Scoping Review Of Qualitative Studies Research Articles

Public trust in national electronic health record systems: A scoping review of qualitative studies

Abstract Background Having public trust in national electronic health record systems (EHRs) is essential for the successful implementation of electronic health records within a country’s healthcare system. Without trust, people are less likely to consent to sharing their health data through an EHR and government stakeholders will have difficulties promoting uptake and facilitation of EHRs. Research investigating public trust in EHRs is limited, however. In response, we conducted a scoping review in order to gain clarity on the influences and themes behind public trust in EHRs, which can support the implementation of EHRs. Methods We reviewed 27 qualitative studies focusing on public trust in EHRs. Studies were identified between January 2022 and June 2022 and were ascertained using an inclusive search method and guided by the PRISMA-ScR checklist. In an iterative process, conceptual themes were derived, and detail the promoters and outcomes of public trust in EHRs. Results Three major themes that describe the promoters of public trust in EHRs and two major themes that detail the outcomes once public trust in EHRs exists were ascertained from the literature. Additional findings bring forth the consequential role of healthcare actors in the public trust building process. Conclusions Results show comprehension, autonomy, and data protection are key concepts that help build and consolidate public trust in EHRs, while the public and the healthcare system benefit from public trust in EHRs. Furthermore, health system actors can be supportive or detrimental to the implementation of EHRs. Their effect is dependent on their activities within the health care system and how the public perceives those activities. Based on: Papadopoulos K, von Wyl V, Gille F. What is public trust in national electronic health record systems? A scoping review of qualitative research studies from 1995 to 2021. DIGITAL HEALTH. 2024;10. doi:10.1177/20552076241228024 Key messages • This research clarifies the conceptualizations that make up the trust relationship between the public and EHRs. • The findings can assist researchers, policymakers, and other health system actors in attaining a better understanding of the intricacies of public trust in EHRs.

Barriers Towards Healthcare Access and Services among People with Disabilities: A Scoping Review of Qualitative Studies

Healthcare access and services is one of the challenges faced by people with physical disability (PWPD). PWPD also has at risk of early death and preventable chronic illness. Lack of access to healthcare services includes delay or failure to receive needed care, lack of continuity of care and financial burden will result in deterioration of health, wellbeing and functional status. The aim of this paper was to review barriers towards healthcare access and services among PWPD based on the existing qualitative studies. We conducted a scoping review of relevant qualitative articles from PubMed, Scopus and ProQuest. The article search was based on the available keyword in the title with the publication restricted within 10 years (between 2012 to 2021). The search strategy was conducted using MeSH terms of ‘barriers, healthcare access, healthcare services and physical disability’. In this review, people with different kinds of physical disabilities were included. There were 2004 articles obtained from the initial search. 27 articles met the inclusion criteria for the final review. In each study, PWPD noted various barriers to access healthcare services. Findings from this review revealed five themes: personal; financial; attitudinal and communication; health system; structural and physical barriers. The findings showed that PWPD faces various barriers when accessing healthcare services. Addressing these barriers could help create a healthcare system that is inclusive and accessible for all.

Development of a Situation-Specific Theory for the Transition of Survivors of Stroke With Dysphagia.

The process by which stroke survivors move toward health while facing various difficulties can be construed as a "transition." Importantly, nurses need to understand and support this state of transition effectively. This study developed a situation-specific theory to explain post-stroke transition by integrating the findings of a qualitative study that explored the rehabilitation experiences of stroke survivors with dysphagia with a scoping review of qualitative studies using the theoretical framework of transition theory. This theory will help understand the transitions that stroke survivors with dysphagia undergo during recovery and provide a framework for exploring nursing care to support healthy transitions.

Experiences and perspectives of adults on using opioids for pain management in the postoperative period: A scoping review.

