Mothers' and Health Care Professionals' Experiences of Remote Provision of One-to-One Synchronous Breastfeeding Support: A Qualitative Systematic Review.

The objective of this review was to evaluate health care professionals' experiences when families participate in clinician handovers in adult, pediatric, and neonatal intensive care units (ICUs). Previous studies report the emotional distress families experience when a relative is admitted to intensive care, including an increased risk of post-traumatic stress disorder symptoms after discharge. Family involvement in patient care in ICU can improve safety and quality health care outcomes. Furthermore, family participation in clinician handovers may improve satisfaction with care, staff communication, and interpersonal relationships with families. However, health care professionals' attitudes toward family participation in multidisciplinary ward rounds are diverse, and little is known about their perspectives toward family participation in clinician handovers. Studies were included if they involved health care professionals and any type of family participation during handover, from bedside presence to participation in decision-making. Clinician handovers included multidisciplinary ward rounds or nursing handovers. Settings were adult, pediatric, or neonatal intensive care units in rural or metropolitan regions in any country. Studies in other clinical contexts were excluded. Qualitative studies were included, as well as mixed methods studies if qualitative data could be clearly extracted. Databases searched included CINAHL Plus (EBSCOhost), MEDLINE (Ovid), Scopus, Embase (Ovid), Emcare (Ovid), PsycINFO (Ovid), ProQuest Central (including ProQuest Dissertations and Theses), Web of Science, MedNar, and Google Scholar, with limiters being English and the year range 2000 to present. The last search was in October 2024. Two reviewers independently screened the titles and abstracts and assessed the full-text articles that met inclusion criteria for methodological quality. Findings were extracted using the JBI data extraction tool and assigned a level of credibility. Meta-aggregation was used to synthesize the findings. Two reviewers discussed any disagreements to reach consensus and consulted a third reviewer when necessary. Eleven studies published from 2003-2024 were included for data extraction. Five studies were qualitative and 6 were mixed methods. Six studies were conducted in the United States, 4 in Canada, and 1 in Australia. Three studies were in adult ICUs, 5 in pediatric, 1 in neonatal, and 2 did not specify the ICU type. All studies were on multidisciplinary bedside rounds, while none were conducted on nursing handovers. The findings revealed that health care professionals generally supported family participation in clinician handovers due to benefits such as improved communication between the health care team and families. However, they also identified barriers, including families' emotional responses to bad news and impact on workflow and teaching opportunities during handovers. Planning, leadership, and clear communication were highlighted as crucial for successfully facilitating family participation in rounds. While this review found that health care professionals value family participation in multidisciplinary bedside rounds, they experienced challenges. Future research is required to explore family participation in clinician handovers. Significant planning, investment and preparation is required to include families in ICU handovers. PROSPERO CRD42020223011.

IntroductionPostpartum depression is considered a major public health problem, which immigrant mothers are at particular risk of being affected by, but it can also have long-lasting traumatic effects on the child’s health and development. The Edinburgh Postnatal Depression Scale is the world’s most commonly employed screening instrument for postpartum depression, used in connection with a clinical interview to screen for symptoms of postpartum depression. The aim of this study was to synthesize health care professionals (HCPs) experiences of identifying signs of postpartum depression and performing screening on immigrant mothers, since previous research suggested that this task might be challenging.MethodsThe databases CINAHL, PubMed, PsycINFO, SocINDEX, Embase and Cochrane were searched for papers published January 2000–December 2020, reporting qualitative data on immigrants, postpartum depression and the Edinburgh Postnatal Depression Scale. Eight papers representing eight studies from four countries were included and the Critical Appraisal Skills Program was used to assess their quality. The synthesis of studies was guided by Noblit & Hare’s seven-step method based on meta-ethnography.FindingsThe synthesis resulted in two final themes: “I do my best, but I doubt that it’s enough” and “I can find no way forward”. The themes convey the fear and frustration that health care professionals experienced; fear of missing mothers with signs of postpartum depression, related to feeling uncomfortable in the cross-cultural setting and frustration in handling difficulties associated with communication, translated versions of the Edinburgh Postnatal Depression Scale and cultural implications of postpartum depression.Conclusions and clinical implicationBy supporting HCPs’ self-efficacy in handling cultural implications of postpartum depression and by developing evidence-based clinical guidelines for the use of interpreters and translated versions of the Edinburgh Postnatal Depression Scale the screening of immigrant mothers may be facilitated.

