Confidence and coincidences in executive decision-making during periods of crisis

PurposeThe purpose of this study, which is grounded in decision-making theory, is to explore whether the occurrence of meaningful coincidences can positively influence executive confidence during periods of crisis. Design/methodology/approachThrough a qualitative study with 24 interviews, this study focuses on Italian hospitality facilities in the Campania Region of southern Italy to explore how an executive confidence led by meaningful coincidences can influence managerial decisions during crisis situations. Data are analyzed through a deductive coding for qualitative analysis. FindingsThe framework proposes the connection by coincidences and confidence, emphasizing the process through which meaningful coincidences can positively influence executive confidence and managerial decision-making. The insights that emerge suggest a number of positive and beneficial aspects for decision-making during a period of crisis such as the COVID-19 pandemic. Originality/valueTo the best of the authors' knowledge, this is the first study in the literature aimed at investigating, by means of qualitative methodologies, the positive outcomes of executive confidence in decision-making led by meaningful coincidences during crisis periods in the specific context of the Italian hospitality industry.

Building Resilient Supply Chains with Information Systems: Key Lessons from Médecins Sans Frontières Logistique During the COVID-19 Crisis

This research aims to analyze the resilience of humanitarian supply chains, with a focus on the role of information systems, through a case study of Médecins Sans Frontières Logistique during the COVID-19 pandemic. The empirical research methodology is based on a qualitative study, which includes semi-structured interviews with key actors and operators from the Médecins Sans Frontières Logistique during the COVID-19 crisis in 2020 and 2021. The paper highlights the crucial and inherent role of information systems on each of the four dimensions of humanitarian supply chain resilience: reorganization capacity, collaboration, flexibility, and humanitarian culture. Drawing on recent theoretical works on supply chain resilience as well as empirical results, the paper underscores the importance of information systems and proposes a conceptual model of the relationship between humanitarian supply chain resilience and the role of information systems. The value of this research is linked to its empirical and qualitative study of a Non-Governmental Organization logistics operation during an international crisis, which contributes not only to the literature on resilience, but also provides guidance for managers to target their actions responsively and proactively to enhance resilience over time.. Copyright © 2023 by SCITEPRESS - Science and Technology Publications, Lda. Under CC license (CC BY-NC-ND 4.0)

Experiences and thoughts of nurses working in the covid-19 clinic: A qualitative study

Background: During epidemics, he spent a long time with patients and witnessed every moment of them closely. At the same time, he took an active role in the health team and continued both the organization and the care and treatment process with a superior effort. Objectives: Determine the experiences and thoughts nurses working in Covid-19 clinics about the care and treatment process pandemic patients. Methods: Phenomenological design, one of the qualitative research methods, was used in our research. Provided nursing services during the care and treatment of pandemic patients in the Covid-19 service and intensive care units, and worked in the pandemic clinic throughout the assignment process, interviews were held with nurses. The data were collected by a single researcher by video conferencing method. Colaizzi's phenomenological analysis method content analysis was carried out. Results: In our study, the findings regarding the experiences and thoughts of nurses working in the Covid-19 clinic;organization, psychological factors, social factors and professional factors are gathered under four main themes. Conclusion: Requiring physical and psychological resilience, During the Covid-19 pandemic, nurses have been exposed to work stress, although have experienced psychological and physical experiences that wont be forgotten, stated they remain committed to the profession and families are the biggest source of support. In line with our findings, it has been suggested that the initiative planning to reduce the difficulties experienced by the nurses working in the Covid-19 clinic in the care process should be supported by the institution managers, as well as the planning of motivationenhancing programs and activities for nurses. © 2023, Dokuz Eylul University. All rights reserved.

Explanation of Factors Affecting Self-care and Diabetes Management During the COVID-19 Pandemic: A Qualitative Study.

