuals living alone were less likely (p = 0.019). Common preparedness actions included safely storing important documents (57.5%), but fewer had backup plans for support workers (9.2%) or home generators (9.7%). Respondents with disaster experience highlighted diverse support needs, encompassing health, emotional well-being, and practical assistance. Inclusive disaster risk reduction should involve individuals with disability in assessing their capabilities and support requirements. This study underscores the necessity of tailored emergency preparedness measures to safeguard the well-being of this demographic. [ABSTRACT FROM AUTHOR]

This study investigates the self-reported impact of children's psychiatric disorders on their siblings and assesses what forms of support such children most value. We used a qualitative research design with open interviews to stimulate children between 8 and 15 years old to talk about their experiences living with a brother or sister with a psychiatric disorder. Their stories were analysed within a hermeneutic phenomenological framework in order to identify narrative themes and interpret the meaning of shared experiences. From our analysis, nine shared narrative themes emerge. Overall, siblings report feeling conflicted about adapting their lives to their brother's or sister's disorder and signal a need for personalized attention from parents. They also indicate that being involved in the care for their brother or sister helps them to better understand their behaviour. Finally, siblings reveal that, in their experience, formal, protocolized forms of support foreground family problems and stress. Thus, we recommend to involve children in the care process; to acknowledge their personal needs and conflicts; and to be mindful of the style of support: help offered in an informal or playful way, instead of formal and protocolized, could be a more effective way of meeting siblings' needs. [ABSTRACT FROM AUTHOR]

Purpose: To explore and describe the enactment of user involvement and combined care in a Danish clinic that aimed at providing integrated diabetes and mental health care. Design: An ethnographic study. Data Sources and Methods: Data consisted of field notes from 96 hours of participant observations and field notes from 32 informal conversations with healthcare providers, users and relatives as well as 12 semistructured interviews with users. Data were analysed using a thematic analysis. This study reports to the SRQR guidelines. Results: Treatment was not combined as intended if only one healthcare provider handled the consultations. Here, the healthcare providers' focus was often on their own area of expertise—either mental health or diabetes. If more than one healthcare provider handled consultations, the consultations were often divided between them, focussing on one condition at the time. Healthcare providers noted, that learning from peer colleagues was a way to increase the possibility for combined care. Furthermore, combined care was highly dependent on the healthcare providers' ability to involve users' illness experiences in their own care planning. Here, a high level of user involvement increased the levels of combined care during consultations. Conclusion: This study set out to explore and describe user involvement and combined care in a specialised diabetes and mental health outpatient clinic. Combined care is complexed and requires that healthcare providers are well‐equipped to manage the complexity of delivering care for people with both conditions. The degree of combined care was linked with the healthcare providers' ability to involve users and their knowledge on the condition outside there are of expertise. Relevance to Clinical Practice: A peer‐learning environment in combination with clinical guidelines and joint display could support healthcare providers in involving users in own care and when delivering care outside their area of expertise. Public contribution: No patient or public contribution. Due to the COVID‐19 pandemic, the original user council withdraw their consent to participate due to health‐related worries and anxiety concerning the pandemic. The user council consisted of three members diagnosed with diabetes and severe mental illness. They were invited to participate in physical meetings, phone or online meetings. Presenting findings from the study to the study participants were also hindered by the second lockdown. This influenced the possibility for data triangulation. [ABSTRACT FROM AUTHOR]

