Systematic Review Of Qualitative Studies Research Articles

The Experience Of Patients with ABI and Their Families During The Hospital Stay: A Systematic Review of Qualitative Literature

ABSTRACTBackground: Patients with acquired brain injury (ABI) and their families have unique experiences and needs during the hospital stay; yet, limited literature exists on this topic. The purpose of this systematic review was to compile and synthesize literature on the experience of patients with ABI and their families during the hospital stay.Methods: A systematic review of qualitative studies was conducted by searching for studies from seven databases. Content analysis was used to analyse and synthesize studies’ findings separately for the patient and family experience.Results: The initial search provided 2871 records. Ultimately, 11 studies relevant to the research question were included in this review. No studies were excluded based on critical quality appraisal. Findings on the patient experience showed patients had negative perceptions of the rehabilitation environment and a perceived need for information. Findings on the family experience included difficulty adjusting after the patient’s injury,...

Understanding factors affecting patient and public engagement and recruitment to digital health interventions: a systematic review of qualitative studies.

BackgroundNumerous types of digital health interventions (DHIs) are available to patients and the public but many factors affect their ability to engage and enrol in them. This systematic review aims to identify and synthesise the qualitative literature on barriers and facilitators to engagement and recruitment to DHIs to inform future implementation efforts.MethodsPubMed, MEDLINE, CINAHL, Embase, Scopus and the ACM Digital Library were searched for English language qualitative studies from 2000 – 2015 that discussed factors affecting engagement and enrolment in a range of DHIs (e.g. ‘telemedicine’, ‘mobile applications’, ‘personal health record’, ‘social networking’). Text mining and additional search strategies were used to identify 1,448 records. Two reviewers independently carried out paper screening, quality assessment, data extraction and analysis. Data was analysed using framework synthesis, informed by Normalization Process Theory, and Burden of Treatment Theory helped conceptualise the interpretation of results.ResultsNineteen publications were included in the review. Four overarching themes that affect patient and public engagement and enrolment in DHIs emerged; 1) personal agency and motivation; 2) personal life and values; 3) the engagement and recruitment approach; and 4) the quality of the DHI. The review also summarises engagement and recruitment strategies used. A preliminary DIgital Health EnGagement MOdel (DIEGO) was developed to highlight the key processes involved. Existing knowledge gaps are identified and a number of recommendations made for future research. Study limitations include English language publications and exclusion of grey literature.ConclusionThis review summarises and highlights the complexity of digital health engagement and recruitment processes and outlines issues that need to be addressed before patients and the public commit to digital health and it can be implemented effectively. More work is needed to create successful engagement strategies and better quality digital solutions that are personalised where possible and to gain clinical accreditation and endorsement when appropriate. More investment is also needed to improve computer literacy and ensure technologies are accessible and affordable for those who wish to sign up to them.Systematic review registrationInternational Prospective Register of Systematic Reviews CRD42015029846Electronic supplementary materialThe online version of this article (doi:10.1186/s12911-016-0359-3) contains supplementary material, which is available to authorized users.

Parental views on otitis media: systematic review of qualitative studies.

This study aims to describe parental experiences and perspectives of caring for a child with otitis media. We conducted a systematic review of qualitative studies on parental perspectives on caring for a child with otitis media. We searched electronic databases to July 2015. Seventeen studies involving 284 participants from six countries were included. We identified seven themes: diminishing competency (guilt over failure to identify symptoms, helpless and despairing, fear of complications, disempowered and dismissed); disrupting life schedules (disturbing sleep, interfering with work, burden on family); social isolation (stigma and judgement, sick consciousness); threatening normal development (delaying growth milestones, impairing interpersonal skills, impeding education); taking ownership (recognising symptoms, diagnostic closure, working the system, protecting against physical trauma, contingency planning); valuing support (needing respite, depending on community, clinician validation); and cherishing health (relief with treatment success, inspiring resilience). The additional medical responsibilities and anxieties of parents caring for a child with otitis media, often discounted by clinicians, can be disempowering and disruptive. Chronicity can raise doubt about treatment efficacy and parental competency, and fears regarding their child's development. Care that fosters parental confidence and addresses their concerns about the child's development may improve treatment outcomes for children with otitis media. • Otitis media is a leading cause of conductive hearing loss in children. • Parental perception of the treatment burden of otitis media can potentially affect their confidence and ability to care for their child. What is New: • We identified five themes to reflect parental perspectives: diminishing competency, disrupting life schedules, social isolation, threatening normal development, taking ownership, valuing support, and cherishing health. • Parents may perceive caring for a child with otitis media as disempowering and disruptive and with reoccurrence doubt treatment efficacy and their parental competency and develop fears regarding their child's development.

