Care Education Research Articles

Implementation of High-Value Care for Physical Therapy Residents Through Systems-Based Practice Curriculum Development: Case Report.

Systems-based practice is a core competency for physical therapy residents, best acquired through experiential learning. Peer health professions are further along than physical therapy in implementing curricula that support systems-based practice. Clinical and practice data in residency programs could provide for education in high-value care (HVC) as a foundation for systems-based practice. Our purpose was to develop and assess a HVC curriculum incorporating reflective practice to help residents achieve competency in systems-based practice. The Logic Model, which evaluates key components needed for success and sustainability, was used to identify resources for a curriculum in HVC. Two orthopedic physical therapy residents and 5 faculty mentors participated in didactic and mentoring sessions. A practice dashboard for each clinician was developed to facilitate resident-mentor discussions. Focus group input was used to refine the curriculum. The validated Systems Thinking Scale, the Quality Improvement Knowledge Application Tool Rubric, and the American Physical Therapy Association Residency Core Competency Score were used to assess residents' progress and to make comparisons to prior years' residents. The residents demonstrated increases in systems thinking and quality-improvement knowledge and improvements in clinical outcomes and practice efficiencies. Three themes emerged from semistructured interviews: challenges to HVC, current approach in HVC, and future-oriented thinking in HVC in practice. This study demonstrates that HVC activities and a personalized clinical dashboard in a physical therapy residency program can facilitate experiential learning of systems-based practice, a core competency for value-centered, inclusive practice.

Factors associated with care partner identification and education among hospitalized persons living with dementia

ObjectiveCare partners of persons living with dementia (PLWD) often feel unprepared to care for their loved ones. Improving PLWD care partner identification and education during hospital stays can improve preparedness. This retrospective EHR study investigated PLWD characteristics that may relate to care partner identification, education, and teaching methods during hospital stays. MethodsEncounters from a Midwestern academic healthcare system were used. Patients were over 18, had a documented dementia diagnosis, were admitted to the hospital for at least 24 h, and had information documented in care partner or education data fields (N = 7982). Logistic regressions assessed patient's demographics, care partner identification and education. Chi-square tests compared education teaching methods and patient discharge location. ResultsPLWD's who were unmarried, discharged to other care facilities, or received the diagnosis “degeneration of nervous system due to alcohol” were associated with lacking care partner identification. Care partners of unmarried PLWDs or those with the diagnosis “Alzheimer's disease, unspecified” received less education. Multiple teaching methods were associated with discharge location. ConclusionMultiple characteristics were related to PLWD care partner identification and education differences during hospital stays. InnovationNovel analyses highlight need for a protocol to systematically prepare dementia care partners.

The Effect of Education Performed Using Mobile Application on Supportive Care Needs and Quality of Life in Women with Breast Cancer: Randomized Controlled Trial

ObjectivesAimed to determine the effect of education provided with a mobile application on the supportive care needs and quality of life of women undergoing breast-conserving surgery. MethodsThe study was conducted in 81 patients. The experimental group received mobile application and the control group received standard education. Fisher's Exact Test, Chi-Square test, Student's t Test, Mann-Whitney U test, mixed design analysis of variance and Bonferroni-Dunn test were used to analyze the data. ResultsWhile the pre-study supportive care needs scores of the women were similar in the experimental (85.37 ± 23.58) and control (83.13 ± 23.03) groups, they decreased significantly in the experimental group at the 4th and 8th-week measurements (54.34 ± 27.28; 58.78 ± 16.51) (p < .05). In the 4th and 8th week measurements, the quality of life of the experimental group (72.26 ± 14.12; 71.04 ± 8.12) increased significantly, while no significant change was found in the control group (42.50 ± 14.38; 45.63 ± 8.28). ConclusionsIt was found that the supportive care needs of the decreased and their quality of life increased after the education given to women with a mobile application. Implications for Nursing PracticeThis study ensured that women who had a sufficiently intense and exhausting process during the cancer treatment process could comfortably receive care support and education with the mobile application at any time and place they wanted. It also revealed that nurses can provide care and education support to their patients at any time and place they want with the mobile application in their busy work tempo.

