Meta-synthesis Of Qualitative Literature Research Articles

The Needs and Experiences of Patients Returning to Work After Total Knee Arthroplasty and Total Hip Arthroplasty: A Systematic Review and Meta-Synthesis.

The objective of this study was to conduct a systematic and comprehensive review of qualitative research to examine the physical and psychological needs, as well as work experiences, of patients undergoing total knee replacement and total hip replacement surgeries during their process of returning to work. A systematic review and meta-synthesis of qualitative literature was conducted. A systematic search was conducted across 8 databases to identify qualitative or mixed-methods research on the needs and experiences of individuals with total knee replacement and total hip replacement who have returned to work. The search period extended from the inception of each database to March 2023. Two researchers independently utilized a predetermined search strategy to retrieve relevant English-language studies published in any year. The included studies were assessed for quality using the Critical Appraisal Skills Program appraisal tool. Findings from the studies were then summarized and integrated using the pooled integration method. There were 10 studies in total. Three key themes were identified from the original research: needs during the return to work process and rehabilitation training, faith and support to return to work, and constraints and challenges at work. Health care professionals and employers should conscientiously consider the physical and psychological requirements of patients who have undergone total knee replacement and total hip replacement when they are resuming work, taking into account the specific constraints and challenges that may arise in the workplace. To ensure a seamless transition back to work, it is essential to develop tailored occupational interventions, implement comprehensive return to work programs, and offer patients sufficient understanding and support. The findings of this study offer valuable insights into the physical and psychological needs, as well as the work experiences, of patients who have undergone total knee replacement and total hip replacement during their reintegration into the workforce. These findings have the potential to assist health care professionals and employers in providing enhanced support to facilitate successful return-to-work outcomes for patients.

The Prerequisites of Executing the Accreditation Program for Primary Healthcare: A Systematic Review and Meta-Synthesis.

In Iran, the primary healthcare system is the front-line for society's encounter with healthcare. Health planners aim to enhance quality and administer an accreditation program. This study examined program administration prerequisites through systematic review and meta-synthesis. We conducted a systematic review and meta-synthesis of qualitative literature using Thomas and Hudson's framework. Peer-reviewed papers were searched in Scopus, PubMed, Web of Science, Google, and Google Scholar up to 2023. The search found 1308 articles, with 37 relevant ones selected for review. Data extraction included setting, participants, study design, data collection, analysis, and themes. Thirteen qualitative subthemes were identified and were categorized under three elements of the Donabedian model. Before implementing a plan, it is crucial to consider its executive prerequisites. Revision and trial-and-error approaches can be costly and time-consuming, potentially hindering the plan's effectiveness and diverting organizations from their primary goal, leading to failure.

Job (dis-)satisfaction in pay-for-performance health care contexts: a meta-synthesis of qualitative literature

PurposeDrawing on the pay-for-performance (P4P) and job satisfaction literatures through an analysis of qualitative studies published on the topic, the purpose of this study is to investigate the effect of a P4P-based system on job satisfaction and dissatisfaction among health care workers.Design/methodology/approachA meta-synthesis of the qualitative literature was conducted to investigate health care workers' opinions, perceptions and behaviors and fully understand what processes generate job satisfaction or dissatisfaction under P4P systems.FindingsThe findings suggest that P4P systems impact the job (dis-)satisfaction of health care workers based on the institutional, organizational, geographic and cultural context of reference. Specifically, job satisfaction – and thus motivation, occupational well-being and work engagement – can occur when the context is supportive, whereas job dissatisfaction – and thus work stress and pressure, burnout and work-life balance issues and distraction – is generated in the case of unsupportive contexts. Moreover, the findings suggest a virtuous/vicious circle whereby job satisfaction leads to positive performance and further fuels job satisfaction, while conversely job dissatisfaction generates worse performance, and this further worsens worker satisfaction.Originality/valueThere is a lack of studies comparing and analyzing current evidence on the job (dis-)satisfaction of health care workers operating in different contexts based on the reward system. This is the first research to analyze a significant number of studies with reference to the relation between P4P and job (dis-)satisfaction, which are topics in need of further study and investigation in health care settings around the world.

Review: Systematic review and metasynthesis of qualitative literature on young people's experiences of going to A&E/emergency departments for mental health support.

