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Nøkleby H, Ames HMR, Langøien LJ, Hestevik CH. Tools for assessing the methodological limitations of a QES-a short note. Syst Rev 2024; 13:103. [PMID: 38582929 PMCID: PMC10998420 DOI: 10.1186/s13643-024-02511-6] [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: 01/10/2024] [Accepted: 03/07/2024] [Indexed: 04/08/2024] Open
Abstract
The increasing prevalence and application of qualitative evidence syntheses (QES) in decision-making processes underscore the need for robust tools to assess the methodological limitations of a completed QES. This commentary discusses the limitations of three existing tools and presents the authors' efforts to address this gap. Through a simple comparative analysis, the three tools are examined in terms of their coverage of essential topic areas. The examination finds that existing assessment tools lack comprehensive coverage, clarity, and grounding in qualitative research principles. The authors advocate for the development of a new collaboratively developed evidence-based tool rooted in qualitative methodology and best practice methods. The conclusion emphasizes the necessity of a tool that can provide a comprehensive judgement on the methodological limitations of a QES, addressing the needs of end-users, and ultimately enhancing the trustworthiness of QES findings in decision-making processes.
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Affiliation(s)
- Heid Nøkleby
- Norwegian Institute of Public Health, Oslo, Norway.
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Aderibigbe T, Srisopa P, Henderson WA, Lucas R. Meta-ethnography on the Experiences of Women From Around the World Who Exclusively Breastfed Their Full-Term Infants. J Obstet Gynecol Neonatal Nurs 2024; 53:120-131. [PMID: 38104632 DOI: 10.1016/j.jogn.2023.11.008] [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: 05/26/2023] [Revised: 11/08/2023] [Accepted: 11/15/2023] [Indexed: 12/19/2023] Open
Abstract
OBJECTIVE To synthesize evidence from qualitative studies on the experiences of women from around the world who exclusively breastfed their full-term infants. DATA SOURCES CINAHL Plus, PubMed, APA PsycInfo, Scopus, and ProQuest Dissertation & Theses Global. STUDY SELECTION We selected reports of qualitative studies that were conducted in high-, middle-, and low-income countries; published between January 2001 and February 2022 in English; and focused on the experiences of women who exclusively breastfed their full-term infants. DATA EXTRACTION We extracted the following data from included studies: methodological characteristics (i.e., country of origin, authors' disciplines, research design, sample size, sampling, data collection, and data analysis method), participants' demographics (i.e., age, parity, marital status, education, and exclusive breastfeeding duration) and direct participant quotes, and key concepts and themes about women's experiences of exclusive breastfeeding. We managed and stored extracted data using a Microsoft Excel spreadsheet. DATA SYNTHESIS We synthesized reciprocal translations using Noblit and Hare's approach to meta-ethnography. Five overarching themes emerged from the meta-synthesis: Favorable Conditions, Not a Smooth Journey,Support, Determination and Perseverance, and Reflections on Benefits. CONCLUSION In the included studies, participants experienced challenges with exclusive breastfeeding; however, they also recounted benefits. We recommend 6-month maternity leave and support from family and health care professionals to improve rates of exclusive breastfeeding.
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Consorti F, Borcea MC, Melcarne R, Giacomelli L. Peer assisted learning: a meta-ethnographic synthesis of qualitative studies and recommendations for cardiovascular training, practice, and research. Minerva Cardiol Angiol 2024; 72:11-23. [PMID: 37158626 DOI: 10.23736/s2724-5683.23.06265-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/10/2023]
Abstract
INTRODUCTION Peer assisted learning (PAL) is a common method to complement more traditional teaching. Several systematic reviews and meta-analyses described the most used ways of implementation and showed that it is effective in fostering learning. A synthesis of qualitative data is missing, to highlight the perceived value by the students and to drive a successful implementation. EVIDENCE ACQUISITION The search was performed in Pubmed, Scopus and ERIC databases, with a combination of the search strings. The quality of the retrieved articles was assessed through the Critical Appraisal Skills Checklist. The analysis was performed according to the meta-ethnographic method. Fifteen articles were considered for the analysis, saturation was reached after 12 articles. EVIDENCE SYNTHESIS Three main themes emerged from the analysis: PAL is effective when implemented in a safe environment, PAL is a driver of development of students' abilities and identity, and the "dark side" of PAL. Nine sub-themes emerged as components of the themes. The final line of argument highlighted the ambivalence of PAL, as an expression of the ambivalence of the still developing professional identity of students. CONCLUSIONS This meta-ethnographic synthesis summarizes the elements of success and the threats of PAL, a method that is particularly suitable for the cardiovascular domain. It must be implemented according to some precautions, such as organization and protected time, tutor selection, training and support, a clear integration and endorsement in the framework of the medical curriculum.
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Affiliation(s)
| | - M Carola Borcea
- Department of General and Specialist Surgery, Sapienza University, Rome, Italy
| | - Rossella Melcarne
- Department of General and Specialist Surgery, Sapienza University, Rome, Italy
| | - Laura Giacomelli
- Department of General and Specialist Surgery, Sapienza University, Rome, Italy
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Conquer S, Iles R, Windle K, Heathershaw R, Ski CF. Transforming Integrated Care Through Co-production: A Systematic Review Using Meta-ethnography. Int J Integr Care 2024; 24:17. [PMID: 38463747 PMCID: PMC10921964 DOI: 10.5334/ijic.7603] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2024] [Accepted: 02/29/2024] [Indexed: 03/12/2024] Open
Abstract
Introduction There is a requirement for health and care systems and services to work on an equitable basis with people who use and provide integrated care. In response, co-production has become essential in the design and transformation of services. Globally, an array of approaches have been implemented to achieve this. This unique review explores multi-context and multi-method examples of co-production in integrated care using an exceptional combination of methods. Aim To review and synthesise evidence that examines how co-production with service users, unpaid carers and members of staff can affect the design and transformation of integrated care services. Methods Systematic review using meta-ethnography with input from a patient and public involvement (PPI) co-production advisory group. Meta-ethnography can generate theories by interpreting patterns between studies set in different contexts. Nine academic and four grey literature databases were searched for publications between 2012-2022. Data were extracted, analysed, translated and interpreted using the seven phases of meta-ethnography and PPI. Findings A total of 2,097 studies were identified. 10 met the inclusion criteria. Studies demonstrated a variety of integrated care provisions for diverse populations. Co-production was most successful through person-centred design, innovative planning, and collaboration. Key impacts on service transformation were structural changes, accessibility, and acceptability of service delivery. The methods applied organically drew out new interpretations, namely a novel cyclic framework for application within integrated care. Conclusion Effective co-production requires a process with a well-defined focus. Implementing co-delivery, with peer support, facilitates service user involvement to be embedded at a higher level on the 'ladder of co-production'. An additional step on the ladder is proposed; a cyclic co-delivery framework. This innovative and operational development has potential to enable better-sustained person-centred integrated care services.
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Tatterton MJ, Fisher MJ. 'You have a little human being kicking inside you and an unbearable pain of knowing there will be a void at the end': A meta-ethnography exploring the experience of parents whose baby is diagnosed antenatally with a life limiting or life-threatening condition. Palliat Med 2023; 37:1289-1302. [PMID: 37129319 PMCID: PMC10548777 DOI: 10.1177/02692163231172244] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/03/2023]
Abstract
BACKGROUND Parents of babies diagnosed with life limiting conditions in the perinatal period face numerous challenges. Considerations include the remainder of the pregnancy, delivery of the baby and decisions around care in the neonatal period. AIM To increase understanding of how parents experience the diagnosis of a life-limiting or life-threatening condition, during pregnancy and following the birth of their baby, by answering the question: 'what is known about the perinatal experiences of parents of babies with a life-limiting or life-threatening diagnosis?' DESIGN A meta-ethnography was conducted to synthesise findings from existing qualitative evidence. DATA SOURCES British Nursing Database, CINAHL, Medline, PsycINFO and Embase databases were searched in January 2023. FINDINGS Relationships between parents and their families and friends, and with professionals influence the needs and experiences of parents, which oscillate between positive and negative experiences, throughout parents' perinatal palliative care journey. Parents highlighted the need for control and a sense of normality relating to their parenting experience. Validation was central to the experience of parents at all stages of parenthood. Relationships between the parent and the baby were unwavering, underpinned with unconditional love. CONCLUSION Professionals, family members and friendship groups influence the experience, validating parents and their baby's identity and supporting parents in having a sense of control and normality by demonstrating empathy, and providing time and clear communication.
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Affiliation(s)
- Michael J Tatterton
- School of Nursing and Healthcare Leadership, Faculty of Health Studies, University of Bradford, Bradford, UK
- Bluebell Wood Children’s Hospice, North Anston, Sheffield, UK
- International Children’s Palliative Care Network, c/o Together for Short Lives, Bristol, UK
| | - Megan J Fisher
- School of Nursing and Healthcare Leadership, Faculty of Health Studies, University of Bradford, Bradford, UK
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Li S, Miles K, George RE, Ertubey C, Pype P, Liu J. A critical review of cultural competence frameworks and models in medical and health professional education: A meta-ethnographic synthesis: BEME Guide No. 79. MEDICAL TEACHER 2023; 45:1085-1107. [PMID: 36755385 DOI: 10.1080/0142159x.2023.2174419] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/18/2023]
Abstract
BACKGROUND Cultural competence resides at the core of undergraduate and postgraduate medical and health professional education. The evolution of studies on cultural competence has resulted in the existence of multiple theoretical frameworks and models, each emphasising certain elements of culturally appropriate care, but generally lacking in providing a coherent and systematic approach to teaching this subject. METHODS Following a meta-ethnographic approach, a systematic search of five databases was undertaken to identify relevant articles published between 1990 and 2022. After citation searching and abstract and full article screening, a consensus was reached on 59 articles for final inclusion. Key constructs and concepts of cultural competence were synthesised and presented as themes, using the lens of critical theory. RESULTS Three key themes were identified: competences; roles and identities; structural competency. Actionable concepts and themes were incorporated into a new transformative ACT cultural model that consists of three key domains: activate consciousness, connect relations, and transform to true cultural care. CONCLUSION This critical review provides an up-to-date synthesis of studies that conceptualise cultural competence frameworks and models in international medical and healthcare settings. The ACT cultural model provides a set of guiding principles for culturally appropriate care, to support high-quality educational interventions.
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Affiliation(s)
- Shuangyu Li
- GKT School of Medical Education, King's College London, London, UK
| | - Katherine Miles
- GKT School of Medical Education, King's College London, London, UK
- Department of Pharmacology, Public Health and Clinical Skills, Faculty of Medicine, The Hashemite University, Zarqa, Jordan
| | - Riya E George
- Barts and the London School of Medicine and Dentistry, Queen Mary University of London, London, UK
| | - Candan Ertubey
- School of Psychology, University of East London, London, UK
| | - Peter Pype
- Department of Public Health and Primary Care, Ghent University, Ghent, Belgium
| | - Jia Liu
- GKT School of Medical Education, King's College London, London, UK
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Xiang M, Soh KG, Xu Y, Ahrari S, Zakaria NS. Experiences of LGBTQ student-athletes in college sports: A meta-ethnography. Heliyon 2023; 9:e16832. [PMID: 37332967 PMCID: PMC10275786 DOI: 10.1016/j.heliyon.2023.e16832] [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: 08/21/2022] [Revised: 05/27/2023] [Accepted: 05/30/2023] [Indexed: 06/20/2023] Open
Abstract
This study aimed to explore and describe the experiences of LGBTQ student-athletes to identify ways in which athletic staff, coaches, and others can support LGBTQ youth's safe participation in sports. Guided by the preferred reporting items for systematic reviews (PRISMA) and eMERGe reporting guidance. We conducted a meta-ethnography to synthesize qualitative research focused on student-athletes' experiences. Fourteen studies were included in the meta-ethnography published between 1973 and 2022. Four themes were identified: (1) experiences of discrimination and violence; (2) perceived stigma; (3) internalized prejudice; and (4) coping and team support, and they were used to generate a line of argument model, which explains the stress process of LGBTQ student-athletes in the sports. LGBTQ student-athletes experience persistent discrimination in college sports, which poses a significant risk to their mental health. Meanwhile, this study identified that qualitative research on LGBTQ youth sports participation is lacking in many regions of the world and lacks knowledge of the sports participation experience of bisexual, gay, and transgender students. These findings revealed a way for research on LGBTQ-related issues and future policy and practice on LGBTQ youth-related issues in sports.
