Experience of Mental Health Professionals Collaborating with Peer Supporters in a Community Mental Health Service Team

This study explored how mental health professionals collaborate with peer supporters with mental disabilities in a community mental health institution.From January 19 to February 23,2021,three 60 min interviews were conducted with six mental health professionals working at a Korean community center.The results were qualitatively analyzed and divided into four themes and eight categories.The four themes were the perceptions of and challenges in working with peer supporters with mental disabilities,conflict and confusion about working with peer supporters,forming partnerships with peer supporters,and policy support for peer supporters’job security.Participants reported vague anxiety about working with a peer supporter and difficulties with the trial-and-error process of adjusting to the role as challenging.Over time,however,they realized that they needed to make an effort to develop meaningful relationships with peer supporters and mental health professionals.Thus,through this study,we realized that there was a need to improve the system,such as building infrastructure for job stability for peer support workers and capacity building tailored to the mental disorders.Although peer supporters play various roles while working with mental health professionals,this study showed the possibility of mutual growth through communication and cooperation.These findings will help prepare systems necessary for collaboration between the two teams amidst the increasing institutionalization of peer support for mental disorders.

Building the Capacity of Health Professionals in Monitoring and Evaluation in a Public Health Institution: Experience of the National Institute of Public Health (NIPH) of Côte d’Ivoire

Background: In the context of the fight against HIV, a lack of skills in monitoring and evaluating the personnel in charge of activities has been identified at the national level. It was the subject of a priority axis of the national plan for monitoring and evaluating the fight against HIV (2006-2010) that was aimed at strengthening the capacities of actors in this area. To increase the critical mass of competent human resources in the short term, the National Institute of Public Health (NIPH) of Côte d’Ivoire organized monitoring and evaluation training sessions for healthcare professionals from 2011 to 2016. Methods: A single case study with multiple levels of analysis was carried out, combining a qualitative survey and a literature review. An evaluation was carried out six months after each training session. In addition, the results of the pre- and post-tests and of the daily and final evaluations that accompanied the various training sessions were used to provide further information. The qualitative data collected were analyzed using INVIVO 15 software. Results: Some 89 health professionals (69% men and 31% women) working at the national level (51% at the central level, including 58% in health programs) and in development partner agencies (37%) participated in this capacity building program. Most participants were senior health managers (56%), data managers (23%), and statisticians and computer scientists (10%). Almost all the trainings were financed by 16 technical and financial partners (85%), mainly the MEASURE Evaluation project (27%). Conclusion: M&E training, despite all its imperfections, has made it possible to identify M&E training needs at the national level and to increase the critical mass of national skills and to have some culture in M&E.

Study on the demand for public health professional after the COVID-19 epidemic in Zhejiang Province, China: A survey based on human-machine collaboration

To understand the needs of public health institutions in Zhejiang Province,China for public health personnel,and provide basis for training public health personnel.Methods:512 public health institutions in Zhejiang Province were randomly selected from different levels and regions,and the number of ublic health professional and the demand for professional ability were investigated by questionnaire.Results:The preventive medicine personnel in public health institutions in Zhejiang Province are insufficient;There is a certain disjunction or dislocation between the abilities and needs of public health professional;The way of continuing education for public health professional is single and the opportunities are few.Conclusion:Zhejiang Province should appropriately expand the enrollment of preventive medicine majors,especially high-level preventive medicine talents,deepen the education and teaching reform of preventive medicine majors,and strengthen the continuing education and training of public health professional to meet the needs of public health services after the COVID-19 epidemic.

Knowledge and skills of neonatal resuscitation of health professionals at a university teaching hospital of Northwest Ethiopia

