Clarke's Framework Research Articles

Facilitating acculturation of internationally educated nurses: A meta-synthesis of social integration strategies.

To explore the social integration strategies adopted by internationally educated nurses during acculturation and to elucidate their role in facilitating successful adaptation to their host countries. With their remarkable resilience, internationally educated nurses navigate numerous challenges in their acculturation process in the host country. While the importance of effective social integration strategies in the acculturation and subsequent retention of internationally educated nurses is well known, the specific strategies adopted by these nurses have not been extensively explored. This study aims to fill this gap with its unique and significant focus on these strategies. Eight electronic databases were searched for English articles from inception to October 2023 to ensure a comprehensive review. The quality of the included studies was appraised using the Critical Appraisal Skills Program checklist. A meta-synthesis was performed using Sandelowski and Barroso's two-step approach, and a thematic analysis was performed according to Braun and Clarke's framework. This review included experiences of 258 internationally educated nurses across 16 primary studies and has yielded the overarching theme of 'fostering a sense of belonging'. The overarching theme is supported by three themes: (1) cultivating social capital, (2) employing effective communications, and (3) engaging with the community. Internationally educated nurses' social integration is a complex process that leverages support networks, establishing connections and overcoming communication barriers. However, the most crucial element is the active involvement of the host community, which plays a significant role in internationally educated nurses' acculturation journey. This review has highlighted the importance of social integration in internationally educated nurses' acculturation journey. Interventions such as having a supportive social network, providing a customised communication programme, organising engagement activities and granting overseas home leave are practical strategies that can enhance this journey.

Child drowning in Indonesia: insights from parental and community perspectives and practices.

Child drowning is a significant public health issue in Indonesia, however, there is insufficient understanding of the issue and its associated risk factors within communities. This qualitative study aimed to explore parental and community perceptions and practices related to child drowning in Indonesian communities, and the perceived causes and risk factors. Seven focus group discussions (n = 62) were conducted with parents of children aged under-5 years and village community leaders in seven villages across all districts of Lombok Island, West Nusa Tenggara Province of Indonesia. Participants were recruited using purposive and snowball sampling. The thematic analysis, guided by Braun and Clarke's framework, used both deductive approaches, utilizing the Health Belief Model's constructs and inductive approaches. Most participants were unaware of the susceptibility of their children and others in their community to drowning and of the potential severe outcomes of drowning such as injury, disability and death. Participants generally associated drowning with beaches or open seas. Unprotected wells, tubs and buckets were identified as notable risk factors for child drowning in and around the home, shaped by some experience of child drowning incidents in the community. Supervision was identified as protective factor, however, mothers were often unavailable to supervise children, and supervision responsibility was often delegated to other family and community members. This study highlights the urgent need to enhance public awareness regarding children's susceptibility to drowning. Further exploration of local contexts and social determinants of drowning in Indonesian communities is crucial for ensuring effective water safety and drowning prevention strategies.

A Qualitative Analysis of a Primary Care Medical-Legal Partnership: Impact, Barriers, and Facilitators.

Certain health-related risk factors require legal interventions. Medical-legal partnerships (MLPs) are collaborations between clinics and lawyers that address these health-harming legal needs (HHLNs) and have been shown to improve health and reduce utilization. The objective of this study is to explore the impact, barriers, and facilitators of MLP implementation in primary care clinics. A qualitative design using a semistructured interview assessed the perceived impact, barriers, and facilitators of an MLP, among clinicians, clinic and MLP staff, and clinic patients. Open AI software (otter.ai) was used to transcribe interviews, and NVivo was used to code the data. Braun & Clarke's framework was used to identify themes and subthemes. Sixteen (n = 16) participants were included in this study. Most respondents were women (81%) and white (56%). Four respondents were clinic staff, and 4 were MLP staff while 8 were clinic patients. Several primary themes emerged including: Patients experienced legal issues that were pernicious, pervasive, and complex; through trusting relationships, the MLP was able to improve health and resolve legal issues, for some; mistrust, communication gaps, and inconsistent staffing limited the impact of the MLP; and, the MLP identified coordination and communication strategies to enhance trust and amplify its impact. HHLNs can have a significant, negative impact on the physical and mental health of patients. Respondents perceived that MLPs improved health and resolved these needs, for some. Despite perceived successes, integration between the clinical and legal organizations was elusive.

