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Williams TL, Patterson LB, Heyes AR, Staff HR, Boardley ID, Petróczi A, Backhouse SH. Barriers and enablers in doping, anti-doping, and clean sport: A qualitative meta-synthesis informed by the theoretical domains framework and COM-B model. Psychol Sport Exerc 2024; 72:102608. [PMID: 38360079 DOI: 10.1016/j.psychsport.2024.102608] [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] [Subscribe] [Scholar Register] [Received: 03/13/2023] [Revised: 01/12/2024] [Accepted: 02/12/2024] [Indexed: 02/17/2024]
Abstract
To protect the integrity of sport, and the health of athletes, global anti-doping programmes seek to prevent doping, and elicit anti-doping and clean sport behaviours, through education, deterrence, detection, enforcement, and rules. To guide programme development, this meta-synthesis of qualitative research applied a behavioural science framework to identify barriers and enablers to doping, anti-doping, and clean sport. A systematic search of electronic databases up to May 2022, followed by critical appraisal, resulted in 73 included articles. Fifty-two articles reported the athlete perspective, thirteen included athletes, athlete support personnel (ASP), and other experts, and eight focused on ASP only. Rigorous methods of thematic synthesis were drawn upon to construct analytical themes in line with the theoretical domains framework (TDF) and the capability, opportunity, and motivation model of behaviour (COM-B). A wide range of barriers and enablers were identified which influenced capability, opportunity, and motivation to participate in a clean sport environment. The weight of evidence pointed to limitations in the current anti-doping education system in providing athletes and ASP with the knowledge and skills to protect against doping, as well as the significant influence of social and cultural norms in shaping doping and clean sport behaviours through a shared social identity, and risky contexts leading to moments of vulnerability to doping. We identified a need for anti-doping programmes to move beyond the current focus on athlete capability, and address the opportunity and motivation components of clean sport behaviours through a targeted and tailored focus on education, training, persuasion, modelling and environmental restructuring interventions.
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Affiliation(s)
- Toni L Williams
- Department of Sport and Exercise Sciences, Durham University, UK; Carnegie School of Sport, Leeds Beckett University, UK.
| | | | | | - Helen R Staff
- Carnegie School of Sport, Leeds Beckett University, UK.
| | - Ian D Boardley
- School of Sport, Exercise and Rehabilitation Sciences, University of Birmingham, UK.
| | - Andrea Petróczi
- School of Life Sciences, Pharmacy and Chemistry, Kingston University, UK; Institute of Health Promotion and Sport Sciences, ELTE Eötvös Loránd University, Hungary.
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Abstract
BACKGROUND Coeliac disease is a chronic autoimmune condition associated with intestinal and extraintestinal symptoms. Coeliac Disease is managed through strict adherence to a gluten-free diet, which, though usually effective, is challenging to maintain. This review synthesised qualitative research on the psychosocial experiences of adults living with coeliac disease. METHODS Keyword searches were conducted of the academic databases CINAHL, EMBASE, MEDLINE, PsychINFO, SCOPUS and Web of Science for articles published (2005-2021), followed by forward and backward searches. Thematic synthesis of included articles was carried out on sections reporting findings or results, discussion, conclusions, and supporting data. The inductive thematic synthesis identified descriptive and analytical themes from the included studies. RESULTS Of 1284 records identified, 17 articles from 15 original studies were included in the thematic synthesis. The majority of studies were from Europe (76%), with the remainder from North America and Australia. Data represented 371 adults with coeliac disease (72% female; 17-85 years old, diagnosed < 1-42 years ago) across eight countries. Findings identified six analytical themes relating to the psychosocial experience of coeliac disease: 'Living with ongoing risk'; 'Losing more than gluten'; 'A changed identity'; 'A changed relationship with food'; 'The gluten-free diet creates a multifaceted burden'; and 'Learning how to live well with Coeliac Disease'. CONCLUSIONS Coeliac disease changes adults' psychosocial experiences. Adaptation involves ongoing learning, and development of psychological acceptance facilitates adjustment. Increased public education about coeliac disease may reduce stigma and risk. Psychosocial assessment and support could improve quality of life post-diagnosis.
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Affiliation(s)
- Catharine Rose
- School of Psychology, University of Birmingham, Birmingham, UK.
| | - Gary U Law
- School of Psychology, University of Birmingham, Birmingham, UK
| | - Ruth A Howard
- School of Psychology, University of Birmingham, Birmingham, UK
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Ford T, Talbot A, Hayward G, Tonkin-Crine S, Ziebland S, McNiven A. Managing recurrent vulvovaginal thrush from patient and healthcare professional perspectives: A systematic review and thematic synthesis. Patient Educ Couns 2024; 118:108004. [PMID: 37826917 DOI: 10.1016/j.pec.2023.108004] [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] [Subscribe] [Scholar Register] [Received: 06/12/2023] [Revised: 09/28/2023] [Accepted: 10/05/2023] [Indexed: 10/14/2023]
Abstract
OBJECTIVE This systematic review aims to identify what is known about patient and healthcare professional experiences of managing recurrent vulvovaginal thrush by synthesising published findings. METHODS Five databases were searched for studies on patient and healthcare professional experiences managing recurrent thrush. Two reviewers independently screened and quality assessed qualitative, quantitative, and mixed-methods studies. Findings from eligible studies were thematically synthesised. RESULTS 720 papers were identified, and 29 were included. Four descriptive themes were developed to depict the repeated management of recurrent thrush. These themes were: (re)experiencing impacts, (re)identifying recurrent thrush, (re)considering consultations, and (re)trying treatments. An analytic high-order frame of 'interwoven and reoccurring uncertainties' was used to understand these themes. CONCLUSIONS Patients and healthcare providers face uncertainties when managing recurrent thrush. The inconsistencies raised across papers suggests an unaddressed gap in knowledge about patient experiences and their informational and support needs; this includes insights about this condition's diagnosis, management, treatment, impacts, and meaning. PRACTICE IMPLICATIONS This review has implications for patient education, health promotion, and communication between patients and providers. Our interpretations suggest the need for more research and resources to help support patients and clinicians in managing this condition to promote more understanding, communication, and collaborative care.
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Affiliation(s)
- Tori Ford
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK.
| | - Amelia Talbot
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK
| | - Gail Hayward
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK
| | - Sarah Tonkin-Crine
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK
| | - Sue Ziebland
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK
| | - Abigail McNiven
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK
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McKenna-Plumley PE, Turner RN, Yang K, Groarke JM. Experiences of Loneliness Across the Lifespan: A Systematic Review and Thematic Synthesis of Qualitative Studies. Int J Qual Stud Health Well-being 2023; 18:2223868. [PMID: 37327403 DOI: 10.1080/17482631.2023.2223868] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/17/2022] [Accepted: 06/08/2023] [Indexed: 06/18/2023] Open
Abstract
PURPOSE Loneliness is a fundamentally subjective experience that is common at various life stages. Studies have qualitatively explored loneliness, but a comprehensive overview is lacking. This research therefore provides a fine-grained review of studies on loneliness experiences across the lifespan. METHODS A systematic review and thematic synthesis were performed on studies that qualitatively investigated experiences of loneliness in people of any age from non-clinical populations. Sensitivity analysis assessed the impact of lower-quality studies and specific age groups on the findings. RESULTS Twenty-nine studies of 1,321 participants aged between 7 and 103 were included. Fifteen descriptive themes and three overarching analytical themes were developed: (1) Loneliness is both psychological and contextual, (2) Loneliness centres on feelings of meaningful connection and painful disconnection, and (3) Loneliness can exist in a general, pervasive sense or can relate to specific other people or relationship types. Some features were particularly pertinent to children, younger adults, and older adults, respectively. CONCLUSIONS Loneliness involves a primarily aversive psychological experience of perceived disconnection which is linked to physical, personal, and socio-political contexts and can be pervasive or relate to specific relationships or relationship types. An awareness of context, life stage, and personal experiences is essential to understand loneliness.
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Affiliation(s)
- Phoebe E McKenna-Plumley
- Centre for Improving Health-Related Quality of Life, School of Psychology, Queen's University Belfast, Belfast, UK
| | - Rhiannon N Turner
- Centre for Identity and Intergroup Relations, School of Psychology, Queen's University Belfast, Belfast, UK
| | - Keming Yang
- Department of Sociology, Durham University, Durham, UK
| | - Jenny M Groarke
- Centre for Improving Health-Related Quality of Life, School of Psychology, Queen's University Belfast, Belfast, UK
- School of Psychology, University of Galway, Galway, Ireland
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Al-Mutawtah M, Campbell E, Kubis HP, Erjavec M. Women's experiences of social support during pregnancy: a qualitative systematic review. BMC Pregnancy Childbirth 2023; 23:782. [PMID: 37950165 PMCID: PMC10638802 DOI: 10.1186/s12884-023-06089-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [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] [Received: 03/27/2023] [Accepted: 10/27/2023] [Indexed: 11/12/2023] Open
Abstract
BACKGROUND Social support during pregnancy can alleviate emotional and physical pressures, improving the well-being of mother and child. Understanding women's lived experiences and perceptions of social support during pregnancy is imperative to better support women. This systematic review explores and synthesises the qualitative research on women's experiences of social support during pregnancy. METHODS Databases PubMed, CINAHL, MEDLINE, APA PsycInfo and Scopus were searched with no year limit. Eligible studies included pregnant women or women who were up to one year postpartum and were assessed on their experiences of social support during pregnancy. The data were synthesised using the thematic synthesis approach. RESULTS Fourteen studies were included with data from 571 participating women across ten countries; two studies used focus groups, and 12 used interviews to collect their data. Four main themes were developed ('a variety of emotional support', 'tangible and intangible instrumental support', 'traditional rituals and spiritual support', and 'the all-encompassing natal home'), and six sub-themes ('female network connections', 'care and affection from the husband', 'dissatisfaction with relationships', 'financial support from the husband and family', 'practical support from family and friends', 'health information support'). CONCLUSIONS This systematic review sheds light on women's experiences of social support during pregnancy. The results indicate a broad variety of emotional support experienced and valued by pregnant women from different sources. Additionally, women expressed satisfaction and dissatisfaction with tangible and intangible support forms. It was also highlighted that spirituality played an essential role in reducing stress and offering coping mechanisms for some, whereas spirituality increased stress levels for others.
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Affiliation(s)
- Mona Al-Mutawtah
- School of Human and Behavioural Sciences, Bangor University, Bangor, UK.
- Community Medicine- Clinical Psychology, Kuwait University, Kuwait City, Kuwait.
| | - Emma Campbell
- School of Human and Behavioural Sciences, Bangor University, Bangor, UK
| | - Hans-Peter Kubis
- School of Human and Behavioural Sciences, Bangor University, Bangor, UK
| | - Mihela Erjavec
- School of Human and Behavioural Sciences, Bangor University, Bangor, UK
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Zheng X, Liu Q, Tao Z, Peng L, Chen H, Tang Y. Caregivers' experiences of caring for non-COVID-19 patients during the pandemic: A qualitative systematic review. Patient Educ Couns 2023; 115:107872. [PMID: 37413807 DOI: 10.1016/j.pec.2023.107872] [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] [Subscribe] [Scholar Register] [Received: 10/07/2022] [Revised: 05/31/2023] [Accepted: 06/26/2023] [Indexed: 07/08/2023]
Abstract
OBJECTIVE To investigate caregivers' experiences of caring for non-coronavirus disease (COVID-19) patients to determine their challenges and needs. METHODS Five electronic databases (PubMed, Web of Science, Ovid, CINAHL, and ClinicalKey) were searched from January 2020 to June 2022. Two authors independently reviewed all studies for eligibility and extracted information on the study aim, sample characteristics, study design, data collection, analysis methods, and so on. RESULTS Finally, 13 studies were included. Four themes were determined: impacts on physical and psychosocial well-being of caregivers, perceived risk of the virus, negative impacts on employment and financial statuses, and changes in support networks. CONCLUSION This is the first qualitative systematic review to describe caregivers' experiences of caring for non-COVID-19 patients during the pandemic. The four themes should be focused on to ease caregivers' physical, psychological, and financial burdens; to provide them with better assistance in terms of formal and informal supports to cope with the epidemic more effectively; and to ensure that their loved ones are much healthier. PRACTICE IMPLICATIONS The findings can be used by healthcare policymakers, social policymakers, and governments to better support caregivers of non-COVID-19 patients. Additionally, it provides suggestions for related medical institutions to pay more attention to caregivers' experiences.
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Affiliation(s)
- Xilin Zheng
- Department of Nursing Teaching and Research, Xiangya Hospital, Central South University, Changsha, China; Xiangya School of Nursing, Central South University, Changsha, China
| | - Qingqing Liu
- Department of Nursing Teaching and Research, Xiangya Hospital, Central South University, Changsha, China; Xiangya School of Nursing, Central South University, Changsha, China
| | - Zirong Tao
- Xiangya Hospital, Central South University, Changsha, China.
| | - Lingli Peng
- Xiangya Hospital, Central South University, Changsha, China; National Research Center on Aging, Xiangya Hospital, Central South University, Changsha, China.
| | - Hua Chen
- Xiangya Hospital, Central South University, Changsha, China
| | - Yunhong Tang
- Xiangya Hospital, Central South University, Changsha, China
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Wilson N, Liu J, Adamjee Q, Di Giorgio S, Steer S, Hutton J, Lempp H. Exploring the emotional impact of axial Spondyloarthritis: a systematic review and thematic synthesis of qualitative studies and a review of social media. BMC Rheumatol 2023; 7:26. [PMID: 37608395 PMCID: PMC10464274 DOI: 10.1186/s41927-023-00351-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2023] [Accepted: 08/07/2023] [Indexed: 08/24/2023] Open
Abstract
BACKGROUND The psychological burden in people with inflammatory arthritis is substantial, yet little is known about the disease-related affect experienced by individuals with axial Spondyloarthritis (axial SpA). The aim of this study was to conduct a qualitative evidence synthesis and a review of social media to explore the emotional impact of living with axial SpA. METHODS We searched nine databases for studies reporting qualitative data about participants' emotional experience of living with axial SpA. In addition, we searched social media platforms for posts from people with axial SpA based in the UK that offered insights into emotional responses to living with the condition. We employed a thematic approach to synthesise the data. RESULTS We included 27 studies (1314 participants; 72% men) in our qualitative evidence synthesis and developed seven descriptive themes from the data: 1) delayed diagnosis: a barrier to emotional wellbeing; 2) disruptive symptoms: a source of mood swings; 3) work disability: a loss of self-esteem; 4) obstacles in interpersonal relationships: a trigger of distress; 5) taking up exercise: personal pride or unwelcomed reminders; 6) anti-TNF therapy: hope reignited despite concerns and 7) a journey of acceptance: worry mixed with hope. Posts extracted from social media fora (537; 48% from women) for the most part supported the seven themes. One additional theme-COVID-19, uncertainty and anxiety during the pandemic, was developed, reflecting common emotions expressed during the UK's first wave of the coronavirus pandemic. CONCLUSION This study highlights a preponderance of negative affect experienced by people living with axial SpA, conditioned through existing and anticipated symptoms, failed expectations, and lost sense of self. Given the bidirectional relationships between negative emotions and inflammation, negative emotions and perceptions of pain, and the influence of affect in self-care behaviours, this finding has important implications for treatment and management of people with axial SpA.
