Primary Qualitative Studies Research Articles

Breast reconstruction after mastectomy in patients with obesity: a narrative review.

Breast reconstruction in patients with obesity presents numerous challenges, both in terms of surgical technique and post-operative complication management. As breast reconstruction techniques continue to evolve, the armamentarium of reconstructive options for patients with obesity has vastly expanded. Options now include immediate or delayed, implant-based, autologous, or hybrid reconstruction. Determining the optimal breast reconstruction in this complex population requires nuanced and experienced decision-making. A literature search was conducted to identify studies assessing breast reconstruction considerations in patients with obesity. The search was performed on PubMed and was limited to English language studies published between 1990 and 2023. Primary studies, case reports, chart reviews, and qualitative studies were included. Additional articles were identified for inclusion based on a review of references, as well as a web-based search, to identify additional studies that were not captured with the primary search strategy. This narrative review article summarizes the current literature available to guide surgeons in breast reconstruction in patients with obesity. The advancements in oncologic surgery and breast reconstruction techniques have expanded available surgical options, including immediate or delayed implant-based, autologous, or hybrid breast reconstruction. Each approach has its unique advantages, disadvantages, and surgical considerations. Despite the challenges, patients with obesity can achieve favorable aesthetic outcomes through careful assessment of comorbidities and expectation management.

Factors affecting the implementation of calcium supplementation strategies during pregnancy to prevent pre-eclampsia: a mixed-methods systematic review

ObjectivesDaily calcium supplements are recommended for pregnant women from 20 weeks’ gestation to prevent pre-eclampsia in populations with low dietary calcium intake. We aimed to improve understanding of barriers and...

Nma nwoke (“Man's Beauty”)

Abstract Since the 1980s, low male enrollment in secondary schools has been observed in Anambra State in southeast Nigeria. Previous studies largely attribute the phenomenon to a masculine drive toward the quick accumulation of material wealth. This article draws on two primary qualitative studies conducted in the state in 2012 and 2020 and on Bourdieu's notion of habitus to discuss how the local construction of masculinity and social expectations influence boys’ aspirations and preferences and contribute to their decision to drop out of high school. Participants were both males and females who dropped out of school of high school or who did not enroll in high school before entering the workforce. While economic factors are central to males’ disengagement from school, they are underpinned by demands and pressures associated with the social construction of masculinity. Material wealth is seen as a symbol of a man's beauty (nma nwoke). Policy and intervention programmes are needed to mitigate societal pressures on boys in Anambra State.

Implementation and Impact of Health Care Gardens: A Systematic Scoping Review.

Background: In community and school settings, gardens and garden interventions have been shown to confer several psychosocial, physiological, and nutritional benefits. However, little is known about the implementation and impact of health care gardens on patients, visitors, and staff health and well-being. The primary aim of this review is to identify and describe the types of gardens and common design elements implemented in health care settings and the impact these gardens have on the health and well-being of patients, visitors, and staff. A secondary aim is to assess the quality of available evidence. Methods: PubMed, CINAHL, EMBASE, and PsycINFO were systematically searched on October 28, 2022. Primary qualitative and quantitative studies (excluding case reports and studies) were eligible for inclusion if they described the types of gardens and common design elements implemented in health care settings (hospitals, aged care, rehabilitation facilities, and medical centers) and/or assessed the impact of garden interventions on the health and well-being of patients, visitors, and staff. Review, selection, and data extraction were conducted by two independent researchers, with findings synthesized and presented in narrative form. Articles were critically appraised using the mixed methods appraisal tool (MMAT). Results: Eighteen articles were included. Eight studies provided detailed descriptions of the types of gardens implemented in health care settings (healing [n = 3], therapeutic [n = 2], sensory [n = 2], children's fairy gardens [n = 1], and enriched [n = 1] gardens). Studies examining the psychosocial impacts of gardens were most frequently reported (n = 16), followed by physical (n = 4) and nutritional (n = 2). A wide range of positive outcomes, predominantly relating to patients (n = 12), were reported, including improvements in stress, quality of life (QOL), cognitive function, physical activity, and fruit and vegetable intake. The evidence was heterogeneous and low-medium quality. Conclusions: The findings suggest that implementing gardens and garden interventions in health care settings may positively impact the health and well-being of patients, visitors, and staff. Most studies related to the impact of gardens on patients' mental health and QOL, indicating the need for further research to explore physical and nutritional outcomes, as well as health outcomes of staff and visitors. Findings also suggest the need for high-quality study designs (e.g., cluster control trials) and standardized measurement tools.