Intensive therapeutic education strategy for patients with acute heart failure (EduStra-HF): Design of a randomized controlled trial

BackgroundHeart failure is associated with reduced quality of life, hospitalizations, death and high healthcare costs. Despite care improvements, the rehospitalization rate after an acute heart failure episode, especially for acute heart failure, remains high. MethodsThe Education Strategy for patients with acute Heart Failure (EduStra-HF; ClinicalTrials.gov Identifier NCT03035123) study will randomize patients admitted for acute heart failure in six French hospitals to usual care (control) or therapeutic education (intervention). All patients will be evaluated at baseline and will meet with a therapeutic education nurse before discharge. Those in the usual care arm will have standard appointments with their cardiologist and general practitioner. Those in the intervention arm will have an intensive follow-up schedule of phone calls, home visits and text messages from the therapeutic education nurses, plus cardiologist visits. Patients will be stratified by discharge location (home or cardiac rehabilitation centre) before randomization, and will be followed up for 1 year. The primary outcome will be the readmission rates for acute heart failure during 1 year in the two groups. Secondary outcomes will include: quality of life; time from inclusion to first readmission for acute heart failure; non-heart failure cardiovascular rehospitalization rates; length of stay for heart failure; cardiovascular and all-cause death; rates of patients receiving optimal medical therapies; evolution of knowledge about heart failure; and cost-effectiveness. ConclusionsThis study will assess the efficacy and feasibility of a standardized management strategy for the care and follow-up of patients discharged after hospitalization for acute heart failure. The EduStra-HF strategy will combine various nurse care methods to help prevent rehospitalization.

Learning Experiences and Didactic Needs of German Healthcare Professions: A Focus Group Study for the Design of Personalized Interprofessional Further Education in Dementia Healthcare

Considering the multifaceted nature of neurodegenerative diseases like dementia and the necessity for interprofessional knowledge, this research extends its scope to encompass professionals with diverse levels of training and experience in dementia care. A need analysis for the project “My INdividual Digital EDucation.RUHR” (MINDED.RUHR) is conducted to develop an automatized recommender system for individual learning content using AI. In this sub-study, the aim was to reveal didactic specialties, knowledge gaps, and structural challenges of further education in dementia care of different health professions and to derive learning preference personae. Eight focus group interviews among nine health professions and up to six participants (N = 34) each took place to survey distinct didactic experiences and learning needs. The results reflect various learning preferences, with a propensity to multimedia, practical, and interactive tasks. Health professions are used to digital education but show aversions against synchronous e-learning formats. The derived learning preference personae constitute profound blueprints for a user-centered digital education design process, aiming to establish personalized and representative further education in dementia care applicable to various individual preferences and structural workplace challenges of healthcare professions.

Mapping Evidence in Teaching Palliative Care in Undergraduate Curriculum of Healthcare Professionals Qualification: A Systematic Scoping Review Protocol.