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Affiliation(s)
- Nicky Wilson
- Department of Rheumatology, King's College Hospital NHS Foundation Trust, London, UK.
| | - Jia Liu
- Centre for Education, Faculty of Life Sciences & Medicine, King's College London, London, UK
| | - Qainat Adamjee
- GKT School of Medical Education, King's College London, London, UK
| | - Sonya Di Giorgio
- King's College London Libraries & Collections, King's College London, London, UK
| | - Sophia Steer
- Department of Rheumatology, King's College Hospital NHS Foundation Trust, London, UK
| | - Jane Hutton
- Department of Clinical Health Psychology, Liverpool University Hospitals NHS Foundation Trust, Liverpool, UK
| | - Heidi Lempp
- Department of Inflammation Biology, Centre for Rheumatic Diseases, School of Immunology and Microbial Sciences, Faculty of Life Sciences & Medicine, King's College London, London, UK
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Talal AH, George SJ, Talal LA, Dharia A, Ventuneac A, Baciewicz G, Perumalswami PV, Dickerson SS. Engaging people who use drugs in clinical research: integrating facilitated telemedicine for HCV into substance use treatment. Res Involv Engagem 2023; 9:63. [PMID: 37533127 PMCID: PMC10399008 DOI: 10.1186/s40900-023-00474-x] [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] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/28/2023] [Accepted: 07/20/2023] [Indexed: 08/04/2023]
Abstract
BACKGROUND People who use drugs (PWUD) have difficulty participating in clinical research. We evaluated approaches to engage PWUD in clinical research, using facilitated telemedicine for hepatitis C virus (HCV) care as an example. METHODS We analyzed stakeholder interview transcripts and study-related data (i.e., progress reports, meeting minutes) from interrelated studies to understand engagement experiences at the patient, site, and organizational levels. Stakeholders include patient-participants, opioid treatment program (OTP) staff and administrators, and research team members involved in HCV management through facilitated telemedicine integrated into OTPs. RESULTS Three themes emerged. Initially, the research team sought understanding of the unique culture and community of each OTP (Theme 1). The team built trusting relationships through education, communication, and feedback (Theme 2). Finally, the research team enhanced collaborative care and incorporated the patients' voice to improve health outcomes (Theme 3). Patient-participants and OTP staff endorsed the integrated HCV care approach. Engagement practices are summarized as the CREATE framework (C = culture, R = respect, E = educate, A = advantage, T = trust, E = endorse). CONCLUSIONS PWUD engagement in clinical research is maximized by building trusting relationships with open communication channels. Understanding the community, demonstrating respect, and augmenting knowledge are foundational for engaging PWUD in clinical research. These practices are transferable to engagement of PWUD in clinical research broadly.
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Affiliation(s)
- Andrew H Talal
- Division of Gastroenterology, Hepatology, and Nutrition, Department of Medicine, University at Buffalo, State University of New York, 875 Ellicott Street, Suite 6090, Buffalo, NY, 14203, USA.
| | - Saliyah J George
- Division of Liver Diseases, Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | | | - Arpan Dharia
- Division of Gastroenterology, Hepatology, and Nutrition, Department of Medicine, University at Buffalo, State University of New York, 875 Ellicott Street, Suite 6090, Buffalo, NY, 14203, USA
| | - Ana Ventuneac
- START Treatment and Recovery Centers, Brooklyn, NY, USA
| | | | - Ponni V Perumalswami
- Division of Liver Diseases, Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Suzanne S Dickerson
- Division of Biobehavioral Health and Clinical Sciences, School of Nursing, University at Buffalo, Buffalo, NY, USA
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Chapman LS, Flurey CA, Redmond AC, Richards P, Hofstetter C, Tapster B, Emmel J, Helliwell PS, Menz HB, Hannan MT, Shea B, Siddle HJ. Living with foot and ankle disorders in rheumatic and musculoskeletal diseases: A systematic review of qualitative studies to inform the work of the OMERACT Foot and Ankle Working Group. Semin Arthritis Rheum 2023; 61:152212. [PMID: 37207417 DOI: 10.1016/j.semarthrit.2023.152212] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [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: 03/20/2023] [Revised: 04/28/2023] [Accepted: 05/02/2023] [Indexed: 05/21/2023]
Abstract
OBJECTIVES This study aimed to determine outcome domains of importance to patients living with foot and ankle disorders in rheumatic and musculoskeletal diseases (RMDs), by exploring the symptoms and impact of these disorders reported in existing qualitative studies. METHODS Six databases were searched from inception to March 2022. Studies were included if they used qualitative interview or focus group methods, were published in English, and involved participants living with RMDs (inflammatory arthritis, osteoarthritis, crystal arthropathies, connective tissue diseases, and musculoskeletal conditions in the absence of systemic disease) who had experienced foot and ankle problems. Quality was assessed using the Critical Appraisal Skills Programme qualitative tool and confidence in the findings was assessed using the Grading of Recommendations Assessment, Development and Evaluation Confidence in the Evidence from Reviews of Qualitative research (GRADE-CERQual) approach. All data from the results section of included studies were extracted, coded and synthesised to develop themes. RESULTS Of 1,443 records screened, 34 studies were included, with a total of 503 participants. Studies included participants with rheumatoid arthritis (n = 18), osteoarthritis (n = 5), gout (n = 3), psoriatic arthritis (n = 1), lupus (n = 1), posterior tibial tendon dysfunction (n = 1), plantar heel pain (n = 1), Achilles tendonitis (n = 1), and a mixed population (n = 3), who live with foot and ankle disorders. Seven descriptive themes were generated from the thematic synthesis: pain, change in appearance, activity limitations, social isolation, work disruption, financial burden and emotional impact. Descriptive themes were inductively analysed further to construct analytical themes relating to potential outcome domains of importance to patients. Foot or ankle pain was the predominant symptom experienced by patients across all RMDs explored in this review. Based on grading of the evidence, we had moderate confidence that most of the review findings represented the experiences of patients with foot and ankle disorders in RMDs. CONCLUSIONS Findings indicate that foot and ankle disorders impact on multiple areas of patients' lives, and patients' experiences are similar regardless of the RMD. This study will inform the development of a core domain set for future foot and ankle research and are also useful for clinicians, helping to focus clinical appointments and measurement of outcomes within clinical practice.
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Affiliation(s)
- Lara S Chapman
- Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, Leeds, UK; Centre for Sport, Exercise and Osteoarthritis Research Versus Arthritis, UK.
| | - Caroline A Flurey
- School of Social Sciences, College of Health, Science, and Society, University of the West of England, Bristol, UK
| | - Anthony C Redmond
- Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, Leeds, UK; Centre for Sport, Exercise and Osteoarthritis Research Versus Arthritis, UK; National Institute for Health Research (NIHR) Leeds Biomedical Research Centre, Leeds, UK
| | | | | | - Bethany Tapster
- Library and Information Service, Leeds Teaching Hospitals NHS Trust, Leeds, UK
| | - Jenny Emmel
- Library Service, Bradford District Care NHS Foundation Trust, Bradford, UK
| | - Philip S Helliwell
- Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, Leeds, UK
| | - Hylton B Menz
- School of Allied Health, Human Services and Sport, La Trobe University, Melbourne, Victoria, Australia
| | - Marian T Hannan
- Hinda and Arthur Marcus Institute for Aging Research, Hebrew SeniorLife, Beth Israel Deaconess Medical Center, Boston, MA, USA
| | - Beverley Shea
- Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, Ontario, Canada
| | - Heidi J Siddle
- Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, Leeds, UK
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Li Y, Wang C, Tan W, Jiang Y. The transition to advanced practice nursing: A systematic review of qualitative studies. Int J Nurs Stud 2023; 144:104525. [PMID: 37263057 DOI: 10.1016/j.ijnurstu.2023.104525] [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: 12/18/2022] [Revised: 05/07/2023] [Accepted: 05/09/2023] [Indexed: 06/03/2023]
Abstract
BACKGROUND Advanced practice nurses have made important contributions to the tasks of stabilising the operation of the health system and improving the quality of care. However, taking on the role of an advanced practice nurse is always challenging and can even result in the intention to leave the profession. Insights into advanced practice nursing role transitions are important to implement effective interventions to help nurses cope with the corresponding turbulence and changes. AIM To explore the experiences of advanced practice nurses during their role transition from registered nurses to their current role. DESIGN A systematic review of qualitative studies. DATA SOURCES Five databases were searched from inception to August 2022: PubMed, Web of Science, Cochrane, Embase and CINAHL. REVIEW METHODS This review was reported in accordance with the Enhancing Transparency in Reporting the Synthesis of Qualitative Research (ENTREQ) guidelines. Two reviewers independently conducted study selection and data extraction, and quality appraisal was performed using the Joanna Briggs Institute critical appraisal instrument for qualitative research. Data synthesis was conducted using thematic analysis. FINDINGS A total of 14 studies were included in this review. Three analytical themes emerged: (1) trudging along a narrow road, (2) driving and restraining forces in the transition, and (3) embracing the new identity. Four subthemes were graded as high confidence and the other four were moderate confidence. Establishing a new role was a priority and a significant challenge for advanced practice nurses. Beliefs regarding advanced practice, the attitudes of colleagues, and the support of mentors impacted the transition process. Advanced practice nurses expressed appreciation for their new role and developed new ambitions at the end of the transition. CONCLUSIONS Advanced practice nurses face a series of challenges during the process of role development, especially struggles with vague feelings and a lack of confidence in practice. These difficulties could be exacerbated without the support of team and organisational managers. The implementation of mentorship and the mediation of interprofessional conflicts are necessary to facilitate successful role transitions.
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Affiliation(s)
- Yijing Li
- Evidence-based Nursing Center, West China Hospital, Sichuan University/West China School of Nursing, Sichuan University, Chengdu, China
| | - Cong Wang
- Evidence-based Nursing Center, West China Hospital, Sichuan University/West China School of Nursing, Sichuan University, Chengdu, China
| | - Wei Tan
- Evidence-based Nursing Center, West China Hospital, Sichuan University/West China School of Nursing, Sichuan University, Chengdu, China
| | - Yan Jiang
- Department of Nursing, West China Hospital, Sichuan University/West China School of Nursing, Sichuan University, Chengdu, Sichuan, China.
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Ilic A, Sievers Y, Roser K, Scheinemann K, Michel G. The information needs of relatives of childhood cancer patients and survivors: A systematic review of qualitative evidence. Patient Educ Couns 2023; 114:107840. [PMID: 37321115 DOI: 10.1016/j.pec.2023.107840] [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: 12/05/2022] [Revised: 05/25/2023] [Accepted: 06/05/2023] [Indexed: 06/17/2023]
Abstract
OBJECTIVES To synthesize qualitative research on the information needs of relatives of childhood cancer patients and survivors. METHODS Systematic searches of PubMed, PsycINFO, CINAHL, and Scopus identified relevant literature. Extracted data were combined using thematic synthesis. Methodological quality was assessed using the JBI critical appraisal tool for qualitative research. RESULTS The review included 27 publications, with most research focusing on parents or primary caregivers. Five areas of information needs were identified: treatment, medication, and care; general information about cancer; coping and support; follow-up, late effects, and rehabilitation; and parenting and everyday life. Appropriateness of information depended on health care professionals' aptitude, message characteristics, communication setting, and relatives' personal factors. Preferences for form, sources, and timing for information provision varied. CONCLUSION The review identified information needs, communication barriers, and preferences among caregivers and siblings of childhood cancer patients and survivors, highlighting areas requiring further research and clinical consideration in addressing the identified challenges. PRACTICE IMPLICATIONS Caregivers and siblings have unique but similar information needs regarding childhood cancer. To ensure that these needs are met, health care professionals could use eHealth and mHealth technologies, assess each family member's knowledge, and create a safe and supportive environment for questions and feedback.
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Affiliation(s)
- Anica Ilic
- Faculty of Health Sciences and Medicine, University of Lucerne, Lucerne, Switzerland; Department of Pediatrics, Emory University School of Medicine, Atlanta, GA, USA; Aflac Cancer & Blood Disorders Center, Children's Healthcare of Atlanta, Atlanta, GA, USA
| | - Yara Sievers
- Faculty of Health Sciences and Medicine, University of Lucerne, Lucerne, Switzerland
| | - Katharina Roser
- Faculty of Health Sciences and Medicine, University of Lucerne, Lucerne, Switzerland
| | - Katrin Scheinemann
- Faculty of Health Sciences and Medicine, University of Lucerne, Lucerne, Switzerland; Center for Pediatric Hematology/Oncology, East Swiss Children's Hospital, St. Gallen, Switzerland; Department of Pediatrics, McMaster Children's Hospital and McMaster University, Hamilton, Canada
| | - Gisela Michel
- Faculty of Health Sciences and Medicine, University of Lucerne, Lucerne, Switzerland.
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Moore L, Larkin F, Foley S. Mental Health Professionals' Experiences of Adapting Mental Health Interventions for Autistic Adults: A Systematic Review and Thematic Synthesis. J Autism Dev Disord 2023:10.1007/s10803-023-06006-6. [PMID: 37179522 DOI: 10.1007/s10803-023-06006-6] [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] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/23/2023] [Indexed: 05/15/2023]
Abstract
Autistic adults experience high rates of metal health difficulties and face significant barriers to accessing appropriate mental health care. Empirical research and recent professional guidelines emphasise the importance of modifying standard mental health interventions to best meet the needs of autistic adults. This systematic review explored mental health professionals' experiences of adapting mental health interventions for autistic adults. A systematic search was conducted on CINAHL, PsychINFO, PubMed, Scopus, and Web of Science in July 2022. The findings from 13 identified studies were synthesised using thematic synthesis. Three major analytical themes were generated, the unique experience of adapting interventions for autistic clients, factors which facilitate successful adaptations, and challenges to adapting interventions. Each theme contained a number of subsequent sub-themes. Professionals view the process of adapting interventions to be a highly individualised process. A range of personal traits, professional experiences, and systemic, service-based issues were identified in facilitating or challenging this individualised process. Further research regarding adaptations with different intervention models and increased supportive resources are required to enable professionals to successfully adapt interventions for autistic adult clients.
