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Background: The under‐detection of depression in adolescents suggests that a better understanding of its presentation may be needed. Conceptualizations of adolescent depression are largely the same as adult depression, with minimal consideration of developmental stage. Exploration of first‐hand accounts could help to identify any unique features of adolescent depression. Therefore, this systematic review aimed to understand the lived experience of adolescents with depression to inform clinical practice. Methods: The review was registered with PROSPERO (CRD42020198141). Databases (PsychINFO, CINAL, MEDLINE and EMBASE) were searched in March 2022 to identify peer‐reviewed qualitative studies on first‐hand experiences of adolescent depression. The Joanna Briggs Institute's qualitative data extraction tool and checklist for qualitative research were used to obtain study data and assess methodological quality of included papers. Meta‐aggregation was the method of synthesis, whereby extracted themes from the papers were grouped according to shared meanings. Results: Fifteen papers of mixed methodological quality were identified for inclusion from screening a total of 1,983 references. Studies were published between 2002 and 2021, spanned seven countries and included participants aged 11 to 22 years old. Aggregation of 56 themes resulted in 16 categories and 3 synthesized findings encompassing key aspects of adolescent depression: causes, symptoms and coping. Variability in adolescents' perspectives across these domains was evident. Some symptoms described, such as social disconnection and anger, are not listed in existing diagnostic criteria. Conclusions: Subjective experiences of depression among adolescents vary and may not entirely match diagnostic criteria. Awareness of this when assessing for depression may improve detection and help to ensure adolescents feel understood. [ABSTRACT FROM AUTHOR]

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]

Rationale, aims and objectives Complex and chronic disease is placing significant pressure on hospital outpatient departments. Novel ways of delivering care have been developed recently and are often described as 'triage' services. This paper reviews the literature pertaining to definitions and descriptions of orthopaedic/musculoskeletal triage processes, in order to provide information on 'best practice' to assist health care facilities. Method A comprehensive open-ended search was conducted using electronic databases to identify studies describing models of triage clinics for patients with a musculoskeletal/orthopaedic complaint, who have been referred to hospital outpatient clinics for a surgical consultation. Studies were critically appraised using the McMaster quality appraisal tool and ranked using the National Health and Medical Research Council hierarchy of evidence. A thematic analysis of the definitions, processes and procedures of triage described within the literature was undertaken. Results 1930 studies were identified and 45 were included in the review (including diagnostic and evaluative research). The hierarchy of evidence ranged from I to IV; however, the majority were at low levels of evidence and scored poorly on the critical appraisal tool. Three broad themes of triage were identified: presence of a referral, configuration of the triage (who, how and where) and the aim of triage. However, there were significant inconsistencies across these themes. Conclusions This systematic review highlighted the need for standardization of the definition of triage, the procedures of assessment and management and measures of outcome used in orthopaedic/musculoskeletal triage to ensure best-practice processes, procedures and outcomes for triage clinics. [ABSTRACT FROM AUTHOR]

Diabetic foot ulceration (DFU) is a common and debilitating complication of diabetes that is preventable through active engagement in appropriate foot‐related behaviours, yet many individuals with diabetes do not adhere to foot care recommendations. The aim of this paper was to synthesise the findings of qualitative papers exploring diabetic people's perceptions and experiences of DFU in order to identify how they could be better supported to prevent ulceration or manage its impact. Five databases (MEDLINE, PsycINFO, CINAHL, EMBASE, Web of Science) were searched in May 2016 to identify eligible articles. Findings were synthesised using a meta‐ethnographic approach. Forty‐two articles were eligible for inclusion. Synthesis resulted in the development of five overarching themes: personal understandings of diabetic foot ulceration; preventing diabetic foot ulceration: knowledge, attitudes, and behaviours; views on health care experiences; development of diabetic foot ulceration and actions taken; and wide‐ranging impacts of diabetic foot ulceration. The findings highlight various barriers and facilitators of foot care experienced by people with diabetes and demonstrate the significant consequences of ulcers for their physical, social, and psychological well‐being. The insights provided could inform the development of interventions to promote foot care effectively and provide appropriate support to those living with ulceration. [ABSTRACT FROM AUTHOR]

