To explore the challenges experienced by people with intellectual disability, their carers and health and social care professionals when using and managing medication.

A synthesis of qualitative research using meta-ethnography.

We searched seven databases: MEDLINE, Embase, CINAHL, Science, Social Science and Conference Proceedings Citation Indices (Web of Science), Cochrane Library, PsycINFO and Proquest Dissertations and Theses from inception to September 2022 (updated in July 2023).

We included studies exploring the challenges and perceptions of people with intellectual disability, their carers and health and social care professionals regarding medication management and use.

We reviewed 7593 abstracts and 475 full texts, resulting in 45 included papers. Four major themes were identified: (1) Medication-related issues, (2) navigating autonomy and relationships, (3) knowledge and training needs and (4) inequalities in the healthcare system. We formulated a conceptual framework centred around people with intellectual disability and described the interconnectedness between them, their carers and health and social care professionals in the process of managing and using medication. We identified challenges that could be associated with the person, the medication and/or the context, along with a lack of understanding of these challenges and a lack of capability or resources to tackle them. We developed an overarching concept of ‘collective collaboration’ as a potential solution to prevent or mitigate problems related to medication use in people with intellectual disability.

The effective management of medication for people with intellectual disability requires a collaborative and holistic approach. By fostering person-centred care and shared decision-making, providing educational and practical support, and nurturing strong relationships between all partners involved to form a collective collaboration surrounding people with intellectual disability, improved medication adherence and optimised therapeutic outcomes can be achieved.

CRD42022362903.

To explore and describe how healthcare professionals within the oncological outpatient setting perceive quality of care.

A qualitative, descriptive design with a phenomenographic approach was used, with focus group discussions as the means of data collection.

Primary care in oncological outpatient units in four hospitals in Sweden.

Through purposive sampling, 20 healthcare professionals entered and completed the study by participating in four focus groups, five participants in each group. Inclusion criteria were assistant nurses, nurses or physicians delivering treatment and care with radiation and/or anticancer drugs in oncological outpatient units. Excluded were healthcare professionals who had worked less than 3 months at the oncological outpatient unit.

Two descriptive categories emerged from the data: ‘The professional’s personal ability for good care’ and ‘The structural conditions for good care’. These categories consist of descriptions of quality of care being perceived as a good meeting with patients, patient participation, continuity, accessibility and care grounded in science.

According to the healthcare professionals, quality of care relies on organisational structures in combination with a professional and personal interaction between the patients and the healthcare professionals. Knowledge about what healthcare professionals believe constitutes quality of care should therefore be highly valuable to policymakers and hospital management.

Virtual reality (VR) technology is increasingly being explored as a medium for delivering mindfulness-based interventions. While studies have investigated the feasibility and efficacy of VR-based mindfulness interventions, there has been limited synthesis of user experiences and perceptions across diverse applications, hindering the iterative refinement of these technologies and limiting evidence-based guidance for effective deployment in real-world settings. This systematic review aims to comprehensively identify, appraise and synthesise qualitative research on end-user experiences and perceptions of VR-based mindfulness interventions. Understanding user experiences is critical for translating research findings into practical design improvements and implementation strategies that enhance intervention effectiveness and user adoption.

A systematic search will be conducted in PubMed, Web of Science, Embase, CINAHL, MEDLINE, The Cochrane Library, PsycINFO and Scopus from inception to present. Studies reporting qualitative data on adult participants’ experiences, perceptions, attitudes or opinions related to VR-based mindfulness interventions will be included. Two independent reviewers will screen studies, extract data and assess methodological quality using the Critical Appraisal Skills Programme checklist. Thematic synthesis will be used to analyse the qualitative data. The Grading of Recommendations Assessment, Development and Evaluation-Confidence in the Evidence from Reviews of Qualitative Research approach will be applied to assess confidence in the review findings.

Ethical approval is not required as this review will be based on published studies. The findings will be disseminated through peer-reviewed publication and conference presentations.

CRD42024594330.