Exploring Faculty Preparedness for Artificial Intelligence-Driven Dental Education: A Multicentre Study.

Introduction In the modern era, technology, including artificial intelligence (AI), is the centre of digital innovation. AI is revolutionising numerous fields, including the healthcare sector, globally. Incorporating AI in dental education may help in improving the diagnostic accuracy, learners' experiences, and effectiveness of the management of dental education institutions. However, successful implementation of AI requires the faculty's willingness to incorporate it into their practices. Thus, this research aims to explore the readiness of faculty members to integrate AI into dental education. Methodology The study employed a qualitative exploratory design to gather in-depth insights into faculty readiness for AI-driven dental education. Purposive sampling was employed, and 21 faculty members from public and private dental colleges in South Punjab participated in semi-structured interviews. The interviews focused on understanding participants' perceptions, experiences, and challenges related to AI integration in dental education. Thematic analysis was conducted utilising Braun and Clarke's framework to identify key themes and subthemes from the qualitative data using inductive coding. Results Five major themes and 14 subthemes emerged from the data analysis. Faculty members had low AI literacy coupled with diverse perceptions; some participants perceived AI as a solution for revolutionising teaching and learning, while others criticised its misuse as academic misconduct by students, an effect on students' critical thinking, and a threat to conventional jobs. However, most of the respondents also considered AI beneficial for students with remote access or from marginalised populations in terms of accessing and learning from limited resources. Concerns that participants highlighted included a lack of training opportunities, limited facilities, ethical concerns pertaining to data privacy, and assessment bias. Some of the recommendations provided by the respondents include the provision of training opportunities, the allocation of resources and infrastructure, and continuous effective support from institutions for the integration of AI in dental education. Conclusions This study emphasised the readiness of the faculty when it comes to the integration of AI in dental education. The faculty considered AI favourable for digitization and innovative education, although there is a lack of awareness of its application. Regarding the benefits of utilising AI, respondents highlighted its quick response, prediction of students' performance, and flexibility in learning. The challenges included lack of awareness regarding its implementation, inadequate training, lack of availability of resources, lack of institutional support, the problem of data confidentiality, and resistance to change. Suggestions included the provision of technical support, skills training, and the provision of required infrastructure. Participants recommended that AI tools must incorporate cultural and contextually specific content, use technical support for problems, and incorporate constant response systems to improve the AI tools for novice users, especially within developing regions such as Pakistan.

Understanding factors to digital wallet discontinuance intention among past users: an exploratory study

