Synthesis Of Qualitative Research Research Articles

Patients' experiences of cancer immunotherapy with immune checkpoint inhibitors: A systematic review and thematic synthesis.

To obtain a deeper understanding of peoples' experiences of cancer treatments with immune checkpoint inhibitors (ICIs). ICIs are transforming survival outcomes for many with certain advanced cancers. Given the possibility of unique immune-related adverse events (irAEs), understanding treatment experiences is crucial to identify support needs and provide safe and effective person-centred care. A systematic review of qualitative research and thematic synthesis. To report this review, the Preferred Reporting Items for Systematic Analysis and Meta Analysis (PRISMA) checklist and Enhancing Transparency in Reporting the Synthesis of Qualitative Research (ENTREQ) guidance have been used. MEDLINE, EMBASE, PsycINFO, CINAHL and Web of Science databases were searched in January 2022 for eligible studies published in English from database inception. Two reviewers independently screened records, identified papers for inclusion and appraised methodological quality using the Critical Appraisal Skills Programme checklist. Themes were developed using thematic synthesis. Eighteen papers were included and three analytical themes developed: immune checkpoint inhibitor treatment decision-making; the experience and impact of immune checkpoint inhibitor treatments; and appraising and responding to irAEs. The synthesis renders visible individuals' unmet information, psychological and practical support needs. It identifies shortcomings in immune checkpoint inhibitor treatment decision-making processes and highlights the need for healthcare professionals to recognise and sensitively handle individuals' treatment expectations. Individuals' understandings of and responses to irAEs are also illustrated, and attention drawn to patients' concerns about healthcare professionals' checkpoint inhibitor and irAEs knowledge. To sensitively manage treatment expectations and uncertainties, and optimise health outcomes, there are distinct points in treatment trajectories where care and support might require adapting and enhancing. This review addresses people's experiences of immune checkpoint inhibitor treatments. The core findings reveal unmet information, psychological and practical support needs. Insights derived from this review will enhance individuals' experiences and outcomes and healthcare professionals' practice. No patient or public involvement.

Pupil Voices: Review of Factors Influencing Pupil Participation in Primary School Physical Activity

ABSTRACT Context Because the purpose of school-based physical activity (PA) interventions is to improve academic and/or health-related outcomes for children, their views must be considered for such programs to be successful. To inform the development of acceptable initiatives, a need exists to examine and synthesize pupil perspectives. Objective This review explores what is known about primary-aged pupils’ perspectives on school-based PA and qualitatively synthesizes the factors that influence pupil participation. Design This rapid qualitative review was conducted systematically and followed the Enhancing Transparency in Reporting the Synthesis of Qualitative Research (ENTREQ) guidelines. Eligibility Criteria Peer-reviewed articles published in the English language between January 2013 and April 2023 that reported qualitative data on primary school pupil participation in school-based PA were included. Study Selection Databases searched were Medline (Web of Science), ERIC (Education Collection-ProQuest), and EBSCO (Academic Search Complete, Education Source, ERIC, APA PsycArticles, APA PsycInfo, SportDiscus, CINAHL complete, Medline Full Text, Humanities Source Ultimate). Twenty-one articles that included qualitative evaluations of pupil participation in school-based PA from the pupil perspective were included. Main Outcome Measures The main outcome measured was pupil perceptions of factors that influence their participation in school-based PA. Results Ten themes emerged from the pupil data. The most prevalent was fun and enjoyment, followed by perceived health benefits, social interaction, and perceived academic benefits. Autonomy, appropriate level of challenge, perceived motor competence, school culture and environment, outdoor play, and influence of teachers were also identified. Conclusion To promote participation in PA, schools must support autonomy with developmentally appropriate equipment and space to facilitate physically active games. Positive and encouraging adults must maintain socially safe environments where pupils can be active with their friends. Physical education must be highly regarded, and pupils should have multiple opportunities to engage in PA throughout the school day.

