Experiences of Patients Living in a Unique Leprosy Hospice in Greece: An Interpretative Phenomenological Analysis.

BACKGROUND: Hansen's disease, or leprosy, has a long-standing presence in human history, and our study uniquely delves into the experiences of individuals who are among the last survivors of this condition in Greece. During the early 1930s, patients with Hansen's disease from Spinalonga, an isolated location in Crete, were moved to a medical facility in Athens. This event represents a significant historical change in the management and treatment of the disease. Following Spinalonga's closure, a Sanatorium emerged, evolving into Greece's sole Hansen's disease center and the present-day refuge for patients, underscoring the enduring stigma and abandonment associated with the disease. METHOD: Our study, conducted through six interviews with unstructured schedules, provides a unique opportunity for these individuals to share personal insights, offering a profound understanding of their interpretations and experiences. RESULTS: Through interpretative phenomenological analysis, we unearthed four superordinate themes: the pivotal nature of the diagnosis, the visible impact of the disease on the body, the stigma associated with leprosy and its effects on individuals, and the significance of 'home' as a place of solace and acceptance. CONCLUSIONS: These themes collectively depict the deep emotional trauma experienced by the participants, shedding light on the enduring impact of historical stressors, confinement practices, and the challenges of living with a devalued identity, shaping their profound sense of self.

Maintaining psychological well-being when living at risk of Huntington's disease: An interpretative phenomenological analysis.

Living at risk of a genetically inherited disease can be a challenging experience causing psychological distress as well as the possibility of the genetic disease leading to physical health problems. Huntington's disease (HD) is a genetic, neurodegenerative condition. It causes motor dysfunction, cognitive decline and, during the progression of the disease, different psychological difficulties are common. A total of 12 participants living at risk of HD were interviewed and interpretative phenomenological analysis methodology was used to understand their experiences of maintaining psychological well-being. This resulted in three themes: (1) "you're constantly in limbo": living in two worlds; (2) "I have to live, just bloody live": managing the possibility of a time-limited lifespan; and (3) "I try and try my hardest to look past the disease": the exhausting quest to keep living well. The findings indicated a need for improved knowledge within professional settings, such as for family doctors, counselors, and other health professionals, specific strategies that genetic counselors can use to support this group, and provision of accessible support and implementation of systemic interventions that would offer support for psychological coping strategies and communication around well-being to the individual and their family unit. Future research could contribute to the formation of such knowledge and the provision of HD-aligned services to help support the psychological well-being of people living at risk of HD.

Reproductive identity of women undergoing IVF: An interpretative phenomenological analysis.

This study investigated how women undergoing IVF make sense of themselves in the context of their reproductive experiences. Interviews were conducted with fourteen women aged 27-42. Interpretative phenomenological analysis was used. Four main themes emerged: Motherhood beyond all, Us and them, Changes in self-perception, My agency. The results are discussed in the context of reproductive identity. It has shown that being a mother is an identity the participants strongly strive for. Participants feel connected to women with whom they share the experience of dealing with infertility and different from those without such an experience. The specificity of their reproductive experience leads to changes in self-perception that can be interpreted as either impairment or growth. On their reproductive journey, they show their agency by undertaking a series of activities (control of thoughts, feelings, and body). Practical implications of the obtained results are discussed.

How to return? experiences of patients in working age after first Ischaemic stroke: an interpretative phenomenological analysis of patient´s perspective at 12 - 24 months post-stroke.

BACKGROUND: Limited evidence of young adult patient-reported outcomes and experiences after ischaemic stroke has been conducted. AIM: To investigate the meaning of the lived experiences of stroke patients in working age 12-24 months after their first IS. MATERIAL AND METHODS: The exploratory qualitative study used an interpretative phenomenological analysis (IPA) design. Nine ischaemic stroke patients (with age ranges from 41 to 50 years) took part in semi-structured qualitative interviews. RESULTS: Even with mild residual neurological deficit, IS negatively impacted the quality of life daily and social life. Six subthemes and three interconnected group experiential themes were generated: (i) From confusion to understanding (ii) Triggers for rebuilding; and (iii) Challenges and benefits. CONCLUSION: The study highlights the current gaps and limitations in supporting the needs of stroke patients in working age in long-term post-stroke care. The findings are crucial for healthcare professionals to develop improved age- and mild- impairment-appropriate strategies or tailor self-management interventions for stroke patients of working age.ClinicalTrials.gov: NCT04839887.

