Health Expectations最新文献

{"title":"Digital Long Covid Communities—Shaping Diagnoses, Treatment Strategies and Modes of Expertise","authors":"Petter Almqvist-Ingersoll","doi":"10.1111/hex.70279","DOIUrl":"https://doi.org/10.1111/hex.70279","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Despite having been created on social media, research into the effects of online engagement on long Covid (LC) as a diagnosis is scarce. Studies on other health-related communities and patient participation argue that social media and other digital technologies have been instrumental in creating new ways for activism, advocacy and sharing of experiences. With its status as patient-made, LC constitutes an example of how diagnoses are (re)constructed through social interactions in addition to Western biomedical science and clinical practice. The aim of the study is to investigate the ways in which lived experiences and larger narratives of LC are communicated and form understandings of the condition as a heterogeneous diagnosis/phenomenon.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This study uses netnography, mainly focused on hidden observations of patient support and advocacy forums in which users' posts are individually sourced and thematically analysed. These themes are further discussed to illustrate overarching discourse that contributes to the sense-making and creation of knowledge surrounding LC.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The study highlights three major themes, namely: users seeking commonalities in experienced symptoms, interpatient tinkering as a form of biohacking conceptualised as an epistemological process, and negotiating expertise.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Discussion</h3>\u0000 \u0000 <p>The study finds that narratives shared in online spaces regarding LC act as critical factors that serve not just the affected individuals' sense-making and understanding of their lived experience, but also in the construction of the diagnosis itself. Through sharing experiences, symptoms, scientific information and treatment options, forum users contribute to knowledge production processes that change the definition of LC as a diagnosis. Building on the sociology of diagnosis, I argue that LC serves as a significant example of how diagnoses are products of the entanglement between biomedicine, clinical practice, the social and the digital.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Patient or Public Contribution</h3>\u0000 \u0000 <p>The project operates under the premise that patients from different social, cultural and professional backgrounds participate in online discussions about long Covid and that these individuals work towards individual as well as collective well-being. As such, highlighting their engagement has","PeriodicalId":55070,"journal":{"name":"Health Expectations","volume":"28 3","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/hex.70279","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143880076","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Experiences and Perceptions of Self-Harm in Rural-Dwelling Adults: A Rapid Review of Qualitative Evidence","authors":"Katie Saunders, William Nicholls, Nadia Corp, Tom Kingstone, Faraz Mughal, Carolyn A. Chew-Graham, Jane Southam, Tamsin Fisher","doi":"10.1111/hex.70268","DOIUrl":"https://doi.org/10.1111/hex.70268","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Self-harm is associated with factors that are relevant to and exacerbated by rurality. Living in rural areas may intensify existing socio-economic disadvantages linked to service access, employment opportunities, transport conditions and risks from hazardous environments. Geographical isolation and fragmented social networks, particularly those related to family, are also common among rural residents. Rurality is therefore likely to shape experiences of mental health problems, including self-harm. However, this literature has not been synthesised.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>To synthesise current qualitative evidence on the experiences and perceptions of self-harm among rural-dwelling adults and care providers' perspectives and to identify knowledge gaps.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Approach</h3>\u0000 \u0000 <p>Rapid review of qualitative evidence identified via relevant electronic literature databases. Thematic synthesis was used to compare findings on perceptions and experiences of self-harm in rural areas. Confidence in synthesis findings was assessed using GRADE-CERQual.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Findings</h3>\u0000 \u0000 <p>Searches identified 1673 unique references, of which 14 were included in the final synthesis. Two themes were generated with high to moderate confidence: ‘experiences of rural self-harm’ with two subthemes ‘reasons for self-harm’ and ‘perceptions of self-harm’, and ‘access to healthcare’ with two subthemes: ‘healthcare practitioners' perceptions of rural self-harm’ and ‘lack of support and resources’. Various reasons and motivations for self-harm were identified; stigma was commonly reported. Services for rural residents who self-harmed were difficult to access. Healthcare practitioners in these areas may lack adequate training, which may maintain stigmatised views.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>The review identified shared experiences and motivations for self-harm across different rural contexts globally. Perceptions of self-harm by people with lived experience, family and healthcare professionals reflected stigmatised views, which impacted access to and provision of care. Experiences and perceptions of self-harm reported in the literature are somewhat overshadowed by data on suicide and suicide behaviours. Methodological implications are noted in terms of the complexity of extracting data about self-harm. Future research would help inform intervention development for ","PeriodicalId":55070,"journal":{"name":"Health Expectations","volume":"28 3","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-04-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/hex.70268","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143871873","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Patient and Clinician