To characterise recent trends in retractions of publications in the psychiatric literature. We examined the Retraction Watch Database for publications with the subject term ‘psychiatry’ between 2003 and 2023. We then characterised publication type, subject, country of origin, reason for retraction and time between publication and retraction.

A total of 315 psychiatry publications were retracted; the annual number and rate (relative to publications) rose steadily across the study period. The median number of days from publication to retraction was 643 (interquartile range 223.0–2966.0). Reasons for retraction were unclear in 20 (6.3%) cases only; most commonly they were attributed to data error (42.5%) or problems relating to peer review (11.4%) – the period between publication and retraction was particularly long for the latter studies (median 3082 days, interquartile range 575–3364). A total of 4.4% were retracted because of falsification, and 6.32% because of plagiarism. Retracted items frequently focused on mood disorders (24.4%), psychosis (14.9%) and neurodevelopmental disorders (13.7%).

Clinicians and policy makers rely on academic literature, but should be aware of the ethical, legal, business and professional dilemmas often encountered, yet not reported, in the process of considering retractions of unreliable data. Contested and unreliable findings may persist in the scientific record, with potential negative consequences for evidence based-care and policy, including the erosion of public trust.

Spiritual care is a key component of holistic palliative care, particularly within Muslim communities where faith plays an important role in shaping illness experiences. This study aimed to explore the perspectives of Muslim family caregivers on spiritual care in palliative settings.

A qualitative descriptive study was conducted among 12 Muslim family caregivers of patients receiving palliative care in Kuantan, Malaysia. Participants were recruited using purposive and snowball sampling. Data were collected through semi-structured interviews and analyzed using thematic analysis to explore patterns and meanings related to spiritual caregiving.

Three major themes emerged: (1) understanding spiritual care as maintaining connection with God through religious practices, (2) caregivers’ roles in providing holistic support, facilitating spiritual engagement, and offering emotional reassurance, and (3) challenges in delivering spiritual care, including patients’ health limitations, practical constraints, and emotional burden. Spiritual care was perceived to enhance patients’ sense of peace, acceptance, and coping.

Findings highlight the central role of family caregivers in sustaining spiritual well-being in palliative care. In the Malaysian context, integrating culturally informed spiritual care into nursing practice and supporting caregivers as partners in care may strengthen holistic and patient-centered outcomes.

Children and young people living with CHD are at increased risk of neurodevelopmental, psychosocial, and educational challenges. Educational professionals play a key role in supporting these pupils but often receive limited condition-specific information, and little is known about how communication between healthcare services and schools can be improved. This study explored educational professionals’ experiences of supporting pupils with CHD and opportunities to strengthen collaboration between paediatric cardiology services and schools.

Semi-structured interviews were conducted with educational professionals (n = 15) from mainstream primary, post-primary, and specialist schools in Northern Ireland. Interviews explored experiences of supporting pupils with CHD, communication, information needs, and training requirements. Data were analysed using reflexive thematic analysis. Findings were complemented by a pre–post evaluation of an online CHD teacher training webinar.

Four interrelated themes were identified: (1) Desire for structured communication; (2) need for individualised information relating to the educational environment; (3) managing uncertainty in the classroom; and (4) striving for inclusivity via flexibility. Participants relied on parents for clinical information and reported limited direct communication with healthcare professionals. Teachers requested practical, child-specific guidance to support classroom decision-making. Webinar findings demonstrated improved knowledge and confidence following training.

Educational professionals are committed to supporting pupils with CHD but often do so with limited clinical guidance and fragmented communication pathways. Strengthening communication between paediatric cardiology services and schools, alongside practical, child-specific resources, may reduce uncertainty, improve teacher confidence, and promote more consistent educational support for pupils with CHD.

University students with celiac disease (CD) are considered a vulnerable group. The number of qualitative studies examining the challenges faced by this group is limited. The aim of the study was to analyse the social and economic impacts of the CD among university students diagnosed with CD who live away from their families.

A qualitative phenomenological design was utilised. Semi-structured, face-to-face interviews were conducted. Data were analysed using Colaizzi’s seven-stage strategy.

Türkiye.

Nine university students (mean age: 22 ± 1·6 years) diagnosed with CD.

The students were living independently at home or dormitory in Konya. The qualitative analysis yielded six main themes: ‘encountering the disease’, ‘adapting to the disease’, ‘living with the disease’, ‘impact on relationships’, ‘economic burden’ and ‘patient expectations’. Participants reported significant challenges regarding social isolation, lack of societal awareness (confusion between gluten and glucose) and food insecurity within university cafeterias and dormitories. The high cost of gluten-free products was identified as a major economic barrier, with the student described CD as a ‘disease of the wealthy’.