BACKGROUND:Competency in neonatal resuscitation is critical in the delivery rooms,neonatology units and pediatrics intensive care units to ensure the safety and health of neonates. Each year,millions of babies do not breathe immediately at birth,and among them the majority require basic neonatal resuscitation. Perinatal asphyxia is a major contributor to neonatal deaths worldwide in resource-limited settings. Neonatal resuscitation is effective only when health professionals have sufficient knowledge and skills. But malpractices by health professionals are frequent in the resuscitation of neonates. The present study was to assess the knowledge and skills of health professionals about neonatal resuscitation.METHODS:An institution based cross-sectional study was conducted in our hospital from February15 to April 30,2014. All nurses,midwives and residents from obstetrics-gynecology(obsgyn),midwifery and pediatric departments were included. The mean scores of knowledge and skills were compared for sex,age,type of profession,qualification,year of service and previous place of work of the participants by using Student's t test and ANOVA with Scheffe's test. A P value <0.05 was considered statistically significant.RESULTS:One hundred and thirty-five of 150 participants were included in this study with a response rate of 90.0%. The overall mean scores of knowledge and skills of midwives,nurses and residents were 19.9(SD=3.1) and 6.8(SD=3.9) respectively. The mean knowledge scores of midwives,nurses,pediatric residents and obs-gyn residents were 19.7(SD=3.03),20.2(SD=2.94),19.7(SD=4.4) and 19.6(SD=3.3) respectively. Whereas the mean scores of skills of midwives,nurses,pediatric residents and obs-gyn residents were 7.1(SD=4.17),6.7(SD=3.75),5.7(SD=4.17) and 6.6(SD=3.97) respectively.CONCLUSIONS:The knowledge and skills of midwives,nurses and residents about neonatal resuscitation were substandardized. Training of neonatal resuscitation for midwives,nurses and residents should be emphasized.

Levels of vocational satisfaction,burnout and compassion fatigue of health professionals working in pediatric clinics

BACKGROUND Burnout and compassion fatigue are affecting the quality of professional life.AIM To investigate the levels of vocational satisfaction,burnout,and compassion fatigue and factors that may be related to health professionals working in children’s clinics.METHODS The study sample was in the west of Turkey.Data were collected using the questionnaire form and the quality of life scale for employees.RESULTS The findings obtained in this study showed that the level of vocational satisfaction of female health professionals and the burnout level of male health professionals were higher.The professional satisfaction of the doctors was lower than that of the nurses and midwives,and the mean score of burnout and fatigue was high.CONCLUSION Further studies are needed on this topic to help improve the factors that may affect the professional quality of life of health professionals.

Compliance with Hand Hygiene among Health Professionals in the Medical-Surgical Emergency Department of the Donka National Hospital

Introduction: The transmission of infectious agents through the hands of nursing staff during care is the main cause of nosocomial infections. Hand hygiene has been recognized for over a century as an effective measure to prevent healthcare associated infections in healthcare settings, the objective of this study was to appreciate the practice of hand hygiene during care by health professionals in the medical-surgical emergency department of the Donka National Hospital. Methods: It was a cross-sectional, analytical study. Data collection took place from March 1 to April 30, 2021. The study covered all health professionals, namely doctors, nurses, laboratory technicians, radiography technicians, pharmacists, students, stretcher bearers, surfactants who were present at the time of the study period. Results: During the study period, out of a total of 104 registered health professionals, we surveyed 99, which is a rate of 95%. The most represented age group was [30 - 39 years] with an average of 37.17 ± 10.34 years, and extremes of 22 years to 65 years. The male sex was the most dominant or 59.60% compared to the female sex or 40.40% with a sex ratio of 1.47. The hand hygiene compliance rate was low at 21%. The practice of hand hygiene during care for 100% of health professionals was very low, at 8.08%. No factors influence the observance of the practice of hand hygiene and the socio-professional characteristics of the conditions of provision of care activities. Conclusion: Hand hygiene during care is an essential aspect that must be considered as an essential measure in the prevention of infections in this period of the COVID-19 pandemic.

The healthcare environment—The importance of aesthetic surroundings: Health professionals’ experiences from a surgical ward in Finland

There is a growing acceptance of the vital role patient centered design plays in shaping the environment. Art can be of use in every area of health care. It is within the power of each person to share and interpret experience by means of the arts, by viewing the work of others, and by using feelings and imagination. Health professionals [n = 24 of a total of n = 35], answered the Wheel Questionnaire test instrument. It measures structure, motivation/engagement, and degree of emotional investment in a situation. Participants were requested to describe, in their own words, their perception of the enrichment of the ward interiordesign and the double-sided photos with a short poetic text, and the photo-book placed at each patient room. The results demonstrate that participants are motivated, structured and emotionally engaged when describing the new enrichment. The domains and themes are: Social interaction domain;rising thoughts and conversations. Comfort domain;atmosphere. Aesthetic do main;enrichment of the working environment. It could be concluded that the surgical ward environmental enrichment stimulated conversations between health professionals and between health professionals and patients and should be regarded as an important aspect in hospital planning.

