Convergent Approach Research Articles

Loss of safe spaces: Ambiguous loss and minority stressors of BIPOC LGBTQ+ communities amidst the covid-19 pandemic

As the world came to a halt in 2020 due to the Covid-19 pandemic, oppressed communities were at the forefront of distress from isolation, lack of resources, and connection. A vast amount of literature has emphasized the necessity of safe spaces and impact of minority stressors on Black, Indigenous, People of Color, Lesbian, Gay, Bisexual, Transgender, Queer, Plus (BIPOC LGBTQ+) communities. However, few have begun to explore relationships among ambiguous loss of safe spaces and minority stressors from pandemic isolation. This study aimed to explore the experiences of BIPOC LBGTQ+ communities during the Covid-19 pandemic using a convergent mixed methodical approach. Through cross-sectional survey, quantitative data examined relationships between minority stressors, LGBTQ community connection, and family environment and support at home (n = 164). Through 7 focus groups, qualitative data captured themes surrounding loss, online connection, trust, and redefinition of safe spaces (n = 29). An integrated discussion utilizing an integrated theoretical framework of minority stress, Bronfenbrenner’s ecological systems, and intersectionality is then presented. Lastly, limitations and future directions are discussed.

Pharmacy stakeholders' views and experiences of the credentialing of advanced or specialist pharmacist practice: A mixed methods systematic review

BackgroundCredentialing of advanced and specialist pharmacist practice (ASPP) provides essential quality assurance for ASPP, which is significantly different to entry-level practice and is developing worldwide. Several credentialing models are in place or under development internationally. Synthesis of the views and experiences of pharmacists and other relevant stakeholders on credentialing is an important research gap. Objective(s)To determine pharmacy stakeholders' views and experiences of ASPP credentialing and to explore facilitators and barriers to credentialing implementation and uptake. MethodsThe Joanna Briggs Institute convergent integrated approach for mixed methods systematic reviews was followed. The review protocol was pre-registered with PROSPERO. Five electronic databases (Medline, CINAHL, Embase, Web of Science, Google Scholar) were searched from inception to August 2022 for qualitative, quantitative, or mixed methods studies that reported the views and experiences of pharmacy stakeholders on ASPP credentialing. The Mixed Methods Appraisal Tool was used to quality appraise included studies. Thematic synthesis was undertaken to analyse and integrate data from included studies. All screening and data analysis steps were performed by two reviewers independently, with additional author input where required. ResultsSixty studies were included, after screening titles and abstracts (n = 9055) and full texts (n = 228). Studies represented the views of pharmacists, pharmacy managers/employers and professional/representative bodies in hospital, community pharmacy, general practice/primary care, and academic sectors, from 40 countries. Four analytical themes were generated describing the factors, including facilitators and barriers, to be considered when developing or optimising ASPP credentialing: I. Drivers of credentialing, II. Developing ASPP competence, III. Optimising credentialing implementation, and IV. Enhancing credentialing uptake. ConclusionsThis systematic review is the first to synthesise pharmacy stakeholders' views and experiences of ASPP credentialing. A conceptual framework highlights contextual factors, facilitators, barriers, and inter-relationships which should be considered by pharmacists, policymakers, and other key stakeholders when implementing ASPP credentialing.

A Toolkit Intervention for School–Aged Jamaican Students: Strategy for Collaborative Involvement During the Pandemic

The Ministry of Education and Youth, Jamaica, designed Home Learning Kits (HLKs) for students in Grades 1–6 to address learner disengagement due to the change in classroom settings because of the COVID-19 pandemic. This intervention required a collaborative approach by diverse educational stakeholders for the production, distribution, collection, implementation, and bi–directional return of the kits. This novel approach to learner engagement prompted a need to understand the implementation of the HLKs and their use by students. Using a convergent explanatory mixed method approach, the sample included 167 of 400 schools and approximately 36,000 students islandwide. The quantitative data was analysed descriptively and thematically for the qualitative data. Overall, the results revealed the need for better collaborative efforts to execute the HLK intervention. The findings are significant to assist the Ministry of Education to implement policies and further initiatives for transformed educational outcomes.

