Open-ended Questions Research Articles

Does a participatory live music practice support nurses to deliver compassionate care to hospitalised patients? A qualitative study.

To gain more insight into how nurses experience a participatory live music practice in relation to their ability to deliver compassionate care to medically hospitalised patients. Qualitative interpretive design. Sixteen nurses participating in a live music practice with patients were interviewed using in-depth interviews with open-ended questions. Audio recordings were transcribed verbatim and subsequently coded. Theory-driven inductive and deductive approaches were applied in thematic data analysis. We identified four themes: (1) Nurses' empathy and compassion; (2) The caring nurse-patient relationship; (3) Person-centred approaches to care and (4) Nurses' subjective wellbeing. By observing patients' reactions to the music, nurses described that they obtained a deeper insight and understanding of patients' emotional wellbeing. These observations led to increased feelings of compassion in patient contact and stimulated informal communication between nurses and patients through a sense of shared humanity. According to nurses, these aspects positively affected collaboration with patients in delivering care and stimulated them to pursue person-centred approaches to care. Participating in the live music practice also positively affected nurses' wellbeing, enhanced relaxation and created an ambiance in which compassion could be expressed. A live music practice can positively contribute to the delivery of compassionate care by providing meaningful shared moments that increase feelings of empathy and compassion and strengthen the caring relationship. Offering a live music practice at the ward and bedside offers a unique possibility to enhance engagement in person-centred, compassionate care. While compassion and compassionate care are essential component of nursing, nurses often experience multiple barriers to its provision in daily practice. An innovative way to stimulate compassionate care is through the participation of nurses and patients in a live music practice, providing a meaningful moment shared between them. This stimulates feelings of shared humanity and bonding in the caring relationship. The COnsolidated criteria for REporting Qualitative research (COREQ). No Patient or Public Contribution.

Conceptualizing patient interactions eliciting empathy, compassion, reflection, and social projection: A model with analysis.

Conceptualizing the next patient interaction is logical, essential, and largely done intuitively with limited literature. The first objective is to elicit student thought experiences to four questions. The secondary objective is to classify responses for respective questions and to review faculty assessments. Forty-two students completed the exercise in the first clinical prosthodontics experience after a simulation course, in the fall of 2023. Four open-ended questions were 1) differentiation from the ideal, 2) desired outcome(s), 3) self-capabilities, and 4) consequences/prognosis. Nine different faculty assessed the exercise. 100% of students responded to all four questions and 83% of responses were judged by faculty to grasp the concept in the question. The authors categorized responses into natural categories for each question. Authors separately assigned responses to categories. The agreement rate was 90%. Little to no overlap in responses was observed among the four questions. The sequence of questions led students to thought experiences from empathy in Question #1, to compassion in Question #2, and to self-reflection in Question #3 to social projection in Question #4. The main objective was met by engaging students in thought-provoking responses to questions the experienced clinician asks of every patient encounter. The exercise elicited different kinds of thought experiences on four topics. The format was succinct with acceptance by students and faculty. The project has progressed from a concept some years ago to a recent pilot to full implementation with the current project. The next steps will be refinement and follow-up in some years. The project follows an emulation model for critical thinking.

Bridging Educational Grant in Nursing (BEGIN) students' intentions for retention in long-term, home and community care: A survey protocol.