Barriers and facilitators to patient and public engagement and recruitment to digital health interventions: protocol of a systematic review of qualitative studies

IntroductionPatients and the public are beginning to use digital health tools to assist in managing chronic illness, support independent living and self-care, and remain connected to health and care providers. However, engaging with and enrolling in digital health interventions, such as telehealth systems, mobile health applications, patient portals and personal health records, in order to use them varies considerably. Many factors affect people's ability to engage with and sign up to digital health platforms.ObjectivesThe primary aim is to identify the barriers and facilitators patients and the public experience to engagement and recruitment to digital health interventions. The secondary aim is to identify engagement and enrolment strategies, leading if possible to a taxonomy of such approaches, and a conceptual framework of digital health engagement and recruitment processes.MethodsA systematic review of qualitative studies will be conducted by searching six databases: MEDLINE, CINAHL, PubMed, EMBASE, Scopus and the ACM Digital Library for papers published between 2000 and 2015. Titles and abstracts along with full-text papers will be screened by two independent reviewers against predetermined inclusion and exclusion criteria. A data extraction form will be used to provide details of the included studies. Quality assessment will be conducted using the Consolidated Criteria for Reporting Qualitative Research checklist. Any disagreements will be resolved through discussion with an independent third reviewer. Analysis will be guided by framework synthesis and informed by normalization process theory and burden of treatment theory, to aid conceptualisation of digital health engagement and recruitment processes.DiscussionThis systematic review of qualitative studies will explore factors affecting engagement and enrolment in digital health interventions. It will advance our understanding of readiness for digital health by examining the complex factors that affect patients’ and the public's ability to take part.Trial registration numberCRD42015029846.

Children's Experiences of Epilepsy: A Systematic Review of Qualitative Studies.

Epilepsy is a common and severe neurologic disease associated with increased mortality, seizure-related injury, and adverse psychological and quality-of-life outcomes. To describe the perspectives of children and adolescents with epilepsy. Medline, Embase, PsycINFO, and CINAHL from inception to August 2015. Qualitative studies on children's experiences of epilepsy. Results from primary studies. We used thematic synthesis to analyze the findings. Forty-three articles involving 951 participants aged 3 to 21 years across 21 countries were included. We identified 6 themes: loss of bodily control (being overtaken, susceptibility to physical harm, fragility of the brain, alertness to mortality, incapacitating fatigue), loss of privacy (declarative disease, humiliating involuntary function, unwanted special attention, social embarrassment of medicine-taking), inescapable inferiority and discrimination (vulnerability to prejudice, inability to achieve academically, consciousness of abnormality, parental shame, limiting social freedom), therapeutic burden and futility (unattainable closure, financial burden, overwhelming life disruption, exhaustion from trialing therapies, insurmountable side effects, awaiting a fabled remission), navigating health care (empowerment through information, valuing empathetic and responsive care, unexpected necessity of transition, fragmented and inconsistent care), and recontextualizing to regain normality (distinguishing disease from identity, taking ownership, gaining perspective and maturity, social and spiritual connectedness). Non-English articles were excluded. Children with epilepsy experience vulnerability, disempowerment, and discrimination. Repeated treatment failure can raise doubt about the attainment of remission. Addressing stigma, future independence, and fear of death may improve the overall well-being of children with epilepsy.

