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ABSTRACT Objective Methods Results Conclusions This review aimed to consolidate existing knowledge on this phenomenon by incorporating direct testimonies from individuals who have experienced breast cancer.A thorough metasynthesis of qualitative studies was conducted. English articles published prior to September 18 2023 were searched from eight databases, including PubMed, Cochrane Library, Web of Science, Embase, the Chinese biomedical literature service system, the China National Knowledge Infrastructure, the Wanfang Database, and the Wipu Database. After screening the titles, abstracts, and full texts, six articles were finally included in the quality appraisal and metaaggregation.A total of 30 research findings were distilled and integrated into three themes: causes of fear of cancer recurrence (FCR); feelings of FCR; coping with FCR; and six subthemes: disease treatment factors; psychological factors; FCR is worry and fear; overcoming; negative response; positive response.FCR is a subjective feeling; it is influenced by the interplay between the external environment (adjuvant therapy) and internal environment (psychological factors). Therefore, future care measures should be designed comprehensively, considering the individual characteristics of breast cancer survivors and the external environment. This could be the primary focus for addressing FCR in cancer patients in the future. [ABSTRACT FROM AUTHOR]

Purpose: To describe which needs and difficulties are experienced by stroke patients and caregivers regarding their return to work and to synthesise the lived experiences of stroke patients and caregivers. Materials and methods: A systematic review and metasynthesis was conducted on PubMed, CINAHL, Scopus, Web of Sciences and PsycInfo, in according to the Enhancing Transparency in Reporting the Synthesis of Qualitative Research. Studies eligible for the review had to fulfil the following inclusion criteria: qualitative studies, stroke patients and their caregivers in a working age (approximately from 18 to 65 years old), discharged from the hospital. Results: Thirty-eight studies involving stroke patients and caregivers were included in this review. For the stroke patients' group, three main themes were identified: (a) Towards the future; (b) Professional support in return to work; and (c) return to work and employment perspective, while for caregivers two main themes were: (a) daily life challenges and role overload; and (b) employment challenges. Conclusions: Integrating public employment, social and health services, support for job placement, return to work, and social participation of stroke patients should be more supported in individual rehabilitation programs to help stroke survivors and caregivers in their return-to-work process. IMPLICATIONS FOR REHABILITATION: A program for returning to work after stroke should be developed as part of neurorehabilitation. Stroke survivors and caregivers need psychological and social support during rehabilitation. Integrating public employment, social and health services, support for job placement, return to work, and social participation would help stroke survivors and caregivers in the return-to-work process. [ABSTRACT FROM AUTHOR]

Background: Although numbers of youth with disabilities (YWD) are increasing, this population continues to be poorly represented in psychological and developmental research. There is a demonstrated need to better understand identity development in YWD. Objective: The purpose of this review was to determine the applicability of a contemporary developmental model, positive youth development (PYD), for YWD. PYD describes six "Cs" that contribute to thriving in youth: competence, confidence, connection, character, caring/compassion, and contribution. We explored which "Cs" contribute to identity development in YWD, what appears to be unique, and how PYD could be adapted to better include this population. Method: Through a qualitative metasynthesis, we explored how PYD emerged across the qualitative literature from psychology and related fields for YWD. We coded 18 qualitative articles according to the original definitions of the "Cs" of PYD and tracked emerging constructs across included studies. Results: Findings reveal evidence for four out of six of the original "Cs" in YWD. Two emerging "Cs," coping and constraints, may be unique to this population. Conclusions: PYD may be applicable for YWD, but an expanded version may be more relevant to this group. The addition of newly defined "Cs" could contribute to a better understanding of positive development in YWD and other marginalized populations. Impact and Implications: This study evaluates existing literature on identity in youth with disabilities in a new way by evaluating an existing framework for development in youth, positive youth development (PYD), applied to a new population. Results suggest that in order for PYD to be relevant to "all youth," adaptation is needed based on identified emerging constructs, "Coping" and "Constraints," which may be unique to youth with disabilities (YWD). Modifying PYD to be more inclusive of YWD could have wide-reaching impacts on the fields of education, healthcare, youth programming, rehabilitation psychology, and psychology as a whole. Findings point to areas for clinical intervention, including assisting YWD in developing more adaptive coping skills and strategies for self- and group-advocacy. [ABSTRACT FROM AUTHOR]

Restorative justice (RJ) has been applied to intimate partner violence (IPV) cases, but some question whether RJ is appropriate for IPV. This review is the first to focus on qualitative research on how RJ is interpreted and used in IPV cases in the United States. Six articles met the inclusion criteria. Findings indicated that RJ is used with the criminal legal system (CLS), initiated by the victim, and is not community-oriented. Concerns for victims being harmed or retraumatized were not supported in RJ processes happening in relation to the CLS, with some providers highlighting the importance of facilitation training and techniques. Additional research is needed to explore RJ processes and their relationship to the CLS for IPV. [ABSTRACT FROM AUTHOR]

This review explored how currently and/or formerly suicidal men perceived masculinities to contribute to, and/or protect against, their suicidal thoughts and/or behaviors and help-seeking. Nine databases were searched using predefined search terms (e.g., masculin*, man, men, boy, suicid*, qualitative), supplemented by searches of key journals, reference and citation lists, and Google Scholar. Twenty-five English-language articles containing qualitative data were obtained. Studies were conducted in Australia, Bangladesh, Canada, Ghana, Ireland, Norway, Pakistan, South Africa, and the United Kingdom. The articles were appraised for quality and thematically synthesized, resulting in three themes. The findings suggest multifaceted roles of masculinities in influencing suicidal ideation, intent, attempts, and help-seeking. Men linked failure to attain socially powerful positions of provision and status to experiencing suicidal thoughts and behaviors. Viewing suicide as courageous and decisive, thus adhering to masculine expectations, appeared contributory to suicidal behaviors. Men described potential protective factors against suicidal behaviors, including perceived masculine expectations to protect and provide for their families, a view of suicide as cowardly and therefore un-masculine, and drawing upon "positive" masculine norms to facilitate help-seeking for suicidal ideation and distress. There was, however, substantial evidence of men describing not seeking help for suicidal ideation and distress due to adhering to "traditional" masculine norms. Clinical implications and future research directions for incorporating masculinities into male suicide prevention theory and practice are discussed, emphasizing the importance of further research into the experiences of higher risk groups of men and of men with diverse and intersecting identities. Public Significance Statement: This review of 25 studies found that men who have experienced suicidal ideation, intent, plans, and/or attempts perceived masculinities to have both potentially detrimental and protective influences upon suicidal ideation, intent, behaviors, and help-seeking. The findings illuminate novel and less-explored aspects of masculinities in potentially influencing suicidal experiences and behaviors, suggest how masculinities might intersect with prominent theories of suicide, and provide directions for clinical practice and research. Limited within the current data and important for future research are detailed explorations of the experiences of men holding diverse identity characteristics, including men from unrepresented global regions and groups of men known to be at higher risk of suicide. [ABSTRACT FROM AUTHOR]

Purpose: To synthesise qualitative research on individuals diagnosed with (or reportedly showing traits of) borderline pattern personality disorder who underwent dialectical behaviour therapy, aiming to comprehend their perceptions of change processes and the therapy's effects. Method: A comprehensive literature search was conducted across multiple online databases and grey literature sources. Papers were quality appraised using an adapted version of the Critical Appraisal Skills Programme tool. A metaethnographic approach was employed during the synthesis. Results: Eleven studies met criteria for inclusion in the review. The main themes identified through the synthesis process were the impact of DBT, the supportive structure and the 1:1 therapy component. Conclusions: The synthesis uncovered the importance of various processes within DBT that patients perceived as active ingredients for their change. Many of these processes aligned with proposed theoretical processes of change and quantitative research on DBT's effectiveness. [ABSTRACT FROM AUTHOR]

