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Schwarz B, Banaschak H, Heyme R, von Kardorff E, Reims N, Streibelt M, Bethge M. A Mega-Ethnography of Qualitative Meta-Syntheses on Return to Work in People with Chronic Health Conditions. Rehabilitation (Stuttg) 2024; 63:39-50. [PMID: 37604194 PMCID: PMC10857889 DOI: 10.1055/a-2129-2731] [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] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 08/23/2023]
Abstract
PURPOSE The aim of this study was to synthesize the findings of qualitative meta-syntheses (QMS) on return to work (RTW) of people with different chronic illnesses and to develop a generic RTW model that can provide advice on how to improve RTW interventions and strategies. METHODS We conducted a systematic literature search in PubMed, Epistemonikos, CENTRAL, and PsycARTICLES to find relevant QMS, published in English or German between 2000 and 2021, and adapted the meta-ethnographic approach of Noblit and Hare to synthesize their findings. RESULTS Nineteen QMS (five focusing on musculoskeletal disorders or chronic pain, four on acquired or traumatic brain injuries, four on cancer, two on mental disorders, one on spinal cord injury, and three on mixed samples) met our inclusion criteria for the meta-ethnographic synthesis. Through systematic comparison and reciprocal translation of the single QMS findings, we could identify a set of key cross-cutting themes/concepts, which formed the basis for four RTW principles and a generic RTW model. CONCLUSIONS RTW is a multifactorial and highly interactive multistakeholder process, embedded in an individual's life and working history, as well as in a determined social and societal context. It runs parallel and interdependently to the process of coping with the disease and realigning one's own identity, thus emphasizing the significance of RTW for the person. Besides symptoms and consequences of the disease, individual coping strategies, and RTW motivation, the course and success of RTW are strongly affected by the adaptability of the person's working environment and the social support in their private and working life. Thus, RTW is not only a problem of the individual, but also a matter of the social environment, especially the workplace, requiring a holistic, person-centered, and systemic approach, coordinated by a designated body, which considers the interests of all actors involved in the RTW process.
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Affiliation(s)
- Betje Schwarz
- Institute for Quality Assurance in Prevention and Rehabilitation (iqpr
GmbH), German Sport University Cologne, Cologne, Germany
| | - Hannes Banaschak
- Institute of Social Medicine and Epidemiology, University of Luebeck,
Luebeck, Germany
| | - Rebekka Heyme
- Department of Rehabilitation, German Federal Pension Insurance, Berlin,
Germany
| | | | - Nancy Reims
- Institut for Employment Research, Nuremberg, Germany
| | - Marco Streibelt
- Department for Rehabilitation Research, German Federal Pension
Insurance, Berlin, Germany
| | - Matthias Bethge
- Institute of Social Medicine and Epidemiology, University of Luebeck,
Luebeck, Germany
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Howe L, Husband A, Robinson‐Barella A. Prescribing pre- and post-operative physical activity interventions for people undergoing breast cancer surgery: A qualitative systematic review. Cancer Med 2024; 13:e7063. [PMID: 38457236 PMCID: PMC10923032 DOI: 10.1002/cam4.7063] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2023] [Revised: 11/26/2023] [Accepted: 02/18/2024] [Indexed: 03/09/2024] Open
Abstract
INTRODUCTION Undertaking physical activity, pre- and post-operatively, can benefit recovery time and improve post-surgical outcomes. One cohort of patients that have reported these benefits are those undergoing surgery for breast cancer. Yet, what remains unclear is the level to which physical activity interventions are implemented into standard surgical care for patients with breast cancer. AIMS This systematic review aimed to examine existing qualitative evidence focusing on pre- and post-operative physical activity interventions to better understand the benefits and shortcomings of physical activity within the surgical journey. METHODS A systematic literature search was undertaken in November 2022, across five databases: MEDLINE, PsycINFO, Embase, CINAHL, and Scopus. Qualitative studies involving people with breast cancer who had undertaken a physical activity intervention, either pre- and/or post-operatively, were included for analysis. The review was registered on PROSPERO: CRD42022372466 and performed according to PRISMA guidelines. The Critical Appraisal Skills Programme qualitative study checklist was used to assess study quality. RESULTS Fourteen studies were included, comprising the perspectives of 418 people receiving surgery for breast cancer. One study implemented preoperative physical activity interventions; the remaining studies focused on post-operative interventions. A narrative systematic review was undertaken due to heterogeneity in reported results. Four themes were developed by thematic analysis, centring on: (1) factors promoting engagement with physical activity interventions; (2) factors preventing engagement with physical activity interventions; (3) the impact of pre- and post-operative interventions on physical and psychological health; and (4) participant recommendations for pre- and post-operative interventions. CONCLUSION Pre- and post-operative physical activity interventions were well-accepted. Patients recognised factors which promoted or prevented engagement with interventions, as well as pre- and post-operative physical and psychological benefits that arose as a result. Evidence based co-design studies may further inform successful implementation of prescribed physical activity into standard care for surgical breast cancer patients.
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Affiliation(s)
- Lauren Howe
- School of Pharmacy, King George VI BuildingNewcastle UniversityNewcastle upon TyneUK
| | - Andy Husband
- School of Pharmacy, King George VI BuildingNewcastle UniversityNewcastle upon TyneUK
- Population Health Sciences InstituteNewcastle UniversityNewcastle upon TyneUK
| | - Anna Robinson‐Barella
- School of Pharmacy, King George VI BuildingNewcastle UniversityNewcastle upon TyneUK
- Population Health Sciences InstituteNewcastle UniversityNewcastle upon TyneUK
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Lyons T, Hennesey T, Noonan M. A systematic review of qualitative evidence: Perspectives of fathers whose partner experienced postpartum psychosis. J Adv Nurs 2024; 80:413-429. [PMID: 37658618 DOI: 10.1111/jan.15832] [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: 01/30/2023] [Revised: 07/07/2023] [Accepted: 08/07/2023] [Indexed: 09/03/2023]
Abstract
AIMS This study aimed to systematically identify, appraise and synthesize qualitative evidence which explored fathers' experiences and perspectives of their partners' postpartum psychosis. DESIGN Qualitative evidence synthesis (QES). DATA SOURCES Seven databases (CINAHL, PsycINFO, Medline, Scopus, Google Scholar, ProQuest Dissertations and Open Grey) were systematically searched for qualitative studies from each database's inception to the 17th of February 2022. REVIEW METHODS Studies that utilized a qualitative research design to explore fathers' experiences and perspectives of their partners' postpartum psychosis were included. Studies were appraised using the Critical Appraisal Skills Programme to determine their methodological quality. Qualitative data were extracted and synthesized using the process of thematic synthesis to form analytical themes. RESULTS Eleven reports (seven journal articles and four theses), representing six unique qualitative studies were included in the review. Two analytical themes and eight subthemes were identified. The analytical themes were 'a sense of loss across multiple domains of their lives', and 'informational and emotional support needs'. CONCLUSION Postpartum psychosis is a severe mental health condition which also impacts the woman's partner. Fathers experienced an array of emotions which they attributed to a lack of knowledge and understanding of postpartum psychosis. The development of appropriate support structures is needed to better support fathers in supporting their partners. REPORTING METHOD This review adhered to Preferred Reporting Items for Systematic Reviews and Meta-Analysis statement and ENTREQ reporting guidelines. PATIENT OR PUBLIC CONTRIBUTION There was no patient or public contribution. IMPACT WHAT PROBLEM DID THIS STUDY ADDRESS?: Fathers play a pivotal role in supporting their partner who has postpartum psychosis, and a supportive father has a positive impact on the mental health of the mother. Several qualitative studies have explored fathers' experiences of their partners' psychosis. This QES integrated findings from these studies to gain a deeper understanding and knowledge of the father's experience. WHAT ARE THE MAIN FINDINGS?: Fathers reported a significant sense of loss across multiple domains of their lives, from a perceived loss of their relationship with their partner to a loss of the future they had planned together. Fathers experienced an array of emotions, such as fear and shock which they attributed to their lack of knowledge and awareness of postpartum psychosis. WHERE AND ON WHOM WILL THIS RESEARCH HAVE AN IMPACT?: This review provides a deeper insight and understanding into the father's experiences and perspectives of their partners' postpartum psychosis. This insight can inform healthcare professionals and policymakers in the development of appropriate support structures which meet the needs of this population. The provision of appropriate support structures could have a positive impact on the father's well-being and ability to support their partner.
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Affiliation(s)
- Theresa Lyons
- Louth Meath Mental Health Services, Community Healthcare Organisation 8, Dublin, Ireland
| | - Therese Hennesey
- Department of Nursing and Midwifery, University of Limerick, Limerick, Ireland
- Health Research Institute, University of Limerick, Limerick, Ireland
| | - Maria Noonan
- Department of Nursing and Midwifery, University of Limerick, Limerick, Ireland
- Health Research Institute, University of Limerick, Limerick, Ireland
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Thoen CW, Sæle M, Strandberg RB, Eide PH, Kinn LG. Patients' experiences of day surgery and recovery: A meta-ethnography. Nurs Open 2024; 11:e2055. [PMID: 38268268 PMCID: PMC10701296 DOI: 10.1002/nop2.2055] [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: 11/10/2022] [Revised: 10/10/2023] [Accepted: 11/19/2023] [Indexed: 01/26/2024] Open
Abstract
AIM To explore and synthesise findings from qualitative studies on adult patients' experiences of day surgery and the processes of recovery. BACKGROUND There has been a shift in the practice of elective surgery, from inpatient to ambulatory treatment. Accordingly, more patients are undergoing day surgery and expected to care for themselves at home. To our knowledge, an updated metasynthesis on patients' experiences of day surgery across diverse contexts and continents is lacking. DESIGN Meta-ethnography. METHODS MEDLINE, EMBASE and CINAHL were systematically searched for qualitative research in English published between 2006 and 2023. Noblit and Hare's meta-ethnographic approach guided the synthesis of findings from 12 qualitative studies, and the eMERGe Reporting Guidance was used in the writing of this article. RESULTS Four themes were revealed: (1) requests for tailored information, (2) challenges of recognising and understanding postoperative symptoms, (3) being dependent on continuous professional and personal support and (4) calling for individual adaptation. CONCLUSION Our meta-ethnography indicates there is a need to improve information provision to better prepare patients for the processes of day surgery and recovery and promote their self-care abilities. Our findings highlight the importance of ensuring adequate levels of individualised care and support throughout the treatment process. RELEVANCE TO CLINICAL PRACTICE To improve quality of care in day surgery practice, implementation of interventions to enhance information provision and promote self-care during recovery at home may be considered. Pre-admission appointments that incorporate provision of tailored information and assessment of the patients' individual needs of care and support, home conditions and access to assistance from family/friends can be recommended.
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Affiliation(s)
- Cathrine Ween Thoen
- Department of Health and Caring Sciences, Faculty of Health and Social SciencesWestern Norway University of Applied SciencesBergenNorway
| | - Monica Sæle
- Department of Health and Caring Sciences, Faculty of Health and Social SciencesWestern Norway University of Applied SciencesBergenNorway
| | - Ragnhild Bjarkøy Strandberg
- Department of Health and Caring Sciences, Faculty of Health and Social SciencesWestern Norway University of Applied SciencesBergenNorway
| | - Petrin Hege Eide
- Department of Health and Caring Sciences, Faculty of Health and Social SciencesWestern Norway University of Applied SciencesBergenNorway
| | - Liv Grethe Kinn
- Department of Welfare and Participation, Faculty of Health and Social SciencesWestern Norway University of Applied SciencesBergenNorway
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Pryce R, Langan E, Tector K, Raggett L, Flynn R, Smart KM. Patients' experiences following total knee arthroplasty: a qualitative evidence synthesis. Disabil Rehabil 2024; 46:214-231. [PMID: 36617965 DOI: 10.1080/09638288.2022.2159548] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2022] [Accepted: 12/12/2022] [Indexed: 01/10/2023]
Abstract
PURPOSE Total knee arthroplasty (TKA) is a common surgical intervention for patients with advanced arthritis. The aim of this qualitative evidence synthesis was to systematically review the qualitative literature on patients' experiences following primary TKA. MATERIALS AND METHODS Four electronic databases (PubMed, CINAHL, Cochrane and Embase) were searched from inception until October 2021. Pairs of reviewers independently screened search results for eligibility, analysed the quality of included studies and extracted data. We undertook a thematic synthesis and used an interpretive approach to identify recurring themes and draw a conclusion. Data were synthesised using thematic analysis and an interpretive approach was used to identify themes. RESULTS Twenty-three studies exploring patients' experiences following TKA were included. Five main themes emerged: (i) Experience of healthcare staff, (ii) Pain/Medications, (iii) Was it worth it? (iv) Social Support (v) Follow up. CONCLUSIONS This review highlights the variability in patients' experiences following TKA. Whether this experience detailed their pain, function, or encounter with healthcare staff or systems, patients reported a variety of both positive and negative sentiments. Each theme invites attention to an area in which healthcare can improve to enhance patients' experiences. The importance of patient support, individualised rehabilitation and appropriate follow-up are highlighted.
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Affiliation(s)
- Robert Pryce
- Department of Physiotherapy and Sports Science, UCD School of Public Health, Health Science Centre, University College Dublin, Belfield, Ireland
| | - Emma Langan
- Department of Physiotherapy and Sports Science, UCD School of Public Health, Health Science Centre, University College Dublin, Belfield, Ireland
| | - Katie Tector
- Department of Physiotherapy and Sports Science, UCD School of Public Health, Health Science Centre, University College Dublin, Belfield, Ireland
| | - Leah Raggett
- Department of Physiotherapy and Sports Science, UCD School of Public Health, Health Science Centre, University College Dublin, Belfield, Ireland
| | - Roisin Flynn
- Department of Physiotherapy and Sports Science, UCD School of Public Health, Health Science Centre, University College Dublin, Belfield, Ireland
| | - Keith M Smart
- Department of Physiotherapy and Sports Science, UCD School of Public Health, Health Science Centre, University College Dublin, Belfield, Ireland
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Mulaku MN, Nyagol B, Owino EJ, Ochodo E, Young T, Steingart KR. Factors contributing to pre-treatment loss to follow-up in adults with pulmonary tuberculosis: a qualitative evidence synthesis of patient and healthcare worker perspectives. Glob Health Action 2023; 16:2148355. [PMID: 36548521 PMCID: PMC9788701 DOI: 10.1080/16549716.2022.2148355] [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] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2022] [Accepted: 11/12/2022] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND Since 2018, over 14 million people have been treated for tuberculosis (TB) globally. However, pre-treatment loss to follow-up (PTLFU) has been shown to contribute substantially to patient losses in the TB care cascade with subsequent high community transmission and mortality rates. OBJECTIVE To identify, appraise, and synthesise evidence on the perspectives of patients and healthcare workers on factors contributing to PTLFU in adults with pulmonary TB. METHODS We registered the title with PROSPERO (CRD42021253212). We searched nine relevant databases up to 24 May 2021 for qualitative studies. Two review authors independently reviewed records for eligibility and extracted data. We assessed methodological quality with the Evidence for Policy and Practice Information Centre tool and synthesised data using the Supporting the Use of Research Evidence framework. We assessed confidence in our findings using Confidence in the Evidence from Reviews of Qualitative Research (GRADE-CERQual). RESULTS We reviewed a total of 1239 records and included five studies, all from low- and middle-income countries. Key themes reported by patients and healthcare workers were communication challenges among healthcare workers and between healthcare workers and patients; knowledge, attitudes, and behaviours about TB and its management; accessibility and availability of facilities for TB care; and human resource and financial constraints, weakness in management and leadership in TB programmes. Patients' change of residence, long waiting times, and poor referral systems were additional factors that contributed to patients disengaging from care. We had moderate confidence in most of our findings. CONCLUSION Findings from our qualitative evidence synthesis highlight multiple factors that contribute to PTLFU. Central to addressing these factors will be the need to strengthen health systems and offer people-centred care.