Introduction: Adopting diabetes self-care behaviors to control blood glucose is essential, but adherence to them has been challenged due to restrictions related to Covid-19. These restrictions have negatively impacted the psychosocial condition of individuals with diabetes, which could lead to poor self-care. Accordingly, this study aimed to explore the experiences of individuals with type 2 diabetes regarding self-care behaviors and diabetes management during the COVID-19 pandemic. Material(s) and Method(s): This qualitative study was conducted using conventional content analysis, the data of which were collected through interviews with people over 18 years of age with type 2 diabetes who were selected from the Endocrinology Clinic of Erfan Hospital in Tehran. Using telephone and WhatsApp, semi-structured interviews were conducted with 20 participants (15 women). Content analysis was done using the constant comparative method, and the open and axial coding method was applied. The data were manually coded, and the main themes and categories emerged from data. Result(s): Two main themes emerged from the data: 1) challenges and limitations toward diabetes self-care and 2) facilitators of efficient self-care. Challenges and limitations included 4 sub-themes: Inevitable lifestyle changes, psychosocial problems, limited/lack of access to health care services and medication, and adverse physical effects. Facilitators had 2 sub-themes: improved individual capability and maintaining social interaction. Conclusion(s): Our findings indicated that inevitable lifestyle changes, limited access to health care, and adverse psychosocial consequences were the most critical challenges for diabetes management during the COVID-19 pandemic. Improving stress management skills and effective coping strategies can facilitate the adoption of self-care behaviors.Copyright © 2022, Research Institute for Endocrine Sciences. All rights reserved.

Research on online inclusive education in Taiwan in the era of COVID-19

Since 2019, many studies explored the effectiveness of online courses, but few investigated how to create an inclusive education context in the online course environment. In June 2021, this study conducted an online questionnaire survey of 208 ordinary class teachers and special education teachers from kindergartens, elementary schools, and middle schools in northern, central, and southern Taiwan via random sampling. The questionnaire consisted of six open-ended questions to examine the views of the participants. We used grounded theory to code and classify the qualitative data, and performed chi-square tests to quantitatively analyze the data obtained. The results indicated that most teachers recommended the use of interactive and cooperative online teaching strategies;the management of online inclusive education courses in the form of synchronous and asynchronous online courses to help students with special needs adapt to online courses;the building of a good cooperative relationship with parents and reducing the digital divide;full cooperation between ordinary class teachers and special education teachers;and sharing of textbooks and teaching strategies with each other. In addition, the majority of teachers considered their digital abilities below average, which was especially obvious among kindergarten and special education teachers.

Exploring the Challenges of Families With Mentally Retarded Children in Care Centers Under the Supervision of the Welfare Organization of Tehran in the COVID-19 Pandemic Conditions: A Qualitative Study

Objective Families with mentally-retarded children need more support than other families in overcoming crises and achieving social adjustment. So, it seems necessary to pay special attention to these families durinzg the COVID-19 pandemic and identify their experiences and challenges to provide more support for this vulnerable group. Therefore, the present study was carried out in care centers under the supervision of the Tehran state welfare organization of Iran (SWO) during the COVID-19 pandemic to identify the challenges of families with mentally retarded children.Materials & Methods The present study was conducted with a qualitative approach and contractual content analysis method of Granheim and Lundman (2004). The participants were 18 families with mentally-retarded children living in care centers under the supervision of the Tehran State welfare organization of Iran (SWO), who were selected by purposive sampling. Sampling was continued until data saturation. Data were collected and analyzed using in-person or online (telephone) in-depth semi-structured interviews from July 11 to September 22, 2021. To evaluate the data strength, four criteria of credibility, transferability, dependability, and confirmability of Guba and Lincoln were used.Results Based on data analysis, 6 main categories and 23 subcategories were obtained. The main categories and subcategories included 1) constant worry about their children getting COVID-19 (inability of the child to protect against coronavirus, not observing protocols by the staff, underlying diseases and deficiency in immune system, few preventive measure for under 18 years people, conflicting information about children and adolescents' in-fection), 2) disconnection and intensification of stress (agitation and irritability of the disabled, worry about the future, parent's mental confusion, fear of losing child), 3) conflict with family tensions and contradiction (intensification of family guilt, overlooking other children, couple's self-blaming, tension in family interactions, intensification of family melancholia), 4) non-supportive community (further social stigma, social exclusion, lack of sup-porting vulnerable groups, the limitations of social distancing), 5) family economic crisis (costs of keeping child in the center, losing job and lower income of the family head, poverty and intensification of unstable economic conditions), and 6) care and educational concerns (decreasing the quality of care for the disabled, suspension of rehabilitation and educational activities, restrictions on leisure activities and communication for the disabled).Conclusion The results showed that the families of mentally-retarded children had encountered many challenges and concerns during the COVID-19 epidemic, some of which were related to the intensification of psychological pressures and some due to insufficient support from governmental and non-governmental institutions for these families. The study findings can be used to provide services and design support programs and policies for children with mental disabilities and their families. In this regard, it is recommended to pay special living allowances, strengthen the communication system between parents and children living in care centers, prepare a care and health packages for parents, design and implement psychological interventions to reduce parents' anxiety and stress, and provide free counseling.

