New Nurses' Perceptions on Transition to Practice: A Thematic Analysis.

BACKGROUND: New nurses' transition to the workforce is often described as challenging and stressful. Concerns over this transition to practice are well documented, with the hypothesis that transition experiences influence the retention of new nurses in the workforce and profession. METHODS: In a cross-sectional survey (N = 217) to assess new nurse transition in the province of Ontario, Canada, an open-ended item was included to solicit specific examples of the transition experience. The comments underwent thematic analysis to identify the facilitators and barriers of transition to practice for new nurses. RESULTS: Comments were provided by 196 respondents. Three facilitator themes (supportive teams; feeling accepted, confident, and prepared; new graduate guarantee) and four barrier themes (feeling unprepared; discouraging realities and unsupportive cultures; lacking confidence/feeling unsure; false hope) to new nurse transition emerged. CONCLUSIONS: Concerns of nursing shortages are heightened in the current COVID-19 pandemic, reinforcing the priority of retaining new nurses in the workforce. The reported themes offer insight into the contribution of a supportive work environment to new nurses' transition. The recommendations focus on aspects of supportive environments and educational strategies, including final practicums, to assist nursing students' development of self-efficacy and preparation for the workplace.

Staying Connected During a Global Pandemic: Telephone Support for Vulnerable Populations

This qualitative organisational ethnography explores and analyses the ways in which a local government-provided volunteer telephone support program for vulnerable and older members of the community quickly adapted to continue working during the pandemic. Thematic analysis of data collected through researcher participation in 26 weekly zoom debrief sessions with local government staff and volunteers captures the experience of providing telephone support during a pandemic. Three key themes emerged as integral to the shaping and reshaping of the service: (1) the importance of care and relationships in service provision;(2) the need for flexibility to make service change;and (3) like a beating heart, the regular calls became part of the rhythm of life, providing certainty for staff, volunteers, and those they called. This program offers a model for best practice in low cost, low risk, place-based interventions that can increase social connection for vulnerable community members. IMPLICATIONS Organisational flexibility and a focus on care and relationships underpin best-practice human service delivery—this is emphasised in times of crisis. Volunteer engagement, commitment, and performance are enhanced by positive and caring relationships with paid staff. Befriending schemes can provide a vital means of social support that contributes to maintaining the health and wellbeing of the ageing population.

Clinical psychologists' well-being and experiences of home working during COVID-19

Purpose: The purpose of this paper was to explore the well-being and experiences of working from home (WFH) for psychology staff across a range of specialties working within one health board in Scotland during the COVID-19 pandemic. Design/methodology/approach: In total, 161 clinical psychology professionals took part in an online survey that explored experiences of WFH during the COVID-19 pandemic and assessed well-being during this period. Findings: A number of challenges with WFH were identified, including challenges with carrying out clinical work (e.g. communication difficulties, risk assessment) and fewer opportunities for collaborative working and technical/equipment issues. During the WFH period, 46% experienced fatigue, 45% felt stressed and anxious and 30% felt lonely and isolated, compared to normal. Physical health complaints were also common with 37% experiencing aches/pains in back compared to normal and 40% experiencing headaches or migraines. Practical implications: Remote therapy should be directed to those with less complex needs or who require straightforward assessments. There should be increased access to occupational health assessments and provision of ergonomic furniture when WFH, and all staff should be supported to access well-being resources available within the health board. Further evaluation should be carried out to support evidence-based practice of remote clinical work. Originality/value: Few studies have explored the experiences of WFH and/or remotely from the perspectives of clinical psychologists in a Scottish health board. It is expected that this way of working will continue, albeit to a smaller extent;therefore, WFH policy will be informed by the findings.

