Aim: To explore how the expression of positive emotions during the interaction between patients and providers can cultivate the patient‐provider relationship.Design: We conducted a realist review guided by the Realist and Meta‐narrative Evidence Syntheses: Evolving Standards.Methods: We systematically searched CINAHL, MEDLINE, PsychINFO and Scopus from inception to March 2019. Study selection and data extraction were performed blinded in pairs. From 3146 abstracts blinded in pairs, 15 papers were included and analysed. From each included paper, we extracted contexts, mechanisms and outcomes that were relevant to answer our research questions, creating a configuration between these elements (CMO configuration).Results: Our findings suggest that in the contexts of person orientation and positive outlook, patient‐provider relationships improve by communication conveying and eliciting positive emotions. We found six underlying mechanisms for this that form either direct or indirect pathways between the context and the outcome.

Background: Patients with inflammatory bowel disease report multiple symptoms, but the relationships among co-occurring symptoms are poorly understood. This study aimed to examine the prevalence of symptoms and explore symptom clusters and possible associations between symptom clusters and socio-demographic and clinical variables in patients newly diagnosed with inflammatory bowel disease. Methods: The IBSEN III study is a prospective population-based inception cohort of patients with inflammatory bowel disease. This study used patient data from the three largest hospitals in the study catchment area. The Memorial Symptom Assessment Scale was used to assess the prevalence of symptoms. Symptom clusters were identified using principal component analysis. Possible associations between socio-demographic and clinical variables and symptom cluster membership were estimated using regression analysis. Results: Of the 573 patients (age, ≥18 years) diagnosed with inflammatory bowel disease, 350 (61.1%) completed the questionnaire (responders). Eleven symptoms were reported by >50% of the responders. The three most prevalent symptoms were bloating (84%), drowsiness (81%), and lack of energy (81%). Three symptom clusters were identified: psychological (56% of the patients), impaired energy (28%), and physical (16%) clusters. Multinomial regression analysis revealed that vitamin D deficiency was significantly associated with the impaired energy cluster (odds ratio=2.49, 95% confidence interval [1.00-6.2], p=0.05). Conclusions: We found high symptom prevalence in patients newly diagnosed with inflammatory bowel disease. Three distinct symptom clusters were identified, and the psychological cluster includes >50% of the patients. Vitamin D deficiency is the only factor associated with cluster membership, namely the impaired energy cluster.

International research in the past 2 decades has suggested that intimate partner violence among adolescents is a significant public health concern. Both are commonly understood as a pattern of behavior that is intended to establish and maintain control over a partner. Recently, a plethora of digital applications and social networking sites have presented new opportunities for adolescents to initiate, develop, and conduct intimate partner relationships. However, research exploring adverse experiences related to digital interactions in the context of adolescents’ intimate partner relations is limited. This scoping review aims to identify and describe the nature and range of difficult experiences in the current published research relating to digital interactions between intimate adolescent partners, from digitalized violence to less severe adverse experiences. Systematic and manual searching resulted in the identification of 1,876 potential articles for inclusion in this review. A total of 18 articles were ultimately included based on the following predefined inclusion criteria. The article must: (a) be an empirical study that has used quantitative, qualitative, mixed, or review methods; (b) include young adolescents and adolescents of 18 years or younger as participants; (c) include accounts of young adolescents and young people’s experiences and/or consequences of digital interactions within intimate partner relationships; and (d) be published in a peer-reviewed journal. Examples of less severe experiences could be different kinds of digital harassment, such as electronic intrusiveness, excessive texting, insults, unpleasant messages, and the spreading of rumors. Other adverse experiences related to digital interactions included being controlled by a partner, verbal abuse, experiences of aggression, sexual pressure, and coercion. Common consequences of adverse experiences included emotional and mental health-related difficulties, self-restricting behaviors, relationship difficulties, and risk behaviors.

Aim: The study includes health‐related quality of life for people in Norway with multiple sclerosis who live at home and are in a wheelchair (N = 6). The purpose is to show how they experience living with a chronic disease such as MS and how they perceive their own situation. How they value their own health and what leads to positive consequences is central to this study.Design: The study has a qualitative design to show what health‐related experiences they had while living with MS.Method: The interviews were conducted in their home and later transcribed. An interview guide with open‐ended questions was used. The transcribed material was analysed with a thematic analysis.Results: Key themes were being free and independent, threat to the self and one's identity, and adaptation to MS. Free and independent in everyday life was essential for all the informants. Being dependent on others for basic needs was something they sought to avoid. Adapting to the new situation of changing roles was a challenge that required a lot of them.

Many employees in schools and kindergartens fail to report vague suspicions (e.g., inadequate clothing, signs of anxiety or lack of sleep, being verbally violent to peers) that children are victims of domestic violence because they are unsure whether their suspicions are well founded. We investigated the degree of emotional discomfort among school staff and student teachers when they had to 'tell' or 'not tell' about vague suspicions of domestic violence. We assumed that they would experience more emotional discomfort when they did not report such vague suspicions. Seventy-one teachers and student teachers (20 men and 51 women; average age: 25, age range: 18-62) were recruited from three primary and lower secondary schools. We used an experimental design in this quantitative vignette study, and the particiants were asked to respond to 54 statements that were related to the need for acceptance by others, seriousness, appraisals (e.g. social self-image and self-image) and self-critical feelings (e.g. rejection, shame, and inferiority). The results of the experimental study show that participants who did not tell about their vague suspicions of violence reported this as being more serious (p < .05), had a more negative self-appraisal (p < .05) and reported a higher degree of negative feelings (p < .05). The study sheds light on the seriousness of 'not telling' about vague suspicions, and shows that 'not telling' is reported as being more emotionally uncomfortable than 'telling'.

Our choice to withhold or disclose displeasing information to another can motivate concern about damage to our social bonds. In two experiments, using two different samples of university students in Norway, (N = 174 and N = 217), we found that withholding unpleasant information led to greater concern for self- image and social-image than did disclosure. We also found that withholding elicited more shame, inferiority and rejection than disclosure, and in Experiment 2, withholding elicited more defensive motivation than disclosure. Consistent with our model, defensive motivation was mostly explained by concern for social-image, whereas relationship repair motivation was mostly explained by concern for self-image and felt shame. We discuss implications for the literature on shame and social bonds.