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Affiliation(s)
- Laura Moore
- School of Applied Psychology, University College Cork, Cork, Ireland.
| | - Fionnuala Larkin
- School of Applied Psychology, University College Cork, Cork, Ireland
| | - Sarah Foley
- School of Applied Psychology, University College Cork, Cork, Ireland
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Wimhurst JJ, Nsude CC, Greene JS. Standardizing the factors used in wind farm site suitability models: A review. Heliyon 2023; 9:e15903. [PMID: 37168883 PMCID: PMC10165411 DOI: 10.1016/j.heliyon.2023.e15903] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2023] [Revised: 04/24/2023] [Accepted: 04/26/2023] [Indexed: 05/13/2023] Open
Abstract
As global wind energy capacity continues to expand, the need to site commercial wind farms in productive, affordable, and technically feasible locations has become increasingly important. The use of wind farm site suitability models to identify these locations has grown consequently, thus increasing interest in standardizing certain aspects of these models' development. This systematic review of wind farm site suitability studies seeks to identify similarities and differences in the selection and representation of their enlisted siting factors. The review focuses on how subjective modeling decisions, such as vocabulary choices and dataset selection, occur in the literature, based on five identified themes: 1) Deciding Upon Siting Factors, which explains how a study's geographical context, selected modeling approach, and modeler decisions can influence siting factor selection; 2) Classifying Data and Siting Factor Terminology, which addresses the extent and the advantages of consistent siting factor vocabulary; 3) Implementing Siting Factors as Constraints or as Evaluation Criteria, which covers the importance of consistent implementation and of specifying logic when enlisting siting factors to assess potential wind farm sites; 4) Utilizing Primary and Secondary Data, which details how a study's reliance on external or self-collected datasets influences siting factor representation; and 5) Data Source and Accessibility, which highlights the inconsistent provision of citations and dataset sources, and the availability of datasets for siting factors to the broader scientific community. Standardizing the selection and representation of siting factors would benefit comparisons between wind farm site suitability studies and communication of model outputs to a wider audience.
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Pratte MM, Audette-Chapdelaine S, Auger AM, Wilhelmy C, Brodeur M. Researchers' experiences with patient engagement in health research: a scoping review and thematic synthesis. Res Involv Engagem 2023; 9:22. [PMID: 37038164 PMCID: PMC10088213 DOI: 10.1186/s40900-023-00431-8] [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] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/04/2022] [Accepted: 04/01/2023] [Indexed: 06/19/2023]
Abstract
CONTEXT Implicating patients in research is gaining popularity around the world and is now the reference of many funding agencies. Understanding these partnerships is necessary to grasp this new reality. The experiences of researchers who have involved patient-partners (PPs) in health research are important for a better understanding of these practices. OBJECTIVE This study aimed to identify and analyze the existing qualitative scientific literature on the experiences of academic researchers involved in health research with patient engagement (PE). DESIGN A scoping review of the available literature with an inductive thematic synthesis, guided by the methodological framework of Arksey and O'Malley. DATA COLLECTION A search strategy was developed to include keywords relating to researchers, patient-partners, experiences, and the qualitative methodologies of the targeted studies. Five databases were searched using the EBSCO-host engine. The search results were screened by four reviewers to only include articles written in English on the topic of the experience of academic researchers having worked with PPs in health research based on qualitative studies or mixed-methods studies with a distinct qualitative section. ANALYSIS Articles included were charted for general information. All "results" sections were coded line by line. These codes were organized inductively to form descriptive and analytical themes. This led to the synthesis of the ideas found in the selected articles. RESULTS The search strategy yielded 7616 results, of which 2468 duplicates were removed. The remaining 5148 articles were screened, resulting in the exclusion of 5114 off-topic studies. The remaining 29 full-text articles were evaluated for inclusion from which 5 additional studies were identified. The final selection consisted of 11 articles that met all the criteria. These articles were published between 2009 and 2019. Five general themes inductively emerged from the analysis: the understanding of PE, motivations, contexts, attitudes, and practical aspects of PE that are central to researchers. CONCLUSION This scoping review provides a better understanding of the experiences of researchers who have implemented patient partnerships in health research projects. Our findings reveal many positive elements central to health researchers' discourses about PE, but they provide insights into the challenges and postures of resistance. This knowledge can support the development of empirically sound improvements in PE practices.
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Affiliation(s)
- Marie-Mychèle Pratte
- Faculté de médecine et des sciences de la santé, Université de Sherbrooke, Sherbrooke, QC, Canada
| | - Sophie Audette-Chapdelaine
- Faculté de médecine et des sciences de la santé, Université de Sherbrooke, Sherbrooke, QC, Canada
- Département de médecine familiale et de médecine d'urgence, Université de Sherbrooke, Sherbrooke, QC, Canada
| | - Anne-Marie Auger
- Faculté de médecine et des sciences de la santé, Université de Sherbrooke, Sherbrooke, QC, Canada
- Département de médecine familiale et de médecine d'urgence, Université de Sherbrooke, Sherbrooke, QC, Canada
| | - Catherine Wilhelmy
- Comité stratégique patient-partenaire, Centre de Recherche du CHUS, Université de Sherbrooke, Sherbrooke, QC, Canada
| | - Magaly Brodeur
- Faculté de médecine et des sciences de la santé, Université de Sherbrooke, Sherbrooke, QC, Canada.
- Département de médecine familiale et de médecine d'urgence, Université de Sherbrooke, Sherbrooke, QC, Canada.
- Centre de recherche du CHUS, Université de Sherbrooke, Sherbrooke, QC, Canada.
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Crépault JF, Russell C, Watson TM, Strike C, Bonato S, Rehm J. What is a public health approach to substance use? A qualitative systematic review and thematic synthesis. Int J Drug Policy 2023; 112:103958. [PMID: 36689841 DOI: 10.1016/j.drugpo.2023.103958] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [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: 10/13/2022] [Revised: 01/04/2023] [Accepted: 01/11/2023] [Indexed: 01/22/2023]
Abstract
BACKGROUND Psychoactive substance use and the regulations that govern it both have the potential to lead to harm. A 'public health approach' (PHA) is frequently invoked as a means of addressing these harms, but the term is used in inconsistent and contradictory ways. This study systematically reviewed the English-language academic literature to understand how a public health approach to substance use is defined and described. METHODS This review employed thematic synthesis, a methodology designed to rigorously synthesize qualitative evidence. Eligible articles were published in peer-reviewed journals, in the English language, with full text available, and focused primarily on substance use. There were no limits on year of publication. Original research, opinion/commentary, and reviews were included. The searches were conducted in October 2021 in CINAHL, Embase, Medline, PAIS Index, PsycINFO, Scopus, Sociological Abstracts, and Web of Science. RESULTS 272 articles from 25 countries, published between 1950 and 2021, were synthesized. Definitions of a PHA have changed over time and differ by substance. The most commonly cited characteristics of a PHA were: for alcohol, regulation, e.g. of price and availability (54% of articles); for cannabis: regulation (68%); for illicit drugs: that a PHA is distinct from a criminal justice approach (63%); for opioids: substance use disorder treatment (55%); and for tobacco: regulation (62%). CONCLUSION There is no consensus on the definition of a public health approach to substance use, but there is substantial agreement when it comes to PHAs to specific substances. There are also similarities in how they are described for legal substances versus illicit ones. This review found areas of disagreement regarding the extent to which PHAs should focus on individual-level factors. Policymakers, academics, and others developing or implementing PHAs to substance use should be explicit about their aims and objectives - as well as the premises and assumptions underlying them.
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Affiliation(s)
- Jean-François Crépault
- Centre for Addiction and Mental Health (CAMH), 1001 Queen Street, Toronto, Ontario, M6J 1H4, Canada; Dalla Lana School of Public Health, University of Toronto, 6th Floor, 155 College Street, Toronto, Ontario, M5T 3M7, Canada.
| | - Cayley Russell
- Centre for Addiction and Mental Health (CAMH), 1001 Queen Street, Toronto, Ontario, M6J 1H4, Canada; Institute of Medical Science, University of Toronto, 1 King's College Circle, Toronto, Ontario, M5S 1A8, Canada
| | - Tara Marie Watson
- Centre for Addiction and Mental Health (CAMH), 1001 Queen Street, Toronto, Ontario, M6J 1H4, Canada
| | - Carol Strike
- Dalla Lana School of Public Health, University of Toronto, 6th Floor, 155 College Street, Toronto, Ontario, M5T 3M7, Canada
| | - Sarah Bonato
- Centre for Addiction and Mental Health (CAMH), 1001 Queen Street, Toronto, Ontario, M6J 1H4, Canada
| | - Jürgen Rehm
- Centre for Addiction and Mental Health (CAMH), 1001 Queen Street, Toronto, Ontario, M6J 1H4, Canada; Dalla Lana School of Public Health, University of Toronto, 6th Floor, 155 College Street, Toronto, Ontario, M5T 3M7, Canada; Institute of Medical Science, University of Toronto, 1 King's College Circle, Toronto, Ontario, M5S 1A8, Canada; Department of Psychiatry, University of Toronto, 8th Floor, 250 College Street, Toronto, Ontario, M5T 1R8, Canada; Institute of Clinical Psychology and Psychotherapy & Center for Clinical Epidemiology and Longitudinal Studies, Technische Universität Dresden, Chemnitzer Str. 46, D-01187 Dresden, Germany; Center for Interdisciplinary Addiction Research (ZIS), Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf (UKE), Martinistraße 52, 20246 Hamburg, Germany
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Ivanova D, Bishop FL, Newell D, Field J, Walsh M. Mixed methods systematic review of the literature base exploring working alliance in the chiropractic profession. Chiropr Man Therap 2022; 30:35. [PMID: 36056368 PMCID: PMC9438171 DOI: 10.1186/s12998-022-00442-4] [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] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2022] [Accepted: 07/06/2022] [Indexed: 11/10/2022] Open
Abstract
Background The construct of working alliance has been used to operationalise the patient–clinician relationship. Research evidence from the rehabilitation literature has established an association between the construct and several patient outcomes. The aim of this systematic literature review was to study working alliance in the chiropractic discipline. Method This review followed a mixed method systematic review methodology: EBSCO (The Allied and Complementary Medicine Database), EBSCO (MEDLINE), EBSCO PsycINFO, Web of Science Core Collection, Chiro index, and grey literature were searched for quantitative, qualitative, and mixed methods studies on 17th March 2021. Qualitative appraisal was conducted using the Mixed Methods Appraisal Tool, version 2018. The qualitative component was synthesised via thematic synthesis and explored patients’ and chiropractors’ perceptions of the nature and role of working alliance. The quantitative component was synthesised via narrative synthesis to examine how the construct has been measured in research and what its effect on clinical outcomes and patient satisfaction is. The findings were integrated in the discussion section. Results Thirty studies were included. The qualitative component found that both patients and chiropractors consider working alliance as a key factor in the treatment journey. The findings illustrated that the construct includes the bond between a patient and a chiropractor which is underpinned by trust and attentiveness to patients’ needs, values and preferences. Qualitative data also suggested that strong working alliance has the potential to improve patients’ adherence to treatment and that it is characterised by ongoing negotiation of expectations about the goals of care and the tasks involved in the treatment plan. The quantitative component highlighted that even though working alliance is relevant to the chiropractic discipline, very few studies have quantitatively measured the construct and its effect. Conclusion The findings of this review emphasise the subjective importance of working alliance in the chiropractic clinical encounter. However, there were not enough homogenous studies measuring the effect of working alliance on clinical outcomes and patient satisfaction to conduct a meta-analysis. Future research should focus on evaluating potential direct and mediated effects on patient outcomes. Supplementary Information The online version contains supplementary material available at 10.1186/s12998-022-00442-4.
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Affiliation(s)
- Dima Ivanova
- University of Southampton, University Road, Southampton, SO17 1BJ, Hampshire, UK.
| | - Felicity L Bishop
- University of Southampton, University Road, Southampton, SO17 1BJ, Hampshire, UK
| | - Dave Newell
- University of Southampton, University Road, Southampton, SO17 1BJ, Hampshire, UK.,Anglo European College of Chiropractic University College, Parkwood Campus, Parkwood Road, Bournemouth, BH5 2DF, Dorset, UK
| | - Jonathan Field
- University of Southampton, University Road, Southampton, SO17 1BJ, Hampshire, UK
| | - Madeleine Walsh
- University of Southampton, University Road, Southampton, SO17 1BJ, Hampshire, UK
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17
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Smith V, O'Malley D, Cithambaram K. Early warning systems in maternity care: A qualitative evidence synthesis of maternity care providers' views and experiences. Midwifery 2022; 112:103402. [PMID: 35724435 DOI: 10.1016/j.midw.2022.103402] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [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: 11/08/2021] [Revised: 06/05/2022] [Accepted: 06/07/2022] [Indexed: 11/19/2022]
Abstract
OBJECTIVE To gain insight and understanding, from the perspective of maternity care providers, on the use and application of maternity early warning systems (MEWS) in clinical practice. DESIGN A qualitative evidence synthesis was conducted. MEDLINE, CINHAL, Web of Science Core Collection and Maternity and Infant Care (MIDIRS), from inception to March 2021, were searched for eligible studies. Grey literature sources were also searched for unpublished studies. The methodological quality of included studies was assessed by at least two reviewers using an Evidence for Policy and Practice Information and Co-ordinating (EPPI) Centre quality assessment tool. Thomas and Harden's thematic synthesis approach was used to guide the data synthesis. Confidence in the findings was assessed using the Grading of Recommendations Assessment, Development and Evaluation of Confidence in the Evidence from Reviews of Qualitative research (GRADE-CERQual). SETTING AND PARTICIPANTS Included studies reported on maternity care providers involved in caring for pregnant or postpartum women in any birth setting. Studies were mostly qualitative in design, although survey designs with open-ended questions that provided qualitative data were eligible for inclusion if the qualitative data had been subjected to formal analyses. FINDINGS Eight eligible studies, reported across nine records, were identified in the search and included in the review. Three themes representative of maternity care providers' views and experiences of MEWS were generated from the synthesis. These were 'Aid to clinical care provision', 'Impact on workload' and 'Factors affecting MEWS implementation'. MEWS was viewed as a useful tool in guiding clinical care, and for identifying deterioration and the need to escalate care. Some maternity care providers viewed MEWS as beneficial in easing workload burden. Others, however, viewed MEWS as adding to workload because of repetition and duplication. Training in MEWS was considered inadequate and concern existed for some care providers that MEWS would lead to deskilling or eroding of professional judgement. KEY CONCLUSIONS AND IMPLICATIONS FOR PRACTICE Maternity care providers hold diverse views on the use of MEWS in clinical practice. While almost all consider MEWS a helpful aid for guiding clinical care, barriers to implementation were identified. These included added workload burden, inadequate training, and concern for deskilling. Attending to implementation barriers will help optimise use of MEWS in clinical practice as currently recommended.