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Affiliation(s)
- Meng Xiang
- Department of Sports Studies, Universiti Putra Malaysia, Seri Kembangan, Malaysia
| | - Kim Geok Soh
- Department of Sports Studies, Universiti Putra Malaysia, Seri Kembangan, Malaysia
| | - Yingying Xu
- Department of Philosophy and Civilization Studies, Universiti Putra Malaysia, Seri Kembangan, Malaysia
| | - Seyedali Ahrari
- Department of Professional Development and Continuing Education, Universiti Putra Malaysia, Seri Kembangan, Malaysia
| | - Noor Syamilah Zakaria
- Department of Counsellor Education and Counselling Psychology, Universiti Putra Malaysia, Seri Kembangan, Malaysia
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Raque TL, Ross KV, Hangge AR, Gaines RC. A Meta-Ethnography on the Impact of Cancer for Lesbian and Queer Women and Their Partners. QUALITATIVE HEALTH RESEARCH 2023; 33:371-387. [PMID: 36802915 DOI: 10.1177/10497323231155403] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/18/2023]
Abstract
Lesbian and queer women face unique experiences navigating cancer care, including challenges in accessing services that incorporate their relational supports. Given the importance of social support for survivorship, this study examines the impact of cancer on lesbian/queer women in romantic relationships. We conducted the seven stages of Noblit and Hare's meta-ethnography. PubMed/MEDLINE, PsycINFO, SocINDEX, and Social Sciences Abstract databases were searched. Two hundred and ninety citations were initially identified, 179 abstracts were reviewed, and 20 articles were coded. Themes were (a) intersectionality of lesbian/queer identity in the cancer context; (b) institutional and systemic supports and barriers; (c) navigation of disclosure; (d) characteristics of affirmative cancer care; (e) survivors' critical reliance on their partner(s); and (f) shifts in connection after cancer. Findings indicate the importance of accounting for intrapersonal, interpersonal, institutional, and socio-cultural-political factors for understanding the impact of cancer for lesbian and queer women and their romantic partners. Affirmative cancer care for sexual minorities fully validates and integrates partners in care, removes heteronormative assumptions in services provided, and offers LGB+ patient and partner support services.
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Affiliation(s)
- Trisha L Raque
- Department of Counseling Psychology, University of Denver, Denver, CO, USA
| | - Kaitlin V Ross
- Department of Counseling Psychology, University of Denver, Denver, CO, USA
| | - Anna R Hangge
- Department of Counseling Psychology, University of Denver, Denver, CO, USA
| | - Rebecca C Gaines
- Department of Counseling Psychology, University of Denver, Denver, CO, USA
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Ridge D, Pilkington K, Donovan S, Moschopoulou E, Gopal D, Bhui K, Chalder T, Khan I, Korszun A, Taylor S. A meta-ethnography investigating relational influences on mental health and cancer-related health care interventions for racially minoritised people in the UK. PLoS One 2023; 18:e0284878. [PMID: 37163472 PMCID: PMC10171693 DOI: 10.1371/journal.pone.0284878] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2022] [Accepted: 04/10/2023] [Indexed: 05/12/2023] Open
Abstract
OBJECTIVE Despite calls to increase the 'cultural competence' of health care providers, racially minoritised people continue to experience a range of problems when it comes to health care, including discrimination. While relevant qualitative meta-syntheses have suggested better ways forward for health care for racialised minorities, many have lacked conceptual depth, and none have specifically investigated the relational dimensions involved in care. We set out to investigate the social and cultural influences on health care interventions, focusing on psychological approaches and/or cancer care to inform the trial of a new psychological therapy for those living with or beyond cancer. METHOD A meta-ethnography approach was used to examine the relevant qualitative studies, following Noblit and Hare, and guided by patient involvement throughout. Papers were analysed between September 2018 and February 2023, with some interruptions caused by the Covid pandemic. The following databases were searched: Ovid MEDLINE, EBSCO CINAHL, Ovid Embase, EBSCO PsycINFO, Proquest Sociology Collection (including Applied Social Sciences Index & Abstracts (ASSIA), Sociological Abstracts and Sociology Database), EBSCO SocINDEX, Ovid AMED, and Web of Science. The systematic review protocol was registered with the International Prospective Register of Systematic Reviews (PROSPERO) (ID: CRD42018107695), and reporting follows the eMERGe Reporting Guidance for meta-ethnographies (France et al. 2019). RESULTS Twenty-nine journal papers were included in the final review. Themes (third-order constructs) developed in the paper include the centrality of the patient-practitioner relationship; how participants give meaning to their illness in connection to others; how families (rather than individuals) may make health decisions; how links with a higher power and spiritual/religious others can play a role in coping; and the ways in which a hierarchy of help-seeking develops, frequently with the first port of call being the resources of oneself. Participants in studies had a need to avoid being 'othered' in their care, valuing practitioners that connected with them, and who were able to recognise them as whole and complex (sometimes described in relational languages like 'love'). Complex family-based health decision-making and/or the importance of relations with non-human interactants (e.g. God, spiritual beings) were frequently uncovered, not to mention the profoundly emergent nature of stigma, whereby families could be relatively safe havens for containing and dealing with health challenges. A conceptual framework of 'animated via (frequently hidden) affective relationality' emerged in the final synthesis, bringing all themes together, and drawing attention to the emergent nature of the salient issues facing minoritised patients in health care interactions. CONCLUSION Our analysis is important because it sheds light on the hitherto buried relational forces animating and producing the specific issues facing racially minoritised patients, which study participants thought were largely overlooked, but to which professionals can readily relate (given the universal nature of human relations). Thus, training around the affective relationality of consultations could be a fruitful avenue to explore to improve care of diverse patients.
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Affiliation(s)
- Damien Ridge
- School of Social Sciences, University of Westminster, London, United Kingdom
| | - Karen Pilkington
- School of Health and Care Professions, University of Portsmouth, Portsmouth, United Kingdom
| | - Sheila Donovan
- Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, United Kingdom
| | - Elisavet Moschopoulou
- Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, United Kingdom
| | - Dipesh Gopal
- Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, United Kingdom
| | - Kamaldeep Bhui
- Department of Psychiatry, Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, United Kingdom
- Wadham College, University of Oxford, Oxford, United Kingdom
- World Psychiatric Association Collaborating Centre, Oxford, United Kingdom
| | - Trudie Chalder
- Department of Psychological Medicine, Kings College London, London, United Kingdom
| | - Imran Khan
- Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, United Kingdom
| | - Ania Korszun
- Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, United Kingdom
| | - Stephanie Taylor
- Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, United Kingdom
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Patterson CW, Golightly M. Adults with intellectual disabilities and third‐wave therapies: A systematic review and
meta‐ethnography. JOURNAL OF APPLIED RESEARCH IN INTELLECTUAL DISABILITIES 2022; 36:13-27. [DOI: 10.1111/jar.13045] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2021] [Revised: 06/20/2022] [Accepted: 10/20/2022] [Indexed: 11/09/2022]
Affiliation(s)
| | - Mark Golightly
- Peterborough Adult locality Team Adult Mental Health Peterborough UK
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Zhao T, Starkweather AR, Matson A, Lainwala S, Xu W, Cong X. Nurses' experiences of caring for preterm infants in pain: A meta-ethnography. Int J Nurs Sci 2022; 9:533-541. [PMID: 36285076 PMCID: PMC9587390 DOI: 10.1016/j.ijnss.2022.09.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2022] [Revised: 08/25/2022] [Accepted: 09/08/2022] [Indexed: 11/28/2022] Open
Abstract
Objective Preterm infants are subjected to numerous painful procedures during their neonatal intensive care unit (NICU) hospitalization. Despite advancements in pain alleviation, nurses remain challenged to provide timely and effective pain management for preterm infants. Greater understanding of the lived experience of nurses caring for preterm infants in pain could provide novel insights to improve pain management for this vulnerable population. The aim of this meta-ethnography was to synthesize and interpret qualitative findings of nurses' experiences of taking care of preterm infants in pain. Methods An extensive literature search in PubMed, CINAHL, PsycINFO, Scopus, BIOSIS and ProQuest Dissertation and Theses Database was conducted, including studies within the past 10 years. Two nursing researchers conducted data extraction and analysis independently. Inclusion criteria were applied to search for qualitative studies of nurse participants who worked in the NICU taking care of preterm infants. Studies published in a language other than English, articles that did not include qualitative data and qualitative data that could not be extracted from the findings or did not discuss nurses' experiences were excluded. Critical Appraisal Skills Programme was used for literature quality evaluation. Results Eight studies remained after further screening according to inclusion and exclusion criteria. These eight studies were conducted from 2013 to 2018 and totally enrolled 205 nurses from Iran, Canada, the United States, Finland, Sweden, Switzerland, and Australia. Five themes emerged on the nurses' perspectives of taking care of preterm infants in pain: 1) They sense the neonatal pain; 2) Adverse consequences of unrelieved pain; 3) Barriers of managing pain; 4) Concerns of available approaches for pain relief; 5) Failure to work with parents. Conclusions This meta-ethnography identified nurses' understanding of pain in preterm infants that can be assessed, and they acknowledged that unrelieved pain could cause developmental deficits in infants. The barriers are lack of training and support on pain assessment and intervention in preterm infants. Optimizing workload and environment, developing age-specified pain assessment and intervention, receiving emotional support and training, and building up a rapport with parents are urgent needs for nurses to provide better care to infants having pain.
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Affiliation(s)
- Tingting Zhao
- School of Nursing, University of Connecticut, Storrs, CT, USA
| | | | - Adam Matson
- Division of Neonatology, Connecticut Children’s Medical Center, Hartford, CT, USA
- Department of Pediatrics, University of Connecticut School of Medicine, Farmington, CT, USA
| | - Shabnam Lainwala
- Division of Neonatology, Connecticut Children’s Medical Center, Hartford, CT, USA
- Department of Pediatrics, University of Connecticut School of Medicine, Farmington, CT, USA
| | - Wanli Xu
- School of Nursing, University of Connecticut, Storrs, CT, USA
| | - Xiaomei Cong
- School of Nursing, University of Connecticut, Storrs, CT, USA
- School of Nursing, Yale University, Orange, CT, USA
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Coopey E, Johnson G. "The male elephant in the room": a qualitative evidence synthesis exploring male experiences of eating disorders. J Eat Disord 2022; 10:131. [PMID: 36056450 PMCID: PMC9440558 DOI: 10.1186/s40337-022-00614-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/21/2022] [Accepted: 06/20/2022] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND Men are believed to be underrepresented in eating disorder services; there are many reasons presented to account for this such as a lack of recognition and detection. Due to the physical and psychological complexity of an eating disorder it is important to understand this underrepresentation. This qualitative evidence synthesis aimed to explore the literature relating to men's experiences of an eating disorder, in order to synthesise the findings and offer a more coherent understanding. METHOD A systematic search of the literature was undertaken. Inclusion and exclusion criteria were applied to the findings resulting in 14 papers deemed suitable for inclusion. A Meta-Ethnographic approach to synthesising the data of the 89 participants was undertaken. RESULTS Four themes were identified: 'Societal Construction of the Perfect Male'; 'Striving to Maintain a Masculine Identity'; 'The Interconnectedness of Control and Self-Worth', and 'The Hidden Man'. There appeared to be an underlying concept relating to the conflict of being a man, with what is perceived to be a 'woman's illness' and how this challenged the men's experiences of masculinity. CONCLUSIONS Being a man with an eating disorder conflicted with societal norms, exacerbating their experience of having an eating disorder.. To resolve this, gendered norms need to shift, at societal level as well as considering how best to improve understanding and recognition of men with an eating disorder at the first point of help seeking.
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Affiliation(s)
- Emily Coopey
- Centre for Applied Psychology, School of Psychology, University of Birmingham, Birmingham, UK.
| | - George Johnson
- Centre for Applied Psychology, School of Psychology, University of Birmingham, Birmingham, UK
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Joanna Y, Rachel L, Alice S, Georgia M, Fehmidah M. Meta-synthesis of qualitative research on the barriers and facilitators to implementing workplace mental health interventions. SSM - MENTAL HEALTH 2022. [DOI: 10.1016/j.ssmmh.2022.100148] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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Krøier JK, McDermott O, Ridder HM. Conceptualizing attunement in dementia care: a meta-ethnographic review. Arts Health 2022; 14:32-48. [DOI: 10.1080/17533015.2020.1827276] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Affiliation(s)
- Julie Kolbe Krøier
- Department of Communication and Psychology, Aalborg University, Aalborg, Denmark
| | - Orii McDermott
- Faculty of Medicine & Health Sciences, University of Nottingham, Nottingham, UK
| | - Hanne Mette Ridder
- Department of Communication and Psychology, Aalborg University, Aalborg, Denmark
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Peel-Wainwright KM, Hartley S, Boland A, Rocca E, Langer S, Taylor PJ. The interpersonal processes of non-suicidal self-injury: A systematic review and meta-synthesis. Psychol Psychother 2021; 94:1059-1082. [PMID: 34090311 DOI: 10.1111/papt.12352] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/06/2020] [Accepted: 05/09/2021] [Indexed: 11/29/2022]
Abstract
BACKGROUND Understanding the processes underlying non-suicidal self-injury (NSSI) is important given the negative consequences of this behaviour. Qualitative research has the potential to provide an in-depth exploration of this. There has been limited research regarding the interpersonal processes associated with NSSI; therefore, a meta-synthesis was conducted to investigate this. METHODS A search of PsycINFO, MEDLINE, Web of Science, and CINAHL electronic databases from date of inception to November 2020 was conducted. In total, 30 papers were included in the final review. A meta-ethnographic approach was utilized to synthesize the data. RESULTS Two overarching themes were found. Within 'Powerful relational dynamics', NSSI was cited as a response to participants becoming stuck in aversive or disempowering relational positions with others. Within the 'Taking matters into their own hands' subtheme, NSSI was reported as a way for participants to get interpersonal and emotional needs met. LIMITATIONS Several included papers did not comment on the researcher-participant relationship, which may have affected qualitative results. A small number of potentially eligible papers were unavailable for synthesizing. CONCLUSION Findings provide a more nuanced investigation of the interpersonal processes underlying NSSI. Consistent with relevant theories, NSSI appears to be a way of mitigating difficult interpersonal experiences or getting interpersonal needs met. NSSI may be engaged in as a substitute to other, less damaging ways to cope. An argument is made for a more empathetic understanding of NSSI and the use of relational interventions. PRACTITIONER POINTS Self-injury may occur in response to interpersonal stressors Self-injury can be a means to get interpersonal needs met Self-injury may replace other means of coping that become blocked or thwarted Emotional distress can be closely linked with interpersonal factors for this group Relational therapies may be beneficial where interpersonal processes are linked to NSSI.
