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ABSTRACT Aims Design Methods Results Conclusion Impact Reporting Method Patient or Public Contribution Trial Registration To develop the core outcome set and identify unique outcomes for the three stages and five types of nursing interventions, respectively, in lactational mastitis.A mixed methods study.A systematic literature search, four semi‐structured interviews for key stakeholders, two rounds of Delphi surveys and two online consensus meetings were conducted.Thirty‐one nursing outcomes were derived from the systematic review (literature research from January 2019 to December 2021) and semi‐structured interviews in 2022. Six A‐category nursing outcomes and 19 B‐category nursing outcomes were determined after Dephi survey and provided in consensus meeting in 2023. The consensus meetings resulted in the agreement on seven core outcomes: Pain Level, Breast Establishment: infant, Breast Establishment: maternal, Breast Maintenance, Client satisfaction: care, Sleep, and Family Support during Treatment. Specifically, the unique outcomes for the three stages were identified as Breastfeeding Maintenance, Infection Severity and Wound Healing: Primary Intention, respectively. The unique outcomes for the five interventions included Pain level, Infection Severity, Wound Healing: Primary Intention, Comfort and Knowledge: breastfeeding, respectively.Based on an evidence‐based, consensus‐driven approach, the core outcome set incorporates the perspectives of key stakeholders. It is recommended that all core outcomes be reported in both lactational mastitis nursing research and clinical quality control and audit. Unique outcomes should be reported based on the stages of lactational mastitis and types of interventions.The core outcome set and unique outcomes developed by our study could provide nursing researchers and clinical practitioners with sensitive outcomes for lactational mastitis, while also promoting standardisation. Utilising these outcomes could enhance comparability among studies, reduce reporting bias and promote standardised evaluation of practice effectiveness.Findings are reported per Core Outcome Set‐STAndards for Reporting: COS‐STAR Statement.None. https://www.comet‐initiative.org/Studies/Details/1650 [ABSTRACT FROM AUTHOR]

ABSTRACT Background Aim Design Methods Results Conclusion Implications for the Profession and/or Patient Care Impact Patient or Public Contribution Adolescent parents are at an increased risk for loneliness and mental health challenges compared to childless peers. Nature‐based interventions are shown to promote social connectedness.To identify elements of a nature‐based intervention to reduce loneliness and foster nature connection among pregnant and parenting adolescents.Sequential exploratory mixed methods.In 2020 and 2021, we piloted the 8‐week MINT program at a school for pregnant and parenting teens. Our qualitative approach (n = 17) included online and in‐person group meetings with nature‐based educational content, discussion, park excursions, mindfulness activities, journaling and nature photography. Subsequently, we recruited 131 young mothers at a children's hospital for a cross‐sectional survey based on qualitative school findings.Qualitative results from the school‐based intervention showed a preference for meditative and contemplative activities and for spending time in nature with extended family. Participants typically accessed nature close to home. Our clinic‐based teen parent survey illustrated that participants' access to nature were most limited by lack of time (25% of responses), company (18%) and energy (28%). While participants showed a close nature connection (mean NR‐6 score = 3.9 (SD = 0.84)), they also showed moderate levels of loneliness (mean UCLA Loneliness score = 4.78 (SD = 1.60)). Walking, hiking and/or running were the most preferred nature activity.These findings provide key details to define nature‐based activities to address loneliness and psychological well‐being among teen mothers.Nature‐based health interventions can address loneliness and nature disconnection by building community resilience, improving provider and patient well‐being and motivating environmental stewardship.We identify key features of a nature‐based intervention for adolescent mothers. These findings support teen mothers in the US and abroad and may serve as a foundation for using nature‐based solutions for vulnerable mothers and for adolescents facing loneliness and mental health challenges.No patient or public contribution. [ABSTRACT FROM AUTHOR]

Aim: To explore self‐care and needs and preferences towards tailored self‐care support of patients with rheumatoid arthritis at the outpatient clinic. Design: A sequential explanatory mixed method design. Methods: The Self‐Care of Chronic Illness Inventory questionnaire, two focus groups and six semi‐structured interviews were conducted between November 2021 and April 2023. Questionnaires of 107 patients were descriptively analysed. Subsequently, 11 patients and 2 healthcare professionals participated in the focus groups and 6 patients in the interviews, which were thematically analysed. Results: Quantitative and qualitative data corresponded and showed that patients perform various self‐care activities at an adequate level and have strategies to exert control and reduce symptoms. One key theme emerged: 'Not only being the person with rheumatoid arthritis' (RA) as patients primarily aim to get on with their lives. Nine subthemes covered self‐care activities for maintaining health including staying physically active, finding the right medication and dose and adapting their diet. Patients differed in how they self‐monitored their symptoms. Recognizing symptoms and finding strategies to manage symptoms included the process of body listening in which patient seek and try different strategies to find what works for them and incorporate routines. Patients experienced positive effects of a warm or cold environment. Patients felt the need for practical and emotional support from others and preferred having credible information. Conclusion: Patients perform adequate self‐care including a diversity of self‐care activities to get on with their lives and have strategies to reduce and control the symptoms and impact of RA. Implications: Tailoring self‐care support to patients' individual needs and preferences is necessary to help patients cope with the erratic nature of the disease and maintain their quality of life. Healthcare providers need to provide practical and emotional support and use credible information to allow patients to make self‐care decisions to manage their lives. Reporting Methods: Quantitative finding are reported according to the STROBE guidelines and qualitative finding are reported according to the COREQ guidelines. What Does This Paper Add: Patients perform various self‐care activities at an adequate level and have strategies to exert control and reduce symptoms.Patients primarily aim to continue their lives and not being seen as the person with rheumatoid arthritis.Healthcare professionals need to provide practical and emotional support and use credible information to inform patients' self‐care decision‐making. Patient or Public Contribution: No patient or public contribution. [ABSTRACT FROM AUTHOR]

ABSTRACT Aim Design Methods Results Conclusion Reporting Method Patient or Public Contribution To conduct a comprehensive review of Undergraduate Nursing and Midwifery Curricula leading to registration in Ireland.A mixed methods approach using a curriculum evaluation framework that was underpinned by the philosophy and principles of appreciative inquiry.Five separate workstreams completed an evaluation of national policy documents and international curriculum documents, a literature review and two phases of stakeholder engagement including a graduate survey and peer‐grouped stakeholder focus groups. The workstreams were emulated for the professions of nursing and midwifery.National policy indicates a significant shift in healthcare delivery to the community environment, with a strong focus on the social determinants of health and a flexible interprofessional workforce. International curricula review revealed that nursing and midwifery education was split equally between academia and clinical practice at bachelor's degree level. Graduates were assessed for clinical competence with a variance of four to seven domains of competence evident for nurses and five principles for midwives. Direct entry midwifery was not widely available. The graduate survey identified that students were satisfied with the academic components of the curriculum; however, significant challenges in clinical placement were reported. Stakeholder focus groups reported a need for a learner‐focused approach to the curricula, increased access to education, a deeper understanding and appreciation of the various roles required to educate nurses and midwives and a recognition of midwifery as a separate profession.There is a need for a significant revision of the current nursing and midwifery curricula to meet the future healthcare needs of the diverse patient population with a community‐focused delivery.The good reporting of a mixed methods study was used to guide the development of this manuscript.An Expert Advisory Group (EAG) was appointed to oversee the conduct of the research project and advise the research team as requested. There were five service user representatives included in the membership of the EAG. This included one representative from each of the divisions of the nursing and midwifery register in Ireland. A separate stakeholder engagement focus group was also conducted for the research upon the request from the service users. [ABSTRACT FROM AUTHOR]

