Nurses' perspectives and experiences on medical errors: A qualitative study.

INTRODUCTION: Medical errors are among the most important factors that threaten patient safety. Therefore, nurses' perspectives and experiences about medical errors are important for this manner. AIMS: The aim of this study was to determine in depth the perspectives and experiences of nurses related to how they define medical error, as well as its causes, management and reporting. DESIGN: This descriptive, exploratory study involved a qualitative design. METHODS: A total of 15 clinical nurses from eleven provinces were reached by snowball sampling method. In the study, nurses' perspectives on medical errors were obtained through semistructured in-depth online interviews conducted based on phenomenological methods. Descriptive analysis was used in the analysis of the data obtained from the interviews. The research was conducted following the COnsolidated criteria for REporting Qualitative checklist. RESULTS: The resulting 26 codes were categorized under seven themes: "Definition of medical error", "Experience of medical errors", "Frequency of medical errors", "Causes of medical errors", "Reporting of medical errors", "Medical error approach" and "Prevention of medical errors". CONCLUSIONS: The results show that it is still necessary to increase the awareness of nurses about medical errors and the importance of error reporting. In addition, it reveals the need for leadership to eliminate the negative approach to medical errors and shows that nurse managers should be empowered accordingly. IMPLICATIONS FOR NURSING PRACTICE AND POLICY: It is the first step of quality and safe care to reveal nurses' perspectives on medical errors, their thoughts about medical errors and their experiences about errors in their institutions. In this study, nurses' knowledge, opinions and experiences regarding medical errors were revealed in this qualitative study. Therefore, this study offers important clues to nursing services, hospital managers and policy makers for clinical and institutional arrangements.

Breaking challenges: queer perspectives on solutions to establish inclusive sexual-reproductive healthcare in Gauteng Province, South Africa.

Introduction: In South Africa's diverse population, queer voices emerge as change agents, proposing new and critical solutions to reform sexual and reproductive healthcare services in the pursuit of inclusivity and equality. Our research aimed to explore and describe queer individuals' perceptions and solutions for promoting sexual-reproductive healthcare services and needs (SRHSN) in Gauteng Province, South Africa. Methodology: An explorative-descriptive study was performed for this research. A total of 22 queer individuals was recruited using respondent-driven sampling (RDS) within a queer-inclusive non-governmental organization (NGO) clinic in Gauteng Province, South Africa. Semi-structured interviews and an interview guide were utilized to collect data using English. Thematic content analysis was applied using NVivo 14. Results: Four main themes and related sub-themes were revealed from the study including the creation of healthcare equity for queer individuals, empowering and supporting healthcare providers (HCPs) to enhance skills, knowledge, and expertise, raising awareness on queer-related issues, and different stakeholders' involvement. Conclusion: As we navigate South Africa's complex landscape of SRHSN for queer individuals, the crucial opinions and solutions offered by queer people not only challenge the status quo but also reveal an approach to a better, more equitable, empathetic, and accommodating healthcare system for everyone. Future studies should ensure the inclusiveness of queer individuals with the interest of improving their health not just for research outputs.

Listening to caregivers' voices about the experience of integrating music therapy-informed activity in community-based rehabilitation in rural India.

BACKGROUND: This project is part of a four-year intercultural collaboration between Indian and Australian stakeholders studying to use of music therapy (MT)-informed activity in community-based rehabilitation (CBR) with disabled children and their families in rural Maharashtra. This paper presents a qualitative study of caregiver perspectives. METHODS: Interviews with four participating caregivers were thematically analysed, with an emphasis on participant voices. The combined thematic analysis of the four interviews revealed shared five themes. RESULTS: Data analysis revealed caregivers' perception that music in CBR supported existing CBR goals. Furthermore, caregivers reported that music in CBR enhanced motivation and participation for children and families and fostered community connection. Importantly, caregivers noted that music made CBR fun and was a pre-existing resource. CONCLUSIONS: Findings were congruent with research with other stakeholders in the intercultural collaboration. Caregiver perspectives offer new insight into the priorities of families in CBR, which has wider relevance arts and health workers in community-based practice.