To critically appraise and synthesise qualitative evidence about patients' experiences of healthcare professionals' competence in digital counselling in healthcare settings. A qualitative systematic review. The review followed the Joanna Briggs Institute methodology for systematic reviews of qualitative evidence. The review included studies that focused on patient experiences of healthcare professionals' competence in digital counselling and were published in English, Finnish or Swedish, with no time limits. Study selection, quality appraisal and data extraction were performed by two independent reviewers. Findings from the studies included were pooled using the meta-aggregation method. Eight databases (Web of Science, CINAHL, Scopus, PsycArticles, Medic, Medline (Ovid), EBSCO Open Dissertations and MedNar) were systematically searched on 25 September 2023. Sixteen studies (published between 2009 and 2023) were included in the review, from which 42 findings were extracted and organised into eight categories based on their meaning. Three synthesised findings were identified: (1) Competence to provide efficient digital counselling, (2) competence to support patient self-management during digital counselling and (3) competence in establishing a reciprocal relationship in digital counselling. The evidence from the review can be used to support healthcare professionals' competence in digital counselling. It was found that competence in digital counselling includes the competence to provide digital counselling that is efficient and enables counselling to be implemented in health care, supports patients to self-manage and establishes a reciprocal counselling relationship in a digital environment. Recognising healthcare professionals' competence in digital counselling can enhance their motivation and professional growth, potentially improving the quality of services and patient outcomes. These findings can inform the development of healthcare education, fostering the training of more competent healthcare professionals and digital counsellors. The review was undertaken and reported using the PRISMA guidelines. PROSPERO CRD42024499509. No Patient or Public Contribution.

The objective of this review was to gain a better understanding of the interprofessional collaboration between health care professionals from the patients' point of view during hospitalisation; the influence of interprofessional collaboration on patient care, safety, and well-being; and patients' perspectives of their role in the interprofessional collaboration process. Interprofessional collaboration is a key factor in improving patient health care outcomes and safety through better communication between health care professionals, better teamwork, and better care coordination. However, implementing interprofessional collaboration in the clinical setting can prove complex. Patients are increasingly interested in becoming partners within the health care system. They have the potential to contribute to their own safety and to observe professionals during the care process, thus gaining a better understanding of the interprofessional collaboration process and facilitating changes in the behavior of health care professionals. This review considered qualitative research and mixed-method studies. Participants were hospitalized patients. Studies were included when they explored i) patients' perceptions of interprofessional collaboration, ii) the influence of interprofessional collaboration on patients' care, safety, or well-being, or iii) patients' perceptions of their own role in interprofessional collaboration. Qualitative studies focusing only on the care process or families' points of view were excluded. Searches of six databases including MEDLINE, CINAHL, Embase, Web of Science, PsycINFO, and Sociological Abstract, limited to English, French, and German were conducted from March 2017 to June 2018. Assessment of methodological quality of studies was performed using the JBI Qualitative Assessment and Review Instrument. Data were extracted using the standardized data extraction tool from JBI. Data synthesis following the JBI approach of meta-aggregation was performed. The level of confidence for each synthesized finding was established based on ConQual. A total of 22 studies were included, which resulted in 89 findings and 24 categories. Eight synthesized findings were generated: patients' perceptions of interprofessional collaboration based on personal experiences and observations; patients' experiences with effective or ineffective interprofessional communication; patients' experience with power imbalance and paternalistic attitudes; patients' perceptions of key factors for a confident relationship with the interprofessional health care team; patients' need for comprehension of discussions between health care professionals; patients' perceptions of their role in an interprofessional health care team; patients' perceptions of opportunities for empowerment in interprofessional health care teams; and patients' need for humanizing care from interprofessional health care teams. The level of confidence of synthesized findings varied from low to moderate according to ConQual. This systematic review synthesized the perspectives of hospitalized patients regarding interprofessional collaboration and their perceived role in collaborative practices. Hospitalized patients observe interprofessional collaboration, either directly or indirectly, and the way interprofessional collaboration is performed may impact both their care and their well-being. However, little evidence has been found regarding the impact of interprofessional collaboration on patient safety. Patients' perspectives on their perceived role is not unanimous; some patients want to play an active role in the collaborative process, whereas others prefer to trust the health care professionals' expertise. Health care professionals should consider patients' preferences and act accordingly regarding both the collaborative process and the inclusion of the patients in collaborative practices.

