Access To Support Services Research Articles

“I Would Not Change [My] Sibling for the World, Maybe the World Can Change for My Sibling”: The Experiences of Adult Siblings of People With Developmental Disabilities

ABSTRACTThe sibling relationship is complex, unique and important. When one sibling has a developmental disability, siblings can be important sources of care, support, advocacy and friendship for one another. We drew on online survey data from 456 UK adult siblings of people with DD. Siblings provided written responses to a prompt about their sibling experiences (> 80,000 words). These data were analysed using qualitative content analysis and organised using the Siblings Embedded Systems Framework (SESF). The SESF helps us to consider how complex interacting mechanisms and factors surrounding siblings, families and wider systems at a local, national and international level, can influence siblings' outcomes, experiences and relationships. Overall, siblings shared a range of experiences related to their: mental health and wellbeing; personal characteristics; sibling relationships; intra‐familial experiences; caring experiences; experiences accessing support services; community experiences; and views on the discrimination and ableism that their disabled siblings experienced. Siblings reflected on the interconnected and dynamic nature of their experiences. We found the SESF to be a useful way of presenting an account of the data overall, as well as to explore the impact of societal factors on siblings' experiences. Siblings' structural, political and social contexts impacted their personal lives. Please refer to the Supporting Information section to find this article's Community and Social Impact Statement.

Health optimisation for patients with obesity before elective orthopaedic surgery: a qualitative study of professionals’ views on restrictive approaches and future practice

BackgroundPreoperative health optimisation for elective surgery entails supporting patients to improve their health in preparation for their treatment and recovery. While there is consensus that this process should address obesity, approaches vary across England. Despite guidance from the National Institute for Health and Care Excellence to the contrary, restrictive approaches with body mass index thresholds for referral to arthroplasty are in use. This qualitative study aimed to investigate the views of professionals on the current use and future implications of these policies.MethodsSemi-structured interviews were conducted with 20 professionals including clinicians, commissioners, policymakers, and health service managers, with experience of developing and/or implementing health optimisation policies for elective arthroplasty. Participants were sampled from areas in England with and without restrictive policies. We undertook thematic analysis of the interview data.ResultsParticipants described pre-surgical health optimisation as an important trigger for health improvement but identified current resourcing and inadequacies in provision of weight management support as significant barriers to success. Participants expressed concerns about the appropriateness and fairness of including obesity as a determinant to restrict access to surgery. They described short-term financial pressures underlying the use of restrictive body mass index thresholds and a lack of an evidence base, such that policies amounted to rationing and risked exacerbations of health inequalities. The study identified four priorities for improvements to future health optimisation practices: developing and implementing national guidance with flexibility for local variation, initiating patient engagement in primary care with onward integration across all services, improving resourcing to support effective equitable impact, and addressing wider determinants of obesity through societal change.ConclusionsOverall, participants had limited expectations of the impact of health optimisation policies on obesity without additional support, investment, and national guideline implementation. They raised strong concerns over current restrictive approaches. We conclude that addressing concerns around weight management support service availability and impacts on health inequalities is essential for shaping effective health optimisation policies. Future policy direction should support health optimisation to be offered early (ideally in primary care). Health optimisation interventions should be non-restrictive, inclusive, and well-monitored, particularly around equality impact.

Population perinatal substance use and an environmental scan of health services in British Columbia, Canada

BackgroundSubstance use during pregnancy is underreported globally and there is limited data on its prevalence and the availability of supportive services. This study determined population perinatal substance use in British Columbia (BC) by region and examined the availability of clinical and community-based programs. MethodsUsing linked provincial health administrative data, we conducted a population-based retrospective cohort study including all BC residents accessing care for substance use (alcohol, opioids, stimulants, sedatives, and cannabis) within 12 months of first perinatal care record to delivery during 2016–2021. We also conducted an environmental scan to identify all programs offering perinatal care and substance use treatment/support in BC as of December 2022 and described program components by region. ResultsThe population included 12,439 people with perinatal substance use with 13,814 linked livebirths during the study period. The incidence rate of perinatal substance use was nearly eight times higher in rural/remote Northern BC compared to the metropolitan Vancouver Coastal region (1044.2 vs. 131.3 per 100,000 population, respectively). We identified 29 related services (19 wrap-around programs, 8 supportive housing, and only 2 acute care programs). Residents outside of Metro Vancouver accounted for 60 % (N=1745) of people with perinatal substance use; however, these regions represented only 35 % of BC’s specialized acute care and supportive housing beds (N=140). ConclusionsExpanding supports for perinatal substance use - particularly acute care and supportive housing within more rural/remote regions in BC - will be critical to address geographic inequities in access to perinatal care and improve health outcomes for pregnant people who use substances and their infants.