Parent and caregiver perspectives on home-based newborn care in low-income settings: protocol for a systematic review of qualitative studies

IntroductionNewborn health and survival are closely linked to essential newborn care provided within the first days and weeks of an infant's life by parents and caregivers at home and within...

Patient-centeredness in physiotherapy: What does it entail? A systematic review of qualitative studies

Patient-centeredness in physiotherapy: What does it entail? A systematic review of qualitative studies

Family experiences of infant and young child feeding in lower-income countries: protocol for a systematic review of qualitative studies.

BackgroundInfant and young child feeding practices, including breastfeeding and complementary feeding of children under 2 years old, are crucially influenced by parent and family perceptions and experiences. Given the urgent need to improve nutrition of young children in low- and low-middle-income countries, both for reduction of morbidity and mortality in childhood and for future health outcomes, we propose to systematically review and synthesize available qualitative data specifically related to infant and young child feeding practices of parents and families in these settings, which may provide greater insights into barriers and facilitators to recommended feeding practices.Methods/designThe proposed study will systematically review existing qualitative research reporting infant and young child feeding practices from low- and low-middle-income settings. The Enhancing Transparency in Reporting the Synthesis of Qualitative Research (ENTREQ) statement will be used for reporting the stages of the review and dissemination. The search period will include all studies published from 2006 to 2016. The study selection process will follow established and recommended guidelines for reviews, and quality assessment will be conducted in two phases using critical appraisal and subsequently a confidence in findings approach derived from Grading of Recommendations, Assessment, Development and Evaluation-Confidence in the Evidence from Reviews of Qualitative (GRADE-CERQual). A full synthesis of the studies identified by the review will begin with thematic analysis and be followed by an interpretive approach to provide actionable information on the topic.DiscussionThe findings will provide insight into the barriers and facilitators related to behavior that may hinder or enable implementation of interventions aimed at improving infant and young child feeding practices in lower-income settings.Systematic review registrationPROSPERO CRD42016035677Electronic supplementary materialThe online version of this article (doi:10.1186/s13643-016-0292-7) contains supplementary material, which is available to authorized users.

Perceptions and experiences of the implementation, management, use and optimisation of electronic prescribing systems in hospital settings: protocol for a systematic review of qualitative studies

IntroductionThere is increasing evidence that electronic prescribing (ePrescribing) or computerised provider/physician order entry (CPOE) systems can improve the quality and safety of healthcare services. However, it has also become clear...

Systematic review of qualitative studies exploring parental experiences in the Neonatal Intensive Care Unit.

To determine the feasibility and utility of a thematic analysis approach to synthesising qualitative evidence about parental experiences in the neonatal intensive care unit. Admission of infants to the neonatal intensive care unit is usually an unexpected event for parents who can cause them to experience psychosocial difficulties. A qualitative systematic review is the best method for exploring these parents' experiences regarding this type of admission. Systematic review. Qualitative studies in peer-reviewed journals aimed at understanding parental experiences regarding infant neonatal intensive care unit admission were identified in six electronic databases. Three reviewers selected relevant articles and assessed the quality of the methodological studies using the Critical Appraisal Skills Programme. Athematic analysis approach was used to identify the most common themes in thestudies describing parental experiences in the neonatal intensive care unit. A total of eighty articles were identified; nine studies were included in this review. Four studies used semistructured interviews, three used interviews, one used self-reporting and one used both focus group and interview methodologies. Common themes across parents' experiences were the stress of hospitalisation, alteration in parenting roles and the impact of infant hospitalisation on psychological health. Having an infant hospitalised in the neonatal intensive care unit is a stressful experience for parents. This experience is the result of exposure to different stressors related to the infant's condition, an alteration in parenting roles or the neonatal intensive care unit environment and staffing. These parents suffered negative psychological effects, experienced an interrupted development of a healthy parent-infant attachment and/or felt parental role alteration. The study's findings are crucial for neonatal intensive care unit nurses to develop intervention strategies and programmes that help parents to decrease the stress of their experience and to support them in facing this stressful situation.