Coping with a patient's death is one of the most challenging events faced by healthcare professionals in clinical practice. A broad understanding of the coping strategies used by healthcare professionals is fundamental to the development of effective interventions and the provision of good bereavement care. This review aims to systematically synthesize the coping experience of healthcare professionals in the course of their work when they are confronted with patient deaths. PubMed, Embase, ScienceDirect, CINAHL, PsycINFO, Web of Science, Cochrane Library, Scopus, and Wiley online library were searched in April 2023 with no restriction on publication date. A 3-stage thematic synthesis method was applied for data integration and analysis. Thirty studies involving 545 participants met the inclusion criteria and scored a high level on quality assessment ranging from 9.0 to 10.0. Six themes were identified: emotional coping, cognitive coping, behavioral coping, relational coping, spiritual coping, and occupational coping. Overall, the coping strategies used by healthcare professionals in response to bereavement were found to be unique and multidimensional. Understanding how healthcare practitioners use emotional, cognitive, behavioral, relational, spiritual, and professional strategies to cope with bereavement will prove extremely beneficial in helping them to manage their grief, and can furthermore promote their professional growth and ensure the provision of excellent bereavement care for patients.

The experiences of adult patients, families, and healthcare professionals of CPR decision-making conversations in the United Kingdom: A qualitative systematic review

Daily life with severe mental health (SMI) and cancer comorbidity entails multiple challenges. The study aims to explore everyday life experiences among individuals with SMI and cancer comorbidity from the perspectives of patients, significant others, and involved healthcare professionals. The study is registered in PROSPERO (CRD42021259604). A qualitative systematic review was conducted through searches in the databases MEDLINE, CINAHL, PsychInfo, and Web of Sciences (last search 14 February 2023). Inclusion criteria were empirical qualitative research studies investigating experiences of healthcare and everyday life among persons living with SMI and who were subsequently diagnosed with cancer from the perspective of the individuals themselves, their significant others, and healthcare professionals involved in their care. Exclusion criteria: Literature reviews, quantitative studies, intervention studies, quantitative parts of mix-methods studies, non-English languages, persons <18 years, dementia/learning disabilities, diagnosed with anxiety/depression as a consequence of cancer. Seven articles, published between January 2011 and February 2023, were included and analysed through a thematic analysis. The PRISMA 2020 checklist guided the study. The results were presented in four themes: 'Navigating between different worlds and logics', 'Decision-making capacity depending on the assessor', 'Cancer must give way to severe mental illness or vice versa', and 'Significant others as a safety net'. Research about the everyday lives of persons with SMI and cancer comorbidities from patients' and relatives' perspectives is lacking and thus called for.

The objective of this review is to examine the perceptions and experiences of health care professionals and staff in implementing or coordinating animal-assisted interventions in health care settings. Animal-assisted interventions are applied in the areas of health, education, and human services to help improve individuals' health and wellness. The positive effects of animal-assisted interventions on individuals have been shown in multiple health disciplines, from pediatrics to long-term care, and include outcomes such as decreased feelings of loneliness and increased feelings of support. The increase of animal-assisted interventions in human health has initiated growing research on health care professionals' perceptions and experiences of these interventions. No current qualitative systematic reviews have focused solely on health care professionals' and staff's perceptions of animal-assisted interventions. Conducting such a review will advance understanding of how these providers perceive and engage with animal-assisted interventions as well as their influence and role in coordinating these interventions. This review will consider qualitative primary studies that address the perceptions and experiences of health care professionals and staff in implementing or coordinating animal-assisted interventions in health care settings. Nine bibliographic databases will be systematically searched for published and unpublished studies by employing a three-step search strategy. Studies published from database inception to present and in English will be considered. Two reviewers will independently appraise the studies and extract qualitative data using the standardized JBI critical appraisal and data extraction instruments. Findings from the review will be categorized according to similarity in meaning, and categories will be subjected to a meta-synthesis to produce a single comprehensive set of synthesized findings. PROSPERO CRD42021258909.