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Affiliation(s)
- Mercy Namuma Mulaku
- Centre for Global Health Research, Kenya Medical Research Institute, Kisumu, Kenya
- Centre for Evidence-based Health Care, Division of Epidemiology and Biostatistics, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
- Department of Pharmacy, Faculty of Health Sciences, University of Nairobi, Nairobi, Kenya
| | - Bruce Nyagol
- Centre for Global Health Research, Kenya Medical Research Institute, Kisumu, Kenya
| | - Eddy Johnson Owino
- Centre for Global Health Research, Kenya Medical Research Institute, Kisumu, Kenya
| | - Eleanor Ochodo
- Centre for Global Health Research, Kenya Medical Research Institute, Kisumu, Kenya
- Centre for Evidence-based Health Care, Division of Epidemiology and Biostatistics, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
| | - Taryn Young
- Centre for Evidence-based Health Care, Division of Epidemiology and Biostatistics, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
| | - Karen R Steingart
- Honorary Research Fellow, Department of Clinical Sciences, Liverpool School of Tropical Medicine, Liverpool, UK
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Anderson AJ, Jones KV, DuBois DL, Çifci F, Teger Z. Cultural humility development in adults serving as mentors for youth: A qualitative evidence synthesis. Am J Community Psychol 2023. [PMID: 38149654 DOI: 10.1002/ajcp.12730] [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: 04/21/2023] [Revised: 09/17/2023] [Accepted: 11/08/2023] [Indexed: 12/28/2023]
Abstract
This qualitative review synthesizes evidence regarding how cultural humility (i.e., critical self-reflection, challenging inequity) may be influenced by the experience of serving as a mentor in a youth program. A systematic search identified 35 qualitative studies with findings that address this question. Thematic synthesis of extracted data identified the following six themes, all but one of which pertains to ways in which serving as a mentor appeared to have enhanced the cultural humility of the adults involved: (1) humanizing others: awareness of experiential differences, (2) reflecting inward on one's own identity, biases, and opportunities, (3) connecting with others, (4) recognizing environmental influences on human development, (5) envisioning contributions to community change, and (6) counterevidence: deficit-oriented attributions. Findings indicate that mentor cultural humility development primarily entailed individual and interpersonal awareness with relatively less evidence of increased awareness of and action to change inequality. The identified themes provide promising directions for future research as well as potentially useful avenues for incorporating consideration of cultural humility more intentionally in the development and evaluation of mentoring programs for youth.
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Affiliation(s)
- Amy J Anderson
- Department of Educational Psychology, University of North Texas, Denton, Texas, USA
| | - Kristian V Jones
- School of Social Work, University of Washington, Seattle, Washington, USA
| | - David L DuBois
- Division of Community Health Sciences, University of Illinois Chicago, Chicago, Illinois, USA
| | - Fatmanur Çifci
- Department of Educational Psychology, University of North Texas, Denton, Texas, USA
| | - Zara Teger
- School of Social Work, University of Washington, Seattle, Washington, USA
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van Rysewyk S, Blomkvist R, Chuter A, Crighton R, Hodson F, Roomes D, Smith BH, Toye F. Understanding the lived experience of chronic pain: A systematic review and synthesis of qualitative evidence syntheses. Br J Pain 2023; 17:592-605. [PMID: 37969135 PMCID: PMC10642495 DOI: 10.1177/20494637231196426] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2023] Open
Abstract
Background Although multiple measures of the causes and consequences of chronic non-cancer pain (CNCP) are available and can inform pain management, no quantitative summary of these measures can describe the meaning of pain for a patient. The lived experience of pain tends to be a blind spot in pain management. This study aimed to: (1) integrate qualitative research investigating the lived experience of a range of CNCP conditions; (2) establish common qualitative themes in CNCP experience; and (3) evaluate the relevance of our results through a survey questionnaire based on these themes, administered across the United Kingdom. Methods Four bibliographic databases were searched from inception to February 2021 to identify Qualitative Evidence Syntheses (QES) that investigated the lived experience of CNCP and its impact on everyday life and activities. Themes and trends were derived by thematic qualitative analysis in collaboration with two patient and public involvement representatives who co-created twenty survey statements. The survey was developed for testing the QES themes for validity in people living with pain. Results The research team identified and screened 1323 titles, and considered 86 abstracts, including 20 in the final review. Eight themes were developed from the study findings: (1) my pain gives rise to negative emotions; (2) changes to my life and to myself; (3) adapting to my new normal; (4) effects of my pain management strategies; (5) hiding and showing my pain; (6) medically explaining my pain; (7) relationships to those around me; and (8) working while in pain. Each theme gave rise to one or two survey questions. The survey was shared with members of the UK pain community over a 2-week period in November 2021, and was completed by 1219 people, largely confirming the above themes. Conclusion/Implications This study provides a validated summary of the lived experience of CNCP. It highlights the adverse nature, complications, and consequences of living with CNCP in the UK and the multiple shortcomings in the ways in which pain is addressed by others in the UK. Our findings are consistent with published meta-ethnographies on chronic non-malignant musculoskeletal pain and chronic low-back pain. Despite the underrepresentation of qualitative research in the pain literature compared to quantitative approaches, for understanding the complexity of the lived experience of pain, qualitative research is an essential tool.
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Affiliation(s)
- Simon van Rysewyk
- Department of Philosophy and Gender Studies, School of Humanities, University of Tasmania, Hobart, TAS, Australia
| | - Renée Blomkvist
- Population Health and Genomics, School of Medicine, University of Dundee, Dundee, UK
| | | | - Rhea Crighton
- Royal Devon University Healthcare NHS Foundation Trust, Barnstaple, UK
| | | | | | - Blair H Smith
- Population Health and Genomics, School of Medicine, University of Dundee, Dundee, UK
| | - Francine Toye
- Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, UK
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Climent-Sanz C, Hamilton KR, Martínez-Navarro O, Briones-Vozmediano E, Gracia-Lasheras M, Fernández-Lago H, Valenzuela-Pascual F, Finan PH. Fibromyalgia pain management effectiveness from the patient perspective: a qualitative evidence synthesis. Disabil Rehabil 2023:1-16. [PMID: 37965900 DOI: 10.1080/09638288.2023.2280057] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2023] [Accepted: 11/01/2023] [Indexed: 11/16/2023]
Abstract
PURPOSE This qualitative evidence synthesis aimed to identify and integrate findings where adults with fibromyalgia discussed how they managed their pain, and their perceptions of prescribed treatments from healthcare professionals. MATERIALS AND METHODS A comprehensive search strategy was implemented in PubMed, Scopus, ISI Web of Science, and Cinahl Plus databases. The GRADE-CERQual framework was used to evaluate the findings confidence. The findings were analyzed using an inductive thematic analysis approach. RESULTS A total of 35 studies (N = 728) were included. The confidence in the findings ranged from high to low confidence. Patients with fibromyalgia often do not benefit from seeking medical attention due to provider stigma, and have varying views on medication effectiveness commonly reporting feeling like "walking chemists." They find mixed effects from exercise, and consider psychological support essential, although the benefits of cognitive-behavioral therapy were controversial. Combining cognitive-behavioral therapy with physical exercise appears more effective, while natural and complementary therapies have short-term benefits and high costs. CONCLUSIONS Pain management is a source for frustration and an unmet need for patients with fibromyalgia. The current findings provide crucial insight for providers and researchers; and support the need for fibromyalgia phenotyping and precision medicine approaches to pain management.Implications for RehabilitationChronic widespread pain is the defining feature of fibromyalgia, yet pain reduction is often an unmet need for these individuals.The lack of effective treatments resulting in long-term relief proves frustrating for patients and healthcare providers.Rehabilitation professional should consider the unique insight into this complex, heterogeneous condition that this qualitative synthesis provides to better understand their patient's perspective on pain management.Given the differing perspectives on pain treatment approaches individuals with fibromyalgia report, providers should discuss with each patient their current strategies and take a patient-centered, individualized approach to form an effective treatment plan.
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Affiliation(s)
- Carolina Climent-Sanz
- Department of Nursing and Physiotherapy, University of Lleida, Lleida, Spain
- Health Care Research Group (GRECS), Lleida Institute for Biomedical Research Dr. Pifarré Foundation, IRBLleida, Lleida, Spain
- Consolidated Research Group in Society, Health, Education and Culture of Care (GESEC), Institute for Social and Territorial Development (INDEST), University of Lleida, Lleida, Spain
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins School of Medicine, Baltimore, MD, USA
| | - Katrina R Hamilton
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins School of Medicine, Baltimore, MD, USA
| | - Oriol Martínez-Navarro
- Department of Nursing and Physiotherapy, University of Lleida, Lleida, Spain
- Health Care Research Group (GRECS), Lleida Institute for Biomedical Research Dr. Pifarré Foundation, IRBLleida, Lleida, Spain
| | - Erica Briones-Vozmediano
- Department of Nursing and Physiotherapy, University of Lleida, Lleida, Spain
- Health Care Research Group (GRECS), Lleida Institute for Biomedical Research Dr. Pifarré Foundation, IRBLleida, Lleida, Spain
- Consolidated Research Group in Society, Health, Education and Culture of Care (GESEC), Institute for Social and Territorial Development (INDEST), University of Lleida, Lleida, Spain
| | | | - Helena Fernández-Lago
- Department of Nursing and Physiotherapy, University of Lleida, Lleida, Spain
- Health Care Research Group (GRECS), Lleida Institute for Biomedical Research Dr. Pifarré Foundation, IRBLleida, Lleida, Spain
- Consolidated Research Group in Society, Health, Education and Culture of Care (GESEC), Institute for Social and Territorial Development (INDEST), University of Lleida, Lleida, Spain
| | - Fran Valenzuela-Pascual
- Department of Nursing and Physiotherapy, University of Lleida, Lleida, Spain
- Health Care Research Group (GRECS), Lleida Institute for Biomedical Research Dr. Pifarré Foundation, IRBLleida, Lleida, Spain
- Consolidated Research Group in Society, Health, Education and Culture of Care (GESEC), Institute for Social and Territorial Development (INDEST), University of Lleida, Lleida, Spain
| | - Patrick H Finan
- Department of Anesthesiology, University of VA School of Medicine, Charlottesville, VA, USA
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Toledo‐Chavarri A, Delgado J, Rodríguez‐Martín B. Perspectives of women living with type 1 diabetes regarding preconception and antenatal care: A qualitative evidence synthesis. Health Expect 2023; 27:e13876. [PMID: 37909855 PMCID: PMC10726142 DOI: 10.1111/hex.13876] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2023] [Revised: 08/21/2023] [Accepted: 09/08/2023] [Indexed: 11/03/2023] Open
Abstract
INTRODUCTION Pregnant women with type 1 diabetes may have an increased risk of complications for both the baby and themselves. Educational programmes, preconception planning, strict glycemic control and comprehensive medical care are some of the antenatal interventions that have been proposed to improve the outcomes of pregnant women with type 1 diabetes. While some evidence-based recommendations about antenatal care are included in clinical practice guidelines (CPGs), the views, and experiences of women with type 1 diabetes about these interventions are not well known. AIM To understand and synthesize the perceptions of women with type 1 diabetes about the interventions before pregnancy. METHOD A qualitative evidence synthesis (QES) was carried out with a framework analysis guided by the Cochrane Qualitative and Implementation Methods Group approach. Three online databases (Medline, Embase and Web of Science) were searched. We included qualitative articles that were published from 2011 to 2021 and which were available in English or Spanish. FINDINGS Ten references met the inclusion criteria of the study and were included. Three main themes were identified: (a) acceptability of antenatal care, (b) feasibility and implementation consideration and (c) equity and accessibility difficulties. CONCLUSION Continuity of care, coordination between health professionals and services, and a more holistic approach are the key aspects women say need to be considered for more acceptable, feasible and equitable preconception and antenatal care. PATIENT OR PUBLIC CONTRIBUTION This QES was carried out as part of the CPGs on diabetes mellitus type 1, carried out as part of the Spanish Network of Health Technology Assessment Agencies. In this CPG, the representatives of the patient associations are Francisco Javier Darias Yanes, from the Association for Diabetes of Tenerife, who has participated in all the phases of the CPG; Aureliano Ruiz Salmón and Julián Antonio González Hernández (representatives of the Spanish Diabetes Federation (FEDE) who have participated as collaborator and external reviewer, respectively.
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Affiliation(s)
- Ana Toledo‐Chavarri
- Canary Islands Health Research Institute Foundation, (FIISC)TenerifeSpain
- The Spanish Network of Agencies for Health Technology Assessment and Services of the National Health System (RedETS)MadridSpain
- Research Network on Health Services in Chronic Diseases (REDISSEC)Spain
- Network for Research on Chronicity, Primary Care, and Health Promotion (RICAPPS)Spain
| | - Janet Delgado
- The Spanish Network of Agencies for Health Technology Assessment and Services of the National Health System (RedETS)MadridSpain
- Department of Philosophy IUniversity of Granada, Campus Universitario de Cartuja CPGranadaSpain
| | - Beatriz Rodríguez‐Martín
- Network for Research on Chronicity, Primary Care, and Health Promotion (RICAPPS)Spain
- Department of Nursing, Physiotherapy and Occupational TherapyFaculty of Health Sciences, University of Castilla‐La ManchaTalavera de la Reina (Toledo)Spain
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11
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Moore TH, Dawson S, Wheeler J, Hamilton-Shield J, Barrett TG, Redwood S, Litchfield I, Greenfield SM, Searle A. Views of children with diabetes from underserved communities, and their families on diabetes, glycaemic control and healthcare provision: A qualitative evidence synthesis. Diabet Med 2023; 40:e15197. [PMID: 37573564 DOI: 10.1111/dme.15197] [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] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/26/2023] [Revised: 08/07/2023] [Accepted: 08/08/2023] [Indexed: 08/15/2023]
Abstract
AIMS Children and young people with diabetes (CYPD) from socio-economically deprived and/or ethnic minority groups tend to have poorer glucose control and greater risk of diabetes-related complications. In this systematic review of qualitative evidence (qualitative evidence synthesis, QES), we aimed to explore the experiences and views of clinical encounters in diabetes care from the perspectives of CYPD and their family/carers from underserved communities and healthcare professionals in diabetes care. METHODS We searched 6 databases to March 2022 with extensive search terms, and used a thematic synthesis following methods of Thomas and Harden. RESULTS We identified 7 studies and described 11 descriptive themes based on primary and secondary constructs. From these, three "analytical themes" were developed. (1) "Alienation of CYPD" relates to their social identity and interaction with peers, family and health service practitioners in the context of diabetes self- and family/carer management and is impacted by communication in the clinical encounter. (2) "Empowerment of CYPD and family/carers" explores families' understanding of risks and consequences of diabetes and taking responsibility for self- and family/carer management in the context of their socio-cultural background. (3) "Integration of diabetes (into self and family)" focuses on the ability to integrate diabetes self-management into the daily lives of CYPD and family/carers beyond the clinical consultation. CONCLUSIONS The analytical themes are interdependent and provide a conceptual framework from which to explore and strengthen the therapeutic alliance in clinical encounters and to foster greater concordance with treatment plans. Communicating the biomedical aspects of managing diabetes in the clinical encounter is important, but should be balanced with addressing socio-emotional factors important to CYPD and family/carers.
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Affiliation(s)
- Theresa H Moore
- NIHR Applied Research Collaboration West (ARC West) at University Hospitals Bristol and Weston NHS Foundation Trust, Bristol, UK
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - Sarah Dawson
- NIHR Applied Research Collaboration West (ARC West) at University Hospitals Bristol and Weston NHS Foundation Trust, Bristol, UK
| | - Jessica Wheeler
- NIHR Applied Research Collaboration West (ARC West) at University Hospitals Bristol and Weston NHS Foundation Trust, Bristol, UK
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | | | - Timothy G Barrett
- Institute of Cancer and Genomic Sciences, College of Medical and Dental Sciences, University of Birmingham, Birmingham, UK
| | - Sabi Redwood
- NIHR Applied Research Collaboration West (ARC West) at University Hospitals Bristol and Weston NHS Foundation Trust, Bristol, UK
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - Ian Litchfield
- IOEM, Institute of Applied Health Research, University of Birmingham, Birmingham, UK
| | - Sheila M Greenfield
- IOEM, Institute of Applied Health Research, University of Birmingham, Birmingham, UK
| | - Aidan Searle
- NIHR Bristol Biomedical Research Centre Nutrition theme, University Hospitals Bristol and Weston NHS Foundation Trust and the University of Bristol, Bristol, UK
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12
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Carvalho M, Dunne P, Kwasnicka D, Byrne M, McSharry J. Barriers and enablers to maintaining self-management behaviours after attending a self-management support intervention for type 2 diabetes: a systematic review and qualitative evidence synthesis. Health Psychol Rev 2023:1-30. [PMID: 37807622 DOI: 10.1080/17437199.2023.2268731] [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: 09/08/2022] [Accepted: 10/04/2023] [Indexed: 10/10/2023]
Abstract
Attendance at type 2 diabetes self-management interventions is associated with improved outcomes. However, difficulties maintaining self-management behaviours attenuate long-term impact. This review aimed to identify and synthesise qualitative research on barriers and enablers to maintaining type 2 diabetes self-management behaviours after attending a self-management intervention. Eight electronic databases were searched to identify relevant peer-reviewed and grey literature studies. Data were synthesised using the best-fit framework synthesis approach guided by the themes and constructs identified by Kwasnicka et al. (2016) on their review of theoretical explanations for behaviour change maintenance. Study methodological limitations and confidence in findings were assessed using an adapted version of the Critical Appraisal Skills Programme (CASP) tool and the GRADE-CERQual approach respectively. Eleven articles reporting on 10 studies were included. Twenty-eight barriers and enablers were coded to the a priori themes. Barriers were commonly coded to the themes self-regulation, resources, and environmental and social influences. Enablers were commonly coded to the themes habits and maintenance motives. Methodological limitations of included studies varied, leading to moderate or low confidence in most findings. Interventions may improve behavioural maintenance by providing post-intervention support, promoting positive behaviour change motives, self-regulation, habit formation, and facilitating access to resources and support.