Aim: To explore the attitudes and experiences of allied health students working with older adults on residential aged care placements. Method: A systematic literature search was conducted to identify studies of any design describing allied health student experience of residential aged care placements. Online databases searched to identify potentially relevant documents included Scopus, Web of Science, PubMed, CINAHL Complete (EBSCOhost) and Health and Medicine (ProQuest). Studies were excluded if residential aged care facilities or allied health professional students could not be extracted from the data. No restrictions were applied to methodological design, language, geographical location or year of publication. The Mixed Methods Appraisal Tool was used to assess methodological quality. Extracted studies were analysed to identify the study design, participant and placement characteristics, study methodology and student experience measures. Data from the included studies were analysed thematically using meta‐synthesis. Results: Six studies (total number of participants, n = 308) met inclusion criteria, with four papers scoring a 5/5 on the Mixed Methods Appraisal Tool. Studies included undergraduate and master's students from physiotherapy (n = 3), speech language pathology (n = 2), dietetics (n = 1) and audiology (n = 1). Placement length varied from two to 15 h, between one and six residential aged care visits. Three themes were identified; (1) Opportunity to improve skills and gain confidence, (2) Development of empathy and shift in attitudes towards older adults and (3) Recognised challenges associated with older adults and residential aged care settings. Conclusion: While the size of the evidence‐base is limited, the studies were largely consistent in demonstrating an increase in positive attitudes towards older adults following residential aged care placements. Future research, innovations and planning around workforce size, preparation and motivation must be prioritised to ensure older adults receive the care they need and deserve. [ABSTRACT FROM AUTHOR]

Introduction: Graduate attributes are the personal qualities, skills and competencies, and values that students develop during their time at university to prepare them for work, and enable them to contribute to their communities. Occupational therapy education may foster well‐rounded individuals if the development of graduate attributes is embedded within curriculum design and delivery. Methods: This study identifies and synthesises existing knowledge on how graduate attributes are embedded in occupational therapy curricula. We conducted a scoping review following PRISMA extension for scoping review guidelines, and a qualitative research synthesis to reach a new conceptual understanding of the process of developing desired graduate attributes during occupational therapy curriculum development. Results: Ten discipline‐specific occupational therapy graduate attributes were identified. Three themes from the analysis of 15 papers explained how these attributes are embedded in curricula: Using a theoretical framework, a Graded process of active learning, and Collaborative curriculum design. Conclusion: Occupational therapy education is enhanced by being explicit about the desired graduate attributes that underpin curriculum design and delivery. Further work is needed to understand the benefits of including service users' perspectives and the value of clinical fieldwork education. [ABSTRACT FROM AUTHOR]

Background: Mindfulness‐based Cognitive Therapy (MBCT) is a relapse‐prevention intervention for people experiencing major depression. Three qualitative meta‐syntheses investigating experiences of taking part in MBCT and/or Mindfulness‐based Stress Reduction (MBSR) across different diagnostic populations reported themes including control, choice, group processes, relationships and struggles. As multiple studies have been published since, we aimed to update, systematically review and synthesize the experiences of participants with depression taking part in MBCT. Methods: Four databases were searched systematically (PsycInfo, Web of Science, Medline and CINAHL) up to and including 12 November 2021. Twenty‐one qualitative studies met the review criteria. All papers were rated as fair using a quality appraisal tool. Meta‐ethnography was applied. Results: Across 21 studies of participants with current or previous depression who had participated in MBCT, three overarching themes were developed: 'Becoming skilled and taking action', 'Acceptance' and 'Ambivalence and Variability'. Participants became skilled through engagement in mindfulness practices, reporting increased awareness, perspective and agency over their experiences. Participants developed acceptance towards their experiences, self and others. There was variability and ambivalence regarding participants' expectations and difficulties within mindfulness practices. Limitations: Many studies were conducted in MBCT‐research centres that may hold conflicts of interest. Many studies did not address the impact of the participant–researcher relationship thus potentially affecting their interpretations. Studies were skewed towards the experiences of female participants. Conclusions: Our findings help to enhance participant confidence in MBCT, alongside understanding the processes of change and the potential for difficulties. MBCT is beneficial and provides meaningful change for many but remains challenging for some. [ABSTRACT FROM AUTHOR]

