Synchronous technology-mediated service experience: conceptualization, scale development, and validation

How AI-driven chatbots shape customer satisfaction and loyalty to chatbot usage in digital service experience

Customer satisfaction represents a critical indicator of service performance and organizational sustainability in service-based industries. In the electric vehicle charging services, customer satisfaction not only reflects customers evaluative judgments of service encounters but also determines their intention to continue usage and maintain long-term relationships with the provider. This study examines the interconnections among service quality, perceived value, customer experience, trust, and customer satisfaction at SPKLU UB Disyan PLN Batam. The population of this study consists of the people of Batam City, particularly users of the SPKLU UB Disyan PLN Batam service. The study aims to analyze the influence of service quality, perceived value, and customer experience on customer satisfaction, with trust serving as a mediating variable. This research employed a quantitative approach using survey data collected from 155 respondents selected through nonprobability purposive sampling, namely customers who had used the SPKLU service within the last six months. This sampling technique is appropriate because the study requires respondents who have direct experience with SPKLU services, ensuring that the data collected are relevant and reflective of actual service evaluations. Purposive sampling is widely used in service research where specific criteria are necessary to obtain valid and meaningful insights. Data were analyzed using Structural Equation Modeling–Partial Least Squares. The results indicate that service quality, perceived value, and customer experience have positive and significant effects on customer satisfaction. These findings emphasize the importance of enhancing service performance and building customer trust to improve customer satisfaction in electric vehicle charging services in Batam City.

Background: Patient satisfaction is a key indicator of quality and responsiveness in maternal health services, particularly in antenatal and postnatal care where women's perceptions strongly influence utilisation, continuity of care and health outcomes. India has witnessed substantial progress in institutional maternal care, yet disparities persist in provider communication, interpersonal behaviour, facility readiness and respect for women's preferences. Understanding user satisfaction at the tertiary-care level remains essential for improving service delivery, strengthening respectful maternity care and reducing inequalities in maternal experience. This study was undertaken to assess satisfaction levels among antenatal and postnatal mothers accessing comprehensive obstetric services in a tertiary care centre. Methods: A hospital-based cross-sectional study was conducted among 100 antenatal and postnatal women aged 18–38 years. Participants were selected using consecutive sampling. Data were collected using a pretested structured questionnaire adapted from PSQ-18 and WHO responsiveness domains. Satisfaction was measured across communication, respect and dignity, clinical care, waiting time, cleanliness and overall organisation using a 5-point Likert scale. Scores ≥4 denoted high satisfaction. Socio-demographic variables were analysed to assess associations using Chi-square and Fisher's exact tests, with p<0.05 considered significant. Results: The mean age of participants was 27.4±4.2 years; 68% were urban residents and 52% had secondary/higher secondary education. Overall, 88% reported high satisfaction. Communication and counselling achieved the highest score (4.5±0.5, 95%), followed by respect, dignity and privacy (4.4±0.5, 92%) and clinical care (4.3±0.6, 89%). Cleanliness scored comparatively lower (4.1±0.7, 85%). Socio-demographic factors significantly influenced satisfaction: age (p=0.027), education (p=0.002) and residence (p=0.029). Urban and better-educated women reported substantially higher satisfaction. Satisfaction did not differ significantly between antenatal and postnatal women across all domains (p>0.05). Conclusion: Satisfaction with antenatal and postnatal services was high, reflecting strong performance in communication, respectful care and clinical competence. However, variations based on education and residence indicate persistent inequities requiring targeted strategies. Improving cleanliness and strengthening rural patient engagement may further enhance service experience. Routine assessment of user perspectives is essential for sustaining patient-centred maternity care and guiding quality improvement interventions.