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Affiliation(s)
- Márcia Carvalho
- Health Behaviour Change Research Group, School of Psychology, University of Galway, Galway, Republic of Ireland
| | - Pauline Dunne
- School of Agriculture and Food Science, University College Dublin, Dublin, Republic of Ireland
| | - Dominika Kwasnicka
- Faculty of Psychology, SWPS University of Social Sciences and Humanities, Wrocław, Poland
- NHMRC CRE in Digital Technology to Transform Chronic Disease Outcomes, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Australia
| | - Molly Byrne
- Health Behaviour Change Research Group, School of Psychology, University of Galway, Galway, Republic of Ireland
| | - Jenny McSharry
- Health Behaviour Change Research Group, School of Psychology, University of Galway, Galway, Republic of Ireland
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13
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Giltenane M, Dowling M. Student nurses' experiences of remote learning during Covid-19 pandemic: A qualitative evidence synthesis. J Adv Nurs 2023. [PMID: 37788086 DOI: 10.1111/jan.15887] [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] [Subscribe] [Scholar Register] [Received: 03/03/2023] [Revised: 08/31/2023] [Accepted: 09/11/2023] [Indexed: 10/05/2023]
Abstract
AIM To systematically synthesize undergraduate student nurses' experience of online, blended or distance learning during Covid-19 pandemic. DESIGN A qualitative evidence synthesis (QES). REVIEW METHODS A QES. Themes were organized using the 'best fit' framework approach. Methodological limitations and confidence in the review findings were informed by GRADE-CERQual (Confidence in the Evidence from Reviews of Qualitative research). DATA SOURCES Qualitative literature from five databases including CINAHL, PubMed, Medline, Education Full Text (H.W. Wilson) and ERIC were searched from March 2020 to November 2021. RESULTS Nine qualitative and two mixed method studies were included in this 'best fit' framework using Chickering and Gamson's Seven Principles for Good Practice in Undergraduate Education. Importance of the social presence of the teacher through effective communication and interpersonal relationships is highlighted. Clinical placement and in-person practical skills training are needed for effective nursing education. CONCLUSIONS This review highlighted that online content can be developed into efficient and high-quality learner-centred education within blended undergraduate nursing programmes incorporating essential face-to-face and practical components. Various supporting measures are required for both students and faculty. We suggest an adaptation of a 'Blending with Purpose: The Multimodal Model' with key considerations for undergraduate nursing programmes where pedagogical objectives and activities drive the approaches to achieve intended learning outcomes and student satisfaction. IMPLICATIONS FOR THE PROFESSION Well-designed online programmes using digital tools that support interaction and teamwork are required for undergraduate nursing education. IMPACT Blended learning approaches offer more flexibility than online learning alone which leads to improved student engagement. Clinical placement and in-person practical skills training are needed for effective nursing education. REPORTING METHOD: 'Enhancing transparency in reporting the synthesis of qualitative research' (ENTREQ) for QES. NO PATIENT OR PUBLIC CONTRIBUTION No Patient or Public Contribution.
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Affiliation(s)
- Martina Giltenane
- HS3-005, Department of Nursing and Midwifery, Faculty of EHS, Health Sciences Building, University of Limerick, Limerick, Ireland
| | - Maura Dowling
- School of Nursing and Midwifery National University of Ireland Galway, Galway, Ireland
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14
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McMahon K, Clark IN, Stensæth K, Wosch T, Odell Miller H, Bukowska A, Baker FA. A qualitative systematic review of the experiences of sharing music for people living with dementia and their family care partners: the thread of connection. Arts Health 2023; 15:229-256. [PMID: 36224535 DOI: 10.1080/17533015.2022.2128381] [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: 10/18/2021] [Revised: 09/01/2022] [Accepted: 09/14/2022] [Indexed: 10/17/2022]
Abstract
BACKGROUND There is a global need for interventions that support the wellbeing of people living with dementia and their family care partners. Studies show that shared musical activities may achieve this. Our systematic review aimed to synthesise existing research exploring dyads' experiences of shared musical activities across a range of contexts. METHOD From 31 October 2020 we searched PubMed, PsycInfo, CINAHL Complete, EMBASE, RILM, Web of Science Core Collection, Google Scholar and ProQuest Dissertations & Theses for studies published up to 14 April 2021, and hand searched five music therapy journals plus citation lists. Thirteen qualitative studies reporting on dyads' experiences and perspectives of shared musical activities across a range of settings were included. Studies with mixed populations or mixed modality interventions were excluded. We analysed the final studies using thematic synthesis, engaging in reflective discussions and reflexivity throughout. The quality of included studies was assessed using the CASP qualitative checklist. This study is registered on PROSPERO: CRD42020169360. RESULTS Six themes were identified from 13 studies: 1) shared musical activities support wellbeing for people living with dementia, 2) music groups become ecological systems, 3) shared musical activities are experienced differently over time, 4) shared musical activities are experienced by me and as we, 5) music is a supportive structure, and 6) the thread of connection (an overarching theme). A GRADE-CERQual assessment found moderate to high confidence in these findings. Findings informed the development of the Contextual Connection Model of Health Musicking. CONCLUSION Shared musical activities foster experiences of connection for people living with dementia and their family care partners. Experiences of connection are supported through professional facilitation and the structural aspects of music, and are influenced by the setting and changes over time. These experiences of connection play a central role in supporting dyadic and individual wellbeing. These findings are largely relevant to a western cultural context; future research should seek to include more diverse cultural experiences.
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Affiliation(s)
- Kate McMahon
- Faculty of Fine Arts & Music University of Melbourne, Melbourne, Victoria, Australia
| | - Imogen N Clark
- Faculty of Fine Arts & Music University of Melbourne, Melbourne, Victoria, Australia
| | - Karette Stensæth
- Centre for Music and Health Norwegian Academy of Music, Oslo, Norway
| | - Thomas Wosch
- Institute for Applied Social Sciences, University of Applied Sciences Würzburg-Schweinfurt, Würzburg, Germany
| | - Helen Odell Miller
- Cambridge Institute for Music Therapy Research, Anglia Ruskin University, Cambridge, UK
| | - Anna Bukowska
- Department of Occupational Therapy, University School of Physical Education, Krakow, Poland
| | - Felicity A Baker
- Centre for Research in Music and Health, Norwegian Academy of Music, Oslo, Norway
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15
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Byrne A, Jones K, Backhouse M, Rose F, Moatt E, van der Feltz-Cornelis C. Patient and primary care practitioners' perspectives on consultations for fibromyalgia: a qualitative evidence synthesis. Prim Health Care Res Dev 2023; 24:e58. [PMID: 37750736 PMCID: PMC10540196 DOI: 10.1017/s1463423623000506] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2022] [Revised: 03/29/2023] [Accepted: 08/28/2023] [Indexed: 09/27/2023] Open
Abstract
BACKGROUND Fibromyalgia presents a challenge to both the patients experiencing symptoms and the staff aiming to treat them. This qualitative review aimed to synthesise how patients and practitioners experience primary care consultations, develop a rounded picture of how they perceive each other, the challenges to primary care consultation and how they might be tackled. METHODS CINAHL, Embase, CENTRAL and Medline were searched from inception to November 2021. Qualitative studies were included if they explored the perspectives and experiences of either fibromyalgia patients or primary care practitioners. Quantitative data, studies not published in English, not set in primary care or that did not distinguish the type of patient or clinician were excluded. Included studies were analysed using thematic synthesis and their quality assessed. RESULTS In total, 30 studies met the inclusion criteria. Thematic synthesis identified three overarching themes: (1) life turned upside down - exploring the chaos experienced by patients as they seek help; (2) negative cycle - highlighting how patient and practitioner factors can create a detrimental cycle; and (3) breaking the cycle - validating patient-doctor relationships underpinned by clear communication can help break the negative cycle. CONCLUSIONS Fibromyalgia patients experience uncertainty and chaos that can clash with the attitudes of GPs and the help they can feasibly provide. Difficult consultations in which neither the GP nor patient are satisfied can easily occur. Promoting supportive, reciprocal and open patient-doctor relationships is essential. Future research is required to further explore GP attitudes and to develop an intervention that could improve consultations, patient outcomes and GP satisfaction.
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Affiliation(s)
- Ailish Byrne
- York Trials Unit, Department of Health Sciences, University of York, Heslington, York, UK
| | - Katherine Jones
- Warwick Clinical Trials Unit, University of Warwick, Coventry, UK
| | | | - Fiona Rose
- York Trials Unit, Department of Health Sciences, University of York, Heslington, York, UK
| | - Emma Moatt
- York Trials Unit, Department of Health Sciences, University of York, Heslington, York, UK
| | - Christina van der Feltz-Cornelis
- Mental Health and Addictions Research Group, Department of Health Sciences, Hull York Medical School, University of York, Heslington, York, UK
- Institute of Health Informatics, University College London, London, UK
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16
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Pinto C, Geraghty AWA, McLoughlin C, Pagnini F, Yardley L, Dennison L. Experiences of psychological interventions in neurodegenerative diseases: a systematic review and thematic synthesis. Health Psychol Rev 2023; 17:416-438. [PMID: 35546326 DOI: 10.1080/17437199.2022.2073901] [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] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/11/2021] [Accepted: 05/01/2022] [Indexed: 11/04/2022]
Abstract
Background: Psychological interventions for managing emotional distress in neurodegenerative diseases are needed, but progressive worsening of symptoms and increasing disability might pose difficulties with engagement. We aimed to synthesise the experiences of engaging with and using psychological interventions in neurodegenerative diseases and identify relevant barriers and facilitators. Methods: Systematic searches were conducted in six electronic databases and results were screened. We included qualitative and mixed methods studies reporting patient or caregivers' views or experiences of psychological interventions. Qualitative data were extracted and thematically synthesised. Results: 34 papers were included, covering a range of diseases and interventions. Engagement was facilitated by flexible intervention formats and tailoring to the specific needs of people with neurodegenerative diseases. Interventions were sometimes inaccessible or burdensome because of physical and cognitive symptoms, and the time and effort required for the intervention. Participants' levels of acceptance and readiness often differed and influenced engagement with the intervention. Across different interventions, participants experienced wide-ranging benefits including changes in insight, perspective, self-efficacy, emotions and relationships. Conclusion: Although people with neurodegenerative diseases and caregivers experience benefits from psychological interventions, burden-reducing adaptations and sensitive tailoring to the specific disease context is required to improve acceptability and engagement.
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Affiliation(s)
- Cathryn Pinto
- Department of Psychology, University of Southampton, Southampton, UK
| | - Adam W A Geraghty
- Primary Care, Population Sciences and Medical Education, University of Southampton, Southampton, UK
| | | | - Francesco Pagnini
- Department of Psychology, Università Cattolica del Sacro Cuore, Milan, Italy
- Department of Psychology, Harvard University, Cambridge, MA, USA
| | - Lucy Yardley
- Department of Psychology, University of Southampton, Southampton, UK
- School of Psychological Science, University of Bristol, Bristol, UK
| | - Laura Dennison
- Department of Psychology, University of Southampton, Southampton, UK
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17
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Rhodes EC, Nyhan K, Okoli N, O’Connor Duffany K, Rodriguez ME, Perkins B, Ross D, Pérez-Escamilla R. Client experience of food assistance programs among adults in the United States: a qualitative evidence synthesis protocol. Front Public Health 2023; 11:1193451. [PMID: 37719734 PMCID: PMC10501444 DOI: 10.3389/fpubh.2023.1193451] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2023] [Accepted: 08/10/2023] [Indexed: 09/19/2023] Open
Abstract
Introduction Policymakers, health practitioners, and other key partners are increasingly focused on ensuring that clients of food assistance programs have positive experiences, a key aspect of high-quality programming. The objectives of this review are to describe the experiences of clients participating in food assistance programs in the United States (US) and to identify ways that these programs promote or hinder positive experiences. Methods and analysis We will conduct a qualitative evidence synthesis with partners from food security organizations and community members. Peer-reviewed literature will be systematically searched in Scopus, CINAHL, and AGRICOLA. To identify grey literature, we will use Google's programmable search engine. This review will consider sources that present results of primary qualitative studies that focus on at least one food assistance program in the US and explore the perspectives of adult clients. Only sources published in English or Spanish from 2007 onward will be included. Multiple reviewers will screen articles for inclusion and extract data from articles that meet the inclusion criteria, using a structured data extraction tool. Thematic synthesis or meta-ethnography may be appropriate approaches for synthesizing the extracted data. The final selection of synthesis method will be determined once the set of primary qualitative studies to be included in the review is complete and the type of data presented in these studies is known. We will assess the methodological quality of the included studies using the CASP (Critical Appraisal Skills Programme) tool for qualitative studies and assess the confidence in the review findings using the GRADE-CERQual (Confidence in Evidence from Reviews of Qualitative research) approach. Discussion The findings of this review will inform the development of measures to assess client experience and quality improvement efforts.
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Affiliation(s)
- Elizabeth C. Rhodes
- Hubert Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, GA, United States
| | - Kate Nyhan
- Harvey Cushing/John Hay Whitney Medical Library, Yale University, New Haven, CT, United States
- Department of Environmental Health Sciences, Yale University School of Public Health, New Haven, CT, United States
| | - Ngozi Okoli
- Department of Social and Behavioral Sciences, School of Public Health, Yale University, New Haven, CT, United States
| | - Kathleen O’Connor Duffany
- Department of Social and Behavioral Sciences, School of Public Health, Yale University, New Haven, CT, United States
| | | | | | - Daniel Ross
- DAISA Enterprises, LLC, South Hadley, MA, United States
| | - Rafael Pérez-Escamilla
- Department of Social and Behavioral Sciences, School of Public Health, Yale University, New Haven, CT, United States
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18
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Eaton A, Ball GDC, Hwang Y, Carson V, Gokiert R, Dennett L, Rajani H, Zhang M, Dyson MP. The Impacts of COVID-19 Restrictions on Physical Activity in Children and Youth: A Systematic Review of Qualitative Evidence. J Phys Act Health 2023; 20:423-437. [PMID: 36965492 DOI: 10.1123/jpah.2022-0350] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2022] [Revised: 12/16/2022] [Accepted: 01/11/2023] [Indexed: 03/27/2023]
Abstract
BACKGROUND The objectives of this systematic review were to synthesize qualitative evidence on the impacts of COVID-19 restrictions on physical activity (PA) for children and youth, and explore factors perceived to influence those impacts. METHODS Five databases (MEDLINE, Embase, SPORTDiscus, ERIC, and CINAHL) were searched initially in June 2021 and updated in December 2021 to locate qualitative articles considering COVID-19 restrictions and PA for children and youth (≤18 y old), in any setting. Eligibility, quality assessments, and data extraction were completed by 2 independent reviewers. Data were synthesized using meta-aggregation with confidence of findings rated using ConQual. RESULTS After screening 3505 records, 15 studies were included. Curriculum-based PA, organized sport, and active transportation were negatively impacted by COVID-19 restrictions. Negative changes were affected by COVID-19 exposure risks, inadequate instruction, poor access, screen time, and poor weather. Unstructured PA was inconsistently impacted; outdoor unstructured PA increased for some. Positive changes were facilitated by family co-participation, availability of outdoor space, and perceived mental health benefits. CONCLUSION Qualitative data indicated restrictions had a predominantly negative impact on PA for children and youth, but inconsistent impacts on unstructured PA. The improved contextual understanding offered by our review will be foundational knowledge for health strategies moving forward.
