Developing Tailored Messages to Improve Mental Health and Adjustment of Asian International Students

The purpose of the study was to develop tailored messages improving mental health and adjustment of Asian international students (AIS) in the US. The PEN-3 cultural model was used to contextualize the role of culture in mental health needs of AIS. Messages were developed through a multi-step participatory process with consisting of three focus groups (n=15), thirteen individual interviews, one expert consultation, and finally an online survey (n=85). The study led to the development of seven broad themes with seven tailored messages under each theme (total 49). Seven broad themes were: increasing the awareness of mental health and reducing stigma; motivational quotes; available and accessible resources for AIS to improve mental health; seeking help from social network and developing interpersonal skills; adjusting to American culture and college life; coping strategies to reduce stress and improve mental health and adjustment; and safety issues. The implications for culturally responsive programs are discussed.

The qualitative experience of telehealth access and clinical encounters in Australian healthcare during COVID-19: implications for policy

Background Adaptive models of healthcare delivery, such as telehealth consultations, have rapidly been adopted to ensure ongoing delivery of essential healthcare services during the COVID-19 pandemic. However, there remain gaps in our understanding of how clinicians have adapted to telehealth. This study aims to explore the telehealth experiences of specialists, based at a tertiary hospital in the Hunter Region, and general practitioners (GP), including barriers, enablers and opportunities. Methods An interpretative qualitative study involving in-depth interviews explored the telehealth experiences of specialists, based at a tertiary hospital in the Hunter Region of Australia, and GPs, including barriers, enablers and opportunities. Data were analysed using an inductive thematic approach with constant comparison. Results Individual interviews were conducted with 10 specialists and five GPs. Key themes were identified: (1) transition to telehealth has been valuable but challenging; (2) persisting telehealth process barriers need to be addressed; (3) establishing when face-to-face consults are essential; (4) changes in workload pressures and potential for double-up; (5) essential modification of work practices; and (6) exploring what is needed going forward. Conclusions While there is a need to rationalize and optimize health access during a pandemic, we suggest that more needs to be done to improve telehealth going forward. Our results have important policy implications. Specifically, there is a need to effectively train clinicians to competently utilize and be confident using this telehealth and to educate patients on necessary skills and etiquette.

Attitudes & behaviors toward the management of tobacco smoking patients: qualitative study with French primary care physicians

Background Smoking cessation is a major public health issue. In France, primary care physicians (PCP) are the first contact points for tobacco management. The objective of this study was to understand how PCPs are involved in the management of smoking cessation: ownership, commitment, barriers. Methods A qualitative study was conducted using group and individual semi-structured techniques with PCPs. A thematic analysis of verbatim transcripts was performed to identify concepts and sub-concepts of interest. Saturation was evaluated retrospectively to ensure adequate sample size. Results A sample of 35 PCPs were interviewed, 31 in four focus groups and four in individual interviews. PCPs discussed their roles in the management of tobacco smoking cessation, including the different strategies they are using (e.g., Minimal Intervention Strategy, Motivational Interviewing), the multiple barriers encountered (e.g., lack of time, patients’ resistance to medical advice), the support resources and the treatment and intervention they prescribed (e.g. nicotine replacement therapy, supporting therapist). Conclusions This study provides a better understanding of the beliefs, attitudes, and behaviors of PCPs in managing smoking cessation. Guiding and encouraging patients toward smoking cessation remains a major objective of PCPs. While PCPs reported that progress has been made in recent years in terms of tools, technology and general awareness, they still face major barriers, some of which could be overcome by appropriate training.

Examining Adaptive Behaviors as Resistance Strategies for African American College Students in Adverse University Contexts

This study explored the adaptive behaviors used by African American college students attending a predominantly White university. In-depth individual interviews were conducted and used as the primary method of data collection for this study. In addition, a focus group session provided member checking opportunity to strengthen the study. The analysis revealed participants utilized multiple adaptive behaviors to combat negative racialized experiences while attending a university where they were underrepresented. These adaptive behaviors were used as resistance strategies by African American students navigating a racially charged university context.