Intention to Leave and Associated Factors among Health Professionals in Jimma Zone Public Health Centers, Southwest Ethiopia

Background: Inadequate human resources are a major constraint to improving global health. The health sector is characterized by a high turnover coupled with internal as well as external brain drain but there is little information on intention to leave among health professionals in public health centers of Jimma Zone, Oromia Regional State. The aim of this study is to assess intention to leave and associated factors among health professionals in public health centers of Jimma Zone, southwest Ethiopia. Methods: A cross-sectional quantitative and qualitative study was conducted on seven randomly selected woredas (districts) which have 53 public health centers. All health professionals in sampled district public health centers were included (n = 505). Factor analysis was employed for all Likert scale instruments to extract factor(s) representing each of the scales using SPSS version 16.0. The qualitative data was analyzed by thematic analysis methods. Ethical approval was obtained from Jimma University. Results: Four hundred fifty five (90.1%) health professionals participated in the study;out of this, 290 (63.7%) had intention to leave. Among variables, job satisfaction (Beta = -0.298, (95% CI, -0.568 to -0.029), working environment (Beta = -0.612, (95% CI, -0.955 to -0.270), and organizational management (Beta = -0.552, (95% CI, 0.289 to 0.815) had statistically significant association with intention to leave among health professionals in public health centers of Jimma Zone. Conclusions: The overall intention to leave among health professionals was high. Level of job satisfaction, working environment, work pressure, and organizational management had statistically significant association with intention to leave. Thus, responsible bodies should aggressively work on the concerns identified, like, improvements in salary, promotion in terms of training/educational opportunity, improving working environment, and transfer of health professionals, and improvement of the leadership skills of managers.

Community Needs Assessment for a Professional University Health Counselling Course in Cambodia

Developing health and counselling professionals remains an important part of supporting mental health services in Cambodia.This paper aims to identify how the key stakeholders and mental health experts in Cambodia consider how a university level health counselling course could contribute to addressing the needs/treatment gap for mental health services in Cambodia.In order to do this,the study consists of semi-structured interviews with stakeholders,community needs assessment,and community resource mapping.The data were drawn from 15 NGOs,various profit and not-for-profit organizations as well as two key government stakeholders.The participants were invited to take part in a stakeholders/expert semi-structured interview that lasted between 30-60 minutes at the participants’organizations.The findings revealed that all participants believe that a university level health counseling course was crucial in Cambodia to address pressing mental health issues in the country.Most participants believed that a graduate or post-graduate level program such as a B.A.or M.A.was necessary to train qualified counsellors.The program should be internationally benchmarked,with a Cambodian context.Topics should include psychopathology,professional ethics and competencies,counselling theories and interventions,trauma treatment,as well as emotional intelligence and addiction.Other topics might need to include parenting,support system for suicidal patients,self-care,staff wellbeing programs,and school counselor programs.

Health professionals’perspective on the impact of community health care reform in different regions of China

Objective:Changes in supplying community health services,degree of satisfaction,and pol-icy suggestions are presented from the perspectives of health professionals in different regions of China with the purpose of further facilitating comprehensive reform of community health services.Methods:Based on geographic location and economic level of development,eight cities were selected and 12 community health service institutions were chosen by random sampling from each city.A questionnaire survey was conducted by the health professionals.Results:With respect to working enthusiasm,reduction in antibiotic drug use,social image and trust of patients,more health professionals in middle and western China showed positive feed-backs than those in eastern China.With respect to preliminary results of the reform,performance and salary,and health care insurance policies,health professionals’satisfaction levels in middle and western China were higher than in eastern China.The health professionals in middle and western China were more concerned about equipment,infrastructure and increasing training op-portunities.The health professionals in both eastern and middle China accentuated improving the variety of essential drugs covered by health insurance,while health professionals in eastern China suggested performance-related payment reform.Conclusions:The performance of health professionals in middle and western China was improved more signifi cantly through comprehensive reform than that of health professionals in eastern China.For health professionals in middle and western China,it is essential to strengthen infrastructure and increase professional training,while health professionals in middle and eastern China would like to see an increase in the variety of essential drugs,and those in eastern China require strengthening performance-related payment reform.

