Clear Communication Research Articles

Patient-centred care and technical challenges during polytrauma imaging - Experiences from radiography students.

Patient-centred care (PCC) is essential in radiography for polytrauma patients emphasising empathy, clear communication, and patient well-being. Polytrauma patients require tailored imaging approaches, often involving multiple modalities. Managing and handling these patients during imaging are key components of radiography training to develop the necessary competencies. This study aimed to explore the experiences of third- and fourth-year radiography students in applying PCC during the imaging of polytrauma patients. A qualitative interpretive phenomenological design was employed to capture the in-depth experiences of third and fourth-year radiography students at the University of Namibia. The study utilised purposive sampling to select participants. Data were collected through face-to-face semi-structured interviews, recorded and transcribed for interpretive phenomenological analysis. Trustworthiness was ensured through credibility, dependability, confirmability, and transferability measures. Twenty-one students (3 males, 18 females; 10 third-year, 11 final-year) participated. Three interpretive themes shaped the findings: Compassionate Patient Care, reflecting students' commitment to balancing technical accuracy with empathy while managing personal fears; Professional Challenges in Polytrauma Imaging, highlighting emotional trauma, technical challenges, and communication barriers as central obstacles; and Professional Transformation Through Collaboration, illustrating how teamwork and reflective practice fostered growth, confidence, and resilience. The findings highlight the human and transformative nature of students' experiences in imaging polytrauma patients. This study highlights radiography students' experiences imaging polytrauma patients, emphasizing compassionate care, professional challenges, and collaborative growth. The interplay between technical skills, emotional resilience, and relational competence underscores the need for curricula that address patient-centred care, adaptive problem-solving, and emotional resilience to prepare students for clinical challenges. Radiography curricula should incorporate emotional resilience training, patient-centred care principles, and adaptive problem-solving to enhance students' preparedness for real-world clinical challenges.

Perspectives on usability and adoption of a new ACL injury prevention programme for female handball players: a mixed methods approach

Effective injury prevention programmes (IPPs) hold promise for mitigating ACL injuries in female handball players, yet adherence remains a challenge. This mixed methods study explores the relationship between programme usability...

Patient and public involvement in the co-design and assessment of unobtrusive sensing technologies for care at home: a user-centric design approach

BackgroundThere is growing interest in developing sensing solutions for remote health monitoring to support the safety and independence of older adults. To ensure these technologies are practical and relevant, people-centred design is essential. This study aims to explore the involvement of various stakeholders across different developmental stages to inform the design and assess the capabilities of unobtrusive sensing solutions being developed as part of the Advanced Care Research Centre (ACRC), Edinburgh, UK.MethodsThis study was conducted in two phases. In Phase I (Ideation), discussions were held with stakeholders (n = 19), including senior geriatricians (n = 2), healthcare and care home professionals (n = 4), PPI experts (n = 2), researchers (n = 4) and public members aged 65 and above from the ACRC Patient and Public Involvement (PPI) Network (n = 7). The goal was to identify clinically significant health parameters and design preferences. Based on this, prototypes of unobtrusive sensors for monitoring movement, hydration, and respiration were developed. In Phase II (Development and Co-Design), an in-person PPI workshop was conducted with PPI experts (n = 2), researchers (n = 4) and PPI members (n = 8). The developed prototypes were demonstrated, and qualitative feedback was collected through focus group discussions on themes such as acceptability, usability, privacy, data sharing, and functionality enhancement.ResultsStakeholder input from Phase I emphasized the importance of non-contact sensing technologies that maintain privacy. Movement, hydration, and respiration were identified as critical health parameters. In Phase II, PPI members were optimistic about the prototypes, valuing their unobtrusive design and privacy-preserving features. Key themes identified included (1) the need for user-customized alarms, (2) clear data-sharing protocols, and (3) the importance of embedding sensors into familiar household objects. Suggestions for refining the prototypes included adding functionality for detecting deviations in daily routines and integrating feedback mechanisms for caregivers.ConclusionsInvolving diverse stakeholders from the early stages of technology development enhanced the relevance and acceptability of unobtrusive sensing solutions. This study highlights the importance of integrating public perspectives into the design process. For successful implementation, developers of healthcare technologies should prioritize privacy, usability, and clear communication with end-users and caregivers.