Aim: To explore nurses' experiences of supporting family caregivers in specialised home care while learning to use the Carer Support Needs Assessment Tool Intervention. Background: The Carer Support Needs Assessment Tool Intervention can provide guidance for discussions with family caregivers in specialised home care concerning their specific support needs. Little attention has been paid to how nurses experience the use of the intervention in their everyday practice. Design: This longitudinal study adopted an inductive qualitative approach using interpretive description. Methods: Interviews were conducted at two time points. A total of 22 interviews took place with 12 nurses recruited from six specialised home care services. Data were analysed using interpretive description. Results Nurses' everyday clinical practice changed while learning to use the Carer Support Needs Assessment Tool Intervention, and they experienced professional and personal growth. Their supportive inputs shifted from being reactive towards being more proactive. Their approach changed from taking on great professional responsibility, towards a shared responsibility with family caregivers. The support altered from ad hoc contacts in the hallway, towards scheduled trustful conversations. Nurses were concerned about the amount of time and energy this kind of support might require. They pointed to the importance of holding good nursing skills to conduct this new way of having conversations. Conclusion: Nurses' everyday clinical practice can be further developed through the use of the Carer Support Needs Assessment Tool Intervention. Nurses may develop both professionally and personally, increasing their ability to provide person‐centred support. Relevance to Clinical Practice: With the use of the Carer Support Needs Assessment Tool Intervention, nurses can create trusting conversations with family caregivers of patients with life‐threatening illnesses cared for in specialised home care. Reporting Method: Reporting of the study follows the Consolidated Criteria For Reporting Qualitative Research (COREQ) checklist (File S1). Patient or Public Contribution: Participating nurses were involved in discussing the study design. [ABSTRACT FROM AUTHOR]

Aims and objectives: To investigate the support needs identified by Taiwanese breast cancer diagnosed mothers for themselves and their 6–12‐year‐old children for implementation in a support group. Background: Mothers with dependent children are burdened with diverse child‐centered concerns while battling breast cancer. A better understanding of the concomitant support needs of mothers and their children can yield tailored support for ill mothers and their children. Design: A qualitative descriptive study employing content analysis of collected data. Methods: Between February and June of 2020, semi‐structured individual interviews were conducted with 20 mothers who had been diagnosed with breast cancer in the last 2 years. Qualitative content analysis was used. This study followed the COREQ guidelines. Results: Ill mothers favoured a hybrid format for support groups, consisting of mother‐only, child‐only, and mother–child group sessions. The content analysis yielded four themes for mother‐only group sessions: (1) learning to reach out to children; (2) dealing with negative emotions; (3) how to say goodbye to children; and (4) resetting for the future. Three themes related to child‐only group sessions emerged: (1) emotional and health education; (2) getting along with a sick mother; and (3) preparing for uncertainty. The core theme for mother–child group sessions was relationship enhancement. Conclusion: The findings revealed that mother‐reported support needs of ill mothers and their children included support for improving children's emotional well‐being and mothers' emotional coping, preparing for uncertainty, and promoting intimacy in the mother–child relationship. Relevance to clinical practice: A relation‐focused approach to psychosocial support group development that allows mother–child mutual influences on each other's coping to be addressed bilaterally is suggested. Patient or public contribution: Mothers diagnosed with breast cancer were interviewed for data collection and invited to review and validate the synthesised data for enhancing the credibility of the study. [ABSTRACT FROM AUTHOR]

Aim: When a public health emergency occurs, nurses play an important role on the front lines and experience tremendous physical and mental stress. This review aims to synthesize existing qualitative studies exploring the psychological impact and support needs of nurses. Design: Qualitative systematic reviews. Registered in PROSPERO (CRD42021288509). Methods: This review uses the PEOD framework to explicitly identify qualitative questions and systematically searches four electronic databases (CINAHL, MEDLINE, PubMed, PsychINFO) for articles published between 25 March 2000 and 27 December 2020. Results: A total of 10 studies published in English from 2005 to 2020 were included in the review. Following the quality critical appraisal, 26 concepts were extracted and six descriptive themes were synthesized into three analytical themes: (1) positive psychological drive, (2) need more formal supports and (3) need to be treated fairly. During sudden public health incidents, it is crucial to provide support to family members, offer psychological counselling and isolation training to nurses, while considering cultural factors and appropriate methods. Organizations and governments should prioritize establishing a robust and effective psychological support system. [ABSTRACT FROM AUTHOR]