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Affiliation(s)
- Valerie Smith
- School of Nursing and Midwifery, University of Dublin Trinity College, 24 D'Olier Street, Dublin, Ireland.
| | - Deirdre O'Malley
- Department of Nursing, Midwifery and Early Years, School of Health and Science, Dundalk Institute of Technology, Ireland
| | - Kumaresan Cithambaram
- School of Nursing, Psychotherapy and Community Health, Dublin City University, Dublin, Ireland
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Mughal F, Troya MI, Dikomitis L, Tierney S, Corp N, Evans N, Townsend E, Chew-Graham CA. The experiences and needs of supporting individuals of young people who self-harm: A systematic review and thematic synthesis. EClinicalMedicine 2022; 48:101437. [PMID: 35783485 PMCID: PMC9249546 DOI: 10.1016/j.eclinm.2022.101437] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/25/2021] [Revised: 04/12/2022] [Accepted: 04/14/2022] [Indexed: 11/30/2022] Open
Abstract
UNLABELLED Self-harm in young people is a serious international health concern that impacts on those providing informal support: the supporting individuals of young people. We aimed to highlight the experiences, views, and needs of these supporting individuals of young people. We conducted a systematic review and thematic synthesis: PROSPERO CRD42020168527. MEDLINE, PsycINFO, EMBASE, AMED, CINAHL, ASSIA, and Web of Science were searched from inception to 6 May 2020 with citation tracking of eligible studies done on 1 Oct 2021. Primary outcomes were experiences, perspectives, and needs of parents, carers, or other family members of young people aged 12-25. Searches found 6167 citations, of which 22 papers were included in synthesis. Supporting individuals seek an explanation for and were personally affected by self-harm in young people. It is important that these individuals are themselves supported, especially as they negotiate new identities when handling self-harm in young people, as they attempt to offer support. The GRADE-CERQual confidence in findings is moderate. Recommendations informed by the synthesis findings are made for the future development of interventions. Clinicians and health service providers who manage self-harm in young people should incorporate these identified unmet needs of supporting individuals in a holistic approach to self-harm care. Future research must co-produce and evaluate interventions for supporting individuals. FUNDING FM was supported by a NIHR School for Primary Care Research GP Career Progression Fellowship (SCPR-157 2020-20) to undertake this review and is now funded by a NIHR Doctoral Fellowship (NIHR300957). CCG is part-funded by the NIHR Applied Research Collaboration West Midlands.
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Affiliation(s)
- Faraz Mughal
- School of Medicine, Keele University, Keele ST5 5BG, United Kingdom
- Corresponding author.
| | | | - Lisa Dikomitis
- School of Medicine, Keele University, Keele ST5 5BG, United Kingdom
| | - Stephanie Tierney
- Nuffield Department of Primary Care Health Sciences, University of Oxford, United Kingdom
| | - Nadia Corp
- School of Medicine, Keele University, Keele ST5 5BG, United Kingdom
| | - Nicola Evans
- School of Medicine, Keele University, Keele ST5 5BG, United Kingdom
| | - Ellen Townsend
- School of Psychology, University of Nottingham, United Kingdom
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Ikhtabi S, Pitman A, Toh G, Birken M, Pearce E, Johnson S. The experience of loneliness among people with a "personality disorder" diagnosis or traits: a qualitative meta-synthesis. BMC Psychiatry 2022; 22:130. [PMID: 35177022 PMCID: PMC8855579 DOI: 10.1186/s12888-022-03767-9] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/15/2021] [Accepted: 02/08/2022] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Loneliness is prevalent among people with a "personality disorder" diagnosis or who have related personality traits, but the experience of loneliness among people with "personality disorder" diagnoses/traits has not been well described. A qualitative approach has potential to help understand the experience of loneliness among people with "personality disorder" diagnoses/traits, and to develop interventions that promote recovery. We therefore aimed to synthesise the qualitative literature relevant to this topic. METHOD We conducted a meta-synthesis of qualitative studies exploring the subjective experience of loneliness as reported by people with "personality disorder" diagnoses/traits. We searched four databases using pre-formulated search terms, selected eligible articles, appraised the quality of each, and analyzed data from eligible studies using thematic synthesis. RESULT We identified 39 articles that described the experience of loneliness in people with "personality disorder" diagnoses/traits. From extracted data, we identified seven themes: (1) disconnection and emptiness: a "haunting alienation", (2) alienation arising from childhood experiences, (3) thwarted desire for closeness and connection, (4) paradox: for both closeness and distance, (5) experiences of existential loneliness, (6) recovery, embedded in a social world, and (7) group therapy: a setback. Our results suggest that for our sample early alienating and traumatic experiences may pave the way for experiences of loneliness, which further exacerbate "personality disorder" symptoms and distress. CONCLUSION Despite describing a need to belong and efforts to cope with unmet social needs, people with "personality disorder" diagnoses/traits (particularly "emotionally unstable personality disorder") report experiencing an intense disconnection from other people. This seems rooted in early adversities, reinforced by later traumatic experiences. Given the apparent salience of loneliness to people with "personality disorder" diagnoses/traits, interventions focused on helping people connect with others, which may include both psychological and social components, have potential to be beneficial in reducing loneliness and promoting recovery.
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Affiliation(s)
| | - Alexandra Pitman
- grid.83440.3b0000000121901201UCL Division of Psychiatry, London, UK ,grid.450564.60000 0000 8609 9937Camden and Islington NHS Foundation Trust, London, UK
| | - Gigi Toh
- grid.83440.3b0000000121901201UCL Division of Psychiatry, London, UK
| | - Mary Birken
- grid.83440.3b0000000121901201UCL Division of Psychiatry, London, UK
| | - Eiluned Pearce
- grid.83440.3b0000000121901201UCL Division of Psychiatry, London, UK
| | - Sonia Johnson
- grid.83440.3b0000000121901201UCL Division of Psychiatry, London, UK ,grid.450564.60000 0000 8609 9937Camden and Islington NHS Foundation Trust, London, UK
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Abstract
Self-concept or sense of self is often altered in the context of neurological illness. Yet, these core aspects of subjective experience are poorly understood for people with multiple sclerosis (MS). This systematic review aimed to synthesize the findings of quantitative and qualitative studies investigating self-concept in MS. PsycINFO, MEDLINE (PubMed), CINAHL, Scopus, and Web of Science were last systematically searched in May 2021, with the Mixed Methods Appraisal Tool and Consolidated Criteria for Reporting Qualiatative Research used to appraise the quality of the eligible articles. Articles were included if they measured or explored self-concept in MS populations, were published in English and peer-reviewed. A total of 30 studies (11 quantitative, 19 qualitative) were identified. Quantitative studies were synthesized using a narrative approach, with results suggesting that MS is associated with some degree of self-concept change. Qualitative studies were synthesized using thematic synthesis, with results illustrating a complex process of self-concept change that is catalyzed by MS-related events and characterized by varying degrees of resistance to, or acknowledgement of, such changes. Future prospective longitudinal studies are needed to characterize the nature of self-concept change in MS using validated tools that measure relevant aspects of self-concept for the MS population.
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Affiliation(s)
- Holly Emery
- School of Psychological Sciences, University of Tasmania, Launceston, Australia
| | - Christine Padgett
- School of Psychological Sciences, University of Tasmania, Hobart, Australia
| | - Tamara Ownsworth
- School of Applied Psychology, Griffith University, Mount Gravatt, Australia
| | - Cynthia A Honan
- School of Psychological Sciences, University of Tasmania, Launceston, Australia
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21
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Daly-Smith A, Morris JL, Norris E, Williams TL, Archbold V, Kallio J, Tammelin TH, Singh A, Mota J, von Seelen J, Pesce C, Salmon J, McKay H, Bartholomew J, Resaland GK. Behaviours that prompt primary school teachers to adopt and implement physically active learning: a meta synthesis of qualitative evidence. Int J Behav Nutr Phys Act 2021; 18:151. [PMID: 34801039 PMCID: PMC8605507 DOI: 10.1186/s12966-021-01221-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2021] [Accepted: 10/27/2021] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND Physically active learning (PAL) - integration of movement within delivery of academic content - is a core component of many whole-of-school physical activity approaches. Yet, PAL intervention methods and strategies vary and frequently are not sustained beyond formal programmes. To improve PAL training, a more comprehensive understanding of the behavioural and psychological processes that influence teachers' adoption and implementation of PAL is required. To address this, we conducted a meta-synthesis to synthesise key stakeholders' knowledge of facilitators and barriers to teachers' implementing PAL in schools to improve teacher-focussed PAL interventions in primary (elementary) schools. METHODOLOGY We conducted a meta-synthesis using a five-stage thematic synthesis approach to; develop a research purpose and aim, identify relevant articles, appraise studies for quality, develop descriptive themes and interpret and synthesise the literature. In the final stage, 14 domains from the Theoretical Domain Framework (TDF) were then aligned to the final analytical themes and subthemes. RESULTS We identified seven themes and 31 sub-themes from 25 eligible papers. Four themes summarised teacher-level factors: PAL benefits, teachers' beliefs about own capabilities, PAL teacher training, PAL delivery. One theme encompassed teacher and school-level factors: resources. Two themes reflected school and external factors that influence teachers' PAL behaviour: whole-school approach, external factors. Ten (of 14) TDF domains aligned with main themes and sub-themes: Knowledge, Skills, Social/Professional Role and Identity, Beliefs about Capabilities, Beliefs about Consequences, Reinforcement, Goals, Environmental Context and Resources, Social influences and Emotion. CONCLUSIONS Our synthesis illustrates the inherent complexity required to change and sustain teachers' PAL behaviours. Initially, teachers must receive the training, resources and support to develop the capability to implement and adapt PAL. The PAL training programme should progress as teachers' build their experience and capability; content should be 'refreshed' and become more challenging over time. Subsequently, it is imperative to engage all levels of the school community for PAL to be fully integrated into a broader school system. Adequate resources, strong leadership and governance, an engaged activated community and political will are necessary to achieve this, and may not currently exist in most schools.
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Affiliation(s)
- Andrew Daly-Smith
- Center for Physically Active Learning, Faculty of Education, Arts and Sports, Western Norway University of Applied Sciences, Sogndal, Norway.
- Faculty of Health Studies, University of Bradford, Bradford, UK.
- Centre for Applied Education Research, Wolfson Centre for Applied Health Research, Bradford Royal Infirmary, Bradford, UK.
| | - Jade L Morris
- Centre for Society & Mental Health, Department of Health Services & Population Health, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - Emma Norris
- Health Behaviour Change Research Group, Brunel University London, London, UK
| | - Toni L Williams
- School of Sport, Carnegie, Leeds Beckett University, Leeds, UK
- Department of Sport and Exercise Sciences, Durham University, Durham, UK
| | | | - Jouni Kallio
- LIKES Research Centre for Physical Activity and Health, Jyväskylä, Finland
| | - Tuija H Tammelin
- LIKES Research Centre for Physical Activity and Health, Jyväskylä, Finland
| | - Amika Singh
- Center for Physically Active Learning, Faculty of Education, Arts and Sports, Western Norway University of Applied Sciences, Sogndal, Norway
- Mulier Instituut, Utrecht, The Netherlands
| | - Jorge Mota
- Research Center in Physical Activity, Health and Leisure, Faculty of Sport, University of Porto and Laboratory for Integrative and Translational Research in Population Health (ITR), Porto, Portugal
| | - Jesper von Seelen
- Department for Research and Development, University College South Denmark, Haderslev, Denmark
| | - Caterina Pesce
- Department of Movement, Human and Health Sciences, University of Rome "Foro Italico", Rome, Italy
| | - Jo Salmon
- Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Geelong, Australia
| | - Heather McKay
- Centre for Hip Health and Mobility, Vancouver Coastal Health Research Centre, Vancouver, Canada
- Department of Family Practice, University of British Columbia, Vancouver, Canada
| | - John Bartholomew
- Department of Kinesiology and Health Education, The University of Texas at Austin, Austin, USA
| | - Geir Kare Resaland
- Center for Physically Active Learning, Faculty of Education, Arts and Sports, Western Norway University of Applied Sciences, Sogndal, Norway
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22
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Levelink M, Brütt AL. Factors influencing health-related quality of life of patients with a left ventricular assist device: a systematic review and thematic synthesis. Eur J Cardiovasc Nurs 2021; 20:803-815. [PMID: 34263313 DOI: 10.1093/eurjcn/zvab056] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/09/2020] [Revised: 02/04/2021] [Accepted: 06/07/2021] [Indexed: 11/14/2022]
Abstract
AIMS Left ventricular assist devices (LVADs) are increasingly being used in the treatment of advanced heart failure. Left ventricular assist device patients frequently report improvements in health-related quality of life (HRQOL) post-implantation. However, HRQOL varies over time and between patients, which can be explained by patient-related and environmental factors, as individual studies suggest. This review aims to synthesize qualitative evidence on factors influencing HRQOL of LVAD patients. METHODS AND RESULTS We systematically searched the databases PubMed, Scopus, PsycINFO, and CINAHL for qualitative studies on factors influencing HRQOL of patients with continuous flow LVADs. The included papers were synthesized using a thematic synthesis. The results were validated in discussion with a patient and practical implications were jointly developed. We included 11 papers and developed 7 themes that represent influencing factors for HRQOL of LVAD patients: disease experiences, emotional reactivity, heart failure and mechanical circulatory support symptoms, medical care, self-care, self-concept, and social environment. CONCLUSION The identified themes highlight influencing factors on HRQOL. These help to explain variation in patient outcomes and to better consider the individual situation in rehabilitation. Based on the results, four strategies are proposed for promoting psychosocial outcomes: facilitate self-care, ensure social support, offer psychosocial support, and manage patient expectations.
