Reciprocal Translation Research Articles

Military Nurses' Deployment Experiences: A Qualitative Metasynthesis.

Military medical personnel, including nurses, face a wide array of emotional and psychological issues while deployed. Understanding the challenges military nurses face in the deployed setting may prove useful in effectively preparing nurse leaders for future disaster responses in the military and civilian sectors. The purpose of this metasynthesis is to answer the following research question: What are the experiences of U.S. military and allied nurses deployed to medical facilities in combat operations and support areas since 9/11/2001? A qualitative metasynthesis was conducted to determine commonality of combat-related deployment experiences for U.S. military and allied nurses. After development of the research question, this metasynthesis included 4 steps: (1) perform structured literature search, (2) critical appraisal, (3) reciprocal translation, and (4) synthesize findings. Studies were limited to the years 2004-2023 to focus the search on Operation Enduring Freedom and Operation Iraqi Freedom-related deployments. Reference review of studies retrieved through database search also contributed to the final sample. Screening criteria included: (1) qualitative or mixed methods studies, (2) sample comprised of U.S. or allied country medical/nursing personnel, and (3) care primarily occurring in a fixed facility located in Iraq, Afghanistan, or Kuwait. Studies focusing on reintegration after deployment or air evacuation personnel/nonfixed facility settings were excluded. A total of 11 studies met inclusion criteria. Critical appraisal was conducted on all studies. Data analysis utilized an inductive and iterative process. Reciprocal translation and meta-ethnographic techniques were used to identify words/phases that contained significant meaning and to identify themes/subthemes. Themes formed that described commonalities across nurses' experiences. Three primary themes arise from critical examination of military nurses' deployment experiences: (1) "care in a combat zone," (2) "leadership in a combat zone," and (3) "personhood." The subthemes address experiences or concerns related to an individual participant's role as a "care giver," "leader," or "person." The 3 themes formed by this qualitative metasynthesis represent a holistic view of a military nurse in a deployed setting. Military nurses' deployment experiences relate to their multiple role(s) as a clinician, officer, and human being. By better understanding military nurses' past deployment experiences and related themes, nurse leaders and individuals can better prepare for supporting staff in future combat operations. The complexities of "caring," "leading," and "personhood" may contribute to emotional distress among deployed military medical personnel.

How Do Home Care Workers Experience A Client's Death, Professionally and Personally? A Systematic Review and Meta-Synthesis.

Background: Home care workers (HCWs) may frequently experience client death. This critical interpretive meta-synthesis aimed to identify the impacts of client death to offer preliminary recommendations with respect to support. Method: Five electronic databases, APA PsycINFO, CINAHL, MEDLINE, Web of Science, and Scopus, were searched systematically using keywords and subject headings. Results: Eight papers focusing on HCWs' experiences of client death were identified. Constructs were elicited and interpreted via Reciprocal Translation Analysis. The interpreted line of argument highlighted four interrelated themes: ''Personal grief: The impact of loss', 'Disenfranchised grief: no space for humanity and connection'', Inherent tension between self-care and organisational expectations: "You need a moment to hit the reset", and 'I wish someone was there to talk to: HCW support needs'. Conclusions: The findings demonstrate that HCWs are affected in multiple ways by client death, but these impacts are not consistently recognised or responded to by their organisations.

아동학대 연구의 질적 메타분석

Objectives This study attempted to find out the change in perception of child abuse through qualitative meta-analysis and seek new understanding and improvement directions for correct perception of child abuse. Methods Among the three strategies of meta-cultural technology in qualitative meta-analysis developed by Noblit & Hare (1988) and applied by Britten et al. (2002) and Atkin et al. (2015), this study was analyzed using reciprocal translation analysis and refutation synthesis among the three strategies of qualitative meta-analysis applied by Lee Seung-ho et al. and described them as individual topics in the research results. In the stage of determining the relevance between the research results, the research results were synthesized and reconceptualized. Results This study examined the perception of child abuse before and after child abuse in order to examine the perception of child abuse by victims, perpetrators, spouses, and neighbors. In the case of child abuse recognition, the victim's tendency to think of child abuse as his or her own fault before the recognition of child abuse was cut, and in the case of perpetrators, the cause of child abuse was recognized as the influence of others other than himself. In the case of spouses and people around them, they tended to think that it was not their job. When the child abuse officials' pre-recognition was summarized, it was recognized as ‘child abuse has nothing to do with me’. After the child abuse officials recognized child abuse, the victims knew that the type of parenting they and their friends received was different, and in the case of the perpetrators, they recognized that their parenting method was wrong. In the case of spouses and neighbors, they recognized that they were avoiding the appearance of child abuse. When the child abuse officials' perception of child abuse was combined, a change in perception was found to ‘face child abuse’. Conclusions This study is meaningful in suggesting ways to improve awareness of child abuse in the future in that it helps to understand the perception of child abuse more deeply and analyzes individual qualitative studies from a broader perspective.

