Interpretive Descriptive Study Research Articles

Family member experience with restricted family presence in Canadian PICUs: an interpretive descriptive study

PurposeWe performed this study to explore family member experiences with restrictions to family presence during their child’s PICU admission, leveraging the unique context of the COVID-19 pandemic to aid in future ethical and informed decision-making.MethodsQualitative interpretive descriptive study with family members of Canadian PICU patients admitted from March 2020 to April 2021 who experienced restricted family presence (RFP) policies. Respondents were purposively sampled for demographic-based maximum variation.We generated themes through inductive thematic analysis of open-ended interviews.ResultsFourteen parental figures from five regions across Canada participated. We identified four themes associated with the lived experience and impact of the restrictions on family members of critically ill children: (1) challenges to fulfilling the parent role, (2) isolation from primary supports during a time of crisis, (3) navigating increased logistical difficulties, and (4) seeking compassionate approaches within the healthcare system.Conclusion: RFP policies created a range of barriers for family members of critically ill children. Healthcare organizations and teams may play a role in removing barriers through consistent and empathetic application of rules with consideration for the duality of the parent role in PICUs, providing important post-pandemic policy and practice implications.What is known:• Parental presence with critically ill children may improve health outcomes for patients and their families.• Restrictions to family presence in PICUs continue to occur internationally and, during COVID-19, resulted in parental isolation, anxiety, and increased stress. What is new:• By isolating family members and removing supports, COVID-19-related restrictions in Canadian PICUs challenged family members’ ability to fulfil their parent roles while meeting their own needs. • Families need empathetic, advocacy-based approaches from clinicians and healthcare systems to maintain trust and therapeutic relationships in a family-centered organization.

How Veterans with Chronic Pain Approach Using Cannabis for Symptom Management: Results from a Qualitative Interpretive Description Study.

Introduction: Veterans use cannabis as a chronic pain treatment due to a combination of the easing of restrictions and dissatisfaction with care standards. The segregation of medical cannabis from conventional health systems may translate to opportunities and disadvantages that are not well defined. Our study aimed to characterize how Veterans with chronic pain approach using cannabis for symptom management, including product access, developing a treatment plan, and its integration into daily life. Materials and Methods: We used an interpretive description design and conducted semi-structured interviews with U.S. Veterans in Michigan who had chronic pain; were aged 21 years or older; and (a) used cannabis, (b) were planning to use cannabis, or (c) interested in learning about how cannabis could help with pain. We analyzed deidentified interview transcripts to develop themes that focused on how Veterans approached new and continued use of cannabis for chronic pain management. Results: Participants were Veterans with chronic pain, median age = 50 years (n = 32). Participants described how factors at the individual, relationship, community, and societal levels influenced their interest in and use of cannabis for chronic pain. We identified five main themes: (1) cannabis supports holistic wellness, but there are also undesired effects; (2) medical cannabis requires a personalized treatment approach; (3) Veterans seek expanded access to medical cannabis and more assurance regarding product safety and efficacy; (4) sociopolitical attitudes and advocacy shape medical cannabis acceptability; and (5) the interest in research to inform treatment approaches and facilitate access. Discussion: This article illustrates how Veterans approached using cannabis for chronic pain management. Findings illuminate the potential value of cannabis for Veterans with chronic pain while also highlighting numerous obstacles and limitations related to its use. There are opportunities for health care providers to support Veterans who are interested in cannabis while research regarding efficacy and safety continues. Future efforts should engage Veterans to collectively work toward a better understanding of cannabis as a pain treatment option.

Indigenous Parents' Perspectives of Factors That Facilitate or Impede Engagement in Internet-Based Parenting Support Programs: Interpretive Description Study.

