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Van Leeuwen E, Maund E, Woods C, Bowers H, Christiaens T, Kendrick T. Health care professional barriers and facilitators to discontinuing antidepressant use: A systematic review and thematic synthesis. J Affect Disord 2024; 356:616-627. [PMID: 38640978 DOI: 10.1016/j.jad.2024.04.060] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/21/2023] [Revised: 04/12/2024] [Accepted: 04/14/2024] [Indexed: 04/21/2024]
Abstract
INTRODUCTION Long-term antidepressant (AD) use, much longer than recommended, is very common and can lead to potential harms. OBJECTIVE To investigate the existing literature on perspectives of health professionals (HPs) regarding long-term AD treatment, focusing on barriers and facilitators to discontinuation. METHODS A systematic review with thematic synthesis. Eight electronic databases were searched until August 2023 including MEDLINE, PubMed, Embase, PsycINFO, CINAHL, AMED, Health Management Information Consortium, and the Networked Digital Library of Theses and Dissertation. RESULTS Thirteen studies were included in the review. Of these, nine focused on general practitioner perspectives, one on psychiatrist perspectives, and three on a mix of HPs perspectives. Barriers and facilitators to discontinuing long-term ADs emerged within eight themes, ordered chronologically based on HP considerations during an AD review: perception of AD use, fears, HP role and responsibility, HPs' perception of AD discontinuation, HPs' confidence regarding their ability to manage discontinuation, perceived patient readiness to stop, support from patient's trusted people, and support from other HPs. LIMITATIONS Coding and development of subthemes and themes was performed by one researcher and further developed through discussion within the research team. CONCLUSION Deprescribing long-term ADs is a challenging concept for HPs. The review found evidence that the barriers far outweigh the facilitators with fear of relapse as a main barrier. HP education, reassurance and confidence-building is essential to increase the initiation of the discontinuation process. Further research into the perspectives of pharmacists and mental health workers is needed as well as exploring the role of trusted people.
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Affiliation(s)
- Ellen Van Leeuwen
- Clinical Pharmacology Unit, Department of Basic and Applied Medical Sciences, Ghent University, Belgium; Department of Public Health and Primary Care, Ghent University, Belgium.
| | - Emma Maund
- Primary Care Research Centre, School of Primary Care, Population Health & Medical Education, University of Southampton, Southampton, United Kingdom
| | - Catherine Woods
- Primary Care Research Centre, School of Primary Care, Population Health & Medical Education, University of Southampton, Southampton, United Kingdom
| | - Hannah Bowers
- Primary Care Research Centre, School of Primary Care, Population Health & Medical Education, University of Southampton, Southampton, United Kingdom
| | - Thierry Christiaens
- Clinical Pharmacology Unit, Department of Basic and Applied Medical Sciences, Ghent University, Belgium
| | - Tony Kendrick
- Primary Care Research Centre, School of Primary Care, Population Health & Medical Education, University of Southampton, Southampton, United Kingdom
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Vinogradov R, Holden E, Patel M, Grigg R, Errington L, Araújo-Soares V, Rankin J. Barriers and facilitators of adherence to low-dose aspirin during pregnancy: A co-produced systematic review and COM-B framework synthesis of qualitative evidence. PLoS One 2024; 19:e0302720. [PMID: 38701053 PMCID: PMC11068207 DOI: 10.1371/journal.pone.0302720] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2024] [Accepted: 04/10/2024] [Indexed: 05/05/2024] Open
Abstract
INTRODUCTION Women at increased risk of developing pre-eclampsia are advised to take a daily low-dose of aspirin from 12 weeks of pregnancy to reduce their risks. Despite the well-established prophylactic effect of aspirin, adherence to this therapy is low. This systematic review aimed to summarise evidence on the barriers and facilitators of adherence to low-dose aspirin to inform intervention development to support decision making and persistence with aspirin use for pre-eclampsia prevention. MATERIALS AND METHODS A systematic review and meta-synthesis of qualitative research was co-produced by representatives from charities, and public, clinical and academic members. Eight electronic databases (MEDLINE, PsycINFO, CINAHL, Web of Science, Scopus, EMBASE, Prospero, OpenGrey), archives of charities and professional organisations were searched (between October and November 2023 and re-run in August 2023) using predefined search terms. Studies containing qualitative components related to barriers and facilitators of adherence to low-dose aspirin during pregnancy were included. Quality assessment was performed using the Critical Appraisal Skills Programme checklist for qualitative research. A combination of the COM-B framework with phases of adherence process as defined by international taxonomy was used as the coding framework. Co-production activities were facilitated by use of 'Zoom' and 'Linoit'. RESULTS From a total of 3377 papers identified through our searches, five published studies and one dissertation met our inclusion criteria. Studies were published from 2019 to 2022 covering research conducted in the USA, Canada, UK, Netherlands and Australia. Barriers and facilitators to adherence were mapped to six categories of the COM-B for three phases of adherence: initiation, implementation, and discontinuation. The discontinuation phase of adherence was only mentioned by one author. Four key themes were identified relating to pregnancy: 'Insufficient knowledge', 'Necessity concerns balance', 'Access to medicine', 'Social influences', and 'Lack of Habit'. CONCLUSIONS The COM-B framework allowed for detailed mapping of key factors shaping different phases of adherence in behavioural change terms and now provides a solid foundation for the development of a behavioural intervention. Although potential intervention elements could be suggested based on the results of this synthesis, additional co-production work is needed to define elements and plan for the delivery of the future intervention. TRIAL REGISTRATION PROSPERO CRD42022359718. https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42022359718.
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Affiliation(s)
- Raya Vinogradov
- Population Health Sciences Institute, Newcastle University, Newcastle, United Kingdom
- National Institute of Health and Care Research Applied Research Collaboration North East and North Cumbria, Newcastle, United Kingdom
- Research Directorate, Newcastle upon Tyne NHS Hospitals Foundation Trust, Newcastle, United Kingdom
| | - Eleanor Holden
- Public Contributor and Expert by Experience, London, United Kingdom
| | - Mehali Patel
- Public Contributor and Expert by Experience, London, United Kingdom
- Stillbirth and Neonatal Death Society (Sands), Charitable Organisation, London, United Kingdom
| | - Rowan Grigg
- Public Contributor and Expert by Experience, London, United Kingdom
- Action on Pre-eclampsia (APEC), Charitable Organisation, Evesham, United Kingdom
| | - Linda Errington
- Population Health Sciences Institute, Newcastle University, Newcastle, United Kingdom
| | - Vera Araújo-Soares
- Medical Faculty Mannheim, Division of Prevention, Center for Preventive Medicine and Digital Health (CPD), Heidelberg University, Heidelberg, Germany
| | - Judith Rankin
- Population Health Sciences Institute, Newcastle University, Newcastle, United Kingdom
- National Institute of Health and Care Research Applied Research Collaboration North East and North Cumbria, Newcastle, United Kingdom
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Fletcher S, Jenner K, Holland M, Khair K. Barriers to gene therapy, understanding the concerns people with haemophilia have: an exigency sub-study. Orphanet J Rare Dis 2024; 19:59. [PMID: 38341591 PMCID: PMC10859013 DOI: 10.1186/s13023-024-03068-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2023] [Accepted: 02/03/2024] [Indexed: 02/12/2024] Open
Abstract
BACKGROUND Gene therapy has the potential to offer people with haemophilia (PwH) a life free from bleeding and the burden posed by current treatment regimens. To date, gene therapy has only been available in clinical trial settings, to PwH without pre-existing or historical factor inhibitors, significant concomitant liver damage or pre-existing neutralising antibodies to the adeno-associated viruses used to deliver the therapy. Thus, most PwH treated at centres not currently involved in gene therapy trials, either as a referral/follow-up centre or as a dosing centre, have been unable to access the therapy. This Exigency sub-study aims to gain a greater understanding of the opinions of PwH in the United Kingdom who have not had access to gene therapy: asking what they understand, what concerns they have, and whether they perceive any barriers preventing their access to gene therapy. RESULTS Twenty-three PwH were approached; 14 consented, and one withdrew prior to interview. The mean age of the participants was 35.7 years (range 25-74 years). Eleven had haemophilia A and two haemophilia B. Two were treated with standard half-life factor products, five with extended half-life products, five with a FVIII mimetic and one with a clinical trial product. One family member (a participant's partner) was also interviewed. The participants identified four barriers to gene therapy: concerns about the process of gene therapy (Expectations), uncertainty about the results (outcomes), (Access) to treatment, and a lack of understanding about gene therapy (education). CONCLUSIONS This Exigency study subgroup sees gene therapy as a positive treatment development that promises an improved quality of life. For this participant group, four issues impact their decision to undergo gene therapy. If the promise of gene therapy is to be realised, these barriers need to be acknowledged and addressed by healthcare professionals, patient organisations, and gene therapy providers.
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Affiliation(s)
- Simon Fletcher
- Haemnet, London, N15 3JR, UK.
- Oxford Haemophilia and Thrombosis Centre, Oxford University Hospitals NHS Foundation Trust, Oxford, OX3 7LE, UK.
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Bayuo J, Aziato L, Wong KCA, Su J, Abu-Odah H, Wong FKY. Phenomenography: An emerging qualitative research design for nursing. J Adv Nurs 2024; 80:821-834. [PMID: 37743604 DOI: 10.1111/jan.15874] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2023] [Revised: 07/25/2023] [Accepted: 09/11/2023] [Indexed: 09/26/2023]
Abstract
BACKGROUND Phenomenography emerged from pedagogy to examine the qualitatively different ways that individuals experience and perceive the same phenomenon. Despite its uniqueness, the uptake of phenomenography in nursing research is still limited. Potentially, this may be related to confusion regarding what the design is about, its philosophical underpinnings and how distinct it is from other qualitative designs. OBJECTIVES To offer a better understanding of phenomenography by comparing it with other established qualitative research designs, examining its theoretical foundations, highlighting some studies that have employed the approach in nursing and offering methodological guidance to improve its uptake in nursing. DESIGN Discussion paper. FINDINGS Compared to the traditional qualitative designs employed in nursing, phenomenography has been utilized in fewer studies. The ontological, epistemological and methodological basis of phenomenography highlights it as a distinct design. The strength of phenomenography lies in its emphasis on understanding the collective variations between participants and presenting these holistically as an 'outcome space'. DISCUSSION Phenomenography is a distinct qualitative research approach that presents a unique opportunity for nursing to further its use. Issues regarding bracketing, the inclusion of phenomenography studies in qualitative meta-synthesis and employing a hermeneutic approach to phenomenography are avenues for further work in nursing. PATIENT AND PUBLIC CONTRIBUTION No patient or public contribution.
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Affiliation(s)
- Jonathan Bayuo
- School of Nursing, The Hong Kong Polytechnic University, Kowloon, Hong Kong
| | - Lydia Aziato
- University of Health and Allied Sciences, Hohoe, Ghana
| | | | - Jingjing Su
- School of Nursing, The Hong Kong Polytechnic University, Kowloon, Hong Kong
| | - Hammoda Abu-Odah
- School of Nursing, The Hong Kong Polytechnic University, Kowloon, Hong Kong
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Rogan J, Bucci S, Firth J. Health Care Professionals' Views on the Use of Passive Sensing, AI, and Machine Learning in Mental Health Care: Systematic Review With Meta-Synthesis. JMIR Ment Health 2024; 11:e49577. [PMID: 38261403 PMCID: PMC10848143 DOI: 10.2196/49577] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/02/2023] [Revised: 10/30/2023] [Accepted: 11/01/2023] [Indexed: 01/24/2024] Open
Abstract
BACKGROUND Mental health difficulties are highly prevalent worldwide. Passive sensing technologies and applied artificial intelligence (AI) methods can provide an innovative means of supporting the management of mental health problems and enhancing the quality of care. However, the views of stakeholders are important in understanding the potential barriers to and facilitators of their implementation. OBJECTIVE This study aims to review, critically appraise, and synthesize qualitative findings relating to the views of mental health care professionals on the use of passive sensing and AI in mental health care. METHODS A systematic search of qualitative studies was performed using 4 databases. A meta-synthesis approach was used, whereby studies were analyzed using an inductive thematic analysis approach within a critical realist epistemological framework. RESULTS Overall, 10 studies met the eligibility criteria. The 3 main themes were uses of passive sensing and AI in clinical practice, barriers to and facilitators of use in practice, and consequences for service users. A total of 5 subthemes were identified: barriers, facilitators, empowerment, risk to well-being, and data privacy and protection issues. CONCLUSIONS Although clinicians are open-minded about the use of passive sensing and AI in mental health care, important factors to consider are service user well-being, clinician workloads, and therapeutic relationships. Service users and clinicians must be involved in the development of digital technologies and systems to ensure ease of use. The development of, and training in, clear policies and guidelines on the use of passive sensing and AI in mental health care, including risk management and data security procedures, will also be key to facilitating clinician engagement. The means for clinicians and service users to provide feedback on how the use of passive sensing and AI in practice is being received should also be considered. TRIAL REGISTRATION PROSPERO International Prospective Register of Systematic Reviews CRD42022331698; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=331698.
