Experiences Of Healthcare Providers Research Articles

The Experiences of Women and Healthcare Providers in Assessing the History of Gender-Based Violence During Perinatal Care.

Despite its prevalence and consequences, perinatal healthcare providers’ identification of gender-based violence (GBV) remains controversial in British Columbia. This study investigated women and healthcare providers’ perspectives regarding their experiences with and views of inquiring about GBV during perinatal care. Twelve in-depth interviews were conducted with women with a history of GBV and 16 perinatal healthcare providers. Data were analyzed thematically. Three themes, including “barriers to disclosure,” “healthcare providers hesitate to open Pandora's Box,” and “how to ask in a culturally safe way,” emerged from the data. Study participants support inquiry about GBV during perinatal healthcare.

Examining the Application and Use of the Baby-Friendly Hospital Initiative Within Rural and Urban Health Facilities in Canada and Australia Among Indigenous Mothers

ObjectivesTo prevent infant mortality and morbidity, the WHO and UNICEF established the Baby-Friendly Hospital Initiative (BFHI) to support breastfeeding initiation and duration by improving the quality of care provided in health facilities globally. Indigenous communities across the world report lower breastfeeding rates compared to non-Indigenous populations. There is very limited research surrounding the implementation of the BFHI to support Indigenous women. The objectives of this research are: to gather firsthand experiences of policymakers, administrators, and health care providers on implementing and supporting access among Indigenous mothers; and apply and adapt the Interactive Theory of Breastfeeding to explore theoretical concepts influencing breastfeeding practices among Indigenous women within Canada and Australia.MethodsA case study research design will be implemented to explore the experiences of policymakers, health service providers, and advocates in implementing the BFHI in health facilities servicing Indigenous women. Targeted emails and flyers will be posted on social media to recruit participants with expertise in Indigenous maternal health and infant feeding. Participants will be recruited from four health facilities, either from a small, rural location or a large urban facility. Examining facilities with different resources available will help shine light on how the implementation of the BFHI may differ. In addition, representatives of local, provincial, and territorial governments, and international organizations such as WHO will be recruited to participate in virtual semi-structured interviews. In total, 15 to 20 participants will be included in this research. Thematic analysis and line-by-line coding will then be utilized to identify themes and patterns.ResultsIt is anticipated the results from this study will highlight current gaps in care surrounding the BFI and its availability and use among Indigenous women within Canada and Australia.ConclusionsThis research has national and international policy implications as it will help uncover whether the BFHI can be used as a tool to promote and support Indigenous maternal-child health through culturally safe infant feeding practice.Funding SourcesCanadian Institutes of Health Research.

Experiences of infected health care team during first wave of COVID-19 at Hilal-e-Ahmer Hospital, Faisalabad

BACKGROUND & OBJECTIVE: COVID-19 has caused a very deep and intense effect on all persons irrespective of age and gender. It was especially a challenging fight for health professionals as they were dealing it from many aspects. All the infected health workers were facing many emotional and mental stresses, and at the same time, they were supposed to provide error free services at the hospital. To explore the experiences of infected Health Care Providers during COVID-19 pandemic.
 METHODOLOGY: The interview based qualitative descriptive research was conducted at Hilal-e Ahmar hospital Faisalabad, Pakistan. To get an in-depth idea about different experiences of the professionals, 15 Semi structured interviews were conducted during the first wave of COVID-19 pandemic in Pakistan. Convenient sampling was done by inviting all the infected members for the interviews. Purposive sampling was done, and a total of 15 interviews were conducted till the data was saturated. Participants gave their convenient time keeping in mind their easy duty days for the study, and they were interviewed in their offices. Interviews were transcribed, rechecked, and analyzed. Thematic analysis was done with narrations.
 RESULTS:5 broader themes were generated with sub-themes. The themes were 1) Diagnosis of disease, 2) Disease impacts, 3) Social reaction, 4) Combating techniques for isolation period and, 5) Dilemmas during the quarantine period. The participants were diagnosed by PCR technique, and the diagnosis was associated with extreme feelings of denial, depression, anxiety, fear of the future and uncertainty. Most of the participants faced negative responses from society and experienced a social boycott.
 CONCLUSION: The first wave of COVID-19 was a period of extreme stress and anxiety, especially for the health care providers working as the first line of defense against the disease. They not only suffer from the physiological effects of the disease but faced mental trauma and social stigmatization. Electronic media had a negative effect on the thought process of people.

