Perspectives Of Health Professionals Research Articles

Clinical care for severe and persistent eating disorders in pediatric populations: Perspectives of health professionals

ObjectiveModels of treatment for adults with severe and enduring eating disorders focus on harm reduction and improving quality of life. However, there is a notable gap in the pediatric literature in this area. The current study set out to assess the perspectives of health professionals regarding clinical care for young people (e.g., ages 10–25 years) with severe and enduring eating disorders, and to explore perceptions about appropriate treatment options for these presentations.MethodsHealth professionals were invited to complete a two-stage online survey about their experiences with clinical care for pediatric eating disorders through Canadian and Australian professional eating disorder networks. Survey 1 included questions about their experiences in supporting individuals with severe and enduring presentations. Participants who completed Survey 2 reviewed clinical vignettes and shared their perspectives about treatment recommendations and models of care, including for a severe and enduring presentation.ResultsA total of 85 clinicians responded to questions on Survey 1 about severe and enduring eating disorder presentations. A portion of these respondents (n = 25) also participated in Survey 2. The majority of respondents to Survey 1 reported providing clinical care for pediatric severe and enduring eating disorder presentations. Amongst respondents to Survey 2, there was low consensus amongst respondents for the clinical care that would be most appropriate for young people with a severe and enduring eating disorder presentation. Numerous challenges in models of care for severe and enduring presentations in pediatric settings were raised in responses on Survey 2, with clinicians sharing their awareness of models focusing on quality of life, while also raising concerns about the appropriateness of these models for young people.ConclusionsThe preliminary results of this study demonstrate that the majority of clinicians report that they have provided care to young people with severe and enduring presentations. There is a clear need for establishing guidance for clinicians working in pediatric eating disorder settings around models of care focused on quality of life. Engagement with interested parties, including those with lived experience, can clarify the development of terminology and clinical pathways for severe and enduring presentations of pediatric eating disorders.

Barriers and enablers to the implementation and sustainability of short-stay arthroplasty programs for elective primary total hip and knee replacement: A systematic review with qualitative evidence synthesis.

We aimed to systematically review contemporary evidence on the barriers and enablers to implementing and sustaining short-stay arthroplasty programs for elective primary total hip and knee replacement from the perspectives of patients, health professionals, carers, healthcare administrators, funders and policymakers and to map the findings to the Theoretical Domains Framework (TDF). Medline, Cumulative Index to Nursing and Allied Health Literature, EMBASE, and the Cochrane Central Register of Controlled Trials were searched (up to 19 August 2023). Primary qualitative or mixed-methods studies reporting on perspectives relating to the review aims that utilised a short-stay programme were eligible for inclusion. Study quality was assessed using the qualitative critical appraisal tool from the Joanna Briggs Institute. Data were analysed inductively. The final themes were mapped to the TDF. The confidence in the findings was assessed using GRADE CERQual. Fifteen studies were included. Twelve barrier themes and twelve enabler themes were identified. Three themes were graded with high confidence, 10 were graded with moderate confidence, three were graded with low confidence, and eight were graded with very low confidence. The most pertinent domains that the themes were mapped to for patients were beliefs about capabilities, reinforcement, and the environmental context and resources. Health professionals identified knowledge, environmental context and resources as important domains. Two domains were identified for carers: (1) social/professional role and identity and (2) memory, attention, and decision processes. We identified key barrier and enabler themes linked to the TDF that can be used to guide implementation initiatives and promote the sustainability of short-stay arthroplasty programs.

Stakeholders' perspectives on adverse effects of ECT: A qualitative thematic analysis.