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Affiliation(s)
- Kelly-Marie Peel-Wainwright
- Divison of Psychology & Mental Health, School of Health Sciences, University of Manchester, Manchester Academic Health Sciences Centre, UK.,Greater Manchester Mental Health NHS Foundation Trust, UK
| | - Samantha Hartley
- Divison of Psychology & Mental Health, School of Health Sciences, University of Manchester, Manchester Academic Health Sciences Centre, UK.,Pennine Care NHS Foundation Trust, UK
| | - Angel Boland
- Divison of Psychology & Mental Health, School of Health Sciences, University of Manchester, Manchester Academic Health Sciences Centre, UK.,Greater Manchester Mental Health NHS Foundation Trust, UK
| | - Eleanor Rocca
- Divison of Psychology & Mental Health, School of Health Sciences, University of Manchester, Manchester Academic Health Sciences Centre, UK.,Greater Manchester Mental Health NHS Foundation Trust, UK
| | - Susanne Langer
- Department of Psychology, Manchester Metropolitan University, UK
| | - Peter J Taylor
- Divison of Psychology & Mental Health, School of Health Sciences, University of Manchester, Manchester Academic Health Sciences Centre, UK
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Strick K, Abbott R, Thompson Coon J, Garside R. Meta-ethnography of the purpose of meaningful occupation for people living with dementia. Int J Older People Nurs 2021; 16:e12391. [PMID: 34075707 DOI: 10.1111/opn.12391] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2020] [Revised: 05/06/2021] [Accepted: 05/07/2021] [Indexed: 11/27/2022]
Abstract
BACKGROUND Guidance on provision of care for people with dementia states that occupation people find meaningful is essential for well-being; however, definitions of 'meaningful occupation' are often broad, with intrinsic meaning coming from within the person rather than the activity, leading to an inconsistent understanding of its purpose. OBJECTIVES This study aimed to create a conceptual framework depicting the types of meaning that are seen as stemming from occupation. METHOD Six electronic databases were searched (CINAHL, PubMed Central, PsycINFO, Embase, AMED, ASSIA) using a pre-specified search strategy to identify qualitative studies relating to meaningful occupation for people living with dementia. From 114 eligible full-text articles, six qualitative studies were identified as sufficiently rich, topically relevant and explicit in their definition of meaningful activity. A further 14 were purposefully sampled for their ability to refute or advance the emerging conceptual framework. The synthesis is based on meta-ethnography and is reported following eMERGe guidance. RESULTS We found the fundamental purpose of occupation is to support the person living with dementia to feel they are living a meaningful and fulfilling life. Three overlapping concepts were identified: (i) catalytic environment, (ii) meaningful life and (iii) occupation as a tool. CONCLUSION The framework proposes how occupation could support meaning in multiple ways and considers how these forms of meaning were influenced by the worldviews and values of the individual, and context in which they were experienced. IMPLICATIONS FOR PRACTICE The conceptual framework offers a consistent theoretical grounding with which to measure effectiveness of meaningful occupation for people living with dementia.
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Affiliation(s)
- Katherine Strick
- European Centre for Environment and Human Health, University of Exeter Medical School, University of Exeter, Exeter, UK
| | - Rebecca Abbott
- Evidence Synthesis Team, NIHR CLAHRC South West Peninsula (PenCLAHRC), College of Medicine and Health, University of Exeter, Exeter, UK
| | - Jo Thompson Coon
- Evidence Synthesis Team, NIHR CLAHRC South West Peninsula (PenCLAHRC), College of Medicine and Health, University of Exeter, Exeter, UK
| | - Ruth Garside
- European Centre for Environment and Human Health, University of Exeter Medical School, University of Exeter, Exeter, UK
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Heinonen K. Strengthening Antenatal Care towards a Salutogenic Approach: A Meta-Ethnography. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18105168. [PMID: 34068114 PMCID: PMC8152723 DOI: 10.3390/ijerph18105168] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/14/2021] [Revised: 05/04/2021] [Accepted: 05/06/2021] [Indexed: 11/16/2022]
Abstract
The aim was to explore how midwives, public health nurses and nurses view caring in antenatal care (ANC) as provided for mothers and fathers/partners. Based on Noblit and Hare (1988), meta-ethnography was used to address meaning by synthesizing knowledge and understanding inductively through selected qualitative studies (n = 16). Four core themes were identified: (1) supporting the parents to awaken to parenthood and creating a firm foundation for early parenting and their new life situation; (2) guiding parents on the path to parenthood and new responsibility; (3) ensuring normality and the bond between baby and parents while protecting life; and (4) promoting the health and wellbeing of the family today and in the future. The overarching theme can be expressed as "helping the woman and her partner prepare for their new life with the child by providing individualized, shared care, firmly grounded and with a view of the future". Caring in antenatal care (ANC) is being totally present, listening and using multidimensional professional competence but also being open-minded to new aspects and knowledge. The health promotion and positive health aspects should be considered an important part of supporting parents and the whole family now and in the future. A more conscious salutogenic approach to ANC would lead to more favorable results and could be a fruitful research topic in the future. There is a need to provide midwives/nurses with enough time to allow them to concentrate on specific needs and support for different kind of families in ANC but also training for midwives to make them more familiar with online and other options.
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Affiliation(s)
- Kristiina Heinonen
- Health Care and Health Promotion, Metropolia University of Applied Sciences, P.O. Box 4000, FI-00079 Helsinki, Finland;
- Department of Nursing Science, University of Eastern Finland, Yliopistonranta 1, FI-70210 Kuopio, Finland
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Giannakou I, Gaskell L. A qualitative systematic review of the views, experiences and perceptions of Pilates-trained physiotherapists and their patients. Musculoskeletal Care 2021; 19:67-83. [PMID: 32929888 DOI: 10.1002/msc.1511] [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: 08/26/2020] [Revised: 08/27/2020] [Accepted: 08/28/2020] [Indexed: 12/16/2022]
Abstract
OBJECTIVES A review of qualitative studies exploring Pilates-trained physiotherapists and their patients' perspectives and experiences of Pilates, aiming to improve practice and provide a deeper insight into the way this method is being utilized along with its effects on participants. DESIGN Qualitative evidence synthesis using meta-ethnography. DATA SOURCES A comprehensive search strategy, limited to English language articles, was conducted to MEDLINE (PubMed), EMBASE, CINAHL, PEDro and Cochrane Central for the period of January 2000 (inception) to June 2020. This was supplemented by identification of Grey literature through Google Scholar, website searching and reference lists. STUDY SELECTION Qualitative studies reporting experiences and perceptions of patients' or Pilates-trained physiotherapists' regarding the efficacy of Pilates for the management of chronic musculoskeletal conditions. After a process of exclusion, eight studies were included in the synthesis. DATA EXTRACTION The textual data were analysed by a qualitative software program. Studies were critically appraised independently by two reviewers. DATA SYNTHESIS Articles were synthesized using a technique of meta-ethnography. Three themes emerged from the process of reciprocal translation: (1) Benefits of the Pilates approach; (2) most effective ways to utilize and most beneficial parameters and (3) risks, precautions, contraindications and indications. CONCLUSION This is the first qualitative evidence synthesis of practitioners' and patients' perspectives of Pilates. Findings support evidence for the various benefits of this approach and provide fresh insight into the way this method can be practiced to maximize efficiency and focus on the patients' needs. KEY RECOMMENDATIONS Pilates-trained physiotherapists identified that Pilates can be tailored to individual requirements, preferences and needs, to promote self-management to facilitate clinical and cost-effective care.
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Affiliation(s)
- Ioanna Giannakou
- School of Health and Society, University of Salford, Manchester, UK
| | - Lynne Gaskell
- School of Health and Society, University of Salford, Manchester, UK
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Pilkington K, Ridge DT, Igwesi-Chidobe CN, Chew-Graham CA, Little P, Babatunde O, Corp N, McDermott C, Cheshire A. A relational analysis of an invisible illness: A meta-ethnography of people with chronic fatigue syndrome/myalgic encephalomyelitis (CFS/ME) and their support needs. Soc Sci Med 2020; 265:113369. [DOI: 10.1016/j.socscimed.2020.113369] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Revised: 08/17/2020] [Accepted: 09/12/2020] [Indexed: 11/28/2022]
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Achore M, Bisung E, Kuusaana ED. Coping with water insecurity at the household level: A synthesis of qualitative evidence. Int J Hyg Environ Health 2020; 230:113598. [PMID: 32862072 DOI: 10.1016/j.ijheh.2020.113598] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2020] [Revised: 07/05/2020] [Accepted: 07/19/2020] [Indexed: 11/25/2022]
Abstract
Water insecurity is a key public health and developmental challenge for many communities across the world. Using a meta-ethnographic synthesis, this study examines how households cope with water insecurity, as well as the socio-economic consequences and determinants of water insecurity coping strategies. A systematized keyword search was conducted in various electronic databases (PubMed, CINAHL EBSCOHost, Embase Ovid, Science Direct, Medline, Global Health, SCOPUS, Google and Google scholar). Out of 1352 potential articles, 21 studies were selected for review. Households employed nine key coping strategies. These strategies include water storage, construction of alternative water source, water sharing and borrowing from social networks, buying water from private vendors, water management and reuse, illegal connections to public water networks, water harvesting, fetching water from distant sources, and water treatment to improve the quality. Some of these coping strategies had far-reaching health and economic consequences, including the risk of water contamination, adverse psychosocial health, and impacts on household savings. We found that poor households, due to their over-reliance on short term labour-intensive and time-consuming coping strategies, are further economically disadvantaged by water insecurity. From a policy perspective, we recommend that investments in effective and efficient water supply infrastructure are needed to help alleviate the day-to-day hassles of water users. While policymakers are looking for long term solutions to these problems, some of the coping strategies identified in this synthesis, such as water conservation, water reuse, and purification of water before consumption, could be encouraged as supplementary strategies to meet households' immediate water needs.
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Affiliation(s)
- Meshack Achore
- School of Kinesiology and Health Studies, Queen's University Kingston, ON, Canada.
| | - Elijah Bisung
- School of Kinesiology and Health Studies, Queen's University Kingston, ON, Canada
| | - Elias D Kuusaana
- Department of Real Estate and Land Management, University for Development Studies, Wa Upper West Region, Ghana
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21
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22
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Park S, Khan N, Stevenson F, Malpass A. Patient and Public Involvement (PPI) in evidence synthesis: how the PatMed study approached embedding audience responses into the expression of a meta-ethnography. BMC Med Res Methodol 2020; 20:29. [PMID: 32041523 PMCID: PMC7011428 DOI: 10.1186/s12874-020-0918-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2018] [Accepted: 01/31/2020] [Indexed: 11/17/2022] Open
Abstract
Background Patient and public involvement (PPI) has become enshrined as an important pillar of health services empirical research, including PPI roles during stages of research development and analysis and co-design approaches. Whilst user participation has been central to qualitative evidence synthesis (QES) for decades, as seen in the Cochrane consumer network and guidelines, meta-ethnography has been slow to incorporate user participation and published examples of this occurring within meta-ethnography are sparse. In this paper, drawing upon our own experience of conducting a meta-ethnography, we focus on what it means in practice to ‘express a synthesis’ (stage 7). We suggest the methodological importance of ‘expression’ in Noblit and Hare’s seven stage process (Noblit, GW and Hare, RD. Meta-ethnography: synthesizing qualitative studies, 1988) has been overlooked, and in particular, opportunities for PPI user participation within it. Methods Meta-ethnography comprises a seven-stage process of evidence synthesis. Noblit and Hare describe the final 7th stage of the meta-ethnography process as ‘expression of synthesis’, emphasizing co-construction of findings with the audience. In a previous study we conducted a meta-ethnography exploring patient and student experience of medical education within primary care contexts. We subsequently presented and discussed initial meta-ethnography findings with PPI (students and patients) in focus groups and interviews. We transcribed patient and student PPI interpretations of synthesis findings. As a research team, we then translated these into our existing meta-ethnography findings. Results We describe, with examples, the process of involving PPI in stage 7 of meta-ethnography and discuss three methodological implications of incorporating PPI within an interpretative approach to QES: (1) we reflect on the construct hierarchy of user participants’ interpretations and consider whether incorporating these additional 1st order, 2nd level constructs implies an additional logic of 3rd order 2nd level constructs of the QES team; (2) we discuss the link between PPI user participation and what Noblit and Hare may have meant by ideas of ‘expression’ and ‘audience’ as integral to stage 7; and (3) we link PPI user participation to Noblit and Hare’s underlying theory of social explanation, i.e. how expression of the synthesis is underpinned by ideas of translation and that the synthesis must be ‘translated in the audience’s (user participants) particular language’. Conclusions The paper aims to complement recent attempts in the literature to refine and improve guidance on conducting a meta-ethnography, highlighting opportunities for PPI user participation in the processes of interpretation, translation and expression. We discuss the implications of user participation in meta-ethnography on ideas of ‘generalisability’.