컨설턴트 역량에 관한 체계적 문헌고찰

The purpose of this study is to analyze previous research on consultant competencies, which has developed from various perspectives, and to suggest directions and implications for future research. Using a systematic literature review method, 42 domestic academic journal articles were selected for analysis, focusing on the publication period, journal type, keywords, and competencies required in different consulting fields. The findings are as follows: First, research on consultant competencies was minimal before 2010 but has increased significantly since. Second, journals show that consultant competencies are needed in diverse fields, with digital technology, talent development, and convergent thinking being key. University-affiliated institutions have contributed to strengthening the theoretical foundation through various methodologies. Third, keyword analysis highlighted relationship-building skills, service quality, and knowledge as essential competencies. Fourth, the analysis identified the need for a systematic competency model, emphasizing problem-solving, communication, customer orientation, change management, and adaptability. Based on these findings, this study highlights the need for systematic research on competencies within the consulting process from a macro perspective, while also emphasizing the importance of expanding research on consultants' intrinsic competencies from a micro perspective. Furthermore, it suggests that the application of methodologies combining various academic perspectives in a convergent approach should be expanded. This study is expected to serve as a foundational resource for future research on consultant competencies.

Navigating Uncharted Waters: A Mixed Studies Systematic Review of Elective Female Fertility Preservation for Women.

This study aimed to review studies exploring the experiences and perceptions of healthcare students and providers regarding their personal choices for elective female fertility preservation and their recommendations of the same to patients. Employing Pluye and Hong's convergent qualitative synthesis approach, a mixed-studies review was conducted. The appraisal of studies was performed using the Mixed Methods Appraisal Tool and data analysis utilised Thomas and Harden's thematic synthesis approach. Six electronic databases (PubMed, Embase, CINAHL, PsycINFO, Scopus and Web of Science) were searched from their inception till November 2023. About 24 studies were reviewed, uncovering four major themes: varied personal perspectives, knowledge gaps and role ambiguities, perceived temporal and financial constraints and apprehensions related to fear and stigma. This review underscored the challenges faced by healthcare professionals and students in their personal pursuit of elective fertility preservation. Addressing these challenges demands the implementation of fertility navigators, culturally and religiously sensitive public health campaigns and staff training. Moreover, standardised guidelines, transparent cost and process reporting, evidence-based education, counselling on risks and success rates and governmental support in the form of subsidies can mitigate barriers, enhance cost-effectiveness and promote equitable access to care. Collaboration among stakeholders is imperative to ensure equitable access and maintain quality care in elective female fertility preservation. This mixed studies review followed the reporting guidelines in the Preferred Reporting Items for Systematic Review and Meta-Analyses (PRISMA) statement. No Patient or Public Contribution. This review has been registered on the Prospective Register of Systematic Reviews (PROSPERO) database (CRD42023395406).

Enhancing the Inference Skills of Selected AP (Araling Panlipunan)-Grade 7 Students at OCABIS (Old Cabalan Integrated School): A Study Utilizing the Snake and Ladder Board Game

The integration of game-based learning has gained popularity for enhancing cognitive skills such as critical thinking and inference. Interactive tools such as board games nurture engagement and assist in comprehending complex concepts. The Araling Panlipunan curriculum in the Philippines emphasizes critical thinking, making innovative teaching methods essential. This study aimed to determine the effectiveness of using the snake and ladder board game in enhancing the inference skills of Grade 7 Emerald students from the Old Cabalan Integrated School (OCABIS) in Araling Panlipunan (Social Studies) during the 2023-2024 academic year. The study employed a convergent parallel approach that included pre-tests, post-tests, and focus group interviews to collect data. Statistical analyses were used to examine the results, including frequency distribution, percentage, mean, Shapiro-Wilk test, Mann–Whitney U test, Wilcoxon signed-rank test, and thematic analysis. The results revealed that integrating the snake and ladder board game positively impacted students' critical thinking and inference skills, with post-test scores showing significant improvement as it revealed a notable enhancement in scores, showing a median pre-test score of 8 and a post-test score of 12 (W = 630.000, z = -5.184, p = .000), resulting in a moderate effect size (d = .62). The study also found that the board game strategy was equally effective for male and female students, providing a more engaging learning environment and reducing boredom. Based on these findings, the researchers proposed guidelines for further improving the snake and ladder board game strategy to enhance students’ inference skills.

