Attention-deficit/hyperactivity disorder (ADHD) is more commonly missed or diagnosed later in females than in males. One explanation is that diagnostic criteria have been informed by research primarily based on male samples and may not adequately capture the female presentation of ADHD.

This study used a qualitative approach to better understand female ADHD in childhood, from the perspective of young women and non-binary adults with ADHD.

Twelve young adults (10 women and 2 non-binary individuals assigned female at birth, aged 18–25 years) with ADHD were interviewed to describe their lived experiences of ADHD throughout childhood. Interviews were transcribed verbatim and qualitatively analysed using the framework method, a codebook approach to thematic analysis.

Participants reported experiencing a range of ADHD symptoms, some of which are not included in current diagnostic criteria. Four core themes were identified: (a) socially oriented and internalised symptoms, (b) social impacts, (c) masking and compensation and (d) the importance of context. Theme one describes how girls with ADHD may experience symptoms as more socially oriented (e.g. losing track of thoughts in a conversation), non-disruptive (e.g. doodling) and internalised (e.g. feeling frustrated) than those described by current diagnostic criteria. Theme two highlights the importance of social impacts of ADHD on friends, home and school. Theme three describes the desire to ‘fit in’ socially, behaviours and strategies used to mask symptoms and associated unfavourable consequences. Theme four highlights variability in symptoms across different environmental contexts.

This study suggests that the presentation of ADHD symptoms in girls may be socially oriented, internalised and especially influenced by the social context. Also, female ADHD symptoms may be less visible due to scaffolding, masking and context. Future research should consider whether current ADHD diagnostic criteria require adjustment, to aid earlier recognition and diagnosis of ADHD in children and young people, especially in females.

More people than ever are receiving support for mental health issues, and instances of suicide continue to grow. Although mental health funding has increased, UK government figures evidence that the National Health Service (NHS) does not have the resources required to respond to such growth in demand. The experiences of staff working in mental health services can offer insight into the efficacy of current provision and assist in service evaluation; however, research examining this issue outside of the COVID-19 pandemic, and in the context of community mental health, is lacking.

We aimed to explore the perspectives of staff working in a variety of mental health services in North-West England, to elucidate the current standard of care provided and highlight areas for improvement.

One-to-one interviews were conducted with 26 staff members as part of a qualitative grounded theory analysis.

Findings portrayed a community in crisis, consisting of the following themes: stabilisation not recovery, inefficient pathways and barriers to collaboration.

NHS services are struggling to meet the mental health needs of the population, resulting in lengthy waiting times for therapy, a lack of intervention-focused care and an over-reliance on the third sector. While crisis cafés are provided at low cost and result in satisfaction, policy-makers must ensure that these receive adequate funding and do not become overburdened. Staff reported that collaboration between clinical and non-clinical services would improve care pathways and reduce strain on the NHS, but judgemental attitudes and inflexible service development must be challenged to achieve this.

The decision-making process regarding antipsychotic continuation or discontinuation following remission from first-episode psychosis (FEP) remains complex and underresearched. While discontinuation increases the risk of relapse, concerns over long-term side-effects such as metabolic disturbances and extrapyramidal symptoms also exist. Current guidelines recommend maintaining antipsychotics for 1–5 years, emphasising shared decision-making (SDM) between clinicians and patients.

This study aimed to explore the decision-making process and describe the factors influencing the decision to discontinue or continue antipsychotic treatment following remission from FEP, from the patients’ perspective.

A descriptive qualitative study was conducted with 12 individuals in remission from FEP who received care at early intervention services in Quebec, Canada. Data were collected through online semi-structured interviews and analysed thematically to identify key factors influencing treatment decisions.

The decision-making process was activated by treatment reflection triggers and shaped by various perceptions (of illness, treatment and stigma) and relationships (with friends, family and the clinical team), ultimately leading to decisions to either discontinue, continue (at standard or reduced dose) or remain ambivalent. This dynamic process was guided by participants’ motivators, such as well-being and societal contribution. Most participants felt that discontinuation discussions were not initiated by the clinical team.

The decision-making process is driven by motivators that were found to be linked to the concept of personal recovery. This study highlights the need for proactive, personalised discussions between clinicians and patients. Future research should focus on decision aids tailored to the FEP population to support SDM and improve treatment outcomes.

This qualitative study aimed to explore the lived experiences, challenges, and perceptions of nurses regarding disaster preparedness in non–first-tier (inland) cities in China. Building upon our previous quantitative findings, we sought to understand the psychological, professional, and organizational factors that influence nurses’ disaster response capabilities in resource-limited settings.

A descriptive phenomenological approach was employed. Semistructured in-depth interviews were conducted with 12 nurses from four comprehensive hospitals at or above the second level in Yongcheng City, Henan Province, China, between September and December 2023. Participants were purposively selected based on their involvement in disaster response activities. Interviews were audio-recorded, transcribed verbatim, and analyzed using Colaizzi’s 7-step method.

Five major themes emerged from the analysis: (1) Psychological Stress and Emotional Adaptation, (2) Disaster Emergency Response Capacity and Management, (3) Communication and Collaboration, (4) Challenges in Disaster Nursing Capacity Development, and (5) Impact of Disaster Relief Participation. Key findings revealed that nurses experienced significant psychological pressure during disaster response, struggled with limited specialized training opportunities, faced challenges in team coordination, and identified institutional barriers to disaster preparedness enhancement. Despite these challenges, participants demonstrated strong professional commitment and developed personal coping strategies.

This study provides critical insights into the lived experiences of nurses during disaster response in Chinese non–first-tier cities. The findings highlight the need for systematic psychological support mechanisms, specialized disaster nursing training programs tailored to local contexts, enhanced interhospital collaboration networks, and stronger institutional commitment to disaster preparedness. These insights complement our previous quantitative findings and offer a comprehensive foundation for developing targeted interventions to enhance disaster nursing capabilities in resource-limited settings.

Meaning-making in psychotic experiences may affect mental health recovery by influencing the degree to which a person experiences Meaning in Life (MIL). However, how meaning made in such experiences impacts MIL is poorly understood. We aimed to explore how service users engage in meaning-making in their experience of a first-episode psychosis (FEP) (as well as subsequent and current psychotic experiences), and to identify if and how this meaning has influenced their current perspective on MIL.

The study aim was addressed using Interpretative Phenomenological Analysis (IPA). We used purposive maximum variation sampling and conducted semi-structured interviews with 16 members of an epidemiologically complete FEP incidence cohort in the Republic of Ireland. Data analysis was guided by IPA procedures.

We found psychotic experiences both contributed to and eroded MIL but also created memory blanks, blocking the process of meaning-making. Meaning-making in psychotic experiences involved: Living with the impact of psychosis on the self and identity (Survival); Reconnecting with time to move forward in time (Restoring temporality); Navigating agency and powerlessness in chaos (Reclaiming control); Generating Meaning in Life in a vacuum (Presence in absence); and Trying to find a home for psychosis or not needing to (Narrative re-storying).

Findings challenge current meaning-making theory; suggesting that it may not be fully applicable to the lives of people experiencing psychosis. Our data also have implications for the implementation of trauma informed care, the recovery approach in mental health, clinical practice, and research.

Although decentralized research is being used more frequently, few data are available regarding barriers for potential subjects related to engaging in decentralized research with remote biospecimen collection, especially within pregnancy and birth cohorts that include individuals of diverse racial and ethnic backgrounds.

Focus groups and individual interviews with pregnant and postpartum women were conducted in English and Spanish. Thematic analysis was used to identify motivators and barriers to participation in decentralized research involving biospecimens.

Sixty women (35% Hispanic/Latino, 23% Black, 18% Asian, 15% non-Hispanic White) participated in 10 focus groups (English = 8, Spanish = 2) and 11 individual interviews (English = 7, Spanish = 4). Three themes emerged about factors that could promote participation in decentralized biospecimen collection: 1) convenience, 2) autonomy, and 3) benefit (to self, community or society). Four themes emerged about potential barriers: 1) lack of interaction with trained professionals, 2) inability to coordinate with existing clinical care, 3) discomfort and invasiveness, and 4) concerns about data transparency and security. Overall, participants felt more comfortable providing biospecimens for themselves compared to their child and with biospecimens perceived as less painful or invasive to obtain.

Our findings suggest that transparency about the purposes and use of collecting biospecimen and clear instructions (such as written and instructional videos) could improve biospecimen collection in decentralized pregnancy and birth cohorts. Additionally, opportunities for virtual interaction with study staff and options related to collection of certain biospecimens such as blood (mobile collection unit with trained staff versus a self-collection device) may also improve participant engagement.

To overcome the dearth of high-quality, evidence-based, role-specific training for community health workers and promotoras (CHW/Ps) working with research teams, we developed and evaluated a peer-led research best practices training for CHW/Ps. This article qualitatively explores the training experiences from the perspectives of CHW/Ps.

CHW/Ps were recruited from communities and partners affiliated with study sites in Michigan, Florida, and California to participate in peer facilitated trainings in English and Spanish. A purposeful sample of CHW/Ps completed interviews from July to December 2023 about their perceptions of the training. Three coders analyzed the interviews using a combination of the rigorous and accelerated data reduction (RADaR) technique and thematic text analysis.

Seventeen CHW/Ps participated in interviews (N = 10 in English; N = 7 in Spanish). The mean age was 43.7 ± 14.5 years, most were female (59%), and 47% identified as Hispanic, Latino, or Spanish. We identified three primary themes, each with resulting subthemes: (1) CHW/Ps’ Perceptions of the Training, (2) Factors Influencing Receipt of the Training, and (3) CHW/Ps’ Recommendations for Future Trainings. Despite offering some opportunities for improvement in various areas, CHW/P learners found the training further clarified their role as CHW/Ps, enhanced their knowledge and skills, and provided a beneficial foundation for CHW/Ps working in community-engaged research.

A peer-led research best practices training for CHW/Ps is an effective strategy for enhancing CHW/Ps’ knowledge and skills. Training CHW/Ps in research best practices is a strategy for enhancing the capacity and capability of this community-engaged research workforce

Timely integration of palliative care (PC) into standard oncology hospital care offers significant benefits to patients with incurable cancer and their families. International recognition of the importance of timely PC has shifted the focus from integration to determining the optimal timing for introducing PC. The specific care responsibilities of oncology clinicians acting as generalists in PC and the optimal timing for involving PC specialists remain uncertain.

This study aimed to (1) explore how the concept of “timely PC” is understood by oncology clinicians and patients with incurable cancer and (2) investigate how PC is provided in a timely manner in daily clinical practice.

An interview study was conducted with 18 oncology clinicians (7 physicians, 1 physician assistant, and 10 nurses/nurse practitioners) and 12 patients with incurable cancer. The interviews were conducted between October 2022 and June 2023 and a thematic analysis of the interviews was performed.

Three main themes emerged regarding “timely PC”: (1) timely PC is individual and situational, (2) identification of the right time is an ongoing challenge, and (3) proactive care is essential. Regarding the provision of timely PC, 3 themes were identified: (1) having a strong collaboration among various clinicians, (2) having the courage to start a clear and sincere conversation, and (3) being sensitive and personal.

Being timely is not a fixed point in time, but depends on the individual patient and their situation. Clinicians should be proactive and gradual in bringing up PC-related topics and be careful to use the right words. Tools such as the surprise question can support in timely integrating PC but being timely PC highly depends on a patient’s individual context. Therefore, clinicians should be aware that timely PC is a constant search for the most fitting moment.

Interventions based on testing and communication training have been developed to reduce antibiotic prescribing in primary healthcare (PHC) for the treatment of acute lower respiratory infections (ALRTIs). However, research based on the experiences of PHC clinicians participating in ALTRIs interventions to reduce antibiotic prescribing in Barcelona is scanty.

This study aimed to explore the perceptions and experiences of clinicians (physicians and nurses) on an intervention to reduce antibiotic prescription in PHC in Barcelona (Spain). This intervention was a randomised controlled study (cRCT) based on three arms: 1) use of a C-reactive protein (CRP) rapid test; 2) enhanced communication skills; and 3) combination of CRP rapid test and enhanced communication skills. In addition, the study aimed to explore the impact of COVID-19 on the detection of ALRTIs.

This qualitative study used a socio-constructivist perspective. Sampling was purposive. Participants were selected based on age, sex, profession, intervention trial arm in which they participated, and the socioeconomic area of the PHC where they worked. They were recruited through the healthcare centres participating in the study. Nine participants (7 women and 2 men) participated in two focus groups, lasting 65–66 min, in September–October 2022. Framework analysis was used to analyse the data.

Three themes were identified: ‘(The intervention) gave us reassurance’: intervention experiences among health professionals. This theme includes accounts of clinicians’ satisfaction with the intervention, particularly with CRP testing to support clinical diagnoses; ‘We don’t have time in primary healthcare’: structural and community resources in healthcare services. This theme encompasses clinicians’ experiences on healthcare pressures and PHC organisational structures barriers to PHC interventions; and ‘I only did three CRP’: impact of COVID-19 pandemic on the intervention. The last theme focuses on the impact of the COVID-19 pandemic on the intervention’s implementation.

