Systematic Review Of Qualitative Literature Research Articles

Global migration and factors that support acculturation and retention of international nurses: A systematic review.

International nurses (migrant nurses who are recruited to work in different countries) make essential contributions to global health and care workforces that are experiencing domestic nurse shortages. Global recruitment and migration is increasing, and with growing dependency on international nurses, health and care employers must understand their lived experiences if they want to support acculturation and subsequent retention. This paper reports a systematic review of qualitative literature on the experiences of international nurses working overseas. The aim is to explore the lived experiences of international nurses working and living in different countries globally. We argue their experiences shape socialisation and contribute to longer term retention of this fundamental nursing workforce. A systematic literature search was carried out in Medline, CINAHL, PsychInfo, PubMed and Web of Science for global research publications from 2010 to 2020. Research studies conducted in Australia, Canada, New Zealand, the United Kingdom and the United States were identified, quality appraised and subjected to data extraction/analysis. The findings of twenty seven papers were synthesised into six themes: (1) individual and organisational preparedness, (2) communication and the art of language, (3) principles and practices of nursing, (4) social and cultural reality, (5) equality, diversity and inclusion, and (6) facilitators of integration and adaptation. Whilst experiences are multifaceted and complex, factors shaping acculturation of international nurses were transferable across various countries. Individual motivations for migration should be recognised, and short term, transitional and long term needs must be identified to support development needs and ongoing career progression. Cultural integration and language barriers should be sensitively managed to enable effective acculturation. Culturally sensitive leadership is also key to ensuring zero tolerance of inappropriate racist and discriminatory behaviours. Health and care employers offer tangible benefits for international nurse workforces and in culturally compassionate and professional sociocultural environments, international nurses can thrive. However, to effectively retain this workforce in the longer term, significant improvement is required across a number of areas. This new systematic review paper explores the factors that can support acculturation and retention of internationally-recruited nurses globally.

How the construction industry can improve the health and well-being of their workers in a post COVID-19 era

UK Construction industry employs 2.7m employees and can lead the economic recovery by adapting to the current crisis. It accounts for a 6.02% share of the GDP and was hit strongly by the COVID-19 pandemic. Research has revealed that construction workers are at an increased risk of suffering from mental health conditions and data shows that male construction workers are three times more likely to commit suicide than the average male in the UK. Job insecurity, long hours, time away from families, lack of support from organisations and late payments are all known to contribute to this crisis. This paper explores how the construction industry can improve the mental health of its work force in the post pandemic era and what measures organisations can take to tackle the mental health crisis that the industry is facing, and which has been exacerbated by the pandemic. The research methodology used is a qualitative systematic literature review of published material including research journal papers, government and industry reports and articles that explore mental health challenges faced by the construction industry before and after the pandemic. The paper identifies the indicators of mental health and the existing initiatives currently operational within the construction sector and examines how mental health issues can be mainstreamed and be incorporated into construction industry policies and programmes to result in a healthy and balanced workforce.

Insulin-Related Biomarkers in Cerebrospinal Fluid in Mild Cognitive Impairment and Alzheimer’s Disease: A Systematic Review

Glucose metabolism and insulin signaling alterations play an important role in Alzheimer's disease (AD) pathogenesis. Researchers have extensively attempted to characterize the exact pathophysiological mechanisms in the cerebrospinal fluid (CSF), as evidence concerning this fluid biomarkers is expected to enhance AD diagnosis' specificity and accuracy and serve as an early disease detection tool. There is controversy about insulin levels in the CSF relationship with mild cognitive impairment (MCI) and AD. This systematic review provides an overview of the state-of-the-art knowledge about insulin-related CSF biomarkers in AD and MCI. We performed a qualitative systematic literature review of reported data of CSF glucose, insulin, or insulin-related molecules in humans with AD or MCI, consulting the electronic databases Medline, Scopus, Web of Science, Cochrane, and BASE until May 2022. We selected 19 studies, 10 of them reporting data on CSF insulin and 8 on insulin-related molecules like growth factors or their binding proteins. They predominantly found decreased levels of CSF insulin and increased levels of CSF insulin-related growth factors and their binding proteins. Due to the studies' protocols and results heterogeneity, we recommend a larger database of clinical trials with similar characteristics for a better understanding of this relationship.