Purpose This exploratory study aims to investigate and identify the factors influencing discontinuance intention among past users of local digital wallets in Brunei Darussalam. Design/methodology/approach This study uses a mixed-method approach that integrates quantitative and qualitative research method. An online survey is distributed via widely used social media platforms, using purposive sampling to target previous users of local digital wallets. Structured questionnaires capture demographic data, whereas open-ended inquiries delve into reasons for discontinuation. Descriptive analysis will extract the demographic profiles of the samples. Inductive thematic analysis, guided by Braun and Clarke's framework, will extract and analyze qualitative responses to unveil emergent themes. Data saturation, anticipated beyond 12 responses, will signify sample adequacy. Findings Demographic profiles based on gender, age and payment preferences of discontinuers supplement the justification for identified themes influencing digital wallet discontinuation in Brunei Darussalam. These themes include “Acceptability Challenge,” highlighting limited vendor acceptance; “Financial Management and Security Issues,” revealing concerns over impulsive buying behavior and security robustness; “Limited Benefits,” referring to short-term interest driven by promotional benefits; “Technological Inertia,” emphasizing reluctance to change from conventional payment methods and “Technical Challenges,” encompassing internet connectivity and operational functionality issues. Research limitations/implications This study acknowledges few limitations, including a limited number of respondents, comprising majorly of the younger age groups and females. Self-reported data usage introduces potential response bias, impacting result validity. The qualitative approach limits comprehensive understanding, suggesting validation through quantitative correlational studies. Additionally, the cross-sectional design restricts insight into the dynamic nature of digital wallet discontinuance in Brunei, suggesting the need for longitudinal studies. Practical implications The findings of this study offer valuable insights for digital wallet providers, policymakers and businesses operating within the realm of Brunei Darussalam. By tackling pertinent issues such as vendor acceptance, financial security and promotional incentives, stakeholders can effectively improve user experiences and mitigate intentions of discontinuing usage. Recommended strategies encompass the enlargement of vendor networks, the implementation of stringent security measures and the customization of promotional campaigns. Furthermore, comprehending demographic inclinations enables the tailoring of offerings, thereby fostering enduring adoption rates. Social implications This study’s findings hold social significance for financial inclusion, technological literacy and consumer empowerment in Brunei Darussalam. Overcoming barriers to digital wallet adoption, such as limited vendor acceptance, promotes financial inclusion in the long run. Improved understanding of digital wallets enhances technological literacy and empowers users to make informed decisions. By catering to diverse demographic needs, stakeholders can promote social equity and ensure widespread access to digital payment benefits, thus positively impacting Brunei Darussalam’s socioeconomic landscape. Originality/value This study contributes to the existing knowledge gap on digital wallet discontinuance in Brunei Darussalam. By uncovering key themes and factors influencing past users’ decisions, it advances understanding in the context of postadoption dynamics. The study provides valuable insights for local and global fintech adoption strategies.

Sociocultural factors affecting first-year medical students' adjustment to a PBL program at an African medical school.

Besides regulatory learning skills, learning also requires students to relate to their social context and negotiate it as they transition and adjust to medical training. As such, there is a need to consider and explore the role of social and cultural aspects in student learning, particularly in problem-based learning, where the learning paradigm differs from what most students have previously experienced. In this article, we report on the findings of a study exploring first-year medical students' experiences during the first semester of an undergraduate problem-based learning medical program at an African medical school. We employed a qualitative case study approach using in-depth interviews with 23 first-year medical students. Participants ranged in age from 18 to 25 years. All students were bi/multilingual (some spoke three to five languages), with English as the learning language. We conducted an inductive thematic analysis to systematically identify and analyze patterns in the data using the Braun and Clarke framework. Before medical school, students worked hard to compete for admission to medical school, were primarily taught using a teacher-centered approach, and preferred working alone. At the beginning of medical school, students found it challenging to understand the problem-based learning process, the role of the case, speaking and working effectively in a group, managing a heavy workload, and taking increased responsibility for their learning. By the end of the first semester, most students were handling the workload better, were more comfortable with their peers and facilitators, and appreciated the value of the problem-based learning approach. Our study highlights the importance of interrogating contextual sociocultural factors that could cause tension when implementing problem-based learning in non-western medical schools. Adjustment to problem-based learning requires a conceptual and pedagogic shift towards learner-centered practice, particularly concerning self-direction, the role of the case, and collaborative learning. As such, there is a need to develop and implement research-informed learning development programs that enable students to reflect on their sociocultural beliefs and practices, and enhance their regulatory learning competence to optimize meaningful and early engagement with the problem-based learning process.

Medical and surgical nurses' experiences of modifying and implementing contextually suitable Safewards interventions into medical and surgical hospital wards.