Lone parents, health, wellbeing and welfare to work: a systematic review of qualitative studies.

BackgroundLone parents and their children experience higher than average levels of adverse health and social outcomes, much of which are explained by high rates of poverty. Many high income countries have attempted to address high poverty rates by introducing employment requirements for lone parents in receipt of welfare benefits. However, there is evidence that employment may not reduce poverty or improve the health of lone parents and their children.MethodsWe conducted a systematic review of qualitative studies reporting lone parents’ accounts of participation in welfare to work (WtW), to identify explanations and possible mechanisms for the impacts of WtW on health and wellbeing. Twenty one bibliographic databases were searched. Two reviewers independently screened references and assessed study quality. Studies from any high income country that met the criteria of focussing on lone parents, mandatory WtW interventions, and health or wellbeing were included. Thematic synthesis was used to investigate analytic themes between studies.ResultsScreening of the 4703 identified papers and quality assessment resulted in the inclusion of 16 qualitative studies of WtW in five high income countries, USA, Canada, UK, Australia, and New Zealand, covering a variety of welfare regimes. Our synthesis found that WtW requirements often conflicted with child care responsibilities. Available employment was often poorly paid and precarious. Adverse health impacts, such as increased stress, fatigue, and depression were commonly reported, though employment and appropriate training was linked to increased self-worth for some. WtW appeared to influence health through the pathways of conflict and control, analytical themes which emerged during synthesis. WtW reduced control over the nature of employment and care of children. Access to social support allowed some lone parents to manage the conflict associated with employment, and to increase control over their circumstances, with potentially beneficial health impacts.ConclusionWtW can result in increased conflict and reduced control, which may lead to negative impacts on mental health. Availability of social support may mediate the negative health impacts of WtW.Electronic supplementary materialThe online version of this article (doi:10.1186/s12889-016-2880-9) contains supplementary material, which is available to authorized users.

Barriers to effective management of type 2 diabetes in primary care: qualitative systematic review.

Despite the availability of evidence-based guidance, many patients with type 2 diabetes do not achieve treatment goals. To guide quality improvement strategies for type 2 diabetes by synthesising qualitative evidence on primary care physicians' and nurses' perceived influences on care. Systematic review of qualitative studies with findings organised using the Theoretical Domains Framework. Databases searched were MEDLINE, Embase, CINAHL, PsycInfo, and ASSIA from 1980 until March 2014. Studies included were English-language qualitative studies in primary care of physicians' or nurses' perceived influences on treatment goals for type 2 diabetes. A total of 32 studies were included: 17 address general diabetes care, 11 glycaemic control, three blood pressure, and one cholesterol control. Clinicians struggle to meet evolving treatment targets within limited time and resources, and are frustrated with resulting compromises. They lack confidence in knowledge of guidelines and skills, notably initiating insulin and facilitating patient behaviour change. Changing professional boundaries have resulted in uncertainty about where clinical responsibility resides. Accounts are often couched in emotional terms, especially frustrations over patient compliance and anxieties about treatment intensification. Although resources are important, many barriers to improving care are amenable to behaviour change strategies. Improvement strategies need to account for differences between clinical targets and consider tailored rather than 'one size fits all' approaches. Training targeting knowledge is necessary but insufficient to bring about major change; approaches to improve diabetes care need to delineate roles and responsibilities, and address clinicians' skills and emotions around treatment intensification and facilitation of patient behaviour change.

Experiences of Self-Management Support Following a Stroke: A Meta-Review of Qualitative Systematic Reviews.