In the Indian context, published systematic research on the opinions of mental health professionals and other stakeholders (patients and caregivers) regarding the different adverse effects of electroconvulsive therapy (ECT) is not available. This type of study allows for an in-depth exploration of complex phenomena, such as the perspectives of mental health professionals, which can provide a rich understanding of their experiences regarding ECT and also helps to understand the views of mental health professionals regarding the adverse effects of ECT during the post-ECT recovery period and its management. Conversely, the perception of patients and caregivers regarding the adverse effects of ECT can provide a more comprehensive understanding of the treatment and its impact on the patients who receive it. To explore the understanding of participants about the various adverse effects following ECT and their perception of managing different adverse effects of ECT during the post-ECT recovery period. A qualitative approach using focus group discussion (FGD) was used. A convenience sampling technique was followed for selecting the participants. FGDs were conducted with stakeholders including mental health professionals, patients, and caregivers. Five FGDs were conducted with psychiatry residents, nursing officers from the ECT suite, and different psychiatry wards at NIMHANS. Four FGDs were held separately for patients receiving ECT and their caregivers, admitted to various psychiatry wards at NIMHANS. A total of 28 mental health professionals, 20 patients, and 20 caregivers participated. The number of participants for FGDs was decided based on data saturation. The FGDs, lasting 30-40 minutes each, occurred between October 2022 and December 2022. The FGDs were audio-recorded with prior permission from the participants. All the participants were informed about the study. Written informed consent was obtained. All FGDs were transcribed. Thematic analysis was done using Atlas. ti software. The broad categories identified were adverse events associated with ECT during the ECT procedure, adverse events associated with ECT after the ECT procedure, prevalence of different adverse effects according to mental health professionals, effects of adverse effects on the continuity of ECT, and difficulties encountered by mental health professionals throughout the management. Other broad categories were found after conducting FGDs with caregivers and patients, which were patients' experience as per the caregivers over the course of ECT, caregivers' and patients' willingness to continue ECT, unfavorable impacts of ECT experienced by the patients immediately after ECT sessions, and, later till the end of that day, suggestions of the caregivers and patients to improvise the management of ECT-related adverse effects and management of adverse effects by the treating team. The findings will develop a standard operating procedure that may help nursing officers monitor and identify the adverse effects immediately after ECT and minimize the complications during the post-ECT recovery period.

A Pilot Evaluation of an Educational Video to Support Consent to a Pediatric Malignancy Biobank.

Introduction: The collection of biological specimens is necessary to support basic and translational research. However, the complexity of biobanking introduces numerous ethical issues, particularly regarding informed consent. Objective: To evaluate the acceptability and perceived benefits of an educational video facilitating the consent process for the Children's Cancer Centre Biobank. Methods: We invited individuals who had previously consented to be (or their child to be) part of the Biobank, and health professionals who were involved in obtaining consent. Participants watched the video and completed a purpose-designed online survey. Results: A total of 16 health professionals (invited = 30) and 15 patients/caregivers (invited = 127) participated. Most patients/caregivers felt informed about the Biobank at consent, however, noted how overwhelmed they were at the time and that they did not engage with the written information. Overall, both patients/caregivers and health professionals rated the video favorably regarding the information provided and format. Participants valued that it was simple and clear, with several health professionals noting the need for linguistic translations to better support the families they work with. Most patients/caregivers agreed that the video provided enough information to begin considering participation. This aligned with the health professionals' feedback that the video was most effective when used as a conversation starter to help formalize the written consent. Conclusion: Our findings suggest that our video is an acceptable and beneficial tool to assist in the Biobank consenting process, from both the perspective of decision-makers and health professionals obtaining consent. It appears particularly valuable as a precursor to an interactive, formal consent discussion. Further work is required to determine whether our video has a significant impact on outcomes such as decision-making satisfaction and knowledge, and to determine the value to adolescents.

