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Dennard S, Patel R, Garety P, Edwards C, Gumley A. A systematic review of users experiences of using digital interventions within psychosis: a thematic synthesis of qualitative research. Soc Psychiatry Psychiatr Epidemiol 2024:10.1007/s00127-024-02692-4. [PMID: 38802509 DOI: 10.1007/s00127-024-02692-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/20/2024] [Accepted: 05/17/2024] [Indexed: 05/29/2024]
Abstract
PURPOSE Although the development of digital mental health support for people with psychosis has been increasing, the development and opportunities to access this have been more limited compared to other mental health conditions. Qualitative research exploring the experiences of using digital interventions amongst people with psychosis is even less well developed; however, such research is crucial in capturing the experiences of using digital interventions to ensure they are meeting the needs of people with psychosis. This paper aimed to synthesise qualitative data related to the experiences of people with psychosis who have used digital interventions. METHODS A systematic literature search was conducted of articles published between 1992 and October 2023 using PubMed, MBase, PsycINFO, & OVID Medline. Two reviewers independently reviewed and screened 268 papers. Papers that met inclusion criteria were quality assessed using The Critical Appraisal Skills Programme (CASP) qualitative studies checklist. The Enhancing Transparency in Reporting the Synthesis of Qualitative Research (ENTREQ) checklist was used to guide the structure of the report. RESULTS A thematic synthesis of 19 studies revealed six overarching themes which related to different aspects and features of the digital interventions: participants' relationship with technology; the accessibility of the interventions; how the interventions could impact on individuals' awareness and management of mental health; enhanced communication and relationships; and opportunities for reflection. CONCLUSIONS Benefits of using digital interventions are discussed. Areas for development and improvements are highlighted. Finally, recommendations for stakeholders who develop and implement digital interventions for psychosis are made.
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JaKa MM, Henderson MG, Alch S, Ziegenfuss JY, Zinkel AR, Osgood ND, Werner A, Borgert Spaniol CM, Flory M, Mabry PL. Qualitative Interviews to Add Patient Perspectives in Colorectal Cancer Screening: Improvements in a Learning Health System. JOURNAL OF CANCER EDUCATION : THE OFFICIAL JOURNAL OF THE AMERICAN ASSOCIATION FOR CANCER EDUCATION 2024; 39:78-85. [PMID: 37919624 DOI: 10.1007/s13187-023-02378-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 10/21/2023] [Indexed: 11/04/2023]
Abstract
Health systems are interested in increasing colorectal cancer (CRC) screening rates as CRC is a leading cause of preventable cancer death. Learning health systems are ones that use data to continually improve care. Data can and should include qualitative local perspectives to improve patient and provider education and care. This study sought to understand local perspectives on CRC screening to inform future strategies to increase screening rates across our integrated health system. Health insurance plan members who were eligible for CRC screening were invited to participate in semi-structured phone interviews. Qualitative content analysis was conducted using an inductive approach. Forty member interviews were completed and analyzed. Identified barriers included ambivalence about screening options (e.g., "If it had the same performance, I'd rather do home fecal sample test. But I'm just too skeptical [so I do the colonoscopy]."), negative prior CRC screening experiences, and competing priorities. Identified facilitators included a positive general attitude towards health (e.g., "I'm a rule follower. There are certain things I'll bend rules. But certain medical things, you just got to do."), social support, a perceived risk of developing CRC, and positive prior CRC screening experiences. Study findings were used by the health system leaders to inform the selection of CRC screening outreach and education strategies to be tested in a future simulation model. For example, the identified barrier related to ambivalence about screening options led to a proposed revision of outreach materials that describe screening types more clearly.
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Affiliation(s)
- Meghan M JaKa
- Center for Evaluation & Survey Research, HealthPartners Institute, Bloomington, MN, USA.
| | - Maren G Henderson
- Center for Evaluation & Survey Research, HealthPartners Institute, Bloomington, MN, USA
| | - Samantha Alch
- Center for Evaluation & Survey Research, HealthPartners Institute, Bloomington, MN, USA
| | - Jeanette Y Ziegenfuss
- Center for Evaluation & Survey Research, HealthPartners Institute, Bloomington, MN, USA
| | - Andrew R Zinkel
- HealthPartners, Bloomington, MN, USA
- University of Minnesota Medical School, Minneapolis, MN, USA
| | | | - Ann Werner
- HealthPartners Institute, Bloomington, MN, USA
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Ravani E, Ali F, Albuainain S, Flamarzi S, Dirar T, O’Brien M, Morris L. Exploring the barriers and facilitators experienced by patients with heart failure when using popular exergaming platforms for self-management-a systematic review. Digit Health 2024; 10:20552076241249823. [PMID: 39070896 PMCID: PMC11282532 DOI: 10.1177/20552076241249823] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/10/2024] [Indexed: 07/30/2024] Open
Abstract
Objective To systematically explore the barriers and facilitators experienced by patients with heart failure when using the most popular commercially-accessible digital exergaming platforms for self-management. Methods A systematic literature search was conducted in: Embase, SCOPUS, PubMed, and ProQuest. Qualitative/mixed methods studies published in English between 2000 and 2024, including adults >18 years with heart failure using digital gaming platforms for exercise as self-management (i.e. Microsoft Xbox/Kinect, Sony PlayStation®, Nintendo™ Wii) were considered. Risk of bias was assessed using the Critical Appraisal Skills Program. The grounded theory method was used to extract, analyze, and synthesize the data. Results Three articles which qualitatively reported on the experiences of the patients with heart failure when using Nintendo™ Wii for self-management were included. Seventy-nine participants (male and female, age 32-81 years) were included in the studies. The three included studies were of high quality. Extracted qualitative data were grouped into subthemes, which were grouped into main themes, namely, Engagement, Apathy, Convenience, Health-related benefits and Gaming Platforms. The main themes were categorized into Barriers and Facilitators. Patients reported that gaming platforms were simple, easy to use, interesting, and motivating (Facilitators). Boredom while playing specific games, preferring other activities and technical issues were reported as Barriers. Conclusion This review provides the first insights into the barriers and facilitators patients with heart failure experience when using popular digital exergaming platforms to participate in exercise programs in the self-management of their condition. However, few high-quality studies exist which limits the conclusions made and warrants further research in this area.