Background: Patients with inflammatory rheumatic diseases (IRDs) face challenges including pain, fatigue and disease flares. Evidence suggests their levels of anxiety and depression are higher compared to the general population. Rheumatology teams report psychologically distressed patients have additional support needs and require more clinical time. Little is currently known about models of support and their integration into care pathways. Aim: To understand rheumatology health professionals' perspectives on patients' psychological distress and ways to meet support needs. Methods: The study used a qualitative design, with data collected in telephone semi‐structured interviews. Inductive thematic analysis was used to analyse the data. Results: Fifteen interviews were conducted. Two main themes with sub‐themes represent the data: Theme 1: 'No one shoe fits all'—the many manifestations of distress in patients (sub‐themes: recognising distress, dealing with distress, dealing with life events alongside an IRD) and Theme 2: 'If rheumatology could be interwoven with psychological principles'—the need to attend to the psychological impact of IRDs, alongside the physical impact (sub‐themes: priority given to physical health, working together to help patients in distress, how should patient distress be measured?, the need for extra time and resources). Conclusion: Distress can be obvious or hidden, cause issues for patients and health professionals and lead to poor engagement with care provision. Health professionals described the powerful link between physical and mental distress. This study suggests psychological support provision should be embedded within the rheumatology team and that patients' emotional wellbeing should be given equal priority to their physical wellbeing. [ABSTRACT FROM AUTHOR]

Usher syndrome is a progressive form of deafblindness, which can have significant psychological consequences. This study aimed to get insight in the perceived impact of Usher syndrome type 2 (USH2) on families with a parent affected by this syndrome, and in the experiences of these families with social, professional, and peer support. Participants were 10 parents with USH2 living in the Netherlands, 10 of their co-parents, and 10 of their children. The parents filled in questionnaires and participated in a semi-structured interview. A photo-elicitation interview and a semi-structured interview were administered to the children. Interviews were transcribed and systematically coded, using thematic and open coding. Parents rated the family's quality of life in general as satisfactory. Both negative and positive consequences were described of USH2 for the family. Parents without USH2 and their children stated to provide support to the parent with USH2, which was often described as self-evident. Some parents without USH2, however, described their family tasks as a burden. Some parents also reported that psychological problems of the parent with USH2 affected the well-being of other family members. Several parents and some children expressed that the syndrome was hardly discussed within the family. Unfulfilled family support needs were mentioned, a lack of involvement of family members in the professional support, as well as a lack of professional and peer support for children and partners. This study revealed that USH2 in a parent has impact on the entire family. Family-centred approaches are recommended for professionals who support parents with Usher syndrome. [ABSTRACT FROM AUTHOR]

Background/Aim: Midwives play an important role in assisting women to cope with the initial trauma of perinatal loss, but their own coping and support needs can be overlooked. The purpose of the study was to explore the coping behaviours and support needs of midwives caring for women with perinatal loss. Methods: A qualitative, exploratory, descriptive design was used. Data were collected using semi-structured one-on-one interviews with 13 purposively sampled participants from the Nelson Mandela Bay Health District. Results: Three themes emerged concerning midwives' coping mechanisms in relation to perinatal loss, their views on support from management and the need for psychological and emotional support. Conclusions: The participants felt the need for unit-based psychological and emotional support. They called for the development of a protocol for midwives to manage perinatal loss events. They felt that the layout of the labour wards needed to be redesigned and that the problem of staff shortages needed to be urgently addressed. [ABSTRACT FROM AUTHOR]

People with coexisting type 1 and 2 diabetes and mental illness have a higher mortality rate compared to the general population, among other reasons due to unregulated diabetes. One explanation might be the complexity of managing both conditions. In this interview study, we explored the accounts of delivered diabetes and mental health care of 16 individuals living with coexisting diabetes and mental illness in Denmark. A thematic analysis by Braun and Clarke was applied in the analysis. Some of the participants described the care for diabetes and mental illness to be inextricably linked to each other. Therefore, health care providers ought to focus and knowledge of both conditions as essential components in the care provided. The participants accounted for support needs in other settings beyond diabetes and mental health outpatient clinics, such as the family doctor, residential institutions, and community care. However, the inefficient collaboration between these health care settings is one of the barriers to supporting the participants' self‐management. [ABSTRACT FROM AUTHOR]

