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OBJECTIVE: Breast cancer has become one of the main diseases threatening women's health and lives. Ultrasound (US) is the first diagnostic option for several patients because of its non-radiation, convenient, and low-cost features. Conventional US combined with contrast-enhanced US (CEUS) has improved diagnostic accuracy, while due to the presence of numerous parameters, no international consensus on diagnostic criteria could be attained. Therefore, it is necessary to develop a reliable diagnostic model with the involvement of a few parameters while increasing the diagnostic accuracy. METHODS: Data from 265 patients, including conventional US, CEUS, and postoperative pathological results, were collected. 21 parameters from the conventional US and both qualitative and quantitative aspects of CEUS were analyzed through univariate and multivariate logistic regression analyses. Specific parameters with independent influential factors were identified. A nomogram was subsequently developed to visually represent the contribution and linear weighting of each parameter. The effectiveness of the new model was assessed through calibration curves and the Hosmer-Lemeshow goodness-of-fit test. RESULTS: Six independent influential factors for breast malignant tumors were identified, including homogeneous echo, lesion vascularity, enhancement mode, enhancement shape, nourishing vessels, and slope. The area under the curve (AUC) values in the training and test datasets were 0.933 and 0.860, respectively. The modified model exhibited satisfactory diagnostic accuracy and operability. CONCLUSION: The modified model, despite incorporating fewer parameters, maintained diagnostic accuracy. It is exhibited as a convenient, effective, and easily deployable model for diagnosing malignant breast nodules.

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While surface-enhanced Raman spectroscopy (SERS) has experienced substantial advancements since its discovery in the 1970s, it is an opportunity to celebrate achievements, consider ongoing endeavors, and anticipate the future trajectory of SERS. In this perspective, we encapsulate the latest breakthroughs in comprehending the electromagnetic enhancement mechanisms of SERS, and revisit CT mechanisms of semiconductors. We then summarize the strategies to improve sensitivity, selectivity, and reliability. After addressing experimental advancements, we comprehensively survey the progress on spectrum-structure correlation of SERS showcasing their important role in promoting SERS development. Finally, we anticipate forthcoming directions and opportunities, especially in deepening our insights into chemical or biological processes and establishing a clear spectrum-structure correlation.

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BACKGROUND: Palliative care (PC) benefits patients with amyotrophic lateral sclerosis (ALS), however the needs of patients and caregivers and the optimal timing of PC discussions remains unclear. This study reports the analysis of PC consult notes from a larger feasibility trial. The specific aims of this analysis were to i) identify the PC needs of patients with ALS via qualitative analysis and ii) identify characteristics of patients and caregivers that could predict specific PC needs. METHODS: This study was nested within a nonrandomized, prospective study of patients with ALS (and their caregivers) being treated at a multidisciplinary ALS clinic. Exclusion criteria of the main study were age <18 years, inability to complete questionnaires, and prior receipt of PC. All patients were offered a PC consultation (PCC); those who accepted were included in this nested study. Consultation notes were reviewed and thematic and content analyses were conducted. The occurrence of themes across patient and caregiver contextual variables were examined. RESULTS: Thirty-two PCCs were completed between October 2020 and April 2022. Six major themes were identified: PC roles (with subthemes encompassing the spectrum of specialist PC practice including symptom management and advance care planning), engagement with PC, patients' concerns for their caregivers, caregiver-specific concerns, finances, and COVID-19. An average of 12 topics were discussed per PCC (range = 3-22). Discussion of advance care planning, care coordination, and symptom management was common, and these topics were not discussed more frequently in PCCs with patients with lower functional status, more bulbar symptoms, or lower quality of life. Time from diagnosis did not impact topics of discussion. Patients reporting more symptoms of depression more frequently required psychological support, particularly regarding loss of independence, employment, and leisure activities. DISCUSSION: Patients with ALS and their caregivers have a wide range of PC needs. These needs vary irrespective of time from diagnosis, functional status, or quality of life, therefore PCC is recommended for all patients with ALS. PCC should be individualized based on patient and caregiver preferences. TRIAL REGISTRATION INFORMATION: The study was registered with ClinicalTrials.gov (NCT04257760; https://clinicaltrials.gov/ct2/show/NCT04257760) on February 6, 2020. The first enrollment occurred on October 20, 2020.