Temporomandibular Joint (TMJ) Replacement Affects Quality of Life: A Systematic Review and Synthesis of Clinical Trials

This systematic review aims to determine the impact of temporomandibular joint (TMJ) replacement on health-related quality of life. The review was reported following the Enhancing Transparency in Reporting the Synthesis of Qualitative Research (ENTREQ) guidelines. An electronic search using the Bielefeld Academic Search Engine was performed to identify primary studies reported in English and published up until November 2023. Ten reports fulfilled the inclusion criteria and were assessed according to the Critical Appraisal Skills Programme (CASP): Qualitative Studies Checklist. The overall research value of the studies ranged from high (dominant) to moderate. The synthesis of the results concerning TMJ replacement in severe degenerative disease showed an improvement in (1) quality of life, (2) pain intensity, (3) mastication efficiency, and (4) mandibular mobility. One study presented favorable outcomes for patients suffering from ankylosis.

The perception of dignity in the hospitalized patient: a meta-synthesis - ensure consistency with authors' details e.g. name, affiliation, city and country Minor comments below.

Dignity is a value inherent to all human beings, guaranteed to every individual from birth, and influenced by culture and society. It is protected by various laws and declarations, and represents one of the fundamental human rights. Preserving human dignity is an essential aspect of nursing practice and a central element of care. Dignity is a highly subjective and personal concept; there may be variations in the way that patients perceive it and in the ways that nurses can guarantee it. A systematic review of the qualitative literature was conducted to obtain a comprehensive understanding of adult patients' perceptions of dignity in a hospital setting. This review adhered to the PRISMA Statement for reporting systematic reviews, and the results were reported in accordance with the Enhancing Transparency in Reporting the Synthesis of Qualitative Research (ENTREQ) guidelines. Major databases (PubMed, CINAHL, Scopus, and PsycINFO) were consulted and resulted in the inclusion of 21 studies. Methodological quality was assessed using the Critical Appraisal Skills Program (CASP) Checklist for Qualitative Studies. Six main themes emerged from the data analysis: (1) The concept of dignity and its various dimensions; (2) The significance of maintaining one's own privacy and confidentiality; (3) The hospital environment's influence on patients' dignity; (4) Healthcare professionals' characteristics and behaviours that affect dignity; (5) The role of communication and the relationship with healthcare providers; and (6) The patient's ability to make choices and be involved actively in their care. These findings underscore the importance of understanding caregivers' perspectives on dignity to ensure that they provide respectful and dignified care and treatment that prioritizes the patient's mental and physical needs.

Influencing factors of inter-nursing lateral violence: A qualitative systematic review.

Lateral violence is a global social problem that has attracted considerable attention in the field of public health. This has seriously affected the quality of care, the safety of patients' lives and the career development of nurses. To systematically evaluate the factors influencing of nursing lateral violence and provide evidence for preventing and reducing inter-nursing lateral violence. A systematic review of qualitative study was performed in accordance with the Enhancing Transparency in Reporting the Synthesis of Qualitative Research (ENTREQ) guidelines. We collected qualitative studies on the factors influencing of inter-nursing lateral violence by searching PubMed, EMbase, The Cochrane Library, Web of Science, CINAHL, Science Direct, WanFang Data, China National Knowledge Infrastructure (CNKI), Chinese Scientific Journal Database (VIP) and Chinese Biomedical Literature Database (CBM). Data from inception to September 2023. Literature screening and data extraction were independently conducted by two reviewers. The Critical Appraisal Skills Program (CASP) scale was employed to assess the quality of the studies, including objectives, methodologies, designs, results and contributions. A total of 25 studies involving 882 participants were included. The results of the thematic analysis indicated that inter-nursing lateral violence was influenced by hospital management, perpetrators, victims and sociodemographic factors. Inter-nursing lateral violence was influenced by multidimensional factors. To reduce the occurrence of horizontal violence among nurses, hospitals need to explore the establishment and improvement of a horizontal violence resolution mechanism, and schools should pay attention to the joint support and education of nursing students, create a good working environment and harmonious nursing culture, and promote mutual respect among nurses. This review emphasises the importance of the influencing factors of horizontal violence among nurses, analyses the importance of influencing factors from different perspectives, and proposes corresponding measures to reduce inter-nursing lateral violence. This study was mostly a literature review; neither patients nor pertinent staff were involved in either the design or conduct of the investigation.

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

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

Rapid reviews methods series: guidance on rapid qualitative evidence synthesis

This paper forms part of a series of methodological guidance from the Cochrane Rapid Reviews Methods Group and addresses rapid qualitative evidence syntheses (QESs), which use modified systematic, transparent and...