Perceptions of risk sharing agreements in South Korea from the viewpoints of key stakeholders: a convergent parallel mixed approach

ABSTRACT Objectives In 2013, South Korea introduced risk-sharing agreements (RSAs) as a new reimbursement mechanism to enhance access to new medicines and to manage pharmaceutical expenditures. This study evaluates RSAs in South Korea from the viewpoints of key stakeholders. Methods In 2022, a survey and semi-structured interviews were conducted. Study participants were recruited from academia (n = 3), domestic (n = 4) and foreign (n = 6) manufacturers, and government agencies (n = 6) using a purposive sampling method. Results Key stakeholders perceived the objective of RSAs to be ‘access to medicines’ and understood RSAs to manage uncertainty about ‘expenditures.’ They responded that financial- and performance-based RSAs address uncertainty about ‘expenditures’ and ‘clinical effectiveness,’ respectively. All stakeholders agreed that RSAs have increased the likelihood that new medicines will be listed and have reduced out-of-pocket expenditures for patients. However, foreign manufacturers insisted that the benefits of RSAs are marginal, while the administrative burden on manufacturers is high. Conclusion The gaps in perception between stakeholders could be narrowed by conducting a comprehensive evaluation. Financial- and performance-based RSAs need to be clearly distinguished and aligned to address the uncertainties of a new medicine in health systems.

Collaboration and support between Chilean schools from an egonet mixed-method approach

AbstractThis study aims to characterise inter-organisational collaboration and support networks between schools in a privatised, marketised, and competitive school system. It is located within and contributes to a body of literature on school networks, which has primarily focused on studying the architecture and conditions for the sustainability of the arrangements where collaboration and support between schools are meant to take place. However, there has been less focus on examining the partnerships themselves, particularly those formed organically by schools. This is an exploratory study that takes a novel convergent mixed-method egonet Social Network Analysis approach. Primary data were produced from interviews with sixteen primary school headteachers from a local area in Santiago, Chile. Participants were encouraged to name and reflect on other schools with which their schools have an inter-organisational relationship. Insights show that schools draw on both mandated and organically formed inter-organisational relationships to collaborate and support each other. These ties tend to be built with schools alike and geographically close. Some of the main drivers to turn to others are ensuring the sustainability of schools, generating coordinated responses to policy mandates, sharing practice and knowledge, and ensuring students’ schooling trajectories. This study, situated within the broader context of school networking literature, proposes that schools exist within multiple networks, with various connections serving different purposes, some of which are rarely acknowledged. It suggests that while formal school networks and governance structure are important, they are insufficient to represent the inter-organisational relationships in which schools are involved.

Studying Religiosity Beyond (Western) Christianity: an Empirical-Psychological Perspective and its Implications

Abstract Over recent decades, empirical research on religion has increasingly criticized its primary focus on Western Christianity. This paper has two aims: Firstly, it addresses challenges in applying ‘Western’ empirical research on religion to non-Western contexts (samples, measurement, results and discussion). Secondly, it highlights the convergent approach, bridging the gap between the perceived dichotomy of cultural universalism and cultural relativism. This approach acknowledges both religiosity’s universal commonalities across contexts and particularities in a certain cultural-religious context. Studying religiosity beyond Christianity enables to explore a nearly limitless field of basic research but also provides a robust empirical, social-scientific foundation for various practical applications that are gaining increasing social relevance, such as therapy, migration, and counseling for religious institutions. Such are vital for the future of our field, ensuring its continued relevance in times of accelerated secularization.

