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Research on women's experiences of infant feeding and related moral discourse suggests that self‐conscious emotions may be highly relevant to breastfeeding support interactions. However, the emotional impact of receiving support has not been fully explored. The aim of this review is to re‐examine qualitative UK research on receiving breastfeeding support, in order to explore the role of self‐conscious emotions and related appraisals in interactions with professional and peer supporters. From 2007 to 2020, 34 studies met criteria for inclusion. Using template analysis to identify findings relevant to self‐conscious emotions, we focused on shame, guilt, embarrassment, humiliation and pride. Because of cultural aversion to direct discussion of self‐conscious emotions, the template also identified thoughts about self‐evaluation, perceptions of judgement and sense of exposure. Self‐conscious emotions were explicitly mentioned in 25 papers, and related concerns were noted in all papers. Through thematic synthesis, three themes were identified, which suggested that (i) breastfeeding 'support' could present challenges to mothering identity and hence to emotional well‐being; (ii) many women managed interactions in order to avoid or minimise uncomfortable self‐conscious emotions; and (iii) those providing support for breastfeeding could facilitate women's emotion work by validating their mothering, or undermine this by invalidation, contributing to feelings of embarrassment, guilt or humiliation. Those supporting breastfeeding need good emotional 'antennae' if they are to ensure they also support transition to motherhood. This is the first study explicitly examining self‐conscious emotions in breastfeeding support, and further research is needed to explore the emotional nuances of women's interactions with supporters. [ABSTRACT FROM AUTHOR]

Aim. To understand nurses' perceptions and experiences of work role transitions. Background. Globally an uncertain healthcare landscape exists and when changing work roles nurses experience periods of transition when they may not cope well. A greater understanding of work role transitions may help facilitate workforce retention and successful careers. Design. Mixed methods systematic review. Data sources. Six data bases were searched for peer reviewed primary empirical research, published in English language between January 1990 and December 2014, supplemented by hand and citation searching. Review methods. Evidence for Policy and Practice Information and Co-ordinating Centre methods for systematic reviews principles were followed. Analysis and synthesis of the qualitative and quantitative papers was conducted separately using thematic analysis. A third synthesis combined the narrative findings and a narrative synthesis of results is presented. Results. Twenty-six papers were included. Across nurses' work role transitions two pathways were found: Novice and Experienced. 'Novice' comprises pre-registration and newly qualified nurses. 'Experienced' comprises, Enrolled/Licensed Practical Nurse to Registered Nurse, experienced to specialist nurse and clinical role changes. Each pathway results in different emphasizes of two themes; 'Striving for a new professional self' includes emotional upheaval and identity while 'Know how' includes competence and boundaries. Novice nurses are more susceptible to the extremes of emotional upheaval while experienced nurses' competence eases aspects of transitions while boundary issues pervade. Conclusion. Informed work and educational environments are required for all groups of nurses. Using existing models of transition can facilitate successful individual transitions and develop the workplace. [ABSTRACT FROM AUTHOR]

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]

Background The indication for implantable cardioverter-defibrillators (ICDs) to prevent sudden death is now consolidated. However, there is no unanimous agreement on how patients experience certain aspects of their lives after an ICD implant. Various clinical studies have evaluated the impact of ICDs on patient mortality, survival, and their beneficial effects. Given the growing number of qualitative studies, a synthesis of qualitative evidence became desirable. Aims To explore and synthesize the results of qualitative studies addressing the experiences of patients with an ICD. Methods We employed a systematic review and meta-synthesis. PubMed, CINAHL, and PsycINFO were systematically searched to identify qualitative studies published between January 2005 and October 2020, which investigate the experience of patients living with an ICD. Selected studies were assessed for quality by two reviewers independently. Results A total of 24 papers were selected. Six themes emerged: fear and insecurity, the need for information, new impacts on life, living with ICD shocks, gender differences, and the role of the family. These results could help clinicians and researchers to develop new strategies and interventions to improve the quality of life in these patients. Conclusion This meta-synthesis underlines the difficulties experienced by patients with ICD implants. Despite the advanced therapeutic management programmes for this type of intervention, it is necessary to adopt and implement the current post-discharge care plans, where the family's involvement is essential to help patients adapt to their new lifestyle. [ABSTRACT FROM AUTHOR]