Transitioning Italian nursing education in the post-pandemic period: priorities in the light of lessons learnt

Transitioning Italian nursing education in the post-pandemic period: priorities in the light of lessons learnt. Introduction. Once back to normalcy, many nursing edu-cation activities have been restored without an in-depth analysis of which transformations enacted in the pandem-ic period should be maintained and valued. Aim. To iden-tify priorities to effectively transitioning nursing education in the post-pandemic period. Method. Descriptive quali-tative design. A network of nine universities involved 37 fac-ulty members, 28 clinical nurse educators and 65 stu-dents/new graduates. Data were collected through semi -structured interviews;the main priorities reported in each university were combined to gain a global view. Results. Nine priorities emerged, including the need to: 1. reflect on dis-tance learning to promote its complementary role to face-to-face teaching;2. rethinking the rotations of clinical prac-tical training by refocusing their aims, duration, and pre-ferred settings;3. understanding how to integrate the vir-tual and the in-presence learning spaces into the educational pathway;4. continuing with inclusive and sustainable strate-gies. Considering that nursing education is essential, it is a priority to develop a pandemic education plan capable of guaranteeing its continuity in all circumstances. Conclusions. Nine priorities have emerged all considering the importance of digitalization;the lessons learnt, however, indicate the need to enact an intermediate phase capable of guiding to-wards the complete transition of the education in the post -pandemic era.

Occupational stress of elementary school teachers after eased COVID-19 restrictions: a qualitative study from China.

Background: On December 7, 2022, China optimized its virus response and significantly shifted its epidemic policy by downgrading COVID management and gradually restoring offline teaching in schools. This shift has brought many impacts on teachers. Aims: Through qualitative research of thematic analysis, this paper studies the occupational pressure of primary school teachers in China after the shift in epidemic policy. Methods: Two recruitment methods are adopted for this study. One was to email the principals of several primary schools in Zhejiang Province to introduce the research project and indicate the idea of recruiting participants. With their help, we have found teachers who volunteer to participate. The second was to release recruitment information in the network forum (e.g., online teacher forums) to find volunteer participants. Through semi-structured interviews and diaries, 18 primary school teachers from different regions and schools in Zhejiang Province were interviewed. All responses in the interviews were transcribed anonymously. Braun and Clarke's thematic analysis was used to analyze the participants' responses. Results: Eighteen participants took part in the research project. Forty-five final codes, generated from 89 codes initially obtained from the dataset, are classified into five final themes: uncertainty, overburdened, neglected, worry about students, and influence, which reflect the professional stress of primary school teachers following the epidemic prevention policies relaxed. Conclusion: Five themes were identified in the research. The problems described by the participants include burdensome offline activities, being disturbed out of hours, and appearing understaffed for the infection. These problems harmed the participants' mental health, including anxiety, fatigue, stress, and other adverse psychological conditions. Awareness and attention to the psychological situation of primary school teachers after the eased COVID control are crucial. We believe protecting teachers' mental health is necessary, especially in this particular period.

To Get Vaccinated or Not? The Vaccination Decision-Making by Healthcare Professionals Working in Haematology: A Qualitative Study.

Haematological patients are more susceptible to infections. Vaccination has always been the most effective primary prevention strategy, even during the COVID-19 pandemic. However, the efficacy of vaccines for some haematological patients is low. Although vaccination of Healthcare Workers (HCWs) could protect patients from vaccine-preventable diseases, there is evidence of a high level of hesitation among healthcare workers in Italy. The aim of this study was to explore the attitudes towards vaccination of HCWs caring for haematology patients. Qualitative descriptive design was conducted. Twenty-one HCWs were interviewed. Content analysis was applied to the qualitative data. The following themes were generated from the analysis: "Trust", "Decision-making process focusing on individual health", "Decision-making process focusing on community health", "Changing opinion", and "Two sides of vaccination commitment". The most hesitant HCWs were oriented towards individual health. They perceived a lack of benefit from vaccines, feared side effects, or were influenced by negative experiences of others. In contrast, community-health-oriented HCWs showed more positive attitudes towards vaccination. Some hesitant HCWs changed their opinion on vaccination because they began to reflect on the importance of vaccination for the community. The change in opinion of some HCWs interviewed provided insight into the importance of focusing organisational efforts on collective responsibility.

Culture and pandemic control at cross-roads: navigating the burial guidelines for COVID-19-related deaths in a Ghanaian setting.

BACKGROUND: Despite the large volume of scientific evidence on the rapid spread of the COVID-19 pandemic and associated high morbidity and mortality, little is known about the sociocultural disruptions which ensued. The current study explored the nuanced navigation of the COVID-19-related death and burial protocols and its impact on traditional burial and funeral rites in Ghana. METHODS: This qualitative study was based on the 'focused' ethnographic design. Data were collected using key informant interviews from nineteen COVID-19-related bereaved family members and public health officials involved in enforcing adherence to COVID-19-related death and burial protocols in the Cape Coast Metropolis of Central region of Ghana. Recursive analysis was conducted to generate the themes and sub-themes from the data. RESULTS: The overarching theme was "Uncultural" connotations ascribed to the COVID-19-related death and burial protocols. The COVID-19-related death and burial protocols were ubiquitously deemed by participants to be 'uncultural' as they inhibited deep-rooted indigenous and eschatological rites of separation between the living and the dead. This was fueled by limited awareness and knowledge about the COVID-19 burial protocols, resulting in fierce resistance by bereaved family members who demanded that public health officials release the bodies of their deceased relatives. Such resistance in the midst of resource limitation led to negotiated compromises of the COVID-19-related death and burial protocols between family members and public health officials. CONCLUSIONS: Insensitivity to socio-cultural practices compromised the implementation of the COVID-19 pandemic control interventions, particularly, the COVID-19-related death and burial protocols. Some compromises that were not sanctioned by the protocols were reached to allow health officials and families respectfully bury their dead. These findings call for the need to prioritize the incorporation of sociocultural practices in future pandemic prevention and management strategies.

A double-edged sword: Teachers' perceptions of the benefits and challenges of online teaching and learning in higher education.

Due to the impact of the recent pandemic, the teaching and learning experience worldwide was marked by a wave of emergency digitalization. The sudden need to transition to online teaching and learning (OTL) has forced Higher Education actors to adapt quickly without proper planning. This study examines teachers' perceptions of the benefits and challenges posed by OTL during the pandemic in Higher Education. Data were collected from 636 teachers from 54 different countries using an internationally distributed online survey, and responses were coded using thematic analysis. While the main benefits perceived by teachers relate to flexibility (in tasks execution), accessibility, pedagogical innovation, and self-regulation, key challenges emerge in domains such as engagement, interaction, infrastructure/technical support, assessment and pedagogical practice. Our results further suggest a phenomenon that we describe as a "double-edged sword" with elements of OTL being perceived both as a benefit and a challenge. Results and implications for OTL and future blended practices in Higher Education are discussed.

Facilitators of Organizational Resilience Within South Carolina AIDS Service Organizations: Lessons Learned from the COVID-19 Pandemic.

HIV care services have been interrupted by the COVID-19 pandemic in many states in the U.S. including South Carolina (SC). However, many HIV care facilities demonstrated organizational resilience (i.e., the ability to maintain needed health services amid rapidly changing circumstances) by addressing challenges to maintaining care during the pandemic. This study, therefore, aims to identify key facilitators for organizational resilience among AIDS Services Organizations (ASOs) in SC. In-depth interviews were conducted among 11 leaders, from 8 ASOs, across SC during the summer of 2020. The interviews were recorded after receiving proper consent and then transcribed. Utilizing a codebook based upon the interview guide, a thematic analysis approach was utilized to analyze the data. All data management and analysis were conducted in NVivo 11.0. Our findings demonstrate several facilitators of organizational resilience, including (1) accurate and timely crisis information dissemination; (2) clear and preemptive protocols; (3) effective healthcare system policies, management, and leadership; (4) prioritization of staff psychological wellbeing; (5) stable access to personal protective equipment (PPE); (6) adequate and flexible funding; and (7) infrastructure that supports telehealth. Given the facilitators of organizational resilience among ASOs in SC during the COVID-19 pandemic, it is recommended that organizations implement and maintain coordinated and informed responses based upon preemptive protocols and emerging needs. ASO funders are encouraged to allow a flexibility in spending. The lessons learned from the participating leaders enable ASOs to develop and strengthen their organizational resilience and experience fewer disruptions in the future.

Experiences of women with cancer living in the rural areas of Iran during the COVID-19 pandemic: a qualitative study.

PURPOSE: This study aimed to explore the challenges of access to treatment and quality of life in female cancer survivors living in rural areas of Iran within the global pandemic context (COVID-19). METHODS: We conducted a qualitative exploratory study where we recruited nine female-identifying individuals diagnosed with cancer, 23 family members, and five healthcare providers from a hospital affiliated with the Birjand University of Medical Sciences in Iran. Data was collected using semi-structured interviews and analyzed using Braun and Clarke's reflective thematic analysis. RESULTS: The three themes constructed were lack of strength from fighting on two fronts (subthemes: (i) fear related to longevity and life span, (ii) disruption of emotional relationships and family functioning, (iii) loneliness and fear of the future, (iv) village culture and double whammy, and (v) isolation and rejection in a rural community); changes during treatment (subthemes: (i) confusion related to treatment and (ii) the hope found during treatment "bottlenecks"); and spiritual growth and clarifying values (subthemes: (i) patience and resilience and (ii) clarifying life values and opportunities when facing uncertainty about the future). CONCLUSION: This study highlights the importance of further evaluating interventions to mitigate barriers to supportive care for female cancer survivors living in rural areas with low-resource contexts during the COVID-19 pandemic.

Exploring tourism business model importance with the emergence of blockchain system: directions for tourism industry of China.

The study aims to explore the importance of the tourism business model with the emergence of the blockchain platform in China. The study focused on the importance of the tourism business model of china, studied the need to improve the tourism business infrastructure, and traced the value of the blockchain system in the tourism industry of china. For this, the researchers used a semi-structured interview approach to conduct a qualitative research design. About nine Chinese tourism and travel industry experts were interwar after initial screening using purposive sampling techniques. The respondents' responses were analyzed by applying a thematic analysis approach, and by this, the researchers extracted the main themes on study topicality to fill the gap in the literature. The study's novelty is in its topicality and context, for which it also provides viable, practical directions for stakeholders.

Psychological experiences of patients recovering from severe COVID-19 in rehabilitation: A qualitative study.

The aim of this study was to describe the experiences of post-sedation COVID-19 patients in rehabilitation. Eleven Israeli men and women were interviewed in semi-structured interviews. They were patients recovering in a neurological rehabilitation unit from severe COVID-19 post-mechanical ventilation and sedation. Five themes were generated through thematic analysis: "an unexpected turn of events," "filling the gaps," "emotional reactions," "ambiguity regarding medical condition," and "sense and meaning-making." Findings suggest a need for improved communication between patients and medical staff to enhance a sense of control and coherence. Psychological support should be considered to facilitate sense and meaning-making processes during hospitalization.