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Affiliation(s)
- Jessica Rogan
- Division of Psychology and Mental Health, School of Health Sciences, Faculty of Biology, Medicine and Health, Manchester Academic Health Sciences, The University of Manchester, Manchester, United Kingdom
- Greater Manchester Mental Health NHS Foundation Trust, Manchester, United Kingdom
| | - Sandra Bucci
- Division of Psychology and Mental Health, School of Health Sciences, Faculty of Biology, Medicine and Health, Manchester Academic Health Sciences, The University of Manchester, Manchester, United Kingdom
- Greater Manchester Mental Health NHS Foundation Trust, Manchester, United Kingdom
| | - Joseph Firth
- Division of Psychology and Mental Health, School of Health Sciences, Faculty of Biology, Medicine and Health, Manchester Academic Health Sciences, The University of Manchester, Manchester, United Kingdom
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Abbasi S, Maleki M, Imanipour M, Mardani A. Nursing students' experiences of teaching and learning during the COVID-19 pandemic: a systematic review and meta-synthesis of qualitative studies. Int J Nurs Educ Scholarsh 2024; 21:ijnes-2023-0094. [PMID: 38407250 DOI: 10.1515/ijnes-2023-0094] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2023] [Accepted: 01/31/2024] [Indexed: 02/27/2024]
Abstract
INTRODUCTION During the COVID-19 pandemic, the sudden transition to virtual learning led to several challenges for nursing students. This study aimed to synthesis nursing students' experiences of teaching and learning during the COVID-19 pandemic. CONTENT A meta-synthesis of qualitative articles were conducted. Three online databases were searched from December 2019 to December 2022. Qualitative studies and qualitative sections of mixed method studies were included. SUMMARY Twenty-four qualitative studies and seven mixed-method studies were included in the review. The findings consisted of one main theme "educational transformation", and three categories "challenging face-to-face clinical training", "transition from face-to-face to virtual education", and "support continua". The evidence indicated that during this health-related crisis, most of the training was provided as distance learning in various forms. According to the findings, distance education alone cannot replace face-to-face education and is suggested to be considered as a supplementary learning method. OUTLOOK This study provides a comprehensive understanding of nursing students' experiences during the COVID-19 pandemic, offering practical implications for educators and institutions globally. The lessons learned can inform strategic decisions, policies, and practices to enhance the resilience and adaptability of nursing education in the face of unforeseen challenges.
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Affiliation(s)
- Soheila Abbasi
- Department of Pediatric and Neonatal Intensive Care Nursing Education, School of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, Iran
| | - Maryam Maleki
- Department of Pediatric and Neonatal Intensive Care Nursing Education, School of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, Iran
| | - Masoomeh Imanipour
- Nursing and Midwifery Care Research Center, Department of Critical Care Nursing, School of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, Iran
| | - Abbas Mardani
- Department of Medical-Surgical Nursing, School of Nursing and Midwifery, Zanjan University of Medical Sciences, Zanjan, Iran
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Bitar S, Collonnaz M, O'Loughlin J, Kestens Y, Ricci L, Martini H, Agrinier N, Minary L. A Systematic Review of Qualitative Studies on Factors Associated With Smoking Cessation Among Adolescents and Young Adults. Nicotine Tob Res 2024; 26:2-11. [PMID: 37648287 DOI: 10.1093/ntr/ntad167] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2023] [Revised: 08/02/2023] [Accepted: 08/28/2023] [Indexed: 09/01/2023]
Abstract
OBJECTIVE To summarize findings from qualitative studies on factors associated with smoking cessation among adolescents and young adults. DATA SOURCES We searched Pubmed, Psychinfo, CINAHL, Embase, Web of Science, and SCOPUS databases, as well as reference lists, for peer-reviewed articles published in English or French between January 1, 2000, and November 18, 2020. We used keywords such as adolescents, determinants, cessation, smoking, and qualitative methods. STUDY SELECTION Of 1724 records identified, we included 39 articles that used qualitative or mixed methods, targeted adolescents and young adults aged 10-24, and aimed to identify factors associated with smoking cessation or smoking reduction. DATA EXTRACTION Two authors independently extracted the data using a standardized form. We assessed study quality using the National Institute for Health and Care Excellence checklist for qualitative studies. DATA SYNTHESIS We used an aggregative meta-synthesis approach and identified 39 conceptually distinct factors associated with smoking cessation. We grouped them into two categories: (1) environmental factors [tobacco control policies, pro-smoking norms, smoking cessation services and interventions, influence of friends and family], and (2) individual attributes (psychological characteristics, attitudes, pre-quitting smoking behavior, nicotine dependence symptoms, and other substances use). We developed a synthetic framework that captured the factors identified, the links that connect them, and their associations with smoking cessation. CONCLUSIONS This qualitative synthesis offers new insights on factors related to smoking cessation services, interventions, and attitudes about cessation (embarrassment when using cessation services) not reported in quantitative reviews, supplementing limited evidence for developing cessation programs for young persons who smoke. IMPLICATIONS Using an aggregative meta-synthesis approach, this study identified 39 conceptually distinct factors grouped into two categories: Environmental factors and individual attributes. These findings highlight the importance of considering both environmental and individual factors when developing smoking cessation programs for young persons who smoke. The study also sheds light on self-conscious emotions towards cessation, such as embarrassment when using cessation services, which are often overlooked in quantitative reviews. Overall, this study has important implications for developing effective smoking cessation interventions and policies that address the complex factors influencing smoking behavior among young persons.
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Affiliation(s)
- Sarah Bitar
- Université de Lorraine, APEMAC, Nancy, France
| | | | - Jennifer O'Loughlin
- École de Santé Publique de l'Université de Montréal (ESPUM), Montreal, QC, Canada
| | - Yan Kestens
- École de Santé Publique de l'Université de Montréal (ESPUM), Montreal, QC, Canada
- Centre de recherche du CHUM (CRCHUM), Université de Montréal, Montreal, QC, Canada
| | - Laetitia Ricci
- Université de Lorraine, APEMAC, Nancy, France
- CHRU-Nancy, INSERM, Université de Lorraine, CIC, Epidémiologie Clinique, Nancy, France
| | - Hervé Martini
- Service de Médecine L/ Addictologie CHRU de Nancy, Hôpitaux de Brabois - Bâtiment Philippe Canton, Rue du Morvan, Vandœuvre-lès-Nancy, France
| | - Nelly Agrinier
- Université de Lorraine, APEMAC, Nancy, France
- CHRU-Nancy, INSERM, Université de Lorraine, CIC, Epidémiologie Clinique, Nancy, France
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Morton J, Vignato J, Anbari AB. Stigma Experienced by Perinatal Women with Opioid Dependency in the United States: A Qualitative Meta-Synthesis. West J Nurs Res 2023; 45:843-853. [PMID: 37382361 DOI: 10.1177/01939459231182495] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/30/2023]
Abstract
Stigma is a barrier to accessing care and treatment for perinatal women with pain and opioid dependency, resulting in increased maternal/neonatal morbidity and mortality, prolonged neonatal hospitalizations, and increased healthcare-related costs. This theory-generating qualitative meta-synthesis includes 18 qualitative research reports and describes the stigma-related experiences of perinatal women with opioid dependency. A model emerged consisting of cyclical yet pivotal care points, facilitators/deterrents of stigma, and stigma experiences including infant-associative stigma. Findings of this qualitative meta-synthesis include the following: (a) Perinatal stigma experiences may prevent women from accessing care; (b) Infant-associative stigma may influence the woman to deflect stigma from her infant onto herself; and (c) There is the risk of mothers withdrawing their infants from healthcare to protect from future anticipated stigma. Implications reveal ideal time points to enact healthcare interventions to reduce perinatal stigma experiences and its consequences on maternal/child health and wellness.
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Affiliation(s)
| | | | - Allison B Anbari
- University of Missouri Sinclair School of Nursing, Columbia, Missouri, USA
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Hill Z, Zafar S, Soremekun S, Sikander S, Avan BI, Roy R, Aziz S, Kumar D, Parveen N, Saleem S, Verma D, Sharma KK, Skordis J, Hafeez A, Rahman A, Kirkwood B, Divan G. Can home visits for early child development be implemented with sufficient coverage and quality at scale? Evidence from the SPRING program in India and Pakistan. Front Nutr 2023; 10:1152548. [PMID: 37404854 PMCID: PMC10315833 DOI: 10.3389/fnut.2023.1152548] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2023] [Accepted: 03/27/2023] [Indexed: 07/06/2023] Open
Abstract
Introduction There is limited evidence from low and middle-income settings on the effectiveness of early child development interventions at scale. To bridge this knowledge-gap we implemented the SPRING home visiting program where we tested integrating home visits into an existing government program (Pakistan) and employing a new cadre of intervention workers (India). We report the findings of the process evaluation which aimed to understand implementation. Methods and materials We collected qualitative data on acceptability and barriers and facilitators for change through 24 in-depth interviews with mothers; eight focus group discussions with mothers, 12 with grandmothers, and 12 with fathers; and 12 focus group discussions and five in-depth interviews with the community-based agents and their supervisors. Results Implementation was sub-optimal in both settings. In Pakistan issues were low field-supervision coverage and poor visit quality related to issues scheduling supervision, a lack of skill development, high workloads and competing priorities. In India, issues were low visit coverage - in part due to employing new workers and an empowerment approach to visit scheduling. Coaching caregivers to improve their skills was sub-optimal in both sites, and is likely to have contributed to caregiver perceptions that the intervention content was not new and was focused on play activities rather than interaction and responsivity - which was a focus of the coaching. In both sites caregiver time pressures was a key reason for low uptake among families who received visits. Discussion Programs need feasible strategies to maximize quality, coverage and supervision including identifying and managing problems through monitoring and feedback loops. Where existing community-based agents are overstretched and system strengthening is unlikely, alternative implementation strategies should be considered such as group delivery. Core intervention ingredients such as coaching should be prioritized and supported during training and implementation. Given that time and resource constraints were a key barrier for families a greater focus on communication, responsivity and interaction during daily activities could have improved feasibility.
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Affiliation(s)
- Zelee Hill
- Institute for Global Health, University College London, London, United Kingdom
| | - Shamsa Zafar
- Fazaia Medical College, Air University, Islamabad, Pakistan
| | - Seyi Soremekun
- London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Siham Sikander
- Global Institute of Human Development, Shifa Tameer-e-Millat University, Islamabad, Pakistan
- Institute of Population Health, University of Liverpool, Liverpool, United Kingdom
| | - Bilal Iqbal Avan
- London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Reetabrata Roy
- London School of Hygiene and Tropical Medicine, London, United Kingdom
- Sangath, Goa, India
| | - Sarmad Aziz
- Institute for Global Health, University College London, London, United Kingdom
| | | | - Nazia Parveen
- Global Institute of Human Development, Shifa Tameer-e-Millat University, Islamabad, Pakistan
| | - Shumaila Saleem
- Global Institute of Human Development, Shifa Tameer-e-Millat University, Islamabad, Pakistan
| | | | | | - Jolene Skordis
- Institute for Global Health, University College London, London, United Kingdom
| | | | - Atif Rahman
- Institute of Population Health, University of Liverpool, Liverpool, United Kingdom
| | - Betty Kirkwood
- London School of Hygiene and Tropical Medicine, London, United Kingdom
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Banwell E, Qualter P, Humphrey N. Barriers and facilitators to training delivery and subsequent implementation of a localised child and adolescent mental health initiative: a qualitative content analysis. BMC MEDICAL EDUCATION 2023; 23:264. [PMID: 37076849 PMCID: PMC10113980 DOI: 10.1186/s12909-023-04238-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/16/2022] [Accepted: 04/06/2023] [Indexed: 05/03/2023]
Abstract
BACKGROUND Ensuring that children and young people (CYP) can obtain mental health support from a broad variety of sources is of upmost importance. This is especially true given the increasing prevalence of mental health difficulties in this population, and the associated challenges with receiving support from specialised healthcare services. Equipping professionals, from a wide range of sectors, with the skills needed to provide this support is a vital starting point. This study explored the experiences of professionals who had participated in CYP mental health training modules that related directly to the local implementation of the THRIVE Framework for System Change in Greater Manchester, UK (GM i-THRIVE) to establish the perceived barriers and facilitators behind the implementation of this training programme. METHODS Directed qualitative content analysis of semi-structured interview data from nine CYP-facing professionals was conducted. Both the interview schedule and initial deductive coding strategy were developed using the findings of a systematic literature review by the authors, that was conducted to explore wider CYP mental health training experiences. This methodology was used to establish the presence or absence of these findings within GM i-THRIVE, before generating tailored recommendations for their training programme. RESULTS When the interview data were coded and analysed, a strong level of thematic similarity with the authors' review was found. However, we deduced that the emergence of additional themes might reflect the contextual uniqueness of GM i-THRIVE, that is likely to be further compounded by the COVID-19 pandemic. Six recommendations were made for further improvement. These included the facilitation of unstructured peer interaction during training, and ensuring that jargon and key words are fully clarified. CONCLUSIONS Methodological limitations, guidance for usage, and potential applications of the study's findings are explored. Whilst the findings were largely akin to those of the review, subtle yet important differences were found. These are likely to reflect the nuances of the training programme discussed, however, we tentatively suggest that our findings are transferable to similar training interventions. This study provides a valuable example of how qualitative evidence syntheses can be used to aid study design and analysis: an underused approach.
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Affiliation(s)
- Emily Banwell
- Institute of Education, University of Manchester, Ellen Wilkinson Building, Manchester, M13 9PL, UK.
| | - Pamela Qualter
- Institute of Education, University of Manchester, Ellen Wilkinson Building, Manchester, M13 9PL, UK
| | - Neil Humphrey
- Institute of Education, University of Manchester, Ellen Wilkinson Building, Manchester, M13 9PL, UK
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Wadi MM, Yusoff MSB, Taha MH, Shorbagi S, Nik Lah NAZ, Abdul Rahim AF. The framework of Systematic Assessment for Resilience (SAR): development and validation. BMC MEDICAL EDUCATION 2023; 23:213. [PMID: 37016407 PMCID: PMC10073620 DOI: 10.1186/s12909-023-04177-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/24/2022] [Accepted: 03/20/2023] [Indexed: 06/19/2023]
Abstract
BACKGROUND Burnout and depression among health professions education (HPE) students continue to rise, leading to unwanted effects that ultimately jeopardise optimal medical care and patient health. Promoting the resilience of medical students is one solution to this issue. Several interventions have been implemented to foster resilience, but they focus on aspects other than the primary cause: the assessment system. The purpose of this study is to develop a framework to promote resilience in assessment planning and practice. METHODS We followed the guidelines suggested by Whetten for constructing a theoretical model for framework development. There were four phases in the model development. In the first phase, different literature review methods were used, and additional students' perspectives were collected through focus group discussions. Then, using the data, we constructed the theoretical model in the second phase. In the third phase, we validated the newly developed model and its related guidelines. Finally, we performed response process validation of the model with a group of medical teachers. RESULTS The developed systematic assessment resilience framework (SAR) promotes four constructs: self-control, management, engagement, and growth, through five phases of assessment: assessment experience, assessment direction, assessment preparation, examiner focus, and student reflection. Each phase contains a number of practical guidelines to promote resilience. We rigorously triangulated each approach with its theoretical foundations and evaluated it on the basis of its content and process. The model showed high levels of content and face validity. CONCLUSIONS The SAR model offers a novel guideline for fostering resilience through assessment planning and practice. It includes a number of attainable and practical guidelines for enhancing resilience. In addition, it opens a new horizon for HPE students' future use of this framework in the new normal condition (post COVID 19).