Aim This paper aimed to suggest possible answers to the question: Why do patients with COPD decline pulmonary rehabilitation ( PR)? Method The study is a metasynthesis inspired by Noblit of the existing qualitative research on the area. The data were collected during 2014. Six studies were found through a systematic literature search in relevant databases. In these six studies, 65 persons were identified as decliners of PR. Four themes were identified from these studies. Results The themes identified were as follows: the referral process, transport problems, perception of health and other obligations or priorities. The problems with the referral of patients relate to different areas: the referring health professional's conviction and commitment, and the patients' understanding of the referral. It seems that various transport problems cause decline, for example long distance to the PR centre or the expenses of getting back and forth. Perceptions of health cause decline. Decliners feel too sick to join PR or do not identify themselves as a sick person, and do not want undertake the 'patient role'. Other obligations or priorities such as work, family obligations and vacations are prioritised on behalf of PR causing decline. Conclusion The studies included show patients' rational accounts and reflections on declining PR. The included studies tend to describe accounts for deselection of PR in relation to the preferences and beliefs of the patients rather than including the social and economic variables framing the behaviour and choices of the patients. [ABSTRACT FROM AUTHOR]

Objective The objective of this study was to conduct a systematic and comprehensive review of qualitative research to examine the physical and psychological needs, as well as work experiences, of patients undergoing total knee replacement and total hip replacement surgeries during their process of returning to work. Methods A systematic review and meta-synthesis of qualitative literature was conducted. A systematic search was conducted across 8 databases to identify qualitative or mixed-methods research on the needs and experiences of individuals with total knee replacement and total hip replacement who have returned to work. The search period extended from the inception of each database to March 2023. Two researchers independently utilized a predetermined search strategy to retrieve relevant English-language studies published in any year. The included studies were assessed for quality using the Critical Appraisal Skills Program appraisal tool. Findings from the studies were then summarized and integrated using the pooled integration method. Results There were 10 studies in total. Three key themes were identified from the original research: needs during the return to work process and rehabilitation training, faith and support to return to work, and constraints and challenges at work. Conclusion Health care professionals and employers should conscientiously consider the physical and psychological requirements of patients who have undergone total knee replacement and total hip replacement when they are resuming work, taking into account the specific constraints and challenges that may arise in the workplace. To ensure a seamless transition back to work, it is essential to develop tailored occupational interventions, implement comprehensive return to work programs, and offer patients sufficient understanding and support. Impact The findings of this study offer valuable insights into the physical and psychological needs, as well as the work experiences, of patients who have undergone total knee replacement and total hip replacement during their reintegration into the workforce. These findings have the potential to assist health care professionals and employers in providing enhanced support to facilitate successful return-to-work outcomes for patients. [ABSTRACT FROM AUTHOR]

Evidence supports the establishment of healthy feeding practices early in life to promote lifelong healthy eating patterns protective against chronic disease such as obesity. Current early childhood obesity prevention interventions are built on extant understandings of how feeding practices relate to infant's cues of hunger and satiety. Further insights regarding factors that influence feeding behaviors in early life may improve program designs and outcomes. Four electronic databases were searched for peer-reviewed qualitative studies published between 2000 to 2014 with transitional infant feeding practice rationale from developed countries. Reporting transparency and potential bias was assessed using the Consolidated Criteria for Reporting Qualitative Research quality checklist. Thematic synthesis of 23 manuscripts identified three themes (and six sub-themes): Theme 1. Infant (physical cues and behavioural cues) focuses on the perceived signs of readiness to start solids and the feeding to influence growth and 'health happiness.' Theme 2. Mother (coping strategies and knowledge and skills) focuses on the early survival of the infant and the family and the feeding to satisfy hunger and influence infant contentment, and sleep. Theme 3. Community (pressure and inconsistent advice) highlights the importance of generational feeding and how conflicting feeding advice led many mothers to adopt valued familial or culturally established practices. Overall, mothers were pivotal to feeding decisions. Satisfying infant's needs to reach 'good mothering' status as measured by societal expectations was highly valued but lacked consideration of nutrition, obesity, and long term health. Maternal interpretation of healthy infant feeding and successful parenting need attention when developing strategies to support new families. [ABSTRACT FROM AUTHOR]

Background: Siblings of children requiring palliative care are often forgotten and overlooked, as the focus tends to be on the ill child and their parents. Limited knowledge of non-bereaved siblings' perspectives makes it challenging to provide appropriate support for them. A review of existing literature is thus needed to better understand the experiences of these siblings and to identify research gaps that may require further examination. Aim: To consolidate the available qualitative evidence on the perspectives of non-bereaved healthy siblings regarding paediatric palliative care. Design: A qualitative systematic review using a meta-synthesis approach was conducted. Data sources: Six electronic databases (PubMed, CINAHL, PsycINFO, Embase, Scopus and ProQuest Dissertations and Theses Global) were searched from each database's inception date until October 2022. The search included qualitative and mixed-method studies that reported the perceptions and associations of siblings of patients receiving paediatric palliative care. Data were synthesised using thematic analysis. Results: Eleven studies were included. The overarching theme of the review would be 'A walking shadow: Living in the darkness shaped by the dying sibling', and three key themes and nine subthemes were identified from the included articles: (1) Changing family dynamics; (2) Impact on school and socialisation and (3) Psychological impact and coping. Conclusion: Siblings demonstrated negative psychological impacts and were affected by changing family structure and relationships. However, socialisation with society, and varied coping skills such as cognitive coping and using distraction techniques, were significant for siblings to go through this journey and even led to some positive outcomes for them. [ABSTRACT FROM AUTHOR]

