Data Saturation Research Articles

A Mixed Methods Study on Character Traits of Nursing Students and Faculty Influencing a 100% Passing Rate in the Nursing Licensure Exam in the Philippines.

This study explores the character traits contributing to the 100% passing rate of nursing graduates in the Nursing Licensure Examination (NLE) in the Philippines over the past decade. Understanding these traits provides insights into the factors driving academic and professional success in nursing. Employing a convergent parallel mixed methods design, this study combined quantitative and qualitative approaches. Data were collected through electronic surveys from 222 nursing alumni and 39 faculty members, focusing on character traits and behaviors linked to NLE success. The quantitative data were analyzed using Statistical Product and Service Solutions (SPSS, version 29; IBM SPSS Statistics for Windows, Armonk, NY) for descriptive statistics and factor analysis. Additionally, in-depth interviews with 21 alumni and 15 faculty members provided qualitative insights. Data saturation was reached with 11 faculty and 13 alumni, ensuring comprehensive coverage of the participants' experiences. Quantitative results from factor analysis showed that spirituality, love of learning, honesty, and kindness are among the qualities that are necessary for success in NLE. These character traits have a significant impact on both career readiness and academic performance. Qualitative results revealed the importance of resilience, faculty support, and peer relationships in fostering these attributes. It became evident that building a healthy learning environment required the support of peers and professors and that resilience was necessary to manage the stress of tests. Both datasets emphasized the need for a strong character and academic achievement in conjunction with long-term success. The study highlights that obtaining a high NLE passing rate is mostly dependent on academic knowledge in addition to character attributes. Character education techniques such as role-playing, reflective writing, and service-learning can be incorporated into nursing curricula to improve attributes such as empathy and resilience. Continuous faculty development and structured mentorship are also crucial. Character development must be incorporated into academic learning in nursing education. Focusing on qualities such as empathy, resilience, and ethical judgment, along with implementing character education tactics such as service-learning and reflective writing, are crucial to prepare graduates to succeed in professional practice and board exams. A comprehensive approach that blends character development with academic achievement produces skilled and compassionate healthcare professionals.

The Role of Elements of Text Analysis in Consecutive Interpreting Performance: A Mixed-Methods Study

Despite the theoretical importance of text analysis in translation process, there is a paucity of experimental research into the role that the elements of the text can play in enhancing interpreting performance. The present study, adopting a mixed-methods design, aimed to investigate whether knowledge of text elements enhances consecutive interpreting performance. In so doing, a sample of 36 homogeneous undergraduate translation students participated in this study based on convenience sampling, and a pool of six students participated in the qualitative phase of the study based on purposive sampling, following the data saturation method. Following Nord’s guidelines for text analysis, the experimental group was exposed to the elements of text during the intervention. A validated assessment rubric was utilized to measure students’ interpreting performance, taking the inter-rater reliability of the scores also into consideration. The results of one-way ANOVA confirmed that there was a statistically significant difference between the control group and the experimental group; the experimental group outperformed the control group. Having calculated the inter-coder reliability of the responses emerged from the interviews, the number of common factors included six themes, namely unique, new information, message analysis, motivating, general lexis, and semiotics. In the end, some practical implications are offered for interpreting students and teachers.

Patients’ Experiences With Complementary and Alternative Treatments to Manage Chemotherapy Symptoms

This phenomenological study aims to explore the experiences of individuals undergoing chemotherapy, focusing on their symptoms and the use of complementary and alternative treatments to cope with these challenges. Thirteen individuals diagnosed with cancer in a city in the central region of Turkey were interviewed using a semi-structured, in-depth approach in this phenomenological study. The criterion sampling method was employed to select participants, and interviews continued until data saturation was achieved. Thematic analysis was applied to the audio-recorded and transcribed interviews. The study adhered to the COREQ checklist for reporting qualitative research. The data analysis revealed 2 main categories (effects of cancer and chemotherapy on individuals, the use of complementary and alternative treatments to cope with the symptoms of patients receiving chemotherapy) and 6 themes (psychological effects, social impacts, physical effects, social practices, psychological practices, and physical practices). The study demonstrated that individuals faced significant psychological, physical, and social challenges due to cancer, posing difficulties in coping. The symptoms had a substantial negative impact on individuals. The research identified the use of various alternative methods, such as yoga, the Mediterranean diet, and music therapy, as coping strategies. It is recommended that individuals undergoing chemotherapy explore complementary and alternative treatment methods to effectively manage symptoms.

