Synthesis Of Qualitative Research Research Articles

Requirements, challenges and impacts of Lean Six Sigma applications – a narrative synthesis of qualitative research

PurposeThe purpose of this paper is to identify, present and categorise the main requirements, challenges and impacts of Lean Six Sigma (LSS) applications. Emphasis is given to the soft impacts of LSS applications, which are intangible in nature and difficult to quantify and measure, highlighting the most frequently cited ones.Design/methodology/approachA qualitative synthesis of the studies using the narrative synthesis approach is adopted to descriptively summarise and categorise the requirements, challenges and impacts of LSS applications. The studies were searched by using the following keywords: “LSS applications,” “LSS requirements,” “LSS challenges” and “LSS impacts” in almost all major electronic databases such as Emerald, Taylor and Francis, ScienceDirect and Wiley. A total of 116 articles published between 2007 and 2017 in 41 academic journals were collected and reviewed. Consideration was also given to a number of substantial publications in 2006, 2018 and 2019.FindingsIn addition to its process efficiency and financial impacts, LSS was found to have another impact category related to individual and organisational behaviours. Management commitment, training and organisational culture were concluded to be amongst the most important and required categories for successful LSS applications. It was also found that the lack of awareness of LSS tools and benefits and the lack of change management and resistance to change were amongst the most cited categories of implementation challenges.Research limitations/implicationsThe studies published between 2007 and 2017 are mainly considered in this paper. It is believed that 10-year publication period considered in this research is sufficient to study the evolution, benefits, limitations and future trends of a particular research topic. However, the exclusion criteria used in the search process with respect to the articles’ year of publication and search terms and keywords may limit the generalisation of the research findings. In addition, the qualitative nature of this research study and the lack of empirical data to support its findings is another limitation that future research should consider.Practical implicationsThis research paper may serve as a valuable source of information for LSS researchers as it will provide them with useful and new insights and directions for further research in LSS. It will also increase the awareness of LSS practitioners about the kind of impact LSS has, and therefore, achieve a better utilisation of its tools by ensuring availability of application requirements and overcoming application challenges.Originality/valueThis study differs from previous research studies as it focusses attention on the soft impacts of LSS applications and highlights them. The study identifies and prioritises LSS application impacts, requirements and challenges. The study on these aspects was found to be limited and lacking in previous research studies.

The role of healthcare professionals in HPV communication with head and neck cancer patients: A narrative synthesis of qualitative studies.

Prevalence rates of human papillomavirus positive (HPV+) head and neck cancers (HNC) have increased over the last decades. Communicating about HPV is an increasingly relevant part of HNC patient care. This systematic review was conducted to explore healthcare professionals' (HCP) views and experiences of discussing HPV with HNC patients. It also examined perceptions among different HCP groups of their professional roles in HPV discussions. A narrative synthesis of qualitative research was conducted. Three databases-Embase, PsycINFO and CINAHL+-were searched from January 2007 to August 2018. Relevant data were extracted and synthesised thematically. Five studies were identified: four were qualitative and one used mixed methods. HCPs varied in their experience and views of discussing HPV. HCPs who engaged in these discussions believed they were beneficial for patients. All HCPs described the need to address their HPV knowledge deficits in order to provide clear HPV information. Changes in professional roles which were linked to HPV communication for HCPs involved in HNC patient care were also evident. Effective HPV discussions are an important part of patient-provider interactions. Evidence-based interventions and professional development activities which support HCPs in their HPV discussions with patients would be valuable.

The experiences of hospital staff who provide care for people living with dementia: A systematic review and synthesis of qualitative studies