Psychosocial well-being is key to living well after stroke, but often significantly affected by stroke. Existing understandings consider well-being comes from positive mood, social relationships, self-identity and engagement in meaningful activities. However, these understandings are socioculturally located and not necessarily universally applicable. This qualitative metasynthesis examined how people experience well-being after a stroke in Aotearoa New Zealand. This metasynthesis was underpinned by He Awa Whiria (Braided Rivers), a model which prompts researchers to uniquely engage with Māori and non-Māori knowledges. A systematic search identified 18 articles exploring experiences of people with stroke in Aotearoa. Articles were analysed using reflexive thematic analysis. We constructed three themes which reflect experiences of well-being: connection within a constellation of relationships, being grounded in one's enduring and evolving identities, and being at-home in the present whilst (re)visioning the future. Well-being is multi-faceted. In Aotearoa, it is inherently collective while also deeply personal. Well-being is collectively achieved through connections with self, others, community and culture, and embedded within personal and collective temporal worlds. These rich understandings of well-being can open up different considerations of how well-being is supported by and within stroke services. Psychosocial well-being is critical for people living with stroke. Well-being should be a priority in rehabilitation, however people with stroke indicate they do no consistently receive psychosocial support. It is clear that well-being has strong cultural elements, and understanding what supports well-being in individuals, whānau (those within wider networks who the person with stroke considers important), and wider cultural groups is important. Supporting whānau is crucial as whānau are core to well-being both during and beyond rehabilitation, and their own well-being is impacted by stroke. [ABSTRACT FROM AUTHOR]

Objective In the context of today's intensely competitive environments, the ability of organizations to meet and exceed the expectations of their key stakeholders has become increasingly crucial for their survival, as well as for boosting their overall competitiveness and productivity. This dynamic forms the crux of a significant issue in the realm of effective interaction between organizations and their external environment, widely recognized as "corporate social responsibility" (CSR). The critical importance of CSR in the competitive landscape of today's markets has led to a proliferation of scholarly studies from varied perspectives, each with distinct objectives. In pursuit of gaining a deeper and more comprehensive understanding of the CSR practices adopted by organizations, this research has undertaken a detailed review and classification of the strategies that banks have implemented in alignment with their responsibilities towards external stakeholders. Methods This study is conducted as qualitative applied research employing a meta-synthesis approach. The data sources for this investigation included a curated selection of articles from international scientific databases, carefully chosen based on stringent criteria designed specifically for the meta-synthesis process. Results The practices that banks have adopted in accordance with their corporate social responsibility towards their external stakeholders can be systematically categorized into five principal groups: actions related to society, the environment, customers, competitors, and suppliers. Delving deeper, societal-related actions are subdivided into six classifications: economic, social, legal, artistic-cultural, educational, and sanitary-health initiatives. Environmental CSR actions by banks are grouped into four distinct categories: resource and energy consumption management, environmental protection efforts, environmental development initiatives, and practices related to green banking. The classifications of actions related to customers are delineated based on the nature of customer interactions, the quality of customer service provided, the intrinsic qualities of the products, and the delivery methods of these products. Additionally, the expectations of stakeholders compel banks not only to act ethically towards their suppliers and competitors but also to avoid any unethical practices. Although the actions taken in this regard are less numerous than those aimed at other stakeholders, their importance in the CSR strategies of banks cannot be underestimated. Conclusion The diligent efforts of banks to align with the expectations of their stakeholders establish them as socially accountable entities, which significantly enhances their sustainability and continuous productivity within competitive markets. The distinctive nature of the research methodology, incorporating both qualitative approaches and meta-synthesis strategies, enabled the researchers to tackle this issue from a holistic perspective. Consequently, the practices of corporate social responsibility in the banking sector with regard to external stakeholders were exhaustively identified and systematically classified. These comprehensive findings provide a valuable and effective framework for banks and other akin organizations to develop and refine their corporate social responsibility programs concerning external stakeholders. [ABSTRACT FROM AUTHOR]

Existing literature documents the importance and difficulty of serving families under a family-centered approach in Early Intervention/Early Childhood Special Education (EI/ECSE). However, less is known about the collective systematic experiences of those families. Through a qualitative metasynthesis of 15 empirical studies, we unveiled how EI/ECSE systems reproduced and/or reduced inequitable practices and that the promise of a family-centered approach is not experienced by all families and children. At a macro-level, a series of structural (e.g., racism, ableism) and social (e.g., access to various capital) factors shaped access to and the quality of services. At a micro-level, a series of facilitators (e.g., parents as experts) and barriers (e.g., disrespectful interactions) shaped everyday access to services and opportunities for meaningful collaboration between parents and service providers. Current gaps in the literature, implications for policy and practice, and recommendations for future research are addressed. [ABSTRACT FROM AUTHOR]

Purpose: Human movement is essential for health and well-being. Understanding human movement is pivotal in physiotherapy, but also an important element of physiotherapy education. This review identified, critically appraised, and synthesized the available evidence on learning and teaching human movement in physiotherapy as perceived by students, therapists, and instructors. Methods: The databases MEDLINE, CINAHL, ERIC, PsycINFO, MEDIC and FINNA, were searched. The search was conducted in March/April 2020 and updated in March 2022. The systematic review followed the JBI methodology for systematic reviews of qualitative evidence and was conducted in accordance with an a priori protocol. Results: The overall quality of the 17 included studies was scored low on ConQual but dependability and credibility were rated as moderate. Four synthesized findings aggregated from 17 categories and 147 findings described the perceived significance of 1) being present in movement, 2) movement quality, 3) movement transfer, and 4) contextual factors for the learning or teaching of human movement in physiotherapy. Conclusion: The synthesized findings indicate that the perceived significance of contextual factors, movement quality and transfer, and being present in movement should be considered in all learning and teaching of movement in physiotherapy. However, the evidence of the review findings was evaluated as low-level, which should be considered when applying these results to physiotherapy education or practice. [ABSTRACT FROM AUTHOR]

Dietitians are included in eating disorder (ED) treatment teams for their expertise in nutrition. However, little is known about an individual's experience of dietetic intervention as part of their ED treatment and what they value as part of dietetic care. Therefore, the aim of this review was to synthesise the available qualitative literature to understand the role and value of a dietitian in ED treatment from the perspective of individuals with lived experience. Six databases and Google Scholar were searched and a thematic synthesis and meta-synthesis of fifteen studies were conducted. Four themes were constructed from the data: (1) "guidance and structure"—Provision of nutrition knowledge and skills; (2) "having all my bases covered"—Dietitians as part of a multidisciplinary team; (3) Challenges in nutritional treatment; and (4) "it was my treatment and my recovery"—Person-centred dietetic treatment. Across all identified themes was the cross-cutting theme of a shared treatment journey between the dietitian and the individual receiving treatment. These findings support dietitians having a role that is not limited only to the provision of nutrition treatment in ED care and illustrates the importance of dietitians engaging with clients by centring on the individual's needs and preferences. Further understanding helpful dietetic treatment components and identifying gaps in training is needed to develop these broader roles for dietetic care. [ABSTRACT FROM AUTHOR]

Background: Studies have established the central role of the family in the recognition, treatment, and recovery of anorexia nervosa. The objective of this study was to review, synthesize, and critically appraise the literature on parents' views on the treatment and recovery process of anorexia nervosa in their adolescent child. Method: A systematic search of Medline, PsychINFO, CINHAL, EMBASE, Cochrane library, and SSCI was conducted for qualitative studies published regarding parents' views about the treatment of anorexia nervosa. The quality of articles was assessed using the critical appraisal skills program (CASP) and findings were analysed using thematic synthesis. Results: A total of 25 studies from nine countries reporting the views of 357 parents met the inclusion criteria. Four major themes were developed from the analysis: understanding the child and the disease, experience of services and treatment modalities, the role of professionals, and the experience of recovery. Conclusion: Parents report struggles with delays in finding help, judgmental attitudes of professionals, and uncertainty about the future. Recognition of the challenges faced by parents and families empowers clinicians to build stronger therapeutic relationships essential for long-term recovery from anorexia nervosa. Plain English Summary: Interventions for adolescents with anorexia nervosa often focus on families. Although prior systematic reviews have incorporated adolescents' perspectives on their treatment for anorexia nervosa, none have previously reviewed parents' perspectives on their adolescents' treatment. We conducted a systematic review and metasynthesis of qualitative data capturing parents' perspectives of anorexia nervosa treatment in adolescents. Four themes emerged from the analysis: understanding the child and the disease, experience of services and treatment modalities, the role of professionals, and the experience of recovery. Parents report struggles with delays in finding help, judgmental attitudes of professionals, and uncertainty about the future. Recognition of the challenges faced by parents and families empowers clinicians to build stronger therapeutic relationships essential for long-term recovery from anorexia nervosa. [ABSTRACT FROM AUTHOR]