Vandalism as a Mode of Visual Sovereignty: A New Definition and Complications Arising

ABSTRACT Visual sovereignty refers to indigenous groups’ authority in the imagery, representation, conservation, and meaning-making of visual heritage belonging to them. While visual sovereignty is often discussed in terms of making, with a focus on art, photography, and filmmaking, this article will discuss it in terms of unmaking. Vandalism—the deliberate destruction of, or performative reconstitution of, public art, monuments, and/or statuary—may be used as a mode of visual sovereignty, where, with clear communication, marginalised indigenous groups are able to guide the representation and meaning-making around visual heritage belonging to them. Certain critical factors should be followed to ensure the success of the unmaking of prescribed representations. Still, vandalism as a mode of visual sovereignty is fraught with complications—as this article shows through the case of the destroyed Krotoa bench in Cape Town, South Africa. In as much as unmaking may be considered an important part of identity recovery, it can only have lasting positive effects if it is coupled with making, and since indigenous perspectives are rarely homogeneous, upholding the dignity of other members of the group should be paramount in decision-making surrounding the use of vandalism in meaning-making of visual heritage. The weakness of vandalism as a mode of visual sovereignty should thus be considered.

Barriers and facilitators to the implementation of PHAROS, a perioperative pharmaceutical management intervention for older adults – a qualitative interview study from the perspective of healthcare providers

BackgroundNumber of drugs are increasing with older age and present a risk factor for various adverse health outcomes. A comprehensive medication therapy management (MTM) before admission for elective surgery may help reduce unnecessary and potentially inadequate medications (PIM) and thus improve patient health. Our goal was to evaluate the implementation of PHAROS, a perioperative MTM intervention study, from the perspective of health care providers. The PHAROS intervention aimed to improve medication appropriateness in older inpatients at the outpatient / inpatient interface.MethodsWe performed a qualitative interview study within a pilot intervention study comparing a comprehensive MTM with standard care in older inpatients (≥ 65 years) in Germany. Semi-structured interviews with health care professionals were performed from March to July 2021. The Consolidated Framework for Implementation Research (CFIR) was used to guide development of interview guide, data coding, analysis, and reporting of findings.ResultsTen health care professionals involved in the implementation of PHAROS were interviewed. Based on CFIR-constructs, facilitators included need for and meaningfulness of the intervention as well as positive and supportive cooperation within the project team. Implementation of MTM at the interface of inpatient to outpatient care before elective surgery was hampered by personal and organizational barriers as well as barriers resulting from broader health care structures in Germany. In particular, lack of documentation standards, missing compatibility with clinical workflow, difficulties in stakeholder engagement, as well as communication barriers between outpatient and inpatient care interfaces hindered implementation of the intervention.ConclusionsFurther studies should consider focusing on facilitators to pharmaceutical implementations such as transparent and clear communication structures between stakeholders, standardization of medication documentation, and intervention structures that are adapted to hospital workflows.Trial registrationhttps://drks.de Identifier: DRKS00014621, this study was part of the PHAROS study.

The complexities of aeronautical transfer of acutely unwell neurosurgical patients.

