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Wu C, Chu X, Tang K, Cheng D, Ren L. Caregiving experiences of caregivers of children with rare diseases: A qualitative meta-synthesis. J Pediatr Nurs 2024; 75:31-40. [PMID: 38101309 DOI: 10.1016/j.pedn.2023.12.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/06/2023] [Revised: 12/05/2023] [Accepted: 12/05/2023] [Indexed: 12/17/2023]
Abstract
PROBLEM Most rare diseases occur in childhood and are difficult to diagnose and treat. The caregivers are faced with the challenge of providing care to the children afflicted with these rare diseases, resulting in a significant burden of care and an altered family dynamic. ELIGIBILITY CRITERIA A meta-synthesis review was conducted to explore the caregivers' experience of children with rare diseases using eight electronic databases PubMed, Web of Science, the Cochrane Library, EMBASE, VIP database, Wan Fang, Chinese BioMedical Literature Database, and China National Knowledge Infrastructure from each database's inception to October 5, 2023. SAMPLE 4207 records were identified and 20 eligible studies were included. RESULTS Three themes emerged: (1) Life is changed by "rare"; (2) many unmet needs; (3) Strive to adapt and grow. CONCLUSIONS Caregivers of children with rare diseases are full of stress and challenges in the process of caring for them, and their lives have changed greatly due to "rare". Appropriate measures need to be taken to reduce the burden on caregivers. IMPLICATIONS According to the findings, both the medical and health systems, as well as society, should pay attention to the care load and unmet requirements of carers of children with rare diseases, and offer them with practical supportive services. Finally, it can improve the quality of life for caregivers and families of children with rare diseases, as well as stimulate the development of rare diseases.
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Affiliation(s)
- Chenxi Wu
- College of Nursing, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Xin Chu
- Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, China.
| | - Kexin Tang
- College of Nursing, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Dongmei Cheng
- Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Liangjuan Ren
- Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, China
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Marrow E, Malik M, Pantalone DW, Peitzmeier S. Power and control, resistance and survival: A systematic review and meta-synthesis of the qualitative literature on intimate partner violence against transgender individuals. Soc Sci Med 2024; 342:116498. [PMID: 38227997 DOI: 10.1016/j.socscimed.2023.116498] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2023] [Revised: 11/10/2023] [Accepted: 12/04/2023] [Indexed: 01/18/2024]
Abstract
Transgender (trans) individuals experience intimate partner violence (IPV) at elevated levels compared to cisgender individuals. Traditional theoretical understandings of IPV as men's patriarchal domination of women, and later, broader theories in which IPV is conceptualized as the relatively privileged partner enacting domination over the relatively oppressed partner, do not fully capture the totality of IPV experiences, including how IPV is perpetrated against trans individuals. We conducted a systematic review and qualitative meta-synthesis of the qualitative and theoretical literatures on IPV against trans individuals (N = 37 articles and books) to generate novel IPV theory inclusive of trans individuals' experiences. We identified five major themes: (1) societal context of IPV, (2) IPV tactics and types, (3) help-seeking, (4) consequences of IPV, and (5) proposed interventions for victims. Synthesizing across themes, we offer a novel theoretical model that demonstrates how abusers can leverage structural discrimination and vulnerabilities against trans victims, regardless of the abuser's own identities. We identify individual power and control tactics abusers use, including identifying a category of IPV that we term leveraging vulnerability, which involves abusers weaponizing their own vulnerabilities to avoid accountability. Reducing IPV in trans communities requires expanding current IPV theory to include trans victims, recognition of a wider range of abuse tactics, and structural interventions that promote the respectful treatment of trans individuals. Our theoretical model of IPV "centers the margins" to make trans victims' experiences, and indeed all victims whose experiences fall outside normative scripts, more legible.
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Affiliation(s)
- Elliot Marrow
- Department of Psychology, University of Massachusetts, Boston, United States.
