Developing Nurses and Interdisciplinary Teams in Caring Science.

This program evaluation assessed a caring science program's impact on nurse and interdisciplinary professionals' self-reported caring, compassion satisfaction, and intent to leave at an academic-affiliated community hospital. A 3-session program resulted in self-caring and intent to leave significant increases at 60 days post intervention. Findings demonstrated caring science interventions alone are insufficient to impact staff engagement and intent to leave. Further actions for organizational culture changes are discussed.

Recommending yoga for health: A survey of perceptions among healthcare practitioners in the UK.

BACKGROUND: Yoga has the potential to support patients across various health conditions. It is slowly being integrated into healthcare worldwide. While healthcare practitioners (HCPs) are critical to integration, there are currently no studies investigating their perceptions of yoga for health, their openness to recommending yoga to patients, and barriers to doing so. This novel UK study aims to address this. METHOD: An online survey was conducted among practising UK HCPs. Recruitment was through multi-modal convenience sampling. The COM-B model was used as a framework. Regression analysis examined predictors of HCPs' likelihood to recommend yoga. Open-end responses were analysed through thematic analysis. RESULTS: 198 HCPs were included in the analysis, including general practitioners (GPs, 18.8%), psychologists (18.3%), and nurses/health visitors (14.7%). A high proportion (68.8%) practised yoga at least monthly. The likelihood of recommending yoga to patients was high (M = 4.03, SD = 0.94; 5-point scale). Older age, not being a GP, and greater capability and motivation significantly predicted a greater likelihood of recommending yoga, explaining 41.4% of the variance (p < 0.001). Barriers to recommending yoga were mostly related to the lack of opportunity. CONCLUSIONS: HCPs in this study had high levels of personal engagement with yoga and were open to recommending yoga to patients, but still faced several barriers. Workplace support, particularly for GPs, and information about how patients can access appropriate and affordable yoga instruction would facilitate referral. Further research with a representative sample is warranted to understand perceptions of HCPs less engaged with yoga.

'It stretches your body but makes you feel good too': A qualitative study exploring young people's perceptions and experiences of yoga.

Whilst research suggests that yoga can positively impact physical and psychological wellbeing, understanding of youth's experiences is limited with no non-clinical studies in the UK. Ten focus groups explored perceptions and experiences of yoga among 35 youth (10-18 years). Inductive thematic analysis revealed that yoga was viewed as a holistic mind-body practice cultivating greater awareness and enhanced physical performance. Youth described yoga as providing tools that developed confidence, stress-management and emotional self-regulation. Social and relational impacts of yoga were highly valued. Despite the perceived biopsychosocial benefits of yoga, gendered and media representations of yoga may serve as a barrier to uptake.

Behavior Change Techniques in Digital Health Interventions for Midlife Women: Systematic Review.