Neurosurgical care is difficult to access in many scenarios. Aeromedical evacuation of acutely unwell neurosurgical patients from remote, isolated or poorly equipped locations can be considered. This article aims to provide a framework of logistical factors which deserve special consideration in the preparation of these patients for transfer. We searched all relevant medical literature, military reports, and travel industry documents on transfer of neurosurgical patients. This review was combined with a senior author's (MJ) extensive relevant experience, to present important factors for neurosurgeons to consider during planning of aeromedical evacuation, highlighting potential preventable causes of deterioration en-route. Several criteria must be met for a transfer to be considered. The safe transfer of patients with cranio-spinal pathology requires efficient collaboration between the referring teams, the receiving units/departments, and the medical transfer service. Clear communication, qualified personnel and appropriate transportation equipment must be available for the transfer. One must consider unique stressors during the air transfer, including the risk of hypoxia on certain types of flights. Vibration, loud noise, acceleration, and changes in barometric pressure en-route may negatively affect the patient during transfer. Patient stabilization before transfer is a priority. Medical conditions which can potentially worsen in-flight should be corrected before transfer. The use of a checklist before departure is highly recommended, and is included below. The timing of transfer concerning the postoperative patient deserves special consideration. Although there is little published information, this review provides useful criteria and parameters needed for safe aeromedical evacuation of neurosurgical patients.

Symptom appraisal and help-seeking before a cancer diagnosis during pregnancy: a qualitative study.

Background Estimated incidence of cancer diagnosis during or shortly after pregnancy is 1 in 1,000 women. Pregnancy can impact symptom appraisal and help-seeking for symptoms subsequently diagnosed as cancer. Little is known about the pathway to cancer diagnosis in pregnancy or delays that women can encounter. Aim To explore symptom appraisal, help-seeking decisions, and experience of receiving a cancer diagnosis during pregnancy. Design and setting Semi-structured interviews with women diagnosed with cancer during or shortly after pregnancy in the previous four years, recruited between January and May 2022 via the charity Mummy's Star. Method Reflexive Thematic Analysis of 20 interviews. Analysis was largely inductive, and the themes generated were mapped onto the intervals of the Model of Pathways to Treatment. Results Symptoms were often interpreted through the lens of pregnancy by both participants and most of the healthcare professionals from whom they sought help. Participants who found breast lumps were likely to suspect cancer and be referred promptly for tests in secondary care. While most participants sought timely help for their symptoms, some subsequently encountered health system delays, partly due to both the vague nature of their symptoms and the COVID-19 pandemic. Conclusion Health services need to better support women presenting with possible cancer symptoms during pregnancy to ensure timely diagnosis. Recommendations include prioritising symptoms over attributing them solely to pregnancy, ensuring timely referrals to rule out serious conditions, and emphasising clear communication alongside robust safety-netting practices. A full assessment is essential before dismissing symptoms as pregnancy related.

Social acceptance of human–wildlife coexistence: a case study about the reintroduction of the large herbivore European bison (Bison bonasus) in Switzerland

This study examines the social acceptance of the reintroduction of large herbivores. Focusing on a representative case study of European bison (Bison bonasus) in Switzerland, this research was carried out alongside a reintroduction project in its early stages in order to measure regional acceptance of human–wildlife coexistence. A representative survey within the reintroduction area and qualitative interviews were used to identify key factors influencing attitudes toward the reintroduction project. The main results showed a very strong polarization of the public, divided into “ecocentric pro‐project” and “anthropocentric and conservative anti‐project” groups. The strongest predictors of acceptance turned out to be the perception of reintroduction project management and communication, the perception of the animal per se, the affiliation to an environmental association and the perception of regional nature parks (the last two aspects constituting different nuances within a person's environmental values). This study shows that project planners need to focus on clear and transparent communication about project management and process, as well as trying to get the public to appreciate the reintroduced species as a friendly animal. The present research highlights the societal challenges of reintroducing large herbivores into rural landscapes and aims to assist in selecting measures that take into account the needs of all parties.

The Impact of Relocations Within Nursing Home Care on Long-Term Care Residents According to Stakeholders: A Qualitative Study.

