Vicki Simpson

Substance Use Disorder (SUD) treatment in sub-Saharan Africa remains poorly understood from the perspectives of those who deliver and receive it. We integrated the perspectives of service users (SUs) and front-line health care workers (HCWs) within a single analytic frame to map SUD treatment trajectories and identify multilevel barriers and facilitators shaping treatment and recovery outcomes in Uganda. We conducted a qualitative study nested within a parent cohort of adults treated for SUDs at two public treatment facilities in Uganda. We conducted in-depth interviews with 43 SUs from this cohort and 10 HCWs directly involved in SUD care. We analysed the data using reflexive thematic analysis. SU and HCW data accounts were first analysed separately before applying integrative mapping to generate cross-cutting meta-themes. We identified four interrelated meta-themes. First, systemic and structural constraints, including human resource gaps, medication stockouts, and inadequate infrastructure, undermined care consistency and quality. Second, accounts suggested that SUD care was only partially aligned with the biopsychosocial model, with acute biomedical stabilisation more consistently implemented than psychosocial support, individualised care, and recovery planning. Third, participants described returning to high-risk post-treatment environments marked by stigma, weak family support, peer and environmental triggers, economic insecurity, and untreated comorbidities, which increased perceived relapse vulnerability. Fourth, they identified supportive anchors for recovery, including faith and spirituality, active coping, family and community engagement, peer mentorship, task-sharing, and strengthened multidisciplinary care. Participants’ accounts indicate that SUD care and recovery in Uganda are shaped by a self-reinforcing cycle of system constraints, fragmented care, and high-risk post-discharge environments. Reorienting SUD care towards a recovery-oriented continuum will require stronger links between facility-based treatment and community support, alongside investment in psychosocial care, workforce capacity, service infrastructure, and locally available recovery resources.

Introduction The United Nations (UN) Sustainable Development Goal 6 seeks to ensure universal access to safe drinking water by 2030, but vast inequities in access exist, especially among vulnerable communities including limited resource, rural, disaster-affected areas. Flood disasters, exacerbated by the climate crisis, hinder the ability of individuals and families to meet essential drinking water needs and increase their susceptibility to waterborne illnesses. Point-of-use (POU) water treatment is an effective solution for water-insecure populations during and immediately following flood emergencies. However, an initial literature search identified knowledge gaps surrounding implementation of POU water systems. This scoping review aims to synthesise published evidence between January 2015 and July 2025 on barriers and facilitators to utilisation of POU water treatment systems during and immediately following flood-related disasters. The findings will inform efforts to promote resilience and agency among water insecure communities, specifically by equipping them with actionable knowledge on sustainable access to safe drinking water. Methods and analysis This scoping review will be guided by the work of Arksey and O’Malley and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews. Search terms will be identified through an iterative process using the PICOT method and Boolean logic. Four databases—Scopus, PubMed, Web of Science and Google Scholar—with the addition of grey literature from UN agencies and non-governmental organisations focused on water-related issues will be searched. Two independent reviewers will apply a priori eligibility criteria to select studies. Conflicts will be resolved through discussion and a third independent reviewer absent agreement between the first two reviewers. Cohen’s kappa statistic will be calculated to assess inter-rater reliability. Data extraction will be guided by predefined data points, and the Consolidated Framework for Implementation Research will guide evidence synthesis through a solution-based approach. Ethics and dissemination Institutional research ethics review is not required because no human subjects are involved. Findings will be disseminated through a peer-reviewed publication, a policy brief, conference presentations and infographics for use by organisations serving flood disaster impacted communities.

Purpose: The coronavirus disease 2019 (COVID-19) pandemic has substantially influenced nursing environments and has underscored the importance of active patient care. Nursing intention plays a critical role in the provision of care for patients with COVID-19; however, limited evidence exists regarding the factors that influence nurses’ intention to provide patient care specific to COVID-19. This study aimed to examine factors associated with nursing intention for COVID-19 patient care, guided by the Theory of Planned Behavior. Methods: This study employed a cross-sectional descriptive design. Data were collected from August 30 to October 1, 2020, using structured questionnaires completed by 169 clinical nurses working in hospitals with more than 600 beds in Seoul, Korea. The collected data were analyzed using multiple regression analysis. Results: Behavioral beliefs (β=.34, p<.001) and perceived behavioral control (β=.24, p<.001) were significantly associated with nursing intention for COVID-19 patient care. Conclusion: There is a need to develop specific strategies and educational programs to enhance nursing intention for COVID-19 patient care in the context of emerging infectious diseases by strengthening behavioral beliefs and perceived behavioral control. Providing up-to-date care protocols or simulation-based education may help increase nurses’ behavioral beliefs and perceived behavioral control.

