Qualitative Meta-synthesis Research Articles

Experience and caring needs of patients with psoriasis: A qualitative meta-synthesis.

As a chronic skin disease, psoriasis often affects the physical, psychological and social status of the patient, which in turn impacts on their experience of illness and needs. However, there is no review of qualitative research that integrates and analyses the experiences and needs of these three influences from a holistic perspective. This review follows the ENTREQ guidelines. Six English databases (JBI, Cochrane Library, PubMed, PsyINFO, CINAHL and Embase) and three Chinese databases (CNKI, VIP and Wanfang) were searched from January 2012 to October 2022. Literature was included if it was relevant to the experience of illness and caring needs of patients with psoriasis. The JBI-QARI was used to rate the quality of included studies. Eleven studies were included in the meta-synthesis. Four analytical themes were identified for analysis: physical challenges, psychological discomfort, social phenomena and caring needs. The combined physical, psychological and social effects of psoriasis and the consequent caring needs should be emphasised. Health professionals, including doctors and nurses, should be aware of the multiple changes in patients and their coping strategies, provide information about psoriasis, monitor and follow-up regularly over time and obtain feedback to inform further treatment and care so as to develop high-quality therapeutic interventions to help and guide patients with their coping strategies. These findings describe the physical, psychological and social experiences of illness and caring needs of patients with psoriasis. Healthcare professionals should be more aware of patients' easily overlooked psychological and social distress, providing prompt attention and recognition of patients' experiences and needs, offering relevant assistance and support and enhancing daily, regular follow-up to help them improve their understanding of and ability to manage their illness. This is a meta-synthesis without direct patient involvement.

Echoes of Support: A Qualitative Meta-Synthesis of Caregiver Narratives in Lung Cancer Care.

Lung cancer stands as one of the prevalent cancers, impacting both men and women globally. Family caregivers, deeply involved in the care of individuals affected by this disease, often endure heightened distress and struggle to navigate the manifold challenges associated with caregiving. Understanding the intricate experiences and challenges of caregivers in the realm of lung cancer care is critical, given its profound impact on their well-being and the quality of patient care. This study aimed to comprehensively examine and synthesize qualitative data concerning caregiver experiences within the context of lung cancer. Six databases were systematically searched for studies with qualitative findings relevant to caregivers and lung cancer. Seventeen studies were included, and findings were reviewed and synthesized. The main challenges identified were: 'Information accessibility', 'Dual roles and family dynamics', 'Coping with emotional challenges and uncertainty', and 'Need for support networks'. These findings underscore the profound challenges faced by caregivers, shedding light on the substantial impact of cancer on their well-being and functionality. Moreover, the study accentuates the pressing need for tailored support systems that can address the emotional toll and information needs of caregivers. This emphasis on supportive interventions is vital to enhance the quality of care and overall well-being for both patients and caregivers within the lung cancer care continuum.

What do we know about the perpetrators of sexual homicide of adult victims? A systematic review and qualitative meta-synthesis

Introduction: sexual homicide is defined as lethal violence associated with sexual elements or motivations, predominantly perpetrated by men against women. Despite being a less frequent crime, there is a growing clinical and forensic interest in its specificities and the characteristics of the aggressor. Objective: to review the scientific literature on men who commit sexual homicide against adult victims. Methods: systematic review with MeSH ((“Sex Offenses”[Mesh]) AND “Homicide”[Mesh]) in the databases of MEDLINE, LILACS, MENDELEY and SciELO, between 1992 and 2023. The PICO strategy was used with the studied population (male sexual offenders), intervention (homicide of adult victims), context (sexual violence), and outcome (potential relationship between the issues). The stages of article selection and analysis involved two independent researchers. Original studies were included, excluding reviews, editorials, conference proceedings, books and chapters, theses, and dissertations. The selected articles were presented through qualitative meta-synthesis. Results: of the 70 selected articles, 66 articles (94.2%) adopted quantitative methods, 2 (2.9%) qualitative design, and 2 (2.9%) case reports. We found 41 articles (58.6%) conducted in North America and 22 articles (31.4%) in Europe, totaling 63 articles (90.0%). Another five articles (7.1%) were from Asia, one (1.4%) from Africa, and one (1.4%) from Oceania. In 52 articles (74.3%), there was an emphasis on aspects related to psychiatric, behavioral, or psychological disorders of the perpetrator, sexual sadism, or forms of sexual violence or lethal outcomes employed. Conclusion: sexual homicidal men possess characteristics that set them apart from other homicidal offenders or those who commit sexual violence, directing their crimes towards a heterogeneous group of adult victims. Studies have focused on the psychiatric and behavioral disorders of the perpetrator, as well as the relationship with traumatic experiences in childhood.