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Affiliation(s)
- Michael Levelink
- Department of Health Services Research, Carl von Ossietzky Universität Oldenburg, School of Medicine and Health Sciences, Ammerländer Heerstr. 114-118, Oldenburg 26129, Germany
| | - Anna Levke Brütt
- Department of Health Services Research, Carl von Ossietzky Universität Oldenburg, School of Medicine and Health Sciences, Ammerländer Heerstr. 114-118, Oldenburg 26129, Germany
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23
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Leggett H, Scantlebury A, Byrne A, Harden M, Hewitt C, O'Carroll G, Sharma H, McDaid C. Exploring what is important to patients with regards to quality of life after experiencing a lower limb reconstructive procedure: a qualitative evidence synthesis. Health Qual Life Outcomes 2021; 19:158. [PMID: 34059081 PMCID: PMC8166062 DOI: 10.1186/s12955-021-01795-9] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2021] [Accepted: 05/24/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Patient reported outcome measures (PROMs) are used to understand the impact of lower limb reconstruction surgery on patients' quality of life (QOL). Existing measures have not been developed to specifically capture patient experiences amongst adults with lower limb conditions that require reconstruction surgery. This review aimed to synthesise qualitative evidence to identify what is important to patients requiring, undergoing, or following reconstructive surgery for lower limb conditions. METHODS MEDLINE, Embase, PsychINFO and Cinahl were searched from inception until November 2020. Studies were included if they employed qualitative research methods, involved patients requiring, undergoing or following lower limb reconstruction and explored patients' experiences of care, treatment, recovery and QOL. Mixed methods studies that did not separately report qualitative findings, mixed population studies that were not separately reported and studies in languages other than English were excluded. Included studies were analysed using thematic synthesis. The Critical Appraisal Skills Programme qualitative studies checklist was used to undertake quality assessment. RESULTS Nine studies met the inclusion criteria. The thematic synthesis identified two overarching themes: (1) areas of living key to QOL for lower limb reconstruction patients and (2) moving towards a new normal. The way in which lower limb reconstruction affects an individual's QOL and their recovery is complex and is influenced by a range of inter-related factors, which will affect patients to varying degrees depending on their individual circumstances. We identified these factors as: pain, daily functioning and lifestyle, identity, income, emotional wellbeing, support, the ability to adapt and adjust and the ability to move forwards. CONCLUSIONS The way patients' QOL is affected after a lower limb reconstruction is complex, may change over time and is strongly linked to their recovery. These findings will aid us in developing a conceptual framework which identifies the outcomes important to patients and those that should be included in a PROM. Further research is then required to establish whether the range of factors we identified are captured by existing PROMs. Depending on the outcome of this work, a new PROM for patients following lower limb reconstruction may be required.
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Affiliation(s)
- H Leggett
- York Trials Unit, The University of York, York, YO10 5DD, UK.
| | - A Scantlebury
- York Trials Unit, The University of York, York, YO10 5DD, UK
| | - A Byrne
- York Trials Unit, The University of York, York, YO10 5DD, UK
| | - M Harden
- Centre for Reviews and Dissemination, The University of York, York, YO10 5DD, UK
| | - C Hewitt
- York Trials Unit, The University of York, York, YO10 5DD, UK
| | - G O'Carroll
- York Trials Unit, The University of York, York, YO10 5DD, UK
| | - H Sharma
- Hull University Teaching Hospitals, Hull, HU3 2JZ, UK
| | - C McDaid
- York Trials Unit, The University of York, York, YO10 5DD, UK
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24
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Newington L, Wells M, Adonis A, Bolton L, Bolton Saghdaoui L, Coffey M, Crow J, Fadeeva Costa O, Hughes C, Savage M, Shahabi L, Alexander CM. A qualitative systematic review and thematic synthesis exploring the impacts of clinical academic activity by healthcare professionals outside medicine. BMC Health Serv Res 2021; 21:400. [PMID: 33926441 PMCID: PMC8082861 DOI: 10.1186/s12913-021-06354-y] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2020] [Accepted: 03/31/2021] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND There are increasing opportunities for healthcare professionals outside medicine to be involved in and lead clinical research. However, there are few roles within these professions that include time for research. In order to develop such roles, and evaluate effective use of this time, the range of impacts of this clinical academic activity need to be valued and understood by healthcare leaders and managers. To date, these impacts have not been comprehensively explored, but are suggested to extend beyond traditional quantitative impact metrics, such as publications, citations and funding awards. METHODS Ten databases, four grey literature repositories and a naïve web search engine were systematically searched for articles reporting impacts of clinical academic activity by healthcare professionals outside medicine. Specifically, this did not include the direct impacts of the research findings, rather the impacts of the research activity. All stages of the review were performed by a minimum of two reviewers and reported impacts were categorised qualitatively according to a modified VICTOR (making Visible the ImpaCT Of Research) framework. RESULTS Of the initial 2704 identified articles, 20 were eligible for inclusion. Identified impacts were mapped to seven themes: impacts for patients; impacts for the service provision and workforce; impacts to research profile, culture and capacity; economic impacts; impacts on staff recruitment and retention; impacts to knowledge exchange; and impacts to the clinical academic. CONCLUSIONS Several overlapping sub-themes were identified across the main themes. These included the challenges and benefits of balancing clinical and academic roles, the creation and implementation of new evidence, and the development of collaborations and networks. These may be key areas for organisations to explore when looking to support and increase academic activity among healthcare professionals outside medicine. The modified VICTOR tool is a useful starting point for individuals and organisations to record the impact of their research activity. Further work is needed to explore standardised methods of capturing research impact that address the full range of impacts identified in this systematic review and are specific to the context of clinical academics outside medicine.
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Affiliation(s)
- Lisa Newington
- Imperial College Healthcare NHS Trust, Education Centre, Charing Cross Hospital, Fulham Palace Road, London, W6 8RF, UK.
- Department of Surgery and Cancer, Faculty of Medicine, Imperial College London, London, UK.
| | - Mary Wells
- Imperial College Healthcare NHS Trust, Education Centre, Charing Cross Hospital, Fulham Palace Road, London, W6 8RF, UK
- Department of Surgery and Cancer, Faculty of Medicine, Imperial College London, London, UK
| | - Adine Adonis
- Imperial College Healthcare NHS Trust, Education Centre, Charing Cross Hospital, Fulham Palace Road, London, W6 8RF, UK
| | - Lee Bolton
- Imperial College Healthcare NHS Trust, Education Centre, Charing Cross Hospital, Fulham Palace Road, London, W6 8RF, UK
- Department of Surgery and Cancer, Faculty of Medicine, Imperial College London, London, UK
| | - Layla Bolton Saghdaoui
- Imperial College Healthcare NHS Trust, Education Centre, Charing Cross Hospital, Fulham Palace Road, London, W6 8RF, UK
- Department of Surgery and Cancer, Faculty of Medicine, Imperial College London, London, UK
| | - Margaret Coffey
- Imperial College Healthcare NHS Trust, Education Centre, Charing Cross Hospital, Fulham Palace Road, London, W6 8RF, UK
- Department of Surgery and Cancer, Faculty of Medicine, Imperial College London, London, UK
| | - Jennifer Crow
- Imperial College Healthcare NHS Trust, Education Centre, Charing Cross Hospital, Fulham Palace Road, London, W6 8RF, UK
| | - Olga Fadeeva Costa
- Imperial College Healthcare NHS Trust, Education Centre, Charing Cross Hospital, Fulham Palace Road, London, W6 8RF, UK
- Department of Surgery and Cancer, Faculty of Medicine, Imperial College London, London, UK
| | - Catherine Hughes
- Imperial College Healthcare NHS Trust, Education Centre, Charing Cross Hospital, Fulham Palace Road, London, W6 8RF, UK
| | - Matthew Savage
- Imperial College Healthcare NHS Trust, Education Centre, Charing Cross Hospital, Fulham Palace Road, London, W6 8RF, UK
| | - Lillie Shahabi
- Imperial College Healthcare NHS Trust, Education Centre, Charing Cross Hospital, Fulham Palace Road, London, W6 8RF, UK
- Department of Brain Sciences, Faculty of Medicine, Imperial College London, London, UK
| | - Caroline M Alexander
- Imperial College Healthcare NHS Trust, Education Centre, Charing Cross Hospital, Fulham Palace Road, London, W6 8RF, UK
- Department of Surgery and Cancer, Faculty of Medicine, Imperial College London, London, UK
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25
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Grilo AM, Santos B, Baptista I, Monsanto F. Exploring the cancer patients' experiences during external radiotherapy: A systematic review and thematic synthesis of qualitative and quantitative evidence. Eur J Oncol Nurs 2021; 52:101965. [PMID: 34023669 DOI: 10.1016/j.ejon.2021.101965] [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: 11/22/2020] [Revised: 03/28/2021] [Accepted: 04/14/2021] [Indexed: 11/20/2022]
Abstract
PURPOSE To investigate the subjective experience of adult cancer patients undergoing external radiotherapy and provide evidence for better practices in radiotherapy services. METHODS A systematic review was performed according to the PRISMA Statement Guidelines. Qualitative and mixed studies were identified through five electronic databases (CINAHL, PsychINFO, Medline, Scopus and Web of Science), between March and April 2020, using defined criteria. Methodological quality assessment was conducted, and the data integrated into a thematic synthesis. RESULTS Of the 886 studies identified, 13 met our inclusion criteria. Patients experiences were described into four main themes: (1) Time, (2) Physical Environment, (3) Treatment Concerns and (4) Radiotherapy Team. Time refers to waiting time and treatment time; Physical Environment states temperature in the treatment room and equipment; Treatment Concerns included side effects, daily activities, positioning and immobilization and treatment preparation (e.g., bladder filling); radiotherapy team comprised patients support; response to patients needs and recognized team. The generating analytical phase of thematic analysis allowed us to recognize that the effectiveness of the radiotherapy team operates as a facilitator of the patients' experience. In contrast, time in the waiting room, the treatment preparation when is required, and the positioning and immobilization, specifically for the neck and head patients, act as barriers. CONCLUSION Four distinct themes were identified to be positively and negatively associated with patients' experience during external radiotherapy. The evidence provides valuable recommendations to improved radiotherapy services organization, as well as to the delivery of more patient-centred care adjusted to the concerns and needs of patients.
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Affiliation(s)
- Ana Monteiro Grilo
- H&TRC-Health & Technology Research Center, ESTeSL- Escola Superior de Tecnologia da Saúde, Instituto Politécnico de Lisboa, Portugal; CICPsi - Research Center for Psychological Science, Faculty of Psychology, University of Lisbon, Portugal.
| | - Bárbara Santos
- Medical Imaging and RT Degree, Escola Superior de Tecnologia da Saúde, Instituto Politécnico de Lisboa, Portugal.
| | - Inês Baptista
- Medical Imaging and RT Degree, Escola Superior de Tecnologia da Saúde, Instituto Politécnico de Lisboa, Portugal.
| | - Fátima Monsanto
- H&TRC-Health & Technology Research Center, ESTeSL- Escola Superior de Tecnologia da Saúde, Instituto Politécnico de Lisboa, Portugal.
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26
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Kerrison RS, Sheik-Mohamud D, McBride E, Whitaker KL, Rees C, Duffy S, von Wagner C. Patient barriers and facilitators of colonoscopy use: A rapid systematic review and thematic synthesis of the qualitative literature. Prev Med 2021; 145:106413. [PMID: 33412167 DOI: 10.1016/j.ypmed.2020.106413] [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] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/07/2020] [Revised: 12/03/2020] [Accepted: 12/30/2020] [Indexed: 12/16/2022]
Abstract
Colonoscopy is the gold standard test in the diagnosis of colorectal cancer. Despite this, many people across the world decline the procedure when invited for screening, surveillance or diagnostic evaluation. The aim of this review was to characterise the barriers and facilitators of colonoscopy use described in the qualitative literature. We searched PubMed and PsychInfo for studies that explored barriers and facilitators of colonoscopy use. To determine the eligibility of studies, we first reviewed titles, then abstracts, and finally the full paper. We started with a narrow search, which we expanded successively, until the number of new publications eligible after abstract review was <1% of the total number of publications identified. Papers were eligible if they: 1) focussed on an adult population, 2) used a qualitative research design and, 3) described at least one patient-related theme regarding colonoscopy use. We then extracted qualitative data from eligible papers and analysed using thematic synthesis. Fifty-seven studies met the inclusion criteria. Most explored barriers and facilitators of screening colonoscopy (n=53, 93.0%) and were conducted in the USA (n=48, 84.2%). Key psychological and social factors included: 'fear of pain and discomfort', 'concerns about doing the bowel preparation', and whether the test was recommended by the patient's physician. Key practical factors included cost, and whether colonoscopy was covered by the patient's healthcare insurance. Studies mostly focussed on screening colonoscopy in the USA, where there is no universal healthcare coverage. To better understand the barriers and facilitators in other contexts, further research is needed.
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Affiliation(s)
- Robert S Kerrison
- Department of Behavioural Science and Health, University College London, London, UK.
| | - Dahir Sheik-Mohamud
- Department of Behavioural Science and Health, University College London, London, UK
| | - Emily McBride
- Department of Behavioural Science and Health, University College London, London, UK
| | | | - Colin Rees
- Population Health Sciences Institute, Newcastle University Centre for Cancer, Newcastle University, Newcastle Upon Tyne, UK; Department of Gastroenterology, South Tyneside NHS Foundation Trust, South Shields, UK
| | - Stephen Duffy
- Wolfson Institute, Queen Mary University London, London, UK
| | - Christian von Wagner
- Department of Behavioural Science and Health, University College London, London, UK
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27
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McKenna-Plumley PE, Groarke JM, Turner RN, Yang K. Experiences of loneliness: a study protocol for a systematic review and thematic synthesis of qualitative literature. Syst Rev 2020; 9:284. [PMID: 33280605 PMCID: PMC7720528 DOI: 10.1186/s13643-020-01544-x] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/28/2020] [Accepted: 11/25/2020] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND Loneliness is a highly prevalent, harmful, and aversive experience which is fundamentally subjective: social isolation alone cannot account for loneliness, and people can experience loneliness even with ample social connections. A number of studies have qualitatively explored experiences of loneliness; however, the research lacks a comprehensive overview of these experiences. We present a protocol for a study that will, for the first time, systematically review and synthesise the qualitative literature on experiences of loneliness in people of all ages from the general, non-clinical population. The aim is to offer a fine-grained look at experiences of loneliness across the lifespan. METHODS We will search multiple electronic databases from their inception onwards: PsycINFO, MEDLINE, Scopus, Child Development & Adolescent Studies, Sociological Abstracts, International Bibliography of the Social Sciences, CINAHL, and the Education Resource Information Center. Sources of grey literature will also be searched. We will include empirical studies published in English including any qualitative study design (e.g. interview, focus group). Studies should focus on individuals from non-clinical populations of any age who describe experiences of loneliness. All citations, abstracts, and full-text articles will be screened by one author with a second author ensuring consistency regarding inclusion. Potential conflicts will be resolved through discussion. Thematic synthesis will be used to synthesise this literature, and study quality will be assessed using the Joanna Briggs Institute Critical Appraisal Checklist for Qualitative Research. The planned review will be reported according to the Enhancing Transparency in Reporting the Synthesis of Qualitative Research (ENTREQ) statement. DISCUSSION The growing body of research on loneliness predictors, outcomes, and interventions must be grounded in an understanding of the lived experience of loneliness. This systematic review and thematic synthesis will clarify how loneliness is subjectively experienced across the lifespan in the general population. This will allow for a more holistic understanding of the lived experience of loneliness which can inform clinicians, researchers, and policymakers working in this important area. SYSTEMATIC REVIEW REGISTRATION PROSPERO CRD42020178105 .
