Psychological experience of breastfeeding among primiparous women with lactating mastitis:A qualitative research

Objective:The objective of this study is to comprehensively understand the psychological experience of primiparous women during breastfeeding while dealing with lactating mastitis and to establish a reliable foundation for tailored support measures.Methods:Twenty primiparous mothers from a tertiary hospital in Beijing between January and March 2023 were chosen using purposive sampling for semi-structured interviews.After conducting 20 interviews,data saturation was achieved.The Colaizzi’s seven-step analytical approach was employed to analyze,summarize,and refine the identified themes.Results:Among primiparous women afflicted by lactating mastitis,the primary themes regarding breastfeeding attitudes included three key aspects:(1)uncertainty during the initial diagnosis phase,(2)intricate emotional journey during treatment,and(3)positive psychological outlook during the recovery stage.Conclusion:Primiparous women undergoing lactating mastitis experience substantial physical and psychological strain.It is crucial for medical personnel,family caregivers,and society at large to be attuned to the emotions of these patients.Tailored support measures should be offered to enhance patients’physical and mental well-being and facilitate disease recovery.

Expert Experience and Data-Driven Based Hybrid Fault Diagnosis for High-SpeedWire Rod Finishing Mills

The reliable operation of high-speed wire rod finishing mills is crucial in the steel production enterprise.As complex system-level equipment,it is difficult for high-speed wire rod finishing mills to realize fault location and real-time monitoring.To solve the above problems,an expert experience and data-driven-based hybrid fault diagnosis method for high-speed wire rod finishing mills is proposed in this paper.First,based on its mechanical structure,time and frequency domain analysis are improved in fault feature extraction.The approach of combining virtual value,peak value with kurtosis value index,is adopted in time domain analysis.Speed adjustment and side frequency analysis are proposed in frequency domain analysis to obtain accurate component characteristic frequency and its corresponding sideband.Then,according to time and frequency domain characteristics,fault location based on expert experience is proposed to get an accurate fault result.Finally,the proposed method is implemented in the equipment intelligent diagnosis system.By taking an equipment fault on site,for example,the effectiveness of the proposed method is illustrated in the system.

Finding biomarkers of experience in animals

At a time when there is a growing public interest in animal welfare,it is critical to have objective means to assess the way that an animal experiences a situation.Objectivity is critical to ensure appropriate animal welfare outcomes.Existing behavioural,physiological,and neurobiological indicators that are used to assess animal welfare can verify the absence of extremely negative outcomes.But welfare is more than an absence of negative outcomes and an appropriate indicator should reflect the full spectrum of experience of an animal,from negative to positive.In this review,we draw from the knowledge of human biomedical science to propose a list of candidate biological markers(biomarkers)that should reflect the experiential state of non-human animals.The proposed biomarkers can be classified on their main function as endocrine,oxidative stress,non-coding molecular,and thermobiological markers.We also discuss practical challenges that must be addressed before any of these biomarkers can become useful to assess the experience of an animal in real-life.

Fast UAV path planning in urban environments based on three-step experience buffer sampling DDPG

The path planning of Unmanned Aerial Vehicle(UAV)is a critical issue in emergency communication and rescue operations,especially in adversarial urban environments.Due to the continuity of the flying space,complex building obstacles,and the aircraft's high dynamics,traditional algorithms cannot find the optimal collision-free flying path between the UAV station and the destination.Accordingly,in this paper,we study the fast UAV path planning problem in a 3D urban environment from a source point to a target point and propose a Three-Step Experience Buffer Deep Deterministic Policy Gradient(TSEB-DDPG)algorithm.We first build the 3D model of a complex urban environment with buildings and project the 3D building surface into many 2D geometric shapes.After transformation,we propose the Hierarchical Learning Particle Swarm Optimization(HL-PSO)to obtain the empirical path.Then,to ensure the accuracy of the obtained paths,the empirical path,the collision information and fast transition information are stored in the three experience buffers of the TSEB-DDPG algorithm as dynamic guidance information.The sampling ratio of each buffer is dynamically adapted to the training stages.Moreover,we designed a reward mechanism to improve the convergence speed of the DDPG algorithm for UAV path planning.The proposed TSEB-DDPG algorithm has also been compared to three widely used competitors experimentally,and the results show that the TSEB-DDPG algorithm can archive the fastest convergence speed and the highest accuracy.We also conduct experiments in real scenarios and compare the real path planning obtained by the HL-PSO algorithm,DDPG algorithm,and TSEB-DDPG algorithm.The results show that the TSEBDDPG algorithm can archive almost the best in terms of accuracy,the average time of actual path planning,and the success rate.