Knowledge levels and attitudes of health care professionals toward patients with hepatitis C infection

AIM:To study knowledge levels and attitudes of health care providers toward patients with hepatitis C virus infection in Guilan,a northern province of Iran.METHODS:This cross-sectional study was performed on 239 health care professionals from the Razi Hospital,including doctors,nurses,and operating room technicians.The questionnaires consisted of questions on demographic characteristics,knowledge levels,and attitudes toward hepatitis C patients.The questionnaire was tested in a pilot study and validated by Cronbach' s alpha coefficient.Data were analyzed using SPSS16 software.RESULTS:The mean ± SD knowledge score was 17.43 ± 2.65(from a total of 22).51.9% of the participants achieved scores higher than the mean.There was a significant relationship between knowledge score and age(P = 0.001),gender(P = 0.0001),occupational history(P = 0.0001),and educational history(P = 0.027).There was also a significant relationship between attitude level and age(P = 0.002),gender(P = 0.0001),occupational history(P = 0.0001),and educational history(P = 0.035).Physicians were significantly more knowledgeable and showed more positive attitudes.There was a positive correlation between knowledge and attitude scores(P = 0.02).CONCLUSION:Discriminatory attitudes are common among health care providers toward hepatitis C patients.It is therefore necessary to improve their knowledge level and attitude toward this disease.

Understanding Health Care Professional-Patient Interactions in Multiple Sclerosis: A Systematic Review and Thematic Synthesis

Aim: To examine the experiences of health care professional (HCP)-patient interactions in Multiple Sclerosis (MS), identifying factors that can influence these interactions. Methods: A three-stage systematic review and thematic synthesis of qualitative and quantitative research was undertaken. Stage 1: the systematic literature search;Stage 2: methodological appraisal of the qualitative papers;Stage 3: thematic synthesis of all qualitative papers and the integration of quantitative findings into the synthesis. Results: Forty-nine qualitative studies were identified. This included 1014 individuals with MS (244 male, 755 female and 15 unknown) and 106 carers and 86 HCPs. Seventeen quantitative studies were identified which included 7680 (2008 male, 5812 females, and 40 unknown) participants as well as 224 carers. Two themes are discussed: 1) The expectations, experiences and perceptions of interactions with HCPs, and 2) The factors that influenced interactions and relationships. Discussion: There is need for improvement in the content and provision of information to patients with MS from HCPs. Specific strategies are suggested and implications for patients and health care providers are considered.

Attitudes of Healthcare Professionals towards Mental Illness: A Survey Study in Ras Al Khaimah

Background: Negative and stigmatizing attitudes and behaviours towards people with mental health problems have the potential to lead to a lack of access to care, under-treatment, social marginalization, and can undermine the relationship between the patient and provider. The study aimed to measure attitude of healthcare professionals towards mental illness. Methods: Across sectional descriptive study was conducted over one month from April to May 2019 at Ras Al khaimah medical and health Science University and affiliated health care facilities. Mental Illness Clinicians’ Attitudes Scale version 4 Questionnaire was used to collect data from participants after obtaining their informed consent with assured confidentiality. Results: The study included 113 health care professionals. The mean score of attitude of health care professionals towards mental illness was 57.8 ± 10.8 out of 96. Negative attitudes were reported about the dangerousness, respect and suspicion over recovery of people with mental health problems, interactions with them in clinical practice, and fear of disclosure to colleagues or friends about mental health problems and confidence in capabilities of assessing mental health problems in primary care. The significant positive attitude was found among participants who were university faculty than those who worked in hospitals and Primary care centres (P = 0.04). Health care professionals who were university faculty and have reported more than 10 years of experience as health professionals reported significantly higher mean scores (P < 0.05). Neither age nor gender, or nationality appeared to be related to overall attitudinal responses towards mental illness. Conclusion: Educational programs might be useful to raise awareness towards the stigmatizing attitudes towards mental health and mental illnesses.

The knowledge level of final year undergraduate health science students and medical interns about cardiopulmonary resuscitation at a university teaching hospital of Northwest Ethiopia