Preventive Counseling in Routine Prenatal Care-A Qualitative Study of Pregnant Women's Perspectives on a Lifestyle Intervention, Contrasted with the Experiences of Healthcare Providers.

Maternal lifestyle during pregnancy and excessive gestational weight gain can influence maternal and infant short and long-term health. As part of the GeMuKi intervention, gynecologists and midwives provide lifestyle counseling to pregnant women during routine check-up visits. This study aims to understand the needs and experiences of participating pregnant women and to what extent their perspectives correspond to the experiences of healthcare providers. Semi-structured interviews were conducted with 12 pregnant women and 13 multi-professional healthcare providers, and were analyzed using qualitative content analysis. All interviewees rated routine check-up visits as a good setting in which to focus on lifestyle topics. Women in their first pregnancies had a great need to talk about lifestyle topics. None of the participants were aware of the link between gestational weight gain and maternal and infant health. The healthcare providers interviewed attributed varying relevance regarding the issue of weight gain and, accordingly, provided inconsistent counseling. The pregnant women expressed dissatisfaction regarding the multi-professional collaboration. The results demonstrate a need for strategies to improve multi-professional collaboration. In addition, health care providers should be trained to use sensitive techniques to inform pregnant women about the link between gestational weight gain and maternal and infant health.

Promoting safety and role clarity among health professionals on Canada's First Alongside Midwifery Unit (AMU): A mixed-methods evaluation

ObjectiveGlobally, midwife-led units are associated with improved clinical outcomes and childbirth satisfaction, but little is known about the impact of the model on health professionals themselves and interprofessional collaboration. The aim of this research was to describe the experiences of health professionals providing care in Canada's first Alongside Midwifery Unit. DesignA mixed-methods evaluation exploring healthcare provider's experiences using an online survey and qualitative semi-structured interviews and focus groups. SettingCanada's first Alongside Midwifery Unit, opened at X in 2018. In the Ontario context, the model reorganizes the way in which midwifery services are integrated in the hospital. ParticipantsMidwives, obstetricians, nurses, pediatricians, anesthetists, and other healthcare providers participated. Measurements & findings82 online surveys, 17 semi-structured interviews and one focus group were completed. Providers agreed that they perceived the Alongside Midwifery Unit was a success (89%) and perceived satisfaction among those receiving care on the unit(93%). The majority of providers were satisfied working on the unit (82%) and reported greater role clarity in the new model (85%) compared to the traditional model of midwifery services. Four main themes emerged from the health professionals' perspectives regarding how the unit impacted care: promoting safety, clarifying roles, facilitating collaboration, and managing change. Implications for practiceOverall, healthcare professionals had positive experiences working on the AMU, including improved role clarity and interprofessional relationships, and they perceived high levels of satisfaction among those giving birth on the unit. Our findings indicate the Alongside Midwifery Unit model can be beneficial for health professionals, women and birthing people.

Coping with ill-health while lacking access to health care: Acceptability of health service provision in rural Malawi – a qualitative study

ABSTRACT Background Large parts of Malawi`s population lack access to health care. A high burden of disease, chronic poverty, and a growing population accelerate the need for extending and improving health care. One region that is struggling with service provision is Malawi´s rural district Phalombe. In addition to adequate resources, acceptability of service provision and productive patient-provider engagements are crucial determinants of health-seeking behaviour. Objective This study aimed to better understand the interdependencies between acceptability, patient-provider engagement, and health-seeking behaviour in Phalombe. By targeting health care providers and community members, different perspectives were assessed and triangulated. Methods Following a qualitative approach, group interviews were conducted with community members of three rural villages (n = 21) in Phalombe. Semi-structured interviews (n = 2) and a group interview among management staff (n = 3) provided insight into experiences of health care providers. Results Community members perceived health care providers’ behaviour as disrespectful, resulting in power gaps between patients and providers. Providers blamed community members’ cultural beliefs and lack of awareness regarding health care as barriers to seek formal services. Systemic shortcomings diminished community members’ trust in service provision, while increasing frustration among providers and thus impacting patient-provider engagement. Due to insufficient resources, lack of acceptability and trust in receiving adequate services, potential patients turned into non-users of health care. Conclusions A patient-centred approach is needed that empowers communities by involving them in health care planning, in facility management, and by raising awareness towards health issues. Trainings for providers need to focus on improving communication and building trustful patient-provider interactions. Yet, without addressing systemic constraints, providers’ frustration and patients’ lack of trust in service provision will remain and impact their health-seeking behaviour. Thus, further budget needs to be allocated to Malawi’s health care sector in order to provide resources needed.