Clinical Practice Guidelines recommend interprofessional collaboration in palliative care. However, healthcare profession educators lack clear curricular guidance, particularly for undergraduate programs, to adequately train future professionals for effective participation in such teams. This systematic scoping review protocol aims to address this gap by: (i) mapping evidence on key characteristics of teaching palliative and end-of-life (EOL) care to undergraduate healthcare and social care students, and (ii) identifying the nature and effectiveness of educational interventions for improving palliative care education in the undergraduate curriculum. The protocol adheres to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Protocol Extension for Scoping Reviews (PRISMA-P-ScR) guidelines, while the proposed systematic scoping review study will be conducted based on methods and steps identified by Arksey and O'Malley and experts in the field. We will conduct systematic searches across five EBSCOhost databases using relevant search terms. Additionally, a limited grey literature search will be conducted on the first 100 results of Google Scholar and Open-Grey. The selection process will follow PRISMA-Extension for Scoping Reviews. Two independent reviewers will screen titles and abstracts for eligibility. Data extraction will be done on standardized forms in duplicate with cross-checking by a third reviewer. Braun and Clarke's thematic analysis approach, combining thematic and directed content analysis, will be employed for analysis. Intervention effectiveness will be narratively summarized based on the TIDieR checklist. Meta-analysis will be considered if applicable and data is homogeneous. Palliative care education (PCE) is a crucial element of undergraduate health professions education. This study's findings may aid educators in fostering optimal learning among healthcare students, who can then positively influence community health outcomes. The protocol was submitted for ethical clearance to the University of KwaZulu-Natal's Biomedical Research Ethics Committee and granted exemption from ethics review (00024289). We will disseminate findings through scientific journal publication and by sharing a summary with relevant institutions and attendees at health promotion and interprofessional education conferences.

Exploring the competency and confidence levels of physiotherapists in the management of patients diagnosed with life-limiting illnesses

Background Globally, palliative care services do not meet demand. The World Health Organisation reports that 14% of people who need palliative care currently receive it. Moreover, the increase in chronic disease prevalence will result in the need for services to continue to grow. In Ireland, to help manage this demand, it is recommended that all physiotherapists should be able to deliver basic palliative care to patients diagnosed with life-limiting illnesses. Objective To explore the competency and confidence levels of physiotherapists in the management of patients with life-limiting conditions. Methods An anonymous, cross-sectional online questionnaire was designed and administered to physiotherapists working across various settings in Ireland. Results There were 90 respondents (response rate = 4.2%). A significant majority (93%, n = 84) agreed that most patients with life-limiting conditions can participate in physiotherapy. Just over half (56%, n = 50) felt confident in their ability to prescribe exercise for this cohort. Less than one-third (29%, n = 26) felt that the role of physiotherapy in palliative care was understood by the multi-disciplinary team. The majority (76%, n = 68) did not agree that their undergraduate training prepared them for work in this area. The ability to access mentorship from specialist palliative care physiotherapists was deemed as a facilitator in providing patient care. Conclusion This study highlights the demand for greater palliative care education, the need for a better understanding among the wider multi-disciplinary team so that patients receive timely access to physiotherapy, and the importance of establishing strong links between specialist physiotherapists and their generalist counterparts.

ChatGPT and other Chatbots in Psychiatry

Aim: Artificial intelligence (AI) is making significant inroads into the field of psychiatry, offering new tools and applications. ChatGPT, a specific chatbot, is at the forefront of this digital revolution. AI’s use in psychiatry ranges from identifying psychiatric symptoms, predicting treatment responses, and improving medication adherence to assisting in patient education, monitoring, and bridging gaps in mental health care. Materials and Methods: This review used a literature study method. Results: ChatGPT functions as a clinical decision support tool. It can analyse patient data and provide diagnostic insights, recommend evidence-based treatments, and offer drug information. It has demonstrated proficiency in generating summaries from medical records, saving clinicians time and enabling them to focus on patient care. Additionally, chatbots like ChatGPT serve as therapist assistants, offering emotional support between therapy sessions and potentially conducting psychotherapy. Studies have shown positive outcomes, with chatbots reducing depression, anxiety symptoms, and providing 24/7 availability for crisis situations. Users find them non-judgmental and comfortable for discussing sensitive issues. Despite their potential, chatbots have limitations, such as the risk of incorrect or biased information due to their training data. They lack genuine understanding, creativity, and the ability to clarify user input. Ethical considerations regarding responsibility and data usage are paramount. Conclusion: AI, particularly ChatGPT, holds substantial promise in modern psychiatry, enhancing diagnostics, patient education, monitoring, and therapeutic support. Its integration into everyday psychiatric practice requires careful use, continuous oversight, and ethical considerations. Psychiatrists must become more familiar with AI tools to leverage their benefits in patient care.