Recovery needs and psychosocial rehabilitation trajectory of stroke survivors (PReTS): A qualitative systematic review of systematic reviews

Objective Stroke has a major impact on a person's life. While much research exists on stroke prevention and treatment, explorations into psychosocial recovery needs are lacking. This review critically consolidates the challenges and needs of stroke survivors and develops a trajectory that encapsulates their journey from illness to recovery. Data sources Six major databases were searched, including Academic Search Premier, CINAHL, Global Health, Medline, PsycArticles, and PsycINFO. Methods This review adhered to the PRISMA guidelines and employed the PICo (population, phenomena of interest, context) framework to screen for relevant qualitative reviews published between 1 January 2010 and 31 August 2023. Following full-text screening and the assessment of methodological quality using a modified version of the Assessment of Multiple Systematic Reviews scale, a total of 17 reviews were included for thematic synthesis. Results Included reviews referenced 400 qualitative primary studies involving more than 5623 stroke survivors. Data synthesis revealed 18 themes that were further organized into six conceptual categories: (1) The unfamiliar body, (2) compassionate healthcare system, (3) holistic rehabilitation, (4) intrapersonal strength, (5) interpersonal relations, and (6) thriving forward to form the psychosocial rehabilitation trajectory of stroke survivor (PReTS) model. The model recognizes the losses that can occur after a stroke and emphasizes the essentiality of addressing psycho-socio-emotional and spiritual needs alongside physical impairments. Conclusion The PReTS model is the first to highlight stroke survivors’ losses, recovery journeys, and psychosocial needs. The conceptualization serves to inform and advance stroke rehabilitation practices with holistic and wellness recovery research.

A Primary Qualitative Study Exploring Adult BAME Individuals' Experiences Regarding Physical Activity from the North-East of England During the COVID-19 Pandemic

Researchers have found that people from BAME communities have worse health outcomes from many health interventions and face health disparities. BAME individuals experience health inequities and lower health intervention results. The experiences of adult Teesside-based BAME individuals' regarding physical activity (PA) during the COVID-19 pandemic were mapped onto the capability, opportunity, and motivation model of behaviour (COM-B). Twelve adult BAME participants were interviewed using semi-structured interviews that lasted 40 to 60 minutes and captured participant perceptions of how their PA and perceptions related to living a healthy PA lifestyle during the pandemic between April and August 2022 via Microsoft Teams. Using thematic analysis, 10 themes were generated, but only three themes were discussed. These include knowledge and awareness of the PA lifestyle, participants' perceptions of the opportunities to improve the PA lifestyle choice of adult BAME, and the change in perceptions of PA due to COVID-19 lockdown. While literature has explored the COM-B model, there have been generalised findings that are not specific to adult BAME individuals' lived PA experiences. The COVID-19 pandemic presents an opportunity to understand the shift in adult BAME perceptions and experiences during the coronavirus pandemic, therefore calling for the urgent need to modify both models in order to combat the high mortality rates of adult BAME individuals related to sedentary lifestyle diseases. This indicates that there is a critical requirement for the COMB model in order to implement policies. Nevertheless, limited PA studies have used lifestyle behaviour models to enhance behavioural modification.

The impact of telemedicine enabled pre-hospital triage in acute stroke - a protocol for a mixed methods systematic review.

Increasing access to thrombolysis and thrombectomy through improved pathway organisation remains a health service challenge that requires contextualisation to the geographic, demographic and resourcing status of any regional stroke service. Pre-hospital delays or delays during inter-hospital transfers can result in patients being outside the window for one or both interventions. Pre-hospital triage using technology-enabled interdisciplinary communication networks may facilitate rapid individualized care decisions, permitting streamlined care pathways to hospital sites most appropriate to their clinical presentation and history in the first instance. Understanding the experience of those involved in efforts to improve or reorganise care may help to explain the impact observed. 1. To review the impact of pre-hospital telemedicine enabled workflow intervention strategies on patient outcomes and on service process metrics in hyper-acute stroke care2. To examine how the experience of those involved in providing or receiving such interventions might identify key characteristics of effective interventions. Quantitative, qualitative and primary mixed methods studies will be included. Quantitative studies will assess effectiveness of telemedicine-enabled interventions that facilitate pre-hospital acute stroke triage. Intervention effects on functional outcomes of patients, on intervention rates and on key time metrics in hyperacute stroke care will be assessed. Qualitative studies will explore the experiences of people involved in or impacted by these interventions. A convergent segregated mixed methods systematic review will synthesise and integrate primary qualitative, quantitative and mixed methods studies using the Joanna Briggs Institute methodology. Database searches will include OVID (MEDLINE), EMBASE, The Cochrane Library, CINAHL and Web of Science. Critical appraisal will include the Mixed Methods Assessment Tool. Results of quantitative studies and findings of qualitative studies will be integrated and configured to explore and contextualize each single method synthesis. This protocol has been submitted for registration with PROSPERO.