Background: Several educational activities in nursing schools worldwide have been implemented to promote transcultural nursing and cultural competence. Despite the diversity of their experiences and outcomes, the available evidence has not been systematically reviewed and reinterpreted. This study aimed to review and reinterpret all rigorous qualitative evidence available, providing an opportunity to understand how students learn transcultural nursing and assisting faculties, researchers, managers, and practitioners in designing new interventions to improve transcultural training. Methods: A meta-synthesis was conducted to review and integrate qualitative studies of these phenomena. English, Spanish and Portuguese articles were searched in Pubmed and Scopus databases. Only peer-reviewed journals in which qualitative approaches were used were included. Quality was assessed using the CASP qualitative version checklist. The metasynthesis technique proposed by Noblit and Hare was used to analyse the data. Results: Twenty-nine studies were included in the analysis. Most studies used phenomenological approaches that were conducted in Australia and the United States of America, with international internships being the most popular learning method. The data revealed one central theme, "From learning opportunity to conscious multidimensional change," and six subthemes. The transcultural nursing learning experience is not a simple or linear process. Instead, it appears to be a complex process formed by the interaction between a) self-awareness, b) reflective thinking, c) Cultural Encounters, d) cultural skills, e) Cultural Desire, and f) Cultural Knowledge. Conclusions: Transcultural nursing learning is a multifaceted process that arises from specific learning opportunities. This process is still to evolving. Therefore, specific educational strategies should be implemented to encourage attitudinal change and promote reflective thinking. Highlights: What is already known: Transcultural care promotes satisfaction among diverse populations. Cultural competence promotes an inclusive environment and mutual benefit. Cultural competence reduces biased decision making and promotes cultural awareness. What this paper adds: Transcultural learning in nursing is a complex learning process. Transcultural nursing learning is multifactorial and has an impact on students' personal and professional lives. Transcultural nursing learning experiences involve self-awareness, reflective thinking, cultural encounters, cultural skills, cultural desires and cultural knowledge. [ABSTRACT FROM AUTHOR]

Men represent 1% of all breast cancer (BC) diagnoses, which means that most treatments and services offered in oncology have been based on women's (biological sex) experiences. However, a comprehensive framework of how breast cancer is experienced by men is lacking. This systematic review and metasynthesis aims to synthesize studies documenting men's breast cancer narratives into an empirically based explanatory framework, as well as to compare experiences across the two sexes. Using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses methodology, six databases were searched to identify studies on men's breast cancer narratives. The narratives were synthesized and analyzed using an interpretative technique which allows elucidating more refined meanings, explanatory theories, and new concepts. Our final sample included 38 qualitative and mixed-method studies from North America, Europe, Israel, Australia, and New Zealand, comprising 586 participants. The narratives highlighted 14 themes: being identified as a mutation carrier, being in the health care system, bearing the burden of breast cancer, contested masculinity, existential ordeal, illness avoidance behaviors, lack of male breast cancer knowledge, receiving female-focused treatments and services, altered self-image, self in relation to others, source support, stigma of living with a "woman's disease," survivor identity, and symptom and illness appraisal. The proposed Trajectory of Male Breast Cancer framework provides an empirical basis to draw from for service provision and future oncology research (PROSPERO: CRD42022310411). Public Significance Statement: Smit et al.'s (2019) Trajectory of Breast Cancer (TBC) framework was developed to better understand the experience of women living with breast cancer through the trajectory, but male breast cancer has not been considered. The proposed Trajectory of Male Breast Cancer (TMBC) framework is adapted for men living with breast cancer and helps explain how men live with the disease from screening to survivorship. This new theoretical framework is an important step toward understanding men living with breast cancer and improving health and mental health services. [ABSTRACT FROM AUTHOR]

Introduction and aims: Interaction and collaboration between researchers, patients/public, clinicians, managers and policy-makers are necessary to enhance the relevance and use of research, improve planning, and optimize healthcare delivery and outcomes. The Integrated Knowledge Translation Research Network (IKTRN) published four casebooks from 2019 to 2021, describing varied approaches to research co-production. Our aim was to examine the case studies to extend existing theoretical and empirical perspectives about how co-production works. Methods: We used metasynthesis, a qualitative research design that includes seven iterative steps (clarify the purpose, delineate the case studies included, extract and code the data, derive themes from the coded data, determine the relationships of the themes to research co-production, synthesize the concepts, and build theory). Results: A total of 35 cases was reviewed. The aggregate findings of this metasynthesis identified multiple contextual and process factors, barriers, and facilitators that influence integrated knowledge translation (IKT), and a range of IKT activities that increased the likelihood of success of co-production during research. In comparing the findings from the metasynthesis with existing literature, we found a number of consistencies, but also new information about barriers, facilitators, IKT activities and outcomes, thereby adding to our understanding about factors that influence co-production. Conclusions: This metasynthesis provided concrete examples to optimize co-produced clinical and health system research. More research is needed to fully understand how to overcome some challenging modifiable barriers, establish relationships, facilitate communication, overcome power differentials and create processes for knowledgeusers working across boundaries (clinical practice and research) to stay engaged and participate fully in research endeavours. [ABSTRACT FROM AUTHOR]

Introduction: Narratives of negative patient experiences expressed in complaints can help health care professionals reflect on their practices. Aims: To synthesise evidence from qualitative primary studies on patients' negative experiences with different health care settings and to obtain a detailed picture of what patients find problematic while receiving health care. Design: Metasynthesis inspired by Sandelowski and Barroso. Methods: A protocol was published in the International Prospective Register of Systematic Reviews (PROSPERO). A systematic search was conducted in CINAHL (EBSCOhost), MEDLINE (EBSCOhost), PsycInfo (Ovid) and Scopus, on 20.04.2021. Backward and forward citations of included reports were searched for relevant studies and the search was completed in March 2022. Two researchers independently screened and appraised the included reports. A metasynthesis using reflexive thematic analysis and a metasummary were conducted. Results: Twenty‐four reports were included, and four main themes were extracted from the metasynthesis: (1) problems with access to health care services; (2) failure to acquire information about diagnosis, treatment and the expected patient role; (3) experiencing inappropriate care and bad treatment; (4) problems with trusting health care service providers. Conclusions: Negative patient experiences impact patients' physical and psychological health, leading to suffering and hampering patients from involving themselves in their health care. Relevance to clinical practice: Narratives of negative patient experiences aggregated from the findings provide knowledge about what patients need and expect from health care providers. These narratives can help health care professionals reflect on the way they interact with patients and improve their practice. Health care organisations need to prioritise patient participation. Reporting method: Preferred Reporting Items for Systematic Reviews and Meta‐Analyses (PRISMA) guidelines were followed. Patient or public contribution: Findings were presented and discussed in a meeting with a reference group representing patients, health care professionals and the public. [ABSTRACT FROM AUTHOR]

Student involvement is integral to transition planning for students with learning disabilities (LD). However, only a small body of research has examined the perspectives of high school students with LD related to this process. We conducted a systematic literature review and subsequent metasynthesis of 14 studies that met criteria and quality indicators for qualitative research in special education. Using a collaborative coding process, we identified five themes: (1) differences in support from professionals, family, and peers for transition, (2) perspectives on transition planning vision, meetings, and documents (3) evaluation of transition activities related to academics and graduation, career, and college, (4) self-determination examples, barriers, and facilitators, and (5) awareness of influence that gender, race, and/or culture have on transition. We discuss implications for practice and future research. [ABSTRACT FROM AUTHOR]

Suicide is a gendered phenomenon, where male deaths outnumber those of women virtually everywhere in the world. Quantitative work has dominated suicide research producing important insights but only a limited understanding of why more men die by suicide. We conducted a qualitative metasynthesis and systematic review of 20 years of narratives both from men who are suicidal and from people who are bereaved by male suicide to identify putative risk and recovery factors. We identified 78 studies that encapsulated insights from over 1,695 people. Using Thomas and Harden's Thematic Synthesis Method, our analysis is built on 1,333 basic codes, 24 descriptive themes, and four analytical themes. We noted an association between cultural norms of masculinity and suicide risk in 96% of studies. Norms relating to male emotional suppression, failing to meet standards of male success, and the devaluing of men's interpersonal needs appeared to be associated with dysregulated psychological pain and suicide risk. Although masculinity is not pathological, we speculate that the interaction and accumulation of cultural harms to men's emotions, self, and interpersonal connections may potentially distinguish men who are suicidal from men who are not. Supporting men to understand and regulate emotions and suicidal pain, expanding possibilities for masculine identity, and building meaningful interpersonal connections were reported as helping support recovery from suicidal crises. Though our sample was predominantly White, cisgendered, and English speaking, and the underlying research designs prevent strong causal inferences, we discuss possible implications of these findings for male suicide intervention and suggestions for future research. Public Significance Statement: This systematic review synthesizes the worldwide English language qualitative research literature on suicide risk and recovery factors in men. Findings suggest a novel framework for understanding the key dynamics involved in suicide risk and recovery, based on the reciprocal relationship between masculine norms, emotions, self-concept, interpersonal connections, and psychological pain. [ABSTRACT FROM AUTHOR]