Compensation and Staffing Challenges in Child Care: Statewide Evidence from Pandemic Relief Applications

Abstract Child care teachers support young children's learning and development and parents’ ability to work. However, they earn far less and turn over at far higher rates than K–12 teachers. COVID-19 exacerbated staffing challenges, and the child care workforce was 5.9 percent smaller in January 2023 than in January 2020. While low compensation likely drives turnover in early childhood education, there is relatively little large-scale evidence on the link between compensation and staffing challenges. We summarize the limited pre-pandemic evidence and use pandemic-era data from 90 percent of publicly funded child care centers in Louisiana to describe the relationship between sites’ compensation and staffing challenges. In October 2022, 15 percent of centers’ lead teacher positions were unfilled—nearly quadruple the 4 percent national vacancy rate for public school teachers. Of centers with any vacancies or hires in the past six months, 65 percent turned families away and 84 percent hired less-experienced or -qualified teachers than desired due to staffing challenges. Centers with higher wages were significantly less likely to report staffing challenges, turn families away, and hire less-experienced teachers, after controlling for center characteristics and region. Our findings and prior evidence suggest that wage increases are promising for stabilizing the child care workforce.

Changes in an early childhood education and care teacher’s practical theory in language pedagogy as a nexus:

This case study focuses on an expert early childhood education and care teacher’s practical theory in language pedagogy when implementing bilingual pedagogy (Finnish–Swedish) in a linguistically heterogeneous group of children aged 3–5 years. Practical theory refers to teachers’ views of good teaching that guide their practices. Applying a mediated discourse analysis approach (nexus analysis), we examine the interplay of factors that promote and challenge changes in the practical theory of language pedagogy in early childhood education and care. The discourses show that the changes are related to Swedish use (a new language for the children) and the use of the children’s home languages. Several personal, interactional, and contextual factors circulate in the expert teacher’s discourses, affecting the changes in her practical theory. Personal factors include reflection, beliefs, and experiences. Feedback from parents and children represents interactional factors, whereas contextual factors cover concepts such as participation and language-enriched teaching. This study highlights the significance of the multiple interrelated factors that are present when an expert teacher’s practical theory of language pedagogy changes, which needs to be reflected upon both in the practice of early childhood education and in teacher training.

Analysis of the subjective quality of choice of term paper topic selection in humanities

Introduction. Global educational trends (pedagogy using artificial intelligence, personalization, lifelong learning, pedagogy of care and relationships, etc.) and the specifics of their influence and spread in the Russian context contribute to the introduction of innovations in the educational process at all levels. Among the significant innovations is a change in the positions of the teacher and the student, the characteristics of their interaction and educational relations: the teacher in the role of a supportive and guiding mentor, a mentor for the “self-managing” student. At the level of higher education, student coursework can be identified as a pedagogical means that promotes the development of the skills of “self-managing” teachers. Choosing a topic for course work is an integral part of the educational process, in which a large share of responsibility lies with the student. The purpose of this article is to analyze the retrospective reflection of the subjective quality of choice of term paper topic selection in humanities. Research methods. 80 third-year students of the Faculty of Linguistics and Translation and the Institute of Education and Practical Psychology of Chelyabinsk State University took part in the empirical study. As diagnostic tools for studying retrospective reflection of the process of choosing a topic for a course work, students used: questionnaire “Subjective quality of choice” D.A. Leontyev, Method for analyzing the argumentation of choice D.A. To statistically verify the results obtained, the Mann-Whitney U test was used. Results of the study. A qualitative analysis of students' choice of coursework topic reveals irrelevant differences between two groups of humanities students. According to the results of the study, it is important to note the following positive manifestations of the majority of students of both specialties (70-95%) in choosing a topic, characterizing them as “self-managing” students: activity, independence, responsibility, taking on a certain degree of risk, a meaningful attitude towards the situation of choice. However, at the same time, students need psychological and pedagogical support from their supervisor, which, in our opinion, allows them to reduce the identified anxiety (40% of educational psychologists and 60% of linguists) and the feeling of pressure (65% of educational psychologists and 75% of linguists) in the process of selecting and actually writing the course work, subject to the necessary requirements. The results obtained allow university teachers to build effective subject-subject interaction based on cooperation and taking into account the “self-governing” position of students. Conclusion. Subjective assessment of the quality of choice allows faculties and departments to moderate their work on the preparatory activities for writing term papers.

