Adequate Resources Research Articles

Strategies to promote the completion of patient-reported outcome measures by culturally and linguistically diverse and Indigenous Peoples in clinical care settings: A systematic review.

There is evidence of low completion of patient-reported outcome measures (PROMs) by people from culturally and linguistically diverse (CALD) backgrounds and Indigenous Peoples with chronic health conditions. We aimed to systematically identify ways to support and promote PROM completion by CALD communities and Indigenous Peoples in clinical care settings. We searched Medline, Embase, Scopus, Web of Science Core Collections and CINAHL databases from 1 January 2000 to 19 September 2024. Primary studies were included if they focused on ways to support and promote PROM completion in the care of CALD and Indigenous populations in clinical care settings. The quality of the included papers was appraised independently by two reviewers, using the Critical Appraisal Skills Programme (CASP) and Mixed Methods Appraisal Tool (MMAT). Data were analysed thematically. PROSPERO registration: CRD42023469317. Of 13,450 title/abstracts retrieved, five papers met eligibility. Strategies to promote PROM completion by Indigenous Peoples included (1) providing training to patients about what PROMs are (2) offering verbal modes of completion and (3) community consultation during design, development, and implementation of PROMs to ensure culturally appropriate and sensitive PROMs are used. Strategies to promote completion by people who are CALD included (1) providing information about how to use electronic PROMs, (2) facilitating self-completion, (3) offering different modes of completion (paper-based, digital), (4) increasing availability of culturally and linguistically appropriate PROM translations, and (5) system-wide financial and administrative support to use translated PROMs. Few studies reported strategies to support the completion of PROMs by people from CALD backgrounds and/or Indigenous Peoples. Adequate training, planning (including community consultation), resourcing, and financial support are required to encourage people who are CALD and Indigenous Peoples to participate in PROM initiatives globally.

Unraveling the impact of social media involvement on public health participation in China: mediating roles of social support, social trust, and social responsibility

Public health participation plays a significant role in reducing risks and protecting community members during public health emergencies, especially in China due to its pronounced population density and the imperative for concerted public coordination to achieve the goal of public health protection. Guided by social capital theory and conservation of resources theory, this study develops an analytical model to explore the effect of social media involvement on public health participation mediated by social support, social trust and social responsibility. A cross-sectional survey was executed and a total of 976 completed questionnaires were collected. Results reveal that (a) social media involvement positively predicts social trust, social support and social responsibility; (b) social trust and social support have positive influence on social responsibility and public health participation; (c) further analysis of the data confirms a two-step mediation model: social support and social trust mediate the effect of social media involvement on social responsibility; social responsibility further mediates the relationship between social media involvement, social trust and social support and the outcome variable public health participation. Findings suggest that only in a society with adequate social resources will people take an active part in social actions for common interests. The study extends our understanding of the vital role of social media in maintaining and growing social resources for community health goals.

How long does it take to start minimal enteral feeding in preterm Neonates admitted to NICUs in Southern Oromia, Ethiopia?

BackgroundThe timely initiation of trophic feeding (TF) is crucial for premature newborns, but challenging due to immaturity, respiratory instability, abdominal distension, resource scarcity, and healthcare worker expertise. Moreover, there is a dearth of information on predictors of full trophic feeding time. Therefore, this retrospective cohort study aimed to investigate the time it takes and its predictors to initiate minimal enteral feeding in preterm neonates in Southern Oromia, Ethiopia.MethodA facility-based retrospective follow up study was conducted among 434 randomly selected preterm neonates admitted to NICU of Bule Hora University Teaching Hospital and Yabello General Hospital from January 1, 2021 to December 30, 2022. Data were extracted by a pretested structured checklist, entered into Epidata 3.1 and then transferred to Stata version 17 for analysis. Kaplan Meier survival curve and log rank test were used to estimate survival time and a statistical comparison respectively. Bivariable and multivariable cox proportional hazard model was fitted to identify predictors of time to initiate TF and their outputs are presented using Adjusted Hazard Ratio (AHR) with 95% Confidence Intervals (CIs).ResultThe overall incidence density of TF initiation was reported as 43.6 per 100 neonate-days. Moreover, the median (IQR) time to initiate TF was found to be 2 (1–4) days. Neonates delivered vaginally had a higher likelihood of early TF initiation (AHR: 1.64, CI: 1.26, 2.13), while those born between 32 and 34 weeks (AHR: 0.61, CI: 0.46, 0.81), VLBW neonates (AHR: 0.45, CI: 0.34, 0.60), neonates without KMC (AHR: 0.59, CI: 0.46, 0.79), and those in level II hospitals were less likely to start TF promptly (AHR: 0.78, CI: 0.62, 0.99). Furthermore, neonates with sepsis (AHR: 1.76, CI: 1.36, 2.28) and hypothermia (AHR: 1.51, CI: 1.19, 1.93) had delayed TF initiation.ConclusionWe observed a significant low rate of early TF initiation and higher death rate of preterm newborn in our study as compared to the global. Preterm neonates with lower GA, no KMC, and a VLBW are more likely to have a delayed initiation. Our results highlight that staff training on identifying neonates suitable for TF, and ensuring adequate resources for KMC in all NICU levels should be considered.

