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Aims: To synthesise the existing literature, which focuses on the impact of critical incidents on nurses and midwives, and to explore their experiences related to the support they received in the current healthcare environment to move on from the event. Design: Systematic review and qualitative synthesis. Data sources: The electronic databases CINAHL, MEDLINE, PsycINFO, PubMed, Embase and Nursing and Allied Health (ProQuest) were systematically searched from 2013–2018, and core authors and journals identified in the literature were manually investigated. Review methods: Qualitative studies of all research design types written in English were included according to the PRISMA reporting guidelines. The methodological quality of included studies was evaluated using the Joanna Briggs Institute (JBI) Critical Appraisal Checklist for Qualitative Research. Results: A total of 7,520 potential publications were identified. After removal of duplicate citations, study selection and appraisal process, 11 qualitative primary research papers progressed to the meta‐synthesis by meta‐aggregation. The 179 findings and sub‐findings from the included studies were extracted, combined and synthesised into three statements addressing three different aspects within the context of critical incidents: the experiences of the impact, the perceptions of support and the ability to move on. Conclusion: This review illuminated that moving‐on after critical incidents is a complex and wearisome journey for nurses and midwives. More attention should to be drawn to second victims within general nursing and midwifery practice to strengthen their ability to navigate the aftermath of critical incidents and reclaim the professional confidence indispensable to remain in the workforce. [ABSTRACT FROM AUTHOR]

Aims and objectives: To understand the intersection of healthcare professionals’ and care workers’ culture and their provision of person‐centred care for people with dementia. Background: Due to the nature of global immigration and recruitment strategies, health care is provided by a culturally diverse workforce. Consequently, there is a need to understand healthcare professionals’ and care workers’ cultural values of illness, disease and dementia. Cultural values and beliefs regarding dementia and care of the older person differ, and currently, there is a lack of clarity regarding the intersection of culture in the provision of person‐centred dementia care. Method: A search of the following databases was completed: Medline, CINAHL, Psychology and Behavioural Sciences, PsycINFO and PubMed for papers published from 1st January 2006 to 31st July 2016. Results: A total of seven qualitative studies met the inclusion and exclusion criteria, all explored the impact of healthcare professionals’ and care workers’ culture in relation to their provision of person‐centred dementia care. A meta‐synthesis of the data from these studies identified four themes: cultural perceptions of dementia, illness and older people; impact of cultural perceptions on service use; acculturation of the workforce; and cross‐cultural communication. Conclusion: Limited evidence was found on the impact of healthcare professionals’ and care workers’ culture on their provision of person‐centred dementia care. The intersection of culture and dementia included the understanding of dementia, care and family roles. Acculturation of migrant healthcare workers to the culture of the host country, workplace, and support with the communication was identified as necessary for the provision of person‐centred dementia care. Relevance to clinical practice: Open access education and training to support communication is required, alongside the development of robust interventions to support the process of acculturation of migrant healthcare professionals and care workers to provide culturally competent person‐centred dementia care. [ABSTRACT FROM AUTHOR]

Aims and objectives To interpret the body of qualitative work focusing on compassion fatigue to distil a common understanding that could then be applied to nursing care. Background Complex demands place extraordinary stress on nurses struggling to work in overburdened healthcare systems. The result can be the inability to care well for others, leading to compassion fatigue, burnout and increased numbers leaving the profession. Metasynthesis offers a means of more fully illuminating compassion fatigue and further understanding of practices which might reduce its negative consequences. Design Metasynthesis. Method As a method designed to facilitate knowledge development, metasynthesis allowed for integration of qualitative study findings conducted between 1992-2016 using defined search terms. Six databases were searched for articles published in English. Nine papers met the criteria for review and metasynthesis was conducted using the meta-ethnographic approach detailed by Noblit and Hare. Results Four themes related to compassion fatigue were found by consensus discussion. The themes included: physical ('just plain worn out') and emotional symptoms ('walking on a tightrope'), triggering factors ('an unbearable weight on shoulders' and 'alone in a crowded room'), and measures to overcome/prevent ('who has my back?'). Conclusions Compassion fatigue is a concept of documented relevance to those in nursing and represents a basic inability to nurture others and engenders a temporal component. Synthesis of studies provides evidence of the veracity of the concept for application to clinical practice and research related to nursing care. Relevance to clinical practice Findings provide insight into the clinical milieu needed to prevent compassion fatigue. A theoretical model is presented which can be used to guide future research, as well as the creation of clinical practice policies which might mitigate the development of compassion fatigue and its potential consequences. [ABSTRACT FROM AUTHOR]

