BACKGROUND: This study aims to explore the varied experiences of patients with drug-resistant tuberculosis in Norway. The study emphasizes challenges and implications of being diagnosed with drug-resistant tuberculosis, including the impact on psychosocial health during the diagnosis, disease, treatment, isolation and recovery phases. Norway is a low endemic country of tuberculosis. Most patients are immigrants, and some of them have recently arrived in the country. Patients undergoing treatment for drug-resistant tuberculosis endure prolonged and demanding treatment that could affect their psychosocial health.
METHODS: This qualitative study conducted 16 in-depth interviews with individuals aged 18 years and above who were diagnosed with drug-resistant tuberculosis. All participants completed the treatment between 2008 and 2020. Fourteen participants were immigrants, and eight of them had resided in Norway for less than four years before diagnosis. Data analysis followed the six-phase reflexive thematic analysis framework, focusing on identifying patterns in participants\' experiences, thoughts, expectations and attitudes.
RESULTS: The narratives of the participants highlighted the complexities of navigating the diagnosis of drug-resistant tuberculosis, treatment, side effects and life after treatment. Immigrants encountered additional challenges, including language barriers and adapting to new social environments. All participants reported experiencing physical health issues that additionally affected their mental health and social activity. Several participants had a delayed or prolonged diagnosis that complicated their disease trajectory. Participants with suspected or confirmed contagious pulmonary tuberculosis underwent hospital isolation for periods ranging from weeks to six months. The participants reported mental health issues, social isolation and stigma, however few were offered follow-up by a psychologist. Many participants had persistent problems at the time of the interviews. Three main themes emerged from the analysis: Delayed and prolonged diagnosis; Psychosocial impact of isolation during treatment; The life after tuberculosis.
CONCLUSIONS: This study highlights the enduring impact of drug-resistant tuberculosis on patients and the significance of timely diagnosis, psychosocial support and post-treatment follow-up. The participants universally faced serious implications of the disease, including stigma and isolation. Participants who experienced delayed diagnosis, reflected on missed early intervention opportunities. We recommend further research in low endemic countries to evaluate the international and local recommendations on psychosocial support.

BACKGROUND: Total joint replacement is the optimal treatment option for patients with severe haemophilic arthritis. Current research emphasizes patient-reported outcomes as a vital measure for evaluating surgical outcomes and patient satisfaction. Nevertheless, very limited information about the subjective experience of perioperative haemophiliacs in the literature, highlighting the need for exploration in this area.
OBJECTIVE: To investigate the psychological experiences and health demands of haemophilic arthropathy patients during the perioperative period of total joint replacement.
METHODS: Qualitative descriptive research with semistructured individual interviews.
METHODS: From June to September 2023, nine patients with severe haemophilic arthropathy who underwent total joint replacement at a Haemophilia Diagnosis and Treatment Centre in China were interviewed for average 37 min per person. Data were analysed using the traditional content analysis method and reported following the consolidated criteria for reporting qualitative research. The study is reported according to the COREQ checklist.
RESULTS: Interviews described two main themes: (1) emotional decline which involves preoperative overoptimism, early postoperative anxiety and disease uncertainty during the early independent rehabilitation. (2) wellness aspiration which includes rehabilitation support and spiritual healing.
CONCLUSIONS: This study reveals the patients\' significant psychological changes and their well-being aspiration, particularly out-of-hospital rehabilitation needs. Strengthening communication between multidisciplinary teams and patients, enhancing the involvement of nurses, broadening the scope of functions at primary Haemophilia Treatment Centres, and developing telerehabilitation, these concerted efforts may improve the overall treatment experience for patients.