Opioids play an important role in peri-operative pain management. However, opioid use is challenging for healthcare practitioners and patients because of concerns related to opioid crises, addiction and side effects. This review aimed to identify and synthesise the existing evidence related to adults' experiences of opioid use in postoperative pain management. Systematic scoping review of qualitative studies. Inductive content analysis and the Theoretical Domains Framework (TDF) were applied to analyse and report the findings and to identify unexplored gaps in the literature. Ovid MEDLINE, PsycInfo, Embase, CINAHL (EBSCO), Cochrane Library and Google Scholar. All qualitative and mixed-method studies, in English, that not only used a qualitative approach that explored adults' opinions or concerns about opioids and/or opioid reduction, and adults' experience related to opioid use for postoperative pain control, including satisfaction, but also aspects of overall quality of a person's life (physical, mental and social well being). Ten studies were included; nine were qualitative ( n = 9) and one used mixed methods. The studies were primarily conducted in Europe and North America. Concerns about opioid dependence, adverse effects, stigmatisation, gender roles, trust and shared decision-making between clinicians and patients appeared repeatedly throughout the studies. The TDF analysis showed that many peri-operative factors formed people's perceptions and experiences of opioids, driven by the following eight domains: Knowledge, Emotion, Beliefs about consequences, Beliefs about capabilities, Self-confidence, Environmental Context and Resources, Social influences and Decision Processes/Goals. Adults have diverse pain management goals, which can be categorised as proactive and positive goals, such as individualised pain management care, as well as avoidance goals, aimed at sidestepping issues such as addiction and opioid-related side effects. It is desirable to understand the complexity of adults' experiences of pain management especially with opioid use and to support adults in achieving their pain management goals by implementing an individualised approach, effective communication and patient-clinician relationships. However, there is a dearth of studies that examine patients' experiences of postoperative opioid use and their involvement in opioid usage decision-making. A summary is provided regarding adults' experiences of peri-operative opioid use, which may inform future researchers, healthcare providers and guideline development by considering these factors when improving patient care and experiences.

Health and well-being needs of Indigenous adolescents: a protocol for a scoping review of qualitative studies

IntroductionImproving the health of Indigenous adolescents is central to addressing the health inequities faced by Indigenous peoples. To achieve this, it is critical to understand what is needed from the...

A scoping review of qualitative studies on sexual and reproductive health and rights in Uganda: Exploring factors at multiple levels.

Uganda is burdened by high unintended and teen pregnancies, high sexually transmitted infections, and harm caused by unsafe abortion. Explore factors influencing sexual and reproductive health and rights (SRHR) in Uganda by synthesizing evidence from qualitative studies using a scoping review. Original qualitative peer-reviewed research studies published between 2002 and 2023 in any language exploring factors influencing SRHR in Uganda. Eight databases searched using qualitative/mixed methods search filters and no language limits. Information extracted included author, article title, publication year, study aims, participant description, data collection type, sample size, main findings, factors at the individual, interpersonal, community, and policy levels, implications for SRHR in Uganda, and study limitations. Quality of the selected articles was assessed using the Critical Appraisal Skills Programme tool. One hundred seventy-three studies met inclusion criteria. At the individual level, knowledge and attitudes toward SRHR, risky sexual behavior, and access to maternal SRHR services were identified as critical factors influencing health outcomes. Interpersonal factors included communication with sexual partners and relationships with family, school, and community members. Healthcare organization factors included adolescent access to education, SRHR services, and HIV prevention. Cultural and social factors included gendered norms and male involvement in SRHR. Policy-level factors included the importance of aligning policy and practice. Multiple factors at individual, interpersonal, community, healthcare, cultural, and policy levels were found to influence SRHR in Uganda. The findings suggest that interventions targeting multiple levels of the socio-ecological system may be necessary to improve SRHR outcomes. This review highlights the need for a holistic approach that considers the broader socio-ecological context. Reducing identified gaps in the literature, particularly between policy and practice related to SRHR, is urgently needed in Uganda. We hope this review will inform the development of policies and interventions to improve SRHR outcomes.

