Background: Posttraumatic stress disorder (PTSD) is common in people with serious mental illness who come into contact with the criminal justice system. Little evidence exists on EMDR treatment in forensic mental health, with no prior qualitative research exploring lived experience perspectives.Objective: This qualitative study recruited adult forensic mental health patients with PTSD and psychotic disorders, predominantly schizophrenia, who had received EMDR as part of a clinical trial, either in prison or in hospital. We sought to understand their experiences of EMDR therapy while receiving forensic care.Method: Ten in-depth, semi-structured qualitative interviews were undertaken and analysed using thematic analysis. We used an inductive, realist approach, reporting the experiences, meanings, and reality of the participants.Results: Five overarching themes were identified. First, severe trauma was ubiquitous and participants felt Seriously Messed Up by their traumatic experiences, with debilitating and enduring PTSD symptoms contributing to offending and psychosis (\'giving the voices something to feed on\'). Second, EMDR was regarded with Early Scepticism. Third, the therapy itself was initially emotionally taxing and Not Easy but participants generally felt safe and persevered. Fourth, they were often surprised and delighted by results (And it Worked!), describing significant symptom reduction and personal transformation. Lastly, EMDR Fits the Forensic Setting, bringing empowerment in a place perceived as disempowering. People reported changes that increased their hope in a violence-free future.Conclusions: The limited research on EMDR in forensic mental health is unfortunate given how common PTSD is in mentally unwell offenders and its potential to impede recovery and contribute to further offending. This first qualitative study found participants experienced positive transformative change, extending beyond symptom reduction. Themes support previously published quantitative outcomes showing EMDR to be safe and effective in this cohort. EMDR was well suited to a forensic setting and was seen as an empowering therapy.Trial registration: Australian New Zealand Clinical Trials Registry identifier: ACTRN12618000683235.Study registration: The study was registered on the Australia and New Zealand Clinical Trials Network, registration number ACTRN12618000683235 (registered prospectively, 24 April 2018), https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id = 374682.
This study canvases the lived experiences of forensic patients receiving EMDR for PTSD – people whose views are seldom captured. They described being profoundly impacted by trauma, developing debilitating and enduring PTSD symptoms which variably contribute to offending and psychosis.Participants did not have favourable first impressions when they first heard about EMDR, thinking it ‘quackery’. However, they were surprised and delighted by results, with the majority describing marked symptom reduction and personal transformation. Having targeted some of the underlying drivers of maladaptive behaviour, people reported hope for a better future.EMDR was well suited to a forensic setting and was seen as an empowering therapy.

BACKGROUND: Family centered developmental care (FCDC) are a philosophy of care in the neonatal care units (NICU), based on the control of sensory stimulation the adequate position and of newborn and the family involvement of cares. Nursing staff are the main providers of this care. Sanitary measure to control of the COVID-19, such as the use of masks, isolation of positive cases and capacity limit, conditioned the implementation of FCDC.
OBJECTIVE: To understand the meaning of the experience of the nursing staff of a neonatal intensive care unit (NICU) on the implementation of the FCDC, under the sanitary measures imposed for the containment of COVID-19.
METHODS: A qualitative study was conducted from the descriptive phenomenological paradigm in which NICU nurses were recruited. The qualitative data collection was carried out through open-ended and semi-structured interviews. These were analyzed respectively through a preliminary narrative analysis and a thematic analysis of the informant nurses\' narratives and discourses.
RESULTS: Three open-ended and 7 semi-structured interviews were conducted from which three main topics emerged: 1) changes in the FCDC derived from the sanitary restrictions implemented for the containment of COVID-19; 2) changes in interpersonal relationships in the context of a pandemic, and 3) transition to normality.
CONCLUSIONS: The nurses of NICU perceived changes in the implementation of the FCDC due to the containment of COVID-19, that modified the relationship with the parents of NB, accelerating their training as caregivers, and involved the implementation of new measures such as video calls.

OBJECTIVE: To explore the opinion of different key stakeholders regarding the requirements that tobacco, alcohol and/or cannabis cessation interventions should meet to be implemented and to be acceptable and useful during pregnancy.
METHODS: A qualitative study with phenomenological approach. SITE: The study was conducted in Spain in 2022.
METHODS: Decision makers, health professionals, pregnant women using tobacco, alcohol and/or cannabis and their partners who are also users.
METHODS: Data were collected through focus groups and in-depth interviews, until discourse saturation was reached and accurately transcribed. Exploratory analysis and inductive open coding were conducted, codes were merged into categories and subcategories were identified.
RESULTS: Four categories and 18 subcategories were identified. The results suggest that interventions should be multicomponent. Among the interventions most accepted by pregnant women and their partners were specific cessation consultations, information, peer support (although they did not specify how) and financial incentives. Among other options to consider, co-oximetry, proposed by managers to obtain an objective register.
CONCLUSIONS: The conclusion is that this intervention should be carried out at the level of prenatal care in primary care. There are doubts regarding the frequency, purpose, and follow-up of this multicomponent intervention, as well as the possibility of incorporating couples.

