We demonstrate that a child-centered approach to identifying the content for a self-report vision-related QoL questionnaire is feasible. We suggest this approach is critical to accurately capturing children and young peoples' subjective perspectives on the impact of living with impaired vision.

ObjectivesSafe pharmaceutical care (PC) requires an interprofessional team approach, involving physicians, nurses and pharmacists. Nurses’ roles however, are not always explicit and clear, complicating interprofessional collaboration. The aim of this study is to describe nurses’ practice and interprofessional collaboration in PC, from the viewpoint of nurses, physicians and pharmacists.DesignA cross-sectional survey.SettingThe study was conducted in 17 European countries, each with their own health systems.ParticipantsPharmacists, physicians and nurses with an active role in PC were surveyed.Main outcome measuresNurses’ involvement in PC, experiences of interprofessional collaboration and communication and views on nurses’ competences.ResultsA total of 4888 nurses, 974 physicians and 857 pharmacists from 17 European countries responded. Providing patient education and information (PEI), monitoring medicines adherence (MMA), monitoring adverse/therapeutic effects (ME) and prescribing medicines were considered integral to nursing practice by 78%, 73%, 69% and 15% of nurses, respectively. Most respondents were convinced that quality of PC would be improved by increasing nurses’ involvement in ME (95%), MMA (95%), PEI (91%) and prescribing (53%). Mean scores for the reported quality of collaboration between nurses and physicians, collaboration between nurses and pharmacists and interprofessional communication were respectively <7/10, ≤4/10, <6/10 for all four aspects of PC.ConclusionsME, MMA, PEI and prescribing are part of nurses’ activities, and most healthcare professionals felt their involvement should be extended. Collaboration between nurses and physicians on PC is limited and between nurses and pharmacists even more.

The findings offer insights into the complex realities of living with visual impairment. They provide the basis for development of patient-reported outcome measures. They can also serve to help enrich the understanding of health professionals working with VI children and young people, potentially enabling them to better support them.

Objectives To understand healthcare professionals’ experiences and perceptions of nurses’ potential or ideal roles in pharmaceutical care (PC). Design Qualitative study conducted through semi-structured in-depth interviews. Setting Between December 2018 and October 2019, interviews were conducted with healthcare professionals of 14 European countries in four healthcare settings: hospitals, community care, mental health and long-term residential care. Participants In each country, pharmacists, physicians and nurses in each of the four settings were interviewed. Participants were selected on the basis that they were key informants with broad knowledge and experience of PC. Data collection and analysis All interviews were conducted face to face. Each country conducted an initial thematic analysis. Consensus was reached through a face-to-face discussion of all 14 national leads. Results 340 interviews were completed. Several tasks were described within four potential nursing responsibilities, that came up as the analysis themes, being: 1) monitoring therapeutic/adverse effects of medicines, 2) monitoring medicines adherence, 3) decision making on medicines, including prescribing 4) providing patient education/information. Nurses’ autonomy varied across Europe, from none to limited to a few tasks and emergencies to a broad range of tasks and responsibilities. Intended level of autonomy depended on medicine types and level of education. Some changes are needed before nursing roles can be optimised and implemented in practice. Lack of time, shortage of nurses, absence of legal frameworks and limited education and knowledge are main threats to European nurses actualising their ideal role in PC. Conclusions European nurses have an active role in PC. Respondents reported positive impacts on care quality and patient outcomes when nurses assumed PC responsibilities. Healthcare professionals expect nurses to report observations and assessments. This key patient information should be shared and addressed by the interprofessional team. The study evidences the need of a unique and consensus-based PC framework across Europe.

Couples who conceive using donated embryos rear a child to whom they are genetically unrelated. It has been suggested that this may have negative consequences for parenting and child development. Findings are presented of the second phase of an exploratory study of families with a child conceived through embryo donation. Seventeen embryo donation families with a 5-9 year old child were compared with 24 adoptive families and 28 in vitro fertilisation families. The quality of the mother's parenting, and the child's social and emotional development were assessed using standardised interviews and questionnaires administered to mothers and teachers. Embryo donation children were not at increased risk of psychological problems during middle childhood and the families were generally functioning well. However, higher emotional over-involvement of embryo donation parents was found, along with more reluctance to disclose the method of family creation. These preliminary findings are discussed in terms of implications regarding the importance of genetic and gestational relationships between parents and children.2 Embryo donation families: Follow-up Since the birth of the first IVF baby nearly 30 years ago (Steptoe & Edwards, 1978), the number of couples using assisted reproductive techniques (ARTs) has steadily increased. By 2002, approximately one in every 100 babies born in the US was conceived through ARTs (American Society for Reproductive Medicine, 2008). Furthermore, in the UK in 2004 nearly 30,000 couples attempted fertility treatment, a three-fold increase on the frequency in 1991 (HFEA, 2005). One form of ART is embryo donation, where an embryo created by the gametes of one couple is donated to another couple who then rear the resulting child. Unlike straightforward IVF, embryo donation was developed more recently and is less frequently used, with an average of ~35 embryo donation children born per year in the UK over the last decade (HFEA, personal communication). Concerns have been raised about the potentially adverse psychological consequences of this new method of family formation, but very little research has investigated the experiences of embryo donation families.Conceiving a child using donated embryos results in a family structure where the child is not genetically related to either parent, paralleling that seen in adoptive families.Adoption presents children with specific psychological tasks including coping with the knowledge that they are adopted, and incorporating this awareness into a coherent sense of identity (Triseliotis, Shireman, & Hundleby, 1997). Outcomes for the psychological development of adopted children are mixed. Non-clinical studies of adopted children do not find them to be at risk of problems with temperament or development in infancy and early childhood (Carey, Lipton, & Myers, 1974;Plomin & DeFries, 1985). However, in middle to late childhood, some adoptees exhibit higher levels of psychological maladjustment than nonadoptees (Brand & Brinich, 1999). One possible explanati...