To explore general nurses' experiences of modifying and implementing contextually suitable Safewards interventions into medical and surgical hospital wards. Qualitative action research was used working with nurses as co-researchers. Pre-implementation focus groups were conducted in April 2022 to understand and explore the current strategies nurses utilized to avert, respond to or decrease violence. Following this, two Safewards interventions were modified by the nurses on the wards. Post-implementation focus groups were conducted in October 2022, to explore the nurses' experience of implementing Safewards interventions and the effect on their nursing practice. Data were analysed using Braun and Clarke's framework for thematic analysis. Three themes emerged from the analysis of the pre-implementation focus groups that reflected the type of violence experienced by these nurses and the context within which they occurred: 'the space is hectic'; 'it can feel like a battlefield'; and 'the aftermath'. These themes encompass the nurses' experience of violence from patients and their visitors. Following the implementation of two modified Safewards interventions, the analysis of the focus groups reflected a change in nursing skills to avert or respond to violence: 'Safewards in action'; 'empathy and self-reflection'; and 'moving forward'. Safewards interventions can be successfully modified and used in general hospital wards and influence nursing practice to manage patient and visitor violence. In the interests of safety, successful interventions to reduce violence towards general hospital nurses should be a priority for managers and healthcare organizations. Averting, mitigating and managing violence can decrease the negative professional and personal effect on nurses and ultimately improve well-being, job satisfaction and retention rates. Furthermore, decreasing violence or aggressive incidents leads to a safer patient experience and decreased number of nursing errors ultimately improving patient experiences and outcomes. Understanding nurses' experiences of violence and working with them to explore and develop contextually relevant solutions increases their capacity to respond to and avert violent incidents. Contextually modified Safewards interventions offer one such solution and potentially has wider implications for healthcare settings beyond the specific wards studied. This study addressed the implementation of modified Safewards strategies in medical and surgical wards to prevent violence. Three themes emerged from the analysis of the pre-implementation focus groups that reflected the type of violence experienced by these nurses and the context within which they occurred. Following the implementation of two modified Safewards interventions, the post-implementation focus groups reported positive changes to their practices using the modified resources to prevent violence from patients and their visitors. Mental health interventions, such as those used in the Safewards model can be modified and provide a tool kit of interventions that can be used by medical and surgical nurses. This paper has adhered to the COREQ guidelines. No patient or public contribution. WHAT DOES THIS PAPER CONTRIBUTE TO THE WIDER GLOBAL CLINICAL COMMUNITY?: This paper outlines and discusses the action research approach undertaken to work with general hospital nurses to modify mental health nurses' Safewards interventions into their clinical practice. This paper provides evidence of the 'real world' application of Safewards interventions by medical and surgical nurses in general hospital wards. This paper presents qualitative findings based on focus group methods to highlight the narratives of general nurses and their experiences of violence.

Factors of success, barriers, and the role of frontline workers in Indigenous maternal-child health programs: a scoping review

BackgroundDespite considerable investment in maternal-child programs in Canada, there has been little positive impact on the health of Indigenous mothers and their children. The reasons for this are unclear and there is a need to identify how such programs can be successfully implemented. Community input is essential for successful programs; however, it is unclear what the contributions of frontline workers have been in the health program process, i.e., program development, delivery, and evaluation. Based on these identified gaps, this scoping review aimed to: (1) identify factors of success and barriers to successful Indigenous maternal-child community health programs for mothers and their children aged 0–6 years; and (2) explore how frontline workers are included in the program process.MethodsThis scoping review was completed using the Arksey and O’Malley framework, informed by Levac et al. Four data bases (Medline, CINAHL, Embase, and Scopus), grey literature, and reference lists were searched for relevant materials from 1990–2019. Data was extracted from included articles and analysed using descriptive statistics, thematic analysis with the Braun and Clarke framework, and a Principal Component Analysis.ResultsForty-five peer-reviewed and grey articles were included in the review. Factors of program success included: relationship building; cultural inclusion; knowledge transmission styles; community collaboration; client-centred approaches; Indigenous staff; and operational considerations. Barriers included: impacts of colonization; power structure and governance; client and community barriers to program access; physical and geographical challenges; lack of staff; and operational deficits. Frontline workers were found to have a role in program delivery (n = 45) and development (n = 25). Few (n = 6) had a role in program evaluation.ConclusionAlthough a better understanding of the frontline worker role in maternal-child health programs was obtained from the review, in a large proportion of literature the authors could not determine if the role went beyond program delivery. In addition, no direct input from frontline workers and their perspectives on program success or barriers were identified, suggesting areas to explore in future research. This review's findings have been applied to inform a community-based participatory research project and may also help improve the development, delivery, and evaluation of Indigenous maternal-child health programs.