A Process Evaluation Revealed That Flexibility Was Key to Delivering Nutrition Education to Vulnerable Tribal Groups in India.

This study is a process evaluation of a nutrition education intervention that is part of a large-scale development program targeting vulnerable tribal groups in Odisha, India. The objectives are to examine whether the intervention is operating as planned (implementation fidelity), investigate potential pathways to achieve greater impact, and provide recommendations on how to design nutrition education interventions in similar contexts. A program impact pathway forms the basis of this process evaluation, tracing inputs, processes, outputs, outcomes, and impacts. The study's mixed-methods approach includes semistructured interviews, focus group discussions, and Process Net-Mapping. Narrative analysis was applied to examine the transcripts. Data were analyzed in the context of the program impact pathway. The intervention was not delivered as intended (low implementation fidelity). Flexibility was key in providing nutrition education to beneficiaries despite challenges, such as the inability to utilize behavior change communication, inadequate funding, and language and cultural barriers. Despite low fidelity, the qualitative results show that the intervention improved awareness of nutrition and health among beneficiaries. Providing adequate resources for training frontline workers and beneficiaries is required for nutrition education programs to achieve their desired effectiveness and impact. Utilizing existing organizations, integration into production-based interventions, and incorporating easy-to-understand nutrition models, practical demonstrations, and videos would increase frontline worker and beneficiary engagement and understanding, leading to improved maternal and child nutritional and health outcomes.

Climate-fuelled disasters and perinatal health: the catch 22 when undertaking research within an under-resourced health sector

Background Climate-fuelled disasters are increasing in frequency and duration, with impacts known to disproportionately affect vulnerable populations, such as perinatal women and young families. Local healthcare workforce engagement into planning responses is required to ensure improved healthcare for these populations. One important component of perinatal care in Australia occurs through the maternal and child health nurses (MCHN). Attempted research engagement with the maternal child health nurse sector regarding the impact of disasters on the care of perinatal women during times of disaster has encountered structural barriers. Aim To understand the structural barriers that impact the research engagement of rural MCHN particularly during times of disasters. Methods A facilitated focus group with semi-structured questions was conducted with five participant-researchers. The focus group discussion underwent reflexive thematic analysis. Results Identified themes were Rationale for Research into Care of Families in the Perinatal Period, Perinatal Health and Service Provision and The Overlay of Disasters. An overarching fourth theme Implications for future Research identified elements that may improve the research engagement of primary healthcare staff, including MCHN. Conclusion There is a need to overcome structural challenges to MCHN engagement in meaningful research around the impacts of multiple disasters. Appropriate research design, including utilising co-design, adequate resourcing, and planned and considered participant communication may help to improve participant engagement for this important research. With improved sector engagement, the ongoing care of perinatal women in the current environment of multiple and compounding climate-fuelled disasters will be improved.

