Major Themes Research Articles

“I Just Know if I Keep Going, I’ll End Up Hating Nursing.” Lived Experiences of Emergency Nurses Three Years Into the Global COVID-19 Pandemic

IntroductionAs the coronavirus disease 2019 pandemic continues globally, the personal and professional pressure on health care workers continues to accumulate. Literature suggests that as the pandemic evolves, nurses are experiencing increased levels of anxiety, depression, and post-traumatic stress, ultimately leading them to voice intentions to leave the profession, if they have not done so already. MethodsInformed by an interpretive hermeneutic phenomenological approach, this longitudinal study was designed to capture how the lived experiences of 9 emergency nurses evolved over the coronavirus disease 2019 pandemic, highlighting their feelings, attitudes, and perceptions toward working in the emergency department at this time in history. Interviews were undertaken in June 2022 and were analyzed using a thematic analysis approach. ResultsData analysis resulted in a total of 2 major themes and 8 minor themes. The 2 major themes included “exposed wounds” and “Band-Aid solutions.” Levels of burnout increased during the pandemic, with most of the emergency nurse participants dropping their hours, moving roles within the profession, or leaving the profession entirely. Findings elucidate where and how concerns may arise in clinical practice and holistic well-being among emergency nurses, particularly surrounding professional boundaries and protecting work-life balance and professional identity. DiscussionAs the world moves to managing coronavirus disease 2019 as a recognized common respiratory illness, providing time and space for emergency nurses to voice their concerns, design their well-being interventions, set professional boundaries, and reconnect with their professional passion may see lower attrition rates and higher levels of professional satisfaction in emergency nurses globally.

It brought us closer: How couples in the United States with children diagnosed with ASC create and maintain relationship functioning

AbstractCouples raising a child diagnosed with autism spectrum condition (ASC) experience unique challenges that can affect their relationship. This grounded theory study explores how couples maintain functioning in their relationship despite ongoing stressors related to raising a child on the spectrum. The presented model shows what couples can do to create and maintain their relationship functioning. It utilises four major themes developed from our analysis of interviews with 19 couples in the United States with a child diagnosed with ASC. This study increases understanding of couple functioning when raising a child on the spectrum. The grounded theory defines couple functioning for couples with a child diagnosed with ASC as balancing four mutually influential themes: togetherness, adaptability, resilience and communication. We also discuss clinical implications for systemic therapists to work with couples with a child diagnosed with ASC effectively.

Exploring the spiritual needs of patients with advanced cancer in China: a qualitative study

This qualitative study aimed to gain a deep understanding of the spiritual needs of patients with advanced cancer. A qualitative study using semi-structured interviews was conducted. The interviews were audio-recorded, transcribed verbatim, and subjected to thematic analysis. Two researchers coded the interviews independently in NVivo 12 plus and developed major themes and subthemes by inductive and constant comparison. This study was conducted in the inpatient ward of a tertiary cancer hospital in Hunan Province, Chinese Mainland. Eligible participants with advanced cancer were recruited using the purposive sampling method. The sample size was determined by data saturation. All interviews were conducted face-to-face individually from May 2021 to July 2021. A total of 13 patients with advanced cancer patients were interviewed. Six themes were identified, namely being treated as normal and independent individuals, receiving and giving love, seeking inner peace, connecting with spiritual sources, finding meaning and purpose, and preparing for death. Different categories of spiritual needs of patients with advanced cancer were identified in this study. Healthcare professionals need to develop interventions that aim to meet patients’ spiritual needs.

Perception and experiences of adolescent mothers and communities in caring for their preterm babies: findings from an in-depth study in rural Bangladesh

