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Huertas-Zurriaga A, Palmieri PA, Edwards JE, Cesario SK, Alonso-Fernandez S, Pardell-Dominguez L, Dominguez-Cancino KA, Leyva-Moral JM. Motherhood and decision-making among women living with HIV in developed countries: a systematic review with qualitative research synthesis. Reprod Health 2021; 18:148. [PMID: 34246286 PMCID: PMC8272303 DOI: 10.1186/s12978-021-01197-6] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2020] [Accepted: 06/24/2021] [Indexed: 12/26/2022] Open
Abstract
BACKGROUND Women living with HIV (WLH) lack evidence-based information about reproductive options while managing pressures from family, clinicians, and communities to give up the idea of having children. As the reproduction intentions of WLH are not well understood, stigmatizing behaviors force them to hide their disease to avoid rejection by their family, partner, and social networks. Compliance with social norms, fear of stigma, and discrimination influence their experience. Current research is individual qualitative studies lacking the synthesis perspective necessary to guide intervention development. The purpose of this study was to synthesize the evidence to explain the reproductive decision-making process for WLH in developed countries. METHODS A systematic review with qualitative research synthesis was conducted through searches in 10 electronic databases (CINAHL, EMBASE, MEDLINE, Scopus, Social Science Citation Index, Web of Science, Google Scholar, Cuidatge, Cuiden Enfispo, and SciELO). Studies published in journals from 1995 to 2019 with qualitative data about reproductive decision-making among WLH in developed countries were eligible for inclusion. Developed country was operationalized by membership in the OECD for comparative conditions of social wellbeing and economic stability. The CASP and JBI checklists for qualitative research were used to assess study quality and methodological integrity. Thematic analysis and qualitative meta-summary techniques were used for the synthesis. RESULTS Twenty studies from 12 developed countries were included in the synthesis. Findings were organized into 3 meta-themes from 15 themes and 45 subthemes, including: (1) Shattered identity, (2) Barriers, inequities, and misinformation, (3) Coping, resiliency, and support. Reproductive decision-making was perceived as a complex process influenced by facilitators and barriers. The facilitators helped WLH cope with their new situation to become more resilient, while the barriers made their situation more difficult to manage. CONCLUSION WLH encounter reproductive decision-making with knowledge deficits and limited social support. An integrated approach to holistic care with comprehensive multidisciplinary counseling is needed to support WLH. Clinicians could benefit from professional development to learn how to be authentically present for WLH, including engaging in conversations, demonstrating compassion, and understanding situations. Evidence-based clinical practice guidelines need to be tailored for the family planning and sexual health needs of WLH.
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Affiliation(s)
- Ariadna Huertas-Zurriaga
- Hospital Universitari Germans Trias I Pujol, Badalona, 08916 Barcelona, Spain
- Grupo de Investigación Enfermera en Vulnerabilidad Y Salud (GRIVIS), Universitat Autònoma de Barcelona, Avda. Can Domènech, Edifici M. Despatx M3/213, Bellaterra (Cerdanyola del Vallès), 08193 Barcelona, Spain
| | - Patrick A. Palmieri
- South American Center for Qualitative Research, Universidad Norbert Wiener, Av. Arequipa 444, Torre 2, Piso 4, Lima, 15046 Perú
- College of Graduate Health Studies, A. T. Still University, 800 W. Jefferson Street, Kirksville, MO 63501 USA
- Center for Global Nursing, Texas Woman’s University, 6700 Fannin St, Houston, TX 77030 USA
- EBHC South America: A JBI Affiliated Group, Calle Cartavio 406, Suite 402, Lima, 15023 Peru
| | - Joan E. Edwards
- Center for Global Nursing, Texas Woman’s University, 6700 Fannin St, Houston, TX 77030 USA
- Nelda C. Stark College of Nursing, Texas Woman’s University, 6700 Fannin St, Houston, TX 77030 USA
| | - Sandra K. Cesario
- Center for Global Nursing, Texas Woman’s University, 6700 Fannin St, Houston, TX 77030 USA