Core outcomes in Brain Tumour Trials – The COBra Study Review of Glioma Trial Registration Data

Abstract AIMS Trial registration supports unbiased reporting of research studies. Despite inconsistent use globally and sub-optimal completeness, registration is associated with publication of the same outcomes as defined in trial protocols, though these are not necessarily reported in published results. In the core outcomes in brain tumour trials (COBra) study a registry review was undertaken, alongside a systematic review of qualitative literature and semi-structured interviews, to develop a core outcome set (COS) outcome longlist. The study aims to identify all outcomes reported across all glioma trial registration data. METHOD Phase 3 interventional glioma trials involving patients aged 18 and over, registered on clinicaltrials.gov or the ISRCTN registry were included. Two researchers independently searched the databases and registered data and available protocols were retrieved. Two reviewers independently extracted basic trial data including primary and secondary outcomes. Outcomes were categorised according to an ontology developed through literature review. RESULTS 91 trials were identified. Primary outcome categories reported were survival (84%), disease activity (14%), symptoms (4%), adverse events (3%) and resource use (1%). Secondary outcome categories reported were survival (60%), adverse events (52%), quality of life (QoL, 41%), disease activity (30%), symptoms (20%), function (12%), resource use (7%), health status (7%), and economic (3%). The review contributed 15 unique outcomes to the final outcome longlist of 35. CONCLUSION Trial registries represent a pragmatic solution in COS development and enabled identification of outcomes not present in other data sources. Under half of registered glioma studies included QoL outcomes; a small minority included functional outcomes or economic evaluation.

Development of a core outcome set and identification of patient-reportable outcomes for primary brain tumour trials: protocol for the COBra study.

IntroductionPrimary brain tumours, specifically gliomas, are a rare disease group. The disease and treatment negatively impacts on patients and those close to them. The high rates of physical and cognitive morbidity differ from other cancers causing reduced health-related quality of life. Glioma trials using outcomes that allow holistic analysis of treatment benefits and risks enable informed care decisions. Currently, outcome assessment in glioma trials is inconsistent, hindering evidence synthesis. A core outcome set (COS) - an agreed minimum set of outcomes to be measured and reported - may address this. International initiatives focus on defining core outcomes assessments across brain tumour types. This protocol describes the development of a COS involving UK stakeholders for use in glioma trials, applicable across glioma types, with provision to identify subsets as required. Due to stakeholder interest in data reported from the patient perspective, outcomes from the COS that can be patient-reported will be identified.Methods and analysisStage I: (1) trial registry review to identify outcomes collected in glioma trials and (2) systematic review of qualitative literature exploring glioma patient and key stakeholder research priorities. Stage II: semi-structured interviews with glioma patients and caregivers. Outcome lists will be generated from stages I and II. Stage III: study team will remove duplicate items from the outcome lists and ensure accessible terminology for inclusion in the Delphi survey. Stage IV: a two-round Delphi process whereby the outcomes will be rated by key stakeholders. Stage V: a consensus meeting where participants will finalise the COS. The study team will identify the COS outcomes that can be patient-reported. Further research is needed to match patient-reported outcomes to available measures.Ethics and disseminationEthical approval was obtained (REF SMREC 21/59, Cardiff University School of Medicine Research Ethics Committee). Study findings will be disseminated widely through conferences and journal publication. The final COS will be adopted and promoted by patient and carer groups and its use by funders encouraged.PROSPERO registration numberCRD42021236979.