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Affiliation(s)
- Phoebe E McKenna-Plumley
- School of Psychology, Queen's University Belfast, David Keir Building, 18-30 Malone Road, Belfast, BT9 5BN, UK.
| | - Jenny M Groarke
- School of Psychology, Queen's University Belfast, David Keir Building, 18-30 Malone Road, Belfast, BT9 5BN, UK
| | - Rhiannon N Turner
- School of Psychology, Queen's University Belfast, David Keir Building, 18-30 Malone Road, Belfast, BT9 5BN, UK
| | - Keming Yang
- Department of Sociology, Durham University, 29-32 Old Elvet, Durham, DH1 3HN, UK
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28
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Reed H, Couturiaux D, Davis M, Edwards A, Janes E, Kim HS, Melendez-Torres GJ, Murphy S, Rotevatn TA, Smith J, Evans R. Co-production as an Emerging Methodology for Developing School-Based Health Interventions with Students Aged 11-16: Systematic Review of Intervention Types, Theories and Processes and Thematic Synthesis of Stakeholders' Experiences. Prev Sci 2020; 22:475-491. [PMID: 33237552 PMCID: PMC8060205 DOI: 10.1007/s11121-020-01182-8] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [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] [Accepted: 10/20/2020] [Indexed: 01/04/2023]
Abstract
Co-production affords an intervention’s target population the opportunity to participate in intervention theory decision-making during the development process. This addresses the over-reliance on developing interventions through academic theories which can be devoid of contextual understanding and result in challenges to implementing school-based health programmes. There is an emergent empirical literature on co-producing school-based health interventions, but an understanding of appropriate theoretical types and processes and stakeholders’ experiences is lacking. Through the conduct of a systematic review, this study seeks to understand the types and underlying theories and processes for co-production in school-based health interventions with students aged 11–16. A thematic synthesis explored stakeholders’ experiences of the different types of co-production. A systematic search of five electronic bibliographic databases, citation tracking of included studies, and consultation with an expert international panel were employed. Of 27,433 unique papers, 30 papers representing 22 studies were retained to describe types, and 23 papers of 18 studies used to synthesise stakeholders’ experiences. Three types were identified: external, individual-level, and system-level capacity-building. Whilst this review showed variability in co-production types, stakeholders involved and processes, shared functions were identified. Students’, school staff, facilitators’ and researchers’ experiences in terms of acceptability, feasibility and undertaking decision-making are discussed. Recommendations for conceptualising and reporting co-production and process evaluations of co-produced school-based health interventions are highlighted.
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Affiliation(s)
- Hayley Reed
- DECIPHer, UKCRC Centre of Excellence, Cardiff University, 1-3 Museum Place, Cardiff, CF10 3BD, UK.
| | - Danielle Couturiaux
- DECIPHer, UKCRC Centre of Excellence, Cardiff University, 1-3 Museum Place, Cardiff, CF10 3BD, UK
| | - Marianne Davis
- DECIPHer, UKCRC Centre of Excellence, Cardiff University, 1-3 Museum Place, Cardiff, CF10 3BD, UK
| | - Amy Edwards
- DECIPHer, UKCRC Centre of Excellence, Cardiff University, 1-3 Museum Place, Cardiff, CF10 3BD, UK
| | - Edward Janes
- DECIPHer, UKCRC Centre of Excellence, Cardiff University, 1-3 Museum Place, Cardiff, CF10 3BD, UK
| | - Hyun Sue Kim
- DECIPHer, UKCRC Centre of Excellence, Cardiff University, 1-3 Museum Place, Cardiff, CF10 3BD, UK
| | - G J Melendez-Torres
- DECIPHer, UKCRC Centre of Excellence, Cardiff University, 1-3 Museum Place, Cardiff, CF10 3BD, UK
| | - Simon Murphy
- DECIPHer, UKCRC Centre of Excellence, Cardiff University, 1-3 Museum Place, Cardiff, CF10 3BD, UK
| | - Torill Alise Rotevatn
- Public Health and Epidemiology Group, Department of Health Science and Technology, Aalborg University, Niels Jernes Vej 14, 9220, Aalborg East, Denmark
| | - Jesse Smith
- DECIPHer, UKCRC Centre of Excellence, Cardiff University, 1-3 Museum Place, Cardiff, CF10 3BD, UK
| | - Rhiannon Evans
- DECIPHer, UKCRC Centre of Excellence, Cardiff University, 1-3 Museum Place, Cardiff, CF10 3BD, UK
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29
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Sumpton D, Kelly A, Tunnicliffe D, Craig JC, Guha C, Hassett G, Tong A. A practical guide to interpreting and applying systematic reviews of qualitative studies in rheumatology. Int J Rheum Dis 2020; 24:28-35. [PMID: 33150738 DOI: 10.1111/1756-185x.14014] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [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: 06/19/2020] [Revised: 09/03/2020] [Accepted: 10/12/2020] [Indexed: 01/07/2023]
Abstract
While patient-centered care is widely advocated in the management of rheumatic diseases, it can be challenging to implement, particularly for patients with complex systemic conditions. Patient-centered care involves identifying and integrating the patient's experiences, attitudes, and preferences in decision-making. Qualitative research is used to describe patient perspectives and priorities that may not always be expressed in clinical settings. Systematic reviews of qualitative studies can provide new and more comprehensive evidence of patients' beliefs and priorities across different populations and healthcare settings and are increasingly being reported across medical specialties, including rheumatology. In rheumatology, they have been used to examine topics including medication-taking and adherence, coping with systemic sclerosis and conservative management and exercise in osteoarthritis. By referencing recent examples of systematic qualitative reviews in the rheumatology literature, this article will outline the methodology and methods used, and provide an approach to guide the appraisal of reviews. We aim to give the reader a practical understanding of systematic reviews of qualitative literature and elucidate how knowledge gained from such reviews can be applied to improve the care of patients with rheumatic conditions.
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Affiliation(s)
- Daniel Sumpton
- Rheumatology Department, Concord Repatriation General Hospital, Sydney, NSW, Australia.,Sydney School of Public Health, The University of Sydney, Sydney, NSW, Australia.,Centre for Kidney Research, The Children's Hospital Westmead, Sydney, NSW, Australia
| | - Ayano Kelly
- Sydney School of Public Health, The University of Sydney, Sydney, NSW, Australia.,Centre for Kidney Research, The Children's Hospital Westmead, Sydney, NSW, Australia.,Department of Rheumatology, Liverpool Hospital, Sydney, NSW, Australia.,Australian National University, Canberra, ACT, Australia
| | - David Tunnicliffe
- Sydney School of Public Health, The University of Sydney, Sydney, NSW, Australia.,Centre for Kidney Research, The Children's Hospital Westmead, Sydney, NSW, Australia
| | - Jonathan C Craig
- Centre for Kidney Research, The Children's Hospital Westmead, Sydney, NSW, Australia.,College of Medicine and Public Health, Flinders University, Adelaide, SA, Australia
| | - Chandana Guha
- Sydney School of Public Health, The University of Sydney, Sydney, NSW, Australia.,Centre for Kidney Research, The Children's Hospital Westmead, Sydney, NSW, Australia
| | - Geraldine Hassett
- Department of Rheumatology, Liverpool Hospital, Sydney, NSW, Australia
| | - Allison Tong
- Sydney School of Public Health, The University of Sydney, Sydney, NSW, Australia.,Centre for Kidney Research, The Children's Hospital Westmead, Sydney, NSW, Australia
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30
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Halvorsen K, Dihle A, Hansen C, Nordhaug M, Jerpseth H, Tveiten S, Joranger P, Ruud Knutsen I. Empowerment in healthcare: A thematic synthesis and critical discussion of concept analyses of empowerment. Patient Educ Couns 2020; 103:1263-1271. [PMID: 32164960 DOI: 10.1016/j.pec.2020.02.017] [Citation(s) in RCA: 27] [Impact Index Per Article: 6.8] [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: 11/05/2019] [Revised: 02/05/2020] [Accepted: 02/12/2020] [Indexed: 05/11/2023]
Abstract
OBJECTIVE The objective of this study is to shed light on common characteristics revealed in concept analyses of empowerment to contribute to further understanding. A further objective is to discuss how the perspective of healthcare service users appeared in the concept analyses. METHODS The review was performed by systematically searching Medline, CINAHL, EMBASE, PsycINFO and ERIC. The search yielded 255 abstracts, which were reduced by relevance and critical appraisal to the 12 concept analyses included. The analysis process involved thematic synthesis as described by Thomas and Harden. RESULTS The synthesis led to 13 descriptive themes structured according to antecedents, attributes and consequences of empowerment. The synthesis revealed how sparsely the question of equality and power in the relation between health professionals and healthcare service users is addressed. DISCUSSION To a great extent empowerment is viewed as a helping process of making patients act differently, rather than redistribution of power. For groups that are particularly vulnerable to oppression, questions of power are of severe importance. PRACTICE IMPLICATIONS As user participation is a growing discourse in health policy, health professionals need education to develop and address dimensions of power and reciprocity in empowering relations between users and themselves.
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Affiliation(s)
- Kristin Halvorsen
- Faculty of Health Sciences, Institute of Nursing and health Promotion, Oslo Metropolitan University, Postbox 4, St. Olavs Plass, N-0130 Oslo, Norway.
| | - Alfhild Dihle
- Faculty of Health Sciences, Institute of Nursing and health Promotion, Oslo Metropolitan University, Postbox 4, St. Olavs Plass, N-0130 Oslo, Norway.
| | - Camilla Hansen
- Faculty of Health Sciences, Institute of Nursing and health Promotion, Oslo Metropolitan University, Postbox 4, St. Olavs Plass, N-0130 Oslo, Norway.
| | - Marita Nordhaug
- Faculty of Health Sciences, Institute of Nursing and health Promotion, Oslo Metropolitan University, Postbox 4, St. Olavs Plass, N-0130 Oslo, Norway.
| | - Heidi Jerpseth
- Faculty of Health Sciences, Institute of Nursing and health Promotion, Oslo Metropolitan University, Postbox 4, St. Olavs Plass, N-0130 Oslo, Norway.
| | - Sidsel Tveiten
- Faculty of Health Sciences, Institute of Nursing and health Promotion, Oslo Metropolitan University, Postbox 4, St. Olavs Plass, N-0130 Oslo, Norway.
| | - Pål Joranger
- Faculty of Health Sciences, Institute of Nursing and health Promotion, Oslo Metropolitan University, Postbox 4, St. Olavs Plass, N-0130 Oslo, Norway.
| | - Ingrid Ruud Knutsen
- Faculty of Health Sciences, Institute of Nursing and health Promotion, Oslo Metropolitan University, Postbox 4, St. Olavs Plass, N-0130 Oslo, Norway.
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31
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Phelps EE, Tutton E, Griffin X, Baird J. A mixed-methods systematic review of patients' experience of being invited to participate in surgical randomised controlled trials. Soc Sci Med 2020; 253:112961. [PMID: 32247942 DOI: 10.1016/j.socscimed.2020.112961] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2019] [Revised: 03/03/2020] [Accepted: 03/22/2020] [Indexed: 11/21/2022]
Abstract
RATIONALE Randomised controlled trials (RCTs) of surgical interventions are increasing. Such trials encounter challenges that are not present in RCTs of non-surgical interventions because of the nature of the intervention. Several studies have explored patients' experiences of surgical trials to improve recruitment or identify barriers and facilitators to research in this setting. Synthesizing these studies may reveal further insights or confirm whether saturation of relevant themes has been achieved. OBJECTIVE This review aimed to understand the experiences of adults who are invited to participate in surgical RCTs. METHOD MEDLINE, Web of Science, and CINAHL were searched to identify articles meeting the inclusion criteria. Assessment of quality was conducted with studies given an overall quality rating of good, fair, or poor. A segregated approach was used to synthesize the data. This method included a thematic synthesis of the qualitative data and a narrative review of the quantitative data. The findings of both syntheses were then integrated. RESULTS Thirty-four articles reporting 28 trials were included. This review found that the decision to participate in a surgical trial is influenced by multiple factors including patients' individual circumstances and attitudes, and the characteristics of the trial itself. The study identified three themes which encompass both qualitative and quantitative findings. These themes reveal it was important for patients to i) make sense of the trial and trial processes, ii) weigh up the risks and benefits of their different treatment options and participation, and iii) trust the trial and staff. CONCLUSIONS A patient-centred approach to trial recruitment may help staff build trusting relationships with patients and address their individual concerns about the trial and the risks and benefits of participation.
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Abstract
BACKGROUND Breast cancer is the most common cancer in women globally. Its negative effects on a woman's quality of life are related to the individual and socio-cultural factors. This review aimed to identify and synthesise the reported experiences and quality of life of women with breast cancer in Arab countries. METHODS PubMed, Embase, Web of Science, SCOPUS, PsychInfo, CINAHL, Allied and Complementary Medicine Database, and Index Medicus for the Eastern Mediterranean Region were searched for articles published from start to March 2019 using PRISMA guidelines. These searches were complimented by citation tracking and hand searching of relevant journals. A thematic synthesis was carried out on the 'findings/results' sections from the identified papers. RESULTS Of 5228 records identified, 19 were included in the review which represented 401 women from 11 Arab countries. All used qualitative methods of data collection to produce rich descriptions of experiences. Thematic synthesis of the extracted data identified three major themes, Perceptions and reactions, Coping or enduring and Changing roles. CONCLUSIONS This review provides a rich description of the reported quality of life and experiences of women with breast cancer in Arab countries. These are influenced by the women's and society's views of cancer, the women's role in society and family, religious faith and the healthcare context and access to treatment choices and information.
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Affiliation(s)
- D Fearon
- International Observatory on End of Life Care, Faculty of Health and Medicine, Lancaster University, Lancaster, UK.
