Category: 3. Business

New York
 — 

McDonald’s is slashing the prices of its combo meals just a few weeks after the CEO publicly admitted that its menu has gotten too expensive and pledged to fix the problem.

McDonald’s and its US franchisees agreed to price eight popular combo meals at 15% less than the total cost of buying the items separately, with the chain offering financial support to franchisees if they agree to lower prices, according to a source familiar with the company’s plans. The lower prices will go into effect next month.

The Wall Street Journal first reported the news. McDonald’s declined to comment.

McDonald’s will also expand its combo offerings with a $5 breakfast deal and an $8 Big Mac and McNugget special in the coming months with the reintroduction of the “Extra Value Meals” branding.

McDonald’s CEO Chris Kempczinski said in its August 6 earnings call that “consumers’ value perceptions are most influenced by our core menu pricing,” a nod to the perception from many customers that the chain has become unaffordable over the past several years.

The inflation crisis that followed the pandemic altered many customers’ views of McDonald’s — from a cheap place to get a quick meal to a pricey fast food restaurant that barely undercut a higher-quality sit-down restaurant alternatives like Applebee’s or Chili’s, with the latter thriving over the past few years.

Value-minded consumers are “too often” seeing combination meals that cost more than $10 and that is “shaping value perceptions in a negative way,” Kempczinski admitted earlier this month.

“The single biggest driver of what shapes a consumer’s overall perception of McDonald’s value is the menu board,” Kempczinski told analysts on McDonald’s earnings call. “And it’s when they drive up to the restaurant and they see the menu board, that’s what’s shaping the that’s the number one driver.”

“We’ve got to get that fixed,” he added.

In 2023, an $18 Big Mac combo meal went viral, sparking a debate that the chain has drifted from its affordability roots. The meal was a one-off at a rest stop – but it sparked furor online, and it later prompted a rare open letter from the president of McDonald’s USA saying the pricey meal was an “exception,” and the chain’s prices haven’t outpaced inflation.

McDonald’s has since focused its efforts on expanding its value menu and improving other parts of its menu, including its revamped chicken strips and new drinks. McDonald’s $5 value meal debuted last year and stabilized sales, at least temporarily, after the company bet correctly that customers were in search of combinations that stretched their dollars.

Themed meals, like a recent collaboration with “A Minecraft Movie,” has also proven to be a winner for the chain, recently putting an end to two consecutive quarters of sinking sales.

In the sun-scorched fields of Zimbabwe’s southern Mwenezi District, where rainfall is rare, a quiet revolution is sprouting – one tiny sesame seed at a time. For years, subsistence farmers like Kastina Sibanda gambled on maize, only to harvest disappointment. 

“For many seasons, our maize crop would fail, and we would barely fill a bag with grain,” says Sibanda of the crop she produced on her 2-hectare plot, and which hardly met the family’s needs. “We struggled financially and had very little food to eat in our home.”


Last year, sesame offered a new path. Drought-tolerant and in growing demand abroad, the crop has become a lifeline for thousands of Zimbabwean farmers. “Our yields are better,” Sibanda says. “And we get paid for the crop – which means we can provide for the family.” 

As she looks over her sesame field, the green plants sprouting delicate white flowers, Sibanda knows her harvest will travel more than 12,500 kilometres beyond Mwenezi. After processing, the seeds’ golden oil will add a delicate finish to meals served on dinner tables in Japan.

The transformation underway in Sibanda’s field is part of a broader resilience-building initiative across five districts in Zimbabwe, funded by the Government of Japan. A partnership between the World Food Programme and local nongovernmental group Sustainable Agriculture Technology (SAT), the project supports small-scale farmers in growing sesame for the market, developing the infrastructure, value chains and capacity to do so. 

“The main driver for our involvement was to improve the ability of smallholder farmers to manage shocks while enhancing their food and nutrition security,” says WFP Programme Officer Bezel Garedondo. “Sesame is climate-resilient and gives farmers an alternative when maize or sorghum fail.”

