ABSTRACT Background Menopause is a major life transition that can affect women's physical, psychological, cognitive, sexual and social well‐being. Despite the availability of evidence‐based interventions, many women remain insufficiently informed and experience difficulties accessing reliable information and appropriate support. Objectives To explore menopause‐related information needs and challenges from the perspectives of menopausal women and healthcare professionals and to identify individual, healthcare‐related and societal factors influencing menopause literacy. Design A qualitative study informed by a constructivist paradigm was conducted using semi‐structured interviews and conventional qualitative content analysis. Methods Twenty‐two peri‐ and postmenopausal women and 10 healthcare professionals were purposively recruited from healthcare settings in Southern Iran. Data were collected until data saturation was achieved, defined as the point at which no new codes or categories emerged from successive interviews. Interview transcripts were analysed using conventional qualitative content analysis following the approach of Graneheim and Lundman. Trustworthiness was enhanced through prolonged engagement, member checking, peer debriefing and established criteria for qualitative research. Results Three interrelated themes were identified: understanding and accepting menopause, menopause management, and challenges of transition. Women described menopause as an unexpected and multidimensional transition affecting physical, psychological, cognitive, sexual, social and occupational well‐being. Both women and healthcare professionals identified substantial gaps in menopause literacy and emphasised the need for timely education, evidence‐based information and supportive healthcare. Symptom management strategies, lifestyle modification, family and peer support, and access to reliable information were perceived as important facilitators, whereas limited awareness, menopause‐related stigma, insufficient provider engagement and difficulty identifying trustworthy information were reported as major barriers. Conclusions Menopause literacy is shaped by interacting individual, healthcare and societal factors. Strengthening evidence‐based menopause education, improving healthcare support and developing accessible, person‐centred information resources may enhance women's ability to navigate the menopausal transition and inform the design of future educational and digital health interventions.
ABSTRACT Background Dysmenorrhoea can disrupt education, work, sleep, mobility and other daily activities, yet recurrent pain that limits daily functioning does not always prompt timely formal care‐seeking. Objective The aim of this study was to explore how young women in Southwest China interpret recurrent function‐limiting dysmenorrhoea and decide whether to seek formal care. Methods This qualitative study was based in Guiyang, Guizhou Province, Southwest China. Seventeen women aged 18–31 years with recurrent dysmenorrhoea affecting daily functioning took part in semi‐structured interviews. Interviews were conducted face‐to‐face or online, audio‐recorded, transcribed verbatim and analysed using reflexive thematic analysis. Results Five themes were developed: making pain ordinary across family, peers and clinics; keeping pain within the logic of warmth and regulation; when pain becomes care‐worthy: functional disruption as a threshold; reproductive expectations and delayed medicalisation; and normal tests, uncertain explanations and delayed re‐entry into care. Care‐seeking was often delayed as participants normalised menstrual pain, relied on culturally familiar warming or body‐regulating practices, had concerns about analgesics or expected pain to improve after childbirth. Non‐specific clinical explanations could also temporarily reassure participants and contribute to delay. Participants described seeking formal care when pain disrupted study, work, sleep, mobility or daily activities, when medication or self‐management no longer worked, or when reproductive or gynaecological concerns emerged. Conclusions Delayed care‐seeking was shaped by whether menstrual pain became recognised as a legitimate reason for formal care. Menstrual health education and clinical communication should validate function‐limiting pain, clarify when assessment is needed and provide clear follow‐up guidance. Patient or Public Contribution Four women with lived experience of function‐limiting dysmenorrhoea helped develop parts of the interview guide. Their feedback during pilot interviews led to additional questions about healthcare access and practical barriers to seeking care. They also supported recruitment and contributed to discussions of interview accounts and developing themes.