Unintended consequences of patient online access to health records: a qualitative study in UK primary care

BackgroundHealth systems around the world are seeking to harness digital tools to promote patient autonomy and increase the efficiency of care. One example of this policy in England is online patient access to full medical records in primary care. Since April 2019, all NHS England patients have had the right to access their full medical record prospectively, and full record access has been the “default position” since April 2020.AimTo identify and understand the unintended consequences of online patient access their medical record.Design and SettingQualitative interview study in 10 general practices in South West and North West England.MethodSemi-structured individual interviews with 13 patients and 16 general practice staff with experience of patient online access to health records.ResultsOnline access generated unintended consequences that negatively impacted patients’ understanding of their health care, for example patients discovering surprising information or information that was difficult to interpret. Online access impacted GPs’ documentation practices, such as when GPs pre-emptively attempted to minimise potential misunderstandings to aid patient understanding of their health care, in other cases, negatively impacting the quality of the records and patient safety when GPs avoided documenting their speculations or concerns. Contrary to assumptions that practice workload would be reduced, online access introduced extra work, such as managing and monitoring access and taking measures to prevent possible harm to patients.ConclusionThe unintended consequences described by both staff and patients show that to achieve the intended consequences set out in NHS policy additional work is necessary to prepare records for sharing and prepare patients about what to expect. It is crucial that practices are adequately supported and resourced to manage the unintended consequences of online access now that it is the default position.

As Steady as a Rock! Gaining Insight in Recruitment and Retention Among Primary School Children With Behavioural Problems in Sport Mix Club

The number of children dealing with behavioural problems is increasing. A major challenge in many health-supportive programmes is the recruitment and retention of these children. In the current study, Sport Mix Club (SMC), an approach to enhance socioemotional disorders of 4- to 12-year-old children through sport classes in municipality Vaals, the Netherlands, is used as an illustration. Where many studies faced difficulties getting and keeping children in their interventions, SMC overcame this challenge. Therefore, we decided to explore “What factors contribute to enhanced recruitment and retention procedures among children with behavioural problems in Sport Mix Club?” A qualitative case study design using the analysis of the administrative logbook of the SMC coach and trainees, individual interviews with the SMC coach, trainees (n = 2), school teachers (n = 3) and parents of participating children (n = 9), and four focus group interviews with children (n = 13) were carried out. During the recruitment and retention of SMC, the human psychological need of relatedness seemed to be of crucial value. The fact that the SMC coach: (1) made efforts to become a familiar face for children, parents and community partners beforehand; (2) showed enthusiasm; and (3) placed her focus on having fun as opposed to the children's problems, seemed to be decisive in the process of getting children to participate in SMC and retaining their participation.

The shift from old age to very old age: an analysis of the perception of aging among older people

Background The oldest-old (individuals over 90 years) are a fast-growing population. Understanding the perceptions of older people about very old age is the first step towards developing optimal geriatric care for an aging population. This study aimed to explore the potential shift from old age to very old age through the exploration of older people’s perception of aging. Methods Qualitative study conducted through individual interviews in the homes of older people. We voluntarily chose to include persons a decade under and above 90 years old to explore other factors than age that could participate in the shift from old age to very old age. The sampling was theoretical. We carried out the analyses using an inductive approach based on the phases of grounded theory. The researchers used triangulation. Collection was concluded when theoretical saturation was reached. Results Fourteen participants were interviewed. The shift from old age to very old age was not based on age but occurred when participants became conscious of the irreversibility of aging and its effects, and when they started living day-by-day, renouncing to any plan in a near future. The transition to very old age seemed to be preceded by a progressive disengagement from non-essentials activities. Participants reported a sensation of progressive social exclusion due to the loss of contemporaries or spouse, the difficulty to connect with younger generations or the absence of relationships in their neighborhood. The last step of life was feared, not because of the idea of death itself but because of the associated suffering and loss of autonomy. Conclusion Precipitating and slowing factors of the shift to very old age were identified to help general practitioners support older patients throughout their life trajectories.