To systematically review and synthesise qualitative data from studies exploring the experiences of hospital staff who care for people living with dementia (Plwd). In hospital, the number of Plwd continues to rise; however, their experiences of care remain problematic. Negative experiences of care are likely to contribute to poorer mental and physical health outcomes for Plwd while in hospital and after discharge. Experiences of the hospital staff who care for Plwd can also be poor or unrewarding. It is important to understand the experiences of staff in order to improve staff well-being and ultimately the experience of care for Plwd while in hospital. Systematic review and evidence synthesis of qualitative research. We searched 16 electronic databases in March 2018 and completed forward and backward citation chasing. Eligible studies explored the experiences of paid and unpaid staff providing care in hospital for Plwd. Study selection was undertaken independently by two reviewers, and quality appraisal was conducted. We prioritised included studies according to richness of text, methodological rigour and conceptual contribution. We adopted approaches of meta-ethnography to analyse study findings, creating a conceptual model to represent the line of argument. Forty-five studies reported in 58 papers met the inclusion criteria, and of these, we prioritised 19 studies reported in 24 papers. The line of argument was that Institutions can improve staff experiences of care for Plwd by fostering person-centred care (PCC). PCC aligned with staff perceptions of 'good care'; however, staff often felt prevented from providing PCC because of care cultures that prioritised tasks, routines and physical health. Staff experienced conflict over the care they wanted to give versus the care they were able to give, and this caused moral distress. When staff were able to provide PCC, this increased experiences of job satisfaction and emotional well-being. Person-centred care not only has the potential to improve the experience of care for Plwd and their carers, but can also improve the experiences of hospital staff caring for Plwd. However, without institutional-level changes, hospital staff are often unable to provide PCC even when they have the experience and knowledge to do so. Institutional-level areas for change include the following: training; performance indicators and ward cultures that prioritise psychological needs alongside physical needs; adequate staffing levels; inclusive approaches to carers; physical environments that promote familiarisation, social interaction and occupation; systems of documentation about individual needs of Plwd; and cultures of sharing knowledge across hierarchies.

Hidden Realities of Infant Feeding: Systematic Review of Qualitative Findings from Parents.

A growing, global conversation, regarding realities and challenges that parents experience today is ever-present. To understand recent parent’s attitudes, beliefs, and perceptions regarding infant feeding, we sought to systematically identify and synthesize original qualitative research findings. Following the Enhancing Transparency in Reporting the Synthesis of Qualitative Research (ENTREQ) framework, electronic databases were searched with a priori terms applied to title/abstract fields and limited to studies published in English from 2015 to 2019, inclusive. Study quality assessment was conducted using the Critical Appraisal Skills Programme (CASP) checklist, and thematic analyses performed. Of 73 studies meeting inclusion criteria, four major themes emerged. (1) Breastfeeding is best for an infant; (2) Distinct attitudes, beliefs, and perceptions of mothers that breastfeed, and those that could not or chose not to breastfeed, are evident; (3) Infant feeding behaviors are influenced by the socio-cultural environment of the family, and (4) Parent’s expectations of education and support addressing personal infant feeding choices from health care providers are not always met. This systematic review, guided by constructs within behavioral models and theories, provides updated findings to help inform the development of nutrition education curricula and public policy programs. Results can be applied within scale-up nutrition and behavioral education interventions that support parents during infant feeding.

A meta-ethnographic synthesis of qualitative research on women's experience of midwifery care.

Labor and birth constitute a significant emotional event for a childbearing woman. The aim was to explore women's reflections on their experiences of labor and birth and how these were influenced by the midwifery care they received. A modified version of Noblit and Hare's meta-ethnographic approach was used to develop an inductive and interpretive synthesis of nine qualitative articles. Relevant databases were searched and qualitative articles appraised by means of the Critical Appraisal Skills Program. Two metaphors were identified: The guide-Please share your knowledge and The motherly midwife as an anchor. The comprehensive understanding of the images evoked by the metaphors resulted in an overall metaphoric representation of the women's experiences: The midwife as a birth pilot, that is, a positive labor and birth experience is dependent on the relationship with the midwife. This finding confirms previous knowledge that a trusting relationship results in confidence, while feeling secure leads to a positive birth experience. The metaphors facilitate understanding of the significance of the midwife for women's labor and birth experiences. Knowledge of labor and birth experiences helps to broaden understanding of the necessity of midwives being willing to engage, act, be aware of errors that may affect women's birth experience, and employ tools to predict unexpected adverse events.

Managing crisis: a qualitative lens on the aftermath of entrepreneurial failure

Every entrepreneur faces barriers when they engage in entrepreneurial activities and for every entrepreneur, their utmost goal is to succeed d in their endeavors. However, some entrepreneurial ventures fail due to several factors. After the failure, the entrepreneur either relapses or seeks for new entrepreneurial opportunities. The present study conducts a qualitative research synthesis to examine what happens after the occurrence of firm failure and how entrepreneurs manage the experiences from failure. In doing so, the present study analyses already published qualitative studies on failure by conducting a literature search from several electronic databases to capture the qualitative studies published under failure. After the elimination of irrelevant data, 21 relevant articles were identified. The identified articles were analyzed using meta ethnography and grounded formal theory to elaborate on three overarching concepts – the experience and cost of failure, the impact from failure and the outcome of failure. The findings from these analyzed qualitative research offers insight into the ongoing discussions on entrepreneurial failure by identifying recurrent themes and concepts as well as by presenting a conceptual model that describes the entrepreneur’s experiences from failure and how they manage these firm failures. The findings also provide avenues on how future research can contribute to the discussion on failure.