Background: Multiple sclerosis (MS) is a chronic serious condition of uncertain course and outcome. There is relatively little literature on the experiences of people who live with a person with MS. They inhabit a locus of care that spans caring for (a relational act) and caring about (a moral stance, addressing fairness, compassion and justice) the person with MS. Methods: Using the theoretical lens of personhood, we undertook a scoping review and meta‐synthesis of the qualitative literature on the experiences of people who live with a person with MS, focusing on the nature of, and constraints upon, caring. Results: Of 330 articles, 49 were included in the review. We identified five themes. One of these—seeking information and support—reflects the political economy of care. Two are concerned with the moral domain of care: caring as labour and living with uncertainty. The final two themes—changing identities and adapting to life with a person with MS—point to the negotiation and reconstitution of personhood for both the person with MS and the people they live with. Conclusion: People with MS are embedded in relational social networks of partners, family and friends, which are fundamental in the support of their personhood; the people who live with them are 'co‐constituents of the patient's identity' assisting them to make sense of their world and self in times of disruption due to illness. Support services and health care professionals caring for people with MS are currently very much patient‐centred; young people in particular report that their roles are elided in the health system's interaction with a parent with MS. There is a need to look beyond the person with MS and recognize the relational network of people who surround them and broaden their focus to encompass this network. Patient and Public Involvement: Our research team includes four members with MS and two members with lived experience of living or working with people with MS. A third person (not a team member) who lives with a partner with MS provided feedback on the paper. [ABSTRACT FROM AUTHOR]

Aim To examine qualitative research exploring older people's experiences of falling and the perceived risk of falling in the community. This will contribute new insights into how falling is perceived by the older community. Background Falls are a major problem for older people and healthcare services across the world. Accidental falls in the community are a persistent problem that is generally recognised as an intrinsic risk of ageing. This review provides a new synthesis of evidence that considers older people's perception of falls in the community as new insights are needed if the increasing problems of falls are to be addressed. Design Synthesis of the qualitative literature employing Noblit and Hare's method of reciprocal translation. CINAHL, Medline, EMBASE, Psych INFO and BNI were searched 1999-2015. Methods Noblit and Hare's method of reciprocal translations was used to conceive this meta-ethnographic synthesis. The ENTREQ statement was employed as a tool for reporting the synthesis of qualitative research. The PRISMA statement was used for reporting the different phase of the literature search, and the Critical Appraisal Skills Programme qualitative research checklist was used as an appraisal framework. Results Eleven papers fit the inclusion criteria and revealed a series of themes. These were falls as a threat to personal identity, falls as a threat to independence, falls as a threat to social interaction and carefulness as a protective strategy. Conclusion Many older people reject the label of 'at risk of falling' because of the perceived implication of dependency and incompetence. To be considered 'at risk' of falling is perceived as threatening the identity of individuals who are comfortable maintaining their own independence. However, there are also those who accept the risk of falling and in doing so choose carefulness as a personal strategy to manage the risk. For the majority of older people, maintaining independence is the key motivator influencing their actions. Independence to pursue social interaction safeguards against loss of identity, social isolation and negative feelings of dependency. Falling in the community is a problem that persists, despite intervention of local health teams. This article contributes to a body of evidence on older people's experience of falling in the community with the aim of providing new insights for nurses as they approach the issues with patients. Implications for practice Management of falls risk improves through constructive, proactive health behaviour. Promoting a positive attitude towards living well encourages older people to engage in healthy, risk reducing behaviours. Older people reject the designation of 'at risk of falling' due to a perceived association with dependency and incompetence. The negative association is a barrier to engaging at-risk populations with fall prevention interventions. [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]