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Affiliation(s)
- S Park
- Research Department of Primary Care and Population Health (PCPH), UCL Medical School, Royal Free Campus, Rowland Hill St., London, NW3 2PY, UK.
| | - N Khan
- Faculty of Medicine and Health, University of Leeds, Leeds, LS2 9JT, UK
| | - F Stevenson
- Research Department of Primary Care and Population Health (PCPH), UCL Medical School, Royal Free Campus, Rowland Hill St., London, NW3 2PY, UK
| | - A Malpass
- Centre for Academic Primary Care, Population Health Sciences, School of Social and Community Medicine, University of Bristol, Office 1.03b, Canynge Hall, 39, Whatley Rd, Bristol, BS8 2PS, UK
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Carver H, Ring N, Miler J, Parkes T. What constitutes effective problematic substance use treatment from the perspective of people who are homeless? A systematic review and meta-ethnography. Harm Reduct J 2020; 17:10. [PMID: 32005119 PMCID: PMC6995160 DOI: 10.1186/s12954-020-0356-9] [Citation(s) in RCA: 35] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2019] [Accepted: 01/05/2020] [Indexed: 11/24/2022] Open
Abstract
Background People experiencing homelessness have higher rates of problematic substance use but difficulty engaging with treatment services. There is limited evidence regarding how problematic substance use treatment should be delivered for these individuals. Previous qualitative research has explored perceptions of effective treatment by people who are homeless, but these individual studies need to be synthesised to generate further practice-relevant insights from the perspective of this group. Methods Meta-ethnography was conducted to synthesise research reporting views on substance use treatment by people experiencing homelessness. Studies were identified through systematic searching of electronic databases (CINAHL; Criminal Justice Abstracts; Health Source; MEDLINE; PsycINFO; SocINDEX; Scopus; and Web of Science) and websites and were quality appraised. Original participant quotes and author interpretations were extracted and coded thematically. Concepts identified were compared to determine similarities and differences between studies. Findings were translated (reciprocally and refutationally) across studies, enabling development of an original over-arching line-of-argument and conceptual model. Results Twenty-three papers published since 2002 in three countries, involving 462 participants, were synthesised. Findings broadly related, through personal descriptions of, and views on, the particular intervention components considered effective to people experiencing homelessness. Participants of all types of interventions had a preference for harm reduction-oriented services. Participants considered treatment effective when it provided a facilitative service environment; compassionate and non-judgemental support; time; choices; and opportunities to (re)learn how to live. Interventions that were of longer duration and offered stability to service users were valued, especially by women. From the line-of-argument synthesis, a new model was developed highlighting critical components of effective substance use treatment from the service user’s perspective, including a service context of good relationships, with person-centred care and an understanding of the complexity of people’s lives. Conclusion This is the first meta-ethnography to examine the components of effective problematic substance use treatment from the perspective of those experiencing homelessness. Critical components of effective problematic substance use treatment are highlighted. The way in which services and treatment are delivered is more important than the type of treatment provided. Substance use interventions should address these components, including prioritising good relationships between staff and those using services, person-centred approaches, and a genuine understanding of individuals’ complex lives.
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Affiliation(s)
- Hannah Carver
- Salvation Army Centre for Addiction Services and Research, 4T26, RG Bomont Building, Faculty of Social Sciences, University of Stirling, Stirling, FK9 4LA, UK.
| | - Nicola Ring
- School of Health and Social Care, Sighthill Campus, Edinburgh Napier University, Edinburgh, EH11 4BN, UK
| | - Joanna Miler
- Salvation Army Centre for Addiction Services and Research, 4T26, RG Bomont Building, Faculty of Social Sciences, University of Stirling, Stirling, FK9 4LA, UK
| | - Tessa Parkes
- Salvation Army Centre for Addiction Services and Research, 4T26, RG Bomont Building, Faculty of Social Sciences, University of Stirling, Stirling, FK9 4LA, UK
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Poyser CA, Tickle A. Exploring the experience of the disclosure of a dementia diagnosis from a clinician, patient and carer perspective: a systematic review and Meta-ethnographic synthesis. Aging Ment Health 2019; 23:1605-1615. [PMID: 30430858 DOI: 10.1080/13607863.2018.1506747] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Objectives: The objective of this review was to identify, appraise and synthesise qualitative research that explores the experience of the disclosure of a dementia diagnosis from the perspectives of clinicians, patients and carers. Method: A systematic search of four databases, grey literature and reference lists identified 13 studies, which met the required criteria to be included in the review. All were appraised using a quality appraisal tool. Data were extracted and synthesised using a meta-ethnographic approach. Results: Five key themes were developed from an interpretation of the results: the clinician's approach; how to tell people the diagnosis is dementia; the importance of the clinician offering hope; level of understanding; and who should attend the disclosure meeting. The process can be improved through a compassionate clinician offering hope, answers to patient and carer questions, and written and/or visual information to support understanding of the diagnosis. These features could be included in guidance to clinicians. There was a large amount of variance in the quality of the studies. Future qualitative research could focus on clinician compassion, giving hope, the management of dynamics within sessions, supporting information and follow-up sessions. Conclusion: Clinical practice can be informed by a body of literature but there is much work to be done to develop evidence-based detailed guidance for improving the dementia diagnosis experience for all parties, and supporting clinicians to manage inherent tensions in this process. Further research is required on this topic to addresses the shortcomings highlighted in this review.
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Affiliation(s)
- Charlotte A Poyser
- Trent DClinPsy Programme, Division of Psychiatry & Applied Psychology, University of Nottingham , Nottingham , UK
| | - Anna Tickle
- Trent DClinPsy Programme, Division of Psychiatry & Applied Psychology, University of Nottingham , Nottingham , UK
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25
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Martin-Saez MM, James N. The experience of occupational identity disruption post stroke: a systematic review and meta-ethnography. Disabil Rehabil 2019; 43:1044-1055. [PMID: 31373246 DOI: 10.1080/09638288.2019.1645889] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
PURPOSE After a stroke, most individuals cannot participate in some of their valued occupations, disrupting their occupational identity. The aim of this interpretive synthesis is to systematically review the existing body of research to develop an understanding of the experience of occupational identity disruption post-stroke. METHODS A systematic review of the literature that included nine electronic databases, reference lists screening and grey literature checking was completed. Ten studies published between January 2012 and October 2018 were included. Meta-ethnography was used for the interpretive synthesis. FINDINGS A three-staged process model was created. Stage 1 illustrates the four factors involved in occupational identity disruption: "A fragmented and externalized body", "losing control, freedom and independence", "changed social and familial interactions", and "occupational participation loss". Stage two explains the experience of occupational identity disruption: "Occupational identity loss", "a de-valued self", and "threat to identity continuity". Stage three shows the individual's coping strategies: "protecting one's self", "social isolation", and "re-inventing one's occupational self". CONCLUSIONS Stroke impacts on an individual's occupational identity, compromising the continuity of a stroke survivor's sense of self. However, occupational identity is fluid; this can be used to support individuals to re-invent the occupational self. A conceptual model was developed to support the application of these results in clinical practice.Implications for rehabilitationOccupational identity disruption impacts on stroke survivors' self-value and sense of self continuity.Health care professionals' understanding of stroke survivors experience of occupational identity disruption could contribute to realign stroke survivors and clinicians' rehabilitation goals.Occupational participation and social interaction should be core aspects of stroke rehabilitation.Occupation-focus rehabilitation could provide opportunities for stroke survivors to pursue their desired occupational identity.
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Affiliation(s)
- Maria M Martin-Saez
- Occupational Therapy Department, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK
| | - Neil James
- School of Health Sciences, University of East Anglia, Norwich, UK
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France EF, Cunningham M, Ring N, Uny I, Duncan EAS, Jepson RG, Maxwell M, Roberts RJ, Turley RL, Booth A, Britten N, Flemming K, Gallagher I, Garside R, Hannes K, Lewin S, Noblit GW, Pope C, Thomas J, Vanstone M, Higginbottom GMA, Noyes J. Improving reporting of meta-ethnography: The eMERGe reporting guidance. J Adv Nurs 2019; 75:1126-1139. [PMID: 30644123 PMCID: PMC7594209 DOI: 10.1111/jan.13809] [Citation(s) in RCA: 49] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2017] [Revised: 06/22/2018] [Accepted: 07/03/2018] [Indexed: 01/26/2023]
Abstract
AIMS The aim of this study was to provide guidance to improve the completeness and clarity of meta-ethnography reporting. BACKGROUND Evidence-based policy and practice require robust evidence syntheses which can further understanding of people's experiences and associated social processes. Meta-ethnography is a rigorous seven-phase qualitative evidence synthesis methodology, developed by Noblit and Hare. Meta-ethnography is used widely in health research, but reporting is often poor quality and this discourages trust in and use of its findings. Meta-ethnography reporting guidance is needed to improve reporting quality. DESIGN The eMERGe study used a rigorous mixed-methods design and evidence-based methods to develop the novel reporting guidance and explanatory notes. METHODS The study, conducted from 2015 - 2017, comprised of: (1) a methodological systematic review of guidance for meta-ethnography conduct and reporting; (2) a review and audit of published meta-ethnographies to identify good practice principles; (3) international, multidisciplinary consensus-building processes to agree guidance content; (4) innovative development of the guidance and explanatory notes. FINDINGS Recommendations and good practice for all seven phases of meta-ethnography conduct and reporting were newly identified leading to 19 reporting criteria and accompanying detailed guidance. CONCLUSION The bespoke eMERGe Reporting Guidance, which incorporates new methodological developments and advances the methodology, can help researchers to report the important aspects of meta-ethnography. Use of the guidance should raise reporting quality. Better reporting could make assessments of confidence in the findings more robust and increase use of meta-ethnography outputs to improve practice, policy, and service user outcomes in health and other fields. This is the first tailored reporting guideline for meta-ethnography. This article is being simultaneously published in the following journals: Journal of Advanced Nursing, Psycho-oncology, Review of Education, and BMC Medical Research Methodology.
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Affiliation(s)
| | | | | | | | | | | | | | | | | | | | | | - Kate Flemming
- Department of Health SciencesUniversity of YorkYorkUK
| | | | | | | | - Simon Lewin
- Global Health UnitNorwegian Institute of Public Health and Health Systems Research UnitOsloNorway,South African Medical Research CouncilCapetownSouth Africa
| | | | | | | | | | - Gina M. A. Higginbottom
- School of Health Sciences & Centre for Evidence Based Health CareThe University of NottinghamNottinghamUK
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Morgan GS, Willmott M, Ben-Shlomo Y, Haase AM, Campbell RM. A life fulfilled: positively influencing physical activity in older adults - a systematic review and meta-ethnography. BMC Public Health 2019; 19:362. [PMID: 30940111 PMCID: PMC6444855 DOI: 10.1186/s12889-019-6624-5] [Citation(s) in RCA: 45] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2018] [Accepted: 03/05/2019] [Indexed: 12/30/2022] Open
Abstract
BACKGROUND Increasing physical activity in older adults remains a key public health priority in countries with a high burden of non-communicable disease, yet current interventions have failed to substantially increase population uptake with UK data suggesting that only half of 65-74 year olds report meeting recommended levels. The aim of this study was to conduct a systematic and inductive qualitative synthesis of the large body of qualitative research describing what influences physical activity at this age, and older adults' experiences of physical activity. METHODS A qualitative meta-ethnography was chosen as the study design as this inductive approach can provide novel insights and generate new theory about physical activity and ageing. Papers were identified by searching electronic databases and key citations. Peer-reviewed primary qualitative studies and systematic reviews were included if they met the following inclusion criteria: community-dwelling participants aged 60 years or older or in the retirement transition period; reporting on leisure-time physical activity; utilising a rigorous qualitative methodology. A line of argument approach was employed to generate a theory about how older adults think and feel about physical activity. RESULTS Thirty-nine papers met the inclusion criteria and were synthesised. The emergent theory suggested transition to older age can challenge people's sense of self and their role in life. Physical activity can help in regaining feelings of purpose, of being needed in collective group activity, and by creating habitual routine and structure to the day. In overcoming real and perceived barriers, and by taking up or sustaining physical activities, older adults can further build self-esteem all of which contributes to a fulfilling older age. CONCLUSION Current failures to increase population levels of physical activity in older adults may be explained by an approach overly focused on the health benefits of activity. Insights from this study suggest we need to reframe our approach to consider the wider set of goals and aspirations which are of greater personal importance to older adults, and future interventions should focus on how physical activity can contribute to life satisfaction, sense of purpose, and sense of role fulfilment in older age. TRIAL REGISTRATION Registered prospectively on PROSPERO on 29th March 2013: CRD42013003796 .