Purpose The metaverse represents an emerging service platform offering advanced assistive technologies, accessible settings and opportunities for inclusive participation. It has the potential to significantly enhance the participation, self-expression and engagement of people with disabilities (PWD) in digital service environments. This study aims to address a significant gap in services marketing literature by investigating how desired self-identity (DSI) expression influences PWD’s perceived usefulness of the metaverse platform and perceived advertising value within the service environment and how advertising value as a service touchpoint affects disability acceptance. Design/methodology/approach A quantitative research design was used. Data were gathered through an online survey completed by 437 PWD users of metaverse service platforms in the UK. Findings The findings demonstrate that when PWD achieve DSI expression through brands in the metaverse, they perceive both the service platform as more useful and service-embedded advertising as more valuable. Perceived service usefulness also positively influences perceived advertising value, which, in turn, positively affects disability acceptance. Originality/value This study contributes to services marketing scholarship by extending self-congruity theory into immersive virtual service environments, demonstrating how self-brand congruence mechanisms operate within digital service platforms. By examining the relationships between DSI, perceived service usefulness, advertising value as a service touchpoint and acceptance of disability, it offers new insights into how inclusive service design in virtual environments can enhance well-being for vulnerable consumers. The study advances transformative service research by demonstrating how service experiences, including service-embedded advertising, influence the psychological well-being of PWD.

Purpose In today’s burgeoning platform-based business landscape, firms frequently outsource major components of their services to third-party providers. This shift makes it crucial to understand how a firm’s actions impact customer experiences at these third-party touchpoints. This research aims to explore the impact of a firm’s signaling interventions, through badges, on the spillover of customer experience evaluations from third-party providers to the firm, within the context of access-based services. Design/methodology/approach This study used a multiphased experimental approach through four distinct studies, whereby the authors used between-subjects designs. Studies 1A and 1B, for example, examine the impact of satisfying versus dissatisfying service encounters on platform evaluations, manipulated through scenarios within an on-demand hair salon app context. Study 2 investigates the underlying mechanisms of spillover effects, while Study 3 focuses on the moderating roles of consumers’ risk attitudes and perceived provider-platform independence. Finally, Study 4 replicates the findings of Studies 1A and 1B, albeit in a different context (on-demand laundry platform services). Findings Through the experimental studies, the authors observe that negative experiences with signaled providers result in significantly lower evaluations of the platform, and demonstrates a greater spillover effect than experiences with nonsignaled providers. However, these differential spillover effects are not observed in cases of positive experiences. In addition, our results reflect that perceived cognitive consistency mediates these effects between the platform’s claims and the third-party provider’s service. Broadly, the findings suggest that these effects are moderated by consumers’ risk aversion and their perception of provider-platform independence. Research limitations/implications Future studies could examine spillover effects in multiplatform scenarios, the impact of diverse signaling types (provider credentials, platform guarantees, customer reviews) and the role of information transparency on consumer evaluations. In addition, understanding the long-term impacts of service experiences on platform evaluations could offer insights into whether observed effects are transient or enduring, guiding strategic platform management. Practical implications Findings recommend a cautious approach in promoting specific providers to avoid potential negative effects on consumer perceptions after unsatisfactory service experiences. Highlighting the importance of effective service recovery strategies, this research underscores their necessity in addressing negative experiences with highlighted providers. Furthermore, it suggests platforms should work to lessen the perceived overlap between the platform and its providers, improving consumer perceptions through consistent branding and joint initiatives. For new ABS platforms, building a strong overall reputation is emphasized as critical to mitigating the impact of early negative consumer experiences. Originality/value This study reveals the asymmetric consequences of a firm’s signaling efforts, and provides crucial insights for firms in their choice of badges as signaling strategies to enhance customer experience and maintain firm reputation.

Purpose: This study aims to analyze the impact of service quality, on-time performance, and promotions on the repurchase intention of low-cost carrier (LCC) users, both directly and indirectly, through brand image as a mediating variable. Methodology/approach: A qualitative descriptive approach with a literature review was used. Data were collected from internationally indexed articles in databases such as Scopus, Web of Science, and Google Scholar. The selected literature was analyzed using data reduction techniques, data presentation in matrix form, and comparative synthesis to identify patterns and differences between the relevant studies. Results: The results show that service quality, on-time performance, and promotions influence repurchase intention among LCC users, either directly or through brand image. Brand image has been proven to act as a mediating variable that strengthens the relationship between operational and marketing factors and the repeat purchase. Conclusions: This study confirms that the competitive advantage of LCC is determined not only by price but also by brand perception built through user service experiences. Brand image plays a significant role in enhancing repurchase intentions. Contribution: This study contributes to the theoretical understanding of consumer behavior in the airline industry, particularly in explaining the role of brand image as a mediating mechanism between service quality, time performance, promotions, and repurchase intention. Limitation: The limitation of this study lies in the use of a literature review method, which does not involve direct empirical testing of primary data from airline passenger.