The development of infant mental health (IMH) services globally is still in its early stages. This qualitative study aims to understand the challenges of setting up IMH services and explores the views and experiences of 14 multi-disciplinary stakeholders who are part of the IMH implementation group in a large Scottish health board. Six major themes were identified through thematic analysis. This paper examines the most prominent theme \"Systems\" alongside the theme \"Gaps in Current Service\". The theoretical framework of \"candidacy\" is found to be a valuable way to conceptualize the complex systemic layers of micro, meso, and macro factors that contribute to the challenges of setting up services. At the micro level, key themes included the view that services must be accessible, individualized, and involve families. At the meso level, in line with the aims of the service, multiagency integration, aspects of early intervention, and clear operating conditions were all seen as important. Finally, at the macro level, perhaps the biggest challenge perceived by stakeholders is delivering a service that is entirely infant-focused. These findings will help inform policy makers about factors considered by professionals to be vital in the establishment of IMH services in Scotland and across the globe.
El desarrollo de los servicios de salud mental infantil (IMH) globalmente está aún en sus niveles básicos. Este estudio cualitativo se propone comprender los retos de establecer los servicios IMH y explora los puntos de vista y experiencias de 14 personas interesadas de múltiples disciplinas que son parte de un grupo de implementación de IMH dentro de una extensa junta de salud escocesa. A través de análisis temáticos se identificaron seis temas de mayor importancia. Este estudio examina el tema más prominente según la mayor percepción, “Sistemas,” junto con el tema “Vacíos en la Actual Prestación de Servicio.” Se estima que el marco teorético de trabajo de “candidatura,” es una manera valiosa de conceptualizar los complejos niveles sistémicos de micro, medio y macro factores que contribuyen a los retos de establecer los servicios. Al nivel micro, los temas claves incluyen el punto de vista de que los servicios deben ser accesibles, individualizados y deben involucrar a las familias. Al nivel medio, alineados con las metas del servicio, la integración de agencias múltiples, aspectos de temprana intervención y claras condiciones operativas fueron todas estimadas como importantes. Finalmente, al nivel macro, quizás el mayor reto percibido por las personas interesadas es cumplir con el ofrecimiento de un servicio que esté enteramente enfocado en el infante. Estos resultados ayudarán a informar a quienes determinan las políticas a seguir acerca de los factores que los profesionales consideran vitales en el establecimiento de servicios IMH en Escocia y alrededor del globo.
Au niveau global, le développement de service de santé mentale du nourrisson et de la petite enfance en est encore à ses débuts. Cette étude qualitative s\'est donnée pour but de comprendre les défis que pose l\'installation de services IMH. Elle explore les vues et les perspectives de 14 parties prenantes de diverses disciplines qui font partie d\'un groupe de mise en place IMH dans un grand conseil de santé en Ecosse. Six thèmes principaux ont été identifiés au travers une analyse thématique. Cet article examine le thème ayant été perçu comme le plus grand et proéminent, Systèmes, ainsi que le thème « Brèches dans les services actuels ». La structure théorique de la ‘candidature’ a été utilisée pour trouver une manière utile de conceptualiser les couches systémiques complexes de facteurs micro, méso, et macro qui contribuent aux défis qu\'il y a dans l\'installation de services. Au niveau micro, les thèmes clés ont inclus l\'idée que les services doivent être accessibles, individualisés et engager les familles. Au niveau méso, s\'alignant avec les buts du service, l\'intégration de plusieurs agences, les aspects d\'une intervention précoce et des conditions d\'opération claires ont tous été estimé être importants. Enfin, au niveau macro, le défi étant peut-être le plus grand selon les parties prenantes est d\'offrir un service qui est entièrement focalisé sur le nourrisson. Ces résultats aideront les décideurs pour ce qui s\'agit des facteurs considérés comme étant vitaux par les professionnels pour ce qui concerne l’établissement de services IMH en Ecosse et au travers du globe.