BACKGROUND: Digital health interventions are efficacious in health-promoting behaviors (eg, healthy eating and regular physical activity) that mitigate health risks and menopausal symptoms in midlife. However, integrated evidence-based knowledge about the mechanisms of change in these interventions is unclear. OBJECTIVE: This systematic review aimed to evaluate studies on behavior change techniques (BCTs) and mechanisms of change in digital health interventions aimed at promoting health-enhancing behaviors in midlife women (aged 40-65 years). METHODS: A systematic literature search of the electronic databases PubMed, Web of Science, PsycINFO, and Cochrane Central Register of Controlled Trials in the Cochrane Library was conducted. In total, 2 independent reviewers selected the studies for inclusion, extracted data, and completed BCT mapping of eligible studies. The mechanism of action and intervention functions of eligible studies were evaluated using the behavior change wheel framework. Reporting of psychological theory use within these interventions was explored using the Theory Coding Scheme. Mode of delivery, psychological theory, and BCTs were presented as descriptive statistics. RESULTS: In total, 13 interventions (including 1315 women) reviewed used 13 (SD 4.30, range 6-21) BCTs per intervention on average. The "Shaping knowledge" and "Repetition and substitution" behavior change categories were used most frequently, with 92% (12/13) of the interventions implementing at least one of the BCTs from these 2 categories. Only 13.98% (169/1209) of the 93 available BCTs were used, with "Instructions on behaviour" most frequently used (12/13, 92%). The behavior change wheel mapping suggests that half of the intervention content aimed to increase "Capability" (49/98, 50% of the intervention strategies), "Motivation" (41/98, 42%), and "Opportunity" (8/98, 8%). "Behavioural Regulation" was the most frequently used mechanism of action (15/98, 15%), followed by increasing "Knowledge" (13/98, 13%) and "Cognitive and Interpersonal skills" (10/98, 10%). A total of 78% (7/9) of the intervention functions were used in the studies to change behavior, primarily through "Enablement" (60/169, 35.5%), whereas no study used "Restriction" or "Modelling" functions. Although 69% (9/13) of the interventions mentioned a psychological theory or model, most (10/13, 77%) stated or suggested rather than demonstrated the use of a theoretical base, and none reported explicit links between all BCTs within the intervention and the targeted theoretical constructs. Technological components were primarily based on web-based (9/13, 69%) modes of delivery, followed by phone or SMS text message (8/13, 62%) and wearables (7/13, 54%). CONCLUSIONS: The findings of this review indicate an overall weak use of theory, low levels of treatment fidelity, insignificant outcomes, and insufficient description of several interventions to support the assessment of how specific BCTs were activated. Thus, the identified limitations in the current literature provide an opportunity to improve the design of lifestyle health-enhancing interventions for women in midlife. TRIAL REGISTRATION: PROSPERO CRD42021259246; https://tinyurl.com/4ph74a9u.

"You're more engaged when you're listening to somebody tell their story": A qualitative exploration into the mechanisms of the podcast 'menopause: unmuted' for communicating health information.

OBJECTIVE: While health podcasts can be effective in reducing stigma and increasing knowledge, we know little about their mechanisms of action. This qualitative study explored the mechanisms of how women connected with the podcast 'menopause: unmuted', which presented menopause information in a storytelling format. METHODS: A diverse sample of 30 women aged 40-60 years were interviewed after listening to the podcast. Interviews covered participant's views and perceptions of the stories presented. Transcripts were analyzed thematically. FINDINGS: Two overarching themes were identified. 'Openness and authenticity' describes the value of personal stories told in an authentic way by real experts-by-experience. 'Relatability and representation' explores participants' emotional reaction to the podcast, influenced by the extent to which they identified with the stories and storytellers on the podcast. CONCLUSIONS: Authenticity and relatability were identified as key mechanisms through which participants connected with audio stories, consistent with Fisher's narrative theory. These findings have important implications for the application of storytelling in podcasts designed to influence health behaviors. PRACTICE IMPLICATIONS: Diverse stories representing a range of demographic characteristics and experiences are needed when creating podcasts about health information to increase listener's relatability and connection.

'Joining a group was inspiring': a qualitative study of service users' experiences of yoga on social prescription.

BACKGROUND: Yoga is becoming an increasingly popular holistic approach in the West to manage long-term health conditions. This study presents the evaluation of a pilot yoga intervention, Yoga4Health, that was developed for the NHS to be socially prescribed to patients at risk of developing specific health conditions (risk factors for cardiovascular disease, pre-diabetes, anxiety/depression or experiencing social isolation). The aim of this qualitative study was to explore service users' experiences of Yoga4Health and the acceptability of the programme. METHODS: Qualitative data were collected from three sources: 1. Open-ended questions on questionnaires completed by services users at three different time-points (baseline, post intervention and 3 months); 2. Interviews and focus groups with a subset of participants (n = 22); 3. interviews with yoga teachers delivering Yoga4Health (n = 7). Each data source was analysed thematically, then findings were combined. RESULTS: Of participants completing baseline questionnaires (n = 240), 82.5% were female, 50% White, with a mean age of 53 (range 23-82) years. Baseline questionnaires revealed key motivations to attend Yoga4Health were to improve psychological and physical health, and believing Yoga4Health would be accessible for people with their health condition. Post-intervention, participants reported a range of benefits across psychological, physical and social domains from Yoga4Health. Increased confidence in self-management of health was also reported, and a number of participants described making positive lifestyle changes after attending the programme. Unanticipated benefits of yoga emerged for participants, such as enjoyment and social connectedness, which facilitated ongoing attendance and practice. Also key to facilitating practice (during and after the intervention) were suitability of the classes for those with health conditions, practising with a group and qualities of the yoga teacher. Home practice was supported by course materials (manual, videos), as well as the teaching of techniques for everyday application that offered immediate benefits, such as breathing practices. Follow-up questionnaires revealed a key challenge was continuation of practice once the intervention had finished, with the structure of a class important in supporting practice. CONCLUSIONS: Yoga4Health was a highly acceptable intervention to services users, which brought a range of biopsychosocial improvements, suggesting yoga is an appropriate intervention to offer on social prescription.