Investigating the predictors of perceived social support to control COVID-19: A qualitative study.

Background: Considering the adverse effects of COVID-19 pandemic, the present study aimed to explore the barriers and facilitators of perceived social support to prevent the further spread of the disease. Methods: In the present qualitative study, a content analysis was done. To this aim, 37 Iranian subjects who had active accounts on Instagram were initially invited to participate in the study. The data were collected through face-to-face (n = 25) and telephone conversations (n = 12). A purposive sampling was used and the data collection continued until data saturation. Finally, 41 interviews were held which took 17-48 min. Results: The data analysis led to the extraction of two main categories, the barriers and facilitators of perceived social support, as well as 12 subcategories. Economic issues, familial factors, socio-cultural factors, personal and psychological factors, ineffective quarantine rules, and poor management were the main barriers to perceived social support. The facilitators were divided into six categories, including familial influences, personal factors, government support, and improved occupational, social, spiritual, and emotional condition. Conclusion: The findings showed that a combination of environmental and social variables might influence the COVID-19 disease, either decreasing or increasing its spread. A sound knowledge of these variables, influenced by the social context and real-life experiences during the pandemic, allows to take the right measures and enrich training programs. The prevalence of the disease can be controlled by increasing environmental and social facilitators and decreasing the influence of barriers.

Healthcare adjustments and concerns: a qualitative study exploring the perspectives of healthcare providers and administrative staff during the COVID-19 pandemic in Saudi Arabia.

Background: Healthcare systems have modified their strategies to manage their staff, supplies, and space to deal systematically with the COVID-19 pandemic. This research aimed to explore the nature of hospital adjustments and the concerns of healthcare providers and administrative staff working in Governmental and private hospitals throughout the Qassim Region of the Kingdom of Saudi Arabia (KSA) during the pandemic. Methods: A qualitative phenomenological study using semi-structured in-depth interviews were conducted with 75 purposively selected healthcare providers and administrative staff working at three main hospitals in the Qassim Region, KSA. The maximum variation sampling technique was utilized. Recruitment of participants was continued until data saturation was reached. All interviews were audiotaped, transcribed verbatim, and analyzed thematically. Results: Four core themes were identified in this paper: (1) changes in hospital policy and procedures, (2) workforce management, (3) the well-being of the workforce, and (4) apprehensions and expectations of the workforce. The participants showed satisfaction with timely administrative decisions and new policies during the COVID-19 pandemic. Furthermore, the psychological health of healthcare professionals was affected more than their physical state. Finally, the providers perceived the emergence of multiple concerns in the coming months. Conclusion: Although healthcare providers were initially overwhelmed, they gradually accepted new administrative policies. Numerous innovative interventions effectively reduced their physical workload and increased their productivity, but they remained significantly affected by a wide range of psychological disorders, with a high prevalence of obsessive-compulsive disorder. There were some concerns about the new SARS-CoV-2 variant, but the majority were optimistic.

Experiences of patients and their caregivers in a Virtual Ward in Singapore: A descriptive qualitative study.

BACKGROUND: The experiences of COVID-19 patients admitted to Virtual Wards and their caregivers are underexplored in Asian communities. A COVID-19 Virtual Ward (CVW) was recently established in Singapore. AIM: This study aims to describe the experiences of high-risk COVID-19 patients admitted to a Virtual Ward and their caregivers in a multi-racial Asian community. METHODS: A descriptive qualitative study was conducted from November 2021 to March 22 among high-risk COVID-19 patients and their caregivers who had been admitted to a CVW. The CVW involved teleconsultation whereby patients submitted their vital signs via a chatbot on their mobile phone and were supported remotely by a team of allied health professionals. In-depth interviews were conducted with patients and their caregivers and analyzed thematically. Findings The findings were supported by three themes. First, CVW admissions were perceived to be safe and effective. The second emerging theme related to the benefits and burdens of receiving care at home. The benefits of CVW were perceived comfort and familiarity with the home environment, while burdens included ensuring discipline in submitting health data and self-isolating from other household members. Last, the role of external factors such as informal support, paid domestic workers, and work arrangements was highlighted by the participants. Overall, key enablers for a successful CVW experience were the availability of social support, timely care from the care team, and 24/7 access to the team. CONCLUSION: In conclusion, CVW was perceived as a safe and effective strategy to manage high-risk patients at home. We recommend that Virtual Wards should be further developed to expand bed capacity in both pandemic and non-pandemic settings.

Barriers to providing internet-based home care services for urban older adults in China: a qualitative study of the service providers.

BACKGROUND: Due to the increasingly aging population in China and the changes in social and family structure, older adults' care problems are becoming more and more prominent. To meet the home care needs of urban older adults, the Chinese government has launched Internet-Based Home Care Services (IBHCS). Although this model innovation can significantly relieve care problems, more and more evidence shows that there are many barriers in the process of IBHCS supply. The current literature is mostly from the perspective of the service users, and there are very few studies on the experience of service providers. METHODS: In this study, we took a qualitative phenomenological approach and used semi-structured interviews to investigate service providers' daily experiences and the barriers they encounter. A total of 34 staff from 14 Home Care Service Centers (HCSCs) were included. Interviews were transcribed and analyzed using thematic analysis. RESULTS: We identified the barriers that service providers encounter in IBHCS supply: (1) bureaucratic repression: unreasonable policy plans, harsh assessment, excessive paperwork, different preferences of government leaders, and obstacles caused by COVID-19 control lead to a shift of focus in their work; (2) profitability crisis in the market: high service costs, dampened effective demand, government intervention in setting prices, and parent companies' excessively high sales targets hinder the service supply process; (3) client-related challenges: the crisis of confidence, the dilemma of popularizing new technology, and communication barriers lead to rejection by older adults; (4) job dissatisfaction: low and unstable salary, heavy tasks, poor social acceptance of occupations, and lack of professional value reduce work enthusiasm. CONCLUSION: We have investigated the barriers faced by service providers when providing IBHCS for urban older adults in China, providing empirical evidence in the Chinese context for the relevant literature. In order to provide IBHCS better, it is necessary to improve the institutional environment and market environment, strengthen publicity and communication, target customer needs, and adjust the working conditions of front-line workers.

Explanation of Factors Affecting Self-care and Diabetes Management During the COVID-19 Pandemic: A Qualitative Study

Introduction: Adopting diabetes self-care behaviors to control blood glucose is essential, but adherence to them has been challenged due to restrictions related to Covid-19. These restrictions have negatively impacted the psychosocial condition of individuals with diabetes, which could lead to poor self-care. Accordingly, this study aimed to explore the experiences of individuals with type 2 diabetes regarding self-care behaviors and diabetes management during the COVID-19 pandemic. Material(s) and Method(s): This qualitative study was conducted using conventional content analysis, the data of which were collected through interviews with people over 18 years of age with type 2 diabetes who were selected from the Endocrinology Clinic of Erfan Hospital in Tehran. Using telephone and WhatsApp, semi-structured interviews were conducted with 20 participants (15 women). Content analysis was done using the constant comparative method, and the open and axial coding method was applied. The data were manually coded, and the main themes and categories emerged from data. Result(s): Two main themes emerged from the data: 1) challenges and limitations toward diabetes self-care and 2) facilitators of efficient self-care. Challenges and limitations included 4 sub-themes: Inevitable lifestyle changes, psychosocial problems, limited/lack of access to health care services and medication, and adverse physical effects. Facilitators had 2 sub-themes: improved individual capability and maintaining social interaction. Conclusion(s): Our findings indicated that inevitable lifestyle changes, limited access to health care, and adverse psychosocial consequences were the most critical challenges for diabetes management during the COVID-19 pandemic. Improving stress management skills and effective coping strategies can facilitate the adoption of self-care behaviors.Copyright © 2022, Research Institute for Endocrine Sciences. All rights reserved.