Rather than delivering aid, the project is boosting trade, Garedondo and others say. By linking smallholder farmers to export markets, it is giving them an opportunity to build successful livelihoods. 

Seeds of resilience

Piloted in two districts, including Mwenezi, in late 2023, the project initially provided nearly 3,000 households with improved seeds and training. This year it scaled to 8,000 farmers in three districts, with plans to reach over 14,000 households.


“Sesame is heat and drought-resistant, making it suitable for growing in Zimbabwe while also ensuring a stable supply for Japan,” says Tetsuya Murakami, Counsellor at the Japan Embassy to Zimbabwe, as Japan kicks off the 9th Tokyo International Conference on African Development. “This project supports food security, climate resilience and the United Nations Sustainable Development Goals, benefitting both producers and consumers.”

In a country buffeted by recurrent droughts, the results have been transformative. “Farmers are now able to earn an income even during the El Niño drought period,” Garedondo says of the weather phenomenon that last year sparked Zimbabwe’s worst drought in decades – and left 5.9 million smallholder farmers food insecure. Despite the harsh weather, sesame farmers “were able to sell something and sustain their livelihoods,” he adds. 

In the northwestern district of Rushinga, bordering Mozambique, smallholder grower Hazvinei Tsongora is also betting on sesame. As she harvests and prepares her crop for market, she explains how the WFP project taught farmers to stick to natural pesticides, like aloe vera, to ensure they crops were organic. 

“They explained buyers want the crop to be chemical-free,” Tsongora says, “and that works for us because it keeps the cost of production down.”

Fair prices

Another sesame farmer, Alexander Gusingo, recalls the difficult farming days of the past – waiting for weeks to get paid for his small surplus harvests of sorghum, cowpeas and maize. By contrast, his sesame harvest this year – on less than a hectare of land – yielded a 600 kg bumper crop.

“When I sold it, I had money in my pocket that very day,” Gusingo says, adding, “with sesame, the prices are good, and the payment is instant. Next season, I want to grow a hectare or more.”

As part of the programme, WFP’s NGO partner SAT supports farmers with training, access to aggregation hubs – gathering harvests from several farms in a single location for sale – along with fair pricing. At buying points, the sesame is weighed openly on calibrated scales, ending years of exploitation by unregistered traders who underpaid farmers.


“The results are undeniable,” says SAT Deputy Country Director Lloyd Masunda, noting how yields have soared, while post-harvest losses are down by a quarter. “Farmers now earn up to US$900 per metric ton,” he adds, “well above the meagre offers from middlemen.” 

The seeds are then processed for export to Japan. Cleaning machines ensure the sesame is “99 percent pure” , before it is packaged, Masunda says. Rigorous tests check for moisture, aflatoxins and chemical residues to meet Japanese market requirements.

From field to kitchen 

Packed into containers, the sesame then travels by road to the Port of Durban, in South Africa. From there, is shipped across the Indian Ocean to Japan – where, thanks to centuries-old craftsmanship, it is carefully transformed into oil. 

The seeds are first cleaned and sorted, then gently toasted to release their nutty aroma. Through traditional pressing methods, the oil is extracted and filtered to ensure purity and quality. Some varieties are distilled to produce a lighter, delicate flavour; others are aged and filtered multiple times for richness.

Some of Zimbabwe’s harvest ends up in Kana Kawasaki’s kitchen, where fragrant, golden sesame oil is an essential part of her daily cooking. “I use it almost every day. It seems nutritious, and my child tends to eat more when I use it, so I mix it with rice and noodles,” she says. “It has a toasty, fragrant smell which is quite nice.”

While sesame is extremely popular in Japanese cuisine, the country imports almost all of it. Zimbabwe’s farmers can help fill the gap – and the project ensures sesame oil fans like Kawasaki know where their product comes from. “With global concern over food safety and human rights in supply chains, traceable sesame from smallholder farmers in Zimbabwe is a strong reassurance to consumers,” says Counsellor Murakami of the Japanese Embassy. 