Children and youth’s perceptions of mental health—a scoping review of qualitative studies

BackgroundRecent research indicates that understanding how children and youth perceive mental health, how it is manifests, and where the line between mental health issues and everyday challenges should be drawn, is complex and varied. Consequently, it is important to investigate how children and youth perceive and communicate about mental health. With this in mind, our goal is to synthesize the literature on how children and youth (ages 10—25) perceive and conceptualize mental health.MethodsWe conducted a preliminary search to identify the keywords, employing a search strategy across electronic databases including Medline, Scopus, CINAHL, PsychInfo, Sociological abstracts and Google Scholar. The search encompassed the period from September 20, 2021, to September 30, 2021. This effort yielded 11 eligible studies. Our scoping review was conducted in accordance with the PRISMA-ScR Checklist.ResultsAs various aspects of uncertainty in understanding of mental health have emerged, the results indicate the importance of establishing a shared language concerning mental health. This is essential for clarifying the distinctions between everyday challenges and issues that require treatment.ConclusionWe require a language that can direct children, parents, school personnel and professionals toward appropriate support and aid in formulating health interventions. Additionally, it holds significance to promote an understanding of the positive aspects of mental health. This emphasis should extend to the competence development of school personnel, enabling them to integrate insights about mental well-being into routine interactions with young individuals. This approach could empower children and youth to acquire the understanding that mental health is not a static condition but rather something that can be enhanced or, at the very least, maintained.

The experience of living with obesity for adults in Asian countries: A scoping review of qualitative studies.

Sociocultural and biological backgrounds significantly influence people's experience of obesity. Yet the experience within the Asian sociocultural context is underexplored. This scoping review aims to summarize the qualitative evidence that explores the lived experience of adults with obesity in Asian countries. Guided by the Joanna Briggs Institute (JBI) approach, we systematically searched five databases (MEDLINE, EMBASE, PsychINFO, CINAHL, and Scopus) for studies exploring the lived experience of adults with obesity in Asian countries. Eligible studies with English full text were screened by two reviewers and analyzed using a descriptive qualitative content analysis. Of the 16,764 articles retrieved, 11 were included. The qualitative data can be summarized into three categories: (1) cultural norms shaped the lived experience with obesity, (2) the influence of obesity on social relationships, and (3) coping with life challenges. Despite the small number of studies, a strong influence of the sociocultural environment on the lived experience of obesity was evident, particularly on social roles and expectations, social relationships, the stigma of obesity, and life challenges. The extent and significance of this sociocultural influence on the Asian population warrant further exploration. Future research should fully report the qualitative methods to provide contextual information about the study.

Examining Black Women's Breastfeeding Experiences in the United States: A Scoping Review of Qualitative Studies.

A growing gap in exclusive breastfeeding across racial/ethnic groups in the United States includes a very low proportion of African American/Black women, with only 17.4% breastfeeding exclusively in 2015. While many quantitative studies examine these disparities, few qualitative studies have examined the overall experience of breastfeeding for Black women. The aim of this study is to evaluate the existing qualitative literature on experiences of African American/Black women who breastfeed to gain insight on barriers and facilitators unique to this population. This scoping review included studies that had a focus on any qualitative study design. Evidence was identified by searching electronic databases (PubMed, CINAHL, and PsychINFO). Thirteen papers met the inclusion criteria for this review. Each study was summarized and then analyzed for content to produce a synthesis. Seven themes that influence Black women's experience with breastfeeding were identified: influence of interpersonal relationship on intention to and sustained breastfeeding experiences, influence of institutional systems on initiating and sustaining infant feeding decision, influence of personal beliefs on breastfeeding decisions and experience, material barriers and facilitators to breastfeeding experience, traditional stigma of breastfeeding, historical stigma of breastfeeding influences feeding choice in Black women, and negative impacts of body image. The breastfeeding experience for Black women is unique and poses additional areas for intervention based on cultural and historical stigma. Incorporating the identified factors into intervention design is key to creating more effective policies for improving breastfeeding rates in the Black women and closing the gap across racial/ethnic demographics in the United States. Still, more qualitative research with culturally relevant theories needs to be done to investigate the full scope and complexities of breastfeeding as a Black woman to develop messaging to encourage the behavior.