BackgroundA significant concern for Bangladesh is the high prevalence of adolescent pregnancy and the associated negative consequences for mother and baby, including a teen-related increased risk of preterm birth (PTB). Bangladesh also has one of the highest incidences of PTB (19%). Despite these high numbers of adolescent pregnancies and PTB, little is reported about the experiences of adolescent mothers in caring for their preterm babies, and the interventions needed to support them. The aim of this study was to explore gaps and opportunities for improved care for preterm babies among adolescent mothers and communities in rural Bangladesh.MethodsWe conducted a qualitative study in rural villages of Baliakandi sub-district of Bangladesh. Data collection involved in-depth interviews with adolescent mothers of premature and term babies, adult mothers with premature babies, and family members (n = 36); focus groups with community members (n = 5); and key informant interviews with healthcare providers (n = 13). Adolescent mothers with term and adult mothers with PTBs were included to elicit similarities and differences in understanding and care practices of PTB. A thematic approach was used for data analysis.ResultsWe explored two major themes- perceptions and understanding of PTB; care practices and care-seeking for illnesses. We observed gaps and variations in understanding of preterm birth (length of gestation, appearance, causes, problems faced) and care practices (thermal management, feeding, weight monitoring) among all, but particularly among adolescents. Immediate natal and marital-kins were prominent in the narratives of adolescents as sources of informational and instrumental support. The use of multiple providers and delays in care-seeking from trained providers for sick preterm babies was noted, often modulated by the perception of severity of illness, cost, convenience, and quality of services. Health systems challenges included lack of equipment and trained staff in facilities to provide special care to preterm babies.ConclusionA combination of factors including local knowledge, socio-cultural practices and health systems challenges influenced knowledge of, and care for, preterm babies among adolescent and adult mothers. Strategies to improve birth outcomes will require increased awareness among adolescents, women, and families about PTB and improvement in quality of PTB services at health facilities.

A qualitative investigation into perceived barriers experienced by European female agri-food entrepreneurs

PurposeAgri-food systems in Europe are predominantly male dominated. Female food entrepreneurs can play a key role in the development of novel, sustainable food products. The aim of the present study was to gain an increased understanding of the various barriers which female agri-food entrepreneurs situated in rural areas perceive as hindrances to their entrepreneurial growth and development and their opinions on mentorship programmes.MethodologySeven separate focus groups comprising of a total of 25 female participants were carried out with agri-food entrepreneurs throughout Europe (Ireland, Belgium, Poland, Italy). Discussions were semi-structured and revolved around individuals’ perceptions of the support received from their surrounding infrastructure and their opinions on barriers and enablers for entrepreneurship development. A reflective thematic analysis was conducted following verbatim transcription of the conversations from the focus groups.FindingsThree major themes were identified. Barriers to business development included the lack of adequate financial support and the frustrations experienced with the complexity of funding applications. Socio-cultural support was oftentimes lacking. Participants were aware of the benefits of an online presence to develop their business but lacked confidence in their digital abilities. Few female entrepreneurs were aware of mentorship programmes, and most were unsure what this practice would entail. These findings highlight a range of issues in need of addressing to improve the infrastructure surrounding female agri-food entrepreneurs throughout Europe.

Does one size fit all? A survey of preceptor perceptions and experiences with remote rotations

Background: During the pandemic, experiential rotations transitioned from in-person to remote rotations. Methods: The authors surveyed preceptors about their experiences and perceptions of remote rotations. Preceptors completed an online questionnaire divided into six domains: 1) General demographics; 2) Preceptor/student relationship; 3) Preceptor support and continuing professional development opportunities; 4) Technology; 5) Preceptor perceptions; and 6) Motivators and challenges. Responses were coded and analysed for emerging themes. Results: A total of 47 out of 157 preceptors (30%) responded to the questionnaire, and most preceptors were willing to precept remotely again (85%). Student responsiveness (87%) and enjoyment of teaching (83%) were the greatest motivators. Major themes reflected the preceptor’s struggles in building rapport and facilitating in-the-moment learning opportunities. Preceptors identified guidance and on-going support as key factors to ensure preceptor and student readiness and to manage expectations. The formula for a successful rotation included careful consideration of appropriate pedagogy, technology, and a dose of motivation. Conclusion: Preceptors reflected a positive experience in leading remote rotations. Traditional precepting approaches employed during in-person rotations need to be adapted and individualised for the context of remote rotations, highlighting that there is no ‘one-size-fits-all’ approach. Transitioning to a remote environment generates new opportunities and drives innovation.

Supporting newcomer children's cultural transitions with contemporary Canadian picture books

AbstractThis article examines major themes in 24 contemporary Canadian picture books to identify their potential to support children who are newcomers to Canada. Transition to a new country can be challenging for children and picture books are an effective tool for supporting their cultural and often linguistic transition. Through multimodal content analysis, the authors identify major themes that emerge from the visual and textual data in the books. Analysis identified prevailing themes related to family, food, multiculturalism, and geographic information. Each theme offers valuable insights into the diverse perspectives represented in the texts, providing a foundation for meaningful pedagogical applications for immigrant and newcomer children.

Digital Déjà vu: The Enduring Presence of Gender Stereotypes in Memes

Memes are a crucial cultural unit for exploring and understanding the dynamics of the digital society in which examining the gender balance is a key pathway for measuring where it states. It is very important for any social science researcher to read and see if the new generation is rewriting the sexist behavior composed by the culture over the past ages and that too in a platform, which is extensively dominated by them. Hence, the main purpose of this study is to explore gender communication and gender construction in new media through memes. The study was conducted by analyzing 152 memes collected from Facebook. Theoretically it attempts to read gender from a gender-constructionist perspective. Thematic analysis was used as the method of going through these memes and the major themes were pointed out and an overall analysis was presented. The main finding from the analysis is that despite the expectation of progressive views, memes continue to reinforce traditional gender stereotypes, with a predominant focus on men narrating content that perpetuates established roles, overshadowing limited challenges to patriarchal norms. This study attempts to decode the influence of memes as cultural artifacts on the portrayal and reinterpretation of gender roles in the digital era. By scrutinizing the interplay between the new generation's expressions and prevailing cultural norms, the study unravels the transformative potential of memes in reshaping societal attitudes towards gender.

Making Room for Faith: Art of Spiritual Care in an Islamic Country

This study explored the perception of spirituality in nursing among Muslim nurses and their provision of spiritual care to patients. To have an in-depth understanding of the phenomenon the researchers utilized a qualitative descriptive phenomenology with eight (8) professional nurses from adult cardiac units at Prince Sultan Cardiac Center, Riyadh Kingdom of Saudi Arabia. The imperative data were requisite to develop themes from the conducted semi-structured guide interviews, recorded and rigorously transcribed. The nurse participants shared experiences and personal testimonies. Seven major themes emerged: One’s Context of Spirituality, Spiritual Awareness, Attributes of Spirituality, Nurse’s Intervention, Professional Competency, Spiritual Vitality, and Care towards Spirituality. The researcher concluded that nurse’s perception of spirituality in nursing plays important role in providing spiritual care. As a result, nurses’ awareness, spiritual and professional characteristics, and nursing interventions are contributing factors to identify, acknowledge, and integrate spiritual care in nursing care delivery which facilitates positive outcomes to patient’s condition. Further, it leads the nurses to provide holistic nursing care, professional development, and promote nursing excellence services in PSCC. The findings of the research empowered the researchers to formulate a program, and recommendations that are significant in the provision of spiritual care which are to be institutionalized in nursing practice, and nursing education that focus on the support, and reinforcement of nurses in Prince Sultan Cardiac Center.

Local tourists’ perception towards mangrove forest conservation and regeneration in the Guang-guang Mangrove Park and Nursery, Davao Oriental, Philippines

Mangroves are crucial for preserving and safeguarding coastal communities and the ecosystem along the shore. This study focused on determining the perception of local tourists towards the importance and current efforts and initiatives for mangrove forest conservation and regeneration in Guang-Guang, Dahican, City of Mati, Davao Oriental, Philippines. Using in-depth interviews with ten local tourists, major themes relating to and difficulties facing conservation and regeneration programs, as well as the ecosystem services and functions of mangrove forests, were investigated. The local tourists perceived that mangroves operate as storm barriers, prevent coastal erosion, and serve as essential habitats for aquatic organisms. However, anthropogenic activities like the establishment of shrimp ponds, plastic pollution, land reclamation, and illegal logging were documented to threaten the mangrove forests. The study also highlighted the government's efforts to implement regeneration programs and engage local communities and stakeholders in tree planting and coastal clean-up activities. The significance of mangrove forest conservation and regeneration was underscored, considering their roles in providing habitats, protecting coastlines, promoting biodiversity, and supporting livelihoods. The implications of the study emphasized the need to raise public awareness, improve environmental education, involve communities in decision-making, and implement regenerative conservation initiatives.

Caregivers' perspectives of community acceptance before and after surgical treatment for their child's disability.

In Tanzania, about 600 000 youth between 5 and 24 years old have a disability. Individuals with disabilities face numerous obstacles due to social stigma. The aim of this formative evaluation is to assess how caregivers of children with correctable disabilities (e.g., cleft lip/palate, club foot, and burn scar contractures) in Tanzania perceive their community's acceptance of their child before and after surgical treatment. Semi-structured interviews were conducted with 80 caregivers of children with disabilities treated at Kafika House in Arusha, Tanzania. The constant comparative method identified themes regarding the caregivers' feelings on their child's functional abilities and experiences of stigma in their community. Caregiver perceptions of stigma before and after surgical treatment were categorized and quantified as 'positive', 'neutral' and 'negative'. Thematic analysis of the 80 interviews resulted in five major themes: (1) stigma and acceptance (pre-treatment) and (2) post-treatment; (3) functional abilities (pre-treatment) and (4) post-treatment; and (5) emotional impact (pre- and post-treatment). These themes indicate caregivers and their children experience a range of emotional impacts before and after treatment, more severe stigma before treatment, and overall better social, emotional and functional status after treatment. Frequency analysis of caregiver experiences indicated that stigma experienced by children and their families decreased from 75% before surgical treatment to 2.5% after surgery. Surgical intervention and rehabilitation of physical disabilities mitigated experiences of social stigma for both children and their caregivers. Findings support the need for expanded treatment of correctable disabilities, larger investments in community-based rehabilitation programmes and further interventions to support stigmatized parents and their children.

Raising patient voices in medical education: an assessment of patient perceived effect of social determinants of health conversations and the patient-physician relationship on quality of obstetric care, to inform the development of patient driven medical education curricula.

Conventional medical education lacks the lived experiences of patients which may authentically convey the social determinants of health (SDOH) and resulting health disparities. Videos of first-person patient narratives may prove a valuable education tool in this regard. The objective of this study is to investigate how patient demographics, satisfaction with care, and patient-physician relationships influence obstetric patient interest and willingness to contribute to a SDOH video curriculum by sharing their lived experiences through first-person narratives. Study design included an anonymous, cross-sectional survey and an optional semi-structured telephone interview. Participants were 18 years old with a live-birth delivery <8 weeks prior to recruitment and received care during their pregnancy at Los Angeles General Medical Center (LAGMC). Variables surveyed included demographics, satisfaction with care, aspects of the patient-physician relationship, perceived utility, and personal interest in contributing to an educational SDOH video. A bivariate analysis was conducted to compare participants' characteristics and responses on interest in contributing and perceived helpfulness of first-person patient SDOH videos. 72.43% of participants (N = 70) believed a patient's first-person video on SDOH would be "Helpful" in preparing physicians to provide competent medical care; however, 71.43% responded "No" to "Interest" in sharing with physicians their experiences with SDOH. English preference and being U.S. born were factors significantly associated with viewing first-person SDOH video as "Helpful" (P > 0.001). Major themes from telephone interviews reflected enthusiasm for first-person patient narratives and perceived benefits of using patient experiences to educate physicians on SDOH. However, participants cited barriers to disclosing SDOH including brief and strictly clinical interactions with physicians, lack of continuity of care, and fear of being judged by physicians. While most participants recognized the utility of addressing social needs in medical education and reported satisfaction with their obstetricians and care, these factors did not uniformly translate into willingness to contribute first-person patient narratives. To improve the representation of patients from racial, ethnic, gender, linguistic, and sexual minorities into medical curricula, further research and strategies are needed to overcome the barriers discouraging patient disclosure of social needs to physicians.

The Effects of Immersive Virtual Reality-Assisted Experiential Learning on Enhancing Empathy in Undergraduate Health Care Students Toward Older Adults With Cognitive Impairment: Multiple-Methods Study.

Immersive virtual reality (IVR)-assisted experiential learning has the potential to foster empathy among undergraduate health care students toward older adults with cognitive impairment by facilitating a sense of embodiment. However, the extent of its effectiveness, including enhancing students' learning experiences and achieving intended learning outcomes, remains underexplored. This study aims to evaluate the impacts of IVR-assisted experiential learning on the empathy of undergraduate health care students toward older people with cognitive impairment as the primary outcome (objective 1) and on their learning experience (objective 2) and their attainment of learning outcomes as the secondary outcomes (objective 3). A multiple-methods design was used, which included surveys, focus groups, and a review of the students' group assignments. Survey data were summarized using descriptive statistics, whereas paired 2-tailed t tests were used to evaluate differences in empathy scores before and after the 2-hour IVR tutorial (objective 1). Focus groups were conducted to evaluate the impacts of IVR-assisted experiential learning on the empathy of undergraduate health care students toward older people with cognitive impairment (objective 1). Descriptive statistics obtained from surveys and thematic analyses of focus groups were used to explore the students' learning experiences (objective 2). Thematic analysis of group assignments was conducted to identify learning outcomes (objective 3). A total of 367 undergraduate nursing and occupational therapy students were recruited via convenience sampling. There was a significant increase in the students' empathy scores, measured using the Kiersma-Chen Empathy Scale, from 78.06 (SD 7.72) before to 81.17 (SD 8.93) after (P<.001). Students expressed high satisfaction with the IVR learning innovation, with a high satisfaction mean score of 20.68 (SD 2.55) and a high self-confidence mean score of 32.04 (SD 3.52) on the Student Satisfaction and Self-Confidence scale. Students exhibited a good sense of presence in the IVR learning environment, as reflected in the scores for adaptation (41.30, SD 6.03), interface quality (11.36, SD 3.70), involvement (62.00, SD 9.47), and sensory fidelity (31.47, SD 5.23) on the Presence Questionnaire version 2.0. In total, 3 major themes were identified from the focus groups, which involved 23 nursing students: enhanced sympathy toward older adults with cognitive impairment, improved engagement in IVR learning, and confidence in understanding the key concepts through the learning process. These themes supplement and align with the survey results. The analysis of the written assignments revealed that students attained the learning outcomes of understanding the challenges faced by older adults with cognitive impairment, the importance of providing person-centered care, and the need for an age-friendly society. IVR-assisted experiential learning enhances students' knowledge and empathy in caring for older adults with cognitive impairment. These findings suggest that IVR can be a valuable tool in professional health care education.

Visual representations of community in scholastic photojournalism: A thematic analysis of award-winning photographs from the national scholastic press association’s photo of the year contest

While journalism awards can enhance social capital and signify quality, they often reinforce a limited, negative perspective of what is newsworthy. This study builds on existing research examining award-winning photojournalism by focusing on the understudied population of student photojournalists. Via a qualitative analysis of 229 photographs from the National Scholastic Press Association’s Photo of the Year Contest, this research analyzes major visual themes and prevalent news values in award-winning scholastic photojournalism. The results from this exploratory study indicate that student journalists visually represent high school as a place for connection, collaboration, and citizenship and present a uniquely positive portrayal of their world. The findings also suggest that conventionalization of topics, tone, and techniques is present in student photojournalism award contests although the themes that are reinforced by this conventionalization are dissimilar to what has been observed in professional photojournalism contests.

Improving Risk Assessment Model for Cyber Security Using Robust Aggregation Operators for Bipolar Complex Fuzzy Soft Inference Systems

Improving a risk assessment technique for the problem of cyber security is required to modify the technique’s capability to identify, evaluate, assess, and mitigate potential cyber threats and ambiguities. The major theme of this paper is to find the best strategy to improve and refine the cyber security risk assessment model. For this, we compute some operational laws for bipolar complex fuzzy soft (BCFS) sets and then propose the BCFS weighted averaging (BCFSWA) operator, BCFS ordered weighted averaging (BCFSOWA) operator, BCFS weighted geometric (BCFSWG) operator, and BCFS ordered weighted geometric (BCFSOWG) operator. Furthermore, we give their properties, such as idempotency, monotonicity, and boundedness. Additionally, we improve the risk assessment technique for the cyber security model based on the proposed operators. We illustrate the technique of multi-attribute decision-making (MADM) problems for the derived operators based on BCFS information. Finally, we compare our ranking results with those of some existing operators for evaluating and addressing the supremacy, validity, and efficiency of these operators under BCFS information.

Evolution and Trends of Aptamers in Cancer Research: A Bibliometric Analysis of the Literature over the Last Decade.

