Meta-narrative Systematic Review Research Articles

Healthcare resilience: a meta-narrative systematic review and synthesis of reviews

ObjectivesThe COVID-19 pandemic has tested global healthcare resilience. Many countries previously considered ‘resilient’ have performed poorly. Available organisational and system frameworks tend to be context-dependent and focus heavily on physical...

Sustainability communication

This paper captures both a historical perspective and the current situation of sustainability communication (SC), the relevance and impact of conceptual and empirical contributions, and the future of SC research. By applying the principles of a meta-narrative systematic literature review, we analyze the concepts, theoretical models, and empirical approaches that researchers use in 116 articles in the field. The main manifestations of SC, including sustainability/green advertising, sustainability reporting, and greenwashing, are presented. The analysis reveals a predominant environmental focus on the literature and the dominance of applied communication approaches in SC. We identify several directions that can help advance the field and vision the leading role of the IJA journal in (re)defining and clarifying the concept and integrating the main communication concepts and theories into SC.

Understanding and Conceptualizing Childhood Animal Harm: A Meta-Narrative Systematic Review

ABSTRACT Several perspectives inform research on Childhood Animal Cruelty (CAC), but these perspectives are poorly integrated with each other and there is little dialogue with the rest of the child–animal interaction (CAI) literature. This study reviews the current empirical and theoretical literature on CAC to explore issues regarding research definitions and methodologies. Following the RAMESES guidelines, we performed a meta-narrative review of the CAC literature from 2010 to 2020, including theoretical papers and original research published in English. Four databases (OVID, Web of Science, PubMed, and EBSCOhost) were searched for terms relating to children, animals, and harm in the title and keyword fields. This generated 416 results, and 69 publications were reviewed here. We explore theories of CAC in relation to the historical research strands and discuss how well they are supported by existing empirical evidence. We thematically classified empirical study findings, which showed that (1) environmental factors that predict CAC include exposure to childhood adversity, especially experiences of violence and witnessing animal cruelty, (2) CAC is recurrent or has extreme links to later interpersonal violence, (3) psychological risk factors linked to CAC include externalizing disorders, lower empathy, lower self-esteem, poorer family functioning, and attitudes accepting of cruelty, (4) witnessing animal cruelty is a serious risk factor for a range of internalizing and externalizing behaviors, and (5) a range of psychosocial barriers exist in measuring and reporting CAC. Issues with measures, population selection, and definitions focusing only on more severe forms of CAC are factors which potentially constrain the generalizability of results. We highlight the need for developmentally appropriate definitions of CAC and methods of measurement and argue that the CAC literature is not well aligned with animal welfare legislation. We propose that CAC should be integrated into a broader spectrum of childhood behaviors toward animals.

Attention and Communication Following TBI: Making the Connection through a Meta-Narrative Systematic Review.

Communication difficulties are one of the hallmark characteristics of adults following traumatic brain injury (TBI), a difficulty that incorporates multiple aspects of cognition and language. One aspect of cognition that impacts communication is attention. This review explores both attention and communication following moderate to severe TBI and aims to connect them through a narrative analysis of the discourse surrounding the terms and how they have evolved over time. This includes exploring and reviewing theories and specific constructs of these two aspects of cognition. A meta-narrative systematic literature review was completed according to RAMESES methodology. A total of 37 articles were included in the review. The disciplines that populated the articles included, but were not limited to, speech language pathology (SLP) 36.5%, psychology 23.8%, and a collaboration of neuropsychology and SLP 7.9%. Of the papers that were included, 10% explored and supported theories of attention related to executive function affecting communication. Specific levels of attention were mapped onto specific communication skills with the corresponding year and authors to create a timeline and narrative of these concepts. The main communication behaviours that are related to attention in the context of post-TBI cognition include discourse, tangential communication, social communication, auditory comprehension, verbal reasoning, topic maintenance, interpretation of social cues and emotions, verbal expression, reading comprehension, verbal response speed, and subvocal rehearsal.

Volvulus of the ileal pouch-anal anastomosis: a meta-narrative systematic review of frequency, diagnosis, and treatment outcomes.