Background: For a healthy lifestyle, people with moderate, severe, and profound intellectual disabilities living in residential facilities and/or participating in day activity centers are dependent on their direct support professionals. However, it is unclear what knowledge and skills these direct support professionals require to support these individuals in living a healthy lifestyle. Therefore, the aim of this study was to identify the needs of direct support professionals for supporting these people with moderate to profound intellectual disabilities to achieve and maintain a healthy lifestyle. Method: Direct support professionals (n = 28) were interviewed with the use of a semi‐structured protocol based on the theoretical domains framework. The interviews were analyzed with a theory‐driven content analysis. Results: The most frequently mentioned needs referred to the following domains of the theoretical domains framework: environmental context and resources (n = 27), social/professional role and identity (n = 25), social influence (n = 25), skills (n = 24), and knowledge (n = 23). Conclusion: To support people with moderate to profound intellectual disabilities in leading a healthy lifestyle, direct support professionals (DSPs) primarily needed support related to the domain environmental context and resources. Within this domain available time, dealing with different seasons, and a healthy lifestyle policy in the organization need attention. Development of interventions targeting these DSPs needs is required. [ABSTRACT FROM AUTHOR]

Background: Few individuals with metastatic prostate cancer have access to prostate cancer-specific exercise support, despite demonstrated benefits. eHealth tools, such as websites, may be viable options for increasing access. To be effective and acceptable, future eHealth websites need to consider end-users' perspectives, capacity and needs. We aim to provide insight into these factors by exploring daily priorities, activities and health literacy of individuals with metastatic prostate cancer and their perspectives towards exercise and exercise-based web-based eHealth interventions. Methods: Semi-structured interviews explored participant's experiences and understanding of their disease, exercise levels, advice received from health care providers, as well as acceptability of and suggested content for an eHealth tool. A thematic analysis was undertaken. Results: Interviews were conducted with eighteen Australians (55–83 years; M = 71.5, SD = 8.9) living with metastatic prostate cancer. Needing to perform daily responsibilities was a key priority. Participants had limited understanding of the benefits of prostate cancer-specific exercise, and less than half discussed exercise with their health team. Fourteen men felt they could report metastases location, but only four could provide detailed information, which has clinical implications for exercise prescription. A potential web-based intervention was considered acceptable by seventeen men for reasons such as affordability, accessibility and convenience. User-friendly design and practitioner support were important. Conclusions: Results identified key aspects useful for person-centred design of exercise programs. Participants were positive towards the proposed web-based tool and expressed the need for individualised, user-friendly and reliable information with support from a professional embedded. Lastly, not all participants could accurately report metastasis locations. [ABSTRACT FROM AUTHOR]

Bereavement by suicide is a unique form of grief characterized by features such as stigma, shame, and rejection that may complicate the grieving process and place people at heightened risk for specific mental health disorders, suicide attempts, and dying by suicide. To better understand the unique support needs of the suicide-bereaved and how these can be met, this Australian study qualitatively explored the experiences of people bereaved by suicide. Fifteen individuals who had lost a spouse or partner or a family member to suicide formed three focus groups across different locations in Queensland, Australia. Analysis identified four dominant themes: changing support needs, difficulties navigating services, experiences of stigma and social isolation, and connecting with others. The results from this study provide a powerful insight into the experiences and specific needs of the suicide-bereaved and could inform further development of suicide bereavement support services. [ABSTRACT FROM AUTHOR]

The diagnosis of childhood cancer not only affects the life of the child but also impacts the lives of the caregivers as well. This study aims to explore the caregiving stress, coping strategies, and support needs of mothers caring for children/adolescents with cancer during the active treatment phase. Individual semi-structured interviews were conducted, and two authors independently and thematically analyzed data. Caregiving mothers went through a process of emotional changes and a change in lifestyles when their children were diagnosed with cancer and undergoing treatments. It is important to ensure that caregiving mothers of children/adolescents with cancer are well supported by family, friends, and healthcare professionals. Healthcare professionals can develop informational booklets on cancer treatment protocols and work together with mothers. Parent support groups and plans for psychoeducational and spiritual care programs for mothers as forms of informational and emotional support may also be established. [ABSTRACT FROM AUTHOR]