Nursing home residents can be faced with relocations within nursing home care for various reasons, whether individual or per group. We aimed to collect a broad stakeholder overview of observed and experienced impacts on residents and aspects that influence the impact. We conducted a qualitative study using semistructured interviews followed by one focus group. We recruited participants from various stakeholder perspectives based on differences in roles while having an interest or involvement in relocations, and experience with relocations. The interviews and focus group were audiorecorded, transcribed verbatim and analysed using responsive and thematic analysis. In 17 interviews including one duo interview, participants described the impact on residents varying from very positive to very negative. In addition, stakeholders addressed differences in impact related to the relocation phase (before, during, after). Aspects influencing the impact of relocations were (1) mental resilience of residents, (2) organisation of relocations, (3) social connections of residents, and (4) the new (care) environment. The focus group with six participants added further insights in the subtheme 'organisation of relocations', emphasising the importance of clear and timely communication with residents and relatives and recognizability of (personal) items and professional caregivers from the former nursing home. Stakeholders described the impact of relocations within nursing homes to vary between and within nursing home residents. Aspects they identified to influence this impact provide incentives to reduce the negative impact on residents and foster positive impact. Further research needs to zoom-in on the perceived impact of relocations within nursing homes of residents themselves.

Factors influencing childbirth fear among Asian women: a scoping review

Fear of childbirth (FOC) or tokophobia adversely affects women during pregnancy, delivery, and postpartum. Childbirth fear may differ across regions and cultures. We aimed to identify factors influencing the fear of childbirth among the Asian population. A systematic literature search was performed using the PubMed, Scopus, and Web of Science databases in November 2023. Original articles in English with research conducted in Asian countries were included. The independent factors associated with childbirth fear, from the relevant studies were identified and discussed. Forty-six papers met the eligibility criteria but only 26 studies were discussed in this review. The significant factors were categorized into (1) demographics, (2) clinical, (3) healthcare service, (4) childbirth education & information, and (5) COVID-19 pandemic. The prevalence of childbirth fear among Asians ranged between 56.6 and 84.8%. Significant demographic factors included age, education, marital status, economic status, and area of residence. Greater levels of tokophobia were linked to nulliparity, unplanned pregnancy, infertility, miscarriage, and pregnancies at risk. Effective doctor-patient communication and more frequent antenatal visits were shown to alleviate maternal childbirth fear. There was consistent evidence of prenatal childbirth education’s benefit in reducing FOC. The usage of smartphone apps and prolonged exposure to electronic devices were linked to a higher degree of tokophobia. Nulliparas who received too much pregnancy-related information also reported increased childbirth fear. There was a positive correlation between maternal fear of COVID-19 infection and FOC. Keeping updated with COVID-19 information increased the maternal childbirth fear by two-fold. In conclusion, a stable economy and relationship contribute to lesser childbirth fear among Asian women. Poor maternal health and pregnancy complications were positive predictors of FOC. Health practitioners may reduce maternal childbirth through women’s education, clear communication as well as accurate information and guidance to expectant mothers. Further study is required into the content of childbirth fear among Asian women. These research findings hopefully will lead to the development of culturally adapted screening tools and interventions that reduce the burden of FOC among expectant mothers.

What do citizens think of central bank digital currencies in the euro context? A Twitter sentiment analysis

