An integrative systematic review of career transitions across STEM and HASS disciplines

It is widely accepted that the academic job market is very limited and unlikely to expand any time soon, yet enrolments in PhDs continue to rise. If the PhD is no longer preparation for academia, where do these graduates go on completing their degrees? This study of Australian PhD graduates in Humanities, Arts and Social Sciences (HASS) explores motivations to undertake a research degree, their experiences of academia, and their current employment. These personalised narratives reveal the impact and value of doctoral education on the employment trajectories of HASS PhD graduates in non-academic careers. These stories uncover both the ‘cruel optimism’ and positive employment outcomes experienced by HASS doctorate holders. It is argued that commencing PhD candidates should be encouraged from the outset to seriously consider their doctorate as preparation for careers beyond academia; rather than being ‘failed academics,’ these graduates succeed as high-level knowledge workers.

Despite limited opportunities for tenured academic positions, the number of PhD graduates in Social Sciences has steadily risen in countries with developed research systems. The current literature predominantly portrays PhD graduates as victims, either of the higher education system or of their own optimism in pursuing an academic career. This paper takes an alternative stance by spotlighting the agency exhibited by PhD graduates in Social Sciences as they deftly navigate their career pathways amid the constrained academic job market. Specifically, we adopt an ecological perspective of agency to explore how PhD graduates in Social Sciences exercise their agency in navigating their career from the beginning of their PhD candidature until up to 5 years after graduation. We employ a narrative approach to delve into the employment journeys of twenty-three PhD graduates. Within this cohort, we select to report four participants from four Australian universities, each possessing distinct career trajectories. Our analysis highlights agency as the link between various personal and institutional factors that shape our participants’ career trajectories. Based on this finding, we offer recommendations for practice and policy changes that appreciate PhD graduates’ agency.

PhD holders are increasingly exploring careers beyond academia, yet, little is understood about their transition experiences, particularly in the Humanities, Arts, and Social Sciences (HASS) disciplines. While research suggests that these transitions are both challenging and satisfactory, there is limited knowledge about the specific engagement (e.g. feeling absorbed) and disengagement (e.g. experiencing detachment) experiences during these transitions, as well as the career factors influencing them. This study aimed to explore the engagement and disengagement experiences of 20 HASS PhD holders from Spain and Finland who transitioned beyond academia. Specifically, we examined how working conditions, personal values, and professional support interacted with these experiences. Interviews were conducted and analysed using an inductive-deductive content analysis approach. Our findings revealed two primary career trajectories: non-academic and hybrid careers. HASS PhD holders described low levels of engagement with academia, while a pronounced engagement was observed towards hybrid careers. Our results showed that work environment and personal values being relevant besides the well-known job stability and work-life balance factors among engagement experiences. Furthermore, results showed the interplay between diverse career factors, revealing misalignments between PhD careers and support mechanisms. Overall, the study underscores the complex interactions between working conditions, personal values, and professional support within engagement and disengagement experiences, highlighting the need for tailored support systems to facilitate sustainable research careers beyond academia.