Implementing smoking cessation in routine primary care-a qualitative study.

The use of digital tools has been proposed as a solution to some of the challenges of providing preventative services in primary care. Although there is a general acceptance among patients to use digital self-help tools to quit smoking, and healthcare organizations are increasingly urged to incorporate these tools in clinical practice, it is unclear how and for whom these innovations can be incorporated into clinical practice. To explore health care professionals' perceptions about smoking cessation practice in routine primary care and the use of digital tools in this work. A qualitative study with nine in-depth telephone interviews with health care professionals working in primary care in Sweden. Convenience sampling and snowball technique was used as recruitment strategy. Informants included registered, district and auxiliary nurses as well as behavioral therapists. All informants were female, between 43 and 57 years old and experience of working with smoking cessation in primary care and possibility to recommend digital interventions to smokers. Informants described smoking cessation practice in primary care as (i) identifying smoking patients, (ii) pursuing standardized routines for smoking cessation practice and (iii) keeping smoking cessation practice on the agenda. Digital tools were described by informants to be used in different ways: (i) replicating practice, (ii) complementing practice and (iii) enabling access to health care practitioners. Finally, the analysis showed that patients' expectations and behaviors contributed to how and when smoking cessation practice was conducted, including the use of digital tools. Implementing smoking cessation practice in primary care in Sweden encompass continuous work of reaching smoking patients, building buy-in among peers and keeping tobacco on the practice agenda. Digital interventions are used to replicate, complement and enabling access to care. The findings suggest that poor continuity of staff and negative attitudes towards preventative work may challenge smoking cessation practice. However, societal changes in the awareness of the health risks of tobacco use including shifting social norms regarding the acceptance of smoking may contribute to a normalization of speaking about smoking in primary care practice. Increased knowledge is needed on how, and for whom digital tools can be incorporated in clinical practice.

Understanding the influence of ethnicity on adherence to antidiabetic medication: Meta-ethnography and systematic review.

A high prevalence of diabetes and diabetes-related complications in people from minority ethnic communities in high income countries is of significant concern. Several studies have indicated low adherence rates to antidiabetic medication in ethnic minority groups. Poor adherence to antidiabetic medication leads to a higher risk of complications and potential mortality. This review aims to qualitatively explore the barriers to and facilitators of adherence to antidiabetic medication among ethnic minority groups in high-income countries. A comprehensive search of MEDLINE, Embase, CINAHL, PsycINFO, and Global Health databases for qualitative studies exploring the barriers to or facilitators of adherence to antidiabetic medication in minority ethnic groups was conducted from database inception to March 2023 (PROSPERO CRD42022320681). A quality assessment of the included studies was conducted using the Critical Appraisal Skills Programme (CASP) tool. Key concepts and themes from relevant studies were synthesised using a meta-ethnographic approach. The Grading of Recommendations Assessment, Development and Evaluation Confidence in the Evidence from Reviews of Qualitative research (GRADE-CERQual) approach was used to assess the Confidence in the review findings. Of 13,994 citations screened, 21 studies that included primary qualitative studies were selected, each of which involved people from minority ethnic communities from eight high income countries. This qualitative evidence synthesis has identified three overarching themes around the barriers to and facilitators of adherence to antidiabetic medication among ethnic minority groups.: 1) cultural underpinnings, 2) communication and building relationships, and 3) managing diabetes during visiting home countries. Based on the GRADE-CERQual assessment, we had mainly moderate- and high-confidence findings. Multiple barriers and facilitators of adherence to antidiabetic medication among people from minority ethnic communities in high-income countries have been identified. A medication adherence intervention focusing on identified barriers to adherence to antidiabetic medication in these communities may help in improving diabetes outcomes in these groups.