BackgroundSupporting self-management in stroke patients improves psychological and functional outcomes but evidence on how to achieve this is sparse. We aimed to synthesise evidence from systematic reviews of qualitative studies in an overarching meta-review to inform the delivery and development of self-management support interventions.MethodsWe systematically searched eight electronic databases including MEDLINE, EMBASE and CINAHL for qualitative systematic reviews (published January 1993 to June 2012). We included studies exploring patients’, carers’ or health care professionals’ experiences relevant to self-management support following a stroke, including studies describing the lived experience of surviving a stroke. We meta-synthesised the included review findings using a meta-ethnographic framework.ResultsSeven reviews, reporting 130 unique studies, were included. Themes emerging from the reviews were pertinent, consistent and showed data saturation; though explicit mention of self-management support was rare. Our meta-review highlighted the devastating impact of stroke on patients’ self-image; the varying needs for self-management support across the trajectory of recovery; the need for psychological and emotional support throughout recovery particularly when physical recovery plateaus; the considerable information needs of patients and carers which also vary across the trajectory of recovery; the importance of good patient-professional communication; the potential benefits of goal-setting and action-planning; and the need for social support which might be met by groups for stroke survivors.ConclusionsThe observed data saturation suggests that, currently, no further qualitative research simply describing the lived experience of stroke is needed; we propose that it would be more useful to focus on qualitative research informing self-management support interventions and their implementation. Our findings demonstrate both the on-going importance of self-management support and the evolving priorities throughout the stages of recovery following a stroke. The challenge now is to ensure these findings inform routine practice and the development of interventions to support self-management amongst stroke survivors.

Health and wellbeing of lone parents in welfare to work: a systematic review of qualitative studies

BackgroundLone parents have worse health than couple parents, which is largely explained by higher levels of poverty. Many high income countries have attempted to address poverty by introducing mandatory requirements to actively seek employment or participate in training for welfare recipients, including lone parents. However, employment might not reduce poverty or improve the health of lone parents. To assess experiences of welfare to work and gain insight into possible mechanisms linking interventions with health and wellbeing, this study systematically reviewed qualitative data from studies of lone parents’ experiences of mandatory welfare to work. Methods21 bibliographic databases were searched (appendix) for articles published between July 16, 2009, and July 6, 2013, with no language restrictions; search-term sets were used for the topics, lone parent and welfare to work. Studies that met the criteria of focusing on lone parents, mandatory welfare to work interventions, and health or wellbeing were imported into NVivo (version 10) for coding. Two reviewers independently screened references, assessed study quality for clarity and appropriateness of methods, and developed the coding framework. Thematic synthesis, a method to facilitate transparency when identifying analytical themes between studies, was used to guide line-by-line coding of the data. FindingsFrom 4703 papers identified, 16 studies (724 participants) from five high income countries were included. Although the balance of evidence was on negative findings—ie, linking welfare to work to negative health effects, such as stress, fatigue, and depression—there were some positive reports of improved self-worth. Available employment was often precarious and poorly paid. The demands of parenting were frequently in direct conflict with employment and welfare to work obligations, and affected parents’ control over major life decisions and everyday routines. Therefore, the concepts of conflict and control seemed to encapsulate how welfare to work affected health. Social support allowed some parents to manage these conflicts, allowing greater control over their circumstances, and for some mediating the adverse health effects of welfare to work. InterpretationParticipation in mandatory welfare to work can result in increased conflict and reduced control for lone parents, leading to negative effects on mental health. The potential benefits of welfare to work are dependent on access to adequate social support and suitable employment opportunities; however these are often unavailable to lone parents in welfare to work. FundingUK Medical Research Council and Scottish Government Chief Scientist Office Informing Healthy Public Policy programme (MC_UU_12017/4).

Men’s self-reported coping strategies for depression: A systematic review of qualitative studies.

Key focal points of existing research on men’s depression have included the role of masculinity and the nature of gender-specific coping styles. Existing quantitative studies may be limited in their ability to detect the full range of coping strategies deployed by men in response to this problem. The analysis of findings from qualitative studies may represent a useful way in which to obtain a more comprehensive representation of men’s responses. To address this, a systematic review of qualitative studies examining the nature of men’s coping and depression was undertaken. Electronic database and hand searching for published studies between 2000 and 2014 produced a total of 14 studies for synthesis from an initial pool of 1,446. A total of 323 participants with an age range of 19–75 years comprised the final sample, with studies taken from Canada, the US, U.K., Sweden and Finland. Reported coping strategies were grouped under 5 metathematic categories with “promote traditional masculinity,” “promote flexible masculinity,” and “social concealment and minimization” representing the most substantive coping domains. Findings suggest that an expanded view of men’s coping strategies is appropriate within the context of depression. Review limitations, implications, and future research are discussed.

