Growing through art – adolescents’ experiences of the open studio in psychiatric care

This research project proposes a series of solutions to mitigate noise and improve speech intelligibility within an open architectural studio environment. Open studio environments pose a unique challenge compared to conventional open office environments. In addition to typical sources of noise found in open offices, such as conversation between co-workers, open studios contain noise generating equipment, such as plotters, 3-D printers and laser cutters. There is substantial research and evidence from the Finnish Institute of Occupational Health and AINS Group which conclude that different sources of noise in an open office environment hinder employee productivity. However, there is limited research that focuses on open architectural studio environments. Existing research regarding productivity, as it relates to acceptable noise level, will serve as a basis for application of Digitally Enhanced Sonic Enclosures (DESE) to mitigate noise within the open studio. Revit 2020, Rhinoceros 6 and Ease 4.4 will be utilized to analyze thesonic environment as it relates to noise and speech intelligibility in the CityLab Orlando design studio. Ultimately, this research offers an effective series of solutions, which can serve as architectural design guides to noise-related challenges in open studio environments.

Psychiatric day care is widely used in Japan, but adolescent-focused programs remain scarce, despite rising school absenteeism and suicide rates. Stigma toward mental illness and low continuity of care hinder engagement. Incorporating youth culture into therapeutic activities may improve participation. To describe an adolescent-oriented psychiatric day care program integrating youth culture and to examine attendance patterns, participant characteristics, and withdrawal reasons. In February 2024, 88 adolescents (46 male, 42 female; mostly early to mid-teens) participated. Fourteen (15.9%) attended regularly for over one year. High-attendance programs included Social Skills Training and Psychodrama, Cognitive Behavioral Therapy, Analog Art, and Digital Art. Digital Art attracted younger users, including those with chronic school refusal but no diagnosis, while Analog Games were popular among participants with autism spectrum disorder, social anxiety disorder, or selective mutism. Lower-attendance programs included Acceptance and Commitment Therapy, Dance, Sports, Yoga, and Short Video Production. Reasons for withdrawal included relocation, return to school, transition to other services, symptom improvement, and loss of interest. Notably, some culturally relevant activities (Dance, Short Video Production) had low attendance, indicating that popularity alone does not ensure engagement. Integrating youth culture into adolescent psychiatric day care can enhance engagement, particularly when paired with structured therapeutic approaches. Program design should account for participants' cognitive, emotional, and practical needs to sustain involvement. Further research should evaluate long-term outcomes and adapt such models for diverse cultural and healthcare settings.

To explore how information concerning ICU patients´ families is included in the ICU clinicians' daily handover. Handover refers to the transfer of information and care responsibility between clinicians. An effective and precise handover are of great importance to ensure quality of care. Although improvements in handovers have received increasing attention in recent decades, little is known about how information about ICU patients' family members is included in handovers. A qualitative study using Charmaz' constructivist grounded theory approach. Data were gathered through participant observation, focus groups, dyadic and individual interviews of physicians and nurses from four ICUs in different Norwegian hospitals. The data consist of 270 observation hours, seven focus groups, three dyadic interviews and two individual interviews. Field notes and transcribed interview data were analysed using constructivist grounded theory approach. COREQ checklist was applied as reporting guideline for this study. "A game of whispers" emerged as the core category, representing missing information about the patient's family during the handover. Together with three subcategories: "documentation dilemmas," "being updated" and "talking together," the core category explains how transfer of family-related information between clinicians is continually processed and resolved. This study indicates challenges related to appropriate and high-quality handover concerning ICU patients´ families. Oral handovers are essential in terms of clinicians' need to elaborate on written information and update each other. However, oral transmission involves a high risk of information loss during the handover. Written documentation about the family seems to be inadequate and poorly structured. The study findings suggest a need for increased awareness in practice and research of the importance of transferring appropriate and reliable information about patients' families between ICU clinicians. User-friendly handover tools and patient records that include information on patients' family members should be developed.

This chapter explores the historical roots of the open studio in art therapy, modern uses, one program’s approach to a campus-based open studio, and the shift to a virtual platform following the closure of the community studio space. Included is a summary of a six-week closed group in the virtual open studio for wellness at Edinboro University of Pennsylvania.

Objective: The objective of the present study is to describe the process of building closer patient-nurse relationships in child and adolescent psychiatric inpatient care. Nurses play important roles in psychiatric inpatient care for children and adolescents, and their care can affect every facet of their daily life. The efficacy of treatment depends on the nurses’ ability to build intimate patientnurse relationships. Methods: A qualitative methodology, based on the tenets of grounded theory approach, was taken. Semi-structured in-depth interviews were conducted with 18 expert nurses and analyzed using a constant comparative method. Results: ‘Developing emotional attachment’ was identified as the core category, substantiated by four interrelated stages: ‘Becoming a target of attachment’; ‘Forming an attachment’; ‘Expanding the target of attachment’; and ‘Preparing to be a target of attachment’. We found that in developing emotional attachments with inpatient children or adolescents, expert nurses achieved a balance between appropriate psychological distance from - and their own increased attachment to - those inpatients. Conclusions: The “expert” nurses become a target of attachment for their patients and then successfully extend that to other nurses during professional nursing intervention.