Chronic tic disorders (CTDs)—such as Tourette Syndrome (TS)—are neurodevelopmental disorders affecting at least 1% of the population, causing repetitive involuntary movements and vocalisations known as tics. This study aimed to explore the lived experiences of accessing healthcare for people with CTD or TS and their families in the United Kingdom (UK), as part of a larger programme of work to inform change to healthcare services for this population.

Informed and designed with extensive patient and public involvement, the design utilised qualitative research using focus groups. Reflexive thematic analysis was used to analyse the data.

Participants were recruited via online support groups, social media and research registers.

Seven focus groups were held separately with young people with tics (n=2), adults with tics (n=10) and parents/guardians of children with tics (n=11), led by a lived experience expert (coauthor PS) and facilitated by researchers. Discussion focused on three areas: the impact of living with tics, experience accessing healthcare for tics and management of tics.

Five themes were developed highlighting challenges across the healthcare pathway, including gaining a diagnosis, and receiving treatment, resulting in the use of self-support methods to reduce tic expression or the impact of tics. Themes also illustrated perceptions that healthcare provider's knowledge impacted initial interactions with the healthcare system, and how healthcare systems were not felt to be prioritising CTDs.

The findings highlight a lack of prioritisation for tic disorders compounded by a healthcare structure which does not support a complex condition that requires a multidisciplinary approach. This research calls for improvements to UK healthcare services for CTD.

Risk perception is a key influencing factor on the adoption of preventative health behaviours. This study aimed to understand the role of health communication on how people perceived the risk of COVID-19 and influenced relevant health behaviours to minimise disease susceptibility during the COVID-19 pandemic among people with a chronic disease.

This qualitative study involved a semi-structured interview of participants diagnosed with a chronic disease. In analysing interview responses, the Health Belief Model was utilised as a sensitising framework to facilitate analysis and explore themes within the domains of the model.

Interviews were completed between August and December 2020 through online platforms with individual participants.

Participants were Australian residents aged ≥18 years with self-reported chronic disease(s). Ninety interviews were completed, and a sample of 33 participants were enrolled for analysis.

Two main themes were identified: cues to action and perception of the threat of infection. Many participants had implemented external cues to preventative behaviours, including, but not limited to, social distancing, hand hygiene and, in some cases, mask use, mirroring enforced government restrictions. Individuals also had several social motivators from family, particularly those working in the health field, and the wider community to employ the enforced preventative behaviours. However, despite having a chronic disease, many participants did not recognise themselves as being susceptible to COVID-19. Rather, they were more concerned for others that they characterised as being at high risk, including the elderly. Geographical location also played a role in risk prevention behaviour; owing to low case numbers in rural and remote areas, the risk of susceptibility was not perceived to be high.

These findings demonstrate the need to clearly communicate the risk of infection to allow individuals to make informed decisions on preventative behaviours. This has ongoing relevance to future emergencies, including future pandemics/epidemics, and highlights the greater challenge if similar public health measures are contemplated again.

Myalgic encephalomyelitis (ME), also known as chronic fatigue syndrome (CFS), is a debilitating chronic illness that affects the central nervous and immune systems, causing core symptoms of extreme fatigue, post-exertional malaise, cognitive issues and sleep disturbance. With reported higher online use than in other chronic illnesses, people with ME/CFS are often housebound and isolated and may struggle to maintain social relationships. Due to a lack of biomarkers, the illness is often contested, causing invalidation and stigma for those affected. This study aims to broaden the knowledge on how people with ME/CFS gain online connections and whether and how these connections integrate into and impact their everyday life.

Qualitative interviews will be conducted with adults aged over 18 years with a diagnosis or self-diagnosis of ME or CFS (n=20–25). A semi-structured topic guide will be used to interview participants and explore online connections and relationships between these and everyday life with ME/CFS. Interviews will be recorded and transcribed verbatim. Data will be thematically analysed to gain in-depth insight into this largely unexplored topic.

The study has ethical approval from the University of Birmingham (reference: RN_1722-Jun2024), and informed written consent will be provided by all participants. Findings will be published in peer-reviewed journals and disseminated to advocacy organisations and health professionals seeking to offer remote support for people with ME/CFS and their families. This study will provide crucial insight into online use and how it can guide the formulation of management plans for people who may currently receive no support from health professionals at all.

