Despite a growing amount of literature on aging and sexual activity, there are still a limited number of studies that capture older people's understanding of sexuality in later life. This study explored the meanings that older people ascribe to sexual activity and how these meanings relate to the continuation, the decline, and the complete cessation of sexual activity. Thirty in-depth semi-structured interviews were conducted with Czechs aged 50-75 years (13 men) who were recruited through a preventive cognitive health program offered at a hospital. The analysis was carried out with a grounded theory approach and the principles of consensual qualitative research. The study identified three dominant understandings of sexual activity in later life that emerged as a reflection of the aging process. The first was sexual activity within a relationship that represented proof of being with someone and where sexual inactivity was linked to the threat of loneliness. The second concerned sexual pleasure and its continuity in later life, while its loss gave room for affliction and the emergence of ageist beliefs. The third linked sexual activity with the connotations of self-identifying as young versus being self-perceived as really old. The study findings suggest that the understanding of sexual activity in later life is ambivalent. Its continuity is viewed as an instrument for mitigating the markers of getting old, while the threat of its decline may activate older people's desire for asexual aging and negative views on aging.

• Klíčová slova
• Aging, Czech Republic, Later life, Older adults, Sexuality,
• MeSH
• kvalitativní výzkum MeSH
• lidé středního věku MeSH
• lidé MeSH
• longitudinální studie MeSH
• senioři MeSH
• sexuální chování psychologie   MeSH
• socioekonomické faktory MeSH
• stárnutí psychologie   MeSH
• Check Tag
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH

BACKGROUND: Early marriage occurs in some regions of the world. Given that early marriage can have many negative consequences for girls by affecting their physical, mental, and social health, the purpose of this study was to investigate the reasons for early marriage from the perspective of women who had experienced it in Zahedan, Iran. METHODS: This qualitative research was conducted based on the qualitative content analysis method in 2020-2021. The target population included women aged 18-35 living in Zahedan who were married under the age of 18 years. Purposeful sampling was used to select the participants. In order to collect data, in-depth interviews were performed to decipher the reasons for early marriage from these women's perspectives. A total of 36 interviews were conducted from October to December 2020 until reaching theoretical saturation. Conventional content analysis was used to analyze the data and extract the relevant concepts and categories. RESULTS: The analysis of the interviews in this study revealed three main categories:(1) "early marriage as a transcendental coercion" ( early marriage as a cultural heritage and early marriage as a control tool, girls' weaknesses and inability to resist, dominant attitudes toward gender and gender restrictions), (2) "early marriage as a solution or a kind of problem solving" (escape from undesirable family environment, escape from financial poverty, and strategic escape from an unpleasant situation), and (3) "early marriage as a voluntary act" (real agency and imaginary agency). To substantiate these findings, we presented excerpts from the interviews conducted with the participants. CONCLUSION: The results of this study suggest a multidimensional picture of early marriage. It seems that improving cultural conditions and empowering families and girls in various areas, including marriage, can reduce the rate of early marriage and/or at least mitigate its undesirable consequences.

• Klíčová slova
• Early marriage, Girls, Qualitative content analysis, Sistan and Baluchestan,
• MeSH
• chudoba * MeSH
• kvalitativní výzkum MeSH
• lidé MeSH
• řešení problému * MeSH
• Check Tag
• lidé MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• Geografické názvy
• Írán MeSH

BACKGROUND: Mobile health (mHealth) is increasingly being used in contemporary health care provision owing to its portability, accessibility, ability to facilitate communication, improved interprofessional collaboration, and benefits for health outcomes. However, there is limited discourse on patient safety in real-world mHealth implementation, especially as care settings extend beyond traditional center-based technology usage to home-based care. OBJECTIVE: This study aimed to explore health care professionals' perspectives on the safety aspects of mHealth integration in real-world service provision, focusing on Hong Kong Special Administrative Region (SAR) and Wuhan city in mainland China. In Hong Kong SAR, real-world mHealth care provision is largely managed by the Hospital Authority, which has released various mobile apps for home-based care, such as Stoma Care, Hip Fracture, and HA Go. In contrast, mHealth care provision in Wuhan is institutionally directed, with individual hospitals or departments using consultation apps, WeChat mini-programs, and the WeChat Official Accounts Platform (a subapp within the WeChat ecosystem). METHODS: A multicenter qualitative study design was used. A total of 27 participants, including 22 nurses and 5 physicians, from 2 different health care systems were interviewed individually. Thematic analysis was used to analyze the data. RESULTS: The mean age of the participants was 32.19 (SD 3.74) years, and the mean working experience was 8.04 (SD 4.05) years. Most participants were female (20/27, 74%). Nearly half of the participants had a bachelor's degree (13/27, 48%), some had a master's degree (9/27, 33%), and few had a diploma degree (3/27, 11%) or a doctoral degree (2/27, 7%). Four themes emerged from the data analysis. Considering the current uncertainties surrounding mHealth implementation, participants emphasized "liability" concerns when discussing patient safety. They emphasized the need for "change management," which includes appropriate referral processes, adequate resources and funding, informed mHealth usage, and efficient working processes. They cautioned about the risks in providing mHealth information without ensuring understanding, appreciated the current regulations available, and identified additional regulations that should be considered to ensure information security. CONCLUSIONS: As health care systems increasingly adopt mHealth solutions globally to enhance both patient care and operational efficiency, it becomes crucial to understand the implications for patient safety in these new care models. Health care professionals recognized the importance of patient safety in making mHealth usage reliable and sustainable. The promotion of mHealth should be accompanied by the standardization of mHealth services with institutional, health care system, and policy-level support. This includes fostering mHealth acceptance among health care professionals to encourage appropriate referrals, accommodate changes, ensure patient comprehension, and proactively identify and address threats to information security.