Aptamers are increasingly applied in cancer research. Here, we have performed the first bibliometric analysis to demonstrate the evolution of aptamers in cancer research over the past decade and to reveal future trends. Original articles and reviews on aptamers in cancer research published from 2013 to 2022 were retrieved from the Web of Science Core Collection database. VOSviewer, CiteSpace, and R software were used for bibliometric analysis of the literature and visualization of the results. A total of 1627 eligible publications were analyzed. Annual and cumulative publications have been found to be steadily increased. China was the most productive country (884 publications) and Hunan University was the most productive institution (97 publications). The United States had the highest level of international collaboration (betweenness centrality = 0.55). Wei-Hong Tan was the most productive author (68 publications) and Craig Tuerk was the most cited author (387 citations). Analytical Chemistry and Biosensors and Bioelectronics were the most influential journals in this field. Three major themes were identified: aptamer selection techniques, aptamer-targeted drug delivery, and aptasensors for cancer detection. The research hotspots have shifted from aptamer selection, targeted drug delivery, molecular imaging, and biomarker detection to electrochemical aptasensors and therapeutic applications. The future may focus on high specificity and affinity in aptamer selection, aptasensor fabrication, aptamer- targeted drug delivery, and therapeutic aptamer development. The field of aptamers in cancer research has been steadily developing over the past decade, and future research may focus on aptamer application in cancer detection and therapy and the improvement of aptamer selection.

A92 THE CURRENT STATE OF PEDIATRIC TO ADULT TRANSITION OF CARE: A ROUND TABLE DISCUSSION WITH KEY STAKEHOLDER GROUPS

Abstract Background There is a severe paucity in available resources to facilitate a safe and effective pediatric to adult health care transition for patients with chronic disease. Aims This study aims to better understand the experiences of key stakeholder groups involved in pediatric to adult transition of care across various chronic disease specialties within a tertiary care urban environment. Methods A focus group was conducted on July 12th, 2018 at Women’s College Hospital with key stakeholder groups. Questions focused on the top issues related to pediatric to adult transition of care and an ideal transition model for their respective patient populations. The second part of this study included individual interviews with patients and carepartners. Focus group meetings and individual interviews were both audio-recorded and transcribed for qualitative thematic analysis. Results Seventeen pediatric and adult care physicians representing ten chronic disease specialties were represented. Seven patients and care partners were interviewed. Major focus group themes included: disproportionate access to resources between and within specialties (n=10), lack of mental health support in the adult setting (n=8), fragmentation of care due to multiple providers as a result of patients leaving for employment or education (n=6), patients feeling alienated due to decrease in allied health support or due to shorter appointment times (n=8), and difficulty retaining consistent care due to missed appointments as a result of inconsistent communications or change in location for education or employment (n=7). Ideal care models were suggested to include: centralized intake procedure to identify patients who may require extra support (n=9), education for scheduling administrators about second chances after a no-show (n=5), implementation of joint clinics with pediatric and adult care teams or back-and-forth clinic sessions to ensure bidirectional provider comfort before discharge to adult care system (n=4), and implementation of a dedicated transitions navigator or point of contact for patients (n=10). The individual patient and carepartner interviews emphasized the need for: centralized and comprehensive online resource (n=7), simple and clear educational content introducing the adult healthcare system (n=7), opportunities to meet and share information with other individuals in a similar position (n=3), and availability of a transitions navigator (n=4). Conclusions Current pediatric to adult transition of care resources are fragmented, allocated inefficiently, difficult to ascertain and often constrained to a specific condition or location. Future efforts should focus on improving the care transition process for high-risk patient populations by taking a comprehensive approach utilizing innovative, and multidisciplinary solutions. Funding Agencies None