There has been an increase in children and young people attending emergency departments for mental health reasons, including self-harm. Patients often report having poor experiences when attending emergency departments for mental health support. However, there has yet to be a review exploring the experiences of young people. Our aim in this study was to synthesise qualitative literature on young people's experiences of going to emergency departments for mental health support. A systematic review and metasynthesis were conducted. Five databases and grey literature were searched for relevant studies. Five articles met study criteria and were analysed using an iterative process of thematic synthesis. The synthesis yielded four overarching themes: (a) emergency departments' inability to meet the mental health needs of young people, (b) emergency departments exacerbating patient distress, (c) patients feeling like a burden or undeserving of treatment and (d) consequences of poor emergency department experiences. These findings (based on a still very limited literature) highlight the role that emergency departments have in relation to being a key point of contact with young people who self-harm. To properly engage with patients, emergency departments need to have the resources to provide compassionate care and follow clinical guidelines regarding assessments.

User-relevant factors influencing the prosthesis use of persons with a transfemoral amputation or knee-disarticulation: A meta-synthesis of qualitative literature and focus group results.

Persons with a transfemoral amputation or knee-disarticulation are heavily reliant on an adequate set of components for their prosthesis. To improve the process of adjusting the specific prosthetic properties to the expectations of the prosthesis users, it is of importance to first identify which factors have an influence on prosthesis use. Therefore, we aimed to identify factors that influence prosthesis use in adults with a transfemoral amputation or knee-disarticulation. A qualitative meta-synthesis was conducted by searching five databases (last update January 20th 2022). Studies were considered eligible if they contained qualitative data about adult persons with a transfemoral amputation or knee-disarticulation with experience in using a prosthesis and focused on the users' opinions. All eligible studies were independently screened by two reviewers. The results sections of the included studies were entered in Atlas.ti software (v8) and coded using the framework approach. The quality of the included studies was assessed using the Critical Appraisal Skills Program (CASP) qualitative research checklist. Results of the meta-synthesis were validated with prosthesis users (n = 8) in a focus group. Out of 5757 articles, 14 studies were included. An overview of seven themes ('prosthesis related'; 'rehabilitation, costs and prosthetist'; 'mental'; 'physical'; 'social'; 'activities and participation' and 'walking') containing 84 factors was created. Ten factors were added during the focus group, resulting in an overview of 94 factors that may influence the prosthesis use of lower-limb prosthesis users. Participants would like more user-involvement from the rehabilitation team. The development of a patient decision aid could help this process in the future. The large number of factors demonstrates that there is a great variety between prosthesis users and the factors that influence their prosthesis use. Therefore, it is important to take individual preferences into account for the selection of a new prosthesis.

Engaging with deepfakes: a meta-synthesis from the perspective of social shaping of technology theory

PurposeThis study aims to establish a comprehensive understanding of the intricacies of how individuals engage with deepfakes, focusing on limiting adverse effects and capitalizing on their benefits.Design/methodology/approachThis study conducted a meta-synthesis of qualitative studies on deepfakes, incorporating study-specific analysis followed by a cross-study synthesis.FindingsBased on the meta-synthesis, the study developed an integrated conceptual framework based on the perspectives from the social shaping of technology theory embedding deepfake-related assertions, motivations, the subtleties of digital platforms, and deepfake-related repercussions.Research limitations/implicationsThe study offers crucial insights into the evolving nature of deepfakes as a socio-technical phenomenon and the significance of platform dynamics in deepfake production. It enables researchers to comprehend the cascading effects of deepfakes and positions them to evaluate deepfake-related risks and associated mitigation mechanisms.Practical implicationsThe framework that emerges from the study illustrates the influence of platforms on the evolution of deepfakes and assists platform stakeholders in introducing effective platform governance structures to combat the relentless proliferation of deepfakes and their consequences, as well as providing guidance for governments and policymakers to collaborate with platform leaders to set guardrails for deepfake engagement.Originality/valueDeepfakes have been extensively contested for both their beneficial and negative applications and have been accused of heralding an imminent epistemic threat that has been downplayed by some quarters. This diversity of viewpoints necessitates a comprehensive understanding of the phenomenon. In responding to this call, this is one of the first to establish a comprehensive, theoretically informed perspective on how individuals produce, process, and engage with deepfakes through a meta-synthesis of qualitative literature on deepfakes.

Experiences of familial stigma among individuals living with mental illnesses: A meta-synthesis of qualitative literature from high-income countries.