The digitalization of health care has many potential benefits, but it may also negatively impact health care professionals' well-being. Burnout can, in part, result from inefficient work processes related to the suboptimal implementation and use of health information technologies. Although strategies to reduce stress and mitigate clinician burnout typically involve individual-based interventions, emerging evidence suggests that improving the experience of using health information technologies can have a notable impact. The aim of this systematic review was to collect evidence of the benefits and challenges associated with the use of digital tools in hospital settings with a particular focus on the experiences of health care professionals using these tools. We conducted a systematic literature review following the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines to explore the experience of health care professionals with digital tools in hospital settings. Using a rigorous selection process to ensure the methodological quality and validity of the study results, we included qualitative studies with distinct data that described the experiences of physicians and nurses. A panel of 3 independent researchers performed iterative data analysis and identified thematic constructs. Of the 1175 unique primary studies, we identified 17 (1.45%) publications that focused on health care professionals' experiences with various digital tools in their day-to-day practice. Of the 17 studies, 10 (59%) focused on clinical decision support tools, followed by 6 (35%) studies focusing on electronic health records and 1 (6%) on a remote patient-monitoring tool. We propose a theoretical framework for understanding the complex interplay between the use of digital tools, experience, and outcomes. We identified 6 constructs that encompass the positive and negative experiences of health care professionals when using digital tools, along with moderators and outcomes. Positive experiences included feeling confident, responsible, and satisfied, whereas negative experiences included frustration, feeling overwhelmed, and feeling frightened. Positive moderators that may reinforce the use of digital tools included sufficient training and adequate workflow integration, whereas negative moderators comprised unfavorable social structures and the lack of training. Positive outcomes included improved patient care and increased workflow efficiency, whereas negative outcomes included increased workload, increased safety risks, and issues with information quality. Although positive and negative outcomes and moderators that may affect the use of digital tools were commonly reported, the experiences of health care professionals, such as their thoughts and emotions, were less frequently discussed. On the basis of this finding, this study highlights the need for further research specifically targeting experiences as an important mediator of clinician well-being. It also emphasizes the importance of considering differences in the nature of specific tools as well as the profession and role of individual users. PROSPERO CRD42023393883; https://tinyurl.com/2htpzzxj.

BackgroundPatients’ adherence to antibiotic treatment and related prevention of AMR is significant. Understanding healthcare professionals’ strategies for advising and educating patients in primary care settings is crucial.AimFrom the perspectives of professionals and patients, to explore how physicians, pharmacists, and nurses educate patients about antibiotic use and antimicrobial resistance in primary care settings.MethodsA qualitative systematic literature review was conducted in MEDLINE, EMBASE, CINAHL Complete, Eric, SocINDEX, PsycInfo, Web of Science and Scopus. The study included 102 publications, followed PRISMA recommendations and was registered in PROSPERO (reg.no. CRD4202455761). The studies were screened and selected based on specific inclusion and exclusion criteria using Covidence. Quality appraisal followed the Critical Appraisal Skills Program (CASP) qualitative study checklist. Data were extracted, and the analysis consisted of a descriptive numerical summary analysis and a qualitative thematic analysis.ResultsThe analyzed studies spanned multiple countries and settings and included perspectives of primary care physicians, pharmacists, nurses and patients. Two main themes emerged: (1) Relationships between professionals and patients influenced educational strategies, showing that trust and rapport between healthcare professionals and patients played a crucial role in shaping educational strategies around antibiotic use; (2) The organizational structures challenged professionals in guiding and educating patients, highlighting how limited resources, time constraints, and system-level pressures hindered healthcare professionals’ ability to provide consistent and effective education. Often, structural challenges led to not educating the patients on the risks of antibiotic misuse and antimicrobial resistance. The use of delayed prescriptions emerged as a strategy for improved AMR stewardship and to meet patients’ expectations for antibiotic treatment, though it raised concerns about undermining professional responsibility and authority in ensuring appropriate antibiotic use.ConclusionHealthcare professionals’ role in educating patients about antibiotic use and AMR in primary care settings was complex, with different challenges faced by nurses, pharmacists and primary care physicians. These challenges extended beyond the clinical level, including relational, social and structural factors. Power dynamics, trust issues, and time pressures often hindered effective education on antibiotic use. Addressing gaps in education on antibiotic use and AMR requires acknowledging these multifaceted challenges, with future efforts focusing on better supporting healthcare professionals in this context.Systematic review registrationhttps://www.crd.york.ac.uk/prospero/, identifier CRD4202455761.

To examine women's experience of professional support for breast-feeding and health-care professionals' experience of providing support. We conducted semi-structured qualitative interviews among women with experience of breast-feeding and health-care professionals with infant feeding roles. Interviews with women were designed to explore their experience of support for breast-feeding antenatally, in hospital and postnatally. Interviews with health-care professionals were designed to explore their views on their role and experience in providing breast-feeding support. Interview transcripts were analysed using content analysis and aspects of Grounded Theory. Overarching themes and categories within the two sets were identified. Urban and suburban areas of North Dublin, Ireland. Twenty-two women all of whom had experience of breast-feeding and fifty-eight health-care professionals. Two overarching themes emerged and in each of these a number of categories were developed: theme 1, facilitators to breast-feeding support, within which being facilitated to breast-feed, having the right person at the right time, being discerning and breast-feeding support groups were discussed; and theme 2, barriers to breast-feeding support, within which time, conflicting information, medicalisation of breast-feeding and the role of health-care professionals in providing support for breast-feeding were discussed. Breast-feeding is being placed within a medical model of care in Ireland which is dependent on health-care professionals. There is a need for training around breast-feeding for all health-care professionals; however, they are limited in their support due to external barriers such as lack of time. Alternative support such as peer support workers should be provided.