Having, making and feeling home as a European immigrant in the United Kingdom post-Brexit referendum: An interpretative phenomenological study.

Migrants' subjective sense of home deserves further research attention. In the particular context of the United Kingdom's (UK's) decision to leave the European Union ('Brexit'), we interviewed 10 European citizens living in the UK about their sense of home, using interpretative phenomenological analysis (IPA). In our analysis, we identified themes of (1) having more than one home, (2) making and finding a new home, (3) being permanently different from the non-migrant population and (4) a concern about feeling safe and welcome. Migration and sense of home involved building and rebuilding personal and social identity. Making a new home was effortful, and neither the old home nor the difference from the native population ever disappeared psychologically. This adds an experiential aspect to the idea of 'integration' in acculturation. Different notions of home were linked to different experiences of the impact of the Brexit referendum. We discuss the connections between acculturation, sense of home and lived experience and propose lived identity as a fruitful subject matter for social psychology.

The lived experience of renal cachexia: An interpretive phenomenological analysis.

Background: Chronic kidney disease is common, affecting up to 13 % of the global population, and is predicted to become the fifth leading cause of 'life years lost' by 2040. Individuals with end-stage kidney disease commonly develop complications such as protein-energy wasting and cachexia which further worsens their prognosis. The syndrome of 'renal cachexia' is poorly understood, under-diagnosed and even if recognised has limited treatment options. Objective: To explore the lived experience of renal cachexia for individuals with end-stage kidney disease and the interrelated experiences of their carers. Design: This interpretive phenomenological study was designed to facilitate an in-depth exploration of how patients and carers experience of renal cachexia. To improve and document the quality, transparency, and consistency of patient and public involvement in this study the Guidance for Reporting Involvement of Patients and the Public-Short Format was followed. Setting: The study was conducted across two nephrology directorates, within two healthcare trusts in the United Kingdom. Participants: Seven participants who met the inclusion criteria were recruited for this study, four patients (three female, one male) and three carers (two male, one female). Methods: We employed a purposive sampling strategy. Data collection was conducted between July 2022 and December 2023. Interviews were semi-structured, audio-recorded, transcribed verbatim and analysed in six steps by two researchers using interpretive phenomenological analysis. Ethical approval was approved by the Office for Research Ethics Committees Northern Ireland (Reference: 22/NI/0107). Results: Analysis generated six group experiential themes: the lived experience of appetite loss, functional decline and temporal coping, weight loss a visual metaphor of concern, social withdrawal and vulnerability, the emotional toll of eating challenges and psychological strain amidst a lack of information about cachexia. Conclusion: This is the first qualitative study exploring the lived experience of renal cachexia for patients and carers. Our study highlights that psycho-social and educational support is urgently needed. Additionally, healthcare professionals need better information provision to help them to recognise and respond to the needs of this population. Further research is required to develop models of holistic support which could help patients and carers cope with the impact of renal cachexia and optimally manage this syndrome within the family unit. Registration: N/A.

Older adults make sense of their suicidal behavior: a Swedish interview study.

Introduction: The aim of this study was to explore how individuals aged 70 or older living in Sweden understood a recent suicidal act, and what changed in them and around them in the aftermath. Method: Four women and five men (age range 71-91 years) receiving care at a geriatric psychiatric outpatient clinic in a large Swedish city took part in two interviews about their most recent suicidal act. Most of the women and none of the men had engaged in prior suicidal acts. Interpretative phenomenological analysis was employed. Results: The suicidal act was explained as a response to losses (in physical and cognitive functions, social roles and relationships) that rendered previous coping strategies unviable. The participants reported being dependent on a healthcare system that they experienced as indifferent and even dismissive of their suffering. The suicidal act was described as an unplanned act of despair. Positive changes followed for participants who reported having had suicidal ideation prior to the suicidal act and had insights into its triggers. Some gained access to needed medical care; others developed greater awareness of their psychological needs and became more effective at coping. Individuals who said that they had not had suicidal thoughts prior to the suicidal act and could not explain it reported no positive change in the aftermath. The respondents' narratives indicated gendered themes. Discussion: Participants' age-related losses were in many cases exacerbated by negative interactions with health care providers, indicating that continued attention needs to be given to implicit ageism in medical professionals. The suicidal acts were described as impulsive, which was unexpected because a dominant belief is that older adult suicidal behavior is planned. One reason for the discrepancy may be that this study focused on nonfatal acts, and planned acts may be more likely to be fatal. Another reason could be shame due to suicide stigma. Alternatively, these acts were truly unplanned. The older adult suicide planning question should be addressed in larger studies across geographical and cultural settings. Future studies should also include questions about gender norms of suicidality and separately examine women's and men's data.