Parents', Families', Communities' and Healthcare Professionals' Experiences of Care Following Neonatal Death in Healthcare Facilities in LMICs: A Systematic Review and Meta-Ethnography.

Ninety-eight percent of neonatal deaths worldwide occur in low- and middle-income countries (LMICs), yet there is little bereavement care guidance available for these settings. To explore parents', families' and healthcare professionals' experiences of care after neonatal death in healthcare facilities in LMICs. Four databases were searched for peer-reviewed literature, meeting the inclusion criteria of qualitative studies exploring the experiences of people who provided or received bereavement care following neonatal death in a LMIC healthcare setting. Data were collected by two independent reviewers, collated through line-by-line coding and then reciprocal and refutational translation, and analysed through Noblit and Hare's seven-step meta-ethnography approach to create first-, second- and third-order themes. Seven first-order themes extracted from the literature included emotional responses, social relationships, staff and systems, religion, connecting with the baby, coping strategies and economic concerns. From these data, three third-order themes arose: The individual, the healthcare setting and the community/context. Overarching themes in bereavement care shape grief responses and are often similar across geographical locations. Analysing these similarities allows a deeper understanding of the important elements of bereavement care and may be helpful to inform the creation of high-quality, bereavement care guidelines suitable for use in LMIC settings.

Tackling Inequalities in Access to Medicines for People Experiencing Homelessness: A Meta-Ethnography and Qualitative Systematic Review.

Despite increased awareness of the detrimental relationship between homelessness and health, people experiencing homelessness remain an underserved population in health and social care research. Due to barriers affecting the accessibility of medicine and healthcare services, as well as reported competing priorities such as food and shelter, evidence has demonstrated that people experiencing homelessness are less likely to undergo routine examinations, receive diagnoses and adhere to prescribed medical treatments. To enhance service design and access for those experiencing homelessness, it is critical to better recognise, understand and address the barriers these individuals face. This meta-ethnography aims to identify barriers, enablers and interventions to begin addressing this inequality gap. A systematic literature search was undertaken in October and re-ran in December 2023 across four databases: MEDLINE, Embase, CINAHL and Scopus. Qualitative studies were included if they addressed barriers, enablers and interventions aimed at tackling medicines and health service inequalities among populations experiencing homelessness. Study quality was assessed using the Joanna Briggs Institute critical appraisal checklist. Data were synthesised using a meta-ethnographic approach, as outlined by Noblit and Hare. The review was registered on PROSPERO (CRD42024511502) and performed according to PRISMA guidelines. This meta-ethnographic systematic review synthesised data from eight studies across multiple countries. Three overarching third-order constructs (termed 'themes') were developed through reciprocal translation and centred around: recognising and acknowledging the discrimination, stigma and barriers experienced when using current services; exploring safe and practical use of medicines and the promotion of general health education and appreciating strategies to tackle inequalities, namely community outreach programmes designed for homeless communities. This work highlighted the barriers, enablers and interventions that sought to address the inequalities affecting people experiencing homelessness in accessing medication and healthcare services. Future research should utilise lived-experience narratives and co-design to further explore ways to tackle wider healthcare accessibility inequalities for this minoritised population. Not applicable, as this is a systematic review. Public contributors (minority research champions and one public health research champion, H.K.G. and T.G.) informed and shaped this project during study design and conceptualisation. They helped to ensure that the study was conducted, and the findings were reported with sensitivity.

Barriers to Care After Intimate Partner Violence Acquired Brain Injury: Current Systems Silence Survivors and Providers.