Maternal health during the perinatal period is a global public health priority. While antenatal education is widely implemented, conventional lecture-based models often fail to achieve sustained behavior change. Innovative approaches that integrate experiential learning with digital support may enhance maternal knowledge, self-management, and pregnancy outcomes. The aim of this study is to evaluate the feasibility and preliminary effectiveness of a combined experiential class and online logging intervention for pregnant women in China and to explore the mechanisms underpinning its impact on health practices and service experiences. A mixed methods design was used in a district-level maternal and child health hospital in Beijing. In the quantitative arm, 40 women (intervention group, n=20; control group, n=20) were enrolled in a quasi-experimental comparison. Outcomes included knowledge-attitude-practice indicators, service satisfaction, and clinical birth outcomes. Given the limited sample size, a qualitative arm was conducted to complement statistical findings: semistructured interviews with 20 women (10 per group) were analyzed thematically. Quantitative and qualitative results were integrated during interpretation to provide a comprehensive evaluation. Compared with the experiential class alone, the combined intervention was associated with higher knowledge scores (mean difference 1.6 points, 95% CI 0.8-2.4), stronger adherence to recommended health practices (composite adherence score difference 1.0, 95% CI 0.4-1.6), and higher overall service satisfaction (mean difference 0.6, 95% CI 0.2-1.0). Across multiple domains, a higher proportion of participants in the intervention group met dietary, exercise, and supplementation recommendations. Clinical outcome differences were exploratory, as the study was not powered for these end points. Qualitative analysis revealed 3 mechanisms, such as empowerment and self-efficacy, practice and persistence, and systemic/environmental support, through which the intervention influenced experiences and practices. The experiential class plus online logging model is feasible and acceptable in a real-world antenatal setting. Although limited by a small sample size, findings suggest that the intervention improves maternal knowledge, health practices, and service experiences and may inform future adequately powered trials to evaluate pregnancy outcomes. Qualitative insights highlight mechanisms of health practice change and provide contextual depth, underscoring the value of mixed methods designs in maternal health research.

Purpose Hospitality research tends to be concerned with linking the intangible, social and emotional aspects of consumer behaviour predominantly to luxury services, whereas for low-cost services the link is mainly to financial concerns. Building on the Value Attitude Behaviour Model and Consumption Value Theory, this study aims to investigate the effect of personalisation on guests' value perceptions of budget hotels – a growing yet often overlooked accommodation segment – and how consumption values impact upon behavioural intentions through the mediators of attitude and memorability. Design/methodology/approach Four value perceptions were included in the analysis – financial value, functional value, hedonic value and social value – each representing a different aspect of customer value. The analysis employed partial least-squares structural equation modelling, with online questionnaires used to capture the views of 264 guests of budget hotels. Findings Contrary to expectations, the findings emphasise the importance of hedonic value, rather than functional or financial value, in forming guests' attitude and memorability. Social value, meanwhile, was not found to be a significant determinant either of attitudes or memorability, suggesting that individual, rather than social motives, tend to be the generators of value for guests of budget hotels. Practical implications Those who market budget hotels should put more emphasis on personalising the experience for their guests. This will help to ensure that guests receive more than just a reasonably priced, functionally adequate stay. The study also demonstrates the importance of positive attitudes in determining revisit intentions to the hotel. This implies that delivering a memorable experience is not the only, or necessarily the optimal, marketing strategy for budget hotels. Originality/value While previous research had predominantly linked personalisation with luxury and up-scale experience of products and services, the present study examines personalisation in the budget hotel context. Beyond the contextual distinctiveness of the budget hotel setting, this study is among the first to employ a value-based analytical framework to empirically show that, within this industry, personalisation results in hedonic value surpassing functional value.