• Klíčová slova
• mHealth, mobile health, mobile health technologies, patient safety, qualitative study, real-world implementation,
• MeSH
• bezpečnost pacientů * MeSH
• dospělí MeSH
• kvalitativní výzkum MeSH
• lidé MeSH
• mobilní aplikace MeSH
• telemedicína * MeSH
• Check Tag
• dospělí MeSH
• lidé MeSH
• mužské pohlaví MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• multicentrická studie MeSH
• Geografické názvy
• Čína MeSH
• Hongkong MeSH

INTRODUCTION: Statin intolerance (SI) occurs in patients with dyslipidemia treated with statins. Statin-associated symptoms have been reported, but the overall patient experience is poorly understood. No instruments are available to collect this patient experience. Our aim is to develop a patient survey to define SI from the patient's perspective, inform clinical practice, and identify potential patient characteristics and barriers associated with discontinuing treatment when statin-related difficulties are encountered. METHODS: We conducted qualitative concept elicitation interviews with 65 patients across 12 European study sites. A semi-structured qualitative interview guide was developed based on literature review and clinician interviews. Concept elicitation interviews with patients were used to describe the patient experience and develop the conceptual framework for the survey. RESULTS: Symptoms experienced by patients included muscle and non-muscle-related pain and discomfort; other muscle-related symptoms; gastrointestinal, cardiovascular, cold-like, fatigue-related, and sensory and systems symptoms; mood changes; and cognitive and memory problems. Impacts included limitations on general physical functioning; physical activities; social functioning; emotional impacts; sleep disturbances; decreased productivity; and increased healthcare use. Conceptual framework elements to support survey goals include demographic and clinical characteristics, health information and beliefs, statin side-effect history, symptom severity, and impact severity. CONCLUSIONS: Symptoms and impacts described by patients showed a wider range of symptoms and impacts than usually discussed clinically. The patient survey is designed to capture information from patients who experience difficulties with statin therapy and may be useful in identifying patients who are at higher risk for giving up or discontinuing their treatment. FUNDING: Amgen Inc.

• Klíčová slova
• Cardiology, Dyslipidemia, Lipid-lowering therapy, Patient experience, Qualitative research, Statin, Survey,
• MeSH
• anticholesteremika škodlivé účinky   terapeutické užití   MeSH
• bolest chemicky indukované   MeSH
• dospělí MeSH
• dyslipidemie farmakoterapie   epidemiologie   MeSH
• kvalitativní výzkum MeSH
• lidé středního věku MeSH
• lidé MeSH
• průzkumy a dotazníky MeSH
• senioři MeSH
• spokojenost pacientů statistika a číselné údaje   MeSH
• statiny škodlivé účinky   terapeutické užití   MeSH
• Check Tag
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH
• Geografické názvy
• Evropa epidemiologie   MeSH
• Názvy látek
• anticholesteremika MeSH
• statiny MeSH

Europe's ageing population increases the demand for housing solutions targeting older citizens' needs and preferences. Establishing age-friendly communities fostering social participation is essential for healthy ageing and various housing options with shared facilities prioritizing social contact have emerged. While involving older people in public service delivery is emphasized, studies on co-production with older people in building age-friendly communities remain limited. This study explores a co-production initiative between older citizens, a municipality and a real estate company in a newly established senior village focusing on organizational settings and physical facilities. A qualitative study inspired by the BIKVA methodology was conducted using focus group interviews with citizens, frontline staff, and management. Through reflexive thematic analysis, the physical environment, organizational setting and other factors influencing the co-production process were analysed. Citizens expressed satisfaction with the unique physical environment, the different activities and being involved in the co-production process on development and building up the senior village. However, the co-production initiative was influenced by the lack of frontline staff involvement, how the physical facilities were organized for building inclusive communities as well as the level of information provided to align expectations among stakeholders. Involving older citizens in the co-production of age-friendly community initiatives has the potential to take the identified challenges into account. To understand what constitutes an optimal environment for healthy ageing further research in collaboration with older citizens is needed.