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Affiliation(s)
- Majed Mohammed Wadi
- Medical Education Department, College of Medicine, Qassim University, Buraydah, Saudi Arabia
| | - Muhamad Saiful Bahri Yusoff
- Medical Education Department, School of Medical Sciences, Universiti Sains Malaysia, Kota Bharu, Kelantan Malaysia
| | - Mohamed Hassan Taha
- College of Medicine and Center of Medical Education, University of Sharjah, Sharjah, United Arab Emirates
| | - Sarra Shorbagi
- Department of Family and Community Medicine and Behavioral Science, College of Medicine, University of Sharjah, Sharjah, United Arab Emirates
| | - Nik Ahmad Zuky Nik Lah
- Obstetrics and Gynecology Department, School of Medical Sciences, Universiti Sains Malaysia, Kota Bharu, Kelantan Malaysia
| | - Ahmad Fuad Abdul Rahim
- Medical Education Department, School of Medical Sciences, Universiti Sains Malaysia, Kota Bharu, Kelantan Malaysia
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See ECW, Koh SSL, Baladram S, Shorey S. Role transition of newly graduated nurses from nursing students to registered nurses: A qualitative systematic review. NURSE EDUCATION TODAY 2023; 121:105702. [PMID: 36577288 DOI: 10.1016/j.nedt.2022.105702] [Citation(s) in RCA: 12] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/21/2022] [Revised: 12/12/2022] [Accepted: 12/15/2022] [Indexed: 06/17/2023]
Abstract
BACKGROUND The transition experience of newly graduated registered nurses is highly stressful and associated with high attrition rates. OBJECTIVES AND DESIGN This qualitative systematic review aims to consolidate the available evidence on the experiences of newly graduated registered nurses' role transition from nursing students to registered nurses. DATA SOURCES English language research published between 2010 and 2022 was searched using PubMed, CINAHL, Scopus, Embase, PsycInfo and ProQuest Dissertations and Thesis databases. REVIEW METHODS Data were extracted using a data extraction form and appraised using the Critical Appraisal Skills Programme (CASP) tool for published studies or the Authority, Accuracy, Coverage, Objectivity, Date, Significance checklist for unpublished studies or grey literature, respectively. RESULTS The review included 25 studies and the meta-synthesis identified four themes: (a) Knowledge deficit, (b) Overwhelming clinical practise, (c) Importance of workplace support, and (d) Meaning of "being a nurse". CONCLUSIONS Newly graduated registered nurses experienced facing knowledge deficits in the clinical setting and felt overwhelmed with work, especially for newly graduated registered nurses during the Covid-19 pandemic. Support from colleagues was invaluable, and they wished for better support through standardised transition programs. Despite nursing being mentally and physically exhausting, many newly graduated registered nurses regarded their profession satisfying and meaningful, however some eventually resigned. Understanding the transition experiences of newly graduated registered nurses can provide valuable insights on how to facilitate their transition and in turn decrease attrition rates, and ensure safe care for the patients and that public healthcare needs are met.
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Affiliation(s)
- Esther Cai Wah See
- Alice Lee Centre of Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Level 2, Clinical Research Centre, Block MD11, 10 Medical Drive, Singapore 117597, Singapore.
| | - Serena Siew Lin Koh
- Alice Lee Centre of Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Level 2, Clinical Research Centre, Block MD11, 10 Medical Drive, Singapore 117597, Singapore.
| | - Sara Baladram
- Alice Lee Centre of Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Level 2, Clinical Research Centre, Block MD11, 10 Medical Drive, Singapore 117597, Singapore.
| | - Shefaly Shorey
- Alice Lee Centre of Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Level 2, Clinical Research Centre, Block MD11, 10 Medical Drive, Singapore 117597, Singapore.
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Family Caregivers' Experiences of Caring for Patients With Head and Neck Cancer: A Systematic Review and Metasynthesis of Qualitative Studies. Cancer Nurs 2023; 46:E41-E61. [PMID: 35439200 PMCID: PMC9722382 DOI: 10.1097/ncc.0000000000001096] [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] [Indexed: 12/15/2022]
Abstract
BACKGROUND Family caregivers of head and neck cancer (HNC) patients undertook heavy care tasks and role responsibilities. They were facing multiple challenges during the patients' cancer trajectory. OBJECTIVE The aim of this study was to synthesize existing qualitative evidence regarding family caregivers' experiences of caring for HNC patients. METHODS A meta-aggregation approach was used. Articles were collected from MEDLINE, EMBASE, CINAHL, Web of Science, PsycINFO, and Cochrane Library. Supplementary resources were collected by scrutinizing reference lists and performing citation tracking. RESULTS A total of 20 studies were included and synthesized. Three meta-themes covering "accepting the diagnosis and treatment on patients: a distressing process," "facing changes of life and adapting to new roles," and "appreciating the external supports" were identified with 10 subthemes. There was high confidence in the evidence for "facing changes of life and adapting to new roles" and moderate confidence in the evidence for the other 2 meta-themes. CONCLUSIONS Taking care of HNC patients is a distressing process. Caregivers took on role responsibilities and developed strategies to make adjustments to life changes, so as to provide better care for patients. External supports regarding caregiving and self-care were desired. IMPLICATIONS FOR PRACTICE Psychological distress was common among caregivers and calls for routine clinical screening. Providing caregivers with practical strategies to deal with daily caregiving tasks was crucial. Healthcare workers can play a critical role in providing tailored support in different caregiving stages. The findings informed the interventions and future research to improve HNC caregivers' experiences.
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Munthe‐Kaas H, Nøkleby H, Rosenbaum S. User experiences of structured stakeholder engagement to consider transferability: The TRANSFER approach. CAMPBELL SYSTEMATIC REVIEWS 2022; 18:e1284. [PMID: 36908834 PMCID: PMC9577259 DOI: 10.1002/cl2.1284] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/18/2023]
Abstract
BACKGROUND Systematic reviews are increasingly used to inform decision-making in health, education, social care and environmental protection. However, decision makers still experience barriers to using reviews, including not knowing how findings might translate to their own contexts, and lack of collaboration with systematic review authors. The TRANSFER approach is a novel method that aims to support review authors to systematically and transparently collaborate with stakeholders to consider context and the transferability of review findings from the beginning of the review process. Such collaboration is intended to improve the usefulness and relevance of review findings for decision makers. OBJECTIVES We aim to explore the user experience of the TRANSFER approach conversation guide, and in doing so gain a better understanding of the role and perceived value of stakeholder engagement in systematic reviews for informed decision-making. METHODS We conducted four user tests of groups using the guide, organized around simulated meetings between review authors and stakeholders. Review authors led the meeting using the TRANSFER approach conversation guide. We audio-recorded and observed the meetings, collected feedback forms and conducted semi-structured interviews with review authors following the meeting. We analysed the data using framework analysis to examine the user experience of the TRANSFER approach conversation guide and of stakeholder engagement more generally. RESULTS Seventeen participants in four user groups participated in the user tests. Most participants were generally positive toward the structured approach using the conversation guide, and felt it would be useful in systematic review projects. We observed examples of misunderstanding of the terminology included in the guide, and received multiple suggestions for how to make the conversation guide more user friendly. We observed numerous challenges related to the hypothetical nature of a user test, including lack of familiarity with the review question/topic among participants and lack of preparation for the meeting. CONCLUSIONS Review authors and stakeholders are positive toward using a structured approach to guide collaboration within the context of a systematic review. The TRANSFER conversation guide helps participants to discuss the review question and context in a structured way. Such structured collaboration could help to improve the usefulness and relevance of systematic reviews for decision making by improving the review question, inclusion criteria and consideration of transferability of review findings. The conversation guide needs to be modified to improve user experience. Further research is needed to explore stakeholder collaboration and the use of the TRANSFER conversation guide in systematic review processes.
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Affiliation(s)
- Heather Munthe‐Kaas
- Reviews and Health Technology AssessmentsNorwegian Institute of Public HealthOsloNorway
- Present address:
Centre for Epidemic Interventions ResearchNorwegian Institute of Public HealthOsloNorway
| | - Heid Nøkleby
- Reviews and Health Technology AssessmentsNorwegian Institute of Public HealthOsloNorway
| | - Sarah Rosenbaum
- Reviews and Health Technology AssessmentsNorwegian Institute of Public HealthOsloNorway
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15
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Nikbakht Nasrabadi A, Abbasi S, Mardani A, Maleki M, Vlaisavljevic Z. Experiences of intensive care unit nurses working with COVID-19 patients: A systematic review and meta-synthesis of qualitative studies. Front Public Health 2022; 10:1034624. [PMID: 36466502 PMCID: PMC9710282 DOI: 10.3389/fpubh.2022.1034624] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2022] [Accepted: 10/24/2022] [Indexed: 11/17/2022] Open
Abstract
Objectives Intensive Care Unit (ICU) nurses are at the forefront of fighting and treating the Coronavirus 2019 (COVID-19) pandemic and are often directly exposed to this virus and at risk of disease, due to their direct care for infected patients. This study aims to synthesize the experiences of ICU nurses working with COVID-19 patients. Methods A systematic review and meta-synthesis of qualitative studies were undertaken. A systematic literature search in four databases, including Web of Sciences, Scopus, Embase, and PubMed (including Medline), was performed. Original qualitative studies and the qualitative section of mixed method studies, written in English, which focused on the experiences of only ICU nurses working with COVID-19 patients, were included. Results Seventeen qualitative studies and two mixed-method studies were included in the review. As a result of the inductive content analysis, six main categories were identified, as follows: "distance from holistic nursing," "psychosocial experiences," "efforts for self-protection and wellbeing," "organizational inefficiency," "job burnout," and "emerging new experiences in the workplace." Conclusions The findings from this study suggest that healthcare authorities and policymakers can facilitate the provision of high-quality patient care during the COVID-19 pandemic through appropriate planning to provide adequate support and training, prevent shortages of nursing staff and equipment, and provide adequate attention to the psychological needs and job satisfaction of ICU nurses. Systematic review registration https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=256070, identifier: CRD42021256070.
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Affiliation(s)
| | - Soheila Abbasi
- Pediatric and Neonatal Intensive Care Nursing Education Department, School of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, Iran
| | - Abbas Mardani
- Nursing and Midwifery Care Research Center, Department of Medical Surgical Nursing, School of Nursing and Midwifery, Iran University of Medical Sciences, Tehran, Iran
| | - Maryam Maleki
- Pediatric and Neonatal Intensive Care Nursing Education Department, School of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, Iran,*Correspondence: Maryam Maleki
| | - Zeljko Vlaisavljevic
- University Clinical Center of Serbia, Clinic for Gastroenterology and Hepatology, Belgrade, Serbia,Department of Nursing, Medical School of Vocational Studies Medika, Belgrade, Serbia
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Lee SL, Rees CE, O'Brien BC, Palermo C. Identities and roles through clinician-educator transitions: A systematic narrative review. NURSE EDUCATION TODAY 2022; 118:105512. [PMID: 36054976 DOI: 10.1016/j.nedt.2022.105512] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/18/2022] [Revised: 07/12/2022] [Accepted: 08/10/2022] [Indexed: 06/15/2023]
Abstract
OBJECTIVE To synthesise the literature exploring nurse and other clinicians' conceptualisations and experiences of roles and identities as they transition to educator positions and to identify facilitators/barriers to, and consequences of, successful transitions. DESIGN A systematic narrative review of empirical research reporting clinician-educator transitions was conducted from database inception to December 2020. DATA SOURCES Our search employed ERIC, CINAHL, PsycINFO, Scopus, Ovid MEDLINE® Plus, ERIC (ProQuest), and Sociological Abstracts (ProQuest). We used search terms and synonyms relating to 'identity', 'role' and 'transitions'. REVIEW METHODS Using the PRISMA protocol for systematic reviews, we reviewed titles and abstracts for inclusion, then used the Critical Appraisal Skills Program tool to evaluate article quality. We extracted evidence from included articles, synthesising data thematically by exploring similarities and differences between studies. RESULTS We screened 2753 articles. 23 studies (across 25 articles) matched our inclusion criteria, 20 of which included nursing clinician-educator transitions. We identified four themes describing clinician-educator transitions: (i) multiple ways of conceptualising roles and identities, (ii) clinician-educator transitions as complex, emotion-laden processes, (iii) personal, interpersonal, and organisational facilitators and barriers of clinician-educator transitions, and (iv) positive and negative consequences of clinician-educator transitions. CONCLUSION Our review supports deeper understandings of transition processes that can be used by organisations to better support clinicians as they adapt to their new educator roles and identities.
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Affiliation(s)
- Sarah L Lee
- MCSHE, Faculty of Medical, Nursing and Health Sciences, Monash University, Clayton, VIC 3800, Australia.
| | - Charlotte E Rees
- School of Health Sciences, College of Health, Medicine and Wellbeing, The University of Newcastle, Callaghan, NSW 2308, Australia.
| | - Bridget C O'Brien
- Department of Medicine and Center for Faculty Educators, University of California, San Francisco, San Francisco, CA 94143, United States of America.
| | - Claire Palermo
- Faculty of Medical, Nursing and Health Sciences, Monash University, Clayton, VIC 3800, Australia.