PurposeThis paper delves into the discourse surrounding central bank digital currencies (CBDC) from the perspective of citizens’ views expressed on Twitter, on the potential implementation of a digital euro. The paper sheds light on citizens’ sentiments regarding CBDCs in relation to the euro and the euro area.Design/methodology/approachUsing “TextBlob” sentiment analysis, this paper analyzes 4,462 Tweets containing the keywords “cbdc” and “euro” posted between September 14, 2018, and June 19, 2023. It explores citizens’ perceptions and concerns, as well as the general sentiment conveyed by the Tweets, through sentiment analysis and word-cloud generation. Text analysis and the “KMeans algorithm” are used to identify similar groups of Tweets. Statistical analysis of Term Frequency-Inverse Document Frequency (TF-IDF) keyword values in each cluster provides information about the relative distribution of words within clusters. In a further step, sentiment analysis is performed on each cluster by rating it positively, neutrally or negatively to identify the relevant dominant themes.FindingsThis paper reveals the evolving nature of CBDC-related discourse on Twitter over a four-year period, demonstrating a slight overall trend of positive sentiments. The distribution includes Tweets with a pronounced negative and positive sentiment, highlighting the need for clear and citizen-friendly communication through social media channels (such as Twitter or LinkedIn) in addition to the traditional channels used by official institutions.Research limitations/implicationsThe extraction of Tweets was limited to English; bilingual Tweets containing English words were also considered. Future research could be expanded to include Tweets in additional languages and compare them to English Tweets. Geographical data on the origin of the Tweets were not considered due to potential inaccuracies resulting from the use of VPNs.Practical implicationsThe findings highlight citizens’ views, expectations and perceptions on the digital euro as a type of CBDC, suggesting ways in which the European Central Bank (ECB) can ensure customer satisfaction with its successful implementation.Originality/valueThe originality of the article revolves around the focus on the digital euro and on analyzing European citizens’ opinions regarding its implementation. In contrast to previous literature, this research discusses critically the pros and cons and possible design aspects of the new digital euro, by taking a citizen-centric approach and focusing solely on one type of currency. Technological advances and the digital era have left their mark on how society communicates and behaves. The implementation of CBDCs will affect the digital society. Therefore, the paper sparks a debate about European citizens’ sentiments toward adopting the digital euro, as a new digital currency, which will impact their lifestyle and financial decisions.

Optimizing claim management process groups to enhance construction project success

In the complex construction projects, claims arising from unforeseen circumstances, contractual disputes, or project changes can significantly impact project outcomes, making effective claim management a critical aspect of overall project success. Ineffective claim management can lead to project delays, cost overruns, and in severe cases, project termination. This study examines critical factors influencing claim management in construction projects, analyzing stakeholder perceptions through a questionnaire distributed to 104 industry professionals. Using convenience sampling, the study utilizes a Relative Importance Index (RII), Frequency Index (FI), and Frequency Adjusted Importance Index (FAII) to rank the significance of 108 identified claim management factors across eight process groups. The findings emphasize the criticality of clear communication and robust contract management in mitigating claims. Poor negotiation skills, adversarial relationships, and inadequate documentation are identified as major obstacles to effective claim resolution. Pearson correlation analysis reveals strong correlations between key factors and their respective process groups, reinforcing the reliability. The research highlights the ‘claims resolution’ phase as particularly crucial, with factors like the use of balanced contracts (e.g. FIDIC/ICE) and comprehensive claim documentation emerging as highly significant. The study provides valuable insights for industry practitioners to enhance claim management practices and ultimately, improve project success rates.

Understanding the experiences of autistic high school students and neurodivergent job coaches in a summer employment program: an interpretive description study

Purpose This study explores the experiences of autistic youth and neurodivergent job coaches during a job training program. Methods Interpretive Description methodology guided this study. Two researchers facilitated virtual focus groups with autistic students and neurodivergent job coaches separately before (n = 14) and after (n = 12) the program. Thematic analysis was conducted to identify codes and develop themes. Results Seven themes were developed, which included both autistic high school students and neurodivergent job coaches’ perspectives about JTP: JTP surprised students; unexpected experience of working, students experienced a sense of community support in transitioning to work, students built rapport with neurodivergent job coaches, neurodivergent job coaches were buffers to students, building trusting connection; neurodivergent job coaches’ interactions with students, unexpected reality and a sense of community in coaching autistic students, and neurodivergent job coaches’ personal growth and the evolving role of coaching. Conclusion The findings of this study suggest that positive work experiences and relationships between neurodivergent job coaches and students occurred within a specific program that recommended clear communication about expectations, roles, and support preferences. The findings can guide future community partnerships to promote workplace participation and facilitate accommodations based on the needs of neurodivergent population, including autistic individuals.