Mental health stigma at primary health care centres in Lebanon: qualitative study

BackgroundMental health-related stigma is a global public health concern and a major barrier to seeking care. In this study, we explored the role of stigma as a barrier to scaling up mental health services in primary health care (PHC) centres in Lebanon. We focused on the experiences of Healthcare Providers (HCPs) providing services to patients with mental health conditions (MHCs), the views of policy makers, and the perceptions of stigma or discrimination among individuals with MHCs. This study was conducted as part of INDIGO-PRIMARY, a larger multinational stigma reduction programme.MethodsSemi-structured qualitative interviews (n = 45) were carried out with policy makers (n = 3), PHC management (n = 4), PHC staff (n = 24), and service users (SUs) (n = 14) between August 2018 and September 2019. These interviews explored mental health knowledge, attitudes and behaviour of staff, challenges of providing treatment, and patient outcomes. All interviews were coded using NVivo and a thematic coding framework.ResultsThe results of this study are presented under three themes: (1) stigma at PHC level, (2) stigma outside PHC centres, and (3) structural stigma. SUs did not testify to discrimination from HCPs but did describe stigmatising behaviour from their families. Interestingly, at the PHC level, stigma reporting differed among staff according to a power gradient. Nurses and social workers did not explicitly report incidents of stigma but described patients with MHCs as uncooperative, underscoring their internalized negative views on mental health. General practitioners and directors were more outspoken than nurses regarding the challenges faced with mental health patients. Mental health professionals revealed that HCPs still hold implicitly negative views towards patients with MHCs however their attitude has improved recently. Our analysis highlights five layers of stigma affecting SUs.ConclusionThis qualitative study reveals that stigma was still a key concern that affects patients with MHC. SUs reported experiencing overt stigmatising behaviour in the community but less explicit discrimination in a PHC setting. Our findings emphasise the importance of (1) combatting structural stigma through legal reform, (2) addressing interpersonal stigma, (3) committing PHC management to deliver high quality mental health integrated services, and (4) reducing intrapersonal stigma by building public empathy.

Healthcare Providers' Experiences With a Clinical Mentorship Intervention to Improve Reproductive, Maternal and Newborn Care in Mwanza, Tanzania.

There is increasing evidence suggesting that clinical mentorship (CM) involving on-the-job training is one of the critical resources-friendly entry points for strengthening the knowledge and skills of healthcare providers (HCPs), which in turn facilitate the delivery of effective reproductive, maternal, and newborn health (RMNH) care. The article explores the experiences of HCPs following participation in the CM program for RMNH in eight districts of Mwanza Region in Tanzania. A qualitative descriptive design employing data from midterm project review meetings and Key Informant Interviews (KIIs) with purposefully selected HCPs (mentors and mentees) and District Medical Officers (DMOs) during endline evaluation were employed. Interview data were managed using Nvivo Software and analyzed thematically. A total of 42 clinical mentors and master mentors responded to a questionnaire during the midterm review meeting. Then, a total of 17 KIIs were conducted with Mentees (8), Mentors (5), and DMOs (4) during endline evaluation. Five key themes emerged from participants' accounts: (i) the topics covered during CM visits; (ii) the benefits of CM; (iii) the challenges of CM; (iv) the drivers of CM sustainability; and (iv) suggestions for CM improvement. The topics of CM covered during visits included antenatal care, neonatal resuscitation, pregnancy monitoring, management of delivery complications, and infection control and prevention. The benefits of CM included increased knowledge, skills, confidence, and change in HCP's attitude and increased client service uptake, quality, and efficiency. The challenges of CM included inadequate equipment for learning and practice, the limited financial incentive to mentees, shortage of staff and time constraints, and weaker support from management. The drivers of CM sustainability included the willingness of mentees to continue with clinical practice, ongoing peer-to-peer mentorship, and integration of the mentorship program into district health plans. Finally, the suggestions for CM improvement included refresher training for mentors, engagement of more senior mentors, and extending mentorship beyond IMPACT catchment facilities. CM program appears to be a promising entry point to improving competence among HCPs and the quality and efficiency of RMNH services potentially contributing to the reduction of maternal and neonatal deaths. Addressing the challenges cited by participants, particularly the equipment for peer learning and practice, may increase the success of the CM program.

