Meta-aggregative Approach Research Articles

Nursing staff's attitudes towards the prevention of adverse events among hospitalized people with dementia: Protocol of qualitative systematic review and evidence synthesis.

People with dementia are more likely than people without dementia to be hospitalized and to experience in-hospital preventable adverse events, such as falls, skin injury, and infection, compared to other hospitalized groups. Negative attitudes towards people with dementia are common among acute healthcare workers and have been linked to a cascade of negative adverse events in this population. However, no qualitative systematic review has ever been conducted to synthesize the existing evidence in this area, which hampers the development of preventative measures. This is a protocol for a qualitative systematic review aimed at exploring and synthesizing existing qualitative evidence regarding the attitudes of nursing staff towards the prevention of adverse events among hospitalized people with dementia. Literature searches will be performed in PubMed, CINAHL, PsycINFO, Web of Science, Biblioteca Virtual de Salud, Scopus, The Cochrane Library, and Google Scholar. The references of eligible studies will be checked for eligibility. All primary qualitative or mixed-methods studies with a qualitative component published in peer-reviewed academic journals in English, Portuguese, or Spanish will be eligible. There will be no limitations to the date of publication. The selection process will be conducted independently by two researchers using the software Rayyan and then compared and discussed. Any disagreements regarding eligibility will be discussed among the entire research team and resolved via consensus. Methodological quality will be assessed using Cochrane's guidance. A meta-aggregative approach will be employed to extract and synthesize the evidence using the software package QARI from the JBI. The confidence in the findings will be graded using ConQual. This review will help identify and better understand specific attitudinal and psychosocial aspects that influence nursing care delivery for people with dementia in hospital settings. Such data can be used to generate novel explanatory models of nursing behaviors in dementia care, as well as capacity building and training to enhance hospital care for people with dementia globally.

Digital storytelling as a strategy for developing 21st-century skills: a systematic review of qualitative evidence

ABSTRACT Digital storytelling (DST) is an educational strategy that has been shown to be capable of developing a wide range of skills. The focus of this review is to examine the relationship between this strategy and the development of 21st-century skills, a highly relevant notion in today’s educational systems. The findings combine qualitative evidence regarding DST and its influence on developing 21st-century skills. A meta-aggregative approach was utilised to analyse the results of 18 selected studies. The results suggest that 1) no matter the characteristics of the DST activity, there will always be 21st-century skills at play when creating a digital story; 2) the relationship between DST and 21st-century skills is solid and clear; and 3) there is a notable influence on critical thinking, creativity and collaboration skills. Finally, design principles and recommendations for practitioners are proposed.

Weight management practices, views, and experiences of adults living with poor socioeconomic circumstances and obesity: a qualitative systematic review protocol.

The objective of this review is to synthesize the best available qualitative evidence on the weight management practices, views, and experiences of adults living with poor socioeconomic circumstances and obesity. Additionally, the review aims to deepen our understanding of the common narratives of obesity according to these people. People living with poor socioeconomic circumstances are at increased risk of obesity, particularly in high-income countries, and their weight management practices (eg, weight-related behaviors) tend to be less healthy. Since prior research on socioeconomic inequalities in obesity is mostly from quantitative studies, the individual views and experiences related to weight management have been largely ignored. Thus, systematic qualitative evidence is needed on the weight management practices, views, and experiences of adults living with poor socioeconomic circumstances and obesity. Qualitative studies examining adults (aged 18 to 74 years) living with poor socioeconomic circumstances and obesity, and conducted in high- and upper-middle-income countries will be considered. The phenomenon of interest is these people's weight management practices, views, and experiences. Searches will be conducted in MEDLINE (Ovid), APA PsycINFO (Ovid), CINAHL (EBSCOhost), Scopus, Web of Science, and the Finnish health sciences database, MEDIC, restricted to the English and Finnish languages. Sources of unpublished studies and gray literature will include Google Scholar and ProQuest Dissertations and Theses. Two independent reviewers will screen the papers, assess methodological quality, and extract data following JBI's procedures. The meta-aggregative approach will be used for data synthesis. Confidence in the findings will be assessed using the ConQual approach. PROSPERO CRD42023407938.