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Affiliation(s)
- Elham Ravani
- Department of Rehabilitation Sciences, College of Health Science, QU Health Sector, Qatar University, Doha, Qatar
| | - Fai Ali
- Department of Rehabilitation Sciences, College of Health Science, QU Health Sector, Qatar University, Doha, Qatar
| | - Sara Albuainain
- Department of Rehabilitation Sciences, College of Health Science, QU Health Sector, Qatar University, Doha, Qatar
| | - Sara Flamarzi
- Department of Rehabilitation Sciences, College of Health Science, QU Health Sector, Qatar University, Doha, Qatar
| | - Tuqa Dirar
- Department of Rehabilitation Sciences, College of Health Science, QU Health Sector, Qatar University, Doha, Qatar
| | - Michelle O’Brien
- Department of Rehabilitation Sciences, College of Health Science, QU Health Sector, Qatar University, Doha, Qatar
| | - Linzette Morris
- Department of Rehabilitation Sciences, College of Health Science, QU Health Sector, Qatar University, Doha, Qatar
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Cheung L, McKay B, Chan K, Heffernan MG, Pakosh M, Musselman KE. Exploring sport participation in individuals with spinal cord injury: A qualitative thematic synthesis. J Spinal Cord Med 2023; 46:658-676. [PMID: 34982645 PMCID: PMC10274558 DOI: 10.1080/10790268.2021.2009676] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/26/2022] Open
Abstract
CONTEXT Individuals with spinal cord injury (SCI) are susceptible to various physical, psychological, and social challenges. Sport is an activity that may holistically address these concerns. No existing research provides an overview of the current landscape of SCI-specific sport participation. OBJECTIVE To synthesize the findings of qualitative studies exploring the perceptions of people with SCI participating in sport, in relation to physical, psychological, and social health. METHODS This thematic synthesis included studies published in APA PsycInfo, CINAHL, Embase, Emcare, Medline, and PubMed. Eligible articles studied adults who had a SCI for ≥12 months and explored experiences following ≥3 months of sport participation using qualitative or mixed-methods. Articles were excluded if participants with SCI composed less than one-third of the study sample. From 8473 unique titles and abstracts screened, 47 articles underwent full-text review and 14 articles were included. The Mixed Methods Appraisal Tool was used to critically appraise the 13 qualitative studies and one mixed-methods study. RESULTS The overarching theme was that sport facilitates the progression to living an enriching life with SCI. Four sub-themes were identified within this theme: adjusting to SCI, factors influencing sport initiation, outcomes resulting from sport participation, and reshaping views of SCI. Participants detailed many benefits of sport, including improved fitness, independence, confidence, and sense of community. Beyond the participants themselves, sport helped reshape views of SCI by breaking stereotypes and inspiring others. CONCLUSION Sport can play a crucial role in facilitating the progression to living an enriching life following SCI.
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Affiliation(s)
- Lovisa Cheung
- Rehabilitation Sciences Institute, Temerty Faculty of Medicine, University of Toronto, Toronto, Canada
- KITE-Toronto Rehabilitation Institute, University Health Network, Toronto, Canada
| | - Brittney McKay
- KITE-Toronto Rehabilitation Institute, University Health Network, Toronto, Canada
- Department of Physical Therapy, Faculty of Medicine, University of Toronto, Toronto, Canada
| | - Katherine Chan
- KITE-Toronto Rehabilitation Institute, University Health Network, Toronto, Canada
| | - Matthew G. Heffernan
- Rehabilitation Sciences Institute, Temerty Faculty of Medicine, University of Toronto, Toronto, Canada
- KITE-Toronto Rehabilitation Institute, University Health Network, Toronto, Canada
| | - Maureen Pakosh
- Library & Information Services, Toronto Rehabilitation Institute, University Health Network, Toronto, Canada
| | - Kristin E. Musselman
- Rehabilitation Sciences Institute, Temerty Faculty of Medicine, University of Toronto, Toronto, Canada
- KITE-Toronto Rehabilitation Institute, University Health Network, Toronto, Canada
- Department of Physical Therapy, Faculty of Medicine, University of Toronto, Toronto, Canada
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Horgan F, Kenny N, Flynn P. A systematic review of the experiences of autistic young people enrolled in mainstream second-level (post-primary) schools. AUTISM : THE INTERNATIONAL JOURNAL OF RESEARCH AND PRACTICE 2023; 27:526-538. [PMID: 35757990 DOI: 10.1177/13623613221105089] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
LAY ABSTRACT Internationally, more autistic pupils are being educated in mainstream schools. Some people have voiced concerns that this policy roll-out is happening before examining the effective outcomes for autistic students. Concerns have also been expressed regarding a lack of the voices of autistic pupils themselves within research and policy. This study was undertaken in order to gather literature that explores the views and experiences of autistic young people in relation to their mainstream school placement at the secondary level. This study aims to summarise the existing literature and provide a new, more complete account of the school experiences of this cohort. After an extensive search, 33 studies were identified by the authors as meeting a set of inclusion criteria. All of the studies included in this review elicited the views and perspectives of at least one autistic young person regarding their mainstream secondary school placement. Upon carefully analysing these studies, the authors developed three key themes as follows: 'Demands of mainstream placements', 'Social participation' and 'Impacts on the student'. Our analysis revealed that for many autistic young people, mainstream school is a complex and demanding social environment. Further research that prioritises the voices and perspectives of this cohort is essential as inclusive policy and practice continues to develop.
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Hirakawa Y. Defining and Implementing Value-Based Healthcare for Older People from a Geriatric and Gerontological Perspective. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:11458. [PMID: 36141730 PMCID: PMC9517297 DOI: 10.3390/ijerph191811458] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/06/2022] [Accepted: 09/07/2022] [Indexed: 06/16/2023]
Abstract
The world's population is ageing at a faster rate than ever before; it is estimated that there are currently over 1 billion people aged 60 years or older, mostly living in low- and middle-income countries [...].
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Affiliation(s)
- Yoshihisa Hirakawa
- Department of Public Health and Health Systems, Nagoya University Graduate School of Medicine, Nagoya 466-8550, Japan
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Emotional Wellbeing in Adolescents Living With Chronic Conditions: A Metasynthesis of the Qualitative Literature. J Adolesc Health 2022; 70:864-876. [PMID: 35168883 DOI: 10.1016/j.jadohealth.2021.12.020] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/25/2021] [Revised: 12/10/2021] [Accepted: 12/11/2021] [Indexed: 11/22/2022]
Abstract
Adolescents living with chronic conditions (ALWCCs) are at a higher risk of suicide (odds ratio: 4.3) than their peers. No consensus exists in the scientific community on a definition or conceptual elements of emotional well-being in this vulnerable population, hindering informed interventional research. This study investigated the meaning of emotional well-being in ALWCCs. A systematic metasynthesis of the qualitative literature was performed and structured using ENTREQ guidelines for reporting qualitative metasynthesis. A final sample of 11 primary qualitative studies met inclusion criteria and was critically analyzed using a team-based thematic synthesis and reciprocal translation approach. The meaning of emotional well-being in ALWCCs is having positive relationships that ease loss, foster hope and resilience, and promote self-efficacy and self-actualization. The role of healthcare providers as a safe, stable nurturing relationship which promotes hope and positive body image emerges an area for future research. Spirituality as it relates to emotional well-being in this population is scarce in the qualitative literature and should be further explored.