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Affiliation(s)
- Andrea Eaton
- Department of Pediatrics, Faculty of Medicine & Dentistry, University of Alberta, Edmonton, AB,Canada
| | - Geoff D C Ball
- Department of Pediatrics, Faculty of Medicine & Dentistry, University of Alberta, Edmonton, AB,Canada
| | - Yeongho Hwang
- Faculty of Kinesiology, Sport & Recreation, University of Alberta, Edmonton, AB,Canada
| | - Valerie Carson
- Faculty of Kinesiology, Sport & Recreation, University of Alberta, Edmonton, AB,Canada
| | - Rebecca Gokiert
- School of Public Health, University of Alberta, Edmonton, AB,Canada
| | | | - Hasu Rajani
- Department of Pediatrics, Faculty of Medicine & Dentistry, University of Alberta, Edmonton, AB,Canada
- Northeast Community Health Centre, Edmonton, AB,Canada
| | - Mona Zhang
- Department of Pediatrics, Faculty of Medicine & Dentistry, University of Alberta, Edmonton, AB,Canada
- Northeast Community Health Centre, Edmonton, AB,Canada
| | - Michele P Dyson
- Department of Pediatrics, Faculty of Medicine & Dentistry, University of Alberta, Edmonton, AB,Canada
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19
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Hogg HDJ, Al-Zubaidy M, Talks J, Denniston AK, Kelly CJ, Malawana J, Papoutsi C, Teare MD, Keane PA, Beyer FR, Maniatopoulos G. Stakeholder Perspectives of Clinical Artificial Intelligence Implementation: Systematic Review of Qualitative Evidence. J Med Internet Res 2023; 25:e39742. [PMID: 36626192 PMCID: PMC9875023 DOI: 10.2196/39742] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2022] [Revised: 09/28/2022] [Accepted: 11/30/2022] [Indexed: 12/03/2022] Open
Abstract
BACKGROUND The rhetoric surrounding clinical artificial intelligence (AI) often exaggerates its effect on real-world care. Limited understanding of the factors that influence its implementation can perpetuate this. OBJECTIVE In this qualitative systematic review, we aimed to identify key stakeholders, consolidate their perspectives on clinical AI implementation, and characterize the evidence gaps that future qualitative research should target. METHODS Ovid-MEDLINE, EBSCO-CINAHL, ACM Digital Library, Science Citation Index-Web of Science, and Scopus were searched for primary qualitative studies on individuals' perspectives on any application of clinical AI worldwide (January 2014-April 2021). The definition of clinical AI includes both rule-based and machine learning-enabled or non-rule-based decision support tools. The language of the reports was not an exclusion criterion. Two independent reviewers performed title, abstract, and full-text screening with a third arbiter of disagreement. Two reviewers assigned the Joanna Briggs Institute 10-point checklist for qualitative research scores for each study. A single reviewer extracted free-text data relevant to clinical AI implementation, noting the stakeholders contributing to each excerpt. The best-fit framework synthesis used the Nonadoption, Abandonment, Scale-up, Spread, and Sustainability (NASSS) framework. To validate the data and improve accessibility, coauthors representing each emergent stakeholder group codeveloped summaries of the factors most relevant to their respective groups. RESULTS The initial search yielded 4437 deduplicated articles, with 111 (2.5%) eligible for inclusion (median Joanna Briggs Institute 10-point checklist for qualitative research score, 8/10). Five distinct stakeholder groups emerged from the data: health care professionals (HCPs), patients, carers and other members of the public, developers, health care managers and leaders, and regulators or policy makers, contributing 1204 (70%), 196 (11.4%), 133 (7.7%), 129 (7.5%), and 59 (3.4%) of 1721 eligible excerpts, respectively. All stakeholder groups independently identified a breadth of implementation factors, with each producing data that were mapped between 17 and 24 of the 27 adapted Nonadoption, Abandonment, Scale-up, Spread, and Sustainability subdomains. Most of the factors that stakeholders found influential in the implementation of rule-based clinical AI also applied to non-rule-based clinical AI, with the exception of intellectual property, regulation, and sociocultural attitudes. CONCLUSIONS Clinical AI implementation is influenced by many interdependent factors, which are in turn influenced by at least 5 distinct stakeholder groups. This implies that effective research and practice of clinical AI implementation should consider multiple stakeholder perspectives. The current underrepresentation of perspectives from stakeholders other than HCPs in the literature may limit the anticipation and management of the factors that influence successful clinical AI implementation. Future research should not only widen the representation of tools and contexts in qualitative research but also specifically investigate the perspectives of all stakeholder HCPs and emerging aspects of non-rule-based clinical AI implementation. TRIAL REGISTRATION PROSPERO (International Prospective Register of Systematic Reviews) CRD42021256005; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=256005. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) RR2-10.2196/33145.
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Affiliation(s)
- Henry David Jeffry Hogg
- Population Health Science Institute, Newcastle University, Newcastle upon Tyne, United Kingdom
- Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, United Kingdom
- Moorfields Eye Hospital NHS Foundation Trust, London, United Kingdom
| | - Mohaimen Al-Zubaidy
- Population Health Science Institute, Newcastle University, Newcastle upon Tyne, United Kingdom
- Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, United Kingdom
| | - James Talks
- Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, United Kingdom
| | - Alastair K Denniston
- Institute of Inflammation and Ageing, College of Medical and Dental Sciences, University of Birmingham, Birmingham, United Kingdom
- University Hospitals Birmingham NHS Foundation Trust, Birmingham, United Kingdom
| | | | - Johann Malawana
- The Healthcare Leadership Academy, London, United Kingdom
- The Institute of Leadership and Management, Birmingham, United Kingdom
| | - Chrysanthi Papoutsi
- Nuffield Department of Primary Healthcare Sciences, Oxford University, Oxford, United Kingdom
| | - Marion Dawn Teare
- Population Health Science Institute, Newcastle University, Newcastle upon Tyne, United Kingdom
| | - Pearse A Keane
- Moorfields Eye Hospital NHS Foundation Trust, London, United Kingdom
- Institute of Ophthalmology, University College London, London, United Kingdom
| | - Fiona R Beyer
- Evidence Synthesis Group, Population Health Science Institute, Newcastle University, Newcastle upon Tyne, United Kingdom
| | - Gregory Maniatopoulos
- Population Health Science Institute, Newcastle University, Newcastle upon Tyne, United Kingdom
- Faculty of Business and Law, Northumbria University, Newcastle upon Tyne, United Kingdom
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20
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Healy D, Flynn A, Conlan O, McSharry J, Walsh J. Older Adults' Experiences and Perceptions of Immersive Virtual Reality: Systematic Review and Thematic Synthesis. JMIR Serious Games 2022; 10:e35802. [PMID: 36472894 PMCID: PMC9768659 DOI: 10.2196/35802] [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: 12/20/2021] [Revised: 05/30/2022] [Accepted: 06/12/2022] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND Immersive virtual reality (IVR) can be defined as a fully computer-generated environment shown on a head-mounted display. Existing research suggests that key features of IVR can assist older adults in their everyday lives, providing opportunities for health promotion and tackling social isolation and loneliness. There has been a surge in qualitative studies exploring older adults' experiences and perceptions of IVR. However, there has been no systematic synthesis of these studies to inform the design of new, more accessible IVR technologies. OBJECTIVE This study aimed to systematically review and synthesize qualitative studies exploring older adults' experiences and perceptions of IVR. METHODS A systematic review and thematic synthesis were conducted following the ENTREQ (Enhancing Transparency in Reporting the Synthesis of Qualitative Research) guidelines. In total, 2 reviewers completed title and abstract screening, full-text screening, data extraction, and quality appraisal. Thematic synthesis is derived from the qualitative method, thematic analysis. It involves 3 key steps: initial coding and grouping of these codes, the formation of descriptive themes from these codes, and going beyond these data to form analytical themes. Confidence in the evidence was assessed using the Grading of Recommendations Assessment, Development, and Evaluation-Confidence in the Evidence from Reviews of Qualitative Research approach. RESULTS Overall, 13 studies were included in the final synthesis, including 224 participants across 9 countries and 5 continents. Confidence in the evidence ranged from high to moderate. Three descriptive themes were generated: practical aspects of IVR use, experiencing unique features of IVR, and perceptions of IVR. The findings from the descriptive themes suggested that there are several improvements that need to be made to existing IVR devices to facilitate older adults' use of this technology. However, older adults' responses to IVR were generally positive. Three analytical themes were generated: tolerating the bad to experience the good, buying in to IVR (don't judge a book by its cover), and "it proves to me I can do it." The analytical themes illustrated that older adults were willing to tolerate discomforts that accompany existing IVR technologies to experience features such as immersive social networking. There was a discrepancy between older adults' perceptions of IVR before use-which were generally negative-and after use-which were generally positive-and IVR provided a platform for older adults to access certain activities and environments more easily than in the real world because of limitations caused by aging. CONCLUSIONS This review offers insights into older adults' experiences and perceptions of IVR and suggests how a few improvements to its existing hardware and software as well as how it is first presented could offer new opportunities for older adults to take part in meaningful activities tailored to their needs and preferences. TRIAL REGISTRATION PROSPERO CRD42020200774; https://tinyurl.com/8f48w2vt. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) RR2-10.1177/16094069211009682.
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Affiliation(s)
- David Healy
- School of Psychology, University of Galway, Galway, Ireland
| | - Aisling Flynn
- School of Nursing and Midwifery, University of Galway, Galway, Ireland
| | - Owen Conlan
- School of Computer Science and Statistics, Trinity College Dublin, Dublin, Ireland
| | - Jenny McSharry
- School of Psychology, University of Galway, Galway, Ireland
| | - Jane Walsh
- School of Psychology, University of Galway, Galway, Ireland
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Hendricks LA, Young T, Van Wyk SS, Matheï C, Hannes K. Storyboarding HIV Infected Young People's Adherence to Antiretroviral Therapy in Lower- to Upper Middle-Income Countries: A New-Materialist Qualitative Evidence Synthesis. Int J Environ Res Public Health 2022; 19:11317. [PMID: 36141589 PMCID: PMC9517626 DOI: 10.3390/ijerph191811317] [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] [Figures] [Subscribe] [Scholar Register] [Received: 06/06/2022] [Revised: 08/15/2022] [Accepted: 08/16/2022] [Indexed: 06/16/2023]
Abstract
Young people living with perinatal infections of Human Immunodeficiency Virus (YLPHIV) face a chronic disease, with treatment including adherence to lifelong antiretroviral treatment (ART). The aim of this QES was to explore adherence to ART for YLPHIV as an assemblage within the framework of the biopsychosocial model with a new materialist perspective. We searched up to November 2021 and followed the ENTREQ and Cochrane guidelines for QES. All screening, data extraction, and critical appraisal were done in duplicate. We analysed and interpreted the findings innovatively by creating images of meaning, a storyboard, and storylines. We then reported the findings in a first-person narrative story. We included 47 studies and identified 9 storylines. We found that treatment adherence has less to do with humans' preferences, motivations, needs, and dispositions and more to do with how bodies, viruses, things, ideas, institutions, environments, social processes, and social structures assemble. This QES highlights that adherence to ART for YLPHIV is a multisensorial experience in a multi-agentic world. Future research into rethinking the linear and casual inferences we are accustomed to in evidence-based health care is needed if we are to adopt multidisciplinary approaches to address pressing issues such as adherence to ART.
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Affiliation(s)
- Lynn A. Hendricks
- Centre for Evidence Based Health Care, Division of Epidemiology and Biostatistics, Stellenbosch University, Cape Town 3000, South Africa
- Research Group SoMeTHin’K (Social, Methodological and Theoretical Innovation/Kreative), Faculty of Social Sciences, Katholieke Universiteit, 3000 Leuven, Belgium
| | - Taryn Young
- Centre for Evidence Based Health Care, Division of Epidemiology and Biostatistics, Stellenbosch University, Cape Town 3000, South Africa
| | - Susanna S. Van Wyk
- Centre for Evidence Based Health Care, Division of Epidemiology and Biostatistics, Stellenbosch University, Cape Town 3000, South Africa
| | - Catharina Matheï
- Department of Public Health and Primary Care, Katholieke Universiteit, 3000 Leuven, Belgium
| | - Karin Hannes
- Research Group SoMeTHin’K (Social, Methodological and Theoretical Innovation/Kreative), Faculty of Social Sciences, Katholieke Universiteit, 3000 Leuven, Belgium
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Broomfield K, Harrop D, Jones GL, Sage K, Judge S. A qualitative evidence synthesis of the experiences and perspectives of communicating using augmentative and alternative communication (AAC). Disabil Rehabil Assist Technol 2022:1-15. [PMID: 36026563 PMCID: PMC9612935 DOI: 10.1080/17483107.2022.2105961] [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] [Subscribe] [Scholar Register] [Received: 09/21/2021] [Revised: 05/12/2022] [Accepted: 07/19/2022] [Indexed: 10/15/2022]
Abstract
PURPOSE This paper presents a review of the existing qualitative research literature concerning people's experience of communicating using augmentative and alternative communication (AAC). The aims of conducting this review were to find out more about the values and outcomes that are important to people about the AAC they use to support their communication. This review was conducted to provide a deeper understanding of these experiences to inform the development of a patient-reported outcome measure (PROM). MATERIALS AND METHODS A qualitative evidence synthesis of existing qualitative research literature was undertaken to explore and appraise current knowledge about the experiences of people who use AAC. RESULTS From 115 qualitative research reports 19 papers were identified that responded directly to the research question and aims of the review. Data were identified that could be organized within an a priori framework consisting of the constructs of values, outcomes, and context. CONCLUSION The review has resulted in a deeper, analytical understanding of the experiences of people who require AAC. The results indicate a set of concepts that can be used to inform the development of a PROM. A PROM can be used to assist clinicians and researchers to better understand the perspectives of people who require AAC and evaluate interventions. The results also encourage professionals to reconsider the terminology and methods used when working alongside people who require AAC and to reflect on the multidimensional factors that influence people's experience of communication.IMPLICATIONS FOR REHABILITATIONPatient-reported outcome measures (PROMs) can be useful tools to support clinician-patient communication, facilitate shared decision making and establish priorities for rehabilitation.It can be difficult to engage people who have complex communication difficulties in decisions about the important outcomes to them from using augmentative and alternative communication (AAC).This qualitative evidence synthesis provides a deeper understanding of the experiences and perspectives of people who use AAC.The results will be used to inform the development of a PROM which can be used to facilitate shared decision-making, and evaluate AAC interventions from the perspective of the people who use these technologies.
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Affiliation(s)
- Katherine Broomfield
- Department of Adult Speech and Language Therapy, Gloucestershire Health and Care NHS Foundation Trust, Gloucestershire, UK
- Department of Nursing, Manchester Metropolitan University, Manchester, UK
| | - Deborah Harrop
- Centre for Health and Social Care, Sheffield Hallam University, Sheffield, UK
| | | | - Karen Sage
- Department of Nursing, Manchester Metropolitan University, Manchester, UK
| | - Simon Judge
- Barnsley Assistive Technology Team, Barnsley Hospitals NHS Foundation Trust, Barnsley, UK
- School of Health and Related Research, University of Sheffield, Sheffield, UK
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McNamara N, Feeney M, Giltenane M, Dowling M. Breast cancer genetic mutation: Synthesis of women's experience. J Clin Nurs 2022. [PMID: 36016506 DOI: 10.1111/jocn.16498] [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] [Subscribe] [Scholar Register] [Received: 04/29/2022] [Revised: 08/02/2022] [Accepted: 08/05/2022] [Indexed: 11/28/2022]
Abstract
AIMS AND OBJECTIVES To systematically identify and synthesise the experiences reported by women with a breast cancer mutation who do not have cancer as reported in qualitative research published between 2013 and 2020. BACKGROUND Women carrying a BReast CAncer (BRC) genetic mutation have an increased risk for breast and ovarian cancer. They must engage in emotional decision-making regarding risk management strategies to prevent cancer, including risk-reducing bilateral mastectomy and bilateral salpingo-oophorectomy. DESIGN AND METHODS The ENTREQ statement guided this review. Eight databases were systematically searched (CINAHL, Pubmed, Embase, Psychinfo [Ovid], Web of Science, Scopus, Proquest and Lenus). Synthesis was guided by "best fit" framework. The Critical Appraisal Skills Programme guided assessment of methodological limitations and confidence in the review findings was informed by GRADE-CERQual. RESULTS Twenty studies met the inclusion criteria for synthesis. Six themes were synthesised from the included studies (anxiety; family planning; it's a family affair; empowerment; actions; pragmatic adjustments). CONCLUSIONS The multidimensional experiences of women living with a BRCA1/2 mutation require an individualised response based on women's needs at their life stages. A decision coaching model adopted during consultations could support women to guide decision-making regarding cancer risk-reducing strategies.