He believes these and other smallholder exports can help strengthen bonds between Japan and Zimbabwe. 

“Zimbabwean smallholder farmers should be proud that their produce is internationally recognised and exported,” Murakami says. “If they can produce safer, higher-quality agricultural products and supply them stably, Zimbabwe can revive its status as the breadbasket of southern Africa.”

Learn more about WFP’s work in Zimbabwe

Rail passengers have been warned that a strike by rail workers could disrupt services on the bank holiday weekend when transport networks are expected to be packed with holidaymakers.

Members of the Rail, Maritime and Transport (RMT) union at the operator CrossCountry are going on strike on Saturday 23 August and bank holiday Monday over pay and conditions.

The company, whose network is centred around Birmingham and runs to cities across Great Britain from Aberdeen in the north to Cornwall in the south, said it would offer a reduced timetable over the weekend with no services on Saturday and cancellations expected across all routes on Sunday.

Visit England has reported that more than 11 million Britons are planning an overnight trip in the UK over the bank holiday break in England and Wales, which would mark an increase on the same weekend a year earlier.

CrossCountry is advising passengers not to travel on Saturday but to travel instead on either side of the weekend, or to claim a full refund.

The train operator said a “very limited” service would operate on Monday between 8am and 6pm, and advised passengers to check their journeys before departing.

Further journey details will be available on CrossCountry’s website in the coming days but it said there would be no service between Birmingham, Reading and the south coast, and no service between Leicester, Cambridge and Stansted airport. Only very limited services will run to south-west England and north of York.

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Planned engineering work in the West Midlands is also expected to have an impact on the CrossCountry services that are running, meaning some journeys will take longer.

Shiona Rolfe, the managing director of CrossCountry, which is owned by Arriva UK Trains, said: “It is hugely disappointing to not operate any services on Saturday, knowing the inevitable disruption to many of our passengers’ journeys over the bank holiday weekend. We are committed to reaching an agreement with the RMT and remain available to continue talks.”

An RMT spokesperson said: “Our members have voted strongly in favour of industrial action and we are seeking further talks with management to bring about a negotiated settlement.”

In June, RMT members at CrossCountry began an overtime ban and also started to refuse to work on rest days, as they accused the company of declining to negotiate over increased pay for overtime and rest-day working, which it said went against previously agreed commitments.

The coach operator National Express said it was increasing capacity on its intercity services over the bank holiday weekend in response to strike action, adding 9,000 extra seats on routes including Birmingham, Cardiff, London, Leeds, Manchester and Nottingham.

Motorists have been warned they could face long delays on the roads over the weekend, when 18m car journeys are expected to take place, while the RAC has advised travellers to set off as early as possible.

The heaviest congestion is expected in the south-east and south-west of England, while delays are expected on the M20 in Kent for drivers crossing the Channel from Dover or Folkestone.

TOKYO — Global shares were mostly lower on Wednesday, tracking a decline on Wall Street led by technology shares including Nvidia and other artificial-intelligence stars.

France’s CAC 40 slipped 0.1% to 7,967.89, while in Germany the DAX dipped 0.4% to 24,333.63. Britain’s FTSE 100 lost 0.1% to 9,177.91.

Futures for the S&P 500 and the Dow Jones Industrial Average were 0.2% lower.

In Asia, benchmarks fell in Japan, South Korea and Taiwan, weighed down by selling of shares in computer chip-related companies.

Tokyo’s benchmark Nikkei 225 declined 1.5% to close at 42,888.55.

Japan reported its exports fell slightly more than expected in July, down 2.6% from the same month a year ago, pressured by higher tariffs on goods shipped to the U.S. Imports also fell, dropping 7.5% from a year ago. Exports to the U.S. fell 10.1%, while imports slipped 0.8%.