Synthesizing qualitative insights: a meta-ethnography of tourism disaster management literature

Purpose Disasters can affect the important sector of tourism across the world. This study aims to combine qualitative findings from 13 publications to enhance disaster management plans for the security and resilience of the tourist industry. Design/methodology/approach The authors used Noblit and Hare’s seven-step meta-ethnography method, identifying 13 qualitative studies on tourism disaster management through extensive searches in key databases (WoS, Scopus and Google Scholar), meeting inclusion criteria. NVivo 12 aided in coding, translation and comprehension of related ideas. Findings Five interrelated and third-ordered conceptual categories were identified: extreme natural and malevolent events, lack of risk management and emerg+ency response, sustainable tourism, tourism resilience factors, disaster awareness and preparedness. Effective strategies demand collaboration, resource allocation and local engagement. Originality/value This study offers a novel synthesis of qualitative research in tourism disaster management, enhancing understanding of resilience in the industry. It provides unique insights on cross-cultural dynamics, stakeholder engagement and integrated strategies while showcasing the utility of meta-ethnography in business and management research.

Experiences of financial toxicity among caregivers of cancer patients: a meta-synthesis of qualitative studies.

The purpose of this study was to explore the experience of financial toxicity among caregivers of cancer patients and to provide recommendations for subsequent intervention strategies. Computer searches of PubMed, EmBase, The Cochrane Library, Web of Science, CINAHL (EBSCO), CNKI, Wanfang database, and SinoMed for qualitative studies experience of financial toxicity among caregivers cancer patients. The search time frame was from the establishment of the database to May 2023. The quality of included studies was assessed using the Qualitative Research Checklist from the Joanna Briggs Institute (JBI) Reviewer's Manual. The meta-synthesis was integrated following the meta-aggregation method proposed by the Joanna Briggs Institute (JBI) and reported following the Enhancing Transparency in Reporting the Synthesis of Qualitative Research (ENTREQ) guidelines. A total of nine studies were included, distilling 25 qualitative findings into nine new categories and synthesizing three synthesized findings: caregivers have strong negative experiences that affect their family relationships, daily work and life; caregivers use different strategies to cope with financial toxicity; needs and expectations of caregivers coping with financial toxicity. Financial toxicity among caregivers of cancer patients affects their daily lives. Receiving timely recognition of this financial burden and providing assistance to enhance their coping skills are crucial in mitigating its impact. Healthcare professionals should focus on the financial toxicity experienced by caregivers of people with cancer, address their supportive needs, and develop a comprehensive support system to improve caregivers' coping abilities and quality of life.

A Qualitative Synthesis of Research on Professional Learning for Multi-Tiered Systems of Support

Researchers and practitioners continue to call for professional learning (PL) for multi-tiered systems of support (MTSS) to promote implementation with fidelity. Different PL interventions and MTSS frameworks raise questions about what types of PL support educators to engage in key practices. Questions also remain regarding educators’ perspectives and experiences with PL for MTSS and factors that facilitate or hinder educators’ learning. In this paper, we report findings from a qualitative research synthesis on PL for MTSS in the United States. We found 46 studies that explored educators’ perspectives and experiences with PL. Findings illuminated educators’ positive experiences with ongoing, job-embedded PL, particularly PL communities and coaching. Studies also illustrated the importance of collaboration and trust within learning communities as well as leaders who empower and trust educators. We discuss the implications of these findings in K–12 school settings.

Reducing Restrictive Interventions in Inpatient Mental Healthcare Facilities: A Literature Review

BACKGROUND: One common characteristic of mental health facilities is the violence and aggression that most patients exhibit. Such characteristics threaten the safety of the patients as well as that of the healthcare providers. Interventions have been put in place to prevent such aggression among mental patients. One of the common interventions is physical or chemical restriction. However, such interventions not only violate the dignity of the patients but also have negative repercussions on the treatment process and recidivism among the patients. Purpose: This study aimed to identify methods and models that would reduce the need for restrictive interventions to challenging behavior by mentally ill patients in inpatient psychiatric healthcare facilities.
 
 METHODS: The researcher examined databases that had information concerning mental health. These included CINAHL, PSYCINFO, EMBASE, MEDLINE, and Google Scholar. The quality appraisal used in the Cochrane Library database encompasses several systematic reviews that have been published. The data analysis that was used in this research was based on the findings of other researchers' content analysis and was an excellent technique in the research methodology. 
 