An evaluation of the severe acute respiratory infection surveillance system in Ireland

BackgroundExpansion of the current single hospital site Severe Acute Respiratory Infection (SARI) surveillance programme in Ireland, to create a SARI sentinel hospital network, commenced in 2023. This evaluation aimed to assess the performance of key surveillance system attributes to improve and guide expansion.MethodsA mixed quantitative and qualitative evaluation was conducted from September 2021 to November 2022 using European Centre for Disease Prevention and Control (ECDC) guidance as a framework. SARI surveillance data were analysed to assess completeness and timeliness. Semi-structured focus group discussions and key informant interviews and an online stakeholder questionnaire, evaluated usefulness, simplicity, flexibility and acceptability. Qualitative data were analysed using thematic analysis.ResultsCompleteness of key variables including age and outcome was 100% (n = 747). COVID-19 vaccination status was completed in 89%, completeness of ethnicity data was only 0.6%. Median time from hospitalisation to commencement of data entry was one day (IQR 1–3). Time to receipt of whole genome sequencing (WGS) results was 40 days (IQR 30–61). Themes identified in the qualitative evaluation were the complexity of SARI surveillance, dependence on key individuals and skilled staff. Suggested areas for improvement included process automation and additional resources to improve timeliness and acceptability, particularly during epidemic or pandemic surge periods.ConclusionsThe SARI surveillance system reports complete and timely data. However, improvement in the timeliness of WGS data and recording of vaccination status and equity stratifiers e.g. ethnicity, would strengthen data quality. Priorities for expansion include process automation and adequate resource allocation, to enable reliable SARI surveillance at all times.

Psilocybin mushroom stewardship: A qualitative inquiry into practices and priorities of “underground” psilocybin mushroom practitioners

AbstractBackground and AimsNetworks of so-called underground, or illegal, psilocybin mushroom practitioners are popularly known to exist, though few systematic investigations of their practices have been conducted. We sought to uncover the experiences of a hidden community of psilocybin practitioners in order to inform scientific and policy dialogues about safe and effective practices in this area.MethodsAn academic-community partnered research team used snowball sampling to recruit 17 underground psilocybin practitioners in a western U.S. state for in-depth individual interviews focused on training, protocols, practices, and policy priorities. Combined deductive and inductive analysis with three independent coders was completed using NVivo v12.ResultsPractitioners were white (76.5%), female-identified (64.7%), aged 31 to 50 (64.7%), non-therapists by training (58.8%), and moderately to highly experienced facilitators. All described multiple years of often difficult personal inner-directed work with psilocybin before guiding others. Benefits ranged from reduction in symptoms of depression, obsessive-compulsive disorder, and addictions to greater self-knowledge, reduced death anxiety, and a greater ability to experience joy. Client screening protocols revealed precautions for persons with severe trauma backgrounds, personality disorders, or lacking social support. Moving too quickly into a high dose mushroom session without adequate preparation or internal resourcing was perceived as a significant risk for harm. Practitioners' direct personal relationship with mushrooms was highlighted as critical to safe practice. Policy priorities centered on respectful reciprocity, defined as an ethos of giving back rather than extraction, and equitable access.ConclusionsWhile some psychedelic research actively examines the role of the mystical-type experience in clients' positive outcomes, findings from underground practitioners suggest an even greater role of mysticism, relationality, and expanded concepts of holistic healing that can inform the development of best practice paradigms of an emerging profession.

The role of adhocracy culture in open innovation in SMEs

Purpose Studies have demonstrated the role of organizational culture on innovative performance. However, there is limited focus on the role of adhocracy culture in facilitating open innovation in organizations, especially in small and medium enterprises (SMEs) that are constrained by a lack of adequate resources, making them dependent on dynamic innovative culture such as adhocracy culture. Design/methodology/approach This study used a quantitative methodology, using both exploratory and descriptive methods. Five hundred manufacturing SMEs in Jordan were chosen through systemic random sampling from a registered list of 2,310 manufacturing SMEs. A questionnaire was used as the study’s instrument on these SMEs. In sum, 335 responses (67%) were considered suitable for analysis. Findings This paper supports the previous studies that suggest that the success of open innovation rests largely on creating an effective organizational culture (e.g., adhocracy culture). However, this paper indicates the positive influence of adhocracy culture on the features of open innovation (i.e., inbound innovation, outbound innovation). Originality/value This study contributes to the literature by emphasizing the organizational elements that encourage open innovation in SMEs. It also provides empirical knowledge of a research model that offers SME stakeholders a cost-effective driver for open innovation activities by transforming intangible resources such as organizational culture, namely, adhocracy culture, to boost the competitiveness of their SMEs.