Computer-chip equipment makers Advantest plunged 5.7% and Disco Corp. dropped 4.9%. Chip maker Tokyo Electron lost 1.4%. and Lasertec Corp. lost 1.7%.

The Taiex in Taiwan fell 3.0% after chip maker TSMC dropped 4.2%.

Hong Kong’s Hang Seng gained nearly 0.2% to 25,165.94, while the Shanghai Composite index gained 1.0% to 3,766.21 after China’s central bank opted to keep the benchmark interest rate unchanged, as markets had expected.

Chinese toy company Pop Mart International Group’s shares traded in Hong Kong soared 12.5% after its CEO said its annual revenue could top $4 billion this year, more than quadrupling after more than doubling in the first half of the year. Its CEO also announced that the company was releasing a mini version of its popular Labubu dolls.

Australia’s S&P/ASX 200 gained nearly 0.3% to 8,918.00.

South Korea’s Kospi dropped 0.7% to 3,130.09, after North Korean leader Kim Jong Un condemned South Korean-U.S. military drills that began this week. He vowed a rapid expansion of his nuclear forces to counter rivals, according to North Korean state media.

The week’s headliner for Wall Street is likely arriving on Friday. That’s when the chair of the Federal Reserve, Jerome Powell, will give a highly anticipated speech in Jackson Hole, Wyoming. The setting has been home to big policy announcements from the Fed in the past, and the hope on Wall Street is that Powell may hint that cuts to interest rates are coming soon.

The Fed has kept its main interest rate steady this year, primarily because of the fear of the possibility that President Donald Trump’s tariffs could push inflation higher. But a surprisingly weak report on job growth across the country may be superseding that.

On Tuesday the S&P 500 fell 0.6% and the Dow gained less than 0.1%. The Nasdaq composite slumped 1.5%.

The heaviest weight on the market was Nvidia, whose chips are powering much of the move into AI. It sank 3.5%.

Another AI darling, Palantir Technologies, dropped 9.4% for the largest loss in the S&P 500. It’s seen bets build up sharply that its stock price will drop, according to S3 Partners. Only Meta Platforms has seen a bigger increase this year in what’s called “short interest,” where traders essentially bet a stock’s price will fall. Meta, the owner of Facebook and Instagram, sank 2.1%.

In other dealings early Wednesday, benchmark U.S. crude added 65 cents to $63.00 a barrel. Brent crude, the international standard, gained 68 cents to $66.47 a barrel.

The U.S. dollar edged down to 147.54 Japanese yen from 147.66 yen. The euro fell to $1.1640 from $1.1648.

LONDON — Higher food and airfare prices pushed U.K. inflation above expectations in July, official figures showed Wednesday, which has tempered market expectations that the Bank of England will cut interest rates again this year.

The Office for National Statistics said consumer price inflation was 3.8% in the year to July, up from 3.6% in June. One of the contributors was airfares soaring by 30.2% between June and July, the biggest jump since the collection of monthly data began in 2001.

Most economists had anticipated a more modest rise in inflation to 3.7%.

With inflation now at its highest rate since January 2024 and nearly double the Bank of England’s target of 2%, the prospects of another rate cut in 2025 are diminishing.

“July’s outturn probably extinguishes hope of a September interest rate cut, while strengthening underlying inflationary pressures calls into question whether policymakers will be able to relax policy again this year,” said Suren Thiru, economics director at the chartered accountants institute ICAEW.

The bank cut its main interest rate by a quarter of a percentage point to 4% earlier this month, its fifth reduction in a year, when policy makers began lowering borrowing costs from a 16-year high of 5.25%.

The Bank of England’s key rate, a benchmark for mortgages as well as consumer and business loans, is now at the lowest level since March 2023.

The latest increase is another blow to the Labour government, which was partly propelled into power last July because of the cost-of-living crisis, which saw inflation rise to over 11% at one time.

Treasury chief Rachel Reeves acknowledged there was “more to do to ease” the cost-of-living.