Perspectives on Communication in Primary Care Centres in Qatar—A Focus Group Study","authors":"Nancy Dixon, Liz Cox, Bayan Fraihat, Tareq Khalil Alzeq, Mohammed Abdalla, Nawal Khattabi","doi":"10.1111/hex.70280","DOIUrl":"https://doi.org/10.1111/hex.70280","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>The Primary Health Care Corporation (PHCC) in Qatar manages 31 health centres serving a diverse population of over 1.7 million people. PHCC is fully committed to providing people-centred care. Patients are routinely asked to complete satisfaction surveys. The surveys have shown continued shortcomings in patients' perceptions of communication with staff. PHCC decided to carry out an improvement collaborative among all centres on improving communication with patients. A realist review was carried out to identify possible communication interventions that improve the outcome of patient satisfaction with communication. Most research studies in the review were carried out in Western countries where patient expectations and experiences may differ. Therefore, focus groups of patients and staff were carried out to learn how patients and staff in Qatar perceive communication in the health centres.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>The purpose of the focus groups was to learn directly how patients and health centre staff experience communication with each other and if the issues experienced could potentially be addressed by the interventions identified in the evidence base. 18 focus groups were carried out, 9 each with patients and multiprofessional staff. Questions were derived from issues raised in research on patient–healthcare professional communication in primary care.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Patients' main concern was how they are welcomed to a health centre, particularly their desire to be greeted with a smile and welcomed courteously. They also discussed confusion about how the health centres work and a lack of understanding of health-related information. Staff groups also raised the importance of welcoming patients; they also discussed patients' lack of understanding of healthcare subjects. Some issues were consistent with research findings; others were unique to the Qatar setting. Patients focused on their expectations to be seen quickly, whereas staff were aware of the demands on the service and difficulties in meeting patient expectations.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>The focus groups identified key issues related to patient–healthcare professional communication in primary care centres in Qatar. These issues were used to set priorities for the improvement collaborative on patient-centred communication involving all the health centres.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Patient and Public","PeriodicalId":55070,"journal":{"name":"Health Expectations","volume":"28 3","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-04-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/hex.70280","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143871874","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Stakeholder Involvement in the Development of a New Proactive Clinical Review of Patients Prescribed Opioid Medicines Long-Term for Persistent Pain in Primary Care","authors":"Sarah A. Harrisson, Clare Jinks, Nicola Cornwall, Charlotte Woodcock, Lisa Dikomitis, Toby Helliwell, Adele Higginbottom, Janet Lefroy, Roger Knaggs, Tamar Pincus, Miriam Santar, Claire Sillitto, Matthew Webb, Simon White, Christian D. Mallen, Julie Ashworth","doi":"10.1111/hex.70264","DOIUrl":"https://doi.org/10.1111/hex.70264","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Stakeholder involvement is a core element of the Medical Research Council (MRC) framework for developing and evaluating complex interventions, but approaches to involve stakeholders are not well-reported. We outline how stakeholders contributed to co-designing a Proactive clinical Review of patients taking Opioid Medicines long-term for persistent Pain led by Pharmacists working in primary care Teams (the PROMPPT intervention—a review and pharmacist training package).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We brought key stakeholders together to co-design the PROMPPT intervention using a person-based approach, alongside evidence from best practice guidance. We established a community of practice comprising three complementary groups: a patient advisory group, a pharmacist advisory group and a mixed stakeholder group. Patient stakeholders were identified from an existing patient involvement group. Professional stakeholders were identified using networks and social media. The three groups met in iterative workshops with predefined aims. We offered reimbursement for the stakeholders' time.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Outcomes</h3>\u0000 \u0000 <p>The patient advisory group (<i>n</i> = 10), pharmacist advisory group (<i>n</i> = 6) and mixed stakeholder group (<i>n</i> = 16) each met for 2 or 3 workshops between April 2019 and February 2020. Stakeholders had expertise, often cross-cutting, in lived experience, persistent pain, opioids, delivering primary healthcare and/or promoting behaviour change. Patient stakeholders provided their perspectives of consulting about their pain and opioids. Pharmacist stakeholders provided their perspectives on how pain reviews were happening in practice and on considerations for training (e.g., vignettes and experiential learning were considered important). The mixed stakeholder group provided a breadth of views highlighting current practice, including the value of engaging the wider GP practice team, issues around clinical responsibility for prescribing and the fact that international clinical guidance was not always relevant to UK primary care.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>By understanding the context of the PROMPPT intervention, stakeholders worked to develop a new pharmacist-led primary care review ahead of feasibility testing. We make recommendations for future developers of complex interventions.