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Brede J, Cage E, Trott J, Palmer L, Smith A, Serpell L, Mandy W, Russell A. “We Have to Try to Find a Way, a Clinical Bridge” - autistic adults' experience of accessing and receiving support for mental health difficulties: A systematic review and thematic meta-synthesis. Clin Psychol Rev 2022; 93:102131. [DOI: 10.1016/j.cpr.2022.102131] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2021] [Revised: 12/04/2021] [Accepted: 01/28/2022] [Indexed: 12/28/2022]
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Petersson-Bloom L, Holmqvist M. Strategies in supporting inclusive education for autistic students-A systematic review of qualitative research results. AUTISM & DEVELOPMENTAL LANGUAGE IMPAIRMENTS 2022; 7:23969415221123429. [PMID: 36382073 PMCID: PMC9620685 DOI: 10.1177/23969415221123429] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
BACKGROUND AND AIM Strategies to modify and adjust the educational setting in mainstream education for autistic students are under-researched. Hence, this review aims to identify qualitative research results of adaptation and modification strategies to support inclusive education for autistic students at school and classroom levels. METHOD In this systematic review, four databases were searched. Following the preferred PRISMA approach, 108 studies met the inclusion criteria, and study characteristics were reported. Synthesis of key findings from included studies was conducted to provide a more comprehensive and holistic understanding. MAIN CONTRIBUTION This article provides insights into a complex area via aggregating findings from qualitative research a comprehensive understanding of the phenomena is presented. The results of the qualitative analysis indicate a focus on teachers' attitudes and students' social skills in research. Only 16 studies were at the classroom level, 89 were at the school level, and three studies were not categorized at either classroom or school level. A research gap was identified regarding studies focusing on the perspectives of autistic students, environmental adaptations to meet the students' sensitivity difficulties, and how to enhance the students' inclusion regarding content taught and knowledge development from a didactic perspective. CONCLUSIONS AND IMPLICATIONS Professional development that includes autism-specific understanding and strategies for adjusting and modifying to accommodate autistic students is essential. This conclusion may direct school leaders when implementing professional development programs. A special didactical perspective is needed to support teachers' understanding of challenges in instruction that autistic students may encounter.
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Affiliation(s)
- Linda Petersson-Bloom
- Linda Peterson-Bloom, Faculty of Learning
and Society, Malmö University, Malmö SE-205 06, Sweden.
| | - Mona Holmqvist
- Faculty of Learning and Society,
Malmö University, Malmö, Sweden
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Rosca EC, Tudor R, Cornea A, Simu M. Parkinson's Disease in Romania: A Scoping Review. Brain Sci 2021; 11:709. [PMID: 34071802 PMCID: PMC8226866 DOI: 10.3390/brainsci11060709] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2021] [Revised: 05/16/2021] [Accepted: 05/25/2021] [Indexed: 12/12/2022] Open
Abstract
Parkinson's disease (PD) is a significant cause of disability, with a fast-growing prevalence. This review summarizes the epidemiological and clinical data, research on the diagnostic approaches and the interventions available in the Eastern European country of Romania. This scoping review follows the recommendations on the scoping review methodology by Joanna Briggs Institute. We searched four databases (up to 27 January 2021). The data of eligible studies were extracted in standardized forms. We identified 149 unique studies from 1133 records, with 11 epidemiological studies, 52 studies investigating clinical aspects of PD, 35 studies on diagnostic tools, and 51 intervention studies. A narrative synthesis is provided and placed in a historical context. Our review revealed a considerable increase in the Romanian research on PD in the latest 15 years, which largely follows international trends. However, we also identified several research gaps that provide useful information for policymakers, public health specialists, and clinicians.
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Affiliation(s)
- Elena Cecilia Rosca
- Department of Neurology, Victor Babes University of Medicine and Pharmacy of Timisoara, Eftimie Murgu Sq. No. 2, 300041 Timișoara, Romania; (R.T.); (A.C.); (M.S.)
- Department of Neurology, Clinical Emergency County Hospital Timisoara, Bd. Iosif Bulbuca No. 10, 300736 Timisoara, Romania
- Neuroscience Research Center Timisoara, Clinical Emergency County Hospital Timisoara, Bd. Iosif Bulbuca No. 10, 300736 Timisoara, Romania
| | - Raluca Tudor
- Department of Neurology, Victor Babes University of Medicine and Pharmacy of Timisoara, Eftimie Murgu Sq. No. 2, 300041 Timișoara, Romania; (R.T.); (A.C.); (M.S.)
- Department of Neurology, Clinical Emergency County Hospital Timisoara, Bd. Iosif Bulbuca No. 10, 300736 Timisoara, Romania
- Neuroscience Research Center Timisoara, Clinical Emergency County Hospital Timisoara, Bd. Iosif Bulbuca No. 10, 300736 Timisoara, Romania
| | - Amalia Cornea
- Department of Neurology, Victor Babes University of Medicine and Pharmacy of Timisoara, Eftimie Murgu Sq. No. 2, 300041 Timișoara, Romania; (R.T.); (A.C.); (M.S.)
- Department of Neurology, Clinical Emergency County Hospital Timisoara, Bd. Iosif Bulbuca No. 10, 300736 Timisoara, Romania
- Neuroscience Research Center Timisoara, Clinical Emergency County Hospital Timisoara, Bd. Iosif Bulbuca No. 10, 300736 Timisoara, Romania
| | - Mihaela Simu
- Department of Neurology, Victor Babes University of Medicine and Pharmacy of Timisoara, Eftimie Murgu Sq. No. 2, 300041 Timișoara, Romania; (R.T.); (A.C.); (M.S.)
- Department of Neurology, Clinical Emergency County Hospital Timisoara, Bd. Iosif Bulbuca No. 10, 300736 Timisoara, Romania
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Vena JA, Copel LC. A Meta-Ethnography of the Experiences of Adults with Lymphoma During Acute and Chronic Survivorship. Semin Oncol Nurs 2021; 37:151142. [PMID: 33773881 DOI: 10.1016/j.soncn.2021.151142] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2020] [Revised: 02/01/2021] [Accepted: 02/10/2021] [Indexed: 12/24/2022]
Abstract
OBJECTIVES The acute and chronic phases of cancer survivorship are the periods of treatment, post-treatment, and early remission. During acute and chronic survivorship, adults with lymphoma have reported both positive and negative changes in health-related quality of life. This meta-ethnography aims to appraise the experiences of adults with lymphoma at the acute and chronic survivorship phases. DATA SOURCES This qualitative review used the established meta-ethnography framework from Noblit and Hare and is outlined following the meta-ethnography reporting guidance (eMERGe). A systematic literature search using four unique databases was completed, including the Cumulative Index to Nursing and Allied Health Literature, PubMed, Ovid Emcare, and Clarivate Web of Science. CONCLUSION In total, nine research studies were included in this review. Study characteristics and sample evidence were extracted from the included studies to produce the synthesis. The review and synthesis formed three main themes and six subthemes that reflect the challenges of cancer treatment and post-treatment, the communication and support from others, and how lymphoma patients reframe and reprioritize during and following treatment. IMPLICATIONS FOR NURSING PRACTICE This meta-ethnography provides a comprehensive analysis of adults' experiences with lymphoma at the acute and chronic survivorship phases. Several approaches for the management and care of lymphoma patients were found in this review, including integrating patient support groups from diagnosis through post-treatment, tailored psychological health care services, personalized care and delivery pathways at post-treatment, and the promotion of strategies to cope with cancer in remission. Additional research should examine younger and older adults to discover age-related issues in lymphoma populations in addition to disparities among minority patients with lymphoma and those from low socioeconomic backgrounds.
