Meta-synthesis Of Qualitative Studies Research Articles

A Meta-synthesis of qualitative studies on early prevention and operating experience of interventions for delirium

Objective To study the experience of medical staff in conducting the interventions for delirium focusing on the promoting and hindering factors. Methods Databases including Wanfang, CNKI, VIP, SinoMed, PubMed, EBSCO, Springer, CINAHL, EMBASE, Web of Science were searched and relevant qualitative studies were included and synthesized and analyzed after quality evaluation. Results Totally 23 relevant articles were included and categorized into 8 themes based on research results: complex measure, psychological conflicts, heavy workload, fear and afraid, hopeless and helpless, pessimistic attitude, partners' support, organizational support. Conclusions During the process of applying the early prevention and intervention for delirium, due to the complexity of the intervention measures, the workload increased and hinders the compliance of medical staff in the application of intervention for delirium. However, with the support from partners or the organization, the medical staff expressed their willingness to carry out the intervention measures. Hospital administrators should make full use of the promoting factors and actively overcome the obstacles so that the medical staff can effectively carry out the prevention and intervention measure for delirium and hence improve the nursing care quality for the patients. Key words: Delirium; Meta analysis; Interventions; Operating experience; Qualitative study

Eating Disorder Recovery: A Metaethnography.

BACKGROUND: Eating disorders seriously affect both physical health and psychosocial functioning. Breaking the confines of an eating disorder requires engagement in a multifaceted recovery process. OBJECTIVE: This article provides a synthesis of 12 qualitative research studies with various eating disordered populations (anorexia nervosa, bulimia nervosa, binge eating disorder, eating disorder not otherwise specified, and other specified feeding and eating disorders) to elucidate the recovery process from the perspective of those who have overcome the disease. METHOD: A metasynthesis of qualitative studies was conducted using Noblit and Hare's metaethnographic methodology. RESULTS: Five overarching themes emerged from the data: (1) the eating disorder as a life jacket, (2) drowning: recognizing consequences, (3) treading the surface: contemplating recovery, (4) swimming: the path toward recovery, and (5) reaching recovery: a sense of freedom. CONCLUSIONS: Eating disorder treatment often entails a cycle of transitions before recovery occurs. Synthesizing the experiences from the perspective of individuals who have overcome an eating disorder presents a unique understanding of the treatment and recovery process.

Emotional development in eating disorders: A qualitative metasynthesis.

Emotions are considered to be an important feature in eating disorders. The present study aimed to conduct a systematic review and metasynthesis of qualitative studies, which considered the role of emotions in eating disorders in order to gain further insight on how these individuals experience various emotions and the strategies they use to manage them. Databases including Web of Science, PsychInfo, EMBASE, Medline, and the Cochrane library were searched for qualitative studies. The search identified 16 relevant studies. Meta‐ethnography was used to synthesize the data, which involved identifying the key findings and concepts of the studies and creating metaphors. The synthesis involved reciprocal translations and lines of argument approaches being applied to the present data. Results of the synthesis identified four second‐order themes and one third‐order theme relating to the emotional experiences of such individuals. The second‐order themes were (a) negative emotional environments, (b) interpersonal vulnerability, (c) the experience of negative emotions in social contexts, and (d) the management of emotions. The third‐order theme was the emotional self within a social environment. This is the first metasynthesis on emotions and eating disorders, and our synthesis highlights the important role that emotions play in the development and maintenance of eating disorders. Our model demonstrates how poor emotional development whilst growing up results in development of poor socioemotional bonds and the inability to handle negative emotions. The most significant finding of the review is that individuals use their eating disorder to manage negative emotions.

A Qualitative Meta-synthesis of Studies on Children's Place Experiences

A Qualitative Meta-synthesis of Studies on Children's Place Experiences

Children’s and caregivers’ perspectives about mandatory reporting of child maltreatment: a meta-synthesis of qualitative studies

ObjectiveTo systematically synthesise qualitative research that explores children’s and caregivers’ perceptions of mandatory reporting.DesignWe conducted a meta-synthesis of qualitative studies.Data sourcesSearches were conducted in Medline, Embase, PsycINFO, Cumulative Index to...