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BACKGROUND: For many, breast reconstruction following mastectomy (BR) forms an integral part of breast cancer survivorship. For those considering BR, provision of information is essential to allow informed decisions. Using free-text responses from a survey of breast cancer survivors, this study aims to understand current gaps in information regarding BR. METHOD: At the end of an online survey assessing BR experiences, participants were asked the open-ended question: "Thinking about women who may experience BR in the future, is there anything you think needs to change so that they have a better experience?". Responses were analysed to identify common themes. RESULTS: 3384 people completed the survey with 2,077 (61%) responding to the open-ended question. Three themes were identified: (1) content of information, (2) managing expectations, and (3) information sources, each associated with multiple subthemes. Information wanted in theme (1) covered a range of topics including BR options, risks, recovery and 'going flat.' Information on BR's psychological impact was also needed, with comments indicating many were not prepared for this. Theme (2) stressed the importance of realistic information about BR outcomes and processes to reduce discrepancies between expectations and experiences. In theme (3), peer insights and photos were important sources of realistic information. CONCLUSION: Multiple gaps exist in BR-related information available to women. BR information needs to be comprehensive, realistic, and provided at the right time to allow informed decision-making. Developing strategies to strengthen existing information provision as well as new resources to fill information gaps might enhance BR experiences.

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The bamboo shoot of Pleioblastus amarus (Keng) Keng f. is a medicinal and edible resource in China. In this study, three separation techniques were applied to identify the primary and secondary metabolites component of P. amarus bamboo shoots, including sheathless capillary electrophoresis electrospray ionization-mass spectrometry (CESI-MS), reverse-phase liquid chromatography-MS (RPLC-MS), and hydrophilic interaction liquid chromatography-MS (HILIC-MS). A total of 201 metabolites were identified by the three methods. Among those metabolites, 146 were identified by RPLC-MS, 85 were identified by HILIC-MS, and 46 were identified by sheathless CESI-MS. These methods were complementary and had a linear coefficient. CESI-MS presented advantages in the identification of isomers, high sensitivity, very low sample usage, and good detection of polar and nonpolar metabolites, showing its unique applications in food analysis and prospects in metabolic research.

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BACKGROUND: Digital mental health interventions (DMHIs) represent a promising solution to address the growing unmet mental health needs and increase access to care. Integrating DMHIs into clinical and community settings is challenging and complex. Frameworks that explore a wide range of factors, such as the Exploration, Preparation, Implementation, Sustainment (EPIS) framework, can be useful for examining multilevel factors related to DMHI implementation efforts. OBJECTIVE: This paper aimed to identify the barriers to, facilitators of, and best practice recommendations for implementing DMHIs across similar organizational settings, according to the EPIS domains of inner context, outer context, innovation factors, and bridging factors. METHODS: This study stems from a large state-funded project in which 6 county behavioral health departments in California explored the use of DMHIs as part of county mental health services. Our team conducted interviews with clinical staff, peer support specialists, county leaders, project leaders, and clinic leaders using a semistructured interview guide. The development of the semistructured interview guide was informed by expert input regarding relevant inner context, outer context, innovation factors, and bridging factors in the exploration, preparation, and implementation phases of the EPIS framework. We followed a recursive 6-step process to conduct qualitative analyses using inductive and deductive components guided by the EPIS framework. RESULTS: On the basis of 69 interviews, we identified 3 main themes that aligned with the EPIS framework: readiness of individuals, readiness of innovations, and readiness of organizations and systems. Individual-level readiness referred to the extent to which clients had the necessary technological tools (eg, smartphones) and knowledge (digital literacy) to support the DMHI. Innovation-level readiness pertained to the accessibility, usefulness, safety, and fit of the DMHI. Organization- and system-level readiness concerned the extent to which providers and leadership collectively held positive views about DMHIs as well as the extent to which infrastructure (eg, staffing and payment model) was appropriate. CONCLUSIONS: The successful implementation of DMHIs requires readiness at the individual, innovation, and organization and system levels. To improve individual-level readiness, we recommend equitable device distribution and digital literacy training. To improve innovation readiness, we recommend making DMHIs easier to use and introduce, clinically useful, and safe and adapting them to fit into the existing client needs and clinical workflow. To improve organization- and system-level readiness, we recommend supporting providers and local behavioral health departments with adequate technology and training and exploring potential system transformations (eg, integrated care model). Conceptualizing DMHIs as services allows the consideration of both the innovation characteristics of DMHIs (eg, efficacy, safety, and clinical usefulness) and the ecosystem around DMHIs, such as individual and organizational characteristics (inner context), purveyors and intermediaries (bridging factor), client characteristics (outer context), as well as the fit between the innovation and implementation settings (innovation factor).