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Affiliation(s)
- Joseph A Vena
- M. Louise Fitzpatrick College of Nursing, Villanova University, Villanova, PA.
| | - Linda C Copel
- M. Louise Fitzpatrick College of Nursing, Villanova University, Villanova, PA
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Dowling M, Fahy P, Houghton C, Smalle M. A qualitative evidence synthesis of healthcare professionals' experiences and views of palliative care for patients with a haematological malignancy. Eur J Cancer Care (Engl) 2020; 29:10.1111/ecc.13316. [PMID: 32902114 PMCID: PMC7757223 DOI: 10.1111/ecc.13316] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2020] [Revised: 04/30/2020] [Accepted: 08/07/2020] [Indexed: 12/28/2022]
Abstract
INTRODUCTION Patients with haematological malignancies may not be receiving appropriate referrals to palliative care and continuing to have treatments in the end stages of their disease. This systematic review of qualitative research aimed to synthesise healthcare professionals' (HCPs) views and experiences of palliative care for adult patients with a haematologic malignancy. METHODS A systematic search strategy was undertaken across eight databases. Thomas and Harden's approach to thematic analysis guided synthesis on the seventeen included studies. GRADE-GRADEQual guided assessment of confidence in the synthesised findings. RESULTS Three analytic themes were identified: (a) "Maybe we can pull another 'rabbit out of the hat'," represents doctors' therapeutic optimism, (b) "To tell or not to tell?" explores doctors' decision-making around introducing palliative care, and (c) "Hospice, home or hospital?" describes HCPs concerns about challenges faced by haematology patients at end of life in terms of transfusion support and risk of catastrophic bleeds. CONCLUSION Haematologists value the importance of integrated palliative care but prefer the term "supportive care." Early integration of supportive care alongside active curative treatment should be the model of choice in haematology settings in order to achieve the best outcomes and improved quality of life.
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Affiliation(s)
- Maura Dowling
- School of Nursing and MidwiferyNational University of IrelandGalwayIreland
| | - Paul Fahy
- School of Nursing and MidwiferyNational University of IrelandGalwayIreland
| | - Catherine Houghton
- School of Nursing and MidwiferyNational University of IrelandGalwayIreland
| | - Mike Smalle
- James Hardiman LibraryNational University of IrelandGalwayIreland
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Neuppmann Feres MF, Roscoe MG, Job SA, Mamani JB, Canto GDL, Flores-Mir C. Barriers involved in the application of evidence-based dentistry principles: A systematic review. J Am Dent Assoc 2020; 151:16-25.e16. [PMID: 31902396 DOI: 10.1016/j.adaj.2019.08.011] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2018] [Revised: 08/06/2019] [Accepted: 08/07/2019] [Indexed: 11/18/2022]
Abstract
BACKGROUND The authors' objective in this systematic review was to investigate the barriers involved in the application of evidence-based dentistry principles, as reported by dentists. The authors registered the protocol in the PROSPERO database. TYPES OF STUDIES REVIEWED Eligible studies included qualitative and quantitative approaches, constituting information about barriers, collected through interviews, questionnaires, or conversation sessions. The authors searched databases and reference lists of preselected studies. After the selection process, the authors evaluated the included studies for potential risk of bias and collected either qualitative or quantitative data. RESULTS After the selection process, the authors included 35 studies, of which 16 were reported in this article. The authors synthesized and classified the barriers in 4 categories: self-related, evidence-related, context-related, and patient-related barriers. Shortage of time and financial constraints were the barriers most frequently studied. However, the quantification of these barriers, as well as others, was not possible because of the variability of the results and methodological issues of the included studies. CONCLUSIONS AND PRACTICAL IMPLICATIONS The authors suggest the development of valid questionnaires and their use in representative samples to quantify the effects of specific barriers. The authors encourage practitioners to participate in educational programs focused on training in evidence-based dentistry abilities, in addition to seeking accessible and synthesized formats of reliable scientific knowledge.
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Clancy C, Lynch J, OConnor P, Dowling M. Breast cancer patients' experiences of adherence and persistence to oral endocrine therapy: A qualitative evidence synthesis. Eur J Oncol Nurs 2019; 44:101706. [PMID: 32007696 DOI: 10.1016/j.ejon.2019.101706] [Citation(s) in RCA: 36] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2019] [Accepted: 11/26/2019] [Indexed: 11/15/2022]
Abstract
PURPOSE Adjuvant endocrine therapy (AET) significantly reduces the risk of breast cancer recurrence and mortality in women with hormone receptor (HR+) breast cancer. Despite the documented survival benefits with AET, non-adherence and non-persistence remains a significant problem. This systematic review of qualitative research aimed to synthesise breast cancer patients' experiences of adherence and persistence to oral endocrine therapy. METHODS The ENTREQ guidelines were followed. A systematic search strategy was performed across eleven electronic databases (Embase, Cinahl, Pubmed, Psychinfo, Proquest, Lenus, Scopus, Web of Science, Rian.ie, EThOS e-theses online, DART Europe). Thomas and Harden's three-stage approach to thematic analysis was undertaken on the findings of all included studies. Confidence in the findings were reviewed using GRADE-CERQual. RESULTS Twenty-four qualitative studies were included in the synthesis. Three analytic themes were identified (We don't have an option; the side effects are worse than the disease; help us with information and support). Adherence was often driven by women feeling they had no option and a fear of cancer recurrence. Persistence was helped with support and information. Non-adherence and non-persistence were associated with debilitating side effects, inadequate information and lack of support. CONCLUSIONS Adherence and persistence to AET was often suboptimal among breast cancer patients. Women commonly felt isolated and neglected as a result of insufficient information and support from healthcare professionals. If women are to persist with AET, primary care providers should be aware of the facilitators and barriers to adherence, and they should be knowledgeable in symptom management strategies.
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Affiliation(s)
- Caroline Clancy
- Oncology department, Letterkenny University Hospital, Ireland.
| | - Johanna Lynch
- Letterkenny University Hospital, Letterkenny, Ireland.
| | - Pamela OConnor
- Library and Information Services, Letterkenny University Hospital, Ireland.
| | - Maura Dowling
- School of Nursing and Midwifery, National University of Ireland Galway, Ireland.
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Lefèvre H, Moro MR, Lachal J. Research in adolescent healthcare: The value of qualitative methods. Arch Pediatr 2019; 26:426-430. [PMID: 31611145 DOI: 10.1016/j.arcped.2019.09.012] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2019] [Accepted: 09/22/2019] [Indexed: 12/31/2022]
Abstract
BACKGROUND The vast majority of publications about adolescent healthcare use a quantitative methodology that often involves long and expensive research protocols with results that do not always provide answers adequate to the complexity of the questions being asked. The qualitative method is sometimes a more effective alternative for exploring some of these. This method can be defined from its objective, which is to generate theoretical hypotheses, its mandatory consideration of the researcher's subjectivity, and the importance it ascribes to the context of the participants' experience. Among the many techniques of qualitative research, the use of phenomenological methods, in particular, interpretative phenomenological analysis (IPA), is highly developed in medical research. OBJECTIVES To define the qualitative method and describe the principal stages of a phenomenological qualitative study. RESULTS The three stages of a qualitative study are data collection (population and sampling, data collection methods), data analysis, and writing up the results. Purposive sampling makes it possible to include participants who can describe in detail, and as experts, their experience during semi-structured interviews. The analysis takes place in two stages, the first very descriptive, the second more interpretative. The results are written-up in a narrative form, including both direct quotations from the interviews and the researchers' interpretation. DISCUSSION The issues of health promotion and healthcare associated with the management of chronic symptoms or diseases in adolescents involve an extremely rich and complex context. Qualitative methods make it possible to approach these questions and to understand them better by generating hypotheses from a rigorous scientific procedure appropriate to the context and objectives. In addition to being used on their own, they can be used on an exploratory basis early in a quantitative study to help define it better, for explanatory purposes, to help understand complex quantitative results, or combined with a quantitative study. The qualitative and quantitative results will then be integrated.