Experiences of advance care planning for community-dwelling older people: a qualitative systematic review protocol.

The objective of this qualitative systematic review is to evaluate and synthesize the recent literature on advance care planning (ACP) experiences of community-dwelling older people in interaction with community healthcare professionals. The importance of healthcare professionals initiating ACP with their patients and clients has been reported. However, older people who live in the community have fewer opportunities to have discussions regarding ACP with healthcare professionals compared with those who live in other settings. Timely initiation of ACP and sustainable discussion among older people, families, and community healthcare professionals is expected, which may lead to improved palliative and end-of-life care in the community. This review will consider studies that include individuals older than 60 years living in their homes in the community. Studies published in English or Japanese that focus on qualitative data and are published from 1999 to present will be considered. The key information sources to be searched are: MEDLINE, CINAHL, Embase, PsycINFO, JSTORE, Scopus, Japan Medical Abstract Society, CiNii for published papers, and Google Scholar, ProQuest Dissertations & Theses Global, and MedNar for unpublished papers and gray literature. Eligible studies will be critically appraised using the standardized JBI tool. Qualitative research findings will be pooled using the meta-aggregation approach. Then the final synthesized findings will be graded according to the ConQual approach for establishing confidence in the output of qualitative research synthesis and presented in a Summary of Findings.

Health professionals' experiences of grief associated with the death of pediatric patients: a systematic review.

The objective of this review was to synthesize the experiences of health professionals who have experienced grief as a result of a pediatric patient dying. There has been some research into health professionals' grief experiences associated with the death of pediatric patients, but there has not been a review that synthesizes the findings of these experiences. Other related reviews have focused on prenatal, perinatal or adult deaths or the coping strategies employed by health professionals. This review highlights the complexities of experiences faced by pediatric health professionals. Qualitative studies involving pediatric health professionals working in any healthcare setting who had experienced grief from the death of a patient were considered for inclusion. Studies were conducted in any country, at any time and published in English. The search was conducted in PubMed, CINAHL, Embase, PsycINFO, Scopus and ProQuest Dissertations and Theses. The search was completed in January 2019. The review followed principles of meta-aggregation in line with the JBI approach. Methodological quality assessment was based on representation of participants' voices and congruence between research methodology and both research question and analysis of data. Meta-aggregation led to three synthesized findings from 12 qualitative studies that met the inclusion and methodological quality criteria. Studies predominantly included nurses working in a hospital, with sample sizes ranging from six to 25 participants. The synthesized findings were physical, behavioral, psychological or spiritual symptoms; compounding grief; and alleviating grief. Physical, behavioral, psychological, or spiritual symptoms highlighted the various characteristics of grief experiences by health professionals. Compounding grief was the largest synthesized finding and incorporated the various factors that contributed to a poorer experience of grief. Alleviating grief showed the limited identified factors that improved the experience of grief. Methodological quality led to synthesized findings receiving a ConQual rating of low or moderate. The synthesized findings from this review highlight the varied reported experiences of grief in health professionals. The methodological quality and reporting of studies, however, led to decreased confidence in the synthesized findings and recommendations arising from this review. Healthcare professionals should be aware of the potential for experiencing grief when a patient dies and the compounding and alleviating factors associated with this. Further research could expand participant and language limitations, and improve methodological quality and reporting.