Parenting support programs enhance parents' health and their child's development. The COVID-19 pandemic necessitated the delivery of these programs over the internet. After the pandemic, internet-based programs are still preferred by some. We aimed to understand Indigenous parents' experiences engaging in internet-based parenting support programs; thus, an interpretive description study was conducted. A total of 20 Indigenous (female, male, and Two-Spirit) parents of children aged <5 years participated in semistructured interviews; data underwent collaborative thematic analysis with Indigenous community partners informed by the Two-Eyed Seeing framework and ethical space. Parents' experiences were classified into five themes: (1) Purpose: Program Delivery and Content, (2) Belonging: Building Relationships and Connections, (3) Hope: Cultural Connection, (4) Meaning: New or Improved Parenting Skills and Mental Wellness, and (5) Recommendations for Organizations. The study findings can inform internet-based parenting program delivery to enhance engagement for Indigenous families.

Summer Camp Clinical Placements in Young Families Nursing: An Interpretive Description Study.

Obtaining meaningful clinical experiences with paediatric and perinatal (young families) populations is increasingly challenging for nursing programs. Care for this population has largely moved to outpatient and tertiary settings. Therefore, a current trend is to use non-traditional clinical settings. While summer camps offer rich learning experiences for nursing students, they are seldom used as clinical placements. Faculty at an Atlantic Canadian university sought a novel way to engage students in young families' learning by partnering with overnight summer camps, staffed by counsellors, camp administrators, and on-site nurses. Campers included those with lived experience of cancer, diabetes, physical and developmental challenges, and socioeconomic challenges. This study assesses how young families course outcomes were met by an innovative clinical experience within a Bachelor of Nursing program and describes the perceptions and experiences of those involved. Study participants included students (n = 4), camp directors (n = 3), a camp nurse (n = 1), and the clinical educator (n = 1). Data collection involved semi-structured interviews and a focus group. Interpretive description methodology was used to identify themes and patterns related to overarching research questions. Students met the outcomes and overall participant perceptions and experiences were positive. However, some participants shared constructive critiques for future consideration. Nursing students who completed a young families clinical placement at summer camps met course outcomes, and those involved reported both positive experiences and constructive critiques for future consideration.

'Dancing with emotions': An Interpretive Descriptive study of facilitators recognition and response to students' emotions during simulation.

Immersive simulations can evoke a range of emotions in students. However, little is known about how facilitators recognise and respond to students' emotions during simulations. This study aims to understand how simulation facilitators perceive and respond to students' emotions during simulation-in order to optimise learning. We conducted semi-structured interviews with 10 simulation facilitators who had varying experiences in simulation-based practice. We explored their experiences of students' emotions in simulations and reactions to these perceived emotional states. Applying an Interpretive Descriptive methodology, drawing upon control-value theory, we iteratively and reflexively developed themes to address our research question. Based on a contrasting analysis, we used the concept of 'crafted stories' to represent our findings. We identified three recurring issues and crafted these into stories: (1) facilitators that recognise emotions and adjust the complexity of the simulation in order to dampen intense negative emotions and 'preserve learning'; (2) those that recognise mainly negative emotions and argue that it is better to let them feel the 'heat' in order to prepare them for the realities of clinical practice; (3) those that recognise both negative and positive emotions but let the simulation run as planned for all learners and attend to emotional responses during debriefing. Simulation facilitators become aware of students' emotional responses through a range of cues. While some facilitators continually move and react to students' emotions, others intentionally hold back from attempting to alter students' emotional responses. Facilitators' beliefs about how to optimise learning mediate how they react to students' emotional states. Beliefs about learning are predominantly shaped by their experiences in both teaching and real-world clinical practice. By understanding the delicate balancing act of students' emotional states and altering the complexity of a simulation, we have the opportunity to inform facilitator training in order to enhance learning.

Unraveling attrition and retention: A qualitative study with rehabilitation professionals.

Health human resources are scarce worldwide. In occupational therapy (OT), physical therapy (PT), and speech-language pathology (S-LP), attrition and retention issues amplify this situation and contribute to the precarity of health systems. To investigate the phenomena of attrition and retention with OTs, PTs and S-LPs who stayed in, or left their profession. Cultural-historical activity theory provided the theoretical scaffolding for this interpretive description study. We used purposeful sampling (maximum variation approach) to recruit OTs, PTs, and S-LPs from Quebec, Canada. Individual interviews were conducted with 51 OTs, PTs, and S-LPs from Quebec, Canada, in English or French (2019-2020). Inductive and deductive approaches, and constant comparative techniques were used for data analysis. Six themes were developed: 1) characteristics of work that made it meaningful; 2) aspects of work that practitioners appreciate; 3) factors of daily work that weigh on a practitioner; 4) factors that contribute to managing work; 5) relationships with different stakeholders that shape daily work; and 6) perceptions of the profession. Meaningfulness was tied to participants' sense that their values were reflected in their work. Factors outside work shaped participants' work experiences. Recurrent negative experiences led some to leave their profession. Findings underscore a critical need to address contributing factors to attrition and retention which are essential to ensuring the availability of OTs, PTs and SLPs for present and future rehabilitation needs.