Diabetic foot self-care knowledge and practice among patients with diabetes attending diabetic clinic in the Gambia.

Diabetic foot ulcer is the most common complication causing lots of admissions among diabetic patients. Understanding patients' level of foot self-care knowledge, practice and associated factors is important for planning interventions to control and prevent diabetic foot complications. This study aimed to assess the level of knowledge and practice of foot self-care among diabetic patients attending diabetic clinics in The Gambia. Two hundred and seventeen patients attending diabetic clinics in two public hospitals were selected using a successive sampling technique. Data were collected using a validated interviewer-administered questionnaire. Descriptive statistics were used to summarize the demographic and clinical data. Multivariate logistic regression was used to identify factors associated with foot self-care knowledge and practice. The findings showed a poor level of foot self-care knowledge (n = 114; 52.5%) and practice (n = 149; 68.7%). Patients' educational level was statistically significantly association with diabetic foot self-care knowledge (p = 0.02). Diabetic foot ulcer history (aOR = 0.23, 95% CI: 0.08-0.63; p < 0.001), diabetic hospitalization (aOR = 2.41, 95% CI: 1.23-4.75, p = 0.01) and diabetic foot care education (aOR = 2.65, 95% CI: 1.39-5.06, p < 0.001) were statistically significantly associated with foot self-care practice. The poor diabetic foot self-care knowledge and practice among these patients emphasize the need for a diabetic health education program in these clinics.

Gauging Public Interest in Pediatric Ophthalmology Conditions Using Google Trends.

Google Trends data were analyzed to assess search trends for pediatric ophthalmology and strabismus terms from 2010 to 2022. The highest average search volumes were "lazy eye," "strabismus," and "vision therapy." "Amblyopia" had the lowest search volume. These data highlight the importance of understanding the utilization of online resources in health care and patient education. [J Pediatr Ophthalmol Strabismus. 2024;61(4):e39-e42.].

Developing Cumbria’s post dementia diagnostic support using Cognitive Stimulation Therapy (CST): Results and reflections on the treatment’s reintroduction post Covid-19

Cognitive Stimulation Therapy (CST, Spector et al., 2006) groups were part of the treatment provided by North Cumbria’s Community Older Adult Service until the Covid pandemic halted provision. Subsequently, treatment provided by the service to those diagnosed with a dementia relied heavily on pharmacological interventions to target the rate of cognitive decline. This paper documents the methodology of a service development project in Cumbria that reintroduced community CST groups, weekly for fourteen weeks across the year 2023. Preliminary findings demonstrate CST’s efficacy as a treatment for those living with a dementia diagnosis and coinciding low mood. Reflections shared from the project on the successes and challenges across its duration show its feasibility despite service pressures and resource limitations in a rural locality.In documenting this work, the project team aim to showcase the benefits of providing biopsychosocial care for older adults living with a dementia diagnosis and hope to inspire other Older Adult services to develop their post dementia diagnosis service provision using the CST protocols. With future iterations, more conclusive findings will be drawn and continued service development work has commenced in Cumbria on this project’s foundation within the Care Home and Educational Support System’s pathway.

Provision of palliative care for people with chronic obstructive pulmonary disease: a narrative review.