Challenges and Academic Performance of Re-Admitted Teenage Mothers in Kenyan Secondary Schools

Aims: The purpose of this study is to examine the influence of challenges faced by admitted teenage mother students on the academic performance in secondary schools in Kenya. The study addressed two specific objectives to achieve its aims These were to examine the challenges faced by the teenage mothers in the learning environment upon being re-admitted to school and its influence on their academic performance; and to explore the family and community perception of teenage mothers and its influence on the academic performance of admitted teenage mothers. Study Significance: The study assesses the impact of re-entry policy on teenage mothers' academic performance in Kenyan secondary schools, highlighting the need for improved support systems. It aims to inform educational practices, enhance program delivery, and contribute to achieving Vision 2030 goals. Study Design: The study a Mixed Methods Design that used a convergent parallel approach. Place and Duration of the Study: The research was conducted in Kenya in four counties namely: Trans Nzoia,xWest Pokot,xUasin Gishu andxElgeyo Marakwet. The variables ofxthe study included challenges faced by teenage mother and academic performance of the admitted teenage mother. The study was conducted in 2022. Methodology: The study used random, stratified and purposive approaches to select the 596 respondents from 102 schools in selected counties. Of this 458 responded to the questionnaire and interviews (72 Principals comprising 52 females and 20 males between 42 – 54 years; 74 Guidance and Counselling teachers 48 females and 24 males with an average age of 38 years; 66 Directors of Studies comprising 50 males and 16 females with a modal age of 36 years; 246 teenage mothers with an age range of 16 – 21 years). Results: The study found out that the challenges the teenage mothers experienced were both from home and the school environment which contributed to their academic performance. The teenage mothers found support from teachers while in school upon being admitted. Conclusion: Parents, schools and even other stakeholders should work in unity to ensure that the teenage mother do not go through challenges that can contribute to poor academic performance.

How influencers motivate inactive adolescents to be more physically active: a mixed methods study.

Regular physical activity offers numerous health benefits, particularly for adolescents. However, only 14% of school-aged children in Switzerland achieve the World Health Organization's recommendation of 60 min of moderate to vigorous physical activity per day. Changing health behaviors is a complex process in which understanding behavioral and communication patterns is crucial. Because adolescents spend substantial time on social media channels and obtain information from them, these are potential channels for accessing health-related content. This study explores the questions of which influencers and what content motivate adolescents to be more physically active and whether influencers can impact enjoyment and the intention to engage in physical activity. The study employed a convergent mixed methods approach, combining self-assessment questionnaires and semi-structured interviews. Ninety-three adolescents aged 14-20 years who exercised < 1 h per day participated. They followed one of the six participating influencers on Instagram. Over 6 weeks, the questionnaires collected quantitative data, measuring enjoyment, stages of change, and physical activity levels. Furthermore, semi-structured interviews were conducted with 23 adolescents and six influencers to gain in-depth insights. The quantitative findings indicate that adolescent followers enjoyed physical activity more after the social media intervention and at follow-up than at the beginning of the study. The followers' stages of change progressed over time. Compared with those following more athletic influencers, followers of nonathletic influencers (that is, a singer, a journalist, and an eFootballer) showed increased physical activity over time. Qualitative analysis highlighted Instagram factors influencing physical activity, including resonance with influencers' lifestyles and preference for simple, relatable activities. Authentic content was positively associated with increased exercise, particularly among already motivated followers. Unexpectedly, nonathletic influencers, such as a singer, a journalist, and an eFootballer, motivated adolescents best despite their nontraditional focus on physical activity. Their success stems from relatable lifestyles and simple activities that are easily incorporated into their daily routines. Conversely, athletic influencers demonstrated challenging exercises that were fascinating but difficult to adopt. This finding suggests the potential for utilizing nonathletic influencers in future campaigns targeting inactive adolescents.