Understanding the perceived psychological distress and health outcomes of children during COVID-19 pandemic

Objective: The study explored the impacts of restrictions on the perceived psychological distress and health outcomes in children by their mothers who acted as their full-time caregivers during the pan-India lockdown after the outbreak of COVID-19. Method: A narrative qualitative research design was used and a purposive heterogeneous sample of 20 mothers of children aged 9–11 years were chosen, who were in a full-time caregiving role. Data obtained through a telephonic semi-structured interview were analysed using Narrative Thematic Method. Results: Four themes were generated: aberrant social responsivity and loneliness, decreased interest in regular activities, psychological distress and defiant emotional responses, and negative health outcomes. Anxiety, irritation, quarrelsome behaviours, anger, frustration, feeling low, reduced interest in games, boredom, etc. were reported in children. Decreased appetite, sleep disturbances, complaints of indigestion and multiple complaints of body aches were major negative health outcomes. Conclusions: Mothers described a variety of psychological distress and health outcomes for children due to the extreme restrictions, uncertainty, apprehension, reduced positive engagement and lowered social connection after the outbreak of the pandemic. Family-, media-, school- and community-based real or virtual intervention programmes are recommended to minimize the negative impacts and to guard children against the ill-consequences of restrictions of current and future pandemics. © 2021 Australian Psychological Society.

94. Implementing Online Public Deliberations on Minor Consent for Biomedical HIV Prevention Research in Diverse Cities

Purpose: Adolescents/young adults (AYA) from racial/ethnic communities have high rates of HIV but little access to biomedical research, due to complexities around consent. Requirement of parental consent for participation in biomedical research is protective and strongly supported by parents, but in biomedical HIV prevention, minors are less likely to participate in research because of concerns about disclosure. Public deliberation (PD) is a process to obtain community input on complex policy issues, by bringing together AYA and adults, who have an investment in an issue, but with potentially opposing views, to provide education, clarify values, and facilitate discussion, reflection, and recommendations. To inform institutional review boards, institutions, and investigators, PDs were held with the goal of obtaining community perspectives and recommendations on minor consent for biomedical HIV prevention research from communities affected by youth HIV. Due to COVID-19 pandemic restrictions, we used an online format and conducted PDs across four evenings. We then conducted post-deliberation interviews to describe participants' experiences in the online PD. Methods: As part of an IRB approved PD, we conducted semi-structured interviews with youth and adult community members who had participated in the deliberations, held in Tampa and Baltimore. The interviews, which were conducted over Zoom, queried deliberants about their experiences voicing their perspectives, their comfort level, their degree of trust in the deliberation process, and ideas for how to better engage future deliberants. Interviews were audio-recorded, transcribed, and field notes were generated. Data were analyzed using thematic analysis. Results: We interviewed 13 community members: seven from Tampa (African American=3, White=3, Latinax=1;AYA=2) and six from Baltimore (African American=6;AYA=1). Facilitators: Deliberants from both communities indicated that personal connections were important for building consensus and understanding. When other participants shared personal stories and perspectives, deliberants were more receptive to hearing and accepting new ideas and opinions that differed from their own. Challenges: Tampa deliberants reported that they preferred an online deliberation because it helped overcome practical barriers to in-person deliberations, such as access to transportation and long commutes. Baltimore participants indicated they would have preferred in-person interactions to build trust, increase comfort, and augment engagement. Participants from both communities discussed distrust in research due to the historical legacy of racism in research and medicine. Due to this legacy, they reported that distrust influenced their views of minor-self-consent and impacted the deliberation process around building consensus. For example, concerns about coercion of minor human subjects influenced their views on minor consent. Recommendations: Participants recommend that strategies be developed to increase engagement in the virtual space. These strategies include use of (a) breakout sessions to increase comfort with sharing;(b) personal storytelling and reviewing group agreements to increase trust, (c) early polling activities to ensure engagement, (d) and asking adults to provide space for youth to voice their perspectives. Conclusions: While online public deliberation on sensitive topics with a vulnerable population is possible, it is important for researchers to focus on providing a safe environment, to acknowledge historical racism in research, and to use methods to maximally engage participants. Sources of Support: PCORI.