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Delphi methods are mostly used in the health sciences to reach agreement among experts on unclear issues. Generally, consensus is reached after several rounds of Delphi using standardized items. Additional open-ended questions offer respondents the opportunity to provide reasons for judgments. Although these free-text responses contribute substantially to the steering and result generation of the Delphi process, so far no analytical strategy has been established which takes into account the context and methodological principles of the Delphi procedure. Moreover, in already published Delphi studies the analysis of qualitative data is often not sufficiently disclosed.•We provide an overview of analytical strategies for free-text responses. We critically reflect on them with regard to their use and suitability in the context of Delphi procedures.•Following established qualitative methods of qualitative content analysis according to Mayring and thematic analysis according to Braun & Clarke, we developed the Argument-based QUalitative Analysis strategy (AQUA) for Delphi studies in the health sciences and presented it using a concrete project example.•This newly developed strategy can significantly support the rule-governed and intersubjective evaluation of free-text responses in Delphi processes, the integration of the results into the feedback design, and thereby also the quality of the results.

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Data-to-Care (D2C) is a public health strategy designed to engage out-of-care (OOC) persons with HIV (PWH) in HIV care. OOC PWH are identified through review of state and local HIV data and engaged in care through individualized efforts that address barriers to HIV care. Perspectives of D2C program staff can contribute to D2C program development and sustainability. We conducted semi-structured interviews in 2017 with 20 D2C program staff from Louisiana (n = 10) and Virginia (n = 10), states with distinct D2C programs. We used content and thematic analysis to analyze interview transcripts. In both states, common barriers to care for OOC PWH include limited transportation, stigma, substance use, poverty, homelessness, and mental illness. To address these barriers and engage OOC clients in HIV care, staff and programs provided transportation vouchers and housing assistance, integrated substance use and mental health services into care engagement processes, provided empathy and compassion, and assessed and addressed basic unmet needs. Identifying and addressing social and structural barriers to HIV care is a critical and often a necessary first step in engaging OOC clients in HIV care. These findings can be used for D2C program design and implementation, facilitating engagement in HIV care for OOC PWH.

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INTRODUCTION: Latinos are underrepresented in brain autopsy research on Alzheimer's disease and related dementias (ADRD). The study's purpose is to identify Latinos' attitudes about brain donation (BD) to inform methods by which researchers can increase autopsy consent. METHODS: Forty Latinos (mean age: 59.4 years) completed a semi-structured interview and were presented with educational information about BD. Participants completed a questionnaire assessing their understanding of BD and willingness to donate their brain for research. RESULTS: Among participants, there was near unanimous support for BD to study ADRD after hearing educational information. However, prior to the information presented, participants reported a lack of knowledge about BD and demonstrated a possibility that misunderstandings about BD may affect participation. DISCUSSION: While nearly all study participants agree that donating is beneficial for research and for future generations, the lack of BD information must be addressed to help support positive attitudes and willingness for participation.