The experience of shared decision-making for people with asthma: A systematic review and metasynthesis of qualitative studies.

To identify, describe and synthesise the views and experiences of adults living with asthma regarding shared decision-making (SDM) in the existing qualitative literature METHODS: We conducted a comprehensive search of 10 databases (list databases) from inception until September 2023. Screening was performed according to inclusion criteria. Tools from the Joanna Briggs lnstitute were utilised for the purposes of data extraction and synthesis in this study. The data extraction process in this study employed the Capability, Opportunity and Motivation Model of Behaviour (COM-B model) as a framework, and a pragmatic meta-aggregative approach was employed to synthesise the collected results. Nineteen studies were included in the metasynthesis. Three synthesised themes were identified: the capability of people living with asthma, the opportunities of people living with asthma in SDM, and the motivation of the people living with asthma in SDM. We have identified specific factors influencing people living with asthma engaging in SDM. The findings of this study can serve as a basis for the implementation of SDM in people living with asthma and provide insights for the development of their SDM training programs. The ConQual score for the synthesised findings was rated as low. To enhance confidence, future studies should address dependability and credibility factors. This review contemplates the implementation of SDM from the perspective of people living with asthma, with the aim of providing patient-centred services for them. The results of this review can benefit the implementation of SDM and facilitate information sharing. It offers guidance for SDM skills training among adults living with asthma, fosters a better doctor-patient relationship and facilitates consensus in treatment decisions, thereby enabling personalised and tailored medical care. Three nursing graduate students participated in the data extraction and integration process, with two students having extensive clinical experience that provided valuable insights for the integration.

Experiences of students and educators with simulated placements in allied health profession and nursing education: a qualitative systematic review

Reduced clinical placement capacity, the COVID-19 pandemic and growing training place numbers have resulted in the development of innovative placement design in healthcare education. Simulation is widely used in healthcare education; however, its use as a placement model is in its infancy. The experiences and perceptions of students and educators are important to shape simulated placements moving forward. A systematic search of the literature was conducted on eight databases to identify qualitative and mixed-methods studies exploring the experiences of students or educators in the nursing and allied health professions. Eight studies met the inclusion criteria and were assessed for methodological quality using the Joanna Briggs Institute (JBI) critical appraisal checklist for qualitative research. A meta-aggregative approach, in accordance with JBI guidelines for reviews of qualitative evidence, was used to synthesize the results. From the eight studies, a total of 69 findings were extracted. These were grouped into nine categories to form three synthesized findings of overall low quality. These findings were related to (1) reality of the simulated placement, (2) emotions evoked during the simulated placement, and (3) opportunities and challenges associated with implementing simulated placements. Simulated placements were considered a useful tool for the enhancement of communication skills, clinical reasoning skills, new knowledge generation, enhancing reflection and for preparation for clinical practice by students as well as educators.

Women's experience of polycystic ovary syndrome management: A systematic review and meta-synthesis.

Polycystic ovary syndrome (PCOS) is a common chronic condition in women of child-bearing age. There is currently no effective treatment, so early and long-term management is essential. However, there are many problems in the practice of disease management in women with PCOS that make it difficult to achieve good outcomes. To explore women's experience of PCOS management and identify the relevant facilitators and barriers to management. A structured search was undertaken in five bibliographic databases (MEDLINE, Web of Science, CINAHL, Embase, PubMed, and Cochrane) from the date of establishment of the database up to December 2022. All qualitative and mixed-methods studies available in English describing the experience of PCOS management from the patients' perspective were included. The Joanna Briggs Institute Qualitative Assessment and Review Instrument was used to appraise study quality. The evidence was synthesized using a pragmatic meta-aggregative approach guided by the capability, opportunity, and motivation model of behavior (COM-B). A total of 13 studies were included with 85 equivocal findings and 12 credible findings. The findings were meta-aggregated into three themes: (1) capability of women with PCOS, including patients' attitudes toward disease and management, knowledge, and skills of the disease; (2) opportunities in PCOS management, including information about PCOS, diagnostic delay, disease characteristics, disease management plan, and logistical and environmental problems; and (3) motivation in PCOS management, including impact of symptoms, perceived needs, support and feedback, and unpleasant medical experience. This study identifies facilitators and barriers to PCOS management from the patient perspective, which can guide the design and implementation of PCOS management programs for patients. This study also provides information for future research into how the COM-B theory can be incorporated into specific management plans to promote patient action.