Diversity in Autistic Play: Autistic Adults' Experiences.

Background: Play is important for mental health and well-being. Descriptions of autistic play have typically focused on "deficits" and are based on comparisons to neurotypical "norms". According to the neurodiversity paradigm, it is important that autistic voices are highlighted and that difficulties, differences, and strengths are explored. With this in mind, we designed the present study to focus on the experiences and perspectives of autistic people concerning the topic of autistic play. Methods: We conducted a consultation with autistic stakeholders, as well as with parents and teachers of autistic individuals to help us design the study and interview questions. We used semi-structured interviews with 22 autistic adults aged 18-57 years (clinically confirmed diagnosis, n = 21; self-diagnosed, n = 1) who live in the United Kingdom. We analyzed the data using interpretative phenomenological analysis to identify themes. Results: We found important commonalities and differences in the ways that socialization in play, imaginary play, and flow (a state involving intense focus on the play) are experienced. Autistic adults discussed the importance of both solitary play and social play, with solitary play having an important recuperative function. They also reported preferences for parallel play and playing with similar autistic people. They also discussed imaginary play experiences, including social role-play and grounded-in-reality play, and the dual nature of flow experiences during play. Conclusions: The findings of this study contrast with deficit-focused understandings of autistic play and build on neurodiversity-informed studies. We highlight, for example, the importance of considering the different circumstances under which solitary play or social play are preferred, as well as the importance of taking an individual approach to play. We encourage wider understanding and acceptance of these play preferences and experiences to support autistic people's well-being.

Why is this an important issue? Usually, descriptions of autistic play are negative and are based on what non-autistic people think autistic play should be like. We think that it is important to challenge this by exploring autistic play in a more balanced way and focusing on what autistic people say about their play. What was the purpose of this study? We wanted to find out how autistic adults experience play. We were also interested in how they think their play is different from non-autistic play. What did the researchers do? We asked autistic and non-autistic people to help us design our study and interview questions. We interviewed 22 autistic adults and asked them about their play now or when they were younger. We then analyzed the data using a qualitative method called interpretative phenomenological analysis. This meant that we could identify themes covering the group's views and experiences. What were the results of the study? We found a range of play experiences and different ways in which some autistic adults play. Many autistic adults talked about the importance of both playing by themselves and with others, with solitary play described as being recuperating. Some described preferring play that involves playing nearby other people without necessarily interacting with them directly. Many preferred to play with similar autistic people. Several autistic adults discussed engaging in imaginary play activities such as role-play and preferring play that is based on reality. They also described the benefits and limitations of something called a flow state, which involves intense focus on the play. What do these findings add to what was already known? Our findings highlight how autistic adults like to play and different ways some autistic adults experience play. For example, we highlight the situations where solitary play and social play are preferred, and the importance of understanding that different people like to play in different ways. What are potential weaknesses in the study? We did not involve autistic people beyond consultation. We think that a better understanding of autistic play can come from using approaches with greater autistic involvement, such as co-production. Most of our participants were White, highly educated, and primarily communicate using speech. We do not know if other autistic people would experience play in a similar way. How will these findings help autistic adults now or in the future? Understanding and acceptance of the ways in which autistic people like to play can help support autistic people's well-being. In practice, this involves limiting the use of supports that aim to make autistic people's play "normal" and instead encouraging authentic autistic play.

Patient's perspectives of epilepsy care by specialists and generalists: qualitative evidence synthesis.