A qualitative study exploring patient shadowing as a method to improve patient-centred care: 10 principles for a new gold standard.

BACKGROUND: In recent years, there has been an increased emphasis on patient experience as a dimension of quality in healthcare and subsequently a drive to understand care from the patient's perspective. Patient shadowing is an approach that has been used in service improvement projects, but its potential as a quality improvement (QI) method has not been studied in practical and replicable detail. OBJECTIVE: This new research aimed to produce clear guidance on patient shadowing for future Quality Improvement projects. METHODS: Qualitative interviews were conducted with 20 clinical and non-clinical participants of a national QI programme in UK, which focused on improving the experience of patients at the end of life. All participants had shadowed patients. Data were analysed using a thematic analysis. RESULTS: There were two broad themes: (i) The process of shadowing: how participants went about shadowing, adopting different approaches and making judgements about the care they observed and any challenges they had encountered. (ii) The impact of shadowing: on the engagement and motivation of those who shadowed and in terms of service changes to benefit patients and their families. CONCLUSION: The findings led to a new set of 'gold standard' principles to benefit both staff and patients where shadowing is used as a QI method. These, together with new guidance, will ensure that shadowing is conducted as a team exercise, that all those involved are more robustly prepared and supported and that its purpose as a method to improve patient experience will be better understood.

"It just makes me feel a little less alone": a qualitative exploration of the podcast Menopause: Unmuted on women's perceptions of menopause.

OBJECTIVE: Menopause can negatively impact women's quality of life, with many women reporting inadequate information and support. Podcasts have grown in popularity in recent years and have been found to be accessible methods for increasing knowledge and challenging perceptions of stigmatized topics. The current research aimed to understand the impact of the podcast "menopause: unmuted" on women's menopause-related knowledge, understanding, and communication practices. METHODS: A diverse sample of 30 women aged 40 to 60 years listened to the podcast series, which focused on menopause stories, before taking part in semistructured interviews to discuss the impact of the podcast on how they understood and communicated about menopause. The interviews were analyzed thematically. RESULTS: Two overarching themes were identified in the data. A "journey of knowledge gain" explores participants' understanding of menopause before listening to the podcast and describes how this is deepened by hearing and connecting with women's stories. "Reframing menopause" describes the impact of the podcast, where women reflect on the value of communication amongst women, challenge and re-evaluate the stigmatization of menopause, and discuss ways to make positive behavioral changes in their lives. CONCLUSIONS: The podcast "menopause: unmuted" helped women to learn about the menopause experience, have a greater sense of belonging to a community of women, and feel empowered to make changes in their own lives. Sharing stories via podcasts has potential as an accessible and impactful medium to educate women and reduce the widespread stigma associated with menopause.

A Population-Practice-Based Model to Understand How Yoga Impacts on Human Global Functioning: A Qualitative Study.