 RESULTS: The researcher employed the inclusion criteria from the previous chapter and identified 108 studies. The author applied qualitative research synthesis to analyze the literature and extract data for interpretation in the study. The majority of the studies used qualitative methodologies. The CASP tool was indispensable in appraising every study considered in the paper. Several health services have committed to the substantial reduction or elimination of the use of restrictive interventions. Restrictive practices can be reduced and often eliminated in healthcare services. The weight of evidence that seclusion and restraint can be reduced and eliminated comes from reports of these outcomes being achieved in mental health services. There is also evidence of seclusion and restraint being reduced in emergency departments and disability services. 
 
 CONCLUSION: Mental healthcare providers might argue that using restrictive interventions within the context of the medical care environment presents an excellent way of dealing with aggressive and violent people. Researchers in the future need to use actual test subjects. They need to conduct clinical trials to ensure that they can validate the results of the current study. 
 
 RECOMMENDATIONS: Intervention development should be theoretically informed and be conducted in collaboration with people who have lived experience of this issue. Limit setting may be effective for preventing and managing aggression. Observation is potentially a powerful strategy for preventing and managing aggression.

Fear of recurrence in women with ovarian cancer: A qualitative evidence synthesis

PurposeApproximately 80% of ovarian cancers recur after first-line treatments. Women with ovarian cancer (OC) are therefore particularly vulnerable to experiencing fear of cancer recurrence (FCR). This study aimed to synthesise experiences of fear of cancer recurrence among women living with ovarian cancer. MethodA qualitative evidence synthesis (QES) was conducted in accordance with the Enhancing Transparency in Reporting the Synthesis of Qualitative Research (ENTREQ) guidelines. A systematic search of seven databases was undertaken to identify all available qualitative research exploring fear of cancer recurrence in women with OC. Thematic synthesis of extracted data from included studies was undertaken and managed in NVivo. ResultsTwenty-two papers reporting on eighteen studies were included in the synthesis. Three main themes were developed (triggers, responses, and coping) and included ten subthemes. FCR was triggered by factors relating to awareness of prognosis, treatment, and negative communication. Women responded to FCR by performing body checking and protecting their families. FCR led to adverse effects on women's wellbeing as it exacerbated uncertainty about their future. Women attempted to cope with FCR through seeking support, regaining control, and redirecting negative thoughts and actions. ConclusionsWomen use a variety of approaches to manage their fear of recurrence. Further research on the most appropriate interventions for FCR tailored specifically to the needs of women with OC is needed.

Challenges of Imaging Obese Patients in General Radiography: A Qualitative Systematic Review to Guide the Training and Practice in Zambia

Background: Obese patients are increasingly being referred for medical imaging examinations across the world. Obese patients require a modified standard of care to compensate for challenges caused by both technical and psychological issues related to their weight and body habitus. There have been research studies conducted on this issue, but no systematic review has brought the findings of these studies together to inform training and practice.
 Aim: This study was aimed at synthesising primary studies on the challenges faced by radiographers and radiography students in imaging obese patients to guide the training and practice in Zambia.
 Methods: This qualitative systematic review was conducted using the Enhancing Transparency in Reporting the Synthesis of Qualitative Research (ENTREQ) guidelines. Two databases (PubMed and ScienceDirect) were systematically searched to identify relevant literature. This was supplemented by other sources: radiography journals, grey literature, and cited references. Data from the included studies were assessed for quality, extracted, and synthesised using thematic analysis.
 Results: Five studies were identified and included in this review. Following data analysis, four themes related to challenges faced in imaging obese patients in general radiography emerged: difficulties in communicating without causing psychosocial distress, manual handling risks, limitation of the equipment, and difficulties in positioning and determining the exposure factors for diagnostic radiographic images.
 Conclusion: This review provides an in-depth understanding of the challenges faced by radiographers and radiography students in imaging obese patients. Strategies to enhance radiography training and practice have been identified to help educators and radiographers.