This study highlights that CD is not merely a clinical condition but a complex lifestyle challenge affecting all aspects of a student’s educational and social life. Recognising CD from this holistic perspective is crucial for developing effective interventions, including targeted psychological counselling and institutional support mechanisms.

Pragmatic trials involve patient recruitment, intervention delivery, and data collection leveraging usual systems and processes of care. Yet pragmatic does not mean easy, such that enacting pragmatic trial protocols requires considerable effort to engage patients and practice members. Home versus Office versus Telehealth for Medication Enhanced Recovery (HOMER) was a national pragmatic trial testing comparative effectiveness of office, home-based, and telehealth induction of medications for opioid use disorder (MOUD). Research implementation practice and patient liaisons (RIPPLs) were employed to support pragmatic trial conduct across 100 participating practices nationwide. The objective of this paper is to report on RIPPL roles and impact.

Fourteen RIPPLs were matched to practices based on geographic proximity, research network membership, and caseload. Study records, field notes, and a qualitative survey were used to describe RIPPL processes and experiences and to assess impact.

RIPPLs had backgrounds in research coordination, project management, primary care delivery support, and adult learning. RIPPL activities supported practice motivation, follow-through, and protocol fidelity, and included several elements of practice facilitation. RIPPLs provided real-time feedback to the research team on opportunities for research protocol adaptations. Impact of the RIPPLs included protocol adaptations to decrease practice burden and improve ease of patient participation, regular eligible criteria fidelity monitoring, data completeness, and quality, and educating clinicians and staff on MOUD delivery.

RIPPLs can effectively support pragmatic trial conduct in primary care. HOMER RIPPLs enabled the research protocol to be iteratively more pragmatic (both feasible and aligned with the primary care context) while maintaining rigor and fidelity of intervention implementation.

Family caregivers play a fundamental role in addressing the spiritual needs of patients receiving palliative care, particularly in cultures where spirituality is deeply embedded in daily life. This study explored how Hindu family caregivers perceived spiritual care, the ways they incorporated spiritual practices into caregiving, and the challenges they experienced while supporting relatives with palliative care needs.

A descriptive qualitative study was undertaken with 12 Hindu family caregivers recruited through purposive and snowball sampling in Kuantan, Malaysia. Individual semi-structured interviews were conducted, and the data were analyzed using Braun and Clarke’s thematic analysis to identify recurring patterns across participants’ experiences.

Three interconnected themes emerged: Perceiving Spiritual Care as a Source of Meaning and Hope, Integrating Spiritual Practices into Family Caregiving, and Navigating Emotional and Practical Challenges in Spiritual Caregiving. Participants described spiritual care as fostering inner peace, hope, and acceptance through practices such as prayer, temple worship, chanting, and family support. Caregivers viewed themselves as facilitators of both spiritual and emotional well-being while simultaneously facing emotional exhaustion, caregiving demands, and limited access to spiritual support services.

The findings demonstrate that spiritual care is a shared responsibility between healthcare professionals and family caregivers in palliative care. Recognizing and supporting culturally grounded spiritual practices may strengthen holistic nursing care, promote family-centered care, and enhance the quality of palliative services for culturally diverse populations.

Access to depression care can be improved by overcoming a combination of supply-side barriers and demand-side factors.

To describe the systematic development of a community-based intervention to improve uptake of, and adherence to, a psychosocial treatment for depression delivered by trained primary healthcare staff in Goa, India.

This mixed-methods study included five steps: Step 1, Synthesis of existing evidence by conducting relevant systematic reviews and a review of public health programmes in India; Step 2, In-depth interviews with community stakeholders (n = 35); Step 3, Consultation workshops with community stakeholders (n = 19) and primary healthcare staff (n = 34); Step 4, Triangulation of findings from the preceding steps; and Step 5, Content development for the intervention (e-course for training and the community intervention toolkit for delivery).

Overall, 20 strategies to enhance help-seeking and 5 strategies to improve adherence were identified to constitute the intervention. The community-based intervention is organised into four domains (Learn, Inform, Engage and Follow-up), with self-care integrated throughout the intervention. This intervention is designed to be delivered by a community volunteer who is motivated to cater to the communities’ needs. The community volunteer is trained to deliver the intervention via a blended approach, an e-course and in-person one-on-one learning support by a coach, who later acts as a facilitator during the intervention delivery phase.

The systematic method enabled the development of a comprehensive intervention with contextually appropriate delivery strategies. The effectiveness of the intervention is presently being tested as part of a Hybrid Type II Implementation-Effectiveness randomised controlled trial. If found effective, the intervention has the potential to be a low-cost and sustainable opportunity to improve demand and adherence to depression treatment while also providing essential social, emotional and logistical support during the recovery process.

The DiRePal model understands dignity at the end of life as relational and temporal, shaped by recognition, narrative continuity, and prudent listening. This study explores how patients with advanced cancer, informal caregivers, and physicians understand and experience dignity, providing empirical foundations for the model.

