"A Turbo Form of Therapy": A Co-produced Investigation of Lived Experience Storytelling.

The aim of this project was to investigate the resilience of mining communities throughout different stages of mining activity. This aim was achieved through the in-depth exploration of mining community wellbeing and sustainability. The sustainability of mining communities is subject to many factors such as economic market trends and the longevity of the resource being mined (Black, 2005). Sustainable development requires consideration of the actions needed at a local level that contribute to or hinder sustainability (Callaghan & Colton, 2008; Epps, 2002; Lubbers & Koorevaar, 1999). As sustainability was investigated at a community level, the community capital framework suggested by Callaghan and Colton (2008) was used. This framework provides a comprehensive view of the factors that can influence community sustainability. These factors are environmental, human, social, cultural, public structural and commercial capital. Social capital is particularly important to consider for community sustainability as it facilitates coordination and cooperation for the mutual benefit of those involved thus allowing for the use of other forms of capital to be more efficient (Putnam, 1993, 2000). This project explored the relationships between community capital and community wellbeing in mining communities. Additionally, this project explored mining community residents' perceptions of the impacts of mining activity. Due to the limited literature on mining community wellbeing in an Australian context, an exploratory approach was taken in this project. Semi-structured interviews were conducted in three Queensland mining communities. Interviews were conducted with a sample of 37 residents (nine male, 28 female) from three research sites - Mount Isa (three male, 17 female), Emerald (four male, seven female) and Moranbah (two male, four female). An exploratory qualitative approach was used within an Interpretative Phenomenological Analysis (IPA) framework. IPA provides a framework for the in-depth description and interpretation of how participants perceive and make sense of their experience within their community (J. A. Smith, Flowers, & Larkin, 2009; J. A. Smith & Osborn, 2008). Thematic analysis was conducted within the IPA framework to identify, analyse and report on patterns within the data (Braun & Clarke, 2006). The reported factors that influence general community wellbeing were reflected in the six forms of community capital and highlighted the interconnected relationships between the forms of community capital. Social capital elements were recognised as playing a key role in residents' perceptions of the community's wellbeing. Additionally, mining activity was perceived to have various impacts on mining communities. Although participants reported some positive impacts, participants more consistently identified mining activity's negative impact on community wellbeing. Again, social capital elements were identified as playing a key role in residents' perceptions towards the mining industry and the negative impacts of mining activity. Social capital elements need to be considered within sustainable community development as these social capital elements were reported as key determinants of community wellbeing. Building trusting and reciprocal relationships between general community members, and community leadership and industry stakeholders is key to facilitating sustainable community development.

Breaking bad news is one of the hardest tasks performed by doctors. The news can significantly impact on the patient's life; however, the process also generates stress for the doctor. The aim of this study was to explore the lived experiences of breaking bad news for obstetrics trainees in Ireland. A qualitative study using interpretative phenomenological analysis (IPA) was performed to capture the experience of breaking bad news for the trainees. Semi-structured interviews were conducted with trainees over Zoom. The transcripts were analysed in line with the IPA framework with the assistance of NVivo software. Seven trainees were interviewed, five at Basic Specialist Training (BST) level and two at Higher Specialist Training (HST) level. Four superordinate themes were identified from the analysis: "the reality of working in obstetrics," "the role of the doctor," "development of communication skills" and "the importance of the patient experience." The trainees described breaking bad news in a variety of clinical contexts. This task could be emotionally draining; however, only two trainees mentioned ways of coping with this. Their formal training was limited with the majority of learning occurring "on the job." This study provides an insight into factors that influence trainees experiences of breaking bad news. The results complemented existing literature and raised questions about how to better support trainees through increased training and psychological support.

Background: For many researchers, the focus of their work exploring the negative consequences of identifying as a gay man living with HIV has centred around stigma. Yet, over the past few years many have questioned whether the broad definition of stigma alone is able to explain the negative implications of identifying both as a sexual minority but also the impacts living with HIV. More recently, some authors have begun to question whether the emotion of shame is of more central concern. However, there has been little investigative research into shame in relation to sexuality or HIV status. Aims: Given the gaps within the literature, the study sought to explore whether shame was something experienced by gay men, and if so how they understood and experienced it in relation to both sexuality and HIV. The study also sought to investigate the impacts on both sense of self and relationships with others. Methods: Drawing on a hermeneutic phenomenological epistemology, this study adopted a qualitative, interpretative phenomenological approach to exploring the shame experiences of 10 gay men living with HIV. The men were all recruited from central London NHS HIV community services and participated in semi-structured interviews. Results: Five master themes were found across participant interviews 1) Sexuality: An Unacceptable Difference, 2) Managing an Unacceptable Self, 3) HIV: Rejection of the “Dirty” Self, 4) Negotiating a “Dirty” Identity, 5) Moving to a More Meaningful Self. Conclusion: Despite arguments of the increasing acceptance of alternative sexual identities and the normalisation of HIV, the participants in the study reported experiencing shame as a distressing, layered emotion in response to living with two highly stigmatising identities. These layered experiences of shame often resulted in a sense of the self as inferior in comparison to heteronormative ideals and a number of unwanted difficulties within interpersonal relationships. However, participants also reported their HIV diagnosis as providing some meaning but after several years of difficulty. Implications for clinical practice, policy and research are discussed.