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Background: There is substantial variability, by culture, in suicide rates, and also in suicide beliefs and attitudes. Suicide beliefs and attitudes predict actual suicidality. They also are elements of cultural scripts of suicide. Most suicide-scripts research has been conducted in Anglophone countries. Aims: This study investigates women's and men's suicide scripts in Italy. Methods: Italy's suicide scripts, including beliefs about what causes suicide, were explored via analyses of newspaper stories (N = 923) of women's and men's suicides. Results: Italian newspapers mostly featured men's suicide stories, consistent with Italian men's higher suicide mortality. Women's suicide was narrated as an unexpected act signaling personal (e.g., emotional and private-relationship) problems. By contrast, men's suicide was framed as relatively understandable response to serious public-life/social adversities (e.g., an economic downturn), and as a death of legitimate despair. Limitations: Social media suicide stories were not included in this study. Conclusion: In Italy, as in several countries with higher male suicide mortality, female suicide is psychologized and considered irrational while male suicide is viewed as a symptom of serious public-life/social problems, and therefore as deserving respect and empathy. The preference for social explanations of male suicide, together with the empathic attitudes, may contribute to male suicide being relatively more permissible and less stigmatized, and therefore also to men's higher suicide mortality.

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BACKGROUND: The assessment of the impact of pediatric traumatic brain injury (TBI) on the health-related quality of life (HRQoL) of the children and adolescents affected can be ameliorated by a disease-specific instrument. Such an instrument does not yet exist. This qualitative study investigates how children and adolescents after TBI subjectively perceive their HRQoL and whether and how this differs from the perspective of individuals without a history of TBI. METHODS: Eight problem-centered interviews were conducted with 11 children and adolescents around four years after mild TBI and with eight children and adolescents around three years after moderate to severe TBI. Nine problem-centered interviews were conducted with 25 participants without a history of TBI. The interviews were recorded and transcribed verbatim. The statements were assigned to inductively and deductively derived categories relevant to the HRQoL of children and adolescents after TBI and compared with those of individuals without a history of TBI. RESULTS: The HRQoL of children and adolescents after TBI tended to display both structural and content-related differences, independently of TBI severity, on several HRQoL dimensions, in contrast to the comparison group. For example, participants after TBI reported a broader range of negative emotions (such as worry, sadness, shame, and guilt), permanent physical impairments, felt that they were treated differently from others, and perceived cognitive limitations. CONCLUSIONS: The results of this qualitative study identified HRQoL dimensions that are relevant to children and adolescents after TBI and underlined the need for the development of a disease-specific instrument.