BackgroundProctocolectomy with ileal pouch–anal anastomosis (IPAA) is the surgical procedure of choice for medically refractory ulcerative colitis and familial adenomatous polyposis. While rare, a pouch volvulus can occur. We aimed to determine the frequency, presentation, and management approach of pouch volvulus in patients with IPAA.MethodsA systematic search of published literature was performed by a medical reference librarian on 10 August 2018 and two independent reviewers identified relevant publications, extracted data, and assessed the methodological quality based on a validated tool. A retrospective review of the Mayo Clinic electronic medical records identified one case of pouch volvulus between January 2008 and August 2018.ResultsThe frequency of pouch volvulus from one large published study reporting long-term outcomes of IPAA was 0.18% (3/1,700). A total of 22 patients (18 ulcerative colitis) were included (median age 32 years, 73% females). Median time to volvulus after IPAA was 36 months while median interval to volvulus diagnosis from symptom onset was 24 hours. Abdominal pain was the most commonly reported symptom (76%). The diagnosis was made primarily by abdominal computed tomography (13/17 patients, 76%). Endoscopic treatment was successful in 1 of 11 patients (9%). Surgery was performed in 20 patients and pouch-pexy and pouch excision were the most frequent surgical operations. A redo IPAA was performed in five patients (25%).ConclusionPouch volvulus is a rare but serious complication of IPAA and should be suspected even in the absence of obstruction symptoms. Endoscopic treatment often fails and surgery is effective when performed early.

Acculturation and mental health among adult forced migrants: a meta-narrative systematic review protocol

BackgroundThe global refugee crisis has become central to health and policy debates. There is a growing need to investigate how acculturation impacts mental health among asylum seekers and refugees. Many forced migrants have an increased risk of experiencing negative mental health outcomes, but this review will only assess the current literature on acculturation and mental health among adults. Research questions include the following: (1) How is acculturation conceptualised? (2) What are the most salient mental health outcomes? (3) How are acculturation and mental health measured and related? and (4) How do macrostructural factors affect the relationship between mental health and acculturation?MethodsWe will use a meta-narrative approach to synthesise the breadth of acculturation and mental health literature from various research traditions. This review will include empirical studies measuring variations of acculturation and mental health among adult forced migrants from low- and middle-income countries residing in high-income countries. Studies will be retrieved from the following academic databases: MEDLINE, Embase, PsycINFO, Global Health, ProQuest Social Science and Web of Science. Additional studies will be collected from King’s College London’s online library databases and e-resources, and reference lists of eligible studies. Studies from database inception and written in English will be included. All full-text papers will undergo quality appraisal using the Mixed Methods Appraisal Tool (MMAT). Extracted data will be analysed using a conceptual framework analysis to construct overarching narratives and a framework that will describe the relationship between acculturation and mental health.DiscussionA meta-narrative systematic review provides a flexible and systematic approach to synthesising the heterogeneous literature on acculturation and mental health. This review will guide the development of a conceptual framework to aid future research on acculturation among adult forced migrants. As high-income countries seek to integrate forced migrants into society and improve their access to vital resources, this review has the potential to transform policies and practices that influence migrant mental health.Systematic review registrationPROSPERO CRD42018089148

Can Patients Trust Online Health Information? A Meta-narrative Systematic Review Addressing the Quality of Health Information on the Internet

The Internet has become a leading source of health information accessed by patients and the general public. It is crucial that this information is reliable and accurate. The purpose of this systematic review was to evaluate the overall quality of online health information targeting patients and the general public. The systematic review is based on a pre-established protocol and is reported according to the PRISMA statement. Eleven databases and Internet searches were performed for relevant studies. Descriptive statistics were used to synthesize data. The NIH Quality Assessment Tool for Observational Cohort and Cross-Sectional Studies was used to assess the methodological quality of the included studies. Out of 3393 references, we included 153 cross-sectional studies evaluating 11,785 websites using 14 quality assessment tools. The quality level varied across scales. Using DISCERN, none of the websites received a category of excellent in quality, 37-79% were rated as good, and the rest were rated as poor quality. Only 18% of websites were HON Code certified. Quality varied by affiliation (governmental was higher than academic, which was higher than other media sources) and by health specialty (likely higher in internal medicine and anesthesiology). This comprehensive systematic review demonstrated suboptimal quality of online health information. Therefore, the Internet at the present time does not provide reliable health information for laypersons. The quality of online health information requires significant improvement which should be a mandate for policymakers and private and public organizations.