Retention of nurses in long-term care (LTC) and home and community care (HCC) settings is a growing concern. Previous evidence underscores factors which contribute to nurses' intentions for retention in these sectors. However, perspectives of nursing students preparing to enter the workforce, and their intentions for short-term and long-term retention, remain unknown. This study aims to explore relationships between short-term and long-term intentions for retention with psychological empowerment, work engagement, career commitment, burnout, prosocial motivation, self-care and personal resilience among students enrolled in nursing educational bridging programs supported by the Bridging Educational Grant in Nursing (BEGIN) program in Ontario, Canada. This cross-sectional design study will use an open online survey to investigate perspectives of current nursing students enrolled in educational bridging programs on factors relating to psychological empowerment, work engagement, career commitment, resilience, burnout, prosocial motivation, self-care and intentions for retention. Additionally, the survey will collect demographic information, including age, gender, ethnicity, citizenship, income, family status, nursing role, and years of employment and/or education. Open-ended questions will elicit participants' perspectives on financial considerations for career planning and other factors impacting intentions for retention. Descriptive data will be presented for contextualisation of participants' demographic characteristics to enhance generalisability of the cohort. Descriptive statistics will be used to summarise participants' scores on various assessment measures, as well as their short-term and long-term intentions for retention in LTC and HCC after completion of BEGIN. A Pearson's product moment r correlation will determine relationships between intentions for retention and other measures, and linear regression will determine whether any potential correlations can be explained by regression. This research protocol received ethical approval from a research-intensive university research ethics board (#123211). Findings will be disseminated to nursing knowledge users in LTC and HCC through publications, conferences, social media and newsletters.

Generalist, specialist, or expert in palliative care? A cross-sectional open survey on healthcare professionals' self-description.

In the Netherlands, palliative care is provided by generalist healthcare professionals (HCPs) if possible and by palliative care specialists if necessary. However, it still needs to be clarified what specialist expertise entails, what specialized care consists of, and which training or work experience is needed to become a palliative care specialist. In addition to generalists and specialists, 'experts' in palliative care are recognized within the nursing and medical professions, but it is unclear how these three roles relate. This study aims to explore how HCPs working in palliative care describe themselves in terms of generalist, specialist, and expert and how this self-description is related to their work experience and education. A cross-sectional open online survey with both pre-structured and open-ended questions among HCPs who provide palliative care. Analyses were done using descriptive statistics and by deductive thematic coding of open-ended questions. Eight hundred fifty-four HCPs filled out the survey; 74% received additional training, and 79% had more than five years of working experience in palliative care. Based on working experience, 17% describe themselves as a generalist, 34% as a specialist, and 44% as an expert. Almost three out of four HCPs attributed their level of expertise on both their education and their working experience. Self-described specialists/experts had more working experience in palliative care, often had additional training, attended to more patients with palliative care needs, and were more often physicians as compared to generalists. A deductive analysis of the open questions revealed the similarities and distinctions between the roles of a specialist and an expert. Seventy-six percent of the respondents mentioned the importance of having both specialists and experts and wished more clarity about what defines a specialist or an expert, how to become one, and when you need them. In practice, both roles were used interchangeably. Competencies for the specialist/expert role consist of consulting, leadership, and understanding the importance of collaboration. Although the grounds on which HCPs describe themselves as generalist, specialist, or experts differ, HCPs who describe themselves as specialists or experts mostly do so based on both their post-graduate education and their work experience. HCPs find it important to have specialists and experts in palliative care in addition to generalists and indicate more clarity about (the requirements for) these three roles is needed.

Erotic Imagination in Latin America: Reflections on Sexual Fantasies and Coloniality.

Latin America comprises 20 countries and 14 dependent territories throughout the Western Hemisphere. It is a diverse and plural region in terms of its geography, cultures, languages, and historical experiences, with fifteenth-century colonialism as a common denominator. Two areas in which the lingering effects of coloniality seem clearly ever-present are the realms of gender and sexuality. The latter encompasses sexual fantasies, a subject of focus in this article. The examination of sexual fantasies remains a ripe area for future research, particularly throughout the Global South, where its linkages to coloniality should be explored in detail. To contribute to this larger and long-term goal, we implemented an online qualitative study designed to document the sexual fantasies of Spanish-speaking individuals living in the Latin American region. We developed a data-gathering form that included open-ended questions to document sexual fantasies. The form was available through the JotForm online platform that was linked to the study webpage entitled "A Calzón Quita'o." We conducted a thematic analysis to identify response patterns. Three main categories emerged from: (1) spatiotemporal references, (2) multiple partners, and (3) power, control, and rough sex. We relied on perspectives linked to ongoing discussions about coloniality to analyze the thematic content in the participants' responses regarding their sexual fantasies. The findings highlight the existing tensions between the reproduction of-and resistance to-the norms associated with gender roles and their embodiment within the framework of the gender binary inherited from coloniality.