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To analyze Taiwanese ecotourism with international standards, this research employed the social learning theory (SLT) to identify the determinants of Taiwanese community ecotourism with the international standards. This basic theory of social psychology comprehensively assays the interplays and interconnections among the three analytical perspectives (ecotourism tours, destinations, and accommodations), the four essential issues (management, social, cultural, and environment) of the Global Sustainable Tourism Council, the six assessed dimensions of ecotourism resolution from the WCC, and the twenty-nine assessed indexes of the KES ecotourism evaluations. It was then possible to comprehensively explore the sustainable determinants of Taiwanese ecotourism with the international standards through the FA of quantitative and qualitative analyses in combination with the highest research validity, reliability, representativeness, and accuracy. After analyzing the evaluated measurements, the empirical and valuable conclusions and findings are (1) these analytical perspectives, appraised attitudes, evaluated criteria, and sub-criteria positively advance Taiwanese ecotourism with the international standards (PITEEICIS); (2) the sustainable determinants of Taiwanese ecotourism with the international standards include the Support for Capacity Building of the Local Community (SCBLC), Cooperation with the Local Community (CLC), Supports for the Local Enterprises (SLE), Local Participation and Benefits Sharing Duties (LPBSD), Tourist Management (TM), and Responsible Tourist Behaviors Inducement (RTBI). Importantly, the majority of ecotourism industrialists and experts still focus on the economic benefits, such as supporting the local community and enterprises, rather than tourist behavior inducement to stimulate ecotourism participation in order to promote and advance the Taiwanese ecotourism to the international standards; (3) in order to promote Taiwanese ecotourism to the international conventions, the Taiwanese government and organizations in ecotourism should contribute toward the local welfare and create and design various training programs and courses to enhance local community's awareness and capability of ecotourism development in order to establish a complete system that stimulates the ongoing planning and decision making of local community participation and regularly monitors, records, and reflects their opinions, based on the area's history, culture, and natural attributes, to develop and sell sustainable local products by creating fair trade principles and valuable products.

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Introduction: Migraine is a common neurovascular disorder disease often characterized by episodic headaches that can develop chronic disorders. Acupuncture as a non-pharmacological therapy has been extensively used to manage migraine prevention and treatment in clinical practice. Many studies focused on acupuncture therapy for migraine, but none analyzed the publications quantitatively and qualitatively. The aim of this study is to show the recent researches and trend of advances in this field based on quantitative and qualitative analyses. Methods: Publications related to acupuncture research about migraine were retrieved from the Web of Science (WoS) Core Collection and Scopus database. The quantitative data analysis was performed to show the recent researches and trend of advances from six perspectives: annual scientific production, countries, institutions, authors, journals, and keywords. For the qualitative analysis, acupuncture research about migraine was analyzed from the top twenty most highly cited articles. Results: The number of annual scientific production steadily increased with some fluctuations over the years. The country and institutions contributing most to this field are China and Chengdu University of Traditional Chinese Medicine. Zhao Ling was the most relevant author in this field, Linde Klaus was the highly co-cited author. The leading journal regarding the number of selected articles was "Zhongguo Zhen Jiu". The top twenty most highly cited articles were divided into two categories: original articles and reviews. Among these two categories, original articles occupied the vast majority. Moreover, the real effectiveness of acupuncture for migraine prevention and treatment was the research frontier and hot spot. Conclusion: Results of our analysis indicate that the number of publications showed an overall increasing trend, demonstrating that this research field still has a promising future. In addition, more researchers will probably focus their work on the difference between verum acupuncture and usual care for preventing and treating migraine.

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The most widely accepted definition of pain considers it a sensory and emotional experience associated with potential or actual physical harm. However, research tends to generalize findings from predominantly European American samples thereby assuming universality across cultures. Because of the high prevalence of pain within the AI group, it is important to consider whether their conceptualization of pain is similar to the universal definition. To accomplish this aim, a semi-structured interview was conducted with 152 AIs (primarily Southern Plains and eastern Oklahoma tribes) and 150 NHWs. Both groups were asked questions including what words describe hurtful experiences, the purpose of painful experiences, individual and culture-specific meanings of pain, and what constituted the opposite of pain. Many similarities were found between groups as well as differences. For example, NHWs used the word pain more often to describe physically hurtful experiences and were more likely to consider pain to be a signal or warning of an abnormality or pathology. By contrast, only AIs reported culture-specific meanings of pain, such as references to AI rituals or ceremonies. These observed differences are attenuated by small effect sizes. These findings are important to consider when hypothesizing the differences in pain among cultural groups.