Dementia caregiving during the COVID-19 pandemic: an interpretative phenomenological analysis of caregivers' experiences.

OBJECTIVE: To explore the lived experience of informal dementia caregivers during the COVID-19 pandemic. METHODS: Interpretative Phenomenological Analysis (IPA) was employed. Eight primary informal caregivers were recruited from a community mental health service for older people when attending in their role as caregiver of a service-user. Semi-structured interviews were conducted at home or in the clinic based on the participants' convenience and preference. IPA was completed following Smith and colleagues framework for analysis. RESULTS: Six group experiential themes, each with a number of subthemes, emerged from the cross-case interpretative analysis: the ambivalent experience of caregiving (subtheme: those complex emotional experiences); navigating lockdown: lived challenges and opportunities (subthemes: the pervasive fear, intensification of existing struggles, being prevented from caring for a loved one, and lockdown as a time for opportunity); transitioning out of lockdown (subthemes: regaining freedom, but restricted freedom after all and being in a lockdown of one's own); the present with COVID-19, but mostly with dementia (subthemes: dementia, a disease that does not pause, and 'takeaways' from the journey); looking into the future (subthemes: embracing COVID-19 and the true needs); and a word on coping (subtheme: managing it all as best one can). CONCLUSION: Findings demonstrate the significance of the meaning caregivers ascribed to their experiences on their wellbeing and ability to cope in times of COVID-19 and thereafter. Gaining an understanding of the caregivers' unique experiences is crucial to appreciate how to best support them.

Exploring the experiences of people with obesity and post-bariatric surgery patients after three months using the mindful eating reflective practice: An interpretative phenomenological analysis.

Background: Experiential dimensions of Mindful Eating Practices are scarce in the literature. Aim: The study focuses on thirteen individuals with clinical obesity and nine post-bariatric surgery patients who engaged in MERP over three months. Methods: The present research utilized Interpretative Phenomenological Analysis (IPA) as the analytical framework of interviews. Results: Four overarching themes emerged from the analysis: 1. "Enhanced Awareness of Eating": This theme underscores MERP's central emphasis on cultivating heightened mindfulness during food consumption, highlighting the importance of being present at the moment while eating; 2. "Facilitating the Transition to Healthier Eating Habits": This theme explores how MERP influences participants' dietary choices, eating pace, portion control, and overall enjoyment of meals. It reveals that MERP encourages individuals to reflect on their eating habits and transition towards healthier choices; 3. "Diverse Perspectives on Satisfaction with MERP": Within the context of MERP, participants held varied interpretations of satisfaction. Some encountered practical limitations or engaged in reflective self-examination, while others found sensory satisfaction, enhancing their overall eating experiences; and 4. "Utilization and Development of MERP": This theme delves into participants' patterns of using MERP. It reveals a tendency to avoid MERP in the morning, a gradual decline in its usage over time, and a preference for an electronic version of the practice. Conclusion: The MERP shows promise in improving overall eating habits by enhancing enjoyment of food, increasing awareness of body cues, promoting healthier choices, and encouraging mindful eating practices. These findings provide valuable insights for future research and the refinement of clinical tools aimed at effective weight management and the promotion of sustainable healthy eating practices by effectively addressing a significant gap in our understanding of the experiential facets of eating practices.

Perceived benefits and limitations of a psychoeducation program for patients with fibromyalgia: an interpretative phenomenological analysis.