| | - Mannat Malik
- Department of Health Behavior, University of North Carolina, United States
| | - David W Pantalone
- Department of Psychology, University of Massachusetts, Boston, United States; The Fenway Institute, Fenway Health, Boston, MA, United States
| | - Sarah Peitzmeier
- Department of Health Behavior and Biological Sciences, University of Michigan, United States
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Øien AM, Dragesund T. Identifying contrasting embodied voices of identity: a qualitative meta-synthesis of experiences of change among patients with chronic musculoskeletal pain in long-term physiotherapy. Physiother Theory Pract 2024; 40:42-55. [PMID: 35833387 DOI: 10.1080/09593985.2022.2100298] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2021] [Accepted: 07/05/2022] [Indexed: 10/17/2022]
Abstract
BACKGROUND The aim is to identify and synthesize qualitative research findings about patients with chronic musculoskeletal pain in long-term Norwegian psychomotor physiotherapy, in connection to their voices of meaning of embodied experiences of change and the possible influence on their identities. METHODOLOGY We systematically searched for qualitative studies in English in ten databases: AMED, Cinahl, Cochrane, Embase, Medline, PsychInfo, Scopus, SportDiscus, Svemed, and Web of Science. We included and analyzed nine publications using meta-ethnography. Bachtin's polyphonic voice perspective influenced the analysis. RESULTS Three overarching themes emerged: 1) voices of body and mind as disconnected and connected; 2) ambiguous voices in the therapeutic relationship; and 3) identification of embodied voices of constraint and freedom influence identity. CONCLUSIONS The patients' polyphonic voices of ambiguous and contrasting expressions of embodied sensations and the therapeutic relationship in inner and external dialog seemed to facilitate the choices of change and the creation of new identities. In practice, the physiotherapists' consciousness of the patients' concurrent polyphonic voices may improve change in treatment.
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Affiliation(s)
- Aud Marie Øien
- Department of Welfare and Participation, Faculty of Health and Social Sciences, Western Norway University of Applied Sciences, Sogndal, Norway
| | - Tove Dragesund
- Department of Health and Function, Faculty of Health and Social Sciences, Western Norway University of Applied Sciences, Bergen, Norway
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Cambridge P, Brockenshire N, Bridge N, Jarden RJ. Entry to practice nursing students' experiences of debriefing during clinical practice: A qualitative meta-synthesis. Nurse Educ Today 2023; 128:105871. [PMID: 37393654 DOI: 10.1016/j.nedt.2023.105871] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/04/2022] [Revised: 05/11/2023] [Accepted: 06/05/2023] [Indexed: 07/04/2023]
Abstract
OBJECTIVES The objectives of this review were to identify, explore and synthesize existing evidence in the literature of nursing students' experiences of debriefing in their clinical practice placements. DESIGN Qualitative meta-synthesis. DATA SOURCES Databases included Cumulative Index of Nursing and Allied Health Literature, Education Resources Information Centre, Medical Literature Analysis and Retrieval System Online, and Scopus. Qualitative studies were considered for inclusion if published in English, reporting primary data analysis including experiences of nursing students. The final search was conducted on 22 October 2021, no time limit was applied. REVIEW METHODS Qualitative studies were identified and appraised. Across the included studies, authors' themes and metaphors, and participant quotes were inductively analysed and interpreted, then expressed in the synthesis. RESULTS Three new themes representing nursing students' experiences of debriefing were constructed. Theme one, 'It didn't happen formally, but I needed it', included students expressing the value of, and wanting to be involved in, debriefing to gain validation, reassurance, and guidance. Theme two, 'I had to release it and it helped' included students' positive experiences of debriefing with another student, nurse, or confidant, through various modalities. These experiences affirmed they were not alone in their feelings, which provided relief, confidence, and new ways of thinking and practicing. Theme three, 'Strengthened clinical experience and learning', included students feeling debriefing supported their awareness and understanding of practice and increased participation in clinical experiences. This awareness and understanding provided an opportunity for students to explore, and reflect on, the impact of patient care. CONCLUSIONS Through debriefing student nurses found relief, confidence, and new ways of thinking through a shared understanding. Debriefing supported student learning and the clinical-academic education team had a key role in creating this opportunity.
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Affiliation(s)
- Prue Cambridge
- Department of Nursing, Faculty of Medicine, Dentistry and Health Sciences, The University of Melbourne, 161 Barry Street, Victoria 3010, Australia.
| | - Naomi Brockenshire
- Department of Nursing, Faculty of Medicine, Dentistry and Health Sciences, The University of Melbourne, 161 Barry Street, Victoria 3010, Australia.
| | - Nicholas Bridge
- Department of Nursing, Faculty of Medicine, Dentistry and Health Sciences, The University of Melbourne, 161 Barry Street, Victoria 3010, Australia.
| | - Rebecca J Jarden
- Department of Nursing, Faculty of Medicine, Dentistry and Health Sciences, The University of Melbourne, 161 Barry Street, Victoria 3010, Australia; Austin Health, Melbourne, Australia.