Readability of Online Health Information: A Meta-Narrative Systematic Review.

Online health information should meet the reading level for the general public (set at sixth-grade level). Readability is a key requirement for information to be helpful and improve quality of care. The authors conducted a systematic review to evaluate the readability of online health information in the United States and Canada. Out of 3743 references, the authors included 157 cross-sectional studies evaluating 7891 websites using 13 readability scales. The mean readability grade level across websites ranged from grade 10 to 15 based on the different scales. Stratification by specialty, health condition, and type of organization producing information revealed the same findings. In conclusion, online health information in the United States and Canada has a readability level that is inappropriate for general public use. Poor readability can lead to misinformation and may have a detrimental effect on health. Efforts are needed to improve readability and the content of online health information.

Men's information-seeking behavior regarding cancer risk and screening: A meta-narrative systematic review.

Preventive strategies are known to reduce cancer risk and incidence and improve prognosis. Men seldom seek medical information about cancer prevention and risk reduction. The aim of this meta-narrative systematic review was to critically appraise evidence from qualitative, quantitative, and mixed-methods studies that explored men's information-seeking behaviors in relation to cancer prevention and risk reduction. MEDLINE, CINAHL Plus with Full Text, PsycINFO, PsycARTICLES, Psychology and Behavioral Sciences Collection, Education Full Text, and ERIC were systematically searched for studies published in English between January 1, 2006 and May 30, 2016. A total of 4117 titles were identified; of which, 31 studies were included (21 qualitative studies, 9 quantitative studies, and 1 mixed-methods study). The methodological quality of the studies was appraised by using different tools. Most studies focused on screening for prostate (n=18) and colorectal cancer (n=7). Most men were passive information-gatherers rather than active information-seekers. Key sources of information included the Internet for active information-seekers and health care professionals for passive information-gatherers. Barriers to information-seeking included information overload, embarrassment, and fear. Low literacy and health literacy levels were addressed in 3 studies and were identified as impediments to active information-seeking. Facilitators to information-seeking included family support, media, celebrity endorsements, and targeted information. Men's information-seeking behavior regarding cancer risk reduction, prevention, and screening is influenced by several factors. This necessitates targeted interventions aimed at raising awareness of cancer prevention and screening, while accounting for men's informational needs, preferred learning strategies, and literacy levels.

Conceptualising paediatric health disparities: a metanarrative systematic review and unified conceptual framework

ObjectiveThere exists a paucity of work in the development and testing of theoretical models specific to childhood health disparities even though they have been linked to the prevalence of adult...

Health assessment of commercial drivers: a meta-narrative systematic review

BackgroundMotor vehicle accidents associated with commercial driving are an important cause of occupational death and impact public safety.ObjectivesWe summarise the evidence regarding the type, prevalence and impact of medical conditions...

INVESTIGATING FORTY YEARS OF STEM RESEARCH: HOW EXPLANATIONS FOR THE GENDER GAP HAVE EVOLVED OVER TIME

The gender gap in college-level STEM remains a persistent issue despite increased efforts to understand and address women's disparate participation. This scholarly article uses a meta-narrative systematic review of the literature to chronicle forty years of STEM-related literature, identify longitudinal patterns and themes in explanations of the gender gap in college STEM majors, and then evaluate the extent to which these explanations have evolved over time. Based on a systematic review of 324 full texts spanning the past 40 years of scholarly literature, five dominant meta-narrative explanations emerged: individual background characteristics; structural barriers in K-12 education; psychological factors, values, and preferences; family influences and expectations; and perceptions of STEM fields. The authors then used the resulting meta-narrative system to examine and document trends both across and within meta-narratives to draw conclusions regarding how scholars, practitioners, and policy makers have conceptualized the determinants of the STEM gender gap over time. Important implications for future research and practice are drawn based upon this analysis. © 2014 by Begell House, Inc.