Breast cancer screening motivation among women: an application of self-determination theory

BackgroundBreast cancer is a major health concern worldwide, especially in Vietnam. This study aimed to explore women’s motivation for and factors related to breast cancer screening.MethodsA mixed-methods study was conducted in Danang, Vietnam, using a convergent parallel approach. This study utilized both quantitative and qualitative methods to gather the data. The quantitative approach involved surveys to assess motivation levels and related factors, including demographic information and experience with breast cancer screening. In-depth qualitative interviews were used to gain deeper insights into participants' perspectives and experiences related to breast cancer screening.ResultsThe average motivation score for breast cancer screening was moderate (3.55 ± 0.55). Ethnicity, regular health check-ups, family history of breast cancer, receiving information about breast cancer, and women’s health issues have direct relationships with breast cancer screening motivation. According to the qualitative data, three categories emerged: intrinsic motivation, external motivation/internalization, and amotivation. The individual, and sociocultural environmental factors impacted screening motivation.ConclusionsThis study highlights the motivations behind breast cancer screening among women. Healthcare providers could use these findings to improve screening policies and guidelines and encourage more women to undergo regular screening, ultimately reducing the incidence of breast cancer in the community.

Contribution of Biometric Fingerprint in Reducing Prevalence of Unauthorized Absenteeism among Employees in Public Organizations in Moshi Municipality

This study investigated the contribution of biometric fingerprint technology in reducing unauthorized absences among employees in public organizations within Moshi Municipality, Tanzania. Grounded in the Social Control Theory, the research utilized a convergent parallel mixed-methods approach. The target population consisted of 3,218 public employees from 45 organizations, with a sample of 356 respondents. The study collected qualitative and quantitative data, ensuring validity and reliability through content, face validity, and Cronbach's alpha. Quantitative data was analyzed using descriptive statistics in SPSS, while qualitative data underwent context analysis. Ethical guidelines were strictly adhered to. The findings revealed that public servants in Moshi Municipality perceived biometric fingerprint technology as a reliable solution for addressing unauthorized absences in the workplace. Implementation of this biometric has created a secure and accountable work environment. The study concludes that the use of biometric fingerprint technology has positive contributions to attendance management, accountability, and productivity of public organization employees. Further, it was recommended that public organizations prioritize clear communication with employees about the purpose, benefits, and safeguards of biometric fingerprint technology. Additionally, further research is suggested to explore the challenges faced by employees in utilizing this technology, with the aim of contributing to the existing knowledge base on biometric fingerprints in public organizations.

Fear of COVID-19 among Frontline Nurses in a National University Hospital in the Philippines: A Mixed-Methods Study.

Nurses are at the forefront of caring for patients during the height of the COVID-19 pandemic. Nurses themselves are exposed to serious risk and even death while providing care for these patients. Among other healthcare professionals, nurses are mostly exposed to psychologically distressing situations during this time of crisis. Fear of COVID-19 can affect nurses' overall well-being, which in turn may affect their job performance and lead to a decline in the quality of patient care. To determine the level of fear of COVID-19, and to explore the experiences of COVID-19-related fear of frontline nurses in a national university hospital in the Philippines. To achieve the study objectives, the study utilized a convergent mixed methodology approach. In the quantitative phase, a random sample of participants completed the Fear of COVID-19 scale (FCV-19S) in order to assess their level of fear of COVID-19. Semi-structured interviews were conducted in the qualitative strand. Participants in the qualitative phase was selected using maximum variation sampling. Integration of data was done through a narrative contiguous approach. Quantitative data was obtained from 206 frontline registered nurses. The mean age of the participants was 35.5 years (SD =8.17). Overall, the composite score of the fear of COVID-19 scale was 21.76 (SD = 4.92), indicating an elevated level of fear. Having friends and relatives who tested positive predicted fear of COVID-19 (β = -3.658; p = 0.005; CI: -6.213 to -1.104). Three major themes categories emerged from qualitative data analysis: (1) balancing feelings of fear and moral obligation, (2) challenges experienced while providing frontline work, and (3) resilience amidst challenges. For the reporting and integration of our mixed-method results, a narrative contiguous approach was implemented. Frontline nurses reported an elevated level of fear during the height of the COVID-19 pandemic. This study was also able to capture the impact of COVID-19 on the mental health of nurses, specifically on their fear experiences. Understanding the underlying causes of fear, such as uncertainties surrounding guidelines and protocols, shortage of personal protective equipment, and moral distress, offers invaluable insights for shaping proactive strategies and policies aimed at mitigating these concerns in subsequent pandemics.