What are the attitudes of health professionals regarding patient reported outcome measures (PROMs) in oncology practice? A mixed-method synthesis of the qualitative evidence

BackgroundThe adoption of Patient Reported Outcome Measures (PROMs) in cancer care has been widely advocated, but little is known about the evidence for the implementation of PROMs in practice. Qualitative research captures the perspectives of health professionals as end-users of PROMs and can be used to inform adoption efforts. This paper presents a systematic review and synthesis of qualitative research conducted to address the question: What are the attitudes of health professionals towards PROMs in oncology, including any barriers and facilitators to the adoption of PROMS, reported in qualitative evidence?MethodsSystematic searches of qualitative evidence were undertaken in four databases and reviewed using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Studies published in English between 1998 and 2018, which reported qualitative findings about the attitudes of health professionals working in oncology towards PROMs were eligible. Studies were assessed using the Critical Appraisal Skills Programme’s Qualitative Research Checklist. A sentiment analysis was conducted on primary text to examine the polarity (neutral, positive or negative) of health professionals’ views of PROMs. Qualitative meta-synthesis was conducted using a constant comparative analysis.ResultsFrom 1227 articles after duplicates were removed, with 1014 excluded against the screening criteria, 213 full text articles remained and were assessed; 34 studies met the inclusion criteria and were included. The majority of studies were of good quality. Sentiment analysis on primary text demonstrated an overall positive polarity from the expressed opinions of health professionals. The meta-synthesis showed health professionals’ attitudes in four domains: identifying patient issues and needs using PROMs; managing and addressing patient issues; the care experience; and the integration of PROMs into clinical practice.ConclusionsFrom the accounts of health professionals, the fit of PROMs with existing practice, how PROMs are valued, capacity to respond to PROMs and the supports in place, formed the key factors which may impede or promote adoption of PROMs in routine practice. To assist policy-makers and services involved in implementing these initiatives, further evidence is required about the relationship between PROMs data collection and corresponding clinical actions.Trial registrationInternational Prospective Register of Systematic Reviews (PROSPERO) CRD42019119447, 6th March, 2019.

Barriers and facilitators to physical activity among children, adolescents, and young adults with cystic fibrosis: a systematic review and thematic synthesis of qualitative research

ObjectivesPhysical activity is widely recommended in the treatment and management of cystic fibrosis (CF). Despite the numerous physical and psychological benefits, many young people with CF are not achieving the...

Young people's conceptualizations of the nature of cyberbullying: A systematic review and synthesis of qualitative research

Abstract Introduction Cyberbullying is a serious public health problem facing young people. Adults do not have first-hand experience of being immersed in social media in their youth and this necessitates the inclusion of youth voice in efforts to understand and address cyberbullying. This study aimed to synthesize qualitative studies which had explored young people's conceptualizations of the nature of cyberbullying, with a view to informing conceptual and intervention development. Methods A systematic review and meta-ethnographic synthesis of qualitative studies was conducted. Nine databases were searched from inception to July 2018. The Critical Appraisal Skills Program assessment tool was used to appraise the quality of included studies. Results Of 4872 unique records identified, 79 were reviewed in detail and 13 studies comprising 753 young people from 12 countries were included. Five key concepts were identified: Intent, Repetition, Accessibility, Anonymity and Barriers to Disclosure. A “line of argument” illustrating young people's conceptualization of cyberbullying was developed. Conclusion The significance of information and communication technology in young people's lives, and the complexity of the cyber world in which they connect, must be recognized in conceptualizations of cyebrbullying. The distinctive features of cyberbullying identified in young people's characterization can be used to inform bottom-up research and intervention efforts.

Patients' Experiences of Emergency Hospital Care Following Self-Harm: Systematic Review and Thematic Synthesis of Qualitative Research.

Rates of hospital presentation for self-harm have increased in recent years, and although clinical practice guidelines on clinical provision prioritize positive patient experiences, the quality of provision remains variable. This systematic review provides an updated and extended synthesis of qualitative research on the following: (a) patients' experiences of treatment following presentation to hospital; and (b) patients' perceptions of the impact of treatment on recurrent self-harm and/or suicidal ideation, and future help-seeking. Twenty-six studies were identified for inclusion in the final synthesis. Three meta-themes emerged: (a) individuals undertake extensive identity work when presenting with self-harm, navigating the process of becoming a patient, and negotiating the type of patient they want to be; (b) care ranges from gentle to hostile, with care at admission and discharge being particularly disorientating; and (c) negative experiences of clinical treatment may increase future self-harm. Emerging research gaps include the need for further theoretically informed qualitative research in this area.

Perceptions of risk and influences of choice in pregnant women with obesity. An evidence synthesis of qualitative research.