Aim(s) Design Prospero ID Data Sources Review Methods Results Conclusions Impact Reporting Method Patient or Public Contribution To identify and summarize evidence on paediatric patient safety in a hospital setting from parents' point of view.A mixed‐methods systematic review.ID number CRD42023453626.PubMed, Scopus, ScienceDirect, the Cochrane Library and the Wiley database were searched in July 2023.Two researchers independently applied eligibility criteria, selected studies and conducted a quality appraisal. Data‐based convergent synthesis and thematic content analysis were employed.Twelve studies were included: eight qualitative research studies, two cross‐sectional studies, one non‐randomized experimental study and one mixed‐methods study. The results were grouped into two themes—parental perceptions of inclusion in paediatric patient safety and parental perceptions of exclusion from paediatric patient safety—and comprised seven main subthemes: comfort in communication, parental engagement, communication difficulties, withdrawal from activity, uncertainty about available information and threats to patient safety.Parents are willing to be engaged in care but require support from healthcare professionals, as they are often anxious about the condition of their children and actions they believe might be helpful. They need to be treated as valuable partners and be engaged in communication and decision processes.The development and implementation of interventions involving parents in ensuring the safety of hospitalized paediatric patients should be of the utmost priority to healthcare organizations, as the common theme throughout the included studies was the need for improved communication with and recognition of parents as allies.The Preferred Reporting Items for Systematic Reviews and Meta‐Analysis (PRISMA) checklist was followed.No Patient or Public Contribution. [ABSTRACT FROM AUTHOR]

Background A multifaceted and interactive teaching approach is recommended for achieving proficiency in evidence-based practice, with critical thinking considered vital for connecting theory and practice. In this context, we advocate the strategic use of health claims in the media to promote critical thinking, complemented by a blended learning approach and a group exam. Method We conducted a convergent mixed methods study, including a cross-sectional survey with structured and open-ended questions as well as focus group interviews, at Oslo Metropolitan University, during the 2020-2021 academic year. Participants were bachelor’s students in healthcare. We employed a blended learning approach, combining digital learning resources, teaching in critical assessment of health claims and evidence-based practice, and a concurrent group exam assignment centered around media health claims. The outcome measures included students’ experiences integrating health claims into evidence-based practice teaching and their experiences with teaching approaches and the group exam. Results Out of 465 participants, 136 (29.2%) responded to the structured questions in the survey. In response to the open-ended questions within the survey, 109 (80.1%) of the respondents shared positive experiences about the course, while 98 (72%) suggested improvements. Additionally, 25 students participated in focus group interviews. Synthesizing the results, we found that students viewed the inclusion of health claim assessment as a useful entry point for learning evidence-based practice. In addition, the students identified both the blended learning design and the group exam as contributors to a positive perception of learning outcomes from the course. Conclusions Based on student feedback, integrating critical reflection on media health claims into evidence-based practice education, alongside a blended learning approach and a group exam, may be beneficial in teaching evidence-based practice to bachelor’s healthcare students. However, further rigorous study designs are needed to objectively assess the effect of the course on learning outcomes. Registration DOI 10.5281/zenodo.6985449

The purpose of this research is to explore the differences in perceived opportunities and potential barriers leading to inequality in our higher education system. To do this, we examine differences in satisfaction and expectations that exist among college students based on three key heterogeneous characteristics – gender identity (male vs. female), major declaration (decided vs. undecided) and generation (first generation vs. non‐first generation). Six hundred twenty‐five students completed a survey about the level of importance and satisfaction with educational services at their institutions. A mixed method design including analysis of variance (ANOVA) was used to test differences between students. At a time where universities are working arduously to increase enrolment numbers, adjusting the strategy to cater to the unique needs of students may prove to be part of the solution and more importantly, help remove barriers to lessen the current inequalities and improve access to education for all types of students. [ABSTRACT FROM AUTHOR]

Aim: To explore barriers and facilitators that influence adherence to evidence‐based guidelines for peripheral intravenous catheter care in different hospital wards. Design: Sequential explanatory mixedmethod study design, with qualitative data used to elaborate on quantitative findings. Method: Data were collected between March 2021 and March 2022 using the previously validated Peripheral Intravenous Catheter mini questionnaire (PIVC‐miniQ) on each ward in a tertiary hospital in Norway. Survey completion was followed by individual interviews with nurses from selected wards. The Pillar Integration Process was used to integrate and analyse the quantitative and qualitative findings. Results: The PIVC‐miniQ screening assessed 566 peripheral intravenous catheters in 448 patients in 41 wards, and we found variation between wards in the quality of care. Based on the quantitative variation, we interviewed 24 nurses on wards with either excellent or not as good quality. The integration of the quantitative and qualitative findings in the study enabled an understanding of factors that influence nurses' adherence to the care of peripheral venous catheters. One main theme and four subthemes emerged. The main finding was that ward culture affects education practice, and this was evident from four subthemes: (1) Deviation from best practice, (2) Gaps in education and clinical training, (3) Quality variation between wards and (4) The importance of supportive leadership. Conclusion: This mixed method study is the first study to explore reasons for variability in peripheral intravenous catheter quality across hospital wards. We found that ward culture was central to catheter quality, with evidence of deviations from best practice correlating with observed catheter complications. Ward culture also impacted nursing education, with the main responsibility for learning peripheral intravenous catheter management left to students' clinical training placements. Addressing this educational gap and fostering supportive leadership, including champions, will likely improve peripheral intravenous catheter care and patient safety. Implications for the Profession and/or Patient Care: Nurses learn good peripheral intravenous catheter care in wards with supportive leaders and champions. This implies that the quality of nursing practice and patient outcomes are situational. Nurses need a strengthened emphasis on peripheral catheter quality in the undergraduate curriculum, and nurse leaders must emphasize the quality of catheter care in their wards. Impact: The study findings impact nurse leaders who must commit to quality and safety outcomes by appointing and supporting local ward champions for promoting peripheral intravenous catheter care. This also impacts nursing education providers, as the emphasis on catheter care must be strengthened in the undergraduate nursing curriculum and continually reinforced in the hospital environment, particularly when guidelines are updated. Reporting Method: The study adhered to the Good Reporting of A Mixed Method Study (GRAMM). Patient or Public Contribution: A patient representative has been involved in planning this study. [ABSTRACT FROM AUTHOR]