UAV maneuvering decision-making algorithm based on deep reinforcement learning under the guidance of expert experience

Autonomous umanned aerial vehicle(UAV) manipulation is necessary for the defense department to execute tactical missions given by commanders in the future unmanned battlefield. A large amount of research has been devoted to improving the autonomous decision-making ability of UAV in an interactive environment, where finding the optimal maneuvering decisionmaking policy became one of the key issues for enabling the intelligence of UAV. In this paper, we propose a maneuvering decision-making algorithm for autonomous air-delivery based on deep reinforcement learning under the guidance of expert experience. Specifically, we refine the guidance towards area and guidance towards specific point tasks for the air-delivery process based on the traditional air-to-surface fire control methods.Moreover, we construct the UAV maneuvering decision-making model based on Markov decision processes(MDPs). Specifically, we present a reward shaping method for the guidance towards area and guidance towards specific point tasks using potential-based function and expert-guided advice. The proposed algorithm could accelerate the convergence of the maneuvering decision-making policy and increase the stability of the policy in terms of the output during the later stage of training process. The effectiveness of the proposed maneuvering decision-making policy is illustrated by the curves of training parameters and extensive experimental results for testing the trained policy.

Qualitative exploration of home life experiences and care needs among elderly patients with temporary intestinal stomas

BACKGROUND This study employed a phenomenological research approach within qualitative research to explore the challenges encountered by elderly individuals with temporary colostomies in managing their daily lives and care needs.Protecting the anus surgery combined with temporary colostomy has emerged as a prevalent treatment modality for low rectal cancer.However,the ileostomy is susceptible to peri-stoma skin complications,as well as fluid,electrolyte,and nutritional imbalances,posing challenges to effective management.The successful selfmanagement of patients is intricately linked to their adjustment to temporary colostomy;nonetheless,there remains a dearth of research examining the factors influencing self-care among temporary colostomy patients and the obstacles they confront.AIM To investigate the lived experiences,perceptions,and care requirements of temporary colostomy patients within their home environment,with the ultimate goal of formulating a standardized management protocol.METHODS Over the period of June to August 2023,a purposive sampling technique was utilized to select 12 patients with temporary intestinal stomas from a tertiary hospital in Shanghai,China.Employing a phenomenological research approach,a semi-structured interview guide was developed,and qualitative interviews were conducted using in-depth interview techniques.The acquired data underwent coding,analysis,organization,and summarization following Colaizzi’s seven-step method.RESULTS The findings of this study revealed that the experiences and needs of patients with temporary intestinal stomas can be delineated into four principal themes:Firstly,Temporary colostomy patients bear various burdens and concerns about the uncertainty of disease progression;secondly,patients exhibit limited self-care capabilities and face information deficits,resulting in heightened reliance on healthcare professionals;thirdly,patients demonstrate the potential for internal motivation through proactive self-adjustment;and finally,patients express a significant need for emotional and social support.CONCLUSION Home-living patients with temporary intestinal stomas confront multifaceted challenges encompassing burdens,inadequate self-care abilities,informational deficits,and emotional needs.Identifying factors influencing patients’self-care at home and proposing strategies to mitigate barriers can serve as a foundational framework for developing and implementing nursing interventions tailored to the needs of patients with temporary intestinal stomas.

Research on Developing an Assessment Scale for Tourism Experience Elements of Ancient Shu Road Heritage Trail