Characteristics and consequences of participatory research approaches in long-term care facilities for older adults: a meta-ethnography of qualitative studies

BackgroundParticipatory research approaches can potentially empower older adults and improve their quality of life and care. These include research designs, methods, and conceptual frameworks in collaboration with people directly involved and invested in the research and research outcomes. However, participatory research approaches have rarely been explored in long-term care facilities for older adults, such as nursing homes or residential care facilities. We aimed to provide increased understanding and recommendations about how participatory research approaches can be conceptualised and used in long-term care facilities for older adults. MethodsInspired by Noblit and Hare (1988) and the seven phases of the eMERGe guidelines (2019), we performed a meta-ethnography (synthesis of qualitative research). We searched MEDLINE, CINAHL, ERIC, Sociological Abstracts, and Web of science in July 2021 and June 2022 for studies published between Jan 1, 2001, and June 27, 2022 (see appendix for search terms). We included peer-reviewed qualitative publications on participatory research approaches with older adults or staff in long-term care facilities, written in English. To promote rigour, a protocol was used with two authors independently screening the articles, reaching consensus through critical discussions with a third author, and using the Critical Appraisal Skills Programme (CASP) checklist. We extracted data regarding types of participatory research approaches and themes. This study is registered with PROSPERO, CRD42021275187. FindingsTen of 1445 articles screened were included in the analysis. Using seven types of participatory research approaches, the included studies investigated experiences of approximately 153 residents and 99 staff from seven countries (Australia, Belgium, England, Guyana, Ireland, Sweden, and the Netherlands). We identified five themes, expressed as a conceptual model with recommendations: (1) participatory backdrop; (2) collaborative places; (3) seeking common ground and solidarity; (4) temporal considerations; and (5) empowerment, growth, and cultural change. We recommend researchers allow flexible time for the slow-paced progression and potentially unintended consequences of this emergent approach. InterpretationThis meta-ethnography provides an international and systematic synthesis of a diverse group of small-scale qualitative studies, which are, however, limited by insufficient reporting of participants’ age, gender, or ethnicity. FundingThe Strategic Research Area in Health Care Science (SFO-V) at Karolinska Institutet and the Swedish Research Council for Health, Working Life and Welfare (FORTE).

Mental health and wellbeing interventions for care-experienced children and young people: Systematic review and synthesis of process evaluations

BackgroundThe mental health and well-being of care-experienced children and young people remains a concern. Despite a range of interventions, the existing evidence base is limited in scope, with a reliance on standalone outcome evaluations which limits understanding of how contextual factors influence implementation and acceptability. The Care-experienced cHildren and young people’s Interventions to improve Mental health and wEll-being outcomes Systematic review (CHIMES) aimed to synthesise evidence of intervention theory, outcome, process and economic effectiveness. This paper reports the process evaluation synthesis, exploring how system factors facilitate and inhibit implementation and acceptability of mental health and wellbeing interventions for care-experienced children and young people. MethodsSixteen databases and 22 websites were searched between 2020 and 2022 for studies published from 1990 and May 2022. This was supplemented with contacting experts in the field, citation tracking, screening of relevant systematic reviews and stakeholder consultations. We drew on framework synthesis of qualitative data and incorporated a systems lens, taking account of contextual influences across socio-ecological domains. Quality appraisal assessed reliability and usefulness. Confidence in synthesised findings was assessed with the GRADE-CERQual tool. We report the review in accordance with relevant elements of both the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA), and the Enhancing transparency in reporting the synthesis of qualitative research (ENTREQ) checklist. ResultsSearches retrieved 15,068 unique study reports, and 23 of these were eligible for process evaluation synthesis, reporting on sixteen interventions. Studies were published between 2003 and 2021. Nine interventions were from the UK and Ireland, six interventions were from the USA, and one was from Australia. They were largely classified as interpersonal, where the aim was to modify carer-child relationships. Five key context factors were identified that supported and prohibited intervention delivery: (1) lack of system resources; (2) intervention burden, which encompasses the time, cognitive, and emotional burden associated with implementation and participation; (3) interprofessional relationships between health and social care professionals; (4) care-experienced young people’s identity; and (5) carer identity. ConclusionWe identified several supportive and restrictive factors across social and health care systems that may impact intervention implementation and acceptability. Key implications include: the importance of involving diverse stakeholders in intervention development and delivery; the need to better resource and support those involved in interventions, particularly training and support for carers; and ensuring future evaluations integrate process evaluations in order to optimise interventions.