Aims: To systematically examine and review relevant qualitative studies exploring the current lifestyle among individuals at high risk of colorectal cancer (CRC), and their awareness of the role of a healthy lifestyle in CRC prevention. Background: The increasing incidence and mortality of CRC have presented a serious threat against the health and life of people. As the major population affected by CRC, the lifestyle of individuals at a high risk of CRC is attracting increasing attention. Design: A qualitative evidence synthesis using the Thomas and Harden method and the PRISMA 2020 checklist provided by the EQUATOR network were used. Data Sources: Literature was retrieved from PubMed, Web of Science, the Cochrane Library, Embase, CINAHL and PsycINFO from the inception to December 2021. Review Methods: Two reviewers independently screened the titles and abstracts and identified the eligible studies. Critical appraisals of each included study were performed. Thematic analysis was used to guide the data synthesis. Results: The data from nine articles were analysed. Three interpretive themes were extracted that formed an overarching synthesis of the experience with healthy lifestyles among high‐risk individuals of CRC. The findings suggested that these individuals with limited awareness of CRC and personal risks lacked sufficient knowledge about the relationship between lifestyle and CRC, and their attitudes and practices towards the role of a healthy lifestyle in CRC prevention were also diversified. Conclusion: Professionals can potentially provide personalised guidance for healthy lifestyles based on knowledge of prevention, the actual background and social support of individuals at high risk of CRC. Impact: Considering that knowledge gaps and health beliefs among these individuals are the premise blocking their adoption of a healthy lifestyle, the findings of this review may make contributions to the design and content of public health policy and prevention programs. No patient or public contribution. [ABSTRACT FROM AUTHOR]

Aims and Objectives: To systematically identify and synthesise the experiences reported by women with a breast cancer mutation who do not have cancer as reported in qualitative research published between 2013 and 2020. Background: Women carrying a BReast CAncer (BRC) genetic mutation have an increased risk for breast and ovarian cancer. They must engage in emotional decision‐making regarding risk management strategies to prevent cancer, including risk‐reducing bilateral mastectomy and bilateral salpingo‐oophorectomy. Design and Methods: The ENTREQ statement guided this review. Eight databases were systematically searched (CINAHL, Pubmed, Embase, Psychinfo [Ovid], Web of Science, Scopus, Proquest and Lenus). Synthesis was guided by "best fit" framework. The Critical Appraisal Skills Programme guided assessment of methodological limitations and confidence in the review findings was informed by GRADE‐CERQual. Results: Twenty studies met the inclusion criteria for synthesis. Six themes were synthesised from the included studies (anxiety; family planning; it's a family affair; empowerment; actions; pragmatic adjustments). Conclusions: The multidimensional experiences of women living with a BRCA1/2 mutation require an individualised response based on women's needs at their life stages. A decision coaching model adopted during consultations could support women to guide decision‐making regarding cancer risk‐reducing strategies. [ABSTRACT FROM AUTHOR]

Background: As places of both residence and work, what constitutes "good quality care" in residential aged care requires consideration of staffs' perspectives. Objective: A meta‐synthesis of the qualitative literature was conducted exploring residential aged care staff perspectives on "quality of care." Methods: Six electronic databases were searched for articles that met the screening inclusion criteria. This meta‐synthesis was informed by the Preferred Reporting Items for Systematic reviews and Meta‐Analyses guidelines, and included studies were critically appraised using JBI SUMARI. Two independent reviewers conducted thematic network mapping and analysis of included articles, with oversight from three additional reviewers. Results: Forty‐seven articles were included, with findings summarised into four organising themes and nine basic themes. The four organising themes about quality care from staff perspectives include direct care, professional values and competence, the care environment and organisational/regulatory factors. Conclusion: Staff describe a wide range of factors that they perceived to influence the quality of care. Some may feel motivated to leave employment in aged care, due to organisational pressures that make staff unable to uphold what they perceive as an acceptable standard of care. There is tension between professional values and organisation/regulatory factors—regulation should be enacted at a level that supports good practice and staff's moral integrity. Relevance to clinical practice: This review found that while person‐centred care is now well established as the benchmark of quality care in residential aged care homes, achieving it in reality remains challenged by limitations on staff members' time, resources and sometimes their competencies and the regularity of their employment. [ABSTRACT FROM AUTHOR]

Background: Medication errors are a frequent phenomenon in nursing, as the nurses are primarily responsible for preparation and administration of medications to patients. Little is known about how nurses make sense of their experiences of medication errors as a lived phenomenon. Objective: To aggregate, synthesise and interpret the qualitative evidence of studies which explored nurses' lived experiences of medication errors. Method: A meta‐synthesis is presented with thematic analysis by Thomas & Harden (BMC Medical Research Methodology, 8, 2008, 45). Qualitative studies (January 1980–June 2018) retrieved from PubMed, BNI, CINAHL, EMBASE, AMED, PsycINFO, ProQuest, ScienceDirect and Wiley Online Library. The PRISMA flow chart, CASP tool and COREQ checklist are integrated in the meta‐synthesis. Findings: Eight primary research studies were included with the follow themes: "moral impact," "emotional impact," "constructive learning," "impact on professional registration and employment," "nurses' coping strategies with the experience," "patient and family," "identification of contributing factors to medication errors" and "preventive measures for medication errors." Conclusion: The moral and emotional impact of medication errors to nurses was devastating for themselves. Yet, they detected strategies to cope with their error and its consequences and even more translated their experience into a constructive lesson and identified ways to prevent future errors. Relevance for clinical practice: The meta‐synthesis provides a holistic perspective about how registered nurses made sense of their lived experiences of medication errors. Its findings reveal that the experience has both positive impact and negative impact to the nurses. Its findings should inform mainly the clinical nursing practice, clinical nurses, nurse educators, nurse leaders and policymakers of medication administration. [ABSTRACT FROM AUTHOR]