Maternal health care for women with disabilities: perspectives of health professionals in Ghana

In many developing countries, like Ghana, persons with disability face a lot of marginalisation and discrimination. Despite WHO’s assertion that disabled persons deserve equal access to healthcare, disparities remain. Health professionals play a pivotal role in reducing maternal mortality. Yet few studies engage professionals to understand these perceptions and how they shape service provision. This highlights the need for research investigating health professionals’ perceptions of delivering maternal healthcare to women with disabilities in Ghana. With the aid of a qualitative approach, this study explored the perceptions of healthcare professionals on disabled women who sought maternal healthcare in Ghana. Data was gathered from 25 healthcare workers, consisting of midwives and doctors. The thematic analysis uncovered two contrasting themes—positive perceptions highlighting the determination and strength of disabled women and negative perceptions shaped by cultural biases questioning the need for disabled women to become pregnant. Bridging this gap necessitates comprehensive training, patient-centred collaborative approaches, and anti-discrimination policies to establish an equitable Ghanaian healthcare system that safeguards the reproductive rights and options of pregnant and disabled women. Dedication from all stakeholders is imperative to ensure inclusiveness and fair treatment.

Crisis responders in Sri Lanka: Exploring impact and treatment considerations through the perspectives of mental health professionals

Purpose – South Asian mental health professionals were invited to identify influences on mental health symptom severity among responders during crisis events in Sri Lanka. Further consideration was given to the treatment that could be applied to improve the mental wellbeing of such individuals. Methodology – Twenty-nine mental health professionals (14 civilian and 15 military based) completed a semi-structured interview that incorporated a guided discussion on the mental health experiences observed in crisis responders. Key findings – Thematic Analysis was conducted, yielding two categories. The first understanding from mental health professionals of the impact of trauma that crisis responders in Sri Lanka can experience providing 10 themes capturing the diversity of impact on mental health and social structures. The second category was effective intervention for crisis mental health responders and yielded two main themes. A number of subthemes underpinned each theme across the two categories. Originality – The current study is one of the first to explore mental health symptomology and treatment considerations for crisis responders in a South Asian sample, through the perspective of mental health responders.

Exploring barriers to access to care following the 2021 socio-political changes in Afghanistan: a qualitative study

BackgroundFollowing the change of government in August 2021, the social and economic landscape of Afghanistan deteriorated into an economic and humanitarian crisis. Afghans continue to struggle to access basic healthcare services, making Universal Health Coverage (UHC) in the country a major challenge. The aim of this study was to perform a qualitative investigation into the main access to care challenges in Afghanistan and whether these challenges have been influenced by the recent socio-political developments, by examining the perspectives of health professionals and hospital directors working in the country.MethodsHealth professionals working in facilities run by an international non-government organisation, which has maintained continuous operations since 1999 and has become a key health reference point for the population, alongside the public health system, and hospital directors working in government hospitals were recruited to participate in an in-depth qualitative study using semi-structured interviews.ResultsA total of 43 participants from ten provinces were interviewed in this study. Four issues were identified as critical barriers to achieving UHC in Afghanistan: (1) the lack of quality human resources; (2) the suboptimal management of chronic diseases and trauma; (3) the inaccessibility of necessary health services due to financial hardship; (4) the unequal accessibility of care for different demographic groups.ConclusionsHealth professionals and hospital directors shed light on weaknesses in the Afghan health system highlighting chronic issues and issues that have deteriorated as a result of the 2021 socio-political changes. In order to improve access to care, future healthcare system reforms should consider the perspectives of Afghan professionals working in the country, who are in close contact with Afghan patients and communities.

Fidelity of family centered care model to early disability diagnosis and rehabilitation in the United Arab Emirates.

