Sequential Explanatory Mixed Methods Study Research Articles

The role of spirituality in pain experiences among adults with cancer: an explanatory sequential mixed methods study.

Foundational research demonstrates that spirituality may affect the way people with cancer experience pain. One potential route is through alterations in thoughts and beliefs, such as pain-related catastrophizing. The purpose of this study is to understand whether spirituality impacts pain experiences through pain-related catastrophizing. This explanatory sequential mixed methods study was informed by an adapted Theory of Unpleasant Symptoms. Data were collected via online surveys (N = 79) and follow-up qualitative interviews (N = 25). Phase 1 employed Empirical Bayesian analysis. Phase 2 used deductive content analysis. Phase 3 involved creating a mixed methods joint display to integrate findings and draw meta inferences. Results indicate that total spiritual well-being was directly negatively associated with pain-related catastrophizing, and indirectly negatively associated with the outcomes of pain interference, pain severity, and pain-related distress. Qualitative categories highlight the supportive role of spirituality when facing pain, while also shedding light on the limitations of spirituality in the context of some pain (i.e., severe, neuropathic, and/or chronic). Mixed methods findings reveal the importance of spirituality for some people as they face cancer and cancer-related pain, as well as the need for integrating spirituality as part of a larger pain management plan. This research advances supportive cancer care by exploring the complex role of spirituality in pain experiences. Findings will inform further exploration into the role of spirituality in supporting holistic symptom management in the context of cancer, as well as developing and testing interventions to enhance spirituality and address symptom-related suffering.

Technology-Enabled Collaborative Care for Type-2 Diabetes and Mental Health (TECC-D): Findings From a Mixed Methods Feasibility Trial of a Responsive Co-Designed Virtual Health Coaching Intervention.

Type-2 diabetes (T2D) is a complex chronic condition associated with a lower quality of life due to disease specific distress. While there is growing support for personalized diabetes programs, care for mental health challenges is often fragmented and limited by access to psychiatry, and integration of care. The use of communication technology to improve team based collaborative care to bridge these gaps is promising but untested. We conducted an explanatory sequential mixed methods study to assess the feasibility and acceptability of the co-designed Technology-Enabled Collaborative Care for Diabetes and Mental Health (TECC-D) program. Participants included adults aged ≥18 years who had a clinical diagnosis of T2D, and self-reported mental health concerns. 31 participants completed the 8-week virtual TECC-D program. Findings indicate that the program is feasible and acceptable and indicate that there is a role for virtual diabetes and mental health care. The TECC-D program, designed through an iterative co-design process and supported by innovative, responsive adaptations led to good uptake and satisfaction. The TECC-D model is a feasible and scalable care solution that empowers individuals living with T2D and mental health concerns to take an active role in their care.

Does language teachers’ intercultural competence influence oral participation in EFL classrooms?: unveiling learner perspectives through a mixed methods inquiry

ABSTRACT The present two-phased sequential explanatory mixed methods study investigates the potential association between foreign language teachers’ (FLTs) intercultural competence and Japanese students’ oral participation through the perspectives of students. In Study 1, a survey questionnaire was administered to second-year advanced-level students at two Japanese universities (N = 115). The participants were asked about their learning styles and FLTs’ teaching practices that promoted and hindered their oral participation based on their prior language learning experiences. The results confirmed the associations between FLTs’ host language proficiency, host cultural understanding, and students’ oral participation. In Study 2, qualitative data were obtained from 21 students to explain and build upon the quantitative results. The findings showed that demonstrating intercultural competence by emphasizing group work, showing tolerance for silence, and using Japanese gestures, personal anecdotes, and stories from Japanese culture could create avenues to students’ own worlds and give them psychological safety to express themselves. The study concludes that FLTs’ intercultural competence needs to be further emphasized in teacher training manuals and school curricula in Japanese EFL settings.