Factors and challenges of driving reduction and cessation: A systematic review and meta-synthesis of qualitative studies on self-regulation

Introduction: Older adults are at a greater risk of injury and death in a motor-vehicle accident. While the ability to drive safely can be challenging with aging, the concept of self-regulation and associated support system have attracted more attention in recent years, especially in developed countries. This review describes the mechanism and summarizes the potential factors that influenced self-regulation of driving amongst older adults to provide new insights into a broader framework for transportation and safe mobility. Methods: We systematically searched 12 online databases for qualitative studies exploring the experiences of older adults aged 60 years and above on their decision to self-regulate their driving. Thematic synthesis was performed to identify elements influencing driving reduction and cessation. The confidence profile of each findings from the meta-synthesis was appraised using the Confidence in the Evidence from Reviews of Qualitative research (CERQual) tool. Results: A total of 17 studies representing views of 712 older adults from four countries were included. Three major themes were identified with each representing a transition phase that can either facilitate or hinder older drivers from ceasing completely or reducing their driving, when transitioning from pre-decision phase to post-cessation phase. Conclusions: Our findings suggest that there is a mismatch between the current traffic collation prevention measures, such as age-specific mandatory license renewal system and travel needs of older adults. As such, it is time for the authorities, researchers, and public from various fields and perspectives to collaborate, sustain, and improve safety and mobility in older adults. Practical applications: Adequate regulations and guidelines from the medical community and legal authorities are warranted to assist older adults and caregivers. Social support (e.g., feedback, assurance, or transportation support) from family members, friends, and healthcare professionals are crucial for a smooth transition. Provision of alternative transportations in rural areas are needed and future interventions should focus on engaging and educating older adults to consider alternative transportation modes for mobility. Age-specific mandatory license renewal procedure can be useful in screening for at-risk groups.

Healing from Childhood Sexual Abuse: A Meta-Synthesis of Qualitative Studies

ABSTRACTAlthough the global prevalence of childhood sexual abuse (CSA) is very high, the experience of healing after such abuse has not been well documented. The goal of this study was to characterize the healing experience among CSA survivors presented in the literature. Metaethnography was used to synthesize an integrative literature review. The CINAHL, PubMed, PsycINFO, and Web of Science databases were used as data sources. Eight articles that explored healing experiences from CSA, published between 2007 and 2017, were included in the analysis. After performing a quality assessment, line-of-argument synthesis was used to construct the integrating scheme of healing experiences from CSA. CSA healing experiences included dissociating oneself from the memories of CSA, finding peace by creating a comfort zone, disclosure as the start of healing, attempting to establish identity through ongoing self-reflective activities, feeling comfort by sharing experiences and connecting with CSA survivors, and accepting CSA as part of the life history and stepping forward. Healing experiences from CSA synthesized from the analysis focused on personal growth, supporting previous theory on CSA health in the broader literature. A tailored care plan could be developed for CSA survivors who are at varying stages of healing.

Crises in Caring for Dying Patients Regarding Cancer Within Iranian Cultural Backgrounds: A Systematic Review of Qualitative Studies

Context: Peaceful death is a primary goal in the philosophy of palliative care. However, there are some distressing situations that can cause this unachievable that are termed “dying process crises”. The leading causes are interrelated to cultural and religious backgrounds of different societies. Objectives: The main causes of end of life crises are sought from integration of viewpoints of health care providers and extracted results are discussed as priorities for a future implication on a cancer end of life framework. Data Sources: A literature search for was performed published English qualitative studies that measured challenges or crises of end of life care in dying patients in perspective of health care providers by interview-based content analysis approaches from January 2008 to March 2018 via PubMed, MedLine, Google Scholar, ScienceDirect, and PsycINFO databases. Study Selection: Studies related to death in acute or non-hospital settings, hastened death, and structural or modeled studies were excluded. At the end, 8 articles were entered in the Meta-synthesis of qualitative studies. Data Extraction: The selected articles were repeatedly read and related themes to research question were extracted. Then, overarching themes were synthesized among descriptive themes of each article. Results: The identified overarching themes were poorly controlled symptoms, unexpected death, time and facility constrains, lack of education or knowledge, weak coping skills, communication barriers, family conflicts, and systematic issues. By discussion on the cultural aspects and isolated palliative care framework of Iran, important priorities to prevent death crises were symptom management and appropriate communication skills. Conclusions: Regarding the themes in priority, planning educational programs for family meetings directed to the Iranian cultural and religious context, besides developing high quality cancer palliative services, are in a real necessity.