An evaluation of a trauma-informed educational intervention to enhance therapeutic engagement and reduce coercive practices in a child and adolescent inpatient mental health unit.

High-risk behaviours are sometimes encountered in Child and Adolescent inpatient mental health units and can prompt the use of coercive practices to maintain safety. Coercive practices may lead to re-traumatisation of young people and deteriorating therapeutic relationships. Trauma-informed practice (TIP) has successfully reduced coercive practices. While education is identified as foundational to implementation, evaluations of programmes remain minimal. The aim of this study was to explore mental health professionals' views and experiences of a trauma-informed education programme and its likely impact on their approach to practice. Five mental health professionals agreed to participate, four contributed in a focus group and one in an individual interview. Data were analysed thematically using the Braun and Clarke Framework. Three main themes were identified. Firstly, shifting attitudes and perceptions of trauma-informed practice. Participants believed they had developed more compassion towards clients and these attitudes were reflected in their clinical practice. Secondly, challenges associated with trauma-informed practice educational intervention. Staffing issues and shift work made it difficult for participants to attend education sessions regularly. Participants identified barriers to practicing in a trauma-informed manner in the current clinical environment. Finally, the need for interdisciplinary communication and support was identified. Participants saw the need for all professionals, not only nurses, to take responsibility for changing practice, and for stronger support at the organisational level. Trauma-informed practice is crucial to recovery-focused mental health nursing practice. These findings highlight the importance of TIP education and suggest areas for further improvement to enhance positive mental health outcomes for young people.

An innovative approach to remodelling bioscience undergraduate final year projects to develop key transferable skills sought by graduate employers

Undergraduate Biomedical Science dissertations are the culmination of a student’s academic journey and allow students to refine technical proficiencies, experimental design and data analysis. However, traditional dissertation projects may not fully meet the requirements of diverse student populations and employer’s needs. This research project aims to assess the effectiveness of modifying the assessment format for final-year projects, incorporating elements such as lay summaries, project proposals, scientific research papers, and oral poster defences. The objective was to cultivate higher-order critical thinking skills and enhance written and verbal communication competencies, in addition to developing a suite of transferable skills which are highly sought by employers. Quantitative data were primarily generated via end-of-module feedback reports and the module satisfaction survey. Students rated their confidence in a suite of transferable skills pre and post-completion of the project module using a four-point Likert scale. Staff perceptions (n = 30) and module board reports were also evaluated. For all data, a paired t-test for related groups was conducted. Thematic analysis was used to analyse qualitative data using the Braun and Clark Framework. The end-of-module feedback was overwhelmingly positive with all students agreeing that they were satisfied with the module. Students reported a statistically significant increase in confidence within 11 transferable skills which are considered core within the industry, for example, critical thinking, problem-solving and time management. Furthermore, the mean module mark increased following the module redesign from 66.3% ± 0.2% in 2019 to 70.9% ± 0.6% in 2020 (p ≤ 0.05). Staff provided free text comments, reporting an overall improvement in the module, a reduction in workload and a better teaching experience. Students exhibited appreciation of the new module structure, assessment suit and creative liberty within the projects. The redesigned project module enhanced the teaching experience for staff, whilst students appreciated the diverse range of projects and assessments that featured shorter word limits and a creative flair. Universities must reinvent undergraduate dissertations to equip students with essential employability skills.

Cultural Competence in Ophthalmic Dispensing Education: A Qualitative Study.