- Nelda C. Stark College of Nursing, Texas Woman’s University, 6700 Fannin St, Houston, TX 77030 USA
| | - Sergio Alonso-Fernandez
- Recerca i Innovació en Cures Infermeres, Hospital Universitari Germans Trias I Pujol, Badalona, 08916 Barcelona, Spain
| | - Lidia Pardell-Dominguez
- Grupo de Investigación Enfermera en Vulnerabilidad Y Salud (GRIVIS), Universitat Autònoma de Barcelona, Avda. Can Domènech, Edifici M. Despatx M3/213, Bellaterra (Cerdanyola del Vallès), 08193 Barcelona, Spain
- EBHC South America: A JBI Affiliated Group, Calle Cartavio 406, Suite 402, Lima, 15023 Peru
- Department D’Infermeria, Facultat de Medicina, Universitat Autònoma de Barcelona, Avda. Can Domènech, Edifici M. Despatx M3/213, Bellaterra (Cerdanyola del Vallès), 08193 Barcelona, Spain
| | - Karen A. Dominguez-Cancino
- EBHC South America: A JBI Affiliated Group, Calle Cartavio 406, Suite 402, Lima, 15023 Peru
- Escuela de Enfermería, Universidad Científica del Sur, Carr. Panamericana Sur 19, Villa EL Salvador, Lima, 15067 Perú
- Escuela de Salud Pública, Universidad de Chile, Independencia 939, Independencia, 8380453 Santiago de Chile, Chile
| | - Juan M. Leyva-Moral
- Grupo de Investigación Enfermera en Vulnerabilidad Y Salud (GRIVIS), Universitat Autònoma de Barcelona, Avda. Can Domènech, Edifici M. Despatx M3/213, Bellaterra (Cerdanyola del Vallès), 08193 Barcelona, Spain
- EBHC South America: A JBI Affiliated Group, Calle Cartavio 406, Suite 402, Lima, 15023 Peru
- Department D’Infermeria, Facultat de Medicina, Universitat Autònoma de Barcelona, Avda. Can Domènech, Edifici M. Despatx M3/213, Bellaterra (Cerdanyola del Vallès), 08193 Barcelona, Spain
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Klimova B, Valis M, Kuca K, Masopust J. E-learning as valuable caregivers' support for people with dementia - A systematic review. BMC Health Serv Res 2019; 19:781. [PMID: 31676005 PMCID: PMC6824008 DOI: 10.1186/s12913-019-4641-9] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2018] [Accepted: 10/15/2019] [Indexed: 01/22/2023] Open
Abstract
Background Present demographic trends show a considerable rise in elderly populations with aging disorders, such as dementia. The current article focused on the exploitation of e-learning as an informal support for caregivers of people with dementia and considered its benefits and limitations to provide proper and relevant care for this target group of people as well as maintain the quality of life of their caregivers. Methods The methodology of this study is based on a literature review of accessible peer-review articles from three recognized databases: Web of Science, Scopus, and PubMed. The findings of the selected studies were compared and evaluated. Results The findings showed that e-learning educational programs/courses helped caregivers feel more confident about dementia care, reduced their perceived stress and enhanced their feelings of empathy, understanding and concern. Conclusions The findings of this study reveal that the exploitation of e-learning as a support tool, especially for informal caregivers, in the management of dementia may be a promising method, but its implementation requires professional training of informal caregivers in the use of this technology. More evidence-based studies are needed on this topic.
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Affiliation(s)
- Blanka Klimova
- Department of Applied Linguistics, Faculty of Informatics and Management, University of Hradec Kralove, Rokitanskeho 62, Hradec Kralove, Czech Republic
| | - Martin Valis
- Department of Neurology, University Hospital Hradec Kralove, Sokolska 581, Hradec Kralove, Czech Republic
| | - Kamil Kuca
- Biomedical Research Centre, University Hospital Hradec Kralove, Sokolska 581, Hradec Kralove, Czech Republic. .,Malaysia Japan International Institute of Technology (MJIIT), Universiti Teknologi Malaysia Kuala Lumpur, Jalan Sultan Yahya Petra, Kuala Lumpur, 54100, Malaysia.
| | - Jiri Masopust
- Department of Neurology, University Hospital Hradec Kralove, Sokolska 581, Hradec Kralove, Czech Republic.,Department of Psychiatry, University Hospital Hradec Kralove, Sokolska 581, Hradec Kralove, Czech Republic
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