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Affiliation(s)
- H Lefèvre
- Maison de Solenn, hôpital Cochin, AP-HP, 97, boulevard de Port Royal, 75014 Paris, France; UVSQ, Inserm, CESP, faculté de médecine, université Paris-Sud, université Paris-Saclay, 94805 Villejuif, France; French Clinical Research Group in Adolescent Medicine and Health, 75014 Paris, France.
| | - M R Moro
- Maison de Solenn, hôpital Cochin, AP-HP, 97, boulevard de Port Royal, 75014 Paris, France; UVSQ, Inserm, CESP, faculté de médecine, université Paris-Sud, université Paris-Saclay, 94805 Villejuif, France; Université Paris-Descartes, Sorbonne-Paris-Cité, 75005 Paris, France
| | - J Lachal
- Maison de Solenn, hôpital Cochin, AP-HP, 97, boulevard de Port Royal, 75014 Paris, France; UVSQ, Inserm, CESP, faculté de médecine, université Paris-Sud, université Paris-Saclay, 94805 Villejuif, France; Université Paris-Descartes, Sorbonne-Paris-Cité, 75005 Paris, France
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Mui EYW, Chan SKW, Chan PY, Hui CLM, Chang WC, Lee EHM, Chen EYH. Systematic review (meta-aggregation) of qualitative studies on the experiences of family members caring for individuals with early psychosis. Int Rev Psychiatry 2019; 31:491-509. [PMID: 31547726 DOI: 10.1080/09540261.2019.1659236] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Despite the importance of the role of caregivers of people with psychosis being widely recognized, comprehensive understanding of their experience is limited. A thorough understanding of the experience of caregivers over the journey of the illness, particularly during its early stages, is crucial. Qualitative studies published between 1 January 1949 and 31 January 2018 were obtained from seven databases based on PICo search strategy. Meta-aggregation methodology of the Joanna Briggs Institute (JBI) was adopted to aggregate existing qualitative findings about caregivers' experiences. Twenty-eight qualitative studies on 635 caregivers and family members were included in the review. Six inter-related categories-'stigma', 'help-seeking', 'service encounter', 'emotional challenges', 'on becoming a caregiver' and 'making sense of experience'-were aggregated from 129 themes from the sub-acute stage, the acute stage and the recovery or residual stage. Three statements about caregivers' experiences of their relative's first episode of psychosis were synthesized from the findings. Results highlighted the need of incorporating caregiver intervention into the existing services to support the emotional challenges, uncertainty, and stigma-related burden along the caregiving journey.
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Affiliation(s)
- Esther Yee Wai Mui
- Department of Psychiatry, Li Ka Shing Faculty of Medicine, The University of Hong Kong , Hong Kong SAR , China
| | - Sherry K W Chan
- Department of Psychiatry, Li Ka Shing Faculty of Medicine, The University of Hong Kong , Hong Kong SAR , China.,The State Key Laboratory of Brain and Cognitive Sciences, The University of Hong Kong , Hong Kong SAR , China
| | - Pik Ying Chan
- Department of Social Work and Social Administration, The University of Hong Kong , Hong Kong SAR , China
| | - Christy L M Hui
- Department of Psychiatry, Li Ka Shing Faculty of Medicine, The University of Hong Kong , Hong Kong SAR , China
| | - Wing C Chang
- Department of Psychiatry, Li Ka Shing Faculty of Medicine, The University of Hong Kong , Hong Kong SAR , China.,The State Key Laboratory of Brain and Cognitive Sciences, The University of Hong Kong , Hong Kong SAR , China
| | - Edwin H M Lee
- Department of Psychiatry, Li Ka Shing Faculty of Medicine, The University of Hong Kong , Hong Kong SAR , China
| | - Eric Y H Chen
- Department of Psychiatry, Li Ka Shing Faculty of Medicine, The University of Hong Kong , Hong Kong SAR , China.,The State Key Laboratory of Brain and Cognitive Sciences, The University of Hong Kong , Hong Kong SAR , China
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Kinnear FJ, Wainwright E, Perry R, Lithander FE, Bayly G, Huntley A, Cox J, Shield JP, Searle A. Enablers and barriers to treatment adherence in heterozygous familial hypercholesterolaemia: a qualitative evidence synthesis. BMJ Open 2019; 9:e030290. [PMID: 31371299 PMCID: PMC6677970 DOI: 10.1136/bmjopen-2019-030290] [Citation(s) in RCA: 40] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
OBJECTIVES Individuals with heterozygous familial hypercholesterolaemia (FH) are at high risk of developing cardiovascular disease (CVD). This risk can be substantially reduced with lifelong pharmacological and lifestyle treatment; however, research suggests adherence is poor. We synthesised the qualitative research to identify enablers and barriers to treatment adherence. DESIGN This study conducted a thematic synthesis of qualitative studies. DATA SOURCES MEDLINE, Embase, PsycINFO via OVID, Cochrane library and CINAHL databases and grey literature sources were searched through September 2018. ELIGIBILITY CRITERIA We included studies conducted in individuals with FH, and their family members, which reported primary qualitative data regarding their experiences of and beliefs about their condition and its treatment. DATA EXTRACTION AND SYNTHESIS Quality assessment was undertaken using the Critical Appraisal Skills Programme for qualitative studies. A thematic synthesis was conducted to uncover descriptive and generate analytical themes. These findings were then used to identify enablers and barriers to treatment adherence for application in clinical practice. RESULTS 24 papers reporting the findings of 15 population samples (264 individuals with FH and 13 of their family members) across 8 countries were included. Data captured within 20 descriptive themes were considered in relation to treatment adherence and 6 analytical themes were generated: risk assessment; perceived personal control of health; disease identity; family influence; informed decision-making; and incorporating treatment into daily life. These findings were used to identify seven enablers (eg, 'commencement of treatment from a young age') and six barriers (eg, 'incorrect and/or inadequate knowledge of treatment advice') to treatment adherence. There were insufficient data to explore if the findings differed between adults and children. CONCLUSIONS The findings reveal several enablers and barriers to treatment adherence in individuals with FH. These could be used in clinical practice to facilitate optimal adherence to lifelong treatment thereby minimising the risk of CVD in this vulnerable population. PROSPERO REGISTRATION NUMBER CRD42018085946.