Factors impeding physical activity in older hospitalised patients: A qualitative meta-synthesis.

Older hospitalised patients have low levels of physical activity and multiple impairing factors. To systematically evaluate the perceived barriers to physical activity among older patients during hospitalisation, and provide reference for future intervention programs. Following ENTREQ, do a systematic evaluation and synthesis of qualitative investigations. An exhaustive exploration was conducted across the CNKI, Wanfang Database, VIP Database, China Biomedical Literature Database, PubMed, Embase, Cochrane Library and Web of Science from their inception until August, 2023 to identify qualitative research on obstacles to physical activity among older hospital patients. The quality of the literature was evaluated using the Joanna Briggs Institute's critical appraisal tool for qualitative research. Meta-synthesis method was used to integrate the results. In total, 8 literatures were included, 43 themes were extracted, and analogous research results were amalgamated to generate 10 categories and 3 syntheses: individual level, interpersonal influencing factors and hospital environment and resources level. Older inpatients are faced with multiple barriers to physical activity. Medical staff should pay attention to changes in physical activity during hospitalisation, identify barriers to physical activity in older inpatients and provide references for promoting physical activity programs for the older. This study is a meta-synthesis and does not require relevant contributions from patients or the public. Older patients are at low physical activity levels during hospitalisation. Older inpatients are faced with multiple barriers to physical activity. Factors of physical activity impairment in hospitalised older patients should be considered in the context of health status, psychological factors, motivation and social support. Disease-induced psychological fallout has a greater impact on physical activity in the older.

How do research participants with age-related vision loss talk about their experiences? A secondary discourse analysis of published qualitative extracts

Abstract Age-related macular degeneration (AMD) is a chronic, progressive eye condition that can affect individuals in later life and lead to loss of central visual function. In this analysis, we aimed to explore the discursive landscape of talk about AMD, drawing on extracts published in peer-reviewed qualitative studies on AMD. Drawing on procedures of qualitative meta-synthesis, we compiled a corpus of raw data extracts from 25 qualitative studies on AMD published in English, largely carried out in high-income countries. Extracts were analysed to identify dominant discourses and key interpretative repertoires (such as recurring metaphors, tropes and figures of speech). We adopted a Foucauldian discourse analytic approach, to consider the implications of dominant discourses, and their associated subject positions, for the subjective experience of living with AMD. Our analysis identified five distinct ways in which AMD was constructed in research participants' talk about experiences of AMD. They included: AMD as a mysterious affliction, linked to biological ageing; AMD as a total loss of independence; AMD as grievous loss; AMD as a condition to be stoically accepted; and – to a more limited extent – AMD as an opportunity for discovery. Drawing on theory from critical disability studies and gerontology, we suggest that the constructions identified are underpinned by broader societal discourses which construct ageing and disability in largely negative, medicalised and individualistic terms. Taking up subject positions within such discourses may compound feelings of isolation, hopelessness and powerlessness. We suggest there may be value in exploring talk about experiences of living with AMD within a broader range of everyday social, relational and environmental contexts.

New Graduate Nurses' Experiences by Generation in South Korea: A Qualitative Meta-Synthesis.