This research was carried out in order to examine the theses and articles related to inquiry education conducted in our country by using meta-synthesis method and to reveal tendency in research inquiry education. In the study, meta-synthesis research method, which is a qualitative research design, was used. A total of 76 studies, prepared in 2010-2022 which could serve the purpose of the meta-synthesis study, were included in the scope of the research. In determining the sample, a coding form prepared by the researcher in accordance with the inclusion criteria was used. The studies included in the research were obtained by scanning YÖK-Tez, Google Akademic and DergiPark Academic databases. When the findings are examined, it is determined that the studies on the ASDÖ approach in Türkiye between 2010-2022 generally focus on studies aiming at scientific process skills, attitudes towards natural sciences, conceptual understanding, academic achievements and learning, ASDÖ methods and applications, self-efficacy belief, awareness, critical and creative thinking. This may be due to the need for new education programs to be supported by the ASDÖ approach applied by the Ministry of National Education in the educational process and to show the impact of the results of implementation. Against this, it is seen that in the studies carried out on the ASDÖ approach, there are fewer studies on course material development, cognitive and affective skills. In order for the education system of our country to be come more qualified, it may be useful to try to gain learning skills based on research questioning in order for students to be who research, question and have developed scientific thinking skills. [ABSTRACT FROM AUTHOR]

Background: Undergraduate education and training are fundamental in preparing student nurses for working in palliative and end-of-life care. Aim: This article explores the experiences of student nurses in their palliative and end-of-life undergraduate nurse education. Methodology: Sandelowski and Barroso's (2007) framework for undertaking a metasynthesis was used. Initial database searches returned 60 articles of interest. Re-reading the articles in the context of the research question identified 10 studies that met the inclusion criteria. Four key themes emerged. Findings: Student nurses voiced concerns regarding their feelings of unpreparedness, and lack of confidence and knowledge when dealing with the complexities of palliative and end-of-life care. Student nurses called for more training and education in palliative and end-of-life care. Conclusion: Flexible nursing curricula responsive to the needs of student nurses and the changing landscape of healthcare provision, including care to ensure a good death experience, should be prioritised at undergraduate level. [ABSTRACT FROM AUTHOR]

This review paper identifies and compares models of inter-organizational relationship development that have evolved in qualitative studies and then proposes an original, situational framework for the evolution of inter-organizational relationships over time. Methodologically, this paper follows a systematic approach and uses metasynthesis of prior qualitative research as a reviewing technique. The analysis of prior qualitative investigations reveals the lack of consistency among authors referring to the number and specificity of phases, with no agreement about the trajectory of relationship development (its linearity, looping of phases, dynamics, start and end points). As its main theoretical contribution, this paper offers a multipath framework covering four phases of relationship development: (1) initiation and initial development, (2) development, (3) maintenance, and (4) dissolution, with three possible subphases to each of them (active, passive, and re-activated). From the managerial perspective, the developed framework may broaden managers' understanding and awareness of the different approaches to modeling the trajectory of the inter-organizational relationship life cycle and configuration of its particular phases. [ABSTRACT FROM AUTHOR]

Background: The impact of the COVID-19 pandemic forced global changes to how nurses practice. Nurse practitioners adjusted their scope, changed how they delivered their service, and worked with limited resources. For some services, patient access was also compromised. Objectives: To synthesize, combine, and present current evidence on the experiences of nurse practitioners working during the COVID-19 pandemic. Data sources: CINAHL, Embase, and MEDLINE electronic databases were used to perform a structured search strategy. Conclusion: During the COVID-19 pandemic, health care services had to leverage their workforce skills to accelerate COVID-19 identification, treatment, and care. Nurse practitioners rapidly found themselves at the forefront and were concerned about infecting others. They also identified the need for support and were able to adapt to the changing environment. Nurse practitioners also recognized the impact on their well-being. Having insight into nurse practitioner's experiences during the pandemic is valuable for future health care workforce planning. Understanding how they coped will help with critical preparedness and response actions to other health care crises. Implications for practice: Having insight into nurse practitioner's experiences during the pandemic is valuable for future health care workforce planning because, as we know, the nurse practitioner workforce is one of the most rapidly growing professions in primary health care. Any future work in this space will help inform future nurse practitioner education and also help by informing critical preparedness and response actions to future health care crises, whether global or local or clinical or nonclinical. [ABSTRACT FROM AUTHOR]

Objective: Digital transformation is a relatively new concept in the university library environment and has become one of the key concepts of success and sustainability for university libraries in the competitive information environment. Based on the reviews conducted on the subject literature, no research was found that could present the construction requirements and the factors affecting the digital transformation of university libraries. Therefore, the purpose of the current research was to identify the components of the digital transformation of university libraries. Methodology: The approach of this research was qualitative and the Sandelowski and Barroso's seven-step meta-synthesis method (2007) has been used. The statistical population of the research includes all the scientific publications related to the foundations and dimensions of the digital transformation of university libraries, counting the scientific publications retrieved from 12 scientific databases in the period from 2004 to 2022 (corresponding to the solar Hijri years of 1383 to 1401), which is based on the Critical Appraisals Skills Programme (CASP) and screening process. Findings: Therefore, 32 works were selected for further review and analysis. In this research, first, a separate code was considered for all the factors extracted from the selected publications, and then considering the concept of each of the codes, they were categorized in a similar concept. In this way, the concepts of the research were determined. Based on the analysis done with the help of content analysis method, there are a total of 7 main categories and 24 concepts, including digital culture (digital attitude, user-oriented, agility, participation and cooperation, creativity and innovation, learning digital skills of employees), digital librarian (individual competence, knowledge competence, communication competence, skill competence), digital manager (individual competence, knowledge competence, skill competence), digital services and resources (optimally reorganizing library resources, providing digital services to users, providing digital services to the organization mother), digital technologies (digital infrastructure, technological readiness, use digital technologies), support and cooperation of upstream institutions and the mother organization (to provide human resources, to provide technological resources and equipment, to make macro policies), and Work process and development of digital strategy (digitalization of processes and development of library digital strategy). Conclusion: The discussion of the digital transformation of organizations, including the digital transformation of university libraries, is complex, and managers and librarians cannot be expected to be familiar with these concepts without training or study and be able to move in the right direction towards the digital transformation of libraries. This research is the first research inside and outside of Iran that identified the components of the digital transformation of university libraries. The results of this research can be a good guide for an easy understanding of the effective factors and requirements of digital transformation of libraries and the importance of understanding it for managers and librarians. [ABSTRACT FROM AUTHOR]

There is a growing expectation of physiotherapists to adopt a person-centred approach to their practice. Person-centredness for musculoskeletal physiotherapy, however, remains an under-researched area. A synthesis of the findings from qualitative studies exploring perceptions of person-centredness in musculoskeletal physiotherapy was conducted to inform future clinical practice. ENTREQ and PRISMA guidelines were used to develop a protocol for a qualitative systematic review registered with PROSPERO (registration number: CRD42020170762). Five electronic databases were searched to identify relevant primary studies. Studies were assessed for quality and data extracted. Data were analysed using thematic synthesis. A total of 3250 studies were identified and screened. Nine studies met the inclusion criteria. Four main themes emerged from the data: treating each patient as a unique person, the importance of communication for achieving a therapeutic alliance, necessary physiotherapist traits for person-centredness, and supporting patient empowerment. Empowerment of patients in musculoskeletal physiotherapy contexts might be improved through a more narrative approach to assessment, with clinical bravery recognised as a specific person-centred physiotherapy trait able to facilitate this. Physiotherapists should also consider the meaningfulness of any treatment activities they provide to maximise the person-centredness of their approach. Empowerment of patients in musculoskeletal physiotherapy contexts might be improved through a more narrative approach to assessment. Clinical bravery is a person-centred physiotherapy trait that facilitates certain conversational freedom to elicit the true patient narrative. Person-centred physiotherapists should reflect on how meaningful their treatment activities are for individual MSK outpatients. [ABSTRACT FROM AUTHOR]