BACKGROUND: In the UK, epilepsy care involves both specialists (eg, neurologists) and generalists (eg, general practitioners). Policymakers typically consider that epilepsy care should be integrated and involve both specialists and generalists. However, few understand exactly how patients view and compare specialist and generalist care. AIM: This systematic review aimed to explore patient perspectives of specialist care and generalist care for epilepsy in a qualitative evidence synthesis. DESIGN & SETTING: Systematic Review, qualitative evidence synthesis using an identified framework. METHOD: Systematic searches in 5 databases retrieved 17 eligible studies. Data was extracted and synthesised using framework analysis informed by the 'United Model of Generalism'. RESULTS: Three themes were developed: 'Epilepsy care can be burdensome' (eg, through care fragmentation); 'Patient's experience is that care is not always accessible' (eg, lack of a continuum between standardised and interpretive care); 'How care could change for people with epilepsy' (eg, clinicians currently have insufficient time to deviate from protocol-driven care to address psychosocial needs). People with epilepsy frequently observe that generalists lack expertise in epilepsy management. CONCLUSIONS: This synthesis of patient experiences indicates recommendations should focus on improving communication and integration between specialists and generalists for epilepsy care. Patient experiences indicate specialist care risks being burdensome and generalist knowledge insufficient, requiring enhanced primary care clinician skills and improved awareness of patient psychosocial needs. The findings argue in favour of healthcare policies, materials and tools to continually support patient perspectives in developing epilepsy services.

Parents Experiences of Racism in the Neonatal Intensive Care Unit.

Few studies have investigated parent's experiences with racism in the neonatal intensive care unit (NICU). Our objective was to explore how parents perceive their interactions with NICU staff and if/how racism in the NICU was experienced. Parents of infants receiving care in an urban NICU completed fixed choice surveys regarding their experiences and demographics, with 6 open-ended questions to elaborate on their fixed-choice responses. Using a constant comparative method informed by Constructivist Grounded Theory, we identified 3 main themes from the comments provided by 97 respondents: Care and harm coexisting, racism often manifesting as neglectful care, and the power differential is most impactful during times of parent advocacy. Parents spoke positively regarding their experiences and also reported disparate treatment attributed to their racial/ethnic identity. Racism was experienced by inappropriate comments and apathy toward parent requests, occurring during intimate interactions between staff and parents. Descriptions of parental advocacy efforts highlighted the lack of power they held in relation to the NICU staff. We recommend strengthening the focus on equity and mitigating power imbalances in the NICU.

Caregiver and child perspectives of wellbeing in school-age children with childhood apraxia of speech.

PURPOSE: Childhood apraxia of speech (CAS) is a communication deficit that impacts a child's overall quality of life, including their academic and social interactions, yet few studies have investigated the impact from the child's perspective. Using The World Health Organization's International Classification of Functioning, Disability, and Health (ICF) framework, we examined the children's and caregivers' perspectives on the impact of CAS on their overall wellbeing. METHOD: Survey data were collected from 32 child-caregiver dyads for children ages 9-17 years with CAS. Items elicited responses along a 5-point scale to examine the perceived impact of children's speech impairments using the framework, including impact on communication, interpersonal interactions/relationships, and major life events. RESULT: Results from non-parametric statistical analyses revealed: (a) caregivers reported a significantly greater impact than children across individual ICF domains; (b) child responses were not significantly correlated with their caregiver's responses or with the child's age, gender, or severity indicators; and (c) both caregivers and children indicated the domain of communication was impacted more than other domains. CONCLUSION: Results suggest a potential disconnect in the perceived impact of CAS between the caregiver and child. Recommendations include facilitating a dialogue between the child-caregiver dyad and considering treatment goals that address wellbeing.

Recent progress in microbial biosurfactants production strategies: Applications, technological bottlenecks, and future outlook.

Biosurfactants are surface-active compounds produced by numerous microorganisms. They have gained significant attention due to their wide applications in food, pharmaceuticals, cosmetics, agriculture, and environmental remediation. The production efficiency and yield of microbial biosurfactants have improved significantly through the development and optimization of different process parameters. This review aims to provide an in-depth analysis of recent trends and developments in microbial biosurfactant production strategies, including submerged, solid-state, and co-culture fermentation. Additionally, review discusses biosurfactants' applications, challenges, and future perspectives. It highlights their advantages over chemical surfactants, emphasizing their biodegradability, low toxicity, and diverse chemical structures. However, the critical challenges in commercializing include high production costs and low yield. Strategies like genetic engineering, process optimization, and downstream processing, have been employed to address these challenges. The review provides insights into current commercial producers and highlights future perspectives such as novel bioprocesses, efficient microbial strains, and exploring their applications in emerging industries.