Experiences of occupational nurses regarding non-adherent mineworkers with chronic illnesses.

Occupational nurses continue to provide service to mineworkers diagnosed with chronic illnesses, however, non-adherence to medication is prevalent, cause overcrowding, long queues and admission at hospitals as they become sick. This study aimed to describe the experience of occupational nurses (ONs) regarding non-adherence to medication among mineworkers diagnosed with chronic illnesses. The study was conducted at a selected mine in Gauteng province, South Africa. A qualitative, exploratory, descriptive design that is contextual in nature, was used with a phenomenological approach. Thirteen ONs were purposively sampled and individual face-to-face interviews were conducted until data saturation was reached. Thematic analysis using ATLAS.ti 24 software was applied to analyse the data collected. The researcher and the independent coder held a consensus discussion and agreed on the themes and the sub-themes. Two themes and various sub-themes emerged along with Care-related challenges linked to the mineworkers and challenges related to the provision of service to mineworkers. Data analysed indicated that the ONs had varying but often similar perspectives regarding non-adherence to medication among mineworkers diagnosed with chronic illnesses. Non-adherence to medication is prevalent among mineworkers diagnosed with chronic illnesses and improving the mineworkers' outcomes requires addressing the issue of non-adherence to primary medication. This study highlights the importance of adhering to prescribed medication among mineworkers diagnosed with chronic illnesses to ensure quality of life.

An exploration of the emotional response among nurses in Bermuda, during the Covid-19 pandemic.

This paper utilizes an ontological approach to conduct a qualitative literature review in order to investigate the emotional impact of the Covid-19 pandemic on nurses internationally. After identifying common themes in the literature review, primary research is conducted to investigate the emotional impact of the Covid-19 pandemic on nurses working in Bermuda´s only acute healthcare facility. The literature review used the FRAMEWORK approach (Richie and Spencer, 1994, as cited in Hackett et al. (2018) to select a total of 16 papers for review, each of them qualitative primary research, aside from one paper reviewing international literature. Within the second part of this paper, investigating the experience of nurses in Bermuda, a grounded theory approach was utilised to collect primary data. Convenience sampling was used to recruit subjects to participate in one-on-one semi-structured interviews. Data saturation was achieved after 9 interviews. The FRAMEWORK method was utilised to analyse the interview transcripts, and identify, organise and collate themes. The literature review highlights that nurses have strong emotional responses to caring for patients during the Covid-19 pandemic. Specific responses include: higher stress levels at work due to higher, more challenging workload, and a reliance on clinical leaders to assuage this stress. Stigma experienced outside of work lead to feelings of anxiety and isolation. Despite this, there was a common theme that nurses felt a satisfaction within their role to ´play their part´ in the pandemic. The primary research conducted in Bermuda demonstrates that there was an initial fear of Covid-19, receding as the pandemic developed. Much anxiety was due to a perceived lack of knowledge about the disease, lack of a coherent strategy, and inadequate equipment to protect staff, and properly care for patients. An increased level of cooperation amongst staff, and mutual support amongst nurses was noted, as was social stigma leading to feelings of isolation and anxiety. Social interactions and holistic activities were identified as primary resources to alleviate stress and uncertainty. Nurses in Bermuda elicited many of the same emotional responses as their international colleagues, as a result of caring for patients during the pandemic. These manifested as a result of higher, more challenging workload, and uncertainty about preparedness plan and quickly changing situations within the working environment. The results from this study can help formulate changes in policy to ensure smoother transitions to pandemic preparedness in the future.

A conceptual framework to improve the quality of life in patients with CKD on dialysis in KwaZulu Natal Province, South Africa