Chronic obstructive pulmonary disease (COPD) is characterized by persistent and progressive airflow restriction and is the third leading cause of death and disability, globally. People with severe COPD generally experience long-term functional decline punctuated by periods of acute exacerbation. Symptom burden can be severe and debilitating, and typically includes breathlessness, cough, fatigue, pain, anxiety, depression, and overall reduced quality of life. Understanding current palliative care needs and provisions in this group is an essential step to expanding access in future. A narrative review of specialist and generalist (primary) palliative care provisions for people with COPD, with an emphasis on breathlessness symptom management. This paper aims to examine the current landscape of palliative care provision and highlight barriers and facilitators to palliative care access for people with severe COPD. People living with severe COPD, as well as the people who care for them, are routinely under-serviced in best-practice end-of-life care, despite having symptom burden that is comparable to that of people with advanced cancer. Barriers to palliative care in this group include lack of specialist palliative care resources, uncertainty surrounding prognostication, and poor recognition of need from both patients and clinicians. Routine early palliative care involvement, including integration of specialist palliative care into respiratory services and upskilling of other healthcare providers to adopt palliative care principals within usual care (primary palliative care), have been shown to improve outcomes indicative of high-quality end-of-life care in this group, including symptom control, place of death, and legal preparations. Ongoing integration of specialist palliative care and professional education for generalist and non-palliative care specialist healthcare providers in the recognition and management of unmet palliative care needs is required to increase capacity beyond traditional specialist palliative care models. Despite high level of symptom burden, many people with COPD miss out on palliative care. Expanding capacity of traditional specialist palliative care by upskilling generalist healthcare providers and integrating specialist palliative care into existing respiratory services is necessary to improve access for people with COPD.

Knowledge Level of Primary Care Givers and Teachers of Students with Intellectual Disabilities' regarding Oral Hygiene

Knowledge Level of Primary Care Givers and Teachers of Students with Intellectual Disabilities' regarding Oral Hygiene

A survey of current specialty palliative care education in the United States.

Palliative care (PC) is a health care specialty that is focused on the holistic care of individuals with serious illness. It requires interprofessional collaboration and expertise to meet the physical, psychosocial, social, cultural, and spiritual needs of patients experiencing serious illness and their families. The interprofessional team (IPT) is most often composed of Advanced Practice Providers (APPs) [including Nurse Practitioners (NPs), Clinical Nurse Specialists (CNSs), and Physician Associates/Assistants (PAs)], Chaplains, Registered Nurses (RNs), Doctors of Medicine and Doctors of Osteopathic Medicine (MDs/DOs), Registered Pharmacists (RPhs), Social Workers (SWs) and other professions depending on site of care, the age of the patient, and the illness. The United States has specialty palliative care (SPC) IPT members who have completed advanced education and training and obtained specialty certification. However, there is currently no interprofessional consensus education and training resulting in interprofessional variability of definitions of education and requirements for academic preparation into the specialty. This article offers the results of an online review and survey of the current availability of SPC education in the United States which includes certificate programs, residencies, fellowships, and immersion programs available to each profession. The purpose of this review is to unify the available information regarding SPC programs, providing a succinct, yet thorough, overview of the SPC educational landscape. It emphasizes the length of time, cost, and delivery method for IPT members in choosing programs.