Preservice teachers’ cultural competence factors in teacher preparation programs: an explanatory sequential mixed methods study

ABSTRACT Cultural competence is a framework that develops preservice teachers’ self-awareness to confront their attitudes, beliefs, biases, and values, to learn and understand culturally diverse groups’ needs, and to translate such knowledge into culturally responsive professional practices and skills. Previous studies investigating teacher preparation programmes through the lens of cultural competence examined its application in early childhood and elementary undergraduate programmes, in an ESOL course, in a study abroad programme, and in a literacy method course. However, questions were left unanswered concerning the factors affecting preservice teachers’ perceptions of being culturally competent to teach culturally and linguistically diverse (CLD) students. The purpose of this study is to examine the factors that affect preservice teachers’ cultural competence development to teach CLD students using an explanatory sequential mixed-method design. The goal is to provide a holistic understanding of preservice teachers’ experiences with cultural competence in their teacher preparation programmes by integrating quantitative and qualitative data. The findings from this study highlight the need to implement intentional efforts to prepare preservice teachers to attend to the increasing demand for offering high-quality education to CLD students.

Biology lecturers’ perceptions of genetics literacy in Indonesia: an explanatory sequential mixed methods study

ABSTRACT Given its impact on medicine, agriculture, and society, genetics literacy has attracted international interest. Biology lecturers play a crucial role in supporting students’ genetics literacy empowerment. However, research into biology lecturers’ perceptions of genetics literacy still needs to be undertaken. This study aimed to explore the understanding, perception, and awareness of genetics literacy among Indonesian biology lecturers. We performed an explanatory sequential mixed method study in two phases: online survey and semi-structured interviews. Results showed that (a) most biology lecturers agreed that genetics literacy was correlated with scientific literacy, information and communication technology literacy, reading literacy, and numerical literacy, and then genetics literacy is understood as consisting of genetics concepts and skills; (b) most biology lecturers agreed that argumentation, informal reasoning, and decision-making skills were appropriate for enhancing genetics literacy development; (c) despite less than half of the biology lecturers teaching skills related to genetics literacy and only a fourth assessing skills related to genetics literacy, most biology lecturers were willing to teach and assess skills related to genetics literacy comprehensively. The findings revealed that biology lecturers’ perceptions of genetics literacy must be explored, given their critical role in ensuring effective and successful genetics educational practice.

Understanding “patient deterioration” in psychotherapy from depressed patients’ perspectives: A mixed methods multiple case study

Objective: This study scrutinizes the meaning of deterioration in psychotherapy beyond the widely used statistical definition of reliable symptom increase pre-to-post treatment. Method: An explanatory sequential mixed-methods multiple case study was conducted, combining quantitative pre–post outcome evaluation of self-reported depression symptoms and qualitative analysis of patients’ interviews. In a Randomized Controlled Study on the treatment of Major Depression, three patients showing reliable increase in symptom severity on the BDI-II pre-to-post therapy were selected. An interpretative phenomenological analysis (IPA) was performed on individual interviews conducted pre-, peri- and post-treatment. Results: Cross-case outcome experiences were: (1) uncontrollable complaints; (2) remaining questions and uninternalized insights and (3) persisting interpersonal difficulties. Within-case idiosyncratic differences revealed that the statistical classification of “deterioration” not necessarily corresponds to a “deteriorated experience,” nor univocally indicates unwanted therapy effects. Our findings point at the influences of the patient’s (lack of) agency in the process, a discrepancy between patients’ expectations and the therapy offer, the therapeutic relationship, interpersonal difficulties, and contextual influences. Conclusion: The meaning of symptomatic deterioration should be interpreted within a patient’s idiosyncratic context. The multi-faceted nature of deterioration requires further research to rely on multiple perspectives and mixed methods.

Acceptability to donate human milk among postnatal mothers at St. Francis hospital Nsambya, Uganda: a mixed method study

BackgroundThe World Health Organization recommends the use of donated human milk (HM) as the second-best option for mothers who are temporarily unable to provide sufficient breast milk to meet the needs of their infants. However, HM donation is yet to become an accepted practice in Uganda. We assessed the level of, and factors associated with acceptability to donate HM among postnatal mothers at St. Francis Hospital Nsambya (SFHN).MethodsA cross-sectional sequential explanatory mixed method study was conducted between October 2018 and March 2019. A questionnaire on sociodemography, awareness and likely acceptability to donate HM was administered to 410 postnatal mothers at SFHN. Multivariate logistic regression analysis was undertaken to determine factors associated with acceptance of HM donation. Focus Group Discussions (4) and Key Informants Interviews (4) were used to explore factors influencing behaviours to donate human milk. Qualitative data were analysed using a content thematic approach.ResultsOverall acceptance of donating the HM was 77.6%, and the significant factors were: willingness to express the HM (AOR 7.5; 95% CI 3.01, 18.68); wet-nursing knowledge (AOR 2.3; 95% CI 1.1, 5.0) and visit to under-5 years’ clinic (AOR 21.3; 95% CI 2.3, 196.9). The major themes in relation to accepting to donate HM were wet nursing experience, and confidence in donating the HM, and its perceived effectiveness. There were concerns about the safety and adequacy of HM and fear of transmitting criminal behaviours and mental illness through human milk.ConclusionsAcceptance to donate HM among postnatal mothers at St. Francis Hospital Nsambya was very high. Willingness to express and store human milk, prior knowledge about wet nursing and a visit to an under-five outpatient clinic were associated with acceptance. Thus, establishing a human milk bank is feasible in the study setting.