• Klíčová slova
• Co-production, Healthy ageing, Healthy ageing communities,
• MeSH
• bydlení MeSH
• kvalitativní výzkum * MeSH
• lidé středního věku MeSH
• lidé MeSH
• senioři nad 80 let MeSH
• senioři MeSH
• zapojení do společnosti MeSH
• zdravé stárnutí * MeSH
• zjišťování skupinových postojů MeSH
• Check Tag
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• senioři nad 80 let MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH

INTRODUCTION: High-quality scientific and technological advancements are necessary if quality improvement is to be achieved in orthodontic treatment. However, suboptimal research uptake in clinical practice and innovation adoption patterns that are not consistent with scientific evidence suggest that a better understanding of the adoption behavior of clinicians is needed. This research aimed to explore the factors that influence orthodontists to adopt innovations into practice. METHODS: This was a qualitative study in which 9 semistructured in-depth interviews were conducted with orthodontists and third-year orthodontic residents. The interviews were digitally recorded, and field notes were taken. Data were professionally transcribed verbatim and deidentified. Thematic analysis was used to inductively generate codes and subsequent themes. This study was reported according to the consolidated criteria for reporting qualitative studies checklist. RESULTS: Six main themes emerged as facilitators or barriers to adoption. In addition, a sequence of events that took place from knowledge encounter through to implementation was described. Factors influencing adoption included: the perceived state of one's current practice; features of the encounter; attributes of the innovation; clinician's personality traits; practice management; and external influences relating to the professional community, patients, and marketing pressures. CONCLUSIONS: The study provides an insight into what orthodontists consider in their decisions to adopt new knowledge into clinical practice. The findings can help clinicians navigate decision making around innovation adoption by increasing awareness of the factors that influence this process to ensure that switching practice leads to quality improvement.

• MeSH
• kvalitativní výzkum MeSH
• lidé MeSH
• ortodontisté * MeSH
• rozhodování * MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH

BACKGROUND: Nursing students are required to spend a significant portion of their educational preparation in clinical practice. Because of the prevalence of missed or rationed care, it seems irrefutable that students are exposed to rationed care during their practice placement, or that they contribute to its prevalence either actively or passively. OBJECTIVES: The study aimed to discover how nursing students interpret the concept of rationed care, and their experiences of rationing in practice. DESIGN: A descriptive qualitative study. PARTICIPANTS: Eighteen final year nursing students from three universities within the Slovak Republic. METHODS: Semistructured face-to-face interviews were conducted (n = 18). Data were analyzed using thematic analysis which resulted in the development of themes and subthemes. RESULTS: We identified three meaningful themes focused on the phenomenon of rationed care from the perspective of nursing students, namely Incomplete care is normalized; Provision of impersonal patient care; and the Existence of a hidden curriculum for practice placements. CONCLUSIONS: Student nurses were quite demanding about the learning experience during their clinical training. They are often frustrated by inconsistencies between their theoretical preparation and the realities of practice. They recognise difficulties for registered nurses in providing safe, high quality care in constrained circumstances, and although they are critical of this, they acknowledge their own acceptance of the situation. Based on this, students must establish an understanding of the theory behind, and reasons for rationed care before commencing clinical placement. A greater understanding would enable students to develop strategies for coping with inconsistencies and voicing concerns.

• Klíčová slova
• Nursing, Patient safety, Quality of care, Rationed care, Students,
• MeSH
• kvalitativní výzkum MeSH
• lidé MeSH
• ošetřovatelská péče * MeSH
• přidělování zdravotní péče MeSH
• studenti ošetřovatelství * MeSH
• studium ošetřovatelství bakalářské * MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH
• Geografické názvy
• Slovenská republika MeSH