What do Adjunct Nursing Instructors Want?

Adjunct nursing instructors (ANIs) are used to meet the needs of nursing education programs, but challenges of adjusting to unfamiliar academic settings often lead to poor job satisfaction and low retention of ANIs. The Adjunct Instructor Survey (Milliken & Jurgens, 2008) was used to query 25 ANIs regarding the importance and availability of support services pre-COVID-19 pandemic and post-pandemic. Mentoring was identified as most important pre- and post-pandemic, with a reported decrease in mentoring opportunities post-pandemic. Developing quality mentoring programs for ANIs needs to be a priority.

Risks for a good life in old age-Importance of selected dimensions of living conditions

Life situation dimensions, such as financial resources, housing, health and social relationships, have asignificant influence on the scope available to older people for coping with everyday life and participation and thus for agood life in old age. As abasis for identifying current and future challenges posed by precarious living conditions in old age, current publicly available data and study results on the income situation, housing, health and care are reported as central dimensions of the living conditions of people aged65 years and over in Germany. The study results presented provide indications as to which groups of older people live in particularly precarious living situations, which provide starting points for municipal action. Inequalities exist in the availability of income, affordable and accessible housing, social networks, health opportunities and care support services. Particular importance is attached to the risk of poverty, which goes hand in hand with the risk of disadvantages in the other dimensions analyzed.

Epidemiological, clinical and psychological aspects of victims of female child sexual abuse in the gynaecology and obstetrics department of tertiary hospital, Karnataka

Child sexual abuse is an alarming reality that although is recognized as a serious violation of human well-being and of the law often goes unreported or overlooked. The present study was planned to identify the clinic-social profile of victims of child sexual abuse, circumstances under which these heinous crimes have occurred and study the psychological status of the victims. A retrospective record-based study from January 1, 2017 to December 31, 2021 conducted in a tertiary care hospital of north Karnataka, India. All the female patients aged less than 18 years admitted during our investigation period who were victims of child sexual abuse were included in the study. All case reports obtained from the medical record division and fulfilling the inclusion criteria were scrutinized by the authors for completeness of data. The data was entered in MS excel master sheet and statistical analysis was performed using SPSS software version 22. A total of 158 victims of female child sexual abuse were documented in our centre. The age of the victims ranged from 1 to 17 years and that of abusers varied from 15 years to 75 years. For most incidents, the offenders were known to the victims. The highest incidence of sexual assault was reported in abusers’ home, followed by victim’s home. Majority of the female children were abused multiple times (45.6%). There is an urgent need for comprehensive prevention programs, awareness campaigns, accessible support services, public awareness campaigns and legal enhancements to address CSA effectively in schools and communities that educate children on recognizing and reporting abuse.

Retraumatization in Undergraduate Medical Education: Evaluating the Prevalence and Support Resources Available to Students