The role of parents in supporting early intervention for young children with disabilities is critical. Indeed, models of family centered care (FCC), which emphasis strong partnerships between health professionals and families in disability health services delivery are now widely associated with best practice. While FCC is consistently argued to be an appropriate model for disability service delivery, its utilization is limited primarily to Western countries such as Australia and the United States. Countries such as the United Arab Emirates (UAE) have prioritized early childhood development and are thus in search of best practices for delivery of early intervention for children and their families. The aim of this study was to explore the appropriateness of the FCC model in disability service delivery in the UAE. This study was conducted from the perspectives of health professionals who are involved in disability diagnosis, referral and ongoing support for families and children with disabilities. A total of 150 health professionals were recruited from health facilities, rehabilitation centers and schools in the Emirates of Abu Dhabi. The 27-item Measure of Process of Care for Service Providers (MPOC-SP) was used for data collection. The data were subjected to confirmatory factor analysis to confirm applicability of the model to this context. Multivariate analysis of variance and moderation analysis were also conducted, to ascertain the relationship between participants' satisfaction levels with their ability to diagnose, refer and provide on-going support and their likelihood of practicing key components of FCC. Computation of confirmatory factor analysis provided support for applicability of the MPOC-SP in the UAE context. Further inspection showed moderate to large correlations between the four components of FCC measured by MPOC-SP, providing further support for utilization of FCC in disability health service delivery in the UAE. The study concludes with a call to policymakers in the UAE to consider developing disability health policy based on key components of FCC. This could be supplemented by development of training modules on FCC to upskill health professionals involved in disability diagnosis and rehabilitation.

Efficiency, accuracy, and health professional's perspectives regarding artificial intelligence in radiology practice: A scoping review

AbstractIn this scoping review, we evaluated the performance of artificial intelligence (AI) in clinical radiology practice and examined health professionals' perspectives regarding AI use in radiology. This review followed the Joanna Briggs Institute (JBI) methodological guidelines. We searched multiple databases and the gray literature from March 15, 2016 to December 31, 2023. Of 49 articles reviewed, 13 assessed the performance of AI in radiology clinical practice, and 36 examined the attitudes of health professionals toward the use of AI in radiology. In four separate studies, AI significantly improved the diagnostic sensitivity or detection rate. Furthermore, six articles emphasized a significant reduction in case reading times with AI use. Although three studies suggested an increase in specificity with the assistance of AI, these findings did not reach statistical significance. Health professionals expressed the belief that AI would have a significant impact on radiology but would not replace radiologists in the near future. Limited knowledge of AI was observed among health professionals, who supported increased education and explicit regulations and guidelines related to AI. Overall, AI can enhance diagnostic efficiency and accuracy in clinical radiology practice. However, knowledge gaps and the concerns of health professionals should be addressed by prioritizing education and reinforcing ethical and legal regulations to facilitate the advancement of AI use in radiology. This scoping review provides evidence toward a comprehensive understanding of AI's potential in clinical radiology practice, promoting its use and stimulating further discussion on related challenges and implications.

Barriers and enablers to a healthy lifestyle in people with infertility: a mixed-methods systematic review

While there is a recognised role of optimising lifestyle behaviours such as diet and physical activity in the management of infertility, the best practice for lifestyle management of infertility remains unknown, and factors influencing the lifestyle behaviours of people with infertility are not well understood. The aim of this systematic review is to evaluate the barriers and enablers to a healthy lifestyle in people with infertility, from the perspectives of people with infertility and health professionals, in order to inform optimal behavioural change strategies for lifestyle management of infertility. Ovid MEDLINE(R), PsycINFO, EMBASE, EBM Reviews, and CINAHL Plus were searched from inception to 12th September 2022. Eligible studies were qualitative, quantitative or mixed-methods primary studies which explored barriers and/or enablers to lifestyle for infertility management, from the perspectives of people with infertility and/or health professionals. Two independent reviewers performed quality assessment, using the Centre for Evidence-Based Management Critical Appraisal of a Survey Tool (quantitative and mixed-methods studies) and the Critical Appraisal Skills Programme Qualitative Checklist (qualitative and mixed-methods studies). Data were analysed by inductive thematic analysis with themes mapped to the Capability, Opportunity, Motivation and Behaviour (COM-B) model(1) and Theoretical Domains Framework (TDF)(2). Relevant behaviour change techniques (BCTs)(3) to target the identified enablers and barriers were suggested. After screening 10703 citations and 82 full-texts, 22 studies were included (12 quantitative, 7 mixed-methods and 3 qualitative) with 18 studies including women with infertility (n = 2442), 10 including men with infertility (n = 1372) and 6 including health professionals (n = 261). From the perspectives of people with infertility, themes related to capability (e.g. strategies for behaviour change), opportunity (e.g. limited time, resources and money) and motivation (e.g. interplay between lifestyle and emotional state); themes mapped to 8 TDF domains. From the perspectives of health professionals, themes related to capability (e.g. identification of patients appropriate for lifestyle intervention), opportunity (e.g. mode of delivery) and motivation (e.g. professional responsibility); themes mapped to 6 TDF domains. 34 BCTs were identified across the suggested interventions. This systematic review found that several interacting factors influence lifestyle in people with infertility as well as health professional behaviour with regards to provision of lifestyle interventions for infertility. These factors can be targeted for optimisation of interventions. In light of the limited number of qualitative studies, there is a need for more qualitative research to gain deeper insights into the perspectives of people with infertility and health professionals for further exploration of the complex and interacting factors which shape lifestyle during the fertility journey.