Chronic kidney disease (CKD) is one non-communicable disease mainly caused by comorbid of diabetes and hypertension, thus compromising quality of life for the patients. Few rigorous Quality of Life frameworks on chronic kidney disease (CKD) have been reported in low-middle income countries including South Africa. Therefore, the study aimed at developing a Conceptual Framework to improve the Quality of Life in Patients with CKD on Dialysis in KwaZulu Natal Province, South Africa. A Mixed method sequential explanatory design which entails collection of quantitative data, followed by qualitative. A purposive sampling of 316 CKD patients for quantitative was initially selected. For qualitative, 17 healthcare professionals were theoretically sampled until data saturation. A structured questionnaire (WHO HRQOL–BREF) was utilized to collect numerical data for quantitative phase, while focus group discussions provided qualitative insights. The quantitative results indicated low quality of life (QoL) in several dimensions: economic (98 %), psychological (95 %), physical (70 %), and social (55 %). Grounded theory analysis of the qualitative data identified key predictors of QoL as the patients' geographic location, accessibility to haemodialysis centres, their ability to adapt and accept the condition, self-management practices, support from family members and caregivers including the presence of well-trained nursing staff.A comprehensive conceptual framework was developed through identifying contextual factors, interventions and outcomes that is expected to improve the QOL. The study recommends the immediate intervention of the policy makers and health care providers in drafting and implementing policies to improve the QOL in patients with CKD.

Stakeholders' Perceptions of Hospital-Based Early Childhood Parenting Education Services: A Thematic Analysis

BACKGROUND: Postnatal parental education is deficient yet necessary to enhance the implementation of evidence-based newborn care practices among families. Educating both mother and father is crucial for optimal childhood development, and interventions targeting families can improve childcare practices. Implementing these interventions through systematic policies and protocols in LMIC hospitals is essential. This study explores the perceptions of pregnant women, parents, and healthcare workers regarding parenting education in a tertiary care hospital in Karachi, Pakistan. METHODS: In a qualitative study conducted in a tertiary care hospital in Karachi, Pakistan, participants included pregnant women, parents, and healthcare workers. The study used in-depth interviews with purposively selected participants, consisting of two individuals from each category. Interviews were conducted using a prepared guide, and data collection was performed by trained staff. Interviews were conducted until data saturation was achieved. The interviews were conducted in Urdu, transcribed, and translated into English. Thematic analysis was carried out manually. RESULTS: The analysis of pregnant women's experiences identified themes of personal pregnancy experiences, support systems, and hospital facilities. Women discussed physical, emotional, and financial challenges during pregnancy. They valued support from family and physicians but expressed a need for better educational resources in hospitals. For parents with children under one-year-old, themes included personal experiences, hospital experiences, and educational resources. Parents faced emotional changes, financial challenges, and desired improved work-life balance. They appreciated outpatient care but found lacking in inpatient experiences, particularly in the NICU. Healthcare workers emphasized the role of parents, families, and hospitals, highlighting the importance of teaching and understanding family dynamics. Also suggested improvement in holistic approaches, mandatory educational programs, and integrating parenting readiness into primary care. CONCLUSION: Hospital-based postpartum parenting education enhance overall baby care. Expanding literature emphasizes the importance of high-quality parenting for lifelong development. Identifying efficient programs and resources to enhance parental abilities and foster positive child growth is increasingly important.

Designing an Entrepreneurial Model of Remote Communication Technologies in Clinical Medicine: A Qualitative Study

Background: Today, information technology has permeated all fields, transforming numerous aspects of our lives, while entrepreneurship has become increasingly essential. In medicine, the integration of this technology is becoming crucial. Objectives: This research focuses on designing an entrepreneurial model that leverages modern communication and information technologies in the health sector. By capitalizing on created opportunities, entrepreneurs can drive innovation, leading to cost savings, time efficiency, and greater access to health and medical services for people everywhere. Methods: In this qualitative study, the sample included faculty members from Iran University of Medical Sciences, selected through purposive sampling. Following this, the sample was expanded using snowball sampling, introduced through key experts, to include additional informed individuals. Data collection was conducted through semi-structured interviews with faculty members, experts, and knowledgeable individuals who were willing to participate. The interviews continued until data saturation was reached. Data analysis was carried out using content analysis, with coding performed using MAXQDA10 software. Results: After coding and identifying the main and sub-themes, content analysis was completed, resulting in 10 main themes and 57 sub-themes. All interviewees highlighted sub-themes such as "infrastructure and hardware," "internet bandwidth," "access to electronic health records," "equipment and supplies," "data privacy," "qualified physicians," and "counseling." Conclusions: When designing an entrepreneurial model in any region or country, it is essential to consider the existing needs and conditions, environmental demands, population characteristics, culture, habits, preferences of service recipients, infrastructural capabilities, governing laws, and security issues. Additionally, the model must incorporate specific leadership, management, and oversight to ensure it becomes a responsive and effective system.