ABSTRACT Context Rising demand for GP services alongside limited change in supply is placing unprecedented pressure on primary healthcare systems in many countries, including the UK and Denmark. The 2026 English GP contract requires practices to provide same day access to all patients considered to have an urgent need. Objectives To study primary care staff reflections on their experiences of prioritising same day access through different approaches, which their practices had chosen and adapted over months and years. Design A subset of three case studies (two in England, one in Denmark) from a larger focussed ethnography. These practices were selected for the sub‐study because they all prioritised same day access but had developed different approaches. We draw on formal and informal interviews with staff and observations in the practices. Results The different rationales for introducing same day access in these three practices had been to reduce long waiting times, to tackle non‐attendance at pre‐booked appointments and to help address limited GP capacity. Systems were maintained by weekly and daily tinkering with appointment capacity, by managing the balance of access and continuity, understanding where exceptions were important for different patient groups and, in the English case studies but not in Denmark, by channelling patients to allied health care professionals. In all cases, consideration was given to the trade‐off for patients between urgency and continuity. Staff drew on their own experiences to caution against entirely open appointment booking systems. Staff in all three sub‐study practices had, based on their experiences, started to think differently about how best to manage same day access. Our findings, comparing the English and Danish practices, raise the counter‐intuitive possibility that, rather than opening the floodgates, making it easier for patients to access GP appointments when needed might help moderate total demand. Conclusions These findings matter in relation to the 2026 GP contract, which has specified that 90% of appointments deemed ‘urgent’ by the practice must be seen on the same day. When dealing with seemingly overwhelming demand, it is tempting to introduce channels and diversions to protect supply, or even to question whether the demand is justified. Our findings suggest a pertinent metaphor: it is now recognised in flood prevention that the introduction of man‐made channels has exacerbated the problem of flash flooding, while the use of open, naturally managed flood plains is beneficial. This metaphor may help practices to understand the consequences of their response to the new requirement for same day access. Patient and Public Contribution The wider ethnographic study was guided from inception to completion by a PPI co‐applicant and eight PPI representatives who, between them, represented a diversity of lived experience. In relation to this article, the PPI co‐applicant reviewed practice summaries and provided sense‐checking of our ideas and interpretations.
ABSTRACT Introduction Children have the right to freedom of expression regarding topics important to them via any communication medium. 1 Conducting research on as opposed to with young children fails to fulfil their rights, promoting misconceptions that children are incapable of providing meaningful data. The start of formal education presents many challenges for young children; very few studies have involved children as active participants sharing their experiences. This co‐design study aimed to produce, through the involvement of young children, methods for a creative interview package to be used with 4–5‐year‐olds to discuss the challenges of starting formal education. Methods Six individual co‐design sessions, and three user‐testing interviews with young children (aged 3‐5 years), alongside one group co‐design session with older children (aged 6–12 years), were used to develop and refine methods. Pictures and photo‐prompts, drawing activities, and the use of a toy puppet were explored within the sessions, collecting children's verbal feedback and recommendations, as well as the researcher's reflective notes and recommendations from parents. The resulting methods were integrated into a four‐stage framework (Exploration, Adaptation, Confirmation, and Evaluation) to curate the final interview methods. Results Barriers to children's engagement were identified with some participatory activities, for example cultural and family belief systems that discouraged self‐portrait drawings within some communities. Children also engaged more in the interview once they had built a rapport with the puppet, and not only a rapport with the researcher. Pre‐made images were sufficient in obtaining more detailed discussion of the children's experiences. Conclusion This study resulted in the first interview methods package for young children which has been co‐designed with young children. The study demonstrates that young children can be active contributors in designing research if provided with the opportunity to do so. Patient or Public Contribution Children, parents and teachers provided input and shaped the design of this study.
ABSTRACT Background Interdisciplinary working for the safety improvement of older patients’ care after discharge is complex. As part of the General Practice Management After Transitions Events (GP‐MATE) study, a consensus workshop was convened bringing together patients, carers, secondary and primary care clinicians to co‐produce and prioritise recommendations for how a patient‐directed post‐discharge communication tool for older people should be implemented in the NHS. Methods We conducted a day‐long, face‐to‐face consensus workshop involving 21 participants: 10 patients, carers and public representatives; 5 secondary care frailty leaders and 6 general practice leaders. Using Nominal Group Technique, in small groups participants generated statements based on pre‐identified key ‘tensions’ derived from the 4‐year GP‐MATE study. These were then combined and moderated by the wider group and rated for acceptability and feasibility using RAND/UCLA voting across two rounds; round 2 conducted online. Results Participants produced 52 statements; 35 were considered acceptable and feasible. The highest‑ranked emphasised patient autonomy, clarity of purpose, and involvement of community‑based professionals (including District Nursing and Urgent Community Response teams) to reach frail or housebound patients. Complete digitisation was the only statement rated inappropriate. The importance of distinguishing GP‐MATE from current ways of working was also prioritised. Conclusion The workshop generated a set of co‑produced, theory‑informed recommendations to guide a definitive trial of GP‑MATE and support wider implementation of patient‑held communication tools in post‑discharge care. The study also demonstrated that RAND/UCLA can be successfully adapted for co‑production with mixed Public and Patient Involvement (PPI) and professional groups. Patient or Public Contribution The GP‐MATE study was centred on Experience‐Based Co‐Design as a method for participatory action research. We began with a patient experience film featuring patients from general practice in the West‐Midlands. Our intervention was developed by three teams of older patients and carers of older persons and is reported in the US patient‐focused journal Patient Education and Counselling. In the workshop described in this paper, patients and their carers were brought to power by working in parity of numbers with hospital professionals in smaller breakout groups. Our three breakout groups were planned to be co‐facilitated by PPI‐E contributors (but on the day, only one was well enough to undertake this role). We also included a local Healthwatch lead among our participants.