Telehealth technologies can enhance patients' and their families' access to high-quality resources in home-based palliative care. Nurses are deeply involved in delivering telehealth in home-based palliative care. However, no previous integrative systematic reviews have synthesized evidence on nurses' roles, facilitators, and barriers to implementing nurse-delivered telehealth in home-based palliative care. This integrative systematic review aimed to provide a comprehensive understanding of the roles of nurses and the multilevel facilitators and barriers to implementing nurse-delivered telehealth in home-based palliative care, which could inform future policy development, research, and clinical practice. This integrative systematic review was conducted using Joanna Briggs Institute methodological guidance. We followed the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analysis) guidelines. We systematically searched articles published from January 1, 2014, to May 2024 in PubMed, Embase, Web of Science, CINAHL, and Cochrane Library. We included English-language; peer-reviewed; original; and qualitative, quantitative, and mixed methods studies that centered on nurse-delivered telehealth in home-based palliative care. We used the Mixed Methods Appraisal Tool to assess the quality of the included articles. Furthermore, 3 authors independently assessed eligibility, extracted data, and assessed the quality of articles. The entities to extract were identified by research questions of interest regardless of the type of study. We applied a convergent synthesis approach to integrate quantitative and qualitative data. Guided by the updated Consolidated Framework for Implementation Research (CFIR) 2.0, we synthesized the facilitators and barriers to implementing nurse-delivered telehealth in home-based palliative care. This integrative systematic review identified 4819 unique articles, including 34 papers encompassing 29 unique primary research studies. Innovations were mainly delivered by nurses (n=8) and nurse-involved multiprofessional teams (n=18). The roles of nurses in telehealth home-based palliative care involve palliative care nurses, community nurses, nurse coordinators, nurse coaches or nurse navigators, and nurse case managers. Guided by CFIR 2.0, facilitators and barriers to implementing nurse-delivered, telehealth, home-based palliative care were identified to 6 implementation levels and 20 constructs. The key facilitators included the COVID-19 pandemic, cost avoidance to the health care system, engagement of patients and their family caregivers, and so on. The barriers included a lack of reimbursement and payment mechanisms, technical problems, insufficiently trained health care providers, and so on. This integrative systematic review synthesizes evidence on nurses' evolving roles in telehealth home-based palliative care and identifies multilevel facilitators and barriers to nurse-delivered, home-based palliative care implementation. With the empowerment of telehealth technologies, nurses could establish a stronger professional identity and develop leadership in home-based palliative care. Nurses should leverage influence to promote nursing practice, clinical management, and policy support in the implementation of telehealth home-based palliative care. PROSPERO CRD42024541038; https://www.crd.york.ac.uk/PROSPERO/view/CRD42024541038.

BackgroundThe number of self-organizing teams is increasing in long-term care organizations. These teams have been implemented for various reasons among which improving the quality of care and the quality of working life. However, self-organizing teams are not always delivering these favorable outcomes. To evaluate the success of self-organizing teams, it is important to understand the reasons for their varying levels of success in long-term care organizations. In the long-term care context, little is known about the role of the organization structure in self-organizing team success, while organization theory indicates that this factor strongly affects their outcomes.MethodsAn integrative systematic review was conducted across four electronic databases: PubMed, Cumulative Index to Nursing and Allied Health Literature (CINAHL), Business Source Complete, and Web of Science, from inception until May 2023. Reference lists of the included studies were screened to identify other relevant studies. Quality appraisal was undertaken using MMAT for empirical studies and JBI checklists for systematic reviews, and text and opinion. Thematic analysis was conducted to synthesize the findings.ResultsForty-one articles were included. Findings were categorized based on structure characteristics that we extracted from organization theory: centralization, specialization, formalization, and functional concentration. We found different forms of each structure characteristic and their influence on self-organizing teams. A higher degree of these structure characteristics generally hinders self-organizing team success, meaning lower quality of care and lower quality of working life. Conversely, a lower degree of these characteristics generally facilitates self-organizing team success, meaning higher quality of care and higher quality of working life. However, the findings also highlight that structure characteristics can reach detrimentally low degrees when too many tasks and responsibilities are allocated to the teams, diminishing self-organizing team success.ConclusionsWhile self-organizing teams hold promise for enhancing the quality of care and improving the quality of working life, they are not always successful in practice. This integrative systematic review highlights the importance of organization structure characteristics for self-organizing team success in long-term care organizations.RegistrationThis review was registered with the PROSPERO International prospective register of systematic reviews (CRD42023418288).