The inadequate handling of obstetrical complications may be attributed to the suboptimal quality of prenatal care (PC) and a lack of trust in healthcare provider (HP) among pregnant women.

This study explores the perceptions of satisfaction among women without social security regarding the PC provided by public health services, and compares the dimensions of satisfaction between those who received group prenatal care (GPC) and those who received individual prenatal care (IPC), as well as to identify the dimensions of satisfaction most valued by women to support the inclusion of said dimensions in primary health guidelines.

We performed a qualitative analysis to explore women’s satisfaction perception regarding PC. Satisfaction was explored using the following dimensions: women-HP relationship, educational support, opportunity of PC, emotional support and perception of clinical procedures.

The study was conducted between 2015 and 2018 across eight primary health facilities, from which four implemented IPC and four implemented GPC. Semi-structured interviews were applied: 28 for women with IPC and 18 for women with GPC. The sample size was defined by theoretical saturation. Content analysis was performed using a combination of deductive–inductive process into dimensions and attributes. To analyse the relationship among dimensions and attributes, we performed onto semiotic networks. ATLAS.ti was used to analyse the information.

Women without social security who received PC care in public health facilities.

Women who received GPC reported higher satisfaction than those who received IPC. In GPC, the most valued dimensions were (1) women-HP relationship, particularly the continuity of care delivered by the same HP and (2) the trust in that same provider. According to semiotic networks, these dimensions showed interconnections with each other, but also connected with attributes of other dimensions. Therefore, they have the potential to enhance trust, communication, the effectiveness of educational activities and emotional support.

A holistic approach to GPC is essential for ensuring a positive prenatal experience. However, a hybrid model that incorporates elements of both IPC can further enhance overall satisfaction among women. Consistency in care, particularly by providing services in public health facilities with the same HP, should be a fundamental strategy in PC, as it can significantly improve women’s satisfaction.

Care pathways (CPs) are widely used to standardise and improve healthcare delivery. However, CP development is often shaped by value (or normative) complexity. This study empirically explores how value complexity unfolds in a CP development programme.

A qualitative single-case study was conducted as part of a 2-year action research programme. The study followed a ‘research-follow-action’ strategy, in which action and learning occurred during the programme phase, followed by retrospective analysis using Greenhalgh et al’s ‘rules of thumb’ as a reflective lens.

A Dutch specialised rehabilitation hospital (13 sites, 800 employees approximately, ~16 000 patients annually). In three CP development cycles, 11 multidisciplinary teams were guided in CP development in a quality collaborative approach.

26 respondents participated in 44 reflective conversations; 19 respondents completed reflective questionnaires and 169 participatory observation reports were included. Participants were purposively sampled and included representatives from the leadership triad (rehabilitation physicians, managers and healthcare professionals) and members of senior management involved in CP development.

Two overarching themes were identified: goal (mis)alignment and prolonged decision-making processes negatively impacted motivation and impeded CP development. Goal alignment between stakeholders was hindered by shifting organisational priorities, creating tensions between improving care quality and ensuring financial viability. Decision-making was challenged by role uncertainty and the complexities of multidisciplinary collaboration in CP development teams. Reflective dialogues, small-scale experimentation and financial modelling supported teams in navigating these tensions to varying degrees.

This study illustrates how value complexity unfolds in CP development and underscores the importance of ongoing stakeholder management, reflectivity, formative evaluation and dialogue. Greenhalgh et al’s rules of thumb provided interpretive value in exploring these complexities but require a solid theoretical understanding and an awareness of the rules’ interrelationships. A complexity-informed approach integrating ongoing reflection and adaptability can enrich CP development methodologies, enabling healthcare professionals and action researchers to engage constructively with value complexity in complex change processes. Further research is needed to develop and implement practical strategies for enhancing stakeholder engagement and decision-making in diverse healthcare settings.

High quality handover is critical for patient safety and care continuity. Existing practice is based on a weak evidence base in which the patient voice is poorly captured. The aim of this study was to identify outcomes of importance to patients, families and carers regarding interventions to improve in-hospital handover between healthcare practitioners.