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Affiliation(s)
- Gemma S. Morgan
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, BS8 2PS UK
| | - Micky Willmott
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, BS8 2PS UK
| | - Yoav Ben-Shlomo
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, BS8 2PS UK
| | - Anne M. Haase
- School of Policy Studies, University of Bristol, Bristol, BS8 1TZ UK
| | - Rona M. Campbell
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, BS8 2PS UK
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Abstract
BACKGROUND In 2005, Pearson et al. presented a developmental framework of evidence-based practice that sought to situate healthcare evidence and its role and use within the complexity of practice settings globally. A decade later, it was deemed timely to re-examine the Model and its component parts to determine whether they remain relevant and a true and accurate reflection of where the evidence-based movement is today. METHODS A two-phase process was employed for this project. Phase 1 involved a citation analysis, conducted using the index citation of the original source article on the Joanna Briggs Institute (JBI) Model by Pearson et al. The databases searched were Web of Science and Google Scholar from year of publication (2005) to July 2015. Duplicates and articles in languages other than English were removed, and all results were imported and combined in an Excel spreadsheet for review, coding and interpretation. Phase 2 (model revision) occurred in two parts. Part 1 involved revision of the Model by an internal working group. This revised version of the Model was then subjected to a process of focus group discussion (Part 2) that engaged staff of the Joanna Briggs Collaboration during the 2015 annual general meeting. These data were recorded then transcribed for review and consideration. RESULTS The citation analysis revealed that the Model was primarily utilized to conceptualize evidence and evidence-based healthcare, but that language used in relation to concepts within the Model was variable. Equally, the working group and focus group feedback confirmed that there was a need to ensure the language utilized in the Model was internationally appropriate and in line with current international trends. This feedback and analysis informed the revised version of the JBI Model. CONCLUSION Based on the citation analysis, working group and focus group feedback the new JBI Model for Evidence Based Healthcare attempts to utilize more internationally appropriate language to detail the intricacies of the relationships between systems and individuals across different settings and the need for contextual localization to enable policy makers and practitioners to make evidence-based decisions at the point of care.
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France EF, Uny I, Ring N, Turley RL, Maxwell M, Duncan EAS, Jepson RG, Roberts RJ, Noyes J. A methodological systematic review of meta-ethnography conduct to articulate the complex analytical phases. BMC Med Res Methodol 2019; 19:35. [PMID: 30777031 PMCID: PMC6380066 DOI: 10.1186/s12874-019-0670-7] [Citation(s) in RCA: 108] [Impact Index Per Article: 21.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2018] [Accepted: 01/28/2019] [Indexed: 01/15/2023] Open
Abstract
BACKGROUND Decision making in health and social care requires robust syntheses of both quantitative and qualitative evidence. Meta-ethnography is a seven-phase methodology for synthesising qualitative studies. Developed in 1988 by sociologists in education Noblit and Hare, meta-ethnography has evolved since its inception; it is now widely used in healthcare research and is gaining popularity in education research. The aim of this article is to provide up-to-date, in-depth guidance on conducting the complex analytic synthesis phases 4 to 6 of meta-ethnography through analysis of the latest methodological evidence. METHODS We report findings from a methodological systematic review conducted from 2015 to 2016. Fourteen databases and five other online resources were searched. Expansive searches were also conducted resulting in inclusion of 57 publications on meta-ethnography conduct and reporting from a range of academic disciplines published from 1988 to 2016. RESULTS Current guidance on applying meta-ethnography originates from a small group of researchers using the methodology in a health context. We identified that researchers have operationalised the analysis and synthesis methods of meta-ethnography - determining how studies are related (phase 4), translating studies into one another (phase 5), synthesising translations (phase 6) and line of argument synthesis - to suit their own syntheses resulting in variation in methods and their application. Empirical research is required to compare the impact of different methods of translation and synthesis. Some methods are potentially better at preserving links with the context and meaning of primary studies, a key principle of meta-ethnography. A meta-ethnography can and should include reciprocal and refutational translation and line of argument synthesis, rather than only one of these, to maximise the impact of its outputs. CONCLUSION The current work is the first to articulate and differentiate the methodological variations and their application for different purposes and represents a significant advance in the understanding of the methodological application of meta-ethnography.
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Affiliation(s)
- Emma F. France
- NMAHP Research Unit, University of Stirling, Unit 13 Scion House, Stirling University Innovation Park, Stirling, FK9 4NF UK
| | - Isabelle Uny
- NMAHP Research Unit, University of Stirling, Unit 13 Scion House, Stirling University Innovation Park, Stirling, FK9 4NF UK
| | - Nicola Ring
- School of Health and Social Care, Edinburgh Napier University, Sighthill Campus, Sighthill Court, Edinburgh, EH11 4BN UK
| | - Ruth L. Turley
- DECIPHEr, School of Social Sciences, Cardiff University, Glamorgan Building, King Edward VII, Cardiff, CF10 3WT UK
| | - Margaret Maxwell
- NMAHP Research Unit, University of Stirling, Unit 13 Scion House, Stirling University Innovation Park, Stirling, FK9 4NF UK
| | - Edward A. S. Duncan
- NMAHP Research Unit, University of Stirling, Unit 13 Scion House, Stirling University Innovation Park, Stirling, FK9 4NF UK
| | - Ruth G. Jepson
- Scottish Collaboration for Public Health Research and Policy, University of Edinburgh, 20 West Richmond Street, Edinburgh, EH8 9DX UK
| | - Rachel J. Roberts
- NMAHP Research Unit, University of Stirling, Unit 13 Scion House, Stirling University Innovation Park, Stirling, FK9 4NF UK
| | - Jane Noyes
- School of Health Sciences, Bangor University, Bangor, Gwynedd LL57 2EF UK
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Toye F, Seers K, Barker KL. Living life precariously with rheumatoid arthritis - a mega-ethnography of nine qualitative evidence syntheses. BMC Rheumatol 2019; 3:5. [PMID: 30886993 PMCID: PMC6390589 DOI: 10.1186/s41927-018-0049-0] [Citation(s) in RCA: 30] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2018] [Accepted: 12/13/2018] [Indexed: 02/08/2023] Open
Abstract
Background Rheumatoid arthritis is an autoimmune disease that causes joint inflammation. It affects around 400,000 people in the UK and 1 million adults in the USA. Given the appropriate treatment, many can have relatively few symptoms. It is therefore important to understand what it is like to live with rheumatoid arthritis and gain insight into peoples’ decisions about utilising healthcare. The aims of this study were: (1) to bring together qualitative evidence syntheses that explore patients’ experience of living with rheumatoid arthritis and (2) develop a conceptual understanding of what it is like to live with rheumatoid arthritis. Methods We used the methods of mega-ethnography. The innovation of mega-ethnography is to use conceptual findings from qualitative evidence syntheses as primary data. We searched four bibliographic databases from inception until September 2018 to identify qualitative evidence syntheses that explored patients’ experience of rheumatoid arthritis. Results We identified 373 qualitative evidence syntheses, removed 179 duplicates and screened 194 full text studies. We identified 42 qualitative evidence syntheses that explored the experience of pain or arthritis and 9 of these explored the experience of rheumatoid arthritis. We abstracted ideas into 10 conceptual categories: (1) rheumatoid arthritis is in control of my body (2) rheumatoid arthritis alters reciprocity; (3) rheumatoid arthritis is an emotional challenge; (4) rheumatoid arthritis disrupts my present and future self; (5) the challenge of balancing personal and work life; (6) I am trying to make sense of what is happening; (7) rheumatoid arthritis is variable and unpredictable; (8) rheumatoid arthritis is invisible; (9) I need a positive experience of healthcare, and (10) I need to reframe the situation. We developed a conceptual model underpinned by living life precariously with rheumatoid arthritis. Conclusions This is the second mega-ethnography, or synthesis of qualitative evidence syntheses using the methods of meta-ethnography. Future research should consider the proliferation of qualitative evidence synthesis in order to avoid duplication of research effort. Our model for rheumatoid arthritis has some important clinical implications that might be transferable to other musculoskeletal conditions. Electronic supplementary material The online version of this article (10.1186/s41927-018-0049-0) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Fran Toye
- 1Nuffield Orthopaedic Centre, Oxford University Hospitals NHS Foundation Trust, Oxford, UK.,2Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, UK
| | - Kate Seers
- 3Warwick Research in Nursing, Warwick Medical School, University of Warwick, Coventry, UK
| | - Karen Louise Barker
- 1Nuffield Orthopaedic Centre, Oxford University Hospitals NHS Foundation Trust, Oxford, UK.,2Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, UK
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Cunningham M, France EF, Ring N, Uny I, Duncan EAS, Roberts RJ, Jepson RG, Maxwell M, Turley RL, Noyes J. Developing a reporting guideline to improve meta-ethnography in health research: the eMERGe mixed-methods study. HEALTH SERVICES AND DELIVERY RESEARCH 2019. [DOI: 10.3310/hsdr07040] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023] Open
Abstract
BackgroundMeta-ethnography is a commonly used methodology for qualitative evidence synthesis. Research has identified that the quality of reporting of published meta-ethnographies is often poor and this has limited the utility of meta-ethnography findings to influence policy and practice.ObjectiveTo develop guidance to improve the completeness and clarity of meta-ethnography reporting.Methods/designThe meta-ethnography reporting guidance (eMERGe) study followed the recommended approach for developing health research reporting guidelines and used a systematic mixed-methods approach. It comprised (1) a methodological systematic review of guidance in the conduct and reporting of meta-ethnography; (2) a review and audit of published meta-ethnographies, along with interviews with meta-ethnography end-users, to identify good practice principles; (3) a consensus workshop and two eDelphi (Version 1, Duncan E, Swinger K, University of Stirling, Stirling, UK) studies to agree guidance content; and (4) the development of the guidance table and explanatory notes.ResultsResults from the methodological systematic review and the audit of published meta-ethnographies revealed that more guidance was required around the reporting of all phases of meta-ethnography conduct and, in particular, the synthesis phases 4–6 (relating studies, translating studies into one another and synthesising translations). Following the guidance development process, the eMERGe reporting guidance was produced, comprising 19 items grouped into the seven phases of meta-ethnography.LimitationsThe finalised guidance has not yet been evaluated in practice; therefore, it is not possible at this stage to comment on its utility. However, we look forward to evaluating its uptake and usability in the future.ConclusionsThe eMERGe reporting guidance has been developed following a rigorous process in line with guideline development recommendations. The guidance is intended to improve the clarity and completeness of reporting of meta-ethnographies, and to facilitate use of the findings within the guidance to inform the design and delivery of services and interventions in health, social care and other fields. The eMERGe project developed a range of training materials to support use of the guidance, which is freely available atwww.emergeproject.org(accessed 26 March 2018). Meta-ethnography is an evolving qualitative evidence synthesis methodology and future research should refine the guidance to accommodate future methodological developments. We will also investigate the impact of the eMERGe reporting guidance with a view to updating the guidance.Study registrationThis study is registered as PROSPERO CRD42015024709 for the stage 1 systematic review.FundingThe National Institute for Health Research Health Services and Delivery Research programme.