Barriers and Facilitators to Pediatric Oncology Social Work Practice: A Qualitative Study

Background: Childhood cancer is significant due to its high prevalence and its impact on the entire family, resulting in various psychological, social, economic, and communication challenges for the families. Objectives: The aim of this study was to explore the barriers and facilitators to pediatric oncology social work practices in Iran. Methods: This qualitative study used a content analysis method and involved 19 pediatric oncology social workers. We used a purposeful sampling method until data saturation was reached. Data were collected through semi-structured interviews and field observations and then analyzed. Results: This study demonstrated that the factors influencing social workers' practice include personal characteristics and interpersonal communication at the micro level, while barriers mainly consist of cultural, social, economic, organizational, and structural dimensions at the macro level. Conclusions: In order to better support children with cancer and their families, policymakers and health system managers need to give special attention to the status of social workers. Strengthening support systems and addressing the challenges they face can be effective in protecting the professional practices of these caregivers.

Beyond error: A qualitative study of human factors in serious adverse events.

The field of healthcare quality and safety has been informed by the study of Human Factors contributing to adverse events. Hitherto, much of the study of Human Factors has been focused on a narrow lens of human error, identifying cognitive-based or knowledge-based errors and cognitive processes such as loss of situational awareness contributing to error. While these factors are important, this narrow approach fails to consider the complexity of relational and systemic factors that also contribute to adverse events. We aimed to explore the relational and systemic human factors, including shared clinician attitudes and behavior, that contribute to serious adverse patient events in a public health setting. The study, set in a metropolitan local health district in New South Wales, Australia, was conducted using a retrospective qualitative multi-incident content analysis design. Serious adverse event reviews (SAER) over 6 months (2022-2023) were subject to qualitative content analysis until data saturation was reached. Data saturation reached at 20 reports. Emergent themes related to human factors in serious adverse events included: (i) delays and inertia-with a subtheme of inertia of ageism; (ii) "All-or-nothing" approach to end-of-life care and planning; (iii) communication lapses; and (iv) implementation gap between standards and practice. Error-based incidents accounted for only 35% of the serious adverse events examined. The sample studied involved mostly (65%) male patients, with a mean age of 69 (70% aged >65), managed across the gamut of specialties, with the most common incident being the management of acutely deteriorating patients. In conclusion, there is more to Human Factors in adverse events than cognitive or knowledge-based error. While identifying and correcting errors is absolutely essential, we need adjunctive "soft measures" to address clinical attitudes, behaviors, and relationships in health care, particularly in increasingly complex, fraught, and stressful health care environments.

Exploring nursing students’ experiences of contemplating self-injury during their clinical practicums: A phenomenological study

AimTo explore nursing students’ thoughts and feelings about self-injuring during their clinical practicums. BackgroundUnfamiliar clinical environments pose challenges for nursing students, potentially leading to high levels of stress. When students find it difficult to cope with emotional triggers, some contemplate self-injury. Yet, it is rare to explore nursing students’ thoughts and feelings related to self-injury during their clinical practicums. DesignA phenomenological approach was used. MethodsPurposive sampling was used and the participants were drawn from nursing students who graduated from universities in Taiwan. In-depth, semi-structured interviews were conducted from August to November 2023. Data saturation was reached after interviewing 15 participants. Colaizzi's seven steps and NVivo software were used for data analysis. ResultsFour themes and 14 subthemes emerged. They were: (1) Sensing an emotional crescendo: participants experienced anxieties about clinical educators, assignments, homework and the clinical practicums and these intensified across time. (2) Physical and mental dysregulation: participants experienced physical discomfort, psychological distress and negative thoughts when subjected to overwhelming pressures during their clinical practicums. (3) Unwholesome self-protective behaviors: participants expressed thoughts of self-injury, engaged in self-injurious behaviors, experienced suicidal ideations and attempted suicide as measures of relieving stress. (4) Compassionate self-protective behaviors: participants coped with stress through emotional voicing, modifying situations to adjust stress, reaching out for help, self-compassion and self-care. ConclusionsFindings raise awareness of the need for clinical educators to demonstrate empathy with nursing students who have thoughts of self-injury during their clinical practicums. Further, it is crucial for them to offer timely guidance on the healing process while simultaneously creating nurturing clinical environments wherein students could flourish and grow.