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Affiliation(s)
- Nichola McNamara
- Symptomatic Breast Unit, University Hospital Limerick, Limerick, Ireland
| | - Meghan Feeney
- Department of Family and Community Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Martina Giltenane
- Department of Nursing and Midwifery, University of Limerick, Limerick, Ireland
| | - Maura Dowling
- School of Nursing and Midwifery, National University of Ireland Galway, Galway, Ireland
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Martinez-Calderon J, Matias-Soto J, Luque-Suarez A. "My Pain Is Unbearable…I Cannot Recognize Myself!" Emotions, Cognitions, and Behaviors of People Living With Musculoskeletal Disorders: An Umbrella Review. J Orthop Sports Phys Ther 2022; 52:243-A102. [PMID: 35536247 DOI: 10.2519/jospt.2022.10707] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [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] [Indexed: 02/07/2023]
Abstract
OBJECTIVE To summarize (1) the emotions, cognitions, and behaviors of people who are living with musculoskeletal disorders related to symptoms and (2) the interactions of emotions, cognitions, and behaviors with the person's environment (family, social, and work roles). DESIGN An umbrella review of qualitative research syntheses and meta-summaries (metasynthesis, meta-ethnographies, meta-aggregation, meta-summary). LITERATURE SEARCH We searched CINAHL, EMBASE, PsycARTICLES, PsycEXTRA, PsycINFO, PubMed, and PubPsych from database inception to January 2021. We also searched gray literature via Open Grey and Google Scholar. STUDY SELECTION CRITERIA We included qualitative evidence syntheses evaluating adults with musculoskeletal disorders, based on the multidimensional diagnostic criteria for acute and chronic pain. Emotions, cognitions, and behaviors were the phenomenon of interest. DATA SYNTHESIS We developed 3 categories of themes ([1] emotions, [2] cognitions, and [3] behaviors) for each objective. We selected the 3 most common emotions, cognitions, and behaviors that appear as themes in our narrative synthesis. RESULTS We included 20 qualitative evidence syntheses that retrieved 284 original qualitative studies. Despair, distress, and fear were the main emotions reported by people living with musculoskeletal disorders. The alterations of the self and how people described their symptoms, what caused them, and how the symptoms impacted their lives were the most common cognitions. Cognitive strategies (ie, acceptance) and perceptions about social support emerged. People often used passive behaviors (eg, social isolation or hiding symptoms) to cope with the challenges that arose related to musculoskeletal symptoms. However, some people actively faced their symptoms, planning their activities or practicing them despite their symptoms. CONCLUSION Clinicians who support people living with musculoskeletal disorders should consider (1) assessing other emotions than pain-related fear (eg, despair and distress), (2) observing their cognitive responses (ie, acceptance), and (3) evaluating what type of behaviors people use (eg, active or passive). J Orthop Sports Phys Ther 2022;52(5):243-261. doi:10.2519/jospt.2022.10707.
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Al-Zubaidy M, Hogg HDJ, Maniatopoulos G, Talks J, Teare MD, Keane PA, R Beyer F. Stakeholder Perspectives on Clinical Decision Support Tools to Inform Clinical Artificial Intelligence Implementation: Protocol for a Framework Synthesis for Qualitative Evidence. JMIR Res Protoc 2022; 11:e33145. [PMID: 35363141 PMCID: PMC9015736 DOI: 10.2196/33145] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2021] [Revised: 12/12/2021] [Accepted: 02/09/2022] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Quantitative systematic reviews have identified clinical artificial intelligence (AI)-enabled tools with adequate performance for real-world implementation. To our knowledge, no published report or protocol synthesizes the full breadth of stakeholder perspectives. The absence of such a rigorous foundation perpetuates the "AI chasm," which continues to delay patient benefit. OBJECTIVE The aim of this research is to synthesize stakeholder perspectives of computerized clinical decision support tools in any health care setting. Synthesized findings will inform future research and the implementation of AI into health care services. METHODS The search strategy will use MEDLINE (Ovid), Scopus, CINAHL (EBSCO), ACM Digital Library, and Science Citation Index (Web of Science). Following deduplication, title, abstract, and full text screening will be performed by 2 independent reviewers with a third topic expert arbitrating. The quality of included studies will be appraised to support interpretation. Best-fit framework synthesis will be performed, with line-by-line coding completed by 2 independent reviewers. Where appropriate, these findings will be assigned to 1 of 22 a priori themes defined by the Nonadoption, Abandonment, Scale-up, Spread, and Sustainability framework. New domains will be inductively generated for outlying findings. The placement of findings within themes will be reviewed iteratively by a study advisory group including patient and lay representatives. RESULTS Study registration was obtained from PROSPERO (CRD42021256005) in May 2021. Final searches were executed in April, and screening is ongoing at the time of writing. Full text data analysis is due to be completed in October 2021. We anticipate that the study will be submitted for open-access publication in late 2021. CONCLUSIONS This paper describes the protocol for a qualitative evidence synthesis aiming to define barriers and facilitators to the implementation of computerized clinical decision support tools from all relevant stakeholders. The results of this study are intended to expedite the delivery of patient benefit from AI-enabled clinical tools. TRIAL REGISTRATION PROSPERO CRD42021256005; https://tinyurl.com/r4x3thvp. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) DERR1-10.2196/33145.
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Affiliation(s)
- Mohaimen Al-Zubaidy
- Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, United Kingdom
- The Royal Victoria Infirmary, Newcastle Upon Tyne, United Kingdom
| | - H D Jeffry Hogg
- Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, United Kingdom
- The Royal Victoria Infirmary, Newcastle Upon Tyne, United Kingdom
| | - Gregory Maniatopoulos
- Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, United Kingdom
- Faculty of Business and Law, Northumbria University, Newcastle Upon Tyne, United Kingdom
| | - James Talks
- The Royal Victoria Infirmary, Newcastle Upon Tyne, United Kingdom
| | - Marion Dawn Teare
- Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, United Kingdom
| | - Pearse A Keane
- Moorfields Eye Hospital National Health Service Foundation Trust, London, United Kingdom
- Faculty of Medicine, University College London, London, United Kingdom
| | - Fiona R Beyer
- Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, United Kingdom
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26
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O'Neill M, Houghton C, Crilly G, Dowling M. A qualitative evidence synthesis of users' experience of mobile health applications in the self-management of type 2 diabetes. Chronic Illn 2022; 18:22-45. [PMID: 33583207 DOI: 10.1177/1742395320983877] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [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] [Indexed: 11/17/2022]
Abstract
AIM The aim of this qualitative evidence synthesis was to identify and synthesise qualitative research relating to experiences of using mobile health (mHealth) applications to aid self-management of Type 2 Diabetes. METHODS Using a systematic search strategy, 11 databases were searched (Medline, CINAHL, PsychInfo, PubMed, Web of Science, Embase, Cochrane Library, Scopus, ProQuest A&1, ProQuest UK & Ireland, Mednar). "Best fit" framework synthesis was used guided by the Health Information Technology Acceptance Model (HITAM). Assessment of methodological limitations was conducted using Critical Appraisal Skills Programme (CASP) and confidence in the review findings were guided by GRADE-CERQual. RESULTS Fourteen eligible studies were included in the synthesis (7 qualitative and 5 mixed methods). Key themes identified under the health, information and technology zones of the HITAM revealed the benefits of mHealth apps, barriers to their use, their perceived usefulness and ease of use. DISCUSSION Most people used the apps for feedback on their self-management and found them helpful in their communication with health care providers. Some embraced the technology and found it easy to use while others found mHealth apps to be counterintuitive.
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Affiliation(s)
| | - Catherine Houghton
- School of Nursing and Midwifery, National University of Ireland, Galway, University Road, Galway, Ireland
| | | | - Maura Dowling
- School of Nursing and Midwifery, National University of Ireland, Galway, University Road, Galway, Ireland
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27
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Izett-Kay M, Barker KL, McNiven A, Toye F. Experiences of urinary tract infection: A systematic review and meta-ethnography. Neurourol Urodyn 2022; 41:724-739. [PMID: 35114012 DOI: 10.1002/nau.24884] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2021] [Revised: 12/13/2021] [Accepted: 01/05/2022] [Indexed: 11/10/2022]
Abstract
AIM To understand the experience of urinary tract infection (UTI) by synthesizing primary qualitative research findings and developing a conceptual model that illustrates this experience. METHOD A systematic search of Medline, PsychInfo, Embase, and CINAHL from inception to August 2020 to find qualitative research exploring the experience of UTI. Qualitative evidence synthesis in the form of meta-ethnography was undertaken. Findings are reported in keeping with eMERGe guidance. RESULTS We included 16 qualitative studies in the synthesis of evidence, providing data from over 1038 participants aged 13-97 years. We developed nine themes: the impact of UTI on my whole body; impact on quality of life, activities, and the associated psychological toll; I know my body and my experience has taught me when I need to seek care; worry and the transition to medicalization; antibiotics are a valuable treatment approach; antibiotics are a last resort; being heard, seen, and cared for with dignity; self-judgment; and the end of the road, a need for information and cure. These themes supported a conceptual model to illustrate the patient experience of UTI. CONCLUSIONS The conceptual model communicates the wide and varied symptoms of patients' UTI experiences and how they process this and make care decision based on past health experiences. For some, there appears to be a sense of hopelessness and frustration. This model may be used to highlight the need for improvements in diagnostic and treatment pathways. Future research to further understand the nuances of acute, recurrent, and persistent UTI is needed.
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Affiliation(s)
- Matthew Izett-Kay
- Department of Urogynaecology, Women's Centre, John Radcliffe Hospital, Oxford University Hospitals FT, Oxford, UK.,Nuffield Department of Women's & Reproductive Health, University of Oxford, Oxford, UK
| | - Karen L Barker
- Physiotherapy Research Unit, Nuffield Orthopaedic Centre, Oxford University Hospitals FT, Oxford, UK
| | - Abigail McNiven
- Nuffield Department of Primary Care Health Sciences, Medical Sociology & Health Experiences Research Group, University of Oxford, Radcliffe Observatory Quarter, Oxford, UK
| | - Francine Toye
- Nuffield Orthopaedic Centre, Oxford University Hospitals NHS Foundation Trust, Oxford, UK.,Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences (NDORMS), University of Oxford, Oxford, UK
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28
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Li KMC, Li KYC, Bick D, Chang Y. Human immunodeficiency virus-positive women's perspectives on breastfeeding with antiretrovirals: A qualitative evidence synthesis. Matern Child Nutr 2021; 17:e13244. [PMID: 34258858 PMCID: PMC8476435 DOI: 10.1111/mcn.13244] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/15/2021] [Revised: 06/23/2021] [Accepted: 06/25/2021] [Indexed: 11/03/2022]
Abstract
Human immunodeficiency virus (HIV)-positive women can breastfeed with minimal risk of mother-to-child transmission if taking antiretrovirals. Guidelines surrounding infant feeding for HIV-positive women have evolved several times over the last two decades. Our review aimed to explore perspectives of breastfeeding with antiretrovirals from HIV-positive women since the World Health Organization (2010) infant feeding and antiretroviral guidelines. HIV-positive pregnant and postnatal women from all countries/settings were eligible. HIV-positive women were either on an antiretroviral regimen at the time of the study, previously on an antiretroviral regimen, not initiated on a regimen yet, or enrolled in prevention of mother-to-child transmission (PMTCT) care. Quality assessment of all included studies were conducted. Four databases (CINAHL, EMBASE, MEDLINE and PsycINFO) were searched for studies conducted from January 2010 to October 2020. Nine papers were included in the review, of which two presented findings from the same study. Five analytical themes were developed via thematic synthesis: (1) awareness of breastfeeding with antiretrovirals, (2) turmoil of emotions, (3) coping mechanisms, (4) the intertwining of secret, stigma and support and (5) support needed. Support from family and health care professionals and coping approaches were important to overcome stigma and the emotional challenges of breastfeeding with antiretrovirals. Health care professionals should be familiar with the most updated national and local guidance surrounding infant feeding and antiretrovirals. Further research into interventions to encourage HIV-positive women to adhere and commit to lifelong antiretroviral treatment (Option B+) for breastfeeding is required.
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Affiliation(s)
- Kan Man Carmen Li
- Guy's and St. Thomas' NHS Foundation TrustEvelina London Children's HospitalLondonUK
| | - Kan Yan Chloe Li
- Institute of Cardiovascular ScienceUniversity College LondonLondonUK
| | - Debra Bick
- Warwick Clinical Trials Unit, Warwick Medical SchoolUniversity of WarwickWarwickUK
| | - Yan‐Shing Chang
- Florence Nightingale Faculty of Nursing, Midwifery and Palliative CareKing's College LondonLondonUK
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Eddy KE, Vogel JP, Zahroh RI, Bohren MA. Factors affecting use of magnesium sulphate for pre-eclampsia or eclampsia: a qualitative evidence synthesis. BJOG 2021; 129:379-391. [PMID: 34520111 PMCID: PMC9291451 DOI: 10.1111/1471-0528.16913] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [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] [Accepted: 07/20/2021] [Indexed: 11/26/2022]
Abstract
Background Hypertensive disorders account for 14% of global maternal deaths. Magnesium sulphate (MgSO4) is recommended for prevention and treatment of pre‐eclampsia/eclampsia. However, MgSO4 remains underused, particularly in low‐ and middle‐income countries (LMICs). Objective This qualitative evidence synthesis explores perceptions and experiences of healthcare providers, administrators and policy‐makers regarding factors affecting use of MgSO4 to prevent or treat pre‐eclampsia/eclampsia. Search strategy We searched MEDLINE, EMBASE, Emcare, CINAHL, Global Health and Global Index Medicus, and grey literature for studies published between January 1995 and June 2021. Selection criteria Primary qualitative and mixed‐methods studies on factors affecting use of MgSO4 in healthcare settings, from the perspectives of healthcare providers, administrators and policy‐makers, were eligible for inclusion. Data collection and analysis We applied a thematic synthesis approach to analysis, using COM‐B behaviour change theory to map factors affecting appropriate use of MgSO4. Main results We included 22 studies, predominantly from LMICs. Key themes included provider competence and confidence administering MgSO4 (attitudes and beliefs, complexities of administering, knowledge and experience), capability of health systems to ensure MgSO4 availability at point of use (availability, resourcing and pathways to care) and knowledge translation (dissemination of research and recommendations). Within each COM‐B domain, we mapped facilitators and barriers to physical and psychological capability, physical and social opportunity, and how the interplay between these domains influences motivation. Conclusions These findings can inform policy and guideline development and improve implementation of MgSO4 in clinical care. Such action is needed to ensure this life‐saving treatment is widely available and appropriately used. Tweetable abstract Global qualitative review identifies factors affecting underutilisation of MgSO4 for pre‐eclampsia and eclampsia. Global qualitative review identifies factors affecting underutilisation of MgSO4 for pre‐eclampsia and eclampsia. This article includes Author Insights, a video abstract available at https://vimeo.com/manage/videos/623192027 Linked article This article is commented on by LA Magee, p. 392 in this issue. To view this mini commentary visit https://doi.org/10.1111/1471-0528.16971.
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Affiliation(s)
- K E Eddy
- Gender and Women's Health Unit, Centre for Health Equity, School of Population and Global Health, University of Melbourne, Carlton, VIC, Australia.,Maternal, Child, and Adolescent Health Programme, Burnet Institute, Melbourne, VIC, Australia
| | - J P Vogel
- Maternal, Child, and Adolescent Health Programme, Burnet Institute, Melbourne, VIC, Australia
| | - R I Zahroh
- Gender and Women's Health Unit, Centre for Health Equity, School of Population and Global Health, University of Melbourne, Carlton, VIC, Australia
| | - M A Bohren
- Gender and Women's Health Unit, Centre for Health Equity, School of Population and Global Health, University of Melbourne, Carlton, VIC, Australia
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Abstract
OBJECTIVE To review and synthesize qualitative research studies exploring the experiences of Healthcare Providers (HCPs) of managing shoulder pain. METHODS A meta-ethnographic approach was adopted to review and synthesize eligible studies. The findings from each included study were translated into one another using Noblit and Hares' seven-stage process. A systematic search of eleven electronic databases was conducted in February 2021. Methodological quality was assessed using the CASP Appraisal Tool. RESULTS Ten studies were included in the meta-synthesis, all deemed of high methodological quality. Three themes were identified; (1) Lack of consensus: "we all have different approaches." (2) Challenges to Changing Practice: It's "really hard to change and switch to a different approach," (3) Getting "Buy in" to Treatment: "…so you have to really sell it early". CONCLUSION Healthcare providers working with people with shoulder pain struggle to reconcile, often conflicting, research recommendations with their own clinical experience, beliefs and patient expectations. These findings help explain the continued lack of consensus on how best to manage shoulder pain in clinical practice.IMPLICATIONS FOR REHABILITATIONHealthcare providers (HCPs) working with people with shoulder pain struggle to resolve conflicts between evidence-based recommendations, clinical experience, their own shoulder pain beliefs and patient expectations and preferences.Stronger collaboration across professional disciplines is needed to address the current lack of consensus on the management of shoulder pain.Many HCP's find it difficult to engage patients with shoulder pain in exercise and they work hard to "sell" this approach to patients using strategies such as education, shared decision making and therapeutic alliance.