Background: Retraumatization is the conscious or unconscious reminder of past trauma that results in a re-experiencing of the initial traumatic event. This phenomenon has been well-studied in primary and secondary education and has been shown to negatively impact the learning environment. Retraumatization in the context of undergraduate medical education has yet to be evaluated. Therefore, we sought to explore the prevalence of retraumatization in medical students, identify specific areas of UME that are retraumatizing, and evaluate effectiveness of psychological support available to students. Methods: A survey was created by a multidisciplinary team of health professions educators, revised through an iterative process, and distributed to all medical students at a single, large, academic institution. Respondents who endorsed prior trauma exposure met inclusion criteria for completing the survey. Data was analyzed using Microsoft Excel. Results: Of the school’s 1400 students, 85 responses were recorded for a response rate of 6.07%; this consisted of 20 males (23.5%), 46 females (54.1%), and 19 nonbinary (22.4%) students. 32 (37.6%) students reported no prior trauma and were excluded from survey completion. Of the 53 (62.4%) students completing the survey, retraumatization was experienced by 32 students (60.4%), which represents a prevalence of 37.6% among all medical students surveyed. 50% of females (n=23), 10% of males (n=2), and 36.8% of nonbinary (n=7) students reported retraumatization. Clinical rotations were identified as a retraumatizing setting by 59.3% (n=19) of students. Despite the availability of support services, 11 students (20.8%) reported being unaware of them when experiencing retraumatization. When asked about utilization of services, the majority of those who had experienced retraumatization did not utilize them (65.6%, n=21). Conclusion: Retraumatization is occurring in undergraduate medical education, particularly in the clinical years. Medical schools should attempt to enhance the ease of utilization of support resources to improve the learning environment for students.

Postdischarge From the Neonatal Intensive Care Unit: Mothers’ Needs for Health Care Resources & Social Supports

Abstract Date Presented 03/22/24 We explore a gap in family-centered care following a neonatal intensive care unit (NICU) discharge, including mothers’ and providers’ perspectives on supports and services for mothers of NICU graduates. Opportunities to support service access for NICU families are discussed. Primary Author and Speaker: Morgan C. Timmerman Additional Authors and Speakers: Evguenia S. Popova

Insights from GoFundMe posts: Analyzing GoFundMe financial aid requests from brain tumor patients in Ontario, Canada

Abstract Background Primary central nervous system (CNS) tumors significantly affect individuals globally, with patients in Ontario, Canada, often bearing financial burdens for treatments such as oral chemotherapy due to insufficient coverage, resulting in complex insurance processes or out-of-pocket payments. However, limited understanding exists regarding other direct and indirect financial implications of their diagnosis. This study examines the financial strains, unmet needs, and overarching challenges encountered by Ontario’s brain tumor patients, utilizing GoFundMe posts as a unique data source to explore additional financial costs linked to CNS tumor diagnoses in the region. Methods A qualitative descriptive design employing thematic analysis analyzed GoFundMe posts supporting CNS tumor patients in Ontario from 2014 to 2021. A search strategy targeted posts featuring primary CNS tumor keywords, with NVivo 10 software facilitating post organization and coding. Results Focused on Ontario, the study yielded a final dataset of 154 posts from an initial pool of 9025, revealing further financial strain due to income loss among patients and caregivers. Posts highlighted various concerns: (1) navigating the complexities of accessing support services, (2) worries about family’s long-term financial and overall well-being, (3) insufficient public awareness about the financial and emotional burden on those affected, and (4) seeking emotional support, hope, and encouragement from the community. Conclusions These GoFundMe posts highlight a connection between financial burden, emotional distress, and the need for improved access to financial and emotional support services. The results emphasize distinct financial challenges faced by CNS tumor patients within Ontario’s healthcare system.

LGBTQIA+ Individuals' Experiences With Intimate Partner Violence and Perceptions of Victim Services.

This study explored lived experiences of LGBTQIA+ survivors of intimate partner violence (IPV). Seven participants completed a one-on-one, in-depth interview to share their experiences of IPV and any internal or external factors that influenced whether they sought support services or reported victimization. Thematic analysis revealed four overarching themes: (a) health complications, (b) coping mechanisms, (c) barriers to seeking professional help, and (d) suggestions for professionals. Results contribute insight into internal and external barriers LGBTQIA+ IPV survivors face when accessing support services and outline practical approaches for professionals providing support to LGBTQIA+ IPV survivors.

Parental Mental Health, Gender, and Lifestyle Effects on Post-Pandemic Child and Adolescent Psychosocial Problems: A Cross-Sectional Survey in Northern Italy.