Understanding and acknowledging cultural diversity in healthcare is essential in providing culturally competent care. Higher education institutions are critical to providing students with the necessary knowledge, attitudes, and skills to respond to cultural diversity in various contexts. Cultural competence teaching in ophthalmic dispensing education has emerged as an essential concept that needs to be included in the curriculum. This study explored ophthalmic dispensing lecturers' understandings, experiences, and attitudes in teaching cultural competence. This study used a qualitative approach within an interpretivist paradigm by conducting semi-structured interviews with lecturers (n = 7) in the ophthalmic dispensing program. Braun and Clarke's framework for thematic analysis was utilized. The research was conducted at an ophthalmic dispensing department at a South African university. The analysis of the semi-structured interviews indicated three main themes of importance regarding factors influencing cultural competence education in the ophthalmic dispensing curriculum: the interplay between experiences and understandings of cultural competence, cross-cultural exposure and teaching practices, and inclusion of cultural competence into the curriculum. The participants recognized that cultural competence was not explicitly included in the curriculum. Including culture in education was rather unsystematic and, in most cases, unplanned. Further training of lecturers on cultural competence skills and evidence-based teaching and assessment strategies are required to assist in developing curricula that include cultural competence.

Insights of healthcare professionals regarding waterbirths and water immersion during labour: A mixed studies review.

To consolidate healthcare professionals' insights about waterbirths and water immersion during labour. Mixed studies review. Seven electronic databases were searched from their inception dates till June 2023: PubMed, Embase, CINAHL, PsycINFO, Web of Science, Scopus, ProQuest Dissertations and Theses Global. The Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines and Pluye and Hong's mixed studies review framework guided this review. The quality of included studies was evaluated using the Mixed Methods Appraisal Tool. Findings were synthesized using the convergent qualitative synthesis method, and results were thematically analysed using Braun and Clarke's framework. Three main themes were identified from the 22 included studies: (1) believing in waterbirths, (2) opposing forces and (3) plotting the course ahead. Healthcare professionals reported different views about waterbirths and water immersion practices; midwives were most likely to support these practices, followed by nurses and lastly, few physicians supported them. Reasons for opposing waterbirths include insufficient training and support from colleagues as well as concerns about work efficiency, waterbirth safety and litigation issues. The available evidence suggests the need to provide waterbirth training for healthcare professionals, equip healthcare facilities with necessary waterbirth-related infrastructure and develop appropriate waterbirth policies/guidelines. Healthcare professionals could also consider providing antenatal waterbirth education to women and obtain women's feedback to improve current policies/guidelines. Future research should explore the views of different types of healthcare professionals from more diverse cultures. The PRISMA guidelines. Systematic review.

Stress and Coping Strategies Among Nursing Students

BACKGROUND: Nursing students experience stress as they progress through their programs of study because they must fulfill numerous theoretical and clinical requirements. Stress describes a dynamic relationship between a person and their surroundings. It is a widespread phenomena of contemporary life styles; it has been discovered to have negative health effects and to adversely impair students’ learning, and it is recognized as one of the most significant problems in the contemporary world.
 
 AIM/OBJECTIVE: The goal of the current study was to identify the sources of stress among undergraduate nursing students and to explore their coping methods.  
 
 DESIGN: a qualitative descriptive methodology.
 
 METHOD: 20 semi-structured interviews were conducted individually in the English language by the principal researcher at female nursing college. The initial section of the interview consisted of a document listing the participants’ age and level. Questions derived from theoretical model were used in the interview’s second section to identify the sources of stress among undergraduate nursing students and to explore their coping methods. The qualitative data was analyzed using thematic analysis based on the Braun and Clarke framework.
 
 RESULTS: four global themes were emerged as the following: stressors, stress symptoms, coping strategies, and educational environment. The first 3 themes were derived deductively from the study theoretical model; whereas, the last theme was derived inductively from the data itself.
 
 CONCLUSION: management of the stress becomes critical. Coping strategies have been found to be effective in lowering the stress among nursing students.

Exploring Psychiatrists' Experiences During Transition from Mental Health Act, 1987 to Mental Healthcare Act, 2017 in Goa, India.

Mental Healthcare Act 2017 (MHCA) came into force on 29 May 2018. Goa State Mental Health Authority (GSMHA) notified the Mental Health Review Board on 8 February 2022, completing the important process of implementation of the act. The transition comes with challenges. A qualitative study was conducted with 18 practicing psychiatrists who had worked under Mental Health Act 1987 as well as MHCA 2017 through purposive sampling across Goa. Data was collected through individual interviews; analysis was done by Braune and Clarke's framework of Thematic Analysis. Eighteen psychiatrists participated: 4 private, 3 secondary and 11 from tertiary levels. The themes extracted were work during MHA 1987, transition, and after the implementation of MHCA 2017. Some participants reported difficulties, felt an increase in workload, and had negative emotions, while a few were neutral, indicating mixed perceptions. This study highlights the administrative struggles and moral dilemmas faced by psychiatrists in handling the new legislation. It's imperative that the implementation of new act should be carried out with sufficient resource allocation and monitoring mechanisms.