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Affiliation(s)
- Christina Maxwell
- Health Research Institute, School of Allied Health, University of Limerick, Limerick, Ireland.,Ageing Research Centre, Health Research Institute, School of Allied Health, University of Limerick, Limerick, Ireland
| | - Katie Robinson
- Health Research Institute, School of Allied Health, University of Limerick, Limerick, Ireland.,Ageing Research Centre, Health Research Institute, School of Allied Health, University of Limerick, Limerick, Ireland
| | - Karen McCreesh
- Health Research Institute, School of Allied Health, University of Limerick, Limerick, Ireland.,Ageing Research Centre, Health Research Institute, School of Allied Health, University of Limerick, Limerick, Ireland
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Carmona C, Baxter S, Carroll C. Systematic review of the methodological literature for integrating qualitative evidence syntheses into health guideline development. Res Synth Methods 2021; 12:491-505. [PMID: 33591605 DOI: 10.1002/jrsm.1483] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2020] [Revised: 12/31/2020] [Accepted: 02/12/2021] [Indexed: 11/05/2022]
Abstract
Guidelines produced by local, national and international bodies underpin clinical practice and healthcare services worldwide. For guidelines to be based on the best available evidence, it is critical that syntheses of both qualitative and quantitative evidence are used to inform decision-making. As methods for qualitative evidence syntheses (QES) develop, they are increasingly able to inform health guideline production. However, the process whereby this form of evidence is considered and incorporated tends to be unclear. This systematic review synthesized existing guidance concerning the use of QES in guideline development. Sources published in English that described or prescribed methods for incorporating QES into evidence-based health guidelines were eligible for inclusion. Seventeen relevant papers were identified. The literature indicates that there is a reasonable consensus about many stages of conducting a QES to inform guideline development. Areas needing further exploration include: the way that committees engage with QES; the usefulness of different QES methodologies; and understanding of how expert committees use evidence. Methods for producing QES for guideline committees tend to be similar to quantitative systematic review methods in terms of searching, quality appraisal, systematic management of data, and presentation of results. While this allows transparency and accountability, it could be argued that it is less "true" to the principles of being led by the data, which are fundamental to most qualitative research. Understanding the process of using QES to produce guidelines is critical to determining their validity and applicability, and to ensure that healthcare provision is based on the best available evidence.
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Affiliation(s)
- Chris Carmona
- School of Health and Related Research (ScHARR), University of Sheffield, Sheffield, UK
| | - Susan Baxter
- School of Health and Related Research (ScHARR), University of Sheffield, Sheffield, UK
| | - Christopher Carroll
- School of Health and Related Research (ScHARR), University of Sheffield, Sheffield, UK
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Smith V, Flaherty SJ, Matvienko-Sikar K, Delaney H. Maternity care during COVID-19: a protocol for a qualitative evidence synthesis of women's and maternity care providers' views and experiences. HRB Open Res 2021; 4:21. [PMID: 34345765 PMCID: PMC8283550 DOI: 10.12688/hrbopenres.13233.1] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/12/2021] [Indexed: 12/20/2022] Open
Abstract
Background: Considerable changes in maternity care provision internationally were implemented in response to COVID-19. Such changes, often occurring suddenly with little advance warning, have had the potential to affect women's and maternity care providers experience of maternity care, both positively and negatively. For this reason, to gain insight and understanding of personal and professional experiences, we will perform a synthesis of the available qualitative evidence on women and maternity care providers' views and experiences of maternity care during COVID-19. Methods and analysis: A qualitative evidence synthesis will be conducted. Studies will be eligible if they include pregnant or postpartum women (up to six months) and maternity care providers who received or provided care during COVID-19. To retrieve relevant literature the electronic databases of CINAHL, EMBASE, MEDLINE, PsycINFO, and the Cochrane COVID study register ( https://covid-19.cochrane.org/) will be searched from 01-Jan-2020 to date of search. A combination of search terms based on COVID-19, pregnancy, childbirth and maternity care, and study design, will be used to guide the search. The methodological quality of the included studies will be assessed by at least two reviewers using the Evidence for Policy and Practice Information (EPPI)-Centre 12-criteria quality assessment tool. The Thomas and Harden approach to thematic synthesis will be used for data synthesis. This will involve line by line coding of extracted data, establishing descriptive themes, and determining analytical themes. Confidence in the findings of the review will be assessed by two reviewers independently using Grading of Recommendations Assessment, Development and Evaluation-Confidence in the Evidence from Reviews of Qualitative research (GRADE-CERQual). Conclusion: The proposed synthesis of evidence will help identify maternity care needs during a global pandemic from the perspectives of those receiving and providing care. The evidence will inform and help enhance care provision into the future.
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Affiliation(s)
- Valerie Smith
- School of Nursing & Midwifery, University of Dublin, Trinity College, Dublin, D02 T283., Ireland
| | | | | | - Hannah Delaney
- School of Nursing & Midwifery, University of Dublin, Trinity College, Dublin, D02 T283., Ireland
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Abstract
Patient engagement (PE) has become embedded in discussions about health service planning and quality improvement, and the goal has been to find ways to observe the potential beneficial outcomes associated with PE. Patients and health care professionals use various terms to depict PE, for example, partnership and collaboration. Similarly, tokenism is consistently used to describe PE that has gone wrong. There is a lack of clarity, however, on the meanings and implications of tokenism on PE activities. The objective of this concept analysis was to examine the peer-reviewed and gray literature that has discussed tokenism to identify how we currently understand and use the concept. This review discusses 4 dimensions of tokenism: unequal power, limited impact, ulterior motives, and opposite of meaningful PE. These dimensions explicate the different components, meanings, and implications of tokenism in PE practice. The findings of this review emphasize how tokenism is primarily perceived as negative by supporters of PE, but this attribution depends on patients’ preferences for engagement. In addition, this review compares the dimensions of tokenism with the levels of engagement in the International Association of the Public Participation spectrum. This review suggests that there are 2 gradations of tokenism; while tokenism represents unequal power relationships in favor of health care professionals, this may lead to either limited or no meaningful change or change that is primarily aligned with the personal and professional goals of clinicians, managers, and decision-makers.
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Affiliation(s)
- Umair Majid
- Institute of Health Policy, Management and Evaluation, University of Toronto, Ontario, Canada.,Clinical Decision-Making and Health Care, University Health Network, Toronto, Ontario, Canada
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Actis Danna V, Bedwell C, Wakasiaka S, Lavender T. Utility of the three-delays model and its potential for supporting a solution-based approach to accessing intrapartum care in low- and middle-income countries. A qualitative evidence synthesis. Glob Health Action 2020; 13:1819052. [PMID: 33040697 PMCID: PMC7580724 DOI: 10.1080/16549716.2020.1819052] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [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: 02/28/2020] [Accepted: 08/28/2020] [Indexed: 10/25/2022] Open
Abstract
BACKGROUND The 3-Delays Model has helped in the identification of access barriers to obstetric care in low and middle-income countries by highlighting the responsibilities at household, community and health system levels. Critiques of the Model include its one-dimensionality and its limited utility in triggering preventative interventions. Such limitations have prompted a review of the evidence to establish the usefulness of the Model in optimising timely access to intrapartum care. OBJECTIVE To determine the current utility of the 3-Delays Model and its potential for supporting a solution-based approach to accessing intrapartum care. METHODS We conducted a qualitative evidence synthesis across several databases and included qualitative findings from stand-alone studies, mixed-methods research and literature reviews using the Model to present their findings. Papers published between 1994 and 2019 were included with no language restrictions. Twenty-seven studies were quality appraised. Qualitative accounts were analysed using the 'best-fit framework approach'. RESULTS This synthesis included twenty-five studies conducted in Africa, Asia, Latin America and the Caribbean. Five studies adhered to the original 3-Delays Model's structure by identifying the same factors responsible for the delays. The remaining studies proposed modifications to the Model including alterations of the delay's definition, adding of new factors explaining the delays, and inclusion of a fourth delay. Only two studies reported women's individual contributions to the delays. All studies applied the Model retrospectively, thus adopting a problem-identification approach. CONCLUSION This synthesis unveils the need for an individual perspective, for prospective identification of potential issues. This has resulted in the development of a new framework, the Women's Health Empowerment Model, incorporating the 3 delays. As a basis for discussion at every pregnancy, this framework promotes a solution-based approach to childbirth, which could prevent delays and support women's empowerment during pregnancy and childbirth.
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Affiliation(s)
- Valentina Actis Danna
- Department of International Public Health, Liverpool School of Tropical Medicine, Liverpool, UK
| | - Carol Bedwell
- Department of International Public Health, Liverpool School of Tropical Medicine, Liverpool, UK
| | - Sabina Wakasiaka
- College of Health Science, School of Nursing, University of Nairobi, Nairobi, Kenya
| | - Tina Lavender
- Department of International Public Health, Liverpool School of Tropical Medicine, Liverpool, UK
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Almoajil H, Theologis T, Dawes H, Parsonage J, Pierce J, Hopewell S, Toye F. Patients' and parents' views about lower limb orthopaedic surgery for ambulant children and young people with cerebral palsy: a qualitative evidence synthesis. J Child Orthop 2020; 14:562-573. [PMID: 33343752 PMCID: PMC7740689 DOI: 10.1302/1863-2548.14.200139] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023] Open
Abstract
PURPOSE The article identifies the aspects of health and outcomes that are considered important from the perspective of ambulatory children with cerebral palsy (CP) and their parents regarding lower limb orthopaedic surgery and explores how they experience surgical interventions. METHODS Four databases (Embase, MEDLINE (Ovid), CINAHL and PsycINFO) were searched from inception to 11 April 2020. Studies were included if they: 1) they involved children or young adults diagnosed with ambulant CP or their family, 2) participants had experience with lower limb orthopaedic surgery and 3) studies employed qualitative research methods. The Critical Appraisal Skills Programme was used to appraise identified studies. The 'Best-fit framework' synthesis approach was used by applying the International Classification of Functioning-Children and Youth (ICF-CY) linking rules and thematic synthesis. The review process was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. RESULTS Six studies were included. Four themes were generated which were linked to the ICF-CY framework: Body function and structure, Activity and participation, Environmental factors, Personal factors, as well as non-ICF-CY themes including Emotional well-being and Goal setting. Important surgical outcomes identified were pain, fatigue, movement-related function, mobility, walking ability, community life, emotional well-being, and adequate provision of public and health services. CONCLUSION These findings are important for understanding patient-centred outcomes in lower limb ortho-paedics surgery and providing focus for future interventional studies aimed at improving outcomes of importance to children with CP. These findings highlight the importance of long-term support to help people negotiate the challenge of surgical regimes and to achieve good outcomes after orthopaedic surgery. The outcomes identified will contribute to the development of a core outcome set in this field. LEVEL OF EVIDENCE III.
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Affiliation(s)
- Hajar Almoajil
- Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, UK,Department of Physical Therapy, College of Applied Medical Science, Imam Abdulrahman Bin Faisal University, Saudi Arabia,Correspondence should be sent to Hajar Almoajil, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, OX3 7LD, UK. E-mail:
| | - Tim Theologis
- Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, UK,Nuffield Orthopaedic Centre, Oxford University Hospitals NHS Foundation Trust Oxford, UK
| | - Helen Dawes
- Centre for Movement, Occupation and Rehabilitation Sciences, Oxford Institute of Nursing, Midwifery and Allied Health Research, Oxford Brookes University Oxford, UK,Oxford Health NHS Foundation Trust, Oxford, UK
| | - Jackie Parsonage
- Centre for Movement, Occupation and Rehabilitation Sciences, Oxford Institute of Nursing, Midwifery and Allied Health Research, Oxford Brookes University Oxford, UK
| | - Jo Pierce
- Faculty of Health and Life Sciences, Oxford Brookes University, Oxford, UK
| | - Sally Hopewell
- Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, UK
| | - Francine Toye
- Nuffield Orthopaedic Centre, Oxford University Hospitals NHS Foundation Trust Oxford, UK
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Camara H, Zhang Y, Lafferty L, Vallely A, Guy R, Kelly-Hanku A. Qualitative Evidence Synthesis on Self-Collection for Human Papillomavirus-Based Cervical Screening: Protocol for Systematic Review. JMIR Res Protoc 2020; 9:e21093. [PMID: 33090114 PMCID: PMC7644378 DOI: 10.2196/21093] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2020] [Revised: 08/11/2020] [Accepted: 08/18/2020] [Indexed: 12/22/2022] Open
Abstract
Background Cervical cancer is the fourth most common cancer affecting women worldwide. In the 1980s, it was found that the sexually transmitted disease human papillomavirus causes over 90% of all cervical cancer cases. Since that discovery, diagnostic technologies have been developed for the detection of human papillomavirus DNA in cervical samples. However, significant sociocultural and structural barriers remain. Considerable strides have taken place in recent years to address these barriers, such as the self-collection for human papillomavirus–based cervical screening method. Objective The purpose of this review is to synthesize qualitative evidence around the self-collection method and identify strategies to increase acceptability and feasibility in different settings. This qualitative synthesis will be used to better understand how to conceptualize and implement more effective, accessible, and socially and culturally acceptable cervical screening programs and policies globally. Methods A systematic search will be conducted in Global Health, Cochrane, CINAHL (Cumulative Index to Nursing and Allied Health Literature), ProQuest, ScienceDirect, EMBASE, EMCARE, Medline (OVID), Scopus, and Web of Science. Published and peer-reviewed articles will be included. Two reviewers will independently screen and assess the studies. The data will be coded and analyzed using a thematic synthesis process. The socioecological model will be used to organize emergent themes at the micro and macro levels. The results will be presented in narrative and tabular form. Results The article search and data extraction were completed in May 2020. The data were analyzed in June 2020. The review will be submitted for publication in Fall 2020. Conclusions This review will present the global evidence of the perspectives and experiences of various key stakeholders and how these perspectives and experiences impact their decision-making process to perform or accept self-collection for human papillomavirus–based cervical screening. The review will provide guidance to implementation researchers as well as implications for future research. Trial Registration PROSPERO International Prospective Register of Systematic Reviews CRD42019109073; https://www.crd.york.ac.uk/PROSPERO/display_record.php?RecordID=109073 International Registered Report Identifier (IRRID) DERR1-10.2196/21093
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Affiliation(s)
- Hawa Camara
- The Kirby Institute, UNSW Sydney, Wallace Wurth Building, Kensington, Australia
| | - Ye Zhang
- The Kirby Institute, UNSW Sydney, Wallace Wurth Building, Kensington, Australia
| | - Lise Lafferty
- The Kirby Institute, UNSW Sydney, Wallace Wurth Building, Kensington, Australia.,Centre for Social Research in Health, UNSW Sydney, Kensington, Australia
| | - Andrew Vallely
- The Kirby Institute, UNSW Sydney, Wallace Wurth Building, Kensington, Australia.,Papua New Guinea Institute of Medical Research, Goroka, Eastern Highlands Province, Papua New Guinea
| | - Rebecca Guy
- The Kirby Institute, UNSW Sydney, Wallace Wurth Building, Kensington, Australia
| | - Angela Kelly-Hanku
- The Kirby Institute, UNSW Sydney, Wallace Wurth Building, Kensington, Australia.,Papua New Guinea Institute of Medical Research, Goroka, Eastern Highlands Province, Papua New Guinea
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Toye F, Seers K, Barker K. "It's like she's talking about me" - Exploring the value and potential impact of a YouTube film presenting a qualitative evidence synthesis about chronic pain: An analysis of online comments. Can J Pain 2020; 4:61-70. [PMID: 33987512 PMCID: PMC7942787 DOI: 10.1080/24740527.2020.1785853] [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] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Background There is very limited research exploring the value and impact of qualitative research in chronic pain despite the large volume of research. Aims The aim of this study was to find out whether viewers’ comments in response to a YouTube film, portraying findings from a qualitative evidence synthesis about living with pain, revealed any potential value or impact to viewers. Methods We collected online data posted in response to the film Struggling to Be Me. We used themes from a large review of qualitative research as an a priori analytic framework. We used inductive thematic analysis to distil the essence of data that did not fit this framework. A thematic analysis of online comments to evaluate the impact of an arts-based health research film on people living with chronic pain is presented. Results We developed two inductive themes that explored the value and potential impact of watching the film online: (1) It has given voice to our suffering and (2) it makes me feel that I am not alone. Two subthemes added insight to the a priori framework: First, I have had enough of me added insight to the theme my life is impoverished and confined; second, I am treated like a criminal because I take opioids added insight to the theme lost personal credibility. Conclusions Our findings indicate that watching the YouTube film has potential value and impact, giving voice to suffering and making people feel that they are not alone. There are specific ethical challenges relating to internet-mediated research.