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Affiliation(s)
- Fiona J Kinnear
- The National Institute for Health Research (NIHR), Bristol Biomedical Research Centre (BRC), Nutrition theme, University Hospitals Bristol NHS Foundation Trust and the University of Bristol, Bristol, UK
| | - Elaine Wainwright
- Psychology Department, Bath Spa University, Bath, UK
- Department for Health, University of Bath, Bath, UK
| | - Rachel Perry
- The National Institute for Health Research (NIHR), Bristol Biomedical Research Centre (BRC), Nutrition theme, University Hospitals Bristol NHS Foundation Trust and the University of Bristol, Bristol, UK
| | - Fiona E Lithander
- The National Institute for Health Research (NIHR), Bristol Biomedical Research Centre (BRC), Nutrition theme, University Hospitals Bristol NHS Foundation Trust and the University of Bristol, Bristol, UK
| | - Graham Bayly
- Department of Clinical Biochemistry, University Hospitals Bristol NHS Foundation Trust, Bristol, UK
| | - Alyson Huntley
- Population Health Science, Bristol Medical School, University of Bristol, Bristol, UK
| | - Jennifer Cox
- The National Institute for Health Research (NIHR), Bristol Biomedical Research Centre (BRC), Nutrition theme, University Hospitals Bristol NHS Foundation Trust and the University of Bristol, Bristol, UK
| | - Julian Ph Shield
- The National Institute for Health Research (NIHR), Bristol Biomedical Research Centre (BRC), Nutrition theme, University Hospitals Bristol NHS Foundation Trust and the University of Bristol, Bristol, UK
| | - Aidan Searle
- The National Institute for Health Research (NIHR), Bristol Biomedical Research Centre (BRC), Nutrition theme, University Hospitals Bristol NHS Foundation Trust and the University of Bristol, Bristol, UK
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18
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Athanasakis E. A meta‐synthesis of how registered nurses make sense of their lived experiences of medication errors. J Clin Nurs 2019; 28:3077-3095. [DOI: 10.1111/jocn.14917] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2018] [Revised: 03/30/2019] [Accepted: 05/03/2019] [Indexed: 10/26/2022]
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Abstract
AIMS Despite an increasing awareness of the importance of spirituality in mental health contexts, a 'religiosity gap' exists in the difference in the value placed on spirituality and religion by professionals compared with service users. This may be due to a lack of understanding about the complex ways people connect with spirituality within contemporary society and mental health contexts, and can result in people's spiritual needs being neglected, dismissed or pathologised within clinical practice. The aim of this qualitative systematic review is to characterise the experiences of spirituality among adults with mental health difficulties in published qualitative research. METHODS An electronic search of seven databases was conducted along with forward and backward citation searching, expert consultation and hand-searching of journals. Thirty-eight studies were included from 4944 reviewed papers. The review protocol was pre-registered (PROSPERO:CRD42017080566). RESULTS A thematic synthesis identified six key themes: Meaning-making (sub-themes: Multiple explanations; Developmental journey; Destiny v. autonomy), Identity, Service-provision, Talk about it, Interaction with symptoms (sub-themes: Interactive meaning-making; Spiritual disruption) and Coping (sub-themes: Spiritual practices; Spiritual relationship; Spiritual struggles; Preventing suicide), giving the acronym MISTIC. CONCLUSIONS This qualitative systematic review provides evidence of the significant role spirituality plays in the lives of many people who experience mental health difficulties. It indicates the importance of mental health professionals being aware of and prepared to support the spiritual dimension of people using services. The production of a theory-based framework can inform efforts by health providers to understand and address people's spiritual needs as part of an integrated holistic approach towards care.
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20
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Salehi A, Ehrlich C, Kendall E, Sav A. Bonding and bridging social capital in the recovery of severe mental illness: a synthesis of qualitative research. J Ment Health 2018; 28:331-339. [DOI: 10.1080/09638237.2018.1466033] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/16/2022]
Affiliation(s)
- Asiyeh Salehi
- School of Health and Human Sciences, Southern Cross University, Gold Coast, Australia,
- The Hopkins Centre, Menzies Health Institute Queensland, Griffith University, Brisbane, Australia, and
| | - Carolyn Ehrlich
- The Hopkins Centre, Menzies Health Institute Queensland, Griffith University, Brisbane, Australia, and
| | - Elizabeth Kendall
- The Hopkins Centre, Menzies Health Institute Queensland, Griffith University, Brisbane, Australia, and
| | - Adem Sav
- Faculty of Health Sciences, School of Allied Health, Australian Catholic University, Brisbane, Australia
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Unger J, Singh H, Mansfield A, Hitzig SL, Lenton E, Musselman KE. The experiences of physical rehabilitation in individuals with spinal cord injuries: a qualitative thematic synthesis. Disabil Rehabil 2018; 41:1367-1383. [PMID: 29334811 DOI: 10.1080/09638288.2018.1425745] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
PURPOSE The purpose of this thematic synthesis review was to identify and synthesise published qualitative research on the perspectives of individuals with spinal cord injuries with respect to physical rehabilitation interventions. MATERIALS AND METHODS The peer-reviewed literature was searched across seven databases and identified abstracts were independently screened by two reviewers. A thematic synthesis methodology was used to code and synthesise the results from the included studies. RESULTS In total, 7233 abstracts were identified; 31 articles were selected for inclusion, representing 26 physical rehabilitation interventions. The methodological quality of studies was moderate (Standards for Reporting Qualitative Research mean ± standard deviation = 14.39 ± 3.61). The four main themes developed were: (1) Benefits of physical rehabilitation, (2) Challenges of physical rehabilitation, (3) Need for support, and (4) Issue of control. CONCLUSIONS This qualitative thematic synthesis provides key insights into the experiences of individuals with spinal cord injuries who received physical rehabilitation. Recommendations for practice, based on the findings, include creating a diverse, encouraging, and educational physical rehabilitation experience with supportive staff who focus on communication and person-centred care. Implications for Rehabilitation Physical rehabilitation provides psychological as well as physical benefits to people with spinal cord injuries, including motivation, hope, improved self-confidence, and acceptance. Challenges identified during physical rehabilitation for people with spinal cord injuries, such as comparisons, negative emotions, recovery expectations, and slow progress, should be addressed by healthcare professionals to ensure person-centred care. People with spinal cord injuries identified a need for support from health care professionals, family, and friends, as well other people with spinal cord injuries. There is an issue of control in physical rehabilitation for people with spinal cord injuries, which can result in a fight with oneself or with healthcare professionals to regain the control that has been lost.
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Affiliation(s)
- Janelle Unger
- a Rehabilitation Sciences Institute , University of Toronto , Toronto , Canada.,b Toronto Rehabilitation Institute , University Health Network , Toronto , Canada
| | - Hardeep Singh
- a Rehabilitation Sciences Institute , University of Toronto , Toronto , Canada.,b Toronto Rehabilitation Institute , University Health Network , Toronto , Canada
| | - Avril Mansfield
- b Toronto Rehabilitation Institute , University Health Network , Toronto , Canada.,c Evaluative Clinical Sciences, Hurvitz Brain Sciences Program, Sunnybrook Research Institute , Sunnybrook Health Sciences Centre , Toronto , Canada.,d Department of Physical Therapy, Faculty of Medicine , University of Toronto , Toronto , Canada
| | - Sander L Hitzig
- a Rehabilitation Sciences Institute , University of Toronto , Toronto , Canada.,b Toronto Rehabilitation Institute , University Health Network , Toronto , Canada.,c Evaluative Clinical Sciences, Hurvitz Brain Sciences Program, Sunnybrook Research Institute , Sunnybrook Health Sciences Centre , Toronto , Canada.,e Department of Occupational Science & Occupational Therapy , University of Toronto , Toronto , Canada
| | - Erica Lenton
- f Gerstein Science Information Centre , University of Toronto , Toronto , Canada
| | - Kristin E Musselman
- a Rehabilitation Sciences Institute , University of Toronto , Toronto , Canada.,b Toronto Rehabilitation Institute , University Health Network , Toronto , Canada.,d Department of Physical Therapy, Faculty of Medicine , University of Toronto , Toronto , Canada
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22
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Fields EL, Bogart LM, Thurston IB, Hu CH, Skeer MR, Safren SA, Mimiaga MJ. Qualitative Comparison of Barriers to Antiretroviral Medication Adherence Among Perinatally and Behaviorally HIV-Infected Youth. QUALITATIVE HEALTH RESEARCH 2017; 27:1177-1189. [PMID: 28682737 PMCID: PMC5953432 DOI: 10.1177/1049732317697674] [Citation(s) in RCA: 31] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
Medication adherence among youth living with HIV (28%-69%) is often insufficient for viral suppression. The psychosocial context of adherence barriers is complex. We sought to qualitatively understand adherence barriers among behaviorally infected and perinatally infected youth and develop an intervention specific to their needs. We conducted in-depth interviews with 30 youth living with HIV (aged 14-24 years) and analyzed transcripts using the constant comparative method. Barriers were influenced by clinical and psychosocial factors. Perinatally infected youth barriers included reactance, complicated regimens, HIV fatigue, and difficulty transitioning to autonomous care. Behaviorally infected youth barriers included HIV-related shame and difficulty initiating medication. Both groups reported low risk perception, medication as a reminder of HIV, and nondisclosure, but described different contexts to these common barriers. Common and unique barriers emerged for behaviorally infected and perinatally infected youth reflecting varying HIV experiences and psychosocial contexts. We developed a customizable intervention addressing identified barriers and their psychosocial antecedents.