The Patients' Presupposed Distrust to Doctors in China: An Explanatory Sequential Mixed Methods Study.

The aim of this study was to investigate the current status of patients' presupposed distrust, and to clarify the causes of high presupposed distrust. An explanatory sequential mixed methods study was conducted using a two-stage design. The first phase was a quantitative cross-sectional survey, a total of 384 patients by convenience sampling completed the survey. Study instruments including demographic and clinical characteristics sheet, patients' presupposed distrust scale. In the qualitative phase, 16 patients on the basis of their mean score for all PPDS items were higher than 4 were identified as extreme cases participated in one-to-one semi-structured interviews. The total item mean score for all patients on PPDS was 3.59(3.18, 4.09), which above the median range of the PPDS (item mean score of 3). Personal income level and educational level were significant predictive influencing factors of patients' presupposed distrust, which could explain 17.347% of the variance. The reasons of high patients' presupposed distrust were as follows: moral character, health knowledge, patient perceptions, and the social circumstance. The level of patients' presupposed distrust was high, which needs to be further decreased. Demographic and clinical variables (personal income level, educational level) are identified to be the major contributing factors. The main causes for the formation of the high patients' presupposed distrust are patients internal factors and social circumstance.

User Requirements in Developing a Novel Dietary Assessment Tool for Children: Mixed Methods Study.

The prevalence of childhood obesity and comorbidities is rising alarmingly, and diet is an important modifiable determinant. Numerous dietary interventions in children have been developed to reduce childhood obesity and overweight rates, but their long-term effects are unsatisfactory. Stakeholders call for more personalized approaches, which require detailed dietary intake data. In the case of primary school children, caregivers are key to providing such dietary information. However, as school-aged children are not under the full supervision of one specific caregiver anymore, data are likely to be biased. Recent technological advancements provide opportunities for the role of children themselves, which would serve the overall quality of the obtained dietary data. This study aims to conduct a child-centered exploratory sequential mixed methods study to identify user requirements for a dietary assessment tool for children aged 5 to 6 years. Formative, nonsystematic narrative literature research was undertaken to delineate initial user requirements and inform prototype ideation in an expert panel workshop (n=11). This yielded 3 prototype dietary assessment tools: FoodBear (tangible piggy bank), myBear (smartphone or tablet app), and FoodCam (physical camera). All 3 prototypes were tested for usability by means of a usability task (video analyses) and user experience (This or That method) among 14 Dutch children aged 5 to 6 years (n=8, 57% boys and n=6, 43% girls). Most children were able to complete FoodBear's (11/14, 79%), myBear's (10/14, 71%), and FoodCam's (9/14, 64%) usability tasks, but all children required assistance (14/14, 100%) and most of the children encountered usability problems (13/14, 93%). Usability issues were related to food group categorization and recognition, frustrations owing to unsatisfactory functioning of (parts) of the prototypes, recall of food products, and the distinction between eating moments. No short-term differences in product preference between the 3 prototypes were observed, but autonomy, challenge, gaming elements, being tablet based, appearance, social elements, and time frame were identified as determinants of liking the product. Our results suggest that children can play a complementary role in dietary data collection to enhance the data collected by their parents. Incorporation of a training program, auditory or visual prompts, reminders and feedback, a user-friendly and intuitive interaction design, child-friendly food groups or icons, and room for children's autonomy were identified as requirements for the future development of a novel and usable dietary assessment tool for children aged 5 to 6 years. Our findings can serve as valuable guidance for ongoing innovations in the field of children's dietary assessment and the provision of personalized dietary support.