EP10.01-016 Cachexia’s Impact on Immunotherapy Dose Reduction, Treatment Discontinuation, and Survival: a Systematic Review

A large proportion people with advanced cancer experience cachexia, a metabolic state which includes involuntary weight loss, sarcopenia, and loss of appetite. This syndrome can have a negative impact on different areas of oncologic disease management, such as surgical, radiation, and chemotherapy outcomes, but its impact on immunotherapy outcomes requires further investigation. This qualitative systematic literature review aimed at assessing the impact of cachexia on immunotherapy dose reduction, treatment discontinuation, and survival.

The experience of transitioning into life-sustaining treatment: A systematic literature review.

Being informed about treatment options for kidney failure and included in the related decision-making process can facilitate a smooth transition. Among patients with kidney failure the initiation of kidney failure replacement therapy is considered a traumatic event, causing physical and emotional distress and disrupting several aspects of one's social life. In order to ease the transition, health care personnel must ensure that the patient understands the parameters of each treatment option. It is imperative to increase the knowledge of patients' lived experiences around initiating kidney failure replacement therapy. To explore how adults with kidney failure describe the lived experience of transitioning into life-sustaining kidney failure replacement therapy. A systematic review of qualitative literature. Primary qualitative studies published in English between 2010 and 2020 from CINAHL, PubMed and PsycINFO were included. Content analysis summarised the patients' lived experience. From 959 records screened, 17 studies were eligible for inclusion. A total of 5 themes that described the patients' lived experience were identified: an existential transformative feeling, a change in quality of life, limitation, safety, and ambivalence. Being prepared and receiving emotional, physical, and social support can ease the transition for the patient. Among all available treatment options, dialysis and transplantation, the transition into kidney failure replacement therapy is experienced as a life-changing event. With this knowledge, it is imperative to clarify the importance of providing a patient with adequate support during the transition.

How are evidence and policy conceptualised, and how do they connect? A qualitative systematic review of public policy literature

Background:While current public policy scholarship can take advantage of a decades-long accumulated knowledge base on the relationship between evidence and policy, it is hard to keep the overview across different literatures. Over time, the ever more differentiated branches of public policy research have developed their own perspectives, languages, and conceptualisations of ‘evidence’ and ‘policy’, as well as their connections. Aims and objectives:Existing reviews have stressed that studies often do not provide clear definitions of ‘policy’ or ‘evidence’, and have outlined the importance of investigating underlying conceptualisations in the literature. Against this backdrop, this article investigates how present-day public policy scholarship approaches the concepts of ‘evidence’, ‘policy’, and their connections. Methods:We conducted a qualitative systematic review following the PRISMA method. Using a keyword search, we identified relevant articles (n=85) in eleven Q1 and Q2 policy journals included in Web of Science in the period 2015 to 2019. Findings:The synthesis confirms that ‘evidence’ and ‘policy’ are often not clearly defined, yet different trends regarding understandings can be identified. There are two approaches taken on the evidence and policy connection: a ‘use of evidence’ or a ‘use for policy’ perspective. Discussion and conclusions:Research on evidence and policy would benefit from more explicit conceptual discussions. This review may provide a heuristic for explicating conceptual choices when working with the notions of ‘evidence’, ‘policy’, and their connections. It also suggests several avenues that are worth exploring in future research.

What Happens Under Crisis: A Covid-19 Pandemic Matter About Social Isolation

"The study aims to understand what happens during a crisis and provides the story of the COVID-19 pandemic about social isolation. The coronavirus outbreak made the government impose specific measures to reduce the spread. The measures include social isolation and social distancing. The study provides a comprehensive analysis of how COVID-19 social isolation had detrimental effects on people’s psychological well-being. The study shows the relationship between the disruption caused by the pandemic, i.e., social isolation, and people’s psychological well-being. Provides an extensive literature review on how the crisis disrupted the workplace, negatively affecting job satisfaction and productivity. The research involves a qualitative systematic literature review on social isolation during the coronavirus pandemic. The study involves articles which are thoroughly assessed using the exclusion and inclusion criteria to provide a comprehensive understanding of the study themes. The study concludes that social isolation influences people’s mental health in their personal lives and work life. People lack the feeling of social connectedness, which leads to increased levels of depression, stress, and anxiety. Working remotely during the pandemic heightened people’s stress and depression and ultimately reducing job satisfaction and productivity. Keywords: social isolation, crisis, Covid-19, mental health, mental well-being JEL Classification: I19, I39, Z13"