Introduction:Research is increasingly demonstrating a range of benefits of practicing yoga, such as improved physical and mental health, social connectedness, and self-care. Mechanisms of action are less well understood, but may include both psychological and physiological changes. The aim of this study was to understand more about benefits and mechanisms of yoga practice, using qualitative data collected from a large-scale survey of yoga use in the United Kingdom. Methods: The mixed methods, cross-sectional online survey collected data on yoga use and perceived benefits from 2434 U.K. yoga practitioners. The qualitative survey element used open-ended questions to gain "real life" data regarding practice and perceived benefits. Data were analyzed thematically and deductively. A practice-based model describing yoga practice, mechanisms, and benefits, based on the Khalsa logic model of yoga, was developed to explain the data. Findings: Findings highlighted that a diverse range of yoga practices and nonspecific contextual factors related to practicing yoga, needed to be considered to understand how yoga was benefitting people. These practices encompassed both modern and traditional conceptions of yoga as a deeper lifestyle practice. Key mechanisms for change included improvements in physical strength and flexibility, stress regulation, resilience, equanimity, mind-body awareness, and spiritual/personal growth. These mechanisms resulted in diverse improvements in global health functioning, particularly physical and mental health and well-being. Conclusions: The Khalsa model provided a useful base upon which to guide the new population-practice-based model, to understand participants' "real life" experiences of yoga, how yoga is helping people and why. It provides important information for practitioners, teachers, and those delivering yoga interventions as to the range of skills and potential benefits of yoga practice. In addition, findings indicate directions for future research, by highlighting key yoga mechanisms that researchers may choose to focus on in future studies.

Feasibility and outcome of an online streamed yoga intervention on stress and wellbeing of people working from home during COVID-19.

BACKGROUND: The outbreak of COVID-19 and its associated measures has resulted in a sizeable working population transitioning to working from home (WFH), bringing additional challenges, and increasing work-related stress. Research has indicated that yoga has promising potential in reducing stress in the workplace. However, there are very few studies exploring the impact of online streamed yoga on stress management for people-WFH. OBJECTIVE: To investigate the feasibility and outcome of an online streamed yoga intervention on stress and wellbeing of people-WFH during COVID-19. METHODS: A six-week pilot randomized controlled trial (RCT) yoga intervention was designed with yoga (n = 26) and a wait-list control group (n = 26). A mixed two-way ANOVA was used to assess changes in standardised outcome measures at baseline and post-intervention. Likert and open-ended questions assessed enjoyment, acceptability and perceived benefits of the program, which were analysed thematically. RESULTS: Compared with the control, the yoga group reported significant improvements in perceived stress, mental wellbeing, depression and coping self-efficacy, but not stress and anxiety. Participants experienced physical and mental health benefits and reported high acceptability and enjoyment of the intervention. CONCLUSIONS: An online yoga intervention can help people WFH manage stress and enhance wellbeing and coping abilities.

Post-traumatic stress, personal risk and post-traumatic growth among UK journalists.

Background: Journalists covering traumatic news events can develop symptoms of post-traumatic stress disorder (PTSD). However, they may also experience perceived post-traumatic growth (PTG). The outcome may be affected by whether work-related traumatic stress has a degree of personal risk. Objective: To investigate the relationship between PTSD symptoms and PTG among journalists who experienced work-related trauma and to examine whether positive associations would exist between exposure to personal risk and PTG. Method: A web-based survey measuring post-traumatic stress symptoms and post-traumatic growth was completed by print and broadcast journalists (N = 69) working for UK-based media organizations. An open-ended question asked participants how media organizations can help to promote growth after work-related trauma. Results: The findings show a significant relationship between PTSD symptoms and PTG (p = 0.04). Journalists working in war-zones had significantly more PTSD symptoms (p < .001) and PTG scores (p < .001) than those who did not. Journalists who described their worst, work-related trauma as having a degree of personal, life-threatening risk, also reported higher levels of PTG than those who did not (p < .001). This was consistent across all PTG subscales. Conclusions: This study, the first to examine PTSD symptoms, personal risk and post-traumatic growth within journalists, suggests those working in conflict areas experience significantly higher levels of post-traumatic stress and post-traumatic growth, than those who do not. Those who experience personal risk also had high PTG levels. Media companies can help develop PTG by recognizing when personal risk plays a role in covering demanding assignments. Participants suggested organizations also needed to allow sufficient time for reflection and meaning-making for all those working in hostile environments.