A qualitative meta-synthesis was conducted to answer the following question-What barriers are experienced by survivors of intimate partner violence and service providers when seeking or providing resources or care after experiencing brain injury (BI)? This approach was completed through 2 main phases-a systematic search and literature appraisal and reciprocal translation with interpretive triangulation of the extracted data. The databases searched were PubMed, CINAHL, and PsycInfo. The initial search yielded 559 articles. The final synthesis included 16 articles for the qualitative meta-synthesis. After data extraction, a qualitative exploratory design evaluated the experiences of survivors and service providers when connecting with resources. The findings highlight larger systemic barriers preventing smooth relationships between survivors and providers. Survivor barriers include risk-driven safety mechanisms and a lack of awareness and understanding of BI. Provider barriers are a lack of clarity within providers' scope and training limitations, diagnosis complexity, first responder's initial response to survivors, lack of open discussion, screening limitations, financial barriers, infrastructure barriers, and lack of resources. Systemic barriers include stigmatization, BI symptoms mistaken as other diagnoses like mental health, access and awareness of resources, and navigation of complex systems. This qualitative meta-synthesis demonstrates that survivors and providers face multiple individual and systemic barriers when seeking and providing resources after BI. Future research is needed to understand survivors' help-seeking behaviors and assistance needs and providers' education about BI and organizational relationships and networks. Recommendations are made for future research to understand how to reduce barriers for providers working with survivors, from trauma-informed education and communication to connecting with resources, where to concentrate, and initiatives for collaboration to increase the network of resources yet improve its accessibility.

Community-based strategies to increase coverage of intermittent preventive treatment of malaria in pregnancy with sulfadoxine–pyrimethamine in sub-Saharan Africa: a systematic review, meta-analysis, meta-ethnography, and economic assessment

Community-based approaches might increase uptake of intermittent preventive treatment of malaria in pregnancy with sulfadoxine-pyrimethamine (IPTp-SP). We assessed the effects of community-based approaches on IPTp-SP and antenatal care coverage, and barriers and facilitators to implementation in sub-Saharan Africa. We did a systematic review, meta-analysis, meta-ethnography, and economic assessment. We searched the WHO International Clinical Trials Registry Platform, PubMed, the Malaria in Pregnancy Library database, Medline, Global Health and Global Health Archives, and the Cochrane Library for trials, mixed-methods, qualitative, and cost-effectiveness studies of community health worker promotion of antenatal care, IPTp-SP delivery, or both, with no language restrictions, published before March 21, 2024. Information on interventions, number of IPTp-SP doses, antenatal care visits, and barriers and facilitators were extracted. We did a meta-analysis (random effects) comparing effects on two or more or three or more IPTp-SP doses and one or more or four or more antenatal care visits. We followed Noblit and Hare's method of meta-ethnography to synthesise qualitative findings, using reciprocal translation and line-of-argument synthesis. We developed a theory for increased community IPTp-SP uptake. We also summarised cost and cost-effectiveness studies. This study is registered with PROSPERO, CRD42022364114. Of 4753 records screened, we included 23 (0·5%) reporting on 15 studies. Community health worker involvement was associated with an increase in two or more IPTp-SP doses (pooled risk ratio 1·48, [95% CI 1·24-1·75]; 12 sub-studies; I2 94·7%) and three or more IPTp-SP doses (1·73 [1·19-2·50]; ten sub-studies, I2 97·5%), with no decrease in four or more antenatal care visits (1·17 [1·00-1·36]; 13 sub-studies; I2 90·3%). Cluster-randomised controlled trials showed a lower increase in coverage of three or more IPTp-SP doses (1·08 [1·00-1·16]; I2 0·0%; six studies) compared with before-and-after studies (2·86 [1·29-6·33]; I2 98·9%; four studies; subgroup analysis p=0·019). Barriers to community health worker delivery of IPTp-SP included women's fear of side-effects, lack of knowledge, lack of trust in community health workers, and sociocultural factors. Community sensitisation, engagement of husbands, pre-established community health worker networks, and trained and supported community health workers facilitated IPTp-SP delivery by community health workers. Incremental cost-effectiveness ratios ranged from $1·1 to $543 per disability-adjusted life-year averted. Community-based approaches increased IPTp-SP coverage and might have a positive effect on the number of antenatal care visits in addition to being cost-effective, although we found high heterogeneity among studies. Community sensitisation and engagement in addition to established, trained, and supported community health workers can facilitate acceptability, delivery, and uptake of IPTp-SP delivered by community health workers. EDCTP-2 supported by the European Union. For the French translation of the abstract see Supplementary Materials section.