Palliative care national plan implementation through stakeholder analysis

BackgroundNational palliative care plans depend upon stakeholder engagement to succeed. Assessing the capability, interest, and knowledge of stakeholders is a crucial step in the implementation of public health initiatives, as recommended by the World Health Organisation. However, utilising stakeholder analysis is a strategy underused in public palliative care.ObjectiveTo conduct a stakeholder analysis characterising a diverse group of stakeholders involved in implementing a national palliative care plan in three rural regions of an upper-middle-income country.MethodsA descriptive cross-sectional study design, complemented by a quantitative stakeholder analysis approach, was executed through a survey designed to gauge stakeholders’ levels of interest and capability in relation to five fundamental dimensions of public palliative care: provision of services, accessibility of essential medicines, palliative care education, financial support, and palliative care vitality. Stakeholders were categorised as promoters (high-power, high-interest), latent (high-power, low-interest), advocates (low-power, high-interest), and indifferent (low-power and low-interest). Stakeholder self-perceived category and knowledge level were also assessed.ResultsAmong the 65 surveyed stakeholders, 19 were categorised as promoters, 34 as advocates, 9 as latent, and 3 as indifferent. Stakeholders’ self-perception of their category did not align with the results of the quantitative analysis. When evaluated by region and palliative care dimensions the distribution of stakeholders was nonuniform. Palliative care funding was the dimension with the highest number of stakeholders categorised as indifferent, and the lowest percentage of promoters. Stakeholders categorised as promoters consistently reported a low level of knowledge, regardless of the dimension, region, or their level of interest.ConclusionsAssessing the capability, interest, and knowledge of stakeholders is a crucial step when implementing public health initiatives in palliative care. It allows for a data-driven decision-making process on how to delegate responsibilities, administer financial resources, and establish governance boards that remain engaged and work efficiently.

Addressing the Health Needs of LGBTQ Persons in Medical Curricula: A Review of Educational Programs.

Given the vulnerability of and the importance of caring for the specific health care needs of the growing lesbian, gay, bisexual, transgender, and queer (LGBTQ) population, the authors attempted to identify all educational interventions in psychiatric settings with quantitative outcomes targeting medical students, residents, and physicians in postgraduate settings. To gain insight from other disciplines that have published research in this area, a second objective was to review studies in teaching in those other disciplines. The authors sought to describe the methods of selected studies. The authors searched the published English-language literature indexed in PubMed, EMBASE, and PsycINFO using key terms for health care education concerning LGBTQ populations. The authors described and critically appraised studies with quantitative outcomes designed to enhance knowledge, skills, and attitudes in treating the LGBTQ community. Of the 15 trials identified, 10 included medical students, 4 included internal medicine residents or medical school faculty, and 1 included oncologists. We did not find any randomized controlled trials or controlled nonrandomized trials of curricula dedicated to teaching learners in psychiatry. All of the studies included a presurvey, followed by an educational intervention and then a postsurvey assessment. The educational interventions, outcome measures, and quality of studies varied widely. Four studies enrolled self-identified members of the LGBTQ community as trainers and facilitators of the educational interventions. The lack of high-quality controlled studies indicates the need to develop evidence-based curricula to support the education of the psychiatric workforce to provide for the special needs of LGBTQ persons.

코로나19 상황 보육교사의 어려움에 대한 개념도 연구

Objectives The purpose of this study is to explore the contents of the difficulties experienced by day care Teachers under the COVID-19 situation using the concept mapping and to verify how much they sympathize with the contents of the difficulties. Methods This study was conducted according to the concept mapping proposed by Kane and Trochim(2007). After interviewing 12 target day care teachers who met the study, 62 statements were finally decided, and a multidimensional scale method was conducted based on the group similarity matrix. Furthermore, dimensions and clusters were named through hierarchical cluster analysis. Results Among the final statements, everyone agreed that they experienced difficulties in carrying out government guidelines that differed from the field in the COVID-19 situation. Furthermore, Two dimensions were named as the dimension of ‘childcare activity-class operation management’ on the X (horizontal) axis and the dimension of ‘Nursery internal factor-Nursery external factor’ on the Y (vertical) axis. Next, 3 clusters were named as ‘cluster 1. teacher role performance’, ‘cluster 2. government guidelines performance’, and ‘cluster 3. stress from a lot of work’. Conclusions Through the results of this study, the contents of the difficulties experienced by day care teachers under the special situation of the COVID-19 pandemic were identified. Therefore, it can be used to establish basic data that can provide help for practical intervention in the situation of infectious diseases that may occur later.