A rapid systematic review of qualitative literature was carried out after prospective registration with PROSPERO and was reported in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses and Enhancing Transparency in Reporting the Synthesis of Qualitative Research guidelines.

The Ovid MEDLINE database was searched.

Qualitative or mixed-methods studies reporting patient, family or caregiver perspectives on in-hospital handovers were eligible for inclusion.

Synthesis was informed by the best-fit framework approach using a published taxonomy of handover-related outcomes and the Core Outcome Measures in Effectiveness Trials taxonomy. Outcomes were reported according to two distinct types of handover: bedside (patient-involved) and provider-focused (patient-uninvolved).

A total of 34 studies, including 1262 participants across a range of specialties and predominantly high-income settings, were analysed. 53 bedside and 31 provider-focused handover outcomes were identified according to four domains; adverse events, quality of patient care, quality of handover and patient/caregiver satisfaction. Bedside handover studies frequently reported outcomes relating to patient engagement and communication with healthcare staff. One study was carried out in a low income country; however, outcomes identified were broadly similar.

These findings expand the known outcomes for evaluating handover interventions and highlight the importance of prioritising the patient and public perspective in research. This work will contribute to developing a core outcome set for trials in surgical handover but can also be applied to handover practices for any other discipline within the hospital environment.

CRD42023493367.

To identify the barriers and facilitators to implementing the social franchising model ‘Smart Focus’ for delivering eye care services to children in rural China, using the updated Consolidated Framework for Implementation Research (CFIR 2.0) as a theoretical basis to evaluate implementation performance drivers and propose strategies for effective scaling and sustainability.

This qualitative study involved semi-structured interviews with key stakeholders from both the supply side and demand side. Interview guide development, coding, analysis and reporting of findings were thoroughly informed by the CFIR 2.0.

Smart Focus operated in 23 poverty-designated counties across four western provinces in China, collaborating with local public hospitals, private optical shops and third-party non-governmental organisations.

Key informants included two Smart Focus project managers, six representatives from local education and health bureaus and ten vision centre employees and franchise operators.

Key facilitators of implementation included a robust evidence base, high trialability and adaptability of the innovation, relative advantages over competitors, standardised resources and effective training programmes. Major barriers included challenges in cross-departmental collaboration, underestimated variable costs, competition from private providers, high employee turnover due to inadequate incentives and the lack of feedback mechanisms for contextual adaptation.

This study highlights critical barriers and facilitators to implementing social franchising models for eye care in low-resource settings. While Smart Focus demonstrated success in scalability, achieving sustainability requires addressing financial constraints, staff retention and adaptive feedback mechanisms. The findings provide a context-specific framework for scaling health innovations in low- and middle-income countries, offering valuable lessons for bridging the gap between social and business objectives in hybrid models.

Smoking is a well-established risk factor that exacerbates multiple sclerosis (MS) progression and increases disease activity. Smoking cessation promotion practices of MS clinicians are not meeting the needs of people with MS (pwMS). This study aimed to explore the current practices and barriers faced by MS clinicians in Germany.

A qualitative study design, using semi-structured interviews and thematic analysis.

Interviews with participants were held online, via telephone or face-to-face at our institute in Hamburg, Germany.

We recruited eight neurologists and four MS nurses from hospitals, neurology practices and rehabilitation facilities in Germany via purposive and snowball sampling.

We identified 27 codes across four themes: (1) knowledge: the 12 participants demonstrated a satisfactory general knowledge of the negative impacts of smoking on MS (2) current practice: significant variability was reported in the current practices, with some clinicians providing detailed advice while others merely assessing smoking status without further advice or assistance. (3) Barriers: key barriers identified included limited consultation time, perceived lack of patient motivation and insufficient availability of resources, like information material, for effective smoking cessation support. (4) Needs and wishes: participants wished for specific smoking cessation courses to which they could refer patients, as well as information material to use during patient counselling.

The study reveals considerable gaps in the consistency and comprehensiveness of smoking cessation support provided by MS clinicians in Germany. Addressing these gaps through targeted interventions, and improving the availability of information materials could enhance smoking cessation promotion for pwMS.