Healthcare providers perspective of chronic pain management in persons with traumatic spinal cord injury accessing the public system in a region of South Africa

Purpose Persons with traumatic spinal cord injury (PWTSCI) have expressed a lack of education from healthcare providers and poor shared-decision making between providers and clients. The aim was to explore the healthcare providers’ perspective on factors influencing the optimal management of chronic pain. Methods Healthcare providers were recruited from two institutions at tertiary healthcare level. Interviews explored current chronic pain management practices, influencing factors and recommendations for improvement. Data saturation occurred after interviewing 11 participants. Thematic analysis was used through a socio-ecological model. Results The challenges to optimal pain management include appropriate assessment and management of psychological health (intrapersonal level), substance abuse amongst patients (intrapersonal level), access to medication for providers and lack of knowledge by providers (interpersonal and organizational level). To improve chronic pain management, an interdisciplinary team approach should be operationalized at policy and organizational level, monitoring and adjustment of interventions should take place (interpersonal), and family members/caregivers should be involved in the planning and monitoring (interpersonal). Conclusion Factors, at the interpersonal, intrapersonal, organizational and policy levels, influence optimal chronic pain management in the traumatic spinal cord injury (TSCI) population. To mitigate challenges, guidelines for chronic pain management should be developed, particularly for low-resourced developing countries.

Swinging Between Hope and Despair: Experiences of Patients with Behçet's Disease: A Phenomenological Research Study

Background: Behçet's disease (BD) can severely impact the psychosocial and emotional aspects of patients, significantly disrupting their quality of life. Objectives: The purpose of this study was to describe the psychosocial and emotional experiences of patients with BD and their coping strategies. Methods: This study was conducted using a qualitative method with a hermeneutic phenomenological approach. Data were collected through unstructured and in-depth interviews (9 conducted face-to-face and 6 via WhatsApp video calls) until data saturation was reached. Face-to-face interviews took place at the rheumatology clinic and the rheumatologist’s office from April to July 2023. Data analysis was performed using Diekelmann's seven-step method. The trustworthiness of the study was ensured based on the criteria of Lincoln and Guba, as well as Sim and Sharp. Results: By analyzing the data, 580 codes were extracted, leading to the identification of 12 sub-themes and 2 main themes. The first theme, "emotional, mental, and communicative instability," included the sub-themes of indecisiveness and uncertainty, moving away from desires and wishes, feelings of despair and demise, fears caused by the disease outcomes, sadness and mental anguish, isolationism, and reluctance to seek support. The second theme, "psychological and communicative strengthening strategies," comprised the sub-themes of having an occupation, seeking support, hoping for miracles and healing, doing mental exercises, and engaging in hobbies. Conclusions: This study revealed numerous emotional, psychological, and communicative challenges faced by patients with BD, as well as the strategies they use to cope with these problems. It is recommended that the findings of this study be used to enhance the care team's understanding of the mental and communicative issues experienced by these patients and to improve their skills in teaching psychological strengthening strategies.

Strength Amidst Struggles: A Descriptive Qualitative Study of Maternal Experiences of Low Socioeconomic Status Mothers in the Third Month Postpartum.

To explore the experiences, expectations and needs of mothers from low socioeconomic status at 3 months postpartum. Descriptive qualitative. Mothers aged 21 years old and above, from low socioeconomic status (monthly household income is less than Singapore Dollar [SGD] $4300), and irrespective of their parity were invited to participate in one-to-one in-depth interviews at 3 months postpartum from September 2022 to June 2023. A semistructured guide was used in the interviews, which were conducted until data saturation. A trained researcher conducted the interviews that were audio recorded, transcribed verbatim and analysed thematically. Written informed consent was obtained and voluntary participation was reinforced. Twenty mothers participated in this study and four themes were identified: (1) difficult trade-offs; (2) help-seeking behaviours and (3) 'But if?' Concerns about Emergencies. This study explored the difficult circumstances that mothers from low socioeconomic status face in their third month postpartum, and how wider societal inequalities exacerbated these circumstances. Current policies and practices need to be relooked, reframed, and reformed to address the unique needs of this community. Nurses should keep mothers' struggles in balancing employment and childcare in consideration and explore other ways of supporting the low socioeconomic status mothers such as online modes in providing patient education and peer support. Mothers from low socioeconomic status are less likely to seek formal help from healthcare professionals, external organizations and the government. These mothers need flexible, affordable and accessible childcare options to return to work. More targeted family-oriented policies that create empowering and understanding workplaces in Singapore could help ease the stress on mothers returning to employment postpartum. Online peer support groups consisting of mothers of similar socioeconomic backgrounds could help engage and retain this hard-to-reach yet vulnerable population. COREQ checklist. No patient or public contribution.