Organizational Culture and Employee Turnover at Dahabshiil Bank in Mogadishu, Somalia

The main objective of this study was to establish organizational culture and employee turnover at Dahabshiil Bank in Mogadishu, Somalia. This study conduct at Dahabshiil Bank in Mogadishu, Somalia. This study started February 2021 and finished August 2024. Methods: The study aimed to analyze the organizational culture and employee turnover of Dahabshiil Bank in Mogadishu, Somalia. A total of 200 employees were included, with a sample size of 133. A quantitative research design was chosen for efficiency and cost-effectiveness. Data was collected through a structured questionnaire tool, and quality control measures included validity and reliability. The study involved random and purposive sampling, and all responses were checked for accuracy. The data analysis involved quantitative data analysis and descriptive evaluation. Result: The survey data on organizational values revealed a diverse range of perceptions among respondents. A significant portion expressed dissatisfaction with the clarity of communication about organizational values, while nearly half agreed that they receive clear communication. Employees' self-assessment of their role in promoting a respect-oriented culture revealed diverse perspectives. The influence of organizational values on employees' decisions to stay at work revealed a wide range of perspectives. Recognition by the bank for observing organizational core values revealed a diverse range of experiences and sentiments. The performance appraisal system showed mixed opinions, with 28.1% strongly disagreeing and 17.3% disagreeing. The study shows a negative perception of employee participation in innovation, with a majority disagreeing (85.7%). The impact of Dahabshiil Bank's innovation orientation on employees' commitment to the bank was varying, with 58.6% disagreeing and 30.0% positive, suggesting that the bank's innovation focus influences their decision to stay. Recommendation: The bank should enhance its organizational values through strategies like improved communication, leadership involvement, employee engagement, and feedback mechanisms. To foster a diverse workforce, the bank should reassess its core values. Effective communication is crucial, and leaders should promote the organization's values. To retain employees, tailored retention strategies should consider career progression, compensation, and work-life balance. The recruitment process should be streamlined, and career progression pathways should be established. Lastly, fostering innovation requires increased resources, support, and recognition for employees who contribute to it.

Evaluation of Environmental Management at Pulang Pisau Regional General Hospital Based on Environmental Impact Assessment Studies and Regional Development

This study aims to evaluate environmental management at Pulang Pisau Regional General Hospital (RSUD) within the framework of participatory development planning. The research employs a qualitative approach with a descriptive method, collecting data through interviews, observations, and documentation. Data analysis follows the Miles and Huberman model, with validation through methodological and source triangulation. The findings indicate that environmental planning and management at RSUD Pulang Pisau remain technocratic, with limited public involvement. The lack of public dialogue spaces and multi-stakeholder consultations results in low community participation in sustainable development. Implementing medical and liquid waste management policies follows national regulations but still faces challenges in resource efficiency and environmental impact monitoring. This study recommends strengthening inclusive environmental governance by establishing multi-stakeholder forums and public consultation mechanisms and enhancing community education and empowerment in environmental monitoring. Policy evaluation based on George C. Edward III's implementation theory highlights the importance of clear communication, resource availability, stakeholder commitment, and an effective bureaucratic structure in successfully implementing environmental policies. This research emphasizes that active public participation in hospital environmental management is not merely a technical aspect but also an integral part of an inclusive and sustainable development process.

Content analysis of perceptions of combined pharmacobehavioral treatment for American Indian people with opioid use disorder.