The vulnerable-empowered mother of academic food discourses: a qualitative meta-synthesis of studies of low-income mothers and food provisioning

ABSTRACTThe nutritional health and wellbeing of children, and by extension their weight, is a heated topic in contemporary discussions of food and health, particularly for low-income populations. Despite contrary understandings, there remains a dominant societal framing that parents – in particular low-income mothers – are solely responsible for the status of their children’s health and wellbeing. In this paper, we examine how low-income mothers are positioned within the academic literature to reveal where responsibility for children’s health and well-being is positioned. We present a meta-synthesis of 18 qualitative studies to identify how mothers’ food choices and feeding are positioned, and the recommendations that researchers identify for promoting child health within this discursive terrain. We found that low-income mothers faced multiple challenges relating to cost, convenience, concerns about health and wellbeing. However, many of the recommendations made by researchers focused extensively on behavioural interventions aimed at the vulnerable mother rather than structural interventions to support mothers’ feeding practices. We argue that discourses of low-income motherhood must recommend structural, and not just individual, change to counteract dominant constructions of the ‘vulnerable-empowered mother’.

Barriers and facilitators to participating in physical activity for adults with breast cancer receiving adjuvant treatment: A qualitative metasynthesis

Physical activity can improve the health and well-being of individuals receiving adjuvant treatment for breast cancer, but engagement in physical activity can be low. This review synthesises the barriers and facilitators to engaging with and participating in physical activity whilst receiving treatment. The metasynthesis of qualitative studies is reported in line with the PRISMA statement. We systematically searched eight databases (MEDLINE, EMBASE, CENTRAL, PsycINFO, CINAHL, British Library, OpenGrey, and Conference Proceedings Citation Index) from inception to November 30, 2017. A total of 1276 abstracts were retrieved and screened by two reviewers independently. Data from eligible studies were extracted and critically appraised. As this review concerns qualitative studies only, a CER-QUAL GRADE assessment was completed. A total of 13 studies were included. Four clear themes emerged (side effects of treatment, beliefs about physical activity, focus on health not illness, and social factors) each containing both barriers and facilitators. Key facilitators to participating in physical activity during adjuvant treatment included positive physical benefits, improvements in psychological well-being, and increased self-esteem and empowerment. Further, having a knowledgeable instructor, tailored information, and a supportive environment were important to women undergoing treatment. Main barriers included fatigue and pain, as well as work and caring responsibilities. Incorporating physical activity into treatment regimens is important. Focusing on being less sedentary and providing accurate, tailored information should be prioritised within future interventions. Having a supportive environment and accounting for the particular barriers or facilitators to engagement identified here should aid the success of future interventions.

Basic Needs of Mothers with Children Undergoing Hemodialysis: A Meta-synthesis of Qualitative Studies