INTRODUCTION: Familial mental illness stigma is a pervasive issue but very subtle in high-income countries. Familial mental illness stigma implies persons living with mental illnesses are discriminated against by their family members or close relatives. This meta-synthesis explored the experiences of familial stigma among individuals living with mental illnesses in high-income countries, focusing on empirical literature, to understand the breadth of current literature and ways to reduce this form of stigma. We conducted a meta-synthesis through a structured search of qualitative data from six electronic databases (Sociological Abstract, CINAHL, Medline, PsycINFO, Google Scholar and Embase). Inclusion criteria comprised: empirical primary research, primary technique for data collection is qualitative, studies published in a peer-reviewed journal in the English language between 2000 and 2020, studies reported on experiences of familial mental illness stigma, and studies conducted in high-income countries. The exclusion criteria were as follows: all grey literature, studies not written in English and non-peer-reviewed, studies not focused on familial mental illness stigma, quantitative peer-reviewed articles on the related concept and peer-reviewed articles on the related topic before the year 2000. The study identified only 28 peer-reviewed articles on the topic within two decades. Concealment of familial stigma was found to be detrimental due to the potential for alienation within one's home environment. Disclosure and social contact within the family system were considered as critical interventions to provide some safety nets for individuals with mental illnesses. The paucity of studies over the review period highlights the need for further attention to support optimal environments for persons living with mental illnesses. Families' understanding of the difficulties of mental illness stigma is vital to supporting the development of policies and interventions towards the avoidance of social exclusion within societies. Families should make concerted efforts to reduce stigma, and this includes within the family system. Education and training approaches around mental illness-related stigma should involve individuals with lived experience and their families, as well as service providers and the general public.

A meta-synthesis of qualitative literature on female chronic pelvic pain for the development of a core outcome set: a systematic review

Introduction and hypothesisQualitative research has an increasing role in the development of core outcome sets (COS) adding patient perspectives to the considerations of core outcomes. We aimed to identify priorities of women with experience of chronic pelvic pain (CPP).MethodsThe search strategy was a systematic review of qualitative studies identified from Cochrane Central Register of Controlled Trials (CENTRAL), CINAHL, EMBASE, MEDLINE and PsycInfo databases. Selection criteria were qualitative studies exploring the experience of women with CPP. Two independent researchers extracted data and summarized findings using thematic analysis. A CERQual assessment was performed to assess the confidence of review findings.ResultsWe identified pertinent issues affecting women with CPP including the lack of holistic care, influence of psychosocial factors and the impact of pain on quality of life. Five meta-themes central to delivering a patient-centred approach were highlighted: acceptance of pain, quality of life, management of CPP, communication and support. Management of CPP was the most commonly reported meta-theme across seven studies and half of studies reported quality of life, management, communication and support. Quality appraisal of included studies identified only a single study that met all CASP (Critical Appraisal Skills Programme) criteria. There was high confidence in the evidence for acceptance of pain, quality of life and communication meta-themes.ConclusionMeta-themes revealed by this review should be considered as a priority and reflected in outcomes reported by future studies evaluating interventions for CPP. In addition, these themes should be considered by clinicians managing women with CPP.

User-relevant factors determining prosthesis choice in persons with major unilateral upper limb defects: A meta-synthesis of qualitative literature and focus group results.

ObjectiveConsidering the high rejection rates of upper limb prostheses, it is important to determine which prosthesis fits best the needs of each user. The introduction of the multi-grip prostheses hands (MHP), which have functional advantages but are also more expensive, has made prosthesis selection even harder. Therefore, we aimed to identify user opinions on factors determining prosthesis choice of persons with major unilateral upper limb defects in order to facilitate a more optimal fit between user and prosthesis.MethodsA qualitative meta-synthesis using a ‘best-fit framework’ approach was performed by searching five databases (PROSPERO registration number: CRD42019126973). Studies were considered eligible if they contained qualitative content about adults with major unilateral upper limb defects experienced in using commercially available upper limb prostheses and focused on upper limb prosthesis users’ opinions. Results of the meta-synthesis were validated with end-users (n = 11) in a focus group.ResultsOut of 6247 articles, 19 studies were included. An overview of six main themes (‘physical’, ‘activities and participation’, ‘mental’, ‘social’, ‘rehabilitation, cost and prosthetist services’ and ‘prosthesis related factors’) containing 86 subthemes that could affect prosthesis choice was created. Of these subthemes, 19 were added by the focus group. Important subthemes were ‘work/school’, ‘functionality’ and ‘reactions from public’. Opinions of MHP-users were scarce. MHPs were experienced as more dexterous and life-like but also as less robust and difficult to control.ConclusionThe huge number of factors that could determine upper limb prosthesis choice explains that preferences vary greatly. The created overview can be of great value to identify preferences and facilitate user-involvement in the selection process. Ultimately, this may contribute to a more successful match between user and prosthesis, resulting in a decrease of abandonment and increase of cost-effectiveness.

Experiences of participating in intergenerational interventions in older people's care settings: A systematic review and meta-synthesis of qualitative literature.