Blood test result communication in primary care: mixed-methods systematic review protocol.

After testing, ensuring test results are communicated and actioned is important for patient safety, with failure or delay in diagnosis the most common cause of malpractice claims in primary care worldwide. Identifying interventions to improve test communication from the decision to test through to sharing of results has important implications for patient safety, GP workload, and patient engagement. To assess the factors around communication of blood test results between primary care providers (for example GPs, nurses, reception staff) and their patients and carers. A mixed methods systematic review including primary studies involving communication of blood test results in primary care. The review will use a segregated convergent synthesis method. Qualitative information will be synthesised using a meta-aggregative approach, and quantitative data will be meta-analysed or synthesised if pooling of studies is appropriate and data are available. If not, data will be presented in tabular and descriptive summary form. This review has the potential to provide conclusions about blood test result communication interventions and factors important to stakeholders, including barriers and facilitators to improved communication.

Influencing Factors to mHealth Uptake With Indigenous Populations: Qualitative Systematic Review.

The advancements and abundance of mobile phones and portable health devices have created an opportunity to use mobile health (mHealth) for population health systems. There is increasing evidence for the feasibility and acceptance of mHealth with Indigenous populations. Providing a synthesis of qualitative findings of mHealth with Indigenous populations will gain insights into the strengths and challenges to mHealth use in Indigenous populations. This review aimed to identify and synthesize qualitative data pertaining to the experiences and perceptions of mHealth from the perspectives of end users (patients and service providers) living in the colonial settler democracies of Canada, Australia, New Zealand, the United States, the Pacific Islands, and the Sápmi region of northern Europe. In May 2021, systematic searches of peer-reviewed, scientific papers were conducted across the 5 databases of PubMed, CINAHL, Embase, PsycINFO, and Web of Science. Qualitative or mixed method studies were included where a mHealth intervention was the primary focus for responding to health challenges with Indigenous populations. Two authors independently screened papers for eligibility and assessed the risk of bias using a modified version of the Critical Appraisal Skills Programme. A meta-aggregative approach was used to analyze the findings of included studies. Seventeen papers met the eligibility criteria, 8 studies with patients, 7 studies with service providers, and 2 studies that included both patients and service providers. Studies were conducted in Australia (n=10), Canada (n=2), New Zealand (n=2), Papua New Guinea (n=1), the United States (n=1), and Samoa (n=1). Our interpretation of these qualitative findings shows commonalities between Indigenous patients' and service providers' perceptions of mHealth. We summarize our findings in six themes: (1) mHealth literacy, (2) mHealth as a facilitator for connection and support, (3) mHealth content needed to be culturally relevant, (4) mHealth security and confidentiality, (5) mHealth supporting rather than replacing service providers, and (6) workplace and organizational capacity. This research suggests that mHealth can meet the needs of both patients and service providers when the mHealth intervention is culturally relevant, accounts for digital and health literacy, incorporates interactive components, is supported by workplaces, fits into health provider workflows, and meets security and confidentiality standards. Future mHealth research with Indigenous populations should partner with key representatives (eg, patients, service providers, and executive leaders) in the mHealth design appropriate to the purpose, people, setting, and delivery.

Reflections on critical appraisal of research for qualitative evidence synthesis.

Reflections on critical appraisal of research for qualitative evidence synthesis.