To explore patients’ experiences and preferences of self-testing using white cell count point-of-care test (POCT) and C reactive protein POCT during antibiotic treatment at home.

A University Hospital in the Region of Zealand (DK).

10 inpatients treated with antibiotics who were discharged from hospital to continue antibiotic treatment at home. They were trained in the hospital supervised by research personnel before self-testing at home.

An explorative qualitative study using thematic analysis.

The participants considered the self-testing beneficial, mainly due to not having to travel to get a blood test drawn, the rapid test time and the ability to closely monitor their treatment. The participants perceived that self-testing at home would make them feel more in control of their disease and would give them the ability to live a more normal life. Moreover, self-testing at home showed to be feasible for some patients but with barriers to overcome, such as the ability to use technology and cognitive challenges.

Our study showed that self-testing at home was feasible for some patients, provided they received thorough training at the hospital ensuring that participants were able to conduct the self-testing and use the smartphone technology before transitioning to their home. This could help reduce barriers to home self-testing by highlighting its benefits and emphasising the need for adequate patient guidance and support.

Social accountability is a key value and aspirational goal of many medical institutions. While much has been studied on social accountability in the context of medical education and institutions, less research has examined how social accountability influences research. In light of this absence, the objective of our scoping review is to research the following questions: (1) What characterises socially accountable research (SAR), and how is it expressed and experienced? (2) How do language, positionality, and worldview influence SAR?, and (3) What structures and considerations are necessary to support successful SAR in local and global contexts?

To answer the above research questions, the Arksey and O’Malley, Levac et al, Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews and Joanna Briggs Institute (JBI) guidelines will be followed. The search strategy was adapted and applied to MEDLINE, Embase, ERIC, and CINAHL databases. A total of n=5289 eligible articles were identified. Articles were excluded if they were published before 1995, were in a language other than English, or were duplicates, leaving n=2840 articles for title/abstract screening.

Ethical approval is not required to complete this study. We will take an integrated knowledge translation approach. Throughout the project, results will be disseminated to knowledge users (ie, consultations, following Arksey and O’Malley). Our findings will be presented to the larger academic community, policymakers, and healthcare practitioners through presentations, reports, newsletters, and an online repository.

Open Science Framework 16 July 2024. osf.io/mvhnu.

In qualitative research, there are different approaches to defining and engaging with social reality. Epistemology, as the study of knowledge and knowledge creation, influences the methodologies and theories used by researchers. A growing literature questions the universality of Western-centric and Global North research methodologies and theories and highlights their Western epistemological roots. While Western frameworks are appropriate for Western contexts, it is a fallacy to assume that they represent global realities, thereby marginalising Global South knowledge systems. Thus, the aim of this scoping review is to analyse the underlying epistemologies, methodologies or theories that are evident in qualitative research conducted by researchers from the Global North in their research on, for or with people from the Global South.

The review will be conducted using the Joanna Briggs Institute framework for scoping reviews. A search strategy will be developed to identify published and unpublished literature in CINAHL, Embase, Google Scholar, MEDLINE, ProQuest, PsycINFO and Web of Science. All potential papers will be exported to the reference manager Zotero, and the results will be uploaded to Rayyan. Studies are selected using a three-step process and documented using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses flowchart. The abstracted studies will then be collated using the PAGER framework to identify the patterns, advances, gaps, evidence and recommendations that help to understand the review question.

As this is a secondary analysis, our research does not require ethical approval, but we will scrutinise all included studies for inclusion of an ethical approval statement. We intend to share our findings through peer-reviewed international journals and presentations at conferences, as well as collaborating with colleagues in related fields.

The protocol for this scoping review has been registered with the Open Science Framework (https://doi.org/10.17605/OSF.IO/5BUZX).