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Affiliation(s)
| | | | | | | | - Margie R. Skeer
- Fenway Health, Boston, Massachusetts, USA
- Tufts University, Boston, Massachusetts, USA
| | | | - Matthew J. Mimiaga
- Fenway Health, Boston, Massachusetts, USA
- Brown University, Providence, Rhode Island, USA
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23
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Gustavson AM, Jones J, Morrow KJ, Stevens-Lapsley JE. Preparing for the Future of Post-Acute Care: A Metasynthesis of Qualitative Studies. HOME HEALTH CARE MANAGEMENT AND PRACTICE 2017; 29:70-80. [PMID: 34908822 DOI: 10.1177/1084822316678195] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
Despite poor outcomes for older adults following hospitalization, practice patterns of post-acute care clinicians and factors impacting quality of care are not well studied, which limits advancements in clinical care. Qualitative research on the factors that influence physician practice patterns with respect to older adults has been studied and may provide a framework for hypothesizing factors relevant to other post-acute care clinicians. Three themes emerged from this qualitative metasynthesis: (1) Current medical education and clinical guidelines are not aligned with the multifaceted care needed for older adults, (2) communication gaps impact quality of care, and (3) health policies constrain quality of care. Identifying potential factors that impact practice patterns in post-acute care providers may guide future research initiatives that shape health professional education and system policies.
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Affiliation(s)
- Allison M Gustavson
- University of Colorado, Physical Therapy Program, Department of Physical Medicine and Rehabilitation, Aurora, CO, USA
| | | | - Kelly J Morrow
- University of Colorado, College of Nursing, Aurora, CO, USA.,University of Nevada, School of Nursing, Las Vegas, NV, USA
| | - Jennifer E Stevens-Lapsley
- University of Colorado, Physical Therapy Program, Department of Physical Medicine and Rehabilitation, Aurora, CO, USA.,Veterans Affairs Medical Center, Geriatric Research, Education and Clinical Center, Denver, CO, USA
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Lachal J, Revah-Levy A, Orri M, Moro MR. Metasynthesis: An Original Method to Synthesize Qualitative Literature in Psychiatry. Front Psychiatry 2017; 8:269. [PMID: 29249996 PMCID: PMC5716974 DOI: 10.3389/fpsyt.2017.00269] [Citation(s) in RCA: 137] [Impact Index Per Article: 19.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/05/2017] [Accepted: 11/17/2017] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Metasynthesis-the systematic review and integration of findings from qualitative studies-is an emerging technique in medical research that can use many different methods. Nevertheless, the method must be appropriate to the specific scientific field in which it is used. The objective is to describe the steps of a metasynthesis method adapted from Thematic Synthesis and phenomenology to fit the particularities of psychiatric research. METHOD We detail each step of the method used in a metasynthesis published in 2015 on adolescent and young adults suicidal behaviors. We provide clarifications in several methodological points using the latest literature on metasyntheses. The method is described in six steps: define the research question and the inclusion criteria, select the studies, assess their quality, extract and present the formal data, analyze the data, and express the synthesis. CONCLUSION Metasyntheses offer an appropriate balance between an objective framework, a rigorously scientific approach to data analysis and the necessary contribution of the researcher's subjectivity in the construction of the final work. They propose a third level of comprehension and interpretation that brings original insights, improve the global understanding in psychiatry, and propose immediate therapeutic implications. They should be included in the psychiatric common research toolkit to become better recognized by clinicians and mental health professionals.
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Affiliation(s)
- Jonathan Lachal
- AP-HP, Cochin Hospital, Maison de Solenn, Paris, France.,Université Paris Descartes, Sorbonne Paris Cité, Paris, France.,CESP, Faculté de médecine, Université Paris-Sud, Faculté de médecine, Université de Versailles Saint-Quentin-en-Yvelines (UVSQ), INSERM, Université Paris-Saclay, Villejuif, France
| | - Anne Revah-Levy
- Service Universitaire de Psychiatrie de l'Adolescent, Centre Hospitalier Argenteuil, Argenteuil, France.,ECSTRA Team, UMR-1153, INSERM, Paris Diderot University, Sorbonne Paris Cité, Paris, France
| | - Massimiliano Orri
- Université Paris Descartes, Sorbonne Paris Cité, Paris, France.,CESP, Faculté de médecine, Université Paris-Sud, Faculté de médecine, Université de Versailles Saint-Quentin-en-Yvelines (UVSQ), INSERM, Université Paris-Saclay, Villejuif, France.,Université Paris-Sud, Paris, France
| | - Marie Rose Moro
- AP-HP, Cochin Hospital, Maison de Solenn, Paris, France.,Université Paris Descartes, Sorbonne Paris Cité, Paris, France.,CESP, Faculté de médecine, Université Paris-Sud, Faculté de médecine, Université de Versailles Saint-Quentin-en-Yvelines (UVSQ), INSERM, Université Paris-Saclay, Villejuif, France
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Barrett A, Galvin R, Steinert Y, Scherpbier A, O'Shaughnessy A, Horgan M, Horsley T. A BEME (Best Evidence in Medical Education) review of the use of workplace-based assessment in identifying and remediating underperformance among postgraduate medical trainees: BEME Guide No. 43. MEDICAL TEACHER 2016; 38:1188-1198. [PMID: 27626710 DOI: 10.1080/0142159x.2016.1215413] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
INTRODUCTION The extent to which workplace-based assessment (WBA) can be used as a facilitator of change among trainee doctors has not been established; this is particularly important in the case of underperforming trainees. The aim of this review is to examine the use of WBA in identifying and remediating performance among this cohort. METHODS Following publication of a review protocol a comprehensive search of eight databases took place to identify relevant articles published prior to November 2015. All screening, data extraction and analysis procedures were performed in duplicate or with quality checks and necessary consensus methods throughout. Given the study-level heterogeneity, a descriptive synthesis approach informed the study analysis. RESULTS Twenty studies met the inclusion criteria. The use of WBA within the context of remediation is not supported within the existing literature. The identification of underperformance is not supported by the use of stand-alone, single-assessor WBA events although specific areas of underperformance may be identified. Multisource feedback (MSF) tools may facilitate identification of underperformance. CONCLUSION The extent to which WBA can be used to detect and manage underperformance in postgraduate trainees is unclear although evidence to date suggests that multirater assessments (i.e. MSF) may be of more use than single-rater judgments (e.g. mini-clinical evaluation exercise).