The Lived Experience of Patients with Vascular Malformations: A Qualitative Meta-synthesis

Objective: The purpose of this study was to synthesize the existing qualitative literature on the lived experience of patients with vascular malformations to identify emergent themes and new areas for clinical care and research. Methods: A formal meta-synthesis was conducted, which followed 4 steps: (1) form the clinical question and refine search criteria; (2) complete a literature review following Preferred Reporting Items for Reviews and Meta-Analysis; (3) quality appraisal of included literature with Lett’s Critical Review Form; and (4) completion of team-based reciprocal translation and thematic analysis to synthesize the literature. PubMed, CINAHL, Johanna Briggs, and Embase were used to retrieve English language, peer-reviewed qualitative, and mixed-method articles from 1996 to May 2023. Results: Six articles met the criteria for inclusion. A wide range of vascular malformations were represented, ranging from slow-flow malformation to high-flow or complex with associated overgrowth. Studies were conducted in the United States, France, and Germany, focusing mainly on the adult experience, with 1 article focusing solely on pediatrics. Three main themes emerged: social isolation, uncertainty and hope, and healthcare experiences. Conclusion: The overarching themes of social isolation, uncertainty and hope, and healthcare experiences each offer avenues to inform clinical practice, provide education for healthcare providers managing patients with vascular malformations, and future research to better understand how each of these themes affect patients. This qualitative meta-synthesis is a novel method for this field and provides new insights into the lived experience of those with vascular malformations.

Subtitled speech: the neural mechanisms of ticker-tape synaesthesia.

The acquisition of reading modifies areas of the brain associated with vision and with language, in addition to their connections. These changes enable reciprocal translation between orthography and the sounds and meaning of words. Individual variability in the pre-existing cerebral substrate contributes to the range of eventual reading abilities, extending to atypical developmental patterns, including dyslexia and reading-related synaesthesias. The present study is devoted to the little-studied but highly informative ticker-tape synaesthesia, in which speech perception triggers the vivid and irrepressible perception of words in their written form in the mind's eye. We scanned a group of 17 synaesthetes and 17 matched controls with functional MRI, while they listened to spoken sentences, words, numbers or pseudowords (Experiment 1), viewed images and written words (Experiment 2) or were at rest (Experiment 3). First, we found direct correlates of the ticker-tape synaesthesia phenomenon: during speech perception, as ticker-tape synaesthesia was active, synaesthetes showed over-activation of left perisylvian regions supporting phonology and of the occipitotemporal visual word form area, where orthography is represented. Second, we provided support to the hypothesis that ticker-tape synaesthesia results from atypical relationships between spoken and written language processing: the ticker-tape synaesthesia-related regions overlap closely with cortices activated during reading, and the overlap of speech-related and reading-related areas is larger in synaesthetes than in controls. Furthermore, the regions over-activated in ticker-tape synaesthesia overlap with regions under-activated in dyslexia. Third, during the resting state (i.e. in the absence of current ticker-tape synaesthesia), synaesthetes showed increased functional connectivity between left prefrontal and bilateral occipital regions. This pattern might reflect a lowered threshold for conscious access to visual mental contents and might imply a non-specific predisposition to all synaesthesias with a visual content. These data provide a rich and coherent account of ticker-tape synaesthesia as a non-detrimental developmental condition created by the interaction of reading acquisition with an atypical cerebral substrate.

The experiences of menstruation in schools in high income countries: A systematic review and line‐of‐argument synthesis

AbstractMenstruation is a global public health issue with negative discourses of shame, embarrassment, and disgust. There is growing anecdotal evidence linking negative menstruation experiences at school to absenteeism. This systematic review and line‐of‐argument synthesis aims to develop a conceptual understanding of menstruation experiences in schools in high‐income countries. MEDLINE (Ovid), PsycINFO (Ovid), EMBASE (Ovid), HMIC (Ovid), and ERIC databases were searched. NVivo was used for thematic synthesis and reciprocal translation to generate third‐order constructs: overarching themes that interpretatively describe social processes around menstruation in schools. One thousand three hundred and thirty‐three studies were screened, with 19 meeting inclusion criteria. Six third‐order constructs were identified and integrated into a synthesized line‐of‐argument illustrating menstrual injustice at school. To ensure menstruating students do not face academic disadvantage because of schools’ failure to accommodate menstrual needs, schools should challenge stigma, provide facilities to improve students’ capability and confidence to manage menstruation, and provide academic support to menstruating students who miss classes. Future research should explore experiences of period poverty in HIC schools, examining the influence of gender identity, disability, race, and class on menstruation experiences.