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Affiliation(s)
- Francine Toye
- Physiotherapy Research Unit, Oxford University Hospitals NHS Foundation Trust, Oxford, UK.,Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, UK
| | - Kate Seers
- Warwick Research in Nursing, Warwick Medical School, University of Warwick, Coventry, UK
| | - Karen Barker
- Physiotherapy Research Unit, Oxford University Hospitals NHS Foundation Trust, Oxford, UK.,Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, UK
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Dowling M, Fahy P, Houghton C, Smalle M. A qualitative evidence synthesis of healthcare professionals' experiences and views of palliative care for patients with a haematological malignancy. Eur J Cancer Care (Engl) 2020; 29. [PMID: 32902114 PMCID: PMC7757223 DOI: 10.1111/ecc.13316] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2020] [Revised: 04/30/2020] [Accepted: 08/07/2020] [Indexed: 12/28/2022]
Abstract
INTRODUCTION Patients with haematological malignancies may not be receiving appropriate referrals to palliative care and continuing to have treatments in the end stages of their disease. This systematic review of qualitative research aimed to synthesise healthcare professionals' (HCPs) views and experiences of palliative care for adult patients with a haematologic malignancy. METHODS A systematic search strategy was undertaken across eight databases. Thomas and Harden's approach to thematic analysis guided synthesis on the seventeen included studies. GRADE-GRADEQual guided assessment of confidence in the synthesised findings. RESULTS Three analytic themes were identified: (a) "Maybe we can pull another 'rabbit out of the hat'," represents doctors' therapeutic optimism, (b) "To tell or not to tell?" explores doctors' decision-making around introducing palliative care, and (c) "Hospice, home or hospital?" describes HCPs concerns about challenges faced by haematology patients at end of life in terms of transfusion support and risk of catastrophic bleeds. CONCLUSION Haematologists value the importance of integrated palliative care but prefer the term "supportive care." Early integration of supportive care alongside active curative treatment should be the model of choice in haematology settings in order to achieve the best outcomes and improved quality of life.
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Affiliation(s)
- Maura Dowling
- School of Nursing and Midwifery, National University of Ireland, Galway, Ireland
| | - Paul Fahy
- School of Nursing and Midwifery, National University of Ireland, Galway, Ireland
| | - Catherine Houghton
- School of Nursing and Midwifery, National University of Ireland, Galway, Ireland
| | - Mike Smalle
- James Hardiman Library, National University of Ireland, Galway, Ireland
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McGeough C, Walsh A, Clyne B. Barriers and facilitators perceived by women while homeless and pregnant in accessing antenatal and or postnatal healthcare: A qualitative evidence synthesis. Health Soc Care Community 2020; 28:1380-1393. [PMID: 32147895 DOI: 10.1111/hsc.12972] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [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: 09/04/2019] [Revised: 01/16/2020] [Accepted: 02/19/2020] [Indexed: 06/10/2023]
Abstract
Evidence indicates that homelessness is increasing within Europe and the United States (US), particularly for women. Pregnancy rates among homeless women are exceptionally high compared to their housed counterparts and homeless women engage poorly with antenatal care. The aim of this review is to explore the barriers and facilitators perceived by homeless women, while pregnant, or within six weeks postpartum in accessing antenatal and/or postnatal healthcare. A qualitative systematic review and synthesis was conducted. Key words and search terms were derived using the SPIDER (Sample, Phenomenon of Interest, Design, Evaluation, Research type) framework. Titles and abstracts were screened in accordance with inclusion and exclusion criteria. The methodological quality of included papers was assessed using criteria described by the Critical Appraisal Skills Programme (CASP) with data analysis using thematic synthesis. Two primary linked themes were generated: (a) lack of person-centred care; (b) complexity of survival. At an organisational level, a fragmented health service and accessibility to the health system were barriers, and resulted in poor person-centred care. At a clinical level, attitude & treatment from healthcare providers together with health knowledge all combined to illustrate poor person-centred care as barriers to homeless women accessing antenatal/postnatal healthcare. Sub-themes associated with complexity of survival included: disillusion with life, distrust of services, competing lifestyle demands and support and relationships. The findings of this review highlight that poor engagement may be partly explained by the complex interplay between both the healthcare system (person-centred care) and the individual (complexity of survival). Future services should be delivered in a way that recognises homeless people's complex and diverse needs, and should be reconfigured in order to try to meet them, through decreasing fragmentation of health services and staff training.
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Affiliation(s)
- Christine McGeough
- Department of General Practice, Royal College of Surgeons in Ireland, Dublin, Ireland
- Our Lady of Lourdes Hospital, Royal College of Surgeons Hospital Group, Dublin, Ireland
| | - Aisling Walsh
- Department of Epidemiology and Public Health Medicine, Royal College of Surgeons in Ireland, Dublin, Ireland
| | - Barbara Clyne
- Department of General Practice, Royal College of Surgeons in Ireland, Dublin, Ireland
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Donnelly S, Manning M, Mannan H, Wilson AG, Kroll T. Renegotiating dimensions of the self: A systematic review and qualitative evidence synthesis of the lived experience of self-managing rheumatoid arthritis. Health Expect 2020; 23:1388-1411. [PMID: 32869404 PMCID: PMC7752197 DOI: 10.1111/hex.13122] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2020] [Revised: 06/25/2020] [Accepted: 07/21/2020] [Indexed: 12/19/2022] Open
Abstract
Background As chronic illnesses, such as rheumatoid arthritis (RA), place an increased burden on health‐care systems, the ability of individuals to self‐manage these diseases is crucial. Objective To identify and synthesize the lived experience of self‐management described by adults living with RA. Design A systematic search of five electronic databases (MEDLINE, CINAHL, EMBASE, PsycINFO and ASSIA) was undertaken to identify relevant studies. Data were extracted and quality‐assessed using CASP guidelines. A meta‐synthesis was conducted based on Thomas and Harden's thematic synthesis approach. Results The search identified 8423 publications. After removing duplicates, 6527 records remained of which 32 studies met the inclusion criteria. Quality of studies was moderate to high, yet a considerable lack of reflection on researcher bias was evident. Our analysis identified 28 dimensions of self‐management RA across six domains: (a) cognitive‐emotional, (b) behavioural, (c) social, (d) environmental, (e) physical and (f) technological. Cognitive‐emotional experiences dominated the analysis. Renegotiating ‘the self’ (self‐concept, self‐esteem, self‐efficacy) was a key focus of self‐management among individuals with RA. Conclusion Our findings highlight the focus of ‘the self’ as a central concern in the self‐management of RA. Standardized self‐management programmes may primarily focus on disease management and daily functioning. However, we suggest that personal biographies and circumstances should move to the fore of self‐management support. Registration PROSPERO International Prospective Register of Systematic Reviews 2018: CRD42018100450. Patient or Public Contribution Patient and public involvement was not explicit in this review. However, three authors provided a patient perspective on the self‐management of arthritis and autoimmune disease.
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Affiliation(s)
- Susie Donnelly
- Centre for Interdisciplinary Research Education and Innovation in Health Systems (IRIS), School of Nursing, Midwifery and Health Systems, University College Dublin, Dublin, Ireland
| | - Molly Manning
- School of Allied Health, Faculty of Education and Health Sciences, University of Limerick, Limerick, Ireland
| | - Hasheem Mannan
- Department of Social Sciences, School of Liberal Education, FLAME University, Pune, India
| | - Anthony G Wilson
- Centre for Arthritis Research, School of Medicine and Medical Science, Conway Institute, University College Dublin, Dublin, Ireland
| | - Thilo Kroll
- Centre for Interdisciplinary Research Education and Innovation in Health Systems (IRIS), School of Nursing, Midwifery and Health Systems, University College Dublin, Dublin, Ireland
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Ramos JB, Duarte GS, Bouça-Machado R, Fabbri M, Mestre TA, Costa J, Ramos TB, Ferreira JJ. The Role of Architecture and Design in the Management of Parkinson's Disease: A Systematic Review. J Parkinsons Dis 2020; 10:1301-1314. [PMID: 32804100 PMCID: PMC7683074 DOI: 10.3233/jpd-202035] [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] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/04/2022]
Abstract
Background: Parkinson’s disease (PD) is a neurological condition characterized by the development of daily disabling symptoms. Although the architecture and design of a PD patient’s environment can hinder or facilitate full participation in daily activities, their putative role in the management of these patients has received little attention to date. Objective: We conducted a systematic review to evaluate the evidence of architectural and design features in the management of people with PD. Methods: An electronic database search of observational and experimental studies was conducted in MEDLINE and Embase from inception to May 2020, with two independent reviewers identifying the studies. Falls, fear of falling, postural instability, gait impairment/disability, and functional mobility were our outcomes of interest. Results: Thirty-six studies were included, among which nineteen were observational and seventeen were experimental studies (overall participants = 2,965). Pavement characteristics, notably unstable surfaces and level differences, were found to be a major cause of falling. Ground-based obstacles and confined/narrowed spaces were found to disturb gait, increase postural instability, and decrease functional mobility. Housing type did not appear to increase risk of falling, nor to significantly explain concerns about falling. Conclusion: Findings suggest a need to adjust architectural features of the surrounding space to ensure appropriate care and provide a safe environment to PD patients. More evidence about the impact of such modifications on PD outcomes is needed.
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Affiliation(s)
- Joana Beisl Ramos
- Laboratory of Clinical Pharmacology and Therapeutics, Faculdade de Medicina, Universidade de Lisboa, Lisbon, Portugal.,Serviço de Anestesiologia, Centro Hospitalar Universitário Lisboa Norte, Lisbon, Portugal
| | - Gonçalo S Duarte
- Laboratory of Clinical Pharmacology and Therapeutics, Faculdade de Medicina, Universidade de Lisboa, Lisbon, Portugal.,Instituto de Medicina Molecular João Lobo Antunes, Faculdade de Medicina, Universidade de Lisboa. Avenida Professor Egas Moniz, 1649-028, Lisboa, Portugal
| | - Raquel Bouça-Machado
- Instituto de Medicina Molecular João Lobo Antunes, Faculdade de Medicina, Universidade de Lisboa. Avenida Professor Egas Moniz, 1649-028, Lisboa, Portugal.,CNS -Campus Neurológico Sénior, Torres Vedras, Portugal
| | - Margherita Fabbri
- Instituto de Medicina Molecular João Lobo Antunes, Faculdade de Medicina, Universidade de Lisboa. Avenida Professor Egas Moniz, 1649-028, Lisboa, Portugal.,Department of Neuroscience Rita Levi Montalcini, University of Torino, Turin, Italy
| | - Tiago A Mestre
- Department of Medicine, Parkinson's Disease and Movement Disorders Center, Division of Neurology, The Ottawa Hospital Research Institute, University of Ottawa Brain and Mind Institute, Ottawa, Ontario, Canada
| | - João Costa
- Laboratory of Clinical Pharmacology and Therapeutics, Faculdade de Medicina, Universidade de Lisboa, Lisbon, Portugal.,Instituto de Medicina Molecular João Lobo Antunes, Faculdade de Medicina, Universidade de Lisboa. Avenida Professor Egas Moniz, 1649-028, Lisboa, Portugal
| | - Tânia Beisl Ramos
- Centro de Investigação em Arquitetura, Urbanismo e Design (CIAUD), Faculdade de Arquitetura, Universidade de Lisboa, Lisbon, Portugal
| | - Joaquim J Ferreira
- Laboratory of Clinical Pharmacology and Therapeutics, Faculdade de Medicina, Universidade de Lisboa, Lisbon, Portugal.,Instituto de Medicina Molecular João Lobo Antunes, Faculdade de Medicina, Universidade de Lisboa. Avenida Professor Egas Moniz, 1649-028, Lisboa, Portugal.,CNS -Campus Neurológico Sénior, Torres Vedras, Portugal
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Campbell F, Booth A, Hackett S, Sutton A. Young People Who Display Harmful Sexual Behaviors and Their Families: A Qualitative Systematic Review of Their Experiences of Professional Interventions. Trauma Violence Abuse 2020; 21:456-469. [PMID: 29739282 DOI: 10.1177/1524838018770414] [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] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
It is estimated that 30-50% of all childhood sexual abuse involves other young people as perpetrators. The treatment of harmful sexual behavior (HSB) in young people has evolved from interventions developed for use with adult perpetrators of sexual offenses. Increasingly, these approaches were not seen as appropriate for use with young people. The purpose of this qualitative systematic review was to establish what intervention components are viewed as acceptable or useful by young people and their families in order to inform the development of interventions for young people with HSB. We conducted searches across 14 electronic databases as well as contacting experts to identify relevant studies. Thirteen qualitative studies were included in the analysis, reporting findings from intervention studies from the United Kingdom, United States, New Zealand, Australia, and Ireland. Thematic analysis was used to combine findings from the studies of young people and parent/carers views. Five key themes were identified as critical components of successful interventions for young people with HSB. These included the key role of the relationship between the young person and practitioner, the significance of the role of parents and carers, the importance of considering the wider context in which the abuse has occurred, the role of disclosure in interventions, and the need to equip young people with skills as well as knowledge. The evidence was limited by the small number of studies that were mainly from the perspectives of adolescent males.