Content of a wound care mobile application for newly graduated nurses: an e-Delphi study.

Wound care represents a considerable challenge, especially for newly graduated nurses. The development of a mobile application is envisioned to improve knowledge transfer and facilitate evidence-based practice. The aim of this study was to establish expert consensus on the initial content of the algorithm for a wound care mobile application for newly graduated nurses. Experts participated in online surveys conducted in three rounds. Twenty-nine expert wound care nurses participated in the first round, and 25 participated in the two subsequent rounds. The first round, which was qualitative, included a mandatory open-ended question solicitating suggestions for items to be included in the mobile application. The responses underwent content analysis. The subsequent two rounds were quantitative, with experts being asked to rate their level of agreement on a 5-point Likert scale. These rounds were carried out iteratively, allowing experts to review their responses and see anonymized results from the previous round. We calculated the weighted kappa to determine the individual stability of responses within-subjects between the quantitative rounds. A consensus threshold of 80% was predetermined. In total, 80 items were divided into 6 categories based on the results of the first round. Of these, 75 (93.75%) achieved consensus during the two subsequent rounds. Notably, 5 items (6.25%) did not reach consensus. The items with the highest consensus related to the signs and symptoms of infection, pressure ulcers, and the essential elements for healing. Conversely, items such as toe pressure measurement, wounds around drains, and frostbite failed to achieve consensus. The results of this study will inform the development of the initial content of the algorithm for a wound care mobile application. Expert participation and their insights on infection-related matters have the potential to support evidence-based wound care practice. Ongoing debates surround items without consensus. Finally, this study establishes expert wound care nurses' perspectives on the competencies anticipated from newly graduated nurses.

유아기 자녀를 둔 부모공감능력의 의미와 구성요인에 관한 델파이 연구

Objectives This study aims to clarify the meaning of parental empathy ability using the Delphi technique and to derive constituent and sub-factors. Methods To this end, the concept of parental empathy ability was defined through preceding research and liter-ature review, and the structuring factors of the ability were derived. An expert Delphi survey was conducted using the derived data to confirm the exploratory study of deriving the components of parental empathy ability. The data analysis method of the first Delphi survey questionnaire was conducted in order to define the concept of parental empathy and derive the structuring factors. A structured questionnaire, free-choice and open-ended questions were conducted with 13 experts in order to confirm the content validity. Using SPSS 25.0, the average value, standard deviation, skewness, agreement, convergence, and CVR ranges of each variable were calculated, and questions that did not meet each criterion were modified and deleted. Since the number of panels participating in the Delphi survey in this study is 13, if the CVR value is .554 or higher, it can be judged that the content validity is valid. The contents, were revised and supplemented with the experts, used to construct the second Delphi survey. It was used to construct the second questionnaire by reflecting the opinions of experts and revising and supplementing the contents. The second survey tool were gathered from the responses of the first survey. In or-der to clarify the opinions of each panel, structured questions with a 5-point rating scale were presented. Results First, the area of the scale consisted of three areas: ‘emotional empathy ability’, ‘cognitive empathy abil-ity’, and ‘behavioral empathy ability’, ‘emotional empathy ability’ consisted of perspective acceptance, cognitive empathy, and perspective acceptance, ‘cognitive empathy ability’ consisted of emotional response, emotional al-location, and emotional perception, and ‘behavioral empathy ability’ consisted of pseudo-movement, expression consistency, listening, and relationship formation. Conclusions The study is significant in that it derives categories and sub-factors of parental empathy ability that have recently come into focus. Furthermore, the study is significant in that it can be used as basic data for deriving the question composition through focus group interviews in the future.