Purpose To review the literature for best practices for engaging clinical nurses in nursing research. Design Review of the research and nonresearch papers published between 2005 and 2015 that answered the evidence-based practice (EBP) question: what are the best practices for engaging clinical nursing staff in nursing research? Methods PubMed, Cumulative Index to Nursing and Allied Health Literature (CINAHL), Joanna Briggs Institute, and Cochrane were searched using a combination of controlled vocabulary and key words. Nineteen papers that answered the EBP question were selected for review. Results It can be difficult to involve clinical nurses in research. There are multiple factors to consider when nursing leadership looks to engage clinical nurses in nursing research. Conclusions Nurse leaders can take many approaches to engage clinical nurses in research. Each organization must perform its own assessment to identify areas of opportunity. Nursing leadership can take these areas of opportunity to structure a multifaceted approach to support clinical staff in the conduct and dissemination of nursing research. Clinical Relevance The evidence from this review offers EBP recommendations as well as reports on the gaps in the literature related to best practices for engaging clinical nurses in nursing research. [ABSTRACT FROM AUTHOR]

Aim The objective of this systematic review was to identify primary health-care or aged-care strategies that have or could support the well-being of older Indigenous peoples. Methods A search was undertaken of primary databases including Medical Literature Analysis and Retrieval System Online and Cumulative Index to Nursing and Allied Health Literature. Papers which reported on the perspectives of older Indigenous peoples, community members and provider participants were included. Findings were pooled using a meta-aggregative approach. Results Three high-level synthesised findings - maintaining Indigenous identity, promoting independence and delivering culturally safe care - were believed to be important for supporting the well-being of older Indigenous peoples. Conclusions As physical independence often diminishes with age, having the support of culturally safe primary health-care and aged-care services that understand the importance of maintaining an Indigenous identity and promoting independence will be crucial for the well-being of older Indigenous peoples. [ABSTRACT FROM AUTHOR]

Transfers of critically ill neonates are frequent phenomena. Even though parents’ participation is regarded as crucial in neonatal care, a transfer often means that parents and neonates are separated. A systematic review of the parents’ experiences of neonatal transfer is lacking. This paper describes a meta‐study addressing qualitative research about parents’ experiences of neonatal transfer. Through deconstruction and reflections of theories, methods, and empirical data, the aim was to achieve a deeper understanding of theoretical, empirical, contextual, historical, and methodological issues of qualitative studies concerning parents’ experiences of neonatal transfer over the course of this meta‐study (2000–2017). Meta‐theory and meta‐method analyses showed that caring, transition, and family‐centered care were main theoretical frames applied and that interviewing with a small number of participants was the preferred data collection method. The meta‐data‐analysis showed that transfer was a scary, unfamiliar, and threatening experience for the parents; they were losing familiar context, were separated from their neonate, and could feel their parenthood disrupted. We identified ‘wavering and wandering’ as a metaphoric representation of the parents’ experiences. The findings add knowledge about meta‐study as an approach for comprehensive qualitative research and point at the value of meta‐theory and meta‐method analyses. [ABSTRACT FROM AUTHOR]

Objectives: To identify, describe and synthesise the views and experiences of adults living with asthma regarding shared decision‐making (SDM) in the existing qualitative literature Methods: We conducted a comprehensive search of 10 databases (list databases) from inception until September 2023. Screening was performed according to inclusion criteria. Tools from the Joanna Briggs lnstitute were utilised for the purposes of data extraction and synthesis in this study. The data extraction process in this study employed the Capability, Opportunity and Motivation Model of Behaviour (COM‐B model) as a framework, and a pragmatic meta‐aggregative approach was employed to synthesise the collected results. Results: Nineteen studies were included in the metasynthesis. Three synthesised themes were identified: the capability of people living with asthma, the opportunities of people living with asthma in SDM, and the motivation of the people living with asthma in SDM. Conclusions: We have identified specific factors influencing people living with asthma engaging in SDM. The findings of this study can serve as a basis for the implementation of SDM in people living with asthma and provide insights for the development of their SDM training programs. The ConQual score for the synthesised findings was rated as low. To enhance confidence, future studies should address dependability and credibility factors. Practice Implications: This review contemplates the implementation of SDM from the perspective of people living with asthma, with the aim of providing patient‐centred services for them. The results of this review can benefit the implementation of SDM and facilitate information sharing. It offers guidance for SDM skills training among adults living with asthma, fosters a better doctor–patient relationship and facilitates consensus in treatment decisions, thereby enabling personalised and tailored medical care. Patient or Public Contribution: Three nursing graduate students participated in the data extraction and integration process, with two students having extensive clinical experience that provided valuable insights for the integration. [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]