Purpose: Family members make an important contribution to informal and formal care, as well as the overall health and wellbeing of individuals with spinal cord injury. Caregiving often results in negative outcomes which, if not addressed, threaten the sustainability of these critical supports. We sought to explore the perceptions of individuals with spinal cord injury and their family caregivers regarding the facilitators and barriers to undertaking and sustaining the caregiving role in the community. Methods: A qualitative descriptive approach with semi-structured interviews. Thematic analysis was employed to determine key themes arising from individuals with spinal cord injury (n = 19) and their family members' (n = 16) experiences. Results: The following four facilitators to caregiving were identified: access to community support services, positive coping in relationship, social support, and mastery of caregiving roles. Conversely, the following six barriers to caregiving were identified: lack of access to community resources, lack of knowledge about resources and formal training, fragmented continuity of care, negative coping in relationship, role strain, and caregiver injury or illness. Conclusions: The current study demonstrated that positive coping, social support, skills training, access to community services and continuity of care contribute significantly to the sustainability of the spinal cord injury family caregiving role. As such, the development of future caregiver interventions should consider these facilitators. Family caregivers make an important contribution to the care processes and overall quality of life of individuals with spinal cord injury post-discharge into the community. The potential negative effects of caregiving could threaten the sustainability of these critical supports. Positive coping, social support, skills training, access to community services, and continuity of care contribute significantly to the sustainability of the spinal cord injury family caregiving role. This study shows the need for better integration of family members during the rehabilitation and discharge process to better prepare them for the caregiving role. [ABSTRACT FROM AUTHOR]

Service organizations for people with intellectual and developmental disabilities (IDD) increasingly use telecare applications to improve their services. This study explored the usefulness of offering the 24/7 online support service DigiContact within a broader mix of professional services for people with IDD living independently. We employed a qualitative multiple case study, in which the cases of nine online support users were reconstructed through semistructured interviews with both support users and their case workers. Thematic analysis showed that online support was used as an addition to regular onsite support to enable a more tailor-made delivery of professional supports. Online support can be valuable for its users by increasing the accessibility of professional support and creating opportunities for more self-direction in support. [ABSTRACT FROM AUTHOR]

Varying perceptions of who should be responsible for supporting individuals with mental health problems may contribute to their needs remaining unmet. A qualitative descriptive design was used to explore these perceptions among key stakeholders. Focus groups were conducted with 13 service users, 12 family members, and 18 treatment providers from an early psychosis intervention program in Montreal, Canada. Individual interviews were conducted with six mental health policy-/decision-makers. Participants across stakeholder groups assigned a range of responsibilities to individuals with mental health problems, stakeholders in these individuals' immediate and extended social networks (e.g., families), macro-level stakeholders with influence (e.g., government), and society as a whole. Perceived failings of the health care system and the need for greater sharing of roles and responsibilities also emerged as important themes. Our findings suggest that different stakeholders should collectively assume certain responsibilities and that systems-level failings may contribute to unmet needs for mental health support. [ABSTRACT FROM AUTHOR]

Aim: To explore the experiences and needs of partners who are supporting adolescents and young adults with cancer. The diagnosis of cancer at any age is significant. Uniquely, in adolescents and young adults this is set against the backdrop of early adult development. This is at a time when young people may be embarking on new experiences and the development of romantic relationships is no exception. There is limited evidence of how partners cope during this time and what their role is alongside how the relationship may change over time. Design: An exploratory qualitative study using narrative enquiry. Methods: The protocol was approved in February 2018 and data will be collected between May – December 2018. The theoretical approach will incorporate positioning theory by considering the contextual situation of the partner with reference to their stories, including their rights and duties. Two interviews will be undertaken which will be approximately 2 months apart, where participants will be asked to share their stories. They will also be given a diary at the end of the first interview to record their thoughts about their role and relationship. The diary and interview data will be thematically analysed. Discussion: It is envisaged that the study will culminate in the identification of key themes which will illuminate the experiences, needs and roles of partners of adolescents and young adults with cancer. Impact: These findings will inform the development of guidance which will help partners in the future in this area of practice. [ABSTRACT FROM AUTHOR]

The gender roles and identity of siblings have been found to be an important factor in the nature and quality of sibling relationships. With an increasing number of young people identifying as gender-diverse or transgender, this research aimed to develop a greater understanding of how young people make sense of their siblings' gender diversity. Semi-structured interviews explored the experiences of eight sibling participants (aged 11–25 years) who have a sibling identifying as gender-diverse. Five overarching themes emerged from the thematic analysis of their transcribed interviews. These themes encapsulated commonalities and nuances within the sibling participants' experiences and revealed a process of adjustment. Developing an increased understanding of transgender issues appeared to enable young people to embrace supportive roles, and as a consequence, they reported that their relationships with their gender-diverse siblings were enhanced. However, the sibling participants' increased understanding of transgender issues also generated significant fears and concerns about their siblings' well-being and their sibling relationships. From understanding more about these eight young people's experiences, suggestions are given for how specialist services might best support siblings of gender-diverse young people along their processes of adjustment. [ABSTRACT FROM AUTHOR]