To investigate the use of different pointing forms in service scenarios, we collected the ShopPoint 1 dataset, a skeleton-based dataset of pointing gestures from customer-shopkeeper interactions in a camera shop scenario. 13 participants took part in the data collection, including 3 shopkeepers with real-world customer service experience and 10 customers. We recorded 61 one-to-one role-played interactions. Coders annotated pointing gestures from videos of these interactions, emphasizing pointing arm forms (straight-arm, bent-arm, and hand-only pointing) and hand forms (index-finger and open-hand pointing). This annotation process resulted in 2959 pointing gestures. We conducted statistical analysis on the annotated data. The analysis revealed that bent-arm pointing was used more frequently than other arm forms. Straight-arm pointing was used more for far targets than for close targets, and hand-only was used more for close targets. Shopkeepers used bent-arm pointing more frequently than customers when referring to far targets. To evaluate the recognition of these pointing gestures, we tested several existing Skeleton-based Action Recognition (SAR) methods on the dataset. The highest accuracy was achieved at 72.51% by using transfer learning (i.e., pre-training and fine-tuning). This evaluation indicates that though transfer learning aids performance, recognizing pointing with diverse forms remains challenging.

Purpose This study investigates how language differences shape tourists' perceptions of service hospitality in fast-paced, casual dining settings, focusing on Chinese-speaking and non-Chinese-speaking tourists. It explores the role of language proficiency and engagement in conversation, applying Communication Accommodation Theory. Design/methodology/approach A multi-group structural equation modeling approach was used to analyze survey data from 391 tourists. Confirmatory factor analysis and metric invariance tests were conducted to assess validity and group differences. Findings Metric non-invariance revealed that Chinese- and non-Chinese-speaking tourists interpret service cues differently. However, the mediation pathway – where engagement in conversation transmits the effect of service experience to perceived hospitality – was statistically equivalent across groups. Once staff provide basic linguistic accommodation (slower speech, simple Mandarin or English, warm tone), further tailoring yields no additional benefit, supporting a “good-enough” convergence threshold. Practical implications The findings highlight the importance of staff communication skills and basic linguistic accommodation in enhancing service hospitality for diverse tourists. Targeted staff training, multilingual service scripts, and heritage storytelling are recommended to strengthen destinations renowned for food tourism and to improve tourist experiences in crowded, culturally diverse casual dining venues. Originality/value This research extends Communication Accommodation Theory to casual, high-turnover dining environments, demonstrating that conversational engagement is a universal mediator of perceived hospitality. By showing simultaneous measurement divergence and structural convergence, the study clarifies a nuanced pattern often overlooked in cross-cultural service research and provides a roadmap for analyzing construct meaning versus construct functioning.

Psychiatric involuntary hospitalization (IH) rates differ across the United States (U.S.), but few studies have investigated what physician characteristics influence the decision-making process for IH. This cross-sectional survey study used the Psychiatric Involuntary Hospitalization Decision-making (PIHD) instrument, a previously validated, vignette-based tool, to measure individual psychiatrists' likelihood to admit patients involuntarily and their confidence in IH decision-making. Psychiatrists and psychiatry trainees (N = 246) from eight pre-selected academic psychiatry departments across major U.S. regions completed an online survey that included the PIHD instrument and questions on physician demographics, clinical experience, attitudes and beliefs about patient care, and level of paternalism. Results indicated that demographic factors and years of experience were not associated with likelihood of admittance or physician confidence in decision-making. Likelihood of IH admittance was higher among participants in the Northeast and Southeast. Among attending physicians, likelihood of IH admittance was higher among those with inpatient experience and lower among those with experience in psychiatric emergency services. Likelihood of admittance was also positively correlated with higher levels of paternalism and physician beliefs that IH is beneficial. Among trainees, greater worries about patient safety were associated with higher likelihood of IH admittance. In the full sample, confidence in IH decision-making was highest in the Northeast, Southeast, and Southwest, and was positively correlated with emergency psychiatry experience. Confidence in IH decision-making was associated with paternalism, but only among attending physicians. This study is one of the first to identify individual factors that may influence psychiatrist decision-making around IH in the U.S.