Introduction: Substance Use Disorders (SUDs) pose significant public health challenges in sub-Saharan Africa. However, there is limited evidence on how service users (SUs) and front-line health care workers (HCWs) experience SUD treatment and recovery within resource constrained settings. This study explored the perspectives of SUs and HCWs to understand treatment trajectories and to identify multilevel barriers and facilitators influencing recovery outcomes. Methods: We conducted a qualitative study at two public treatment facilities in Uganda; the Alcohol and Drug Unit at Butabika National Referral Mental Hospital and the Mental Health Unit at Gulu Regional Referral Hospital. Using purposive sampling, we interviewed 10 HCWs directly involved in SUD care (five per site) and randomly selected 43 SUs from a parent cohort of 439 adults treated for SUDs at the same sites. We transcribed all audio recordings verbatim and translated them into English where necessary. We coded SUs and HCWs data separately and then applied integrative mapping to generate cross-cutting meta-themes. Results: We identified four interrelated meta-themes that described how individual, social, community and health system factors influenced treatment journey and recovery outcomes. Both SUs and HCWs highlighted resource constrained service environments characterized by shortages of specialist staff, medications and secure infrastructure, which compelled clinicians to improvise and resulted in fragmented care. Human resource gaps contributed to rushed assessments, minimal psychosocial engagement, and limited follow-up. Treatment pathways were described as heavily biomedical, with services centred on detoxification and management of acute withdrawal, while psychosocial needs, and contextual stressors insufficiently addressed. Outside the treatment facility, individual, social and community barriers like stigma, strained family relationships, peer pressure, poverty, alcohol-dependent livelihoods, and untreated mental or physical comorbidities made recovery difficult, as SUs returned to the same environments that precipitated their substance use. Despite these challenges, participants identified opportunities to strengthen recovery pathways, including integration of family and spiritual support, involvement of “expert-client” models, anti-stigma interventions, and task-sharing with community health workers. Conclusion: Sustained recovery from SUDs in Uganda is constrained by fragmented clinical services, systemic resource shortages, stigma, and unsupportive social contexts. Improving recovery therefore demands a multilevel response including strengthening psychosocial support, integrating family and spiritual support, peer role models, anti-stigma initiatives and task-sharing with community health workers to strengthen recovery pathways and sustain long-term treatment outcomes.

Background: Compassion fatigue and satisfaction impact nurses’ patient care. Resilience acts as a mediator between protective organizational practices and mental health. Objective: This study aimed to examine the mediating effect of resilience among nurses during the recent emerging infectious disease outbreak, the COVID-19 pandemic. Methods: This is a cross-sectional study of 233 nurses who were caring for COVID-19 patients in the United States, Japan, Korea, and Guinea. Path analysis was used to assess associations between protective organizational practices and compassion fatigue and satisfaction. Results: Path analysis indicated that resilience significantly mediated the association between protective organizational practices and the study outcomes of compassion satisfaction (indirect effect: β = 0.11, p < .01) and compassion fatigue (indirect effect: β = −0.11, p < .01). The analysis also indicated that resilience mediated associations between being asked to work at a higher patient acuity level and compassion satisfaction (indirect effect: β = −0.09, p < .05) and compassion fatigue (indirect effect: β = 0.09, p < .01). Our results provide further support for the mediating effect of resilience on compassion fatigue and compassion satisfaction during the COVID-19 crisis and the impact of poor protective organizational practices on compassion fatigue and compassion satisfaction. Conclusions: This study highlights the critical impact of supportive protective organizational practices in enhancing nurse resilience, reducing compassion fatigue, and improving compassion satisfaction during emerging infectious disease outbreaks, such as the COVID-19 pandemic. The results emphasize the need for robust resiliency programs and organizational resources for infection control in health care settings to enhance nurses’ psychological well-being.

Background: Due to the rapid spread of COVID‐19 variants, the number of people hospitalized for COVID‐19 may create psychological burdens on nurses. Nurses with high levels of compassion fatigue (CF) are more likely to make work errors, deliver poor‐quality care, and have greater intent to leave their position.Objectives: This study utilized the social‐ecological model to examine factors associated with nurses' CF and compassion satisfaction (CS) during the COVID‐19 pandemic.Methods: Data were collected from the United States, Japan, and South Korea from July to December 2020. The Professional Quality of Life Scale was used to measure burnout (BO), secondary traumatic stress (STS), and CS.Results: Data from 662 responses were used in the analysis. Mean scores were 25.04 (±6.44) for BO, 24.81 (±6.43) for STS, and 37.85 (±7.67) for CS. Multiple regression analyses indicated that resilience and intention to leave nursing were related to each study outcome (i.e., BO, STS, and CS). Greater resilience predicted lower BO and STS but greater CS, whereas intention to leave nursing indicated greater BO and STS, but lower CS. Furthermore, intrapersonal factors and organizational factors (i.e., nurses involved in developing policies to prepare for COVID‐19 patients, organizational support, and personal protective equipment [PPE] provisions) were related to BO, STS, and CS.Linking Evidence to Practice: To promote nurses' psychological well‐being, improvement of organizational factors such as support, PPE, and programs to enhance resilience is recommended to prepare for future emerging infectious disease crises.

Objective: Identify the scope of the literature which reports use of social network analysis to inform, support, or evaluate health promotion–focused community network/partnership development. Data Source: A comprehensive search (not date-limited) of PubMed, CINAHL, Web of Science Core Collection, PsycInfo, and the Cochrane Library Database for Systematic Reviews. Inclusion and Exclusion Criteria: Criteria for inclusion included published in the English language and used social network analysis to inform, support, or evaluate development of community networks/partnerships aiding health promotion efforts. Studies were excluded if they did not use social network analysis or were not focused upon health promotion. Data Extraction: Three of the four authors extracted data using a summary chart to document information regarding study aims, target issue/population, methods, and key outcomes of the social network analysis. Data Synthesis: The extracted data were qualitatively analyzed by 3 authors to categorize key social network analysis outcomes into categories. Results: Ninety-seven studies representing 9 geographical regions were included, with the majority (69) published after 2010. Key outcomes included the effectiveness of social network analysis to identify network characteristics, track network change over time, compare similar networks across locations, and correlate network attributes with outcomes. Conclusion: Findings support the utility of social network analysis to inform, support, and evaluate development of sustainable health promotion–focused networks/partnerships.