Influencing factors of interprofessional collaboration in multifactorial fall prevention interventions: a qualitative systematic review

BackgroundWith the ageing population worldwide, falls are becoming a severe and growing health problem. Interprofessional multifactorial fall prevention interventions (FPIs) have effectively prevented falls in community-dwelling older adults. However, the implementation of FPIs often fails due to a lack of interprofessional collaboration. Therefore, gaining insight into the influencing factors of interprofessional collaboration in multifactorial FPI’s for older adults living in the community is essential. Consequently, our aim was to provide an overview of factors influencing interprofessional collaboration in multifactorial FPIs for community-dwelling older adults.MethodsThis qualitative systematic literature research was performed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement. Pubmed, CINAHL, and Embase electronic databases have been systematically searched for eligible articles, with a qualitative design. The quality was appraised using the Checklist for Qualitative Research by the Joann Briggs Institute. The findings were inductively synthesized using a meta-aggregative approach. Confidence in the synthesized findings was established using the ConQual methodology.ResultsFive articles were included. Analysis of the included studies resulted in 31 influencing factors for interprofessional collaboration, which were labelled as findings. These findings were summarized in ten categories and combined into five synthesized findings. Results showed that communication, role clarity, information sharing, organization, and interprofessional aim influence interprofessional collaboration in multifactorial FPIs.ConclusionsThis review provides a comprehensive summary of findings on interprofessional collaboration, specifically in the context of multifactorial FPIs. Knowledge in this area is considerably relevant given the multifactorial nature of falls, which demands an integrated, multidomain approach, including both health and social care. The results can be utilized as a fundament for developing effective implementation strategies aiming to improve interprofessional collaboration between health and social care professionals working in multifactorial FPIs in the community.

First-Hand Recommendations for Nursing Management to Support Nurses Involved in the Process of Hastened Death: A Systematic Review of the Qualitative Evidence

Aim. The aim of this review was to support nursing management in creating frameworks for the care of people requesting hastened death, based on the best available evidence on the experiences of nurses. Background. The legalisation of hastened death presents nurses with a complex set of ethical and moral risks. The largely unregulated role of nurses in the politics of hastened death can lead to moral distress and burnout. Evaluation. A systematic database search was conducted in CINAHL, LIVIVO, Medline, OVID, and Web of Science. The meta-aggregative approach was used to synthesise the findings. Quality appraisal was done using criteria of the Joanna Briggs Institute. Key Issues. Sixteen studies from four different countries were included. Interview data were from 200 nurses. Meta-aggregation resulted in ten synthesised findings including the need for guidelines; time resources; a supporting team; and professional, social, and personal skills. Conclusions. A working environment with clear guidelines, sufficient resources, structured professional adjustment programmes, and educational measures is supportive for nurses. Implications for Nursing Management. Nursing management should create a professional strategy, guidelines, promote good team culture, implement education, and training activities.

Medication Adherence in People with Asthma: A Qualitative Systematic Review of Patient and Health Professional Perspectives.

Increased medication adherence leads to better asthma control and health outcomes. However, many studies have found that patient adherence to maintenance medication is poor. We undertook a meta-synthesis of qualitative studies, to investigate asthma patient and healthcare professionals' perspectives of medication adherence. This systematic review was reported by following the PRISMA guidelines. The Joanna Briggs Institute (JBI) meta-aggregative approach was used for the qualitative synthesis. The protocol was registered in PROSPERO (CRD42022346831). In total, 12 articles were included in the review. These articles reported findings from 433 participants in total, which included 315 patients and 118 healthcare professionals. Four synthesised findings with sub-themes were identified from the reviewed studies. These synthesised findings were described as: 1) The role of relationship and communication with/between Healthcare Professionals in medication adherence; 2) Insufficient information from Healthcare Professionals acting as a barrier for adherence; 3) How patient's attitude/beliefs effect their adherence to medication; and 4) Patients' personal behaviour and other relevant barriers. The synthesized findings provide a strong evidence-base of patient and health professionals' perspectives and behaviours toward medication adherence, which helps to identify and address non-adherence. Healthcare providers can use these findings to support patients' adherence to asthma medications. The findings suggest that empowering people to make informed decisions around medication adherence rather than "adherence controlling" by health professionals is very important. Effective dialogue and appropriate education are critical approaches to increase medication adherence.