A qualitative evidence synthesis (QES) exploring the barriers and facilitators to screening in emergency departments using the theoretical domains framework

BackgroundValidated screening tools can be utilised to detect early disease processes and risk factors for disease and adverse outcomes. Consequently, identifying individuals in need of early intervention and targeted assessment can be achieved through the implementation of screening in the ED. Successful implementation can be impacted by a lack of resources and ineffective integration of screening into the clinical workflow. Tailored implementation processes and staff training, which are contextually specific to the ED setting, are facilitators to effective implementation. This review will assist in the identification of barriers and facilitators to screening in the ED using a QES to underpin implementation processes. Healthcare workers engage in screening in the ED routinely. Consequently, this review focused on synthesizing the experience of healthcare workers (HCWs) who are involved in this process. This synthesis is informed by a QES protocol published by the lead author in 2021 (Barry et al., HRB Open Res 3:50, 2021).MethodologyA comprehensive literature search, inclusive of grey literature sources, was undertaken. Initially, an a priori framework of themes was formed to facilitate the interpretation and organisation of search results. A context specific conceptual model was then formulated using “Best fit” framework synthesis which further assisted in the interpretation of data that was extracted from relevant studies. Dual blind screening of search results was undertaken using RAYYAN as a platform. Thirty studies were identified that met the inclusion criteria. Dual appraisal of full text articles was undertaken using CASP, GRADE CERQual assessed confidence of findings and data extraction was performed by two reviewers collaboratively. FindingsThis is the first known synthesis of qualitative research on HCW’s experiences of screening in the ED. Predominantly, the findings illustrate that staff experience screening in the ED as a complex challenging process. The barriers and facilitators identified can be broadly categorised under preconditions to screen, motivations to screen and knowledge and skills to screen. Competing interests in the ED, environmental stressors such as overcrowding and an organisational culture that resists screening were clear barriers. Adequate resources and tailored education to underpin the screening process were clear facilitators.Trial registrationPROSPERO: CRD42020188712 05/07/20.

Student nurses' experiences of remote learning during Covid-19 pandemic: A qualitative evidence synthesis.

To systematically synthesize undergraduate student nurses' experience of online, blended or distance learning during Covid-19 pandemic. A qualitative evidence synthesis (QES). A QES. Themes were organized using the 'best fit' framework approach. Methodological limitations and confidence in the review findings were informed by GRADE-CERQual (Confidence in the Evidence from Reviews of Qualitative research). Qualitative literature from five databases including CINAHL, PubMed, Medline, Education Full Text (H.W. Wilson) and ERIC were searched from March 2020 to November 2021. Nine qualitative and two mixed method studies were included in this 'best fit' framework using Chickering and Gamson's Seven Principles for Good Practice in Undergraduate Education. Importance of the social presence of the teacher through effective communication and interpersonal relationships is highlighted. Clinical placement and in-person practical skills training are needed for effective nursing education. This review highlighted that online content can be developed into efficient and high-quality learner-centred education within blended undergraduate nursing programmes incorporating essential face-to-face and practical components. Various supporting measures are required for both students and faculty. We suggest an adaptation of a 'Blending with Purpose: The Multimodal Model' with key considerations for undergraduate nursing programmes where pedagogical objectives and activities drive the approaches to achieve intended learning outcomes and student satisfaction. Well-designed online programmes using digital tools that support interaction and teamwork are required for undergraduate nursing education. Blended learning approaches offer more flexibility than online learning alone which leads to improved student engagement. Clinical placement and in-person practical skills training are needed for effective nursing education. REPORTING METHOD: 'Enhancing transparency in reporting the synthesis of qualitative research' (ENTREQ) for QES. No Patient or Public Contribution.