Patient and service user engagement in research: a systematic review and synthesized framework

There is growing attention towards increasing patient and service user engagement (PSUE) in biomedical and health services research. Existing variations in language and design inhibit reporting and indexing, which are crucial to comparative effectiveness in determining best practices. This paper utilizes a systematic review and environmental scan to derive an evidence-based framework for PSUE. A metanarrative systematic review and environmental scan/manual search using scientific databases and other search engines, along with feedback from a patient advisory group (PAG). English-language studies, commentaries, grey literature and other sources (including systematic and non-systematic reviews) pertaining to patient and public involvement in biomedical and health services research. Study description (e.g. participant demographics, research setting) and design, if applicable; frameworks, conceptualizations or planning schemes for PSUE-related endeavours; and methods for PSUE initiation and gathering patients'/service users' input or contributions. Overall, 202 sources were included and met eligibility criteria; 41 of these presented some framework or conceptualization of PSUE. Sources were synthesized into a two-part framework for PSUE: (i) integral PSUE components include patient and service user initiation, reciprocal relationships, colearning and re-assessment and feedback, (ii) sources describe PSUE at several research stages, within three larger phases: preparatory, execution and translational. Efforts at developing a solid evidence base on PSUE are limited by the non-standard and non-empirical nature of much of the literature. Our proposed two-part framework provides a standard structure and language for reporting and indexing to support comparative effectiveness and optimize PSUE.

A meta-narrative review of recorded patient–pharmacist interactions: Exploring biomedical or patient-centered communication?

Pharmacists worldwide require improved patient-centered communication skills as they transition from a dispensing role to enhanced involvement in patient care. Researchers have studied pharmacist communication through audio and video recordings of patient-pharmacist encounters. A meta-narrative review of research using these recordings will offer insight into the extent of biomedical vs. patient-centered communication in patient-pharmacist exchanges. This review aimed to characterize research on patient-pharmacists interactions using audio or video recordings and explore the 1) focus of research questions, 2) study design, 3) data analysis methods, 4) main findings and 5) presence of patient-centered vs. biomedical models of interaction. Drawing on the principles of meta-narrative systematic review, a literature search was performed to identify studies published in English. No publication date limits were implemented. Key search terms included: "audio recording", "video recording", "communication", "patient counseling", "patient interaction", "discourse analysis", "conversation analysis", "narrative analysis", and "content analysis". The search was conducted in five databases: Medline, Embase, International Pharmaceutical Abstracts (IPA), Web of Science, and Academic Search Complete. Forty-one articles met the inclusion criteria and represent 32 unique collections of patient-pharmacist recordings. The 23 quantitative studies focused on "what" was in the interaction, whereas the 5 qualitative studies characterized specialized pharmacy practice and 13 studies used conversational analysis to describe "how" patients and pharmacists interact. The majority of research described the content of recorded interactions in community pharmacies. Twenty-three studies presented evidence of a biomedical model, whereas 8 studies characterized a patient-centered focus. A developing body of research used recordings to describe the content of patient-pharmacist communication and explore the quality of the interactions, validation of coding tools, impact of an intervention, and patient-pharmacist power asymmetry. Study findings, particularly the identification of biomedical vs. patient-centered communication, were guided by the quantitative, qualitative, or conversational analysis research paradigm.

Measuring quality in the therapeutic relationship—Part 1: objective approaches

BackgroundThe therapeutic relationship is complex. Any attempt to capture its quality in a score or metric must involve an element of reductionism. But policymakers increasingly ignore the unmeasured.AimTo review the...

Measuring quality in the therapeutic relationship—Part 2: subjective approaches

BackgroundThe therapeutic relationship is complex and incompletely captured in objective metrics.AimTo review the different concepts, theoretical models and empirical approaches which researchers have used to capture in qualitative terms what...