Balancing on life's ladder: A meta-ethnography of the existential experiences of siblings of children with complex care needs.

To synthesize and interpret existing qualitative research on the existential experiences of siblings of children with complex care needs. Noblit and Hare's interpretive meta-ethnography. The study has been registered in the international prospective register for systematic reviews (PROSPERO). Noblit and Hare's 7-step procedure was followed and reciprocal translation was performed to analyse the data and develop a line of argument synthesis. A comprehensive systematic literature search of five databases, along with extensive manual searches, was completed in November 2022. The final sample comprised 18 studies published between 2010 and 2022. A line of argument, expressed through an overarching metaphor, "balancing on life's ladder", illustrates the core findings of siblings' fluctuating experiences of existential well-being, and encapsulates four third-order themes: the emotional turmoil of siblings, interrupted family life, siblings strive to be themselves and siblings struggle to cope. Growing up with a sibling with complex care needs made children feel invisible, lonely and struggling to find the courage to cope. By adopting a lifeworld approach, nurses can become aware of healthy siblings' unmet needs. Future research is needed on how nurses can contribute to siblings' existential well-being, in primary - and secondary health care settings. The study provides insight into siblings' existential experiences and factors improving their well-being, enabling nurses to provide a more optimized lifeworld-led clinical practice. Healthcare, nursing education and practice should be informed by the knowledge of existential issues. Nurses are well-positioned to work alongside families to provide family-centered care. Our findings have implications for health policies tailored to the needs of children with chronically ill siblings. This review adheres to the Equator and improving reporting of meta-ethnography (eMERGe) guidelines. No patient or public contribution, because the data comprised previously published studies.

A critical review: developing a birth integrity framework for epidemiological studies through meta-ethnography

Over the past decade, there has been growing evidence that women worldwide experience sub-standard care during facility-based childbirth. With this critical review, we synthesize concepts and measurement approaches used to assess maternity care conditions and provision, birth experiences and perceptions in epidemiological, quantitative research studies (e.g., obstetric violence, maternal satisfaction, disrespect or mistreatment during childbirth, person-centered care), aiming to propose an umbrella concept and framework under which the existing and future research strands can be situated. On the 82 studies included, we conduct a meta-ethnography (ME) using reciprocal translation, in-line argumentation, and higher-level synthesis to propose the birth integrity multilevel framework. We perform ME steps for the conceptual level and the measurement level. At the conceptual level, we organize the studies according to the similarity of approaches into clusters and derive key concepts (definitions). Then, we ‘translate’ the clusters into one another by elaborating each approach’s specific angle and pointing out the affinities and differences between the clusters. Finally, we present an in-line argumentation that prepares ground for the synthesis. At the measurement level, we identify themes from items through content analysis, then organize themes into 14 categories and subthemes. Finally, we synthesize our result to the six-field, macro-to-micro level birth integrity framework that helps to analytically distinguish between the interwoven contributing factors that influence the birth situation as such and the integrity of those giving birth. The framework can guide survey development, interviews, or interventional studies.

Reciprocal multilingual awareness for linguistic citizenship

In this paper, we build on southern and decolonial theories of multilingualism and invite a south-north conversation through a concept we propose as ‘reciprocal multilingual awareness’. Reciprocity is a core value of southern societies that balance pluralities of episteme, language, and communality. Central features of southern multilingualisms, including transknowledging (reciprocal exchanges and translation of knowledge), and linguistic citizenship (the exercise of linguistic agency and choice), are usual moves that people make every day. Here, we lift forward southern reciprocities and linguistic citizenship together in conversation with northern conceptualisations of ‘multilingual awareness’. We draw attention to the longue durée of expertise and knowledge of multilingualism in post-colonial societies to invite conversation with critical multilingual language awareness (CMLA) as a contribution to this special issue. In this frame, we recognise the potential in ‘multilingual awareness’ for a dynamic and reciprocal process situated within specific place, time and ideology. We offer eirical experiences of multilingual reciprocities from Australia and Brazil in which community, student and teacher agency are foregrounded to illustrate and amplify southern theorisation of multilingualisms and linguistic citizenship. In conceptualising reciprocal multilingual awareness as a practice of linguistic citizenship our primary concern is to offer a contribution to teacher education that can more fully engage with organic, community and student-generated language ideologies.

A Mega-Ethnography of Qualitative Meta-Syntheses on Return to Work in People with Chronic Health Conditions.

The aim of this study was to synthesize the findings of qualitative meta-syntheses (QMS) on return to work (RTW) of people with different chronic illnesses and to develop a generic RTW model that can provide advice on how to improve RTW interventions and strategies. We conducted a systematic literature search in PubMed, Epistemonikos, CENTRAL, and PsycARTICLES to find relevant QMS, published in English or German between 2000 and 2021, and adapted the meta-ethnographic approach of Noblit and Hare to synthesize their findings. Nineteen QMS (five focusing on musculoskeletal disorders or chronic pain, four on acquired or traumatic brain injuries, four on cancer, two on mental disorders, one on spinal cord injury, and three on mixed samples) met our inclusion criteria for the meta-ethnographic synthesis. Through systematic comparison and reciprocal translation of the single QMS findings, we could identify a set of key cross-cutting themes/concepts, which formed the basis for four RTW principles and a generic RTW model. RTW is a multifactorial and highly interactive multistakeholder process, embedded in an individual's life and working history, as well as in a determined social and societal context. It runs parallel and interdependently to the process of coping with the disease and realigning one's own identity, thus emphasizing the significance of RTW for the person. Besides symptoms and consequences of the disease, individual coping strategies, and RTW motivation, the course and success of RTW are strongly affected by the adaptability of the person's working environment and the social support in their private and working life. Thus, RTW is not only a problem of the individual, but also a matter of the social environment, especially the workplace, requiring a holistic, person-centered, and systemic approach, coordinated by a designated body, which considers the interests of all actors involved in the RTW process.

Patient, Caregiver, and Clinician Perceptions of Palliative Care that Influence Access and Use: A Qualitative Meta-Synthesis.

Objective: Benefits of integration of palliative care early in the trajectory of a patient's serious illness are well established in the literature. Yet, barriers to palliative care access in the US continue to exist. The purpose of this study is to synthesize existing qualitative data of patient, caregiver, and clinician perceptions of palliative care (PC) that influence PC access and use in the US. Methods: A formal qualitative meta-synthesis was completed. The meta-synthesis included 1) a systematic literature search of qualitative studies conducted from 2016 to 2021, 2) a critical appraisal of the included studies, and 3) a reciprocal translation of the study's findings through an interpretive thematic analysis. Results: Seven articles met inclusion criteria resulting in a sample size of patients (n=18), caregivers (n=15), and clinicians (n=118). Three themes emerged with associated subthemes: knowledge and opinions of PC (subthemes of patient and caregiver knowledge and awareness and clinician knowledge and beliefs); care coordination and collaboration (subthemes of communication and trust); and social and structural drivers (subthemes of socioeconomic demographics and time and resources). Conclusions: This qualitative meta-synthesis identifies barriers and facilitators to palliative care access and use. The study findings illuminate the commonalities and differences of the perceptions of the three key stakeholder groups. In addition, this qualitative meta-synthesis reveals the complexities within the US healthcare system, and the challenges patients and their caregivers face accessing PC.

Using a meta-ethnographic approach to explore the role of interprofessional education in inclusion health for health and care staff