Aims and objectives To critically review the existing qualitative studies to identify, from the perspective of staff, the barriers to physical restraint reduction in long-term geriatric care facilities. Background Despite the adverse physical and psychosocial effects, physical restraints are still used frequently in many geriatric long-term care facilities around the world. There is, however, no study that synthesises the existing qualitative literature regarding the barriers to the restraint reduction from the perspective of facility staff. Design/Methods The metastudy research process guided this qualitative synthesis. Five electronic databases were searched, and ten studies were included in this metastudy. Results Five themes were identified through metasynthesis of the findings: concern about and responsibility for safety, unclear and inconsistent definitions of restraint and restraint-free care, difficulties in the transition from acceptance to removal, noninvolvement in decision-making to remove restraint and insufficient resources and education. Conclusion A concept analysis of physical restraint is sorely needed, and future studies should explore the prevalence of restraint, the effects of education for staff and family on restraint reduction, and success stories related to restraint-free care. More research is needed regarding the restraint reduction effectiveness and cost issues. Relevance to clinical practice Physical restraints, commonly used in many geriatric long-term care facilities, result in many negative effects and ethical issues. To achieve success in reducing physical restraint use, governmental policies and long-term care institutions should underpin staff efforts with legal, educational and practical support. [ABSTRACT FROM AUTHOR]

Aims and objectives To explore the needs of and support given to lesbian, gay, bisexual, transgendered and inter-sex parents within the Nordic child health field. Background The number of lesbian, gay, bisexual, transgendered and inter-sex parents is growing around the world. However, they face fear, discrimination and heteronormativity within the child health field. The Nordic countries (Sweden, Norway, Denmark, Finland and Iceland) rank as the most gender equal countries in the world; therefore, they may support lesbian, gay, bisexual, transgendered and inter-sex parents to a greater extent. Design Systematic literature review and meta-synthesis. Method A systematic search was conducted for lesbian, gay, bisexual, transgendered and inter-sex parents' experiences in the child health field, which consists of prenatal, labour and birth, postnatal and child health clinics, using PubMed, PsychInfo, Sociological Abstracts and CINAHL, as well as searching the grey literature, from 2000-2015. Ten articles were included. A quality assessment and a meta-synthesis of the articles were performed. Results Nearly all studies were qualitative, and most articles had at least one area of insufficient reporting. Only two countries, Sweden and Norway, had lesbian, gay, bisexual, transgendered and inter-sex parents reporting on the child health field. However, gay, bisexual, transgender and inter-sex parents' perspectives were nonexistent in the literature; therefore, the results all relate to same-sex mothers. Five themes were found: Acceptance of Same-sex Mothers, Disclosing Sexual Orientation, Heteronormative Obstacles, Co-mothers are Not Fathers, and Being the Other Parent. Conclusions Same-sex mothers are generally accepted within the Nordic child health field, but they still face overt and covert heteronormative obstacles, resulting in forms of discrimination and fear. Co-mothers feel invisible and secondary if they are not treated like an equal parent, but feel noticed and important when they are given equal support. Relevance to clinical practice Changes at the organisational and personnel levels can be made to better support same-sex mothers and co-mothers. Recognising both parents benefits the whole family. [ABSTRACT FROM AUTHOR]

Aims and objectives To interpret, describe and analyse the results of various qualitative studies and comprehensively elucidate the self-monitoring of blood glucose experiences of diabetic patients, and to make recommendations based on these findings for clinical practices. Background Patients exhibited both positive and negative perceptions towards the self-monitoring of blood glucose. Numerous recent qualitative studies have explored the self-monitoring of blood glucose experiences of diabetic patients; however, no integrated results have been provided. Design Qualitative metasynthesis. Methods A systematic literature search of English and Chinese databases was undertaken, covering the period between January 2004 and April 2014. The following databases were searched: CINAHL, Pub Med, MEDLINE, Cochrane Library, Airiti library and Psyc Info. Seven studies were assessed in the final analysis; the Joanna Briggs Institute Qualitative Assessment and Review Instrument was used to evaluate these studies. Results The self-monitoring experiences of patients with diabetes were divided into five themes: perceived disease severity, effects on daily life, lifestyle adjustments after becoming aware of blood glucose levels, determining the meaning of self-monitoring, and the differences between diabetic patients who use and do not use insulin. Individual differences in blood glucose self-monitoring vary widely among diabetic patients. Conclusions These differences result from personal cognition and feelings concerning blood glucose monitoring. Insights into and discussions regarding the self-monitoring of blood glucose experiences of diabetic patients enable health care professionals to understand the factors that influence the intentions of patients to perform self-monitoring of blood glucose and facilitate establishing customised self-monitoring of blood glucose treatment plans. Relevance to clinical practice Health care professionals must adopt flexible and individualised criteria to determine patient cognitive misconceptions, understand negative emotional reactions and provide individualised assistance. [ABSTRACT FROM AUTHOR]