Across research, policy, and practice, the experiences, knowledge, and collective experiences of Families of Color have been routinely erased, disregarded, and ignored, despite their potential for engaging and motivating students, creating inclusive classrooms, and addressing educational inequities. In this metasynthesis, we explicitly focus on what can be learned from Scholars of Color who have strong affinities to research communities and study the language and literacy practices of families. We attend to research findings that are relevant to children and families. We focus on four particularly salient sets of findings related to: 1. Family strengths and resources; 2. In‐betweenness, 3. Past, present, future and intergenerational connections; and 4. Advocacy and agency. [ABSTRACT FROM AUTHOR]

Meta-analyses and metasyntheses perform a crucial role in advancing a field of study by highlighting themes and patterns that emerge from a large body of research, yet they remain utilized research methods in the psychology of men and masculinities. Therefore, in this special issue on research syntheses in the psychology of men and masculinities, we showcase three metasynthetic studies and four meta-analytic studies that address men's victimization experiences with sexual violence, experience of breast cancer, and male friendships; the links between paternal and child anxiety and depression symptoms; and the connections between masculinities and violence, sexism, and muscularity concerns. We provide guidance on best practices in conducting research syntheses, summarize key findings from the studies in this special issue, and identify future directions for meta-analytic and metasynthetic research in the psychology of men and masculinities. Public Significance Statement: Meta-analyses and metasyntheses are useful research methods for summarizing themes and patterns in the psychology of men and masculinities. [ABSTRACT FROM AUTHOR]

Background: Men are believed to be underrepresented in eating disorder services; there are many reasons presented to account for this such as a lack of recognition and detection. Due to the physical and psychological complexity of an eating disorder it is important to understand this underrepresentation. This qualitative evidence synthesis aimed to explore the literature relating to men's experiences of an eating disorder, in order to synthesise the findings and offer a more coherent understanding. Method: A systematic search of the literature was undertaken. Inclusion and exclusion criteria were applied to the findings resulting in 14 papers deemed suitable for inclusion. A Meta-Ethnographic approach to synthesising the data of the 89 participants was undertaken. Results: Four themes were identified: 'Societal Construction of the Perfect Male'; 'Striving to Maintain a Masculine Identity'; 'The Interconnectedness of Control and Self-Worth', and 'The Hidden Man'. There appeared to be an underlying concept relating to the conflict of being a man, with what is perceived to be a 'woman's illness' and how this challenged the men's experiences of masculinity. Conclusions: Being a man with an eating disorder conflicted with societal norms, exacerbating their experience of having an eating disorder.. To resolve this, gendered norms need to shift, at societal level as well as considering how best to improve understanding and recognition of men with an eating disorder at the first point of help seeking. Plain English Summary: Men are underrepresented in eating disorder (ED) services; are less likely to notice symptoms of an ED, and have this identified by professionals. To date, there has been limited research into the male experience of ED's and this appears to be related to a difficulty with getting men involved in studies, as well as the lack of men in services. This review synthesised the existing literature, and four themes were generated: 'Societal Construction of the Perfect Male'; 'Striving to Maintain a Masculine Identity'; 'The Interconnectedness of Control and Self-Worth', and 'The Hidden Man'. The results highlighted that the male experience is complex and influenced by societal assumptions and gender norms. EDs are predominately seen as a 'women's illness', which affected the male experience in many ways but most importantly it prevented help seeking and recognition of eating disorders in men, arguably impacting their access to treatment. It is important to change the expectations we place upon men; enabling them to ask for help when needed in ways we allow women. Addressing societal pressures, combined with targeted training to improve understanding at the first point of seeking help, ensuring appropriate recognition of an ED and timely intervention for men. [ABSTRACT FROM AUTHOR]

Objective Government data contains a large amount of valuable data that can be exploited in various fields if opened. Utilizing open government data, in addition to providing the opportunity to monitor government performance and to create transparency and justice, has another very important function. It helps with developing innovation and the issue has recently been considered by many researchers. However, past research has inconsistently examined the intra-organizational factors influencing open government data to achieve innovation. The present study seeks to identify the intra-organizational factors affecting open government data to achieve innovation in government services through applying the systematic metacombination method. Methods In this research, to identify the intra-organizational factors affecting open government data, the systematic meta-synthesis method was used. For this purpose, 888 related articles based on title, abstract and content were filtered and 51 final articles were obtained. Results Based on the results obtained from the theme analysis method, four main categories including technological, managerial, human, and governance dimensions were distinguished. Also, 13 sub-categories including infrastructure, application systems, data, structural, process, strategic, economic, individual, organizational communication, organizational culture, policy, legal, and governance data were extracted which includes 101 concepts and 479 final codes. Conclusion The results of this study, contrary to the initial expectations, proved hard technological factors as the least important and other factors, including data, structural and legal factors, respectively as the most important. Thus, in data policies, first, it’s necessary to access data and consider the data quality. In structural policies, it is necessary to pay attention to how to mobilize resources and facilities. In strategic policies, how to interact with stakeholders is vital to be explained. Based on the findings of this research, the internal organizational factors affecting the formation of innovation based on open government data were classified into four main categories for better policy-making. In the category of technology, it is necessary to consider the technical and technological principles of open data from the aspect of required infrastructure, application systems, and data sources. In the management category, it is necessary to pay attention to structural and process requirements along with strategic and economic aspects. In the human category that examines the soft aspects, it is necessary to pay attention to the issue of open data from individual perspectives, communication, and organizational culture. In the category of governance, policy aspects, organizational rules, and factors related to data governance need to be considered with the aim of achieving innovation from open government data. Therefore, the present study initially tried to provide a comprehensive framework for policy-making in government institutions by interpreting and presenting a new category of internal factors. Secondly, it sought to smooth the path of future research to expand and spread innovation based on open data. [ABSTRACT FROM AUTHOR]

Les violences sexuelles sont un problème majeur de santé publique. Leur révélation à un professionnel de santé pourrait permettre de réduire leur impact dans la vie des victimes. L'objectif de cette métasynthèse, associant revue systématique et analyse des études qualitatives, était d'explorer la littérature qualitative concernant l'expérience de révélation des violences sexuelles subies dans l'enfance par les victimes auprès d'un professionnel de santé. Quatre bases de données et deux journaux ont été utilisées (Medline, PsycINFO, EMBASE, SSCI, Journal of Sexual Abuse et Child Abuse and Neglect) afin d'identifier les études portant sur la révélation de violences sexuelles aux professionnels de santé du point de vue des victimes et des professionnels de santé. La qualité méthodologique des articles a été évaluée par la « Critical Appraisal Skills Programme ». Une analyse thématique des données extraites a ensuite été réalisée. Vingt-six articles ont été inclus, couvrant les données de 673 participants (333 victimes adultes au moment de l'étude, 122 victimes mineures au moment de l'étude et 218 professionnels de santé). L'analyse thématique a produit trois thèmes : (1) révéler ou ne pas révéler à un professionnel de santé, (2) le récit de la révélation par les participants et (3) aspect positif et négatif de la révélation. Nos résultats montrent que les professionnels de santé et les victimes mineures ont un vécu plutôt négatif de l'expérience de révélation qui pourrait se potentialiser et entraver le processus de révélation, alors que certaines victimes adultes reconnaissent rétrospectivement l'importance et l'impact positif que la révélation a eu pour eux. Cette étude permet de dégager des perspectives de recherches dans le champ pédopsychiatrique ainsi que de formuler des propositions cliniques concrètes, en particulier l'implication de victimes adultes dans la sensibilisation et la formation des professionnels de santé concernés. Child sexual abuse is a major public health issue, and disclosure of such abuse to a healthcare professional could mitigate its impact on the survivor's life. Qualitative studies are relevant in this context, focusing as they do on the lived experience of the stakeholders, victims and professionals. We aimed to conduct a metasynthesis, i.e. a systematic review and analysis of qualitative studies, exploring the qualitative literature about the lived experience of child's sexual abuse disclosure. Four databases and two journals were screened (Medline, PsycINFO, EMBASE, SSCI, Journal of Sexual Abuse and Child Abuse and Neglect) so as to identify studies concerning the lived experience of child sexual abuse disclosure from the point of view of survivors or healthcare professionals or both. We used the "Critical Appraisal Skills Program" to assess the methodological quality of each article and performed a thematic analysis of the data extracted to identify key themes and synthesize them. Twenty-six articles were included, covering data from 673 participants (333 survivors, adult at the time of the study; 122 survivors still minor at the time of the study and 218 health professionals). Data analysis produced three themes: (1) to reveal or not to reveal, (2) the narrative of the disclosure by the participants, (3) positive and negative outcomes of the disclosure. Our results show that, on the one hand, health professionals and minor survivors both have a negative experience of disclosure that could impede the process. On the other hand, some adult survivors underlined the importance and the positive impact of such disclosure to a healthcare professional. We identified a gap in the literature regarding disclosure of such abuse within child and adolescent psychiatry services and drew research perspectives. Concrete clinical implications can also be drawn from our results, especially the involvement of adult survivors within the training of concerned healthcare professionals so as to raise awareness among them and help them better cope with the disclosure process. [ABSTRACT FROM AUTHOR]