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Background: Parents play an important role in the psychosocial care of their children. Previous research has primarily examined their role in care entry, whereas evidence on their role in other stages of the care process is scarce and lacking particularly in regard to the perspective of care providers. Our aim was therefore to examine how psychosocial care providers perceive the role of parents in the process of psychosocial care for adolescents. Methods: We used data from 25 semi-structured interviews with psychosocial care providers on the roles of parents in the care process. We analyzed data using consensual qualitative research and thematic analysis. Results: Four main themes were identified: (1) parents as a source of adolescents' problems; (2) parents trying to escape from responsibility for adolescents with problems; (3) parents as an active part of the care for adolescents; and (4) parents as a barrier to effective care. Conclusion: Psychosocial care providers should specifically address the role of the parents in psychosocial care to improve outcomes. Specific interventions are needed to support the involvement of parents in care, as their role is important. Moreover, professionals can be better trained in working with multi-problem families also to resolve some of the negative perceptions of these parents.

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'Background: For patient centered counseling to take place in community pharmacies, patients should feel encouraged to share their perspectives, yet studies show that this rarely happens. The process of patient perspective sharing relies on the interactional details that unfold during an encounter i.e. how patients verbally and nonverbally are encouraged to share their perspective, which in turn is affected by patients’ and pharmacy staff members’ psychological processes in the situation, i.e. how they perceive and feel when acting. Therefore, employing complimentary methods that study both interactional and psychological processes could deepen the understanding of the dynamics governing patients’ perspective sharing in pharmacy encounters. Objective: The objective of this study is twofold: 1) a methodological consideration of the benefits of employing Conversation Analysis (CA) and Video-Stimulated Recall Interviews (VSRI) in parallel, 2) to use the methodological combination to understand patient perspective sharing in community pharmacy interactions. Method: A single case study of one pharmacy encounter to explore the objectives in-depth. This was done through video recording of pharmacy encounters and subsequent CA-analysis; VSRIs were conducted with the involved patient and pharmacy staff member and analyzed using a qualitative thematic approach. Results: By exploring detailed interactional and psychological processes in parallel, specific occurrences which might hinder patients’ perspective sharing were revealed. CA demonstrated that staff member’s listening activities restricted the patient’s perspective sharing. VSRIs with patient and staff member supported this result: the staff member had a narrow conception of what counted as suitable answers and did not consider listening an active process. The patient harbored shame about needing to take the medication which affected her behavior during the encounter (AU)

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Background: Spirituality is a multidimensional construct which includes religious, existentialistic, and relational issues and has different layers such as faith as the core, related attitudes and conviction, and subsequent behaviors and practices. The perceptive aspects of spirituality such as wondering awe are of relevance for both, religious and non-religious persons. These perceptions were related to perceiving the Sacred in life, mindful awareness of nature, others and self, to compassion, meaning in life, and emotional wellbeing. As awe perceptions are foremost a matter of state, it was the aim (1) to empirically analyze the frequency of wondering awe perceptions (i.e., with respect to gender, age cohorts, religious or non-religious persons) and (2) to qualitatively analyze a range of triggers of awe perceptions. Methods: Data from 7,928 participants were analyzed with respect to the frequency of Awe/Gratitude perceptions (GrAw-7 scale), while for the second part of the study responses of a heterogeneous group of 82 persons what caused them to perceive moments of wondering awe were analyzed with qualitative content analysis techniques. Results: Persons who experience Awe/Gratitude to a low extend were the youngest and had lowest wellbeing and lowest meditation/praying engagement, while those with high GrAw-7 scores were the oldest, had the highest wellbeing, and were more often meditating or praying (p<0.001). Gender had a significant effect on these perceptions, too (Cohen's d=0.32). In the qualitative part, the triggers can be attributed to four main categories, Nature, Persons, Unique Moments, and Aesthetics, Beauty, and Devotion. Some of these triggers and related perceptions might be more a matter of admiration than wondering awe, while other perceptions could have more profound effects and may thus result in changes of a person's attitudes and behaviors. Conclusion: Emotionally touching experiences of wondering awe may result in feelings of interconnectedness, prosocial behavior, mindful awareness, and contribute to a person's meaning in life and wellbeing and can also be a health-relevant resource. These perceptions can be seen as a perceptive aspect of spirituality, which is not exclusively experienced by religious people but also by non-religious persons.