팀 빌딩 비주얼 싱킹을 활용한 현대 소설 수업이 고등학교 남학생의 국어 수업에 미치는 영향

Objectives The purpose of this study is as follows. First, what perceptions do learners have about Korean language (modern novel) classes? Second, what are the responses of learners who have used team building visual thinking in all modern novel classes? Third, what is the effect of modern novel classes using team building visual thinking on learners' interest, confidence, attitude, and anxiety? The purpose of this study was to empirically verify the ef-fect on Korean language classes through the experience of modern novel classes using team building visual sink-ing for students in five classes in the second year of Y High School in Seoul. Methods The class was conducted for second-year students at Y High School in Seoul, data was collected through worksheets and questionnaires to analyze the results. The questionnaires were divided into a pre-test and a post-test after review by experts (one Korean language professor and two doctors of education), and a survey was conducted to examine the students' reactions to modern novel classes using team building visual thinking. The survey results were analyzed with descriptive statistics using SPSS 28.0, and open-ended questions and worksheets were analyzed. Results Team building visual thinking classes provided an opportunity for learners, who deeply understood the work, to express their thoughts and impressions visually and then communicate and share their opinions with oth-er learners. This enhanced learners' understanding of the novel while improving their creative thinking, expression skills, and teamwork skills. In addition, team building visual thinking was effective in increasing their learning mo-tivation, thereby making the classes more active. Conclusions Team building visual thinking classes helped build a collaborative learning environment through ac-tivities that team members do together, from idea visualization to idea sharing and feedback. This served as an opportunity to lay the foundation for teaching and learning that can actively respond to changes in education: digi-tal transformation. In particular, this study is significant in that it is a new attempt to utilize team building visual thinking in modern novel classes according to the 2022 Revised National Curriculum.

Navigating the complex dynamics of anesthesiologists’ professional identity formation in the context of their specialty training program: a phenomenographic perspective

BackgroundA specialty training program is crucial for shaping future specialist doctors, imparting clinical knowledge and skills, and fostering a robust professional identity. This study investigates how anesthesiologists develop their professional identity while navigating unique challenges specific to their specialty. The formation of professional identity in anesthesiology significantly influences doctors’ well-being, teamwork, and ultimately patient care, making it a crucial aspect of anesthesiology education. Utilizing a phenomenographic approach, the research explores the learners’ personal experiences and perspectives of professional identity formation in their specialty training programs, providing valuable insights for enhancing future anesthetic educational programs.MethodThe data for this phenomenographic study were collected through semi-structured interviews with anesthesiology trainees and specialists, guided by open-ended questions. The interviews were conducted at a Swedish university hospital, and participant selection used purposive sampling, providing rich and diverse data for analysis after 15 interviews. Iterative analysis followed the seven-step phenomenographic approach. The research team, comprising qualitative research and anesthesiology education experts, ensured result validity through regular review, discussion, and reflective practices.ResultsThe study reveals three fundamental dimensions: ‘Knowledge of Subject Matter,’ ‘Knowledge of Human Relations,’ and ‘Knowledge of Affect.’ These dimensions offer insights into how anesthesiologists comprehend anesthesiology as a profession, navigate interactions with colleagues and patients, and interpret emotional experiences in anesthesiology practice – all crucial elements in the formation of professional identity. The findings could be synthesized and further described by three conceptions: The Outcome-Driven Learner, the Emerging Collaborator, and the Self-Directed Caregiver.ConclusionThe study uncovers differing learner understandings in the development of anesthesiologists’ professional identity. Varying priorities, values, and role interpretations highlight the shortcomings of a generic, one-size-fits-all educational strategy. By acknowledging and integrating these nuanced learner perspectives, as elucidated in detail in this study, the future of anesthesia education can be improved. This will necessitate a holistic approach, intertwining both natural sciences and humanities studies, focus on tacit knowledge, and flexible teaching strategies, to guarantee thorough professional development, lifelong learning, and resilience.