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Liao L, Feng M, You Y, Chen Y, Guan C, Liu Y. Experiences of older people, healthcare providers and caregivers on implementing person-centered care for community-dwelling older people: a systematic review and qualitative meta-synthesis. BMC Geriatr 2023; 23:207. [PMID: 37003992 PMCID: PMC10067217 DOI: 10.1186/s12877-023-03915-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2022] [Accepted: 03/21/2023] [Indexed: 04/03/2023] Open
Abstract
BACKGROUND Person-centered care (PCC) is a critical approach to improving the quality of care for community-dwelling older people. Old-age care services could be provided according to older peoples' choices, needs, and preferences. The purpose of this study was to synthesize research evidence on the experiences of older people, healthcare providers, and caregivers with PCC and to identify the enablers and barriers to implementing PCC for community-dwelling older people. METHODS A meta-synthesis of qualitative research design was adopted. Data searches were performed using CINAHL (EBSCOhost), PubMed (OvidSP), Embase (Ovid), Cochrane Database, and PsycINFO (Ovid) in published articles and were reviewed from the earliest date to February 2023. The Qualitative Method Appraisal Tool was used to conduct a quality appraisal on selected articles. Data were extracted based on the capacity, opportunity, and motivation-behavior model (COM-B model), and the findings were synthesized using the meta-aggregative approach. RESULTS Twelve included articles were analyzed to identify 122 findings that were organized into 11 categories and combined into three synthesized findings-capacities of older people, healthcare providers, and caregivers; opportunities in the implementation of PCC; motivation in implementing PCC. Capacities consisted of a lack of person-centered knowledge and skills, negative attitudes toward shared decision-making, and a lack of formal training to enhance capabilities among HCPs. Opportunities included a lack of coordination in resource allocation, strengthening multidisciplinary teamwork, establishing a desirable environment, and time constraints. Motivation in implementing PCC included encouraging self-reflection and regulation, respecting the autonomy of older people, lack of clear reward and empowerment mechanisms, and being resilient and optimistic. CONCLUSIONS The findings of this research provide a reference for implementing successful PCC in the community. The researchers identified barriers and facilitators of implementing PCC, facilitating through stakeholder's person-centered knowledge and skills being valued and respecting the autonomy of older people. Establishing a positive environment and strengthening multidisciplinary team members also promotes the implementation of PCC. However, additional studies are required to explore the influencing factors and address the barriers.
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Affiliation(s)
- Lulu Liao
- Department of Nursing, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
- School of Nursing, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Mingjiao Feng
- School of Nursing, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Yanjie You
- School of Nursing, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Yuqin Chen
- School of Nursing, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Chunyan Guan
- Department of Otolaryngology Head and Neck Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China.
| | - Yilan Liu
- Department of Nursing, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China.
- School of Nursing, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China.
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Huang Y, Pan Y, Chen M, Jiang H, Ren L, Wang Y, Zhang L, Dong C. The resilient process of the family after diagnosis of childhood chronic illness: a qualitative meta-synthesis. J Pediatr Nurs 2022; 67:e180-e190. [PMID: 35906113 DOI: 10.1016/j.pedn.2022.07.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/11/2022] [Revised: 07/15/2022] [Accepted: 07/17/2022] [Indexed: 12/14/2022]
Abstract
PROBLEM Childhood chronic illness has a serious effect on the whole family. As there is yet little known about how the families adjust to the diagnosis of childhood chronic illness, this qualitative meta-synthesis aims to further our knowledge regarding the resilient process. ELIGIBILITY CRITERIA A meta-synthesis review was conducted to explore the resilient process of the family after diagnosis of childhood chronic illness using nine electronic databases PubMed (MEDLINE), Web of Science, the Cochrane Library, SCOPUS, PsycINFO, CINAHL, Wan Fang, CBM, and CNKI from each database's inception to December 31,2020. Snowball sampling and manual search were performed to identify other relevant studies. SAMPLE Seventeen qualitative studies met the inclusion criteria and were analyzed into meta-synthesis. RESULTS Three key meta-themes were identified across the studies: (a) disintegration and vulnerability: emotional fluctuation and household chaos; (b) adjustment and adaptation: struggle with family needs; (c) recovery and reconstruction: growth and expectation. CONCLUSION Family adjustment to childhood chronic illness presents a complex, multifaceted and dynamic process. Identifying characteristics of family processes provides some practical interventions for families with a chronically ill child. IMPLICATIONS There is a need for all health professionals and social care services to be aware of the experience of family adjustment of children diagnosed with chronic illness. The specific intervention targeted at different periods of the family adjustment process is warranted to help families to recover from crises and deal better with challenges.
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Affiliation(s)
- Yingying Huang
- The Second Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
| | - Yinzhu Pan
- School of Nursing, Wenzhou Medical University, Wenzhou, China
| | - Meijia Chen
- School of Nursing, Wenzhou Medical University, Wenzhou, China
| | - Hao Jiang
- School of Nursing, Wenzhou Medical University, Wenzhou, China
| | - Liya Ren
- School of Nursing, Wenzhou Medical University, Wenzhou, China
| | - Yuxin Wang
- School of Nursing, Wenzhou Medical University, Wenzhou, China
| | - Liping Zhang
- The Second Affiliated Hospital of Wenzhou Medical University, Wenzhou, China.
| | - Chaoqun Dong
- School of Nursing, Wenzhou Medical University, Wenzhou, China.