Clinician Perspectives of Gene Therapy as a Treatment Option for Duchenne Muscular Dystrophy.

Background: Duchenne muscular dystrophy (DMD) is a progressive, life-limiting, neuromuscular disorder. Clinicians play an important role in informing families about therapy options, including approved gene therapies and clinical trials of unapproved therapies. Objective: This study aimed to understand the perspectives of clinicians about gene therapy for DMD, which has not previously been studied. Methods: We conducted interviews with specialist clinicians treating patients with DMD in the United States (n = 8) and United Kingdom (n = 8). Interviews were completed in 2022, before any approved gene therapies, to gain insight into barriers and facilitators to implementing gene therapy and educational needs of clinicians. Results: Most respondents expressed cautious optimism about gene therapy. Responses varied regarding potential benefits with most expecting delayed progression and duration of benefit (1 year to lifelong). Concern about anticipated risks also varied; types of anticipated risks included immunological reactions, liver toxicity, and cardiac or renal dysfunction. Clinicians generally, but not uniformly, understood that gene therapy for DMD would not be curative. Most reported needing demonstrable clinical benefit to justify treatment-related risks. Conclusions: Our data demonstrate variability in knowledge and attitudes about gene therapy among clinicians who follow patients with DMD. As our knowledge base about DMD gene therapy grows, clinician education is vital to ensuring that accurate information is communicated to patients and families.

Patients' perspectives on oral decitabine/cedazuridine for the treatment of myelodysplastic syndromes/neoplasms.

Background: Hypomethylating agents (HMAs) are guideline-recommended treatment for higher-risk myelodysplastic syndromes/neoplasms (MDS). However, a prior survey of patients with MDS reported challenges with intravenous (IV) and subcutaneous (SC) HMA therapies, including pain related to treatment administration and interference with daily activities; most patients also indicated a preference to switch to an oral therapy if one were available. Objectives: This study evaluated the perspectives of US patients with MDS receiving oral decitabine/cedazuridine (DEC-C), an alternative to IV/SC HMAs. Methods: An online survey was conducted among adult patients with MDS in the United States (10 November 2022 to 5 December 2022) who had filled a prescription for oral DEC-C between 2021 and 2022. Results: A total of 150 patients completed the survey; 61% were aged ⩾60 years and 63% were male. Of these, 123 (82%) were still receiving oral DEC-C, and 27 (18%) had stopped oral DEC-C treatment. Half (50%) of patients had received oral DEC-C for ⩾6 months. The majority reported that treatment was convenient (83%) and that they were satisfied with treatment (86%). Most patients also reported very little/no interference with regular daily activities (82%), social activities (78%), and productivity (78%). When queried about negative impacts on quality of life (QOL), treatment side effects were the most commonly reported (30% of respondents). Among patients who had previously received IV/SC HMAs (n = 91), most agreed that oral DEC-C interfered less with daily life (91%) and had experienced improvement in QOL (85%) compared with previous treatment; 91% reported that oral DEC-C reduced the number of times they needed to travel to a healthcare facility. Conclusion: Survey results suggest very little/no impact on regular daily activities and improved QOL with oral DEC-C relative to IV/SC HMAs, highlighting the potential for oral DEC-C to reduce the treatment burden associated with parenteral HMA therapy.

Uptake of a self-guided digital treatment for depression and anxiety: A qualitative study exploring patient perspectives and decision-making.

