'Them Two Things are What Collide Together': Understanding the Sexual Identity Experiences of Lesbian, Gay, Bisexual and Trans People Labelled with Intellectual Disability.

BACKGROUND: Previous research aiming to understand the lives of lesbian, gay bisexual and trans (LGBT) people labelled with intellectual disabilities is limited. There are few recent studies and available findings are often contradictory and inconsistent. METHOD: This study aimed to explore how LGBT people labelled with intellectual disabilities experienced their sexual identities. Five LGBT people labelled with intellectual disabilities were interviewed, and data were analysed using interpretative phenomenological analysis methodology. RESULTS: Four superordinate themes represented the following: common experiences of bullying/abuse, understanding sexualities, other's responses to intellectual disabilities and sexualities, and navigating acceptance. CONCLUSIONS: Strategies for coping with abuse maintained participant's engagement in local communities. Sexuality was often problematized by others despite being generally accepted by participants. Coming out was a continual process of decision-making to facilitate safety and acceptance. To feel fully supported, participants desired holistic service provision sensitive to their sexuality and intellectual disability needs. Clinical and research implications are suggested.

'You're putting thoughts into my head': a qualitative study of the readiness of patients with breast, lung or prostate cancer to address emotional needs through the first 18 months after diagnosis.

OBJECTIVE: To investigate the readiness of patients to address emotional needs up to 18 months following a diagnosis of breast, lung or prostate cancer. METHOD: Patients (N = 42) attending pre-treatment, treatment and follow-up clinics were provided with information designed to help them manage their emotional reactions to cancer. Patients were interviewed 3-4 weeks later about their emotional experience of cancer and their attitudes towards managing emotional problems. Qualitative data analysis followed a constant comparative approach. RESULTS: Patients early in the cancer trajectory, who had not yet been engaged in chemotherapy or radiotherapy, described emotional distress as a temporary and understandable reaction that did not warrant professional intervention. They valued knowing that support was available, but did not want to use it, and were reluctant to acknowledge or address emotional needs. Conversely, patients currently or recently engaged in treatment readily acknowledged their emotional needs and welcomed help to address these. CONCLUSIONS: Drawing on social cognitive and other theories, we suggest that engagement in physical treatment and care allows patients to address emotional needs following a cancer diagnosis. Guidance that emotional needs should routinely be assessed and addressed at key points in the cancer trajectory should therefore be implemented cautiously when patients are only recently diagnosed; psychological intervention may be less appropriate at this time than later.

Project integrate: translating screening and brief interventions for alcohol problems to a community hospital emergency department.

Screening and brief intervention (SBI) for alcohol problems in the emergency department (ED) is effective. The objective of this study was to examine the translation of SBI into a busy community ED environment. The authors assessed key stakeholders views of SBI delivery model, then utilized feedback to adapt model. Adoption of SBI was recorded, with data collected on use of screening tool, and referral for a BI. Model was modified due to physicians' and nursing resistance; physicians only screened and a research assistant (RA) delivered the BI. When the RA was present, screening by ED staff increased from 50% to 71% but returned to 50% after the RA left. An identified opportunity was increased nursing interest after observation of SBI, with 15 nurses trained in SBI after ED intervention concluded. Important barriers to translating SBI to community ED clinical practice exist. However, with additional staff present, high levels of SBI can occur.