A289 EXPLORING THE LIVED EXPERIENCES OF ADULT USING HOME ENTERAL NUTRITION AND THEIR CAREGIVERS: A QUALITATIVE SYSTEMATIC REVIEW

Abstract Background Home enteral nutrition allows individuals to receive food and water through a tube at home when they are unable to meet their needs by mouth. To date, systematic literature reviews to date have focused on specific insertion methods, coordinated community care models, and prophylactic vs. reactive use. Few qualitative systematic reviews exist and those that do have only explored the lived experiences of sub-populations of adults using home enteral nutrition, such as those with head and neck cancers. Given healthcare services often serve adult home enteral nutrition populations with various underlying conditions, a synthesis describing the lived experiences of all adult using home enteral nutrition and caregivers is needed. Purpose To conduct a meta-aggregation systematic review to evaluate lived experiences of home enteral nutrition in adult users and their caregivers. Method A systematic search of Medline, PsychINFO, EmBase and CINAHL was conducted September 2021. Only studies with a full-text and published in English were included. Study quality was assessed using the Johanna Briggs Institute meta-aggregation methodology. Details of the study design, participants, and experiences were recorded, and themes across all studies collatedCollated themes were reviewed with a team of healthcare providers, home enteral nutrition users and a caregiver to ensure trustworthiness. Result(s) A total of 38 studies representing 702 participants were included. Using the meta-aggregative approach, three different synthesized findings were identified: (1) positive experiences, (2) negative experiences, and (3) facilitators and coping mechanisms. While, overall, the findings reported more negative experiences than positive experiences, users and caregivers who had developed coping mechanisms or had access to supportive services tended to share more positive experiences with home enteral nutrition. In contrast, those with few to no supports or coping mechanisms reported greater dissatisfaction and negative experiences. Image Conclusion(s) Home enteral nutrition impacts the lived experience of users and their caregivers. While more negative than positive experiences were reported by adults and their caregivers using home enteral nutrition, overall, they still view home enteral nutrition as a positive intervention if they are adequate supported or developed adequate coping mechanisms. It is imperative that healthcare providers working with adults using home enteral nutrition explore and understand their patients’ and caregivers’ needs, in order to ensure community programs are designed to provide the necessary supports to maximize users experiences. Please acknowledge all funding agencies by checking the applicable boxes below None Disclosure of Interest None Declared PANCREATIC DISORDERS

A Qualitative Systematic Review of Experiences and Barriers Faced by Migrant Women with Perinatal Depression in Canada

Perinatal depression is the onset of depressive symptoms during pregnancy and up to one year after childbirth. Migrant women are at higher risk of experiencing perinatal depression due to numerous psychosocial stressors related to their experiences. This qualitative review aims to aggregate the experiences and barriers to care faced by immigrant and refugee women in Canada who have perinatal depression. Qualitative research can elucidate the barriers to treatment and culturally-impacted experiences of Canadian migrant women with perinatal depression. Following PRISMA and Joanna Briggs Institute (JBI) guidelines for conducting qualitative systematic reviews, 13 eligible studies representing 10 samples (N = 262 participants) were identified and included in this review. Participants included service providers, immigrant women, and refugee women. Three synthesized themes were identified by this review using the JBI meta-aggregative approach: (1) culture-related challenges; (2) migration-related challenges; and (3) service accessibility and quality. Within these themes were experiences of migrant women that encompass six categories: (1) conceptualization of perinatal depression; (2) childbirth-specific challenges; (3) migration-related challenges; (4) social isolation; (5) accessibility of services; and (6) quality of care. The role of family, cultural differences, financial challenges, and the effects of these on service accessibility are impactful in the experiences of migrant women. A greater understanding of the role of both culture and migration in the delivery of care, especially regarding service provider attitudes in more representative samples, is recommended.