Motivational Factors in Adherence among Elderly with Diabetes and Hypertension

This qualitative study aims to explore the motivational factors in adherence among the elderly with diabetes and hypertension from the perspectives of patients and health professionals in China. Semi-structured face-to-face interviews were conducted. Thematic analysis of the interview transcripts unveiled eight master themes, including vicarious experiences, health beliefs, self-efficacy, feedback on health outcomes, the desire for improved health and longevity, understanding of diseases, perceived personal deterioration in health conditions, external regulation, and support. This study emphasizes the need for comprehensive strategies that align with the motivations of older individuals facing the dual challenges of diabetes and hypertension in China.

Development of core sets for deafblindness: an international expert survey on functioning and disability of individuals living with deafblindness using the International Classification of Functioning, Disability, and Health.

The development of International Classification of Functioning, Disability, and Health (ICF) Core Sets greatly enhances the global recognition of health conditions, thereby advancing research, education, and care provision. Aside from the work of researchers, and the viewpoint of persons with lived experience, the development of Core Sets for deafblindness needs to include the viewpoints of professionals with expertise unique to this condition. To represent the perspective of health and social service expert professionals in the development of ICF Core Sets for deafblindness. Cross-sectional cohort study. Global online survey representing all six regions of the World Health Organization. One hundred and five professionals providing and health or social service to individuals living with deafblindness with a minimum of 2 years of work experience with this population. An online survey was distributed through professional networks and social media for individuals working with persons living with deafblindness. Demographic items were summarized using descriptive statistics. Six open-ended questions explored the perceptions of body functions and structures that influence activities and participation, as well as environmental and personal factors that facilitate functioning. Data were linked to the ICF codes using established linking rules and procedures. The 2934 survey response units were linked using IFC categories. Of the 421 unique categories, 133 were used by 5% or more of respondents. Most categories within the Activities and Participation component were equally emphasized. The most frequent Environmental factors were support and relationships, services, systems, and policies, as well as and the physical environment (e.g., hearing aids or noise). Mental functions, including higher level cognitive functions, temperament and personality were frequently emphasized. Almost three quarters (73.3%) of the entire ICF classification categories were included in the expert survey results. This proportion emphasizes the importance of a multidimensional tool, such as the ICF, for assessing functioning and health for persons with deafblindness. The representation of this professional perspective in Core Set development will improve standardized assessment and documentation, intervention planning, and facilitate interprofessional communication with the goal of improving person-centered care for persons living with deafblindness.

Navigating complexity of the medication management system within the home setting-a functional resonance analysis method (FRAM) analysis of people with dementia and their carers' experiences.