BackgroundImmigration is not a new phenomenon but, rather, has deep roots in human history. Documents from every era detail individuals who left their homelands and struggled to reestablish their lives in other countries. The aim of this study was to explore and understand the experience of Iranian immigrants who accessed Canadian health care services. Research with immigrants is useful for learning about strategies that newcomers develop to access health care services.MethodsThe research question guiding this study was, “What are the processes by which Iranian immigrants learn to access health care services in Canada?” To answer the question, a constructivist grounded theory approach was applied. Initially, unstructured interviews were conducted with 17 participants (11 women and six men) who were adults (at least 18 years old) and had immigrated to Canada within the past 15 years. Eight participants took part in a second interview, and four participants took part in a third interview.ResultsUsing a constructivist grounded theory approach, “tackling the stumbling blocks of access” emerged as the core category. The basic social process (BSP), becoming self-sufficient, was a transitional process and had five stages: becoming a stranger; feeling helpless; navigating/seeking information; employing strategies; and becoming integrated and self-sufficient. We found that “tackling the stumbling blocks of access” was the main struggle throughout this journey. Some of the immigrants were able to overcome these challenges and became proficient in accessing health care services, but others were unable to make the necessary changes and thus stayed in earlier stages/phases of transition, and sometimes returned to their country of origin.ConclusionDuring the course of this journey a substantive grounded theory was developed that revealed the challenges and issues confronted by this particular group of immigrants. This process explains why some Iranian immigrants are able to access Canadian health care effectively while others cannot. Many elements, including language proficiency, cultural differences, education, previous experiences, financial status, age, knowledge of the host country’s health care services, and insider and outsider resources work synergistically in helping immigrants to access health care services effectively and appropriately.

Design studio courses take place at the core of education disciplinary design such as architecture and interior architecture. Studios in which design studio courses are conducted can also be used for other practical courses as well. Another important feature of these studios is that they are extensively used by students for individual or group work other than during class hours. Since the students, either on their own or with the project coordinator, experience design process in these studios, their spatial characteristics are highly significant to conduct this process effectively. Within this scope, the aim of the research is to evaluate open and cell type studios commonly used in traditional architecture education through Post-occupancy evaluation (POE) approach, to discuss to what extent these studios meet the spatial requirements of today’s instructional methods and to develop a suggestion for design studio spatial use by taking the strengths and weaknesses of these studios. Accordingly, technical, physical and behavioral variables determining the performance of design studios within the context of spatial requirements have been identified through reviewing the related literature. In framework of a case study, a survey formed with the aforementioned variables was administered to architecture and interior architecture students studying in open and cell type design studios in order to measure their spatial performance. Followingly, in the final part of the study, referring to survey results and evaluation of spatial requirements of today’s instructional methods and tools, a combi design studio space organization has been suggested.

To explore how healthcare professionals in an acute medical setting make decisions when managing the care of patients diagnosed with end stage heart failure, and how these decisions impact directly on the patient's end of life experience. A constructivist grounded theory approach was adopted. A purposive sample was used to recruit participants that included 16 registered nurses, 15 doctors and 16 patients. Data were collected using semi-structured interviews and focus groups over a 12-month period of fieldwork concluding in 2017. The interviews were recorded and transcribed and the data were analysed using constant comparison and QSR NVivo. Four theoretical categories emerged from the data to explain how healthcare professionals and patients negotiated the process of decision making when considering end of life care. These were: signposting symptoms, organizing care, being informed and recognizing dying. The themes revolved around a core category 'a vicious cycle of heart failure care'. Healthcare professionals need to engage in informed decision making with patients to break this 'vicious cycle of care' by identifying key stages in the terminal phase of heart failure and correctly signposting the patient to the most suitable healthcare care professional for intervention. This study provides a theoretical framework to explain a 'vicious cycle of care' for patients diagnosed with end stage heart failure. This theory grounded in data demonstrates the need for both acute and primary care to design an integrative end of life care pathway for heart failure patients which addresses the need for early shared decision making between the healthcare professional, family and the patient when it comes to end of life conversations.

“Architectural design studio” class constitutes the basis of architectural education. In Istanbul Technical University Faculty of Architecture, architectural design studios are categorized into two types in terms of spatial use: “open design studios” and “cell-type design studios”. This study primarily aims to determine the physical characteristics of both studio types as learning environments where the “design process” takes place in architectural education, as well as investigating the studio space with its sub-components. Second, it aims to cross-examine the relation of communication and interaction between students and the tutor to the physical characteristics of the architectural studio space. Finally, the study attempts to examine various effects of different physical characteristics pertaining to “open” and “cell-type design studios” on both positive and negative behavior patterns among students. To this purpose, the study includes a survey on user experiences in design studios. The findings of the survey are expected to be useful for determining the design of architectural design studios.

Objective: The aim of this study was to construct a grounded theory regarding patients' activity behaviour over time after referral to an outpatient clinic for diabetic foot ulcer (DFU) care. Method: A constructivist grounded theory approach was used. Data from observations of and interviews with participants were collected and analysed using the constant comparative method. Based on this, the grounded theory ‘Just a bump in the road’ was constructed. Results: The cohort included five participants who considered their ulcers as ‘Just a bump in the road’ in their lives, and four subcategories were embedded in this core category: ‘Restricting my freedom’; ‘Trusting or doubting the system’; ‘Feeling no pain or illness’; and ‘Receiving insufficient information’. Together, these categories describe the participants' behaviour and underlying concerns related to daily activities after referral to an outpatient clinic for the care of their DFU. Conclusion: The grounded theory ‘Just a bump in the road’ describes how participants with a DFU viewed their condition as merely a passing phase that would end with them regaining what they considered a normal life. Integrating these results into clinical practice could lead to improved care and a focus shift among health professionals from viewing patients as being defined by their wounds to seeing them as people who live with a wound.

A year and a half later: Clinical experiences of intern nursing students in the COVID-19 Pandemic: A constructivist grounded theory

BackgroundPediatric obesity is a major public health concern worldwide. In Saudi Arabia, school nurses can play a pivotal role in prevention, yet their practices are influenced by multiple contextual factors. This study explored the factors shaping school nurses’ attitudes and behaviors toward pediatric obesity prevention.MethodsA constructivist grounded theory approach was used. Semi-structured interviews were conducted with 11 school nurses working in private primary schools in Saudi Arabia. Data were analyzed using Charmaz’s process, with theoretical sampling to refine emerging categories. A focus group with three experts was conducted to confirm and validate the generated theory.ResultsEleven participants contributed to the analysis. Three categories (Struggling, Avoiding, and Competing Priorities) and one core category (Lacking Support) emerged to collectively represent the social process, Jumping Hurdles: A Pathway to Professional Growth.ConclusionsThis substantive theoretical model advances understanding of the factors shaping school nurses’ roles in pediatric obesity prevention in Saudi Arabia. Findings highlight the need for actionable policies and school-level support to strengthen nurses’ contributions. For policymakers and school administrators, investing in structural support, targeted training, and resource allocation may enhance nurses’ capacity to engage effectively in obesity prevention and ultimately improve student health outcomes.Supplementary InformationThe online version contains supplementary material available at 10.1186/s12912-025-04021-9.

The objective of this dissertation is to explore the meanings of knowledge as understood by senior medical staff in the UK’s National Health Service. It asks the question: 'What does it mean to know something?' The assumption is that an exploration of these meanings will help in designing systems to manage such knowledge. This is because the meaning of knowledge in the literature is contested and the models for its management are extremely variable, to the extent that it is proving challenging to establish knowledge management as an academic discipline or credible business tool. Twelve in-depth interviews were completed and analysed using a constructivist grounded theory approach. Six main categories were constructed. These are: finding motivating factors to pursue knowledge; interacting with knowledge sources; undergoing a process of knowledge acquisition; practising skills; seeking peers’ views; and, finally, building confidence as knowledge. Confidence was selected as the core category and the backbone of the constructed theory. The constructed theory argues that confidence is an important, integral aspect of our knowledge. One knows something if one thinks confidently that one knows it. Someone who understands a subject very well but lacks confidence simply does not know that subject. On the other hand, people can be overconfident or possess completely unjustified, misplaced confidence in situations where they lack understanding or ability. According to the emergent theory, these individuals are still knowledgeable, albeit in an incorrect or negative way. The emergent theory provides a new understanding of the concept of knowledge: knowledge as a type of emotion, i.e. confidence. This differs from the current understanding of knowledge, which views it as either objective information that requires cognitive processing or as human behaviour that influences practice. According to the emergent theory, knowledge is not necessarily a logical mental process nor purposeful human behaviour, but a fallible emotion, which can be harder to measure, observe or control than the two former phenomena. Confidence is an essential feature of knowledge and this thesis concludes by proposing a tool for confidence management within the NHS.

Based on in-depth interviews with 15 physicians on long-term sick leave in the north of Sweden, the aim of this paper is to describe and understand what happened before, during and after sick leave. A constructivist grounded theory approach was used to construct a framework inductively from the stories of the physicians. As a result of hierarchical coding procedures in terms of initial, focused and theoretical coding, the circular or helical road back to well-being was constructed. This core category, formed in response to structure and to the culture of the medical profession, is constituted of five categories, including dealing with changing working conditions, resisting sick and patient role, resisting sick leave, spending time on sick leave and, finally, returning to work. Not only were the physicians expected to work very hard, but also they were expected to take charge, and did take charge, of their own treatment and rehabilitation. They reinforced these phenomena, by employing strategies to deal with high workload and to avoid sick leave. None of them later returned to full-time work. Notwithstanding that, some aspects of the culture of the medical profession are destructive; in this case, it promoted a strong will and motivation to return to work.

Navigating Uncertainty in Serious Illness: A Grounded Theory of Palliative Care Consultation in Nursing Homes.