Accessing Trauma- and Violence-Informed Breastfeeding Support from Primary Care Providers among Women with Histories of Intimate Partner Violence: An Exploratory Interpretive Description Study.

Intimate partner violence (IPV) is a wicked social problem affecting women of all social strata and geographical location, globally. Pregnancy may be a time of heightened risk of IPV and more deleterious outcomes. Breastfeeding - a protective factor for maternal and child well-being - may be jeopardized or more challenging for women experiencing IPV. This study explored the experiences of postpartum women with histories of IPV who sought trauma- and violence-informed breastfeeding support from primary care providers. Using interpretive description and philosophically underpinned by intersectionality, in-depth semi-structured interviews were completed at 12-weeks postpartum with five breastfeeding mothers with a history of IPV who sought breastfeeding support from a family physician clinic employing a trauma- and violence-informed (TVIC) model of care. Four themes and two sub-themes shed light onto the experience of accessing breastfeeding support for women with a history of IPV and the perceived barriers that they faced when attempting to accesses this support, including: 1) The (demoralizing) navigation of the perinatal system; 2) Fostering trust: i) "It's support, but it's also knowledge"; and ii) TVIC: feeling safe and feeling "I mattered"; 3) Informal support: partners, family, and friends; and 4) Baby in focus: overcoming challenges and building confidence. TVIC may aid in the development of trusting therapeutic relationships, in turn improving access to breastfeeding support, breastfeeding self-efficacy, and breastfeeding success for women who experience violence. Further research on the implementation and evaluation of TVIC for perinatal breastfeeding education and care among women is required.

Exploring occupational therapy practice with children who are picky eaters and their families

Introduction: Picky eating is a complex phenomenon, impacting family routines and relationships. Occupational therapists often work with picky eaters and their families, yet little is understood about the occupational therapy process and reasoning in this context. This study was guided by the following research question: How do Australian occupational therapists choose and deliver interventions for children with picky eating and their families? Method: This qualitative interpretive descriptive study used in-depth semi-structured online interviews with 10 Australian-based occupational therapists working with children who are picky eaters. Data was analysed inductively following a thematic analysis process, and emergent themes were identified. Findings: Participants indicated that they used a complex reasoning process, with ‘Tailoring Occupational Therapy for Picky Eating’ emerging as the central finding. Key factors underpinning these tailored interventions were finding the why; addressing the why; and practising within context. Conclusion: To our knowledge, this is the first qualitative study to investigate occupational therapists’ reasoning processes when working with families impacted by picky eating. Occupational therapists described the complexity of picky eating, and the subsequent reasoning to find suitable interventions. Findings may guide occupational therapists’ clinical practice when working with children with picky eating and their families.

The Experience of Hospitalisation for People Living With Dementia: A Qualitative Exploration of How Context Shapes Experiences.

