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Martin Heidegger’s phenomenology provides methodological guidance for qualitative researchers seeking to explicate the lived experience of study participants. However, most phenomenological researchers apply his philosophy loosely. This is not surprising because Heidegger’s phenomenological philosophy is challenging and the influence of his philosophy in shaping the conduct of interpretive phenomenological research is broadly debated. This article presents an exploration of Dasein, a key tenet of Martin Heidegger’s interpretive phenomenology and explicates its usefulness for phenomenological research. From this perspective, we present guidance for researchers planning to utilize Heidegger’s philosophy underpinning their research.

Background Cancer treatments have many adverse effects on patient’s health leading to poor cardiorespiratory capacity, muscular- degeneration, fatigue, loss of strength and physical function, altered body-composition, compromised immune-function, peripheral neuropathy, and reduced quality of life (QOL). Exercise programs can significantly increase functional capacity when tailored to individual needs, thus improving health. Exercise interventions in cancer rehabilitation, when supported by appropriate nutrition can be effective in attaining a healthy weight and body-composition. The successful rehabilitation program should also include psycho-social education aimed to reduce anxiety and improve motivation. Methods The current study aimed to collect information on the post-treatment needs of cancer patients including barriers and expectations facing them, their caregivers and their families through consultation in focus group interviews. Cancer survivors living in the Republic of Ireland were recruited from the University Hospital Galway, community-based cancer centres, cancer support groups and social media platforms to participate in the study and attend a focus group interview. The focus group discussions were designed to obtain information on the collective views of cancer survivors on relevant topics selected. The topics were developed in consultation with a patient and public involvement (PPI) group supporting the study. The topics list was circulated to all participants prior to the focus group. The interviews were audio recorded and transcribed verbatim. Focus group transcripts were analysed subjected to a thematic framework analysis using NVivo. Results Thirty-six participants took part in 9 focus groups. Our analysis uncovered two main themes. The first theme ‘cast adrift with no direction’ was grouped into three sub-themes: everything revolves around treatment ; panic and fear ; and what exercise should I be doing? The second theme ‘everybody is different’ was clustered into two sub-themes: side effects get in the way ; and personalised exercise program. Conclusion The study highlighted the lack of information and support needed by patients living with and beyond cancer. The study also highlighted the need for a personalised exercise programme designed to target the individual patient symptoms that would be ideal for the mitigation of long term symptoms and in improving QOL.

More than one-third of cancer-related health information is unreliable or misleading. With increasing health information seeking, the risks of misinformation exposure are growing. Educational approaches that are delivered clearly and in accessible formats are a promising way to strengthen critical thinking and decision-making skills, thereby helping to reduce the exposure of those impacted by cancer to misleading cancer information. This pilot randomised trial will assess the feasibility and acceptability of conducting a larger definitive trial evaluating the Informed Health Choices-Cancer (IHC-C) programme. The IHC-C is an online evidence-based education programme co-designed by stakeholders, including public and patient partners. It aims to equip people impacted by cancer (i.e., current patients, survivors, caregivers, and loved ones) with the skills and knowledge necessary to think critically about the reliability of health information and claims and make informed health choices. Participants will be randomised to either the IHC-C intervention group or a waitlist control group. The primary outcome of this pilot trial are feasibility (recruitment and retention rates, etc.) and acceptability (participant satisfaction and perceived usefulness, etc.). Demographic and cancer-related data will be collected to characterise the sample and inform recruitment strategies for a future definitive trial. Preliminary measures of critical thinking and decision-making skills will also be gathered to support the selection of key outcomes for the future trial. This pilot trial will inform the design and conduct of a future definitive randomised trial. Insights gained will inform sample size estimations, refine recruitment strategies, optimise programme delivery, and improve data collection processes, ensuring a robust and scalable approach for the definitive trial.

