Background: Used primarily as a pedagogical evaluation tool for didactic teaching and skill development, reflective practice (RP) for its own merits is poorly understood. This study aimed to systematically review the literature regarding the role of group RP in fostering empathy, wellbeing, and professionalism in medical students. Methods: Electronic searches of empirical studies published between 1 January 2010 and 22 March 2022 from Medline, Embase, and PsychINFO databases were conducted. Empirical studies of any design (qualitative or quantitative) which included RP (1) involving medical students; (2) with a focus on fostering empathy, or professionalism, or personal wellbeing; and (3) provided in a group setting were included. Duplicates, non-English articles, grey literature and articles using RP to examine pedagogy and specific technical skills were excluded. Both authors screened articles independently to derive a final list of included studies, with any discrepancies resolved by discussion, until consensus reached. Articles were rated for methodological quality using the Attree and Milton checklist for qualitative studies; the Oxford Centre for Evidence-Based Medicine criteria, and the Alberta Heritage Foundation for Medical Research Standard Quality Assessment Criteria for quantitative studies. Results: Of 314 articles identified, 18 were included: 9 qualitative; 4 quantitative and 5 mixed methodology. Settings included United States (6), United Kingdom (3), Australia (3), France (2), Taiwan (2), Germany (1), and Ireland (1). Themes were (i) professionalism: bridging theoretical paradigms and practice; (ii) halting empathy decline; (iii) wellbeing: shared experience. Additional themes regarding the “successful“ delivery of RP groups in facilitating these outcomes also emerged. Conclusions: This first systematic review of group RP in medical students shows that RP may bring theory to life in clinical dilemmas, while fostering collegiality and mitigating against isolation amongst students, despite the absence of studies directly examining wellbeing. These findings support the value of RP integration focusing on emotive and humanitarian processes into contemporary medical education for medical students. Systematic review registration: PROSPERO CRD42022322496.

Objectives: The objective of this systematic review was to synthesise literature pertaining to patient and family violence (PFV) directed at Intensive Care Unit (ICU) staff. Design: Study design was a systematic review. The data was not amenable to meta-analysis. Data Sources and Review Methods: Electronic searches of databases were conducted to identify studies between 1 January 2000 and 6 March 2023, limited to literature in English only. Published empirical peer-reviewed literature of any design (qualitative or quantitative) were included. Studies which only described workplace violence outside of ICU, systematic reviews, commentaries, editorials, letters, non-English literature and grey literature were excluded. All studies were appraised for quality and risk of bias using validated tools. Results: Eighteen studies were identified: 13 quantitative; 2 qualitative and 3 mixed methodology. Themes included: (i) what is abuse and what do I do about it? (ii) who is at risk? (iii) it is common, but how common? (iv) workplace factors; (v) impact on patient care; (vi) effect on staff; (vii)the importance of the institutional response; and (viii) current or suggested solutions. Conclusions: This systematic review demonstrated that PFV in the ICU is neither well-understood nor well-managed due to multiple factors including non-standardised definition of abuse, normalisation, inadequate organisational support and general lack of education of staff and public. This will guide in future research and policy decision making.

Objectives: This study aims to explore the feasibility and impact of Schwartz Rounds® led by psychiatrists/mental health professionals in an urban Australian public hospital setting and to develop strategies for optimising participants’ experiences. Methods: Being a mixed-methods study collecting qualitative and quantitative data through post-Rounds evaluation surveys, this study thematically analysed responses from 105 participants attending four consecutive monthly Rounds between February and May 2023 to assess the perceived benefits and challenges of Schwartz Rounds. Results: Respondents highly valued the Rounds and felt cared for by the healthcare organisation. Themes related to perceived benefits included (i) Connectedness and shared experience; (ii) Understanding other professionals; (iii) Normalisation of emotional distress, validation and a safe space for vulnerability; and (iv) Fostering authenticity and humanitarian aspects of healthcare. Challenges included (i) Fear of exposure and judgment; (ii) Emotional discomfort; (iii) Unfamiliarity with reflection; and (iv) Safety concerns. Conclusions: This study suggests acceptability and feasibility of implementing Schwartz Rounds within an Australian public health setting, particularly when facilitated by skilled mental health professionals. The outcomes provide preliminary support for the use of group interventions to enhance staff collegiality and culture in healthcare settings, thereby addressing critical needs for health professional wellbeing.