Background and Aims: Research suggests that females with an Autism Spectrum Condition (ASC) face specific identity threats by not ‘fitting’ with societal representations of gender and ASC. Despite this little is understood about how females form an understanding of self and what mechanisms facilitate positive identity formation. This study draws upon novel methods to address this gap in the literature asking how do young females with an ASC understand themselves? And how does gender influence this self-understanding? Method: Eight females with ASC, aged 11-16years, participated in two semi-structured interviewed guided by a photo-elicitation task. Interpretative Phenomenological Analysis (IPA) was used to analyse participants’ accounts. Recruitment of an Expert Author, discussion with the research team and reflexive journals ensured credibility of the research findings. Results: IPA identified three superordinate themes; “I’m not like them”, “So who am I and Where do I fit?” and “I accept who I am” outlining the struggles participants’ faced in understanding themselves and how these were overcome. The themes were interpreted within an Identity Process Theory (IPT) framework. This showed that although some females navigated identity formation well, others faced multiple identity threats. To cope with these threats participants engaged in various strategies that negatively impacted their psychological wellbeing. Conclusions: The findings, facilitated by novel research methods, contribute to the growing field of ASC, gender and identity. Together they demonstrate the complexity of identity formation and highlight possible clinical interventions that may support this process. Future research could further explore what supports young females to develop a positive view of self and evaluate clinical interventions aimed at supporting this. Additional consideration could also be given to the protective role of alternate gender identities and the prevalence of gender dysphoria in ASC.

Transgender women bear a high burden of HIV in South Africa, and are not fully engaged in healthcare across the HIV continuum of care. The aim of this study was...

As globalisation increases more families than ever are relocating from their passport countries for periods of temporary employment overseas. This has resulted in an increasing number of young people being raised in overseas locations. These young people are collectively referred to as Third Culture Kids (TCK) their adult counterparts are Adult Third Culture Kids (ATCKs). They are different from immigrants, as they do not expect to permanently settle in the location in which they have been residing. This lack of permanence has been criticised for engendering a variety of difficulties that TCKs and ATCKs must face. Of interest to this study was the observation that TCKs experience various difficulties with their friend relationships. This is problematic, as friendship has been found to be crucial to indicators of well-being such as happiness, and longevity. An interpretative phenomenological analysis of Adult Third Culture Kids’ experiences of friendship was undertaken. Eight ATCKs from the UK, three men and five women, were interviewed using a semi-structured interview schedule. Analysis revealed that participants’ experience of friendship was situated in various themes. These included: the challenges of friendship; multiple identities in response to friendship; the psychological impact of friendship; and valued characteristics of friendship. Each theme was comprised of various subordinate themes that facilitated further understanding of the super ordinate theme. The findings were discussed with reference to the TCK literature and a wider review of psychological theory. Particular attention was given to the discussion of attachment theory, as this underscored several of the findings related to the Superordinate theme, the psychological impact of friendship; particularly the finding that ATCKs experience anxiety in friendships, report negative views of self and others and reveal a lack of strong attachments to their peers. In addition identity theory was also utilised in the discussion as the findings indicated a high salience of identity issues for ATCKs in relation to their friendship experiences, reflected in the theme, multiple identities in response to friendship. The implications for clinical practice were considered. These included suggestions for working with ATCKs who present with difficulties in their friend relationships, by exploring their history of loss, their anxiety about friend relationships and the meaning attached to becoming involved in peer relationships. Suggestions were also made for therapists to explore the ATCKs sense of self in terms of negative thoughts about self and other, including being ‘English/British’ or forming relationships with ‘English/British’ peers.