There is a growing body of qualitative literature describing the lived experiences of people with tic disorders (TDs). The aim of this paper was to conduct a systematic review of this literature, synthesizing the perspectives of individuals on their experiences. Meta-synthesis methodology was utilized to review and draw together findings from 10 articles, from which key concepts were extracted, and over-arching themes generated. Six themes were identified to encompass the experience of TDs, including (1) cultural, semantic issues of the condition; (2) negative experiences in organizations and treatment; (3) the value and negative impact on interpersonal relationships; (4) personal identity in the constant presence of TDs; (5) concerns for the future; and (6) strategies to control and manage the observable presence of tics. Adaptive coping strategies were found to encompass continuous social adaptation, strategies to manage tics and social perceptions, self-acceptance, advocacy, and support from others. The results highlighted the significant role of social and cultural issues related to understanding and stigma, which underpinned many of the lived experiences. Implications for clinical practice in supporting individuals with TDs were also highlighted. [ABSTRACT FROM AUTHOR]

Background: Hospital avoidance services are important for older people who risk deteriorating health and independence when in hospital. However, the evidence base for nurse‐led community services is equivocal. Objectives: To determine the impact of community nurse‐led interventions on the need for hospital use among older adults. Methods: The integrative review method of Whittemore and Knafl was employed and reported in accordance with PRIMSA guidelines. Medline, EMBASE and CINAHL were searched from January 2011 to January 2019. Outcomes were coded and findings reported by outcome domain to provide an integrated, narrative synthesis. Results: Nine studies were included in the review. Whilst disparities in the evidence base persist, specialist high‐intensity, team‐based hospital‐at‐home services were significantly more likely to reduce hospital admissions than standard care. An individual case management services that incorporated self‐help education for chronic disease management also reduced hospital admissions. Financial data suggest that whilst high‐intensity services are costly, they can lead to significant efficiency savings in the longer‐term. Conclusion: This topic remains an important area for further investment, managerial support and research because of the risks faced by older people when admitted to hospital, for whom health, quality of life and independence are vital considerations. Implications for practice: The provision of high‐intensity team‐based services and self‐help education can optimise health outcomes and reduce the need for hospital use among older adults living in the community. [ABSTRACT FROM AUTHOR]

Context: Interprofessional practice is required to manage complex health care needs globally. It is well established that interprofessional placements (IPP) prepare students to work collaboratively, yet IPP implementation remains limited and disjointed. Objectives: This review synthesised student, educator and service user perspectives in order to better understand challenges of IPP and provide recommendations for sustainable IPP implementation. Methods: A systematic metasynthesis of qualitative literature sourced from databases including CINAHL, Embase and PsycINFO was completed. Studies that incorporated student, educator and/or service user perspectives on IPP experiences were included. We focused specifically on factors limiting implementation of IPP. The presage‐process‐product (3P) theory provided the theoretical framework for inductive synthesis of 41 empirical studies. A confidence rating for findings was formulated using CERQual (confidence in evidence from reviews of qualitative research). Results: We developed three themes, which represent key challenges to IPP becoming embedded in placement culture: (i) thin theoretical foundations underpinned IPP, limiting understanding of the learning processes involved; (ii) implementation relied heavily on individual champions, which curtails investment and sustainability when personnel change, and (iii) students, educators and service users were unsure of the function of IPP and their respective roles, leading to uncertainty along with some negative perceptions of this placement approach. Conclusions: In line with the 3P theoretical framework, IPP would benefit from explicit connections with educational and change management theories during presage stage IPP requires coordinated leadership and resource investment, and during product stage clear integration of interprofessional learning outcomes in curricula is advised. Addressing the identified challenges across the stages of IPP will support further development of IPP, firmly establishing this approach within placement culture. IPP can them make a significant contribution to the development of a collaborative practice‐ready workforce. This in turn will enhance service user outcomes and safety. This review provides an overview of the challenges faced during interprofessional placements and makes recommendations for facilitating collaborative practice to address increasingly complex healthcare needs. [ABSTRACT FROM AUTHOR]