Background: Mothers of children undergoing hemodialysis encounter severe changes in their daily lives. It is of utmost importance to raise the awareness of treatment teams about the needs of these specific groups of mothers and different problems they may experience. The reason is that it can help health care professionals to support the mothers to fulfill their roles as the primary caregivers of such children. Aim: This study aimed to identify basic needs in mothers of children undergoing hemodialysis. Method: This meta-synthesis review of qualitative studies investigating the needs and experience of mothers whose children had kidney disease and published from January 1997 to October 2017. The articles were searched in four databases, including Web of Science, EMBASE, PubMed, and ProQuest. The search process was accomplished using the keywords “chronic kidney disease,” “hemodialysis,” “children,” “mothers,” “parents,” “caregivers,” “needs,” “experiences,” “perspectives,” and “perceptions”. Finally, 7 articles were chosen out of 567 papers and theses. The MAXQDA software was used to facilitate data management. Results: The systematic review of the qualitative studies revealed three main themes, including the need for child care management skills, the need to maintain family cohesion, and the need for emotional–psychological support. Implications for Practice: Mothers of children under hemodialysis should be considered as nursing clients. Accordingly, a multidisciplinary team can empower mothers to take care of the children under hemodialysis and preserve family coherence, as well as supporting them emotionally and psychologically.

Barriers to accessing mental health services for women with perinatal mental illness: systematic review and meta-synthesis of qualitative studies in the UK

ObjectiveLack of access to mental health services during the perinatal period is a significant public health concern in the UK. Barriers to accessing services may occur at multiple points in...

Mutuality in psychotherapy: A meta-analysis and meta-synthesis.

This manuscript presents a systematic review of mutuality in psychotherapy, including meta-analysis of quantitative and meta-synthesis of qualitative studies. A search with specified keyword combinations yielded 21 studies, including 10 quantitative studies with 1,071 participants and 11 qualitative studies with 81 participants. Researchers calculated effect sizes, conducted homogeneity tests, and assessed potential variables moderating the relationship between mutuality and therapeutic variables from quantitative studies; they analyzed qualitative studies to identify and synthesize themes related to mutuality in psychotherapy. Meta-analysis showed a large weighted mean effect size with a statistically significant overall relationship between mutuality and therapeutic variables (r = 0.51, 95% CI [0.37; 0.66], p < 0.001). The relationship between mutuality and session quality was strongest of the six relationships analyzed (r = 0.70, 95% CI [0.43; 0.97], p < 0.001). Qualitative meta-synthesis of studies produced six themes: 1. Lack of mutuality/strategies for disconnection, 2. Co-created relational process, 3. Meta-communication and misunderstanding, 4. Therapist congruence/being real, 5. Mutual impact and client agency, and 6. Asymmetric role power and boundaries. These findings suggest that mutuality is worthy of further research in psychotherapy, particularly in relation to its strong relationship with session quality.

Development of a Core Outcome Set for Studies on Obesity in Pregnant Patients (COSSOPP): a study protocol

BackgroundMaternal obesity is a risk factor for adverse maternal, fetal, and neonatal events. Numerous clinical trials are currently exploring the effectiveness of antenatal and peripartum interventions in improving pregnancy outcomes that can in future inform clinical practice. However, the heterogeneity in outcome reporting limits our ability to compare outcomes across studies, and there is a lack of stakeholder representation in outcome choice. A pragmatic solution to this problem is the development of a core outcome set (COS) that defines the minimum criteria for outcome reporting in clinical trials undertaken in this population, arrived at by the involvement of relevant stakeholders.MethodsThe development of a COS for studies on obesity in pregnant patients (COSSOPP) will comprise five steps. First, a systematic review of published literature will identify the long list of outcomes, their definitions and measurements if applicable, and outcome reporting quality. This will be followed by a meta-synthesis of qualitative studies with patients, and qualitative interviews in Toronto with patients, clinicians, researchers, hospital administrators, and policy-makers, to identify novel outcomes that were not obtained through systematic review. Third, the long list of outcomes will be narrowed down through online Delphi surveys involving an international group of patients and relevant stakeholders. This will be followed by a face-to-face consensus meeting with representatives of all stakeholder groups to arrive at a consensus on the final COS. Finally, in order to determine how the identified core outcomes should be measured, we will conduct another literature review and Delphi process.DiscussionCOSSOPP will engage patients, clinicians, researchers, and other relevant stakeholders in determining the core set of outcomes that should be reported and measured in order to harmonize outcome reporting in studies evaluating the effectiveness of antepartum and peripartum interventions in obese pregnant women. This protocol provides a detailed overview of the steps involved in the development of a COS, to guide researchers in developing COS within their areas of specialization.COMET Core Outcome Set Registrationhttp://www.comet-initiative.org/studies/details/939.