PurposeThis article aims to present a systematic review and synthesis of evidence on the experiences, role and use of IPE in IH fields by using a meta-ethnographic approach including key concepts, reciprocal and refutational translation and lines of argument. Inclusion health (IH) practice suggests that the needs of excluded groups are more effectively addressed through collaborative working. Interprofessional education (IPE) occurs when two or more professions engage in shared practice and learning, resulting in improved collaboration and quality of care. Studies on IPE to train staff in fields relating to IH exist, but without a settled consensus on the best approaches/activities to foster inclusive practice.Design/methodology/approachThis synthesis is underpinned by a meta-ethnographic approach. It provides explicit stages of data collection and interpretation, while providing space to engage with emerging themes and concepts iteratively (reflecting on author experiences) and inductively (reasoning and interpretation). This study made use of electronic databases and journals for English language peer reviewed articles between 2000 and 2020. Of the 2217 articles, 19 papers were included. The lead author and reviewer completed the review process and a second reviewer reviewed 10% at each stage. The quality was assessed using a modified CASP checklist. Iterative analysis involved PPI and staff stakeholders.FindingsA total of 16 concepts embedded in 19 papers provide insight into the nature of IPE in IH (IH) for staff. It was found that IPE in IH covers a broad group of practitioners and is a complex activity involving individual and organisation readiness, practical and pedagogical factors, influenced by setting, method, curriculum, lived experience, reflection and a learner-driven approach. Barriers to design, implementation and translation into practice were also found to exist.Practical implicationsMost studies used a combination of core learning and group work. Educational modes include mentoring or coaching, reflective practice, immersive learning and people lived experience of exclusion involved in or facilitation thematically centred in trauma-informed informed care, cultural competence, communities of practice and service learning. The aim of these methods was to promote collaboration through identifying shared experiences, problems and tensions and critical reflection of services and organisations. Such transformative learning is reported to challenge stigma, discrimination and misinformation and promote collective empowerment to address social injustice through human connection. Effective models of IPE re-instated the therapeutic relationship and alliances between patients and staff.Social implicationsThis review also calls for the development of health and care workers’ professionalism in relation to their own reflexivity, establishing anti-racist curricula, challenge stigma and ensuring clinicians are aware of and able to negotiate tension and difference identified within the consultation and between themselves. Apart from developing generalist skills, this analysis suggests that IPE in IH may be able to challenge stigma and discrimination towards IH groups by destabilising existing norms and siloed working with the aim of achieving robust interprofessional practice.Originality/valueIPE in IH is a complex activity affected by individual and organisation readiness, setting, experiential, practical and pedagogical factors. Models of teaching are focused on re-instating the therapeutic relationship. There are no systematic reviews in this field and previously there was no settled consensus on the best approaches and learning activities to foster inclusive and collaborative practice.

Growing beyond sickle cell disease: A metasynthesis of children, adolescents, and young adult experiences living with sickle cell disease.

Children, adolescents, and young adults living with sickle cell disease (SCD) often experience an unpredictable and complex disease course. Although there is a growing literature on the lived experience of patients with SCD, qualitative syntheses are lacking. Therefore, a qualitative metasynthesis was conducted to inform care and potential interventions. Noblit and Hare's phases of metaethnographic research were used to guide the synthesis of qualitative data. Data extracted from the identified studies were directly compared through reciprocal translation. The 12 studies that met inclusion criteria for the meta-synthesis included 177 participants ranging in age from 6 to 35 years old from six different countries. The authors identified three key metaphors: Ubiquitous Intrusion, Coping to Learn: Learning to Cope, and Part of the Whole. The metaphors were elucidated by three essential concepts that underlie the experience of children, adolescents, and young adults living with SCD: (1) recognition of SCD implications, (2) identifying ways to balance responsibilities, and (3) positioning oneself to thrive with SCD. The metaphors and essential concepts support the global theme of "Growing Beyond SCD." The metasynthesis revealed the shared complexity of living with SCD among children, adolescents, and young adults from diverse cultures in which the yearning for a normal life drove learning to adapt and manage SCD with their support network. The key metaphors may be used to guide development of nursing interventions designed to promote self-acceptance, coping, and adaptation skills among children, adolescents, and young adults that will help them to flourish while managing SCD as a chronic condition.

A systematic meta-ethnography of simulation debrief practice: A study protocol to investigate debrief interactions and the relationship to participant learning

Simulation-based education is now an established and curricula-integrated pedagogical activity in health professions education with the debriefing component seen to be critical to learning. There is limited empirical research examining the debrief activity, specifically addressing the question of how are interactions in simulation debriefing related to participant learning? The research that does exist is disparate, with researchers selecting different foci of interest, thus producing siloed knowledge. There is a need to both synthesise the current literature whilst simultaneously furthering the subject knowledge. This is a protocol to undertake a systematic meta-ethnography in accordance with Noblit and Hare’s established methodology, consisting of seven phases. At the core of this approach is the process of reciprocal translation, where the key interpretations (termed ‘metaphors’) of included studies are juxtaposed with one another to enable new concepts to emerge. This protocol presents the first two phases, covering aspects of question formulation and search strategy utilising PICOS and STARLITE frameworks. We also present the protocol for the deeply interpretive analytical phases (four through six). We provide a comprehensive rationale for undertaking a meta-ethnography, and throughout emphasise the way we intend to navigate the tensions in a predominately positivist systematic review and deeply interpretive nature of a qualitative synthesis. We discuss the issue of quality appraisal in qualitative syntheses and present a modified framework which will function to enable contextual interpretation and bring a sense of collective rigor, and detail why quality appraisal should not be used to exclude articles. Lastly, we highlight the reflexive nature of a meta-ethnography where the final findings are imbued with the researchers’ identity.