Study design

This exploratory qualitative design study is part of a sequential multi-methods research project developing and testing the feasibility of a multicomponent tailored intervention targeting sedentary behaviour and physical inactivity among nursing home residents at risk of, or with sarcopenia. The qualitative results were reported following the COREQ checklist [19] to ensure comprehensive standards and transparency, while drawing on Braun and Clark’s guidelines for thematic analysis reporting [20].

Setting

Two public-private partnership nursing homes with 85 beds and 120 beds, respectively located in cities in Hunan Province, China. The localities comprise high-aged populations, with in 2023, 22.2% of people aged 60 and older, above the national average of 21.1% [21]. The nursing homes were selected based on facility type (i.e., size, nursing home provision) and geographical location within Hunan province to reduce logistical challenges related to transportation, communication, and institutional policies.

Sample size and selection of participants

Criterion-based purposive sampling was applied to residents (i.e., by age, risk of sarcopenia) to include participants central to the study’s focus. Maximum variation purposive sampling was used for staff (i.e., by professional roles, work experiences) to reflect diverse perspectives on the study’s topic. The planned sample size comprises approximately 20 residents and 10 staff, guided by the concept of information power [22] and related studies [23, 24], continuously evaluating participant group size based on study relevance and quality of data. Inclusion criteria for residents were those aged 60 years and over, with mental capacity to give informed consent, and at risk of sarcopenia. Residents’ risk of sarcopenia was identified using sarcopenia case-finding criteria recommended for research and clinical care using the Asian Working Group of Sarcopenia. The criteria consist of: (1) Presence of any of the following clinical conditions: functional decline or limitation; unintentional weight loss; depressive mood; cognitive impairment; repeated falls; malnutrition; and/or chronic conditions (e.g., heart failure, chronic obstructive pulmonary disease, diabetes mellitus, chronic kidney disease). And (2), if no clinical conditions above are present: low calf circumference (male < 34 cm, female < 33 cm), or score of Strength, Assistance in walking, Rising from a chair, Climbing stairs, and Falls (SARC-F) questionnaire ≥ 4, or score of SARC-F combined with Calf circumference (SARC-CalF) questionnaire ≥ 11. Inclusion criteria for staff were individuals working at the selected sites with three months or more experience in long-term care, including managers, registered nurses, and healthcare assistants.

Finally, 26 participants (14 residents and 12 staff members) included in this study. A total of 20 interviews were conducted, with 17 individual interviews (14 residents and 3 staff) and 3 small group interviews with 9 staff (Table 1). Although the final numbers slightly differed from the initial plan, the achieved sample was sufficient. No new themes emerged in the final interviews, and given the study’s narrow focus, sample specificity, and high-quality data, the sample provided adequate information power to address the research aims. Of the 30 participants approached, 2 residents were unable to participate due to severe hearing impairment and lack of cognitive capacity, and 2 staff were excluded due to limited working experience. Most participants were female (residents 57% and staff 83%). Residents were mean age 78.7 years. Most residents had a primary education (n = 6), followed by junior high (n = 4) and high school (n = 3), with one resident being without formal education. Their duration of residence in nursing home was evenly distributed across short-term (≤ 1 year, n = 5), mid-term (1–3 years, n = 4), and long-term (≥ 3 years, n = 5). Professional roles of staff included managers, registered nurses, and healthcare assistants, with most (n = 7) having over three years of experience in nursing homes.

Recruitment

Residents and staff were separately identified, approached, and recruited face-to-face. For residents, study flyers were posted on bulletin boards in the nursing home sites. Researcher (YM) introduced the study to potential participants using an information sheet and, with staff assistance, gauged residents’ willingness to participate. Residents mental capacity to give informed consent was assessed according to the Mental Capacity Act Code of Practice, focusing on understanding, retaining and weighing up relevant information, and communicating their decision [25]. Residents were asked to talk through detail in the information sheet to check understanding and recall, encouraged to discuss the pros and cons of participating with staff and/or family, and to express their choice clearly verbally or through other means [25]. Researcher (YM) made every effort to maximise residents’ autonomy, for example for those with impaired capacity, iterative communication methods (i.e., oral, and written information, body language) were used [26]. Any questions were addressed, and at least 24 h were provided for decision-making.