How Are Historical Villages Changed? A Systematic Literature Review on European and Chinese Cultural Heritage Preservation Practices in Rural Areas

Background: In the past century, the importance of historical villages has been highly recognized, as they serve aesthetic, functional, and environmental values and can foster local socioeconomic development through the heritagization process. The purpose of this paper is to outline the core features of the preservation and management of historical villages in the European and Chinese contexts. Methods: Using a qualitative systematic literature review, the research was based on international academic papers covering 73 case studies from the two contexts, addressing the fact that little work has been carried out comparing European and Chinese realities. Results: Similarities and differences in rural cultural heritage preservation and management between Europe and China were compared and discussed, paying particular attention to historical villages in both contexts. Using this method, rural heritage preservation in China can be better framed and analyzed for scholars engaged in both the Chinese and international contexts. Conclusions: Inspired by the European case studies, the research suggests that capacity building of different types of stakeholders, contextualized financial mechanism and multiple values the civic society perceived and recognized during the Chinese rural heritage preservation and management process should be further studied and implemented case by case based on a historical-sensitive approach. In addition, the issue of the lack of social capital and policy arrangements in rural areas should be further addressed to stimulate community resilience.

Nurses' Influenza Vaccination and Hesitancy: A Systematic Review of Qualitative Literature.

Vaccine hesitancy (VH) is defined as “delaying or refusing a secure vaccine despite its availability”. This hesitancy affects caregivers and more specifically nurses. The purpose of this study is to assess determinants of influenza VH in the nurse’s community. We conducted a systematic review of qualitative literature according to criteria of Preferred Reporting Items for Systematic Review and Meta-Analysis and Enhancing Transparency in Reporting the synthesis of Qualitative Research from 2009 until October 2020. Eleven qualitative studies analysed (ten thematic content analyses and one grounded theory method) found three main factors in VH. The first determinant was the benefit–risk equation considered as unfavourable due to an ineffective vaccine and fears about adverse effects as the pain of the injection. Wrong immunological beliefs brought into hesitancy. Disease barriers (hand washing and masks) and personal immunity were regarded as more effective than the vaccine. Lastly, dehumanised vaccination and the difficulties of access to healthcare were institutional determinants. Nurses ask for a vaccine promotion by hierarchy and doctors with transparent information and respect for autonomy. The availability of vaccines and methods of pain control seem to be some tracks to reduce nurses’ VH.

Cancer cachexia impact on chemotherapy dose reduction, treatment discontinuation, and survival: A qualitative systematic review.

e24103 Background: Cachexia is a syndrome of muscle wasting, weight loss, and anorexia, that frequently affects patients with advanced cancer across all major areas of oncology (surgical, medical, radiation, and chemotherapy), contributing to poorer treatment outcomes, including survival. In this qualitative systematic literature review, we reviewed the recent literature to assess the impact of cancer cachexia on chemotherapy dose reduction, treatment discontinuation, and survival. Methods: A systematic search was conducted on PubMed and Embase on November 26th, 2021, using the following search terms, among others: “cancer”, “cachexia”, “sarcopenia”, “muscle loss”, “body weight loss”, “chemotherapy”, “drug dose reduction”, “survival”, “treatment withdrawal”, and “treatment interruption”. 1,559 entries published between 2018 and 2021 were identified, of which 175 were duplicates. Publications were screened for eligibility and only original research in peer-reviewed journals were considered eligible. Inclusion criteria included: chemotherapy-specific studies; studies reporting on cachexia, body weight, or body composition changes; and studies reporting data on survival, chemotherapy dose reduction or treatment discontinuation, or occurrence of toxicities which may lead to chemotherapy dose reduction or treatment discontinuation in these patients. All studies that did not analyze the impact of cachexia on these outcomes were excluded. Results: A total of 63 studies, comprising a total of 15,832 patients, were considered eligible and selected for further analysis. The majority of analyzed studies, comprising 14,493 patients, reported associations between cancer cachexia (or its characteristics, such as weight loss or muscle wasting) and chemotherapy dose reductions in 7% of the studies, treatment discontinuation in 20% of the studies, and increased toxicity in 25% of the reports. Cachexia parameters were associated with inferior survival in 90% of the studies. The types of cancer most commonly associated with this effect were pancreatic (31% of studies), foregut (gastric, esophageal, and others, 17%), and lung cancer (14%). Conclusions: More than 70% of studies identified in the literature were retrospective assessments of patient records, while the remaining were prospective observational and interventional studies. In this review, cancer cachexia parameters were associated with reduced treatment delivery and inferior survival in multiple types of advanced cancer. These observations could have important implications for clinical practice, as early detection and successful treatment of cachexia might provide better outcomes for cancer patients undergoing chemotherapy. Disclosure: This study was funded by Helsinn Healthcare SA. Contact: Gianluca.Ballinari@helsinn.com .