Prevalence of and reasons for women's, family members', and health professionals' preferences for cesarean section in China: A mixed-methods systematic review.

BackgroundChina has witnessed a rapid increase of cesarean section (CS) rates in recent years. Several non-clinical factors have been cited as contributing to this trend including maternal request and perceived convenience. We aimed to assess preferences for mode of delivery and reasons for preferences for CS in China to inform the development of future interventions to mitigate unnecessary CSs, which are those performed in the absence of medical indications.Methods and findingsWe conducted a mixed-methods systematic review and included longitudinal, cross-sectional, and qualitative studies in mainland China, Hong Kong, and Taiwan that investigated preferences for mode of delivery among women and family members and health professionals, and the reasons underlying such preferences. We searched MEDLINE/PubMed, Embase, CINAHL, POPLINE, PsycINFO, Global Health Library, and one Chinese database (CNKI) using a combination of the key terms ‘caesarean section’, ‘preference’, ‘choice’, ‘knowledge’, ‘attitude’, ‘culture’, ‘non-clinical factors’, and ‘health professionals-patient relations’ between 1990 and 2018 without language restriction. Meta-analysis of quantitative studies and meta-synthesis of qualitative studies were applied. We included 66 studies in this analysis: 47 quantitative and 19 qualitative. For the index pregnancy, the pooled proportions of preference for CS reported by women in longitudinal studies were 14% in early or middle pregnancy (95% CI 12%–17%) and 21% in late pregnancy (95% CI 15%–26%). In cross-sectional studies, the proportions were 17% in early or middle pregnancy (95% CI 14%–20%), 22% in late pregnancy (95% CI 18%–25%), and 30% postpartum (95% CI 19%–40%). Women’s preferences for CS were found to rise as pregnancy progressed (preference change across longitudinal studies: mean difference 7%, 95% CI 1%–13%). One longitudinal study reported that the preference for CS among women’s partners increased from 8% in late pregnancy to 17% in the immediate postpartum period. In addition, 18 quantitative studies revealed that some pregnant women, ranging from 4% to 34%, did not have a straightforward preference for a mode of delivery, even in late pregnancy. The qualitative meta-synthesis found that women’s perceptions of CS as preferable were based on prioritising the baby’s and woman’s health and appeared to intensify through interactions with the health system. Women valued the convenience of bypassing labour because of fear of pain, antagonistic relations with providers, and beliefs of deteriorating quality of care during labour and vaginal birth, fostering the feeling that CS was the safest option. Health professionals’ preference for CS was influenced by financial drivers and malpractice fears. This review has some limitations, including high heterogeneity (despite subgroup and sensitivity analysis) in the quantitative analysis, and the potential for over-reporting of women’s preferences for CS in the qualitative synthesis (due to some included studies only including women who requested CS).ConclusionsDespite a minority of women expressing a preference for CS, individual, health system, and socio-cultural factors converge, contributing to a high CS rate in mainland China, Hong Kong, and Taiwan. In order to reduce unnecessary CSs, interventions need to address all these non-clinical factors and concerns.Systematic review registryProspero CRD42016036596.

Barriers and facilitators to dental care during pregnancy: a systematic review and meta-synthesis of qualitative studies.