Many products (goods and services) experience rapid adoption followed by decline, transformation, or absorption into broader technological and cultural systems. These phenomena, often described as innovation fads, provide valuable insight into the cultural mechanisms that shape the lifecycle of innovations. This article analyzes sixty-six cases of products (goods and services) that experienced explosive growth between the late 1990s and the mid-2020s across multiple sectors, including consumer electronics, media formats, communication technologies, lifestyle products, and digital platforms. The study applies the Cultural Innovation Construct Process Model that classify innovations according to four cultural drivers: Neowel (technology-driven), Beutel (aesthetic-driven), Moral (rule-driven), and Gnosil (knowledge-driven). Using comparative historical analysis and cross-sector case examination, the research identifies recurring patterns in how innovations emerge, diffuse, and decline. The findings suggest that aesthetic-driven innovations tend to generate rapid but short-lived diffusion, while technology-driven innovations frequently become absorbed by new technological platforms. Norm-driven innovations display greater stability when supported by institutional frameworks. The most durable cultural transformations, however, appear to be associated with knowledge-driven innovation, where new scientific or systemic understanding reshapes behavior and decision-making. The study proposes a strategic framework indicating that innovations integrating knowledge transformation, institutional alignment, technological enablement, and cultural symbolism are more likely to evolve from temporary fads into sustained cultural practices.

ABSTRACT Objectives Evidence has highlighted that the COVID-19 pandemic worsened ongoing mental health inequity among population groups, such as those with pre-existing mental health problems. This is further compounded for ethnic minority communities. Research emphasises the importance of coping strategies in lessening the negative impacts of the pandemic; however, there is a scarcity of research among ethnic minority communities. Design To explore the experiences of coping during the COVID-19 pandemic among ethnic minority individuals with existing mental health difficulties and to identify changes and continuity in coping strategies across two different timepoints. A secondary thematic analysis was conducted of interviews with ethnic minority individuals with mental health conditions, using a cross case comparison approach to analyse interviews conducted at two timepoints during the COVID-19 pandemic. Results Seeking social support, implementing new habits, and self-care approaches to mental health, as well as access to and experience of mental health services, were adaptive coping strategies used, further highlighting the importance of these strategies being culturally sensitive. Several expressed difficulties with access to mental health services. Conclusions Whilst the pandemic has ended, this research highlights that there is still a need for future studies exploring the experiences of ethnic minority groups, and focus should be placed on developing solutions that facilitate uptake among people with mental health problems from these communities. This should involve adaptive, culturally appropriate coping strategies and implementing modifications for effective mental health care for future public health crises or other social stressors.

Early intervention in psychosis (EIP) services provide care for individuals experiencing first-episode psychosis and are considered both clinically and cost-effective. While many have positive experiences of EIP, there have also been reports of perceived harm. This scoping review synthesized qualitative evidence on service user perspectives of potential harm in EIP services in the UK, to consider how services may continue to improve practice to meet the needs of their service users. We conducted a scoping review following a pre-registered protocol. Systematic searches were performed in PsycINFO, Web of Science Core Collection, Scopus, Embase, CINAHL Plus and Medline on 9th October 2024, and updated searches on 12th January 2026. We included peer-reviewed qualitative studies exploring service user experiences in EIP services in the UK. Data on reported harms from eligible studies were thematically analysed. Thirteen studies met inclusion criteria. We identified four main themes: (1) Intersection of stigma and lack of cultural awareness; (2) Inappropriate or inadequate support; (3) Poor relationships and communication; and (4) Challenges in the discharge process. While EIP services offer the current gold standard of care for first-episode psychosis, our review highlighted some areas where harm was perceived to have arisen. Such information presents potential targets for service improvement. Strengthening communication and enhancing information sharing may help mitigate potential harms and optimize service user experiences. Further research to quantify the prevalence of harms within EIP services is needed to inform best practices and ensure equitable, person-centred care.