As the nursing organization environment evolves into one in which several generations work together, there are concerns about generational differences leading to conflicts. A synthesis of qualitative studies was used to gain insight into the experiences and perceptions of new nurses working in South Korean hospitals and identify generational differences between nurses of Generations X and Y. Eight databases were searched systematically for qualitative studies published up to June 2020. The Critical Appraisal Skills Programme Checklist for Qualitative Research was used to evaluate the quality of the retrieved studies, and the data were synthesized thematically using the Thomas and Harden method. Of the 2,482 studies retrieved, 19 were included in this meta-synthesis. The experience of new nurses were presented in the three analytical themes of work experience, interpersonal relationships, and adaptation, from which eight descriptive themes were derived: (a) dissatisfied with own work performance, (b) negative feedback on work outcomes, (c) irregular daily life, (d) colleagues who help adapt to work life or make work life harder, (e) feelings of sympathy toward peers, (f) disrespectful patients or caregivers, (g) effective reactions, and (h) ineffective reactions. Although the new nurses from Generations X and Y reported similar experiences during their first year of nursing, differences were found in their values and tendencies regarding work and interpersonal relationships. Compared with new Generation X nurses, new Generation Y nurses placed more value on the meaning of individual work contributions, intimacy with colleagues, and appropriate feedback. The findings of this study support nursing administrators implementing strategies that both acknowledge and reduce the impact of generational category on nursing teams. Furthermore, emphasizing communication and acknowledging ongoing change as generations progress may strengthen bonds that lead nurses to value each other and their work.

Defining urban segregation: A qualitative meta-synthesis

Despite more than a century of research on urban segregation, this phenomenon is still one of the main concerns of urban planners and policymakers and a characteristic of cities that require intervention. Any policy-making in this field as an urban reality requires a clear understanding and definition of this phenomenon. But which definition? In response to this question and obtaining a basis for the definition of segregation, many efforts have been made in the past decades. However, these efforts have failed to present a framework that theoretically and practically responds to all dimensions and approaches in defining segregation. To fill this gap, the present study provides a comprehensive and integrated definition of urban segregation based on a meta-synthesis and qualitative content analysis by reviewing, categorizing, and combining the various and complex definitions in the existing literature. It presents two main categories of definitions of urban segregation: definitions based on the structural dimension and definitions based on the spatial dimension. Considering the complexity and multiple dimensions of urban segregation, a comprehensive definition of this phenomenon to present all aspects of segregation must answer six main questions: What is the nature of segregation? What people, on what basis, why, in what places and times, and how are segregated? The answers to the questions show that the presented categorization of the definitions of urban segregation covers different dimensions and aspects of this phenomenon. Therefore, combining them contributes to a comprehensive definition of it. Being more comprehensive than the previous definitions, the presented definition in this study specifies the main dimensions of urban segregation. It can provide an efficient basis for future theories, policies, and planning in urban segregation. Although the presented categories are inseparable parts of a whole, they can be examined in detail separately in future studies. Also, by connecting the definitions in the literature to intellectual paradigms and planning theories, a deeper understanding of the shaping factors and components of urban segregation can be achieved.

Analysis of Postgraduate Theses on Environmental Literacy in Türkiye through Meta-Synthesis

Environment is the habitat where humans, animals, plants, and other living organisms sustain their lives and interact with one another. Environmental literacy, as for that, is a skill that enables us to understand the environment we live in, to create a common consciousness towards the environment, to know the responsibilities towards the environment, and to transmit the environment to future generations by protecting it. In this study, the aim is to analyse postgraduate theses prepared on environmental literacy in Türkiye by using the meta-synthesis method. Answers to the main question of "What is the trend of postgraduate theses prepared in Türkiye in the field of environmental literacy?" and the accompanying sub-questions are scrutinized. During the preparation of this study as a qualitative research, literature review and meta-synthesis methods are utilized. The study group of the research consist of 24 postgraduate theses found in the Higher Education Board National Thesis Center Database by typing the keyword "environmental literacy" in the search bar, which were prepared in the field of education. These theses were examined, classified, and evaluated based on certain criteria. It can be said that interesting results related to environmental literacy were obtained within the scope of the study.

Composite Experiences of Intimate Partner Violence in Women: A Qualitative Meta-Synthesis

ABSTRACT This study explored the composite experiences of women subjected to intimate partner violence (IPV) by applying a qualitative meta-synthesis approach. A systematic review identified 44 studies, conducted across 27 countries from 1996 to 2022, for inclusion in the analysis. Three core themes emerged characterizing the comprehensive experiences of women enduring IPV: 1) experiencing violence as a form of ownership, 2) feeling powerless in a society that condones violence, and 3) suffering oppression in a male-dominated society. The findings predominantly reflect a feminist perspective, suggesting that IPV stems from patriarchal structures that perpetuate male dominance, power, and control over women.