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Affiliation(s)
- Fiona Campbell
- School of Health and Related Research (ScHARR), University of Sheffield, Sheffield, United Kingdom
| | - Andrew Booth
- School of Health and Related Research (ScHARR), University of Sheffield, Sheffield, United Kingdom
| | - Simon Hackett
- School of Applied Social Sciences, Durham University, Durham, United Kingdom
| | - Anthea Sutton
- School of Health and Related Research (ScHARR), University of Sheffield, Sheffield, United Kingdom
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Cruz-Martínez RR, Wentzel J, Asbjørnsen RA, Noort PD, van Niekerk JM, Sanderman R, van Gemert-Pijnen JE. Supporting Self-Management of Cardiovascular Diseases Through Remote Monitoring Technologies: Metaethnography Review of Frameworks, Models, and Theories Used in Research and Development. J Med Internet Res 2020; 22:e16157. [PMID: 32436852 PMCID: PMC7273239 DOI: 10.2196/16157] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [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: 09/06/2019] [Revised: 12/19/2019] [Accepted: 02/07/2020] [Indexed: 02/07/2023] Open
Abstract
Background Electronic health (eHealth) is a rapidly evolving field informed by multiple scientific disciplines. Because of this, the use of different terms and concepts to explain the same phenomena and lack of standardization in reporting interventions often leaves a gap that hinders knowledge accumulation. Interventions focused on self-management support of cardiovascular diseases through the use of remote monitoring technologies are a cross-disciplinary area potentially affected by this gap. A review of the underlying frameworks, models, and theories that have informed projects at this crossroad could advance future research and development efforts. Objective This research aimed to identify and compare underlying approaches that have informed interventions focused on self-management support of cardiovascular diseases through the use of remote monitoring technologies. The objective was to achieve an understanding of the distinct approaches by highlighting common or conflicting principles, guidelines, and methods. Methods The metaethnography approach was used to review and synthesize researchers’ reports on how they applied frameworks, models, and theories in their projects. Literature was systematically searched in 7 databases: Scopus, Web of Science, EMBASE, CINAHL, PsycINFO, Association for Computing Machinery Digital Library, and Cochrane Library. Included studies were thoroughly read and coded to extract data for the synthesis. Studies were mainly related by the key ingredients of the underlying approaches they applied. The key ingredients were finally translated across studies and synthesized into thematic clusters. Results Of 1224 initial results, 17 articles were included. The articles described research and development of 10 different projects. Frameworks, models, and theories (n=43) applied by the projects were identified. Key ingredients (n=293) of the included articles were mapped to the following themes of eHealth development: (1) it is a participatory process; (2) it creates new infrastructures for improving health care, health, and well-being; (3) it is intertwined with implementation; (4) it integrates theory, evidence, and participatory approaches for persuasive design; (5) it requires continuous evaluation cycles; (6) it targets behavior change; (7) it targets technology adoption; and (8) it targets health-related outcomes. Conclusions The findings of this review support and exemplify the numerous possibilities in the use of frameworks, models, and theories to guide research and development of eHealth. Participatory, user-centered design, and integration with empirical evidence and theoretical modeling were widely identified principles in the literature. On the contrary, less attention has been given to the integration of implementation in the development process and supporting novel eHealth-based health care infrastructures. To better integrate theory and evidence, holistic approaches can combine patient-centered studies with consolidated knowledge from expert-based approaches. Trial Registration PROSPERO CRD42018104397; https://tinyurl.com/y8ajyajt International Registered Report Identifier (IRRID) RR2-10.2196/13334
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Affiliation(s)
- Roberto Rafael Cruz-Martínez
- Department of Psychology, Health and Technology, Faculty of Behavioural, Management and Social Sciences, Technical Medical Centre, University of Twente, Enschede, Netherlands
| | - Jobke Wentzel
- Department of Psychology, Health and Technology, Faculty of Behavioural, Management and Social Sciences, Technical Medical Centre, University of Twente, Enschede, Netherlands.,Saxion University of Applied Sciences, Deventer, Netherlands
| | - Rikke Aune Asbjørnsen
- Department of Psychology, Health and Technology, Faculty of Behavioural, Management and Social Sciences, Technical Medical Centre, University of Twente, Enschede, Netherlands.,Research and Innovation Department, Vestfold Hospital Trust, Tønsberg, Norway
| | - Peter Daniel Noort
- Embedded Information Services, Library, ICT Services & Archive, University of Twente, Enschede, Netherlands
| | - Johan Magnus van Niekerk
- Department of Psychology, Health and Technology, Faculty of Behavioural, Management and Social Sciences, Technical Medical Centre, University of Twente, Enschede, Netherlands
| | - Robbert Sanderman
- Department of Psychology, Health and Technology, Faculty of Behavioural, Management and Social Sciences, Technical Medical Centre, University of Twente, Enschede, Netherlands.,GZW-Health Psychology-GZW-General, University Medical Center Groningen, University of Groningen, Groningen, Netherlands
| | - Julia Ewc van Gemert-Pijnen
- Department of Psychology, Health and Technology, Faculty of Behavioural, Management and Social Sciences, Technical Medical Centre, University of Twente, Enschede, Netherlands
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44
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Nevin M, Hynes G, Smith V. Healthcare providers' views and experiences of non-specialist palliative care in hospitals: A qualitative systematic review and thematic synthesis. Palliat Med 2020; 34:605-618. [PMID: 32020829 DOI: 10.1177/0269216319899335] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
BACKGROUND Healthcare providers working in hospitals are frequently exposed to patients with palliative care needs. For most patients, these reflect non-specialist rather than specialist palliative care needs. Embedding palliative care principles early in patients' disease trajectories within acute care delivery in hospitals, however, is a challenge. How to best understand the experiences of those providing non-specialist palliative care in hospitals has not been systematically assessed. AIM To synthesise the evidence on healthcare providers' views and experiences of non-specialist palliative care in hospitals. DESIGN A qualitative systematic review and thematic synthesis using Thomas and Harden's thematic synthesis framework. DATA SOURCES Databases of MEDLINE, CINAHL, PsycINFO and EMBASE were searched from date of inception to March 2018. Studies were eligible for inclusion if they reported on healthcare providers' views and experiences of non-specialist palliative care in hospitals. Studies were appraised for quality but not excluded on that basis. The review was prospectively registered with the International Prospective Register of Systematic Reviews. RESULTS Thirty-nine papers of 37 studies were included, representing 985 hospital healthcare providers' views and experiences. Four major analytical themes emerged; 'Understanding of Palliative Care', 'Complexities of Communication', 'Hospital Ecosystem' and 'Doctors and Nurses - a Different Lens'. CONCLUSIONS Non-specialist palliative care in hospitals is operationalised as care in the last weeks and days of life. The organisation of acute care, inter-disciplinary working practices, clinician attitudes, poor communication structures and lack of education and training in palliative care principles exacerbates poor implementation of this care earlier for patients in hospitals.
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Affiliation(s)
- Mary Nevin
- School of Nursing & Midwifery, Trinity College Dublin, The University of Dublin, Ireland
| | - Geralyn Hynes
- School of Nursing & Midwifery, Trinity College Dublin, The University of Dublin, Ireland
| | - Valerie Smith
- School of Nursing & Midwifery, Trinity College Dublin, The University of Dublin, Ireland
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Brunton G, Oliver S, Thomas J. Innovations in framework synthesis as a systematic review method. Res Synth Methods 2020; 11:316-330. [PMID: 32090479 DOI: 10.1002/jrsm.1399] [Citation(s) in RCA: 52] [Impact Index Per Article: 13.0] [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: 02/11/2019] [Revised: 01/25/2020] [Accepted: 02/04/2020] [Indexed: 01/09/2023]
Abstract
Framework synthesis is one systematic review method employed to address health care practice and policy. Adapted from framework analysis methods, it has been used increasingly, using both qualitative and mixed-method systematic review methods. This article demonstrates a spectrum of approaches to framework synthesis that are dependent on the extent to which theory is tentative, emergent, refined, or established; and that stakeholder involvement may help to understand the topic's complexity where theory is more nascent. The choice of approach depends on the degree of match with existing theories and, in the absence of existing theory, the scale and heterogeneity of the literature to be managed.
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Affiliation(s)
- Ginny Brunton
- OntarioTech University, Faculty of Health Sciences, School of Nursing, Oshawa, ON, Canada
- University College London Institute of Education, EPPI-Centre, London, UK
- McMaster University, McMaster Midwifery Research Centre, Hamilton, ON, Canada
| | - Sandy Oliver
- University College London Institute of Education, EPPI-Centre, London, UK
- University of Johannesburg Faculty of Humanities, Africa Centre for Evidence, Johannesburg, South Africa
| | - James Thomas
- University College London Institute of Education, EPPI-Centre, London, UK
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Nichols VP, Toye F, Eldabe S, Sandhu HK, Underwood M, Seers K. Experiences of people taking opioid medication for chronic non-malignant pain: a qualitative evidence synthesis using meta-ethnography. BMJ Open 2020; 10:e032988. [PMID: 32075828 PMCID: PMC7044883 DOI: 10.1136/bmjopen-2019-032988] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
OBJECTIVE To review qualitative studies on the experience of taking opioid medication for chronic non-malignant pain (CNMP) or coming off them. DESIGN This is a qualitative evidence synthesis using a seven-step approach from the methods of meta-ethnography. DATA SOURCES AND ELIGIBILITY CRITERIA We searched selected databases-Medline, Embase, AMED, Cumulative Index to Nursing and Allied Health Literature, PsycINFO, Web of Science and Scopus (Science Citation Index and Social Science Citation Index)-for qualitative studies which provide patients' views of taking opioid medication for CNMP or of coming off them (June 2017, updated September 2018). DATA EXTRACTION AND SYNTHESIS Papers were quality appraised using the Critical Appraisal Skills Programme tool, and the GRADE-CERQual (Grading of Recommendations Assessment, Development and Evaluation working group - Confidence in Evidence from Reviews of Qualitative research) guidelines were applied. We identified concepts and iteratively abstracted these concepts into a line of argument. RESULTS We screened 2994 unique citations and checked 153 full texts, and 31 met our review criteria. We identified five themes: (1) reluctant users with little choice; (2) understanding opioids: the good and the bad; (3) a therapeutic alliance: not always on the same page; (4) stigma: feeling scared and secretive but needing support; and (5) the challenge of tapering or withdrawal. A new overarching theme of 'constantly balancing' emerged from the data. CONCLUSIONS People taking opioids were constantly balancing tensions, not always wanting to take opioids, and weighing the pros and cons of opioids but feeling they had no choice because of the pain. They frequently felt stigmatised, were not always 'on the same page' as their healthcare professional and felt changes in opioid use were often challenging. TRIAL REGISTRATION NUMBER 49470934; Pre-results.
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Affiliation(s)
- Vivien P Nichols
- Warwick Clinical Trials Unit, Warwick Medical School, University of Warwick, Coventry, West Midlands, UK
- Warwick Research in Nursing, Division of Health Sciences, Warwick Medical School, University of Warwick, Coventry, West Midlands, UK
| | - Francine Toye
- Physiotherapy Research Unit, Nuffield Orthopaedic Centre, Oxford University Hospitals NHS Trust, Oxford, UK
| | - Sam Eldabe
- Department of Pain Medicine, The James Cook University Hospital, Middlesbrough, UK
| | - Harbinder Kaur Sandhu
- Warwick Clinical Trials Unit, Warwick Medical School, University of Warwick, Coventry, West Midlands, UK
| | - Martin Underwood
- Warwick Clinical Trials Unit, Warwick Medical School, University of Warwick, Coventry, West Midlands, UK
| | - Kate Seers
- Warwick Research in Nursing, Division of Health Sciences, Warwick Medical School, University of Warwick, Coventry, West Midlands, UK
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47
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Rousseva C, Kammath V, Tancred T, Smith H. Health workers' views on audit in maternal and newborn healthcare in LMICs: a qualitative evidence synthesis. Trop Med Int Health 2020; 25:525-539. [PMID: 31994815 DOI: 10.1111/tmi.13377] [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] [Indexed: 11/30/2022]
Abstract
OBJECTIVES To identify and summarise health workers' views on the use of audit as a method to improve the quality of maternal and newborn healthcare in low- and middle-income countries (LMICs). METHODS We conducted a qualitative evidence synthesis. PubMed, CINAHL and Global Health databases were searched using keywords, synonyms and MeSH headings for 'audit', 'views' and 'health workers' to find papers that used qualitative methods to explore health workers' views on audit in LMICs. Titles and abstracts were then screened for inclusion. The remaining full-text papers were then screened. The final included papers were quality assessed using the Critical Appraisal Skills Programme tool for qualitative research. Data on audit type and health workers' perceptions were extracted and analysed using thematic synthesis. RESULTS Nineteen papers were included in the review, most from sub-Saharan Africa. Health workers generally held favourable views of audit and expressed dedication to the process. Similarly, they described positive experiences conducting audit. The main barriers to implementing audit were the presence of a blame culture, inadequate training and the lack of time and resources to conduct audit. Health workers' motivation and dedication to the audit process helped to overcome such barriers. CONCLUSIONS Health workers are dedicated to the process of audit, but must be supported with training, leadership and adequate resources to use it. Decision-makers and technical partners supporting audit should focus on improving audit training and finding ways to conduct audit without requiring too much staff time.
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Affiliation(s)
| | | | - Tara Tancred
- Centre for Maternal and Newborn Health, Liverpool School of Tropical Medicine, Liverpool, UK
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48
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Abstract
Advances in health care mean that we can now treat diseases that once cut lives short. However, the increase in life expectancy has not been matched by improvements in quality of life. The World Health Organization warns us that all countries should prepare to meet the challenges of an aging population and this is integral to the United Nations 2030 Agenda for Sustainable Development. This may require a shift in attitude toward aging. We aimed to use meta-ethnography to explore the experience of adults living beyond the age of 80. Our conceptual model illuminates the phenomenon of connection in older age and reflects on the paradox of time: ephemeral, yet interminable. Our findings encourage us to reflect on the influence of enlightenment philosophies that underpin the desire for autonomy at all costs. Our study challenges the stereotypes of old age and has the potential to influence people's perspectives toward aging.
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Affiliation(s)
- Francine Toye
- Oxford University Hospitals NHS Foundation Trust, Oxford, United Kingdom
| | - Cathy Jenkins
- Oxford University Hospitals NHS Foundation Trust, Oxford, United Kingdom
| | - Karen L Barker
- Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, United Kingdom
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49
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Clyne B, O'Neill SM, Nuzum D, O'Neill M, Larkin J, Ryan M, Smith SM. Patients' spirituality perspectives at the end of life: a qualitative evidence synthesis. BMJ Support Palliat Care 2019; 12:e550-e561. [PMID: 31771958 DOI: 10.1136/bmjspcare-2019-002016] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2019] [Revised: 10/15/2019] [Accepted: 11/04/2019] [Indexed: 11/03/2022]
Abstract
BACKGROUND Understanding patient perceptions of their spiritual needs when approaching the end of life is essential to support the delivery of patient-centred care. AIM To conduct a qualitative evidence synthesis on spirituality and spiritual care needs at the end of life in all healthcare settings from the patients' perspective. DESIGN Studies were included where they were primary qualitative studies exploring spirituality in patients with a life expectancy of 12 months or less in any setting. Two reviewers independently screened titles, extracted data and conducted methodological quality appraisal. A thematic synthesis was conducted. Grading of Recommendations, Assessment, Development and Evaluation (GRADE) - Confidence in the Evidence from Reviews of Qualitative research (CERQual) was used to summarise the certainty of the evidence. DATA SOURCES Six databases (Medline, Embase, Cochrane, CINAHL, PsycINFO, Applied Social Science Index and Abstracts) were searched from inception up to January 2019. RESULTS Fifty papers (42 unique datasets), incorporating data from 710 patients were included. Studies recruited from a mix of inpatient, outpatient, hospice and community settings across 12 different countries. Three overarching themes were generated: the concept of spirituality, spiritual needs and distress, and spiritual care resources. Relationships were an intrinsic component of spirituality. CONCLUSION Meeting patients' spiritual needs is an integral part of end-of-life care. This work emphasises that supporting relationships should be a central focus of spiritual care for patients at the end of life. PROSPERO REGISTRATION NUMBER CRD42019122062.
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Affiliation(s)
- Barbara Clyne
- Department of General Practice, Royal College of Surgeons in Ireland, Dublin, Ireland .,Health Research Board - Collaboration in Ireland for Clinical Effectiveness Reviews (HRB-CICER), Health Information and Quality Authority Dublin Regional Office, Dublin, Ireland
| | - Sinead M O'Neill
- Health Research Board - Collaboration in Ireland for Clinical Effectiveness Reviews (HRB-CICER), Health Information and Quality Authority Dublin Regional Office, Dublin, Ireland
| | - Daniel Nuzum
- Pastoral Care Department, Marymount University Hospital and Hospice, Cork, Ireland.,Department of Obstetrics and Gynaecology, Cork University Maternity Hospital, Cork, Ireland
| | - Michelle O'Neill
- Health Research Board - Collaboration in Ireland for Clinical Effectiveness Reviews (HRB-CICER), Health Information and Quality Authority Dublin Regional Office, Dublin, Ireland
| | - James Larkin
- Department of General Practice, Royal College of Surgeons in Ireland, Dublin, Ireland
| | - Máirín Ryan
- Health Research Board - Collaboration in Ireland for Clinical Effectiveness Reviews (HRB-CICER), Health Information and Quality Authority Dublin Regional Office, Dublin, Ireland
| | - Susan M Smith
- Department of General Practice, Royal College of Surgeons in Ireland, Dublin, Ireland.,Health Research Board - Collaboration in Ireland for Clinical Effectiveness Reviews (HRB-CICER), Health Information and Quality Authority Dublin Regional Office, Dublin, Ireland
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50
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Allison R, Flemming K. Mental health patients' experiences of softer coercion and its effects on their interactions with practitioners: A qualitative evidence synthesis. J Adv Nurs 2019; 75:2274-2284. [PMID: 31012149 DOI: 10.1111/jan.14035] [Citation(s) in RCA: 5] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2018] [Revised: 12/16/2018] [Accepted: 12/21/2018] [Indexed: 01/26/2023]
Abstract
AIMS To synthesize qualitative evidence of mental health patients' treatment-related experiences of softer coercion and its effect on their interactions with practitioners. BACKGROUND Coercion is controversial but global in mental health care. It ranges from softer to harder forms, but less attention is given in the literature to softer coercion. DESIGN Qualitative thematic synthesis examining patients' experiences of softer coercion. DATA SOURCES Electronic databases searched from inception to September 2015 and further updated January 2018. REVIEW METHODS Thematic synthesis of 11 UK/Irish articles, quality appraised using the Critical Appraisal Skills Programme tool. RESULTS Three analytic themes were developed: Losing a sense of self, Less than therapeutic relationship, and Journey through treatment. CONCLUSION Softer coercion is experienced across mental health care in a context of broader coercion.
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Affiliation(s)
- Rob Allison
- Department of Health Sciences, University of York, York, UK
| | - Kate Flemming
- Department of Health Sciences, University of York, York, UK
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