This article examines the problem of the role of the State Security Committee (KGB) in organizing arrests and conducting investigative actions against Ukrainian dissidents during the wave of repressions of 1965 – 1966. The study is devoted to the currently relevant problem of rethinking the mechanisms of functioning of the Soviet repressive system in the post-Stalin decades. The idea is substantiated that the arrests of 1965 – 1966 were not a spontaneous reaction to manifestations of dissent, but were the result of purposeful operational development and strategic planning. The question of the correlation of the initiative of the republican state security bodies and the directives of the union center continues to be debatable, which is also reflected in the article. The study is devoted to a comprehensive analysis of the organizational, legal and propaganda aspects of the KGB's activities during the specified period. The purpose of the article is to analyze the study of the forms and methods of implementing the repressive campaign, as well as to clarify the mechanisms for coordinating operational and investigative measures. The article reveals the processes of preparing and conducting mass searches, seizing self-published materials, and qualifying charges under articles of the criminal legislation of the Ukrainian SSR. Particular attention is paid to the practices of moral and psychological pressure, the organization of “preventive” measures, and public condemnation campaigns that accompanied the investigation. The article summarizes new material on the topic under study, introduces into scientific circulation individual documents from the declassified KGB archives that expand the understanding of the scale of the operation. The idea is substantiated that it was during this period that the model for subsequent repressive campaigns of the 1970s was laid. The author concludes that the activities of the KGB in 1965 – 1966 combined operational, judicial, and information and propaganda tools of influence on the Ukrainian dissident movement. The article examines the key stages of the campaign’s deployment and summarizes the practical experience of the special service’s functioning in conditions of ideological confrontation. The article summarizes some of the results of studying the role of the KGB in the system of Soviet political repressions and outlines the prospects for further research. This view will be of interest to specialists in the field of the history of Ukraine in the second half of the 20th century, the history of special services, and researchers of the dissident movement.

Background AI-enabled technologies are increasingly empowering hotel guests and reshaping customer–brand interactions. Yet, how this perceived technological empowerment drives brand advocacy through AI service quality and customer engagement remains underexplored. Objective This study investigates the mechanisms through which perceived technological empowerment (PTE) drives hotel brand advocacy (BA), emphasizing the mediating and moderating roles of AI service quality (AI-SQ), customer engagement (CE), and customer ability readiness (CAR). Methods A survey was conducted among customers of five-star hotels in Egypt, yielding 432 valid responses. Data were analyzed using Partial Least Squares Structural Equation Modeling (PLS-SEM) with WarpPLS 8.0. Results The findings reveal that PTE positively influences both CE and AI-SQ, while AI-SQ further enhances CE and mediates the relationship between PTE and CE. Moreover, CAR moderates the relationship between PTE and AI-SQ, with higher customer readiness strengthening the effect. Both PTE and CE are found to positively impact BA, with CE partially mediating the link between PTE and BA. Conclusion These results highlight the critical role of empowering hotel technologies and customer readiness in enhancing AI service experiences, fostering engagement, and ultimately driving brand advocacy. The study provides practical implications for hotel managers seeking to leverage AI-enabled services to strengthen customer relationships and brand loyalty.

The fast growth in advancement of digital technologies has significantly transformed the insurance sector by improving he delivery of services and enhancing customer interaction. The study examines the role of digital platforms in enhancing customer experience in insurance services by focusing on important factors like digital platform usability, information transparency and service personalization. Customers trust is considered as mediating variable, while customer experience and customer loyalty are treated as dependent outcomes. Primary data were collected from 346 valid respondents using an online questionnaire, and the relationship among the variables were analyzed using structural equation modelling. The findings shows that effective digital platform usability, transparent information and personalized services positively influence customer trust and overall customer experience. Furthermore, improved customer experience significantly contributes to strengthening customer loyalty toward insurance services. The study highlights the importance of digital innovation in improving service quality and fostering long-term customer relationship in the insurance sector.