Motivations, Challenges, and Attitudes to Self-management in Kidney Transplant Recipients: A Systematic Review of Qualitative Studies

Kidney transplantation offers better outcomes compared to dialysis, but requires patients to adhere to an ongoing and complex self-management regimen. Medication nonadherence remains a leading cause of transplant loss, and inadequate self-management undermines transplantation and other health outcomes. We aimed to describe kidney transplant recipients' motivations, challenges, and attitudes toward self-management. Systematic review and thematic synthesis of qualitative studies. Kidney transplant recipients. MEDLINE, EMBASE, PsycINFO, and CINAHL were searched to October 2014. Thematic synthesis. 50 studies involving 1,238 recipients aged 18 to 82 years across 19 countries were included. We identified 5 themes: empowerment through autonomy (achieving mastery, tracking against tangible targets, developing bodily intuition, routinizing and problem solving, and adaptive coping), prevailing fear of consequences (inescapable rejection anxiety, aversion to dialysis, minimizing future morbidity, trivialization and denial, and defining acceptable risks), burdensome treatment and responsibilities (frustrating ambiguities, inadvertent forgetfulness, intrusive side effects, reversing ingrained behaviors, and financial hardship), overmedicalizing life (dominating focus, evading patienthood, and succumbing to burnout), and social accountability and motivation (demonstrating gratitude toward medical team, indebtedness to donor, and peer learning). Non-English articles were excluded. Self-efficacy and social accountability are motivators for self-management, although adherence can be mentally and physically taxing. Multicomponent interventions incorporating personalized care planning, education, psychosocial support, decision aids, and self-monitoring tools may foster self-management capacity and improve transplantation outcomes.

Postpartum smoking relapse—a thematic synthesis of qualitative studies

Many women quit smoking during pregnancy, but relapse after the baby is born. To understand why and identify ways of preventing this, this study reviewed the qualitative literature on women's experience of postpartum smoking relapse. A systematic review of qualitative studies and process evaluations of trials. We undertook a thematic synthesis of published qualitative data. We screened 1336 papers. Twenty-two papers reporting on 16 studies were included, reporting on the views of 1031 postpartum women. Factors affecting relapse and barriers and facilitators to relapse prevention were identified around the key themes of beliefs, social influences, motivation, physiological factors and identity. Women's beliefs about smoking as a means of coping with stress and the need for social support, especially from a partner, emerged as important. Extrinsic motivation to quit during the pregnancy (for the health of the fetus) appeared to be a factor in prompting relapse after the baby was born. During the immediate postpartum period women believed that physiological changes influence cigarette cravings. The stress of caring for a newborn, sleeplessness and adjusting to a new mothering identity were also reported to be important. Among women who quit smoking during pregnancy, those who relapse postpartum talk commonly about no longer needing to protect the baby and the effects of stress. Partner support and a sense of changed identity are cited as factors preventing relapse.

Adolescents' perspectives on the barriers and facilitators of physical activity: a systematic review of qualitative studies.

This article examined qualitative studies of adolescents' perspectives about the facilitators and barriers of physical activity, published from 2007 to 2014. A systematic review of 'Web of Science', 'EBSCO', 'Psychinfo' and 'ERIC' databases was performed according to Preferred Reporting Items for Systematic reviews and Meta-analyses guidelines. The following keywords were used: 'physical activity' and 'physical education', each one individually associated with 'correlate', 'determinant', 'facilitator', 'barrier', 'factor influen*', and with 'qualitative', 'focus group', 'interview', "narrative'. Out of 3815 studies initially identified, due to inclusion and quality criteria, only 12 were fully reviewed. Studies' outcomes were analyzed through thematic analysis. The majority of these reported research with young adolescent girls. Few studies have considered the socioeconomic status influence. According to young people's perspectives, the main facilitators and hampering factors to their participation in physical activity were the following: attitude toward physical activity; motivation; perceptions of competence and body image; fun; influence of friends, family and physical education teachers and environmental physical activity opportunities. Specific life transition periods were referred only as a barrier to physical activity. Strategies of pedagogical actions and for developing physical activity intervention programs were discussed, in order to effectively promote the adoption of active lifestyles among youth.