P102 Barriers and facilitators to lifestyle change in people living with gout: a scoping review of qualitative studies

Abstract Background/Aims Lifestyle, especially diet and alcohol, has been implicated in the causation of gout for centuries and the dietary factors which may trigger flares remain of great interest to people living with gout and their families. However, there is a lack of robust clinical trial evidence about the effectiveness of lifestyle change in people living with gout. The aim of this review was to establish the thoughts, feelings and experiences of people with gout, partners and healthcare professionals about gout, to identify barriers and facilitators to behaviours relating to lifestyle change (diet, alcohol, and physical activity) in people living with gout. Methods A scoping review was undertaken following the stages recommended in Arksey & O’Malley’s scoping studies methodological framework. Databases Embase, MEDLINE, CINAHL, PsycINFO and AMED were searched from January 2000 to October 2021 to identify qualitative studies in gout. Themes were identified within the results of included qualitative studies using thematic synthesis (coding text in the results and then developing themes) and were discussed with both a stakeholder community of practice (COP) group and a patient and public involvement and engagement (PPIE) group. Results 1871 title/abstracts and 158 full papers were screened and 38 qualitative studies in gout were identified. Themes identified in the scoping review are presented in Table 1 and were corroborated with COP and PPIE group members. Examples of potential barriers to lifestyle change in people with gout include poor knowledge, confusing or inadequate information, uncertainty about effectiveness of diet in gout management, stigma, and a reluctance to see healthcare professionals. Potential facilitators for lifestyle change include the desire to prevent flares and pain, the provision of information, and that people with gout already search for information and avoid or consume certain foods. Conclusion This is the first scoping review to identify potential barriers and facilitators to behaviours relating to lifestyle change in people living with gout. Potential barriers include poor knowledge, problems with current information and stigma. The findings will be used to inform the development of the new lifestyle intervention for people living with gout in primary care. Disclosure L. Watson: Grants/research support; Lorraine Watson is funded by the National Institute for Health and Care Research (NIHR) School for Primary Care Research. [Post-doctoral Fellowship Grant reference 2020-347], this (abstract) presents independent research funded by the NIHR. The views expressed are those of the author(s) and not necessarily those of the (partner organisation), the NHS, the NIHR or the Department of Health and Social Care. N. Cornwall: None. C. Jinks: Grants/research support; Clare Jinks is part funded by the National Institute for Health and Care Research (NIHR) Applied Research Collaboration West Midlands. K. Bradbury: Grants/research support; Katherine Bradbury is funded by the National Institute for Health and Care Research (NIHR) Applied Research Collaboration Wessex. L. Goff: None. P. Little: None. C.D. Mallen: Grants/research support; Christian Mallen is funded by the National Institute for Health and Care Research (NIHR) Applied Research Collaboration West Midlands and the NIHR School for Primary Care Research, The School of Medicine as received funding from BMS for a non-pharmacological AF screening trial, Christian Mallen has received grant funding from Wellcome and the Medical Research Council. E. Roddy: None.

Experiences in Adult Relationships After Nonsexual Child Maltreatment: A Systematic Scoping Review of Qualitative Studies

Experiences in Adult Relationships After Nonsexual Child Maltreatment: A Systematic Scoping Review of Qualitative Studies

The role of movement in young children’s spatial experiences: a review of early childhood mathematics education research

Young children’s spatial reasoning is critical to mathematics learning from an early age. Recent reviews have drawn attention to the importance of mathematical experiences in the early years; however, an explicit focus on research in spatial reasoning can contribute to a more coherent account of the field. This paper reports a scoping review of qualitative studies (n = 37) during the years 2009–2021. The studies analysed in this review provide insight into children’s embodied spatial concepts and non-verbal expressions such as gesture and the relationship between spatial reasoning and mathematics learning in early childhood (birth to 8 years). Four main themes were found: (i) children’s manipulation and transformation of objects, (ii) children’s bodily engagement with and within spaces, (iii) children’s representation and interpretation of spatial experiences, and (iv) contexts for spatial learning. While the review illuminates a deeper awareness and a more holistic and embodied view of children’s spatial competencies, there remains few studies focussed on children under three years of age. Future directions for ongoing research are identified.