Cultural ancient roads,known in Chinese as gudao,serve as heritage trails that carry historical exchanges across various regions in China.Due to their extensive preservation,wide geographical distribution,diverse thematic variations,and considerable tourist appeal,these paths have emerged as representative heritage trails,increasingly transforming into a novel tourism product experience that is highly favored by tourists and recognized by government authorities.However,research on ancient roads for tourism in China currently lacks a systematic theoretical framework,as well as relevant policies,regulations,and standards to guide their practical development.Therefore,there is a pressing need to draw upon international best practices and conduct foundational research to develop an experience element system that aligns with the perceptions,behaviors,and consumption characteristics of Chinese tourists,thereby advancing theoretical exploration in this field.This study focuses on the representative Ancient Shu Road as a case study and employs a mixed-method approach that integrates qualitative and quantitative research.It aims to construct a tourist-centric scale for the experience elements of ancient road tourism while analyzing the interactive relationship between these experience elements and tourist needs.This study addresses a significant gap in the development of indicator systems for domestic studies of ancient road tourism experiences.Ultimately,the study establishes a comprehensive scale that encompasses three core categories—trail resources and environment,facilities and services,and modes of tourism activities—along with eight primary dimensions:core resources,surrounding cultural environment,surrounding natural environment,tourism reception facilities and services,infrastructure and support services,information facilities and information services,and outdoor and recreational activities.This scale consists of thirty-two specific items,providing a robust reference for future research endeavors.Additionally,the study proposes specific development strategies related to key mechanisms,spatial configuration,and facility construction to enhance the overall development of ancient road tourism.

Citizens’Mental Health Issues and Psychological Trauma Experience due to a Crowd-Crush Disaster in Korea

This study evaluated the state of anxiety, depression, post-traumatic stress disorder, general mental health, and mental well-beingamong citizens after a crowd-crush disaster in Korea. Individuals who experienced the crowd crush had significantly higheranxiety, depression, and post-traumatic stress disorder (PTSD) scores than those who did not (p < 0.001). Additionally,people who avoided the disaster area had significantly higher depression and PTSD scores than those who did not avoid thearea (p < 0.001). Those who directly witnessed the Seoul Halloween crowd crush had a significant difference in PTSD levels ineither group than those who experienced it indirectly (p = 0.005). There was a significant difference in PTSD scores in cases ofdirect damage or death of an acquaintance (p < 0.001). The Seoul Halloween crowd crush caused psychological damagethrough indiscriminate exposure to the public, and symptoms of PTSD appeared over a long period. It is crucial to provideessential resources for ongoing treatment and case management.

First experience in laparoscopic surgery in low and middle income countries: A systematic review

BACKGROUND Laparoscopic surgery has reduced morbidity and mortality rates,shorter post-operative recovery periods and lower complication rates than open surgery.It is routine practice in high-income countries and is becoming increasingly common in countries with limited resources.However,introducing laparoscopic surgery in low-and-middle-income countries(LMIC)can be expensive and requires resour-ces,equipment,and trainers.AIM To report the challenges and benefits of introducing laparoscopic surgery in LMIC as well as to identify solutions to these challenges for countries with limited finances and resources.METHODS MEDLINE,EMBASE and Cochrane databases were searched for studies reporting first experience in laparoscopic surgery in LMIC.Included studies were published between 1996 and 2022 with full text available in English.Exclusion criteria were studies considering only open surgery,ear,nose,and throat,endoscopy,arthro-scopy,hysteroscopy,cystoscopy,transplant,or bariatric surgery.RESULTS Ten studies out of 3409 screened papers,from eight LMIC were eligible for inclusion in the final analysis,totaling 2497 patients.Most reported challenges were related to costs of equipment and training programmes,equipment pro-blems such as faulty equipment,and access to surgical kits.Training-related challenges were reliance on foreign trainers and lack of locally trained surgeons and theatre staff.The benefits of introducing laparoscopic surgery were economic and clinical,including a reduction in hospital stay,complications,and morbidi-ty/mortality.The introduction of laparoscopic surgery also provided training opportunities for junior doctors.CONCLUSION Despite financial and technical challenges,many studies emphasise the overall benefit of introducing laparoscopic surgery in LMICs such as reduced hospital stay and the related lower cost for patients.While many of the clinical centres in LMICs have proposed practical solutions to the challenges reported,more support is critically required,in particular regarding training.

How Sense of Ritual in Tourism Impacts Tourists’Co-Creation of Tourism Experience Values:A Study Based on the Theory of Value Co-Creation

Establishing a sense of ritual within tourism consumption scenarios offers tourists the opportunity for interactive engagement.Drawing upon the value co-creation theory,this study constructed an influence mechanism model to examine tourists'active engagement in the process of co-creating tourism experience values.It employed Partial Least Squares Structural Equation Modeling(PLS-SEM)to empirically test the proposed hypotheses.The findings demonstrate that the model constructed in the present study exhibits robust reliability,validity,and explanatory power.The perception of the sense of ritual in tourism exerts a significant positive influence on tourists’co-creation of tourism experience values,thereby significantly enhancing both the communitas and flow experienced by tourists during their travels.Moreover,such communitas and flow can mediate the influence of the sense of ritual in tourism on tourists’co-creation of tourism experience values.This study contributes to advancing the current research on tourists’co-creation of tourism experience values and the sense of ritual in tourism,thereby providing theoretical foundations for cultivating a sense of ritual within tourism consumption scenarios.