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Jarden RJ, Jones V, McClunie-Trust P, Winnington R, Merrick E, Shannon K, Turner R, Donaldson AE, Macdiarmid R. Exploring the experiences and perceptions of students in a graduate entry nursing programme: A qualitative meta-synthesis. Nurse Educ Today 2021; 107:105121. [PMID: 34482206 DOI: 10.1016/j.nedt.2021.105121] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/22/2021] [Revised: 08/11/2021] [Accepted: 08/24/2021] [Indexed: 06/13/2023]
Abstract
BACKGROUND Students commencing graduate entry fast-tracked nursing programmes leading to registration are highly motivated and characterised by rich life experiences. Given their unique motivations and characteristics, gaining insight into their experiences of graduate entry programmes will inform strategic directions in education. OBJECTIVE To synthesise graduate entry nursing students' self-reported experiences and perceptions of their accelerated programme. DESIGN Qualitative meta-synthesis. DATA SOURCES Databases included Cumulative Index of Nursing and Allied Health Literature, Emcare, Education Resources Information Centre, Medical Literature Analysis and Retrieval System Online, Psychological Information and Scopus. Qualitative studies published in English and reporting primary data analysis including experiences and perceptions of graduate entry nursing students were considered. REVIEW METHODS Qualitative studies were systematically identified and critically appraised. The meta-synthesis used an open card sort technique to organise data into a matrix of graduate entry nursing students' experiences and perceptions. RESULTS Fourteen studies were included. The analysis revealed three primary themes: what I bring and what I come with, developing a sense of self and nursing self, and what I need. Within these themes we found potential enablers of student success in learning; space, working together, and balancing work and life and learning to bridge two worlds. Students reflected on the benefits of academic support and shared their experiences of learning in clinical placement. In addition, students acknowledged the importance of clinical educators and preceptors who provided bridging that was further scaffolded by simulated learning experiences. CONCLUSIONS Findings indicate graduate entry nursing students have important needs and expectations of support in transition. The experiences and perceptions of graduate entry nursing students differentiated into what students arrived with, what support they need in their journey to become a nurse, alongside their experience of building a sense of self and their nursing self. SYSTEMATIC REVIEW REGISTRATION NUMBER CRD42020220201.
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Affiliation(s)
- Rebecca J Jarden
- Department of Nursing, Faculty of Health and Environmental Sciences, The University of Melbourne, 161 Barry St, Carlton, Victoria 3053, Australia.
| | - Virginia Jones
- Centre for Postgraduate Nursing, University of Otago, 72 Oxford Terrace, Christchurch 8052, New Zealand.
| | - Patricia McClunie-Trust
- Centre for Health and Social Practice, Waikato Institute of Technology, Tristram Street, Hamilton 3240, New Zealand.
| | - Rhona Winnington
- Department of Nursing, Faculty of Health and Environmental Sciences, Auckland University of Technology, 90 Akoranga Drive, Northcote, Auckland 0627, New Zealand.
| | - Eamon Merrick
- Department of Nursing, Faculty of Health and Environmental Sciences, Auckland University of Technology, 90 Akoranga Drive, Northcote, Auckland 0627, New Zealand.
| | - Kay Shannon
- Department of Nursing, Faculty of Health and Environmental Sciences, Auckland University of Technology, 90 Akoranga Drive, Northcote, Auckland 0627, New Zealand.
| | - Rosemary Turner
- Department of Nursing, Faculty of Health and Environmental Sciences, The University of Melbourne, 161 Barry St, Carlton, Victoria 3053, Australia.
| | - Andrea E Donaldson
- School of Nursing, Massey University, Manawatu Campus, Tennent Drive, Palmerston North 4474, New Zealand.
| | - Rachel Macdiarmid
- Department of Nursing, Faculty of Health and Environmental Sciences, Auckland University of Technology, 90 Akoranga Drive, Northcote, Auckland 0627, New Zealand.