Healthcare providers' experiences with advance care planning and goals of patient care medical treatment orders in residential aged care facilities: an explanatory descriptive study.

Advance care planning (ACP) is a process by which people communicate their healthcare preferences and values, planning for a time when they are unable to voice them. Within residential aged care facilities (RACF), both the completion and the clarity of ACP documents are varied and, internationally, medical treatment orders have been used to address these issues. In this study, goals of patient care (GOPC) medical treatment orders were introduced alongside usual ACP in three RACF to improve healthcare decision-making for residents. This study explored the experiences of RACF healthcare providers with ACP and GOPC medical treatment orders. The study used an explanatory descriptive approach. Within three RACF where the GOPC medical treatment orders had been introduced, focus groups and interviews with healthcare providers were performed. The transcribed interviews were analysed thematically. Healthcare providers not only reported support for ACP and GOPC but also discussed many problematic issues. Analysis of the data identified four main themes: enablers, barriers, resident autonomy and advance documentation (ACP and GOPC). Healthcare providers identified ACP and GOPC as positive tools for assisting with medical decision-making for residents. Although barriers exist in completion and activation of plans, healthcare providers described them as progressing resident-centred care. Willingness to follow ACP instructions was reported to be reduced by lack of trust by clinicians. Families were also reported to change their views from those documented in family-completed ACP, attributed to poor understanding of their purpose. Participants reported that GOPC led to clearer documentation of residents' medical treatment plans rather than relying on ACP documents alone.

Strengths and Challenges to the Integration of Mental Health Services into the Primary Health Care System in Developing Countries: A Systematic Review

The existence of a treatment gap for persons with mental disorders has led the WHO to implore leaders around the world to integrate mental health services into the community or primary health care system. Whilst there are strengths, there are great challenges to the integration process that are hindering the implementation of this initiative in developing countries. The aim of this paper is to synthesize evidence from various researchers regarding the strengths and challenges to the integration of mental health services into the primary or community health care system in developing countries. The sources of information included Pubmed, Medline, Google Scholar, Ebsco Host, and the WHO website. Seventeen (17) studies met the inclusion criteria out of the search results of 2,200. The challenges most reported were inadequate support and supervision structures; lack of key resources, limited Knowledge, inadequate training, and lack of experience of healthcare providers in mental health; time constraints for the primary healthcare workers; lack of regulatory measures to encourage the integration. The strengths most reported were health care workers’ acceptance of responsibility to provide mental health services in the community setting. This paper has proven a number of strengths and challenges regarding the integration of mental health services into the primary or community health care system. It is hoped that this paper will assist stakeholders and policymakers in overcoming the majority of the challenges identified in the integration of mental health services in the primary health care system.

Digital Self-monitoring of Multiple Sclerosis: Interview Study With Dutch Health Care Providers on the Expected New Configuration of Roles and Responsibilities.

BackgroundDigital self-monitoring allows patients to produce and share personal health data collected at home. This creates a novel situation in which health care providers and patients must engage in a reconfiguration of roles and responsibilities. Although existing research pays considerable attention to the perceptions of patients regarding digital self-monitoring, less attention has been paid to the needs, wishes, and concerns of health care providers. As several companies and public institutions are developing and testing digital self-monitoring at the time of writing, it is timely and relevant to explore how health care providers envision using these technologies in their daily work practices. Our findings can be considered in decision-making processes concerning the further development and implementation of digital self-monitoring.ObjectiveThis study aims to explore how health care providers envisage using smartphone apps for digital self-monitoring of multiple sclerosis (MS) in their daily work practices, with a particular focus on physician-patient communication and on how health care providers respond to self-monitoring data and delegate tasks and responsibilities to patients.MethodsWe conducted semistructured in-depth interviews with 14 MS health care providers: 4 neurologists, 7 MS specialist nurses, and 3 rehabilitation professionals. They are affiliated with 3 different hospitals in the Netherlands that will participate in a pilot study to assess the efficiency and effectiveness of a specific smartphone app for self-monitoring.ResultsThe interviewed health care providers seemed willing to use these smartphone apps and valued the quantitative data they produce that can complement the narratives that patients provide during medical appointments. The health care providers primarily want to use digital self-monitoring via prescription, meaning that they want a standardized smartphone app and want to act as its gatekeepers. Furthermore, they envisioned delegating particular tasks and responsibilities to patients via digital self-monitoring, such as sharing data with the health care providers or acting on the data, if necessary. The health care providers expected patients to become more proactive in the management of their disease. However, they also acknowledged that not all patients are willing or able to use digital self-monitoring apps and were concerned about the potential psychological and emotional burden on patients caused by this technology.ConclusionsOur findings show that health care providers envisage a particular type of patient empowerment and personalized health care in which tensions arise between health care providers acting as gatekeepers and patient autonomy, between patient empowerment and patient disempowerment, and between the weight given to quantitative objective data and that given to patients’ subjective experiences. In future research, it would be very interesting to investigate the actual experiences of health care providers with regard to digital self-monitoring to ascertain how the tensions mentioned in this paper play out in practice.