BackgroundWith a diversity in midwifery education across the South-East Asia region, and with the knowledge about the lifesaving competency of the midwife profession, this study’s aim is to describe facilitators of and barriers to providing high-quality midwifery education in South-East Asia. MethodsInspired by Whittemore and Knafl, we conducted a systematic integrative literature review including the five key stages of problem identification, literature search, data evaluation, data analysis, and presentation of results. The literature searches were conducted in October 2020 in the databases CINAHL, PubMed, and Scopus. A deductive data analysis based on global standards was performed. ResultsThe search identified 1257 articles, 34 of which were included. Countries in South-East Asia did not fully comply with the ICM global standards. Midwifery education was not separated from that of nursing, and educators lacked formal qualifications in midwifery. Curriculum implementation in the clinical area was a key barrier to achieving learning outcomes. Higher academic education for midwifery educators and mentorship programs facilitated the pedagogic and assessment process, focusing on the abilities of critical thinking, reflection, and decision-making. ConclusionsCountries in South-East Asia still have a long way to go before they can provide high-quality midwifery education. The identified facilitators can lead to a difference in students’ academic achievement and confidence in their clinical work. Coordinated actions will enable the progress in achieving competent midwives matching national health priorities. The findings highlight a need for more research on midwifery education in both theory and practice across the region.

IntroductionAboriginal and Torres Strait Islander children in Australia experience a higher prevalence of disability and socio-economic disadvantage than other Australian children. Early intervention is vital for improved health outcomes, but complex and fragmented service provision impedes access. There have been international and national policy shifts towards inter-sector collaborative responses to disability, but more needs to be known about how collaboration works in practice.MethodsA systematic integrative literature review using a narrative synthesis of peer-reviewed and grey literature was undertaken to describe components of inter- and intra-sector collaborations among services to Aboriginal and Torres Strait Islander children with a disability and their families. The findings were synthesized using the conceptual model of the ecological framework.ResultsThirteen articles published in a peer-reviewed journal and 18 articles from the grey literature met inclusion criteria. Important factors in inter- and intra-sector collaborations identified included: structure of government departments and agencies, and policies at the macro- (government) system level; communication, financial and human resources, and service delivery setting at the exo- (organizational) system level; and relationships and inter- and intra-professional learning at the meso- (provider) system level.ConclusionsThe policy shift towards inter-sector collaborative approaches represents an opportunity for the health, education and social service sectors and their providers to work collaboratively in innovative ways to improve service access for Aboriginal and Torres Strait Islander children with a disability and their families. The findings of this review depict a national snapshot of collaboration, but as each community is unique, further research into collaboration within local contexts is required to ensure collaborative solutions to improve service access are responsive to local needs and sustainable.

This systematic integrative review provides a unique pioneering perspective on community support practices in social, community, and cooperative housing, improving our understanding of the practice and its outcomes. Two research questions guided this work: 1) What are the community support practices in social and community housing serving individuals in the context of socioeconomic deprivation in permanent housing structures? And 2) What are the outcomes of the community support practices in social and community housing. Studies describing and/or reporting on outcomes of community support practices in social and community housing (psychosocial, economic, and health/mental health) were included from the journals’ inception to September 2022. A total of 42 studies were included in the systematic review, of which 20 were qualitative, 14 quantitative, and eight mixed-method studies. Of them all, 34 studies reported on public housing, four on community housing, and four on cooperative housing. Results inform practitioners and decision makers on issues related to community practices in permanent supportive housing and their outcomes in relation to tenure orientations and potential impact. Community practice workers are pillars in housing settings who provide bridging, bonding, and linking that builds social capital in adverse conditions. This review provides insight into innovative research avenues in this domain, while bringing to the forefront the fundamental challenges of individual support pathways to collective empowerment, increased health needs, and unequalled peer-tenant support engagement, as well as their precarious conditions.