Objective: To analyze the perceived benefits and limitations of a pain psychoeducation program as a non-pharmacological treatment for patients with fibromyalgia. Methods: An interpretative phenomenological analysis was applied to analyze the subjective experiences of 11 patients with fibromyalgia who participated in a pain psychoeducation program. This program includes educational sessions that address pain understanding, coping strategies, and relaxation techniques. Semi-structured interviews were conducted, transcribed, and analyzed using ATLAS.ti software. Results: Patients reported significant improvements in cognitive-functional capacity and socio-emotional ability, including better disease understanding and management, emotional stability, and interpersonal relationships. Despite these benefits, they identified limitations in program individualization and insufficient coverage of certain topics, such as sexual health and legal aspects of disability. Enhanced self-management skills were evident, with observed shifts in disease perception and coping strategies. Conclusion: The psychoeducation program was viewed positively, influencing functional, cognitive, and emotional enhancements. Nonetheless, the need for increased program personalization and expanded socio-economic support was noted. Future research should focus on the long-term impacts of psychoeducation and the feasibility of tailored interventions.

"I feel like a fish out of water": interpreting the occupational stress and well-being experiences of professional classical musicians.

Introduction: Professional classical musicians operate within a highly demanding environment, which includes organizational, social, and emotional demands. When not effectively coped with, these demands may cause stress and negatively impact well-being. This qualitative study explored the perceived stress and well-being experiences of professional classical musicians through a transactional theory of stress. The study employed a double hermeneutic interpretation of the lived experiences of the perceived demands faced, stress appraisals made, resources used, and the influence on well-being. Methods: Six professional classical musicians were purposefully selected for participation. Semi-structured interviews were conducted and participants reflected on two events: one they perceived as a positive experience and one that was negative. Transcripts were analyzed using Interpretative Phenomenological Analysis and Group Experiential Themes emerged. Results: Three Group Experiential Themes were identified: (a) Performance Demands; (b) Organizational Demands; and, (c) Relationship Demands. Participants predominantly appraised demands as a threat. A small number of demands were appraised as a challenge or benefit, and the fewest demands were appraised as causing harm or loss. Participants' appraisals were informed by underlying properties of stress appraisal such as self and other comparison, and preparation. Participants often relied on personal resources as opposed to available workplace resources. They perceived well-being to relate to stress appraisals with participants experiencing acute and long-term outcomes. Discussion: This study offers insight into the lived experience of the occupational stress process within professional classical musicians. The findings demonstrate that organizational interventions targeted at continuing professional development and social support are appropriate to help musicians cope more effectively with demands.

Examining change in the mental health of young people with epilepsy following a successful psychological intervention.

OBJECTIVE: Evaluate the cognitive, behavioural and affective processes involved in therapeutic change for young people with epilepsy and mental health difficulties receiving an integrated mental health intervention. METHODS: As part of a mixed methods convergent design, qualitative data were gathered in parallel to quantitative data at two timepoints in a randomised controlled trial testing the Mental Health Intervention for Children with Epilepsy in addition to usual care. Twenty-five young people and/or their families were interviewed before and after the intervention about the young person's mental and physical health, and their experience of therapy. Interview data were analysed inductively, idiographically and longitudinally using Interpretative Phenomenological Analysis combined with Framework Analysis. RESULTS: The young people's emotional and behaviour problems improved, mirroring the trial's quantitative outcomes. Their anxiety decreased and behaviour improved as they acquired tools and understanding through therapy. Problems, like aggressive behaviours and emotional outbursts, were also reduced, with young people gaining increased awareness and ability to self-regulate and parents learning to contain their child's impulsive behaviours. CONCLUSIONS: The qualitative findings complement the MICE trial's significant positive quantitative results by providing insight and context to the therapeutic change, providing vivid insight into the mechanisms of therapy for individual families.