Comparative Study of Common Core Curriculum Implementation in Urban and Rural Basic Schools in Ghana: Unveiling the Integration of Global Citizenship Education

AbstractThis study examined stakeholders' perspectives on the integration of Global Citizenship Education (GCE) into the Common Core Curriculum (CCC) in urban and rural basic schools in Ghana. A quantitative research approach was adopted and data was collected from 460 participants through a structured questionnaire. The analysis employed t-tests, ANOVA and Fisher’s F-tests to interpret the findings. The t-tests revealed significant differences in collaborative learning (t (458) = 3.008, p = 0.003), competency-based assessment opportunities (t (458) = -2.461, p = 0.014), and stakeholder engagement (t (458) = -2.087, p = 0.037), all favouring urban contexts. To test for variance differences, Fisher’s F-tests indicated significant disparities, such as in critical thinking and problem-solving skills (F (212, 246) = 2.215, p < 0.0001) and interpersonal skills (F (212, 246) = 0.029, p < 0.0001), reflecting urban schools' advantage due to greater resource availability and support systems. The study concludes that, although the CCC aims to standardize educational quality, rural settings face significant limitations in its effective implementation. It was recommended that adequate resources, enhanced teacher training, and context-sensitive policies should be provided to rural schools to promote equitable educational outcomes and ensure that the curriculum meets diverse educational needs across Ghana.

Implementasi Program Bantuan Keuangan Khusus Desa Untuk Pemberdayaan Bum Desa Dari Provinsi Jawa Timur Di Kabupaten Kediri

The East Java Provincial Government through the Community and Village Empowerment Service has launched the Special Financial Assistance (BKK) Village Program for the Empowerment of Village-Owned Enterprises (BUM Desa), which is in the form of capital participation for the development of business units managed by BUM Desa. In Kediri Regency, there are 6 villages that receive this capital assistance for the development of BUM Desa. This program aims to encourage village economic growth, provide additional capital for the development of BUM Desa, and increase the institutional capacity of BUM Desa. This is done because many BUM Desa in Kediri Regency still lack adequate human resources to manage their business units optimally. This study aims to determine the implementation of the special village financial assistance program for the empowerment of BUM Desa in Kediri Regency. Data collection techniques used in this study include interviews and relevant literature reviews. Through these techniques, this study can identify supporting and inhibiting factors for program implementation. In this study, the theory of Van Meter and Van Horn (1975) was used, which includes six variables, namely standards and targets, resources, characteristics of implementing organizations, inter-organizational communication, implementing attitudes, and the social, economic, and political environment. The results of the study indicate that the implementation of the special village financial assistance program for empowering BUM Desa in Kediri Regency is still not optimal. This is due to the limited human resources owned by BUM Desa to manage business units optimally, as well as the many rules in implementing the program that make BUM Desa administrators feel difficult, especially in terms of administration

Supporting Primary Care for Medically and Socially Complex Patients in Medicaid Managed Care