BACKGROUND: Cardiopulmonary resuscitation(CPR) is a life-saving technique which is used after cardiopulmonary arrest. Chance of survival after arrest will increase if it is coupled with sufficient knowledge. Final year undergraduate health science students and interns manage many trauma and critically ill patients in our hospital. Even though all students took CPR training in undergraduate course, we sometimes saw difficulties in the resuscitation of patients after cardiopulmonary arrest by undergraduate health professionals. This study was to assess the level of knowledge of undergraduate health science students and medical interns about cardiopulmonary resuscitation.METHODS: Hospital based cross-sectional study was conducted from February 1 to March 30, 2013. All undergraduate health professionals were included. The mean score of knowledge was compared for sex, original residence and department of the participants by using Student's t test and ANOVA with Scheffe's test. P values <0.05 were considered statistically significant.RESULTS: Four hundred sixty-one out of 506 students were included in this study with a response rate of 91.1%. The overall mean knowledge score of final year undergraduate health science students and interns was 11.1(SD=0.2). The mean knowledge scores of nurses, interns, health officer, midwifery, anesthesia and psychiatry nursing students were 9.84(SD=2.5), 13.34(SD=2.8), 9.81(SD=3.0), 8.77(SD=2.6), 13.31(SD=2.7) and 8.43(SD=2.4) respectively.CONCLUSIONS: The knowledge level of undergraduate health professionals about cardiopulmonary resuscitation was insufficient. Training about CPR for undergraduate health professionals should be emphasized.

Health Training Needs at Primary Care Level Health Facilities in Rural Western Uganda

Introduction: Continual education is recognized worldwide as a tool for the professional development of health care practitioners. It is however effective when the training targets the appropriate needs of the target beneficiaries. This study was therefore aimed at identifying priority training needs of Primary Care Level health professionals in rural Western Uganda. Methods: This was a descriptive cross-sectional survey among 35 rural community health facilities represented by their managers in rural Western Uganda. Participants were invited to Mbarara University of Science and Technology and responded to a self-administered questionnaire and also participated in qualitative group discussions guided by Facilitators from the Community Based Education and Research Services unit within the Community Health Department of Mbarara University of Science and Technology. Priority health training needs were determined based on the computed weighted scores. Results: The majority of managers of rural primary care level health facilities were medical officers by the level of training (51.43%) and male by gender (68.57%). Priority health training needs identified were child health and maternal health with total weighted scores of 12.0 and 10.9 respectively. Qualitatively, emerging themes included;leadership and management, and supervisory roles during student field attachments. Conclusion: Priority health training needs at rural Primary Care level health facilities were child health, maternal health, leadership and management, and supervisory skills. There is dire need to train rural primary care level, health professionals. In-service training based on identified needs should be offered by MUST in partnership with regional stakeholders. This is likely to enhance the quality of services provided by rural primary care level health facilities.

Family Health History and Behavioral Change among Undergraduate Students: A Mixed Methods Study

Background: We examined family health history (FHH) as a public health intervention tool in undergraduate students. We hypothesized that the FHH assignment would positively relate to students’ FHH knowledge and health and healthcare-seeking behavioral change. Methods: Health professional students’ (n = 103) pre/post-test surveys and research papers were collected in 2011-2012, from a mid-western and southern university in the United States of America, using mixed methods research. Results: The majority of students were aged 18 - 30, women, White, had healthcare access and health insurance, and awareness of the term FHH. Significant logistic regression relationships existed between: 1) helping students understand important strengths and weaknesses in their health and quality of life and outcomes of talking with family and doctors about FHH;and 2) improving students’ understanding of what they needed to do to maintain their health and the outcome statement “FHH tells you about inherited genes.” Key themes from the research papers included actions and FHH and proposed behavioral changes. Conclusions: Quantitative findings supported the relationship between students’ assignment evaluation and knowledge change, while qualitative findings supported relationships between assignment evaluation and knowledge and behavioral change. This study highlights regional differences in students’ FHH and the need to address family support barriers to behavioral change.

Oncofertility in adolescent and young adult hereditary cancer: Considerations for genetics professionals

Adolescents and young adults(AYA)with a cancer diagnosis or those at risk for cancer due to hereditary cancer syndromes may benefit from genetic counseling and testing not only to manage personal risk but also to address reproductive concerns,especially fertility.The opportunity for genetic counselors to provide important risk information is relevant to both the newly diagnosed as well as to unaffected carriers and survivors.However,genetic counselors may need additional training in reproductive options related to AYA cancer to provide this valuable counsel.This commentary uses hereditary breast and ovarian cancer syndrome as a model to highlight important considerations when discussing preimplanatation genetic diagnosis and prenatal diagnosis,particularly in the context of expanded testing for hereditary cancer risk including multigene panels or whole exome or whole genome sequencing.Other hereditary cancers are also addressed;however,less is known about the psychosocial and fertility concerns in these AYA populations.Additionally,we provide an overview of the concept of"oncofertility"-the linkage between cancer care and reproductive medicine that aims to expand the reproductive opportunities of cancer patients-and offer support for the expansion of guidelines to include genetic counselors in AYA cancer patients’treatment planning related to reproductive health and fertility.