A scoping review of qualitative research on barriers and facilitators to the use of supervised consumption services.

A substantial body of evidence demonstrates that supervised consumption services (SCS) mitigate a variety of drug-related harms, including decreasing overdose deaths, infectious disease transmission, and connecting people who use drugs (PWUD) to various health and social services. Research on SCS has predominantly been quantitative, though qualitative research on these services has increased substantially over the last decade. Qualitative methods provide a framework for developing a richer and more nuanced understanding of meanings and contexts associated with drug use, health service implementation, and experience. We present findings from a scoping review of qualitative studies on experiences of PWUD with SCS published between 1997 and 2022. In total, forty-two papers were included in this analysis. Four primary themes emerged from our analysis: 1) Influence of SCS on health and wellbeing among PWUD, 2) the physical environment of SCS can be both a facilitator and barrier to use, 3) social resources can shape and reshape the context within which PWUD benefit from SCS, and 4) various intersecting forces at play both support and harm PWUD in relation to their experiences with SCS. We discuss the primary facilitators and barriers of SCS use and conclude with suggestions to inform future qualitative research, SCS implementation, and PWUD-centered approaches to drug policy.

Exploring loss and grief during the COVID-19 pandemic: A scoping review of qualitative studies

The COVID-19 pandemic has brought about multiple losses to various groups, namely patients, families and healthcare professionals. Grief, which is the reaction to these losses, could cause strain on these individuals' physical and mental health if not identified and managed early. This scoping review analysed loss, grief and how they were managed among these groups during the pandemic. This scoping review utilised the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Statement extension for Scoping Reviews (PRISMA-ScR) and the Joanna Briggs Institute framework for scoping reviews. Only qualitative studies relating to loss and grief and their management were included. Of 166 studies screened, 69 were included in the study. Qualitative analysis and data coding of each record were conducted through qualitative data analysis software. Losses included the death of family members, patients, colleagues and others. They also included the loss of usual routines, lifestyles and physical health. The grief experienced was multidimensional, affecting mainly the emotional, physical, social and existential realms. Anger, guilt and fear resulted from unsatisfactory farewells, issues with funerals, social isolation, financial strain and stigmatisation. Management strategies could be categorised into 5 themes: communication, finance, counselling, education and spiritual care. Loss and grief identification and management among patients, family members and healthcare professionals are critically important during this COVID-19 pandemic. Current operating guidelines have proven insufficient in managing loss and grief. Innovative strategies are essential to tackle the many dimensions of loss and grief. Nevertheless, further research is necessary to better understand the effectiveness of implemented policies.

Everyday Experiences of People Living with Mild Cognitive Impairment or Dementia: A Scoping Review.

Increasing attention has been paid to the ‘voice’ of people living with mild cognitive impairment (MCI) or dementia, but there is a lack of clarity about how everyday life is perceived from this insider’s perspective. This study aimed to explore the everyday life experiences, challenges and facilitators of individuals with MCI and dementia living at home. A scoping review of qualitative studies, guided by the Joanna Briggs Institute Reviewers Manual, was conducted. Eight databases were searched, resulting in 6345 records, of which 58 papers published between 2011 and 2021 were included. Analysis was carried out by descriptive content analysis. Findings were categorized into seven spheres of everyday life: experiences related to the condition, self, relationships, activities, environment, health and social care and public opinions. The results show many disruptions and losses in everyday life and how people try to accommodate these changes. In all areas of everyday life, people show a deep desire to have reciprocal relationships, stay engaged through participation in activities and have a sense of belonging in the community. However, more research is needed on the factors that promote and impede the sense of reciprocity and belonging.