Exploring the effect of EFL students’ self-made digital stories on their vocabulary learning

In spite of the growing interest in digital storytelling (DST) in the English as a foreign language (EFL) context, there is a lacuna in research on the role it plays in learning vocabulary. This sequential explanatory mixed-methods study explored the potential of collaborative learner-generated digital stories (DSs) for vocabulary knowledge development and students’ attitudes towards DST-based vocabulary learning experiences. The primary data sources included pre/post-treatment vocabulary tests, collective reflection journals, weblog comments, and interviews. Two experimental groups of undergraduate EFL students were engaged in collaborative DST projects and their vocabulary test scores were compared with those of students in two control groups. The quantitative data were analyzed using independent and paired samples t-tests. Constant comparative method was employed to analyze the qualitative data. As the results showed, the students that were involved in learning the new words through collaborative DSs in the experimental groups outperformed the students in the control groups. The findings further demonstrated that DST empowers the students to integrate vocabulary learning into immediate daily contexts, experience peer-promoted vocabulary learning, contextualize vocabulary in multimodal stories, personalize the vocabulary knowledge development process, and enhance cognitive-affective engagement with stories to learn new words. The students also stated that DST is not a stand-alone pedagogical approach and recommended using animated, game-based, immersive, synchronous, social media-based, and micro DSs to facilitate vocabulary learning. The study promises implications for technology-assisted vocabulary instruction.

Development and psychometric properties evaluation of nurses’ innovative behaviours inventory in Iran: protocol for a sequential exploratory mixed-method study

IntroductionNurses’ innovative behaviours play a crucial role in addressing the challenges including adapting to emerging technologies, resource limitations and social realities such as population ageing that are intricately tied to...

Improving Athletic Trainers' Knowledge of Clinical Documentation through Novel Educational Interventions: A Randomized Controlled Trial.

Athletic trainers (ATs) have reported the need for more educational resources about clinical documentation. To investigate the effectiveness of passive and active educational interventions to improve practicing ATs' clinical documentation knowledge. Randomized control trial, sequential explanatory mixed methods study. Online module(s), knowledge assessment and interviews. We emailed 18,981 practicing ATs across employment settings, of which 524 ATs were enrolled into a group [personalized learning pathway (PLP=178), passive reading list (PAS=176), control (CON=170)] then took the knowledge assessment. There were 364 ATs who did not complete the intervention and/or post-knowledge assessment; therefore, complete responses from 160 ATs (PLP=39, PAS=44, CON=77; age=36.6±11.2y, years certified=13.9±10.7y) were analyzed. Knowledge assessment (34 items) and interview guides (12-13 items) were developed, validated, and piloted with ATs prior to study commencement. We summed correct responses (1 point each, 34 points maximum) and calculated percentages and pre- and post-knowledge mean change scores. Differences among groups (PLP, PAS, CON) and time (pre- intervention, post-intervention) were calculated using a 3X2 repeated-measures ANOVA (P≤.05) with post hoc Tukey HSD. Semi-structured interviews were conducted (PLP=15, PAS=14), recorded, transcribed, and analyzed following the consensual qualitative research tradition. No differences in the pre-knowledge assessment were observed between-groups. We observed a group x time interaction (F2,157 = 15.30, P<.001; partial eta-squared=0.16). The PLP exhibited greater mean change (M=3.0±2.7) than PAS (M=1.7±3.0, P=.049) and CON (M=0.4±2.2, P<.001). Descriptively, ATs scored lowest on legal (61.3%±2.1%), value of the AT (63.7%±4.3%), and health information technology (65.3%±3.7%) items. Whereas ATs described being confident in their documentation knowledge, they also identified key content (eg, legal considerations, strategies) they deemed valuable. The educational interventions improved ATs' knowledge of clinical documentation and provided valuable resources for their clinical practice; however, targeted continuing education is needed to address knowledge gaps.

Key elements to support primary healthcare nurses to thrive at work: A mixed-methods sequential explanatory study.