The exacerbation of psychosocial problems among children and adolescents during the coronavirus disease 2019 (COVID-19) pandemic necessitates an assessment of the long-term mental health impact of pandemic interventions. Focusing on both pandemic-related factors and demographic variables, such as gender and daily habits, an analysis was conducted to understand how these elements continue to affect young populations in the post-pandemic era. In April 2023, a comprehensive online survey was administered to families in South Tyrol, Italy, with children aged 7-19 years, to ensure age and gender representation. The survey included parent ratings and adolescent (11-19 years) self-reports using standardized instruments to measure the symptoms of mental health problems (Strengths and Difficulties Questionnaire, SDQ), anxiety (Screen for Child Anxiety Related Emotional Disorders, SCARED), and depression (Patient Health Questionnaire-2, PHQ-2). Statistical analyses included descriptive statistics, chi-square tests, and unadjusted odds ratios (ORs). Of the 4525 valid responses, 1831 were self-reported by adolescents. Notable gender differences in mental health outcomes were identified, along with significant demographic predictors, such as age, single parenthood, parental mental health problems, and immigrant background. Negative effects were associated with reduced family climate and increased screen time, whereas physical activity showed beneficial effects. Proxy reports overestimated adolescents' mental health problems, whereas self-reports tended to underestimate them. Persistent mental health problems and gender disparities highlight the need for a public health approach. This should include accessible support services, resilience building, targeted support for vulnerable families and gender-specific interventions.

Framework for managing inappropriate behavior in clinical dental learning environments.

Workplace violence (WPV), such as physical violence, harassment, intimidation, or other threatening behavior, commonly occurs within healthcare settings including dentistry. The objective of this study was to analyze the behavioral and environmental factors contributing to WPV, determine its prevalence within one dental institution, and develop a WPV prevention and management protocol that is dental specific. To identify factors that impact WPV occurrence, the PRECEDE-PROCEED planning model was employed. A pilot cross-sectional survey was then conducted among faculty, staff, and dental learners (students/residents) to evaluate the prevalence of WPV incidents experienced and witnessed over the past year. The survey also assessed the locations where incidents took place, their type, and the strategies employed to manage them. A comprehensive protocol aimed at preventing and managing WPV in dental settings was subsequently developed. Multiple factors influence the occurrence of WPV. The prevalence of experienced and witnessed WPV incidents was 22% and 24% among faculty/staff and 7% and 5% among learners, respectively. Verbal aggression was the most common type of WPV. Most respondents lacked awareness of the available reporting mechanisms for WPV. A WPV prevention and management protocol was developed, consisting of five steps: intervene, report, document, access support services, and resolve (IRDAR). Administrators must have a comprehensive understanding of the prevalence of violence in their workplace and the underlying factors that contribute to it in order to take appropriate action. IRDAR is a clearly defined and easily implemented protocol designed for preventing and managing WPV in dental learning environments.

P-473 Assessing patient perceptions: emotional support and clinic culture in fertility care. Examining changes in emotional support and clinic culture over 4 years