Objective: To synthesize the qualitative literature on adults' experiences of psychological therapy assessments. The review was led by people with experience of undergoing assessments, with high levels of client involvement throughout. Search strategy: A comprehensive search of electronic databases was undertaken, with additional search strategies employed to locate further literature. Inclusion criteria: Studies were included that qualitatively explored the experiences of people aged 16+ who had been assessed for psychological therapy services. Assessments could be structured or unstructured. Qualitative was defined as any analysed account of people's experiences, including qualitative survey data. Data extraction and synthesis: Literature quality was appraised using the Critical Appraisal Skills Program checklist, modified to include client involvement and intersectionalities. Following data extraction, thematic synthesis was used to synthesize findings across studies. Results: Of 12 743 titles were screened, with 13 studies relevant to the review. Themes and subthemes were identified at three stages of the assessment process: the journey to the assessment, at the assessment, and after the assessment. Findings highlighted the emotional impact of assessments, collaboration, intersectionalities, rights, pathologization, socioeconomic restrictions, and information and support needs. Implications and limitations were indicated. Discussion and conclusions: Findings were situated within the trauma‐informed (TIA) literature. Trauma‐informed assessment principles, including collaborative assessments, may be fruitful means of improving people's experiences. Whilst the benefits of collaboration appear self‐evident, explicitly collaborative approaches were not the norm, nor were studies conducted independently. Further service user research is needed. A greater understanding of the experience of minority groups is also needed. [ABSTRACT FROM AUTHOR]

Abstract: Introduction: Parent‐delivered therapy interventions for children with cerebral palsy can help achieve a sufficient therapy dose, improve parental mental well‐being, and facilitate parent–child relationships creating a more relaxed familial environment. However, parent‐delivered interventions may also lead to increased parental stress, guilt if the therapy is not delivered, and time constraints. The primary aim of this review was to gain a deeper understanding of the determinants of effective parent‐delivered therapy interventions. Method: Searches were conducted in the following databases: Medline, PubMed, Scopus, Embase, CINAHL, and Cochrane. Studies had to meet the following inclusion criteria: descriptions of parent/health care professional/child experiences of parent‐delivered therapy interventions for children and young people age 0–18 years with cerebral palsy, published in the English language between January 1989 and May 2017, with qualitative or mixed methods research design. The articles were critically appraised, then synthesized using a meta‐ethnographic approach. Results: A literature search identified 17 articles, which met the inclusion criteria. Three main themes were identified: (a) building trusting relationships, (b) enabling the parents to cope, and (c) for parents and health care professionals to see the intervention as a priority. Further synthesis presented three concepts identifying the important aspects of the interventions: empowerment, motivation, and relationships. Conclusions: The themes and concepts emerging from this qualitative synthesis can be addressed by specific points of action to support parent‐delivered therapy interventions. We have summarized these in a checklist for use by intervention developers, health care professionals, and parents. [ABSTRACT FROM AUTHOR]

Objectives: Rising demand for emergency and urgent care services is well documented, as are the consequences, for example, emergency department (ED) crowding, increased costs, pressure on services, and waiting times. Multiple factors have been suggested to explain why demand is increasing, including an aging population, rising number of people with multiple chronic conditions, and behavioral changes relating to how people choose to access health services. The aim of this systematic mapping review was to bring together published research from urgent and emergency care settings to identify drivers that underpin patient decisions to access urgent and emergency care. Methods: Systematic searches were conducted across Medline (via Ovid SP), EMBASE (via Ovid), The Cochrane Library (via Wiley Online Library), Web of Science (via the Web of Knowledge), and the Cumulative Index to Nursing and Allied Health Literature (CINAHL; via EBSCOhost). Peer-reviewed studies written in English that reported reasons for accessing or choosing emergency or urgent care services and were published between 1995 and 2016 were included. Data were extracted and reasons for choosing emergency and urgent care were identified and mapped. Thematic analysis was used to identify themes and findings were reported qualitatively using framework-based narrative synthesis. Results: Thirty-eight studies were identified that met the inclusion criteria. Most studies were set in the United Kingdom (39.4%) or the United States (34.2%) and reported results relating to ED (68.4%). Thirty-nine percent of studies utilized qualitative or mixed research designs. Our thematic analysis identified six broad themes that summarized reasons why patients chose to access ED or urgent care. These were access to and confidence in primary care; perceived urgency, anxiety, and the value of reassurance from emergency-based services; views of family, friends, or healthcare professionals; convenience (location, not having to make appointment, and opening hours); individual patient factors (e.g., cost); and perceived need for emergency medical services or hospital care, treatment, or investigations. Conclusions: We identified six distinct reasons explaining why patients choose to access emergency and urgent care services: limited access to or confidence in primary care; patient perceived urgency; convenience; views of family, friends, or other health professionals; and a belief that their condition required the resources and facilities offered by a particular healthcare provider. There is a need to examine demand from a whole system perspective to gain better understanding of demand for different parts of the emergency and urgent care system and the characteristics of patients within each sector. [ABSTRACT FROM AUTHOR]