Both opioid misuse and overdose mortality have disproportionately impacted the American Indian population. Although medications for opioid use disorder, such as buprenorphine (BUP-NX), are highly effective in reducing overdose mortality, questions have been raised about the cultural acceptability of Western medical approaches in this population. Understanding patients' desired recovery pathways can lead to more culturally appropriate, patient-centered, and effective approaches to opioid use disorder (OUD) treatment. In this qualitative study, we document experiences with combined pharmacobehavioral treatment for OUD and suggestions for enhancing it. Participants (N = 45) were American Indian patients and community members impacted by OUD. They participated in one-time, 45- to 60-min, semistructured interviews. Findings from conventional content analysis indicated participants were grateful for a Tribally run combined pharmacobehavioral OUD treatment program, which made treatment more financially and geographically accessible over a large, rural area. Participants expressed satisfaction with BUP-NX and the accompanying behavioral health programming but were interested in making it more accessible through telemedicine appointments and mailed prescriptions. Participants noted the importance of clear communication about this kind of programming, which tends to be less structured than other substance-use treatment programs, but also appreciated its tailored, compassionate, and holistic approach. Participants were interested in robust counseling options; a low-barrier, acceptance-based, and harm-reduction orientation; as well as more culturally aligned programming that honored their Native heritage and traditional medicine. Treatment providers, researchers, and policymakers should consider integration of more patient-driven, compassionate, and culturally aligned means of intervention for American Indian patients with OUD. (PsycInfo Database Record (c) 2025 APA, all rights reserved).

A Delphi study on health literacy competencies for health professionals

BackgroundHealth professionals play a key role in promoting health literacy, as they continue to be one of the main points of contact and most trusted source of information for healthcare users on questions and concerns regarding health and disease. To adequately support individuals in dealing with health information and services and to strengthen health literacy, health professionals need a corresponding set of knowledge, skills, and attitudes, hence they need a wide range of health literacy competencies. Despite their crucial role in guiding and supporting patients and their relatives in terms of health-related information and services, in-depth studies on health literacy competencies of health professionals are still scarce. Thus, the aim of this study was to identify and prioritize health literacy competencies of health professionals in German-speaking countries.MethodsA modified, two-round Delphi study was conducted with 24 experts in the field of health literacy or a relevant field from Switzerland, Austria, and Germany. The experts were asked to evaluate and rate different competencies of health professionals regarding health literacy.ResultsAs a result, 14 core competencies have been identified by the experts, including five items referring to the category “knowledge”, seven items to the category “skills” and two items referring to the category “attitude”. The identified competences indicate that health literate health professionals understand health literacy’s importance, employ clear communication techniques, and actively engage patients to ensure comprehension. Furthermore, health literate health professionals recognize cultural barriers, use plain language, and maintain that effective communication is crucial for quality healthcare. Among the 14 core competencies, communication practices were reported to be of particular importance for practice-oriented, professional health literacy skills of health professionals.ConclusionsThe identified set of health literacy competencies provides an essential groundwork for future assessments of competencies concerning professional health literacy among health professionals, their integration into curricula, and further development of tailor-made trainings and education.

Navigating choices: understanding the decision-making journey of patients with localised kidney cancer.

To explore patients' experience of decision making regarding treatment of localised kidney cancer. A total of 21 patients with localised kidney cancer, across three countries, participated in either four focus groups or seven semi-structured interviews that lasted on average 2 h. Focus groups and interviews were all conducted in the participants' native language, recorded, transcribed and (if applicable) translated into English. Thematic analysis was used to develop a codebook and identify themes. All participants expressed a desire to be actively involved in the treatment decision-making process. However, due to the emotional toll of the cancer journey, which often necessitates quick decisions, actively engaging in the decision-making process was described as challenging. The study revealed 12 key themes. These themes included the impact of diagnostic paths, patient characteristics, patient empowerment, health literacy, source of support, fear of recurrence, trust in treatment and healthcare providers, shared decision making (SDM), professional interaction, personal belief system, and organisational and administrative issues. The findings highlight the complexity of decision making, underscoring the desire for patient involvement, SDM, and clear communication. We reveal a significant gap between research recommendations and clinical practice, emphasising the need to translate research findings to clinical application to enhance patient-centred care.