The experience of women researchers during the Covid-19 pandemic: a scoping review

Responses to the COVID-19 pandemic globally disrupted lives and contributed to the exacerbation of pre-existing inequalities. Women in research were also affected. The prominent role that women played in professional and personal care duties had a detrimental effect on their research outputs, potentially hindering their career progression. Moreover, the challenges faced by women academics during the pandemic, including job loss, increased mental health issues, and the intersection of gender with other socio-demographic traits exacerbated existing gender disparities within academia. By systematically scoping the qualitative literature on the experiences of women researchers during the pandemic, this study sought to explore how women experienced and reacted to the challenges generated by the COVID-19 pandemic. A qualitative meta synthesis of the included studies revealed three themes: gendered professional expectations, colliding identities and coping strategies. These themes show how gendered roles such as teaching and professional care work, associated with the hierarchical and gendered division of tasks both at home and in the workplace, made women feel unsupported and alienated as relevant agents in the academic context. The study reveals the importance of pastoral care, teaching and service work as the essential backbone of the academic infrastructure, especially in times of crises. It also exposes how productivity-focused researcher assessment criteria, rewarding mainly individual results and unrewarding of care and service work, can be viewed as perpetuating structural inequalities based on gender, parenting situations, contractual situations and background. In conclusion, this study exposes the need to proactively address the gendered practices and implicit biases which reproduce inequalities within academia and highlights how paying attention to the experiences and needs of women researchers is essential for improving the resilience and crises preparedness of academic the system.

Decision-making for bilateral risk-reducing mastectomy for an increased lifetime breast cancer risk: A qualitative metasynthesis.

Previvor is a term applied to a person with an identified, elevated lifetime cancer risk but without an actual cancer diagnosis. Previvorship entails the selection of risk management strategies. For women with a genetic mutation that increases their predisposition for a breast cancer diagnosis, bilateral risk-reducing mastectomy (BRRM) is the most effective prevention strategy. However, BRRM can change a woman's breast appearance and function. The purpose of this qualitative metasynthesis (QMS) was to better understand the decision-making process for BRRM among previvors. A theory-generating QMS approach was used to analyze and synthesize qualitative findings. Research reports were considered for inclusion if: (1) women over 18years of age possessed a genetic mutation increasing lifetime breast cancer risk or a strong family history of breast cancer; (2) the sample was considering, or had completed, BRRM; (3) the results reported qualitative findings. Exclusion criteria were male gender, personal history of breast cancer, and research reports which did not separate findings based on cancer diagnosis and/or risk-reduction surgery. A theory and corresponding model emerged, comprised of seven themes addressing the decision-making process for or against BRRM. While some factors to decision-making were decisive for surgery, others were more indefinite and contributed to women changing, processing, or suspending their decision-making for a period of time. Regardless of the decision previvors make about BRRM, physical and psychosocial well-being should be considered and promoted through shared decision-making in the clinical setting.

Health and medical experience of migrant workers: qualitative meta-synthesis

BackgroundMigrant workers in Korea are contributing to economic development by resolving labour shortages due to the increase in the ageing population, and they have become necessary and important in the Korean economy. However, long working hours, poor working conditions, and cultural differences can cause migrant workers to experience disadvantages in using health and medical services. Therefore, this study aimed to understand and analyse the health and medical service experience of migrant workers in Korea by reviewing previous studies in order to improve their health and access to medical services.MethodThe qualitative meta-synthesis method suggested by Thomas and Harden was used. The key question for searching the literature is ‘What is the status of the use of health and medical service by migrant workers in Korea and the attributes that affect them?' Five electronic databases (RISS, KCI, KISS, Science ON, and KMbase) were searched for Korean literature published in academic journals until 6 November 2022 using a combination of “migrant worker or foreign worker or foreign labourer or migrant” and “medical or health” in Korean.ResultsA total of nine studies out of 1,006 were included in the review after methodological quality assessment using the Critical Appraisal Skills Program (CASP). The results of studies were synthesised into three themes and ten sub-themes: ‘Personal factors’ of personal health beliefs and the financial burden of healthcare costs; ‘Cultural factors’ of cultural differences in the lifestyle, cultural differences in the healthcare environment, and traditional medicine in the country; and ‘Socio-institutional factors’ of poor and difficult working environment, insufficient information about medical institutions, policies with a lack of practical applicability, systems of healthcare institutions, and healthcare services usage.ConclusionsThis study identified the experiences of migrant workers in using health and medical care services. The results of this study can be used as a basis for improving the health of migrant workers and access to healthcare services. Based on the results of this study, it is necessary to improve the health management ability of migrant workers by developing a health management platform that can support Korean medical information and provide professional and accurate self-health management information.