There is a strong imperative to support people with dementia to live independently in their homes for as long as possible. A starting point is to understand how they manage medications on a daily basis. To understand how people with dementia and their informal carers manage medications within the home setting to inform the identification of opportunities to improve medication management. A qualitative study using the Functional Resonance Analysis Method (FRAM). Interview data with people with dementia and informal carers were analysed to (i) Identify and describe key functions, (ii) identify and describe variability in performing key functions, and its potential consequences and (iii) map performance variability to Resilient Healthcare capacities. A FRAM model was developed and consisted of 14 interdependent key functions. The interdependent nature of functions, and the different nature and sources of variability in how each key function was performed highlighted the level of complexity of the medication management system within the home setting. The medication system was managed almost entirely by the person with dementia and/or their informal carers. This shows the lack of system-level controls to support the safe functioning of the medication management system in the home setting. Future work will develop a comprehensive FRAM model that includes the perspectives of health and social care professionals and those from the third sectors to underpin the development of a range of system recommendations to strengthen resilience in the medication management system within the home setting.

Content Coverage as a Persistent Exclusionary Practice: Investigating Perspectives of Health Professionals on the Influence of Undergraduate Coursework.

STEM undergraduates navigate lengthy sequences of prerequisite courses covering volumes of science content. Given that these courses may contribute to attrition and equity gaps in STEM, research is needed to test the assumption that prerequisite content benefits students in their future studies and careers. We investigated the relevance of prerequisite course content for students' careers through semistructured interviews with practicing nurses regarding their undergraduate anatomy and physiology (A&P) courses. Nurses reported that A&P content does not align with the skills and knowledge needed in the nursing profession. Interviewees averaged 39% on a brief A&P assessment, suggesting A&P prerequisites failed to impart a high degree of long-term A&P knowledge among nurses. Further, practicing nurses perceived overcommitment to A&P content coverage as an exclusionary practice that eliminates capable individuals from the prenursing pathway. These findings challenge assumptions surrounding the justification for prerequisite course content and raise questions of whether content expectations actively exclude individuals from STEM or healthcare careers. We aspire for this study to stimulate conversation and research about the goals of prerequisite content, who is best positioned to articulate prerequisite content objectives, and the influence of content coverage on equity and justice in undergraduate STEM education.

Safe Transportation of Children With Disabilities and Medical Conditions in Motor Vehicles: Experiences and Perspectives of Australian Health Professionals and Organisations

Providing safe and accessible transportation for children with disabilities and medical conditions can be challenging and complex, as they are particularly vulnerable during road vehicle transportation. Health professionals and organisations play a vital role in supporting families and other involved individuals to ensure their child is transported safely. To obtain a better understanding of the experiences and perspectives of health professionals and organisations involved in the safe transportation of children with disabilities and medical conditions, a large-scale national survey was undertaken in Australia. A total of 295 responses were obtained from 234 health professionals and 61 organisations. Responses were analysed to explore the experiences, difficulties, and demands related to supporting the provision of safe transportation for these children. Although these key stakeholders believed safe transportation to be an important right, health professionals faced many challenges and had low confidence in their abilities to address the barriers associated with it. The findings suggest that health professionals may benefit from additional training, support, and resources. Organisations need access to evidence-based information to address this transportation topic in their strategies and plans. Without adequate support for health professionals to improve their knowledge and capability in this area, and organisational commitment in their strategies and plans that include the transport needs of children with disabilities and medical conditions, these children and their families will remain at a disproportionate risk of injury and fatality on the roads.

Challenges and opportunities for improving mental health care and preventing suicide among people living with HIV: Perspectives of mental health professionals in Tanzania.