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Affiliation(s)
- Maggie Cunningham
- Nursing Midwifery and Allied Health Professions Research Unit, University of Stirling, Stirling, UK
| | - Emma F France
- Nursing Midwifery and Allied Health Professions Research Unit, University of Stirling, Stirling, UK
| | - Nicola Ring
- School of Health and Social Care, Edinburgh Napier University, Edinburgh, UK
| | - Isabelle Uny
- Nursing Midwifery and Allied Health Professions Research Unit, University of Stirling, Stirling, UK
| | - Edward AS Duncan
- Nursing Midwifery and Allied Health Professions Research Unit, University of Stirling, Stirling, UK
| | - Rachel J Roberts
- Nursing Midwifery and Allied Health Professions Research Unit, University of Stirling, Stirling, UK
| | - Ruth G Jepson
- Scottish Collaboration for Public Health Research and Policy, University of Edinburgh, Edinburgh, UK
| | - Margaret Maxwell
- Nursing Midwifery and Allied Health Professions Research Unit, University of Stirling, Stirling, UK
| | - Ruth L Turley
- Development and Evaluation of Complex Interventions for Public Health Improvement (DECIPHer), School of Social Sciences, Cardiff University, Cardiff, UK
| | - Jane Noyes
- School of Social Sciences, Bangor University, Bangor, UK
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France EF, Cunningham M, Ring N, Uny I, Duncan EAS, Jepson RG, Maxwell M, Roberts RJ, Turley RL, Booth A, Britten N, Flemming K, Gallagher I, Garside R, Hannes K, Lewin S, Noblit GW, Pope C, Thomas J, Vanstone M, Higginbottom GMA, Noyes J. Improving reporting of meta-ethnography: the eMERGe reporting guidance. BMC Med Res Methodol 2019; 19:25. [PMID: 30709371 PMCID: PMC6359764 DOI: 10.1186/s12874-018-0600-0] [Citation(s) in RCA: 227] [Impact Index Per Article: 45.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
AIMS The aim of this study was to provide guidance to improve the completeness and clarity of meta-ethnography reporting. BACKGROUND Evidence-based policy and practice require robust evidence syntheses which can further understanding of people's experiences and associated social processes. Meta-ethnography is a rigorous seven-phase qualitative evidence synthesis methodology, developed by Noblit and Hare. Meta-ethnography is used widely in health research, but reporting is often poor quality and this discourages trust in and use of its findings. Meta-ethnography reporting guidance is needed to improve reporting quality. DESIGN The eMERGe study used a rigorous mixed-methods design and evidence-based methods to develop the novel reporting guidance and explanatory notes. METHODS The study, conducted from 2015 to 2017, comprised of: (1) a methodological systematic review of guidance for meta-ethnography conduct and reporting; (2) a review and audit of published meta-ethnographies to identify good practice principles; (3) international, multidisciplinary consensus-building processes to agree guidance content; (4) innovative development of the guidance and explanatory notes. FINDINGS Recommendations and good practice for all seven phases of meta-ethnography conduct and reporting were newly identified leading to 19 reporting criteria and accompanying detailed guidance. CONCLUSION The bespoke eMERGe Reporting Guidance, which incorporates new methodological developments and advances the methodology, can help researchers to report the important aspects of meta-ethnography. Use of the guidance should raise reporting quality. Better reporting could make assessments of confidence in the findings more robust and increase use of meta-ethnography outputs to improve practice, policy, and service user outcomes in health and other fields. This is the first tailored reporting guideline for meta-ethnography. This article is being simultaneously published in the following journals: Journal of Advanced Nursing, Psycho-oncology, Review of Education, and BMC Medical Research Methodology.
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Affiliation(s)
- Emma F France
- University of Stirling, Stirling, UK.
- NMAHP Research Unit, Unit 13 Scion House, Stirling University Innovation Park, Stirling, FK9 4NF, UK.
| | - Maggie Cunningham
- University of Stirling, Stirling, UK
- NMAHP Research Unit, Unit 13 Scion House, Stirling University Innovation Park, Stirling, FK9 4NF, UK
| | | | | | - Edward A S Duncan
- University of Stirling, Stirling, UK
- NMAHP Research Unit, Unit 13 Scion House, Stirling University Innovation Park, Stirling, FK9 4NF, UK
| | | | - Margaret Maxwell
- University of Stirling, Stirling, UK
- NMAHP Research Unit, Unit 13 Scion House, Stirling University Innovation Park, Stirling, FK9 4NF, UK
| | - Rachel J Roberts
- University of Stirling, Stirling, UK
- NMAHP Research Unit, Unit 13 Scion House, Stirling University Innovation Park, Stirling, FK9 4NF, UK
| | | | | | | | - Kate Flemming
- Department of Health Sciences, University of York, York, UK
| | | | | | | | - Simon Lewin
- Global Health Unit Norwegian Institute of Public Health and Health Systems Research Unit, Oslo, Norway
- South African Medical Research Council, Capetown, South Africa
| | - George W Noblit
- University of North Carolina at Chapel Hill, Chapel Hill, USA
| | | | | | | | - Gina M A Higginbottom
- School of Health Sciences & Centre for Evidence Based Health Care, The University of Nottingham, Nottingham, UK
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Connery A, McCurtin A, Robinson K. The lived experience of stuttering: a synthesis of qualitative studies with implications for rehabilitation. Disabil Rehabil 2019; 42:2232-2242. [DOI: 10.1080/09638288.2018.1555623] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Affiliation(s)
- Amy Connery
- School of Allied Health, University of Limerick, Limerick, Ireland
- HSE Dublin South West, Dublin, Ireland
| | - Arlene McCurtin
- School of Allied Health, University of Limerick, Limerick, Ireland
- Health Research Institute, University of Limerick, Limerick, Ireland
| | - Katie Robinson
- School of Allied Health, University of Limerick, Limerick, Ireland
- Health Research Institute, University of Limerick, Limerick, Ireland
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Flemming K, Booth A, Garside R, Tunçalp Ö, Noyes J. Qualitative evidence synthesis for complex interventions and guideline development: clarification of the purpose, designs and relevant methods. BMJ Glob Health 2019; 4:e000882. [PMID: 30775015 PMCID: PMC6350756 DOI: 10.1136/bmjgh-2018-000882] [Citation(s) in RCA: 144] [Impact Index Per Article: 28.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2018] [Revised: 06/21/2018] [Accepted: 07/20/2018] [Indexed: 01/30/2023] Open
Abstract
This paper is one of a series exploring the implications of complexity for systematic reviews and guideline development, commissioned by the WHO. The paper specifically explores the role of qualitative evidence synthesis. Qualitative evidence synthesis is the broad term for the group of methods used to undertake systematic reviews of qualitative research evidence. As an approach, qualitative evidence synthesis is increasingly recognised as having a key role to play in addressing questions relating to intervention or system complexity, and guideline development processes. This is due to the unique role qualitative research can play in establishing the relative importance of outcomes, the acceptability, fidelity and reach of interventions, their feasibility in different settings and potential consequences on equity across populations. This paper outlines the purpose of qualitative evidence synthesis, provides detail of how qualitative evidence syntheses can help establish understanding and explanation of the complexity that can occur in relation to both interventions and systems, and how qualitative evidence syntheses can contribute to evidence to decision frameworks. It provides guidance for the choice of qualitative evidence synthesis methods in the context of guideline development for complex interventions, giving 'real life' examples of where this has occurred. Information to support decision-making around choice qualitative evidence synthesis methods in the context of guideline development is provided. Approaches for reporting qualitative evidence syntheses are discussed alongside mechanisms for assessing confidence in the findings of a review.
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Affiliation(s)
- Kate Flemming
- Department of Health Sciences, Faculty of Science, The University of York, York, UK
| | - Andrew Booth
- School of Health and Related Research, University of Sheffield, Sheffield, UK
| | - Ruth Garside
- European Centre for Environment and Human Health, University of Exeter, Truro, UK
| | - Özge Tunçalp
- Department of Reproductive Health and Research including UNDP/UNFPA/UNICEF/WHO/World Bank Special Programme of Research, Development and Research Training in Human Reproduction (HRP), World Health Organization, Geneva, Switzerland
| | - Jane Noyes
- School of Social Sciences, Bangor University, Bangor, UK
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Tatterton MJ, Walshe C. Understanding the bereavement experience of grandparents following the death of a grandchild from a life‐limiting condition: A meta‐ethnography. J Adv Nurs 2019; 75:1406-1417. [DOI: 10.1111/jan.13927] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2018] [Revised: 09/12/2018] [Accepted: 11/21/2018] [Indexed: 11/28/2022]
Affiliation(s)
- Michael J. Tatterton
- Martin House Children's Hospice Wetherby West Yorkshire UK
- International Observatory on End of Life Care Lancaster University Lancaster UK
| | - Catherine Walshe
- International Observatory on End of Life Care Lancaster University Lancaster UK
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France EF, Cunningham M, Ring N, Uny I, Duncan EA, Jepson RG, Maxwell M, Roberts RJ, Turley RL, Booth A, Britten N, Flemming K, Gallagher I, Garside R, Hannes K, Lewin S, Noblit GW, Pope C, Thomas J, Vanstone M, Higginbottom GMA, Noyes J. Improving reporting of meta-ethnography: The eMERGe reporting guidance. Psychooncology 2019; 28:447-458. [DOI: 10.1002/pon.4915] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2017] [Revised: 06/22/2018] [Accepted: 07/03/2018] [Indexed: 01/22/2023]
Affiliation(s)
| | | | | | | | | | | | | | | | | | | | | | - Kate Flemming
- Department of Health Sciences; University of York; York UK
| | | | | | | | - Simon Lewin
- Global Health Unit Norwegian Institute of Public Health and Health Systems Research Unit; Oslo Norway
- South African Medical Research Council; Capetown South Africa
| | - George W. Noblit
- University of North Carolina at Chapel Hill; Chapel Hill North Carolina
| | | | | | | | - Gina M. A. Higginbottom
- School of Health Sciences & Centre for Evidence Based Health Care; The University of Nottingham; Nottingham UK
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Abstract
To explore and derive new conceptual understanding of nurse leaders' experiences and perceptions of caring in nursing. RESEARCH QUESTION What is caring in nursing leadership from the nurse leaders' perspectives? There is a paucity of theoretical studies of caring in nursing leadership. Noblit and Hares interpretative meta-ethnography was chosen because of its interpretative potential for theory development. Caring in nursing leadership is a conscious movement between different "rooms" in the leader's "house" of leadership. This emerged as the metaphor that illustrates the core of caring in nursing leadership, presented in a tentative model. There are 5 relation-based rooms: The "patient room," where nurse leaders try to avoid patient suffering through their clinical presence; the "staff room," where nurse leaders trust and respect each other and facilitate dialogue; the "superior's room," where nurse leaders confirm peer relationships; the "secret room," where the leaders' strength to hang on and persist is nurtured; and the "organizational room," where limited resources are continuously being balanced. Caring in nursing leadership means nurturing and growing relationships to safeguard the best nursing care. This presupposes that leaders possess a consciousness of the different "rooms." If rooms are not given equal attention, movement stops, symbolizing that caring in leadership stops as well. One room cannot be given so much attention that others are neglected. Leaders need solid competence in nursing leadership to balance multiple demands in organizations; otherwise, their perceptiveness and the priority of "ministering to the patients" can be blurred.
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Booth A. Harnessing Energies, Resolving Tensions: Acknowledging a Dual Heritage for Qualitative Evidence Synthesis. QUALITATIVE HEALTH RESEARCH 2019; 29:18-31. [PMID: 30799763 DOI: 10.1177/1049732318808247] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
Qualitative evidence synthesis (QES) encompasses more than 20 methods for synthesizing qualitative accounts of research phenomena documenting real-life contexts. However, tensions frequently arise from the different heritages that shape QES methodology: namely, systematic reviews of effectiveness and primary qualitative research. Methodological innovations either derive from each heritage or are stimulated when both are in juxtaposition; it is important to broker a rapprochement. This article draws on practical experience from a range of syntheses and methodological development work conducted with the Cochrane Qualitative and Implementation Methods Group. The legacy of both heritages is briefly characterized. Three stages of the QES process offer exemplars: searching/sampling, quality assessment, and data synthesis. Rather than an antagonistic clash of research paradigms, this dual heritage offers an opportunity to harness the collective energies of both paradigms. Future methodological research is needed to identify further applications by which this dual heritage might be optimally harnessed.