Internal isolation has become a mainstay of behaviour management across UK schools. However, despite the extensive use of isolation rooms/booths (IRBs), the supporting evidence-base for such measures remains scant. In contrast, there is growing concern about the impact such punitive spaces have on well-being. This study used the methodological framework of Interpretative Phenomenological Analysis (IPA) to explore how young people made meaning of their lived experiences of isolation rooms/booths (IRBs) in UK mainstream secondary schools through the lens of psychology. Unstructured interviews were conducted with five participants aged 11–18 with repeated experiences of spending time in IRBs. This article focuses on the superordinate theme ‘The Process’ (a restrictive process, the punishment, a process that separates). The findings highlight the impact of isolation on YP’s well-being and add to the evidence-base for further understanding IRBs, whilst questioning their appropriateness as a legitimate, psychologically safe sanction in schools.

Background Acquired Brain injury (ABI) causes ripples throughout the occupational and social fabric. It enters people’s lives at a significant personal cost, encroaching on people’s sense of self. Vocational rehabilitation is a viable venue to regain control of their life and support them in forming a new sense of self. From an occupational perspective, little is known about how vocational rehabilitation can support people through transforming their sense of self. Aim This study aims to explore how vocational rehabilitation may influence the relationship between sense of self and occupational engagement for persons with ABI. Material and Methods: Six persons with ABI were purposely sampled. Data were collected using semi-structured individual interviews and analysed using a hermeneutic approach. Results The analysis resulted in three themes: a new sense of my former self, engaging in occupations as transformation, and the significance of support. Conclusions Participating in vocational rehabilitation can enable persons with ABI to form a new sense of self. Engaging in occupations and professional support is significant in the transformation process. Significance From an occupational perspective, the knowledge gained in this study stresses the essential role occupational engagement and proper targeted support have for people struggling to return to work after ABI.

This paper deals with the question concerning the effects of the sense of self on agency, particularly the implications that a disharmonious sense of self can have for agency. Consciousness, as intimately connected with a sense of self has a unique status in being accessible both from a first-person and a third-person perspective. A study of self therefore requires phenomenological approaches as well as neurological, psychological or sociological ones. A promising approach to understanding how the sense of self affects agency is studying pathologies. Such studies support the view that both the sense and the conception of self as unified and as an initiator of agency are valued, while a sense of conflict or dissonance is avoided. The frequency with which confabulations occur in pathologies of self can be taken as an indicator that distortions of perception, memory and narration are considered a fair price to pay to counteract a sense of diffused self. The picture or narrative of the self that is thereby produced necessarily involves a sense of what the individual regards as good. However a strong urge to maintain an idealised, unified and stable picture of self and agency may involve the danger that mechanisms used against a diffusion of the self misrepresent both self and the other.

While foster carers experience the rewards and challenges of parenting vulnerable and complex adolescents, some of these placements break down. Compared to research into the impact of placement breakdown on looked after children, there are relatively limited reports on how foster carers are affected. The aim of the present study was to provide an exploratory account of foster carers’ lived experience of ending adolescent foster placements. Nine participants from seven foster families in the UK were recruited. Semi-structured interviews were conducted and analysed within an Interpretative Phenomenological Analysis (IPA) framework. Exploration of the foster carers’ experience identified four superordinate themes, two of which are relevant here: ‘emotional aftermath’ and ‘we’re only human’. Following a placement ending, foster carers identified different emotions including joy, relief and sadness. A grieving process was also identified, which involved coming to terms with loss and accepting the termination of the relationship. It is further suggested that foster carers are likely to experience shame and guilt as a consequence of placement breakdown.

Oral storytelling events for healthcare professionals are gaining in popularity, yet evaluation of these initiatives is scarce. We designed and assessed the impact of a hospital-wide storytelling event at an academic medical center in New England. This study was grounded in social constructivism, which posits that knowledge and collaborative meaning-making are socially constructed through interpersonal interactions and shared language. Stories were solicited from interdisciplinary staff on a theme, and six selected storytellers were paired with coaches. The hybrid in-person/virtual event was held in 2021. Attendees were invited to complete a post-event survey, as well as a semi-structured interview or written response. Storytellers were invited to reflect via a post-event focus group or written responses. Qualitative data were coded using a mixed inductive and deductive content analytic approach. Survey data were analyzed using descriptive statistics. The storytellers included representation from internal and emergency medicine, nursing, infrastructure project management, and research administration. The 155 attendees included 25 in-person/130 virtual. Qualitative data (nine participants) revealed that sharing stories fostered interpersonal connection and a sense of common humanity, enhanced by the storytellers’ vulnerability and diversity. Storytellers valued coaches’ emotional and creative support in co-creating stories with them. Lastly, the event was felt to strengthen the hospital community. These themes were echoed in the survey data (30 participants): > 75% of respondents indicated that the event helped them reflect on their values, connect with others, and access a sense of purpose. A multidisciplinary hospital-wide oral storytelling event is one way to enhance self-reflection, interpersonal connection, and a sense of community among healthcare professionals.