Adolescents’ Experiences of Participating in Sensitive Research: A Scoping Review of Qualitative Studies

Despite an increasing emphasis on adolescents’ participation rights, there are concerns about their participation in research on sensitive topics, such as trauma and violence. This review reports findings of a scoping review that examined the nature and extent of qualitative studies conducted with adolescents about their experiences of participating in research on sensitive topics. Studies were identified by searching electronic databases and grey literature and reported on qualitative and mixed-methods studies eliciting adolescents’ experiences of participating in research on sensitive topics. Seventeen (17) studies were included after screening 4426 records. The scoping review revealed significant adolescent benefits from participation, relating to positive emotions, skill acquisition and enhanced self-efficacy and interpersonal relationships. To a lesser extent, participants also experienced burdens relating to negative emotions, concerns about confidentiality and privacy and inconvenience of participation, which were mitigated by careful attention to research design and researcher engagement and training. Participants shared insights into their motivation to participate, and factors that impacted their experiences of research, such as ethical considerations, including consent procedures, safety and connection in research, study procedures and documentation and researcher characteristics. There were tangible benefits and some burdens involved in adolescents’ participation in sensitive research. This review considers implications for research and practice, such as the need to regularly publish findings of consultations, assessing caregiver consent requirements, obtaining adolescent views on study documents and measures and building on existing research, differentiated by age, gender and dis/ability status, especially in diverse and under-represented regions.

Abstract PO-120: Need for more sociodemographic data in qualitative childhood cancer research: Findings from a scoping review

Abstract Childhood cancer is increasingly recognized as a global health priority. In comparison with other childhood diseases, researchers have long- emphasized–the need to include children in empirical studies on cancer diagnosis, treatment, and recovery, particularly through the use of qualitative methods (Bluebond-Langner 1978). Children's inclusion originated from the theoretical perspective that adults may not understand the needs of children and that, to understand children's perspectives, we must engage and involve them in the research process. Given the new focus on global childhood cancer, we ask if and how sociodemographic factors, such as age, ethnicity, financial status and other categories, have been included in qualitative research with children who have cancer. Reporting ofn the inclusion and analysis of these factors is necessary to address disparities; research on adult cancer has shown that sociodemographic factors shape experiences with cancer diagnosis, treatment, and survival. The authors conducted a scoping review of qualitative studies involving children in cancer research between 2007-2019. Articles were retrieved from Ovid Medline, Embase, and CINAHL. Article titles and abstracts were screened and included in full text review if they were cancer related, used qualitative methods, and included participants aged 6 to 11. Additional articles that met the inclusion criteria but were found after the database search were considered and coded. A total of 88 articles were screened, with 76 articles met the inclusion criteria the full text retrieved for coding. Articles were coded for reported sociodemographic factors of children and their caretakers involved in the study. Further, each study's identified sociodemographic categories were analyzed for their significance/importance to the respective study. Results show gaps in sociodemographic reporting and analysis (e.g., factors such as race, education, financial status not reported or included in analysis), little research being conducted in under-resourced areas (e.g., studies outside of the US, Canada, Europe), and frameworks used in the reviewed articles exclude the social/environmental context as a contributing factor in medical care. With the popular frameworks in current childhood studies, including Humanistic Nursing Theory and phenomological theory, adding sociodemographic reporting and analysis can contribute to childhood cancer research by increasing the variety and number of children to whom the research findings will be contextually relevant. Reporting the inclusion of these factors in children's cancer research is needed to highlight populations who have been traditionally underrepresented, and to identify areas for future research examining how sociodemographic factors impact the cancer care experience. We hope in identifying these gaps and opportunities for future research, this work will invite childhood cancer research to expand its reach and combat disparities that exist within cancer diagnosis, care, and survival. Citation Format: Sarah Burack, Eric M. Wiedenman, Melanie Ward, Lindsay Kaufman, Thembekile Shato, Jean Hunleth. Need for more sociodemographic data in qualitative childhood cancer research: Findings from a scoping review [abstract]. In: Proceedings of the AACR Virtual Conference: 14th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2021 Oct 6-8. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2022;31(1 Suppl):Abstract nr PO-120.