BACKGROUND: Despite the demonstrated efficacy and potential scalability of self-guided digital treatments for common mental health conditions, there is substantial variability in their uptake and engagement. This study explored the decision-making processes, influences and support needs of people taking up a self-guided digital treatment for anxiety and/or depression. METHODS: Australian-based adults (n = 20) were purposively sampled from a trial of self-guided digital mental health treatment. One-to-one, semistructured interviews were conducted, based on the Ottawa Decision-Support Framework. Interviews were transcribed verbatim and analysed thematically using framework methods. Baseline sociodemographic, clinical and decision-making characteristics were also collected. RESULTS: Analyses yielded four themes. Theme 1 captured participants' openness to try self-guided digital treatment, despite limited deliberation on potential downsides or alternative options. Theme 2 highlighted that immediacy and ease of access were major drivers of uptake, which participants contrasted with gaps in access and continuity of care in face-to-face services, especially rurally. Theme 3 centred on participants as the main agents in their decision-making, with family and health professional attitudes also reportedly influencing decision-making. Theme 4 revealed participants' primary motivations for deciding to take up treatment (e.g., the potential to increase insight and coping skills), while also acknowledging that pre-existing characteristics (e.g., health and digital literacy, insight) determined participants' personal suitability for self-guided digital treatment. CONCLUSION: Findings help to elucidate the decision-making influences and processes amongst people who started a self-guided treatment for depression and anxiety. Additional information and decision support resources appear warranted, which may also improve the accessibility of self-guided treatments. PUBLIC OR PATIENT CONTRIBUTION: Patients were interviewed about their views and experiences of decision-making about accessing and taking up treatment. As such, patient contribution to the research was as study participants.

Roles and perspectives in supporting radiography student mental health: A qualitative exploration.

INTRODUCTION: University-based mental health services are crucial to supporting radiography students' mental health and addressing university mental health risk factors. This study aimed to identify factors causing mental health challenges among radiography students, understand their academic impact, and explore lecturers' potential roles in supporting students' well-being at a Zimbabwean tertiary institution. METHODS: A qualitative explorative study employing in-depth semi-structured interviews with 10 radiography students and eight educators was conducted. The interviews were recorded and transcribed verbatim using Otter.ai software. The data was then analyzed inductively using thematic analysis in Nvivo 12, following Braun and Clarke's six-step approach. RESULTS: Three themes were created that describe the factors causing mental health challenges among radiography students, their academic impact, and lecturers' potential roles in supporting students' well-being. The themes are i. Mental health challenges in diverse social, personal, and environmental landscapes ii. Coping and building resilience, and iii. Educator roles in holistic support for mental health and personal growth. A six-step "Cascade" model of the educator roles was proposed. CONCLUSIONS: The study highlights the complex mental health issues faced by radiography students, emphasizing the need for increased attention, resources, and support in academic environments. It highlights the importance of encouraging healthy coping strategies and cultivating a well-being culture, with educators playing a crucial role in fostering friendly environments and providing comprehensive support. Future research should investigate educators' ability to take on these roles while maintaining their current duties in Education 5.0.

Understanding the barriers and facilitators of healthcare services for brain injury and concurrent mental health and substance use issues: a qualitative study.

BACKGROUND: People with acquired brain injury (ABI) may experience concurrent conditions such as, mental health and substance use concerns, that require specialized care. There are services that aim to support people with ABI and these conditions separately; however, little is known about the facilitators and barriers of these services. Therefore, the purpose of this study was to engage stakeholders to investigate the facilitators and barriers of healthcare services for ABI and concurrent issues. METHODS: Semi-structured focus groups were conducted in-person and virtually with people with ABI, caregivers, healthcare professionals, and policy makers during a one-day event in British Columbia, Canada. Manifest content analysis was used with a constructivist perspective to analyze data. RESULTS: 90 participants (including 34 people with ABI) provided insights during 15 simultaneous focus groups. Three categories were identified: (1) complexity of ABI, (2) supports, (3) structure of care. Complexity of ABI outlined the ongoing basic needs after ABI and highlighted the need for public awareness of ABI. Supports outlined healthcare professional and community-based supports. Structure of care described people with ABI needing to meet criteria for support, experiences of navigating through the system and necessity of integrated services. CONCLUSIONS: These findings highlight the facilitators and barriers of healthcare services for ABI and concurrent conditions and provide insights into the changes that may be needed. Doing so can improve the accessibility and quality of ABI healthcare services.