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Affiliation(s)
- Aileen Barrett
- a Education, Innovation and Research , Royal College of Physicians of Ireland , Dublin , Ireland
- b School of Medicine, College of Medicine and Health Sciences, Brookfield Health Sciences Complex, University College Cork , Cork , Ireland
| | - Rose Galvin
- c Discipline of Physiotherapy, Department of Clinical Therapies, Faculty of Education and Health Sciences , University of Limerick , Limerick , Ireland
| | - Yvonne Steinert
- d Centre for Medical Education, Faculty of Medicine, McGill University , Montreal , Quebec , Canada
| | - Albert Scherpbier
- e Faculty of Health, Medicine and Life Sciences , University of Maastricht , Maastricht , The Netherlands
| | - Ann O'Shaughnessy
- a Education, Innovation and Research , Royal College of Physicians of Ireland , Dublin , Ireland
| | - Mary Horgan
- b School of Medicine, College of Medicine and Health Sciences, Brookfield Health Sciences Complex, University College Cork , Cork , Ireland
| | - Tanya Horsley
- f Research Unit, Royal College of Physicians and Surgeons of Canada , Ottawa , Canada
- g Faculty of Medicine , University of Ottawa , Ottawa , Ontario , Canada
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Chong L, Jamieson NJ, Gill D, Singh-Grewal D, Craig JC, Ju A, Hanson CS, Tong A. Children's Experiences of Epilepsy: A Systematic Review of Qualitative Studies. Pediatrics 2016; 138:peds.2016-0658. [PMID: 27511947 DOI: 10.1542/peds.2016-0658] [Citation(s) in RCA: 42] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 06/06/2016] [Indexed: 11/24/2022] Open
Abstract
CONTEXT Epilepsy is a common and severe neurologic disease associated with increased mortality, seizure-related injury, and adverse psychological and quality-of-life outcomes. OBJECTIVE To describe the perspectives of children and adolescents with epilepsy. DATA SOURCES Medline, Embase, PsycINFO, and CINAHL from inception to August 2015. STUDY SELECTION Qualitative studies on children's experiences of epilepsy. DATA EXTRACTION Results from primary studies. We used thematic synthesis to analyze the findings. RESULTS Forty-three articles involving 951 participants aged 3 to 21 years across 21 countries were included. We identified 6 themes: loss of bodily control (being overtaken, susceptibility to physical harm, fragility of the brain, alertness to mortality, incapacitating fatigue), loss of privacy (declarative disease, humiliating involuntary function, unwanted special attention, social embarrassment of medicine-taking), inescapable inferiority and discrimination (vulnerability to prejudice, inability to achieve academically, consciousness of abnormality, parental shame, limiting social freedom), therapeutic burden and futility (unattainable closure, financial burden, overwhelming life disruption, exhaustion from trialing therapies, insurmountable side effects, awaiting a fabled remission), navigating health care (empowerment through information, valuing empathetic and responsive care, unexpected necessity of transition, fragmented and inconsistent care), and recontextualizing to regain normality (distinguishing disease from identity, taking ownership, gaining perspective and maturity, social and spiritual connectedness). LIMITATIONS Non-English articles were excluded. CONCLUSIONS Children with epilepsy experience vulnerability, disempowerment, and discrimination. Repeated treatment failure can raise doubt about the attainment of remission. Addressing stigma, future independence, and fear of death may improve the overall well-being of children with epilepsy.
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Affiliation(s)
- Lauren Chong
- Sydney School of Public Health and Kids Research Institute
| | | | | | - Davinder Singh-Grewal
- Discipline of Paediatrics and Child Health, University of Sydney, Sydney, New South Wales, Australia; Department of General Medicine, The Children's Hospital at Westmead, Sydney, New South Wales, Australia; and School of Maternal and Child Health, University of New South Wales, Sydney, New South Wales, Australia
| | | | - Angela Ju
- Sydney School of Public Health and Kids Research Institute
| | | | - Allison Tong
- Sydney School of Public Health and Kids Research Institute,
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Tong A, Hanson CS, Chapman JR, Halleck F, Budde K, Josephson MA, Craig JC. 'Suspended in a paradox'-patient attitudes to wait-listing for kidney transplantation: systematic review and thematic synthesis of qualitative studies. Transpl Int 2015; 28:771-87. [PMID: 25847569 DOI: 10.1111/tri.12575] [Citation(s) in RCA: 40] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2015] [Revised: 02/23/2015] [Accepted: 03/31/2015] [Indexed: 12/21/2022]
Abstract
Patients on waiting lists for kidney transplantation have higher mortality rates and have specific anxieties about their eligibility, process, and outcomes of wait-listing. We aimed to describe patient experiences and attitudes to wait-listing for kidney transplantation. Electronic databases were searched to September 2014. Thematic synthesis was used to analyze the findings. From 22 studies (n = 795 patients), we identified six themes: accepting the only option (chance to regain normality, avoiding guilt, impulsive decision-making); maintaining hope (determined optimism, appreciating a fortuitous gift, enduring for optimal outcomes, trust in clinical judgment); burden of testing (strenuous commitment, losing the battle, medical mistrust); permeating vulnerability (eligibility enigma, being threatened, angst of timing uncertainty, desperate urgency, living in limbo, spiraling doubt and disappointment, residual ambivalence); deprived of opportunity (unfairly dismissed, unexpected disqualification, self-resignation and acceptance, jealousy, suspicious of inequity); and moral guilt (awaiting someone's death, questioning deservingness). The waiting list offered hope of restored normality. However, the demands of workup, uncertainty about eligibility, and waiting times that exceeded expectations impelled patients to disillusionment, despair, and suspicion of inequity. Managing patient expectations and ensuring transparency of wait-listing and allocation decisions may allay patient disappointment and skepticism, to improve patient satisfaction and treatment outcomes.
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Affiliation(s)
- Allison Tong
- Sydney School of Public Health, The University of Sydney, Sydney, NSW, Australia.,Centre for Kidney Research, The Children's Hospital at Westmead, Westmead, NSW, Australia
| | - Camilla S Hanson
- Sydney School of Public Health, The University of Sydney, Sydney, NSW, Australia.,Centre for Kidney Research, The Children's Hospital at Westmead, Westmead, NSW, Australia
| | - Jeremy R Chapman
- Centre for Transplant and Renal Research, Westmead Hospital, Westmead, NSW, Australia
| | - Fabian Halleck
- Department of Nephrology, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Klemens Budde
- Department of Nephrology, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | | | - Jonathan C Craig
- Sydney School of Public Health, The University of Sydney, Sydney, NSW, Australia.,Centre for Kidney Research, The Children's Hospital at Westmead, Westmead, NSW, Australia
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