Feasibility of a Digital Patient-Provider Communication Intervention to Support Shared Decision-Making in Chronic Health Care, InvolveMe: Pilot Study.

BackgroundEnhanced communication with health care providers (HCPs) can improve symptom management and health-related quality of life (HRQoL) for patients with chronic health conditions. Access to appropriate communication venues is needed to improve communication, however. As such, digital communication interventions mediated by patient portals carry the potential to support patient-provider communication and interaction and through this, also facilitate shared decision-making (SDM). The InvolveMe intervention was designed to provide patients with the opportunity to communicate symptoms and informational needs prior to consultation via digital assessment, including prioritizing what is most important to discuss with their HCPs, as well as to interact with HCPs through secure messages between outpatient visits.ObjectiveThe aim of this study was to assess the feasibility of the InvolveMe intervention by investigating acceptability, demand (ie, system use), and limited efficacy.MethodsThe study was designed as a single-arm, pre-post feasibility study combining quantitative and qualitative methods for data collection. Patients from an endocrine outpatient clinic were invited to use the InvolveMe intervention for 3 months, and HCPs administering InvolveMe were invited to participate in a focus group. Guided by descriptions of how to design feasibility studies by Bowen et al, feasibility was tested by exploring (1) acceptability, using data collected during recruitment from patient participants and nonparticipants (ie, declined to participate or did not meet study requirements), HCP experiences with recruitment, and the System Usability Scale (SUS); (2) demand via exploration of system use through extraction of system log data and HCP experiences with system use; and (3) limited efficacy testing, via exploration of potential effects from the Short-Form Health Survey (RAND 36), Hospital Anxiety and Depression Scale, and Health Literacy Questionnaire.ResultsPatient participants (N=23) were a median 54 (range 26-78) years old and primarily male (14/23, 61%). Nonparticipants (N=16) were a median 73 (range 55-80) years old and primarily male (12/16, 75%). The average SUS score was 72.2, indicating good system usability. Assessments were completed by 8 participants from home prior to outpatient visits. The assessments entailed various bodily symptoms and needs for information. Participants sent 17 secure messages related to patient administrative matters, symptoms, and challenges. Focus group participants (N=4) were all female and registered nurses. Data were analyzed in 2 predefined themes: Acceptability and Demand. Acceptability included the subthemes intervention attractiveness and intervention suitability. Demand included the subthemes elements of SDM and intervention challenges and opportunities. All patient participants completed outcome measures at baseline, and 19 (19/23, 83%) completed outcome measures at 3 months. These preliminary efficacy findings were mixed and inconclusive.ConclusionsThe study design provided findings from both patient and HCP perspectives and supported feasibility of the InvolveMe intervention. The investigation of acceptability and demand supported the potential for remote SDM mediated by patient portals using assessments and secure messages.Trial RegistrationClinicalTrials.gov NCT NCT04218721; https://www.clinicaltrials.gov/ct2/show/NCT04218721

Translating Clinical Research to Clinical Care in Nephrology: A Qualitative Study of Nephrology Clinicians