This systematic integrative literature review explores how clinicians make decisions for patient management plans in telehealth. Telehealth is a modality of care that has gained popularity due to the development of digital technology and the COVID-19 pandemic. It is recognized that telehealth, compared to traditional clinical settings, carries a higher risk to patients due to its virtual characteristics. Even though the landscape of healthcare service is increasingly moving towards virtual systems, the decision-making process in telehealth remains not fully understood. A systematic integrative review. Databases include CINAHL, APA PsycInfo, Academic Search Complete, PubMed, Web of Science and Google Scholar. This systematic integrative review method was informed by Whittemore and Knafl(2005). The databases were initially searched with keywords in November 2022 and then repeated in October 2023. Thematic synthesis was conducted to analyse and synthesize the data. The search identified 382 articles. After screening, only 10 articles met the eligibility criteria and were included. Five studies were qualitative, one quantitative and four were mixed methods. Five main themes relevant to decision-making processes in telehealth were identified: characteristics of decision-making in telehealth, patient factor, clinician factor, CDSS factor and external influencing factor. The decision-making process in telehealth is a complicated cognitive process influenced by multi-faceted components, including patient factors, clinician factors, external influencing factors and technological factors. Telehealth carries higher risk and uncertainty than face-to-face encounters. CDSS, rather than bringing unification and clarity, seems to bring more divergence and ambiguity. Some of the clinical reasoning processes in telehealth remain unknown and need to be verbalized and made transparent, to prepare junior clinicians with skills to minimize risks associated with telehealth. Not applicable.

This paper reviews the management and business research field of autonomous vehicles (AVs) in a bibliometric context aiming to identify strategies, practices, and management tools; and summarises the existing studies and highlight research gaps. Methodologically, the study is qualitative and descriptive, based on a bibliometric review on Web of Science, Scopus, and Science Direct, followed by a systematic integrative review. Results show that, in the near future, AVs will certainly be introduced in the society. However, such insertion is still surrounded by uncertainties, doubled by governments' lack of planning. The absence of business-related studies can be a determinant for AVs introduction, once business models (BM) play an important for AVs advancement. Nevertheless, especially in Europe, studies related to AVs 'car-sharing' seem to be predominant. As such, we observe a research gap regarding BM and platforms and radical and responsible innovation theories.

Although team-based work is deemed key to improving the quality of national health care systems, adverse events related to teamwork account for up to one third of all incidents. Health care teams are typically multiprofessional and diverse in many aspects, but cultural diversity is one of the most challenging. The objective of this review is to systematically analyze the literature to better understand the impact of cultural diversity in health care teams on team processes as well as team and patient outcomes. This study also explores the conditions that enable or hinder team functioning. Through a systematic integrative literature review, this study builds on the input-process-output-context framework. Multiple searches of the main databases led to identifying 43 relevant articles. The results suggest that, when not proactively managed, cultural diversity may have a negative effect on team communication and integration, increasing team conflict and thereby negatively influencing team performance, team climate, and patient safety, both directly and indirectly. Yet, when managed properly and in the presence of engaged and culturally sensitive leadership, cultural training, and open and transparent procedures, cultural diversity in health care teams can be an asset to health care organizations. Analyzing and aggregating these findings into an integrative framework, our study identifies several themes and a research agenda for future studies on culturally diverse health care teams. Our findings suggest that culturally diverse health care teams experience a number of challenges, pointing to the need for action or structures that enable these teams to perform better, such as emphasizing learning and allowing team members time to get to know each other outside work.

BackgroundDue to medical advancements the number of children living with life-limiting and life-threatening conditions is rising, meaning more children and their families will require palliative and end-of-life care in the future. While ‘home’ is often the preferred place of end-of-life care, the evidence around best practice for decision-making about place of end-of-life care remains inadequate.AimTo synthesise evidence on the factors influencing decision-making regarding place of end-of-life care for children with life-limiting and life-threatening conditions.DesignA systematic integrative literature review. The review protocol was registered in Prospero: CRD42023406800.Data sourcesCINAHL, MEDLINE, EMBASE, PsycINFO, and Maternal and Infant Health were searched for studies published between 2013 and 2024. Any empirical, peer-reviewed journal articles published in English that included data pertaining to decision-making about place of end-of-life care for children (≤ 18 years) with life-limiting or life-threatening conditions were considered. Quality appraisal was conducted using the Mixed Methods Appraisal Tool.ResultsEleven eligible studies were included. Using an iterative process of constant data comparison, four themes were identified, highlighting that (i) consideration of the child, (ii) availability and suitability of end-of-life care services, (iii) parents’ capacity and control in providing care, and (iv) family and sibling well-being were factors influencing decision-making about place of end-of-life care.ConclusionThere are a complex range of factors surrounding decision-making regarding place of end-of-life care for children with life-limiting and life-threatening conditions. Studies focused primarily on parents’ perspectives. Further research is needed to identify how to best support decisions about place of end-of-life care for families of children with life-limiting and life-threatening conditions.