Decolonising the field of violence against women and girls: A scoping review and recommendations for research and programming.

In response to continuing legacies of colonialism, there is increasing recognition of the need to decolonise various fields of research and practice, including within work on violence against women and girls (VAWG). An emerging body of literature critiques how VAWG is framed, how prevention and response interventions may be imposed on communities as part of White Saviourism, and the existence of hierarchical approaches to data collection, analysis and interpretation. This scoping review is the first known attempt to describe global published and grey literature on colonialism and decolonisation within VAWG research and programming. We conducted an extensive search across databases and search engines including research studies, reports, commentaries and blogs, and identified 55 sources that focused on VAWG and related to the legacy of colonialism and/or decolonial approaches within the field. Included literature discussed the role of colonialism in shaping VAWG, referenced decolonial approaches to respond to VAWG and identified five key recommendations for VAWG research and practice: 1. Consider the context and power hierarchies within which VAWG occurs; 2. Incorporate community resources and perspectives into efforts to end VAWG; 3. Use methods and approaches to researching VAWG that centre perspectives and lived experience of communities; 4. Shift VAWG funding to local actors and ensure VAWG funding streams are more responsive to local needs and realities; and 5. Ensure local, contextually-relevant framings of feminisms inform decolonising of VAWG. We conclude that shifting towards a bottom-up approach to decolonising VAWG research and programming is essential to prevent decolonisation from being reduced to a buzzword. While literature explored the use of specific methods to decolonise research on VAWG, researchers need broader strategies to embed a decolonial perspective throughout the research process, transcending mere methodological adaptations. There is a need for VAWG research and programming to scrutinise structural inequities, particularly acknowledging how colonial practices entrenched within wider societal power structures impact the field of VAWG.

Experience of admission and readmission to the emergency department for patients with acute abdominal pain: A qualitative study.

BACKGROUND: Abdominal pain is one of the most common complaints when patients are admitted to emergency departments (ED). Unfortunately, many of these patients are readmitted to the ED shortly after initial discharge. The perspectives of these patients have not yet been explored. PURPOSE: The study aimed to explore how patients readmitted with acute abdominal pain in the ED experienced their initial admission, the time after discharge, and the cause of readmission. METHODS: The study had a qualitative explorative design with a phenomenological-hermeneutic approach. Semi-structured individual telephone interviews were conducted with 14 patients readmitted with acute abdominal pain. RESULTS: The analysis showed four themes: 1) being vulnerable during hospitalisation, 2) the meaning of information during hospitalisation, 3) discharged without being diagnosed, and 4) readmitted in the pursuit of relief. The patients wanted more knowledge and better communication despite their vulnerable condition. Patients were discharged whilst still in pain, and uncertainty of the situation at home contributed to mistrust of the health professionals. CONCLUSION: Patients' experience of the first ED admission due to acute abdominal pain was loneliness, minimal contact with healthcare professionals, and lack of information and involvement in pain management. Discharge was associated with feelings of insignificance and contributed to a fear of death. Pain was the main reason for readmission. Patients described how multiple readmissions contributed to being taken seriously by healthcare professionals.

The role of age, grade level, and subject area in determining the inclusion of digital citizenship elements in elementary school curricula: Perspectives of teachers in the Kingdom of Saudi Arabia.

This study examined teachers' inclusion of digital citizenship elements in elementary school curricula. Employing a quantitative research design, the study utilized a survey questionnaire as the primary data collection instrument. A quantitative approach was employed in this study because it could efficiently measure the extent and variance of digital citizenship inclusion across diverse teacher demographics, enabling statistically significant comparisons and actionable insights for curriculum development. The sample consisted of 300 elementary school teachers at an educational institution in the Kingdom of Saudi Arabia. The questionnaire assessed the degree to which participants incorporated digital citizenship elements, including respect for self and others, self-education and communication with others, and protecting oneself and others, in curricula. The data were analyzed using descriptive statistics and one-way ANOVA tests. The findings revealed significant differences in teachers' inclusion of digital citizenship elements based on age, grade level of instruction, and taught subject matter. The study highlights the importance of tailoring digital citizenship education to meet the diverse needs of teachers. These findings contribute to the development of targeted professional development programs and curriculum frameworks that foster responsible and ethical digital participation. The study also holds pedagogical significance by emphasizing the need to account for variations in digital citizenship inclusion across teacher demographics.