Social service providers under COVID-19 duress: adaptation, burnout, and resilience

Summary : This article examines the response of social services organizations and their workers to the COVID-19 pandemic in a northeastern U.S. state. Using an exploratory, cross-sectional survey design with a convenience sample (N = 1472), we ask: (1) how did agencies and social service workers manage service disruptions associated with COVID-19;(2) how did social service workers perceive shifts in clients' needs;(3) how did social service workers experience the transition to remote interactions with clients;and (4) how did social service workers cope with COVID-related transitions and demands. Findings : Our findings tell a story of unprecedented crises alongside powerful attempts at adaptation, innovation, and resilience. Faced with extraordinary need among their clients, fears for their own health, and a breakdown of organizational and community functioning and guidance, social workers were able to learn and implement new technologies, adapt to increasing demands, manage new work-life boundaries, and find ways to address gaps in service while experiencing symptoms of burnout. Application : The impact of supervisory and administrative fragmentation and communication breakdowns in the face of crisis put social workers in an untenable position despite surprising abilities to adapt, innovate, and manage their professional lives while under duress. Assuring better supervisory/administrative infrastructure to support workers as they deliver services during crises will help in future crises.

Zooming into Feminist Family Therapy Telesupervision: Experiences of Supervisors during the COVID-19 Pandemic

The COVID-19 pandemic has altered the way feminist clinical supervisors provide supervision to family therapist trainees. This study explored the experiences of feminist family therapy supervisors who engaged in supervision remotely or had transitioned to virtual supervision. Using thematic analysis, four themes emerged from analysis of eight supervisors' answers to an online survey: using technology as a collaborative medium, self-of-the-supervisor process, intentional supervisory relationship, and supervisor responsibilities. In telling their stories, the supervisors described how they pivoted to support therapists, attended to parallel processes, and adjusted their own supervision techniques to maintain their feminist focus. The authors discuss implications of supervision adjustments and offer suggestions and considerations for remote feminist supervision and recommendations for future research.

Social workers' adaptation in times of pandemic crisis: A Hong Kong case

Through the lens of the theory of planned behavior, this article explores how social workers adapt to a new situation due to the outbreak of the COVID-19 pandemic. Three focus group sessions were conducted with 23 social workers from child and youth, family, and elderly services in Hong Kong. Three major themes were generated: (1) repositioning the social work profession, (2) renegotiating contracts with funders, and (3) exploring novel intervention methods. Implications of the findings are discussed. To ensure social workers can respond effectively in crises, an evolving nature of the profession is advocated to enshrine its spirit to serve.

The Potential Barriers and Benefits of an Online Physical Activity Program during the COVID-19 Restrictions: Latrobe Virtual Streetgames. A Qualitative Study

COVID-19 saw the global reduction of many physical activity programs. To maintain engagement, many programs adjusted their delivery to online formats. To explore the impact that a youth targeted virtual community exercise program had on its participants during the COVID-19 pandemic. Seven participants of Virtual Streetgames took part in a semi-structured one-on-one interview, with questions around the impact of COVID-19, in addition to their view on the virtual program. Three major themes were identified. "Dawning of a new world" described the changes that occurred due to the pandemic. "Traveling together" identified the difficultly to maintain regular wellbeing activities. "Making a difference" contextualized how the virtual delivery was able to influence participants. The COVID-19 pandemic had a significant impact on the participants physical, mental and social health. The use of an online physical activity program had some positive impacts on health, however it did not seem to warrant the same level of engagement when compared to face-to-face. The study helped identify those who are at risk of both short and long-term health impacts due to the COVID-19 pandemic. Additionally, it provided information on how virtual innovative interventions can influence wellbeing outcomes. A AJHE Self-Study quiz is online for this article via the SHAPE America Online Institute (SAOI)

‘There is light despite all of the darkness': Exploring perceptions of faith and hope during the pandemic in Australian church settings

The pandemic and resulting stay-at-home orders since March 2020 have come at a high cost to lives and livelihoods around the globe including ways in which faith communities meet. This paper forms part of a wider study Exploring hope, grace, and resilience in parish communities in COVID-19 times. It investigates how members of Christian faith communities in Melbourne (Australia) made meaning of their understanding of hope during the pandemic. The authors draw on survey data gathered between November 2021 and mid-March 2022 and using thematic analysis they discuss two overarching themes (Light despite the darkness and Connection to God). While generalisations to other faith communities cannot be made, the findings indicate churches fostered hope and offered a sense of belonging. The paper discusses implications for ways in which churches can continue to build faith with church members and the wider community in the changing landscape of the pandemic. © The Author(s)2022.