- Cairdeas International Palliative Care Trust, Nouakchott, Mauritania.
| | - S Hughes
- International Observatory on End of Life Care, Faculty of Health and Medicine, Lancaster University, Lancaster, UK
| | - S G Brearley
- International Observatory on End of Life Care, Faculty of Health and Medicine, Lancaster University, Lancaster, UK
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Leedham AT, Thompson AR, Freeth M. A thematic synthesis of siblings' lived experiences of autism: Distress, responsibilities, compassion and connection. Res Dev Disabil 2020; 97:103547. [PMID: 31869772 DOI: 10.1016/j.ridd.2019.103547] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [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: 12/06/2018] [Revised: 11/24/2019] [Accepted: 11/26/2019] [Indexed: 06/10/2023]
Abstract
BACKGROUND Despite increased understandings that the whole family system is influenced by a family member being diagnosed with an Autism Spectrum Condition (ASC), the experiences of siblings can be overlooked. However, recently understanding of siblings' experiences has begun to develop via qualitative studies. AIMS This review aimed to systematically identify, appraise and review the qualitative literature investigating the lived experience of siblings of autistic people. METHODS AND PROCEDURES Six databases were systematically searched for studies reporting empirical qualitative data on the lived experience of neurotypical siblings of autistic people. Eighteen studies met inclusion criteria and were analysed using Thematic Synthesis. OUTCOMES AND RESULTS Data synthesis revealed four superordinate themes; Roles and responsibilities, different to what may be expected typically; Impact of behaviours, particularly aggressive behaviours; Process of adjustment, including learning and developing empathy and acceptance; Interpersonal experiences with others and between siblings. CONCLUSIONS AND IMPLICATIONS A narrative of love and empathy was present throughout. However, several participants also experienced significant difficulties affecting their mental health. Findings suggest a sense of agency, understanding ASC, time spent alone with parents, supportive environments and the chance to relate to other siblings as protective factors in facilitating positive psychological wellbeing for siblings of autistic people.
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Affiliation(s)
- Alexandra T Leedham
- Chesterfield Royal Hospital NHS Foundation Trust, S44 5BL, Chesterfield, UK.
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Rawlings GH, Williams RK, Clarke DJ, English C, Fitzsimons C, Holloway I, Lawton R, Mead G, Patel A, Forster A. Exploring adults' experiences of sedentary behaviour and participation in non-workplace interventions designed to reduce sedentary behaviour: a thematic synthesis of qualitative studies. BMC Public Health 2019; 19:1099. [PMID: 31409324 PMCID: PMC6692932 DOI: 10.1186/s12889-019-7365-1] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [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: 11/19/2018] [Accepted: 07/24/2019] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND Sedentary behaviour is any waking behaviour characterised by an energy expenditure of ≤1.5 metabolic equivalent of task while in a sitting or reclining posture. Prolonged bouts of sedentary behaviour have been associated with negative health outcomes in all age groups. We examined qualitative research investigating perceptions and experiences of sedentary behaviour and of participation in non-workplace interventions designed to reduce sedentary behaviour in adult populations. METHOD A systematic search of seven databases (MEDLINE, AMED, Cochrane, PsychINFO, SPORTDiscus, CINAHL and Web of Science) was conducted in September 2017. Studies were assessed for methodological quality and a thematic synthesis was conducted. Prospero database ID: CRD42017083436. RESULTS Thirty individual studies capturing the experiences of 918 individuals were included. Eleven studies examined experiences and/or perceptions of sedentary behaviour in older adults (typically ≥60 years); ten studies focused on sedentary behaviour in people experiencing a clinical condition, four explored influences on sedentary behaviour in adults living in socio-economically disadvantaged communities, two examined university students' experiences of sedentary behaviour, two on those of working-age adults, and one focused on cultural influences on sedentary behaviour. Three analytical themes were identified: 1) the impact of different life stages on sedentary behaviour 2) lifestyle factors influencing sedentary behaviour and 3) barriers and facilitators to changing sedentary behaviour. CONCLUSIONS Sedentary behaviour is multifaceted and influenced by a complex interaction between individual, environmental and socio-cultural factors. Micro and macro pressures are experienced at different life stages and in the context of illness; these shape individuals' beliefs and behaviour related to sedentariness. Knowledge of sedentary behaviour and the associated health consequences appears limited in adult populations, therefore there is a need for provision of accessible information about ways in which sedentary behaviour reduction can be integrated in people's daily lives. Interventions targeting a reduction in sedentary behaviour need to consider the multiple influences on sedentariness when designing and implementing interventions.
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Affiliation(s)
- G H Rawlings
- Department of Clinical Psychology, University of Sheffield, Sheffield, UK
| | - R K Williams
- Academic Unit of Elderly Care and Rehabilitation, Leeds Institute of Health Sciences, Temple Bank House, University of Leeds, Bradford Royal Infirmary, Bradford, BD9 6RJ, UK
| | - D J Clarke
- Academic Unit of Elderly Care and Rehabilitation, Leeds Institute of Health Sciences, Temple Bank House, University of Leeds, Bradford Royal Infirmary, Bradford, BD9 6RJ, UK.
| | - C English
- School of Health Sciences and Priority Research Centre for Stroke and Brain Injury, University of Newcastle, Newcastle, Australia
| | - C Fitzsimons
- Physical Activity for Health Research Centre, University of Edinburgh, Edinburgh, UK
| | - I Holloway
- Leeds Institute of Clinical Trials Research, University of Leeds, Leeds, UK
| | - R Lawton
- School of Psychology, University of Leeds, Leeds, UK
| | - G Mead
- Geriatric Medicine, Division of Health Sciences, Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, UK
| | - A Patel
- Anita Patel Health Economics Consulting Ltd, London, UK
| | - A Forster
- Academic Unit of Elderly Care and Rehabilitation, Leeds Institute of Health Sciences, Temple Bank House, University of Leeds, Bradford Royal Infirmary, Bradford, BD9 6RJ, UK
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Warwick H, Mansell W, Porter C, Tai S. 'What people diagnosed with bipolar disorder experience as distressing': A meta-synthesis of qualitative research. J Affect Disord 2019; 248:108-30. [PMID: 30731279 DOI: 10.1016/j.jad.2019.01.024] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/13/2018] [Revised: 01/10/2019] [Accepted: 01/19/2019] [Indexed: 01/27/2023]
Abstract
BACKGROUND Bipolar disorder (BD) is considered to have a significantly negative impact on functioning and prognosis is considered poor. Current treatments are modestly effective and predominantly focus on reducing extreme mood fluctuations and symptoms, yet less is known about what patients themselves describe as distressing. Therefore we aimed to assess this through a systematic review. METHODS A comprehensive literature search was conducted in four major bibliographic databases in August 2017, updated in July 2018. Qualitative studies exploring BD were included if they contained themes related to distress. First person accounts from people with BD discussing what they experience as distressing were extracted and synthesised using thematic synthesis. Author interpretations were also extracted to support the synthesis. RESULTS Twenty-four studies were included. Five main analytical themes were developed: 1) diagnosis, 2) loss, 3) uncertainty, 4) threat and 5) relationships. Two further crosscutting themes were identified as 1) stigma and 2) fear of relapse. Implications for interventions to focus on these causes of distress also emerged. LIMITATIONS The included studies did not adequately examine the authors' potential own biases and influences within their interpretations of the data. One author predominantly undertook data extraction and coding for the current review, although research team discussions led to an agreed consensus on themes. CONCLUSIONS This was the first qualitative study to specifically explore distress in BD. The meta-synthesis highlights important areas that people with BD experience as distressing. Adaptations to current interventions, to focus on what people find distressing could seek to improve treatment outcomes.
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Parke H, Michalska M, Russell A, Moss AC, Holdsworth C, Ling J, Larsen J. Understanding drinking among midlife men in the United Kingdom: A systematic review of qualitative studies. Addict Behav Rep 2018; 8:85-94. [PMID: 30140728 PMCID: PMC6104518 DOI: 10.1016/j.abrep.2018.08.001] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2018] [Revised: 08/01/2018] [Accepted: 08/01/2018] [Indexed: 12/12/2022] Open
Abstract
OBJECTIVES This study reviews qualitative research into the sociocultural meanings and subjective experiences that midlife men in the United Kingdom (UK) associate with their drinking. In the UK, average weekly alcohol consumption is highest among midlife men, and they are disproportionately affected by alcohol harm. There is increasing recognition that public health messages to support behaviour change must be based on an in-depth understanding of drinking motivations and experiences. STUDY DESIGN AND METHODS Systematic literature review of studies exploring motivations for and experiences of drinking among UK men aged 45-60 using qualitative methodology. Medline, PsycINFO and the Social Science Citation Index were used, along with manual searches of key journals, Google searches and a call for evidence. The Critical Appraisal Skills Programme tool was used to quality-assess papers. Thematic synthesis was used to combine and analyse the data. RESULTS From 5172 titles and abstracts (1995-2018), 11 publications were included, representing 6 unique studies. Five themes were identified: 'Drinking Motivations'; 'Drinking Justifications'; 'Drinking Strategies and Control'; 'Social Norms and Identity' and 'Harm'. Motivations for drinking among midlife men were associated with relaxation, socialising and maintenance of male friendships. They justified drinking as a choice and emphasised their ability to meet responsibilities, which they contrasted with 'problem drinkers'. Social norms governed drinking behaviours as an expression of masculinity. CONCLUSION This review highlights the significance of the meanings and social importance of alcohol consumption among midlife men. Interventions using information and guidance should consider these when aiming to effectively influence the way this group drinks.
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Affiliation(s)
| | - Monika Michalska
- Centre for Addictive Behaviours Research, London South Bank University, London, United Kingdom
| | | | - Antony C. Moss
- School of Applied Sciences, London South Bank University, London, United Kingdom
| | - Clare Holdsworth
- School of Physical and Geographical Sciences, Keele University, Keele, United Kingdom
| | - Jonathan Ling
- Department of Pharmacy, Health and Wellbeing, University of Sunderland, Sunderland, United Kingdom
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Hadgraft NT, Brakenridge CL, Dunstan DW, Owen N, Healy GN, Lawler SP. Perceptions of the acceptability and feasibility of reducing occupational sitting: review and thematic synthesis. Int J Behav Nutr Phys Act 2018; 15:90. [PMID: 30227861 PMCID: PMC6145345 DOI: 10.1186/s12966-018-0718-9] [Citation(s) in RCA: 34] [Impact Index Per Article: 5.7] [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: 06/11/2018] [Accepted: 08/28/2018] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND Reducing workplace sedentary behaviour (sitting) is a topic of contemporary public health and occupational health interest. Understanding workers' perspectives on the feasibility and acceptability of strategies, and barriers and facilitators to reducing workplace sitting time, can help inform the design and implementation of targeted interventions. The aim of this qualitative synthesis was to identify and synthesise the evidence on factors perceived to influence the acceptability and feasibility of reducing sitting at work, without, and with, an associated intervention component. METHODS A systematic search of the peer-reviewed literature was conducted across multiple databases in October 2017 to identify studies with a qualitative component relating to reducing workplace sitting time. Relevant data were extracted and imported into NVivo, and analysed by three of the authors by coding the results sections of papers line-by-line, with codes organised into sub-themes and then into overarching themes. Studies with and without an associated intervention were analysed separately. RESULTS Thirty-two studies met the inclusion criteria, 22 of which had collected qualitative data during and/or following a workplace intervention. Sample sizes ranged from five through to 71 participants. Studies predominately involved desk-based workers (28/32) and were most frequently conducted in Australia, USA or the United Kingdom (26/32). Similar themes were identified across non-intervention and intervention studies, particularly relating to barriers and facilitators to reducing workplace sitting. Predominately, work and social environment attributes were identified as barriers/facilitators, with desk-based work and work pressures influencing the perceived feasibility of reducing sitting, particularly for low-cost interventions. Support from co-workers and managers was considered a key facilitator to reducing sitting, while social norms that discouraged movement were a prominent barrier. Across all studies, some consistent perceptions of benefits to reducing sitting were identified, including improved physical health, enhanced emotional well-being and associated work-related benefits. CONCLUSION Common barriers and facilitators to reducing workplace sitting time were identified across the literature, most prominently involving the social environment and job-related demands. These findings can inform the design and implementation of workplace sitting reduction strategies. To increase the generalisability of findings, further research is needed in a more diverse range of countries and industries.
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Affiliation(s)
- Nyssa T Hadgraft
- Centre for Urban Transitions, Swinburne University of Technology, Melbourne, VIC, Australia.,Baker Heart and Diabetes Institute, Melbourne, VIC, Australia.,School of Public Health, The University of Queensland, Herston Rd, Herston, Brisbane, QLD, 4006, Australia
| | - Charlotte L Brakenridge
- School of Public Health, The University of Queensland, Herston Rd, Herston, Brisbane, QLD, 4006, Australia.,RECOVER Injury Research Centre, The University of Queensland, Brisbane, QLD, Australia
| | - David W Dunstan
- Baker Heart and Diabetes Institute, Melbourne, VIC, Australia.,School of Public Health, The University of Queensland, Herston Rd, Herston, Brisbane, QLD, 4006, Australia.,Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, VIC, Australia.,Institute of Physical Activity and Nutrition Research, School of Exercise and Nutrition Sciences, Deakin University, Melbourne, VIC, Australia.,Mary MacKillop Institute of Health Research, Australian Catholic University, Melbourne, VIC, Australia.,School of Sport Science, Exercise and Health, The University of Western Australia, Perth, WA, Australia
| | - Neville Owen
- Centre for Urban Transitions, Swinburne University of Technology, Melbourne, VIC, Australia.,Baker Heart and Diabetes Institute, Melbourne, VIC, Australia.,School of Public Health, The University of Queensland, Herston Rd, Herston, Brisbane, QLD, 4006, Australia.,Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, VIC, Australia.,Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, VIC, Australia
| | - Genevieve N Healy
- Baker Heart and Diabetes Institute, Melbourne, VIC, Australia.,School of Public Health, The University of Queensland, Herston Rd, Herston, Brisbane, QLD, 4006, Australia.,Curtin University, School of Physiotherapy and Exercise Science, Perth, WA, Australia
| | - Sheleigh P Lawler
- School of Public Health, The University of Queensland, Herston Rd, Herston, Brisbane, QLD, 4006, Australia.
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Wood L, Alsawy S. Recovery in Psychosis from a Service User Perspective: A Systematic Review and Thematic Synthesis of Current Qualitative Evidence. Community Ment Health J 2018; 54:793-804. [PMID: 29188393 DOI: 10.1007/s10597-017-0185-9] [Citation(s) in RCA: 47] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/08/2016] [Accepted: 11/04/2017] [Indexed: 10/18/2022]
Abstract
There is a growing number of qualitative accounts regarding recovery from psychosis from a service user perspective. The aim of this study was to conduct a systematic review of these qualitative accounts. A thematic synthesis was utilised to synthesise and analyse seventeen studies included in the review. Studies were included if they used a qualitative methodology to explore service users' experiences of recovery from psychosis as a primary research question. All included studies were subjected to a quality assessment. The analysis outlined three subordinate themes: the recovery journey, facilitators of recovery (e.g. faith and spirituality, personal agency and hope), and barriers to recovery (e.g. stigma and discrimination, negative effects of mental health services and medication). Recovery is an idiosyncratic process but includes key components which are important to people who experience psychosis. These should be explored within clinical practice.