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McGrath M, Bagul D, Du Toit SHJ. Barriers and facilitators of meaningful engagement among older migrants living with dementia in residential aged care facilities: A mixed studies systematic review. Scand J Occup Ther 2022; 29:530-541. [PMID: 33761300 DOI: 10.1080/11038128.2021.1898675] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2020] [Revised: 02/24/2021] [Accepted: 02/28/2021] [Indexed: 10/21/2022]
Abstract
BACKGROUND Migrants with dementia living in residential care may be at risk of disengagement. OBJECTIVE To synthesize research relating to the meaningful engagement of migrants with dementia who are living in residential care. METHOD Mixed studies systematic review following PRISMA guidelines. Nine electronic databases were searched for relevant studies. Studies were eligible for inclusion if they reported original research relating to meaningful engagement of migrants with dementia living in residential aged care and were published in English. Two independent reviewers screened the title and abstracts, full texts of eligible studies and conducted a quality appraisal of included texts. A convergent qualitative synthesis approach was used. RESULTS From 1460 articles, 14 papers representing 12 studies were included. Facilitators of meaningful engagement included: the presence of cultural artefacts in the care environment, the use of multimodal communication and a shared but flexible understanding of residents' culture. Barriers were the absence of a common language and a task-orientated approach to care. CONCLUSIONS Migrants with dementia who are living in residential care are at increased risk of disengagement. Our review highlights the need for culturally congruent residential care to go beyond issues of language and to consider how occupations can be tailored to support ongoing participation and engagement.
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Affiliation(s)
- Margaret McGrath
- Sydney School of Health Sciences, University of Sydney, Camperdown, Australia
| | - Deepali Bagul
- Sydney School of Health Sciences, University of Sydney, Camperdown, Australia
| | - Sanetta H J Du Toit
- Sydney School of Health Sciences, University of Sydney, Camperdown, Australia
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Price J, Brunet J. Exploring women's experiences participating in yoga after a cancer diagnosis: a protocol for a meta-synthesis. Syst Rev 2022; 11:166. [PMID: 35953865 PMCID: PMC9373540 DOI: 10.1186/s13643-022-02042-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/21/2021] [Accepted: 07/28/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The benefits of yoga for clinical and non-clinical populations have been summarized in published systematic reviews. The vast majority of systematic reviews on the topic are syntheses of quantitative research that evaluated the effects of yoga. As qualitative research related to women's experiences participating in yoga after a cancer diagnosis is growing in quantity, systematic synthesis and integration of qualitative research are necessary to facilitate the transfer of knowledge. This paper describes the protocol for a meta-synthesis of qualitative research exploring women's experiences participating in yoga after a cancer diagnosis. METHODS Using a meta-study methodology, six electronic databases were searched to identify relevant articles. Additionally, the reference lists of relevant articles retrieved during the electronic database search were scanned to identify other relevant articles. Two reviewers independently screened the titles and abstracts, retaining those that appeared to relate to the review objectives. Next, they reviewed the retained full-text articles to assess eligibility according to four inclusion criteria. They will extract data from eligible studies and assess the quality of included studies. Data analysis will involve three main analytical steps: meta-data analysis, meta-method analysis, and meta-theory analysis. Findings from the three analytical steps will be interpreted collectively to generate additional insights beyond the findings of the primary studies to facilitate a more comprehensive understanding of women's experiences participating in yoga after a cancer diagnosis. DISCUSSION By systematically collecting, analysing, and interpreting findings across multiple primary qualitative studies, we will develop an overarching narrative and interpretation of the role and value of yoga for women diagnosed with cancer. A synthesis of qualitative research is vital as it embraces the heterogeneity of the research so as to provide important context for understanding the experiences of various women participating in yoga. SYSTEMATIC REVIEW REGISTRATION PROSPERO CRD42021229253.
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Affiliation(s)
- Jenson Price
- School of Human Kinetics, University of Ottawa, Ottawa, Ontario, K1N 6N5, Canada
| | - Jennifer Brunet
- School of Human Kinetics, University of Ottawa, Ottawa, Ontario, K1N 6N5, Canada. .,Cancer Therapeutic Program, Ottawa Hospital Research Institute, The Ottawa Hospital, Ottawa, Ontario, Canada. .,Institut du savoir Montfort, Hôpital Montfort, Ottawa, Ontario, Canada.
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Communicating is analogous to caring: A systematic review and thematic synthesis of the patient-clinician communication experiences of individuals with ovarian cancer. Palliat Support Care 2022; 21:515-533. [PMID: 35582975 DOI: 10.1017/s1478951522000621] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
OBJECTIVE To systematically review and synthesize the patient-clinician communication experiences of individuals with ovarian cancer. METHODS The CINAHL, Embase, MEDLINE, PsycINFO, and Web of Science databases were reviewed for articles that described (a) original qualitative or mixed methods research, (b) the experiences of individuals with ovarian cancer, and (c) findings related to patient-clinician communication. Relevant data were extracted from study results sections, then coded for descriptive and analytical themes in accordance with Thomas and Harden's approach to thematic synthesis. Data were coded by two authors and discrepancies were resolved through discussion. RESULTS Of 1,390 unique articles, 65 met criteria for inclusion. Four descriptive themes captured participants' experiences communicating with clinicians: respecting me, seeing me, supporting me, and advocating for myself. Findings were synthesized into three analytical themes: communication is analogous to caring, communication is essential to personalized care, and communication may mitigate or exacerbate the burden of illness. SIGNIFICANCE OF RESULTS Patient-clinician communication is a process by which individuals with ovarian cancer may engage in self-advocacy and appraise the extent to which they are seen, respected, and supported by clinicians. Strategies to enhance patient-clinician communication in the ovarian cancer care setting may promote patient perceptions of patient-centered care.
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Bode K, Whittaker P, Dressler M, Bauer Y, Ali H. Pain Management Program in Cardiology: A Template for Application of Normalization Process Theory and Social Marketing to Implement a Change in Practice Quality Improvement. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19095251. [PMID: 35564643 PMCID: PMC9104749 DOI: 10.3390/ijerph19095251] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/17/2022] [Revised: 02/28/2022] [Accepted: 04/24/2022] [Indexed: 12/04/2022]
Abstract
Quality improvement plays a major role in healthcare, and numerous approaches have been developed to implement changes. However, the reasons for success or failure of the methods applied often remains obscure. Normalization process theory, recently developed in sociology, provides a flexible framework upon which to construct quality improvement. We sought to determine if examination of a successful quality improvement project, using normalization process theory and social marketing, provided insight into implementation. We performed a retrospective analysis of the steps taken to implement a pain management program in an electrophysiology clinic. We mapped these steps, and the corresponding social marketing tools used, to elements of normalization process theory. The combination of mapping implementation steps and marketing approaches to the theory provided insight into the quality-improvement process. Specifically, examination of the steps in the context of normalization process theory highlighted barriers to implementation at individual, group, and organizational levels. Importantly, the mapping also highlighted how facilitators were able to overcome the barriers with marketing techniques. Furthermore, integration with social marketing revealed how promotion of tangibility of benefits aided communication and how process co-creation between stakeholders enhanced value. Our implementation of a pain-management program was successful in a challenging environment composed of several stakeholder groups with entrenched initial positions. Therefore, we propose that the behavior change elements of normalization process theory combined with social marketing provide a flexible framework to initiate quality improvement.
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Affiliation(s)
- Kerstin Bode
- Department of Electrophysiology, Heart Center Leipzig, Struempellstr. 39, 04289 Leipzig, Germany;
- Department of Cardiology, Asklepios Clinic Weißenfels, Naumburger Str. 76, 06667 Weissenfels, Germany
- Correspondence: ; Tel.: +49-3443-401921
| | - Peter Whittaker
- The University of Edinburgh, Old College, South Bridge, Edinburgh EH8 9YL, UK;
| | - Miriam Dressler
- Medical Faculty, University of Leipzig, Liebigstr. 21, 04109 Leipzig, Germany;
| | - Yvonne Bauer
- Department of Electrophysiology, Heart Center Leipzig, Struempellstr. 39, 04289 Leipzig, Germany;
| | - Haider Ali
- Business School, The Open University, Walton Hall, Milton Keynes MK7 6AA, UK;
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Klimas P, Czakon W. Gaming innovation ecosystem: actors, roles and co-innovation processes. REVIEW OF MANAGERIAL SCIENCE 2022. [DOI: 10.1007/s11846-022-00518-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
AbstractBurgeoning research on innovation ecosystems offers a variety of conceptual approaches. Recent systematic literature reviews and syntheses provide a rich, diverse, but somehow abstract view of IEs. Our study advances the literature by taking the perspective of those involved in IEs. We aim to identify how various actors contribute to co-innovation in innovation ecosystems. In order to do so, our aim is to establish the various types of actors (who?), the distinct roles (what?), the different stages (when?), and the diverse engagement in co-innovation processes (how?). The study investigates the Polish Gaming Innovation Ecosystem as a globally successful example of a knowledge-intensive and highly creative innovation ecosystem. Data was collected over 3 years (between 2015 and 2017), in three waves of interviews (38) and non-participatory observations (5). We find that Gaming Innovation Ecosystem participants identify a total of 12 types of collective actors, 9 types of individual actors, and 1 community of individuals. Furthermore, we find four distinctive roles that actors may play in the co-creation processes, that is: direct value creation, supporting value creation, encouraging entrepreneurship, and leadership. Finally, we structure the co-innovation process into five stages: co-discovery, co-development, co-deployment, co-delivery and co-dissemination. We identify the diverse scope and varied intensity of actors’ engagement, depending on the co-innovation phase, as perceived by our informants.
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Davidson N, Hammarberg K, Romero L, Fisher J. Access to preventive sexual and reproductive health care for women from refugee-like backgrounds: a systematic review. BMC Public Health 2022; 22:403. [PMID: 35220955 PMCID: PMC8882295 DOI: 10.1186/s12889-022-12576-4] [Citation(s) in RCA: 21] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2021] [Accepted: 01/06/2022] [Indexed: 11/10/2022] Open
Abstract
Background Globally, the number of forcibly displaced women is growing. Refugee and displaced women have poorer health outcomes compared to migrant and host country populations. Conflict, persecution, violence or natural disasters and under-resourced health systems in their country of origin contribute to displacement experiences of refugee and displaced women. Poor health outcomes are further exacerbated by the migration journey and challenging resettlement in host countries. Preventive sexual and reproductive health (SRH) needs of refugee and displaced women are poorly understood. The aim was to synthesise the evidence about access to preventive SRH care of refugee and displaced women. Methods A systematic review of qualitative, quantitative and mixed methods studies of women aged 18 to 64 years and health care providers' (HCPs’) perspectives on barriers to and enablers of SRH care was undertaken. The search strategy was registered with PROSPERO in advance of the search (ID CRD42020173039). The MEDLINE, PsycINFO, Embase, CINAHL, and Global health databases were searched for peer-reviewed publications published any date up to 30th April 2020. Three authors performed full text screening independently. Publications were reviewed and assessed for quality. Study findings were thematically extracted and reported in a narrative synthesis. Reporting of the review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses recommendations. Results The search yielded 4083 results, of which 28 papers reporting 28 studies met inclusion criteria. Most related to contraception and cervical or breast cancer screening. Three main themes and ten subthemes relating to SRH care access were identified: interpersonal and patient encounter factors (including knowledge, awareness, perceived need for and use of preventive SRH care; language and communication barriers), health system factors (including HCPs discrimination and lack of quality health resources; financial barriers and unmet need; HCP characteristics; health system navigation) and sociocultural factors and the refugee experience (including family influence; religious and cultural factors). Conclusions Implications for clinical practice and policy include giving women the option of seeing women HCPs, increasing the scope of practice for HCPs, ensuring adequate time is available during consultations to listen and develop refugee and displaced women’s trust and confidence, strengthening education for refugee and displaced women unfamiliar with preventive care and refining HCPs’ and interpreters’ cultural competency. More research is needed on HCPs’ views regarding care for refugee and displaced women. Supplementary Information The online version contains supplementary material available at 10.1186/s12889-022-12576-4.
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Winter C, Camarão AAR, Steffen I, Jung K. Network meta-analysis of transcriptome expression changes in different manifestations of dengue virus infection. BMC Genomics 2022; 23:165. [PMID: 35220956 PMCID: PMC8882220 DOI: 10.1186/s12864-022-08390-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2021] [Accepted: 02/15/2022] [Indexed: 11/10/2022] Open
Abstract
Abstract
Background
Several studies have been performed to study transcriptome profiles after dengue virus infections with partly different results. Due to slightly different settings of the individual studies, different genes and enriched gene sets are reported in these studies. The main aim of this network meta-analysis was to aggregate a selection of these studies to identify genes and gene sets that are more generally associated with dengue virus infection, i.e. with less dependence on the individual study settings.
Methods
We performed network meta-analysis by different approaches using publicly available gene expression data of five selected studies from the Gene Expression Omnibus database. The study network includes dengue fever (DF), hemorrhagic fever (DHF), shock syndrome (DSS) patients as well as convalescent and healthy control individuals. After data merging and missing value imputation, study-specific batch effects were removed. Pairwise differential expression analysis and subsequent gene-set enrichment analysis were performed between the five study groups. Furthermore, mutual information networks were derived from the top genes of each group comparison, and the separability between the three patient groups was studied by machine learning models.