A multicentre qualitative study comprised six semi-structured focus groups involving oncology patients (n = 10), informal caregivers (n = 14), and pulmonology/oncology physicians (n = 15), conducted via a secure digital platform between April and November 2025 with IQVIA Portugal. Transcripts underwent reflexive thematic analysis, with independent initial coding, discussion-based consensus, and researcher reflexivity. Given participants’ clinical fragility, member checking was not undertaken; credibility relied on triangulation, thick description, and an audit trail.

Six themes emerged: personal understanding of dignity, narrative flexibility, negotiating technical rationality and relational care, temporal sensitivity, professional reciprocity, and digital/structural integration. Dignity was inseparable from personal recognition, interpersonal gestures, and listening within time-constrained encounters. Physicians’ emotional overload and insufficient institutional support compromised their dignity and, indirectly, patients’; caregivers frequently rendered themselves invisible. Patients associated dignity with respect, autonomy, and relief of suffering, while depersonalised or fragmented care eroded it.

These findings ground a relational–temporal account of dignity in reciprocal recognition between patients, caregivers, and clinicians across shared, unevenly experienced time. Listening, temporal prudence, and recognition of clinicians’ vulnerability should be clinical priorities, alongside cautious, relationally framed integration of digital tools.

This study aimed to explore how individuals with complex multimorbidity perceive and experience the management of their health in everyday life and healthcare encounters.

Patients with two or more health conditions may be challenging for general practitioners (GPs) who must provide adequate treatment(-s) in a healthcare system structured mainly around single-disease models. For patients, the lived experience of this multimorbidity can be demanding, as it often involves managing multiple appointments, medications, and medical advice alongside everyday life. This situation may be particularly challenging for patients who live with multiple physical and mental health conditions.

Semi-structured individual interviews with eight individuals with complex multimorbidity living in Denmark. Analysis was guided by thematic analysis.

The analysis resulted in two main themes. First, ‘Multiple diagnoses – not multimorbidity’ describes how the participants did not expect overall continuity across diagnoses but appreciated recognition of the cumulative burden of multimorbidity. They expected continuity within each speciality and developed agentic strategies to achieve this. Some were successful; others were not. Second, ‘Managing treatment and illness in everyday life’ describes how the participants navigated tensions between medical recommendations and personal priorities as they deliberately pursued valued activities at the expense of their long- or short-term health. A professional lifeline, was a significant support for the participant. This person was often the GP. These findings underscore the active role of patients and the GP’s role in recognizing their resources to develop patient-centred care that is responsive to and realistic for the individual patient.

This article examines how general practitioners (GPs) in Italy and Spain manage patients with mental health needs in daily primary care practice, and how their discretionary choices shape the substantive reach of universal access to care.

Modern healthcare systems in Italy and Spain formally guarantee universal access to primary care. However, mental health services in primary care reveals persistent gaps between this normative principle and everyday practice. Drawing on Lipsky’s Street-Level Bureaucracy (SLB) theory, GPs are understood as frontline professionals whose discretion operates within, and is shaped by, conditions of resource scarcity, time pressure, and limited access to psychosocial services.

A qualitative cross-national design was employed, including 42 semi-structured interviews with 20 GPs and 22 patients with mental health needs in Spain and Italy, conducted between June and November 2022. Data were analysed through an inductive-deductive coding process.

Two principal patterns of discretionary practice emerged. First, GPs exercise discretion differentially by patient age: investing in psychoeducation, counselling, and motivational support with younger patients, while moving more rapidly towards pharmacological management with older patients. This age-based categorization operates as a coping strategy that shapes patients’ candidacy for psychosocial versus pharmacological care. Second, GPs actively normalize psychological distress as a counter-medicalization strategy, primarily with younger patients. Despite significant institutional differences between the two healthcare systems, these patterns converge across Italy and Spain, suggesting they reflect structural features of the SLB role under resource scarcity rather than system-specific dynamics.

This study aimed to explore patient perspectives on standardized screening for social needs within the context of primary care in Canada.

Social determinants of health significantly influence patient health outcomes. While standardized screening for patient social needs has gained momentum, patient perspectives on the utility of said screening, particularly within the Canadian context, remains underexplored.

Semi-structured interviews were conducted with participants aged 18 and older (n = 195), recruited from a larger multi-site study, using purposive maximum-variation sampling across four Canadian provinces (Ontario, Manitoba, Saskatchewan, and Newfoundland and Labrador). Questions asked during the interviews focused on financial well-being (ability to afford basic needs), housing status, social well-being, transportation, ability to afford utilities, and employment status. These interviews followed another study component where participants were asked to complete a short social needs questionnaire (the SPARK tool). Data was analysed using a thematic content analysis. Five themes were generated, including (1) openness to screening for social needs, (2) value in healthcare providers knowing patients’ social needs, (3) overall scepticism and trust/distrust in the healthcare system and professionals; (4) potential for harm; (5) meaningful engagement and provider training on social needs.