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Walpole G, Clark H, Dowling M. Myeloma patients' experiences of haematopoietic stem cell transplant: A qualitative thematic synthesis. Eur J Oncol Nurs 2018; 35:15-21. [PMID: 30057079 DOI: 10.1016/j.ejon.2018.05.002] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [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: 12/21/2017] [Revised: 02/16/2018] [Accepted: 05/08/2018] [Indexed: 01/20/2023]
Abstract
PURPOSE The aim of this study was to synthesise all qualitative evidence on the experiences of myeloma patients undergoing haematopoietic stem cell transplant (HSCT). METHOD A systematic search strategy was developed and a rigorous search of the literature was undertaken searching six databases (CINAHL, Embase, Medline, Psych Info, Ethos and Proquest). The software for systematic reviews www.covidence.org was used to blind screen for eligible papers. Quality appraisal of each study was undertaken using the Critical Appraisal Skills Programme (CASP). Confidence in each finding was assessed using Confidence in the Evidence from Reviews of Qualitative research (CERQual). RESULTS Eight qualitative studies (reported in eleven papers and including seventy six myeloma patients) were selected in the final sample for evidence synthesis. Four themes were identified relating to patients' feeling 'dead', disconnecting and isolating themselves, cognitive impairment and engagement with exercise and its benefits in recovery. CONCLUSIONS The burden of cognitive functioning among myeloma patients was often under detected. Nurses should ask patients regularly about their memory and any challenges they may be experiencing to their concentration and recall, Exercise during the transplant process can help improve patients' recovery, both physically and psychologically. A structured exercise programme developed by a physiotherapist to suit the needs of each patient should be standard practice in the transplant process.
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Affiliation(s)
| | - Helen Clark
- Library and Information Services, Sligo University Hospital, Sligo, Ireland.
| | - Maura Dowling
- School of Nursing and Midwifery, National University of Ireland Galway, University Road, Galway, Ireland.
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Forster AS, Rockliffe L, Chorley AJ, Marlow LA, Bedford H, Smith SG, Waller J. A qualitative systematic review of factors influencing parents' vaccination decision-making in the United Kingdom. SSM Popul Health 2016; 2:603-612. [PMID: 28018959 PMCID: PMC5165048 DOI: 10.1016/j.ssmph.2016.07.005] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2016] [Revised: 06/20/2016] [Accepted: 07/22/2016] [Indexed: 01/22/2023] Open
Abstract
BACKGROUND High uptake of vaccinations is crucial for disease prevention. Although overall uptake of childhood immunisations is high in the United Kingdom (UK), pockets of lower uptake remain. Novel systematic methods have not been employed when reviewing the qualitative literature examining parents' vaccination decisions. AIMS We aimed to conduct a qualitative systematic review of studies in the UK to understand factors influencing parental decisions to vaccinate a child. METHODS On 12/2/14 we searched PsycINFO, MEDLINE, CINAHL plus, Embase, Social Policy and Practice and Web of Science for studies using qualitative methods and reporting reasons why parents in the UK had or had not immunised their child. Participant quotes and authors' interpretations of qualitative data were extracted from the results of articles. Thematic synthesis was used to develop higher-order themes (conducted in 2015). RESULTS 34 papers were included. Two types of decision-making had been adopted: non-deliberative and deliberative. With non-deliberative decisions parents felt they had no choice, were happy to comply and/or relied on social norms. Deliberative decisions involved weighing up the risks and benefits, considering others' advice/experiences and social judgement. Emotions affected deliberative decision-making. Trust in information and vaccine stakeholders was integral to all decision-making. Practical issues affected those who intended to vaccinate. CONCLUSIONS Parents adopted two different approaches to decision-making about childhood vaccinations. By understanding more about the mechanisms underpinning parents' vaccination behaviour, in collaboration with vaccine stakeholders, we can better design interventions to enhance informed uptake.
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Affiliation(s)
- Alice S. Forster
- Health Behaviour Research Centre, UCL, Gower Street, London WC1E 6BT, United Kingdom
| | - Lauren Rockliffe
- Health Behaviour Research Centre, UCL, Gower Street, London WC1E 6BT, United Kingdom
| | - Amanda J. Chorley
- Health Behaviour Research Centre, UCL, Gower Street, London WC1E 6BT, United Kingdom
| | - Laura A.V. Marlow
- Health Behaviour Research Centre, UCL, Gower Street, London WC1E 6BT, United Kingdom
| | - Helen Bedford
- Institute of Child Health, UCL, 30 Guilford Street, London WC1N 1EH, United Kingdom
| | - Samuel G. Smith
- Wolfson Institute of Preventive Medicine, Queen Mary University of London, Charterhouse Square, London EC1M 6BQ, United Kingdom
| | - Jo Waller
- Health Behaviour Research Centre, UCL, Gower Street, London WC1E 6BT, United Kingdom
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Nicholson E, Murphy T, Larkin P, Normand C, Guerin S. Protocol for a thematic synthesis to identify key themes and messages from a palliative care research network. BMC Res Notes 2016; 9:478. [PMID: 27769317 PMCID: PMC5073737 DOI: 10.1186/s13104-016-2282-1] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [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: 08/30/2016] [Accepted: 10/13/2016] [Indexed: 11/29/2022] Open
Abstract
Background Research networks that facilitate collaborative research are increasing both regionally and globally and such collaborations contribute greatly to knowledge transfer particularly in health research. The Palliative Care Research Network is an Irish-based network that seeks to create opportunities and engender a collaborative environment to encourage innovative research that is relevant for policy and practice. The current review outlines a methodology to identify cross-cutting messages to identify how dissemination outputs can be optimized to ensure that key messages from this research reaches all knowledge users. Methods/design Preferred reporting items for systematic review and meta-analysis protocol guidelines will inform the search and analysis plan to ensure that the synthesis of the data is as rigorous as possible. An approach based on critical interpretative synthesis will be adapted to include a thematic synthesis for the identification of higher-order themes and messages from a body of dissemination products generated by the Palliative Care Research Network. Discussion The thematic synthesis outlined in the present protocol offers a novel method of synthesising data from a focused research network that employs a variety of dissemination materials as a means of identifying key themes and messages from a specific body of research. The high-level themes and messages will be identified from the thematic synthesis, widely disseminated and targeted towards a range of stakeholders and knowledge users such as carers, health and social care professionals, policy makers and researchers. Electronic supplementary material The online version of this article (doi:10.1186/s13104-016-2282-1) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Emma Nicholson
- All Ireland Institute of Hospice and Palliative Care, 2nd Floor Education and Research Centre, Our Lady's Hospice and Care Services, Harold's Cross, Dublin, 6W, Ireland.
| | - Tara Murphy
- All Ireland Institute of Hospice and Palliative Care, 2nd Floor Education and Research Centre, Our Lady's Hospice and Care Services, Harold's Cross, Dublin, 6W, Ireland.
| | - Philip Larkin
- UCD School of Nursing, Midwifery and Health Systems, UCD College of Health Sciences Belfield, Dublin, 4, Ireland
| | - Charles Normand
- Trinity College Dublin, School of Medicine, 3-4 Foster Place, Dublin, 2, Ireland
| | - Suzanne Guerin
- UCD School of Psychology, John Henry Newman Building, University College Dublin, Belfield, Dublin, 4, Ireland
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Birchley G, Jones K, Huxtable R, Dixon J, Kitzinger J, Clare L. Dying well with reduced agency: a scoping review and thematic synthesis of the decision-making process in dementia, traumatic brain injury and frailty. BMC Med Ethics 2016; 17:46. [PMID: 27461340 PMCID: PMC4962460 DOI: 10.1186/s12910-016-0129-x] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [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: 03/15/2016] [Accepted: 07/13/2016] [Indexed: 12/02/2022] Open
Abstract
Background In most Anglophone nations, policy and law increasingly foster an autonomy-based model, raising issues for large numbers of people who fail to fit the paradigm, and indicating problems in translating practical and theoretical understandings of ‘good death’ to policy. Three exemplar populations are frail older people, people with dementia and people with severe traumatic brain injury. We hypothesise that these groups face some over-lapping challenges in securing good end-of-life care linked to their limited agency. To better understand these challenges, we conducted a scoping review and thematic synthesis. Methods To capture a range of literature, we followed established scoping review methods. We then used thematic synthesis to describe the broad themes emerging from this literature. Results Initial searches generated 22,375 references, and screening yielded 49, highly heterogeneous, studies that met inclusion criteria, encompassing 12 countries and a variety of settings. The thematic synthesis identified three themes: the first concerned the processes of end-of-life decision-making, highlighting the ambiguity of the dominant shared decision-making process, wherein decisions are determined by families or doctors, sometimes explicitly marginalising the antecedent decisions of patients. Despite this marginalisation, however, the patient does play a role both as a social presence and as an active agent, by whose actions the decisions of those with authority are influenced. The second theme examined the tension between predominant notions of a good death as ‘natural’ and the drive to medicalise death through the lens of the experiences and actions of those faced with the actuality of death. The final theme considered the concept of antecedent end-of-life decision-making (in all its forms), its influence on policy and decision-making, and some caveats that arise from the studies. Conclusions Together these three themes indicate a number of directions for future research, which are likely to be applicable to other conditions that result in reduced agency. Above all, this review emphasises the need for new concepts and fresh approaches to end of life decision-making that address the needs of the growing population of frail older people, people with dementia and those with severe traumatic brain injury. Electronic supplementary material The online version of this article (doi:10.1186/s12910-016-0129-x) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Giles Birchley
- Centre for Ethics in Medicine, University of Bristol, Bristol, UK.
| | - Kerry Jones
- Faculty of Health and Social Care, The Open University, Milton Keynes, UK
| | - Richard Huxtable
- Centre for Ethics in Medicine, University of Bristol, Bristol, UK
| | - Jeremy Dixon
- Department of Social and Policy Sciences, University of Bath, Bath, UK
| | - Jenny Kitzinger
- Coma and Disorders of Consciousness Research Centre, Cardiff University, Cardiff, UK
| | - Linda Clare
- REACH: The Centre for Research in Ageing and Cognitive Health, University of Exeter, Exeter, UK
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Rathbone AP, Todd A, Jamie K, Bonam M, Banks L, Husband AK. A systematic review and thematic synthesis of patients' experience of medicines adherence. Res Social Adm Pharm 2016; 13:403-439. [PMID: 27432023 DOI: 10.1016/j.sapharm.2016.06.004] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [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: 02/22/2016] [Revised: 06/06/2016] [Accepted: 06/06/2016] [Indexed: 11/26/2022]
Abstract
BACKGROUND Medicines non-adherence continues to be problematic in health care practice. After decades of research, few interventions have a robust evidence-based demonstrating their applicability to improve adherence. Phenomenology has a place within the health care research environment. OBJECTIVE To explore patients' lived experiences of medicines adherence reported in the phenomenonologic literature. METHODS A systematic literature search was conducted to identify peer-reviewed and published phenomenological investigations in adults that aimed to investigate patients' lived experiences of medicines adherence. Studies were appraised using the Critical Appraisal Skills Programme (CASP) Qualitative Research Tool. Thematic synthesis was conducted using a combination of manual coding and NVivo10 [QSR International, Melbourne] coding to aid data management. RESULTS Descriptive themes identified included i) dislike for medicines, ii) survival, iii) perceived need, including a) symptoms and side-effects and b) cost, and iv) routine. Analytic themes identified were i) identity and ii) interaction. CONCLUSIONS This work describes adherence as a social interaction between the identity of patients and medicines, mediated by interaction with family, friends, health care professionals, the media and the medicine, itself. Health care professionals and policy makers should seek to re-locate adherence as a social phenomenon, directing the development of interventions to exploit patient interaction with wider society, such that patients 'get to know' their medicines, and how they can be taken, throughout the life of the patient and the prescription.
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Affiliation(s)
- A P Rathbone
- School of Medicine, Pharmacy and Health, Durham University, University Boulevard, Queen's Campus, Stockton-on-Tees TS17 6BH, United Kingdom
| | - A Todd
- School of Medicine, Pharmacy and Health, Durham University, University Boulevard, Queen's Campus, Stockton-on-Tees TS17 6BH, United Kingdom
| | - K Jamie
- School of Applied Social Sciences, Durham University, 32 Old Elvet, Durham DH1 3HN, United Kingdom
| | - M Bonam
- AstraZeneca PLC, Charter Way, Macclesfield SK10 2NA, United Kingdom
| | - L Banks
- AstraZeneca PLC, Charter Way, Macclesfield SK10 2NA, United Kingdom
| | - A K Husband
- School of Medicine, Pharmacy and Health, Durham University, University Boulevard, Queen's Campus, Stockton-on-Tees TS17 6BH, United Kingdom.
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Rylatt L, Cartwright T. Parental feeding behaviour and motivations regarding pre-school age children: A thematic synthesis of qualitative studies. Appetite 2015; 99:285-297. [PMID: 26719102 DOI: 10.1016/j.appet.2015.12.017] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [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: 07/25/2015] [Revised: 12/16/2015] [Accepted: 12/18/2015] [Indexed: 11/19/2022]
Abstract
Poor childhood diet is a major risk factor for disease and obesity, and parents of pre-school children are in a powerful position to influence diet for life. The technique of thematic synthesis (Thomas & Harden, 2008) was used to synthesise recent qualitative research on parental feeding of pre-school age children (18 months-6 years). The aim was to inform development of nutrition advice by gaining a comprehensive picture of parental feeding behaviours and motivations. Six key parental feeding behaviours were identified: modelling, rewards, pressure and encouragement, repeated exposure, creativity, and limiting intake. Four overarching themes regarding motivations were identified: promoting good health (balance and variety, and weight control); building positive relationships (child involvement, and parental engagement and responsiveness); practicalities and constraints (time, cost, and lack of culinary skill, and pressure and flexibility); and emotional motivations (problem avoidance, and emotional investment). Practicalities and constraints, and emotional motivations impacted more significantly on low income parents. In order to be effective, nutrition advice ought to tap into parents' strong desire to build positive relationships and promote good health while remaining sensitive to the significant constraints and practicalities faced.
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Affiliation(s)
- Louise Rylatt
- Department of Psychology, Faculty of Science and Technology, University of Westminster, London, UK.
| | - Tina Cartwright
- Department of Psychology, Faculty of Science and Technology, University of Westminster, London, UK
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