Results
From the 10 possible pairwise group comparisons in the study network, six genes (IFI27, TPX2, CDT1, DTL, KCTD14 and CDCA3) occur with a noticeable frequency among the top listed genes of each comparison. Thus, there is an increased evidence that these genes play a general role in dengue virus infections. IFI27 and TPX2 have also been highlighted in the context of dengue virus infection by other studies. A few of the identified gene sets from the network meta-analysis overlap with findings from the original studies. Mutual information networks yield additional genes for which the observed pairwise correlation is different between the patient groups. Machine learning analysis shows a moderate separability of samples from the DF, DHF and DSS groups (accuracy about 80%).
Conclusions
Due to an increased sample size, the network meta-analysis could reveal additional genes which are called differentially expressed between the studied groups and that may help to better understand the molecular basis of this disease.
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Barriers and Benefits Experienced by Caregivers Seeking Medical Care for Their Children with Autism Spectrum Disorders: a Qualitative Meta-synthesis. REVIEW JOURNAL OF AUTISM AND DEVELOPMENTAL DISORDERS 2022. [DOI: 10.1007/s40489-022-00306-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Knauss M, Adams CL, Orsel K. Producer Perceptions Toward Prevention and Control of Lameness in Dairy Cows in Alberta Canada: A Thematic Analysis. Front Vet Sci 2022; 9:812710. [PMID: 35211540 PMCID: PMC8861376 DOI: 10.3389/fvets.2022.812710] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2021] [Accepted: 01/04/2022] [Indexed: 11/27/2022] Open
Abstract
Lameness in dairy cattle poses both an animal welfare and economic threat to dairy farms. Although the Canadian dairy industry has identified lameness as the most important health issue, lameness prevalence in the province of Alberta has not decreased over the last decade. Factors related to lameness have been reported, but the prevalence remains high. Therefore, this study was conducted to investigate dairy producers' perceptions on lameness and how these perceptions influence lameness prevalence in their cows. Qualitative interviews with open-ended questions were conducted with nine dairy producers in Alberta, Canada presenting farms with a wide variety of lameness prevalence. Thematic analysis of these interviews revealed five major themes, as well as five distinct types of producers regarding their perceptions. All nine producers mentioned similar challenges with lameness prevention and control. Identifying lameness, taking action, delays in achieving success, various approaches to prevention and control strategies, and differences between farms were the challenges encountered. However, producers' attitudes when dealing with these challenges varied. We concluded that understanding producers' perceptions is essential as no “one size fits all”, when advising them regarding how to address lameness, as guidance and support will be most successful when it is aligned with their viewpoint.
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Affiliation(s)
- Marlena Knauss
- Department of Production Animal Health, Faculty of Veterinary Medicine, University of Calgary, Calgary, AB, Canada
| | - Cindy L. Adams
- Department of Veterinary Clinical and Diagnostic Sciences, Faculty of Veterinary Medicine, University of Calgary, Calgary, AB, Canada
| | - Karin Orsel
- Department of Production Animal Health, Faculty of Veterinary Medicine, University of Calgary, Calgary, AB, Canada
- *Correspondence: Karin Orsel
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Zhu Z, Xing W, Liang Y, Hong L, Hu Y. Nursing students' experiences with service learning: A qualitative systematic review and meta-synthesis. NURSE EDUCATION TODAY 2022; 108:105206. [PMID: 34773814 DOI: 10.1016/j.nedt.2021.105206] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/29/2021] [Revised: 10/15/2021] [Accepted: 11/03/2021] [Indexed: 06/13/2023]
Abstract
OBJECTIVE The aim of this review was to synthesize qualitative evidence on nursing students' experiences with service learning (SL). DESIGN A systematic review. DATA SOURCES Comprehensive searches were performed using databases including PubMed, MEDLINE (Ovid), Embase (Ovid), CINHAL (EBSCO), ProQuest Dissertations and Theses, Web of Science, Wangfang (Chinese), CNKI (Chinese), Google Scholar, and Baidu Scholar (Chinese). REVIEW METHODS The Joanna Briggs Institute Critical Appraisal Checklist for Qualitative Research was used to assess the methodological quality of the included studies. We conducted a meta-aggregation to synthesize the findings of the included studies. The Confidence in the Output of Qualitative Research Synthesis (ConQual) approach was used to assess confidence in the synthesized findings. RESULTS Forty-two studies were identified, and 39 studies were included in the meta-aggregation. One hundred and sixty-seven findings, 16 categories, and 6 synthesized findings were identified. The six synthesized findings identified from the 39 studies concerned the following topics: adaption and emotion shifting, knowledge translation and skills development, leadership and collaboration in multidisciplinary teams, cultural sensitivity, discovery of nursing roles and professional growth, and overall appraisal and suggestions. CONCLUSIONS We recommend empowering nursing students by developing their self-confidence in their leadership abilities and their identities before they participate in SL programs. During SL, educators should provide sufficient space for students and should not become involved in students' teams to avoid decreasing their self-confidence in their leadership abilities. After SL programs, maintaining long-term relationships between the university and the community is a prerequisite for students working smoothly in the community and is a key factor for program sustainability.
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Affiliation(s)
- Zheng Zhu
- School of Nursing, Fudan University, Shanghai, China; Fudan University Centre for Evidence-based Nursing: A Joanna Briggs Institute Centre of Excellence, Shanghai, China
| | - Weijie Xing
- School of Nursing, Fudan University, Shanghai, China; Fudan University Centre for Evidence-based Nursing: A Joanna Briggs Institute Centre of Excellence, Shanghai, China.
| | - Yan Liang
- School of Nursing, Fudan University, Shanghai, China
| | - Liu Hong
- Department of Social Work, Fudan University, Shanghai, China
| | - Yan Hu
- School of Nursing, Fudan University, Shanghai, China; Fudan University Centre for Evidence-based Nursing: A Joanna Briggs Institute Centre of Excellence, Shanghai, China
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Omanović V, Langley A. Assimilation, Integration or Inclusion? A Dialectical Perspective on the Organizational Socialization of Migrants. JOURNAL OF MANAGEMENT INQUIRY 2021. [DOI: 10.1177/10564926211063777] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Given the increasing importance of migrations around the world, and the challenges that migrants face in entering the labor market, the process of socialization of migrants into organizations deserves more attention from management scholars. Indeed, societal discourses promoting equality and diversity often appear to be in contradiction with the unequal power relations migrants experience on entering the workforce. Drawing on a dialectic perspective and a qualitative meta-synthesis methodology, we show how the practices engaged in by organizations to socialize migrant employees are deeply embedded in and influenced by macro-social contexts that may place migrants at a disadvantage, giving rise to emerging tensions. We examine a range of contingencies that can mitigate the inequalities that migrants experience, and we reveal a variety of dynamic dialectical pathways surrounding migrant socialization practices through which they may be reproduced or transformed depending on the mutual relationships between situated conditions, emerging tensions and human praxes.
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Affiliation(s)
- Vedran Omanović
- School of Business, Economics and Law, Gothenburg University, Sweden
| | - Ann Langley
- Département de Management, HEC Montreal, Montreal, Canada
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Chahley ER, Reel RM, Taylor S. The lived experience of healthcare professionals working frontline during the 2003 SARS epidemic, 2009 H1N1 pandemic, 2012 MERS outbreak, and 2014 EVD epidemic: A qualitative systematic review. SSM - QUALITATIVE RESEARCH IN HEALTH 2021; 1:100026. [PMID: 34901922 PMCID: PMC8645281 DOI: 10.1016/j.ssmqr.2021.100026] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/18/2021] [Revised: 11/06/2021] [Accepted: 12/02/2021] [Indexed: 12/23/2022]
Abstract
Objective To synthesize qualitative literature exploring the lived experience of healthcare workers (HCWs) who cared for patients during the following infectious disease outbreaks (IDOs): the 2003 SARS epidemic, 2009 H1N1 pandemic, 2012 MERS outbreak, and 2014 EVD epidemic. We aim to reveal the collective experience of HCWs during these four IDOs and to create a reference for comparison of current and future IDOs. Methods Three electronic databases were searched, yielding 823 results after duplicates were removed. Forty qualitative and mixed-methods studies met the criteria for full file review. Fourteen studies met the inclusion and exclusion criteria. The data from the Results or Findings sections were manually coded and themes were conceptualized using thematic analysis. Results Of the 14 studies, 28.6% focused on SARS, 21.4% on H1N1, 21.4% on MERS, and 28.6% on EVD. Studies occurred in six different countries and included physicians, nurses, paramedics, and emergency medical technicians as participants. Five themes were conceptualized: Uncertainty, Adapting to Change, Commitment, Sacrifice, and Resilience. Conclusion This review identified the collective experience of HCWs caring for patients during four 21st century IDOs. This qualitative systematic review offers a reference to compare similarities and differences of other IDOs, including the COVID-19 pandemic.
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Affiliation(s)
- Erin R Chahley
- Island Medical Program, University of British Columbia, PO Box 1700 STN CSC, Victoria, BC, V8W 2Y2, Canada
| | - Riley M Reel
- Island Medical Program, University of British Columbia, PO Box 1700 STN CSC, Victoria, BC, V8W 2Y2, Canada
| | - Steven Taylor
- Department of Psychiatry, Faculty of Medicine, University of British Columbia, 2255 Wesbrook Mall, Vancouver, BC, V6T 2A1, Canada
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Parrott J, Armstrong LL, Watt E, Fabes R, Timlin B. Building Resilience During COVID-19: Recommendations for Adapting the DREAM Program - Live Edition to an Online-Live Hybrid Model for In-Person and Virtual Classrooms. Front Psychol 2021; 12:647420. [PMID: 34322055 PMCID: PMC8311233 DOI: 10.3389/fpsyg.2021.647420] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2021] [Accepted: 04/12/2021] [Indexed: 11/18/2022] Open
Abstract
In standard times, approximately 20% of children and youth experience significant emotional, behavioral, or social challenges. During COVID-19, however, over half of parents have reported mental health symptoms in their children. Specifically, depressive symptoms, anxiety, contamination obsessions, family well-being challenges, and behavioral concerns have emerged globally for children during the pandemic. Without treatment or prevention, such concerns may hinder positive development, personal life trajectory, academic success, and inhibit children from meeting their potential. A school-based resiliency program for children (DREAM) for children was developed, and the goal of this study was to collaborate with stakeholders to translate it into an online-live hybrid. Our team developed a methodology to do this based on Knowledge Translation-Integration (KTI), which incorporates stakeholder engagement throughout the entire research to action process. KTI aims to ensure that programs are acceptable, sustainable, feasible, and credible. Through collaboration with parents and school board members, qualitative themes of concerns, recommendations and validation were established, aiding in meaningful online-live translation. Even though the original program was developed for intellectually gifted children, who are at greater risk for mental health concerns, stakeholders suggested using the program for both gifted and non-gifted children, given the universal applicability of the tools, particularly during this pandemic time period when mental health promotion is most relevant. An online-live approach would allow students studying at home and those studying in the classroom to participate in the program. Broader implications of this study include critical recommendations for the development of both online-live school programs in general, as well as social-emotional literacy programs for children.
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Affiliation(s)
- Julia Parrott
- Department of Human Sciences, DREAM Lab/Child Meaning and Resilience Laboratory, Saint Paul University, Ottawa, ON, Canada
| | - Laura L Armstrong
- Department of Human Sciences, DREAM Lab/Child Meaning and Resilience Laboratory, Saint Paul University, Ottawa, ON, Canada
| | - Emmalyne Watt
- Department of Human Sciences, DREAM Lab/Child Meaning and Resilience Laboratory, Saint Paul University, Ottawa, ON, Canada
| | - Robert Fabes
- Department of Human Sciences, DREAM Lab/Child Meaning and Resilience Laboratory, Saint Paul University, Ottawa, ON, Canada
| | - Breanna Timlin
- Department of Human Sciences, DREAM Lab/Child Meaning and Resilience Laboratory, Saint Paul University, Ottawa, ON, Canada
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Taber P, Weir C, Butler JM, Graber CJ, Jones MM, Madaras-Kelly K, Zhang Y, Chou AF, Samore MH, Goetz MB, Glassman PA. Social dynamics of a population-level dashboard for antimicrobial stewardship: A qualitative analysis. Am J Infect Control 2021; 49:862-867. [PMID: 33515622 DOI: 10.1016/j.ajic.2021.01.015] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2020] [Revised: 01/15/2021] [Accepted: 01/19/2021] [Indexed: 12/21/2022]
Abstract
OBJECTIVE To evaluate antimicrobial stewards' experiences of using a dashboard display integrating local and national antibiotic use data implemented in the U.S. Department of Veterans Affairs (VA). This paper reports early formative evaluation. DESIGN Qualitative interviewing. SETTING Eight VA hospitals participated with established antimicrobial stewardship (AS) programs participated in the pilot. PARTICIPANTS Six infectious disease physicians and eight clinical pharmacists agreed to be interviewed (n = 14). METHODS A 3-part qualitative interview script was used involving a description of local stewardship activities, a Critical Incident description of dashboard use, and general questions regarding attitudes towards the tool. An inductive open coding approach was used for analysis. RESULTS We found 4 themes showing the complexities of using stewardship tools: (1) Data validity is socially negotiated; (2) Performance feedback motivates and persuades social goals when situated in an empirical distribution; (3) Shared problem awareness is aided by authoritative data; and (4) The AS dashboard encourages connections with local quality improvement culture. CONCLUSIONS Social dimensions of AS tool use emerged as distinct from, and equally important as decision support provided by the dashboard. Successful stewardship tools should be designed to support both the social and cognitive needs of users.