Service organizations for people with intellectual disabilities (ID) increasingly look for technological applications to improve their services. DigiContact is an online support service developed by Philadelphia Care Foundation in the Netherlands which enables independently living people with ID to contact specially trained support workers 24/7. The purpose of this study was to explore the support needs for which people with ID use online support. We first conducted interviews with 21 individuals with ID who use the online support service. Transcriptions of the interviews were analyzed using inductive thematic analysis. Second, online support workers registered items regarding the support needs when in contact with support users. These data were analyzed to assess which and how often the support needs were present. Online support is used for a broad variety of issues. Four themes emerged during analysis of the interviews: mental health, social contacts (conflicts with others as well as lack of contacts), practical issues, and physical health. Analysis of the support workers' data showed that making a connection with someone and talking about worries and stress are the two most frequent support needs. Most support needs did not differ across the time of day or across the week. The results suggest that 24/7 online support is a useful way of providing services to independently living people with ID. Unlimited access to support has multiple advantages. It appears to have a signaling and a preventive function with regard to emotional and behavioral problems. [ABSTRACT FROM AUTHOR]

Malignant melanoma is an aggressive, recalcitrant disease. Its impact on people can be compounded by the physical and psychosocial consequences of medical management. Providing melanoma patients with patient-centered care that is effective, safe, and supportive throughout their journey requires knowledge of patients' progressive experiences and evolving perspectives. With ethical approval, we undertook a meta-narrative study of 214 experiential accounts of melanoma collected from the personal story sections of melanoma and cancer support websites. Using a narrative approach, we qualitatively examined the care experiences represented in these accounts and identified needs for supportive care in a framework reflective of the personal patient journey. We differentiate these across three key periods: lead-up to diagnosis; diagnosis, treatment, and recovery; and posttreatment and recurrence, and provide a visual representation of the patient journey. This article contributes to the growing body of work that utilizes Internet content as sources of qualitative, experiential health care data. [ABSTRACT FROM AUTHOR]

Aim To explore first-time fathers' postnatal experiences and support needs in the early postpartum period. Background The postnatal period is a stressful transition period for new fathers. It is imperative to understand their needs and experiences to provide appropriate support for them. The majority of previous studies were based in Western countries and explored fathers' needs during pregnancy and childbirth, with few studies conducted in the postnatal period. In Singapore, a multiracial society with differing paternal cultural values from its Western counterparts, there is considerable need to examine the experiences and needs of first-time fathers. Design A descriptive qualitative design was used. Methods Data were collected from November 2015-January 2016. Fifteen first-time fathers were recruited from two postnatal wards of a public hospital, using a purposive sampling method. A semi-structured interview guide was used to conduct face-to-face interviews. A thematic analysis was conducted and ethics approval was sought for this study. Results Four overarching themes and seventeen subthemes were generated. The four overarching themes were: (1) No sense of reality to sense of responsibility; (2) Unprepared and challenged; (3) Support: needs, sources, experience and attitude; and (4) Future help for fathers. Conclusion Fathers undergo a transition phase where they have unmet support needs during the early postnatal period. Understanding and addressing these needs may facilitate smooth transition to fatherhood. This study's findings can be used to involve fathers and design future supportive educational programs to promote positive parenting experiences and family dynamics. [ABSTRACT FROM AUTHOR]

This study explored oncology healthcare professionals’ perspectives on the psychosocial support needs of diverse cancer patients during oncology treatment. Six themes were identified using thematic analysis. Healthcare professionals highlighted the importance of their sensitivity, respect and emotional tact during appointments in order to effectively identify and meet the needs of oncology patients. Participants also emphasised the importance of building rapport that recognises patients as people. Patients’ acceptance of treatment-related distress and uncertainty was described as required for uptake of available psychosocial supportive services. We offer some practical implications that may help improve cancer patients’ experiences during oncology treatment. [ABSTRACT FROM AUTHOR]