Perceived structural empowerment, resilience, and intent to stay among midwives and registered nurses in Saudi Arabia: a convergent parallel mixed methods study

BackgroundRetaining midwives and registered nurses in the Obstetrics and Gynecology department/unit (OB/GYN) is not just a matter of organizational effectiveness and financial wellness. It’s a crucial aspect of ensuring quality healthcare delivery. This study aimed to discuss the degree to which midwives and nurses in OB/GYN departments are structurally empowered, resilient, and committed to remaining at the organizations and to examine whether nurses’ and midwives’sense of structural empowerment and resilience is a good predictor of their decision to stay with the organization.MethodsThis study employed a unique convergent parallel mixed methods approach. The research was conducted in two distinct phases. The first phase involved a cross-sectional quantitative survey with a convenience sample of 200 midwives and nurses in OB/GYN departments. The second phase was a qualitative study utilizing semi-structured, open-ended interviews. Eighteen nurses and midwives, specifically chosen as the target population, were invited to participate in individual interviews. The data collection took place at three major hospitals in Saudi Arabia, starting in January 2023 and concluding in February 2023.ResultsThe study results revealed that structural empowerment and resilience were statistically significant predictors of the intent to stay in the organization (F = 35.216, p < 0.001), with 26.3% variation, the structural empowerment is higher predictor (β = 0.486, p < 0.000) to intent to stay if compared to resilience (β = 0.215, p < 0.008). Five major themes emerged from the narratives of the nurses and midwives: the nurturing of the physical and physiological, the development of the psychological, the managing finances, the restructuring of the organization, and the enrichment of the professional and occupational.ConclusionThe study’s findings have significant implications for healthcare organizations. They highlight the importance of cultivating a culture of empowerment and resilience, which can serve as a powerful tool to encourage registered nurses and midwives to remain in their organizations. This insight empowers healthcare administrators, human resource managers, and obstetrics and gynecology professionals to take proactive steps toward improving retention rates.

“En El Campo, Siempre Es Asi”: A Mixed Methodological Assessment of Spanish-Speaking Immigrant Farmworker Legal Needs in Oregon

This paper uses a convergent mixed method approach to assess the legal needs of Oregon's immigrant (Spanish-speaking) farmworking population. We adapt an English-language survey into Spanish, ensuring the validity of the quantitative results by employing intercept surveys at farmworkers' housing complexes, recording qualitative data regarding the ensuing social interactions, and generating ethnographic fieldnotes on the interactions, participants, and surrounding environs. We find that immigration is an umbrella category that structures other legal needs, rather than a legal need co-equal with other important categories such as healthcare, employment, housing, discrimination, and harassment. Our mixed methods approach provided rich descriptions of surveyed concerns as well as detecting and explaining the undercounting of categories such as law enforcement contact and sexual harassment.

A Systematic Review of Barriers and Facilitators Impacting the Utilization of Mental Health Services Among Asian American Youth

ABSTRACT Background Asian American youth are the least likely racial/ethnic group to receive mental health services in the U.S. perpetuating mental health disparities within this population. In response, studies have begun to identify barriers and facilitators influenced by Asian cultural factors that impact access to mental health care in this population. Objective As no published studies have synthesized this literature, our preregistered systematic review sought to consolidate the existing literature on barriers and facilitators of mental health service use for Asian American youth across 1) knowledge, 2) structural, 3) attitudinal, and 4) relational domains, and to examine the role of cultural factors. Method All procedures were conducted in accordance with PRISMA guidelines. Searches were conducted in October 2023 using PsycINFO, PubMed, and Medline. Of the 605 articles identified, 6 met criteria for inclusion. We used a convergent integrated approach to synthesize the coded barriers and facilitators of mental health service use. All six studies examined barriers that included structural, attitudinal, relational, knowledge, cultural, and other factors. Two studies described facilitators that included structural, attitudinal, and relational factors. Results We found that: 1) Asian American youth faced barriers known to impact service use more generally in the literature (i.e. knowledge, relational, attitudinal, and structural barriers), and 2) Cultural factors were part of these themes and distinct barriers. Conclusions The findings highlight the pressing need to address barriers perpetuating Asian American youth mental health disparities and the potential for culturally relevant facilitators to improve access to care.