In 2023, the Massachusetts Medicaid and Children's Health Insurance Program (MassHealth) required accountable care organizations (ACOs) to increase payments to primary care practices and shift to monthly payments, currently calibrated to historical revenues and enhanced practice capabilities, such as being staffed to address behavioral health needs. To prevent rewarding practices for avoiding difficult patients, future payments to primary care practices should reflect their patients' apparent need. To describe MassHealth's initiative and a complexity-adjusted payment model. This cross-sectional study of payment model development and performance was conducted between February 2022 and November 2024. Participants included all 2019 Massachusetts Medicaid managed-care eligible members who were enrolled for 183 days or longer. Medical and social complexity. For each member, the primary care activity level (PCAL) outcome proxies the resources that primary care clinicians need to provide comprehensive, coordinated care. Models were evaluated via R2 and through ratios of observed-to-expected (ie, estimated by the model) outcomes for selected subgroups, which will be approximately 1.0 when payments and expected costs are well matched. The implications of paying practices using PCAL (vs a model based only on age and sex) were explored by examining financial and practice-level characteristics in high and low deciles of practice-level estimated mean. Among 1 092 742 MassHealth members enrolled in 3602 primary care practices (1 014 252 person-years; mean [SD] age, 25.9 [18.4] years; 538 065 [53.1%] female), the PCAL model achieved R2 = 69.6% and estimates within 10% of observed PCAL spending for high-risk populations (mental health disorders, substance use disorders, complex chronic conditions, and disabilities) and across racial and ethnic groups. Age-adjusted and sex-adjusted payments would overpay practices in the lowest-need decile by 10% and underpay those in the highest-need decile by 34%, while the PCAL model would match payment to estimated need almost exactly in the lowest decile and underpay by just 6% in the highest decile. MassHealth's 2023 reform invests in primary care. This cross-sectional study developed a risk model that can adjust primary care payments to patient needs. Neither age and sex adjustments nor inflated historical payments would provide adequate resources to primary care practices caring for the most complex patients.

Role of Technology Integration in the Development of 21st-Century Skills STEM University in Zimbabwe

Technology use is crucial and fundamentally alters how universities teach and learn in the twenty-first century. The influx of various technologies supports the development of three key 21st-century skills: life and career skills, learning and innovation skills, and information, media, and technology skills. Social constructivism theory serves as the study’s theoretical foundation, emphasizing the importance of collaborative learning environments where students construct knowledge through social interaction. A case study design and a qualitative methodology were employed in the investigation to gain deep insights into the experiences of participants. Those involved in the study included STEM lecturers, faculty technicians, and both first- and final-year undergraduate students; they were chosen using a purposeful sampling procedure to ensure a rich variety of perspectives. Data were collected through in-depth interviews, which provided valuable qualitative insights. The paper explores the 21st-century skills essential for STEM learning, focusing on the implications, competencies, and perceptions of various stakeholders. The study established a pressing need for training in technology integration among faculty. Additionally, there was minimal support from administration and technicians, as well as a lack of adequate resources. Participants expressed the need for ample time to prepare for lessons, highlighting the challenges educators face. Consequently, it is recommended that the implementation of technologies should begin with strong support from administrators and technicians in sourcing necessary resources. Lecturers play a crucial role in preparing students for the modern workplace, and they require continuous training and support from technicians. Furthermore, administrators should foster collaboration with other STEM-offering universities to stay current with rapidly evolving technologies, ensuring a comprehensive approach to education in the digital age. This collaboration can significantly enhance the educational quality and effectiveness of STEM programs.

Improving Students’ Economic Learning Outcomes through Problem-Based Learning Methods

This study aims to evaluate the effectiveness of the problem-based learning method (PBL) in improving student learning outcomes in economics subjects at SMA Negeri 15 Palembang. The research method used was a quasi-experimental with a non-equivalent control group design, involving two classes of XI IPS selected as the experimental and control groups. The experimental group received economics learning with the PBL method, while the control group used conventional learning methods. Data were collected through learning outcome tests (pre-test and post-test) and analyzed using paired sample t-tests and independent sample t-tests to determine significant differences in learning outcomes between the two groups. The results showed that there was a significant increase in the learning outcomes of the experimental group compared to the control group. The average post-test score in the experimental group was higher than in the control group, indicating that the PBL method is effective in improving students’ understanding and critical thinking skills in economics material. In addition, observations during learning showed that the PBL method increased students’ active involvement in group discussions and problem-solving processes. This study concludes that the PBL method is an effective approach to improve students’ economic learning outcomes and can be used as an alternative learning method in the school curriculum. Recommendations are given for teachers to receive training to implement PBL optimally, as well as support from the school in providing adequate resources. The implication of this study is that PBL not only improves academic learning outcomes but also students’ collaborative and independent skills, which are important to face the challenges of 21st-century education.