People living with HIV (PLWH) experience unique stressors that contribute to emotional distress, and PLWH are more than twice as likely to die by suicide when compared to the general population. In countries like Tanzania, there is a relatively high burden of HIV but few resources to support mental health needs. To gain a better understanding of mental health challenges experienced by PLWH in northern Tanzania and identify opportunities for intervention, we interviewed 12 mental health professionals working in the Kilimanjaro region. Thematic analysis was used to explore drivers and impacts of emotional distress, community influences on mental health, and gaps and barriers to existing mental health care. Perspectives from mental health workers highlight the compounding effects of stress related to HIV status, family conflict, finances, and other social challenges, which can lead to poor HIV treatment outcomes and suicidal ideation. Cultural beliefs and stigma surrounding both mental health and HIV limit care-seeking behavior for mental health issues. Those who do seek care often encounter barriers related to poor mental health infrastructure, including a lack of providers, limited financial resources, and little integration into other health services. There is a clear need for investment in the mental health care system, as well as interventions to improve knowledge and perceptions of mental health and comprehensively address stressors. We describe feedback on a proposed telehealth counseling intervention integrated into routine HIV services, which shows strong potential to mitigate barriers to mental health treatment, reduce suicidal ideation, and support the wellbeing of PLWH.

Power, policy, and transgender identities: A case study of gatekeeping by mental health professionals in accessing gender affirming surgeries in India.

Transgender individuals seeking gender-affirming surgeries (GAS) are often denied or delayed by mental health professionals (MHPs). Studies on the gatekeeping of GAS have been mainly conducted in the Global North and primarily focus on the perspectives of health professionals. This case study from India incorporates health professional, community, advocate, and activist perspectives to contribute new evidence about MHP gatekeeping in GAS. The study aims to examine the role of power and gender in MHP gatekeeping of GAS in India. A qualitative multi-method case study including thematic analyses of key informant interviews (n = 9) and policy analysis using the policy triangle framework. Health professionals and transgender persons participate in the construction, performance, and reproduction of gender indicating the persistence of gender normativity in India which enables gatekeeping by MHPs. However, evidence suggests some signs of a change from binormativity to a culturally intelligible and historically familiar "trinormativity". To understand MHP gatekeeping, there is a need to contextualise this example of biopower within the larger social construction of gender within which MHPs operate. A transition from binormativity to "trinormativity" enables MHP gatekeeping of transgender persons seeking GAS. This risks creating new forms of gender-related oppression, such as new hierarchies and class differences between the gender binary and the "third gender".

Role of belief in miracles in clinical settings – a literature review

Health professionals, in their daily clinical practice, are often faced with the verbalization of belief in miracles by patients and surrogates, in cases of serious diseases. Many of them consider the content of this belief in decision-making in terminal stages of the disease. However, this topic is little discussed in academic and scientific circles, together with a large gap in health training. The objective of this study is to understand the research scenario for the topic in question, how it has been approached in contemporary times, what perspectives and methodologies have been adopted in published studies, what results they have achieved, and to what extent they are or are not convergent or divergent each other in terms of implications for clinical practice. A literature review was carried out, using the descriptors: faith healing, delivery of health care, belief, miracle, clinical practice and divine cure, in Portuguese and English, in the VHL, PubMed, SciELO, PsycInfo databases. From a total of 2,369 articles initially found, 32 were selected, 14 of which resulted from empirical research, 13 were theoretical in nature and five were opinion-based. Twenty-three articles focused on the professional's perspective on the topic. In addition to the onesided nature of the studies, which tend to present only the perspectives of health professionals and neglect the experiences of patients and caregivers themselves in relation to the phenomenon of belief in miracles, it was observed that it tends to be stigmatized and interpreted as a mere denial of reality, with the potential to trigger conflicts between patients/surrogates and health professionals. It may be concluded that there is a need for more studies focusing on the genuine experiences of patients and surrogates, in order to support an epistemologically qualified clinical practice, for an understanding of the phenomenon of belief in miracles and its subjective and intersubjective impacts in clinical contexts and, consequently, consistent with a more comprehensive conception of physical and mental health

Mental Health Professionals' Perspectives on Group Intervention for Women Survivors of Intimate Partner Violence: A Qualitative Study.