ORGANISATIONAL APPROACHES TO THE FORMATION OF SOCIAL RESPONSIBILITY OF HIGHER EDUCATION INSTITUTIONS IN THE MARKET OF EDUCATIONAL SERVICES

BACKGROUND AND OBJECTIVES. Social responsibility is a system of innovative working relationships that acts as an essential technology that enhances the effectiveness of a higher education institution with employees, partners, customers and the community, and ultimately contributes to its prosperity and civil society. Social responsibility should focus on enhancing the image of the higher education institution, recognising its successes in society by civil institutions and individual citizens. This will increase the social value of the higher education institution, its competitiveness, sustainability and efficiency, allowing society to use the resource voluntarily provided by the higher education institution to balance organisational and social interests.METHODS. The methods used to conduct the research were: interview, expert. The questions selected for this study were taken either from the literature or from individual interviews. The literature helped to identify important dimensions of the concept of social responsibility. The interviews helped to identify new points and possible dimensions to contextualise organisational approaches to shaping the social responsibility of higher education institutions.FINDINGS. Organizational approaches to the formation of social responsibility of higher education institutions in the market of educational services are proposed. Mechanisms to increase socio-commercial value of socially responsible higher education institutions are argued: creation of public institutions to identify, formulate public interests and present them to corporations; selection of social projects taking into account stakeholder expectations.CONCLUSION. In order to increase the efficiency of using the principles of social responsibility in HEIs, to improve their ratings, students' competitiveness in the labour market and their involvement in the task-setting and decision-making process, it is necessary to develop a programme of corporate social activity, which can become the basis for developing the HEIs' development strategy. The formation and adoption of such a strategy should be based on the interests of all stakeholders, based on the core values of the university to achieve the indicators at micro-, meso- and macrolevels.

Developing a comprehensive tool to assess professional attitude among physicians and medical students

It appears that up until now, no comprehensive tool has been developed to assess medical students’ attitudes toward the different dimensions of professionalism. The present study aimed to develop a comprehensive quantitative tool to evaluate medical students’ attitudes toward professionalism. This study consisted of two phases: The first phase was item generation and questionnaire design based on literature review and a qualitative survey. The qualitative data were extracted from 49 semi-structured individual interviews and one focus group discussion. In the second phase, the questionnaire was developed and its face, content, and structure validity and reliability were evaluated. To measure the construct validity of the questionnaire, a cross-sectional study was conducted on 354 medical students at different academic levels at Isfahan University of Medical Sciences. The final questionnaire was loaded on five factors. The factors accounted for 43.5% of the total variance. Moreover, Cronbach's alpha was 0.84 for the total scale, and the interclass correlation coefficient was 0.77 for the test-retest reliability. The 17-item questionnaire measuring medical students’ professional attitude had acceptable validity and reliability and can be adopted in other studies on physicians’ and medical students’ professional attitudes.

Nurse competence in the post-anaesthesia care unit in Sweden: a qualitative study of the nurse’s perspective

Background To enable safe and successful recovery for surgery patients, nurses working in post-anaesthesia care units need competence in postoperative care. No consensus defines what this specific competence includes, and it has not been studied from the perspective of nurses working in post-anaesthesia care units. The aim of this study is twofold: 1) To explore and describe nurses’ perception of the competence needed to work in post-anaesthesia care units. 2) To explore and describe nurses’ perception of what characterizes an expert nurse in post-anaesthesia care units. Methods This qualitative inductive study uses individual interviews. Sixteen nurses were recruited from two post-anaesthesia care units located in different parts of Sweden. Inclusion criteria were nurses employed in the post-anaesthesia care units for ≥1 years. Semi-structured individual interviews were conducted; data were analysed using thematic analysis. Results The interview analysis identified six subthemes and three themes. The themes being adaptable in an ever-changing environment and creating safe care represent the overarching meaning of competence required when working as a nurse in a Swedish post-anaesthesia care unit. Nurses must possess various technical and nontechnical skills, which are core competences that are described in the sub-themes. The theme seeing the bigger picture describes the nurse’s perception of an expert nurse in the post-anaesthesia care unit. Conclusions Nurse competence in post-anaesthesia care units entails specific knowledge, acknowledging the patient, and working proactively at a fast pace with the patient and team to provide safe, high-quality care. An expert nurse in post-anaesthesia care units can see the bigger picture, helping share knowledge and develop post-anaesthesia care. The expert competence to see a bigger picture can be used in supervising novices and creating a knowledge base for postgraduate education in order to promote safe, high-quality post-anaesthesia care.