Realities and Challenges of Healthcare Workers in Kosovo during COVID-19: An Overview in Healthcare Workers

Introduction: Healthcare workers across the world have been raised to the demands of treating COVID-19 patients, potentially at significant cost to their own health and wellbeing. The coronavirus disease 2019 (COVID-19) pandemic has caused an increasing of challenges for healthcare professionals not only in Kosovo but globally. However, the psychological impact and change behavior, of the coronavirus disease 2019 pandemic, among healthcare workers, are still unknown. Aim: The purpose of this paper is to know the reality and challenges of healthcare workers in Kosovo during the current COVID-19 outbreak. Methodology: This is a cross-sectional, online survey which was conducted from 15 March 2020 to 30 July 2020 on 309 healthcare workers at three hospitals in Kosovo. An online survey questionnaire was used to collect data on participants’ characteristics, questions about gel hand sanitizer, disposable gloves, masks, facial protective shields, including questions such as: Do they have any chronic disease? Do they have fear from infection? Were they getting information about COVID-19? Do they have a stress during their work? Do they carry about public health measures and policies? The study protocol was approved by the ethical commission of our university. Findings: A total of 309 healthcare workers and medical practices completed the online survey. Most participants were female (n = 233;75.4%), and live in city (n = 174;56.3%). Based on their income (n = 250;80.9%), by having a middle income and (n = 44;14.2%) low income. Regarding provide services to people with COVID-19, 69.3% of participants were directly with infected patients, and during this time those who were worried to get infected with coronavirus were 31.4%, who said that they were afraid of becoming infected. The frustration was that if they become infected, the possibility of transmitting the virus to other family members will increase, where 35% stated that they are very scared and extremely scared 21.4%. Conclusion: Our study highlighted the importance of taking into consideration the experiences and concerns on front-line staff during pandemic. Factors such as older age, being female, chronic diseases and trainings may protect healthcare workers from fear during pandemic.

Why Multi-Sectoral Approaches Are Rarely Applied in Community Health Interventions in Some Countries in Sub-Saharan Africa?

The objective of this work is to analyze the reasons why community health interventions in Africa do not consider multisectoral approaches. To achieve it, we perform a mini-review of health development policies and plans available online in seven countries from four regions of Sub-Saharan Africa. Thus, two main reasons have been highlighted. First, national strategic plans and policies for health development, in their formulation, neither sufficiently emphasize multisectoral approaches, nor sufficiently make these approaches operational in strategies and activities. Second, the mindset of health professionals due to their initial training orientation based on the biomedical approach, stands that disease is only a result of a physiological imbalance in the body;therefore, to restore health, such an imbalance only needs sophisticated procedures and interventions to be overcome. Such an orientation completely ignores the social, cultural and economic context in which the individual lives, which has an irretrievable influence on the health imbalance. However, health, influenced by the conditions in which people are conceived, born, grow, live, work and aged, cannot be effectively improved in a sustainable way without taking into account all these conditions. Whence the importance of approaches based on every sector of human activity that influences the living conditions.

The Hermeneutic Circle Helps to Accumulate Knowledge and Understanding： An Empirical Example of Public Health Nurses＇ Experiences of Supporting Multiple-birth Families

In phenomenological research, the reduction is a complex reflective attentiveness required for phenomenological understanding. A literature review revealed that little research has been done on health care professionals working with multiple-birth families. Van Manen＇s method has been variously used in nursing science. The aim of this article is to describe the hermeneutic circle and the method of reduction, providing an empirical example of the experiences of public health nurses working with multiple-birth families. The data consisted of open interviews （n = 38） with three participant groups--parents of twins, nurses, and family care workers--written output from them and the researcher＇s notes. The phenomena of the lifeworld of multiple-birth families as described by nurses can be expressed as： ＂recognizing the strain＂, ＂targeting special needs＂, and ＂lightening the load of daily life＂. Reduction enables in-depth phenomenological hermeneutic research, helping to see the research stages both as parts and as a whole and the hermeneutic circle that accumulates understanding. Social and health care professionals need to listen more to parents＇ voices to better understand the needs and situation of multiple-birth families. More education and training is needed to empower parents of twins. This article can stimulate discussion on phenomenology, hermeneutic research and reduction.