1101 Patient Experiences of Teleconsultations Follow-Up After Cancer Surgery Within the National Health Service. a Qualitative Systematic Review

Abstract Background Teleconsultations were introduced for cancer surgery follow-up to ease pressure on hospital services and facilitate patients’ access to those services. Currently, there is limited evidence of patients’ perception of the swift shift in service provision. Aim This qualitative systematic review aimed to explore patient experiences of teleconsultations within UK-based NHS cancer surgery follow-up services; to better understand patient perception, satisfaction, and acceptability of the teleconsultation approach. Method MEDLINE, EMBASE, PUBMED, and Google scholar were searched up to the 1st of January 2022. Articles were screened by two independent reviewers and qualitative studies were synthesized using the Braun and Clarke framework. Concepts identified were summed up into relevant themes and subthemes. Results A total of 1226 articles were screened, of which six were retained after full-text screening and quality assessment. The main findings revealed three overarching themes: accessibility, patient experience, and consultation. Most patients reported a positive experience with remote consultation, although others had uncertainties about its effectiveness due to the inability to build rapport with clinicians and the lack of emotional support. Conclusions Teleconsultations were widely accepted among cancer surgical patients. More research is needed to explore clinicians’ views of teleconsultations in cancer surgery and audits should be carried out to evaluate the system currently in place.

Harm reduction services for people engaging in chemsex in Brighton, UK: A pilot qualitative study.

A broad range of stakeholders commission and provide harm reduction support for people who engage in chemsex, including public health, sexual health, mental health, HIV services and substance misuse services. Understanding the experiences of stakeholders could provide important insights and suggest ways to improve outcomes. We aimed to explore the experiences of stakeholders providing harm reduction support to people who engage in chemsex in Brighton, UK. We conducted semi structured interviews with chemsex harm reduction stakeholders who provide support for people in Brighton, UK. The semi-structured interviews were recorded, transcribed, and analysed thematically using NVivo 1.6.2: Braun & Clarke framework. We recruited ten stakeholders with at least 6months of experience in providing commissioning, managing or providing harm reduction services to people who engage in chemsex. Five themes emerged from the stakeholders: stakeholder perception of client pathways (inefficiency in client pathways, inequitable access to services, unmet client mental health needs) and stakeholder experiences (having to use an 'empathy', 'non judgement' and 'guiding hand' approach), and experiencing emotional burnout as a result of the chemsex harm reduction work. This pilot study of stakeholders suggests that to improve chemsex harm reduction outcomes, a more integrated approach between providers with clear client pathways and a broader reach including services tailored towards non-MSM, and offering services outside of typical business hours is needed. Furthermore, the sustainability of services requires increased workplace support for chemsex service providers to prevent burnout and maintain service quality.

Referral challenges for early-onset colorectal cancer: a qualitative study in UK primary care.

The incidence of early-onset colorectal cancer (EOCRC) in adults aged <50 years has increased in several Western nations. National surveys have highlighted significant barriers to accessing timely care for patients with EOCRC, which may be contributing to a late stage of presentation in this population group. To explore awareness of the increasing incidence of EOCRC, and to understand the potential barriers or facilitators faced by GPs when referring younger adults to secondary care with features indicative of EOCRC. Qualitative methodology, via virtual semi-structured interviews with 17 GPs in Northern Ireland. Reflective thematic analysis was conducted with reference to Braun and Clarke's framework. Three main themes were identified among participating GPs: awareness, diagnostic, and referral challenges. Awareness challenges focused on perceptions of EOCRC being solely associated with hereditary cancer syndromes, and colorectal cancer being a condition of older adults. Key diagnostic challenges centred around the commonality of lower gastrointestinal complaints and overlap in EOCRC symptoms with benign conditions. Restrictions in age-based referral guidance and a GP 'guilt complex' surrounding over-referral to secondary care summarised the referral challenges. Young females were perceived as being particularly disadvantaged with regard to delays in diagnosis. This novel research outlines potential reasons for the diagnostic delays seen in patients with EOCRC from a GP perspective, and highlights many of the complicating factors that contribute to the diagnostic process.