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Affiliation(s)
- Andrew Booth
- 1 The University of Sheffield, Sheffield, United Kingdom
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Kristensen FB, Husereau D, Huić M, Drummond M, Berger ML, Bond K, Augustovski F, Booth A, Bridges JFP, Grimshaw J, IJzerman MJ, Jonsson E, Ollendorf DA, Rüther A, Siebert U, Sharma J, Wailoo A. Identifying the Need for Good Practices in Health Technology Assessment: Summary of the ISPOR HTA Council Working Group Report on Good Practices in HTA. VALUE IN HEALTH : THE JOURNAL OF THE INTERNATIONAL SOCIETY FOR PHARMACOECONOMICS AND OUTCOMES RESEARCH 2019; 22:13-20. [PMID: 30661627 DOI: 10.1016/j.jval.2018.08.010] [Citation(s) in RCA: 67] [Impact Index Per Article: 13.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/12/2018] [Revised: 08/10/2018] [Accepted: 08/14/2018] [Indexed: 05/11/2023]
Abstract
The systematic use of evidence to inform healthcare decisions, particularly health technology assessment (HTA), has gained increased recognition. HTA has become a standard policy tool for informing decision makers who must manage the entry and use of pharmaceuticals, medical devices, and other technologies (including complex interventions) within health systems, for example, through reimbursement and pricing. Despite increasing attention to HTA activities, there has been no attempt to comprehensively synthesize good practices or emerging good practices to support population-based decision-making in recent years. After the identification of some good practices through the release of the ISPOR Guidelines Index in 2013, the ISPOR HTA Council identified a need to more thoroughly review existing guidance. The purpose of this effort was to create a basis for capacity building, education, and improved consistency in approaches to HTA-informed decision-making. Our findings suggest that although many good practices have been developed in areas of assessment and some other key aspects of defining HTA processes, there are also many areas where good practices are lacking. This includes good practices in defining the organizational aspects of HTA, the use of deliberative processes, and measuring the impact of HTA. The extent to which these good practices are used and applied by HTA bodies is beyond the scope of this report, but may be of interest to future researchers.
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Affiliation(s)
| | - Don Husereau
- School of Epidemiology, Public Health and Preventive Medicine, University of Ottawa, Ottawa, ON, Canada; Department of Public Health, Health Services Research and Health Technology Assessment, UMIT - University of Health Sciences, Medical Informatics and Technology, Hall in Tirol, Austria.
| | - Mirjana Huić
- Agency for Quality and Accreditation in Health Care and Social Welfare, Zagreb, Croatia
| | | | | | - Kenneth Bond
- Patient Engagement, Ethics and International Affairs, Canadian Agency for Drugs and Technologies in Health (CADTH), Ottawa, ON, Canada
| | - Federico Augustovski
- Economic Evaluations and HTA Department, Institute for Clinical Effectiveness and Health Policy (IECS), Buenos Aires, Argentina
| | - Andrew Booth
- ScHARR, The University of Sheffield, Sheffield, UK
| | - John F P Bridges
- Department of Biomedical Informatics, The Ohio State University College of Medicine, Columbus, OH, USA
| | - Jeremy Grimshaw
- Cochrane Canada and Professor of Medicine, University of Ottawa, Ottawa, ON, Canada
| | - Maarten J IJzerman
- School of Population and Global Health, University of Melbourne, Melbourne, Australia; Department of Health Technology & Services Research, University of Twente, Enschede, The Netherlands
| | - Egon Jonsson
- Institute of Health Economics, Edmonton, AB, Canada
| | - Daniel A Ollendorf
- Center for the Evaluation of Value and Risk in Health (CEVR), Tufts University, Boston, MA, USA
| | - Alric Rüther
- International Affairs, Institute for Quality and Efficiency in Health Care (IQWiG), Cologne, Germany
| | - Uwe Siebert
- Department of Public Health, Health Services Research and Health Technology Assessment, UMIT - University of Health Sciences, Medical Informatics and Technology, Hall in Tirol, Austria; Division of Health Technology Assessment, ONCOTYROL - Center for Personalized Cancer Medicine, Innsbruck, Austria; Institute for Technology Assessment, Department of Radiology, Massachusetts General Hospital, Harvard Medical School, and Department of Health Policy and Management, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Jitendar Sharma
- AP MedTech Zone & Advisor (Health), Department of Health & Family Welfare, Andhra Pradesh, India
| | - Allan Wailoo
- ScHARR, The University of Sheffield, Sheffield, UK; NICE Decision Support Unit, Sheffield, UK
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Campbell M, Katikireddi SV, Sowden A, Thomson H. Lack of transparency in reporting narrative synthesis of quantitative data: a methodological assessment of systematic reviews. J Clin Epidemiol 2019; 105:1-9. [PMID: 30196129 PMCID: PMC6327109 DOI: 10.1016/j.jclinepi.2018.08.019] [Citation(s) in RCA: 66] [Impact Index Per Article: 13.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2018] [Revised: 07/26/2018] [Accepted: 08/31/2018] [Indexed: 12/02/2022]
Abstract
OBJECTIVE To assess the adequacy of reporting and conduct of narrative synthesis of quantitative data (NS) in reviews evaluating the effectiveness of public health interventions. STUDY DESIGN AND SETTING A retrospective comparison of a 20% (n = 474/2,372) random sample of public health systematic reviews from the McMaster Health Evidence database (January 2010-October 2015) to establish the proportion of reviews using NS. From those reviews using NS, 30% (n = 75/251) were randomly selected and data were extracted for detailed assessment of: reporting NS methods, management and investigation of heterogeneity, transparency of data presentation, and assessment of robustness of the synthesis. RESULTS Most reviews used NS (56%, n = 251/446); meta-analysis was the primary method of synthesis for 44%. In the detailed assessment of NS, 95% (n = 71/75) did not describe NS methods; 43% (n = 32) did not provide transparent links between the synthesis data and the synthesis reported in the text; of 14 reviews that identified heterogeneity in direction of effect, only one investigated the heterogeneity; and 36% (n = 27) did not reflect on limitations of the synthesis. CONCLUSION NS methods are rarely reported in systematic reviews of public health interventions and many NS reviews lack transparency in how the data are presented and the conclusions are reached. This threatens the validity of much of the evidence synthesis used to support public health. Improved guidance on reporting and conduct of NS will contribute to improved utility of NS systematic reviews.
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Affiliation(s)
- Mhairi Campbell
- MRC/CSO Social and Public Health Sciences Unit, University of Glasgow, 200 Renfield Street, Glasgow G2 3AX, UK.
| | | | - Amanda Sowden
- Centre for Reviews and Dissemination, University of York, York YO10 5DD, UK
| | - Hilary Thomson
- MRC/CSO Social and Public Health Sciences Unit, University of Glasgow, 200 Renfield Street, Glasgow G2 3AX, UK
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Welk B, McGarry P, Kennelly M, Myers J. Bladder management experiences among people living with neurologic disease: A systematic review and meta-synthesis of qualitative research. Neurourol Urodyn 2018; 38:668-676. [PMID: 30499226 DOI: 10.1002/nau.23887] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2018] [Accepted: 10/11/2018] [Indexed: 12/19/2022]
Abstract
AIM To systematically review the qualitative literature on neurogenic bladder management to better understand the relevant psychosocial issues. METHODS We used two reviewers to systematically review EMBASE, CINAHL, and PsycINFO for qualitative studies that included a neurogenic bladder patient population and were relevant to bladder management. We used a meta-ethnography technique to summarize and synthesize the data. RESULTS We found 13 studies that were relevant. When choosing a bladder management technique (three studies), there were two major themes (bladder management decision makers, and characteristics and risks) that impacted the process. For studies evaluating life with a urinary catheter (five about intermittent catheters, and five about indwelling catheters), relevant themes could be arranged into three consecutive periods: First, a changed life (the initial stage of selecting and using a catheter: coping, teaching and technical challenges, and control and independence). Second, learning to live with a catheter (the practical skill and knowledge that goes into using a catheter: knowledge, adjustments, and normalization). Third, a new life (the acceptance and integration of a catheter into a person's life: problems and benefits, unpredictability, travel and social activities, intimacy and relationships, and dealing with negative emotions). Themes were generally consistent across studies. Conclusions Several important themes were identified from the existing qualitative literature; these can provide insight into how neurogenic bladder patients select a bladder management method, and how physicians can optimize their counseling and the long-term management of these patients.
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Affiliation(s)
- Blayne Welk
- Department of Surgery, Western University, London, Ontario, Canada.,Department of Epidemiology and Biostatistics, Western University, London, Ontario, Canada
| | - Patrick McGarry
- Department of Surgery, Western University, London, Ontario, Canada
| | - Michael Kennelly
- Department of Surgery, Carolinas HealthCare System, Charlotte, North Carolina
| | - Jeremy Myers
- Department of Surgery, University of Utah, Salt Lake City, Utah
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The work undertaken by mechanically ventilated patients in Intensive Care: A qualitative meta-ethnography of survivors’ experiences. Int J Nurs Stud 2018; 86:60-73. [DOI: 10.1016/j.ijnurstu.2018.05.013] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2017] [Revised: 05/18/2018] [Accepted: 05/22/2018] [Indexed: 02/02/2023]
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Nybakken S, Strandås M, Bondas T. Caregivers’ perceptions of aggressive behaviour in nursing home residents living with dementia: A meta‐ethnography. J Adv Nurs 2018; 74:2713-2726. [DOI: 10.1111/jan.13807] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/05/2018] [Indexed: 11/30/2022]
Affiliation(s)
- Solvor Nybakken
- Faculty of Nursing and Health Science Nord University Bodø Norway
| | - Maria Strandås
- Faculty of Nursing and Health Science Nord University Bodø Norway
| | - Terese Bondas
- Faculty of Nursing and Health Science Nord University Bodø Norway
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Toye F, Seers K, Barker K. A meta-ethnography of health-care professionals’ experience of treating adults with chronic non-malignant pain to improve the experience and quality of health care. HEALTH SERVICES AND DELIVERY RESEARCH 2018. [DOI: 10.3310/hsdr06170] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
BackgroundPeople with chronic pain do not always feel that they are being listened to or valued by health-care professionals (HCPs). We aimed to understand and improve this experience by finding out what HCPs feel about providing health care to people with chronic non-malignant pain. We did this by bringing together the published qualitative research.Objectives(1) To undertake a qualitative evidence synthesis (QES) to increase our understanding of what it is like for HCPs to provide health care to people with chronic non-malignant pain; (2) to make our findings easily available and accessible through a short film; and (3) to contribute to the development of methods for QESs.DesignWe used the methods of meta-ethnography, which involve identifying concepts and progressively abstracting these concepts into a line of argument.Data sourcesWe searched five electronic bibliographic databases (MEDLINE, EMBASE, Cumulative Index to Nursing and Allied Health Literature, PsycINFO and Allied and Complementary Medicine Database) from inception to November 2016. We included studies that explored HCPs’ experiences of providing health care to people with chronic non-malignant pain. We utilised the Grading of Recommendations Assessment, Development and Evaluation Confidence in the Evidence from Reviews of Qualitative research (GRADE-CERQual) framework to rate our confidence in the findings.ResultsWe screened 954 abstracts and 184 full texts and included 77 studies reporting the experiences of > 1551 HCPs. We identified six themes: (1) a sceptical cultural lens and the siren song of diagnosis; (2) navigating juxtaposed models of medicine; (3) navigating the patient–clinician borderland; (4) the challenge of dual advocacy; (5) personal costs; and (6) the craft of pain management. We produced a short film, ‘Struggling to support people to live a valued life with chronic pain’, which presents these themes (seeReport Supplementary Material 1; URL:www.journalslibrary.nihr.ac.uk/programmes/hsdr/1419807/#/documentation; accessed 24 July 2017). We rated our confidence in the review findings using the GRADE-CERQual domains. We developed a conceptual model to explain the complexity of providing health care to people with chronic non-malignant pain. The innovation of this model is to propose a series of tensions that are integral to the experience: a dualistic biomedical model compared with an embodied psychosocial model; professional distance compared with proximity; professional expertise compared with patient empowerment; the need to make concessions to maintain therapeutic relationships compared with the need for evidence-based utility; and patient advocacy compared with health-care system advocacy.LimitationsThere are no agreed methods for determining confidence in QESs.ConclusionsWe highlight areas that help us to understand why the experience of health care can be difficult for patients and HCPs. Importantly, HCPs can find it challenging if they are unable to find a diagnosis and at times this can make them feel sceptical. The findings suggest that HCPs find it difficult to balance their dual role of maintaining a good relationship with the patient and representing the health-care system. The ability to support patients to live a valued life with pain is described as a craft learnt through experience. Finally, like their patients, HCPs can experience a sense of loss because they cannot solve the problem of pain.Future workFuture work to explore the usefulness of the conceptual model and film in clinical education would add value to this study. There is limited primary research that explores HCPs’ experiences with chronic non-malignant pain in diverse ethnic groups, in gender-specific contexts and in older people living in the community.FundingThe National Institute for Health Research Health Services and Delivery Research programme.