Women represent almost half of the 20 million refugees worldwide, and although they play a key role in their communities, their voices and needs are often missing from research and policies directed to this population. A qualitative systematic review, or metasynthesis, was conducted to examine the experiences, perceptions, coping mechanisms, and psychological discourses of women refugees in situations of sexual and gender-based violence (SGBV) that occur during the travel, interception, and destination migratory stages. A systematic search was conducted on five multidisciplinary databases and was complemented with a manual search, resulting on a total of 511 articles which were screened for eligibility. Only qualitative, peer-reviewed, and English-written research articles were selected, and they were required to (1) focus on women refugees above 15 years of age and (2) report on their experiences, perceptions, psychological discourses, and/or coping with SGBV during their migration across countries (international migration). Ultimately, a total of 14 qualitative research articles were selected for the review. Using the thematic synthesis approach as a guideline, the results were summarized in the following themes: experiences of SGBV, perception of SGBV, perception of the risk factors creating and perpetuating their vulnerability, coping with SGBV, barriers to help-seeking, and psychological consequences. Despite the broad search, only information about some types of SGBV experiences from Asian and African refugee communities was found. Nonetheless, the available qualitative information on this topic is effectively integrated, knowledge gaps are identified, and future research, interventions, and policies using an integrated and culturally sensitive framework are suggested. [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]

Background: The reproductive and perinatal health of sexual and gender‐diverse (SGD) individuals is a research priority area for the National Institutes of Health. Over the past decade, this childbearing population has been the focus of several qualitative studies providing the opportunity to evaluate and synthesize the qualitative literature on SGD childbearing experiences in a metasynthesis. Methods: We conducted a literature search of four databases to identify original research published from January 2011 through June 2021. These results were augmented by forward and backward searching strategies. Two authors independently screened studies. All qualitative studies of the childbearing experience were eligible. Data were extracted and inductively coded using conventional content analysis, and studies underwent a quality appraisal by two authors. Results: From 2396 articles, 127 full‐text articles were screened, and 25 were included in this synthesis. Three overarching themes were identified: (a) Systematic Invisibility; (b) Creating Personhood Through Parenthood; and (c) Resilient Narratives of Childbearing. Conclusions: Relative to heterosexual and cisgender parents, SGD childbearing parents experience unique structural and interpersonal challenges and employ critically important resilience strategies and coping techniques to manage an overwhelming heterocisnormative experience. These findings provide an important target for health care organizations and professionals to improve SGD perinatal health. In addition, this metasynthesis identified persistent gaps in our understanding of this marginalized childbearing population, which have important implications for reducing health disparities that SGD parents experience. [ABSTRACT FROM AUTHOR]

Inadequate attendance to antenatal care has been associated with negative maternal and fetal outcomes, including stillbirth. This study aimed to identify facilitators and barriers to antenatal care attendance. A systematic search was conducted in March 2019 and updated in January 2021. Qualitative studies involving pregnant or post‐partum women up to 12 months from high‐income countries that provided data about facilitators and barriers to antenatal care attendance were sought. Meta‐ethnography was used to inform this meta‐synthesis. Fifteen studies were included in the analysis. Findings indicate that inadequate antenatal care attendance is influenced at different levels. Aspects like sociodemographic factors, difficulties navigating the health system, administrative delays, lack of flexibility and tailored care, constant change of carer and communication issues also act as barriers. These issues affect women's access to knowledge and the formation of women's beliefs and feelings towards seeking care. On the contrary, having a positive attitude towards the pregnancy, encountering empathetic healthcare professionals and availing of social support acted as facilitators. The reasons why women seek or delay attending antenatal care are multifactorial and can be explained using the Social Determinants of Health Framework. Any response needs to be taken across all levels of influence and not just focused on the individual. A better understanding of the barriers and facilitators to antenatal care might contribute to informing intervention or policy development addressing this issue. [ABSTRACT FROM AUTHOR]