The Tenth Anniversary of Free Trade Pilot Zones in China:Fundamental Experiences and Enhancement Strategies

Since the 18th National Congress of the Communist Party of China,the country has established 21 Free Trade Pilot Zones(FTZs),achieving significant pioneering results in reform and opening up and creating a strong demonstrative effect nationwide.The basic experience from a decade of FTZs includes:adhering to the centralized and unified leadership of the CPC Central Committee;combining top-level design with encouragement of grassroots innovation;leveraging the distinct characteristics and strengths of FTZs to form a differentiated development pattern;maintaining the integration of opening up with domestic reforms;using openness to drive reforms;and organically combining openness with national security assurance.Under the current and future new circumstances,China’s FTZs face new challenges and tasks.In accordance with the directives of the 20th National Congress of the Communist Party of China,an enhancement strategy for the FTZs needs to be implemented.This involves the following:First,accurately understanding and responding to the changing situation to create strategic opportunities.Second,shifting paradigms to implement innovation-driven strategies,using the new development pattern concept to guide the reform experiments and construction of the FTZs.Third,granting more autonomy to FTZs for reforms,pursuing progress while maintaining stability,and solidly advancing the reform experiments in the FTZs.Fourth,orderly expanding the opening up of the service sector and cautiously advancing the internationalization of the renminbi.Fifth,promoting innovative development in trade to build a strong trade nation.Sixth,establishing synergy with bilateral FTZs,Belt and Road cooperation,and national diplomatic strategies to enhance the linkage effect.

Acceptance and Experience of HIV-Infected Adolescents in Two Hospitals in Yaoundé

Introduction: Access to antiretroviral drugs has improved the survival of children infected with the Human Immunodeficiency Virus (HIV). As they reach adolescence, they are confronted with various constraints related to the infection and its treatment, in addition to those of the growth period they are going through. The main aim of the study was to assess the acceptance and describe the experience of HIV infection by infected adolescents but also to investigate the factors associated with good acceptance and a positive experience. Methodology: The cross-sectional analytic study concerned HIV-infected adolescents aged 15 to 19 followed up at the Chantal Biya Foundation-Mother and Child Centre (CME-FCB) and the Yaoundé University Hospital Centre (CHUY) between February 2020 and June 2020. The study saw participants complete a questionnaire containing socio-demographic data and assessing acceptance and experience with the infection. Data analysis was accomplished using Epi info software version 7.2.2.6. Results: One hundred and thirteen HIV-infected adolescents were included in the study. The sex ratio was 0.68 and the mean age was 17 years. More than half of the adolescents had a good acceptance and positive experience with the infection. Related factors were the adolescent’s perception of good health and participation in an association with other infected adolescents. Conclusion: Emphasizing the psychological and educational follow-up of infected adolescents and encouraging their participation in associations for adolescents living with HIV could reduce the consequences of poor acceptance and ensure a better transition to adulthood. .

“Luminous Conflicts:Navigating Architecture,Light,and Visitor Experience in Museums”:The Case of Yale Center for British Art

The architectural design of the YCBA(Yale Center for British Art)exemplifies Kahn’s exploration of light as a transformative element.However,preserving sensitive materials within the museum challenges the building’s original intent.The potential harm caused by light necessitates control measures,potentially compromising the intended luminous ambiance envisioned by Kahn.A comprehensive survey revealed a strong preference for natural light in the museum environment.Visitors appreciated the ethereal qualities and heightened engagement with exhibits facilitated by natural light.This research critically examines the balance between architectural vision,preservation imperatives,and visitor expectations,highlighting the museum space as a dynamic field of action.The architectural elements,interior configuration,lighting,and movement are in constant harmony and conflict.This investigation contributes to a deeper understanding of the relationship between architecture,light,the museum experience,and knowledge.It underscores the importance of considering preservation,design,and visitor preferences when balancing these elements in museums.