Develop evidence-based recommendations for managers to support primary healthcare nurses to thrive at work. A mixed-methods sequential explanatory design. National data were collected in 2020 via an e-survey based on a meta-analysis of antecedents of thriving from 213 primary healthcare nurses across New Zealand. Structural equation modelling analysis identified the key factors supporting primary healthcare nurses to thrive. This informed a second open-ended e-survey in 2022 of 19 nurses from one primary healthcare organization. The thematic analysis provided recommendations for improving management strategies to support thriving primary healthcare nurses. The vitality component of thriving significantly reduced burnout and intention to leave organization and profession. In contrast, the learning component of thriving had a significant positive effect on burnout. The key factors that support thriving at work are empowering leadership and perceived organizational supports (decreases burnout and intention to leave organization and profession through enhanced vitality). Recommendations for improving thriving were made in eight key areas: communication, effective management, professional development, scope of practice, autonomy, effective orientation, reward and work-life balance. Vitality is important in reducing burnout and turnover intentions. While learning was identified as increasing burnout, professional development and training for managers were identified as essential. Hence, the vitality dimension of the thriving at work construct should be studied at the dimension level, but more research is needed into the impact of learning on thriving over time. Primary healthcare nurses have identified that empowering leadership and perceived organizational support are critical factors in supporting them to thrive, and they provide specific recommendations for managers to improve these factors in the clinical setting. This study collected data from Registered Nurses only. A plethora of existing research focuses on resilience in nurses rather than thriving at work. Enabling employees to thrive at work contributes to improved well-being and sustainable organizational performance. Empowering leadership and perceived organizational support are the key factors that support primary healthcare nurses to thrive at work. The vitality dimension of the thriving at work construct should be studied at the dimension level, and further research is needed into the impact of learning on thriving over time. Primary healthcare nurses recommend that managers focus on improving communication, management efficiency, professional development, scope of practice, autonomy, orientation, reward and work-life balance.

Effective English teachers in online EFL learning: A post-pandemic reflection on students’ perspectives

In the framework of conventional academic settings, there have been a large number of studies on the qualities of effective teachers; however, studies in the context of online environments seem to be scarcely documented in the literature. This explanatory sequential mixed-method study of 224 secondary school students, 21 of whom were interviewed in detail, examined their perspectives on effective teacher characteristics in online EFL instruction. This study differed from earlier investigations of the qualities of effective teachers in terms of its research site and inquiry emphasis. The results of the surveys and interviews provided students’ judgments of effective teacher traits in terms of roles, professional abilities, personal qualities, and pedagogical expertise. According to the results of the polls, the most significant criteria for effective online learning management were instructors’ classroom management roles and their professional skills. The interviews stressed the importance of teachers’ qualities in managing classrooms and their pedagogical knowledge. In an online EFL instruction, students needed their teachers to scaffold them and explain what they should do with the lesson and the procedures they should follow for activities and assignments. In addition, the interviews validated teachers’ capacity to establish a favorable rapport with the students to facilitate their meaningful learning. As this study identified teachers’ professional abilities in managing online learning as a requirement, an online-learning-based professional development program for teachers is highly recommended as the most plausible alternative for the post-pandemic reflection of this current study.

Development and psychometric evaluation of nurse’s intention to care for patients with infectious disease scale: an exploratory sequential mixed method study

AimsNurses who care for patients with infectious disease may experince significant stress and negative psychological reactions. The intention of nurses to care is a complex and multifaceted concept that is influenced by a range of factors. Therefore, this study was conducted to explain the concept of nurses’ intention to care for patients with infectious disease and then develop a reliable and valid scale to measure this concept accurately in Iranian nurses.DesignThis study is a cross-sectional study with a sequential-exploratory mixed-method approach from May 2022 to July 2023. The concept of nurses’ intent to care for patients with infectious disease was explain using deductive content analysis, and item pools were generated. In the sconed step the samples were 455 nurses. Data was collected by an online form questionnaire using a convenience sampling technique. In this step to determine the psychometric properties of nurse’s intention to care for patients with infectious disease scale (NICPS), face and content validity performed. Then construct validity was determined and confirmed using exploratory and confirmatory factor analysis followed by convergent and divergent validity respectively. Finally, scale reliability including stability and internal consistency were evaluated.ResultsThe finding showed that NICPS with seventeen items were classified into three factors namely “Social support” with seven items, “Spiritual motivation” with six items and “Job satisfaction” with four items. These three factors explained 56.14% of the total variance. The fit indices showed that the model has a fit and acceptable (TLI, CFI, IFI > 0.9; PNFI, PCFI > 0.5, REMSEA > 0.049, CMIN/DF = 2.477). Reliability revealed acceptable internal consistency and stability (> 0.7).ConclusionThe finding showed that NICPS has three factors in Iranian nurses. Nursing managers can use these results to provide training and support intervention for nurses in order to increase their intention to care for this patient. Also, the NICPS is a reliable and valid for evaluating this concept in future studies.