OBJECTIVE: Comprehensive bachelor's, master's, and doctorate-level curricula of Addiction Studies (Addictology) were developed and implemented at Charles University (First Faculty of Medicine) between 2003 and 2012. This Prague model combines three evidence-based approaches to addressing substance use - prevention, treatment, and public health - into a balanced professionalised discipline. Graduates from this programme are licensed by the State Authority as addictology, a regulated profession in the Czech Republic. Professionals with these degrees are recognised as healthcare professionals, can perform directly in the field and can be contracted by health insurance companies. In 2016, it was decided to integrate the Universal Prevention Curriculum (UPC) into these programmes of study. The UPC was developed by a group of prevention researchers from the United States. This article describes the technical steps involved when adapting the UPC into an established university degree programme. We describe the requirements needed for successful implementation and reaccreditation. Finally, we examine both barriers and enhancers of the adoption of UPC as a university programme. METHODS: A qualitative process evaluation study was conducted on the activities carried out in 2017-2018, demarcated by a successful university accreditation of the new curricula combining the original Prague model and the UPC curriculum. Field records, observation methods, official documents, curricular documents, syllabuses, content analysis, and thematic analysis were used for this process. RESULTS: We identified three clusters of issues and challenges during the adaptation and implementation process: technical (developing a new credit scheme, adopting new terminology using local and culture-specific examples, and cancelling, establishing, and/or fusing particular courses, identifying some critical issues for any practical implementation of the UPC); teaching staff-related (team work, involving motivated and qualified staff for moving from a national to an international perspective); and content and contextual (the conflict between different theoretical perspectives such as public health vs. mental health and drug use prevention vs. risk behaviour prevention). CONCLUSION: The adaptation of the UPC had a significant impact on study profiles and competencies. Such an implementation necessarily requires a team of staff members with sufficient capacities to be able to coordinate the process, facilitating each step and supervising it. The current adaptation of the UPC involved specific merging procedures to fit in with existing courses and emphasising an international perspective. This process opened a national discussion about the implementation of the UPC in the system of life-long education programmes and training. Beginning in September 2019, when the first group of students will attend this new model of Addictology studies, we will continue our evaluation of the implementation process and the factors that played a role in either hindering or supporting the implementation. The findings from this evaluation will be used to make adjustments to the curriculum.

• Klíčová slova
• academic degree study programmes, adaptation, curriculum, implementation process, prevention, specialised addiction programmes,
• MeSH
• adiktologie výchova   MeSH
• hodnocení programu MeSH
• kurikulum * MeSH
• kvalitativní výzkum MeSH
• lidé MeSH
• studium lékařství pregraduální organizace a řízení   MeSH
• studium lékařství specializační postgraduální organizace a řízení   MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH
• Geografické názvy
• Česká republika MeSH

INTRODUCTION: Divorce rates among individuals aged 50 and above are on the rise. Given the greater life expectancy compared to previous generations, this is an issue that is affecting an increasing number of people. Therefore, it warrants an inquiry into the challenges these individuals encounter in their intimate relationships. METHODS: This study analyzed 225 relationship-related queries posted on Czech counselling websites to identify the strains and stressor patterns that older adults face in their relationships. The queries were limited to those that concerned themes and problems related to partnerships, were posted by one of the partners aged 60 or over, and were analyzed using inductive thematic analysis. RESULTS: Four main relationship issues were identified: infidelity and jealousy; relationship estrangement and cooling; undesirable changes in personality; and illness and somatic issues. Additionally, three recurring themes were identified that made the problems more demanding and that were specific to older age: lack of norms for relationships in that age group, absence of resources to tackle the issues, and personal calculation for Time Spent and Time Remaining. DISCUSSION: The research found that the types of problems encountered by older adults were similar to those experienced by younger individuals. However, the way these problems were perceived and processed was influenced by specific aspects of aging, such as societal expectations, available coping resources, and the perception of time. The findings also highlighted the challenges faced by older adults in terms of relationship norms, sexual functioning, and personality changes.

• Klíčová slova
• ageing, later-life relationships, online counselling, partnership problems, qualitative study,
• Publikační typ
• časopisecké články MeSH

Predatory journals are a blemish on scholarly publishing and academia and the studies published within them are more likely to contain data that is false. The inclusion of studies from predatory journals in evidence syntheses is potentially problematic due to this propensity for false data to be included. To date, there has been little exploration of the opinions and experiences of evidence synthesisers when dealing with predatory journals in the conduct of their evidence synthesis. In this paper, the thoughts, opinions, and attitudes of evidence synthesisers towards predatory journals and the inclusion of studies published within these journals in evidence syntheses were sought. Focus groups were held with participants who were experienced evidence synthesisers from JBI (previously the Joanna Briggs Institute) collaboration. Utilising qualitative content analysis, two generic categories were identified: predatory journals within evidence synthesis, and predatory journals within academia. Our findings suggest that evidence synthesisers believe predatory journals are hard to identify and that there is no current consensus on the management of these studies if they have been included in an evidence synthesis. There is a critical need for further research, education, guidance, and development of clear processes to assist evidence synthesisers in the management of studies from predatory journals.

• Klíčová slova
• evidence synthesis, methodology, predatory journal, predatory publishing, qualitative research, systematic review,
• MeSH
• kvalitativní výzkum MeSH
• lidé MeSH
• periodika jako téma * MeSH
• průzkumy a dotazníky MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH