To explore adults’ perceptions towards obesity and factors influencing eating behaviour and physical activity in North Lebanon, using a variation of the Photovoice method.

This research is part of a broader qualitative study exploring factors influencing the rising levels of obesity and understanding the barriers and enablers for effective policy for obesity prevention using a socio-ecological model as a guiding framework. For this study, a variation of “Photovoice” was used to collect photographs to explore participants’ perspectives of obesity and its causes in Lebanon, using these photographs to generate discussion in one-to-one face-to-face interviews. Inductive and deductive thematic analyses were used to analyse the transcribed interviews.

Tripoli, North Governorate, Lebanon.

Twenty Lebanese adults aged 20-64 years were recruited.

The participants (n=20) generated 257 photographs representing various factors perceived to be associated with rising obesity in Lebanon: changes in the food and eating landscape, sedentary behaviours, food environments, eating out, and food marketing on social media platforms. Several themes specific to Lebanon were also identified, including the perceptions towards obesity, the central role of women in Lebanese food preparation and the family, and the sociocultural importance of food and social gatherings.

This study highlights how influences across the five levels of the socio-ecological model shaped the participants’ food choices and physical activity levels. Collaborative initiatives and public policies are necessary to address the identified barriers and curb the increasing prevalence of obesity in Lebanon.

This study aimed to investigate self-management experiences at home among gynaecological cancer patients with lower limb lymphoedema.

Lower limb lymphoedema is a common complication following gynaecological tumour treatment, causing physical and psychological distress and significantly impacting patients’ quality of life. Clinical observations reveal that many patients with lower limb lymphoedema following gynaecological tumour treatment exhibit poor compliance with family self-management, leading to complications such as worsening oedema, cellulitis, or erysipelas. This study seeks to gain insight into patients’ actual self-management experiences within their families, offering insights for tailored intervention plans and improved patient self-management compliance in clinical practice.

Employing a phenomenological approach in qualitative research, one-on-one semi-structured interviews were conducted to gather face-to-face data from participants. A total of 16 gynaecological cancer patients with lower extremity lymphoedema were selected via purposive sampling from a tertiary cancer hospital. Semi-structured in-depth interviews took place between February and July 2021, with data analysed via the Colaizzi 7-step analysis method.

Five key themes emerged: inadequate and uneven availability of medical resources for patients with lymphoedema, limited support for patients, deficient home self-management skills, considerable psychological stress during home management, and variations in self-management behaviours.

Based on the study findings, increased investment in lymphoedema-related medical care is recommended. Additionally, healthcare professionals can consider promoting family and social support, enhancing patient health education, offering remote psychological counselling, encouraging positive coping behaviours among gynaecological cancer patients with lower limb lymphoedema, and ultimately enhancing their self-management at home.

The LGBTQIA+ community faces pervasive discrimination, including in healthcare settings. This discrimination can be particularly detrimental during hospice and palliative care, where patients are especially vulnerable and may have distinct needs related to their sexual orientation or gender identity.

This study aimed to identify the barriers and enablers to accessing equitable and inclusive palliative care for LGBTQIA+ individuals.

A self-administered online survey was conducted in November 2023 among LGBTQIA+ adults residing in Portugal. Thematic analysis was applied to identify barriers and enablers, mapped using an adapted socioecological framework.

Fifty-five respondents participated, primarily cisgender women (49.1%) identifying as homosexual (50.9%), with most aged 18–34 (76.4%). Barriers included caregiver homophobia, lack of LGBTQIA+-specific knowledge among professionals, fear among patients, misaligned care priorities, exclusion of partners from decision-making, and limited access to care. Enablers involved professional LGBTQIA+-specific training, psychological support, integration of partners or chosen families in care, workforce diversity, dissemination of palliative care information, community engagement, and inclusive societal values.

Inclusive and responsive palliative care is essential to addressing the unique needs of LGBTQIA+ individuals. The findings highlight the need for systemic reforms to advance equity in care. The study calls for mandatory LGBTQIA+-focused training for healthcare providers, recognition of chosen families in care decisions, and public health campaigns that promote inclusivity. Collaboration with LGBTQIA+ organizations to improve outreach and access is vital, along with legislative measures to ensure equitable and inclusive care.

The Dutch National Health Care Institute (ZIN) advises the Dutch Minister of Health on the basic benefit package using Health Technology Assessment (HTA), focusing on necessity, clinical effectiveness, cost-effectiveness, and feasibility. Despite the huge environmental impact of the healthcare sector, this impact is not taken into consideration. Several methodological approaches to integrate the environmental impact into HTA have been proposed, including information conduit, integrated evaluation, parallel evaluation, and environment-focused evaluation. There is significant uncertainty as to which approach is the most appropriate. Therefore, it is important to understand stakeholders’ perspectives on these approaches.

To explore Dutch stakeholders’ perspectives on integrating environmental impacts into HTA and assess preferred methods and challenges.

A qualitative study using a focus group with members from ZIN (n = 7) and individual interviews (n = 7) with experts in HTA, market access, and reimbursement. Interviews were transcribed and analyzed thematically.

Stakeholders highlighted the importance of addressing environmental impacts such as pharmaceutical pollution, greenhouse gas emissions, and waste. Integrated and parallel evaluations were preferred, but barriers such as data gaps, methodological complexity, and lack of guidelines were noted.

Incorporating environmental impacts into HTA is crucial but requires clear guidelines, better data, and stakeholder collaboration to support sustainable healthcare practices.

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