Antecedentes: Los periodistas que cubren eventos noticiosos traumáticos pueden desarrollar síntomas de Trastorno de Estrés Postraumático (TEPT). Sin embargo, también pueden experimentar Crecimiento Postraumático percibido (PTG, por su sigla en inglés). El resultado puede ser afectado por la presencia de un grado de riesgo personal en el estrés traumático relacionado al trabajo.Objetivo: Investigar la relación entre los síntomas de TEPT y PTG entre los periodistas que experimentaron trauma relacionado al trabajo y examinar la existencia de asociaciones positivas entre la exposición a riesgo personal y PTG.Método: Periodistas de medios impresos y de difusión, que trabajaban en organizaciones de medios localizados en el Reino Unido (N = 69) completaron una encuesta en la web que midió síntomas de estrés postraumático y crecimiento postraumático. Se consultó a los participantes mediante una pregunta abierta cómo podrían las organizaciones de medios ayudar a promover el crecimiento después de un trauma relacionado al trabajo.Resultados: Los hallazgos muestran una relación significativa entre los síntomas de TEPT y PTG (p = 0.04). Los periodistas que trabajaban en zonas de guerra tuvieron significativamente más síntomas de TEPT (0 < .001) y puntajes de PTG (p < .001) que los que no lo hacían. Los periodistas que describieron su peor trauma relacionado al trabajo con un grado de riesgo personal, con amenaza a su vida, también reportaron mayores niveles de PTG que quienes no lo hicieron (p < .001). Esto fue consistente en todas las subescalas de PTG.Conclusiones: Este estudio, el primero en examinar los síntomas de TEPT, riesgo personal y crecimiento postraumático entre periodistas, sugiere que aquellos que trabajan en áreas en conflicto experimentan niveles significativamente mayores de estrés postraumático y crecimiento postraumático que quienes no lo hacían. Aquellos que experimentaron riesgo personal también tuvieron mayores niveles de PTG. Las compañías de medios pueden ayudar a desarrollar PTG reconociendo cuando el riesgo personal juega un rol al cubrir tareas exigentes. Los participantes sugirieron que las organizaciones también necesitaban conceder suficiente tiempo para la reflexión y construcción de significados para todos quienes trabajan en ambientes hostiles.

'As soon as you've been there, it makes it personal': The experience of health-care staff shadowing patients at the end of life.

BACKGROUND: Patient shadowing is an experiential technique intended to enable those who shadow to understand care experience from the patient's point of view. It is used in quality improvement to bring about change that focuses on what is important for patients. AIM: To explore the acceptability of patient shadowing for health-care staff, the impact of the experience and subsequent motivations to make improvements. METHOD: A qualitative study with a diverse sample of 20 clinical and non-clinical health-care staff in different end-of-life settings. Data were analysed thematically. RESULTS: Anticipated anxieties about shadowing did not materialize in participant accounts, although for some it was a deeply emotional experience, intensified by being with patients who were at the end of life. Shadowing not only impacted on participants personally, but also promoted better insights into the experience of patients, thus focusing their improvement efforts. Participants reported that patients and families who were shadowed welcomed additional caring attention. CONCLUSION: With the right preparation and support, patient shadowing is a technique that engages and motivates health-care staff to improve patient-centred care.

A mixed methods evaluation of an individualised yoga therapy intervention for rheumatoid arthritis: Pilot study.

OBJECTIVES: to explore patients' experiences of an individualised yoga therapy intervention for rheumatoid arthritis (RA), specifically in terms of its acceptability and impact on patient-reported outcomes. DESIGN: Ten patients took part in a 16 week yoga therapy intervention in a hospital setting, consisting of 10 one-to-one consultations with a yoga therapist followed by two group review sessions. Changes in health (EQ-5D, HADS) were assessed pre- and post-intervention and at 12-month follow-up. In-depth interviews were conducted post-intervention and analysed using thematic analysis. RESULTS: Attendance of the 1-to-1 sessions was high (98 %) and all participants reported strong commitment to their personalised home practice. There were significant improvements in measures of depression, anxiety, pain, quality of life and general health at post-intervention and 12-months (p < 0.05). In interviews, all but one participant reported positive changes to their symptoms and several reported reductions in their medication and broader benefits such as improved sleep, mood and energy, enabling re-engagement with life. The personally tailored nature of the practice and perceived benefits were key motivational factors. Particular value was placed on the therapeutic function of the consultation and provision of tools to manage stress and build resilience. CONCLUSION: This yoga therapy intervention was positively received by patients with RA, with high levels of adherence to both the treatments and tailored home practice. The findings suggest that yoga therapy has potential as an adjunct therapy to improve RA symptoms, increase self-care behaviours and manage stress and negative affect such as anxiety. A larger multi-centre study is therefore warranted.