BackgroundWhile empirical research on obstetric violence has focused primarily on women's experiences, the perspectives of healthcare personnel remain relatively neglected. Consequently, this study synthesized qualitative evidence regarding healthcare professionals’ perceptions of obstetric violence to understand how their views are constructed and which contextual factors influence the reproduction of these practices.MethodologyA qualitative systematic review was conducted, covering literature published between 2019 and 2025. The search encompassed the ProQuest Central, Sage Journals, Web of Science, Scopus, SciELO, and PubMed databases. Following PRISMA guidelines, 22 studies that met the inclusion criteria and addressed the research question were included. The data were analyzed using a hermeneutic approach oriented toward recovering the meanings attributed to obstetric violence within its specific production contexts.ResultsThe reviewed studies reveal tension between recognizing and denying obstetric violence among professionals. Some discourses justify institutionalized practices under biomedical logic, while others express discomfort and internal contradictions toward actions perceived as violent yet considered part of the clinical routine. Medical hierarchy, professional training, work overload, and lack of awareness of reproductive rights were identified as factors shaping these perceptions. Differences were also observed between disciplines (e.g., midwifery vs. obstetrics) and levels of experience (e.g., professionals vs. students).DiscussionFindings suggest that obstetric mistreatment is a systemic and modifiable phenomenon rather than merely a product of individual intent. Empirical intervention literature demonstrates that professional perceptions can be shifted through structured institutional reforms and training. Eradicating obstetric violence requires moving towards a systemic thinking approach that addresses institutional stressors and promotes humanized, woman-centered care models.

This systematic review aimed to appraise and synthesize evidence about licensed health care professionals' experiences and perceptions of treatment decision-making affecting older people with memory loss and comorbid conditions. Treatment decision-making affecting older people with memory loss and comorbid conditions presents significant challenges for health care professionals, as existing clinical practice guidelines and health care services are designed to focus on managing single-disease conditions. The complexity of balancing comorbid conditions, in addition to memory loss, has led to increased research in this area. Given the growing body of literature exploring health care professionals' decision-making, a synthesis of this evidence is needed to provide clearer insights and inform practice. This review considered qualitative studies that explored licensed health care professionals' treatment decisions when providing care for older people (over 65 years) living with memory loss and comorbid conditions. We considered studies conducted across community and clinical settings. A 3-step search strategy was used in May 2022 to identify published and unpublished studies across CINAHL (EBSCOhost), MEDLINE (EBSCOhost), PsycINFO (EBSCOhost), Scopus, and ProQuest Dissertations and Theses (ProQuest). Additionally, relevant websites were searched using keywords to identify gray literature. Searches covered all available literature from database inception using a combination of controlled vocabulary (MeSH and CINAHL headings) and keywords to capture qualitative studies, with an updated search conducted in June 2023. Two reviewers independently completed the title/abstract and full-text screening, critical appraisal, data extraction, and data synthesis. Findings classified as unequivocal or credible were grouped into categories that were synthesized to generate a comprehensive set of findings. The ConQual approach was applied to assess confidence in qualitative research synthesis. Fourteen studies published between 2006 and 2022 met the eligibility criteria. A total of 76 findings were extracted and grouped into 8 categories. Three synthesized findings were assembled from the findings: i) Health care professionals experience uncertainty and perceive older people with memory loss in ways that influence their treatment decision-making; ii) Communication challenges and contextual factors unique to older persons, families, and health service organizations influence health care professionals' treatment decision-making affecting older people with memory loss and comorbid conditions; and iii) Health care professionals identify processes to support safeguarding older people with memory loss in treatment decision-making. Health care professionals' treatment decision-making practices varied across medical specialties, with similarities spanning clinical settings. Health care professionals were committed to ensuring that older patients with memory loss and comorbid conditions received treatment to enhance their quality of life while promoting safe and ethical care. However, they held assumptions about these patients' abilities, viewed communication as challenging, and did not always have a clear understanding of patient preferences. This review identified that health care professionals who care for this population require further education. Changes to health care professionals' treatment decision-making are needed to ensure that older people and their family members are actively engaged in the processes of shared decision-making, which will support a person- and family-centered care approach. PROSPERO CRD42021271485.

The experiences of adolescent solid organ transplantation recipients, parents, and healthcare professionals in healthcare transition: A qualitative systematic review

Nurses\u2019 and midwives\u2019 experiences of supporting parents following perinatal bereavement: A qualitative systematic review