Abstract Study question How do patients perceive emotional support and clinic culture in the context of fertility care, what factors contribute to their overall experiences within fertility clinics? Summary answer Patients find clinic support lacking, rated 4.8/10, with <45% perceiving a supportive clinic culture. Despite increased awareness, emotional support perception declined from 2019 to 2023. What is known already Despite abundant research emphasising the necessity of psychosocial care in fertility treatment, notably by ESHRE, patients’ experiences indicate clinics are not consistently following these guidelines or offering sufficient emotional support. UK studies by the Human Fertilisation and Embryology Authority and Fertility Network emphasise the genuine emotional toll of fertility treatment, revealing that 40% of women undergoing treatment have experienced suicidal thoughts. These findings underscore the critical need for robust emotional support throughout the treatment journey. Study design, size, duration This study involved surveying 210 respondents undergoing fertility treatment. Employing an online survey format, disseminated within my online support communities (approx. 7,000 individuals), the study incorporated both qualitative and quantitative questions. Responses were collected across two distinct periods, 2019 and 2023, providing a comprehensive understanding of patients’ emotional experiences over the 4-year interval. Participants/materials, setting, methods The study gathered insights from 210 global respondents (97% receiving treatment in the UK, 3% in Europe and the USA), all participants were fertility patients undergoing treatment. Cohorts were surveyed in 2019 and 2023, responding to a 10-question online survey. This design enabled a comprehensive exploration of diverse perspectives on emotional support within fertility care over the specified 4-year period. Main results and the role of chance The study reveals a significant disparity between perceived and actual emotional support in fertility clinics. Despite clinics asserting excellence in support, patients rated the emotional support they received at 4.8 out of 10. An alarming 58% expressed scepticism about their clinic fostering a culture of support embraced by all staff, showcasing a disconnect between clinic claims and patient experiences. The study determined a decline in perceived support levels from 2019 to 2023, from 5.3/10 in 2019 to 4.6/10 in 2023. This downward trend raises concerns about the efficacy of efforts to enhance emotional support over the years despite an escalating focus and awareness surrounding the emotional challenges of fertility treatment. The participants’ qualitative responses unveiled a recurring theme across 2019 and 2023, indicating a persistent lack of improvement in emotional support. Patients felt like part of a production line, reduced to mere numbers in the clinic during their treatment journey. A resounding 66% of respondents expressed a desire for more accessible support services within their clinics. This study’s comprehensive findings shed light on the critical need for clinics to re-evaluate and fortify their emotional support infrastructure, ensuring it aligns with patient expectations and contributes positively to their overall experience. Limitations, reasons for caution Differences in participant demographics over study years may influence individual perspectives. Feedback could be influenced by participants’ mood on the survey day, and the global online distribution encompassing diverse clinics adds variability to responses. Wider implications of the findings The study reveals a gap in emotional support provision despite extensive research on IVF’s emotional impact. Patients hesitate to voice concerns, contributing to treatment dropout rates. Addressing this, the study suggests guidelines to help clinics establish a supportive culture from initial contact, potentially reducing dropout rates and improving patient experiences. Trial registration number not applicable

“You're on your own, kid”: A critical analysis of Australian universities' international student mental health strategies

AbstractMental ill‐health is a serious and growing problem among university students in Australia. Within this cohort, international students are particularly vulnerable. International students in Australia have fewer social rights than domestic students and are at elevated risk of social isolation, exploitation in employment, precarious housing, financial insecurity, and racism and discrimination. When mental health challenges arise, international students are also less likely than their domestic counterparts to access support services. Against the backdrop of this escalating problem, this article presents a critical analysis of Australian universities' policy approaches to international student mental health. We ask: (a) How many universities have such policies publicly available, and (b) how do these policies understand and seek to address the problem of international student distress? Drawing on a documentary analysis of publicly available university mental health strategies, we find that—in the comparatively rare cases where such documents exist—international students' mental ill‐health is generally framed in these documents as an individual concern, placing the onus on individual students to develop “resilience” and/or seek out help. Leveraging theoretical insights concerning the collective production of (mental) health and illness, we caution that this individualisation of student distress naturalises and depoliticises the logics of financial exploitation and neglect that contribute to many international students' mental health problems to begin with.

Promoting Inclusive Learning Environments: Leveraging University Websites for Digital Empowerment in the Post-COVID-19 Era.

In an era of global interdependence, universities play a crucial role in promoting social responsibility and sustainable development. The United Nations Convention on the Rights of Persons with Disabilities emphasizes the empowerment of individuals with disabilities, a key aspect of inclusion. The COVID-19 pandemic underscored the necessity of digital platforms to ensure equitable opportunities, particularly for those with disabilities. It highlighted challenges in transitioning to remote operations and stressed the importance of accessible digital tools in maintaining inclusivity during disruptions. This study investigates how university websites promote social responsibility and empower individuals with disabilities in Saudi Arabia, the UK, and the US. It also examines how these websites foster inclusivity, advocate for disability rights, and contribute to societal change. Using a qualitative case study design, the study evaluated university websites focusing on accessibility services, inclusive policies, and academic accommodations. Qualitative content and thematic analyses identified recurring themes and variations. The findings reveal diverse strategies in empowerment initiatives, website maintenance practices, community engagement approaches, the accessibility of support services, and the presentation of success stories. Despite differences among websites, this study underscores their significance in empowering individuals with disabilities. Recommendations aim to guide universities worldwide in enhancing their digital platforms, ensuring inclusivity, especially during challenges like the COVID-19 pandemic.