Die Entwicklung von Leistungen für die psychische Gesundheit von Kindern (infant mental health; IMH) befindet sich weltweit noch in einem frühen Stadium. Diese qualitative Studie zielt darauf ab, die Herausforderungen bei der Einrichtung von IMH-Leistungen zu verstehen. Untersucht werden die Ansichten und Erfahrungen von 14 multidisziplinären Interessenvertretenden, die Teil der IMH-Implementierungsgruppe in einem großen schottischen Gesundheitsamt sind. Durch eine thematische Analyse wurden sechs Hauptthemen ermittelt. In diesem Beitrag wird neben dem Thema “Lücken im derzeitigen Angebot” das als am stärksten wahrgenommene Thema “Systeme” untersucht. Der theoretische Rahmen der “Candidacy” hat sich als wertvoller Weg erwiesen, um die komplexen systemischen Schichten von Mikro-, Meso- und Makrofaktoren zu konzeptualisieren, die zu den Herausforderungen bei der Leistungseinrichtung beitragen. Zu den Schlüsselthemen auf der Mikroebene gehörte die Ansicht, dass die Leistungen zugänglich und individuell gestaltet sein und die Familien einbezogen werden müssen. Auf der Mesoebene wurden im Einklang mit den Zielen der Leistung die Integration mehrerer Stellen, Aspekte der Frühintervention und klare Arbeitsbedingungen als wichtig angesehen. Auf der Makroebene schließlich sehen die Beteiligten die vielleicht größte Herausforderung in der Bereitstellung einer Leistung, die ausschließlich auf Kleinkinder ausgerichtet ist. Diese Ergebnisse werden dazu beitragen, die politischen Entscheidungstragenden über Faktoren zu informieren, die von Fachleuten als entscheidend für die Einrichtung von IMH-Leistungen angesehen werden - in Schottland und auf der ganzen Welt.
世界的な乳幼児精神保健(IMH)サービスの開発は、まだ初期段階にある。この質的研究は、IMHサービス立ち上げの際の課題を理解することを目的とし、スコットランドの大規模な保健委員会でIMH実施グループの一員である14人の多職種の関係者の見解と経験を調査するものである。6つの主要なテーマが主題分析法により特定された。本論文では、最も大きく認識され注目しているテーマ「システム」を、テーマ「現状のサービスにおけるギャップ」とともに検証する。「キャンディダシー(candidacy)」という理論フレームワークはサービス立ち上げの課題に寄与するミクロ、メゾ、マクロ因子からなる複雑なシステム層の概念化に有用であるとされている。ミクロレベルでは、サービスはアクセスしやすく、個別化され、家族を含むものでなければならないという見解が主要なテーマに含まれた。メゾレベルでは、サービスの目的に沿って、複数機関の統合、早期介入の側面、明確な運営条件がすべて重要であると考えられている。最後に、マクロレベルでは、関係者が認識しているおそらく最大の課題は、徹底して乳幼児に焦点を当てたサービスを提供することであろう。これらの結果は、専門家がスコットランドや世界のIMHサービスの確立に不可欠とみなしている要素を、政策立案者に情報提供するのに役立つであろう。.
婴儿心理健康 (IMH) 服务的全球发展仍处于早期阶段。这项定性研究旨在了解建立IMH服务的挑战, 并探讨苏格兰一家大型卫生委员会IMH实施团队中14位多学科利益相关者的观点和经验。通过专题分析确定了六大主题。本文探讨了被认为最突出的主题“系统”以及“现有服务的差距”。“候选资格”的理论框架被认为是一种有价值的方法, 可以将微观、中观和宏观因素的复杂系统层概念化, 这些因素导致了建立服务的挑战。在微观层面, 关键主题包括这样一种观点, 即服务必须是易获得的、个性化的, 并让家庭参与。在中观层面, 根据服务目标, 多机构整合、早期干预以及清晰的运行条件都被视为重要因素。最后, 在宏观层面, 利益相关者认为的最大挑战可能是提供一种完全以婴儿为中心的服务。这些发现将有助于决策者了解专业人士认为对在苏格兰和全球建立IMH服务时至关重要的因素。.
لا يزال تطوير خدمات الصحة النفسية للأطفال (IMH) على مستوى العالم في مراحله الأولى. تهدف هذه الدراسة الوصفية إلى فهم تحديات إنشاء خدمات الصحة النفسية للأطفال واستكشاف آراء وخبرات 14 من أصحاب المصلحة متعددي التخصصات الذين يشكلون جزءًا من مجموعة تنفيذ IMH في لجنة إدارة صحية على مستوى عالي في اسكتلندا. تم تحديد ستة مواضيع رئيسية من خلال التحليل المواضيعي. تبحث هذه الدراسة في أكبر موضوع بارز وهو “الأنظمة” إلى جانب موضوع “الثغرات في الخدمة الحالية”. وقد تم استخدام الإطار النظري المعروف بـ (candidacy) أو السعي لتلقي الرعاية الصحية ليكون وسيلة لوضع تصور مفاهيمي لجوانب النظام المعقدة للعوامل الجزئية والمتوسطة والكلية التي تساهم في تحديات إنشاء الخدمات. على المستوى الجزئي ، تضمنت الموضوعات الرئيسية وجهة النظر القائلة بأن الخدمات يجب أن تكون في المتناول ، وأن تكون فردية ، وأن تشمل العائلات. على المستوى المتوسط ، تمشياً مع أهداف الخدمة ، تم اعتبار التكامل وجوانب التدخل المبكر واجراءات العمل الواضحة جميعها مهمة. أخيرًا ، على المستوى الكلي ، ربما يكون التحدي الأكبر الذي يدركه أصحاب المصلحة هو تقديم خدمة تركز بالكامل على الأطفال الرضع. ستساعد هذه النتائج على إعلام صانعي السياسات بالعوامل التي يعتبرها المتخصصون حيوية في إنشاء خدمات الصحة النفسية للأطفال في اسكتلندا وفي جميع أنحاء العالم.

BACKGROUND: The Team Strategies and Tools to Enhance Performance and Patient Safety (TeamSTEPPS®) programme has been shown to improve interprofessional work among healthcare professionals by enhancing teamwork. Intensive care professionals were trained in this methodology through the course \"Simulation Trainer: Improving Teamwork through TeamSTEPPS®\".
OBJECTIVE: To analyse the teamwork performance and good practice in simulation of the intensive care professionals attending the course and to explore their perceptions of the training experience carried out during the course.
METHODS: A cross-sectional descriptive and phenomenological study was carried out using a mixed methodology. The 18 course participants were administered the questionnaires \"TeamSTEPPS™ 2.0 Team Performance Observation Tool\" to evaluate teamwork performance and \"Educational Practices Questionnaire\" for good practices in simulation after the simulated scenarios. Subsequently, a group interview was conducted through a focus group with 8 attendees using the Zoom™ videoconferencing platform. A thematic and content analysis of the discourses was carried out using the interpretative paradigm. Quantitative and qualitative data were analysed using IBM SPSS Statistics™ 27.0 and MAXQDA Analytics Pro™ respectively.
RESULTS: Both the level of teamwork performance (mean = 96.25; SD = 8.257) and good practice in simulation (mean = 75; SD = 1.632) following the simulated scenarios were adequate. The following main themes were identified: satisfaction with the TeamSTEPPS® methodology, usefulness of the methodology, barriers to methodology implementation and non-technical skills improved through TeamSTEPPS®.
CONCLUSIONS: TeamSTEPPS® methodology can be a good interprofessional education strategy for the improvement of communication and teamwork in intensive care professionals, both at the care level (through on-site simulation strategies) and at the teaching level (through its inclusion in the students\' curriculum).

OBJECTIVE: To understand the experiences of adults over 65 years of age with type 2 diabetes mellitus, regarding foot self-care.
METHODS: Qualitative phenomenological study with a descriptive approach. It is carried out in the facilities of the Primary Care Center of Les Planes de Sant Joan Despí, Barcelona, belonging to the Catalan Institute of Health. For the data collection, a semi-structured and individual interview was used, with a script of basic aspects to be explored, not closed and focused on the objectives of the research. The interviews were carried out between June 2019 and December 2020. A thematic analysis was carried out concomitantly with the collection of these.
RESULTS: A final sample of 13 persons (4 men and 9 women) participated in the study. Adherence to diabetic foot self-care recommendations is irregular. Participants explain risky behaviours despite knowing that they can cause injury to feet previously considered high risk. The evaluation of the podiatrist supposes an economic cost that some people cannot afford.
CONCLUSIONS: The nurse has to do an exhaustive follow-up of how persons with diabetes take care of her feet, insisting on preventive recommendations not only in the annual review but every time the person attends the diabetes follow-up consultation. Effective nurse-podiatrist communication is needed to improve prevention and follow-up of people at risk of diabetic foot disease.

To identify missed opportunities in the diagnosis of ovarian cancer (OC) in the public health system of Catalonia, through the analysis of the perceptions of health professionals on the stories\'s experiences of OC patients.
Qualitative exploratory-descriptive study, with two focus groups.
Primary Care, November 2017.
Thirty-four professionals based on theoretical sampling: 21 family doctors, 8 professionals from sexual and reproductive health centres and 5 hospital gynaecologists.
Participants discussed the different diagnostic pathways for women with OC through the presentation of flowcharts which were developed with three storie\'s and experiences of OC patients.
Three themes with various sub-themes were identified as follow: a)lack of cancer diagnostic suspicion (lack of knowledge of symptoms of OC, anamnesis and physical examination overlooked, fragmentation of patient\'s care and bias and prejudice); b)difficulties in activating the diagnostic process (limited access to tests, unequal accessibility to gynaecology and lack of follow-up); and c)absence of fast-track referral system.
The results offer insight into the difficulties of early diagnosis of OC in our setting. We believe that their identification will allow the development of strategies to improve diagnostic accuracy and quality of care for women with OC in our setting.

To identify the elements involved in adequate health and social care for old people living in nursing homes, determine their possible barriers and enablers and define primary care\'s role in it.
Qualitative study with phenomenological approach.
State funded private nursing home and its corresponding primary care center in the southeastern urban area of Madrid.
Elderly residents, their relatives, and professionals from the nursing home and the primary care center.
Five focus groups were conducted between November 2019 and January 2020, with semi-structured interviews based on the variables of analysis and themes related to the objectives. The sessions were recorded and transcribed. An open and axial coding was performed to identify categories after a triangulation of the data.
The elements of adequate care identified are individualized care, promotion of autonomy, adequate information to residents and relatives, quality of services, coordination between professionals, and a continuous end of life care. The main barriers are the deficit of professionals, the differences in expectations between users and workers, and the organizational gap between the healthcare system and nursing homes providing healthcare services. The role identified for primary care is mostly bureaucratic.
It is necessary to continue exploring these elements and to outline the role of primary care in nursing homes with different characteristics.

Maternal mortality continues to pose a critical challenge in obstetric practice, with postpartum haemorrhage as one of the major causes. This study aimed to explore the lived experiences of midwives regarding the management of postpartum haemorrhage (PPH).
The study employed a qualitative phenomenological approach. Participants were selected using purposive sampling technique, and 15 participants were recruited for the study. Data collection was done using a semi-structured interview guide for in-depth interviews. The interviews were audio-recorded, and data analysis was done using thematic analysis.
Two themes emerged from the analysis, including 1) management practices adopted against PPH and 2) hospital protocol for the management of PPH. The major management practices adopted by the midwives were using uterotonics, especially oxytocin, and other management practices such as anti-shock garments, stimulation of contractions by rubbing the uterus, and assessment of the cause of bleeding and suturing of lacerations. It was also deduced that different healthcare facilities had policies for managing postpartum haemorrhage. Barriers affecting the effective management of PPH were understaffing, unavailability of suitable facilities and equipment, restrictions on nurses/midwives in managing PPH, unfavourable hospital policy and lack of communication among the healthcare team.
The participants\' experiences suggest they are somewhat satisfied with PPH management in their facilities. However, barriers such as understaffing, unavailability of equipment, poor communication among healthcare teams and restrictions on nurses in PPH management should be addressed to improve midwives\' experiences in PPH management.

OBJECTIVE: To delve into the experiences of people living with gout regarding its causes and triggers, recommended treatments and therapeutic measures, and the impact of living with this problem.
METHODS: Descriptive qualitative study. Opinion sampling, looking for discursive variability according to sex, age, socioeconomic position and treatments. Three focus groups were made with 11, 6 and 7 people, following a pre-established script of topics. Analysis following thematic content analysis procedures.
RESULTS: Participants were 19 men and 5 women, of different ages, socioeconomic status and treatments. Frequent comorbidities: hypertension and hypercholesterolemia. Genetics and the lack of renal elimination of urate were mentioned as causes of gout. They reported little knowledge of the causes and need more explanations about them. As triggers of the attack they identified: excess food and/or alcohol, trauma, stress or not following the treatment. Various drug treatment and expressed concern about their possible adverse effects were listed. Difficulties in adherence to the recommendations were also described. Non-pharmacological measures: rest, cold, proper footwear, walking, drinking water, and diet were also described. Chronic gout has an important impact on the daily life of patients and their families. Pain invalidates and leads to difficulties in performing daily activities. Irritations and mood swings were reported, which affect their family relationships.
CONCLUSIONS: These findings provide proposals to improve the care of people with gout. Information on its causes, the triggers of the crisis, dietary recommendations and exercise should be improved. The variability of treatments and recommendations on lifestyle should be analysed in depth.