'Breaking the cycle': a qualitative study exploring general practitioners' views of infant mental health.

Infants living in areas of socioeconomic deprivation are more likely to have adverse childhood experiences (ACEs), which are associated with infant mental health (IMH) problems and poor physical and mental health outcomes throughout the life course. As part of the development of IMH services in Scotland, studies are being conducted to explore various stakeholders' perspectives. To understand the views and experiences of GPs working in socioeconomically deprived areas in relation to IMH. Qualitative study with GPs working in deprived urban communities in Scotland, UK. Semi-structured interviews were conducted with 12 GPs from 11 practices. Transcribed interviews were thematically analysed, following the Braun and Clarke framework, using NVivo (version 12) software. The following three overarching themes are presented: (1) Deep End GPs' inherent understanding of IMH, owing to their placement in deprived communities and their under-recognised role in current IMH provision; (2) Factors influencing how communities might perceive IMH, including the potential associations of IMH with parental blame or judgement in areas of socioeconomic deprivation; and (3) Using previous experience to visualise future IMH service delivery, particularly improving on current shortcomings of connectivity and accessibility of services, to develop successful new services. GPs in areas of socioeconomic deprivation have a deep understanding of the issues affecting IMH, although do not necessarily relate to the term 'IMH'. New community-based IMH services are much needed, particularly in deprived areas. However, the pre-existing role of primary care must be recognised, supported, and integrated into new services, alongside training to increase IMH awareness among GPs and other primary healthcare professionals (HCPs).

Patients' experience of teleconsultations in the UK.

Teleconsultations were introduced for cancer surgery follow-up to ease pressure on hospital services and facilitate patients' access to those services. There is limited evidence on patients' perceptions of this swift shift in service provision. The purpose of this qualitative systematic review was to explore patient experiences of teleconsultations within NHS cancer surgery follow-up services to better understand patient perceptions, satisfaction and acceptability of teleconsultations within cancer services. Medline, Embase, PubMed and Google Scholar were searched up to 1 July 2022. Qualitative studies were synthesised using the Braun and Clarke framework. There were three overarching themes: accessibility; patient experience; and consultation. Teleconsultations were widely accepted among cancer surgical patients. However, there were reports of a lack of rapport building and emotional support because of the absence of visual cues and patient camaraderie.

A Qualitative Study of Medical Students' Perspectives on Distance Learning During COVID-19.

With the Coronavirus disease 2019 [COVID-19] pandemic, changes were undertaken out of necessity to allow medical students to continue their education. The aim of this study is to create key themes for educators to consider when implementing distance learning strategies into the curriculum based on 2nd year graduate entry medical students experience of learning and engagement with the use of distance learning during the COVID-19 pandemic. A qualitative study with a phenomenological methodology was set within a constructivist paradigm. A volunteer sampling strategy was used to recruit participants. Nine semi-structured, audio-recorded interviews were undertaken and transcribed verbatim. A thematic analysis was undertaken of the transcripts using the Braun and Clarke framework with an open-coded approach. Exploration of the student experience generated an understanding of the learning process. The concept of adaptability emerged based on the themes of technology, environment, study skills and human interaction. Necessary changes to the formal curriculum affected medical students learning and experience that demanded adaptability. The 'new normal' generated a context within which students were communicating and interacting in ways creating individual challenges for students and educators. With the advancements in information, communication and technology, distance learning is likely to be further incorporated in undergraduate training long term. Its position should be one that is harmonious within the wider educational realm that engages and meets the needs of the students. The rich understanding exposes adaptations and considerations for educators to improve the student experience.