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Sud A, Salamanca-Buentello F, Buchman DZ, Sabioni P, Majid U. Beyond harm-producing versus harm-reducing: A qualitative meta-synthesis of people who use drugs' perspectives of and experiences with the extramedical use and diversion of buprenorphine. J Subst Abuse Treat 2021; 135:108651. [PMID: 34728134 DOI: 10.1016/j.jsat.2021.108651] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2021] [Revised: 08/27/2021] [Accepted: 10/26/2021] [Indexed: 12/01/2022]
Abstract
INTRODUCTION This review synthesizes the literature on the perspectives and experiences of people who use drugs to better understand motivations and behaviors related to the extramedical use and diversion of buprenorphine. Given the particular social construction of buprenorphine against methadone, and the centrality of concerns around extramedical use in delivering opioid agonist therapies, a focus on extramedical buprenorphine use can provide an important lens through which to analyze treatment for opioid use disorder. This review is framed within persistent tensions between potential harm-producing versus harm-reducing effects of extramedical use that have long been described for opioid agonist therapies. METHODS The research team conducted a qualitative meta-synthesis based on a systematic search of eight databases as well as hand searching. The review includes all primary qualitative and mixed-methods studies related to the perspectives and experiences of people who use drugs on extramedical buprenorphine use. The study team carried out three rounds of qualitative coding using NVivo 12, and constructivist grounded theory and the constant comparative method informed the synthesis. RESULTS The review includes twenty-one studies. Findings are organized into the following three themes: 1) the experiences of people who use drugs (PWUD) with extramedical use of buprenorphine and their motivations to engage in it (including the desire to self-medicate and achieve "stability", to manage ongoing use of other opioids, and to "get high"); 2) the relationship between extramedical use and formal medical opioid agonist therapy programs; and 3) the established drug economy of extramedical buprenorphine. CONCLUSIONS The review identified varied and often divergent perspectives and experiences with extramedical buprenorphine use. An examination of the reported "normalizing" effects of extramedical buprenorphine suggests this practice as extending medicalized discipline beyond the clinical environment. Taken together, these findings identify a need to move beyond the tension of harm-reducing versus harm-producing effects toward forms of health care and promotion that focus on the needs, perspectives, and priorities of people who use drugs.
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Affiliation(s)
- Abhimanyu Sud
- Department of Family and Community Medicine, Temerty Faculty of Medicine, University of Toronto, 500 University Avenue, 5th Floor, Toronto, Ontario M5G 1V7, Canada; Bridgepoint Collaboratory for Research and Innovation, Lunenfeld-Tanenbaum Research Institute, Sinai Health, 1 Bridgepoint Drive, Toronto, Ontario M4M 2B5, Canada; Institute for Health Policy, Management and Evaluation, University of Toronto, Health Sciences Building, 155 College Street, Suite 425, Toronto, Ontario M5T 3M6, Canada.
| | - Fabio Salamanca-Buentello
- Bridgepoint Collaboratory for Research and Innovation, Lunenfeld-Tanenbaum Research Institute, Sinai Health, 1 Bridgepoint Drive, Toronto, Ontario M4M 2B5, Canada
| | - Daniel Z Buchman
- Centre for Addiction and Mental Health, 1025 Queen Street West, Toronto, Ontario M6J 1H1, Canada; Dalla Lana School of Public Health, University of Toronto, Health Sciences Building, 155 College Street, Toronto, Ontario M5T 3M6, Canada; University of Toronto Joint Centre for Bioethics, Health Sciences Building, 155 College Street, Suite 754, Toronto, ON M5T 3M6, Canada
| | - Pamela Sabioni
- Bridgepoint Collaboratory for Research and Innovation, Lunenfeld-Tanenbaum Research Institute, Sinai Health, 1 Bridgepoint Drive, Toronto, Ontario M4M 2B5, Canada
| | - Umair Majid
- Institute for Health Policy, Management and Evaluation, University of Toronto, Health Sciences Building, 155 College Street, Suite 425, Toronto, Ontario M5T 3M6, Canada
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Camara H, Zhang Y, Lafferty L, Vallely AJ, Guy R, Kelly-Hanku A. Self-collection for HPV-based cervical screening: a qualitative evidence meta-synthesis. BMC Public Health 2021; 21:1503. [PMID: 34348689 PMCID: PMC8336264 DOI: 10.1186/s12889-021-11554-6] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2020] [Accepted: 07/22/2021] [Indexed: 12/20/2022] Open
Abstract
Background Cervical cancer is the fourth most common cancer affecting women worldwide, with 85% of the burden estimated to occur among women in low and middle-income countries (LMICs). Recent developments in cervical cancer screening include a novel self-collection method for the detection of oncogenic HPV strains in the collected samples. The purpose of this review is to synthesise qualitative research on self-collection for HPV-based testing for cervical screening and identify strategies to increase acceptability and feasibility in different settings, to alleviate the burden of disease. Methods This review includes qualitative studies published between 1986 and 2020. A total of 10 databases were searched between August 2018 and May 2020 to identify qualitative studies focusing on the perspectives and experiences of self-collection for HPV-based cervical screening from the point of view of women, health care workers and other key stakeholders (i.e., policymakers). Two authors independently assessed studies for inclusion, quality, and framework thematic synthesis findings. The Socio-Ecological Model (SEM) was used to synthesize the primary studies. Results A total of 1889 publications were identified, of which 31 qualitative studies were included. Using an adapted version of SEM, 10 sub-themes were identified and classified under each of the adapted model’s constructs: (a) intrapersonal, (b) interpersonal, and (c) health systems/public policy. Some of the themes included under the intrapersonal (or individual) construct include the importance of self-efficacy, and values attributed to self-collection. Under the intrapersonal construct, the findings centre around the use of self-collection and its impact on social relationships. The last construct of health systems focuses on needs to ensure access to self-collection, the need for culturally sensitive programs to improve health literacy, and continuum of care. Conclusion This review presents the global qualitative evidence on self-collection for HPV-based testing and details potential strategies to address socio-cultural and structural barriers and facilitators to the use of self-collection. If addressed during the design of an HPV-based cervical cancer screening testing intervention program, these strategies could significantly increase the acceptability and feasibility of the intervention and lead to more effective and sustainable access to cervical screening services for women worldwide. Supplementary Information The online version contains supplementary material available at 10.1186/s12889-021-11554-6.