Exploring access to support services for medical students: recommendations for enhancing wellbeing support

BackgroundMedical students have reported facing unique challenges in their academic journey that can have a significant impact on their mental health and wellbeing; therefore, their access to support services and wellbeing resources has been deemed crucial for dealing effectively with the various challenges they tend to face. While previous research has highlighted certain barriers affecting medical students’ help-seeking and access to wellbeing support more generally, there is a pressing need for more in-depth research into the factors that may hinder or facilitate medical students’ acceptability and uptake of the wellbeing resources available to them within institutional contexts. The current study aims to explore students’ perceptions and utilization of wellbeing interventions and welfare resources within a medical school setting, as well as the factors influencing their help-seeking attitudes or behaviours. Additionally, it seeks to instigate medical students’ deeper reflections on potential enhancements that could be applied to wellbeing resources so that they are better suited to address their needs.MethodsThis study employed a qualitative design, involving semi-structured interviews and a series of focus groups with medical students at the University of Nottingham (UK). Post-interview, focus groups were deemed necessary to gain deeper insights into emerging findings from the interviews regarding students’ views on wellbeing support services. Qualitative data from the interviews was subjected to thematic analysis while a hybrid thematic analytic approach was applied for the focus group data in order to allow for both pre-defined themes from the interviews and newly emerging patterns to be identified and analysed in a combined manner.ResultsTwenty-five participants took part in the semi-structured interviews and twenty-two participants were recruited in a total of seven focus groups. Thematic analysis findings identified several key barriers to medical students’ accessing wellbeing resources, including difficulties in finding relevant information, lengthy processes and difficulties receiving prompt help in urgent situations, learning environment issues, confidentiality concerns, and stigma around mental health. Student suggestions for the enhancement of wellbeing provision were centered around proposed improvements in the format that the relevant information was presented and in the structure underlying the delivery of support services.ConclusionThe study findings shed light on multi-faceted factors contributing to medical students’ challenges in accessing support services; and provided a deeper understanding of medical students’ wellbeing needs through a consolidation of their recommendations for the implementation of practical steps to address these needs. These steps can potentially inform key medical education stakeholders so that they can actively and proactively foster more supportive environments that may help improve medical students’ help-seeking, as well as their acceptability and uptake of wellbeing services.

Uncovering community needs regarding violence against women and girls in southern Ethiopia: An explorative study.

Violence against women and girls (VAWG) is a significant global public health problem and a violation of human rights experienced by one in three women worldwide. This study explores community perceptions of and responses to VAWG and challenges in accessing support services among female violence survivors in Arbaminch City. We adopted a phenomenological explorative qualitative study design. A total of 62 participants including female violence survivors, religious leaders, service providers, police, women, and men in participated in interviews, focus group discussions, and observations in August 2022. Participants were selected purposively, and the findings were analyzed thematically. We applied data source and respondent triangulation to increase the findings' trustworthiness. Community perceptions of VAWG, specifically of intimate partner violence (IPV) and non-partner sexual violence (NPSV), varied depending on gender, age, and social position. IPV and NPSV were normalized through tolerance and denial by young and married men, while resistance to all forms of violence was common among women. Survivors of violence responded to the act of violence by leaving their homes, separating from their husbands, or taking harsh actions against their husbands, such as murder. Support for VAWG survivors was available through health care, free legal services, and a temporary shelter. Yet factors ranging from individual to societal levels, such as fear, lack of knowledge, lack of family and community support, and social and legal injustice, were barriers to accessing existing services. Nonetheless, violence survivors desired to speak about their experiences and seek psychosocial support. Our qualitative evidence gathered here can inform tailored VAWG prevention and response services such as interventions to shift social norms and the perception towards VAWG among different population group through raising awareness in schools, health care settings, faith-based venues, and using social media.

Afghan refugees at risk in the UK: enhancing healthcare access and integration.