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Patient and Public Contribution</h3>\u0000 \u0000 ","PeriodicalId":55070,"journal":{"name":"Health Expectations","volume":"28 3","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-04-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/hex.70264","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143875550","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Multimodal Analysis of Stories Told by Mental Health Influencers on TikTok","authors":"Alex Christiansen, Shioma-Lei Craythorne, Paul Crawford, Michael Larkin, Aalok Gohil, Spencer Strutt, Ruth Page","doi":"10.1111/hex.70226","DOIUrl":"https://doi.org/10.1111/hex.70226","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Social media influencers are powerful storytellers who function as conduits of public health communication and may contribute significantly to young people's mental health literacy. Influencers who discuss mental health include health professionals, wellness practitioners and experts by lived experience. As yet, there has been no multimodal analysis of how these three influencer types narrate mental health issues. This study critically evaluates 398 TikTok videos to show how three distinct types of influencers construct multimodal narratives around mental health.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Data was collected using the TikTok Research API and annotated for narrative patterns and visual formatting using an inductively created multimodal framework.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The analysis shows important differences between the storytelling practices of health professionals, who inform others through talking head explainers, enactments and stitches, and lived experience influencers who invited shared perspectives on their stories of illness, treatment and recovery through compilations and ‘watch as I do this’ formats. Wellness practitioners occupy an interdiscursive mid-space, blending the verbal aspects of ‘informing’ (explainers) with the visual narration of ‘shared experience’ to promote solutions through recommendation and advertising. The data also highlights similarities between the health professionals and wellness influencers in their use of marketing calls to action, indicating the commercialisation of mental health solutions offered in TikTok videos.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>It is concerning that the gap between information and support provided on TikTok may lead to partial and imbalanced development of mental health literacy by adolescent users and that content provided by certain influencer types mimics authoritative and authentic communication but promotes non-medical solutions to mental health, unsupported by evidence.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Patient or Public Involvement</h3>\u0000 \u0000 <p>Twelve young people with lived experience of mental health challenges, aged between 16 and 25, were recruited through The McPin Foundation to form the young people's advisory group (YPAG) for the project. This age range incorporates adolescents and ‘emerging adults’ who are likely to experience a range of life transitions and encounter challenges in mental","PeriodicalId":55070,"journal":{"name":"Health Expectations","volume":"28 3","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/hex.70226","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143871452","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Synergies, Discrepancies, and Action Priorities: A Statewide Engagement Study to Strengthen Clinical Research in Cerebral Palsy","authors":"Melissa M. Murphy, Gavin T. Colquitt, Paige S. Ryals, Katie Shin, William C. Kjeldsen, Allison McIntyre, Sydni V. W. Whitten, Christopher M. Modlesky, Nathalie L. Maitre","doi":"10.1111/hex.70257","DOIUrl":"https://doi.org/10.1111/hex.70257","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Cerebral palsy (CP) clinical research is fraught with challenges, in part due to health-related disparities common among people with disabilities. Perspectives of people with lived experience of CP, clinicians and researchers vary on how to address these disparities. The present initiative explores synergies and discrepancies among stakeholders (<i>n</i> = 212) representing these partner groups in perceived barriers and facilitators to high-quality clinical CP research and robust trainee pathways. The overarching goal is to generate priority actions to empower meaningful partner group engagement in CP research and, ultimately, improve health outcomes for people with CP.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Grounded in empowerment theory, mixed methods needs assessments were conducted separately with partner groups to capture perspectives on barriers and facilitators to high-quality CP research and strong trainee pathways. Thematic analysis was applied to focus groups and interviews to identify themes and subthemes.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Discrepancies among partner groups emerged related to informational needs, community connection, ethical research and equitable representation in research, and fair compensation for lived experience partner engagement in the research process.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Ongoing opportunities for researcher action to empower partner group engagement include building shared purpose, nurturing social connection within and among groups and intentional efforts to build trust and codesign studies.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Patient or Public Contribution</h3>\u0000 \u0000 <p>The initiative described here was informed by caregivers of children with CP from Georgia, USA, using a community-based participatory research (CBPR) approach. CPBR is a collaborative approach, designed to give communities, which here include people with lived experience of CP, control over research processes and outcomes. Their perspectives were essential to the premise of this study and guided data interpretation, especially with regard to how their perspectives may or may not correspond to those of CP researchers and clinicians. To ensure inclusion of all perspectives, individuals with CP were also represented in these latter two engagement groups. Finally, the design, conduct, analysis and interpretation of data were informed by a researcher and a clinician-scient","PeriodicalId":55070,"journal":{"name":"Health Expectations","volume":"28 3","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/hex.70257","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143871681","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"‘The Second Arrow’: A Collaborative Autoethnographic Exploration of What Can Be Learned From One Long COVID Journey","authors":"Sarahjane Belton, Kate Sheridan","doi":"10.1111/hex.70227","DOIUrl":"https://doi.org/10.1111/hex.70227","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Long COVID is a complex multisystem illness with multiple relapsing-remitting symptoms, which can vary in severity and impact people's daily lives. This study utilises the first author's experience of falling ill with and recovering from long COVID to investigate the lived experience of the illness. Learnings that could positively influence how people with long COVID, and health professionals, approach rehabilitation and recovery from the illness going forward are identified.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Employing collaborative autoethnography, the first author investigated her personal experience of falling ill with, and rehabilitating from, long COVID, while soliciting input of the second author (an athletic therapist and physiotherapist, and researcher with expertise in chronic pain) for the purpose of analysis and interpretation. Reflexive thematic analysis was employed across a number of data sources available to the first author, including journal entries, text messages, emails, and pharmacy receipts.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Four themes were generated from the data, supported by a number of subthemes: (i) Psychosocial impact of long COVID, (ii) Invalidated, (iii) Validated, and (iv) Power and Ownership. The negative impact of a siloed and reductionist approach to care for long COVID is evident in the findings of this study. In addition, the need for healthcare environments that enhance autonomy and empowerment, and that implement patient-centred care, where the person living with chronic illness is supported to engage in management strategies that meet their needs, is underlined.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>This study highlights the detrimental cost, both personally and financially, of the ongoing use of the biomedical model of care in the treatment of long COVID. Findings support the need for an interdisciplinary approach to care that considers the whole person and adopts a biopsychosocial approach to care. Furthermore, the need for healthcare professionals to actively listen to, respect, validate and support the person living with long COVID on their individualised recovery journey is evident.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Patient or Public Contribution</h3>\u0000 \u0000 <p>The first author was a long COVID patient, the context and extent of this is explained within the paper. As such, this paper is developed and written primarily from the perspective o","PeriodicalId":55070,"journal":{"name":"Health Expectations","volume":"28 3","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-04-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/hex.70227","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143861941","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Coproduced Youth Priorities Project: Australian Youth Priorities for Mental Health and Substance Use Prevention Research","authors":"Kate Ross,&nbsp;Jessica Houston,&nbsp;Emma Barrett,&nbsp;Felicity Duong,&nbsp;Tanya Dearle,&nbsp;Smrithi Ravindra,&nbsp;Cheryl Ou,&nbsp;Kirsty Rowlinson,&nbsp;Marlee Bower,&nbsp;Louise Birrell,&nbsp;Katrina Prior,&nbsp;Lucinda Grummitt,&nbsp;Chloe Conroy,&nbsp;Anna Grager,&nbsp;Maree Teesson,&nbsp;Catherine Chapman","doi":"10.1111/hex.70274","DOIUrl":"https://doi.org/10.1111/hex.70274","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>New approaches to mental health and substance use prevention, that bridge research and diagnostic silos are urgently needed to address rising trends in mental illness amongst young people. Engaging diverse stakeholders, including young people, in setting research priorities could aid the development of innovative responses, enhance research and improve translation. While previous activities have identified priorities for Australian mental health and substance use prevention research, none have centred young people as a primary stakeholder. The current study is a critical next step to understand youth perspectives.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This Youth Priorities Project was coproduced with members of The Matilda Centre and PREMISE NHMRC Centre of Research Excellence Youth Advisory Board. The project involved three iterative stages: (1) an online survey; (2) consultations via focus groups and (3) a final consensus workshop to summarise key recommendations for principles, priorities and actions.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A diverse group of young people aged 16–25 were recruited for Stage 1 (<i>n</i> = 653), Stage 2 (<i>n</i> = 7) and Stage 3 (<i>n</i> = 3). Youth participants emphasised the need for increased investment in prevention research targeting a broad range of social determinants and health behaviours and their intersecting effects on youth mental ill health. There were strong calls to government to address economic drivers of mental health, to increase timely access to subsidised mental health support, and to better equip schools to support student wellbeing and mental health.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Young people had valuable and unique insights on how research and policy responses regarding youth mental health and substance use could be improved.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Public Contribution</h3>\u0000 \u0000 <p>A coproduction Research Team (CPRT) was established, including two youth researchers who guided all stages of the research from conceptualisation, ethics approval, survey and study design, analysis and write-up. A Youth Advisory Board was also consulted.</p>\u0000 </section>\u0000 </div>","PeriodicalId":55070,"journal":{"name":"Health Expectations","volume":"28 3","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-04-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/hex.70274","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143861940","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"‘I Have Never Been in That Kind of All-Consuming Pain … I Did Not Know What Else to Do’: The Journey to Hospital Admission With Low Back Pain From the Perspectives of Patients","authors":"Joseph F. Orlando,&nbsp;Matthew Beard,&nbsp;Anne L. J. Burke,&nbsp;Michelle Guerin,&nbsp;Saravana Kumar","doi":"10.1111/hex.70269","DOIUrl":"https://doi.org/10.1111/hex.70269","url":null,"abstract":"&lt;div&gt;\u0000 \u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Background&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;There is a need to better understand patient factors contributing to low back pain (LBP)-related hospitalisations to improve health service delivery and reduce avoidable admissions.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Objective&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;This study explored the experiences of people with LBP leading up to and resulting in hospital admission.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Design&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;Qualitative descriptive methodology using semi-structured interviews.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Setting and Participants&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;Patients admitted with non-specific LBP at a large Australian tertiary public hospital meeting specific inclusion and exclusion criteria were pragmatically identified and recruited, and they consented to participate. Interviews were audio-recorded, and thematic analysis generated codes and themes from the data.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Results&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;Sixteen patients consented to participate. The cohort had an average age of 52 years (SD = 17) and had an average hospital length of stay of 13 days (SD = 10.8, range = 2–31). Two themes were identified. The first related to the impact of LBP on patients' lives, with sub-themes including difficulty coping with pain, difficulty managing daily activities and escalating distress. The second theme related to unmet treatment needs, with sub-themes including ineffectiveness of past treatments, inability to access timely and affordable community healthcare, and expectations for emergency care.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Conclusion&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;Patients impacted by severe LBP regarded hospitals as a last resort for management of pain when community healthcare was perceived to be ineffective or inaccessible. This study highlights the practice gaps before hospitalisation for LBP from the perspectives of patients and the need to improve the delivery and access of healthcare for this condition.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Patient or Public Contribution&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;This study sought insights from patients with low back pain (LBP) who were admitted to hospital with LBP. The findings will inform stakeholders, including consumers, on the co-design of an optimal system of care to improve the delivery and access of health services for LBP. All patients were offered the oppor","PeriodicalId":55070,"journal":{"name":"Health Expectations","volume":"28 3","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-04-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/hex.70269","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143865616","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Communication Processes Related to Decision-Making in Medication Management Between Healthcare Providers, Older People and Their Carers: A Systematic Review","authors":"Deana M. Copley,&nbsp;Elizabeth Manias,&nbsp;Vanessa Watkins,&nbsp;Alison M. Hutchinson","doi":"10.1111/hex.70252","DOIUrl":"https://doi.org/10.1111/hex.70252","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>To examine decision-making between healthcare providers (HCPs), older people and their carers in relation to medication management.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Four databases were systematically searched up to June 2023. Two authors screened the search results. Extracted quantitative data were analysed descriptively, and qualitative data were analysed thematically.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Fifty-three papers reporting on 49 studies were included. A variety of research methods were utilised. Few authors provided a definition of shared decision-making (SDM). Three major themes were identified: provider-driven decision-making, patient-driven decision-making and a shared role in decision-making. Some older people preferred or deferred to provider-driven decision-making, mainly due to trust in the HCP's expertise. Other reasons for provider-driven decision-making were patient anxiety, declining health, lack of medical knowledge or poor communication during the clinical encounter. Evidence of patient-driven decision-making was often prompted by concerns about the adverse effects of medication. Most older people preferred or adopted a shared role in decision-making.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Whilst most patients and carers preferred to engage in SDM related to medication management, at times, they felt unable to do so, deferring to provider-driven decision-making. There is a need for a standardised definition and measurement of SDM.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Patient or Public Contribution</h3>\u0000 \u0000 <p>This systematic review did not directly involve older people or carers of older people in the design or conduct of the review. However, the findings will inform a qualitative study aimed at exploring older people and their carers' experiences of medication-related decision-making in collaboration with their healthcare provider.</p>\u0000 \u0000 <p><b>Trial Registration:</b> CRD42019124862.</p>\u0000 </section>\u0000 </div>","PeriodicalId":55070,"journal":{"name":"Health Expectations","volume":"28 2","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-04-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/hex.70252","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143852905","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}