Teachers’ perceptions: What happened after more than 10 years of developing the mathematics textbook

This qualitative study describes teachers’ perceptions of a mathematics textbook after more than a decade of developments in Saudi textbooks, including introducing English terms into Arabic textbooks. The sample of this study was 14 mathematics teachers at the high school level. The analysis of teachers’ interviews allowed the researcher to develop a deep understanding of the perceptions of fundamental changes in mathematics education. The findings expose the concerns of teachers regarding resource adequacy in light of the modern learning style that considers students as the center of the education process, and language issues in connection with textbook comprehensibility. These findings indicate that the Saudi Ministry of Education and leaders in mathematics education should focus on all elements of constructive alignment if they seek to meet the targets set to reform mathematics education.

Effective Waste Management in Urban Centres in South Sudan

Purpose: The objective of this study was to assess effective solid waste management in urban centres in South Sudan with special reference to Juba City Council. This included the types of solid waste generated, solid waste management practices and factors hindering effective solid waste management in relation to population growth and behavior. Methodology: The study used random sampling technique to determine a sample size of 200 respondents who were versed or partly versed with the subject in question. This included the Ministry of environment officials, City council waste management directorate, Members of parliament and the residents of Juba city council. Qualitative data was obtained from interviews using interview guides which were coded, interpreted. Further data was analyzed to give it a broader and more meaningful picture of the sample. Findings: The study findings revealed that paper and carton, yard trimmings, food, scraps, wood, glass, plastics, metal and clothes were the types of solid waste generated within the urban centres in South Sudan. The study further revealed that urban population growth significantly affects solid waste management in Juba city and poses the challenges of solid waste segregation since the waste is indiscriminately disposed of. In addition, insufficient funding led to inadequate provision of facilities and equipment for solid waste management coupled with inadequate enforcement of public health legislations and solid waste management by-laws. Unique Contribution to Theory, Policy and Practice: The study therefore recommended the use of integrated solid waste management, adequate resourcing, law enforcement and strengthening of the capacity of the Juba City/Municipal/urban councils’ policies and regulations.

The Role of Community Health Cadres in Reducing Stunting Cases in Ciliang Village, Pangandaran Regency, West Java Province

Stunting is a significant public health concern in Indonesia, particularly in rural areas like Pangandaran Regency. This study investigates the role of Community Health Cadres (CHCs) in reducing stunting in Ciliang Village, Pangandaran Regency, West Java Province. Employing a qualitative case study approach, the research involved in-depth interviews with 50 CHCs and data collection from 200 households with children under five. The study found that CHCs played a crucial role in improving nutritional knowledge among parents, promoting balanced dietary practices, and ultimately reducing stunting prevalence. CHC-led interventions led to a significant increase in parental awareness of essential nutrients and a marked improvement in dietary diversity. Consequently, stunting rates among children under five decreased from 25% to 18% within a year. However, CHCs face cultural barriers, resource limitations, and sustainability issues. The study underscores the importance of comprehensive training programs, adequate resources, and consistent funding to support CHC activities. Integrating CHC programs into broader health and nutrition policies is recommended to ensure these successful interventions' long-term sustainability and scalability. This research contributes valuable insights into the effectiveness of community-based approaches in addressing stunting and improving child health outcomes in rural Indonesia.

When do different scenarios of projected electricity demand start to meaningfully diverge?

Resource adequacy studies look at balancing electricity supply and demand on 10- to 15-year time horizons while asset investment planning typically evaluates returns on 20- to 40-year time horizons. Projections of electricity demand are factored into the decision-making in both cases. Climate, energy policy, and socioeconomic changes are key uncertainties known to influence electricity demands, but their relative importance for demands over the next 10–40 years is unclear. The power sector would benefit from a better understanding of the need to characterize these uncertainties for resource adequacy and investment planning. In this study, we quantify when projected United States (U.S.) electricity demands start to meaningfully diverge in response to a range of climate, energy policy, and socioeconomic drivers. We use a wide yet plausible range of 21st century scenarios for the U.S. The projections span two population/economic growth scenarios (Shared Socioeconomic Pathways 3 and 5) and two climate/energy policy scenarios, one including climate mitigation policies and one without (Representative Concentration Pathways 4.5 and 8.5). Each climate/energy policy scenario has two warming levels to reflect a range of climate model uncertainty. We show that the socioeconomic scenario matters almost immediately – within the next 10 years, the climate/policy scenario matters within 25–30 years, and the climate model uncertainty matters only after 50+ years. This work can inform the power sector working to integrate climate change uncertainties into their decision-making.