Background The COVID-19 pandemic marked a unique period characterised by an extraordinary global virus spread. The collective effort to halt the transmission of the virus led to various public health initiatives, including a variety of COVID-19 vaccine trials. Many of these trials used adaptive methods to address the pandemic’s challenges, such as the need for rapid recruitment. These adaptive methods allow for modifications to the trial procedures without undermining the trial’s integrity, making the research process more flexible and efficient. However, recruiting participants for vaccine trials remains a considerable challenge. The aim of this qualitative evidence synthesis (QES) is to explore the factors that influence a person’s decision to participate in a COVID-19 vaccine trial. Lessons learned from this could help shape future trials’ design and conduct, particularly those conducted within a pandemic. Methods We conducted a systematic search for qualitative studies and mixed methods studies with a qualitative component in the WHO COVID-19 Research Database, MEDLINE, CINAHL, PsycINFO, Epistemomikos, Online Resource for Research in Clinical Trials (ORCCA), and the Cochrane COVID-19 Study Register. We used the best-fit framework synthesis approach and the Social Ecological Model as an a priori framework. We used the GRADE-CERQual approach to assess our confidence in the review findings. Results Five studies involving 539 participants were included. One of these studies included participants in a COVID-19 vaccine trial. In three of the studies, participants were asked hypothetically about their attitudes. Another study included people who had either not responded to or declined an invitation to participate in a COVID-19 vaccine trial. We developed six themes outlining the factors that influence a person’s decision to participate in a COVID-19 vaccine trial: (1) personal gains, (2) perceived risk, (3) influence of family and community, (4) contributing for others, (5) institutional trust and mistrust, and (6) accessibility of the trial. Conclusion This review sheds light on how people perceive the potential personal, family, and community advantages of trial participation and how these perceptions may be weighed against concerns about vaccine safety. The findings also point toward specific aspects of trial methodology to consider when designing COVID-19 vaccine trials. Graphical Abstract

Background The translation of research into clinical practice is a key component of evidence-informed decision making. We implemented a multi-component dissemination and implementation strategy for healthcare professionals (HCPs) called Evidence Rounds. We report the findings of focus groups and interviews with HCPs to explore their perceptions of Evidence Rounds and help inform the implementation of future similar initiatives. This is the second paper in a two-part series. Methods We employed total population, purposive sampling by targeting all of the health care professionals who attended or presented at group sessions exploring the evidence on clinical questions or topics chosen and presented by the HCPs. We conducted and audio-recorded in-person focus groups and one-to-one interviews, which were then transcribed verbatim. Two authors independently coded transcripts. NVivo software was used to collate the primary data and codes. We analysed data guided by the five steps involved in framework analysis; 1) familiarization 2) identifying a thematic framework 3) indexing 4) charting 5) mapping and interpretation. Results Thirteen HCPs participated, of which 6 were medical doctors an d 7 were nursing or midwifery staff. We identified the following key domains; organisational readiness for change, barriers and facilitators to attendance, barriers and facilitators to presenting, communication and dissemination of information, and sustainability. During focus groups and interviews HCPs reported that Evidence Rounds had a positive impact on their continuing education and clinical practice. They also provided insights into how future initiatives could be optimised to support and enable them to narrow the gap between research evidence and practice. Conclusions Individual, departmental and organisational level contextual factors can play a major role in implementation within complex health services. HCPs highlighted how in combination with clinical guideline development, implementation of evidence could be increased. Further research after a longer period of implementation could investigate how initiatives might be optimised to promote the uptake of evidence, improve implementation and expedite behaviour change.

Background Striae gravidarum are a common occurrence in pregnancy and many women use a topical product to prevent their development or lessen their appearance if they do develop. There is a lack of evidence on the effectiveness of many of the products used by women. This study arose from challenges in recruitment to a pilot randomised trial (ISRCTN trial registration number:76992326) designed to evaluate the feasibility of a definitive trial to compare a moisturising oil to no treatment in the prevention and reduction in severity of striae gravidarum. The study reported here explored the factors influencing recruitment to that pilot trial. Methods A qualitative descriptive study was undertaken involving primigravid women attending an Irish maternity hospital. Data were collected by semi-structured telephone interviews over a four-week period and analysed using the framework method of analysis. Fifteen interview transcripts were included in the analysis. Results Four main themes consisting of twelve categories were identified from the interview data. The themes focused on women’s prevention of stretch marks and their choice of anti-stretch mark product, who and what influenced that choice and influences on trial participation. In relation to influences on trial participation, the possibility of being randomised to the non- intervention or control group was a deterrent for many women. Conclusions The prevention of stretch marks is important to pregnant women, as is their choice of product to prevent them. Offering women the opportunity to be part of a trial that would be of low burden and would test a well-known product may optimise recruitment. However, reluctance to be randomised because of the possibility of being allocated to the non-intervention control group suggests that further work is needed in this field on how best to communicate uncertainty to potential participants.