Practical Experience of Management of Urban Parks at Home and Abroad

By systematically reviewing the practical experience of management of urban parks at home and abroad,the advanced experience in organization,management system,operation mechanism and social participation were summarized,and the optimization and improvement measures for the construction and management of urban parks in Chengdu were proposed to provide reference for the high-level construction,high-quality experience and efficient management of urban parks in the construction of park city demonstration zone in Chengdu.

On the Morphological Perception and Virtual Experience of Digital Signage in Spatial Orientation Design

In space-oriented design,the guide logo is often combined with the overall visual style and spatial positioning of the space design through the designer’s whims.With the development of digital technology and the application of artificial intelligence,the practice of designers is reflected in the integration of digital information into media content and physical objects.Digital-oriented identity from touch,voice to eye sensing;static and dynamic conversion of multi-dimensional presentation,real to virtual possibilities are expanded,so that people experiencing in space can produce a variety of morphological perception and virtual immersion experience.

Psychological Experience of Mothers of Children with Sickle Cell Disease Followed at the Pediatric Department of Bouaké University Teaching Hospital

Introduction: Sickle cell disease has physical and emotional repercussions on the child and his family. The aim of this study was to describe the psychosocial experiences of mothers of children with sickle cell disease in order to improve the overall care of the child. Methods: This was a descriptive cross-sectional study carried out in the pediatrics department of Bouaké University Teaching Hospital from June to September 2023. It focused on mothers of major sickle-cell-affected children followed up in the pediatrics department of the Bouaké University Teaching Hospital. The variables studied were sociodemographic, psychological, social and economic. Results: Of the 40 mothers surveyed, 15% were not in school and 32.5% were unemployed. For them, sickle cell disease was of natural (genetic) origin in 90% and supernatural in 10%. They stated that the child had an average age of 36 months (extremes 7 and 108 months) when the disease was discovered. And 52% of them were satisfied with the way the disease was clearly and completely announced. Following the announcement, the questioned mothers said they had felt shock (35%), sadness (31.7%), guilt (23.3%) and discouragement (10%). Anxiety and depression were experienced by 77.5% and 22.5% respectively. In 60% of cases, they stated that the disease was incurable, and the outcome was fatal in 2.5% of cases. The child’s illness was a source of problems in the home in 25% of cases, represented by arguments in 92% and divorce in 8%. In 97.5% of cases, the mother told her family and friends about the child’s illness. In 90% of cases, the mother and child benefited from psychological support from family and friends. Conclusion: Sickle cell disease is a serious illness with a psychological and social impact on mothers. We recommend psychological support for mothers from the moment of diagnosis and throughout follow-up.

Experiences of Mothers on the Utilization of Elimination of Mother to Child Transmission of HIV Services at Mtendere Clinic, Lusaka

Introduction: Acquired immunodeficiency syndrome is one of the leading causes of mortality among women of reproductive age and Mother to Child Transmission of Human immunodeficiency virus is still a challenge affecting many countries. Globally, an estimation of 180,000 children under 15 years acquire the Human immunodeficiency virus every day, and more than 90% of those infections are due to Mother to Child Transmission. The study sought to explore the experiences of mothers on the Elimination of Mother to Child Transmission-HIV services at Mtendere Clinic, Lusaka. Materials and Methods: Qualitative interpretive phenomenology study design was employed using in-depth interviews to collect data from a sample that was selected using purposive sampling technique. Thirteen participants were recruited, and these were HIV-positive mothers at least between the ages of 15 and 49 years and enrolled in the Elimination of Mother To Child Transmission-HIV program. The in-depth interviews were audiotape recorded and transcribed verbatim. Data was analyzed using thematic method. Findings: Three main themes that emerged are;living with HIV, support system and barriers to utilization of Elimination of Mother To Child Transmission-HIV services. Most of the participants expressed having acquired knowledge from the program, and received counselling and support from spouses, family as well as health personnel at Mtendere health facility which culminated into a positive experience and enhanced their uptake of the Elimination of Mother to Child Transmission-HIV services. However, barriers to service utilization were identified and these included fear of stigma, negative attitudes from health workers, long waiting times, lack of support and lack of transport to the health facility. Conclusion: Interventions such as community awareness campaigns on Elimination of Mother To Child Transmission-HIV, male involvement and implementing mother-to-mother peer support strategies in Elimination of Mother To Child Transmission-HIV service utilization should be prioritized so as to alleviate stigma and enhancing a positive experience for these mothers thus reducing on the Mother to Child HIV Transmission burden and mortality rates.