Rationale & ObjectiveThe translation of clinical research to practice has been the subject of intense scrutiny in the efforts to identify ways to improve the uptake of findings that can enhance patient care.Study DesignThis study evaluated the experience of nephrology health care providers who manage patients with autosomal dominant polycystic kidney disease (ADPKD) to identify promoters and barriers to the translation of research results into clinical practice. We used inductive thematic analysis to evaluate the experience, attitudes, and beliefs of physicians in the evaluation and translation of research findings into clinical practice for the care of patients with ADPKD.Setting & ParticipantsParticipants in a continuing education activity on ADPKD volunteered for semistructured interviews exploring their experience translating new knowledge into care for patients with ADPKD. An independent institutional review board (Solutions IRB) found the study to be exempt as an educational survey.Analytical ApproachTranscripts were coded and excerpted, and emergent themes and relationships were identified through an analysis performed using Dedoose software. Particular attention was paid to characterizing the facilitators and barriers to research translation at different levels of the health care environment.ResultsTextual interpretation of data from 13 interviews showed that while well-established barriers to research translation are prevalent among health care providers managing patients with ADPKD, these clinicians also face unique challenges. Principal among these is the burden of interpreting the clinical research literature given the lack of official guidelines.LimitationsThis study did not explore the translation of all levels of research, such as basic science and animal studies, and it was limited to the translation of knowledge from clinical studies. The number of participants was limited but was found to be sufficient for saturation.ConclusionsWe identified factors that may either enhance or impede research translation for nephrology health care providers. These observations may help in the design of continuing education interventions to promote innovation.

Empathy as a Factor Conditioning Attitudes towards the Elderly among Physiotherapists-Results from Poland.

Attitudes of healthcare workers towards the elderly significantly affect the quality of care dedicated to this group of patients. The purpose of this study was to assess the approach of Polish physiotherapists to the elderly and to analyze the factors influencing these attitudes. The study was based on a cross-sectional Internet-based survey that was conducted in the period from May to September 2021. It was completed by 252 subjects: 189 women and 63 men. The study was based on the involvement of physiotherapists with the right to practice their profession in accordance with the law in force in Poland. The tools used in the study were The Kogan Attitudes towards the Elderly (KAOP) score and The Jefferson Empathy Scale (JSE). To model the KOAP score as a function of the predictors, Bayesian linear regression was used. The average KOAP score in the sample was M (SD) = 100.7 (17.46), with the central 50% of the observations ranging from 81 to 113 points. We observed one statistically credible relationship: relevance of contacts with elderly people was positively and moderately related to KOAP. Additionally, we observed that the JSE scale was positively, but very weakly, associated with KOAP. Empathy and own experience of health care providers may protect against negative attitudes towards the elderly, meaning empathy in healthcare professionals is crucial.

Noninvasive mobile EEG as a tool for seizure monitoring and management: A systematic review.

In the last two decades new noninvasive mobile electroencephalography (EEG) solutions have been developed to overcome limitations of conventional clinical EEG and to improve monitoring of patients with long‐term conditions. Despite the availability of mobile innovations, their adoption is still very limited. The aim of this study is to review the current state‐of‐the‐art and highlight the main advantages of adopting noninvasive mobile EEG solutions in clinical trials and research studies of people with epilepsy or suspected seizures. Device characteristics are described, and their evaluation is presented. Two authors independently performed a literature review in accordance with Preferred Reporting Items for Systematic Reviews and Meta‐Analyses (PRISMA) guidelines. A combination of different digital libraries was used (Embase, MEDLINE, Global Health, PsycINFO and https://clinicaltrials.gov/). Twenty‐three full‐text, six conference abstracts, and eight webpages were included, where a total of 14 noninvasive mobile solutions were identified. Published studies demonstrated at different levels how EEG recorded via mobile EEG can be used for visual detection of EEG abnormalities and for the application of automatic‐detection algorithms with acceptable specificity and sensitivity. When the quality of the signal was compared with scalp EEG, many similarities were found in the background activities and power spectrum. Several studies indicated that the experience of patients and health care providers using mobile EEG was positive in different settings. Ongoing trials are focused mostly on improving seizure‐detection accuracy and also on testing and assessing feasibility and acceptability of noninvasive devices in the hospital and at home. This review supports the potential clinical value of noninvasive mobile EEG systems and their advantages in terms of time, technical support, cost, usability, and reliability when applied to seizure detection and management. On the other hand, the limitations of the studies confirmed that future research is needed to provide more evidence regarding feasibility and acceptability in different settings, as well as the data quality and detection accuracy of new noninvasive mobile EEG solutions.