A256 NAVIGATING IBD CARE : HEALTHCARE PROVIDERS’ INSIGHTS ON IMPLEMENTATION OF NURSE NAVIGATOR-LED IBD FLARE PATHWAY

Abstract Background Disparities in access to healthcare for persons living with inflammatory bowel disease (IBD) persist. An IBD nurse navigational role promises to improve access to evidence-based specialist care by minimizing inequities in access to care. Little is known about how to implement a provincial nurse navigational role in the Canadian health system. Aims This study aims to explore healthcare providers' perceptions of barriers and facilitators to the implementation of an evidence-based IBD flare pathway through a provincial nurse navigational role. Methods This was a national qualitative study performed in collaboration with the CCC PACE Program, in which two virtual semi-structured group interviews were conducted in 2022. One group interview was with six IBD nurses from three provinces, and the second was with five gastroenterologists from five provinces. Participants were purposefully recruited. The Consolidated Framework for Implementation Research (CFIR) and the Capability, Opportunity, Motivation, and Behaviour (COM-B) frameworks informed the interview script development. Data were transcribed verbatim and subjected to content analysis, with major themes categorized into the COM-B domains. The results of preliminary data analysis are presented. Results While IBD nurses emphasized the critical role of effective communication tools, standardized referral systems, strong administrative support and patient education and engagement as facilitators, they also highlighted challenges like patient resistance, variability of training and the necessity for tailored patient care. Other barriers identified were the medical complexity of managing overlapping conditions, remote vs in-person considerations and the perception and definition of a flare. On the other hand, IBD-focused gastroenterologists emphasized the potential of integrating pathways into electronic medical records and the value of empowering nurse navigators. However, they pointed out concerns regarding the inherent variability in disease presentation, entrenched medical beliefs, comfort levels with nurse-led pathways and the inherent diversity in medical practices. Both groups identified resource constraints as a barrier and an effective triage process as a facilitator. Conclusions This study sheds light on the multifaceted perceptions of healthcare providers concerning the implementation of an evidence-based IBD flare pathway through a provincial nurse navigational role. These insights underline the complexity of implementing a nurse navigational role and the need for targeted interventions and resources to address the identified barriers while leveraging the facilitators. Funding Agencies CCC

Proceedings From the 2022 ACR-RSNA Workshop on Safety, Effectiveness, Reliability, and Transparency in AI

Despite the surge in artificial intelligence (AI) development for health care applications, particularly for medical imaging applications, there has been limited adoption of such AI tools into clinical practice. During a 1-day workshop in November 2022, co-organized by the ACR and the RSNA, participants outlined experiences and problems with implementing AI in clinical practice, defined the needs of various stakeholders in the AI ecosystem, and elicited potential solutions and strategies related to the safety, effectiveness, reliability, and transparency of AI algorithms. Participants included radiologists from academic and community radiology practices, informatics leaders responsible for AI implementation, regulatory agency employees, and specialty society representatives. The major themes that emerged fell into two categories: (1) AI product development and (2) implementation of AI-based applications in clinical practice. In particular, participants highlighted key aspects of AI product development to include clear clinical task definitions; well-curated data from diverse geographic, economic, and health care settings; standards and mechanisms to monitor model reliability; and transparency regarding model performance, both in controlled and real-world settings. For implementation, participants emphasized the need for strong institutional governance; systematic evaluation, selection, and validation methods conducted by local teams; seamless integration into the clinical workflow; performance monitoring and support by local teams; performance monitoring by external entities; and alignment of incentives through credentialing and reimbursement. Participants predicted that clinical implementation of AI in radiology will continue to be limited until the safety, effectiveness, reliability, and transparency of such tools are more fully addressed.

PERCEPTIONS OF FILIPINO PHYSICAL THERAPISTS ON TELE-ERGONOMICS: A PHENOMENOLOGICAL QUALITATIVE STUDY

Introduction: Tele-ergonomics is a telehealth service that shows great potential use given people’s growing reliance on the internet, highlighted during the COVID-19 pandemic. Studies have been conducted internationally regarding the implementation, feasibility, and efficiency of tele-ergonomics. As perceptions of physical therapists regarding this technology have not been explored in the Philippines, the objective of the study is to explore their perceptions on the practice. Methods: The study utilized a phenomenological design involving 10 licensed Filipino physical therapists selected through purposive sampling. Key informant interviews were conducted via Google Meet for data collection. The interview questions derived from Rosenstock’s Health Belief Model were self-made, semi-structured, and validated by two methodological experts. All interviews were audio-recorded, transcribed verbatim, coded, and analyzed for the emergence of patterns by thematic content analysis through manual coding using Google Sheets to group themes and subthemes. The data was consolidated into an in-depth analysis and was further proofread by all researchers. Results: Thematic content analysis yielded a total of 52 codes, further categorized into four major themes, namely: (1) emergence of tele-ergonomics; (2) practices of tele-ergonomics; (3) its outcomes; and (4) recommendations for the future of the practice. Discussion: The study found that tele-ergonomics is necessary with the rise of digitalization and provided recommendations for the continuity of tele-ergonomics. It highlighted the need for proper training to refine the skills of physical therapists. As digitalization opens up new avenues of learning and delivery of services, it is important to establish comprehensive training that incorporates a more in-depth assessment of digital aspects. Hence, readiness is contingent upon proper training. The data further emphasizes one’s control over their motivation, behavior, and efficacy in providing the services.