Identifying key beliefs underlying QR code check-in and compliance behaviours in the COVID-19 pandemic.

The implementation of quick response (QR) code check-in compliance behaviour during the COVID-19 pandemic featured in infection control strategies in several global jurisdictions, but was of particular interest in the Australian context, where it became mandated on a nationwide scale. We aimed to identify the salient beliefs people hold toward complying with the QR code check-in using a Theory of Planned Behaviour belief-based framework. An elicitation study using open-ended questions (Queensland; N = 93, Mage = 4.77 years, SD = 13.62 and Victoria; N = 76, Mage = 44.92 years, SD = 11.63) and a prospective correlational study using a two-wave online survey (Queensland; N = 290, Mage = 38.99, 46.6% female and Victoria; N = 290, Mage = 38.27, 53.4% female) were conducted. Qualitative data were coded through an iterative content analysis, while quantitative data were analysed using linear multiple regression. Behavioural, normative and control beliefs were associated with intention and behaviour in both samples. Variation in beliefs across the states also were observed. Across both samples, beliefs in positive outcomes consistently exhibited stronger associations with both intention and behaviour than the reported negative outcomes. Distinct differences emerged between the two samples in terms of regression effects. SO WHAT?: Results indicate individual experience may affect the beliefs which guide behaviour, supporting the potential efficacy of health promotion campaigns tapping into context specific beliefs and experiences if QR code check-in is to be implemented as an infection control measure in future.

The Provision and Perceptions of Telemedicine Services Among Traditional Chinese Medicine Practitioners During COVID-19: A Cross-Sectional Study in Hong Kong, China.

Objectives: Telemedicine has been widely used during the COVID-19 pandemic. Among other health care professionals, Chinese medicine practitioners (CMPs) face practical challenges in providing telemedicine consultations. This study aims to explore CMPs' experience and perceptions of telemedicine service provision before and during the pandemic. Methods: A territory-wide cross-sectional online survey was conducted in Hong Kong between April and May 2022. A structured questionnaire with open-ended questions was used to investigate the provision of and perception on telemedicine service, as well as usability of telemedicine among CMPs. Results: A total of 195 CMPs participated the survey. Before COVID-19, 42% (81/195) had been providing telemedicine services, and the proportion doubled during COVID-19. CMPs in the private sector are the main providers. Mobile apps including WhatsApp, WeChat, and Zoom were commonly used for consultations (75%, 120/161). Barriers in providing telemedicine included inability of conducting physical examination on patients (69%, 134/195), legal and ethical concerns over medical negligence (61%, 118/195), and patients' incompetence on e-literacy (50%, 98/195). Respondents urged professional and regulatory bodies to provide an explicit clinical guideline that demonstrate best practice in traditional Chinese medicine telemedicine, and to clarify legal and ethical implications of such practice. Conclusions: CMPs demonstrated their competency in telemedicine, and most of them provided telemedicine during COVID-19. Development of appropriate guidelines on the provision of telemedicine would support CMPs to continue provision after the pandemic, whereas a user-friendly and comprehensive telemedicine e-platform would enhance quality of such service. Facilitating patients with lower e-literacy to access telemedicine is key to reduce disparities.

A longitudinal study of breastfeeding relationships at home during the COVID-19 pandemic: A grounded theory method.