What can we learn from general practitioners who left Spain? A mixed methods international study

BackgroundInternational mobility of health workforce affects the performance of health systems and has major relevance in human resources for health policy and planning. To date, there has been little research exploring the reasons why general practitioners (GPs) migrate. This mixed methods study aimed to investigate the reasons why Spain-trained GPs migrate and develop GP retention and recruitment health policy recommendations relevant to Spanish primary care.MethodsThe study followed an explanatory sequential mixed methods study design combining surveys with semi-structured interviews and focus groups with GPs who qualified in Spain and were living overseas at the time of the study. The survey data examined the reasons why GPs left Spain and their intention to return and were analysed using quantitative methods. The transcripts from interviews and focus groups centred on GPs’ insights to enhance retention and recruitment in Spain and were analysed thematically.ResultsThe survey had 158 respondents with an estimated 25.4% response rate. Insufficient salary (75.3%), job insecurity and temporality (67.7%), excessive workload (67.7%), poor primary care governance (55.7%), lack of flexibility in the workplace (43.7%) and personal circumstances (43.7%) were the main reasons for leaving Spain. Almost half of the respondents (48.7%) would consider returning to Spanish general practice if their working conditions improved. Interviews and focus groups with respondents (n = 24) pointed towards the need to improve the quality of employment contracts, working conditions, opportunities for professional development, and governance in primary care for effective retention and recruitment.ConclusionEfforts to improve GP retention and recruitment in Spain should focus on salary, job security, flexibility, protected workload, professional development, and governance. We draw ten GP retention and recruitment recommendations expected to inform urgent policy action to tackle existing and predicted GP shortages in Spanish primary care.

Navigating Multiple Identities for Positive Change Through Organizational Listening

Organizational listening is critical in times of change, especially for organizations that must meet diverse stakeholder interests. Organizations’ views on who they are—whether they are altruistic or self-oriented entities—may shape organizational listening practices in meaningful ways. To explore the undertheorized topic of organizational listening, we conducted a mixed-method sequential explanatory study. Drawing on survey and interview data from 122 U.S. nonprofits, we found an organization’s utilitarian identity for economic value creation is only related to practical motivation to engage in listening, whereas a normative identity for social mission is related to listening motivation, information analysis, and information integration. In addition, we found that organizational listening fully mediates the relationship between organizational identity and organizational change potential and implementation, indicating positive change would most likely occur through soliciting and incorporating stakeholder inputs. These results contribute to theorizing organizational listening and suggest implications for navigating multiple identities in organizational change processes.

Deprescribing as a Way to Reduce Inappropriate Use of Drugs for Overactive Bladder in Primary Care (DROP): Protocol for a Cluster Randomized Controlled Trial With an Embedded Explanatory Sequential Mixed Methods Study.