Despite a significant growth in the number older former family carers, they remain largely invisible in carer-related research and literature. To begin to address this deficit, a four-stage literature review was conducted to identify existing knowledge about older former carers. Narrative synthesis of the findings yielded five themes - the concept of 'older former carer', the legacies of caring, influences on the legacies of caring, conceptualising post-caring and support services for older former carers. Critical analysis of these findings suggests that existing evidence has a number of strengths. It highlights the terminological and conceptual confusion in the field, identifies the profound financial and health-related legacies older former carers' experience, the factors which shape these legacies and some of the complexities of bereavement older former carers face. The support needs of older former carers are also illuminated. However, the field is characterised by key weaknesses. The evidence base is fragmented and uneven. In part this reflects lack of definitional consensus and in part the fact that there is much more evidence about some sub-groups, such as carers of relatives admitted to a care home, than others. Methodology-related weaknesses include small sample sizes and a focus on a single, often condition-specific, group of older former carers. An overarching criticism relates to the narrow conceptual/theoretical purview. As post-caring tends to be viewed as one of the final temporal 'stages' of the carer's 'care-giving career', a bifurcatory model of carer/former carer is created, i.e. that a carer actively provides care and a former carer is no longer caring. This constructs being a former carer - namely formerality - as a single fixed state failing to capture its dynamic and shifting nature and constrains the potential of research to generate new knowledge and extend understanding. [ABSTRACT FROM AUTHOR]

Introduction Fathers are increasingly involved in caring for children, and involvement by fathers of children with ASD is distinctly impacted by added demands of their child's diagnosis. Yet supports for families of children with ASD are not tailored to needs of fathers. We use an ecological framework to examine how fathers' needs are influenced by contexts ranging from the immediacy of their child's behaviour to overarching expectations for good fathering. Methods We thematically analyse data from semi-structured interviews with 28 fathers of children with ASD who shared parenting stories of navigating their immediate and broader environments. Findings Fathers are responsive and reflective in their parenting and value recreationally based support activities that include their children. Fathers endorse father-to-father support and are interested in mentoring fathers newer to the experience of having a child with ASD. Conclusions Fathers are resourceful parents who compel a critical re-examination towards advances in father-friendly practices. [ABSTRACT FROM AUTHOR]

The systems of support for people with a visual impairment in the United Kingdom are complex and can be difficult to access, involving input from a range of health and social care services. In this article, we report qualitative findings from research looking at people’s experiences of accessing health and social care services. These highlight the inconsistencies and variability in existing systems of support for people with a visual impairment, and show that access to services is largely dependent on the agency and initiative of individual service users in establishing networks of support for themselves. This means that those who are less able to do this may find themselves without the support necessary to maintain or improve their quality of life. We argue that health and social care agencies need to be more proactive in addressing the support needs of people with a visual impairment beyond the point of initial diagnosis or registration. [ABSTRACT FROM AUTHOR]

The article reports on supporting family caregivers to identify their own needs in end-of-life care. Topics discussed include family caregivers, home-based palliative care, and Carer Support Needs Assessment Tool. Also being discussed are the practicality and usefulness of the systematic assessment, and emotional responses to caregiver reflection.

Information seeking and good communication have acquired increasing importance in aiding people to cope with cancer. The purpose of this study was to investigate parents' perceptions of their knowledge- seeking behaviour, experience of the communication process and to identify what support and guidance they may have desired. In this study 100 parents of children (6 to 18 years of age) diagnosed with cancer were interviewed. Interviews were analysed using thematic content analysis Parents' narratives revealed the following themes: most did not want nor seek information beyond that volunteered; communicating about the illness was generally limited to physiological and medically related matters, with emotional issues being rarely articulated; parents felt overwhelmed by the emotional experience of their child's illness and expressed the need for psychosocial services. This study concludes that: (i) information is not in every instance a sought after resource; (ii) communication is complex and whilst open communication is generally advocated it is not always desired or required as there may be context related factors that may militate against it; and (iii) psychosocial support could facilitate understanding of the cognitive, social and emotive trajectory associated with childhood cancer. [ABSTRACT FROM AUTHOR]