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Affiliation(s)
- Hawa Camara
- Kirby Institute for Infection and Immunity in Society, UNSW Sydney, Level 6, Wallace Wurth Building, Sydney, NSW, 2052, Australia.
| | - Ye Zhang
- Kirby Institute for Infection and Immunity in Society, UNSW Sydney, Level 6, Wallace Wurth Building, Sydney, NSW, 2052, Australia
| | - Lise Lafferty
- Kirby Institute for Infection and Immunity in Society, UNSW Sydney, Level 6, Wallace Wurth Building, Sydney, NSW, 2052, Australia.,Centre for Social Research in Health, UNSW Sydney, Goodsell Building, Sydney, NSW, 2052, Australia
| | - Andrew J Vallely
- Kirby Institute for Infection and Immunity in Society, UNSW Sydney, Level 6, Wallace Wurth Building, Sydney, NSW, 2052, Australia.,Papua New Guinea Institute of Medical Research, Homate Street, PO Box 60, Goroka, Eastern Highlands Province, Papua New Guinea
| | - Rebecca Guy
- Kirby Institute for Infection and Immunity in Society, UNSW Sydney, Level 6, Wallace Wurth Building, Sydney, NSW, 2052, Australia
| | - Angela Kelly-Hanku
- Kirby Institute for Infection and Immunity in Society, UNSW Sydney, Level 6, Wallace Wurth Building, Sydney, NSW, 2052, Australia.,Papua New Guinea Institute of Medical Research, Homate Street, PO Box 60, Goroka, Eastern Highlands Province, Papua New Guinea
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Tarzia L, Cameron J, Watson J, Fiolet R, Baloch S, Robertson R, Kyei-Onanjiri M, McKibbin G, Hegarty K. Personal barriers to addressing intimate partner abuse: a qualitative meta-synthesis of healthcare practitioners' experiences. BMC Health Serv Res 2021; 21:567. [PMID: 34107941 PMCID: PMC8191204 DOI: 10.1186/s12913-021-06582-2] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2021] [Accepted: 05/21/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Healthcare practitioners (HCPs) play a crucial role in recognising, responding to, and supporting female patients experiencing intimate partner abuse (IPA). However, research consistently identifies barriers they perceive prevent them from doing this work effectively. These barriers can be system-based (e.g. lack of time or training) or personal/individual. This review of qualitative evidence aims to synthesise the personal barriers that impact HCPs' responses to IPA. METHODS Five databases were searched in March 2020. Studies needed to utilise qualitative methods for both data collection and analysis and be published between 2010 and 2020 in order to qualify for inclusion; however, we considered any type of healthcare setting in any country. Article screening, data extraction and methodological appraisal using a modified version of the Critical Appraisal Skills Program checklist for qualitative studies were undertaken by at least two independent reviewers. Data analysis drew on Thomas and Harden's thematic synthesis approach. RESULTS Twenty-nine studies conducted in 20 countries informed the final review. A variety of HCPs and settings were represented. Three themes were developed that describe the personal barriers experienced by HCPs: I can't interfere (which describes the belief that IPA is a "private matter" and HCPs' fears of causing harm by intervening); I don't have control (highlighting HCPs' frustration when women do not follow their advice); and I won't take responsibility (which illuminates beliefs that addressing IPA should be someone else's job). CONCLUSION This review highlights the need for training to address personal issues in addition to structural or organisational barriers. Education and training for HCPs needs to: encourage reflection on their own values to reinforce their commitment to addressing IPA; teach HCPs to relinquish the need to control outcomes so that they can adopt an advocacy approach; and support HCPs' trust in the critical role they can play in responding. Future research should explore effective ways to do this within the context of complex healthcare organisations.