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Providing refugees with psychosocial support is particularly important considering the high level of mental health problems prevalent in this population. A psychosocial walk-in clinic operating within a state reception and registration center in Germany has been supporting mentally burdened refugees since 2016. This study focused on patients' perspectives on their mental health burden, the psychosocial walk-in clinic, and future help seeking. We conducted interviews with n = 22 refugees attending the walk-in clinic from March to May 2019. Qualitative analysis focused on the following four topics: (1) mental burden from the patients' perspective, (2) access to the psychosocial walk-in clinic, (3) perception of counseling sessions, and (4) perception of follow-up treatment. The results show that the majority of interviewees were burdened by psychological and somatic complaints, mostly attributed to past experiences and post-migratory stress. Therapeutic counseling and psychiatric medication were found to be particularly helpful. Most of the participants felt motivated to seek further psychosocial support. Key barriers to seeking psychosocial help included shame, fear of stigma, and lack of information. Overall, the psychosocial walk-in clinic is a highly valued support service for newly arrived refugees with mental health issues.

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Background: For patient centered counseling to take place in community pharmacies, patients should feel encouraged to share their perspectives, yet studies show that this rarely happens. The process of patient perspective sharing relies on the interactional details that unfold during an encounter i.e. how patients verbally and nonverbally are encouraged to share their perspective, which in turn is affected by patients' and pharmacy staff members' psychological processes in the situation, i.e. how they perceive and feel when acting. Therefore, employing complimentary methods that study both interactional and psychological processes could deepen the understanding of the dynamics governing patients' perspective sharing in pharmacy encounters. Objective: The objective of this study is twofold: 1) a methodological consideration of the benefits of employing Conversation Analysis (CA) and Video-Stimulated Recall Interviews (VSRI) in parallel, 2) to use the methodological combination to understand patient perspective sharing in community pharmacy interactions. Method: A single case study of one pharmacy encounter to explore the objectives in-depth. This was done through video recording of pharmacy encounters and subsequent CA-analysis; VSRIs were conducted with the involved patient and pharmacy staff member and analyzed using a qualitative thematic approach. Results: By exploring detailed interactional and psychological processes in parallel, specific occurrences which might hinder patients' perspective sharing were revealed. CA demonstrated that staff member's listening activities restricted the patient's perspective sharing. VSRIs with patient and staff member supported this result: the staff member had a narrow conception of what counted as suitable answers and did not consider listening an active process. The patient harbored shame about needing to take the medication which affected her behavior during the encounter. Conclusion: The novelty of the methodological combination is promising in order to grasp the complex process of patient perspective sharing in pharmacy encounters, as it affords aspects such as emotionality to be considered a central part of pharmacy encounters. As a consequence, it is suggested that the psychological concept of mentalizing is added to pharmacy education, as it is a trainable capacity enabling staff to become aware of the mental states that affect both patients and staff themselves during the pharmacy encounter.

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Iterative categorisation (IC) is a systematic and transparent technique for analysing qualitative textual data, first presented in Addiction in 2016. IC breaks the analytical process down into stages, separating basic 'description' from more advanced 'interpretation'. This paper focuses on the interpretive analytical stage that is shown to comprise three core processes: (i) conceptualising (undertaken inductively, deductively or abductively); (ii) differentiating; and (iii) externalising. Each process is described, followed by published examples to support what has been explained. As qualitative analyses tend to be recursive rather than linear, the three processes often need to be repeated to account for all the data. Following the stages of IC will ensure that qualitative research generates improved understanding of the phenomena being studied, study findings contribute to and enhance the existing literature, the audience for any qualitative output is broad and international, and any practical implications or study recommendations are relevant to other contexts and settings.

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