Yoga practice in the UK: a cross-sectional survey of motivation, health benefits and behaviours.

OBJECTIVES: Despite the popularity of yoga and evidence of its positive effects on physical and mental health, little is known about yoga practice in the UK. This study investigated the characteristics of people who practise yoga, reasons for initiating and maintaining practice, and perceived impact of yoga on health and well-being. DESIGN, SETTING AND PARTICIPANTS: A cross-sectional online anonymous survey distributed through UK-based yoga organisations, studios and events, through email invites and flyers. 2434 yoga practitioners completed the survey, including 903 yoga teachers: 87% were women, 91% white and 71% degree educated; mean age was 48.7 years. MAIN OUTCOME MEASURES: Perceived impact of yoga on health conditions, health outcomes and injuries. Relationships between yoga practice and measures of health, lifestyle, stress and well-being. RESULTS: In comparison with national population norms, participants reported significantly higher well-being but also higher anxiety; lower perceived stress, body mass index and incidence of obesity, and higher rates of positive health behaviours. 47% reported changing their motivations to practise yoga, with general wellness and fitness key to initial uptake, and stress management and spirituality important to current practice. 16% of participants reported starting yoga to manage a physical or mental health condition. Respondents reported the value of yoga for a wide range of health conditions, most notably for musculoskeletal and mental health conditions. 20.7% reported at least one yoga-related injury over their lifetime. Controlling for demographic factors, frequency of yoga practice accounted for small but significant variance in health-related regression models (p<0.001). CONCLUSION: The findings of this first detailed UK survey were consistent with surveys in other Western countries. Yoga was perceived to have a positive impact on physical and mental health conditions and was linked to positive health behaviours. Further investigation of yoga's role in self-care could inform health-related challenges faced by many countries.

Walking in a Patient's Shoes: An Evaluation Study of Immersive Learning Using a Digital Training Intervention.

Objectives: Evidence suggests that immersive learning increases empathy and understanding of the patient experience of illness. This study evaluated a digital training intervention 'In Their Shoes' which immerses participants in the experience of living with inflammatory bowel disease (IBD), highlighting the biopsychosocial impact. The simulation program uses a mobile application to deliver time-based tasks and challenges over 36 h, supplemented with telephone role-play and 'kit' items to open and use. This study investigated changes in IBD understanding and connection to patients, empathy and perception of job value in a group of pharmaceutical employees. Additionally, it explored experiences and impact of taking part in the intervention. Methods: A mixed methods pre-post design was utilized, with an opportunity sample of employees taking part in the training. 104 participants from sites in 12 countries completed measures at baseline and 97 post-intervention. Measures included the Toronto Empathy Questionnaire, Prosocial Job Characteristics Scale, and structured questions around IBD understanding and connection to patients. Two focus groups (N = 14) were conducted regarding participants experiences of the intervention to complement an open-response question in the questionnaire (N = 75). Qualitative data was analyzed using thematic analysis. Results: Following the intervention, there were statistically significant increases in IBD understanding and connection to patients (p < 0.00025), evaluation of organizational innovation (p < 0.00025), empathy (d = 0.45) and prosocial job perceptions (d = 0.28). Qualitative analysis revealed more fully the transformative personal journey undertaken by participants which provided 'eye opening' insight into the psychosocial impact of living and working with IBD. This insight encouraged patient perspective-taking and a strong desire to promote patient advocacy and reduce stigma around chronic illness. Finally, greater organizational pride and connectivity was evident for some participants. Conclusions: An immersive training program, focussing on the lived experience of illness, led to significant increases in disease understanding and empathy. These findings align with other literature evaluating immersive learning and the potential for increasing knowledge, empathy and motivation. The present study offers opportunities to extend this outside of the body of work focussing on healthcare practitioners and explores the benefits of using this type of learning experience within an organizational setting.

Parental feeding behaviour and motivations regarding pre-school age children: A thematic synthesis of qualitative studies.