Participants were generally comfortable being asked about their social needs but stressed the importance of privacy, especially regarding financial well-being (ability to afford basic needs and extended health-care related expenses), as well as clear usefulness of the data and building physician-patient trust. Participants were generally open to social needs screening, though discomfort emerged when discussing race, employment, housing, and financial well-being, largely driven by concerns about privacy, trust, and data use. These findings highlight the importance of transparent communication, robust data governance, and explicit informed consent to support acceptable and effective implementation of social needs data collection.

To explore general practitioners’ and radiologists’ expectations of ankle radiography for chronic complaints.

Ankle complaints are a frequent reason for general practitioner (GP) consultations and ±20% of ankle radiography requests are for chronic complaints. It is unknown what GPs and radiologists expect from ankle radiography for chronic complaints.

A qualitative study was conducted with GPs and radiologists. Semi-structured focus group discussions were held online or live until data saturation was reached. The topic guide included: reasons for radiography, content of requests and reports, and the impact of results on patient management. The recorded interviews were transcribed and subsequently coded inductively in Max-QDA.

Five focus groups with 24 GPs and 3 focus groups with 11 radiologists were held. Radiologists focussed more on urgent diagnoses that were less considered by GPs for their rareness. GPs indicated to request ankle radiography more often for patient-, physician-related and organizational reasons than for medical indications. Radiologists expect requests to include a specific question accompanied by applicable clinical information including a specific pain location. GPs in their turn expect a short conclusion of the report answering their question.

GPs and radiologists have different expectations of radiography for chronic ankle complaints. Important in GPs’ rationale behind requesting ankle radiography for chronic complaints are non-medical factors and prevalence of ankle disorders, while radiologists also focus on more rare diagnoses than GPs. More research on the added value and accuracy of ankle radiography for chronic complaints in primary care settings is necessary.

To examine school food service directors’ (FSD) perceived barriers and facilitators to increase scratch cooking as a strategy to reduce ultra-processed foods (UPF) in school meals.

A mixed-methods study design was used, incorporating semi-structured interviews and surveys. A Community Advisory Board provided input on the study design, interview guide and interpretation of results. Interviews were audio-recorded, transcribed verbatim, de-identified and double-coded. A hybrid thematic analysis was conducted, integrating emergent and a priori themes based on the socio-ecological model.

California San Joaquin Valley, USA, from January to June 2024.

Twenty FSD were randomly selected from a stratified sample of San Joaquin Valley school districts, categorised by locale (rural/urban) and whether they received a California supplementary funding award requiring at least 40 % of school meals to be freshly prepared.

Key barriers to increasing scratch cooking in school meals included labour costs, staff shortages, inadequate kitchen infrastructure and food procurement challenges, with many districts relying on UPF. State and federal funding supported scratch cooking, but limited kitchen space and funding uncertainty hindered sustainable changes. While some FSD identified student preferences as a challenge, others described successful strategies to engage both students and parents to increase acceptance of scratch-cooked meals and boost participation in school meals.

Given the current momentum at the federal, state and local levels to reduce UPF in school meals, this study provides timely insights to guide policies and practices that support the transition from UPF to scratch-cooked meals.

Community-based programmes exist to support older people and their caregivers remaining out of hospital on discharge. Little is known about how consumers of a community-based programme perceive the different components provided during community TCP.

To explore how older people and caregivers perceive how a transition care programme (community-based TCP) influenced older people staying at home following hospital discharge. Secondly, to assess if experience of TCP could be explained by the person-centred care model (PCC).

Both (i) older people and (ii) caregivers were interviewed at a single metropolitan health setting. Experiences leaving hospital, the challenges, and the TCP components identified that supported or hindered consumers to remain at home were explored. Thematic content analysis was used to examine the two consumer groups separately. Secondarily, a mapping exercise assessed if PCC could be identified during analysis.

Fifteen interviews (older people (n = 8), caregivers (n = 7)) were conducted between April 2019 and January 2021. There were seven older people themes including, (i) Limited understanding of TCP content, (ii) Things are different once home, (iii) Developing action plans for continence care, (v) Developing action plans for walking. Three caregiver themes including, (i) Challenges with the discharge home on many fronts, (ii) Getting the right resources in the right way, were found. Most thematic sub-groups could be mapped to PCC constructs (6/9 (67%) caregiver, 5/9 (56%) older people). Health and social care resources are acknowledged, particularly equipment and information access, however gaps exist in how TCP fully aligns with PCC, according to consumers.