To describe the process of breastfeeding relationships among stay-at-home mother and infant dyads at 1, 3, 5 and 6 months. A longitudinal qualitative online survey design was used. Data were obtained at 1, 3, 5 and 6 months from 26 breastfeeding mothers who stayed home with their infants and directly breastfed at least once a day for the first 6 months between June 2022 and August 2023. Mothers' written responses to 3 open-ended questions were analysed to assess breastfeeding experiences at home, thoughts/comments while directly breastfeeding and breastfeeding concerns/problems and strategies they used. Based on grounded theory, inductive content analysis was used to analyse the data. Trustworthiness of results was established by coding to consensus, formal peer debriefing and maintaining an audit trail. 'Breastfeeding Relationships at Home,' the core construct, was identified and organized the process of breastfeeding relationships into 5 domains: (1) mothers' emotional well-being while breastfeeding, (2) infant-led feeding, (3) alternatives to breastfeeding, (4) evaluation of breastfeeding and (5) changes in breastfeeding as infants grow older. Breastfeeding is not simply about feeding breast milk but also involves nurturing and developing a relationship between mother and infant. Across the domains, mutual responsiveness, a central element of the breastfeeding relationship was clear. Mothers who were committed to breastfeeding with embedded infant suckling reached emotional well-being in return for their engagement which has potential to reduce maternal stress and prevent postpartum depression. Findings from the current study add to nurses' knowledge about the relationship building process between stay-at-home mothers and their infants in the first 6 months of breastfeeding during the COVID-19 pandemic. Nurses must remain sensitive to aid the development of breastfeeding relationships in the home environment to maximize mutual responsiveness. No patients or public involved.

Patient and Caregiver Satisfaction With the Brain Injury Rehabilitation: Improving the Transition Experience (BRITE) Intervention.

To ascertain patient and caregiver satisfaction with an individualized case management intervention to improve transition from inpatient rehabilitation care to the community after traumatic brain injury (TBI). Participants from 6 National Institute on Disability, Independent Living, and Rehabilitation Research-funded TBI Model Systems sites in the United States. Adult, English-speaking patients with TBI who had moderate-to-severe TBI and were discharged from a TBI Model Systems site and who were in the intervention arm of the Brain Injury Rehabilitation: Improving the Transition Experience pragmatic clinical trial, as well as their caregivers. A survey of participants in the intervention arm, which included an individualized case management program administered by a TBI Care Manager (TCM) who facilitated resource connection, education, and support. Satisfaction with intervention was measured through Likert-scaled and open-ended questions. The survey was administered verbally through telephone, audio-recorded, and transcribed. Descriptive statistics were calculated for categorical variables, and content analysis was conducted for open-ended responses. Patient and caregiver participants were satisfied with the intervention and highlighted the benefits of the interpersonal and practical support provided by the TCM. Participants identified the need for a more intensive intervention and clear expectations of the TCM role, as well as gaps in available medical and rehabilitation services in the community, as areas for improvement. Patients with TBI and their caregivers reported satisfaction with the individualized case management program in supporting their transition from inpatient rehabilitation to the community. Further research is needed to understand the impact on outcomes.

Aboriginal and Torres Strait Islander community members’ experiences of care in an urban Aboriginal Community Controlled Health Service transforming to a Patient Centred Medical Home

Background Few studies have examined patient experiences of the Patient Centred Medical Home (PCMH). This qualitative study explores the experiences of patients of an urban Aboriginal Community Controlled Health Service during its transition to a model of a PCMH. Methods Twenty-eight community members who were registered as patients of an urban Aboriginal Community Controlled Health Service were purposively recruited to participate in yarning interviews. Yarns were conducted using a guide containing open-ended questions in the same domains as those used in patient satisfaction surveys at the participating clinic. Data from yarns were analysed by Aboriginal and non-Indigenous researchers using thematic analysis. The interpretations of Aboriginal and Torres Strait Islander researchers were privileged in the analysis. Results Key themes highlighted the importance of relationships, connectedness, and personal growth and empowerment to community members’ health and wellbeing, which they described as a journey of healing and recovery. Delays in implementing a process to empanel patients in a care team meant that most community members were unaware a PCMH had been implemented. However, community members commonly reported a more welcoming environment, more contact with the same doctor and more involvement of Aboriginal Health Workers in their care. Conclusions Aboriginal and Torres Strait Islander community members’ narratives of their experiences bear evidence of the acceptability of a PCMH model for delivery in Aboriginal Community Controlled Health Services to improve relational care between patients and health staff. A patient-directed empanelment process has been implemented to better connect patients to their care team in the clinic, and the role of the Aboriginal Health Worker reshaped to strengthen connections between patients and their care team in and outside the clinic.