Barriers and facilitators to feeling safe for inpatients: a model based on a qualitative meta-synthesis.

To review and synthesize qualitative research exploring patients' safe experience and construct a model to present barriers and facilitators to feeling safe for inpatients. A qualitative met-synthesis. We conducted a systematic electronic search of articles published in English with no date limitation across five databases (Ovid MEDLINE, EMBASE, Web of Science, CINAIL via EBSCO, and PsyINFO) in May 2023. Qualitative research focused on the safe experiences of inpatients was considered. Systematic searches yielded 8,132 studies, of which 16 articles were included. Two reviewers independently extracted and analyzed data. Qualitative meta-synthesis was performed through line-by-line coding of original texts, organizing codes into descriptive themes, and generating analytical themes. We identified four themes and 11 sub-themes. Across the four themes, control included a barrier (Uncertainty) and two facilitators (Patient participation and safe care); responsible included three facilitators (Confidence in the profession, care for, and responsive); dignity included two barriers (Privacy and Neglect); stability included a barrier (Potential risk), and two facilitators (Harmonious and safe culture). We constructed a model to present the logical connection between these themes and related barriers and facilitators. Feeling safe for inpatients is a complex perception, including four themes: control, responsible, dignity, and stability. Surrounding four themes and related barriers and facilitators, we outline principles for creating a safe environment and present strategies for improving patients' hospitalization experience and ensuring patient safety. This review provides valuable insight into the clinical practice and health policy and helps medical staff to identify and overcome the potential barriers to implementing interventions in safe care. In addition, the model comprehensively describes the nature and dimensions of feeling safe, informing high-quality care service and related research. Identifier, CRD42023435489.

Experiences of postpartum Chinese women undergoing confinement practices: A qualitative meta-synthesis.

We aim to review the experiences and needs of postpartum Chinese women undergoing 'confinement' or 'doing-the-month' a postpartum practice after childbirth. A meta-synthesis was reported in alignment with the Enhancing Transparency in Reporting the Synthesis of Qualitative Research (ENTREQ) statement. Ten electronic databases were searched for eligible primary qualitative or mixed-methods studies in English and Chinese from their inception until December 2021. Two reviewers independently reviewed the methodological quality of the included studies using the 10-item Critical Appraisal Skills Program (CASP) qualitative checklist, with discrepancies resolved through discussions. The meta-synthesis was conducted based on the two-step approach by Sandelowski and Barroso. Four themes were meta-synthesized from 13 studies: 'confinement' as an essential practice; physical and psychological stressors during 'confinement'; coping strategies by postpartum women; and needs for family, social, and professional support in enhancing satisfaction with 'confinement'. The review showed that 'confinement' remains a significant practice shaped by socio-cultural and health constructs. This review suggested re-evaluating the 'confinement' practice and promoting evidence-based care to improve maternal well-being. Nurses and midwives should be cognisant of such postpartum customs and adopt non-judgemental attitudes as early as the prenatal period to provide culturally sensitive care.

Understanding the impact of children's and young people's self-harm on parental well-being: a systematic literature review of qualitative and quantitative findings.