Abstract Introduction Community pharmacies are a highly accessible source of medicines and healthcare advice in many societies, yet their role within the wider health system remains underutilised.[1] Leveraging the accessibility and capacity of community pharmacies offer a viable strategy to strengthen primary healthcare (PHC) delivery, improve health service utilisation, and promote equitable access to quality healthcare.[2] Understanding patients’ experiences and perspectives of community pharmacy services is essential to inform strategies for integrating these facilities into PHC framework and strengthening health systems. Aim To explore patients’ perceptions and experiences of community pharmacy services and identify barriers and facilitators to the provision of these services that could inform strategies for integrating community pharmacies into the PHC system. Methods This was a qualitative study involving adult clients accessing services at purposively selected (based on accessibility and service provision) community pharmacies located within the metropolitan area of Kaduna State, Nigeria. Eligible participants were those able to communicate in English and willing to participate. Participants were recruited on-site while visiting the community pharmacies. While some participants opted for immediate on-site interviews, others preferred scheduled phone interviews. Semi-structured interviews, using a topic guide developed from literature and expert input, were conducted and audio-recorded with consent of the participants. Transcripts were analysed thematically to identify key themes and subthemes. Results Fifteen participants (5 females, 10 males; age range 22–55 years) were interviewed. Three main themes emerged. Theme 1: Perceptions of community pharmacy roles. Participants described their utilisation of community pharmacy services and valued community pharmacists’ contributions to health promotion and disease prevention [e.g. ‘The availability of health screening services like blood pressure checks was very helpful… early signs of illness were detected and managed well’ (P11)]. Theme 2: Patient/client experiences regarding quality of care, accessibility, privacy, and strong pharmacist-patient relationships [e.g. ‘the pharmacy is closer to me than the hospital… it is the first point for treatment during emergencies, except in situations where I need further investigations, then I have to go to the hospital’ (P03)]. Theme 3: Factors influencing service delivery, with points raised regarding location, pharmacists’ skills and training, opening hours, and availability of additional services [e.g. ‘Community pharmacies can help by creating public awareness on preventive measures of certain diseases and also they should be equipped with devices which would be useful in monitoring and managing of illnesses’ (P07)]. Overall, participants recognised community pharmacies as accessible, trusted providers, though noted gaps in service hours, staffing, and awareness of available services. Conclusion Community pharmacies contribute significantly to healthcare delivery. However, improvements are needed in service availability, staffing, and patient awareness. This study provides a key strength by offering rich, contextual insights into patient experiences, but is limited by its small sample and focus on a few community pharmacies located within the metropolitan part of the State. Findings from this study show that community pharmacies already function as accessible first points of care, indicating strong potential for their formal integration into Nigeria’s PHC system.

Violence against women (VAW) is a global public health problem and the health sector has an especially important role to play, considering the serious health risks faced by women. Women who experience violence are, more than others, at risk of acute and chronic health problems, as well as premature death. Medical services—especially Emergency Departments (EDs)—play a crucial role in a system that aims to intercept VAW at an early stage and guarantee women’s fundamental rights. In 2017, Italy approved National Guidelines for healthcare and Hospital Organizations on emergency and socio-healthcare assistance for women experiencing violence . World Health Organization (WHO) and national policy guidelines state that healthcare providers must develop integrated and multidimensional responses to intervene in cases of violence. The study aims to draw attention to the implementation of the guidelines because of two reasons. The first one is that no systematic assessment has yet been conducted to determine how effectively they are being applied. The second one is about how an integrated and multidimensional response can be developed in a complex setting such as an EDs to support women experiencing violence. The ongoing research makes use of desk and field research. Regarding the desk analysis, the study used technical reports and scientific literature to reconstruct the origins, characteristics and goals of national guidelines. The field research was conducted in Rome, because of its historical significance as one of the longest-running experiences of this kind in Italy. The case was studied by analyzing documentation and conducting field interviews with three anti-violence association referees present in the EDs and by visiting their EDs workplaces. This contribution presents selected findings. Specifically, it: outlines the objectives of the National Guidelines; reconstructs the heterogeneity of organizations operating in the city of Rome; examines three experiences of healthcare services that host anti-violence practitioners; highlights critical issues in the implementation of integrated and sustainable measures; emphasizes the need for stronger engagement by regional and hospital authorities to ensure that the Guidelines can fulfill their potential within broader policies to combat male violence against women.