This paper reviews the management and business research field of autonomous vehicles (AVs) in a bibliometric context aiming to identify strategies, practices, and management tools; and summarises the existing studies and highlight research gaps. Methodologically, the study is qualitative and descriptive, based on a bibliometric review on Web of Science, Scopus, and Science Direct, followed by a systematic integrative review. Results show that, in the near future, AVs will certainly be introduced in the society. However, such insertion is still surrounded by uncertainties, doubled by governments' lack of planning. The absence of business-related studies can be a determinant for AVs introduction, once business models (BM) play an important for AVs advancement. Nevertheless, especially in Europe, studies related to AVs 'car-sharing' seem to be predominant. As such, we observe a research gap regarding BM and platforms and radical and responsible innovation theories.

Women experiencing homelessness may face heightened vulnerabilities and encounter barriers to accessing social services, which could perpetuate their situation and exacerbate the impact on their physical and mental health. This research aims to identify barriers and opportunities for women experiencing homelessness to access social care services based on a systematic integrative literature review. The inclusion criteria encompassed scientific articles and gray literature, focusing on studies of the access to social care services for women experiencing homelessness. English and Spanish documents from the past 20 years were considered, excluding publications lacking full‐text access. The search was conducted until April 30, 2024, across 6 databases including Web of Science, Scopus, PsycINFO, Social Services Abstracts, Sociology, and Cochrane. Article quality was assessed before inclusion to mitigate bias. Data analysis employed a narrative approach using categories and subcategories. Thirty‐eight publications were included, consisting of 36 articles and 2 theses. These publications predominantly relied on qualitative methods. Two main areas and eight categories emerged, covering structural, institutional, social, and personal barriers and opportunities, with 36 subcategories identified. Study limitations include a predominance of women in the study sample who had access to social care services, making it hard to include those experiencing hidden homelessness. Nonetheless, the research underscores the significance of gender‐specific barriers and opportunities in access to social care. The need for gender‐sensitive and intersectional policies is emphasized, as well as professional practices and training, to enhance the well‐being of women experiencing homelessness and improve their access to services.

PurposeThe purpose of this review was to explore the literature for evidence of the impact of interprofessional practice models on health service inequity, particularly within community care settings for diverse ageing populations.Design/methodology/approachAn integrative systematic literature review was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) framework combined with the EndNote reference management system. Following the collection and comprehensive screening process completion, a thematic analysis of the included articles occurred utilising within NVivo 12 software.FindingsThe review found that there was a paucity of evidence related to the relationship between interprofessional practice models (IPM) and health service equity for ageing populations. There is a need to improve collaborative practices between social care, public health care and health service providers to more clearly define team member roles. Key aspirations included the need for future innovations in health service delivery to place health service equity as a goal for interprofessional practice. There is a need to find ways to measure and articulate the impact for vulnerable populations and communities.Research limitations/implicationsThe review offers insight into the need for health care delivery models to place health service equity at the centre of the model design. In practice settings, this includes setting interprofessional team goals around achieving equitable care outcomes for, and with, vulnerable populations. Implications for practice relate to improving how interprofessional teams work with communities to achieve health care equity.Originality/valueThere is a consensus across the literature that there continues to be health service inequity, yet IPE and interprofessional collaborative practice (IPC) have been growing in momentum for some time. Despite many statements that there is a link between interprofessional practice and improved health service equity and health outcomes, evidence for this is yet to be fully realised. This review highlights the urgent need to review the link between education and practice, and innovative health models of care that enable heath care professionals and social care providers to work together towards achieving health equity for ageing populations. It is clear that more evidence is required to establish evidence for best practice in interprofessional care that has the mitigation of health care inequity as a central objective.