Self-harm in children and young people is increasing. Parents are vital in supporting young people; however, parents may experience distress linked to the self-harm. Previous reviews have highlighted the emotional impact and need for information and support, however, have not elucidated the relationships between these themes, nor examined the quantitative data examining parents' well-being. We conducted a mixed methods review, with qualitative meta-synthesis focusing on links between themes and quantitative synthesis of parental well-being findings, including pooled means. PsycInfo, Medline, EMBASE, AMED, CINHAL and Web of Science were searched to identify relevant records. References of included studies were also searched. Every abstract was screened by two authors. Data were extracted by one author and checked by another. We identified 39 reports of 32 studies: 16 with qualitative data and 17 with quantitative data (one had both). Qualitative findings showed how parents' emotions were associated to their knowledge and beliefs about self-harm. Parents' emotions often evidenced the need to self-care, but emotions of guilt reduced engagement in self-care. How parents supported their young person was linked to their knowledge, and the management of their own emotions, and influenced if they could engage in self-care. Quantitative findings were mixed, however suggested poor general mental health amongst these parents. Further good quality quantitative studies are needed, with measurement of psychological mechanisms that may underpin parental distress. Current evidence supports peer-support and interventions that go beyond information provision to address the connected factors of knowledge, emotion, self-care, and parenting behaviours.

Presenting an evolutionary model of entrepreneurial intelligence components in women: approaches to opportunity discovery and creation

PurposeA better understanding of the characteristics and capabilities of women entrepreneurs can significantly improve their chances of success. Therefore, three studies were conducted for this exploratory paper. We have discovered the characteristics of entrepreneurial intelligence among female entrepreneurs through semi-structured interviews based on conventional content analysis. According to the second study, qualitative meta-synthesis was utilized to identify characteristics of women's entrepreneurial intelligence at the international level. As a third study, we examined the evolutionary relationships of entrepreneurs' intelligence components following the discovery and creation of opportunities.Design/methodology/approachThe present paper was based on three studies. In the first study, 15 female entrepreneurs were interviewed using purposive sampling in the Guilan province of Iran to identify the characteristics of entrepreneurial intelligence at the national level. An inductive content analysis was performed on the data collected through interviews. Using Shannon entropy and qualitative validation, their validity was assessed. In the second study, using a qualitative meta-synthesis, the characteristics of women's entrepreneurial intelligence were identified. Then the results of these two studies were compared with each other. In the third study, according to the results obtained from the first and second studies, the emergence, priority and evolution of entrepreneurial intelligence components in two approaches to discovering and creating entrepreneurial opportunities were determined. For this purpose, interviews were conducted with 12 selected experts using the purposeful sampling method using the fuzzy total interpretive structural modeling (TISM) method.FindingsIn the first research, this article identified the components of entrepreneurial intelligence of women entrepreneurs in six categories: entrepreneurial insights, cognitive intelligence, social intelligence, intuitive intelligence, presumptuous intelligence and provocative intelligence. In the second study, the components of entrepreneurial intelligence were compared according to the study at the national level and international literature. Finally, in the third study, the evolution of the components of entrepreneurial intelligence was determined. In the first level, social intelligence, presumptuous intelligence and provocative intelligence are formed first and social intelligence and provocative intelligence have an interactive relationship. In the second level, entrepreneurial insight and cognitive intelligence appear, which, in addition to their interactive relationship, take precedence over the entrepreneur's intuitive intelligence in discovering entrepreneurial opportunities. With the evolution of the components of entrepreneurial intelligence in the opportunity creation approach, it is clear that intuitive intelligence is formed first at the first level and takes precedence. At the second level, there is cognitive intelligence is created. At the third level, motivational intelligence and finally, at the last level, entrepreneurial insight, social intelligence and bold intelligence.Originality/valueThis study has the potential to discover credible and robust approaches for further examining the contextualization of women's entrepreneurial intelligence at both national and international levels, thereby advancing new insights. By conceptualizing various components of entrepreneurial intelligence for the first time and exploring how contextual factors differ across nations and internationally for women's entrepreneurship, this paper challenges the assumption that the characteristics of women's entrepreneurial intelligence are uniform worldwide. It also depicts the evolution of the components of entrepreneurial intelligence.

The adult experience of being diagnosed with autism spectrum disorder: A qualitative meta-synthesis.