A Qualitative Systematic Literature Review on Phonological Awareness in Preschoolers Supported by Information and Communication Technologies

This review is a systematic literature review (SLR) with the aim of advancing the state of the art in Phonological Awareness in preschoolers (4–6 years) by means of Information and Communication Technologies (ICT). The SLR provides an important guide to newcomers to this domain and researchers who seek a structured body of knowledge in the subject for gaining new, important insights. Searches were carried out in the indexed database Scopus© between June and July 2020. Among the inclusion and exclusion criteria were studies reported in English, Spanish and Portuguese, updated electronic documents from the last ten years and studies cited by others at least once, except for those with publication acknowledgement after 2017. To complete the task, a triangulation assessment was made among three researchers using the same tool developed in Microsoft Excel©, in which the search terms, the search strings, inclusion and exclusion criteria and the study collection process were systematized along with a word cloud of keywords to improve the systematic feature of the SLR. Fifty-nine (59) scientific articles were selected and from those, 24 articles met the experts’ criteria. The method included: (1) search and selection of terms; (2) inclusion and exclusion criteria; (3) the searching process; and (4) reporting study collection. The SLR synthesis reported in this paper is a novel contribution built on two conceptual categories: Computer assisted learning systems (CAL) and Computer assisted instruction systems (CAI) which frame works on Phonological Awareness processes with Preschoolers and provide an appraisal of the results to advance knowledge of systematic reviews of preschoolers’ phonological awareness strictly supported by ICT.

Causes of Shoulder Dysfunction in Diabetic Patients: A Review of Literature.

Objective: Understanding the underlying mechanisms behind shoulder dysfunctions in patients with diabetes mellitus. Study Design: Systematic qualitative literature review. Participants: Patients with shoulder dysfunctions and diagnosed with impaired glucose tolerance or diabetes mellitus. Intervention: Published scientific literature containing evidence about the mechanisms of shoulder dysfunctions in the diabetic population. Articles were selected based on criteria containing diabetic population, shoulder dysfunction, methodological quality ≥ 6/9 and >20 subjects. Main Outcome measures: range of motion; questionnaires (QoL, UCLA-m, SPADI, DASH); blood glucose, blood HbA1C; calculated capsular stiffness (Kcap); calcification shoulder joint; shoulder dysfunction in patients with glucose metabolism disorders and diabetes mellitus. Results: We found 17 published articles with level 2 and 3 evidence. Multiple factors such as age, duration of diabetes mellitus (DM), glycated hemoglobin (HbA1c), advanced glycation end products (AGE), vascular endothelial growth factor (VEGF), interleukin-1ß (IL-1ß) were shown to be associated with tendon changes and increased capsular stiffness (Kcap) conceivably leading to limited range of motion (ROM) or frozen shoulder. Decreased ROM and frozen shoulder have a significantly higher prevalence in DM than in non-DM. Conclusions: Based on the current literature we confirm a high prevalence of shoulder dysfunctions in patients with diabetes mellitus. The cause of the shoulder complications is unknown, and more research is mandatory to shed more light on the complex interplay between the multifactorial causes of shoulder dysfunction in diabetes mellitus.