The pandemic and working mothers: perspectives from American and South African working mothers

The purpose of the current study was to examine the effects of the COVID-19 pandemic on working mothers from the United States and South Africa. This study sought to highlight both cross-cultural similarities and differences. American and South African working mothers took part in online interviews. Eighteen participants were included in the sample, ten participants lived in the United States, while eight participants currently resided in South Africa. The age range of the participants’ children was from 0 to 21 years old. Each participant met individually with the researcher and answered a series of open-ended questions regarding their experiences of being a working mother during the COVID-19 pandemic. Researchers analyzed interviews using thematic analysis. Common themes emerged in the interviews with both American and South African working mothers. Mothers in the United States and South Africa both noted the need for flexible work schedules as well as expressed difficulty balancing roles as mothers and professionals during the pandemic. Increased motivation and resiliency as well as lack of representation of women leaders were themes specific to South African mothers in this study. Conversely, feelings of decreased interest in pursuing leadership opportunities was a theme specific to American mothers in this study. The current study adds to the growing body of literature documenting the effect of the pandemic on working mothers, and builds on this research by including a qualitative component to gain knowledge from working mothers themselves. The narratives collected in the current study highlight commonalities as well as differences in the experiences of working mothers in the United States and South Africa, which holds important implications for how workplaces and the broader community can best attend to the unique needs of working mothers.

Delivering the diagnosis of multiple system atrophy: a multicenter survey on Japanese neurologists’ perspectives

BackgroundMultiple system atrophy (MSA) is a progressive, incurable, life-threatening neurodegenerative disease uniquely characterized by the risk of sudden death, which makes diagnosis delivery challenging for neurologists. Empirical studies on breaking a diagnosis of MSA are scarce, with no guidelines currently established. This study aimed to investigate neurologists’ current practices and experiences in delivering the diagnosis of MSA.MethodsWe conducted a multicenter online survey and employed a mixed-methods (quantitative and qualitative) study design in which responses to open-ended questions were analyzed qualitatively using critical incident technique.ResultsAmong the 194 neurologists surveyed, 166 opened the survey (response rate = 85.6%), of whom 144 respondents across various Japanese regions completed the survey. Accordingly, 92.3% and 82.8% of the participating neurologists perceived delivering the diagnosis of MSA and explaining the risk of sudden death as difficult, respectively. Factors independently associated with difficulties in diagnosis delivery included explaining the importance of the family decision making process in life-prolonging treatment, perceived difficulties in delivering information regarding the risk of sudden death, and perceived difficulties in differential diagnosis of MSA.ConclusionsOur findings showed that the majority of neurologists perceived delivering the diagnosis of MSA and explaining the risk of sudden death as difficult, which could have been associated with the difficulty of breaking the diagnosis of MSA. Difficulty in conveying bad news in MSA are caused by various factors, such as empathic burden on neurologists caused by the progressive and incurable nature of MSA, the need to explain complex and important details, including the importance of the family decision-making process in life-prolonging treatment, difficulty of MSA diagnosis, and communication barriers posed by mental status and cognitive impairment in patients or their family members. Neurologists consider various factors in explaining the risk of sudden death (e.g., patient’s personality, mental state, and degree of acceptance and understanding) and adjust their manner of communication, such as limiting their communication on such matters or avoiding the use of the term “sudden death” in the early stages of the disease. Although neurologists endeavor to meet the basic standards of good practice, there is room for the multiple aspects for improvement.