To synthesize the findings of qualitative research exploring the experiences of being involved in intergenerational interventions in older people's care settings. A meta-synthesis of the qualitative literature, employing Sandelowski and Barroso's method, was conducted. Eight databases were searched in March 2017. The PRISMA statement was used for reporting the different phases of the literature search and the Critical Appraisal Skills Programme (CASP) qualitative research checklist was used as an appraisal framework. Data synthesis was conducted using Sandelowski and Barroso's method. Four qualitative studies were included in the meta-synthesis. Thematic analysis revealed four themes: 'Recreating the family'; 'Building intergenerational empathy and respect';'Uplifting and energizing'; and 'Engagement risks and challenges'. The meta-synthesis strengthens the evidence that intergenerational interventions can be positive. However, it also shows that there may also be some negative aspects if not planned or managed carefully. This review contributes to the body of evidence by synthesizing the experiences of older people and children involved in intergenerational interventions. Although qualitative literature supports the quantitative evidence that intergenerational interventions can have a positive effect, intergenerational interventions could also have negative effects on some participants. Older people may feel tired, or experience feelings of infantilization. Practitioners need to be more aware of the potential negative effects of intergenerational interventions and include risk assessment, possibly by requiring ethical scrutiny.

Parental decision-making following a prenatal diagnosis that is lethal, life-limiting, or has long term implications for the future child and family: a meta-synthesis of qualitative literature

BackgroundInformation on the factors influencing parents’ decision-making process following a lethal, life-limiting or severely debilitating prenatal diagnosis remains deficient. A comprehensive systematic review and meta-synthesis was conducted to explore the influencing factors for parents considering termination or continuation of pregnancy following identification of lethal, life-limiting or severely debilitating fetal abnormalities.MethodsElectronic searches of 13 databases were conducted. These searches were supplemented by hand-searching Google Scholar and bibliographies and citation tracing. Thomas and Harden’s (2008) thematic synthesis method was used to synthesise data from identified studies.ResultsTwenty-four papers were identified and reviewed, but two papers were removed following quality assessment. Three main themes were identified through systematic synthesis. Theme 1, entitled ‘all life is precious’, described parents’ perception of the importance of the fetus’ life, a fatalistic view of their situation alongside moral implications as well as the implications decisions would have on their own life, in consideration of previous life experiences. Theme 2 (‘hope for a positive outcome’) contained two sub-themes which considered the parent’s own imagined future and the influence of other people’s experiences. Finally, Theme 3 (‘a life worth living’) presented three sub-themes which may influence their parental decision-making: These described parental consideration of the quality of life for their unborn child, the possibility of waiting to try for another pregnancy, and their own responsibilities and commitments.ConclusionThe first review to fully explore parental decision-making process following lethal, life-limiting, or severely debilitating prenatal diagnosis provided novel findings and insight into which factors influenced parents’ decision-making process. This comprehensive and systematic review provides greater understanding of the factors influential on decision-making, such as hope, morality and potential implications on their own and other’s quality of life, will enable professionals to facilitate supported decision-making, including greater knowledge of the variables likely to influence parental choices.

PO525 A Systematic Review and Meta-Synthesis of Qualitative Literature On Health Professionals’ Experiences Communicating With Chinese Immigrants

PO525 A Systematic Review and Meta-Synthesis of Qualitative Literature On Health Professionals’ Experiences Communicating With Chinese Immigrants

Motivations for Remittances and Philanthropy – Lessons from a Qualitative Meta-Synthesis of Literature

Why do people send remittances? Also, what are the motivations for diaspora philanthropy? While each of these questions have been addressed by scholars in different way – with the most influential theories suggesting that ‘identification’ is the key theme that explains each of these phenomenon, we contend that there is much more than purely ‘identification’ with the recipients that is at play. In this study, based on synthesis of various theories and some empirical studies, we propose a new ‘mid-range’ theory, that seeks to explain the motivations for giving – both remittances and philanthropy. We explain how the motivations in each can be similar and distinct and offer insights that aim to further the scholarship on philanthropy and remittances. We hope to contribute to the discussion on the motivations for remittances and philanthropy and how it plays out, in the context of international development. With the urgency in fund-raising efforts and the need to accurately identify mechanisms and tools that will address the urgent needs of millions of people around the world, scholars are also coming together with innovative approaches and models to help understand how and why people give money. In addition, there is also the factor of donor fatigue that one has to contend with.