Impacts of Second Home and Visiting Friends and Relatives Tourism on Migration: A Conceptual Framework

What is the thread that unites tourism and migration? A review of existing literature suggests two forms of tourism linked to migration: visiting friends and relatives and second home tourism. Tourism related to visiting friends and relatives can be stimulated by migratory movements, and, in turn, gives rise to new migrations. Second home ownership, however, serves as the main connection between tourism and migration, promoting tourism that generates from or relates to current and past migrations. This exploratory study is based on a qualitative systematic literature review and focuses on the characteristics of second home and visiting friends and relatives-related tourism, and migration, in order to clarify little studied linkages among them that can affect tourism-related development. The study shows that many of the migration-led tourism segments reflect factors that may promote sustainable development.

Determinants of routine cervical screening participation in underserved women: a qualitative systematic review

Objective Routine, population-wide cervical screening programmes reduce cervical cancer incidence and mortality. However, socioeconomically deprived communities and ethnic minority groups typically have lower uptake in comparison to the general population and thus are described as ‘underserved.’ A systematic qualitative literature review was conducted to identify relevant determinants of participation for these groups. Methods Online databases were searched for relevant literature from countries with well-established, call-recall screening programmes. Overall, 24 articles were eligible for inclusion. Data was synthesized via Framework synthesis. Dahlgren & Whitehead’s social model of health was used as a broad a priori coding framework. Results Participation was influenced by determinants at multiple levels. Overall, patient-provider relationships and peer support facilitated engagement. Cultural disparities, past healthcare experience and practical barriers hindered service access and exacerbated negative thoughts, feelings and attitudes towards participation. Complex interrelationships between determinants suggest barriers have a cumulative effect on screening participation. Conclusions These findings present a framework of psychosocial determinants of cervical screening uptake in underserved women and emphasise the role of policy makers and practitioners in reducing structural barriers to screening services. Additional work, exploring the experience of those living within socioeconomically disadvantaged areas, is needed to strengthen understanding in this area.

Sexuality, Education and Support for People with Intellectual Disabilities: A Systematic Review of the Attitudes of Support Staff and Relatives

Support staff and relatives are uncertain about multiple aspects of the sexuality of people with intellectual disabilities. Given that their attitudes embody positive and negative views, they can respectively support and restrict free sexual expression among people with intellectual disabilities and their potential for (intimate) relationships. A qualitative systematic literature review was conducted on the attitudes of support staff and relatives toward the sexuality of people with intellectual disabilities. A systematic search strategy was deployed across seven databases. The identified articles were screened on predetermined inclusion and exclusion criteria, and assessed on quality, which resulted in 31 included studies. A metasynthesis of these studies resulted in two major themes emerging, namely (a) attitudes toward the sexuality of people with intellectual disabilities, and (b) attitudes toward the sex education and support. Themes represented both positive and restrictive attitudes among support staff and relatives. The findings suggest that despite a general acceptance of the sexual rights of people with intellectual disabilities, certain forms of sexuality were approached more cautiously. Moreover, the sexual needs of some subgroups of people with intellectual disabilities received scarce attention. Those support staff and relatives holding rather restrictive attitudes appear to emphasize sexual risks. Finally, support staff and relatives stressed the importance of providing sex education and support for people with intellectual disabilities, while, simultaneously, expressing insecurity over the subject. The findings can help to improve the support provided to support staff and relatives to promote sexual health among people with intellectual disabilities.

Women's experiences of prison-based mental healthcare: a systematic review of qualitative literature.