Application and Challenges of the Technology Acceptance Model in Elderly Healthcare: Insights from ChatGPT

The Technology Acceptance Model (TAM) plays a pivotal role in elderly healthcare, serving as a theoretical framework. This study aimed to identify TAM’s core components, practical applications, challenges arising from its applications, and propose countermeasures in elderly healthcare. This descriptive study was conducted by utilizing OpenAI’s ChatGPT, with an access date of 10 January 2024. The three open-ended questions administered to ChatGPT and its responses were collected and qualitatively evaluated for reliability through previous studies. The core components of TAMs were identified as perceived usefulness, perceived ease of use, attitude toward use, behavioral intention to use, subjective norms, image, and facilitating conditions. TAM’s application areas span various technologies in elderly healthcare, such as telehealth, wearable devices, mobile health apps, and more. Challenges arising from TAM applications include technological literacy barriers, digital divide concerns, privacy and security apprehensions, resistance to change, limited awareness and information, health conditions and cognitive impairment, trust and reliability concerns, a lack of tailored interventions, overcoming age stereotypes, and integration with traditional healthcare. In conclusion, customized interventions are crucial for successful tech acceptance among the elderly population. The findings of this study are expected to enhance understanding of elderly healthcare and technology adoption, with insights gained through natural language processing models like ChatGPT anticipated to provide a fresh perspective.

Unleashing the Potential of TikTok: Exploring the Power of Mobile in Enhancing English Speaking Skills

The swift advancement of social media programs has facilitated their incorporation into language teaching. This study sought to examine the impact of the TikTok application on improving English language speaking abilities and learner independence in a cohort of 15 female English language students at the University of Jeddah, Khulais branch. A qualitative research methodology was employed to ascertain the students' perceptions regarding the efficacy of utilizing the TikTok application for enhancing their English language proficiency. This study utilized data collection and interviewing approaches to get information from a sample of pupils. An online survey was conducted utilizing a mixed method approach, which included both closed- and open-ended questions. The results demonstrated a beneficial effect of using the application for educational purposes on students' speaking abilities. Moreover, most participants indicated that their vocabulary range expanded and their pronunciation improved as a result of engaging with TikTok video content. Furthermore, it was observed that the application played a role in enhancing self-assurance in English communication.

First Year Students’ Perceptions of the Transition to University: The Role of Informational, Instrumental, and Emotional Support

First Year Students’ Perceptions of the Transition to University: The Role of Informational, Instrumental, and Emotional Support

Decentralized Governance and the Performance of Garissa County, Kenya

Devolution is the strongest form of governance decentralization. Devolution involves rescaling of responsibilities or powers from the national to the regional political organization. The actual form and politics of such rescaling will vary substantially between states, however, amounting to a radical transfer of powers and resources in some cases and a more modest and rhetorical shift of responsibility and service delivery in others. The conceptual scope of this study will be limited to four governance structures variables namely financial decentralization, administrative decentralization, political decentralization and citizen participation. This study targeted staff of Garissa County and were composed of senior managers, middle level managers and operational staff. The study employed descriptive survey design. The researcher used questionnaires as research instruments to collect data to the study. The study adopted both primary and secondary data analysis research design. Primary data was collected using semi structured questionnaires containing both closed and open-ended questions to allow variety. The quantitative data was analyzed using descriptive statistics. In addition, the study used multiple regression analysis to analyze the data. From the study findings, this study concluded that administration decentralization has a significant and a positive effect on the performance of Garissa County. The study also concluded that political decentralization has a significant and a positive effect on the performance of Garissa County. From the findings, the study further concluded that financial decentralization had significant and a positive effect on the performance of Garissa County. The study finally concluded that citizen participation had a significant and positive effect on the performance of Garissa County. The study recommended that the government should increase county government autonomy to promote administrative decentralization. The study also recommended that national and county governments should put in place measures to safeguard the independence of political decentralization. The study further recommended that national and county governments should put in place a set of deliberate and proactive processes, policies and structures that support financial decentralization. Finally, the study recommended that county governments should improve citizen participation practices to ensure citizen involvement in governance.