Social Workers Response to Domestic Violence and Abuse during the COVID-19 Pandemic

The rapid global spread of COVID-19 has put increased pressure on health and social service providers, including social workers who continued front line practice throughout the pandemic, engaging with some of the most vulnerable in society often experiencing multiple adversities alongside domestic violence and abuse (DVA). Movement restrictions and stay-at-home orders introduced to slow the spread of the virus, paradoxically leave these families at even greater risk from those within the home. Utilising a survey methodology combining both open- and closed-ended questions, this study captured a picture of social work practice in Ireland with families experiencing DVA during the early waves of the COVID-19 pandemic. Findings highlight both the changes and challenges in work practices and procedures that limit social work assessment and quality contact with families, changes to the help-seeking behaviours from victims/survivors, as well as emerging innovative practice responses with enhanced use of technology. Implications for practice include an increased awareness of the risk and prevalence of DVA accelerated by the pandemic. Conclusions assert that social work assessment and intervention with families experiencing DVA must remain adaptive to the changing COVID-19 context and continue to develop innovative practice approaches.

Identifying and understanding challenges to inform new approaches to improve vaccination rates: A qualitative study in Indonesia

Purpose: This study aimed to identify and understand challenges to inform new strategies to increase the COVID‐19 vaccination rate according to involved vaccinators' perspectives in Belitung, Indonesia. Design A qualitative descriptive study design was used. Methods: Online interviews and chatting were done among 11 vaccinators for data collection between August 2021 and January 2022. Data were analyzed using a content analysis model. Findings Four main themes emerged, including (1) communication strategies (evidence‐based, electronic‐based, and culturally based communication), (2) cross‐sectoral strategies (collaboration with police, religious leaders, customary leaders, heads of village divisions, and non‐governmental organizations), (3) "picking‐up the ball" system (home visits for elderly and people with disability and school visits for children), and (4) setting‐up priorities (between mandatory vaccines and boosters). Conclusion: Despite making vaccination mandatory, the roles of communication, cross‐sectoral innovations, "picking‐up the ball" system, and priority setting may have useful potential to improve vaccination rates. Clinical Relevance: The findings may serve as an input to overcome challenges and accelerate the vaccination coverage in Indonesia and beyond. However, further research is needed.

Parent resolution of diagnosis and intervention fidelity in a parent-delivered intervention for pre-school children with autism: A mixed methods study

Background: There is growing interest in parent-delivered interventions (PDI) for children with autism. Treatment fidelity has been associated with child outcomes in PDI but little is known about what impacts fidelity. One factor not previously examined is parents' resolution to the autism diagnosis which involves adjusting expectations about the child and sensitively responding to their cues, strengths and needs. Relatively little is known about resolution in the context of autism but there is evidence of an association between resolution and parent wellbeing. Method: The study adopted a mixed methods approach to examine whether there is an association between PDI fidelity and parent resolution to diagnosis, and whether resolution is associated with parent wellbeing. Parents of 31 preschool children diagnosed with autism who attended up to 12 Parent-delivered Early Start Denver Model (P-ESDM) coaching sessions participated in the study. A thematic analysis of parent interviews was also undertaken to identify themes raised by resolved and unresolved parents in interviews. Results: There was no difference in overall mean fidelity scores between resolved and unresolved parents. Those classified as resolved had lower depression scores and parenting stress scores than parents classified as unresolved. The qualitative analysis revealed that parents' perceptions of their child's progress and their hopes for the future appeared to distinguish resolved and unresolved parents. Conclusions: Findings suggest that parent wellbeing and child progress may predict resolution which was not related to parent treatment fidelity in this study. Parent wellbeing and resolution status should be assessed at entry to PDI.