Carers' experiences, needs and preferences during inpatient stroke rehabilitation: a protocol for a systematic review of qualitative studies.

BackgroundLarge numbers of people provide carer roles for survivors of stroke. Person-centred stroke rehabilitation must consider the perspectives of carers, as stroke affects not only the stroke survivor but also the quality of life and health of the carers. There is little collective knowledge about stroke carers’ experiences, needs and preferences during the inpatient stroke rehabilitation process to then inform person-centred service improvements.Our objective is to report and synthesise experiences, needs and preferences of the carers of stroke survivors undergoing rehabilitation in inpatient settings.Methods/designWe will conduct a systematic review of qualitative studies using a thematic synthesis methodology.We will follow the Enhancing Transparency in Reporting the Synthesis of Qualitative Research Guidelines (ENTREQ) and search the following databases for relevant articles: MEDLINE, Cumulative Index to Nursing and Allied Health Literature (CINAHL), PsycINFO, Embase, and Web of Science. No language or publication date constraints will be applied. Eligible studies will have to use qualitative methods of data collection and analysis and reported data from the carers of stroke survivors who underwent inpatient stroke rehabilitation. Studies will be eligible for inclusion if they report the experiences, needs and preferences of carers regarding inpatient rehabilitation environments, organisation, care systems, therapeutic interventions, information exchange, carer training, discharge and community service planning and other issues of relevance to their roles as carers. Study selection and assessment of quality will be performed independently by two reviewers. Any disagreement will be resolved by a third reviewer. Data will be extracted by one reviewer, tabled, and checked for accuracy by another reviewer. All text reported in studies’ results, discussion and conclusion sections will be entered into the NVivo software for analysis. Extracted texts will be inductively coded independently by two reviewers and analysed in three phases using thematic synthesis. Descriptive and analytical themes will be developed.DiscussionThis study is expected to provide new insights into the perspectives of stroke survivors’ carers. Increased knowledge about carer perspectives and preferences will inform person-centred improvements in stroke rehabilitation.Study registrationPROSPERO registration number: CRD42015017315.Electronic supplementary materialThe online version of this article (doi:10.1186/s13643-015-0097-0) contains supplementary material, which is available to authorized users.

Contributions of Qualitative Research in Informing HIV/AIDS Interventions Targeting Black MSM in the United States

This article presents a systematic review of qualitative studies focusing on human immunodeficiency virus (HIV) and acquired immune deficiency syndrome (AIDS) among Black men who have sex with men (BMSM) in the United States. We reviewed studies that were published between 1980 and 2014. Qualitative methods employed in the studies reviewed include in-depth interviews, focus groups, participant observation, and ethnography. We searched several databases (PubMed, PsychINFO, JSTOR, ERIC, Sociological s, and Google Scholar) for relevant articles using the following broad terms: “Black men” “Black gay/bisexual” or “Black men who have sex with men,” and “qualitative” and/or “ethnography.” We include 70 studies in this review. The key themes observed across studies were (1) heterogeneity, (2) layered stigma and intersectionality, (3) risk behaviors, (4) mental health, (5) resilience, and (6) community engagement. The review suggests that sexual behavior and HIV-status disclosure, sexual risk taking, substance use, and psychological well-being were contextually situated. Interventions occurring at multiple levels and within multiple contexts are needed to reduce stigma within the Black community. Similarly, structural interventions targeting religious groups, schools, and health care systems are needed to improve the health outcomes among BMSM. Community engagement and using community-based participatory research methods may facilitate the development and implementation of culturally appropriate HIV/AIDS interventions targeting BMSM.