The Role of the Organization in Promoting Information Security-Related Behavior Among Resident Physicians in Hospitals in Germany: Cross-Sectional Questionnaire Study.

Nowadays, optimal patient care should be based on data-driven decisions. In the course of digitization, hospitals, in particular, are becoming complex organizations with an enormously high density of digital information. Ensuring information security is, therefore, essential and has become a major challenge. Researchers have shown that-in addition to technological and regulatory measures-it is also necessary for all employees to follow security policies and consciously use information technology (compliance), because noncompliance can lead to security breaches with far-reaching consequences for the organization. There is little empirical research on information security-related behavior in hospitals and its organizational antecedents. This study aimed to explore the impact of specific job demands and resources on resident physicians' information security-related compliance in hospitals through the mediating role of work engagement and information security-related awareness. We used a cross-sectional, survey-based study design to collect relevant data from our target population, namely resident physicians in hospitals. For data analysis, we applied structural equation modeling. Our research model consisted of a total of 7 job demands and resources as exogenous variables, 2 mediators, and information security-related compliance as the endogenous variable. Overall, data from 281 participating physicians were included in the analyses. Both mediators-work engagement and awareness-had a significant positive effect on information security-related compliance (β=.208, P=.001 vs β=.552, P<.001). Quality of leadership was found to be the only resource with a significant indirect effect on physicians' compliance, mediated by work engagement (β=.086, P=.03). Furthermore, awareness mediated the relationships between information security-related communication and information security-related compliance (β=.192, P<.001), as well as between further education and training and the endogenous variable (β=.096, P=.02). Contrary to our hypothesis, IT resources had a negative effect on compliance, mediated by awareness (β=-.114, P=.02). This study provides new insights into how a high standard of information security compliance among resident physicians could be achieved through strengthening physicians' security work engagement and awareness. Hospital management is required to establish an information security culture that is informative and motivating and that raises awareness. Particular attention should be paid to the quality of leadership, further education and training, as well as clear communication.

Barriers and enablers to opioid deprescription: A qualitative study.

Canada has the fourth highest per capita rate of opioid prescriptions in the world, contributing to the country's opioid crisis. Due to both their pain-relieving and euphoric properties, opioids can be highly addictive, leading to potential overdose and death. Deprescription is an endorsed and organized method of discontinuing a drug but very little is known about the barriers that Canadian physicians face when attempting to deprescribe opioids, particularly those who practice in rural areas (which have some of the highest rates of opioid users). This was an explorative, qualitative study describing rural family doctors' experiences and practices regarding opioid deprescription in primary care. A convenience sample of family doctors who had experience working with patients taking opioid medications was recruited from the professional networks of study team members. After consenting to participate, data was collected using semi-structured telephone interviews and analyzed by researchers experienced in applying the Theoretical Domains Framework to assess barriers and enablers of behavior change. 10 physicians participated in this study. Our analysis revealed four barriers and five enablers related to opioid deprescription in rural primary care. Barriers include a lack of knowledge and skills related to deprescribing, discomfort initiating deprescription, patient pressure to continue prescribing opioids, and a lack of foundational support required to deprescribe. Enablers include working with colleagues who share common views on overuse of opioids and deprescription; access to other healthcare providers, community-based resources, and clinical tools; using a systematic approach to deprescription; previous experience successfully deprescribing opioids; and practicing in a rural setting. Opioid dependence and over-prescription continue to be a problem for our health system. Deprescription is necessary but challenging for family physicians. Rural physicians are keenly aware of the importance of preserving the physician-patient therapeutic relationship and open and clear communication about opioid medications and deprescription but feel unprepared to manage this in the face of difficult issues surrounding deprescription. They also feel unprepared to deal with deprescription effectively without access to other resources, healthcare professionals, patient education materials and time. Rural physicians would benefit most from added foundational supports for deprescription.