336 Exploring the barriers and facilitators to screening in Emergency Departments (ED): a qualitative evidence synthesis using the theoretical domains framework

Abstract Background Validated screening tools, such as the Identification of Seniors At-Risk tool, can be utilised to detect early disease processes, risk factors and the risk of adverse outcomes. Identifying individuals in need of early intervention and targeted assessment can be achieved by implementing screening in the ED. Successful implementation can be impacted by a lack of resources and ineffective integration of screening into the clinical workflow. Tailored implementation processes and staff training, which are contextually specific to the ED setting, are facilitators to effective implementation. This review identified barriers and facilitators to screening in the ED to underpin implementation processes. Furthermore, this review focused on synthesising the experience of healthcare workers who are routinely involved in this process. Methods A rigorous search strategy was employed and reported using PRISMA. Subsequently, an a-priori framework of themes was formulated to facilitate the interpretation of search results. A conceptual model was then formed using ‘Best fit’ framework synthesis, this assisted in the organisation of data from relevant studies during data extraction. Dual blind screening of results was undertaken using RAYYAN as a platform. Thirty studies met the inclusion criteria. Dual appraisal of full text articles was completed using CASP, GRADE CERQual assessed confidence of findings and data extraction was performed by two reviewers collaboratively. Results This is the first known synthesis of qualitative research, focused on screening in the ED. Predominantly, the findings illustrate that screening in the ED is perceived as a complex and challenging process. The barriers and facilitators identified can be broadly categorised as identifying preconditions to screen, recognising motivations to screen and acknowledging the required knowledge and skills to screen. Conclusion Competing interests in the ED, environmental stressors such as overcrowding and an organisational culture that resists screening were clear barriers. Adequate resources and tailored education to underpin the screening process were facilitators.

Patients' Experiences of Digital Health Interventions for the Self-Management of Chronic Pain: Protocol for a Systematic Review and Thematic Synthesis.

Chronic pain is a highly prevalent condition that requires multidisciplinary treatment. However, in the United Kingdom, access to specialist pain clinics where patients can receive medical multidisciplinary treatment is limited, and provision varies between health boards. As such, self-management of chronic pain using digital tools has been gaining traction recently, but evidence of its effectiveness from clinical-based trials focuses mainly on quantitative outcomes. This systematic review aims to identify, appraise, and synthesize qualitative evidence on patients' experiences with digital health interventions (DHIs) for the management of chronic pain. This systematic review will consider qualitative and mixed methods studies that explore the experience of patients (aged 18 years and older) with chronic pain engaging in DHIs to manage their pain. MEDLINE Ovid, PubMed, Embase, CINAHL, PsycINFO, and Scopus databases will be searched for published studies. The systematic review will be conducted in accordance with the ENTREQ (Enhancing Transparency in Reporting the Synthesis of Qualitative Research) guidelines. Following the 3-step thematic synthesis methodology of Thomas and Harden, titles and abstracts will be screened by 2 independent reviewers (AM and HM), and a third reviewer (MI or FM) will resolve any conflict that arises before the full-text screening. The Critical Appraisal Skills Programme checklist tool will be used to critically appraise the included studies. The extracted data will be imported to NVivo (QSR International), where thematic synthesis will be used to derive analytical themes from the included studies. Themes that encapsulate the patient experience will be identified from qualitative evidence, and these themes will shed light on the perceived benefits and disadvantages, usability, acceptability, and the overall impact digital tools can have on the lives of those with chronic pain. This systematic review will identify, appraise, and synthesize the overall experience of patients engaging in DHI to manage a diverse range of chronic pain conditions. By elaborating the patient experience through qualitative analysis, the findings from this review will enhance our current understanding of the experiences of patients with chronic pain using digital tools for the self-management of their pain and highlight what person-centered elements are essential for future DHI development. PROSPERO CRD42023445100; http://tinyurl.com/4z77khfs. DERR1-10.2196/52469.

Researching for justice: using meta-ethnographic synthesis to develop knowledge for research for social transformation

ABSTRACT In a special issue article on ethnographic synthesis from 2017, Karen Borgnakke addressed some of the challenging methodological questions and dilemmas associated with meta-ethnography by ethnographic researchers. The article compared meta-ethnography with evidence-based models for measuring learning effects in education, but highlighted that the founders of meta-ethnography, Noblit and Hare, described the methodology and its aims quite differently to this. Rather than the aggregation of findings, the aim was to, in the interests of social justice and social transformation, generalise findings from individual research based on critical interpretations of several ethnographic products. Using a qualitative synthesis of meta-ethnographic research from ethnographies on Sweden’s school system, the present article examines this aim further. It tries to generate and communicate knowledge about how ethnographers of education can engage in research to fulfil commitments connected to social justice and transformation. In short, it attempts to describe what this research can look like.