UNASSIGNED: Although the concept of telehealth is of great interest globally, its potential has not yet been realized in Pakistan. It is therefore essential to explore the perspectives of stakeholders on the technology, particularly for mental health, to be able to increase and improve its use.
UNASSIGNED: To assess the perceptions and experiences of patients receiving tele-mental health services, including telepsychiatry and tele-psychotherapy, in Pakistan.
UNASSIGNED: For this qualitative exploratory study, we conducted in-depth interviews with 49 individuals at a tertiary care hospital in Karachi, Pakistan. Using the Cresswell framework for content analysis, we identified 3 major themes that focused on the positive and negative aspects of tele-mental health services and made suggestions for enhancing them.
UNASSIGNED: Twenty-six of the participants received telepsychiatry, while the remaining 23 received tele-psychotherapy services. Technical literacy, cost of consultation, privacy, and therapeutic alliance were the major challenges identified by the patients, while convenience and the absence of stigma were highlighted as key facilitators for tele-mental health. Tele-consultations reduced travel and waiting time, thus improving access to healthcare. Participants suggested that the processes for booking appointments and making payments should be streamlined and the cost of tele-consultation reduced.
UNASSIGNED: This study provides insightful findings on tele-mental health services from the perspectives of patients living in an Asian culture. The major benefits highlighted were destigmatization of mental health and elimination of commuting costs and travel time. There were concerns about privacy, therapeutic alliance and availability and affordability of the technology.
تجارب المرضى في باكستان في خدمات الصحة النفسية عن بُعد في أثناء جائحة كوفيد-19.
نرجس أسد، شاهينا بيراني، خان أسامة، تانيا نديم.
UNASSIGNED: على الرغم من أن مفهوم الصحة عن بُعد يحظى بأهمية كبيرة على الصعيد العالمي، فإنه لم يجرِ تقصِِّّي كامل إمكاناته في باكستان بعدُ. لذلك، من الضروري استكشاف وجهات نظر أصحاب المصلحة بشأن هذه التكنولوجيا، لا سيَّما في مجال الصحة النفسية، للتمكن من زيادة استخدام هذه التكنولوجيا وتحسينها.
UNASSIGNED: هدفت هذه الدراسة الى تقييم تصورات وتجارب المرضى الذين يتلقون خدمات الصحة النفسية عن بُعد في باكستان، ومن ذلك الطب النفسي عن بُعد والعلاج النفسي عن بُعد.
UNASSIGNED: من أجل هذه الدراسة الاستكشافية الوصفية، أجرينا مقابلات وافية مع 49 فردًا في مستشفى للرعاية التخصصية في كراتشي، في باكستان. وباستخدام إطار كريسويل لتحليل المحتوى، حددنا 3 مواضيع رئيسية ركزت على الجوانب الإيجابية والسلبية لخدمات الصحة النفسية عن بُعد، وقدَّمنا اقتراحات لتعزيزها.
UNASSIGNED: تلقَّى ستة وعشرون مشاركًا خدمات الطب النفسي عن بُعد على يد طبيب نفسي، في حين تلقَّى الثلاثة والعشرون مشاركًا الباقون خدمات العلاج النفسي عن بُعد على يد معالج نفسي. وكانت القراءة والكتابة التقنية، وتكلفة الاستشارة، والخصوصية، والتحالف العلاجي من التحديات الرئيسية التي حددها المرضى، في حين سُلط الضوء على الراحة وعدم الوصم باعتبارهما ميسرين رئيسيين للصحة النفسية عن بُعد. وخفضت الاستشارات عن بُعد إلى وقت السفر والانتظار، الأمر الذي أدى إلى تحسين فرص الحصول على الرعاية الصحية. واقترح المشاركون تبسيط عمليات حجز المواعيد وتسديد المدفوعات، وخفض تكلفة الاستشارة عن بُعد.
UNASSIGNED: تقدم هذه الدراسة نتائج متعمقة بشأن خدمات الصحة النفسية عن بُعد من وجهة نظر المرضى الذين يعيشون في ثقافة آسيوية. وإزالة الوصمة عن الصحة النفسية والتخلص من تكاليف التنقل ووقت السفر كانت من أهم الفوائد التي سُلِّط الضوء عليها. وكانت ثمة شواغل بشأن الخصوصية والتحالف العلاجي وتوفُّر التكنولوجيا والقدرة على تحمُّل تكاليفها.
Expériences des patients avec les services de télésanté mentale pendant la COVID-19 au Pakistan.
UNASSIGNED: Bien que le concept de la télésanté présente un grand intérêt à l\'échelle mondiale, son potentiel n\'a pas encore été pleinement exploré au Pakistan. Il est donc essentiel d\'explorer les perspectives des parties prenantes concernant la technologie, en particulier pour la santé mentale, afin de pouvoir augmenter et améliorer son utilisation.
UNASSIGNED: Évaluer les perceptions et les expériences des patients recevant des services de télésanté mentale, y compris la télépsychiatrie et la télépsychothérapie, au Pakistan.
UNASSIGNED: Pour cette étude qualitative exploratoire, nous avons mené des entretiens approfondis avec 49 personnes dans un hôpital de soins tertiaires à Karachi (Pakistan). En utilisant le cadre de Cresswell pour l\'analyse de contenu, nous avons identifié trois thèmes principaux qui se concentrent sur les aspects positifs et négatifs des services de télésanté mentale et nous avons proposé des suggestions pour les améliorer.
UNASSIGNED: Vingt-six des participants ont bénéficié de services de télépsychiatrie, tandis que les 23 autres ont reçu des services de télépsychothérapie. La littératie technique, le coût de la consultation, le respect de la vie privée et l\'alliance thérapeutique étaient les principaux défis identifiés par les patients, alors que la commodité et l\'absence de stigmatisation étaient soulignées comme des éléments clés qui facilitaient la pratique de télésanté mentale. Les téléconsultations ont permis de réduire les déplacements et les temps d\'attente, améliorant ainsi l\'accès aux soins de santé. Les participants ont suggéré de rationaliser les procédures de prise de rendez-vous et de paiement et de réduire le coût de la téléconsultation.
UNASSIGNED: La présente étude fournit des résultats pertinents sur les services de télésanté mentale du point de vue des patients qui vivent dans une culture asiatique. Les principaux avantages mis en évidence étaient la déstigmatisation de la santé mentale et l\'élimination des coûts et du temps de déplacement. Des inquiétudes ont été exprimées concernant le respect de la vie privée, l\'alliance thérapeutique, la disponibilité et l\'accessibilité financière de la technologie.