Following Kabul's fall in August 2021, there was influx of Afghan refugees in the UK. Southampton's Bridging Hotel provided temporary shelter to 22 families, totaling 116 individuals. The Living Well Partnership (LWP); assumed primary care provision for these vulnerable residents facing health inequalities. Enhancing refugee healthcare access and integration into the NHS system. Improving healthcare education, boosting confidence in appropriate healthcare use, and utilisation of electronic consultations effectively. Working with the local authorities, primary care services were brought to the hotel. Regular 3-hour drop-in sessions with a health and wellbeing coach were established and attended by residents. Non-identifiable data was recorded in individual patient care records and summarised quantitatively. Qualitative data was collected via a pre-established questionnaire during the sessions. RESULTS: Identified issues included language barriers, mental health problems, infectious diseases, contraception, and healthcare access. Language barriers were addressed with interpreters. Fifty-nine patients accessed support services, with 13 benefiting from e-consultations, and nine requiring on-site medical consultations in a 3-month period. Mental health support and infectious disease referrals were facilitated. Access challenges were mitigated by transitioning to e-consultations or face-to-face appointments. Outcomes included improved patient independence, awareness of healthcare processes, familiarity with LWP services, and confidence in navigating the NHS. A multifaceted approach is vital for addressing language and access barriers for refugees. Providing educational resources through facilitated groups empowered refugees and improved healthcare access. This initiative highlights the importance of organised support for vulnerable populations during crises and can be applied more widely.

Pressure injury education for older adults and carers living in community settings: A scoping review.

Older adults are at increased risk of pressure injuries (PIs) due to age-related changes. Traditionally, PI knowledge and education have been delivered in hospitals and residential aged care facilities, however, there remains a critical gap in understanding how PI knowledge on prevention and management is shared with older adults and their carers living in the community. We aimed to describe the nature and characteristics of structured and unstructured PI education programs available to community-dwelling older adults and their carers. As coping review was undertaken. We searched five databases: CINAHL, Medline, Scopus, Cochrane Library and ProQuest from 2009 to August 2023. The review was guided by Arksey and O'Malley's six-step framework and adhered to the PRISMA-ScR guidelines. It included primary peer-reviewed papers published in English, which focus on PI education for older adults and/or their carers living in community settings. Data extraction was organised in a table, and findings presented as a narrative summary. One-hundred and thirty-six papers were screened and four included in the review. Results indicate that consideration was placed on literacy levels and cognitive status of older adults and their carers when designing PI education materials. Educational materials such as leaflets/brochures, in-person training sessions or a combination of both were used. However, duration of these interventions varied, lasting for 1-4 weeks while others were completed over 12 months. Some improvements in PI knowledge such as how to treat PI, dietary requirements and importance of mobility were noted. However, information retention and its translation into effective long-term behaviour change remained unclear. In conclusion, adopting a multifaceted educational approach increases the effectiveness of PI knowledge translation. Continuous education, support and reinforcement on PIs over time are necessary when interacting with older adults and caregivers to ensure long-term management and prevention success. Conversations on PIs should start at the primary care levels when older adults and carers are visiting their GP clinics and accessing support services for other healthcare needs. Understanding older adults' and carers' literacy levels, cognitive status and cultural background can assist clinicians in designing and delivering fit-for-purpose PI educational interventions that are accessible, relatable and effective in promoting knowledge transfer and behaviour change. Carers are vital conduits in the care continuum. These factors will lead to a more informed, collaborative and person-centred approaches to PI management and prevention.

Role of the addiction clinical nurse specialist in acute hospital settings.

The role of an addiction clinical nurse specialist (ACNS) is focused on individuals who misuse drugs and alcohol, and several benefits of the role have been identified in the literature. When people who misuse substances are admitted to acute general hospitals, there is an opportunity to engage with them and ensure they access support services to facilitate their recovery. To determine general nurses' experience of caring for patients who misuse substances, and to gauge nurses' views on the implementation of an ACNS role in an acute general hospital. This study used a qualitative design involving online interviews with 11 hospital nurses. Many participants felt that an ACNS could provide them with education and support around substance misuse, while also advocating for patients who misuse substances, reducing stigma and enhancing patient care. Participants indicated several benefits to implementing an ACNS role in their hospital, such as ensuring that patients who misuse substances experienced continuity of care which began at admission, was followed-up during inpatient stays and was maintained in the community.