Issues In substance use disorder, connection to social communities plays a significant role in the recovery process. The aim here has been to identify and synthesise the qualitative research examining the process of social recovery from a first‐person perspective and how social communities assist in this process. Approach: Metasynthesis using the following databases: CINAHL, Embase, MEDLINE, PsycINFO, Scopus, SocIndex and Web of Science. The search returned 6913 original articles, of which 18 met the following criteria: examining the experience of social recovery from a first‐person perspective and how social communities support this process, age of 18+, recovery of at least 12 months, in an English‐language peer‐reviewed journal. Review protocol registration: PROSPERO (CRD42020190159). Key Findings: The persons in recovery emphasised communities that they perceived as being safe and non‐stigmatising. These are qualities that contributed to positive self‐change, and these communities were perceived as suitable arenas in which to confront responsibility and trust. Additionally, participants found that their relationship skills were improving due to the new social bonds forged in these communities. A sense of citizenship was gained along with a regaining of social dignity through voluntary work and giving back to society. Implications: The pivotal role of the social community identified in this review underscores the importance of recognising and supporting persons in recovery's needs when connecting with such communities Conclusion: We propose a four‐stage model to guide research into social recovery from a first‐person perspective and how social communities support this process. [ABSTRACT FROM AUTHOR]

Although forced displacement may lead to many adverse psychological problems, this experience may also result in positive psychological consequences. Given the increasing disturbance in countries, many people are forcibly displaced, a comprehensive understanding of the posttraumatic growth (PTG) experiences of refugees is warranted. In this study, we examined 12 primary studies exploring PTG among refugees using the qualitative metasynthesis method. Our analysis of the primary studies consisting of 319 adults revealed four themes: (a) improved psychologic functioning; (b) enhanced interpersonal relationships; (c) reconstruction of the meaning of life; and (d) positive future direction. These findings indicate that no matter how traumatic experiences are painful, people can hold on to life, build a new life, and grow from adversity. [ABSTRACT FROM AUTHOR]

Background: There has been a considerable increase in the number of traditional and complementary medicine (T&CM) practitioners over the past 20 years and in some jurisdictions are estimated to outnumber general practitioners. Despite this globally significant role, it is apparent that worldwide not all T&CM professions operate under adequate accountability and regulatory oversight for maintaining public protection. To date there has been no published systematic examination of stakeholder opinions regarding regulated and unregulated T&CM occupations. In response, this review aims to investigate, describe, and analyse attitudes held by a range of stakeholder groups towards the regulation of T&CM professions. Methods: A database search of AMED, CINAHL, Embase, Ovid MEDLINE, ProQuest, PsycINFO, PubMed, Scopus, and Google Scholar was conducted for original research published between 2000 and 2020 on stakeholder opinions regarding the regulation of T&CM professions. Results: Sixty studies across 15 countries reported on the views of six health care stakeholder groups: consumers, T&CM practitioners, conventional medicine practitioners, professional associations, education providers, and policy-makers. Across all stakeholder groups there was between 15% and 95% (median 61%) support for, and 1% to 57% (median 14%) opposition to the regulation of various T&CM professions. The main reasons for supporting regulation included providing greater public protection, raising training and practice standards, establishing title protection, and gaining acceptance from conventional medicine providers. Concerns regarding regulation included potential restrictions to practice, misappropriation of practice, and medical oversight of T&CM practitioners. Few studies canvassed the views of professional associations (n = 6), education providers (n = 2), and policy-makers (n = 2). Conclusions: There appears to be broad support for the regulation of T&CM professions, although there was wide variation in attitudes as to how this should be applied. Further research, with a particular focus on policy-makers, education providers, and professional associations, is critical to inform appropriate health policy and practice recommendations relating to T&CM professional regulation across jurisdictions. Systematic review registration: the a priori protocol for this systematic review was registered in PROSPERO and is available at: www.crd.york.ac.uk/PROSPERO/display_record.asp?ID=CRD42020198767. [ABSTRACT FROM AUTHOR]

Aim of the Study: There is currently no meta-synthesis focused on the lived experiences of health-care providers during COVID-19. This meta-synthesis adds to evidence-based literature with an in-depth exploration of how health-care providers responded to the COVID-19 crisis. Materials and Methods: The meta-synthesis approach was used for the extraction and synthesis of data. Results: Fifteen qualitative research articles were identified and analyzed; the majority of which were done in China 7 (48%) and Iran 6 (40%). The total sample size was 383, and the majority of the samples were nurses 282 (74%). Three overarching themes identified were "It is my duty," "I am exhausted and about to fall," and "I have overcome it." The subthemes were professional responsibility, challenges faced, the unexpected burden at work, self-coping and reflection, hospital support, government support, and social support. Conclusion: The recommendations for the policy-makers, put forward by the current study are; designing and engineering effective personal protective equipment (lightweight protective suit with long-lasting durable diapers and face masks with a portal for drinking juice or water), rostering minimal working hours, live-in care facilities, exclusion of pregnant and sick health care providers during an epidemic assignment and frequent outbreak training sessions for all department staff. [ABSTRACT FROM AUTHOR]

Background: Midwifery Units (MUs) are associated with optimal perinatal outcomes, improved service users' and professionals' satisfaction as well as being the most cost-effective option. However, they still do not represent the mainstream option of maternity care in many countries. Understanding effective strategies to integrate this model of care into maternity services could support and inform the MU implementation process that many countries and regions still need to approach.Methods: A systematic search and screening of qualitative and quantitative research about implementation of new MUs was conducted (Prospero protocol reference: CRD42019141443) using PRISMA guidelines. Included articles were appraised using the CASP checklist. A meta-synthesis approach to analysis was used. No exclusion criteria for time or context were applied to ensure inclusion of different implementation attempts even under different historical and social circumstances. A sensitivity analysis was conducted to reflect the major contribution of higher quality studies.Results: From 1037 initial citations, twelve studies were identified for inclusion in this review after a screening process. The synthesis highlighted two broad categories: implementation readiness and strategies used. The first included aspects related to cultural, organisational and professional levels of the local context whilst the latter synthesised the main actions and key points identified in the included studies when implementing MUs. A logic model was created to synthesise and visually present the findings.Conclusions: The studies selected were from a range of settings and time periods and used varying strategies. Nonetheless, consistencies were found across different implementation processes. These findings can be used in the systematic scaling up of MUs and can help in addressing barriers at system, service and individual levels. All three levels need to be addressed when implementing this model of care. [ABSTRACT FROM AUTHOR]

Purpose: This metasynthesis reviews and synthesizes the existing qualitative research on adolescent well-being, with explicit attention to how context shapes girls' well-being. Well-being can be understood as a product of transactions between the individual and their context. Using qualitative research, this metasynthesis shows that girls face several threats to their well-being, often related to gender interwoven with the context in which girls operate. Methods: A Qualitative Metasynthesis was used. It included 10 qualitative studies. Results: Findings of this metasynthesis explain that context plays a relevant role in girls' access to resources and opportunities within families and communities. They show that context defines expectations on how girls should behave and spend their time, which often become stressors for girls. Girls examine their context and use it to set up ideals and compare themselves to others. These comparisons impact girls' self-image and structure aspects of their social life. Conclusions: Context and gender affect girls' well-being at different levels. Therefore, interventions and public policies should study the key factors girls identified as influencing their well-being, and address them using a multilevel rationale. Qualitative research can offer complex and illustrative insights on girls' well-being, exploring their perspectives and experiences, and shedding light on how interlocking systems of oppression affect their well-being. [ABSTRACT FROM AUTHOR]