Self-management Behaviors and Associated Factors in Adult Cancer Survivors: An Integrative Review.

Despite numerous systematic reviews on self-management interventions for cancer survivors, little is known about survivors' daily self-management practices and the influencing factors. To identify self-management behaviors and related factors among cancer survivors. Six databases were searched for primary quantitative, qualitative, and mixed-methods studies on self-management behaviors in cancer survivors that were published in English-language, peer-reviewed journals between 2012 and July 2022. The methodological quality of the included studies was evaluated using the Mixed Methods Appraisal Tool. The data extracted using a predetermined form were analyzed using qualitative content analysis. A total of 22 articles were included in the review; the majority were qualitative research, and half had moderate to high quality of evidence. Nine domains of self-management behaviors were identified, namely, physical activity/exercise, diet, emotional management, complementary and alternative medicine, symptom management, religiosity/spirituality, attending regular follow-ups, adjustment of other lifestyles, and medication management. Four categories of factors were associated with self-management behaviors in cancer survivors: (1) personal factors (demographic and psychological), (2) health status, (3) family factors, and (4) healthcare system. However, the relationships between self-management behaviors and these factors were mainly identified from qualitative studies or addressed in single studies. Self-management behaviors in cancer survivors are multifaceted. There is an urgent need for quantitative exploration of factors associated with self-management in cancer survivors. This review provides nurses with a comprehensive basis for designing self-management support interventions for cancer survivors.

Educational technology for reading instruction in developing countries: A systematic literature review

AbstractDespite significant initiatives to improve education globally, policy makers and researchers are concerned about literacy outcomes in developing countries, as students lack basic literacy skills even after many years in schooling. Educational technology has been championed as a potential solution to low‐quality education in developing countries, yet little rigorous research on this topic exists. Since Covid‐19 has caused enormous global disruption and teachers have been forced to adopt technology globally, research into the effectiveness of using technology for teaching literacy in low‐income contexts is vital. This systematic review of the literature analyses and synthesises the range of international research available on educational technology to improve reading in developing countries. This review includes primary qualitative, quantitative and mixed methods studies, which were analysed using thematic synthesis. The review concludes that there is some suggestive evidence that reasons for the success of educational technology literacy interventions may include ongoing teacher professional development, interactive multimedia features, and a focus on phonics and progressive reading skills. The current limited research base supports technology designs that are adaptive, engaging, and child‐centred, utilising software that can differentiate for students' levels. Engaging the community using context‐specific resources and incorporating the technology into a broader literacy programme and pedagogy, were also features highlighted in multiple studies. However, with a limited number of studies the strength of the evidence is weak; therefore, definitive conclusions cannot be made. The findings provide some suggestive evidence that could guide future research. Context and implicationsRationale for this studyThis systematic review addresses the gap in current research into which types of educational technology are effective for the teaching of reading in developing countries. By synthesising the findings of qualitative, quantitative and mixed methods primary studies, this review presents tentative recommendations for policy makers and future research.Why the new findings matterThe findings present specific features of effective educational technologies that could be used by policy makers to improve literacy outcomes. This is directly relevant for the millions of students in developing countries who lack literacy skills even after many years in school. Educational technology is widely used and promoted as a solution for improving educational or literacy outcomes in developing countries, yet little rigorous research exists. This systematic review addresses this by synthesising existing research and highlighting areas for future research. Since Covid‐19 caused teachers to adopt technology globally, research into the effectiveness of using technology for teaching literacy in low‐income contexts is vital.Implications for research and practiceThis systematic review synthesises current research so that policy makers have guidelines when designing interventions. The review provides a comprehensive map of existing literature and gaps for researchers. Based on the findings from this systematic review, policy makers are encouraged to consider how technology engages students through multimedia and interactive features, is adapted to the local context and language, and is differentiated to students' different ability levels. Policy makers should also consider how technology supports student learning through the scaffolding of specific reading skills with a holistic connection to a broader literacy programme, teacher training and the local curriculum. Since little quality data exists in this area, these recommendations for policy are tentative, and it is recommended future research further explore some of the promising features that were found in numerous successful interventions.