Poor childhood diet is a major risk factor for disease and obesity, and parents of pre-school children are in a powerful position to influence diet for life. The technique of thematic synthesis (Thomas & Harden, 2008) was used to synthesise recent qualitative research on parental feeding of pre-school age children (18 months-6 years). The aim was to inform development of nutrition advice by gaining a comprehensive picture of parental feeding behaviours and motivations. Six key parental feeding behaviours were identified: modelling, rewards, pressure and encouragement, repeated exposure, creativity, and limiting intake. Four overarching themes regarding motivations were identified: promoting good health (balance and variety, and weight control); building positive relationships (child involvement, and parental engagement and responsiveness); practicalities and constraints (time, cost, and lack of culinary skill, and pressure and flexibility); and emotional motivations (problem avoidance, and emotional investment). Practicalities and constraints, and emotional motivations impacted more significantly on low income parents. In order to be effective, nutrition advice ought to tap into parents' strong desire to build positive relationships and promote good health while remaining sensitive to the significant constraints and practicalities faced.

Men's strategies for preserving emotional well-being in advanced prostate cancer: An interpretative phenomenological analysis.

OBJECTIVE: This study explores men with advanced prostate cancers' own practices for promoting and maintaining emotional well-being using Interpretative Phenomenological Analysis. DESIGN: Five men with advanced prostate cancer participated in face-to-face, semi-structured, in-depth interviews. RESULTS: Within rich narratives of lost and regained well-being, two super-ordinate themes emerged--'living with an imminent and uncertain death' and 'holding on to life.' Well-being was threatened by reduced sense of the future, isolation and uncertainty. Yet, the men pursued well-being by managing their emotions, striving for the future whilst enjoying life in the present, taking care of their families and renegotiating purpose. Running through participant's accounts was a preference for taking action and problem-solving. Sense of purpose, social connectedness, and life engagement were revealed as concepts central to improving well-being, indicating areas which practitioners could explore with men to help them re-establish personal goals and life purpose. CONCLUSIONS: The findings also add weight to the evidence base for the potential value of psychological interventions such as cognitive behaviour therapy and mindfulness in men with prostate cancer.

Pakistani children's experiences of growing up with beta-thalassemia major.

In this study, we explored the lived experiences of children with beta-thalassemia major (ß-TM). We considered children as experts on their experiences in contrast to the prevalent approach of asking parents or other adults about children's perspectives. The sample consisted of 12 children aged 8 to12 years. There were two stages to data collection. In Stage 1 we employed two focus group discussions and two role plays and analyzed the data thematically. This directly informed Stage 2, consisting of 12 in-depth interviews subjected to interpretative phenomenological analysis. From our findings we show that living with ß-TM involves a continuous struggle between feelings of being different and strategies to minimize these differences to strive for normalcy. We suggest that understanding the experiences of living with ß-TM from children's perspectives can provide unique insights into their experiences, which can fill the gap in the existing, predominantly adult-oriented research on chronic illness.

Engagement with meditation as a positive health trajectory: divergent narratives of progress in male meditators.

OBJECTIVE: Studying personal narratives can generate understanding of how people experience physical and mental illness. However, few studies have explored narratives of engagement in health positive behaviours, with none focusing on men specifically. Thus, we sought to examine men's experiences of their efforts to engage in and maintain healthy behaviours, focusing on meditation as an example of such behaviour. DESIGN: We recruited 30 male meditators, using principles of maximum variation sampling, and conducted two in-depth interviews with each, separated by a year. MAIN OUTCOME MEASURES: We sought to elicit men's narratives of their experiences of trying to maintain a meditation practice. RESULTS: We identified an overall theme of a 'positive health trajectory,' in particular, making 'progress' through meditation. Under this were six main accounts. Only two articulated a 'positive' message about progress: Climbing a hierarchy of practitioners, and progress catalysed in other areas of life. The other four reflected the difficulties around progress: Progress being undermined by illness; disappointment with progress; progress 'forgotten' (superseded by other concerns); and progress re-conceptualised due to other priorities. CONCLUSION: Men's narratives reveal the way they experience and construct their engagement with meditation - as an example of health behaviour - in terms of progress.