Between 7-35% of the maternity population are obese in high income countries and 1-40% in lower or middle-income countries. Women with obesity are traditionally limited by the choices available to them during pregnancy and birth because of the higher risk of complications. This evidence synthesis set out to summarise how women with obesity's perceptions of pregnancy and birth risk influence the care choices that they make. A search of medical and health databases for qualitative studies written in the English language, published Jan 1993-April 2019 and reporting on pregnant women with obesity's perception of risk and influence of pregnancy and birth choices. Data was extracted by two reviewers onto a questions framework and then analysed using a thematic synthesis technique. Confidence in the qualitative findings was assessed using GRADE-CERQual. 23 full texts were included. The common themes on perception of risk were: 'Self-blame arising from others' stereotyped beliefs ', 'Normalisation', 'Lack of preparation', 'Fearful acceptance and inevitability' and 'Baby prioritised over mother'. For influence of choices, the themes were: 'External influences from personal stresses', 'Restrictive guidelines', 'Relationship with healthcare professional' and 'Perception of Risk'. Evidence on what influences women with obesity's pregnancy choices is limited. Further research is needed on the best methods to discuss the risks of pregnancy and birth for women with obesity in a sensitive and acceptable manner and to identify the key influences when women with obesity make choices antenatally and for birth planning.

Educational Migration from Kazakhstan to China: Reality and Prospects

Introduction. The relevance of the study is determined by the gradual expansion of educational cooperation between Kazakhstan and China and the need to identify the competitive advantages of the educational system of China over Kazakhstan’s system of higher education. The purpose of the article is to identify factors stimulating dynamic growth of educational migration from Kazakhstan to China, as a relatively recent phenomenon, and to evaluate its possible consequences. Materials and Methods. In order to identify main trends and the way of development of Kazakhstan-China educational relations, we used empirical methods; namely: qualitative research method, description, expert interviews, content analysis, and synthesis. A survey of Kazakhstani students studying in China was conducted. The students of the Department of Chinese Studies of Al-Farabi Kazakh National University were interviewed, as well as those who participated in the joint training program with the Lanzhou University. Kazakhstani students from Beijing University of Language and Cu lture also participated in the survey. Results. The main reasons for the dynamic growth of educational migration from Kazakhstan to China are high quality of education in China, access to education in Chinese universities, comfortable learning and living conditions for Kazakhs, etc. By analysing the statistical data of the Chinese Ministry of Education, timing of the dynamics of Kazakhstani students’ flows to China was presented. The legislative and governmental measures of the two countries aiming to create a basis for educational cooperation were also analysed. An attempt to predict the future activities of Kazakhstan students as the “soft power” of China in Kazakhstan was made. Discussion and Conclusion. This problem can be further investigated in the study of factors affecting the increase in the academic mobility of Kazakhstani students, which should contribute to the expansion of cooperation between Kazakhstan and China in the field of education. The results of this study may be useful to scientists and lecturers engaged in research on various aspects of the educational migration of Kazakhstan to China.

Activating social change together: A qualitative synthesis of collaborative change research, evaluation and design literature