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Affiliation(s)
- Laura Tarzia
- Department of General Practice, The University of Melbourne, Melbourne, Victoria, Australia. .,Centre for Family Violence Prevention, The Royal Women Hospital, Parkville, Victoria, Australia.
| | - Jacqui Cameron
- Department of General Practice, The University of Melbourne, Melbourne, Victoria, Australia.,School of Health and Society, University of Wollongong, Wollongong, New South Wales, Australia
| | - Jotara Watson
- Department of General Practice, The University of Melbourne, Melbourne, Victoria, Australia.,Centre for Family Violence Prevention, The Royal Women Hospital, Parkville, Victoria, Australia
| | - Renee Fiolet
- Department of General Practice, The University of Melbourne, Melbourne, Victoria, Australia.,School of Nursing & Midwifery, Deakin University, Geelong, Victoria, Australia
| | - Surriya Baloch
- Department of General Practice, The University of Melbourne, Melbourne, Victoria, Australia
| | - Rebecca Robertson
- Department of General Practice, The University of Melbourne, Melbourne, Victoria, Australia.,Centre for Family Violence Prevention, The Royal Women Hospital, Parkville, Victoria, Australia
| | - Minerva Kyei-Onanjiri
- Department of General Practice, The University of Melbourne, Melbourne, Victoria, Australia
| | - Gemma McKibbin
- Department of Social Work, The University of Melbourne, Melbourne, Victoria, Australia
| | - Kelsey Hegarty
- Department of General Practice, The University of Melbourne, Melbourne, Victoria, Australia.,Centre for Family Violence Prevention, The Royal Women Hospital, Parkville, Victoria, Australia
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Oga-Omenka C, Wakdet L, Menzies D, Zarowsky C. A qualitative meta-synthesis of facilitators and barriers to tuberculosis diagnosis and treatment in Nigeria. BMC Public Health 2021; 21:279. [PMID: 33535990 PMCID: PMC7860048 DOI: 10.1186/s12889-021-10173-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2020] [Accepted: 01/05/2021] [Indexed: 11/23/2022] Open
Abstract
Background Despite progress in tuberculosis (TB) control globally, TB continues to be a leading cause of death from infectious diseases, claiming 1.2 million lives in 2018; 214,000 of these deaths were due to drug resistant strains. Of the estimated 10 million cases globally in 2018, 24% were in Africa, with Nigeria and South Africa making up most of these numbers. Nigeria ranks 6th in the world for TB burden, with an estimated 4.3% multi-drug resistance in new cases. However, the country had one of the lowest case detection rates, estimated at 24% of incident cases in 2018 - well below the WHO STOP TB target of 84%. This rate highlights the need to understand contextual issues influencing tuberculosis management in Nigeria. Our synthesis was aimed at synthesizing qualitative evidence on factors influencing TB care in Nigeria. Methods A three-stage thematic meta-synthesis of qualitative studies was used to identify barriers and facilitators to tuberculosis case finding and treatment in Nigeria. A search of eleven databases was conducted. The date of publication was limited to 2006 to June 2020. We analyzed articles using a three-stage process, resulting in coding, descriptive subthemes and analytical themes. Results Our final synthesis of 10 articles resulted in several categories including community and family involvement, education and knowledge, attitudes and stigma, alternative care options, health system factors (including coverage and human resource), gender, and direct and indirect cost of care. These were grouped into three major themes: individual factors; interpersonal influences; and health system factors. Conclusion Case finding and treatment for TB in Nigeria currently depends more on individual patients presenting voluntarily to the hospital for care, necessitating an understanding of patient behaviors towards TB diagnosis and treatment. Our synthesis has identified several related factors that shape patients’ behavior towards TB management at individual, community and health system levels that can inform future interventions.
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Affiliation(s)
- Charity Oga-Omenka
- School of Public Health of the University of Montreal (ESPUM), Montreal, Canada. .,Centre de Recherche en Santé Publique, Université de Montréal (CReSP), Montreal, Canada. .,McGill University International TB Centre, Montreal, Quebec, Canada.