Studies about Individual Life Structure: A Meta-Synthesis Study

Adulthood period, which forms the most satisfying and wearing years of life psychologically, has been defined by many theorists. One of these theorists is Levinson, who developed the theory of Life Structure. There is a need for investigating the studies about life structure in a developmental process from a holistic and systematic point of view in order to learn what the studies about life structure enhance in adult individuals’ life. In this regard, the purpose of this study is to investigate how adult people’s life structures are shaped in the transition periods and the factors that affect their career developments in the qualitative studies about life structure. This study that is qualitative in nature is based on meta-synthesis approach. The data used in the study were composed of 12 qualitative studies selected using criterion sampling method. Based on the research in academic databases, the data were subjected to thematic content analysis methods in order to obtain common themes from the findings of the primary qualitative studies. The results of this study revealed four sub-themes and eight categories related to the themes of transition periods and career development.Results of the studies indicated that adult people experienced changes in their sense of self and life goals in a transition period they were in. Adult people who are in a transition period are determined to give a special place to their hobbies while they are shaping their life structures. Finally, factors affecting success in adult individuals’ career development were found to be mainly intrinsic motivation and a mentor.

Experiences of nurses managing parenthood and career: A systematic review and meta-synthesis.

Consolidate and synthesize evidence on working nurse-parent experiences of parenthood. Demands in healthcare strain the workforce, causing burnout and high turnover rates, especially among nurses. Balancing work and family responsibilites is even more challenging for nurse-parents. Nursing is highly stressful, and the experiences of nurse-parents are under-researched highlighting the need to better understand and support nurse-parents in their dual roles. Seven databases (PubMed, Embase, CINAHL, PsycINFO, ProQuest, Scopus, and Web of Science) were systematically searched for published and unpublished primary qualitative studies. Extracted data were meta-summarized and synthesized using Sandelowski and Barroso's approach. Twelve peer-reviewed studies, conducted between 2007 and 2022, investigated the challenges faced by 339 female nurse-parents across various countries. The meta-synthesis revealed two main themes: (a) Clashes of dual roles, and (b) Accept, adapt, and compromise, which were supported by six subthemes. Nurse-parents struggled with dual roles, often neglected self-care, and experienced work-family conflicts. However, they learned to accept their situations, adapt by seeking help from family, friends, and colleagues, and compromise on career aspirations to prioritize their families. The importance of organizational support and flexibility in accommodating their dual roles was emphasized. Female nurse-parents face challenges in balancing their dual roles, resulting in fatigue, compromised self-care, and limited social interactions. The culture of self-sacrifice in nursing contributes to these challenges, impacting patient safety. Supportive interventions like mindfulness programs and exercise classes can promote well-being. Staffing shortages and shift work further affect the work-life balance for nurse-parents. Creating a supportive work environment for nurse-parents is crucial. Family-friendly shifts revised parental leave policies, and improved childcare support are needed. Supporting nurse-parents benefits their well-being and enhances patient care. Collaboration between healthcare organizations and policymakers is essential to address workforce shortages and implement changes.

Experiences with remote communication in adult intensive care units during the COVID-19 pandemic: a systematic review protocol.

The objective of this review is to explore the lived experiences of critically ill adults, their families, or health care professionals with remote communication in intensive care units (ICUs) during the COVID-19 pandemic. Family visiting restrictions in ICUs during the COVID-19 pandemic imposed significant challenges to communication between critically ill adults, their families, and the health care team. Evidence shows that several communication strategies were developed and implemented in ICUs during the COVID-19 pandemic to promote family engagement; however, the experiences of critically ill adults, their families, and health care professionals with these strategies are scattered across primary qualitative studies. This review will consider qualitative studies that include critically ill adults, their families, or health care professionals, focusing on their experiences with remote communication strategies in ICUs during the COVID-19 pandemic. This review will be conducted in accordance with JBI methodology. The search strategy will aim to locate both published and unpublished qualitative studies in English, Spanish, and Portuguese. Studies published after January 2020 will be included. Study selection, critical appraisal, and data extraction will be performed independently by 2 reviewers. Data will be presented in narrative format and synthesized using the JBI meta-aggregation process. A ConQual Summary of Findings will be presented. PROSPERO CRD42022383603.

Perspectives on Healthy Eating of Adult Populations in High-Income Countries: A Qualitative Evidence Synthesis.