The study investigated the influence of organizational resources on implementation of strategic plans (SPs) in Tanzania’s Local Government Authorities. The idea behind was to establish the influence of available resources (financial, human, material and information) on implementation of SPs in LGAs. The underlying theory on this study was resource-based view. The study opted Pragmatism philosophy which hinges on the mixed methods approach (explanatory sequential design), and the study was a cross- sectional, where data were collected at one point in time. The sample size of 204 respondents was drawn from a target population of 860 employees in five randomly selected LGAs in Morogoro region. The findings revealed that, all predictors (financial, human, material and information resources) had a statistically significant positive relationship with the implementation of SPs in LGAs: Whereby, financial resources had (t=2.147, P=0.033

Education for Sustainability (EfS) seeks to empower children with knowledge, skills, values, and attitudes to address global challenges while adhering to sustainability principles. This study investigates the conceptual understanding and pedagogical practices of EfS among early childhood education (ECE) teachers in Norway. Using mixed-methods design, data were collected through reflection notes, surveys, and didactic development projects, revealing fragmented understanding primarily focused on action-oriented, fact-based, and normative aspects of sustainability. The teachers emphasised waste sorting, recycling, and nature experiences, with limited attention to holistic and pluralistic perspectives. Despite curriculum mandates, sustainability had low implementation in ECE educational plans and collaboration meetings. The findings highlight the need for comprehensive teacher education and support to promote EfS and foster agents for sustainability in the context of ECE. [ABSTRACT FROM AUTHOR]

Background A multifaceted and interactive teaching approach is recommended for achieving proficiency in evidence-based practice, with critical thinking considered vital for connecting theory and practice. In this context, we advocate the strategic use of health claims in media to promote critical thinking and provide an accessible entry point to evidence-based practice for early-stage university healthcare students. Method We conducted a convergent mixed methods study, including a cross-sectional survey with structured and open-ended questions as well as focus group interviews, at the Faculty of Health Sciences, Oslo Metropolitan University, during the 2020-2021 academic year. Participants were bachelor’s students in bioengineering, physiotherapy, social education, and occupational therapy. We employed a blended learning approach, combining digital learning resources, teaching in critical assessment of health claims and evidence-based practice, and a concurrent group exam assignment centered around health news. The outcome measures included students’ experiences integrating health claims into evidence-based practice teaching and their experiences with teaching approaches, including the group exam. Results Out of 446 participants, 136 (30.5%) responded to the structured questions in the survey. In response to the open-ended questions within the survey, 109 (80.1%) of the respondents shared positive experiences about the course, while 98 (72%) suggested improvements. Additionally, 25 students participated in focus group interviews. Synthesizing the results, we found that students viewed the inclusion of health claim assessment as a useful entry point for learning evidence-based practice. In addition, both the blended learning design and the group exam were identified as contributors to a positive perception of learning outcomes from the course. Conclusions Integrating critical reflection on media health claims into evidence-based practice education, alongside a blended learning approach and a group exam, may be beneficial for educating bachelor’s healthcare students. However, further rigorous study designs are needed to assess the effect of the course on learning outcomes. Registration DOI 10.5281/zenodo.6985449

Dementia caregiving, besides encompassing various challenges in tandem to the diagnosis of the care recipient, is associated with decreased psychological well-being and mental health. Accordingly, caregivers' wellbeing has an impact on the quality of care they provide and on the relationship quality with the person in their care. The aim of the present study is to examine the effectiveness of a mindfulness-based intervention on relational and psychological wellbeing, tailored to the needs of dementia caregivers. This clinical trial (NCT04977245) will apply a randomized controlled mixed method design. Caregivers will be randomly allocated to either the mindfulness intervention or the active control group. The intervention arm is based on experiential learning and is targeted to promote caregivers' well-being and empowerment. Assessments will include, standardized self-report questionnaires, task performance measures, and qualitative measures. All assessments will be held at three time points (baseline; t0, 0 months, post-intervention; t1, 2 months, and after maintenance; t2, 3 months) focused on three core domains (1. relational well-being, 2. psychological well-being, and 3. dementia patient's lifestyle/activities). The primary outcome will be relational well-being, and data will be analyzed using linear mixed modelling.

Abstract Aim The present study aimed to evaluate the status of WCC provided by Iranian midwives. Design A sequential explanatory mixed method study protocol. Methods The present study was conducted in three phases: quantitative, qualitative and mixed. The first phase is a cross‐sectional study that will be performed on midwives working in health centres, public and private hospitals in Iranian. The second phase is a qualitative study, in which purposeful sampling will be used, meaning that the midwives who are part of the extreme cases according to the results of quantitative phase and are willing and able to express their own experiences regarding WCC will be selected. Also, pregnant and parturient women under their cover will also be interviewed. Finally, in the mixed phase, we will use a combination of two quantitative and qualitative studies, a literature review and expert opinion using a Delphi method to provide strategies to improve and promote WCC in midwives. Results Achieving this goal is expected to provide positive outcomes such as strengthening the midwives professional relationship with women and reducing health care costs. No Patient or Public Contribution.

• Peripheral intravenous catheter insertion can be a painful and worrisome experience for patients. • Rose oil aromatherapy and hand-holding interventions reduce pain during peripheral intravenous catheter insertion. • Rose oil aromatherapy was more effective on pain than the hand-holding intervention during peripheral intravenous catheter insertion. The study aimed to evaluate the effectiveness of rose oil (Rosa Damascene Mill.) aromatherapy and hand-holding in reducing pain associated with peripheral intravenous catheter insertion. A comparative mixed-method design. A total of 126 patients were included in the study. For the study's quantitative data, sociodemographic characteristics of the patients and the Patient Interview Form for the qualitative data of the Numeric Rating Scale were used. In all patients included in the study, PIVC insertion was performed a single time by the same nurse using a standard procedure. Chi-square and Bonferroni tests were used for comparative statistics. No statistically significant difference between the groups regarding age, gender, marital status, BMI, and education level (p>0.05). Pain scores: it was 2.40±1.78 in the rose oil group, 3.53±1.98 in the hand-holding group, and 4.88±1.56 in the control group. The difference between the groups regarding pain scores is statistically significant (p=0.001). The study determined that rose oil aromatherapy and hand-holding interventions reduce pain during PIVC. However, rose oil aromatherapy was more effective on pain than the hand-holding intervention. (Clinical Trial ID: NCT05425849) [ABSTRACT FROM AUTHOR]

Abstract Aim To describe demographic, physical and psychological characteristics associated with insomnia in patients with cardiovascular disease (CVD) participating in nurse‐led Internet‐based cognitive behavioural therapy for insomnia (I‐CBTI), and their motives and expectations regarding participation in I‐CBTI. Design A mixed method design was applied, including primary care patients with angina pectoris, myocardial infarction, heart failure, atrial fibrillation and atrial flutter or arrhythmia in southern Sweden. Methods Data on demographics, insomnia severity and physical and psychological characteristics were collected through self‐rated validated questionnaires (n = 126). Motives and expectations were collected through interviews (n = 19) and analysed using the ‘personas’ model. Results Physical symptoms and psychological characteristics were associated with insomnia. Three personas were identified: the pragmatist (a curious and optimistic persona), the philosopher (a problem‐solving persona) and the philanthropist (an altruistic persona). Expectations were positive among the three personas, but comorbid conditions reduced the perceived ability to make necessary behavioural changes.