Mapping experiences and perspectives of equity in international health collaborations: a scoping review

BackgroundWhilst global health research often involves international collaborations, achieving or promoting equity within collaborations remains a key challenge, despite established conceptual approaches and the development of frameworks and guidelines to promote equity. There have also been several empirical studies documenting researchers’ experiences of inequity and views on what is required to advance equity in global health collaborations. While these empirical studies provide critical insights, there has been no attempt to systematically synthetize what constitutes equity and how it can be achieved. To address this gap, we conducted a scoping review of qualitative studies, opinion and editorial pieces about what equity is and how it can be promoted in international collaborations.MethodsWe conducted a scoping review to explore domains of equity in international health collaborations. This review included qualitative studies and opinion pieces or editorial pieces on equity in international health collaborations. We mapped the data and identified common themes using a thematic analysis approach.ResultsThis initial search retrieved a total of 7611 papers after removing duplicates. A total of 11 papers were included in this review, 10 empirical studies and 1 editorial piece. We conducted our search between October – November 2019. We identified 10 key domains which are important for promoting equity in international collaborations: funding; capacity building; authorship; sample ownership and export; trust; research agreement; acknowledging inequality; recognition and communication.DiscussionOur findings suggest that for international collaborations to be considered more equitable, it must at least consider the 10 domains we highlighted. The 10 domains map onto five key aspects of social justice theory, namely avoiding unequal power relations like subordination, group recognition and affirmation, promoting the well-being of all, inclusion in decision-making and ensuring self-development.

Mishel's Model of Uncertainty Describing Categories and Subcategories in Fibromyalgia Patients, a Scoping Review.

The aim of this review was to demonstrate the presence of categories and subcategories of Mishel’s model in the experiences of patients with fibromyalgia by reviewing qualitative studies. Uncertainty is defined as the inability to determine the meaning of disease-related events. A scoping review of qualitative studies was carried out. Twenty articles were included, with sample sizes ranging from 3 to 58 patients. Articles from different countries and continents were included. Three categories of the model and eight subcategories could be shown to be present in the experiences of fibromyalgia patients through the scoping review. The first category, concerning antecedents of uncertainty in patients with fibromyalgia, is constituted by the difficulty in coping with symptoms, uncertainty about the diagnosis and uncertainty about the complexity of the treatment. The second concerns the cognitive process of anxiety, stress, emotional disorder and social stigma. The third category refers to coping with the disease, through the management of social and family support and the relationship with health care professionals.

Older patients' perspectives on mealtimes in hospitals: a scoping review of qualitative studies.

The increasing age of populations throughout the world means that healthcare services are faced with new challenges, not least regarding the provision of food during hospital stay. There is a lack of knowledge of how hospital mealtimes are experienced by older patients, and so the aim of this article was to review current knowledge regarding mealtimes in hospitals from the perspectives of older patients. A literature search was performed using seven databases: PubMed, Web of Science, Scopus, Sociological Abstracts, SweMed+, ASSIA and CINAHL with no limits regarding publication date. The inclusion criteria were peer-reviewed articles in English or Swedish that used qualitative methods to examine older patients' (>65years) mealtime experiences. The Five Aspect Meal Model (FAMM) served as a framework for understanding the complexity behind a mealtime experience. Qualitative content analysis was used as a guide when analysing the material. The search produced 415 studies, 14 of which were included in the review. The findings generated three main themes for understanding how older patients experience mealtimes while in hospital: (1) the food and the food service, (2) mealtime assistance and commensality during mealtimes and (3) the importance of retaining one's independence. The review also clearly indicated a shortage of studies that solely focus on older patients' experiences of their mealtime. More research is therefore needed to be fully able to understand the complex task of providing meals in hospitals.