For staff, the study was introduced during informal meetings. They were given at least 24 h to decide on participation, and informed that their decision would not affect their work or rights. Separate individual or small group interviews were scheduled for managers, nurses, and healthcare assistants, following informed consent.

Participation in the study was entirely voluntary, and no financial or material incentives were offered to either residents or staff. Participants were informed that they would not receive any personal or financial benefit from taking part, and that their decision to participate or not would have no impact on their care, treatment, or employment status. Participants were assured that they could withdraw from the study at any time and for any reason, without any adverse impact on their accommodation or care (for residents), or their employment or working conditions (for staff).

The researcher (YM) was highly attentive to the potential vulnerability of nursing home residents due to advanced age and multimorbidity. All participants were also informed about the potential consequences of participation, including the minimal risks and possible fatigue and emotional discomfort during interviews.

Data collection

Data collection involved semi-structured interviews conducted between January and March 2023, carried out individually with residents and either individually or in small groups with staff members. All data collection was completed by YM, a local of the study area, fluent in the local dialect and customs, and a registered nurse and PhD candidate in nursing trained in qualitative research and supported by an experienced qualitative researcher (CE). Interviews were conducted face-to-face in Chinese and with the researcher’s fluency in the local dialect enabling rapport with participants and understanding of cultural cues and dynamics during interviews. Individual interviews with residents were conducted in their rooms or public areas based on their choices. The median interview length was 49 min (range: 23–106 min), with adjustment into shorter interviews according to the situation of the interviewee. Individual or small group interviews with staff were undertaken in the nursing home, in an office or meeting area. In small group interview, semi-structured interviews are conducted with several people at the same time. It sought to prioritise individual input within the group, with for example directing questions to each person to ensure each could contribute [27].

To minimise fatigue and distress during interviews, participants were offered the option of multiple shorter interview sessions, with breaks as needed. For example, one resident completed the interview in three sessions averaging 15 min each. During interviews, participants were regularly reminded that they could pause or stop the interview at any time. The interviewer monitored participants for signs of discomfort and responded by offering breaks or stopping the interview if requested. No participant reported distress or chose to withdraw during or after the interview.

The interview topic guides included sections for collecting demographic data, exploring participants’ experiences with sitting/lying/reclining time reduction and physical exercise, and identifying reasons for engaging in or avoiding sedentary reduction and exercise. The Behaviour Change Wheel, centred around Capability, Opportunity, Motivation-Behaviour model [28], informed the design of the interview topic guides. Questions were designed to assess residents’ physical abilities, residents’ and staff’s understanding, knowledge, and skills (Capability) related to reducing sedentary behaviour and increasing physical activity for nursing home residents (Behaviour). External factors that might facilitate or hinder physical activity, such as social support from staff or family, available resources, and the physical environment (Opportunity) were covered. Participants’ reflective (e.g., beliefs and intentions) and automatic (e.g., emotions and habits) responses (Motivation) were also considered. Interview topic guides were adjusted separately for residents, senior staff (managers and nurses), and healthcare assistants (Supplementary material). Pilot interview conducted by YM with a researcher (YZ) and a nursing home resident refined and confirmed the topic guide’s relevance and accessibility. Interviews were digitally audio-recorded with consent. Field notes recording interview process, contextual factors, participant responses and reflexive journaling recording personal reflections were completed after interviews and used in the data analysis.