Black college women's preventive health behaviors: Applications of a Black Feminist-Womanist research paradigm

ObjectiveThe researchers applied Lindsay-Dennis' Black Feminist-Womanist research paradigm to Andersen's Behavioral Model for Health Service Use to guide initial research about Black American women's preventive health behaviors. MethodsThis article highlights this application, using interpretive phenomenological analysis for qualitative questions assessing how 40 Black college women define health and their experiences in health care. This was part of a larger convergent parallel mixed-methods approach in a 2022 cross-sectional online survey. ResultsParticipants defined health as a concept involving health literacy, physical and mental health, and being free from health conditions or disease. Regarding health-related lived experiences, negative experiences were more frequently reported than positive experiences. However, many participants reported both positive and negative health care related experiences. Predisposing, enabling, and need factors were all present in qualitative responses. ConclusionsThis article highlights the fit of a Black Feminist-Womanist research paradigm to Andersen's model to better understand Black women's health experiences and illustrates ways that medical mistrust, health literacy, and past experiences with health care can influence health service use. Areas for future research on barriers and facilitators to preventive care and implications for reducing health disparities are also discussed.

A Mixed-Method Study of Medication-Related Burden Among Multi-Drug Resistant Tuberculosis Patients in West Java, Indonesia.

Multidrug-resistant tuberculosis presents a challenging obstacle in global TB control. It necessitates complex and long-term therapy, which can potentially lead to medication-related burdens that may ultimately reduce therapy adherence and quality of life. This study aimed to gain a deep understanding of the medication-related burdens experienced by multidrug-resistant tuberculosis patients. The study was conducted using a convergent mixed-method approach involving MDR-TB patients and their caregivers. Qualitative data were collected through semi-structured in-depth interviews, while quantitative data were gathered using the validated Living with Medicine Questionnaire 3. In the quantitative part, associations between patients' characteristics and burden levels were analysed using bivariate and multivariate analyses. Seventy-four participants were involved in the study, with 71 of them completing the questionnaire and 36 participating in interviews. The qualitative results revealed the subjectivity of medication-related burden perception, which could not be fully captured by the quantitative method. Four themes of medication-related burdens emerged: personal beliefs, regimen burdens, socioeconomic burdens, and healthcare burdens. The quantitative results provided a generalized representation of the population. Age and side effects were found to be significantly associated with higher burden levels, with those aged 18-30having an odds ratio (OR) of 7.303 (95% CI: 1.045-51.034), and those aged 31-40having an OR of 6.53 (95% CI: 1.077-39.607). Additionally, experiencing side effects had a substantial impact, with an OR of 46.602 (95% CI: 2.825-768.894). Both sets of results are valuable for designing patient-centered care. MDR-TB therapy imposes a significant burden, particularly regarding the characteristics of regimen. By understanding this burden, healthcare professionals can help improve the quality of life for these patients.

Preparing Health Professions Educators for Online and Blended Learning Environments: A Mixed Methods Study

Online and blended teaching and learning (OBTL) are integral to the future and success of higher education, including health professions education. Institutions with a goal of developing high-quality online and blended programs must prioritize time and resources dedicated to professional development and training. This research study utilized an online professional development course as an intervention to gain deeper insights into the scope of faculty development to effectively teach in online and blended learning environments. The study, utilizing a convergent mixed methods approach, gathered data through a pre- and post- intervention survey measuring health professions faculty readiness to teach online, a knowledge-based test, and post-intervention focus group discussions. Statistically significant differences in survey and test scores were observed between pre- and post-intervention and advantages of the intervention were highlighted in the focus group discussions. These key findings suggest the efficacy and influence of the educational intervention. Additionally, barriers and recommendations for enhancement were identified, including a notable gap between perceived importance and perceived capability among faculty members. This information pinpoints areas where professional development and support may be beneficial. Outcomes of the study provide valuable insights into health professions faculty members' knowledge, readiness, and perceptions related to teaching in online or blended educational environments.