There is little research looking at the experience of individuals diagnosed with autism spectrum disorder as adults. Adults diagnosed with autism spectrum disorder face different challenges than children, and more research is needed to better understand those challenges. For this review, autistic and non-autistic researchers looked at research on the experience of receiving a diagnosis of autism spectrum disorder as an adult. We looked for themes in people's experience leading up to diagnosis, going through the diagnostic process, and living their life after diagnosis. We analyzed 24 studies and found three overarching themes that captured thirty-two themes describing the experience of diagnosis. The three overarching themes expressed issues with identity and relationships before and after the diagnosis and identified that the diagnosis of autism spectrum disorder in adulthood impacted people's adaptation to and assimilation (i.e. the making sense of and internalizing the diagnosis) of autism spectrum disorder. While the diagnostic process itself was confusing and disappointing for many, it often led to a sense of relief and clarity regarding past experiences and had effects on identity and self-esteem. It created opportunities to connect with other autistic individuals and to access services, though appropriate supports were widely lacking. Recommendations are made that the impact of the diagnosis on people's identity and choices about telling others about their diagnosis, and whether and how people want to make adaptations, should be discussed and thought through in the process of diagnosis.

Barriers to and Facilitators of Delabelling of Antimicrobial Allergies: A Qualitative Meta-synthesis.

Patients who report penicillin allergies may receive alternative antibiotics. Such substitution contributes to antimicrobial resistance, lower treatment efficacy, increased frequency of adverse events, and increased costs. Approximately 90% of individuals who report a penicillin allergy can tolerate a penicillin. To identify the barriers to and facilitators of removal by health care workers of inaccurate antimicrobial allergies from patient records, known as delabelling. The MEDLINE database was searched from inception to December 29, 2020. Qualitative studies evaluating health care professionals' perceptions of barriers to and/or facilitators of the act of delabelling a patient's antimicrobial allergies were included in the meta-synthesis. The Theoretical Domains Framework was used to code and group individual utterances from the included studies, which were mapped to the Behaviour Change Wheel and corresponding intervention function and policy categories. Four studies met the inclusion criteria. Eight themes were identified as representing barriers to delabelling: delabelling skills, patient education skills, knowledge, electronic health records (EHRs), communication frameworks, time, fear about allergic reactions, and professional roles. Behaviour change interventions that may overcome these barriers include education, training, algorithms and toolkits, changes to EHRs, use of dedicated personnel, policies, incentivization of correct labelling, and an audit system. Eight themes were identified as barriers to delabelling of antimicrobial allergies. Future behaviour change interventions to address these barriers were proposed. Confidence in the findings of this study was judged to be moderate, according to the GRADE CERQual approach.

Toward recognizing characteristics of women’s entrepreneurial intelligence: a comparative study

PurposeRecognizing women’s potential and directing their talents to realize these potentials can be of great benefit. Accordingly, this paper aims to identify the characteristics of entrepreneurial intelligence in female entrepreneurs, drawing on a national-level study and the international literature on this topic.Design/methodology/approachThe present paper conducted two studies. First, 15 female entrepreneurs in the Guilan province of Iran, who were selected using purposive sampling, were interviewed to identify the characteristics of entrepreneurial intelligence nationally. The data gathered by interviews were analyzed using inductive content analysis. Then, their validity was tested using qualitative validation and analyzed using Shannon entropy. In the second study, the characteristics of female entrepreneurial intelligence were identified through a qualitative metasynthesis. The results of the two studies were compared together.FindingsThis categorized entrepreneurial intelligence into six categories, namely, entrepreneurial insights, cognitive intelligence, social intelligence, intuitive intelligence, presumptuous intelligence and provocative intelligence. Ultimately the characteristics of women’s entrepreneurial intelligence in each category were compared according to the national-level study and the international literature.Originality/valueThis study has the potential to discover credible and robust approaches for further examining the contextualization of women’s entrepreneurial intelligence at both national and international levels, thereby advancing new insights. By conceptualizing various dimensions of entrepreneurial intelligence for the first time and exploring how contextual factors differ across nations and internationally for women’s entrepreneurship, this paper challenges the assumption that the characteristics of women’s entrepreneurial intelligence are uniform across the world.

The experience of poor sleep in people with fibromyalgia: a qualitative meta-synthesis

The experience of poor sleep in people with fibromyalgia: a qualitative meta-synthesis