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Affiliation(s)
- Fran Toye
- Physiotherapy Research Unit, Nuffield Orthopaedic Centre, Oxford University Hospitals NHS Foundation Trust, Oxford, UK
- Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences (NDORMS), University of Oxford, Oxford, UK
| | - Kate Seers
- Royal College of Nursing Research Institute, Warwick Medical School, University of Warwick, Coventry, UK
| | - Karen Barker
- Physiotherapy Research Unit, Nuffield Orthopaedic Centre, Oxford University Hospitals NHS Foundation Trust, Oxford, UK
- Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences (NDORMS), University of Oxford, Oxford, UK
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Booth A, Noyes J, Flemming K, Gerhardus A, Wahlster P, van der Wilt GJ, Mozygemba K, Refolo P, Sacchini D, Tummers M, Rehfuess E. Structured methodology review identified seven (RETREAT) criteria for selecting qualitative evidence synthesis approaches. J Clin Epidemiol 2018; 99:41-52. [PMID: 29548841 DOI: 10.1016/j.jclinepi.2018.03.003] [Citation(s) in RCA: 91] [Impact Index Per Article: 15.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2017] [Revised: 01/04/2018] [Accepted: 03/07/2018] [Indexed: 01/14/2023]
Abstract
OBJECTIVE To compare and contrast different methods of qualitative evidence synthesis (QES) against criteria identified from the literature and to map their attributes to inform selection of the most appropriate QES method to answer research questions addressed by qualitative research. STUDY DESIGN AND SETTING Electronic databases, citation searching, and a study register were used to identify studies reporting QES methods. Attributes compiled from 26 methodological papers (2001-2014) were used as a framework for data extraction. Data were extracted into summary tables by one reviewer and then considered within the author team. RESULTS We identified seven considerations determining choice of methods from the methodological literature, encapsulated within the mnemonic Review question-Epistemology-Time/Timescale-Resources-Expertise-Audience and purpose-Type of data. We mapped 15 different published QES methods against these seven criteria. The final framework focuses on stand-alone QES methods but may also hold potential when integrating quantitative and qualitative data. CONCLUSION These findings offer a contemporary perspective as a conceptual basis for future empirical investigation of the advantages and disadvantages of different methods of QES. It is hoped that this will inform appropriate selection of QES approaches.
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Affiliation(s)
- Andrew Booth
- Health Economics and Decision Science (HEDS), School of Health and Related Research (ScHARR), University of Sheffield, Regent Court, 30 Regent Street, Sheffield S1 4DA, UK.
| | - Jane Noyes
- School of Social Sciences, Bangor University, Bangor, UK
| | - Kate Flemming
- Department of Health Sciences, University of York, Heslington, York YO10 5DD, UK
| | - Ansgar Gerhardus
- Department for Health Services Research, Institute for Public Health and Nursing Research (IPP) and Health Sciences Bremen, University of Bremen, Bremen, Germany
| | - Philip Wahlster
- Center for General Practice, Medical Faculty, Saarland University, Homburg (Saar), Germany; Department of Health Services Research, University of Bremen, Bremen, Germany
| | - Gert Jan van der Wilt
- Radboud Institute for Health Sciences, Radboud University Medical Center, PO Box 9101, Nijmegen 6500 HB, The Netherlands
| | - Kati Mozygemba
- Department for Health Services Research, Institute for Public Health and Nursing Research (IPP) and Health Sciences Bremen, University of Bremen, Bremen, Germany
| | - Pietro Refolo
- Institute of Bioethics and Medical Humanities, "Agostino Gemelli" School of Medicine, Università Cattolica del Sacro Cuore, 1 Largo F. Vito, Rome 00168, Italy
| | - Dario Sacchini
- Institute of Bioethics and Medical Humanities, "Agostino Gemelli" School of Medicine, Università Cattolica del Sacro Cuore, 1 Largo F. Vito, Rome 00168, Italy
| | - Marcia Tummers
- Radboud Institute for Health Sciences, Radboud University Medical Center, PO Box 9101, Nijmegen 6500 HB, The Netherlands
| | - Eva Rehfuess
- Institute for Medical Information Processing, Biometry and Epidemiology, Pettenkofer School of Public Health, LMU Munich, Marchioninistr. 15, Munich 81377, Germany
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Munn Z, Stern C, Aromataris E, Lockwood C, Jordan Z. What kind of systematic review should I conduct? A proposed typology and guidance for systematic reviewers in the medical and health sciences. BMC Med Res Methodol 2018; 18:5. [PMID: 29316881 PMCID: PMC5761190 DOI: 10.1186/s12874-017-0468-4] [Citation(s) in RCA: 445] [Impact Index Per Article: 74.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2017] [Accepted: 12/28/2017] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND Systematic reviews have been considered as the pillar on which evidence-based healthcare rests. Systematic review methodology has evolved and been modified over the years to accommodate the range of questions that may arise in the health and medical sciences. This paper explores a concept still rarely considered by novice authors and in the literature: determining the type of systematic review to undertake based on a research question or priority. RESULTS Within the framework of the evidence-based healthcare paradigm, defining the question and type of systematic review to conduct is a pivotal first step that will guide the rest of the process and has the potential to impact on other aspects of the evidence-based healthcare cycle (evidence generation, transfer and implementation). It is something that novice reviewers (and others not familiar with the range of review types available) need to take account of but frequently overlook. Our aim is to provide a typology of review types and describe key elements that need to be addressed during question development for each type. CONCLUSIONS In this paper a typology is proposed of various systematic review methodologies. The review types are defined and situated with regard to establishing corresponding questions and inclusion criteria. The ultimate objective is to provide clarified guidance for both novice and experienced reviewers and a unified typology with respect to review types.
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Affiliation(s)
- Zachary Munn
- The Joanna Briggs Institute, The University of Adelaide, 55 King William Road, North Adelaide, Soueth Australia 5005 Australia
| | - Cindy Stern
- The Joanna Briggs Institute, The University of Adelaide, 55 King William Road, North Adelaide, Soueth Australia 5005 Australia
| | - Edoardo Aromataris
- The Joanna Briggs Institute, The University of Adelaide, 55 King William Road, North Adelaide, Soueth Australia 5005 Australia
| | - Craig Lockwood
- The Joanna Briggs Institute, The University of Adelaide, 55 King William Road, North Adelaide, Soueth Australia 5005 Australia
| | - Zoe Jordan
- The Joanna Briggs Institute, The University of Adelaide, 55 King William Road, North Adelaide, Soueth Australia 5005 Australia
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Cahill M, Robinson K, Pettigrew J, Galvin R, Stanley M. Qualitative synthesis: A guide to conducting a meta-ethnography. Br J Occup Ther 2018. [DOI: 10.1177/0308022617745016] [Citation(s) in RCA: 57] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Affiliation(s)
- Mairead Cahill
- PhD student, Department of Clinical Therapies, Faculty of Education and Health Sciences, University of Limerick, Republic of Ireland
| | - Katie Robinson
- Senior Lecturer, Department of Clinical Therapies, Faculty of Education and Health Sciences, Health Research Institute, University of Limerick, Republic of Ireland
| | - Judith Pettigrew
- Senior Lecturer, Department of Clinical Therapies, Faculty of Education and Health Sciences, University of Limerick, Republic of Ireland
| | - Rose Galvin
- Lecturer, Department of Clinical Therapies, Faculty of Education and Health, Health Research Institute, University of Limerick, Ireland
| | - Mandy Stanley
- Senior Lecturer, School of Health Sciences, University of South Australia, Adelaide, Australia
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Kitzmüller G, Clancy A, Vaismoradi M, Wegener C, Bondas T. "Trapped in an Empty Waiting Room"-The Existential Human Core of Loneliness in Old Age: A Meta-Synthesis. QUALITATIVE HEALTH RESEARCH 2018; 28:213-230. [PMID: 29235943 DOI: 10.1177/1049732317735079] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
Loneliness in old age has a negative influence on quality of life, health, and survival. To understand the phenomenon of loneliness in old age, the voices of lonely older adults should be heard. Therefore, the purpose of this meta-synthesis was to synthesize scientific studies of older adults' experiences of loneliness. Eleven qualitative articles that met the inclusion criteria were analyzed and synthesized according to Noblit and Hare's meta-ethnographic approach. The analysis revealed the overriding meaning of the existential human core of loneliness in old age expressed through the metaphor "trapped in an empty waiting room." Four interwoven themes were found: (a) the negative emotions of loneliness, (b) the loss of meaningful interpersonal relationships, (c) the influence of loneliness on self-perception, and (d) the older adults' endeavors to deal with loneliness. The joint contribution of family members, health care providers, and volunteers is necessary to break the vicious circle of loneliness.
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Affiliation(s)
| | - Anne Clancy
- 2 UiT, The Arctic University of Norway, Harstad, Norway
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Nichols VP, Ellard DR, Griffiths FE, Kamal A, Underwood M, Taylor SJC. The lived experience of chronic headache: a systematic review and synthesis of the qualitative literature. BMJ Open 2017; 7:e019929. [PMID: 29248887 PMCID: PMC5778309 DOI: 10.1136/bmjopen-2017-019929] [Citation(s) in RCA: 36] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
OBJECTIVE To systematically review the qualitative literature of the lived experience of people with a chronic headache disorder. BACKGROUND Chronic headaches affect 3%-4% of the population. The most common chronic headache disorders are chronic migraine, chronic tension-type headache and medication overuse headache. We present a systematic review and meta-ethnographic synthesis of the lived experience of people with chronic headache. METHODS We searched seven electronic databases, hand-searched nine journals and used a modified Critical Appraisal Skills Programme checklist to appraise study quality. Following thematic analysis we synthesised the data using a meta-ethnographic approach. RESULTS We identified 3586 unique citations; full texts were examined for 86 studies and 4 were included in the review. Included studies differed in their foci: exploring, patient-centred outcomes, chronic headache as a socially invisible disease, psychological processes mediating impaired quality of life, and the process of medication overuse. Initial thematic analysis and subsequent synthesis gave three overarching themes: 'headache as a driver of behaviour' (directly and indirectly), 'the spectre of headache' and 'strained relationships'. CONCLUSION This meta-synthesis of published qualitative evidence demonstrates that chronic headaches have a profound effect on people's lives, showing similarities with other pain conditions. There were insufficient data to explore the similarities and differences between different chronic headache disorders.
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Affiliation(s)
- Vivien P Nichols
- Warwick Clinical Trials Unit, Division of Health Sciences, Warwick Medical School, University of Warwick, Coventry, UK
| | - David R Ellard
- Warwick Clinical Trials Unit, Division of Health Sciences, Warwick Medical School, University of Warwick, Coventry, UK
| | - Frances E Griffiths
- Division of Health Sciences, Warwick Medical School, University of Warwick, Coventry, UK
| | - Atiya Kamal
- Warwick Clinical Trials Unit, Division of Health Sciences, Warwick Medical School, University of Warwick, Coventry, UK
| | - Martin Underwood
- Warwick Clinical Trials Unit, Division of Health Sciences, Warwick Medical School, University of Warwick, Coventry, UK
| | - Stephanie J C Taylor
- Complex Intervention and Social Practice in Health Care Unit, Centre for Primary Care and Public Health, Blizard Institute, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, Coventry, UK
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Flemming K, Booth A, Hannes K, Cargo M, Noyes J. Cochrane Qualitative and Implementation Methods Group guidance series-paper 6: reporting guidelines for qualitative, implementation, and process evaluation evidence syntheses. J Clin Epidemiol 2017; 97:79-85. [PMID: 29222060 DOI: 10.1016/j.jclinepi.2017.10.022] [Citation(s) in RCA: 58] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2016] [Revised: 10/03/2017] [Accepted: 10/04/2017] [Indexed: 10/18/2022]
Abstract
OBJECTIVES To outline contemporary and novel developments for the presentation and reporting of syntheses of qualitative, implementation, and process evaluation evidence and provide recommendations for the use of reporting guidelines. STUDY DESIGN AND SETTING An overview of reporting guidelines for qualitative, implementation, and process evaluation evidence syntheses drawing on current international literature and the collective expert knowledge of the Cochrane Qualitative and Implementation Methods Group. RESULTS Several reporting guidelines exist that can be used or adapted to report syntheses of qualitative, implementation, and process evaluation evidence. Methods to develop individual guidance varied. The use of a relevant reporting guideline can enhance the transparency, consistency, and quality of reporting. Guidelines that exist are generic, method specific, and for particular aspects of the reviewing process, searching. CONCLUSION Caution is expressed over the potential for reporting guidelines to produce a mechanistic approach moving the focus away from the content and toward the procedural aspects of the review. The use of a reporting guideline is recommended and a five-step decision flowchart to guide the choice of reporting guideline is provided. Gaps remain in method-specific reporting guidelines such as mixed-study, implementation, and process evaluation evidence syntheses.
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Affiliation(s)
- Kate Flemming
- Department of Health Sciences, Faculty of Science, University of York, Seebohm Rowntree Building, Heslington, York YO10 5DD, UK.
| | - Andrew Booth
- School of Health and Related Research (ScHARR), Regent Court, 30 Regent Street, Sheffield S1 4DA, UK
| | - Karin Hannes
- Social Research Methodology Group, Centre for Sociological Research, Faculty of Social Sciences, KU Leuven, Leuven, Belgium
| | - Margaret Cargo
- Spatial Epidemiology & Evaluation Research Group/Centre for Population Health Research, University of South Australia, 8th Floor Office 310, South Australia Health & Medical Research Insitute, North Terrace, Adelaide SA 510, Australia
| | - Jane Noyes
- School of Social Sciences, 2 Bangor University, Bangor, Gwynedd, LL57 2DG, UK
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