Environmentally-special responsible leadership and employee green creativity: The role of green job autonomy and green job resource adequacy

Environmentally-special responsible leadership and employee green creativity: The role of green job autonomy and green job resource adequacy

Hospital-to-Home Transitions for Lung Cancer Patients-A QualitativeStudy of Healthcare Professionals' Experiences.

To explore the professional practice of transferring patients with lung cancer from hospitals to their homes through the experiences of healthcare professionals (HCPs) working in hospitals. Hospital-to-home transitions are particularly challenging for vulnerable patients, including lung cancer patients, and could threaten patient safety. There is a need to improve coordination between specialised and community care and to develop knowledge on the practice of transferring patients with lung cancer. A descriptive qualitative design was used. Consolidated criteria for reporting qualitative research (COREQ) were followed for reporting. Six focus group interviews with nurses and two focus group interviews with physicians at pulmonary medicine units in two hospitals in Norway were conducted. Qualitative content analysis was used to analyse the focus group interviews. Patients' vulnerability and gratitude motivated HCPs to ensure that patients experienced the best hospital-to-home transition. The following obstacles made it challenging to plan for a good hospital-to-home transition and to transfer the responsibility for the patient to the municipality: lack of time and routines to attend to the patient's individual needs, lack of established standards for patient information, absence of resources and predictability, and inadequate communication tools for collaborating with the primary healthcare services. The healthcare system does not provide hospital units and HCPs with adequate resources to accommodate the individual needs of lung cancer patients in hospital-to-home transitions. HCPs compensate with supplementary initiatives to secure patient safety, but the additional responsibility and tasks leave them overworked. The study provides knowledge on lung cancer patients' needs in hospital-to-home transitions and how HCPs try to ensure patient safety by compensating for the healthcare system's deficiencies. A reference group comprising one patient representative from the Norwegian Cancer Society and five HCPs with varied relevant backgrounds contributed to the overall design, recruited participants, and provided feedback on the interview guide.

Predictors of Nurses' Job Satisfaction in Home Care Settings: Findings From the AIDOMUS-IT Study.

Nurses' job satisfaction in hospitals is fundamental for the quality of care and the safety of patients. However, sociodemographic trends require moving care to patients' homes, and the predictors of job satisfaction for nurses working in the home care settings remain largely unknown. Therefore, the aim of this study was to investigate job satisfaction of nurses working in Italian home care settings and its determinants. Multicenter observational cross-sectional study. This study was conducted in the districts of 70 local health authorities in Italy. Data on the characteristics of the organization and nurses were collected. Nursing job satisfaction was evaluated on a four-point scale ranging from "very satisfied" to "very dissatisfied." Additionally, the following variables were assessed: workload, quality of leadership, work-private life conflict, burnout symptoms, possibility for development, staffing and resource adequacy, nurse manager ability, safety climate, and teamwork climate. A logistic regression analysis was conducted to identify factors influencing job satisfaction. Only organizational variables had a predictive value for nurses' job satisfaction. Workload (OR = 1.01; p = 0.033), work-private life conflict (OR = 1.02; p < 0.001), burnout (OR = 1.02; p < 0.001), and staffing inadequacy (OR = 1.44; p = 0.003) predicted higher levels of nurse dissatisfaction. Instead, high-quality leadership (OR = 0.981; p < 0.001), possibility for development (OR = 0.973; p < 0.001), and good teamwork climate (OR = 0.994; p = 0.003) were predictors of better levels of satisfaction. This study suggested that home care nurses are generally satisfied with their jobs. To enhance job satisfaction, it is essential to improve nurses' work environment, the leadership quality and ensure professional development. Our results are globally relevant as they contribute to the limited evidence available on this topic in home care settings. This study emphasizes the need of measuring nurses' job satisfaction and implementing interventions to promote healthy work environments.