Some barriers to dental treatment during pregnancy are poorly understood, especially those related to psychosocial factors, which are better explored in qualitative studies. The aim of this systematic review was to explore the barriers and facilitators to dental care during pregnancy through a thematic synthesis of qualitative studies. Qualitative or mixed-methods studies published in English, Portuguese, Spanish and French, from 2000 to 2016, were included. The search strategies were conducted in PubMed, Scopus, Web of Science, LILACS, BBO and CINAHL. To evaluate the quality of the studies, we used the Critical Appraisal Skills Programme tool. Thematic synthesis was performed in order to interpret and summarize the results. From 2,581 screened studies, ten were included in the synthesis. We found 14 analytical themes related to barriers and facilitators to dental care during pregnancy that interacted in complex ways: physiological conditions, low importance of oral health, negative stigma regarding dentistry, fear of/anxiety toward dental treatment, mobility and safety, financial barriers, employment, time constraints, social support, lack of information, health professionals' barriers, family and friends' advice, beliefs and myths about the safety of dental treatment. Myths and beliefs about oral health and dental treatment during pregnancy appear to be the most frequent barriers, both to pregnant women and to dentists or other health professionals. The findings of this review may support new studies, especially to test intervention protocols and to guide effective public policies for the promotion of oral health during pregnancy.

The Experiences of Gay and Bisexual Men Post-Prostate Cancer Treatment: A Meta-Synthesis of Qualitative Studies.

Studies suggest that gay and bisexual men are affected by the psychological aspects of prostate cancer treatment differently than that of heterosexual men; however the data have not yet been synthesized. The focus of this meta-synthesis is to explore gay and bisexual men’s experiences of prostate cancer posttreatment. Empirical research published in peer reviewed journals between January 1990 and January 2018 were identified in six databases: CINAHL, Cochrane, Medline, PsycINFO, PubMed, and Web of Science. Titles and abstracts were checked by two reviewers. The six studies that met the inclusion criteria were selected and reviewed for quality and the extracted data were then synthesized. The main themes that emerged were sexual impact, physical and psychological difficulties, challenges to intimacy, and support mechanisms. Gay and bisexual men can have specific sexual roles and developing prostate cancer and undergoing treatment may compromise their ability to perform their sexual role. The needs of heterosexual men were perceived to be accommodated more often than that of gay and bisexual men because of engrained heteronormativity in the health-care system. The review suggests that more support groups specifically for gay and bisexual men should be established, while urologists should cater to the sexual and masculine implications of treatment, and not frame problems for gay and bisexual men in heterosexual terms. By failing to address the salient needs and concerns of gay and bisexual men, health-care professionals are reinforcing invisibility and marginalization of gay and bisexual men with prostate cancer.

Meta-syntese af kvalitative studier

This article is written for students and PhD students in psychology. The article is in Danish. The purpose of this article is to introduce a special kind of review of existing literature known as meta-synthesis. In a meta-synthesis, qualitative studies are integrated or compared and, as a result, the essence of meta-synthesis is as a result an analytic generalization of findings in qualitative studies. Stages in meta-synthesis are outlined, especially emphasizing the interchange between research topic and aim, the systematic literature search and analysis of identified studies. An example of a meta-synthesis is used to illustrate the stages. Finally, the article includes a comparison of the knowledge derived from meta-analysis of quantitative studies and meta-synthesis of qualitative studies. The conclusion is that meta-synthesis is well suited for generating theory and may improve decision-making about intervention.

Flexible Work Arrangements and Work–Family Conflict: A Metasynthesis of Qualitative Studies Among Academics

Quantitative research has reported variable and inconsistent findings regarding the relationship between flexible work arrangements (FWA) and work–family conflict (WFC). In this article, we address this inconsistency through the lens of qualitative research. We synthesize the findings of 45 qualitative studies from a variety of disciplines that have explored work–family interface (WFI) among academics whose profession offers high levels of FWA by nature. Analyzing the findings of these qualitative studies, we developed six themes of which five could be translated to moderators of the relationship between FWA and WFC. These moderator variables are boundary management preferences, time management skills and approach, career/family stage, nature of an academic job, and workplace culture. Our findings have theoretical, methodological, and practical implications for work–family and human resource development (HRD) scholars and practitioners motivated to improve the quality of employees’ work–life through initiation of FWA interventions.

Protocol for a meta-integration: investigating positive aspects of caregiving in dementia

IntroductionThe current work describes the protocol for a meta-integration investigating the positive aspects of providing care to someone living with dementia. We aim to understand the position of positive aspects...