Dementia has become an increasingly pressing issue in healthcare systems, and acute care settings such as hospitals have been shown to be particularly problematic for people living with dementia. People living with dementia are hospitalised at higher rates than those without and often have poor experiences and outcomes of hospitalisation. To support the evolution of hospital systems to better meet the needs of people living with dementia, it is important to consider the relationship between the context of the hospital and the experiences of people living with dementia and their caregivers. The term context refers to the environment and conditions that shape experiences and includes elements such as policies, procedures, design and social norms. A greater understanding of the relationship between the hospital context and the experiences of people living with dementia will support the future development of interventions to modify contextual elements to improve the experiences of people living with dementia. Our aim was to explore the relationship between the experiences of people living with dementia and their caregivers in hospital, and the contextual elements of the hospital. In this interpretive descriptive study, we conducted interviews with people living with dementia and caregivers of people living with dementia about their experiences in hospital. Interviews were conducted with people living with dementia (n = 3), caregivers of people living with dementia (n = 8) and one dyad of a person living with dementia and their caregiver (n = 1) about the hospitalisation of the person living with dementia. Using inductive and deductive methods of analysis, we describe contextual factors that shape their experiences. Our findings demonstrate how the hospital context shaped the experiences of people living with dementia and their caregivers while the person living with dementia was hospitalised. The themes reflect elements of the hospital context: communication systems, the value of caregivers, the focus on acute physical needs, staff capacity, the physical environment and normalised practices. The findings suggest that there are aspects of the hospital context that can be modified to influence the experiences of people living with dementia and their caregivers. This study demonstrates how the context of hospital shapes the experiences of people living with dementia and their caregivers and points to aspects of the context that health system leaders could explore to begin to improve the capacity of hospitals to support people living with dementia. The study provides evidence of the need for health system leaders and practitioner to explore how the hospital context shapes the experiences of people wtih dementia and their caregivers, and begins to explore ways that contextual changes can improve their experiences.

Impact of the COVID-19 pandemic on Canadian performing and creative artists: An interpretive descriptive study using the social-ecological model.

Public health restrictions during the Coronavirus-2019 (COVID-19) pandemic in Canada have substantially reduced the work and income of performing and creative artists. We aimed to understand how factors at the public policy, community, organizational, interpersonal and individual levels affected Canadian performing and creative artists' health and livelihood during the pandemic. We interviewed 14 creative and performing artists from an academic hospital-based healthcare center in Toronto, Canada. In addition, we conducted secondary data analysis on an existing set of 17 transcribed interviews from a quality improvement study that included relevant information to answer the present study's research question. We applied an interpretive descriptive approach to our qualitative inquiry and used the social-ecological model (SEM) as our analytic framework. We identified factors at all levels of the SEM that tended to synergistically affect the health and livelihood of artists during the COVID-19 pandemic. Public health restrictions and government financial assistance programs have downstream effects on other levels. During the pandemic, many artists sensed an overwhelming loss of community, financial instability, and limited access to healthcare; which in turn affected their health. For those who accessed financial assistance programs, the stability of income afforded time for rest without the stress of food insecurity or housing instability. Use of the SEM as an analytic framework reflects the multidirectional intricacy and dynamic interplay among factors operating within and across all five levels, bringing to light potential areas of improvement at various levels to strengthen resilience and reduce risk factors associated with artists' health and healthcare access. Findings also accentuated the fragility of precarious work that inundates the performing arts industry, which emphasizes the need for interventions and policies to address this issue. Such interventions might include financial support programs for artists, access to affordable healthcare services, and efforts to strengthen social support networks within the arts community.

Informing Culturally Safe Advance Care Planning: An Interpretive Descriptive Study of Internationally Educated Nurses in Ontario.

Maintaining cultural safety during advance care planning (ACP) discussions is an essential component of holistic care provision. Most nurses feel unprepared to engage in ACP and the current literature offers limited recommendations on how nurses can lead culturally safe ACP discussions. Internationally educated nurses (IENs) have unique personal and professional experiences to address this gap. The purpose of this study was to understand IENs' contributions to culturally safe ACP and its implications to nursing practice and ACP policy. An interpretive descriptive approach was undertaken. Ten IENs working in Ontario, Canada were individually interviewed using a semi-structured guide to understand their perspectives and experiences of engagement in culturally safe ACP practices. IENs utilized various approaches that were reflected in three actions: practicing cultural humility, utilizing a cautious approach, and empowering clients and families. IENs engaged in intrapersonal and interpersonal cultural humility practices to recognize the unique influence of one's culture on the ACP process. Establishing trust in the nurse-client relationship and cautiously approaching ACP conversations was recognized as important in maintaining cultural safety. IENs also empowered clients by addressing knowledge deficits, misconceptions about ACP, and informing them of their decision-making rights. Nurses require education and resources to carry out culturally safe ACP. Education should begin at the undergraduate level and include self-engagement in ACP and cultural humility training. Practicing nurses need ACP training and clear standards/guidelines. There is an opportunity for healthcare organizations and professional/governing nursing bodies to collaborate on developing culturally safe ACP guidelines.