Background Evidence-informed practice is fundamental to the delivery of high quality health care. Delays and gaps in the translation of research into practice can impact negatively on patient care. Previous studies have reported that problems facing health care professionals such as information overload, underdeveloped critical appraisal skills, lack of time and other individual, organisational and system-level contextual factors are barriers to the uptake of evidence. Health services research in this area has been restricted largely to the evaluation of program outcomes. This paper aims to describe the implementation process of an educational initiative for health care professionals working in midwifery, neonatology or obstetrics aimed at disseminating evidence and enhancing evidence-informed clinical care. Methods We designed and implemented an educational initiative called Evidence Rounds for health care professionals working in the women and children’s division of an urban hospital in Ireland. It consisted of three core components: (1) group educational sessions examining evidence on topics chosen by staff (2) a dedicated website and (3) facilitation, enablement and support from a knowledge translation professional. We evaluated user engagement in the educational program by monitoring attendance figures and website analytics. We followed up with staff at 3, 16 and 21-month intervals after the last educational session to find out whether evidence had been implemented. We use Lavis’s organising framework for knowledge transfer and the Template for Intervention Description and Replication (TIDieR) checklist to describe the educational program and document the implementation process. Results Six educational sessions presented by 18 health care professionals took place over a nine month period with 148 attendances of which 85 were unique (individuals who attended at least one session). During the period spanning from one month before, during and one month after the running of the group sessions, 188 unique visitors, 331 visits and 862 page views were recorded on our website. Conclusions Audit and feedback processes can provide quantitative data to track practice outcomes. Achieving sustainable educational programs can be challenging without dedicated resources such as staffing and funding.

Objective: This study aimed to understand public health nurses’ (PHNs) views and experiences of their role as part of a primary care team (PCT) and developments within primary care. Design: The study adopted a qualitative design guided by interpretative phenomenological analysis (IPA). Participants: Ten PHNs who were working as part of a PCT for at least two years and who also had PHN experience prior to PCT development were interviewed. Findings: Three super-ordinate themes representing the study participants’ lived experience and meanings of PCT involvement were interpreted. ‘We are a team’ represents mostly positive experiences of being part of a team such as improved communication and teamwork. However, GP non-attendance at PCT meetings was also highlighted by all the PHNs. ‘Pushed to the limit’ revealed the PHNs’ frustrations attributed to lack of resources. In addition, this theme represented PHNs’ views of always having to ‘take up the slack’ within the team. Finally, ‘PHN’s role’ revealed that the health promotion aspect of the PHNs’ job was perceived to have been ‘pushed aside’, and mixed feelings around PHNs’ future role were relayed. Conclusion: The findings contribute to the knowledge of PHNs’ roles as part of PCT developments and highlight the need for more dialogue among PCTs on all roles within the team. It is clear that more resources for PHNs in Ireland are needed if they are to fulfil a vision of primary care. In addition, the study findings point to a need to investigate whether policy and practice changes introduced with the introduction of PCTs has improved patient outcomes.

Definition of reflexivity and its role as a qualitative research methodology. Reflexivity has often been used in feminist research and is referred to in the context of counselling and psychotherapy. [(BNI unique abstract)] 61 references

Aim: The aim of this study was to highlight nursing issues associated with overcrowding (or access block) in the Accident and Emergency (A and E) department. Design: An interpretive phenomenological approach was adopted, with the utilisation of unstructured interviews. Setting: The A and E department of a general hospital situated in the West of Ireland. Participants: Eleven nurses working in the A and E department volunteered to be interviewed. Finding: Three central themes, with inter-related sub-themes, emerged from the data. The central themes identified were: lack of space, elusive care, and powerlessness, with sub-themes being health and safety issues, infection control issues, poor service delivery, lack of respect/dignity, nurses hovering, unmet basic human needs, not feeling valued, moral distress, and stress/burnout. Conclusions: The nurses in this study provide a distressing picture of nursing in an A and E department, as they pursue the provision of effective, holistic care of patients in overcrowded conditions.