How to Facilitate Disclosure of Violence while Delivering Perinatal Care: The Experience of Survivors and Healthcare Providers

Gender-based Violence (GBV) during the perinatal period is a serious concern as it is associated with many adverse outcomes for both the mother and the baby. It is well known that violence is under-reported. Thus, official statistics (both police reports and survey data) underestimate the prevalence of violence in general and during the perinatal period specifically. In this study conducted in Canada, we sought to explore the barriers to and facilitators of women disclosing their experiences of GBV within healthcare services to safely facilitate more disclosure in the future and reduce the harms that arise from GBV. We used thematic analysis to analyze in-depth interviews with 16 healthcare providers (nurses, midwives and physicians) and 12 survivors of GBV. The data reflect three main themes: “raising awareness of gender-based violence”, “creating a shift in the healthcare system’s approach toward gender-based violence” and “providing support for survivors and care providers.” Our findings suggest that the healthcare system should increase its investments in raising awareness regarding GBV, training healthcare providers to respond appropriately, and building trust between survivors and healthcare providers. Healthcare providers need to be aware of their role and responsibility regarding identifying GBV as well as how to support survivors who talk about violence. Expanding a relationship-based approach in the care system and providing support for both survivors and health care providers would likely lead to more disclosures.

'Down to the person, the individual patient themselves': A qualitative study of treatment decision-making for shoulder pain.

IntroductionMany inconsistencies have been identified in the translation of evidence‐based treatment recommendations for musculoskeletal shoulder pain into healthcare services, with little known about factors influencing decision‐making. The objective of this study was to explore the views and experiences of healthcare providers (HCPs) and people living with shoulder pain on treatment decision‐making.MethodsAdopting a qualitative design, purposeful sampling was employed to recruit 13 individuals with nonspecific musculoskeletal shoulder pain and 30 HCPs. Data were collected through 1:1 semi‐structured interviews and analysed using an approach informed by Constructivist Grounded Theory. To facilitate analysis, two patient and public involvement (PPI) meetings were conducted.ResultsMost participants (69%) had shoulder pain of ≥1‐year duration. Biomechanical beliefs about shoulder pain predominated and were heavily influential in decision‐making for both patients and HCPs. Despite a consensus that therapeutic alliance facilitated decision‐making, the extent of collaboration between HCPs and patients in treatment decision‐making was rather limited. In addition to condition‐specific factors, Individual patient characteristics and resources also influenced treatment decisions.ConclusionFindings revealed the complexity of the decision‐making process for both patients and HCPs, exposing substantial gaps between the reported views and experiences of participants and the principles of client‐centred and evidence‐based practice. There is a pressing need to enhance the translation of evidence‐based knowledge into practice in this clinical area.Patient or Public ContributionIn line with a consultative approach to collaborative data analysis, a subgroup of participants attended two PPI meetings to provide commentary and feedback on preliminary findings.

Developing an evaluation framework for assessing the impact of recovery colleges: protocol for a participatory stakeholder engagement process and cocreated scoping review

IntroductionRecovery colleges (RCs) are mental health centres aimed at equipping people with skills to live a meaningful life despite the presence of mental distress. Unique to them is the aspect...

Effects of the COVID-19 Pandemic on Healthcare Providers: Policy Implications for Pandemic Recovery.

Background:Notably higher rates of mental health issues have been reported among healthcare providers (HCPs) during the COVID-19 pandemic. Concerns over the impact of policy decisions on the well-being of HCPs is growing, yet it remains underexplored in the literature.Method:HCPs from a 301-bed mental health hospital and a 408-bed acute care community hospital, both located in central Ontario, participated in interviews (N = 30) and answered open-ended questionnaires (N = 88) to provide their experiences with the COVID-19 pandemic.Results:Using interpretive description methods, we found that public health policies and other strategies intended to mitigate COVID-19 transmission variably impacted HCP well-being and professional practice.Discussion:Pandemic-related policies contributed to HCP stress by changing the healthcare environment and clinical practice. Understanding HCP experiences is key for leaders, policy makers and health system planners to deal with the current state, recovery and preparation for future pandemics. Direct input into policy development, implementation and evaluation from HCPs may support their well-being.

Experiences of Healthcare Providers in Care Delivery to Older Persons

Experiences of Healthcare Providers in Care Delivery to Older Persons