Motivations of family advisors in engaging in research to improve a palliative approach to care for persons living with dementia: an interpretive descriptive study

BackgroundA Strategic Guiding Council (SGC) was created within a Family Carer Decisions Support study, to engage family carers of persons with advanced dementia as advisors to inform the design and implementation of the study. The SGC consists of an international group of family advisors from Canada, the Republic of Ireland, the United Kingdom, the Netherlands, and the Czech Republic. There are limited studies that have explored the integration of Patient and Public Involvement (PPI) in dementia research, end-of-life care and long-term care. Therefore, this study explores PPI engagement in health research with family carers to understand further their interest in being involved in the SCG within the FCDS intervention which is focused on supporting caregivers to make decisions about end-of-life care for residents with advanced dementia.MethodsThis study utilized an interpretive descriptive design and explored the motivations of ten family advisors from Canada, the Republic of Ireland, the United Kingdom, and the Netherlands in being part of the SGC. Semi-structured interviews were conducted by phone or videoconferencing and were recorded, transcribed, and analyzed using thematic analysis.ResultsThree themes generated from the findings of the study were (1) engaging in reciprocal learning; (2) using lived experience to support other family carers; and (3) creating a collective momentum for advocacy and change.ConclusionsFamily carers motivations to being part of the SCG was driven by their intent to help carers navigate the health system and to create a psychosocial support system for other carers experiencing end-of-life with their loved ones. Being part of the SCG provided a benefit to family carers which provided a venue for them to contribute meaningful information from their experience, learn from other health professionals, research and other advisors and an avenue for advocacy work to improve access to end-of-life care supports through education. To our knowledge, this is the first study that explores the motivations of an international group of family advisors’ engagement in health research to promote integration of a palliative approach to dementia care in long-term care homes. This study further contributes to the literature from an international perspective the importance of PPI in research. Further research is warranted that explores PPI in research to improve access to end-of-life supports.

P036 INFLUENCE OF FOOD ENVIRONMENT IN AND AROUND SCHOOLS ON FOOD CHOICES AND PRACTICES OF STUDENTS: A MIXED METHODS STUDY – ANTICIPATORY FINDINGS

Background: The health behaviors of adolescents are significantly influenced by their living environments, with schools serving as crucial settings for promoting healthy behaviors. The school food environment, encompassing areas where food is provided and consumed within and around schools, plays a key role in shaping adolescents’ dietary choices. However, there is a notable scarcity of evidence regarding the school food environment in Pakistan. This study aims to examine the school food environment and associated factors, including the availability, accessibility, and affordability of foods within and around schools for adolescents, the facilitators and barriers school vendors face while offering healthy food options, and the perspective of policymakers on the role of food environments. Objectives: • To assess the school lunchtime food practice and sources of adolescents in schools in Karachi • To explore facilitators and barriers to offering healthier food options to adolescents through school vendors both within and outside school premises • To explore the perspectives of adolescents regarding the food choices available to them Methods: A mixed methods concurrent study design i.e. a cross-sectional study, interpretive descriptive qualitative study. Six schools, comprising three government and three private schools from District Central of Karachi, will be recruited. Students from grades 6 and 7 who provide consent and assent will be included, with an anticipated sample size of 430 participants. Descriptive statistics will be utilized to analyze quantitative data and a manual thematic analysis approach will be employed to analyze qualitative data. Results: The anticipated outcome of this study is to understand the school food environment holistically taking into consideration the practices and perspectives of key stakeholders i.e. school-going adolescents, vendors, and policymakers. Conclusion The groundwork done through this research project will help develop evidence-based healthy school food environment programs/interventions that can be feasibly deployed in government and private schools in Pakistan. The research outcomes will foster collaborative efforts among various stakeholders to co-create and implement viable solutions.