Researchers, evaluators and designers from an array of academic disciplines and industry sectors are turning to participatory approaches as they seek to understand and address complex social problems. We refer to participatory approaches that collaboratively engage/partner with stakeholders in knowledge creation/problem solving for action/social change outcomes as collaborative change research, evaluation and design (CCRED). We further frame CCRED practitioners by their desire to move beyond knowledge creation for its own sake to implementation of new knowledge as a tool for social change. In March and May of 2018, we conducted a literature search of multiple discipline-specific databases seeking collaborative, change-oriented scholarly publications. The search was limited to include peer-reviewed journal articles, with English language abstracts available, published in the last five years. The search resulted in 526 citations, 236 of which met inclusion criteria. Though the search was limited to English abstracts, all major geographic regions (North America, Europe, Latin America/Caribbean, APAC, Africa and the Middle East) were represented within the results, although many articles did not state a specific region. Of those identified, most studies were located in North America, with the Middle East having only one identified study. We followed a qualitative thematic synthesis process to examine the abstracts of peer-reviewed articles to identify practices that transcend individual disciplines, sectors and contexts to achieve collaborative change. We surveyed the terminology used to describe CCRED, setting, content/topic of study, type of collaboration, and related benefits/outcomes in order to discern the words used to designate collaboration, the frameworks, tools and methods employed, and the presence of action, evaluation or outcomes.
 Forty-three percent of the reviewed articles fell broadly within the social sciences, followed by 26 percent in education and 25 percent in health/medicine. In terms of participants and/or collaborators in the articles reviewed, the vast majority of the 236 articles (86%) described participants, that is, those who the research was about or from whom data was collected. In contrast to participants, partners/collaborators (n=32; 14%) were individuals or groups who participated in the design or implementation of the collaborative change effort described. In terms of the goal for collaboration and/or for doing the work, the most frequently used terminology related to some aspect of engagement and empowerment. Common descriptors for the work itself were ‘social change’ (n=74; 31%), ‘action’ (n=33; 14%), ‘collaborative or participatory research/practice’ (n=13; 6%), ‘transformation’ (n=13; 6%) and ‘community engagement’ (n=10; 4%). Of the 236 articles that mentioned a specific framework or approach, the three most common were some variation of Participatory Action Research (n=30; 50%), Action Research (n=40; 16.9%) or Community-Based Participatory Research (n=17; 7.2%). Approximately a third of the 236 articles did not mention a specific method or tool in the abstract. The most commonly cited method/tool (n=30; 12.7%) was some variation of an arts-based method followed by interviews (n=18; 7.6%), case study (n=16; 6.7%), or an ethnographic-related method (n=14; 5.9%). While some articles implied action or change, only 14 of the 236 articles (6%) stated a specific action or outcome. Most often, the changes described were: the creation or modification of a model, method, process, framework or protocol (n=9; 4%), quality improvement, policy change and social change (n=8; 3%), or modifications to education/training methods and materials (n=5; 2%). The infrequent use of collaboration as a descriptor of partner engagement, coupled with few reported findings of measurable change, raises questions about the nature of CCRED. It appears that conducting CCRED is as complex an undertaking as the problems that the work is attempting to address.

The state of IFRS in Africa

PurposeThe purpose of this paper is to appraise existing literature on International Financial Reporting Standards (IFRS) in Africa. It covers all 54 African countries and their membership in regional and international accounting bodies.Design/methodology/approachThis paper uses qualitative research methods, including review and synthesis of a variety of archival materials.FindingsUnlike the numerous variations in IFRS adoption on other continents, IFRS countries in Africa have adopted the standards as issued by International Accounting Standard Board (IASB). However, most countries are slow to implement the ROSC (AA) recommendations for IFRS adoption due to lack of institutional and professional capacity. With regards to the unintended consequences, IFRS adoption has made international professional qualifications such as Association of Certified Chartered Accountants popular in Africa; hence, national accounting qualifications are not attractive to prospective accountants. Similarly, IFRS adoption has created a competitive advantage for the Big4 audit firms because companies in IFRS countries prefer the services of the Big4 to that of the local audit firms.Originality/valueIt is concluded that international organisations that recommend IFRS to Africa, such as the IFRS foundation, IMF and World Bank, should build the sustainable professional and institutional capacity of the countries before persuading them to adopt IFRS, because in Africa, adopting a law is easy but operationalising it has always been the challenge.

No straight lines \u2013 young women\u2019s perceptions of their mental health and wellbeing during and after pregnancy: a systematic review and meta-ethnography

BackgroundYoung mothers face mental health challenges during and after pregnancy including increased rates of depression compared to older mothers. While the prevention of teenage pregnancy in countries such as the United States and the United Kingdom has been a focus for policy and research in recent decades, the need to understand young women’s own experiences has been highlighted. The aim of this meta-ethnography was to examine young women’s perceptions of their mental health and wellbeing during and after pregnancy to provide new understandings of those experiences.MethodsA systematic review and meta-ethnographic synthesis of qualitative research was conducted. Seven databases were systematically searched and forward and backward searching conducted. Papers were included if they were from Organisation for Economic Co-operation and Development countries and explored mental health and wellbeing experiences of young mothers (age under 20 in pregnancy; under 25 at time of research) as a primary research question – or where evidence about mental health and wellbeing from participants was foregrounded. Nineteen papers were identified and the Critical Appraisal Skills Programme checklist for qualitative research used to appraise the evidence. Following the seven-step process of meta-ethnography, key constructs were examined within each study and then translated into one another.ResultsSeven translated themes were identified forming a new line of argument wherein mental health and wellbeing was analysed as relating to individual bodily experiences; tied into past and present relationships; underpinned by economic insecurity and entangled with feelings of societal surveillance. There were ‘no straight lines’ in young women’s experiences, which were more complex than dominant narratives around overcoming adversity suggest.ConclusionsThe synthesis concludes that health and social care professionals need to reflect on the operation of power and stigma in young women’s lives and its impact on wellbeing. It adds to understanding of young women’s mental health and wellbeing during and after pregnancy as located in physical and structural factors rather than individual capacities alone.

