qualitative exploration
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Child and adolescent mental health services (CAMHS), especially inpatient units, have arguably never been more in demand and yet more in need of reform. Progress in psychotherapy and more broadly in mental health care is strongly predicted by the therapeutic relationship between professional and service user. This link is particularly pertinent in child and adolescent mental health inpatient services where relationships are especially complex and difficult to develop and maintain. This article describes a qualitative exploration of the lived experienced of 24 participants (8 young people, 8 family members/carers and 8 nursing staff) within inpatient CAMHS across four sites in the UK. We interviewed participants individually and analysed the transcripts using thematic analysis within a critical realist framework. We synthesised data across groups and present six themes, encapsulating the intricacies and impact of therapeutic relationships; their development and maintenance: Therapeutic relationships are the treatment, Cultivating connection, Knowledge is power, Being human, The dance, and It’s tough for all of us in here. We hope these findings can be used to improve quality of care by providing a blueprint for policy, training, systemic structures and staff support.

Background: Stroke is a chronic disease that requires stroke survivors to be supported long-term by their families. This is especially because of the inaccessibility to post-stroke rehabilitation outside hospitals. The Corona Virus Disease 2019 (COVID-19) crisis and the pandemic restrictions in Malaysia are expected to exponentially increase the demand from family caregivers in supporting stroke survivors. Thus, this study aims to explore the burden, experience, and coping mechanism of the family caregivers supporting stroke survivors during the COVID-19 pandemic. Methodology: A phenomenological qualitative study was conducted from November 2020 to June 2021 in Malaysia. A total of 13 respondents were recruited from two public rehabilitation centers in Kota Bharu, Kelantan. In-depth interviews were conducted with the participants. Comprehensive representation of perspectives from the respondents was achieved through purposive sampling. The interviews were conducted in the Kelantanese dialect, recorded, transcribed, and analyzed using thematic analysis. Results: Three themes on burdens and experiences were identified. They were worsening pre-existing issues, emerging new issues, and fewer burdens and challenges. Two themes on coping strategies were also identified. They were problem-focused engagement and emotion-focused engagement. Conclusions: The COVID-19 pandemic has changed the entire system of stroke management. While family caregivers mostly faced the extra burden through different experiences, they also encountered some positive impacts from the pandemic. The integrated healthcare system, especially in the era of digitalization, is an important element to establish the collaborative commitment of multiple stakeholders to compensate burden and sustain the healthcare of stroke survivors during the pandemic.

Schwartz Centre Rounds (SCRs) provide a structured forum for staff from all disciplines to meet and discuss the difficult emotional and social challenges that arise in caring for patients. Research into the implementation of SCRs has shown that staff who attend report increased insight into the emotional and social aspects of care; greater understanding of the roles of their colleagues; improved teamworking and decreased feelings of isolation and stress. However, little research has explored the implementation of SCRs within forensic settings, and no research has focused solely on the experiences of panel members. Three focus groups were facilitated with participants who had participated in a SCR panel within a forensic mental health service. Semi-structured interviews were carried out, audio-recorded and subsequently transcribed. Interpretive phenomenological analysis was utilised to analyse the transcripts, and four key themes were identified. These themes were: feeling vulnerable, the importance of validation, exposure to intense emotional experiences and improved understanding and connection. We conclude that SCRs can be an emotionally challenging but rewarding experience, with the potential to enhance teamworking and general well-being. Limitations and recommendations for future research are also discussed.

Introduction: Social media allows a user to be a content creator and consumer. This paper focuses on the social media engagement of everyday women who participate in CrossFit, exploring differences in how they consume and use social media content. CrossFit women are celebrated for their strength, power, and fitness in the social media community, which is not consistent for all women. Methods: This study used semi-structured focus groups with 47 participants between the ages of 18-54 who were everyday women who participate in CrossFit. The participants self-identified their level of CrossFit as recreational, semi-competitive, competitive, or high-level competitors.   Results: Findings reveal two major themes: consuming corporate messaging and using social media for their own benefit, included the subthemes of social support and shifting perceptions. The findings, including supportive quotations from the participants, reveal that these women are critical consumers of social media who express disapproval of traditional media portrayals of women’s bodies. Conclusions: Women’s experiences with CrossFit seem to offer some protection from the negative outcomes associated with consumption of traditional media messaging about women’s bodies.

Abstract Background Medical students are vulnerable to test anxiety (TA), which impacts their professional lives and jeopardizes the optimal health care of their patients. The qualitative exploration of TA among medical students is crucial to understanding the problem. Hence, this study examined medical students’ insights into TA and their suggestions on how to reduce it. Methods We conducted a phenomenological study on medical students at a public university. We utilized focus group discussions (FGDs) to investigate their experiences of TA. The FGDs were transcribed verbatim, and these transcripts were analyzed using Atlas.ti software. The thematic analysis followed the recommended guidelines. Results Seven FGD sessions were conducted with 45 students. Three major themes emerged: the students, their academic resources, and the examiner. Each theme comprised mutually exclusive subthemes. The “students” theme was divided into negative vs. positive thoughts and self-negligence vs. self-care, “academic recources” into heavy curriculum vs. facilitative curricular aids, and “examiner” into criticism vs. feedback and strict vs. kind approaches. Conclusion This study provides a solid foundation for policymakers and decision makers in medical education to improve current assessment practices and student well-being. Medical students will be able to significantly alter and reduce TA if they are provided with additional psychological support and their examiners are trained on how to deal with examinees.

Background Breastfeeding intention can predict breastfeeding behaviour and is influenced by theory of planned behaviour constructs. Despite associations with reduced breastfeeding duration, there is a lack of research to explore the intention to mixed feed infants. Aims This study aimed to explore the factors that influence pregnant women's intentions to mixed feed their first child. Methods Semi-structured interviews were conducted with four women pregnant with their first child who intended to mixed feed. An in-depth idiographic multiple case study approach grounded in a ‘subtle realist’ epistemology was used. Results The interviews highlighted the importance of flexibility in feeding decisions, a perception of breastfeeding as restrictive and obstructive to normality and the presence of misinformation and unrealistic expectations about breastfeeding. Conclusions Women need to be informed and supported by professionals, peers, families and broader communities. Cultural narratives must be challenged to enable mothers to feel in control of feeding decisions and without the need to justify feeding activities to protect themselves from anticipated negative emotions.

Background In the UK, rates of exclusive breastfeeding at 6 months are at 1%, highlighting the need to encourage and improve the support provided to women to initiate and continue breastfeeding and to improve infant and maternal health. This study aimed to qualitatively explore the influence of media on the intention to initiate and continue breastfeeding. Methods This ethnographic study recruited 40 women; 31 with children and nine of childbearing age (19–28 years), with the intention to have children. Data were collected with semi-structured interviews and analysed using thematic analysis. Results Five themes associated with sociocultural influences on breastfeeding perceptions and behaviour were identified: family influence, privacy, media as a double-edged sword, negative exposure to breastfeeding and planned behaviour versus experience. Conclusions Media influences strengthened preconceived notions of breastfeeding. Social media can play an important role in maintaining breastfeeding though support but can also put undue negative pressure on mothers who struggle to breastfeed.