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Affiliation(s)
- Peter Taber
- Department of Biomedical Informatics, University of Utah, Salt Lake City, UT.
| | - Charlene Weir
- Department of Biomedical Informatics, University of Utah, Salt Lake City, UT; IDEAS Center, VA Salt Lake City Healthcare System, Salt Lake City, UT.
| | - Jorie M Butler
- Department of Biomedical Informatics, University of Utah, Salt Lake City, UT; IDEAS Center, VA Salt Lake City Healthcare System, Salt Lake City, UT; Geriatric Education and Clinical Center, VA Salt Lake City Healthcare System, Salt Lake City, UT; Department of Medicine, University of Utah, Salt Lake City, UT
| | - Christopher J Graber
- Center for Healthcare Innovation, Implementation, and Policy, VA Greater Los Angeles Healthcare System, Los Angeles, CA; Department of Medicine, David Geffen School of Medicine at the University of California-Los Angeles, Los Angeles, CA; Infectious Diseases Section, VA Greater Los Angeles Healthcare System, Los Angeles, CA
| | - Makoto M Jones
- IDEAS Center, VA Salt Lake City Healthcare System, Salt Lake City, UT; Geriatric Education and Clinical Center, VA Salt Lake City Healthcare System, Salt Lake City, UT; Division of Epidemiology, University of Utah, Salt Lake City, UT
| | - Karl Madaras-Kelly
- Department of Pharmacy Boise VA Medical Center, Boise, ID; College of Pharmacy, Idaho State University, Meridian, ID
| | - Yue Zhang
- IDEAS Center, VA Salt Lake City Healthcare System, Salt Lake City, UT; Geriatric Education and Clinical Center, VA Salt Lake City Healthcare System, Salt Lake City, UT; Division of Epidemiology, University of Utah, Salt Lake City, UT
| | - Ann F Chou
- Department of Family and Preventive Medicine, College of Medicine, University of Oklahoma Health Sciences Center, Oklahoma City, OK
| | - Matthew H Samore
- IDEAS Center, VA Salt Lake City Healthcare System, Salt Lake City, UT; Geriatric Education and Clinical Center, VA Salt Lake City Healthcare System, Salt Lake City, UT; Division of Epidemiology, University of Utah, Salt Lake City, UT
| | - Matthew Bidwell Goetz
- Center for Healthcare Innovation, Implementation, and Policy, VA Greater Los Angeles Healthcare System, Los Angeles, CA; Department of Medicine, David Geffen School of Medicine at the University of California-Los Angeles, Los Angeles, CA; Infectious Diseases Section, VA Greater Los Angeles Healthcare System, Los Angeles, CA
| | - Peter A Glassman
- Center for Healthcare Innovation, Implementation, and Policy, VA Greater Los Angeles Healthcare System, Los Angeles, CA; VA Pharmacy Benefits Management Services, Department of Veterans Affairs, Washington, DC; Department of Medicine, VA Greater Los Angeles Healthcare System, Los Angeles, CA
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Delaney AE, Qiu JM, Lee CS, Lyons KS, Vessey JA, Fu MR. Parents' Perceptions of Emerging Adults With Congenital Heart Disease: An Integrative Review of Qualitative Studies. J Pediatr Health Care 2021; 35:362-376. [PMID: 33581995 DOI: 10.1016/j.pedhc.2020.11.009] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/03/2020] [Accepted: 11/30/2020] [Indexed: 12/15/2022]
Abstract
BACKGROUND As the primary caregivers for children with congenital heart disease (CHD), parents' perceptions are important for emerging adults to achieve independence. This integrative review of qualitative studies aimed to describe parents' perceptions of emerging adults with CHD. METHOD Seven electronic databases were searched. Data extraction and quality assessment were performed. A meta-synthesis was conducted to inductively develop essential themes from five included studies. RESULTS Three essential themes encompassing the parents' perspective of emerging adults with CHD were: (1) concerns about emerging adults' ability to be independent; (2) concerns about emerging adults' future; and (3) impact of disease on family. The themes depicted parents' concerns and worries about their children's ability to successfully achieve independence, especially in disease self-management and life goals. DISCUSSION This review highlights parents' concerns about their emerging adult children's independence. Understanding these concerns allows for developing interventions to facilitate emerging adults' independence and ease parents' worries.
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Mendonça AB, Pereira ER, Magnago C, Medeiros AYBBV, Silva RMCRA, Martins ADO, Meira KC. Suffering experiences of people with cancer undergoing chemotherapy: A meta-ethnographic study. Nurs Health Sci 2021; 23:586-610. [PMID: 33817939 DOI: 10.1111/nhs.12839] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2021] [Revised: 03/30/2021] [Accepted: 03/31/2021] [Indexed: 12/14/2022]
Abstract
This meta-ethnography had the objectives of identifying, evaluating, and summarizing the findings of qualitative studies regarding the suffering experiences of people undergoing chemotherapy, as well as developing an explanatory conceptual structure regarding what affects these experiences. A systematic literature review was carried out, covering the past 10 years, in the following databases: CINAHL, Embase, Medline, LILACS and Scopus. By using meta-ethnographic synthesis methods, the following themes were found: the pain of loss; evaluating, measuring, and neutralizing the threat; and social contours of suffering. The experience of living with cancer and undergoing chemotherapy was synthesized into a theoretical-explanatory model with a structure that resembles barbed-wire loops. The model expresses people's suffering experiences as marked by the feeling of loss, restraint of emotions, and resilience. While transcendent movements broke the cycle of suffering, resilience emerged as a learning experience that made patients more resistant to the pain of loss. The results indicated a complex and diverse set of factors that influence suffering, which confirmed that experiences are individual, comprehensive, and continuously reinterpreted.
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Affiliation(s)
- Angelo Braga Mendonça
- Healthcare Sciences Program, School of Nursing, Universidade Federal Fluminense, Niterói, Brazil
| | - Eliane Ramos Pereira
- Healthcare Sciences Program, School of Nursing, Universidade Federal Fluminense, Niterói, Brazil
| | - Carinne Magnago
- Public Health Faculty, Universidade de São Paulo, Niterói, Brazil
| | | | | | | | - Karina Cardoso Meira
- Health Sciences School, Universidade Federal do Rio Grande do Norte, Natal, Brazil
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Mlambo M, Silén C, McGrath C. Lifelong learning and nurses' continuing professional development, a metasynthesis of the literature. BMC Nurs 2021; 20:62. [PMID: 33853599 PMCID: PMC8045269 DOI: 10.1186/s12912-021-00579-2] [Citation(s) in RCA: 113] [Impact Index Per Article: 37.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2020] [Accepted: 03/31/2021] [Indexed: 11/30/2022] Open
Abstract
Background Continuing professional development (CPD) is central to nurses’ lifelong learning and constitutes a vital aspect for keeping nurses’ knowledge and skills up-to-date. While we know about the need for nurses’ continuing professional development, less is known about how nurses experience and perceive continuing professional development. A metasynthesis of how nurses experience and view continuing professional development may provide a basis for planning future continuing professional development interventions more effectively and take advantage of examples from different contexts. The aim of this paper is to conduct such a metasynthesis, investigating the qualitative research on nurses’ experiences of continuing professional development. Methods A metasynthesis of the qualitative literature was conducted. A total of 25 articles fulfilled the inclusion criteria and were reviewed. Results We determined five overarching themes, Organisational culture shapes the conditions, Supportive environment as a prerequisite, Attitudes and motivation reflect nurse’s professional values, Nurses’ perceptions of barriers and Perceived impact on practice as a core value. This metasynthesis highlights that nurses value continuing professional development and believe that it is fundamental to professionalism and lifelong learning. Moreover CPD is identified as important in improving patient care standards. Conclusions Based on the metasynthesis, we argue that access to continuing professional development could be made more attainable, realistic and relevant. Expediently, organizations should adequately fund and make continuing professional development accessible. In turn, nurses should continue to actively engage in continuing professional development to maintain high standards of nursing care through competent practice. This paper highlights the perceived benefits and challenges of continuing professional development that nurses face and offers advice and understanding in relation to continuing professional development. We believe that this metasynthesis contributes with insights and suggestions that would be valuable for nurses and policy makers and others who are involved in nurse education and continuing professional development.
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Affiliation(s)
- Mandlenkosi Mlambo
- Jersey General Hospital, St Helier, Jersey.,Department of LIME, Karolinska Institutet, Stockholm, Sweden
| | - Charlotte Silén
- Department of LIME, Karolinska Institutet, Stockholm, Sweden
| | - Cormac McGrath
- Department of LIME, Karolinska Institutet, Stockholm, Sweden. .,Department of Education, Stockholm University, Stockholm, Sweden.
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Hays DG, McKibben WB. Promoting Rigorous Research: Generalizability and Qualitative Research. JOURNAL OF COUNSELING AND DEVELOPMENT 2021. [DOI: 10.1002/jcad.12365] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
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Park EJ, Kang H. Experiences of undergraduate nursing students with faculty incivility in nursing classrooms: A meta-aggregation of qualitative studies. Nurse Educ Pract 2021; 52:103002. [PMID: 33691253 DOI: 10.1016/j.nepr.2021.103002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2020] [Revised: 02/18/2021] [Accepted: 02/21/2021] [Indexed: 11/19/2022]
Abstract
Faculty-to-student incivility can have detrimental impacts on both the individual students and the nursing profession. This study synthesized the current qualitative research evidence on the experiences of undergraduate nursing students with faculty incivility in nursing classrooms. A meta-aggregation approach was applied in a systematic review of qualitative studies based on the guideline of the Joanna Briggs Institute. The analysis of 11 qualitative studies identified four synthesized findings: (1) faculty incivility included a wide range of uncivil behaviors from disruptive to threatening behaviors, (2) pedagogical incompetence, including ineffective teaching, unresponsiveness, and unfairness, was perceived as uncivil, (3) faculty incivility negatively impacted on psychological well-being and learning, and (4) adaptation efforts included seeking support from family and friends and voicing the need for an official support system. Nursing faculty members need to be aware of the malicious impacts of faculty incivility, have formal teaching preparation, and develop pedagogical competency. The students and faculty members should be empowered by establishing official support systems for students and training faculty members to be role models for civility, respectively. Faculty perspectives of their incivility to students, interventions for cultivating faculty civility, and the long-term effects of faculty incivility are suggested as areas for further research.
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Affiliation(s)
- Eun-Jun Park
- Department of Nursing, Konkuk University, Chungju-Si, Chungcheongbuk-Do, Republic of Korea.
| | - Hyunwook Kang
- College of Nursing, Kangwon National University, Gangwondaehak-gil, Chuncheon-si, Gangwon-do, 24341, Republic of Korea.
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Richter PC, Brühl R. Shared service implementation in multidivisional organizations: A meta-synthesis study. JOURNAL OF GENERAL MANAGEMENT 2021. [DOI: 10.1177/0306307020914139] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
The purpose of this article is to explore shared service center (SSC) implementation. Shared service is a key concept by which corporations organize their resources. Research indicates that some organizations struggle with implementing SSC and sometimes entirely fail to implement them. Although prior research exploring the determinants of implementation success is relatively scarce, researchers have conducted several SSC implementation case studies. However, these valuable findings remain isolated in stand-alone case studies. We aggregated the results of these studies using a qualitative meta-synthesis to identify, extract, and synthesize variables, their interrelations, and their relationships to SSC success. The outcome is a theoretical model that describes which factors are important and how and why they are related to SSC success. Overall, we make important contributions to the growing SSC research by shedding theoretical light on SSC implementation. We also provide a set of propositions and make suggestions for future research.
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Aziz NAA, Hanafiah MH, Hussin NSN, Latif MNA, Aziz ZA. Franchising Relationship: Malaysian Franchisees’ Perspectives. THE IMPORTANCE OF NEW TECHNOLOGIES AND ENTREPRENEURSHIP IN BUSINESS DEVELOPMENT: IN THE CONTEXT OF ECONOMIC DIVERSITY IN DEVELOPING COUNTRIES 2021:317-335. [DOI: 10.1007/978-3-030-69221-6_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/01/2023]
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Neubert A, Brito Fernandes Ó, Lucevic A, Pavlova M, Gulácsi L, Baji P, Klazinga N, Kringos D. Understanding the use of patient-reported data by health care insurers: A scoping review. PLoS One 2020; 15:e0244546. [PMID: 33370405 PMCID: PMC7769438 DOI: 10.1371/journal.pone.0244546] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2020] [Accepted: 12/11/2020] [Indexed: 12/03/2022] Open
Abstract
Background Patient-reported data are widely used for many purposes by different actors within a health system. However, little is known about the use of such data by health insurers. Our study aims to map the evidence on the use of patient-reported data by health insurers; to explore how collected patient-reported data are utilized; and to elucidate the motives of why patient-reported data are collected by health insurers. Methods The study design is that of a scoping review. In total, 11 databases were searched on. Relevant grey literature was identified through online searches, reference mining and recommendations from experts. Forty-two documents were included. We synthesized the evidence on the uses of patient-reported data by insurers following a structure-process-outcome approach; we also mapped the use and function of those data by a health insurer. Results Health insurers use patient-reported data for assurance and improvement of quality of care and value-based health care. The patient-reported data most often collected are those of outcomes, experiences and satisfaction measures; structure indicators are used to a lesser extent and often combined with process indicators. These data are mainly used for the purposes of procurement and purchasing of services, quality assurance, improvement and reporting, and strengthening the involvement of insured people. Conclusions The breadth to which insurers use patient-reported data in their business models varies greatly. Some hindering factors to the uptake of such data are the varying and overlapping terminology in use in the field and the limited involvement of insured people in a health insurer’s business. Health insurers are advised to be more explicit in regard to the role they want to play within the health system and society at large, and accommodate implications for the use of patient-reported data accordingly.