Coping with the stigma of mental illness: An interpretive descriptive study of out‐patients in a public mental health hospital in Ghana

Coping with the stigma of mental illness: An interpretive descriptive study of out‐patients in a public mental health hospital in Ghana

Environmental Literacy in Initial Teacher Training: Pre-Service Teachers’ Perceptions of the Socio-Environmental Impact of Food

This qualitative descriptive-interpretive study aims to understand and describe the perceptions of a group of pre-service teachers of the degree of environmental literacy in primary education at the University of Seville. They participated in a training proposal focused on the current eco-social crisis related to the socio-environmental impact of food in which the different dimensions constituting environmental literacy were analysed. Those dimensions are knowledge, attitudes and emotions, behaviour, and the didactic knowledge associated with socio-environmental issues. The students’ diaries were used as a data-collecting tool in this study. The results reveal a heterogeneous distribution in the students’ understanding and internalisation of concepts related to the dimensions of environmental literacy. In terms of knowledge, most students show a deep and holistic understanding. Diversity is observed in their attitudes and emotions towards socio-environmental issues, and tentative attitudes towards change prevail. Finally, their intentions and proposals for solutions mainly reflect simplistic perceptions. This emphasises the importance of encouraging active participation and collaboration in the search for socio-environmental solutions. In general, the results stress the need to continue improving the preparation of future teachers with regard to environmental education. A deeper understanding and a committed attitude towards sustainability and the preservation of the social and natural environment should be encouraged in initial teacher training.

Where engagement happens: Parent perspectives on engagement in behavioural interventions

ABSTRACT Engagement of parents in interventions for their children has many reported benefits. Despite recent advances in conceptualisations of parent engagement within child development and rehabilitation fields, there are limited understandings of parent engagement from a behaviour analytic account. This study aimed to understand how parents experience engagement in child-focused behaviour analytic interventions in Aotearoa New Zealand. An Interpretive Description study was undertaken, involving 14 semi-structured interviews with a sample of 15 parents who had experienced a child-focused behavioural intervention. Four themes were developed including a) the system as the environment, b) what parents bring, c) what clinicians bring, and d) where engagement happens. Themes are presented using an analogy of a river ecosystem, detailing how each theme comes together into an intervention context, where engagement is negotiated through humble communication, development of working relationships, and responsive approaches to intervention delivery. Findings support behaviour analysts attending to antecedent conditions for parent engagement, in efforts to further effective intervention, rather than prioritising focus on treatment adherence at the outset of intervention delivery. The outcomes of the study closely align with other allied health literatures, offering behaviour analysts insight into parent engagement from related service delivery contexts.

Assessing Clinical Judgment and AACN Domains in Self-Reflection of Video Recorded High-Fidelity Simulation Scenarios.

Clinical judgment is the hallmark of safe patient care. Nurse educators continue to explore best practices to assist prelicensure nursing students in developing clinical judgment. The 3-part purpose of this study was to identify what students learned about themselves related to clinical judgment after viewing their video-recorded high-fidelity simulation scenarios, to assess if video recording is an effective post-debriefing teaching strategy, and to evaluate if the 2021 American Association of Colleges of Nursing (AACN) Domains can be assessed longitudinally. Qualitative interpretive description study of 37 prelicensure nursing students. Ten codes were derived from 314 excerpts: communication, body language, confidence in self, putting data together, collaboration, leadership, safety, skillfulness, areas of improvement, and growth. Longitudinal data showcased the development of clinical judgment, effectiveness of self-evaluation of video recorded simulations as a teaching strategy, and assessment of 5 AACN Domains.