| | | | - Dick Menzies
- McGill University International TB Centre, Montreal, Quebec, Canada.,Department of Epidemiology and Biostatistics, McGill University, Montreal, Canada
| | - Christina Zarowsky
- School of Public Health of the University of Montreal (ESPUM), Montreal, Canada.,Centre de Recherche en Santé Publique, Université de Montréal (CReSP), Montreal, Canada.,School of Public Health, University of the Western Cape, Cape Town, South Africa
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12
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Cernat A, De Freitas C, Majid U, Trivedi F, Higgins C, Vanstone M. Facilitating informed choice about non-invasive prenatal testing (NIPT): a systematic review and qualitative meta-synthesis of women's experiences. BMC Pregnancy Childbirth 2019; 19:27. [PMID: 30642270 DOI: 10.1186/s12884-018-2168-4] [Citation(s) in RCA: 57] [Impact Index Per Article: 11.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2018] [Accepted: 12/28/2018] [Indexed: 01/09/2023] Open
Abstract
Background Non-invasive prenatal testing (NIPT) can be used to accurately detect fetal chromosomal anomalies early in pregnancy by assessing cell-free fetal DNA present in maternal blood. The rapid diffusion of NIPT, as well as the ease and simplicity of the test raises concerns around informed decision-making and the potential for routinization. Introducing NIPT in a way that facilitates informed and autonomous decisions is imperative to the ethical application of this technology. We approach this imperative by systematically reviewing and synthesizing primary qualitative research on women’s experiences with and preferences for informed decision-making around NIPT. Methods We searched multiple bibliographic databases including Ovid MEDLINE, EBSCO Cumulative Index to Nursing & Allied Health Literature (CINAHL), and ISI Web of Science Social Sciences Citation Index (SSCI). Our review was guided by integrative qualitative meta-synthesis, and we used a staged coding process similar to that of grounded theory to conduct our analysis. Results Thirty empirical primary qualitative research studies were eligible for inclusion. Women preferred to learn about NIPT from their clinicians, but they expressed dissatisfaction with the quality and quantity of information provided during counselling and often sought information from a variety of other sources. Women generally had a good understanding of test characteristics, and the factors of accuracy, physical risk, and test timing were the critical information elements that they used to make informed decisions around NIPT. Women often described NIPT as easy or just another blood test, highlighting threats to informed decision-making such as routinization or a pressure to test. Conclusions Women’s unique circumstances modulate the information that they value and require most in the context of making an informed decision. Widened availability of trustworthy information about NIPT as well as careful attention to the facilitation of counselling may help facilitate informed decision-making. Trial registration PROSPERO 2018 CRD42018086261. Electronic supplementary material The online version of this article (10.1186/s12884-018-2168-4) contains supplementary material, which is available to authorized users.
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13
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Li H, Marley G, Ma W, Wei C, Lackey M, Ma Q, Renaud F, Vitoria M, Beanland R, Doherty M, Tucker JD. The Role of ARV Associated Adverse Drug Reactions in Influencing Adherence Among HIV-Infected Individuals: A Systematic Review and Qualitative Meta-Synthesis. AIDS Behav 2017; 21:341-351. [PMID: 27613645 DOI: 10.1007/s10461-016-1545-0] [Citation(s) in RCA: 36] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
Poor adherence remains a major barrier to achieving the clinical and public health benefits of antiretroviral drugs (ARVs). A systematic review and qualitative meta-synthesis was conduct to evaluate how ARV adverse drug reactions may influence ARV adherence. Thirty-nine articles were identified, and 33 reported that ARV adverse drug reactions decreased adherence and six studies found no influence. Visually noticeable adverse drug reactions and psychological adverse reactions were reported as more likely to cause non-adherence compared to other adverse drug reactions. Six studies reported a range of adverse reactions associated with EFV-containing regimens contributing to decreased adherence. Informing HIV-infected individuals about ARV adverse drug reactions prior to initiation, counselling about coping mechanisms, and experiencing the effectiveness of ARVs on wellbeing may improve ARV adherence.
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Affiliation(s)
- Haochu Li
- School of Public Health, Shandong University, Jinan, China.
- UNC Project-China, Institute for Global Health and Infectious Diseases, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
| | - Gifty Marley
- School of Public Health, Shandong University, Jinan, China
| | - Wei Ma
- School of Public Health, Shandong University, Jinan, China
| | - Chongyi Wei
- Department of Epidemiology and Biostatistics, University of California, San Francisco, CA, USA
| | - Mellanye Lackey
- UNC Project-China, Institute for Global Health and Infectious Diseases, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Qingyan Ma
- UNC Project-China, Institute for Global Health and Infectious Diseases, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | | | - Marco Vitoria
- HIV Department, World Health Organization, Geneva, Switzerland
| | - Rachel Beanland
- HIV Department, World Health Organization, Geneva, Switzerland
| | - Meg Doherty
- HIV Department, World Health Organization, Geneva, Switzerland
| | - Joseph D Tucker
- UNC Project-China, Institute for Global Health and Infectious Diseases, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
- UNC Project-China, Guangdong Provincial Skin Diseases and STI Control, Number 2 Lujing Road, Guangzhou, 510095, China.
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