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Affiliation(s)
- Anne Neubert
- Department of Orthopaedics and Traumatology, Medical Faculty, Heinrich Heine University Düsseldorf, Düsseldorf, Germany
- Institute for Health Service Research and Health Economics, Centre for Health and Society, Heinrich-Heine-University, Düsseldorf, Germany
| | - Óscar Brito Fernandes
- Department of Health Economics, Corvinus University of Budapest, Budapest, Hungary
- Department of Public and Occupational Health, Amsterdam UMC, University of Amsterdam, Amsterdam Public Health research institute, Amsterdam, The Netherlands
- * E-mail:
| | - Armin Lucevic
- Department of Health Economics, Corvinus University of Budapest, Budapest, Hungary
- Department of Public and Occupational Health, Amsterdam UMC, University of Amsterdam, Amsterdam Public Health research institute, Amsterdam, The Netherlands
| | - Milena Pavlova
- Department of Health Services Research, CAPHRI, Maastricht University Medical Center, Faculty of Health, Medicine and Life Sciences, Maastricht University, The Netherlands
| | - László Gulácsi
- Department of Health Economics, Corvinus University of Budapest, Budapest, Hungary
| | - Petra Baji
- Department of Health Economics, Corvinus University of Budapest, Budapest, Hungary
| | - Niek Klazinga
- Department of Public and Occupational Health, Amsterdam UMC, University of Amsterdam, Amsterdam Public Health research institute, Amsterdam, The Netherlands
| | - Dionne Kringos
- Department of Public and Occupational Health, Amsterdam UMC, University of Amsterdam, Amsterdam Public Health research institute, Amsterdam, The Netherlands
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Climent-Sanz C, Morera-Amenós G, Bellon F, Pastells-Peiró R, Blanco-Blanco J, Valenzuela-Pascual F, Gea-Sánchez M. Poor Sleep Quality Experience and Self-Management Strategies in Fibromyalgia: A Qualitative Metasynthesis. J Clin Med 2020; 9:jcm9124000. [PMID: 33321937 PMCID: PMC7763602 DOI: 10.3390/jcm9124000] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2020] [Revised: 11/26/2020] [Accepted: 12/09/2020] [Indexed: 12/17/2022] Open
Abstract
Poor sleep quality is a major concern and a highly prevalent symptom in fibromyalgia. We aimed to develop a metasynthesis of qualitative studies to assess how people diagnosed with fibromyalgia experience and manage poor sleep quality following the concepts of the Symptom Management Theory. The principles of metasynthesis established by Sandelowski and Barroso were utilized. A pre-planned comprehensive search was implemented in PubMed, Scopus, ISI WebofScience, and Cinahl Plus databases. The methodological quality was assessed following the CASP Qualitative Checklist. The findings of the studies were subjected to a metasummary and a metasynthesis. Seventeen studies were included in the metasynthesis. Two overarching themes were pre-established: (1) experience of poor sleep quality in Fibromyalgia and (2) poor sleep quality management strategies in Fibromyalgia. Four sub-themes emerged from the results: (1) evaluation of poor sleep quality, (2) response to poor sleep quality, (3) management strategies to favor sleep, and (4) managing the consequences of a sleepless night. Poor sleep quality is a severe and disabling symptom that negatively impacts the general health status of people diagnosed with FM. Prescribed treatments are commonly seen as ineffective and self-management strategies are a last resort and do not show beneficial effects.
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Affiliation(s)
- Carolina Climent-Sanz
- Department of Nursing and Physiotherapy, University of Lleida, 25198 Lleida, Spain; (C.C.-S.); (G.M.-A.); (R.P.-P.); (J.B.-B.); (F.V.-P.); (M.G.-S.)
- Grup de Recerca de Cures en Salut, GRECS, Institut de Recerca Biomèdica de Lleida, Fundació Dr. Pifarré, 25198 Lleida, Spain
- Grup d’Estudis Societat, Salut, Educació i Cultura, GESEC, Department of Nursing and Physiotherapy, University of Lleida, 25198 Lleida, Spain
| | - Genís Morera-Amenós
- Department of Nursing and Physiotherapy, University of Lleida, 25198 Lleida, Spain; (C.C.-S.); (G.M.-A.); (R.P.-P.); (J.B.-B.); (F.V.-P.); (M.G.-S.)
| | - Filip Bellon
- Department of Nursing and Physiotherapy, University of Lleida, 25198 Lleida, Spain; (C.C.-S.); (G.M.-A.); (R.P.-P.); (J.B.-B.); (F.V.-P.); (M.G.-S.)
- Grup de Recerca de Cures en Salut, GRECS, Institut de Recerca Biomèdica de Lleida, Fundació Dr. Pifarré, 25198 Lleida, Spain
- Grup d’Estudis Societat, Salut, Educació i Cultura, GESEC, Department of Nursing and Physiotherapy, University of Lleida, 25198 Lleida, Spain
- Correspondence: ; Tel.: +34-973-70-24-68
| | - Roland Pastells-Peiró
- Department of Nursing and Physiotherapy, University of Lleida, 25198 Lleida, Spain; (C.C.-S.); (G.M.-A.); (R.P.-P.); (J.B.-B.); (F.V.-P.); (M.G.-S.)
- Grup de Recerca de Cures en Salut, GRECS, Institut de Recerca Biomèdica de Lleida, Fundació Dr. Pifarré, 25198 Lleida, Spain
- Grup d’Estudis Societat, Salut, Educació i Cultura, GESEC, Department of Nursing and Physiotherapy, University of Lleida, 25198 Lleida, Spain
| | - Joan Blanco-Blanco
- Department of Nursing and Physiotherapy, University of Lleida, 25198 Lleida, Spain; (C.C.-S.); (G.M.-A.); (R.P.-P.); (J.B.-B.); (F.V.-P.); (M.G.-S.)
- Grup de Recerca de Cures en Salut, GRECS, Institut de Recerca Biomèdica de Lleida, Fundació Dr. Pifarré, 25198 Lleida, Spain
- Grup d’Estudis Societat, Salut, Educació i Cultura, GESEC, Department of Nursing and Physiotherapy, University of Lleida, 25198 Lleida, Spain
| | - Fran Valenzuela-Pascual
- Department of Nursing and Physiotherapy, University of Lleida, 25198 Lleida, Spain; (C.C.-S.); (G.M.-A.); (R.P.-P.); (J.B.-B.); (F.V.-P.); (M.G.-S.)
- Grup de Recerca de Cures en Salut, GRECS, Institut de Recerca Biomèdica de Lleida, Fundació Dr. Pifarré, 25198 Lleida, Spain
- Grup d’Estudis Societat, Salut, Educació i Cultura, GESEC, Department of Nursing and Physiotherapy, University of Lleida, 25198 Lleida, Spain
| | - Montserrat Gea-Sánchez
- Department of Nursing and Physiotherapy, University of Lleida, 25198 Lleida, Spain; (C.C.-S.); (G.M.-A.); (R.P.-P.); (J.B.-B.); (F.V.-P.); (M.G.-S.)
- Grup de Recerca de Cures en Salut, GRECS, Institut de Recerca Biomèdica de Lleida, Fundació Dr. Pifarré, 25198 Lleida, Spain
- Grup d’Estudis Societat, Salut, Educació i Cultura, GESEC, Department of Nursing and Physiotherapy, University of Lleida, 25198 Lleida, Spain
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Esashika D, Masiero G, Mauger Y. An investigation into the elusive concept of smart cities: a systematic review and meta-synthesis. TECHNOLOGY ANALYSIS & STRATEGIC MANAGEMENT 2020. [DOI: 10.1080/09537325.2020.1856804] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Affiliation(s)
- Daniel Esashika
- Department of Management, University of São Paulo, São Paulo, Brazil
| | - Gilmar Masiero
- Department of Management, University of São Paulo, São Paulo, Brazil
| | - Yohann Mauger
- Department of Management, Northern Kentucky University, Highland Heights, USA
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Meta-synthesis in Library & Information Science Research. JOURNAL OF ACADEMIC LIBRARIANSHIP 2020. [DOI: 10.1016/j.acalib.2020.102217] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Johnston K, Preston R, Strivens E, Qaloewai S, Larkins S. Understandings of dementia in low and middle income countries and amongst indigenous peoples: a systematic review and qualitative meta-synthesis. Aging Ment Health 2020; 24:1183-1195. [PMID: 31074290 DOI: 10.1080/13607863.2019.1606891] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Objectives: Dementia is a growing health priority, particularly in less resourced countries and amongst indigenous populations. Understanding cultural meanings ascribed to dementia is an important aspect of policy development and the provision of culturally congruent care and support for people with dementia, their families and the caring professions. This review investigates conceptualizations of dementia amongst indigenous peoples and populations living in low and middle income countries (LMIC), who experience limited diagnosis and formal care for dementia, and how these shape responses to dementia.Methods: A systematic search was conducted for qualitative studies, reported in English, that investigated the perceptions, attitudes or understandings of dementia in LMIC and amongst indigenous populations. A qualitative analysis and meta-synthesis was carried out.Findings: Nineteen articles were included in the review following quality assessment. Dementia was rarely conceptualized as a defined, pathological condition characterized by progressive cognitive decline. Rather, notions of dementia existed within conceptualizations of aging, mental illness, traditional cultural beliefs and the trauma of colonization. Responses to dementia were influenced and perpetuated by community and health providers, and cultural norms for caregiving.Conclusions: There is a need to understand conceptualizations of dementia from the perspective of all stakeholders within a setting, and the dynamic responses that exist between key stakeholders. Community knowledge systems could facilitate understanding about appropriate and acceptable health and community care responses to dementia, and approaches to stigma reduction. Inclusive discussions about dementia are essential if awareness campaigns are to improve the wellbeing of people with dementia and caregivers.
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Affiliation(s)
- Karen Johnston
- College of Medicine and Dentistry, James Cook University, Townsville, Queensland, Australia.,Anton Breinl Research Centre for Health Systems Strengthening, James Cook University, Townsville, Queensland, Australia
| | - Robyn Preston
- College of Medicine and Dentistry, James Cook University, Townsville, Queensland, Australia.,Anton Breinl Research Centre for Health Systems Strengthening, James Cook University, Townsville, Queensland, Australia
| | - Edward Strivens
- Sub-acute and Rehabilitation Services, Cairns and Hinterland Hospital Health Service, Cairns, Queensland, Australia
| | - Sefanaia Qaloewai
- College of Medicine, Nursing and Health Sciences, Fiji National University, Suva, Fiji
| | - Sarah Larkins
- College of Medicine and Dentistry, James Cook University, Townsville, Queensland, Australia.,Anton Breinl Research Centre for Health Systems Strengthening, James Cook University, Townsville, Queensland, Australia
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Wiig S, Rutz S, Boyd A, Churruca K, Kleefstra S, Haraldseid-Driftland C, Braithwaite J, O'Hara J, van de Bovenkamp H. What methods are used to promote patient and family involvement in healthcare regulation? A multiple case study across four countries. BMC Health Serv Res 2020; 20:616. [PMID: 32631343 PMCID: PMC7336629 DOI: 10.1186/s12913-020-05471-4] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2019] [Accepted: 06/25/2020] [Indexed: 11/24/2022] Open
Abstract
Background In the regulation of healthcare, the subject of patient and family involvement figures increasingly prominently on the agenda. However, the literature on involving patients and families in regulation is still in its infancy. A systematic analysis of how patient and family involvement in regulation is accomplished across different health systems is lacking. We provide such an overview by mapping and classifying methods of patient and family involvement in regulatory practice in four countries; Norway, England, the Netherlands, and Australia. We thus provide a knowledge base that enables discussions about possible types of involvement, and advantages and difficulties of involvement encountered in practice. Methods The research design was a multiple case study of patient and family involvement in regulation in four countries. The authors collected 1) academic literature if available and 2) documents of regulators that describe user involvement. Based on the data collected, the authors from each country completed a pre-agreed template to describe the involvement methods. The following information was extracted and included where available: 1) Method of involvement, 2) Type of regulatory activity, 3) Purpose of involvement, 4) Who is involved and 5) Lessons learnt. Results Our mapping of involvement strategies showed a range of methods being used in regulation, which we classified into four categories: individual proactive, individual reactive, collective proactive, and collective reactive methods. Reported advantages included: increased quality of regulation, increased legitimacy, perceived justice for those affected, and empowerment. Difficulties were also reported concerning: how to incorporate the input of users in decisions, the fact that not all users want to be involved, time and costs required, organizational procedures standing in the way of involvement, and dealing with emotions. Conclusions Our mapping of user involvement strategies establishes a broad variety of ways to involve patients and families. The four categories can serve as inspiration to regulators in healthcare. The paper shows that stimulating involvement in regulation is a challenging and complex task. The fact that regulators are experimenting with different methods can be viewed positively in this regard.
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Affiliation(s)
- Siri Wiig
- SHARE-Centre for Resilience in Healthcare, Faculty of Health Sciences, University of Stavanger, Stavanger, Norway.
| | - Suzanne Rutz
- Erasmus School of Health Policy and Management, Erasmus University, Rotterdam, the Netherlands.,Dutch Health and Youth Care Inspectorate, Utrecht, the Netherlands
| | - Alan Boyd
- Alliance Manchester Business, University of Manchester, Manchester, England
| | - Kate Churruca
- Australian Institute of Health Innovation, Macquarie University, Sydney, Australia
| | - Sophia Kleefstra
- Dutch Health and Youth Care Inspectorate, Utrecht, the Netherlands
| | - Cecilie Haraldseid-Driftland
- SHARE-Centre for Resilience in Healthcare, Faculty of Health Sciences, University of Stavanger, Stavanger, Norway
| | - Jeffrey Braithwaite
- Australian Institute of Health Innovation, Macquarie University, Sydney, Australia
| | - Jane O'Hara
- School of Healthcare, University of Leeds, Leeds, England
| | - Hester van de Bovenkamp
- Erasmus School of Health Policy and Management, Erasmus University, Rotterdam, the Netherlands
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Lochnan H, Kitto S, Danilovich N, Viner G, Walsh A, Oandasan IF, Hendry P. Conceptualization of Competency-Based Medical Education Terminology in Family Medicine Postgraduate Medical Education and Continuing Professional Development: A Scoping Review. ACADEMIC MEDICINE : JOURNAL OF THE ASSOCIATION OF AMERICAN MEDICAL COLLEGES 2020; 95:1106-1119. [PMID: 31996559 DOI: 10.1097/acm.0000000000003178] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
PURPOSE To examine the extent, range, and nature of how competency-based medical education (CBME) implementation terminology is used (i.e., the conceptualization of CBME-related terms) within the family medicine postgraduate medical education (PGME) and continuing professional development (CPD) literature. METHOD This scoping review's methodology was based on Arksey and O'Malley's framework and subsequent recommendations by Tricco and colleagues. The authors searched 5 databases and the gray literature for U.S. and Canadian publications between January 2000 and April 2017. Full-text English-language articles on CBME implementation that focused exclusively on family medicine PGME and/or CPD programs were eligible for inclusion. A standardized data extraction form was used to collect article demographic data and coding concepts data. Data analysis used mixed methods, including quantitative frequency analysis and qualitative thematic analysis. RESULTS Of 470 unique articles identified, 80 (17%) met the inclusion criteria and were selected for inclusion in the review. Only 12 (15%) of the 80 articles provided a referenced definition of the coding concepts (i.e., referred to an article/organization as the definition's source), resulting in 19 highly variable-and 12 unique- referenced definitions of key terms used in CBME implementation (competence, competency, competency-based medical education). Thematic analysis of the referenced definitions identified 15 dominant themes, among which the most common were (1) a multidimensional and dynamic concept that encompasses a variety of skill components and (2) being able to use communication, knowledge, technical skills, clinical reasoning, judgment, emotions, attitudes, personal values, and reflection in practice. CONCLUSIONS The construction and dissemination of shared definitions is essential to CBME's successful implementation. The low number of referenced definitions and lack of consensus on such definitions suggest more attention needs to be paid to conceptual rigor. The authors recommend those involved in family medicine education work with colleagues across medical specialties to develop a common taxonomy.
