Methodological issues and challenges in data collection and analysis of qualitative meta-synthesis

A systematic review and meta-ethnography of client and therapist perspectives of the therapeutic alliance in the context of psychotherapy and suicidal experiences

This review aimed to develop a conceptual model of the therapeutic alliance in the context of psychotherapy and suicidal experiences from therapist and client perspectives. The protocol was pre-registered on PROSPERO (CRD42021268273). MEDLINE, PsycINFO, Web of Science, Embase and CINAHL were systematically searched from database inception to April 2024. Eligible studies were peer-reviewed, qualitative, and included client and/or therapist's perspectives of the therapeutic alliance in the context of psychotherapy and suicidal experiences. Studies were critically appraised and analysed using a meta-ethnography approach involving a reciprocal translation of studies and line of argument synthesis. Thirty-seven papers were included, generating two overarching themes; 'Working on the edge' and 'Being ready, willing, and able to build an alliance in the context of suicidal experiences'. Therapeutic alliance in the context of suicidal experiences is unique, fluid, potentially lifesaving, and influenced by multiple inter-connected internal and external processes and systems. Clinical implications emphasise the need to improve training, supervision, and support for therapists to equip them with the additional skills required in navigating the intricacies of the therapeutic alliance with clients who have suicidal experiences. Flexibly interweaving risk assessment into therapeutic conversation was beneficial to the alliance with suicidal clients and enhanced their safety.

Perspectives on palliative oxygen for breathlessness: systematic review and meta-synthesis

Oxygen therapy is frequently prescribed for the palliation of breathlessness, despite lack of evidence for its effectiveness in people who are not hypoxaemic. This study aimed to compare and contrast patients', caregivers' and clinicians' experiences of palliative oxygen use for the relief of chronic breathlessness in people with advanced life-limiting illnesses, and how this shapes prescribing.A systematic review and meta-synthesis of qualitative data was conducted. MEDLINE, CINAHL and PsycINFO were searched for peer-reviewed studies in English (2000-April 2019) reporting perspectives on palliative oxygen use for reducing breathlessness in people with advanced illnesses in any healthcare setting. After data extraction, thematic synthesis used line-by-line coding of raw data (quotes) to generate descriptive and analytical themes.Of 457 articles identified, 22 met the inclusion criteria by reporting perspectives of patients (n=337), caregivers (n=91) or clinicians (n=616). Themes common to these perspectives were: 1) benefits and burdens of palliative oxygen use, 2) knowledge and perceptions of palliative oxygen use beyond the guidelines, and 3) longitudinal trajectories of palliative oxygen use.There are differing perceptions regarding the benefits and burdens of using palliative oxygen. Clinicians should be aware that oxygen use may generate differing goals of therapy for patients and caregivers. These perceptions should be taken into consideration when prescribing oxygen for the symptomatic relief of chronic breathlessness in patients who do not quality for long-term oxygen therapy.

Barriers to the advancement of women of color faculty in STEM

Purpose

The purpose of this paper is to highlight critical issues facing women of color (WOC) faculty and to synthesize the research literature in order to offer recommendations for action to address inequities using an intersectionality framework.

Design/methodology/approach

The authors conducted a qualitative meta-analysis. Relevant articles were obtained through a search of the EBSCO and Google Scholar databases entering in combinations of specific keywords. In order to be included in this review, the manuscripts had to be published between the years 2001 and 2017; in a peer-reviewed journal; and available through the university library system.

Findings

The majority of manuscripts in the meta-analysis revealed high teaching and service loads, ambiguous standards for tenure and lack of culturally responsive mentorship are challenges experienced by WOC faculty. Moreover, there is limited research that examines STEM WOC faculty experiences at minority-serving institutions and in leadership roles. Further research is needed to examine the long-term efficacy of mentoring strategies and institutional transformation efforts for WOC. These numerous challenges cumulatively undermine institutions’ abilities to implement institutional transformation that impacts WOC in higher education.

Originality/value

The recommendations provided are based on the results of the meta-analysis and are intended to promote systemic change for STEM WOC faculty in institutions through intersectional and transformational approaches.

An Analysis of the Structural Factors Affecting the Public Participation in Health Promotion

The present study focuses on analyzing national and international Community-Based Participatory Research (CBPR) studies published from 2000 to 2012 in order to identify and categorize the possible factors that affect social participation for improving the public health. Clearly, improving the public health necessitates a combination of the participation and responsibility by the social members and the attempts by public health policy-makers and planners. CBPR studies are selected as the corpus since they seek to encourage active and informed participation of the social members in fulfilling the health related goals. The present study is conducted through meta-synthesis within a qualitative framework. The results revealed a set of factors within the structural capacities which were employed by the CBPR researchers for achieving the health promotion goals. The structural capacities employed in the interventions could be considered on the cultural and social grounds. The cultural grounds were divided into scientific and religious attempts. For the scientific attempts, the results highlighted the participation of higher education institutes including universities and research centers as well as educational institutes such as schools and the relevant institutions. And regarding the religious attempts, the results indicated that the cooptation of religious centers played the greatest role in enhancing the public participation.

Family Adaptation to Stroke: A Metasynthesis of Qualitative Research based on Double ABCX Model

PURPOSE

There is growing interest in synthesizing qualitative research. Stroke is a very common cause of disability often leaving stroke survivors dependent on their family. This study reports an interpretive review of research into subjective experience of families with stroke survivors based on the components of the Double ABCX Model including stressors, resources, perception, coping strategies, and adaptation of these families.

METHODS

Metasynthesis was applied to review qualitative research looking at stroke family members' experiences and responses to having a stroke survivor as a family member. Electronic database from 1990 to 2013 were searched and 18 separate studies were identified. Each study was evaluated using methodological criteria to provide a context for interpretation of substantive findings. Principal findings were extracted and synthesized under the Double ABCX Model elements.

RESULTS

Loss of independence and uncertainty (as stressors), struggling with new phase of life (as perception), refocusing time and energy on elements of recovery process (as coping strategy), combined resources including personal, internal and external family support (as resources), and striking a balance (as adaptation) were identified as main categories. Family members of stroke survivor respond cognitively and practically and attempt to keep a balance between survivor's and their own everyday lives.

CONCLUSIONS

The results of the study are in conformity with the tenets of the Double ABCX Model. Family adaptation is a dynamic process and the present study findings provide rich information on proper assessment and intervention to the practitioners working with families of stroke survivors.