Sleep should not be this difficult: An interpretive descriptive study of older adults' perspectives on behaviour change elements in Sleepwell and experiences with benzodiazepine discontinuation

SummaryBenzodiazepine receptor agonists are often used for insomnia in older adults contrary to current evidence. The harms outweigh the benefits, which are limited. Cognitive behavioural therapy for insomnia is the first‐line recommended treatment. Sleepwell was created as a repository of evidence‐based resources to promote cognitive behavioural therapy for insomnia and limit benzodiazepine receptor agonist use. This qualitative study uses an interpretive description design and reflexive thematic analysis to explore older adults' perspectives on behavioural change techniques used in Sleepwell resources. It also explores challenges and opportunities towards benzodiazepine receptor agonist discontinuation and cognitive behavioural therapy for insomnia use. Participants were recruited from the Sleepwell arm of a randomized controlled trial. Data were collected from 15 older adults using semi‐structured interviews. Two main themes were developed: (1) sleep should not be this difficult; and (2) whether you know it, or learn it, drugs are bad. Two sub‐themes were created within the first theme: (1) justification of benzodiazepine receptor agonist use to achieve sleep goals; (2) efforts of committing to cognitive behavioural therapy for insomnia. Several behavioural change techniques (e.g. information about consequences, anticipated regret, salience of consequences) were enablers of benzodiazepine receptor agonist‐related behaviour change. For committing to cognitive behavioural therapy for insomnia, several behavioural change techniques (e.g. self‐monitoring of behaviour, distraction, stimulus substitution) were beneficial, but social support, which was perceived as useful, was absent. Older adults experienced tension with benzodiazepine receptor agonist use and deprescribing, despite knowing or learning the potential consequences of benzodiazepine receptor agonists. Cognitive behavioural therapy for insomnia implementation was challenging. Embedded behavioural change techniques in the Sleepwell booklets were identified as helpful, but more (e.g. social support) are needed to optimize cognitive behavioural therapy for insomnia use.

Gender Matters: Exploring the Mental Health of Youth Experiencing Homelessness in Canada

The gender gap in adolescent mental health experiences is notable, with gender adding an additional layer to the already complex experience of being a young person who is experiencing homelessness. Yet, research in this area is limited. The purpose of this qualitative, interpretive description study was to understand how gender shapes the mental health of youth who are experiencing homelessness in the Niagara Region of Ontario, Canada. Eleven young people between the ages of 16 and 24 were recruited from a youth shelter and participated in individual semi-structured interviews. Thematic analysis and Gender-Based Analysis Plus was used to analyze the data, and findings revealed four contextual factors that appear to influence a young person’s mental health while homeless but that is experienced differently depending on one’s gender identity. These factors are: (1) housing acquisition is challenging, (2) physical presentation is meaningful, (3) cleanliness and hygiene are expected, and (4) utilizing mental health resources is complicated. Additionally, the many strengths that the youth identified and demonstrated in navigating their circumstances are highlighted in the results. These strengths involve (1) exhibiting resilience, (2) expressing the ability to survive, (3) imagining a world that is better, (4) articulating their needs, and (5) drawing on their social connections. The gendered lens that guides this study provides a challenge to the homogenous way that young people experiencing homelessness are often portrayed within the literature. Intersecting identities that include gender and age need to be considered within the mental health-related experiences of youth who live with homelessness. Ensuring that interventions are tailored to meet young people’s specific gendered needs is both a matter of human rights and health equity. Practical implications for service providers are discussed.

Educational and professional experiences of men in nursing: An interpretive description study to guide change and foster inclusive environments for men in nursing

BackgroundNursing shortages are occurring due to decreased student enrollment, nurse burnout, staffing deficits, nurse retirements, and increasingly low numbers of nursing faculty. Men are an untapped resource that can offset these crises. However, men's presence in nursing remains underwhelming. Changes aimed at improving diversity and inclusivity related to men's presence is needed in the nursing workforce. PurposeExplore men's experiences in modern nursing environments to identify barriers to men's presence in nursing faculty and clinical workforce roles. MethodThis study used interpretive description design. Data were collected through individual and group interviews. Interviews were video recorded. Interview questions were semi-structured and open ended. Data were analyzed using thematic analysis. ResultsTwo themes were identified and reflected men's experiences in nursing: educational and professional change. Subthemes for educational change included increasing numbers of men in student and faculty roles; instructional change; admission, retention, and advising. Subthemes for professional change included inclusive hiring practices; healthy working environments; and leadership outcomes. ConclusionFindings constitute calls for action. Change implementation should address barriers to diversity and inclusivity related to men's presence in nursing. Recommendations and strategies presented can guide change implementation. Change implementation is expected to strengthen the nursing profession.