The rate of female committals to prison has grown rapidly in recent years. Women in prison are likely to have trauma histories and difficulties with their mental health. This paper aims to synthesise the findings of qualitative literature to gain a deeper understanding of the experiences of women in the context of prison-based mental health care. A systematic search of five academic databases, Cumulative Index to Nursing and Allied Health Literature, Applied Social Sciences Index and Abstracts, Psychological Information Database (PsycINFO), Excerpta Medica DataBASE (EMBASE) and Medline, was completed in December 2020. This study's search strategy identified 4,615 citations, and seven studies were included for review. Thomas and Harden's (2008) framework for thematic synthesis was used to analyse data. Quality appraisal was conducted using the Joanna Briggs Institute Checklist for Qualitative Research (Lockwood et al., 2015). Four analytic themes were identified that detail women's experiences of prison-based mental health care: the type of services accessed and challenges encountered; a reduction in capacity to self-manage mental well-being; the erosion of privacy and dignity; and strained relationships with prison staff. There is a paucity of research conducted with women in the context of prison-based mental health care. The findings suggest there is a need for greater mental health support, including the need to enhance relationships between women and prison staff to promote positive mental health. To the best of the authors' knowledge, this is the first systematic review conducted on the experiences of women in the context of prison-based mental health care.

Knowledge hiding behavior in higher education institutions: a scientometric analysis and systematic literature review approach

PurposeThe purpose of this paper is to systematically review knowledge hiding (KH) behavior in higher education institutions (HEIs). KH is regarded as an unethical and antisocial behavior by many scholars, which should not be prevalent in HEIs.Design/methodology/approachA two-phase analysis through quantitative scientometric analysis and qualitative systematic literature review method through the preferred reporting items for systematic reviews and meta-analyses (PRISMA) model was applied. In phase 1,174 articles were analyzed using the VOSviewer through co-word and co-citation analyses. In Phase 2, 20 related studies on KH in HEIs were qualitatively analyzed on the fundamental concept of KH. The main themes were determined based on current research findings, through the identification of relevant gaps in the context of higher education.FindingsIn Phase 1, co-word and co-citation analyses resulted in six and three clusters, respectively. Subsequently, in Phase 2, five themes were discovered: terminology of KH, scale of KH, cultural and geographical context, KH among academics and students and relevant theories. Further, discussion on the institutional factors of individuals, organizations, technology and culture is presented.Practical implicationsThis review lays out a practical guide to facilitate HEIs in managing KH behavior among academics, employees, and students. Strategies can be planned and implemented to foster and inculcate knowledge sharing behavior to circulate knowledge while at the same time diminishing KH behavior in HEIs.Originality/valueTo the best of the author’s knowledge, this study is the first to review KH behavior in the context of HEIs through quantitative and qualitative analysis.

Key Considerations for Understanding Usability of Digital Health Initiatives for Adults With Type 2 Diabetes: A Systematic Qualitative Literature Review.

The rapidly growing number of adults with type 2 diabetes globally means the uses and benefits of digital health initiatives to enhance self-management of diabetes warrant review. This systematic qualitative literature review aimed to understand usability of digital health initiatives for adults with type 2 diabetes. This systematic qualitative literature review was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses, the PRISMA 2020 Statement methodology. Three databases were used (SCOPUS, Medline, and CINAHL) to identify studies published from 2016 to 2021 that focused on experiences, evaluations, and usability of digital health initiatives aimed at helping adults with type 2 diabetes to self-manage their condition. From the 407 studies identified, 35 studies were assessed for eligibility with 10 studies included in the final synthesis. Five main themes emerged: (1) unmet emotional needs, (2) enhancing self-management, (3) desire for education, (4) usability/user-experience, and (5) risk of biomedical marker reductionism. This review identified 5 key themes for consideration to understand usability of digital health initiatives. If these unmet psychosocial needs of adults with type 2 diabetes are better addressed in digital health initiatives, enhanced daily self-management will lead to more optimal diabetes management which can increase overall health outcomes, reduce the risk of longer-term complications, enhance quality of life for type 2 diabetes and improve more widespread adoption of digital health initiatives.