Despite the growing number of older adults engaging in voluntary migration, there is a lack of knowledge about their psychological well-being in cross-cultural contexts. This cross-sectional study investigated factors associated with psychological well-being among older Chinese migrants residing in Chiang Mai, Thailand. Between December 2024 and February 2025, 204 Chinese migrants aged 60 and above who had resided in Chiang Mai for at least six months participated in a survey in Chinese. The survey measured sociodemographic and psychosocial factors including perceived health, income, marital status, number of co-residing family members, social support, acculturative stress, sense of mastery, and loneliness. Multiple regression analysis showed that gender (female) (p = 0.006), better perceived health status (p = 0.021), higher income (p = 0.007), more co-residing family members (p = 0.037), a greater sense of mastery (p = 0.009), and lower levels of loneliness (p < 0.001) were each independently associated with better psychological well-being. In contrast, neither general family support nor acculturative stress was a statistically significant predictor. These findings highlight the significant roles of financial security, family co-residence, personal empowerment, and social connectedness in shaping overall well-being. Strategies to improve psychological well-being in this population should focus on strengthening emotional connectedness, supporting the development of meaningful family and social relationships, and supporting economic stability.

In China, preschool teachers significantly influence the development of young children aged 3–6 years. Understanding their mental health and its associated factors is imperative to informing policies, optimizing their mental well-being, and supporting their job performance. This study aimed to investigate the factors contributing to anxiety symptoms among preschool teachers. A sample of 393 Chinese preschool teachers (279 women, 114 men), aged 21–56, completed online questionnaires collecting their sociodemographic and work-related information and assessing anxiety symptoms, interpersonal difficulties, personality traits, perceived stress, resilience, and inner strength. Pearson correlation and multiple linear regression analyses identified significant predictors of anxiety symptoms. The prevalence of anxiety symptoms among the studied cohort was found to be 12.2%. Statistically significant factors that positively correlated with anxiety symptoms included objective work-related stress (B = 0.149, p < 0.001), interpersonal difficulties (B = 0.921, p < 0.001), perceived stress (B = 0.108, p = 0.001), and neuroticism (B = 0.071, p = 0.002). These findings highlight the urgent need for measures to reduce work-related stress and anxiety. However, when negative mental health factors were included, the effect of positive psychological factors became nullified. Positive mental health might have a moderating role in a negative mental health outcome such as anxiety. Therefore, further research is required to understand the impact of positive mental health factors more clearly.

Background: The metabolic syndrome (MetS) is a collection of risk factors for cardiovascular disease and type-2 diabetes, that includes central obesity, hypertension, hyperglycaemia and dyslipidaemia. An audit indicated inadequate MetS screening in an Australian psychiatric recovery service.Objectives: We aimed to improve MetS screening, identification and intervention by offering streamlined lifestyle education, clinical reviews and discharge planning. This pilot program prioritized holistic, culturally-sensitive, patient-centric, and trauma-informed approaches to enhance metabolic health outcomes.Methods: A Metabolic Clinic was piloted in two psychiatric rehabilitation cottages (n=35), which involved disciplines of dietetics, exercise physiology, diversional therapy, occupational therapy, peer workforce, social work, clinical psychology, pharmacy, nursing and medical. Another cottage (n=15) was assigned as the comparison and received standard care. A 12-week, 3-times-per-week lifestyle and behavioral program, called MetFit, was devised and offered to those identified at screening for the treatment cottages. Outcome measures were feasibility measures, the five metabolic parameters (waist circumference, blood pressure, fasting serum triglycerides, high-density lipoprotein, and glucose), functional measures, and a meal questionnaire.Results: The treatment cottages had qualitative advantages in screening and identifying MetS. Of four enrolled consumers in MetFit, an improvement of triglycerides (p=0.08), squats (p=0.02), and push-ups (p=0.07) was observed. Major challenges of enrolment included an overall lack of acknowledgment of its importance, poor motivation of consumers and resources limitation.Conclusions: The one-stop provision of groups, peer support and inpatient pathway with multidisciplinary team-integration was generally accepted by consumers and the MDT and has iteratively demonstrated the urgent need for consumer-centered physical care and a cultural shift to foster collaboration within a psychiatric service.