ABSTRACT Aims and objectives This review examined the literature across 12 years that explored nurses' perceptions of their role when communicating with families in adult intensive care units ( ICUs). The objectives were: (1) to describe how ICU nurses facilitated communication with families; (2) the perceived barriers to that communication; (3) strategies to improve their skills. Background Evidence demonstrates that effective communication by health care providers can improve families' understanding of their situation and decrease their psychological burden. The continuous presence of ICU nurses, combined with the use of effective empathic communication skills, can impact on families' ICU experience in a positive way. Nevertheless, research continues to demonstrate that communication with families in ICU is inadequate and of poor quality. Search strategies and design Eight databases were systematically searched to identify peer reviewed studies published in English between 2002 and 2014. The results are presented via a thematic literature review. Findings Four major themes emerged from a synthesis of the review findings: 'Nurses as information and communication facilitators', 'Nurses as family support providers', 'Nurses' non-supportive behaviours' and 'Improving nurses' communication skills'. Conclusions Most ICU nurses considered communicating with families a vital part of their role, and described supportive behaviours. However, they perceived significant barriers to effective communication; some as a result of active decisions on their part, and some beyond their control. These barriers often resulted in nurses believing that families received suboptimal information and support. Peer support and formal training were identified as key strategies to overcome inadequacies. Relevance to clinical practice This review summarizes nurses' perceptions of the means and barriers for communicating with families in ICUs. Intensive care nurses need skills and knowledge in how to communicate effectively with families. This skill can be learnt formally, or acquired from role modelling of more experienced peers. [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]

Background: The Australian 2021 Royal Commission identified that the dietetic workforce needs to grow in size and capacity to support nutrition care in older adults. However, little is known about dietitians' knowledge, skills and attitudes (KSA) regarding working with older adults in residential aged care facilities (RACFs) or their homes. This review describes dietitians' KSA regarding older adults in RACFs and home care services. Methods: A systematic literature search was conducted in August 2021 to identify studies examining any aspect of dietitians or student dietitians' KSA working in RACFs and home care services. No restrictions were applied to methodological design, language, location or publication year. Studies were assessed for quality using the Johanna Briggs Institute Quality Appraisal Tools. Study findings were analysed thematically using meta‐synthesis. Results: All 17 studies that met the inclusion criteria explored dietitians' attitudes towards their role, three studies examined perceived knowledge, although no studies objectively explored dietitians' skill levels. Five themes were developed inductively: (1) recognising their contribution as dietitians; (2) lacking clarity about the boundaries of their role; (3) all team members have a role to play in nutrition care; (4) assumptions and biases about working with older people; and (5) needing to build capacity in the workforce. Discussion: Dietitians have mixed attitudes about working in RACFs and home care services. Future directions include evaluating dietitians' role in RACFs, reviewing education and training and practical opportunities for student dietitians, and assessing the impact of more dietitian support on an older person's dietary intake and nutrition. Key points: Dietitians have mixed attitudes about working in residential aged care facilities and home care services.There is an opportunity to further explore dietitians' knowledge and skills about working with older adults. [ABSTRACT FROM AUTHOR]