This study aimed to synthesize all qualitative evidence on the experiences of hematopoietic stem cell transplant (HSCT) patients attending long-term monitoring clinics from their perspective. A systematic search of the literature was undertaken across 8 databases. The Critical Appraisal Skills Program was used to evaluate each study\'s quality. Confidence in the Evidence from Reviews of Qualitative Research was employed to assess confidence in each finding. Three themes from 4 qualitative studies were identified relating to patients\' experiences, \"[It\'s] important to maintain a good relationship with the nurses and doctors,\" \"There\'s always the thing about the logistics,\" and \"Once you have cancer, you\'re always thinking do I have it again?\". The findings suggest that HSCT patients\' experiences of long-term follow-up care clinics are influenced by the patient-provider relationship and the logistical set-up of monitoring practices, and weakly connected with fear of cancer recurrence. Future research is needed to understand the impact of each finding of this review, specifically in relation to patients\' country of residence to gain a greater understanding of their monitoring support needs.

UNASSIGNED: To describe the process of becoming aware of and acting on personal cardiovascular (CVD) risk in type 2 diabetes (T2D).
UNASSIGNED: A purposive sample of 14 persons living with T2D participated in semi-structured, open-ended, in-dept interviews. The interviews were analysed with grounded theory.
UNASSIGNED: The analysis identified the core category \"Balancing emotions, integrating knowledge and understanding to achieve risk awareness and act on it.\" Five categories describe the movement from not being aware of the risk of cardiovascular disease (CVD) to becoming aware of this risk and taking action to reduce it. Persons with T2D need to transform their knowledge and experience of CVD risk and incorporate it in their individual situations. Emotional and existential experiences of CVD risk can lead to awareness about the severity of the condition and contribute to increased motivation for self-management. However, an overly high emotional response can be overwhelming and may result in insufficient self-management.
UNASSIGNED: Persons with T2D seemed not to fully grasp their increased risk of CVD or recognize that self-management activities were aimed at reducing this risk. However, their awareness of CVD risk gradually increased as they came to understand the severity of T2D and became more emotionally and existentially engaged.

UNASSIGNED: A diabetes diagnosis has significant implications and affects the individual\'s health and social opportunities; it may also carry ethical and cultural consequences, especially when self-injectable treatment is involved. Therefore, it is important to understand lived experiences of patients on self-injectable diabetes treatment to establish initiatives and develop coping mechanisms that may reduce disease morbidity.
UNASSIGNED: This study explored and described patients\' lived experiences of self-injectable treatment for diabetes mellitus type 1 and 2.
UNASSIGNED: The study was conducted in the Rundu health district, Kavango east region, Namibia.
UNASSIGNED: A phenomenological qualitative design was used. The sample consisted of 10 purposively selected patients on self-injectable treatment and data were collected through unstructured individual interviews. Data analysis followed an interpretative phenomenological approach. Ethical principles were adhered to, including respect for autonomy, non-maleficence, beneficence, and justice and ethical clearance was obtained.
UNASSIGNED: Self-injectable treatment is cost-effective, promotes self-care, and relieves the burden on nurses and doctors. But it is a lonely journey, causing uncertainty about the future and self-stigmatisation. Moreover, unfamiliarity with injection techniques, challenges in storing medication, and disposing of used needles and other waste were revealed.
UNASSIGNED: Patients on self-injectable diabetes treatment have positive and negative lived experiences. It is recommended that family members provide adequate support and that healthcare workers reinforce education on diabetes for these individuals.
UNASSIGNED: The findings can be used to develop patients\' education and training packages, guide the development and implementation of diabetes coping mechanisms, and initiate intersectoral collaboration to assist patients undergoing injectable treatment.