WP7.15 - Surgical dogma… Why change?

Abstract Aims Surgical dogma still persists today despite up-to-date evidence. Implementation of evidence into clinical practice takes on average 17 years. Acute appendicitis is typically managed with surgery, despite evidence recommending a non-operative, antibiotic-only strategy as an appropriate first line treatment in uncomplicated cases. This study investigates barriers to, and facilitators of, changing practice with regards to management of acute appendicitis. Methods Surgeons involved in emergency general surgery in U.K. hospitals were invited to participate in online/telephone semi-structured interviews. Thematic analysis based on the theoretical domains framework was used to develop belief statements. Results 16 interviews were conducted to achieve data saturation. 8 consultant surgeons, 8 surgical trainees from secondary and tertiary centres participated. Numerous barriers and facilitators were identified. There is a lack of awareness of current research with variable interpretation of evidence and its practical applications. There were concerns regarding loss of training opportunities in a “benchmark” procedure; failure of treatment and subsequent complications; missed malignancy and cost implications. Surgeons identified a reluctance to change from long standing practice and recognised their communication may skew patients’ decision making. Decision making practice varied from paternalistic to shared/supported. Surgeons believe they undertake a fully informed consent process, despite some not offering non-operative management as an alternative treatment. Conclusions Numerous barriers and facilitators exist to implementing change and are often based on surgeons’ personal experiences rather than evidence. The identified factors will be used to develop an implementation strategy to drive evidence-based practice and may be transferable to other surgical conditions.

Experiences of Faculty in Nursing Colleges: A Descriptive Phenomenology Study

The future of patient care is being paved by nurse educators, who mentor, teach, and inspire the next generation of novice nurses. Without them, aspiring nurses wouldn't be prepared to handle the constantly shifting needs of the modern, dynamic healthcare system. Nursing faculty needs to be knowledgeable and competent in evidence-based practice, informatics, quality improvement, inter-professional teamwork, and patient-centred care that are delivered with a focus on a culture of safety. As nursing faculties perform multidimensional work with balancing their home environment can create chaos in their life. Hence this aspect lit a spark within us to conduct a qualitative study on Nursing facultiesof southern region of Tamilnadu to analyse their work experiences. Further the study was led by in-depth face to face interview by using semi structured questionnaires. The data saturation was attained with sixteen participants. Colaizzi’s method was incorporated to analyse the data from the nursing faculty. This qualitative study lead a hand for us to showcase various themes like daily routine, job satisfaction, work life balance, interpersonal relationship and difficulties and challenges. There were also various subthemes which gave us insight on work atmosphere of the staff. Hence this study gave us an in-depth knowledge and understanding of individual nursing faculty and improvement so that the work balance could be maintained.

Assistance time and peripheral oxygen saturation in prehospital emergency data as predictors of COVID19 hospital outcomes

To verify if data obtained in the prehospital evaluation of patients with severe acute respiratory syndrome (SARS) during the initial response to the COVID-19 pandemic is associated with clinical outcomes: mechanical ventilation, hospital discharge, and death. This is a retrospective analysis involving secondary data from the Emergency Medical Service (EMS) records and the Health Surveillance Information System of patients assisted by the EMS in Manaus, from January to June 2020, the period of the first peak of COVID-19 cases. The combination of the two databases yielded a total of 1.190 patients, who received a first EMS response and were later admitted to hospital with SARS and had data on clinical outcomes of interest available. Patients were predominantly male (754, 63.4%), with a median age of 66 (IQR: 54.0–78.0) years. SARS illness before medical assistance was associated to need for invasive mechanical ventilation (IMV, p < 0.001). Lower pre-hospital SpO2 was associated to death (p = 0.025). Death was more common among patients with respiratory support needs, especially in the invasive ventilation group (262/287; 91.3%) (p < 0.001). In addition, IMV was more common among elderly individuals (p < 0.001). Patients admitted to ICU had a greater chance of dying when compared to non-ICU admitted patients (p < 0.001), and closely related to IMV (p < 0.001). Patients in ICU were also older (p = 0.003) and had longer hospital stay (p < 0.001). Mortality was associated with mechanical ventilation (p < 0.001), ICU admission (p < 0.001), and older age (p < 0.001). Patients who died had a shorter length of both ICU and total hospital stay (p < 0.001). Prehospital EMS may provide feasible and early recognition of critical patients with SARS in strained healthcare systems, such as in low-resource settings and pandemics.