Academic development to support the internationalization of the curriculum (IoC): a qualitative research synthesis

ABSTRACT While the literature acknowledges the central role of academics in internationalization of the curriculum (IoC), little has been published regarding training of academic developers themselves to support IoC initiatives. However, higher education institutions around the globe are responding to strategic demands for IoC that prepare students as global citizens. We employed qualitative research synthesis to identify journal articles that consider academic development to support IoC. Despite their diversity, we found common themes in the five selected studies. We weave these themes with Betty Leask’s five-stage model of the IoC process, and Cynthia Joseph’s call for a pedagogy of social justice.

A qualitative research synthesis of contextual factors contributing to female overweight and obesity over the life course in sub-Saharan Africa.

ObjectiveAdult women are disproportionately affected by overweight and obesity in Sub-Saharan African (SSA) countries. Existing evidence on the sociocultural context remains unconsolidated. In this qualitative research synthesis, we aggregate research literature on contextual factors that potentially predispose adult women and adolescent girls to overweight and obesity to inform research, policies and programs over the life course.MethodsPubMed, CINAHL, PsychInfo, ProQuest Central, EMBASE, and Web of Science were searched to locate qualitative research articles conducted in SSA countries beginning in the year 2000. After assessment for eligibility and critical appraisal, 17 studies were included in the synthesis. Textual data and quotes were synthesized using meta-aggregation methods proposed by the Joanna Briggs Institute.ResultsThe synthesized studies were conducted in South Africa, Ghana, Kenya and Botswana. The three overarching themes across these studies were body size and shape ideals, barriers to healthy eating, and barriers to physical activity, with cultural and social factors as cross-cutting influences within the major themes. Culturally, the supposedly ideal African woman was expected to be overweight or obese, and voluptuous, and this was associated with their identity. Although being overweight or obese was not acceptable to adolescent girls, they desired to be voluptuous. Healthy food choices among women and adolescent girls were hampered by several factors including affordability of nutritious foods and peer victimization. Both adult women and adolescent girls experienced ageism as a barrier to physical activity.SignificanceThis is the first qualitative research synthesis to amplify the voices of women and girls in SSA countries highlighting the challenges they face in maintaining a healthy body weight. Sociocultural, institutional and peer-related factors were powerful forces shaping body size preferences, food choices and participation in physical activity. Our study findings provide insights for the design of contextually appropriate obesity prevention interventions and lay the foundation for further research studies.

Experiences of Living With Varicose Veins: A Systematic Review of Qualitative Research

AIM: To identify the symptoms and quality of life impacts that are important from the perspective of patients with varicose veins, and to compare identified themes to items in varicose vein Patient Reported Outcome Measures (PROMs). BACKGROUND: Varicose veins are common worldwide, and are considered a chronic condition with implications for quality of life. Treatment is predominantly conservative, therefore understanding patients' experiences' of living with varicose veins is important to inform the provision of clinical care. PROMs are often used to collect data about patients' quality of life. DESIGN: Thematic synthesis of qualitative research reported according to ENTREQ guidelines. METHODS: Multiple electronic databases, including MEDLINE and CINAHL, were systematically searched to identify qualitative research examining experiences of adults with varicose veins. Thematic synthesis was then conducted on the included studies. RESULTS: Three studies met the inclusion criteria; the quality of the studies was high. The range and intensity of reported symptoms and participant's experiences of living with varicose veins were varied. Five overarching themes were identified; physical, psychological and social impact of varicose veins, adapting to varicose veins and reasons for seeking treatment. The overall key theme to emerge was adaptation, with patients' demonstrating how they adapted to the various impacts. CONCLUSION: This review demonstrates that varicose veins have a wide range of symptoms, and may have a significant impact on quality of life; people made significant adaptations to enable them to live their lives as fully as possible. RELEVANCE TO CLINICAL PRACTICE: Healthcare professionals need to be aware of the range of symptoms, and their impact on quality of life. The use of PROMs to gather information about quality of life and symptoms is well established globally; however, PROMs currently used may not capture the full extent of the impact on patient's quality of life. This article is protected by copyright. All rights reserved.