Purpose: Invisible symptoms have a negative impact on people living with Multiple Sclerosis (MS), related to the very notion that they are "unseen." It is important to understand the notion of "invisibility" in MS, as invisible symptoms are particularly distressing, and there is a paucity of research focussing on their invisible nature and its specific impact. We aimed to systematically identify, appraise and synthesise qualitative research regarding the notion of "invisibility" in relation to people's lived experience of symptoms of MS. Methods and materials: Articles meeting inclusion criteria were critically appraised and synthesised using a meta-ethnographic approach. Results: 17 articles were identified from six electronic databases. Three third-order themes were presented as a line of argument. "Invisibility" was conceptualised by people with MS as a discrepancy between the internal experience of symptoms and what is observed externally. "Invisibility" of MS symptoms was found to have numerous impacts, including not feeling understood or validated by others, issues around the perceived legitimacy of the illness, and living with needs which are hidden. We found that "invisibility" by its nature offers people a choice of strategies they use to navigate it. This choice introduces a dilemma: disclose the diagnosis to be "seen," or remain "invisible." Conclusions: This review revealed the manner in which people with MS are affected by the invisibility of their symptoms and the various adaptations used to navigate these lived experiences. We highlight the need to improve clinician and public understanding, and to better respond to these experiences. Future research focusing on the exploration of people's experiences of "invisibility" in MS, including the ways in which "invisibility" is managed on a day-to-day basis could raise clinical and public awareness of the impact of "invisibility" and how to provide support for this, thus easing the dilemmas faced by those with MS. [ABSTRACT FROM AUTHOR]

Purpose: To systematically review and synthesise the qualitative literature on experiences that challenge self-identity following traumatic brain injury (TBI). Method: Four electronic databases were searched systematically for qualitative research published between 1965 and August 2017, investigating subjective experiences of identity change following TBI. Papers which met the inclusion criteria were evaluated using the Critical Skills Appraisal Programme (CASP) tool and synthesised using guidelines by Thomas and Harden (2008). Results: Of the 1965 papers retrieved, 36 met inclusion and quality criteria. Synthesis resulted in six themes: (1) awareness of change in physical, cognitive, emotional and social functioning; (2) autobiographical memory loss; (3) responses of other people that highlight change; (4) loss of autonomy; (5) comparing old me and new me-loss of valued roles and activities; (6) social rejection and stigma. Conclusions: An in-depth understanding of the experiences that challenge self-identity after TBI can inform rehabilitation to support individuals to negotiate these processes with less distress and more successfully. [ABSTRACT FROM AUTHOR]

Background the perceptions and experiences of care home residents and their families are important for understanding and improving the quality of emergency care. Methods we conducted a systematic review and metasynthesis to understand the perceptions and experiences of care home residents and their family members who experienced medical emergencies in a care home setting. The review protocol was registered in PROSPERO (CRD42020167018). We searched five electronic databases, MEDLINE, CINAHL, PubMed, Cochrane Library and PsycINFO, supplemented with internet searches and forward and backward citation tracking from included studies and review articles. Data were synthesised thematically following the Thomas and Harden approach. The Critical Appraisal Skills Programme qualitative checklist was used to assess the quality of studies included in this review. Results of the 6,140 references retrieved, 10 studies from four countries (Australia, Canada, UK and USA) were included in the review and metasynthesis. All the included studies were assessed as being of good quality. Through an iterative approach, we developed six analytical themes: (i) infrastructure and process requirements in care homes to prevent and address emergencies; (ii) the decision to transfer to hospital; (iii) experiences of transfer and hospitalisation for older patients; (iv) good communication is vital for desirable outcomes; (v) legal, regulatory and ethical concerns and (vi) trusting relationships enabled residents to feel safe. Conclusions the emergency care experience for care home residents can be enhanced by ensuring resources, staff capacity and processes for high quality care and trusting relationships between staff, patients and relatives, underpinned by good communication and attention to ethical practice. [ABSTRACT FROM AUTHOR]

We developed and applied metasynthesis methods to expand previously reported thematic descriptions of parents' internal definition of "being a good parent to my seriously ill child" as part of a larger study to examine parenting of children with serious illness. Our systematic approach included: literature search, purposeful selection of grounded theories regarding parenting a seriously ill child, study summaries, mapping evidence of good parent themes onto structural elements of grounded theory, cross-study comparisons, and theoretical memoing to summarize analytic insights. Twenty-five grounded theory studies from 32 reviewed reports reflected multiple conditions (n=5), countries (n=10) and family members (n=386 families). We report a worked example of the processes used to extend the original good parent themes and detail our processes through one good parent theme. The methods we describe are a promising approach to extend thematic analysis findings and advance thematic expansions toward development of more formal theoretical syntheses. [ABSTRACT FROM AUTHOR]

Although negative symptoms of psychosis are frequently researched, the subjective experience of these symptoms is not often studied in detail. This paper addresses this shortcoming by reviewing qualitative research about first-person perspectives on negative symptoms. A systematic literature search using Web of Science, Scopus, PsychArticles, PubMed, CiNAHL and Embase revealed 12 relevant studies. Our review yields a model with five clusters: failing social interactions; experiences of disconnection; overwhelming psychotic experiences; an eroded self-image; and detrimental side effects of psychotropic medication. In the discussion, the authors conclude that disturbances underlying negative symptoms should be studied in greater detail, starting explicitly from theoretical frameworks like phenomenology or psychoanalysis. [ABSTRACT FROM AUTHOR]

Although generalizability is not typically considered a feature or goal of qualitative research, it is an integral part of applying findings to advance knowledge in the counseling profession. First, we describe types of generalizability, the use of trustworthiness criteria, and strategies for maximizing generalizability within and across studies, then we discuss how the research approaches of grounded theory, autoethnography, content analysis, and metasynthesis can yield greater generalizability of findings. We then describe six phases for aggregating qualitative research to conduct a metasynthesis, which can be applied as relevant to the metastudy approaches of formal grounded theory, autoethnography, and content analysis. [ABSTRACT FROM AUTHOR]

Background: There has been a considerable increase in the number of traditional and complementary medicine (T&CM) practitioners over the past 20 years and in some jurisdictions are estimated to outnumber general practitioners. Despite this globally significant role, it is apparent that worldwide not all T&CM professions operate under adequate accountability and regulatory oversight for maintaining public protection. To date there has been no published systematic examination of stakeholder opinions regarding regulated and unregulated T&CM occupations. In response, this review aims to investigate, describe, and analyse attitudes held by a range of stakeholder groups towards the regulation of T&CM professions.Methods: A database search of AMED, CINAHL, Embase, Ovid MEDLINE, ProQuest, PsycINFO, PubMed, Scopus, and Google Scholar was conducted for original research published between 2000 and 2020 on stakeholder opinions regarding the regulation of T&CM professions.Results: Sixty studies across 15 countries reported on the views of six health care stakeholder groups: consumers, T&CM practitioners, conventional medicine practitioners, professional associations, education providers, and policy-makers. Across all stakeholder groups there was between 15% and 95% (median 61%) support for, and 1% to 57% (median 14%) opposition to the regulation of various T&CM professions. The main reasons for supporting regulation included providing greater public protection, raising training and practice standards, establishing title protection, and gaining acceptance from conventional medicine providers. Concerns regarding regulation included potential restrictions to practice, misappropriation of practice, and medical oversight of T&CM practitioners. Few studies canvassed the views of professional associations (n = 6), education providers (n = 2), and policy-makers (n = 2).Conclusions: There appears to be broad support for the regulation of T&CM professions, although there was wide variation in attitudes as to how this should be applied. Further research, with a particular focus on policy-makers, education providers, and professional associations, is critical to inform appropriate health policy and practice recommendations relating to T&CM professional regulation across jurisdictions. Systematic review registration: the a priori protocol for this systematic review was registered in PROSPERO and is available at: www.crd.york.ac.uk/PROSPERO/display_record.asp?ID=CRD42020198767 . [ABSTRACT FROM AUTHOR]

Family caregivers play an integral role in supporting patient self-management, yet how they perform this role is unclear. We conducted a qualitative metasynthesis of family caregivers' processes to support patient self-management of chronic, life-limiting illness and factors affecting their support. Methods included a systematic literature search, quality appraisal of articles, data abstraction, and data synthesis to produce novel themes. Thirty articles met inclusion criteria, representing 935 international family caregivers aged 18 to 89 years caring for patients with various health conditions. Three themes characterized family caregivers' processes to support patient self-management: "Focusing on the Patient's Illness Needs," "Activating Resources to Support Oneself as the Family Caregiver," and "Supporting a Patient Living with a Chronic, Life-Limiting Illness." Factors affecting family caregivers' support included Personal Characteristics, Health Status, Resources, Environmental Characteristics, and the Health Care System. The family caregiver role in supporting patient self-management is multidimensional, encompassing three processes of care and influenced by multiple factors. [ABSTRACT FROM AUTHOR]

Background: Moral distress has detrimental effects on nurses which impacts the entire healthcare cycle. Described as a crescendo effect, resolved situations of moral distress leave residue on the nurse with three potential outcomes: moral numbing, conscious objection to the situation, and burnout. Objective: This metaethnography strives to achieve a fuller understanding of moral distress by interpreting the body of qualitative work of moral distress in emergency and critical care nurses. Method: This study used the Noblit and Hare's approach of interpretative synthesis. Ten studies met the criteria and were used in this synthesis. Ethical considerations: Ethical issues were minimal since no human subjects were involved. Ethical requirements were respected in all study phases. Results: The synthesis of qualitative research on moral distress resulted in one central theme, "the battle within," and five subthemes. Conclusions: The unique nature of this nursing specialty resulted in a lasting inner conflict for nurses that is consistent with the previously described crescendo effect. The effects are complex and long lasting and may potentially affect the nurses' future patient care. [ABSTRACT FROM AUTHOR]

Dementia is a serious condition that has become a public health priority worldwide. Reminiscence is the process of recollecting personal memories from the distant past. This metasynthesis aims to present a thorough analysis of available qualitative literature concerning patients' perspectives about reminiscence in dementia care. A search of CINAHL, PubMed, PsycINFO, Scopus, and ProQuest for qualitative studies published in English between 2005 and 2019 generated 110 studies. Eleven studies were retrieved, assessed for quality using the Critical Appraisal Skills Programme tool, and then synthesized according to Noblit and Hare's seven-step approach. Metaphors were arranged in a list and translated into one another. Five reciprocal themes emerged: Promoting a Comfort Zone, Keeping the Conversation Going, Creating a Dynamic Life, Reliving Painful Memories and Emotional Turmoil, and Strengthening Inner Forces. Increased awareness of patients' perspectives about reminiscence can help design a better framework for interventions that will serve this vulnerable population. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this systematic review was to address two questions: what is the qualitative evidence for the effects of the Wellness Recovery Action Plan (WRAP) training, as perceived by adults with mental health difficulties using it? What is the quality of qualitative literature evaluating WRAP? Design/methodology/approach: Five electronic reference databases and the EThOS database for unpublished research were systematically searched, as well as two pertinent journals. Study quality was assessed using Critical Appraisal Skills Programme criteria and results analysed using thematic synthesis. Findings: Of 73 studies, 12 qualitative papers met inclusion criteria and were generally good quality. Analyses demonstrated expected findings, such as increased understanding and active management of mental health in the context of group processes. Results also highlighted that WRAP training promoted acceptance and improved communication with professionals. Peer delivery of WRAP was highly valued, with contrasting perceptions of peers and professionals evident. Some cultural considerations were raised by participants from ethnic minorities. Research limitations/implications: WRAP training participation has positive self-perceived effects beyond those captured by measures of recovery. Broader implications are suggested regarding earlier access to WRAP, professional support and communication between professionals and service users. Recommendations for further research include the relationship between social support and illness self-management and peer-delivered acceptance-based approaches. Multiple time-point qualitative studies could offer insights into WRAP training processes and whether changes are sustained. Originality/value: As the first review of qualitative evidence regarding WRAP training, value is offered both through increased understanding of outcomes and also guidance for future research. [ABSTRACT FROM AUTHOR]

Background: The purpose of this systematic review (PROSPERO Ref: CRD42017053264) was to describe and interpret the qualitative research on parent's decision-making and informed choice about their pregnancy and birth care. Given the growing evidence on the benefits of different models of maternity care and the prominence of informed choice in health policy, the review aimed to shed light on the research to date and what the findings indicate.Methods: a systematic search and screening of qualitative research concerning parents' decision-making and informed choice experiences about pregnancy and birth care was conducted using PRISMA guidelines. A meta-synthesis approach was taken for the extraction and analysis of data and generation of the findings. Studies from 1990s onwards were included to reflect an era of policies promoting choice in maternity care in high-income countries.Results: Thirty-seven original studies were included in the review. A multi-dimensional conceptual framework was developed, consisting of three analytical themes ('Uncertainty', 'Bodily autonomy and integrity' and 'Performing good motherhood') and three inter-linking actions ('Information gathering,' 'Aligning with a birth philosophy,' and 'Balancing aspects of a choice').Conclusions: Despite the increasing research on decision-making, informed choice is not often a primary research aim, and its development in literature published since the 1990s was difficult to ascertain. The meta-synthesis suggests that decision-making is a dynamic and temporal process, in that it is made within a defined period and invokes both the past, whether this is personal, familial, social or historical, and the future. Our findings also highlighted the importance of embodiment in maternal health experiences, particularly when it comes to decision-making about care. Policymakers and practitioners alike should examine critically current choice frameworks to ascertain whether they truly allow for flexibility in decision-making. Health systems should embrace more fluid, personalised models of care to augment service users' decision-making agency. [ABSTRACT FROM AUTHOR]

Clinical practice guidelines recommend a biopsychosocial approach for the management of musculoskeletal pain conditions, but physiotherapists have reported feeling inadequately trained and lacking in confidence to deal with psychosocial issues. Although a growing number of studies are exploring physiotherapists' perceptions of biopsychosocial training, the results have not been synthesized. Therefore, the aim of this systematic review and metasynthesis of qualitative studies was to explore physiotherapists' perceptions of learning and implementing a biopsychosocial intervention to treat musculoskeletal pain conditions. A search of the electronic databases: MEDLINE, EMBASE, CINAHL, ERIC, PsycInfo, SportDiscus, and Sociological abstracts identified eligible studies. We included full-text qualitative and mixed-methodology studies published in English, which investigated physiotherapists' perceptions of learning and implementing biopsychosocial interventions. Twelve studies involving 113 participants met the inclusion criteria, and a thematic synthesis was conducted. The quality of the included studies was appraised using the Clinical Appraisal Screening Program. Four main themes emerged from the data: changed understanding and practice, professional benefits, clinical challenges, and learning requirements. The results of this study indicate that although the physiotherapists reported a shift towards more biopsychosocial and person-centered approaches, the training interventions did not sufficiently help them feel confident in delivering all the aspects. Planning future implementation interventions and training physiotherapists through a biopsychosocial approach should focus on adequate training and individualized mentoring related to psychosocial factors, and discussion of role boundaries, patient expectations, and organizational factors such as time constraints and referral pathways. [ABSTRACT FROM AUTHOR]

Supporting parents to meet the challenges of their caregiving role is identified as a public health concern and a priority in policies internationally. Quantitative research has established the efficacy of parenting programmes but less is understood about the key aspects that make interventions meaningful and helpful to families. We aimed to explore parents' experiences and perceptions of parenting programmes in order to highlight the parent voice and identify key factors that parents perceive to be meaningful and improve our understanding of the acceptability and perceived benefits of parenting programmes. Six key electronic databases were searched systematically for qualitative research and eligibility for inclusion was established. A thematic synthesis was undertaken. Twenty-six studies were included, spanning 17 years of parenting research and involving 822 parents. Three main themes and nine subthemes were identified: (1) a family's journey (prior to the parenting programme, outcomes (including changes in the parent, child and wider family) and post-intervention), (2) aspects perceived to be important or valuable (group leader or facilitator, programme content and delivery and value of the group) and (3) challenges or difficulties (barriers to engagement or attendance, programme content and suggestions for improvement). Reported outcomes of parenting programmes included changes in the parent alongside changes in the child and family more widely. Key recommendations to improve provision of accessible, clinically and cost-effective interventions for parents include ensuring high-quality training and supervision of facilitators, balancing flexibility and fidelity to ensure tailored content to meet individual needs, a sensitivity to parental adversity, the need for wider familial support and the availability of ongoing support following the end of a parenting programme. [ABSTRACT FROM AUTHOR]

The body is central to the experience of aging. In this metasynthesis, the authors located, analyzed, and reconceptualized phenomenological research on how life is experienced within and through the body after 85 years. Sandelowski and Barroso's metasynthesis method was employed. Seven databases were searched for primary phenomenological studies. After systematic screening and quality appraisal, 19 studies were included for review. Analysis was guided by Maurice Merleau-Ponty's existential philosophy of embodiment. Findings were organized using Max van Manen's reflective lifeworld existentials. Four ontological dimensions emerged, namely, being in a body (corporeality), being in time (temporality), being in place (spatiality), and being with others (relationality). Each dimension captures a distinct experiential dimension of this stage of the life course. The results suggest vast heterogeneity in the ontological experience of aging, supporting the view that diversity grows with age. The ability to adapt to multidimensional losses was identified as a source of resilience. [ABSTRACT FROM AUTHOR]