Introducing a short-medium format, paediatric surgical podcast into the formal teaching resources of a medical school

BackgroundPodcasts are a popular form of extracurricular education. They provide a range of benefits for listeners including an opportunity for learning whilst mobile. We aimed to assess the interest of medical students in a podcast series as a part of their formal paediatric surgery teaching resources; to determine the optimal format for such a podcast and, following their introduction, if they were considered to have a beneficial effect on student learning. MethodWe conducted focus groups with medical students to explore interest in a podcast series and to determine the optimal format. Our findings guided production and introduction of 5 short-format podcast episodes as an adjunct to available formal learning resources. We ran student focus groups to evaluate the podcasts until data saturation was reached. Transcripts were analysed through thematic analysis by two researchers, who used the constant comparison process to produce a coding framework, through which they identified relevant themes. ResultsMedical students utilised outsourced medical podcasts as an adjunct to formal medical school curricula. All students supported the introduction of a podcast series into formal teaching resources to extend paediatric surgical teaching. The preferred medical podcast format was a short, conversational style podcast that begins with a clinical case and ends with a summary. The introduction of podcasts increased student engagement in, and understanding of, podcast topics. ConclusionMedical students enthusiastically embraced paediatric surgical podcasts in their curriculum. The addition of short-medium format podcasts enhances learning and engagement. Medical schools should utilize the teaching benefits that podcasts offer.

A qualitative, theory-based exploration of facilitators and barriers for implementation of pharmacist prescribing in chronic kidney disease.

While there is an accumulation of evidence that pharmacist prescribing is safe and effective, there is a lack of research on processes of implementation into practice, particularly for patients with complex clinical conditions such as chronic kidney disease (CKD). The aim was to explore the facilitators and barriers to the implementation of pharmacist prescribing for patients with CKD in the United Kingdom (UK). Semi-structured interviews were conducted with UK Renal Pharmacy Group members who were independent prescribers. The Consolidated Framework for Implementation Research (CFIR) underpinned the interview schedule. Interviews were recorded, transcribed, and independently coded by two researchers. A thematic approach was used for analysis, with data generation continuing until saturation of themes. Ethical approval was granted. Data saturation was achieved following 14 interviews. Most interviewees were female (n = 11), all had secondary care as their main practice setting, and were highly experienced prescribers with 8 having 11 or more years of prescribing practice. Interviewees were positive regarding the development of their prescribing practice. Facilitators and barriers emerged across all 5 of the CFIR domains. Key facilitators were aspects of inner setting (e.g., organisational support and communication) while key barriers were also related to inner setting, specifically the need for adequate structural and financial resources. This theory-based study has illuminated the facilitators and barriers for the implementation of pharmacist prescribing in CKD. There is a need to consider the resources required for implementation of prescribing practice at an early stage of planning and development.

Exploring the challenges of emergency medical service providers in the initial phase of the COVID-19 pandemic: a qualitative content analysis

BackgroundAs the COVID-19 pandemic continues to unfold, there has been a substantial increase in the demand for prehospital services. Emergency medical service (EMS) providers have encountered a myriad of challenges that have had a discernible impact on their professional performance. This study was designed to explore the challenges faced by EMS providers during the initial phase of the COVID-19 pandemic.MethodsThis qualitative research was conducted using a content analysis approach at emergency medical centers affiliated with Hamadan University of Medical Sciences in Iran between April and August 2021. This study included the participation of 21 EMS personnel, which was conducted using purposive sampling and semistructured interviews, and continued until data saturation was reached. The conventional content analysis method, as outlined by Graneheim and Lundman, was applied for data analysis.ResultsThe analysis of the interview data resulted in the identification of 219 primary codes, which were then organized into ten distinct categories. These categories were further consolidated into three overarching themes: personal safety challenges, professional-organizational challenges, and threatened mental health.ConclusionsEMS personnel play a critical role in healthcare during disasters and pandemics, facing challenges that can have negative effects. Managing these challenges can impact mental health and professional well-being, but awareness, support, resources, and services can help mitigate adverse consequences.