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Affiliation(s)
- Heather Lochnan
- H. Lochnan is assistant dean of continuing professional development, Education Programming, Faculty of Medicine, an endocrinologist, and professor, Department of Medicine, University of Ottawa, Ottawa, Ontario, Canada. S. Kitto is director of research, Office of Continuing Professional Development, and professor, Department of Innovation in Medical Education, University of Ottawa, Ottawa, Ontario, Canada. N. Danilovich is a research associate, Office of Continuing Professional Development, Department of Innovation in Medical Education, University of Ottawa, Ottawa, Ontario, Canada. G. Viner is director of evaluation in postgraduate program and associate professor, Department of Family Medicine, University of Ottawa, Ottawa, Ontario, Canada. A. Walsh is professor emeritus, Department of Family Medicine, McMaster University, Hamilton, Ontario, Canada. I.F. Oandasan is director, Education/directrice, Éducation, College of Family Physicians of Canada, Mississauga, Ontario, Canada. P. Hendry is vice dean of continuing professional development and professor of surgery, Faculty of Medicine, University of Ottawa, and a cardiac surgeon, University of Ottawa Heart Institute, Ottawa, Ontario, Canada
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Ogundele OJ, Pavlova M, Groot W. Socioeconomic inequalities in reproductive health care services across Sub-Saharan Africa. A systematic review and meta-analysis. SEXUAL & REPRODUCTIVE HEALTHCARE 2020; 25:100536. [PMID: 32526462 DOI: 10.1016/j.srhc.2020.100536] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2019] [Revised: 05/01/2020] [Accepted: 05/23/2020] [Indexed: 10/24/2022]
Abstract
BACKGROUND Women in Sub-Saharan African experience socioeconomic barriers in the use of reproductive health care services. This paper analyzes the evidence on socioeconomic inequalities in reproductive health care utilization in Sub-Saharan Africa and identifies the variance in the estimates of these inequalities. METHODS We performed a systematic review and meta-analysis of studies on socioeconomic inequalities in the use of reproductive health care services published between January 2008 and June 2019. We used meta-regression to identify heterogeneity sources in reproductive care services use. RESULTS Twenty-two studies were included and they reported 305 estimates of the concentration index for different reproductive health care services. We grouped the services into ten categories of reproductive health care services. Socioeconomic status was associated with inequality in reproductive health care use and was on average high, with a pro-wealthy inequality magnitude of the concentration index of 0.202. The meta-analysis indicated that inequality was highest for skilled childbirth services with an average concentration index of 0.343. The average concentration index for family planning and components of antenatal care was 0.268 and 0.142 respectively. Random-effects meta-regression showed that the heterogeneity in reproductive health care use was explained by contextual differences between countries. CONCLUSION The magnitude of inequality in reproductive health care use varies with the type of service and the focus on skilled childbirth services through user fees removal appears to have fostered inequality. The one-size-fits-all approach to reproductive health care initiatives has ignored differences in reproductive health care needs and the ability to overcome use barriers.
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Affiliation(s)
- Oluwasegun Jko Ogundele
- Department of Health Services Research, CAPHRI, Maastricht University Medical Center, Faculty of Health, Medicine and Life Sciences, Maastricht University, the Netherlands.
| | - Milena Pavlova
- Department of Health Services Research, CAPHRI, Maastricht University Medical Center, Faculty of Health, Medicine and Life Sciences, Maastricht University, the Netherlands
| | - Wim Groot
- Department of Health Services Research, CAPHRI, Maastricht University Medical Center, Faculty of Health, Medicine and Life Sciences, Maastricht University, the Netherlands; Top Institute Evidence-Based Education Research (TIER), Maastricht University, the Netherlands
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Coventry A, Ford R, Rosenberg J, McInnes E. A qualitative meta-synthesis investigating the experiences of the patient's family when treatment is withdrawn in the intensive care unit. J Adv Nurs 2020; 76:2222-2234. [PMID: 32406076 DOI: 10.1111/jan.14416] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2019] [Revised: 03/24/2020] [Accepted: 04/21/2020] [Indexed: 11/26/2022]
Abstract
AIM To synthesize qualitative studies of patients' families' experiences and perceptions of end-of-life care in the intensive care unit when life-sustaining treatments are withdrawn. DESIGN Qualitative meta-synthesis. DATA SOURCES Comprehensive search of 18 electronic databases for qualitative studies published between January 2005 - February 2019. REVIEW METHOD Meta-aggregation. RESULTS Thirteen studies met the inclusion criteria. A conceptual 'Model of Preparedness' was developed reflecting the elements of end-of-life care most valued by families: 'End-of-life communication'; 'Valued attributes of patient care'; 'Preparing the family'; 'Supporting the family'; and 'Bereavement care'. CONCLUSION A family-centred approach to end-of-life care that acknowledges the values and preferences of families in the intensive care unit is important. Families have unmet needs related to communication, support, and bereavement care. Effective communication and support are central to preparedness and if these care components are in place, families can be better equipped to manage the death, their sadness, loss, and grief. The findings suggest that health professionals may benefit from specialist end-of-life care education to support families and guide the establishment of preparedness. IMPACT Understanding the role and characteristics of preparedness during end-of-life care will inform future practice in the intensive care unit and may improve family member satisfaction with care and recovery from loss. Nurses are optimally positioned to address the perceived shortfalls in end-of-life care. These findings have implications for health education, policies, and standards for end-of-life care in the intensive care unit.
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Affiliation(s)
- Alysia Coventry
- School of Nursing, Midwifery and Paramedicine, Australian Catholic University, Fitzroy, Australia
| | - Rosemary Ford
- School of Nursing, Midwifery and Paramedicine, Australian Catholic University, Fitzroy, Australia
| | - John Rosenberg
- School of Nursing, Midwifery and Paramedicine, University of Sunshine Coast, Maroochydore DC, Australia
| | - Elizabeth McInnes
- School of Nursing, Midwifery and Paramedicine, Australian Catholic University, Fitzroy, Australia.,Professor of Nursing, St Vincent's Hospital Melbourne, Deputy Director, Nursing Research Institute St Vincent's Health Australia Sydney, St Vincent's Hospital Melbourne & Australian Catholic University, Fitzroy, Australia
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Sebrant L, Jong M. What's the meaning of the concept of caring?: a meta-synthesis. Scand J Caring Sci 2020; 35:353-365. [PMID: 32271480 DOI: 10.1111/scs.12850] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2019] [Accepted: 03/12/2020] [Indexed: 11/28/2022]
Abstract
BACKGROUND Registered Nurses are expected to have acquired knowledge about the fundamental concepts within nursing science throughout their training and clinical work. However, the terminology and the concept of caring are debated; therefore, there is a need for a continuous critical investigation of scientific concepts within the area of nursing. OBJECTIVES To illuminate nurses' perception about the meaning of the scientific concept of caring. DESIGN A qualitative systematic literature search was performed that subsequently underwent a descriptive meta-synthesis in line with Deborah Finfgeld's descriptive meta-synthesis methodology. DATA SOURCES/REVIEW METHOD Scientific articles published between 1 January 2003 and 25 January 2018 were identified and retrieved from CINAHL and PubMed. Each included study was assessed and critically appraised. Data were extracted, analysed and coded into categories resulting in four different themes in accordance with descriptive meta-synthesis. RESULTS Four themes emerged in the analysis: 'To be', 'To want', 'To be able to' and 'To do'. These comprise different aspects within physical and metaphysical dimensions where simultaneously interact and influence each other. CONCLUSION There are central elements to the practice of caring that are separated in their simplicity but at the same time coherent, where no part can exist without the others in the practice of caring. There are shortcomings concerning current nursing theories, nursing philosophies and organisational documents related to varied aspects based on what is included in the practice of caring.
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Affiliation(s)
- Lovisa Sebrant
- Department of Orthopedics, Nyköping Hospital, Nyköping, Sweden.,Centre for Clinical Research Sörmland, Uppsala University, Eskilstuna, Sweden.,Department of Nursing, Mid Sweden University, Östersund, Sweden
| | - Mats Jong
- Department of Health Sciences/Sports Science, Mid Sweden University, Östersund, Sweden
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Kokorelias KM, Lu FKT, Santos JR, Xu Y, Leung R, Cameron JI. "Caregiving is a full-time job" impacting stroke caregivers' health and well-being: A qualitative meta-synthesis. HEALTH & SOCIAL CARE IN THE COMMUNITY 2020; 28:325-340. [PMID: 31769128 DOI: 10.1111/hsc.12895] [Citation(s) in RCA: 37] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/31/2019] [Revised: 10/29/2019] [Accepted: 11/06/2019] [Indexed: 06/10/2023]
Abstract
Family caregivers contribute to the sustainability of healthcare systems. Stroke is a leading cause of adult disability and many people with stroke rely on caregiver support to return home and remain in the community. Research has demonstrated the importance of caregivers, but suggests that caregiving can have adverse consequences. Despite the body of qualitative stroke literature, there is little clarity about how to incorporate these findings into clinical practice. This review aimed to characterise stroke caregivers' experiences and the impact of these experiences on their health and well-being. We conducted a qualitative meta-synthesis. Four electronic databases were searched to identify original qualitative research examining stroke caregivers' experiences. In total, 4,481 citations were found, with 39 studies remaining after removing duplicates and applying inclusion and exclusions criteria. Articles were appraised for quality using the Critical Appraisal Skills Programme (CASP), coded using NVivo software, and analysed through thematic synthesis. One overarching theme, 'caregiving is a full-time job' was identified, encompassing four sub-themes: (a) restructured life, (b) altered relationships, (c) physical challenges, and (d) psychosocial challenges. Community and institution-based clinicians should be aware of the physical and psychosocial consequences of caregiving and provide appropriate supports, such as education and respite, to optimise caregiver health and well-being. Future research may build upon this study to identify caregivers in most need of support and the types of support needed across a broad range of health conditions.
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Affiliation(s)
- Kristina M Kokorelias
- Faculty of Medicine, Rehabilitation Sciences Institute, University of Toronto, Toronto, ON, Canada
| | - Fiana K T Lu
- Department of Occupational Science and Occupational Therapy, University of Toronto, Toronto, ON, Canada
| | - Jennifer R Santos
- Department of Occupational Science and Occupational Therapy, University of Toronto, Toronto, ON, Canada
| | - Yi Xu
- Department of Occupational Science and Occupational Therapy, University of Toronto, Toronto, ON, Canada
| | - Robin Leung
- Department of Occupational Science and Occupational Therapy, University of Toronto, Toronto, ON, Canada
| | - Jill I Cameron
- Department of Occupational Science and Occupational Therapy, University of Toronto, Toronto, ON, Canada
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Knowledge management infrastructure to support quality improvement: A qualitative study of maternity services in four European hospitals. Health Policy 2020; 124:205-215. [DOI: 10.1016/j.healthpol.2019.11.005] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2019] [Revised: 11/05/2019] [Accepted: 11/16/2019] [Indexed: 11/17/2022]
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50
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Systematic Review of Displacement and Health Impact From Natural Disasters in Southeast Asia. Disaster Med Public Health Prep 2020; 15:105-114. [PMID: 31959272 DOI: 10.1017/dmp.2019.125] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Disaster-induced displacement is associated with an increased risk of physical and mental health disorders. We aim to understand (1) the magnitude and pattern of natural disasters, affected-population, and deaths by analyzing the surveillance data by the Emergency Events Database and (2) health outcomes by a systematic review of previous studies (1975-2017), which reported physical or mental health outcomes and epidemiological measure of association among population displaced by natural disasters in Southeast Asia. A total of 674 disasters, mainly floods, storms, and earthquakes, occurred between 2004 and 2017. From the systematic review, among 6 studies met inclusion criteria, which focused on mental health (n = 5) and physical health (n = 1). All studies describing mental health resulted from the 2004 tsunami in Ache, Indonesia. We found over 7 times more publications for the disasters in Far East Asia. Selected studies revealed significantly worse mental health outcomes and poor physical health among displaced population compared with nondisplaced population. Despite the alarmingly large population displaced by natural disasters in Southeast Asia, very few studies investigate physical and mental health outcomes of such crisis. Following the Sendai Framework for Disaster Risk Reduction 2015-2030, researcher and policy-makers have to present more resources toward preventing and mitigating health outcomes.
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