An Exploration of Care Home Staff’s Perceptions Regarding Physical Activity Among Older Adults: A Qualitative Systematic Review

<strong>Context:</strong> Older adults residing in care home settings often require support from staff to take part in physical activity; however, limited information is available regarding how staff perceive physical activity among this population. <strong>Objective: </strong>We aim to explore care home staff’s perceptions of physical activity among older adults. <strong>Method:</strong> A systematic review was conducted following the Joanna Briggs Institute (JBI) meta-aggregative approach to qualitative synthesis. Searches were completed in AMED, CINAHL, EMBASE, PsycINFO and MEDLINE. Peer-reviewed studies that used qualitative approaches to study how care home staff perceive physical activity were included. Methodological quality assessment used the JBI Critical Appraisal Checklist for Qualitative Research. Primary findings were extracted, assigned a level of credibility, then aggregated into categories and synthesised findings. Synthesised findings were given a confidence rating using the ConQual approach. <strong>Findings:</strong> The qualitative synthesis included 25 studies. From these, 508 primary findings were extracted and supported findings were grouped into 38 categories. Categories formed eight synthesised findings: 1) resident’s individualised needs, preferences and experiences, 2) perceived benefits of physical activity for residents, 3) perceived risks of physical activity for residents, 4) the role of care home staff in physical activity promotion, 5) support from others, 6) environmental influences, 7) organisational influences, and 8) motivational and sustainable physical activity. <strong>Limitations:</strong> A low confidence rating was assigned to all synthesised findings due to dependability and credibility issues across the studies which may limit ability to inform policy and practice decisions. Not all studies underwent critical appraisal and data extraction by two reviewers. Grey literature was excluded; therefore, some relevant information may have been missed. <strong>Implications:</strong> Based on care home staff’s perceptions, adult social care policies should ensure care homes have sufficient resources to plan and develop personalised physical activity strategies which address the diverse needs and preferences of residents. At a practice level, collaborative, strength-based approaches are required to provide personalised physical activity approaches which are acceptable to older adults and care home staff. Embedding physical activity promotion into each care home’s organisational structures and support systems may be beneficial.

Critical care nurses' experiences of physical restraint in intensive care units: A qualitative systematic review and meta-synthesis.

Physical restraint is widely used in intensive care units. Critical care nurses are the primary decision makers and practitioners of physical restraint. However, little is known about the qualitative evidence of their experience of physical restraint. To aggregate, synthesise and interpret the qualitative evidence of studies that explored critical care nurses' experiences of physical restraint in intensive care units. A qualitative systematic review and meta-synthesis was conducted following Joanna Briggs Institute methodology and reported following the ENTREQ statement. Qualitative studies published in the English and Chinese were systematically searched in eight databases. PubMed, Web of Science, CINAHL, EMBASE, PsycINFO, China National Knowledge Infrastructure, Wan Fang, and Chinese Biomedical Literature Database from inception to November 2021. Two reviewers independently assessed the study eligibility and performed the data extraction and the quality appraisal. A meta-aggregative approach was used to synthesise findings. The review protocol was registered prospectively with PROSPERO (CRD42021278671). Thirteen studies were included. A total of 48 intact and definite codes were extracted and classified into ten sub-categories. Four themes were finally identified: intention, alternatives, determinants, and reflection. The intention of critical care nurses to use physical restraint is primarily driven by patient safety. Nurses will consider alternatives; however, many determinants urge nurses to implement physical restraint. Nurses prefer to sacrifice patients' comfort to ensure their safety. When nurses reflect on what they have done, some experience moral distress, but most rationalise their decision making. Further studies should explore the safety of alternatives, reduce the use of physical restraint, and pay more attention to nurses' moral distress through these insights. Developing alternatives, providing relevant training for nurses, physicians, patients, and families to facilitate a restraint-free culture, and developing high-quality guidelines and regulations are essential strategies to reduce the use of physical restraint in ICUs.