High blood pressure (BP) is a significant global health issue, with many treated patients failing to achieve BP control. The Triple Pill vs Usual Care Management for Patients with Mild-to-Moderate Hypertension (TRIUMPH) trial evaluated the effectiveness, cost-effectiveness and acceptability of early use of low-dose triple fixed-dose combination of BP-lowering drugs (‘triple pill’) compared with usual care in the management of hypertension. The TRIUMPH trial showed superior BP control with the triple pill strategy compared with usual care. This process evaluation of the TRIUMPH trial aimed to explore the contextual factors that influenced the trial outcomes, implementation of the triple pill strategy, mechanisms of its effects and potential barriers and facilitators for implementing the triple pill strategy in routine practice.

Guided by the UK Medical Research Council’s framework, semistructured interviews were conducted with 23 patients and 13 healthcare providers involved in the TRIUMPH trial. Data were analysed using the framework analysis method in NVivo.

Hypertension care in Sri Lanka was hindered by the absence of systematic screening and overcrowded public clinics. Despite free medication provision at public clinics, long waiting times and occasional stock-outs posed challenges. In the TRIUMPH trial, both intervention and usual care were delivered in the context of ‘better than usual’ care, including team-based management, reduced waiting times, monetary assistance for travel, routine adherence monitoring and intensive follow-up. The triple pill strategy provided a simplified regimen, better access to BP-lowering medications and better BP-lowering efficacy. Key barriers to implementation in routine practice included the triple pill’s large size, therapeutic inertia and restrictive regulatory policies regarding fixed-dose combinations.

Implementation of the triple pill strategy into routine practice requires health system strengthening, provider training and supportive policy measures to replicate its effectiveness seen in the trial.

ACTRN12612001120864, SLCTR/2015/020.

This study aimed to investigate the opportunities and challenges associated with integrating artificial intelligence (AI) in healthcare by exploring the perspectives of various stakeholders. The objective was to provide a nuanced understanding of stakeholder views to address concerns and promote the acceptance and successful integration of AI technologies in medical practice.

This exploratory qualitative study used semi-structured interviews. Data were analysed using a combination of deductive and inductive coding, followed by content analysis to identify and develop categories.

This study was conducted in Tübingen, Germany, within the framework of the TüKITZMed project (Tübingen AI Training Center for Medicine), between August 2022 and March 2023.

A total of 38 stakeholders participated, including 6 lecturers, 9 clinicians, 10 healthcare students, 6 AI experts and 7 institutional stakeholders. Inclusion criteria included professionals involved in or affected by AI in healthcare, while exclusion criteria comprised individuals without relevant experience.

Not applicable.

The main outcome was the identification of thematic categories capturing stakeholders’ perceptions, expectations and concerns regarding the integration of AI in healthcare.

The analysis identified two main thematic categories: two main categories encompassing a total of 14 subcategories: (1) perceived opportunities of AI in medicine, including aspects of increased efficiency, reduced workload and improved patient safety and (2) perceived challenges of AI in medicine, such as its impact on medical decision-making and concerns about dependence on technology. These themes reflect diverse perspectives and insights across stakeholder groups.

Diverse stakeholder perspectives offer valuable insights into the anticipated effects of AI in healthcare. Understanding these perspectives can support decision-makers in designing context-sensitive AI strategies and identifying areas for further professional and institutional development. Future research should monitor how these attitudes evolve in response to technological progress and real-world implementation.

This study explored how humble leadership among nursing faculty influences team performance and the success of quality improvement and accreditation projects in Jordanian private universities, where such leadership approaches remain understudied despite growing accreditation demands.

A qualitative study was conducted using face-to-face semistructured interviews with 20 nursing faculty members from two private universities in Jordan (April–July 2023), selected via convenience snowball sampling. Thematic analysis followed A framework to examine participants’ perspectives on (1) manifestations of humble leadership, (2) its impact on team dynamics and (3) project outcomes. Data collection continued until thematic saturation was achieved, with member checking used to validate interpretations.

The analysis revealed three key findings. First, humility manifested at both leadership and team levels through shared learning and mutual growth. Second, humble leadership strengthened team performance by fostering open communication and psychological safety. Finally, accreditation success was facilitated by leaders who exemplified humility through inclusive delegation and recognition of contributions, proving particularly impactful in resource-limited academic environments.