Aims: To review and synthesize qualitative studies to gain a deeper understanding of critical care nurses' inter‐departmental and shift‐to‐shift handover challenges. Background: Good‐quality nurse‐to‐nurse handover promotes patient safety, while poor handover has been associated with medical errors. However, systematic reviews of qualitative approaches for better understanding the handover experiences of critical care nurses are lacking. Evaluation: Systematic review methods incorporating meta‐synthesis were used. A comprehensive search of seven databases was conducted. Two independent reviewers performed data extraction and evaluated ten studies using the Critical Appraisal Screening Program. Findings were analysed and synthesized using thematic analysis. The transactional model of communication was used to guide the analysis. Key issues: A total of 10 qualitative studies were included. Seven major handover themes were identified: (a) expectations of perfection, (b) need for partnership, (c) unilateral communication, (d) obstacles to information acquisition, (e) lack of pertinent patient information, (f) need for a structured handover and (g) interruptions/distractions. Conclusions: Handovers should be considered an essential part of patient‐centred care for ensuring continuity of care. Implications for Nursing Management: Poor communication during a handover could increase the nurse's burden or stress and adversely affect patient care. Therefore, training should be provided on explicit handover communication. [ABSTRACT FROM AUTHOR]

Background: Cesarean section (CS) rates have been increasing globally. Iran has one of the highest CS rates in the world (47.9%). This review was conducted to assess the prevalence of and reasons for women's, family members', and health professionals' preferences for CS in Iran. Methods and findings: In this mixed-methods systematic review, we searched MEDLINE/PubMed, Embase, CINAHL, POPLINE, PsycINFO, Global Health Library, Google scholar; as well as Iranian scientific databases including SID, and Magiran from 1 January 1990 to 8th October 2019. Primary quantitative, qualitative, and mixed-methods studies that had been conducted in Iran with Persian or English languages were included. Meta-analysis of quantitative studies was conducted by extracting data from 65 cross-sectional, longitudinal, and baseline measurements of interventional studies. For meta-synthesis, we used 26 qualitative studies with designs such as ethnography, phenomenology, case studies, and grounded theory. The Review Manager Version 5.3 and the Comprehensive Meta-Analysis (CMA) software were used for meta-analysis and meta-regression analysis. Results showed that 5.46% of nulliparous women (95% CI 5.38–5.50%; χ2 = 1117.39; df = 28 [p < 0.00001]; I2 = 97%) preferred a CS mode of delivery. Results of subgroup analysis based on the time of pregnancy showed that proportions of preference for CS reported by women were 5.94% (95% CI 5.86–5.99%) in early and middle pregnancy, and 3.81% (95% CI 3.74–3.83%), in late pregnancy. The heterogeneity was high in this review. Most women were pregnant, regardless of their parity; the risk level of participants were unknown, and some Persian publications were appraised as low in quality. A combined inductive and deductive approach was used to synthesis the qualitative data, and CERQual was used to assess confidence in the findings. Meta-synthesis generated 10 emerging themes and three final themes: 'Women's factors', 'Health professional factors', andex 'Health organization, facility, or system factors'. Conclusion: Despite low preference for CS among women, CS rates are still so high. This implies the role of factors beyond the individual will. We identified a multiple individual, health facility, and health system factors which affected the preference for CS in Iran. Numerous attempts were made in recent years to design, test and implement interventions to decrease unnecessary CS in Iran, such as mother-friendly hospitals, standard protocols for labor and birth, preparation classes for women, midwives, and gynaecologists, and workshops for specialists and midwives through the "health sector evolution policy". Although these programs were effective, high rates of CS persist and more efforts are needed to optimize the use of CS. [ABSTRACT FROM AUTHOR]

Abstract: Loneliness and social isolation are major problems for older adults. Interventions and activities aimed at reducing social isolation and loneliness are widely advocated as a solution to this growing problem. The aim of this study was to conduct an integrative review to identify the range and scope of interventions that target social isolation and loneliness among older people, to gain insight into why interventions are successful and to determine the effectiveness of those interventions. Six electronic databases were searched from 2003 until January 2016 for literature relating to interventions with a primary or secondary outcome of reducing or preventing social isolation and/or loneliness among older people. Data evaluation followed Evidence for Policy and Practice Information and Co‐ordinating Centre guidelines and data analysis was conducted using a descriptive thematic method for synthesising data. The review identified 38 studies. A range of interventions were described which relied on differing mechanisms for reducing social isolation and loneliness. The majority of interventions reported some success in reducing social isolation and loneliness, but the quality of evidence was generally weak. Factors which were associated with the most effective interventions included adaptability, a community development approach, and productive engagement. A wide range of interventions have been developed to tackle social isolation and loneliness among older people. However, the quality of the evidence base is weak and further research is required to provide more robust data on the effectiveness of interventions. Furthermore, there is an urgent need to further develop theoretical understandings of how successful interventions mediate social isolation and loneliness. [ABSTRACT FROM AUTHOR]