Community Caregivers’ Experiences and Programmatic Strategies to Improve Active Case Finding in Community Tuberculosis Care in Botswana 2016-2021

Background: The community tuberculosis care program was started to reduce the impact of TB and increase successful treatment outcomes, thus contributing to meeting WHO targets on TB. According to the Botswana Ministry of Health, community tuberculosis care was introduced with the main goal of reducing tuberculosis-related morbidity and mortality among communities through the expansion of direct observed therapy and community involvement to community settings. The community caregivers were to support tuberculosis patients throughout their treatment period until they were cured or had completed their treatment. Settings: Two major cities of Botswana, Francistown and Gaborone, with more than twenty-two health clinics offering tuberculosis care. Objective: To investigate community caregivers’ experiences and identify programmatic strategies to improve active TB case findings under the community TB care (CTBC) program in Botswana during 2016-2021. Methods: We adopted a descriptive qualitative research design, followed by convenience purposive sampling. We obtained consent and interviewed 40 participants who met the inclusion criteria, 16 out of 73 in Gaborone and 24 out of 38 from Francistown. Results: We interviewed 40 caregivers with a mean age of 43.4 years. Accepting the caregiving role was identified as the main experience by more than two thirds of the caregivers. While at least more than two-fifth felt obligated to care for the patient at home due to personal relations. More than half of the respondents found caregiving difficult or frustrating due to some challenges encountered during the caregiving role. Behavioral modifications were suggested under different subthemes as strategies to improve active case finding. [-rId13-]Conclusion: Acceptance was the major experience in CTBC. Intensification of known programmatic strategies was suggested by caregivers to improve tuberculosis active case finding in CTBC.

Mothers’challenges and experiences of children with cerebral palsy:a qualitative meta-synthesis

Objective:To examine what challenges and experiences a mother faces in caring for children with cerebral palsy(CP).As the main caregiver of children with CP,mothers are under multiple pressures.Even though mothers’challenges and experiences of children with CP will affect their quality of life and the rehabilitation of the children,little is known about their challenges and experiences during the whole care.Methods:A qualitative meta-synthesis was conducted to extract and analyze qualitative research from the PubMed,CINAHL,PsycINFO,Web of Science,Ovid and MEDLINE databases.Thirteen articles were selected and analyzed using thematic syntheses.Results:From 2522 screened abstracts,84 texts were reviewed,and 13 studies met the inclusion criteria.Mothers’challenges and experiences of children with CP include 4 themes,both positive and negative.Conclusions:The mothers of children with CP suffer from physical burden,as well as psychological pressure,in the care experience;social and healthcare support are their main challenges.Interventions to help them face the difficulties and adapt to the role of caregivers as soon as possible should target multiple aspects in order to maximize effectiveness,to promote the healthy growth of children with CP.

Overcoming Adversity:The Severe COVID-19 Illness Experience

This viral outbreak of the novel SARS-CoV-2 has profoundly disrupted lives globally and has placed unparalleled burdens on individual physical and psychological health.It is imperative to comprehend the psychological journey of COVID-19 patients to provide them with effective care.This study aimed to explore the psychological illness experience of severe COVID-19 survivors from the first symptoms,to hospitalization,recovery,and post-discharge adjustment.Semi-structured interviews were conducted from November 2022 to April 2023,with 30 Romanian former COVID-19 patients.Thematic analysis of transcribed interviews identified four major themes:(1)a distant threat;(2)the tipping point;(3)the turning point;and(4)readjustment and growth.Some participants faced denial or uncertainty early on,misattributing symptoms and delaying seeking care.Hospitalization as a last resort brought anxiety,isolation,and closer confrontations with mortality perception.As symptoms improved,and participants received supportive care from both healthcare professionals and family members,hope and optimism appeared.Despite health improvements and feelings of safety,lingering anxiety persisted.Post-discharge adjustment involved managing lasting effects and selectively resuming activities.For some of the participants,reflection afterward prompted greater self-understanding,empathy and connection,and motivation for self-care.The results have implications for healthcare practitioners,policymakers,and researchers.