Patients' and Healthcare Professionals' Experiences and Views of Recurrent Urinary Tract Infections in Women: Qualitative Evidence Synthesis and Meta-Ethnography.

Urinary tract infections (UTIs) are a common and significant problem for patients, clinicians, and healthcare services. Recurrent UTIs (rUTIs) are common, with a 3% prevalence in the UK. Although acute UTIs have a significant negative impact on the lives of patients, evidence of the impact of rUTIs is limited. To enhance shared decision-making around rUTI management, it is important to understand both the patients' and healthcare professionals' (HCPs') perspectives. The objective of this qualitative evidence synthesis is to understand patients' and HCPs' experiences and views in the management of rUTIs. A qualitative evidence synthesis (QES) was performed that included primary qualitative studies involving patients with rUTIs or primary care HCPs who manage patients with rUTIs, up to June 2022. The following databases were searched: MEDLINE, Embase, CINAHL, PsycInfo, ASSIA, Web of Science, Cochrane Database of Systematic Reviews, Epistemonikos, Cochrane Central Registry of Controlled Trials, OpenGrey, and the Health Management Information Consortium (HMIC). The QES was prospectively registered on PROSPERO (CRD42022295662). Reciprocal translation was conducted and developed into a line of argument synthesis. We appraised the confidence in our review findings by using GRADE-CERQual. Twelve studies were included in the final review; ten of those included patients, and three included HCPs (one study included both). Our review demonstrates that women with rUTIs have a unique experience, but it is generally of a chronic condition with significant impacts on numerous aspects of their lives. Antibiotics can be "transformative", but patients have serious concerns about their use and feel non-antibiotic options need further research and discussion. HCPs share similar views about the impacts of rUTIs and concerns about antibiotic use and find the management of rUTIs to be complex and challenging. Based on our GRADE-CERQual assessment of the review findings, we have moderate confidence in those related to patients and low confidence in those related to HCPs. New conceptual models for both patients and HCPs are presented. This review has significant clinical implications. Patients require information on antibiotic alternative acute and preventative treatments for rUTIs, and this is not currently being addressed. There are communication gaps around the impact of rUTIs on patients, their perceived expectation for antibiotics, and the reasons for treatment failure. Further development of current clinical guidance and a patient decision aid would help address these issues.

“You are either with me on this or not”: A meta-ethnography of the influence birth partners and care-providers have on coping strategies learned in childbirth education and used by women during labour

BackgroundChildbirth education, which includes providing information and practical techniques to help manage childbirth, aims to support women and their birth partners. It is unknown how birth partners and care providers influence the utilisation of childbirth education information and techniques during women’s labour and birth. AimTo explore the literature that investigates the influence that birth partners and care-providers have on the application of childbirth education information and techniques used by women during childbirth. MethodsA meta-ethnography was performed using a systematic synthesis of reciprocal translation and refutational investigation. There were 22 papers included in the final synthesis. Quality appraisal was undertaken using the Joanna Briggs Institute Qualitative Assessment and Review Instrument (JBIQARI) quality appraisal tool for qualitative studies. FindingsAn over-arching theme of ‘you are either with me on this or not’ emerged from the data, which expressed the positive and negative influences on the use of childbirth education information and techniques during labour and birth. The influence of birth partners was captured in the themes ‘stepping up to their full potential’ and ‘a spare part’. The themes ‘in alignment with the woman’ and ‘managed by another’ were conceptualised from the data in relation to care-providers’ influence. A theme, ‘the right fit’, described organisational and contextual influences. ConclusionBirth partners and care-providers who are present during a woman’s labour have significant potential to influence her use of childbirth education strategies in labour, which provides important insights for translation of evidence into practice.