Barriers and facilitators related to self-management of shoulder pain: a systematic review and qualitative synthesis

Objective The objective of this review was to identify barriers and facilitators related to self-management from the perspectives of people with shoulder pain and clinicians involved in their care. Data sources CINAHL, MEDLINE, PsycINFO, SPORTDiscus, Embase, ProQuest Health, Web of Science, and Scopus were searched from inception to March 2022. Review methods A meta-aggregative approach to the synthesis of qualitative evidence was used. Two independent reviewers identified eligible articles, extracted the data, and conducted a critical appraisal. Two reviewers independently identified and developed categories, with validation by two further researchers. Categories were discussed among the wider research team and a comprehensive set of synthesized findings was derived. Results Twenty studies were included. From the perspective of patients, three synthesized findings were identified that influenced self-management: (1) support for self-management, including subthemes related to patient-centred support, knowledge, time, access to equipment, and patient digital literacy; (2) personal factors, including patient beliefs, patient expectations, patient motivation, pain, and therapeutic response; and (3) external factors, including influence of the clinician and therapeutic approach. From the perspective of clinicians, two synthesized findings were identified that influenced self-management: (1) support for self-management, including education, patient-centred support, patient empowerment, time, and clinician digital literacy; and (2) preferred management approach, including clinician beliefs, expectations, motivation, therapeutic approach, and therapeutic response. Conclusion The key barriers and facilitators were patient-centred support, patient beliefs, clinician beliefs, pain, and therapeutic response. Most of the included studies focused on exercise-based rehabilitation, and therefore might not fully represent barriers and facilitators to broader self-management.

Notion of a good death for patients with cancer: a qualitative systematic review protocol

IntroductionPromoting the quality of death and achieving a good death is one of the most important goals of palliative care in cancer care. Few studies synthesised views of patients with...

Perspectives of Children and Youth With Disabilities and Special Needs Regarding Their Experiences in Inclusive Education: A Meta-Aggregative Review

Inclusive education is important to achieve high-quality education for all; however, there is an important gap in the literature surrounding inclusive education, namely representation of the perspectives of children and youth with disabilities and special needs. In this study, we used a meta-aggregative approach to qualitative evidence synthesis to bring together systematically the perspectives of these children and youth regarding their experiences in inclusive education, and to generate recommendations for action. After selecting and critically appraising the methodological quality of eligible qualitative studies, we extracted the findings from the results sections of 27 studies involving children and youth with various diagnoses and special needs. We aggregated the findings to develop 19 categories, which we further synthesized into six overarching statements pertaining to: (i) teachers’ and education workers’ support and attitudes; (ii) implementation of support and accommodations; (iii) need for safe and accommodating physical environment; (iv) preparation for high school transitions; (v) friendships and peer interactions; and (vi) participants’ own views of themselves. Implications of our findings include: (i) a need for strong leadership at the school level to support implementation of inclusive education; (ii) a need for leadership from government agencies and schools to provide opportunities for teachers to train and collaborate with other professionals; and (iii) a need for flexibility in curriculum and instruction, for which educators require training and experience. Most importantly, our findings show that children and youth with disabilities and special needs, when provided opportunities, demonstrate profound personal understandings of their strengths and needs, their conditions and how these impact their lives, leading to insightful information that can enhance inclusive education practice and policy.

Childhood Experiences and Perspectives of Individuals With Orofacial Clefts: A Qualitative Systematic Review.

Children and adolescents with orofacial clefts may experience ongoing psychosocial impacts due to the continuous nature of cleft treatments, facial and dental differences, and speech and hearing difficulties. The aim of this qualitative systematic review was to better understand the experiences of children and adolescents with orofacial clefts. A systematic search strategy using PubMed, Embase, Emcare, Scopus, and Web of Science databases was performed to identify relevant qualitative studies evaluating the lived experience of children and adolescents with orofacial clefts from inception through to June 2021. Eligible studies were critically appraised using the Joanna Briggs methodology and a meta-aggregative approach. The search identified 2466 studies, with 13 found to meet the inclusion criteria. Extraction of 155 findings resulted in 27 categories, which were meta-aggregated into 7 overarching synthesized findings. These 7 core findings included aspects of child experience and findings that enhanced or impeded child experience at the individual, family, and community levels. Factors that impeded child experience at the individual, family, and community levels were more pronounced than factors that enhanced their experience among children and adolescents with orofacial clefts. Further initiatives are needed to provide support to individuals, families, and school communities to enhance children's experience of orofacial cleft during the formative childhood and adolescent years.