To examine the perspectives of mental health professionals on providing group intervention for female spouses of men with alcohol dependence who experienced intimate partner violence (IPV). A qualitative research design was used, and a purposive sample technique was used to select the participants. Nine experts with more than five years of experience in handling partner violence cases provided insights through in-depth interviews. The transcripts were carefully examined several times, coded and re-coded. The codes were subsequently organized into thematic categories. Most of the experts were between the age of 35-45 years (66.7%), females (77.8%) and had more than five years of experience in mental health and IPV (55.6%). Most of the experts (66.7%) were working in teaching institutions related to mental health and IPV. The remaining one-third (33.3%) of the experts were legal and women empowerment practitioners. The thematic analysis generated six main themes and 19 subthemes, with 189 codes. The six mean themes were: psychosocial needs and concerns, psychosocial interventions, enhancing psychological well-being, enhancing the social support systems, challenges, and therapeutic strategies. Experts emphasized the importance of a holistic approach to IPV intervention. Group intervention addresses multiple issues that contribute to violence. Survivors need safe housing, counseling, legal help, and financial assistance.

Factors influencing public health engagement in alcohol licensing in England and Scotland including legal and structural differences: comparative interview analysis.

Greater availability of alcohol is associated with higher consumption and harms. The legal systems, by which premises are licensed to sell alcohol in England and Scotland, differ in several ways. The 'Exploring the impact of alcohol licensing in England and Scotland' study measured public health team activity regarding alcohol licensing from 2012 to 2019 and identified seven differences between England and Scotland in the timing and type of activities undertaken. To qualitatively describe the seven previously identified differences between Scotland and England in public health approaches to alcohol licensing, and to examine, from the perspective of public health professionals, what factors may explain these differences. Ninety-four interviews were conducted with 52 professionals from 14 English and 6 Scottish public health teams selected for diversity who had been actively engaging with alcohol licensing. Interviews focused primarily on the nature of their engagement (n = 66) and their rationale for the approaches taken (n = 28). Interview data were analysed thematically using NVivo. Findings were constructed by discussion across the research team, to describe and explain the differences in practice found. Diverse legal, practical and other factors appeared to explain the seven differences. (1) Earlier engagement in licensing by Scottish public health teams in 2012-3 may have arisen from differences in the timing of legislative changes giving public health a statutory role and support from Alcohol Focus Scotland. (2) Public Health England provided significant support from 2014 in England, contributing to an increase in activity from that point. (3) Renewals of statements of licensing policy were required more frequently in Scotland and at the same time for all Licensing Boards, probably explaining greater focus on policy in Scotland. (4) Organisational structures in Scotland, with public health stakeholders spread across several organisations, likely explained greater involvement of senior leaders there. (5) Without a public health objective for licensing, English public health teams felt less confident about making objections to licence applications without other stakeholders such as the police, and instead commonly negotiated conditions on licences with applicants. In contrast, Scottish public health teams felt any direct contact with applicants was inappropriate due to conflicts of interest. (6) With the public health objective in Scotland, public health teams there were more active in making independent objections to licence applications. Further in Scotland, licensing committee meetings are held to consider all new applications regardless of whether objections have been submitted; unlike in England where there was a greater incentive to resolve objections, because then a meeting was not required. (7) Finally, Scottish public health teams involved the public more in licensing process, partly because of statutory licensing forums there. The alcohol premises licensing systems in England and Scotland differ in important ways including and beyond the lack of a public health objective for licensing in England. These and other differences, including support of national and local bodies, have shaped opportunities for, and the nature of, public health engagement. Further research could examine the relative success of the approaches taken by public health teams and how temporary increases in availability are handled in the two licensing systems. This article presents independent research funded by the National Institute for Health and Care Research (NIHR) Public Health Reseacrh programme as award number 15/129/11.