This study involves young people with epilepsy and mental health difficulties who received an integrated mental health intervention called the Mental Health Intervention for Children with Epilepsy (MICE). The effectiveness of the MICE intervention (in addition to usual care) was assessed by comparing it to only usual care. This article reports on the changes in the behaviour, thinking, feeling of the young people after they received therapy. The research data was qualitative, using transcripts from interviews with 25 young people and/or their families. There was also some quantitative data, in the form of questionnaires. Both types of data were gathered at two different time points and compared over time. Then the results from the two types of data were considered together in a so-called mixed methods approach. During the qualitative interviews, participants were asked about the young person's mental and physical health, as well as their therapy experiences. The interview data were analysed using an in-depth approach to the analysis. This article describes improvements in emotional and behavioural problems among the young participants, which align with the positive mental health outcomes observed in the trial's quantitative data. Participant quotes before and after the intervention reveal reduced anxiety and improved behaviour as the therapy gave the young people new tools and understanding. Parents of young people with intellectual disabilities also felt more confident in managing their children's fears. Aggressive behaviours and emotional outbursts decreased, and young people developed greater self-awareness and self-control. The qualitative findings provide context and insight into the therapeutic change observed in the MICE trial. Understanding the mechanisms of therapy is crucial. In summary, this study sheds light on how therapy positively impacts young people's mental health and behaviour, with benefits for both the young people and their families.

The lived experience of weight loss maintenance in young people.

INTRODUCTION: There continues to be an imbalance of research into weight loss and weight loss maintenance (WLM), with a particular lack of research into WLM in young people under 18 years. Failure to coherently understand WLM in young people may be a potential contributor to the underdeveloped guidance surrounding long-term support. Furthermore, no research has investigated young people's preferences around WLM support following the attendance of a residential intensive weight loss intervention from a qualitative perspective. This study explored the influences of WLM in young people following a residential intensive weight loss intervention, considered how interventions could be improved and sought to develop recommendations for stakeholders responsible for designing WLM interventions. METHODS: The context in which this research is framed was taken from a residential Intensive Weight Loss Intervention for young people aged 8-17 years in England. Six semi-structured interviews were carried out to understand the lived experience of WLM, including barriers and enablers influencing WLM, adopting an interpretative phenomenological analysis design. FINDINGS: Three superordinate themes were developed to explain the barriers and enablers to WLM; (1) Behavioural control and the psychosocial skills to self-regulate WLM; (2) Delivering effective social support; and (3) Conflicting priorities and environmental triggers. CONCLUSION: The findings of this research mirror that of other studies of WLM in young people, with the majority of young people struggling to maintain weight loss. However, by exploring the experience of WLM in young people through qualitative means, it was possible to understand the specific motivators and barriers influencing WLM behaviours in this context, providing recommendations to support WLM. PATIENT OR PUBLIC CONTRIBUTION: The interview guide was developed in consultation with a young person from the intervention, and through discussions with the intervention stakeholders (delivery staff and management staff). The interview guide included topics such as knowledge and skills; experience of weight loss; reflections on weight maintenance, and experiences of daily life postintervention. We piloted the interview schedule with one young person who had consented to take part in the research. This first interview was used to check for understanding of questions and to assess the flow of the interview.

Infant feeding for women with an eating disorder: An interpretative phenomenological analysis.

Mothers with eating disorders can face additional challenges with infant feeding, and there is evidence they are likely to cease breastfeeding earlier than intended. However, there is little research exploring this. The present study used interpretative phenomenological analysis to explore the lived experience of infant feeding for mothers suffering from or recovering from an eating disorder. Semistructured interviews were conducted with six women-five who had breastfed and one who formula-fed. The women experienced two incompatible worlds-motherhood and an eating disorder. Tensions were sometimes resolved by reducing eating disordered behaviour alongside immersion in motherhood. Two participants did not find infant feeding particularly important for their journey into motherhood. Four recounted a positive shift in their relationship to their body through breastfeeding and felt their embodied experience of mothering provided a route out of eating disordered behaviour. However, doubts about their mothering and infant feeding capabilities could be amplified by feeling mistrusted by others and by the relative silence around eating disorders within maternity care services. Respectful dialogue with health care professionals was particularly valued where this occurred. Although long-term outcomes for the participants are unknown, the study suggests women with a history of eating disorders can form successful breastfeeding relationships and may be motivated to engage in collaborative risk assessment. However, they need support in managing emotional challenges. Training around eating disorders for maternity care professionals is likely to be useful for enhancing confidence in engaging mothers proactively to share concerns about eating, weight and body shape.