The findings suggest humble leadership may serve as a valuable approach for nursing faculties navigating accreditation challenges, particularly in private university settings. While demonstrating potential benefits for team cohesion and project outcomes, the study highlights the need for intentional leadership development programmes that cultivate these competencies among nursing educators. Future research should explore how these findings translate to clinical nursing leadership contexts.

Chronic heart failure management can involve considerable healthcare workload for the patient that impacts on well-being and results in treatment being perceived as burdensome. This can result in non-adherence to treatments. This systematic review aims to identify, appraise and synthesise the available qualitative evidence exploring the experience of treatment burden in heart failure patients participating in a self-care intervention. Findings will provide an in-depth understanding of the patient journey, providing knowledge that will enable the development of targeted interventions that reduce the burden of treatment for patients.

The databases will include Medline, PsycINFO, Embase, CINAHL, Cochrane and Web of Science. The review protocol is registered in the International Prospective Register for Systematic Reviews (PROSPERO ID no 1052512). This review will systematically scour qualitative research studies in databases from 2010 to January 2025 with carefully chosen search terms such as heart failure, self-care and burden. Searches are limited to studies in English. Two reviewers, guided by the Joanna Briggs Institute Critical Appraisal Checklist for Qualitative Research, will independently appraise the methodological quality of the selected studies. Any disagreements will be resolved through discussion with a third reviewer. This review will employ a rigorous thematic synthesis approach informed by the burden of treatment theory, where two researchers will analyse and synthesise data by double-coding.

Ethical approval is not required for this systematic review as primary data will not be collected. The result of the review will be disseminated through publication in an academic journal and scientific conferences.

ID 1052512.

The COVID-19 pandemic prompted a significant increase in the use of remote consultations—by telephone or video—in both primary and secondary healthcare. The reported advantages of remote consulting for both patients and clinicians include greater efficiency, flexibility and convenience. However, disadvantages, such as the uncertainty created by a loss of face-to-face contact, have also been highlighted. The aim of this study was to explore, explain and interpret patients’ and clinicians’ perceptions and experiences of remote consultations and assist decision-making about their future use.

A qualitative study based on semistructured online interviews.

Primary mental healthcare or secondary care cardiology services, London, UK, February–March 2022.

Primary care mental health patients (n=5), primary care clinicians (general practitioners) (n=15), secondary care cardiology patients (n=9) and secondary care cardiology clinicians (n=5).

The results demonstrate that a range of factors have influenced the experiences of both clinicians and patients and indicate shifts in the norms of professional practice and clinician–patient relationships.

Patients and clinicians demonstrated pragmatic acceptance of remote consultations and, looking forward, a preference for a balanced ‘hybrid model’ of remote and face-to-face appointments. The study also highlights a need to consolidate and build on the informal learning and adaptation to remote consulting that has already taken place.

Incidents of suicide remain a major public health concern worldwide, including in Bangladesh. Scholarly research in Bangladesh has primarily focused on factors contributing to the high prevalence of suicide and suicide attempts among students. However, there is limited research on the community-level factors contributing to suicide, particularly in Jhenaidah, a southeastern region in Bangladesh with a higher prevalence of suicide thoughts and behaviours. Therefore, this study aims to explore the factors responsible for the disproportionate rates of suicides and attempts in Jhenaidah.

We used an exploratory qualitative study design.

A total of 48 participants (Male 29 and Female 19) were purposively recruited from six subdivisions of Jhenaidah. Participants who attempted suicide, their family members, community representatives and healthcare providers comprised the sample.

We conducted a semistructured in-depth interview with a purposively selected participant. Interviews were transcribed verbatim. Thematic analysis with the inductive method was used.

Qualitative data analysis led to the emergence of six major contributing factors, each yielding at least one category and subcategory. These factors are broadly associated with interpersonal relationships, physiological and psychological complaints, a range of socioeconomic issues, educational and moral issues, and knowledge and accessibility of methods for suicide.

Results highlight the intricacies of various factors for the disproportionate rates of suicidal thoughts and behaviours in Jhenaidah and reinforce the importance of implementing a biopsychosocial perspective on suicide prevention. The results also contribute to the global understanding of suicide through the exploration of indigenous factors.