Data analysis

Interviews were transcribed verbatim by YM and a bilingual (Chinese and English) postgraduate student with transcription experience and checked for accuracy by YM. Data underwent codebook thematic analysis (framework method, primarily inductive with supplemental deductive) [29, 30]. This was achieved by combining inductive data analysis with deductive theoretical interpretation to enhance the relevance and applicability of results. MAXQDA 2020 software was used for analysis. The analysis process started with transcription and data familiarisation. Inductive coding was then conducted line by line by two Chinese researchers (YM and LC) in Chinese, for half of the interviews (n = 10). Four bilingual (Chinese and English) researchers (YM, HC, YZ and LC) reviewed the coding and translated the codes, sub-themes/themes, and key quotes in English. An English working analytical framework was developed after initial coding, reviewed, discussed, and agreed upon by the wider team (CE, MM and AB) and bilingual researchers (HC, YZ and LC), with iterations continuing until no new codes were identified. This framework was then applied to subsequent transcripts, with some codes combined and no new codes developed. Data were summarised into a framework matrix using a spreadsheet, included references to illustrative quotations.

The Ecological Social Theory [31] was used post-coding to contextualise and organise emerging themes and codes within a multi-system perspective, covering microsystem (individual), mesosystem (organizational), exosystem (family), and macrosystem (societal factors), that influence sedentary behaviour and physical inactivity in nursing homes. This theory recognises the ecology of human growth and development, emphasising the complex interplay of individual, socio-cultural, and environmental factors [31]. We interpreted and discussed the results with consideration of field notes and reflexive journaling. Our findings were reported in a descriptive way.

In addition, a Theory of Change logic model, previously developed through a systematic review [32], provided a theoretical model for interventions addressing sedentary behaviour and physical inactivity in nursing homes. Theory of Change is a pragmatic framework used to plan, describe and evaluate the processes through which a desired change or outcome is expected to occur [33]. Theory of Change presented in a logic model visually illustrate the relationships between intervention activities and desired outcomes, outlining underlying assumptions and contextual factors. The findings of this study were applied afterward to update and contextualise the model, particularly for Chinese nursing homes.

Establishing rigour and trustworthiness

Credibility and auditability are crucial criteria for assessing the rigour and trustworthiness of qualitative data [34]. Three strategies were implemented to strengthen credibility and auditability: (a) audio-recording and verbatim transcription of the interviews, (b) investigator triangulation was applied during data analysis through independent coding followed by group meetings for data analysis and interpretation, (c) maintaining a detailed audit trail, which included comprehensive records of data collection methods, coding decisions, analysis procedures, and their rationales [34], and (d) data triangulation was achieved by including participants from diverse stakeholder groups, residents and staff in various roles (nurses, healthcare assistants, and managers), to ensure a broad range of perspectives on the phenomenon under study. Chinese transcripts were initially coded in their original language, then reviewed and translated by four bilingual team members, resulting in an English working analytical framework that was reviewed, discussed, and agreed upon by co-authors until no new codes emerged. In line with Braun and Clarke’s guideline on thematic analysis reporting [20], YM, as the lead researcher, used reflexive journaling to engage in critical reflections on how the position as a PhD student and registered nurse with limited clinical experience shaped interactions with participants and influenced the research process [35].

Ethical considerations

Ethical approval for this study was obtained from the King’s College London (KCL) Research Ethics Committee (Ref: HR/DP-22/23-33808). The researcher (YM) conducted fieldwork in China with the support of the China Scholarship Council. Although not affiliated with a Chinese institution, formal permission to conduct the study was granted by the management of the two participating nursing homes in Hunan province, who acknowledged the KCL ethical approval as sufficient.

To protect participants’ privacy, all transcripts were anonymised by removing any personally identifiable information and assigning unique ID number to each participant. The audio recordings were securely stored on a password-protected device accessible only to the research team. After transcription, the audio files were deleted to further ensure confidentiality. The anonymised transcripts are stored securely and will be destroyed within the specified time in accordance with the ethically approved data management plan.

All procedures adhered to the principles of the Declaration of Helsinki [36], including obtaining written informed consent from all participants, ensuring autonomy, confidentiality, and the protection of vulnerable groups.

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