Potentially inappropriate medication remains a significant concern in general practices, particularly in the context of overactive bladder (OAB) treatment for individuals aged 65 years and older. This study focuses on the exploration of alternative options for treating OAB and the deprescribing of anticholinergic drugs commonly used in OAB. The research aims to comprehensively evaluate the efficiency of deprescribing through a mixed methods approach, combining quantitative assessment and qualitative exploration of perceptions, experiences, and potential barriers among patients and health care personnel. This study aims to evaluate the efficiency and safety of the intervention in which health care staff in primary care encourage patients to participate in deprescribing their drugs for OAB. In addition, we aim to identify factors contributing to or obstructing the deprescribing process that will drive more informed decisions in the field of deprescribing and support effective and safe treatment of patients. The drugs for overactive bladder in primary care (DROP) study uses a rigorous research design, using a randomized controlled trial (RCT) with an embedded sequential explanatory mixed methods approach. All general practices within the North Denmark Region will be paired based on the number of general practitioners (GPs) and urban or rural locations. The matched pairs will be randomized into intervention and control groups. The intervention group will receive an algorithm designed to guide the deprescribing of drugs for OAB, promoting appropriate medication use. Quantitative data will be collected from the RCT including data from Danish registries for prescription analysis. Qualitative data will be obtained through interviews and focus groups with GPs, staff members, and patients. Finally, the quantitative and qualitative findings are merged to understand deprescribing for OAB comprehensively. This integrated approach enhances insights and supports future intervention improvement. The DROP study is currently in progress, with randomization of general practices underway. While they have not been invited to participate yet, they will be. The inclusion of GP practices is scheduled from December 2023 to April 2024. The follow-up period for each patient is 6 months. Results will be analyzed through an intention-to-treat analysis for the RCT and a thematic analysis for the qualitative component. Quantitative outcomes will focus on changes in prescriptions and symptoms, while the qualitative analysis will explore experiences and perceptions. The DROP study aims to provide an evidence-based intervention in primary care that ensures the deprescription of drugs for OAB when there is an unfavorable risk-benefit profile. The DROP study's contribution lies in generating evidence for deprescribing practices and influencing best practices in health care. ClinicalTrials.gov NCT06110975; https://clinicaltrials.gov/study/NCT06110975. DERR1-10.2196/56277.

Medical students' perceptions on preparedness and care delivery for patients with autism or intellectual disability.

To provide competent care to patients with autism spectrum disorder (ASD) or intellectual developmental disorder (IDD), healthcare professionals must recognize the needs of neurodivergent populations and adapt their clinical approach. We assessed the perceived preparedness of medical students to adapt care delivery for patients with ASD/IDD, as well as their perceptions on neurodiversity education. We conducted a sequential explanatory mixed-methods study on undergraduate medical students at McGill University during the academic year 2020-2021. We administered an online survey, followed by semi-structured interviews. We analyzed data using descriptive statistics and thematic analysis. We integrated findings at the interpretation level. We included two-hundred-ten survey responses (~29% of class), and 12 interviews. Few students felt prepared to adjust care for patients with ASD/IDD despite most indicating doing so was important. Ninety-seven percent desired more training regarding care accommodation for neurodivergent patients. Thematic analysis unveiled the perception of current insufficient education, and the value of experiential learning. This study highlights low perceived preparedness of medical students to accommodate care for neurodivergent patients, and a desire for more instruction. Incorporating interactive training in medical school curricula regarding modifying care delivery for neurodivergent individuals may improve the perceived preparedness of medical trainees to work with these patients and care quality.

Epidemiology and perceptions of non-fatal burns among select youth (15–24 years old) from Peshawar Pakistan; a sequential explanatory mixed methods study

PurposeBurns are among the top five cause of unintentional injuries among youth. We aimed to determine the incidence and risk factors of burns in select youth from Pakistan and also explored their perceptions about burns. MethodsA sequential explanatory mixed methods study was conducted which comprised of two phases. Phase 1 consisted of a cross-sectional quantitative survey (QUAN) in which 550 vocational school youth (15 to 24 years-olds) filled out the WHO community survey tool for injuries and violence and provided data on burns in previous 12 months (2021–22). Phase 2 consisted of qualitative (QUAL), in-depth interviews (IDIs) with participants selected from Phase 1 based on the occurrence of burns. STATA™ version 15.1 was used for Phase 1 data analysis and Zero-Inflated Negative Binomial regression was used for determining the Incidence Rate Ratio (IRR) of burns. Thematic analysis was performed for in-depth interviews from Phase 2. ResultsOut of 547 participants, 356 (65%) were males while 191 (35%) were females. Burns were reported by 85 participants (15%). A total of 137 counts of burns were reported showing multiple burns by some participants. The IRR for burns among young females was 2.89 (1.78–4.69) compared to males in the previous 12 months (2021–22). Age, sex, father’s education, and combined family income were significant risk factors for burns in youth. Six IDIs were conducted with burn victims, two were males while six were females. Four cooking-related burns, and two occupational burns during vocational training were reported. Themes that emerged from IDIs were internal and external factors, personal carelessness and lack of knowledge and safety about burns. Two sub-themes that were significant for recovery from burns were family support and access to healthcare. ConclusionYoung females are at a higher risk of burn injuries in Pakistan. Various social, demographic, and behavioral risk factors are associated with burns. Pre-burn and post-burn interventions are needed for prevention from burns in youth.