Introduction:Western societies are aging rapidly, and habitual use of alcohol is changing among older adults. Hence, care facilities are facing novel challenges regarding alcohol use. This pioneering qualitative study seeks to investigate the role of alcohol in care homes, as seen from the perspectives of residents, care workers, relatives, and institution management simultaneously.Method:Five residents, four care workers, three relatives, and two care home managers participated in semi-structured interviews lasting 60 minutes maximum. An interpretative phenomenological analysis framework were utilised for the analysis.Results:It seems that there is a positive attitude towards the use of alcohol in care homes across the four groups of participants. They find that the use of alcohol is presently low among the residents. Importantly there appears to be an important symbolic value in the rituals surrounding alcohol which is upheld by all four groups.Conclusion:While experiences between the four groups seem to converge regarding the use of alcohol, there are still some important differences. Importantly, we suggest that these unique views be utilised in developing methods for handling alcohol use in care homes in the future.

Investigating the level of glaucoma awareness and perception of its risk factors in Anambra State, Nigeria

Day care services for patients with dementia (PWD) are generally under-utilized worldwide despite evidence of positive outcomes, such as improved behavioral, psychological, and cognitive functioning for patients, and reduced caregiver burden. This study sought to gain an in-depth understanding of the reasons for non-utilization of day care services in Singapore using qualitative methodology. A purposive sample of 16 caregivers of PWD who had never attended day care services participated in semi-structured interviews. Interviews were audio-recorded and transcribed verbatim. Data analysis was based on an Interpretative Phenomenological Analysis framework. Caregivers recognized the importance of engagement for PWD, yet were constrained by patients' refusal to attend day care, which caregivers attributed to the patients' negative beliefs about day care and fear of abandonment by their families. Caregivers also raised concerns about service delivery issues, the suitability of activities at day care, and their perceptions of the patients' ability to integrate into the setting. Non-utilization was also related to caregivers' low perceived need due to the availability of alternative care arrangements (e.g. having a domestic helper and adequate family support). Caregivers generally understand the value of day care but several factors tip the balance in favor of non-use. These include culturally bound caregiving values and perceptions, and inadequacies in service delivery. Negative perceptions about services highlight the need to enhance the image and standards of day care and increase awareness of the benefits of day care for PWD beyond its custodial role.

Introduction: Globally, over-crowding within Emergency Departments is becoming a serious concern (Walker et al 2016) impacting on patient safety (Pines et al 2011) and work-related stress (The College of Emergency Medicine 2013; Lavoie et al 2011). One reason for over-crowding is that, in addition to treating urgent medical and surgical conditions, Emergency Departments act as the ‘front doors’ of hospitals, and people wait for admission to acute-care (Walker et al 2016), a process known as unscheduled care (The Royal College of General Practitioners 2011). Occupational therapists are well-placed to address some of the issues around unscheduled care (Mearns et al 2008). This is because they assess and treat people directly in the Emergency Department and determine whether a discharge directly home is feasible (Mearns et al 2008). The College of Occupational Therapists recently claimed that 70% of patients referred to occupational therapy in this way were discharged directly (College of Occupational Therapists 2016). This presentation claims a role for occupational therapists in Emergency Departments in terms of their potential to reduce over-crowding. It will report on the findings from two linked studies: - a critical review of the literature (James et al 2016) and a qualitative study (James et al 2016a). Methods: A systematic search was performed for occupational therapy in the Emergency Department using database platforms, internet search engines and grey sources. Critical analysis of each record was undertaken and synthesised. An Interpretative Phenomenological Analysis framework was applied to the qualitative study. Nine occupational therapists with experience of working in the Emergency Departments were recruited from across Scotland. Individual, semi-structured interviews were audio-recorded and transcribed verbatim. Interview transcripts were analysed line-by-line and interpreted using Interpretative Phenomenological Analysis methods. Results: The systematic search returned 23 potentially relevant papers of which 16 met the criteria for further inclusion and seven were critically analysed. Not all study sample sizes were small, but variable methodological quality meant current evidence can only be taken into professional practice with caution. Findings from the qualitative study led to two over-arching themes. Theme one captured the experience of occupational therapists working in Emergency Departments. Theme two encapsulated what it was like to enter and establish a new role. Discussion: There are good reasons why occupational therapists are well-placed to address issues of over crowding in the Emergency Department. However, based on current evidence, there can only be a limited understanding of its role and efficacy. There is a need for large-scale, well designed research studies of occupational therapy within emergency care.