Exploring perceptions of sexuality among youth with physical disabilities in Gweru, Zimbabwe.

Background: Disability and sexuality are topical issues although they are not given much-deserved attention in most societies, and Zimbabwe is not an exception. The socio-cultural stigma associated with disability adversely impacts sexuality and seeps into the social existence of youth with disability. Youths with disability are assumed to be hypersexual or asexual. Objectives: This article explores the sexuality views and experiences of youth with disability in the context of the negative stigma associated with disability and sexuality in Gweru, Zimbabwe. Method: Semi-structured interviews and focus group discussions were conducted among 20 Gweru youth (18-35 years old) with physical disabilities and five key informants. Perceptions of youth with disability and socio-cultural assumptions regarding their sexuality were analysed. Results: The study established that most youths with disability faced social closure in terms of sexuality, with sparse offerings of sexuality education in their families. One sexual education theme that emerged from this study is sexual abstinence. Some suggestions of more open forms of communication on sexuality and disability also emerged although as a minority view. Conclusion: It was concluded from the study that, most youth feel that they are denied information on sexuality in their families and communities, as they are wrongfully assumed to have no need for it. However, youths with disability do not passively accept the negative perceptions about their sexuality, and they demonstrate their agency in resisting such negative perceptions. Contribution: The study contributes to knowledge on sexuality and disability among youths with disability in contexts where strong traditional beliefs, myths, and misconceptions exist.

Routine Hearing Screening for Older Adults in Primary Care: Insights of Patients and Clinic Personnel.

BACKGROUND AND OBJECTIVES: Hearing loss frequently goes undiagnosed and untreated, with serious sequelae. Hearing screening facilitates diagnosis and treatment but is not routinely conducted in primary care. This study addresses attitudes and insights of patients and primary care clinic personnel relative to routinization of hearing screening in primary care for older adults. RESEARCH DESIGN AND METHODS: Data presented are from the qualitative portion of a larger study. The main study compared screening completion for three approaches to coordinating telephone-based hearing screening with primary care - one offering hearing screening within the primary care encounter and two providing information for at-home screening (one with and one without provider encouragement). Focus groups/interviews were conducted with personnel (n=38) at the six participating clinics, patients who completed screening and were referred for diagnosis (n=14) and patients who did not complete screening (n=10). Analysis used the general inductive approach. RESULTS: Most patients had unaddressed hearing concerns prior to the study. Negative attitudes towards hearing loss/treatment were common, and experiences of family and friends influenced attitudes, but lack of urgency was the primary barrier to screening completion. Respondents favored routine primary care-based hearing screening for older adults, but clinic personnel noted challenges of time, space, workflow, and reimbursement. DISCUSSION AND IMPLICATIONS: Findings favor greater routinization of hearing screening in primary care. Routinization will be enhanced by improved reimbursement for screening and follow-up; specialist engagement with primary care and the public (including leveraging older adults' social networks); and further research on specific integration options.

Exploring User Views on Telemedicine to Support Cancer Patients: Insights from Focus Group Discussions in the Context of the eCAN Joint Action.

This paper provides insights into user perspectives on telemedicine for cancer based on Focus Group Discussions (FGDs) within the eCAN Joint Action. Two FGDs centered on the eCAN mobile app and the eCAN dashboard, aiming to confirm user acceptance and understand cancer patients' and healthcare professionals' views. The findings highlight the importance of personalized deployment of telemedicine technologies to meet the specific needs of end users.