'It is up to me because I gave him this life' How the awareness of being permanently and unconditionally responsible shapes the experience of chronic sorrow in parents of disabled children.

OBJECTIVE: The majority of parents with a disabled child experience chronic sorrow, characterized by recurrent feelings of grief and loss related to their child's disability. There is a significant lack of research on parents' lived experiences of chronic sorrow, which limits our ability to understand parents' needs and provide proper support. DESIGN: Interpretative Phenomenological Analysis (IPA) was conducted based on in-depth interviews with six parents of severely disabled children. RESULTS: In the literature on chronic sorrow, an important aspect has been consistently overlooked: the particular position of being a parent, experiencing an awareness of being ultimately responsible for their children. The analysis revealed how this awareness, experienced as a deeply felt ethical commitment, unconditional, largely in isolation, and without a limit in time, shaped the experience of chronic sorrow. Because of this awareness, the parents experienced themselves facing a Herculean task of navigating their intricate emotions while struggling to maintain their ability to function. CONCLUSIONS: By revealing the importance of considering the unique parental position, the study enriches the concept of chronic sorrow, simultaneously offering insights into what it means to be a parent of a disabled child. These insights can improve care professionals' responsiveness to parental needs.

Making Sense of Spiritual, Metaphysical, and Eschatological Elements in Delusions: A Qualitative Study Using Interpretative Phenomenological Analysis.

BACKGROUND: Spiritual, metaphysical, or eschatological elements in delusions (SMEDs) are frequent and often subjectively regarded as profound transformational experiences, similar to mystical experiences. This study aimed (1) to explore how SMEDs are experienced and in which aspects they are similar to mystical experiences and (2) to investigate how individuals make sense of SMED. METHODS: Seven participants were interviewed, and their expressions were analyzed using interpretative phenomenological analysis. RESULTS: We found that SMEDs were similar to mystical experiences with regard to alterations in perception of space, time, and unity. Furthermore, SMEDs were accompanied by a sense of enlightenment that however remained ineffable. SMEDs were interpreted from different viewpoints, i.e., as a source of ontological insight, as a mental health issue, as an inspiration for a new orientation in the world, and, for some participants, as an example of the limits of knowledge. Making sense of SMED appeared to follow a lively internal dialogue in which various, sometimes contradictory positions were reflected upon. Participants usually struggled to align the ostensible ontological significance of SMED to the dominating illness explanation. CONCLUSION: SMEDs have similarities to mystical experiences, but integrating SMED into one's own life is challenging. We propose a philosophical, non-pathological interpretation of SMED derived from a novel perspective on mystical experience which may also have some therapeutic utility.

The Experience of Phenylketonuria in Pregnancy and the Developing Maternal-Infant Relationship: A Qualitative Study.

Phenylketonuria (PKU) is a rare metabolic condition characterised by an inability to metabolise phenylalanine (Phe), found in many foods. When pregnant with PKU, women must adhere to a strict low-Phe diet. If they do not, foetal abnormalities or pregnancy loss can occur. Pregnancies are therefore closely clinically monitored and dominated by dietary management, leaving little "space" for women's emotional experience. This article explores the emotional impact of PKU during pregnancy and how this effects pre-natal bonding. Based on interviews with six women with PKU, conducted whilst they were pregnant, this article explores their unusual and previously undocumented experience. Image-making during interviews allowed women to uncover aspects of their experience that might otherwise have remained hidden. Interpretative phenomenological analysis of the transcripts and images generated five themes summarising the women's experiences. Some themes reiterated findings from previous studies, for example, the huge cognitive burden associated with PKU pregnancies and the importance of both expert and informal support to successful pregnancy management. However, new understanding also emerged, including rich description of the emotional load of these pregnancies and strategies that women use to manage this. Anxiety about baby safety was central to their experiences, and the effect of this on pre-natal bonding was explored. This article calls for increased formal and informal support for women with the emotional aspects of their PKU pregnancies, for example, the creation of "attachment-aware" services that support women with their anxiety, promoting strong pre-natal attachment and subsequently protecting maternal and infant mental health throughout pregnancy and beyond.