3. Adolescents' Perceptions of Mental Health around the World: Key Findings from a 13-Country Qualitative Study

Purpose: Adolescence (ages 10-19) is a sensitive developmental period for the emergence of mental and behavioral health problems, but there is a lack of multi-country qualitative studies that explore how adolescents themselves understand these critical challenges. As part of UNICEF's 2021 State of the World's Children Report, the Global Early Adolescent Study collaborated with organizations in 13 countries to hold a series of focus group discussions (FGDs) with adolescents focused on mental health. These FGDs aimed to (1) understand adolescents' perspectives on significant mental health challenges in their age group, (2) understand adolescents' perspectives on the key risk and protective factors driving these challenges, and (3) understand the ways in which adolescents cope with these challenges, including barriers and facilitators to help-seeking. Methods: A total of 71 FGDs were conducted across 13 countries between February and June of 2021. Countries were selected to ensure geographic, economic, and cultural diversity, and included: Belgium, Chile, China, the Democratic Republic of Congo, Egypt, Indonesia, Jamaica, Jordan, Kenya, Malawi, Sweden, Switzerland, and the United States. Within each country, FGDs were stratified by sex and age such that there were at least two younger (ages 10-14) and two older (ages 15-19) focus groups. Depending on the COVID-19 restrictions at the time, FGDs were either held in-person or online. All FGDs were held in local languages and lasted between 60 and 90 minutes. FGDs were recorded, transcribed verbatim, and translated into English when necessary. These English translations were then coded and analyzed using an inductive thematic analysis approach. Results: Across diverse cross-cultural settings, a number of consistent findings emerged from the voices of adolescents. In particular, adolescents around the world emphasized the many contexts that drive mental health challenges, including family adversity, community violence, unsupportive school environments, poverty, social media culture, and restrictive gender norms. They also discussed significant barriers to seeking help for mental health challenges, such as community stigma, lack of social support, and fears of invalidation. These barriers frequently resulted in adolescents coping with these challenges without support, often using maladaptive strategies. Importantly, adolescents generally described and understood mental health in terms of distress (e.g., sadness, loneliness, shame, anger) rather than disorder (e.g., depression, anxiety). Conclusions: Above all, it was clear that adolescents around the world need much better formal and informal supports to adequately address mental and behavioral health problems, and that these responses must take into account the many contexts that contribute to these problems. Further, the non-clinical terminology frequently used by adolescents suggests that taking a purely diagnostic approach in addressing mental health challenges may exclude many adolescents in need of assistance. Sources of Support: Wellcome Trust.

Measured and unmeasured contributions of peer education: experiences from the Get Up, Speak Out for Youth Rights! (GUSO) programme in Kisumu and Siaya Counties, Kenya

Peer education is a widely used strategy in sexual reproductive health and rights (SRHR) programmes for young people, yet measurement of its effectiveness often focuses on a narrow set of outcomes. This qualitative study explored how peer education was integrated into the Get Up, Speak Out for Youth Rights! (GUSO) programme in Kisumu and Siaya Counties, Kenya and the contribution it made to measured and unmeasured outcomes. Findings indicate that whilst peer educators were a central part of the GUSO theory of change, the intentionality of design varied between partners and sites, and their contributions were formally measured only in relation to two of five outcome areas. In addition to their contributions to these measured outcomes, the study found that peer educators also contributed to a range of other, unmeasured outcomes related to community support and mobilisation;gender norms;and economic empowerment. Findings show that peer educators may contribute to many unmeasured – and sometimes unexpected – outcomes that go beyond traditional measurement of their contributions. These merit further exploration in the literature and in programming. Programme developers are encouraged to be more intentional in the design and measurement of peer education, ensuring that the breadth of its contribution to programming are recognised.

Implementing clinical guidelines for co-occurring substance use and major mental disorders in Swedish forensic psychiatry: An exploratory, qualitative interview study with mental health care staff.