BACKGROUND: Publicly available patient-focused mobile health (mHealth) apps are being increasingly integrated into routine heart failure (HF)-related self-care. However, there is a dearth of research on patients\' experiences using mHealth apps for self-care in real-world settings.
OBJECTIVE: The purpose of this study was to explore patients\' experiences using a commercially available mHealth app, OnTrack to Health, for HF self-care in a real-world setting.
METHODS: Patient satisfaction, measured with a 5-point Likert scale, and an open-ended survey were used to gather data from 23 patients with HF who were provided the OnTrack to Health app as a part of routine HF management. A content analysis of patients\' responses was conducted with the qualitative software Atlas.ti (version 8; ATLAS.ti Scientific Software Development GmbH).
RESULTS: Patients (median age 64, IQR 57-71 years; 17/23, 74% male) used OnTrack to Health for a median 164 (IQR 51-640) days before the survey. All patients reported excellent experiences related to app use and would recommend the app to other patients with HF. Five themes emerged from the responses to the open-ended questions: (1) features that enhanced self-care of HF (medication tracker, graphic performance feedback and automated alerts, secured messaging features, and HF self-care education); (2) perceived benefits (provided assurance of safety, improved HF self-care, and decreased hospitalization rates); (3) challenges with using apps for self-care (giving up previous self-care strategies); (4) facilitators (perceived ease of use and availability of technical support); and (5) suggested improvements (streamlining data entry, integration of apps with an electronic medical record, and personalization of app features).
CONCLUSIONS: Patients were satisfied with using OnTrack to Health for self-care. They perceived the features of the app as valuable tools for improving self-care ability and decreasing hospitalization rates. The development of apps in collaboration with end users is essential to ensure high-quality patient experiences related to app use for self-care.

UNASSIGNED: Strong primary care has positive impact on patients\' and population health, and high continuity of care is one of its hallmarks. Insight into the underlying mechanisms is limited and research on this topic requires measures of primary care outputs, which are states that mediate between processes and outcomes of primary care.
UNASSIGNED: Nine potential outputs of high continuity of care were specified to examine 45 validated patient questionnaires, which were identified in a systematic review. Eighteen questionnaires covered one or more primary care outputs, yet at variable and mostly limited extent.
UNASSIGNED: Measures of primary care outputs can strengthen clinical and health services research, but such measures have yet to be developed and validated for most primary care outputs. The use of these measures in outcome evaluations of interventions in healthcare would enhance the interpretation of intervention effects. Validated measures are also needed to tap the full potential of advanced methods of data-analysis in clinical and health services research. Better understanding of the primary care outputs may also help to mitigate broader challenges in healthcare systems.

UNASSIGNED: This qualitative study explored the experiences of patients with bladder cancer with a tailored \'explanimation\' video (EV) as a supportive information tool used before and during treatment.
UNASSIGNED: Using a qualitative approach, data were collected through semi-structured interviews with 12 patients with bladder cancer and thematically analysed.
UNASSIGNED: Participants advised future use of the EV, noting it is user friendly and has a fitting difficulty level and clarifying animations. However, some mentioned practical information on \'life after treatment\' was lacking, and some emphasized the importance of choosing the right moment of delivery. Patients\' experiences were described in four major themes: taking own responsibility, providing opportunity for postponed information supply, easing decision-making processes and gaining a sense of calm.
UNASSIGNED: Findings indicate the EV supported patients with bladder cancer in the process of being informed and in decision-making. Future use of the EV in the treatment of patients with bladder cancer is recommended.
UNASSIGNED: The use of audiovisual information in patient education is innovative. Tailored audiovisual information in shape of the EV is a step forward in streamlining information processes, meeting individual preferences and highlighting the most important general information for patients with bladder cancer.

OBJECTIVE: Despite a haematopoietic stem cell transplant (HSCT) being a potentially curative treatment option for malignant and non-malignant disorders, patients may develop complex physical and psychological post-transplant complications. Consequently, transplant centres remain responsible for patients\' life-long monitoring and screening practices. We sought to describe how HSCT survivors experience long-term follow-up (LTFU) monitoring clinics in England.
METHODS: A qualitative approach was adopted with data collected from written accounts. Seventeen transplant recipients were recruited from across England, and the data was analysed using thematic analysis.
RESULTS: Data analysis elicited four themes: Transfer to LTFU care: \'will there be a change in my care, or will appointments just become less frequent?\'; Care Coordination: \'it is good to know I am still in the system\'; Relationship continuity: \'a good knowledge of me, my health and what is important to me\'; and Late-effects Screening: \'there was not much information about what to expect or be aware of\'.
CONCLUSIONS: HSCT survivors in England experience uncertainty and lack of information regarding the transfer from acute to long-term care and clinic screening practices. However, patients gain reassurance from remaining on a healthcare pathway and maintaining relationships with healthcare professionals.
CONCLUSIONS: HSCT recipients entering LTFU monitoring clinics are a growing population of cancer survivors. Understanding and acknowledging this cohort of patients\' needs may inform the development of tailored support to help patients navigate the complicated healthcare pathway.