An Interpretative Phenomenological Analysis That Seeks to Describe and Understand the Personal Experience of Burnout in General Practitioners.

Minimal research has explored the personal experience of burnout in doctors from any medical speciality. Consequently, we aimed to provide a relatable description and understanding of this globally recognised problem. We employed an interpretative phenomenological analysis (IPA) of face-to-face interviews with seven general practitioners (GPs) in Northern Ireland, having selected interviewees best able to speak about burnout. We sought to understand how these GPs understood their burnout experiences. Our participants' continuous work involved more than their busy weekdays and also working on supposedly off evenings and weekends. In addition, draining intrusive thoughts of work filled most, if not all, of their other waking moments. There was no respite. Work was 'always there.' Being constantly busy, they had no time to think or attend to patients as doctors. Instead, participants were going through the motions like GP automatons. Their effectiveness, efficiency, and caring were failing, while their interactions with patients had changed as they tried to conserve their now-drained energy and empathy. There was no time left for their families or themselves. They now "existed" to continuously work rather than "living" their previous, more balanced lives that at one time included enjoying being a doctor. Worryingly, participants were struggling, isolated, and vulnerable, yet unwilling to speak to someone they trusted. We intend our burnout narrative to promote discussion between medical colleagues and assist in its recognition by GPs and other doctors. Our findings warn against working excessively, prioritising work ahead of family and oneself, and self-isolation rather than seeking necessary support.

Experience of compassion-based practice in mindfulness for health for individuals with persistent pain.

Purpose of the Study: Research indicates that acquiring compassion is an integral part to positive outcomes to Mindfulness-based interventions (MBI), yet there is both theoretic and empirical literature suggesting that people with persistent pain are more likely to experience challenges and distress when engaging compassion-based practices. Mindfulness for Health is a standardised MBI for people with persistent pain and health conditions. This study sought to explore the positive, neutral and difficult experiences of compassion-based practice and meditation for participants in Mindfulness for Health to further understand implications and risks for participants of MBI's. Method and Design: A qualitative design using Interpretative Phenomenological Analysis was applied to explore how participants understood of the experience of compassion-based practice and the meaning they gave to it. Eight participants who had completed the Mindfulness for Health from four separate groups were interviewed about their experience. Results: Five master themes were identified 'turning away from self-with-pain', 'self-with-pain experienced as shameful', 'facilitating change', 'turning towards self-with-pain', and 'accepting self'. Participants identified both perceived positive changes and difficult emotional experiences during the meditation practice, which they related to the context of compassion in their past and present life. Conclusions: Developing compassion is an important part of Mindfulness for Health, which is salient for participants as both a challenging and potentially valuable experience. Acquisition of mindfulness skills, supporting group dynamics and modelling compassion are understood as helpful in overcoming personal barriers and challenging experiences. Further research is needed to understand processes involved and explore the experience of non-completers.

A tradeoff between safety and freedom: Adults' lived experiences of ARFID.

BACKGROUND: Avoidant restrictive food intake disorder (ARFID) is characterized as a pattern of restrictive eating leading to significant medical and/or psychosocial impairment (American Psychiatric Association in Diagnostic and statistical manual of mental disorders, American Psychiatric Association, Washington, D.C., 2013). Most existing research on ARFID utilizes quantitative methodologies to study children and adolescents. As a result, the experiences of adults with ARFID have been underrepresented in research. To fill this gap, the current study examines the lived experiences of adults with a DSM-5 diagnosis of ARFID. METHOD: Participants (n = 9) included adult women aged 20-42 (M = 27, SD = 6.2) recruited from social media advertising. Open-ended, semi-structured interviews were conducted. Data were analyzed using interpretative phenomenological analysis (IPA). RESULTS: One of three overarching themes identified by IPA will be discussed in this study: "A tradeoff between safety and freedom," which consists of two subthemes: (a) Ensuring safety from food unknowns and (c) Longing for Freedom. This overarching theme explores the influence of ARFID on an individual's sense of safety and freedom. DISCUSSION: This study is one of few to qualitatively examine ARFID, and the only to do so using IPA. Findings offer novel insights relevant to researchers and clinicians who treat adults with ARFID and who wish to increase consideration and understanding of patient lived experience in their work.