INTRODUCTION: Patients with substance use disorders (SUD) and co-occurring mental disorders (COD) within forensic psychiatric care often suffer poor treatment outcomes and high rates of criminal recidivism, substance use, and psychiatric problems. This study aimed to describe the conditions for, and mental health care staff's experiences with, implementing integrated SUD-focused clinical guidelines, including assessment and treatment for patients with COD at a high-security forensic mental health services (FMHS) facility in Sweden. METHODS: Study staff conducted nineteen semi-structured interviews with health care staff experienced in administering the new SUD assessment and treatment. The study conducted a thematic analysis to describe the health care staff's experiences with these guidelines and suggestions for improvement. RESULTS: Most participants reported appreciation for the implementation of clinical guidelines with an SUD focus, an area they considered to have previously been neglected, but also noted the need for more practical guidance in the administration of the assessments. Participants reported the dual roles of caregiver and warden as difficult to reconcile and a similar, hindering division was also present in the health care staff's attitudes toward SUD. Participants' reports also described an imbalance prior to the implementation, whereby SUD was rarely assessed but treatment was still initiated. One year after the implementation, an imbalance still existed, but in reverse: SUD was more frequently assessed, but treatment was difficult to initiate. CONCLUSIONS: Despite indications of some ambivalence among staff regarding the necessity of the assessment and treatment guidelines, many participants considered it helpful to have a structured way to assess and treat SUD in this patient group. The imbalance between frequent assessment and infrequent treatment may have been due to difficulties transitioning patients across the "gap" between assessment and treatment. To bridge this gap, mental health services should make efforts to increase patients' insight concerning their SUD, flexibility in the administration of treatment, and the motivational skills of the health care staff working with this patient group. Participants considered important for enhancing treatment quality a shared knowledge base regarding SUD, and increased collaboration between different professions and between in- and outpatient services.

Experiences and impact of the UK lockdown amongst adults who have a facial visible difference.

Globally, COVID-19 has been shown to have had a wide ranging and significant impact on individuals' daily living, and physical and mental health. However, there are some groups of individuals who may encounter unique challenges with regards to COVID-19 and whose experiences have not been investigated thus far. Therefore, this study aimed to understand the experiences of adults with a facial visible difference in relation to COVID-19 and lockdown. Semi-structured interviews were conducted with 21 adults with a variety of facial visible differences (e.g., cleft lip/palate, facial scars, skin conditions) and analyzed using inductive reflexive thematic analysis. This analysis generated three themes (Escaping the external gaze; Existing feelings manifesting in new challenges; COVID-19 taking priority). The results of this study suggest that the first U.K. lockdown from the COVID-19 pandemic created significant challenges for some individuals with a facial visible difference, and ongoing restrictions and social distancing measures might be particularly challenging for those who experience anxiety around social encounters. These findings highlight the importance of providing appropriate and accessible support for people with facial differences during lockdown and as restrictions ease.

Public understanding of sustainable diets and changes towards sustainability: A qualitative study in a UK population sample.

Dietary consumption contributes significantly to the environmental impacts of daily life. Changes to consumption are required, but limited work investigates the reasoning underlying relevant dietary choices. This study aimed to explore public understanding of sustainable diets and any willingness or attempts to make changes towards sustainability in a sample of the UK population. A qualitative approach was used. Twenty-one participants (10 males; predominantly young adults; with a range of living circumstances and cooking responsibilities) were interviewed. Interviews were analysed using inductive thematic analysis. Four themes were identified that related to understanding sustainable diets: 'Consistent with the definition by the FAO', 'Multiple benefits', 'Unsure' and 'Competing Interests'. Four themes related to making changes: 'Willing, but unsure', 'Small easy changes', 'Enablers' and 'Barriers'. An additional theme 'COVID-19 pandemic' reflected the period when the work was done (February-May 2021). Within these themes, participants were able to define sustainable eating in a manner that was consistent with and incorporated aspects of the definition by the FAO, could identify sustainable actions that they were undertaking or could undertake, and considered these to be beneficial, but there was a lot of uncertainty, and alternative or competing definitions and actions were also given. Participants were also willing to make changes to make their diet more sustainable, and preferences were expressed for small easy changes of high impact, but there was again considerable uncertainty as to what changes to make. Caution due to the small and select sample is required, but suggestions from this work include increasing awareness and knowledge of the environmental impacts of dietary choices, focusing on small easy changes of likely impact and personal benefit, and increasing availability and accessibility to sustainable diets.