CPR testing and promoting communication skills can be useful tools to support clinical decisions for ALRTIs. Structural barriers (e.g., healthcare pressures) and social inequities amongst service users were acknowledged as the main barriers for the implementation of ALRTIs interventions.

While nutrition plays a major role in health, medical students have generally not received adequate nutritional education, lack confidence in their nutritional knowledge and feel unqualified to offer nutrition advice to future patients. Culinary medicine programmes have been developed to address this gap and employ an active learning approach that integrates medical and nutritional learning with the acquisition of culinary competencies and skills. This study aimed to qualitatively evaluate the Université Laval culinary medicine course based on students’ experiences of the course structure, active learning approach and its influence on their lifestyle, clinical practice and future approach to nutrition as physicians.

Discussion groups were conducted. Thematic content analysis of discussion group data was performed.

A first French-language culinary medicine course was developed and pilot tested at Université Laval. The curriculum of this course combined online training videos on medical and nutritional concepts, hands-on cooking sessions and the realisation of a collaborative project.

Pre-clerkship medical students enrolled in the elective culinary medicine course at each pilot project semesters (fall 2022: n 12, winter 2023: n 12).

Students valued the course’s innovative active learning approach, noting improvements in their diet, nutrition and cooking knowledge, skills, self-efficacy and confidence. They also developed greater critical thinking regarding nutrition and recognised their role in collaborating with dietitians.

The culinary medicine course demonstrated prospective benefits for medical students, potentially improving their personal and future patients’ health and the integration of nutrition into medical education and practice.

Cash transfer programmes (CTPs) provide financial support to alleviate poverty and promote economic stability. The Bolsa Família Programme (BFP), a Brazilian initiative and the world’s largest CTP by number of beneficiaries, aims to improve living conditions. While poverty is closely linked to poor mental health, evidence regarding the specific effects of CTPs on young adults’ mental health remains limited, underscoring the need for further research.

To understand the meaning attributed to the BFP by young adults regarding their future aspirations and mental health, as well as perspectives from providers.

This qualitative study was conducted at the outskirts of São Paulo city, involving 12 in-depth interviews with young adults aged 18–24 years and 2 focus groups comprising 17 health and social assistance professionals.

Thematic analysis identified four themes according with interviews and focus groups: (a) perceptions about poverty (hopelessness and lack of opportunities); (b) impact of poverty on mental health (anxiety, unpredictability and hopelessness as consequences of living in poverty); (c) young adults’ needs and aspirations (job opportunities as the main expectation for a better future); and (d) BFP limitations and opportunities for improvement (BFP perceived as just one of the survival strategies but not impacting life opportunities for young adults).

The BFP was valued as essential for meeting poor families’ basic needs. Employment opportunities were central to young adults’ expectations, often causing anguish and anxiety. Expanding the BFP to include employment and income-generation policies could better support the mental health and life opportunities of vulnerable youth.

There is a need for better collaborative care between services to improve healthcare provision for people with intellectual disabilities. In the UK, the learning disability psychiatry multidisciplinary team (MDT) is a specialist team responsible for providing and coordinating care for people with intellectual disabilities.

To document learning disability MDT perspectives on factors influencing healthcare quality for people with intellectual disabilities.

Healthcare professionals who were members of a learning disability MDT within a National Health Service Trust in the West Midlands were purposively sampled for interview (n = 11). Participants included psychiatrists, nurses, occupational therapists and speech and language therapists. Data were analysed thematically using Braun and Clarke’s six-stage approach.

Factors influencing the quality of healthcare provision included: the learning disability MDT working to overcome systemic barriers; the consequences of specific failures within mainstream healthcare services, such as diagnostic overshadowing; inadequate use of information collated in health passports; and inadequate capacity assessments of people with intellectual disabilities. Improvements in healthcare provision for people with intellectual disabilities require better accessibility to healthcare and better training for healthcare professionals so they can understand the health needs of people with intellectual disabilities.

A rapid review of practices around health passports for people with intellectual disabilities should be conducted. Healthcare professionals working in mainstream healthcare services need an increased awareness of the harms of diagnostic overshadowing and inadequate capacity assessments. Conclusions are based on findings from MDTs within one health board; future work may focus on understanding perspectives from different teams.