BackgroundInformal carers play an increasingly vital role in supporting the older population and the sustainability of health care systems. Care Companion is a theory-based and coproduced Web-based intervention to help support informal carers’ resilience. It aims to provide personalized access to information and resources that are responsive to individuals’ caring needs and responsibilities and thereby reduce the burdens associated with caregiving roles. Following the development of a prototype, it was necessary to undertake user acceptability testing to assess its suitability for wider implementation.ObjectiveThis study aimed to undertake user acceptance testing to investigate the perceived usefulness and ease of use of Care Companion. The key objectives were to (1) explore how potential and actual users perceived its usefulness, (2) explore the barriers and facilitators to its uptake and use and (3) gather suggestions to inform plans for an area-wide implementation.MethodsWe conducted user acceptance testing underpinned by principles of rapid appraisal using a qualitative descriptive approach. Focus groups, observations, and semistructured interviews were used in two phases of data collection. Participants were adult carers who were recruited through local support groups. Within the first phase, think-aloud interviews and observations were undertaken while the carers familiarized themselves with and navigated through the platform. In the second phase, focus group discussions were undertaken. Interested participants were then invited to trial Care Companion for up to 4 weeks and were followed up through semistructured telephone interviews exploring their experiences of using the platform. Thematic analysis was applied to the data, and a coding framework was developed iteratively with each phase of the study, informing subsequent phases of data collection and analysis.ResultsOverall, Care Companion was perceived to be a useful tool to support caregiving activities. The key themes were related to its appearance and ease of use, the profile setup and log-in process, concerns related to the safety and confidentiality of personal information, potential barriers to use and uptake and suggestions for overcoming them, and suggestions for improving Care Companion. More specifically, these related to the need for personalized resources aimed specifically at the carers (instead of care recipients), the benefits of incorporating a Web-based journal, the importance of providing transparency about security and data usage, minimizing barriers to initial registration, offering demonstrations to support uptake by people with low technological literacy, and the need to develop a culturally sensitive approach.ConclusionsThe findings identified ways of improving the ease of use and usefulness of Care Companion and demonstrated the importance of undertaking detailed user acceptance testing when developing an intervention for a diverse population, such as informal carers of older people. These findings have informed the further refine...
Pre-exposure prophylaxis (PrEP) is currently being trialed for seronegative gay and other men who have sex with men (GMSM) at risk of HIV infection in England. However, research from other countries where PrEP is available shows limited literacy and uptake by GMSM at risk of HIV. We collected focus group data from 18 GMSM (13 HIV− and 5 HIV+) from Leicester, an ethnically diverse city in the English Midlands. Data were analysed using thematic analysis and three themes are presented. The first theme 'I can't get my head around people like that': Representations of PrEP users within and beyond gay communities explores how PrEP users are vilified by some GMSM and the wider media. The second theme, 'There's a culture of anti-trust': PrEP, stigma and the interpersonal politics of HIV disclosure discusses how PrEP influences HIV disclosure and sexual decision-making in casual sero-discordant sexual encounters in a context where seropositive men experienced pervasive HIV stigma and HIV− men were suspicious of HIV+ sexual partners. In the final theme, 'I'm still suspicious': Discourses of doubt and distrust participants voiced concern over the safety of PrEP and the motives of drug companies, healthcare agencies and PrEP activists. We consider these findings through a critical lens of wider theorising around the relationship between public health agencies and GMSM communities and consider the impact of these perspectives on likely engagement with PrEP in an English context. We call for more critically informed and nuanced ways of promoting health and well-being amongst men from these communities.
Findings suggest that beliefs conducive to acceptance helped carers to develop more sustainable, less over-protective, care. Interventions to help carers develop similar beliefs could be provided in therapeutic settings. Recommendations for future research are made. Implications for Rehabilitation Caring for a long-term partner with acquired brain injury has considerable challenges which can threaten an individual's health and well-being. Our research reports on carers' experiences of anxiety which they managed through hypervigilant and overprotective practices which put them at risk of burnout. Consequently, we recommend the promotion of care beliefs that reframe caregiving: recognising the carer's limitations to safeguard a spouse, whilst accepting the vulnerability of the spouse's health. We propose that promoting such principles in therapeutic settings may better equip carers emotionally to provide sustainable care, something which could benefit the carer and spouse's rehabilitation alike.
Metacognition, the cognition about cognition, is closely linked to intelligence and therefore understanding the metacognitive processes underlying intelligence test performance, specifically on Raven’s Progressive Matrices, could help advance the knowledge about intelligence. The measurement of metacognition, is often done using domain-general offline questionnaires or domain-specific online think-aloud protocols. This study aimed to investigate the relationship between metacognitive awareness and intelligence via the design and use of a novel Meta-Cognitive Awareness Scale – Domain Specific (MCAS-DS) that encourages reflection of task strategy processes. This domain-specific scale was first constructed to measure participants’ awareness of their own metacognition linked to Raven’s Progressive Matrices (SPM). Following discriminatory index and Exploratory Factor Analysis, a 15-item scale was derived. Exploratory Factor Analysis showed five factors: Awareness of Engagement in Self-Monitoring, Awareness of Own Ability, Awareness of Responding Speed/Time, Awareness of Alternative Solutions and Awareness of Requisite Problem-Solving Resources. The intelligence level of ninety-eight adults was then estimated using Raven’s Standard Progressive Matrices. Participants also completed the MCAS-DS, and further items that examined their test-taking behavior and Confidence level. Metacognitive awareness was positively correlated to standardized IQ scores derived from the SPM whilst Over-Confidence derived using the Confidence level measure was negatively correlated to SPM. Despite some limitations, this study shows promise for elucidating the relationship between metacognitive awareness and intelligence using the task-specific scale.
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