Aim: The present study aimed to evaluate the status of WCC provided by Iranian midwives. Design: A sequential explanatory mixed method study protocol. Methods: The present study was conducted in three phases: quantitative, qualitative and mixed. The first phase is a cross‐sectional study that will be performed on midwives working in health centres, public and private hospitals in Iranian. The second phase is a qualitative study, in which purposeful sampling will be used, meaning that the midwives who are part of the extreme cases according to the results of quantitative phase and are willing and able to express their own experiences regarding WCC will be selected. Also, pregnant and parturient women under their cover will also be interviewed. Finally, in the mixed phase, we will use a combination of two quantitative and qualitative studies, a literature review and expert opinion using a Delphi method to provide strategies to improve and promote WCC in midwives. Results: Achieving this goal is expected to provide positive outcomes such as strengthening the midwives professional relationship with women and reducing health care costs. No Patient or Public Contribution. [ABSTRACT FROM AUTHOR]

Abstract Aim The aim was to (1) examine the feasibility aspect of a music intervention, (2) examine the association between music and pain, relaxation and well‐being and (3) explore patients' experience of listening to music while waiting for acute surgery. Design The design was a mixed‐method study. Methods Participants were offered a music pillow for 30 min. Before and after the intervention, participants reported their pain, relaxation and well‐being using a visual analogue scale ranging from 0 to10. The qualitative part was based on field observation followed by a semi‐structured interview. Results The quantitative part included 30 participants. The Wilcoxon signed‐rank test showed a positive significant association between music and pain, relaxation and well‐being (p

Globally, COVID 19 caused closure of all educational institutions to control the spread of this pandemic. The spread of the disease has caused various emotional and mental distortions of university students. Thus, this study aims to establish students’ coping strategies used to cope with COVID-19 pandemic. The cross-sectional study was conducted among four (4) universities where 389 valid respondents out of 400 sampled students out of 3200 final year students in the faculty of social science and humanities through stratified random sampling technique within Morogoro Municipality in Tanzania. The study used structured questionnaires and interview guide to obtain data. The study used multiple linear regressions and content analysis to analyse the collected data. The findings of the study indicated that seeking for social support and social distancing were significantly and positively related to students coping strategies with COVID-19 in Tanzania’s universities. Also, students copying strategies contributed about 79.1% of all initiatives of copying with COVID 19, while 20.1% is contributed by other copying strategies which were not part of this study. The study concluded that, COVID 19 pandemic has an adversative effect on the health of university students and their studying environments. In this vein, the study recommends that, students should be encouraged to maintain social distancing among each other, wash hands with running water, do physical exercises, and get social support so as to reduce anxiety and the spread of COVID-19 pandemic within universities.

Low literacy within Muslim families can seriously affect developing individuals and society. This study aims to test the effectiveness of a new model of Islamic parenting based on family religiousness to address the low literacy issue in Muslim families. Using a mixed-method with triangulation design, in Study 1, researchers conducted action research by delivering a six-session parent training program to 10 women with children aged 11 years old, grouped into high and low-literate families. Practice at home, guided by facilitators, followed each session. Data were collected using interviews and parents’ reflection journals and were analyzed using content analysis. In Study 2, concurrently with Study 1, a quasi-experimental research was conducted using a one-group pre-test and post-test design to test the model’s effectiveness. Before and after the programs, the researchers administered the Family Literacy Questionnaire to the women and the Literacy Activity Questionnaire to their children. The data were analyzed using the Wilcoxon signed-rank test to examine differences between pre-test and post-test scores. The program was perceived as impactful and highly appreciated by the participants, who expected its continuation in the future. The hypothesis test results indicated that the Islamic parenting model improved family literacy (p=0.043) and the literacy activities of their children (p=0.039). The Islamic parenting model effectively enhanced women’s family literacy in low literacy groups and children’s literacy activity in both groups. This finding can be widely implemented to provide parents with understanding and skills to support their children’s literacy.

The development of artificial intelligence (AI) technology has enhanced the use of automated speech evaluation systems for language learners to practice speaking skills. This study investigated whether various automatic feedback offered by AI speech evaluation programs can help English as a foreign language (EFL) learners develop speaking skills. Forty EFL learners in China participated in this study. Data collection included qualitative and quantitative data. The results showed that the majority of participants believed they improved their speaking skills with the feedback offered by the AI speaking evaluation program. The findings also revealed that there were significant improvements in their mean scores of speaking skills in pre- and posttests. Therefore, it is suggested that AI speaking evaluation systems could provide more varied textual feedback and practical suggestions to assist EFL learners in developing speaking skills. [ABSTRACT FROM AUTHOR]

Aim: To describe demographic, physical and psychological characteristics associated with insomnia in patients with cardiovascular disease (CVD) participating in nurse‐led Internet‐based cognitive behavioural therapy for insomnia (I‐CBTI), and their motives and expectations regarding participation in I‐CBTI. Design: A mixed method design was applied, including primary care patients with angina pectoris, myocardial infarction, heart failure, atrial fibrillation and atrial flutter or arrhythmia in southern Sweden. Methods: Data on demographics, insomnia severity and physical and psychological characteristics were collected through self‐rated validated questionnaires (n = 126). Motives and expectations were collected through interviews (n = 19) and analysed using the 'personas' model. Results: Physical symptoms and psychological characteristics were associated with insomnia. Three personas were identified: the pragmatist (a curious and optimistic persona), the philosopher (a problem‐solving persona) and the philanthropist (an altruistic persona). Expectations were positive among the three personas, but comorbid conditions reduced the perceived ability to make necessary behavioural changes. [ABSTRACT FROM AUTHOR]

Aim: The aim was to (1) examine the feasibility aspect of a music intervention, (2) examine the association between music and pain, relaxation and well‐being and (3) explore patients' experience of listening to music while waiting for acute surgery. Design: The design was a mixed‐method study. Methods: Participants were offered a music pillow for 30 min. Before and after the intervention, participants reported their pain, relaxation and well‐being using a visual analogue scale ranging from 0 to10. The qualitative part was based on field observation followed by a semi‐structured interview. Results: The quantitative part included 30 participants. The Wilcoxon signed‐rank test showed a positive significant association between music and pain, relaxation and well‐being (p < 0.001). The qualitative part included 15 participants. Two themes derived from the analysis: (1) feelings of physical and mental well‐being and (2) a break from the acute preoperative context. Patient or Public Contribution: No patient or public contribution. [ABSTRACT FROM AUTHOR]

Aims: To understand the enablers and barriers for delivering fundamental care to hospitalized older patients. Design: Explanatory sequential mixed methods design, with qualitative data used to elaborate quantitative results. Methods: Set in one medical and one surgical unit of a tertiary hospital in southeast Queensland, Australia. Observations of nursing practice using the Work Sampling Technique were conducted over two 2‐week periods in 2019. Data were analyzed and presented to groups of nurses who appraised the findings of the observations. Results: There were 1176 and 1278 observations of care in the medical unit over two time periods and 1380 and 1398 observations over the same period in the surgical unit. Fundamental care activities were recorded in approximately 26% (i.e. medical) and 22% (i.e. surgical) of all observations. Indirect care was highest, recorded in 41% (i.e. medical) and 43% (i.e. surgical) of observations. Nurses prioritized the completion of reportable activities, which is perceived as a potential enabler of fundamental care. Potential barriers to fundamental care included frequent delays in indirect care and difficulty balancing care requirements across a group of patients when patients have high fundamental care needs. Conclusion: The cultural acceptance of missed nursing care has the potential to erode public confidence in health systems, where assistance with fundamental care is expected. Relational styles of nurse leadership should focus on: (1) making fundamental care important work in the nurses' scope thereby offering an opportunity for organizational change, (2) promoting education, demonstrating the serious implications of missed fundamental care for older patients and (3) investigating work interruptions. Impact Fundamental care is necessary to arrest the risk of functional decline and associated hospital‐acquired complications in older patients. However, nurses commonly report fundamental care as missed or omitted care. Understanding the challenges of implementing fundamental care can assist in the development of nurse leadership strategies to improve older patients' care. Fundamental care was observed between 22% (i.e. surgical) and 26% (i.e. medical) of all observations. Nurses explained that they were focused on prioritizing and completing reported activities, experienced frequent delays when delivering indirect care and found balancing care requirements across groups of patients more challenging when patients had fundamental care needs. Clinical nurses working in acute health services with increasing populations of older patients can lead improvements to fundamental care provision through relational leadership styles to demonstrate how this work is in nurses' scope of practice, promote education about the serious implications of missed fundamental care and investigate the root cause of work interruptions. [ABSTRACT FROM AUTHOR]

Perceptions of teachers and students about curriculum viability inhibitors are equally important yet may differ. Divergence can lead to destructive friction and adversely affect curriculum viability. Our team aimed to find the perceptions of teachers and students on inhibitors affecting the viability of an implemented medical curriculum, report their convergence or divergence, and explore approaches to reduce divergence. Through a mixed-method approach, using valid and reliable questionnaires, we found the curriculum under review had no clear inhibitors. Whereas teachers exhibited complete agreement that no educational programme inhibitors existed, students did not fully agree. Upon qualitative inquiry, using focus group discussion with students and teachers, we found that 'improving the communication gap', 'enhancing the role of faculty and students in curriculum', and 'improving the assessment process' can reduce the friction between teachers and students. This study provides an approach that identifies the curriculum viability inhibitors and solutions to address them. [ABSTRACT FROM AUTHOR]

Today, we live in a VUCA world, which stands for Volatility, Uncertainty, Complexity, and Ambiguity, raised to the third power. That is because of current changes in the world, such as social, business, financial and economic, technological, cultural, and educational changes. The purpose of this research is to attempt to develop a concept for organizational resilience in the face of economic change for travel agencies in the 2nd district of Albay. The study used a mixed-method research design to determine the perceptions of both owners and their employees, while five-point indicators were provided in the different areas to determine the respondents' business resiliency practices with the aid of the Likert scale. The analyzed data of the travel agency believed “slightly agree” on the business resiliency when the practice is exceedingly observed and predominantly exercised along with the services delivery platform (4.61), sales and marketing (4.21), human resource (4.23), financial management (4.32), and safety and security (4.69). Furthermore, all the above-mentioned variables were tabulated t at 1% and had a value of 10.48. Therefore, it is proposed that there are still necessary actions and resolutions to be made in order to be ready to further enhance the business resiliency of the VUCA World under this study. In this light, more effective management skills and strategies are required in order to address the identified challenges of the respondents. The travel agency owners must have a strategic model that will guide them in achieving their goals and sustaining their business.

Introduction: Systemic cultural factors related to excessive alcohol consumption have been identified in Australian university residential colleges. In this mixed methods study, we conducted focus groups with student leaders at three Australian residential colleges. We aimed to explore students' perceptions of alcohol use and related consequences in their current college environment and gather feedback from students on the utility of alcohol harm minimisation strategies in this context. Methods: In November 2020, 77 student leaders from three colleges participated in focus groups. Each focus group ran for 1.5–2 hours and included three sections: (i) quantitative survey; (ii) semi‐structured group interview; and (iii) feedback on a potential alcohol harm minimisation workshop. Results: The survey revealed that 81% of participants reported drinking hazardously. Thematic analysis of the interview data indicated many students perceived college as a supportive environment regarding students' alcohol use choices (direct peer pressure to drink was uncommon). However, indirect social influence to drink appeared to maintain a 'culture of intoxication'. Specifically, social norms to attend college events (where drinking is implied) and modelling of excessive drinking were key indirect influences on heavy drinking norms. Students were aware and accepting of many alcohol harm minimisation strategies and interested in improving current strategies. Discussion and Conclusions: Despite the supportive college environment described by students, regarding alcohol use choices, a 'culture of intoxication' driven by indirect social influences was evident. Student leaders' interest in increasing the availability of harm minimisation strategies highlights the potential utility of peer‐led alcohol interventions in colleges. [ABSTRACT FROM AUTHOR]

Aims and objectives: To understand whether exposure to an incident of violence directed at nurses, evoke among the public a sense of identification with the victim or with the perpetrator. Background: Worldwide, evidence regarding workplace violence (WPV) in healthcare systems, explored the characteristics of the perpetrator, the healthcare settings and staff. Nevertheless, no studies examine the emotions of the public towards WPV in the healthcare systems. Design: A convergent mixed method parallel design. Methods: A structured questionnaire was distributed among 925 adults. Two scenarios were presented, with verbal and physical violence towards nurses. The participants rated how intensely they felt positive and negative emotions regarding the nurse and the perpetrator (quantitative stage). Sixty participants were also interviewed concerning their emotions regarding violence committed towards nurses (qualitative stage). Paired samples t‐test were used to compare the emotions that were aroused regarding the perpetrator and the nurse. The effect size and Bonferroni correction for multiple comparisons were calculated. Constant comparative analysis method was used to analyzed the qualitative data. The STROBE checklist for cross‐sectional studies and the COREQ guidelines for qualitative studies were used for reporting. Results: Positive emotions were significantly higher towards the nurse than the perpetrator. Nevertheless, there were both positive and negative emotions towards the perpetrator and the nurse. The qualitative findings yielded two themes: (1) Mixed emotions towards the perpetrator, and (2) Mixed emotions towards the nurse. Conclusions: The public may emotionally identify with both the nurse and the perpetrator while positive and negative emotions are intertwined. Likewise, positive emotions are more intensely felt for the victims in both verbally and physically violent scenarios. Relevance to clinical practice: These complemented findings highlight the need for campaigns promoting positive emotions toward healthcare professionals in an attempt to reduce and eliminate WPV in healthcare. [ABSTRACT FROM AUTHOR]

Objective The aim of this study was to understand clinicians' experiences of teleneuropsychology service implementation within rural inpatient rehabilitation settings and the variability of those experiences across rural settings and clinical disciplines. Method Clinicians (n  = 56 from four rehabilitation settings) who were involved in a hub-and-spoke teleneuropsychology service completed surveys throughout service implementation. A purposive sample of 16 clinicians then completed semi-structured interviews at the conclusion of the service implementation period. Quantitative data were analyzed descriptively and qualitative data were analyzed using thematic analysis, prior to the results being converged. Results Four themes characterizing clinicians' experiences were identified. Pre- and early-implementation considerations included factors such as early collaboration and consultation, which were identified as important for service integration into rural settings. Facilitators/barriers included factors such as technology usability, which positively or negatively influenced service implementation. Benefits and outcomes included perceptions on the impact of the service, such as improved equity and quality of care in rural settings. Finally, future applications encapsulated what the clinicians envisaged for the future of teleneuropsychology services, such as hybrid teleneuropsychology/in-person services. Some differences were identified in clinicians' experiences across rural settings and disciplines, including preferences for technology infrastructure and satisfaction with teleneuropsychology sessions. Conclusions Most clinicians reported positive experiences and acceptability of the teleneuropsychology service. Facilitators and barriers, which can guide the successful establishment of future teleneuropsychology services, were identified. These findings may be used to contribute to improving equity and quality of care for people living with neuropsychological impairments, especially those living in rural areas. [ABSTRACT FROM AUTHOR]

Copyright of Industrielle Beziehungen is the property of Rainer Hampp Verlag 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.)

Loops concept is one of the basic programming concepts. Students have difficulties in learning loops concept. Helping learners understand loops is an important task. Visualization is one of the ways to help students improve their understanding. The aim of the study was to construct and evaluate a visualization based instruction related to loops. A mixed method study was conducted. In the experimental phase of the study, the effect of visualization based instruction on pre-service teachers’ achievement, perceived learning and programming attitude was examined. In the qualitative phase of the study, the main purpose was to get more in depth data related to experimental phase. Visualization based instruction helped pre-service teachers improve their understanding of loops concept.

For the past two decades, Virtual Exchange (VE) has enjoyed increasing popularity in university education, including initial (language) teacher education programmes (O’Dowd, 2018). Collaborating online with colleagues and students from different cultural backgrounds and educational systems has allowed trainees to experience and reflect on issues related to technology and pedagogy in authentic linguistic and intercultural contexts. In 2017/2018, the Evaluating and Upscaling Telecollaborative Teacher Education (EVALUATE) project – an Erasmus+ funded European Policy Experimentation (EPE) – collected and analysed data from VEs across the curriculum involving over 1,000 participants at Initial Teacher Education (ITE) institutions in Europe and beyond. Here, we specifically focus on the impact of VE on their digital-pedagogical competence development. Following a mixed method design we used the Technological Pedagogical Content Knowledge (TPACK) work of Mishra and Koehler (2006) and Schmidt et al. (2009) in a pre-post-test manner. These were complemented by qualitative content analysis of prompted diary entries at key stages during the exchanges to collect further evidence of existing and emerging digital-pedagogical skills among the trainees. Based on one case study of a German-Polish EVALUATE exchange we will exemplify the aforementioned research methods and associated challenges. We will illustrate the urgent need for initial and in-service teacher education that combines technology and pedagogy and argue for VE as an ideal context to this effect. Finally, we will demonstrate how the chosen research approach has contributed to providing the kind of evidence required by education administrators and policy makers for a systematic integration of VE into teacher education programmes.

Introduction: Health care costs consciousness refers to care that aims to assess the benefits, harms and costs of interventions by the physicians. Rising health care costs have created an urgent need to improve physicians’ knowledge on health care costs for providing cost conscious care. Objectives: This study was done to assess and compare the knowledge and attitude towards health care cost consciousness of the undergraduate medical students and interns. Methodology: A Mixed Method study was done using a standardized questionnaire among 388 medical students and a Qualitative approach using In-depth interviews with 15 practicing physicians and a Focus group discussion to understand their perceptions on cost-conscious care and their opinions on introducing Cost-conscious curriculum for the medical students. Data analysed using a framework analytical approach and NVivo12. Results: 84% of the students agreed that all health personnel should be familiar with health care costs, 84.5% agreed that inclusion of the health care cost consciousness in medical curriculum is important for their carrier. The themes emerged identified the various perceptions, determinants on health care costs, cost-conscious decision making and their responsibility as a physician. Conclusion: The physicians and interns strongly suggested including a structured learning on Cost-Conscious Care as a part of medical education to educate and train the future physicians.

Background: A multifaceted and interactive teaching approach is recommended for achieving proficiency in evidence-based practice, with critical thinking considered vital for connecting theory and practice. In this context, we advocate the strategic use of health claims in the media to promote critical thinking, complemented by a blended learning approach and a group exam., Method: We conducted a convergent mixed methods study, including a cross-sectional survey with structured and open-ended questions as well as focus group interviews, at Oslo Metropolitan University, during the 2020-2021 academic year. Participants were bachelor's students in healthcare. We employed a blended learning approach, combining digital learning resources, teaching in critical assessment of health claims and evidence-based practice, and a concurrent group exam assignment centered around media health claims. The outcome measures included students' experiences integrating health claims into evidence-based practice teaching and their experiences with teaching approaches and the group exam., Results: Out of 465 participants, 136 (29.2%) responded to the structured questions in the survey. In response to the open-ended questions within the survey, 109 (80.1%) of the respondents shared positive experiences about the course, while 98 (72%) suggested improvements. Additionally, 25 students participated in focus group interviews. Synthesizing the results, we found that students viewed the inclusion of health claim assessment as a useful entry point for learning evidence-based practice. In addition, the students identified both the blended learning design and the group exam as contributors to a positive perception of learning outcomes from the course., Conclusions: Based on student feedback, integrating critical reflection on media health claims into evidence-based practice education, alongside a blended learning approach and a group exam, may be beneficial in teaching evidence-based practice to bachelor's healthcare students. However, further rigorous study designs are needed to objectively assess the effect of the course on learning outcomes., Registration: DOI 10.5281/zenodo.6985449., Competing Interests: No competing interests were disclosed., (Copyright: © 2024 Elvsaas IKO et al.)

Background: Gaming disorder (GD) is a new official diagnosis in the International Classification of Diseases, 11th Revision, and with its recognition, the need to offer treatment for the condition has become apparent. More knowledge is needed about the type of treatment needed for this group of patients., Objective: This study aims to evaluate the effectiveness and acceptability of a novel module-based psychological treatment for GD based on cognitive behavioral therapy and family therapy., Methods: This study is a nonrandomized intervention study, with a pretest, posttest, and 3-month follow-up design. It will assess changes in GD symptoms, psychological distress, and gaming time, alongside treatment satisfaction, working alliance, and a qualitative exploration of patients' and relatives' experiences of the treatment., Results: This study started in March 2022 and the recruitment is expected to close in August 2024., Conclusions: This study evaluates the effectiveness and acceptability of a psychological treatment for patients with problematic gaming behavior and GD. It is an effectiveness trial and will be conducted in routine care. This study will have high external validity and ensure that the results are relevant for a diverse clinical population with psychiatric comorbidity., Trial Registration: ClinicalTrials.gov NCT06018922; https://clinicaltrials.gov/study/NCT06018922., International Registered Report Identifier (irrid): DERR1-10.2196/56315., (©Per Bore, Sara Nilsson, Mitchell Andersson, Kajsa Oehm, Joel Attvall, Anders Håkansson, Emma Claesdotter-Knutsson. Originally published in JMIR Research Protocols (https://www.researchprotocols.org), 16.08.2024.)

Mary D Adu,1 Usman H Malabu,1 Aduli EO Malau-Aduli,2 Bunmi S Malau-Aduli11College of Medicine and Dentistry, James Cook University, Townsville, QLD 4811, Australia; 2College of Public Health, Medical and Veterinary Sciences, James Cook University, Townsville, QLD 4811, AustraliaBackground: Mobile applications (apps) have proven to be useful in supporting diabetes self-care, but non-consideration of users’ needs and non-inclusion of educational features are reasons for low continual use. Well-designed mobile apps that meet the needs of diabetes patients and provide ongoing self-management education and support are required. It was hypothesized that apps designed with such features can improve a range of measures including clinical outcomes, knowledge of diabetes, medication adherence, perceived ability for self-management, and quality-of-life. This may eventually facilitate a more robust and cost-effective approach for improving skills and motivation for the management of diabetes.Methods: This project will be conducted in two phases. It will initially employ a mixed methods study design to investigate the self-management needs and perceptions of diabetes patients on the use of mobile apps to support diabetes self-management. Results of the mixed methods study will inform the content and design of an app which will be employed as an intervention tool in a 12-month parallel randomized controlled trial (RCT). The RCT will compare outcomes in relation to standard-of-care alone with standard-of-care plus a mobile phone diabetes app among 150 insulin-requiring types 1 and 2 diabetes patients. The primary outcome measures are clinical parameters such as hemoglobin A1c (HbA1c), lipids, urine albumin-to-creatinine ratio, blood pressure, frequency in events of emergency hyperglycemia and hypoglycemia. Secondary outcomes include knowledge of diabetes, medication intake and adherence, perception of self-care, and quality-of-life.Discussion: Results from this study will provide empirical evidence on the usefulness of a mobile app developed based on self-management needs analysis of diabetic patients. The long-term goal is to harness knowledge gained from this study to provide evidenced-based data, which promote the scale-up or adoption of mobile applications that provide regular, ongoing education and self-management support to people living with diabetes.Trial registration: Australian New Zealand Clinical Trials Registry, ACTRN12618000065291, Registered on 17 January, 2018 (prospectively registered).Keywords: randomized controlled trial, mixed methods design, diabetes, self-management education, mobile application

Abstract Background Humanistic nursing practice constitutes the cornerstone of the nursing profession. However, according to some authors, such practice tends to fade over time in favour of non-humanistic behaviours. To contrast this tendency, an educational intervention (EI) based on Watson’s Theory of Human Caring was developed and tested in two pilot studies involving, respectively, rehabilitation nurses in Quebec (Canada) and haemodialysis (HD) nurses in Switzerland. In light of the positive results obtained in these, another study is being undertaken to examine more in depth the EI’s effects on both HD nurses and patients in French Switzerland. The EI is expected to have positive effects on quality of nurse-patient relationship (NPR), team cohesion, nurse quality of working life (QoWL), and patient quality of life (QoL). Methods/design The study described in this protocol will use a mixed-method cluster randomised controlled trial design. For the quantitative component, nurse and patient data will be collected through questionnaires. The accessible population of 135 nurses and 430 patients will be clustered into 10 HD units. These units will be randomised into an experimental group (EG) and a waiting-list control group (WLCG). Measurements will be taken at baseline (pre-intervention) and repeatedly over time (post-intervention): immediately at EI completion and six and 12 months thereafter. For the qualitative portion of the study, 18 semi-structured interviews will be conducted with EG nurses picked at random two months after EI completion to explore perceived changes in nurse humanistic practice. Qualitative data will be analysed through the relational caring inquiry method, a phenomenological approach. Descriptive and inferential statistics will be computed from the quantitative data. Discussion The study described in this protocol will determine if and how the proposed EI promotes humanistic nursing practice and how this practice affects quality of NPR, nurse QoWL, and patient QoL. Moreover, it will lay the groundwork for offering the EI to nurses in other healthcare sectors. Trial registration This clinical study was registered with ClinicalTrials.gov [NCT03283891, 14/09/2017].

Loops concept is one of the basic programming concepts. Students have difficulties in learning loops concept. Helping learners understand loops is an important task. Visualization is one of the ways to help students improve their understanding. The aim of the study was to construct and evaluate a visualization based instruction related to loops. A mixed method study was conducted. In the experimental phase of the study, the effect of visualization based instruction on pre-service teachers' achievement, perceived learning and programming attitude was examined. In the qualitative phase of the study, the main purpose was to get more in depth data related to experimental phase. Visualization based instruction helped pre-service teachers improve their understanding of loops concept. [ABSTRACT FROM AUTHOR]

Aim: To explore how the patient is constructed and socially positioned in discourses of web‐based pathways information available to people with cancer in Norway. Design: Mixed qualitative and quantitative design, using Corpus‐Assisted Critical Discourse Analysis. Methods: The study, conducted in January 2020, examined the language of one general and six specific web‐based cancer pathways information brochures. The approach combines analysis of word frequencies and concordance lines using corpus analysis software to identify the 'linguistic fingerprint' or 'aboutness' of the text prior to further qualitative critical discourse analysis. Results: The analysis identified three core discourses which constructed the patient differently: (a) a participating active person, in a brief, inclusive discourse; (b) a passive person lacking knowledge or perception of their situation in dominant, medical and interprofessional expert discourse; and (c) reduced to a disease and a code in the pathways discourse. Conclusion: This study offers insight into the construction of patients in online clinical pathways information for cancer treatment. The analysis revealed how governance systems such as New Public Management and its demands on efficiency and productivity influence the cancer pathways. The World Health Organization has promoted a person‐centred approach, emphasizing the importance of participation and a partnership of equals. A person‐centred approach to care was not evident in the discourse of the online documents. The dominant ideology of these pathways was paternalistic with patients constructed as passive persons who get standardized treatment. Impact: This study gives new insight that can be valuable for nurses, other healthcare professionals and the government. The lack of a person‐centred focus in the cancer pathway information could have a negative impact on the patient's health outcomes by promoting a culture of inattention to the patients' needs and wishes among practitioners. The results may provide a stimulus for discussion about the role of patients in cancer treatment. [ABSTRACT FROM AUTHOR]

Copyright of Croatian Journal of Education / Hrvatski Časopis za Odgoj i Obrazovanje is the property of Uciteljski Fakultet u Zagrebu 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.)

This study aims to investigate the associations between bullying and moral disengagement in a Brazilian sample, using a mixed method design. Two-thousand three hundred and thirty-four adolescents (11–19 years; 42.9% girls) answered self-report measures on bullying and moral disengagement in response to bullying situations. Fifty-five participants were randomly selected and interviewed on their experiences on bullying at school. Results allowed to identify specific mechanisms of moral disengagement associated with bullying behavior among Brazilian adolescents. Qualitative analysis highlighted how moral disengagement mechanisms were spontaneously used by the adolescents to explain both the bullying and the bystander behaviors. Findings support the relevance of moral disengagement mechanisms in explaining bullying behaviors. The value of addressing these mechanisms when designing anti-bullying interventions is discussed.

Objective: This study aims to is to develop a disorder-specific patient-reported outcome measure to be used in Islamic clergymen with voice disorders and to investigate its validity and reliability., Methods and Procedures: Employing an exploratory sequential mixed-methods design, this study conducted in two phases. Initially, semistructured interviews were conducted with 10 clergymen experiencing voice disorders. Subsequently, the questionnaire underwent rigorous validation, encompassing content, construct, and criterion validity assessments, in addition to test-retest reliability and internal consistency analyses. The index was administered to a sample of 110 male clergy, including imams, muezzins, and Quran course teachers, with an age range from 19 to 61years., Results: Construct validity was established through factor analysis, resulting in a final 23-item scale categorized into two factors: physical-functional and emotional. Known group validity demonstrated a significant distinction between the study and control groups. Criterion validity reinforced the index's validity, displaying a correlation coefficient of 0.758 between the Voice Handicap Index for Clergymen and the well-established Voice Handicap Index. The questionnaire exhibited commendable internal consistency, with a Cronbach's Alpha (α) coefficient value of 0.971. Test-retest reliability analysis exhibited strong consistency, with a Pearson correlation coefficient of 0.863., Conclusions: It is recommended that the developed valid and reliable handicap index in the present study be included in the voice assessment batteries of Islamic clergymen with voice complaints with the clinical and research purposes. In future studies, the validity of the questionnaire can be investigated more by examining the difference between the Voice Handicap Index for Islamic Clergymen (CVHI) scores obtained before and after treatment. Identifying a cut-off point that discriminates between dysphonic and normophonic clergymen may allow the use of the CVHI as a screening tool for this population., Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 The Voice Foundation. Published by Elsevier Inc. All rights reserved.)

Study Background: Incivility in nursing educational institutions, which may be perpetrated by both students and faculty, is troubling given that such institutions have a mandate to prepare students for caring, relational nursing practice., Purpose: The purpose of this study was to contribute to understanding nursing academic incivility through an examination of nursing faculty's perspectives on student and faculty incivility., Methods: The study was conducted using a mixed methods, descriptive, survey design with collection and analysis of quantitative and qualitative data. The sample consisted of 52 faculty members., Results: A large majority of faculty thought that incivility in the nursing academic environment is a problem, with most considering it to be a mild or moderate problem. Students acted unprofessionally by showing disrespect, displaying superiority, engaging in disruptive behaviors, or not taking responsibility for their role in their learning. Faculty acted unprofessionally by showing disrespect, displaying superiority, or not being supportive. Faculty perceived that stress, personality, failure to deal with incivility, and an attitude of entitlement contributed to incivility. They thought that educational interventions, policies, and an academic environment that is conducive to civility are needed to address the problem., Conclusion: Until evidence is available to support the effectiveness of interventions for academic incivility, nursing educational institutions are encouraged to implement strategies suggested by faculty in this study., Competing Interests: Declaration of Conflicting InterestsThe authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

This study aims to investigate the associations between bullying and moral disengagement in a Brazilian sample, using a mixed method design. Two-thousand three hundred and thirty-four adolescents (11–19 years; 42.9% girls) answered self-report measures on bullying and moral disengagement in response to bullying situations. Fifty-five participants were randomly selected and interviewed on their experiences on bullying at school. Results allowed to identify specific mechanisms of moral disengagement associated with bullying behavior among Brazilian adolescents. Qualitative analysis highlighted how moral disengagement mechanisms were spontaneously used by the adolescents to explain both the bullying and the bystander behaviors. Findings support the relevance of moral disengagement mechanisms in explaining bullying behaviors. The value of addressing these mechanisms when designing anti-bullying interventions is discussed. [ABSTRACT FROM AUTHOR]

Copyright of Pedagogische Studien is the property of Vereniging Onderwijsresearch 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: Interoception is the ability to perceive one's inner bodily feelings and is thought to be associated with the capacity of recognising and experiencing emotions. Previous research on interoception and emotion regulation has presented limitations arising from the low reliability of the interoceptive measurement and provided inconsistent results. The current study used a mixed method approach to investigate this relationship from the individuals' perspective.Methods: In the first phase (quantitative), questionnaires assessing interoceptive sensibility, the subjective, self-reported ability to perceive internal states, were administered to 100 healthy participants. In the second phase (qualitative), individual semi-structured interviews were conducted with nine participants. The interviews were analysed using the Interpretative Phenomenological Analysis. Three main dimensions were explored with open questions: 1) Perception of internal bodily states; 2) Emotion regulation; 3) Potential relationship between bodily states perception and emotion recognition and regulation.Results: Findings revealed that people with low interoceptive abilities show more difficulties in verbalizing their feelings and in decreasing the impact of emotions generated by negative experiences in daily life LIMITATIONS: The generalization of the results is limited by the specific age and gender of the recruited sample.Conclusions: Responses of the participants supported recent evidence regarding the lack of reliability of the heartbeat counting task as a measure of interoceptive accuracy, however interviews sustained the importance of recognising the bodily states in order to be able to understand and regulate emotions. [ABSTRACT FROM AUTHOR]