Understanding how individuals currently perceive healthy eating is essential for developing food policies and dietary recommendations that improve the health and well-being of populations. The purpose of this qualitative evidence synthesis was to systematically outline the views and understandings of healthy eating, focusing on how foods are classified as healthy and unhealthy and what meanings are attached to food and eating by the general adult population in high-income countries. A systematic search of four electronic databases was conducted and yielded 24 relevant primary qualitative studies of generally healthy, community-dwelling adults. Thematic synthesis of the included studies identified three analytic themes: constructions of healthy and unhealthy eating, considerations on dietary recommendations, and meanings attached to food and eating. Study participants generally understood what constitutes a healthy and unhealthy diet which was in line with dietary recommendations, but those of lower socioeconomic status exhibited gaps in nutrition knowledge. Participants expressed diverse opinions on dietary recommendations, including skepticism and a lack of trust. Food and eating were associated with various meanings, including pleasure, stress relief, and feelings of guilt. Moral, health, and sociocultural considerations also played a role in dietary behaviors. The findings suggest that improving population diet requires considering how dietary recommendations are phrased and communicated to ensure that healthy eating is associated with pleasure and immediate well-being. This review provides valuable insights for developing consumer-oriented, practicable, and acceptable food policies and dietary recommendations that effectively improve population health and well-being.

Medical students' honesty in summative reflective writing: A rapid review.

Reflection is a highly individual metacognitive process of contextualising experiences in our environment. It is a core skill for medical students, as it helps future practitioners tackle complex scenarios. It is subject to assessment, which goes against the philosophical underpinnings of reflection, thus risking students only emulating reflective practice without actually engaging with it. We sought to provide an overview of the current literature on medical students' views of summative reflective writing. A rapid review of literature was carried out. Keywords were searched in six databases; items were retrieved and screened against the inclusion/exclusion criteria. Ten papers were included in the final review. Their quality was appraised by utilising the CASP checklist tools. Seven primary research papers addressed honesty of reflective practice in a variety of different settings. Students were found to 'game the system' by tailoring their reflections to meet the assessment criteria. One paper postulated that students are honest in their reflections. Three expert opinions showed congruent views on the need for diversification of reflective practice in medical school and going back to the definition of reflection. This rapid review provides an account of medical students' views of summative reflective writing within the literature. Instrumentalising reflection can lead to students only emulating reflective practice, although not engaging with deeper learning. More primary qualitative studies exploring medical students' views of assessment of reflection would better detail the problem of emulated reflective practice.

Client experience of food assistance programs among adults in the United States: a qualitative evidence synthesis protocol.

Policymakers, health practitioners, and other key partners are increasingly focused on ensuring that clients of food assistance programs have positive experiences, a key aspect of high-quality programming. The objectives of this review are to describe the experiences of clients participating in food assistance programs in the United States (US) and to identify ways that these programs promote or hinder positive experiences. We will conduct a qualitative evidence synthesis with partners from food security organizations and community members. Peer-reviewed literature will be systematically searched in Scopus, CINAHL, and AGRICOLA. To identify grey literature, we will use Google's programmable search engine. This review will consider sources that present results of primary qualitative studies that focus on at least one food assistance program in the US and explore the perspectives of adult clients. Only sources published in English or Spanish from 2007 onward will be included. Multiple reviewers will screen articles for inclusion and extract data from articles that meet the inclusion criteria, using a structured data extraction tool. Thematic synthesis or meta-ethnography may be appropriate approaches for synthesizing the extracted data. The final selection of synthesis method will be determined once the set of primary qualitative studies to be included in the review is complete and the type of data presented in these studies is known. We will assess the methodological quality of the included studies using the CASP (Critical Appraisal Skills Programme) tool for qualitative studies and assess the confidence in the review findings using the GRADE-CERQual (Confidence in Evidence from Reviews of Qualitative research) approach. The findings of this review will inform the development of measures to assess client experience and quality improvement efforts.

What Nursing-Sensitive Outcomes Have Been Investigated to Date among Patients with Solid and Hematological Malignancies? A Scoping Review.