Physical disabilities in Asia: A meta-synthesis of qualitative literature written in English

Introduction Research shows that occupational therapists and occupational therapy students are increasingly taking up positions in cross-cultural contexts where occupational form, social values and understanding of occupation are different to Western norms. It may be difficult for the occupational therapist to identify the implication of cultural differences. Method This meta-synthesis investigated lived experience of physical disability in East and Southeast Asia with the aim of identifying local understandings of disability, using the technique of meta-ethnography as described by Noblit and Hare. Findings Fourteen articles met the selection criteria and six overarching themes were identified concerning disability in Asia: theme (1), the influence of disability on relationships within primary groups; theme (2), journeys in resilience vary among individuals; theme (3), managing poor health makes disability difficult; theme (4), education is important and difficult for people with disabilities to achieve; theme (5), financial hardship is closely linked to disability; and theme (6), values and beliefs are enmeshed in the experiences of living with disabilities. Conclusion There is a wide range of experiences of disability. Occupational therapy services and research may be more effective for people with disabilities in cross-cultural settings, when these factors are investigated and incorporated into practice.

Connectivity, contest and the ties of self-management support for type 2diabetes: a meta-synthesis of qualitative literature.

This paper presents a meta-synthesis of the literature on community-based self-management to support experiences of people diagnosed with type 2 diabetes. The aim was to synthesise findings on both formal and informal self-management support with particular reference to the relevance and influence of the social context operating at different levels. The review forms part of EU-WISE, a project financed through EU's 7th Framework Programme. The review was performed by systematically searching MEDLINE, PubMed, EMBASE, CINAHL, PsycINFO and Web of Science for English language publications between 2005 and 2014 presenting research conducted in Europe on the experiences and perspectives of self-management concerns of patients diagnosed with type 2 diabetes. The search yielded 587 abstracts, which were reduced through search strategy refinement and eligibility and quality criteria to 29 papers that were included in the review. This review highlights the relevance of contextual factors operating at micro- and macro-levels. The synthesis yielded six second-order thematic constructs relating to self-management: sense of agency and identity, the significance and meaning of social networks, minimal disruption of everyday life, economic hardship, the problem of assigning patients' responsibility and structural influences of primary care. Using a line of argument synthesis, these themes were revisited, and a third-order construct, connectivity emerged which refers to how links in daily life are interwoven with peoples' social networks, local communities, economic and ideological conditions in society in a way which support self-management activities. This meta-synthesis indicates a need to heed the notion of connectivity as a means of mobilising and supporting the self-management strategies of people with type 2 diabetes in everyday life.

Primary health care assessment tools: a literature review and metasynthesis.

This study comprises a systematic review and metasynthesis of qualitative literature on national and international databases to identify the main tools used to assess Primary Health Care (PHC). A total of 3,048 results were returned for literature written in Portuguese, Spanish and English published between 1979 and 2013. Thirty-three articles/studies were selected after thorough reading and analysis. Eight of these studies addressed the use of one or more of the following validated PHC assessment tools: the WHO Primary Care Assessment Tool (PCET); the ADHD Questionnaire for Primary Care Providers (AQ-PCP); the General Practice Assessment Questionnaire (GPAQ), PACOTAPS (primary health care software); and the PCAT (Primary Care Assessment Tool). The study showed that the majority of these tools were used internationally. The PCAT and EUROPEP were used in Brazil and the most commonly used tool in this country was the PCAT. The results show that the use of research tools to assess PHC may assist in the creation of new proposals to improve family healthcare and that PCAT is the most adequate tool for this purpose.

Developing stroke rehabilitation and community services: a meta-synthesis of qualitative literature

Purpose: To identify the key factors that are necessary to account for in planning and developing rehabilitation and community services for stroke based on users’ perspectives. Method: A meta-synthesis of qualitative research comprising three stages: (i) systematic searching and identification of relevant reports; (ii) critical appraisal of selected reports; (iii) analysis and synthesis of included reports. Results: A total of 138 reports were identified, 101 were rejected after applying the inclusion criteria. Following critical appraisal, 18 papers were included. The main interconnecting themes relate to how the impact of stroke is influenced by: (i) the person; (ii) close social relationships; (iii) the social environment; (iv) interactions between all three. The lines-of-argument synthesis relates to the social world a person inhabits and its effect on how a person will perceive and deal with their stroke. Support will be most effective when delivered in the context of this social world. Conclusion: How stroke is perceived is highly dependent on a person’s identity. Support can be effective if delivered within the existing structures of a stroke survivor’s unique social world.Implications for RehabilitationRehabilitation of stroke survivors needs to be considered in its broadest context and include an equal focus on the social, psychological and physical aspects.Traditional rehabilitation practice needs to be expanded if stroke survivors are to be supported in maintaining an active and positive presence in their unique social world.