Nursing-sensitive outcomes are those outcomes attributable to nursing care. To date three main reviews have summarized the evidence available regarding the nursing outcomes in onco-haematological care. Updating the existing reviews was the main intent of this study; specifically, the aim was to map the state of the art of the science in the field of oncology nursing-sensitive outcomes and to summarise outcomes and metrics documented as being influenced by nursing care. A scoping review was conducted in 2021. The MEDLINE, Cumulative Index to Nursing and Allied Health, Web of Science, and Scopus databases were examined. Qualitative and quantitative primary and secondary studies concerning patients with solid/haematological malignancies, cared for in any setting, published in English, and from any time were all included. Both inductive and deductive approaches were used to analyse the data extracted from the studies. Sixty studies have been included, mostly primary (n = 57, 95.0%) with a quasi- or experimental approach (n = 26, 55.3%), conducted among Europe (n = 27, 45.0%), in hospitals and clinical wards (n = 29, 48.3%), and including from 8 to 4615 patients. In the inductive analysis, there emerged 151 outcomes grouped into 38 categories, with the top category being 'Satisfaction and perception of nursing care received' (n = 32, 21.2%). Outcome measurement systems included mainly self-report questionnaires (n = 89, 66.9%). In the deductive analysis, according to the Oncology Nursing Society 2004 classification, the 'Symptom control and management' domain was the most investigated (n = 44, 29.1%); however, the majority (n = 50, 33.1%) of nursing-sensitive outcomes that emerged were not includible in the available framework. Continuing to map nursing outcomes may be useful for clinicians, managers, educators, and researchers in establishing the endpoints of their practice. The ample number of instruments and metrics that emerged suggests the need for more development of homogeneous assessment systems allowing comparison across health issues, settings, and countries.

Family Resilience as an Emerging Concept in Neonatology: Evidence From a Metasummary Review.

Family resilience can be observed through specific resilience-promoting processes, namely, shared belief systems, communication, and organizational processes, but the concept remains mostly unstudied in neonatology. This metasummary aims to evaluate the frequency of family resilience processes in qualitative scientific literature to illustrate how family resilience is exhibited in the neonatal intensive care unit (NICU) setting. A search among 4 databases yielded 7029 results, which were reviewed for inclusion. Following Sandelowski and Barroso's qualitative metasummary method, findings from each study were independently coded and frequency effect size was calculated. Forty-six primary qualitative studies published between 2016 and 2022 conducted with parents of preterm infants who discussed their NICU hospitalization experience were included in this metasummary. All 9 of Walsh's family resilience processes were identified in the literature, and their frequency effect size ranged from 4% to 91%. Four additional themes emerged pertaining to specific family resilience behaviors exhibited by NICU families. This analysis sheds new light on the most recent qualitative evidence of parents' experiences in the NICU by analyzing it through the lens of family resilience and posits family resilience as a promising concept in relation to the predominance of the family-centered care philosophy in neonatal units.

P05 Comparing patients’ and healthcare professionals’ experiences and views on the management of recurrent urinary tract infections: qualitative evidence synthesis and meta-ethnography

Abstract Background Urinary tract infections (UTIs) are common and result in significant morbidity, negative impacts on daily life, reduced quality of life and reduced work attendance. Recurrence is common and recurrent UTIs have an estimated annual prevalence of 3%. The experience of women with recurrent UTIs is not well understood and how this compares to the views of healthcare professionals (HCPs) is unknown. Objectives This qualitative evidence synthesis aims to understand the experiences of women with recurrent UTIs and compare them to primary care HCPs. Methods We systematically searched MEDLINE, Embase, CINAHL, PsychInfo, ASSIA, Web of Science and the grey literature from inception to June 2022 for primary qualitative studies. Meta-ethnography was conducted to synthesize the studies and the findings for women with recurrent UTIs and HCPs were then compared. Results Twelve primary qualitative studies published from 2005 to 2022 and conducted in Europe and the USA were included. Two studies involved primary care staff; nine studies involved women with experience of recurrent UTIs. One study involved both. Patients and HCPs had similar views in terms of the causes of recurrent UTIs and self-management and similar concerns about an underlying cause and antibiotic use. They also had similar views on the impact of recurrent UTIs, however patients felt HCPs did not appreciate the impact of recurrent UTIs. There were conflicts in terms of the expectation for antibiotics and the need for further investigation and referral. Conclusions This is the first qualitative evidence synthesis on the experiences of women with recurrent UTIs and the views of primary care HCPs. It demonstrates that women with recurrent UTIs and HCPs share several similar views and concerns but there were significant communication gaps. Further guidance development and a patient decision aid could help address these gaps.