Aim: The aim of this meta‐synthesis was to identify and synthesize qualitative research evaluating the real feelings, inner needs and emotional experience of women undergoing hysterectomy. Design: Meta‐synthesis. Methods: The PubMed, Web of Science, Cochrane Library, CINAHL, Embase, Ovid Medline and Sino Med were systematically searched until November 2021 and updated until June 2022. Two reviewers independently extracted data into a Microsoft Excel sheet. Qualitative meta‐synthesis was performed by coding relevant citations, organizing codes into descriptive themes and developing analytical themes. Results: Qualitative meta‐synthesis yielded three themes and nine sub‐themes: comprehensive consideration before hysterectomy (a. disease factors; b. fertility factors; c. opinions of others); emotions and experience after hysterectomy (a. postoperative physical condition; b. psychological resilience to the loss of the uterus; c. changes in the couple's relationship); coping strategies (a. self‐denial and avoidance; b. change of perception and self‐adjustment; c. seek help from others). [ABSTRACT FROM AUTHOR]

Introduction: Post‐burn scarring is often cosmetically unappealing and create discomfort. This makes it crucial to understand the experience of individuals living with scars which can offer insights into their recovery. This review sought to develop an in‐depth understanding of living with post‐burn scars. Design: A systematic review and meta‐ethnography approach were employed. We utilized an interpretive approach to inductively generate codes. These codes were examined iteratively using a constant comparison strategy following which they were re‐interpreted to formulate themes which formed the basis of undertaking a narrative synthesis. Results: Twenty‐five studies were retained. The analytical process yielded two themes: emergence of a new identity and living with the redefined self. The experience of living with scars is entwined with the initial trauma as the scars served as a permanent reminder of the injury. Emergence of a new identity involved a process of meaning making, mourning the loss of the old self, confronting the new self, reconciling the remains of the old self with the new, rebuilding a new identity, and navigating through functional restrictions. These processes were particularly challenging for persons involved in self‐immolation. Positive coping and changing one's perspective emerged as strategies to facilitate living with the redefined self. Conclusion: Living with scars is a challenging process which is more difficult for persons whose injuries are due to self‐immolation (act of burning oneself). The findings highlight a latent yet ongoing process towards subjective recovery. Clinicians need to be aware of the processes and incorporate these into rehabilitation programmes. Clinical relevance: Burn survivors need ongoing professional support to adjust to and live with the scars. Victims of self‐immolation should be considered for early psychosocial support. [ABSTRACT FROM AUTHOR]

Aim: To explore the experiences and perspectives of the combined use of continuous subcutaneous insulin infusion (CSII) and continuous glucose monitoring (CGM) on parents of children with TIDM on their daily life. Design: A systematic review and meta‐synthesis of qualitative studies. Methods: A systematic literature search of English studies published in seven databases between 2006–2021: CINAHL, MEDLINE, EMBASE, PubMed, PsycINFO, Cochrane Library and Scopus. All included studies underwent the process of thematic interpretive integration by the author team. Results: Nine studies met the inclusion criteria. Six derived themes were generated which contained interacting with devices, interacting with glycaemic information, improving quality of life for parents of children with T1DM, burden of living with CSII therapy and CGM, impact on the parent–child relationship, requirement and expectation to advanced diabetes technology. Advanced diabetes technologies affect physical, emotional and relationship between the daily life of parents and their children with T1DM. [ABSTRACT FROM AUTHOR]

Background: Parents who experience involuntary pregnancy loss encounter nurses and midwives when requiring care. But the environment in which this attention is provided turns it into a stressful and challenging event that favours the concealment of emotions. Literature supports the development of compassion in nurses and midwives who tend to parents who experience pregnancy losses. Aim: To synthesise the emotional experiences of midwives and nurses when caring for parents who have suffered an involuntary pregnancy loss. Method: This is a synthesis of qualitative studies following Noblit and Hare's interpretive meta‐ethnography. Eleven studies met the research objective and inclusion criteria. Results: An overarching metaphor, 'Unravelling the grief of loss', accompanied by four major themes provided interpretive explanations to the experiences of midwives and nurses in caring for involuntary pregnancy losses: 'Pulling the thread' – looking for the meaning of loss; 'Yarn entanglement degree' – determinants for grief expression; 'Detangling tools' – focusing on the loss; and 'Fraying the thread' – moving away from the loss. Discussion: The provision of whole care to these parents requires midwifery and nursing training and continued education. Furthermore, the organisational culture should prioritise the health and well‐being of midwives and nurses. Conclusion: Midwives and nurses encounter the parents' loss in care and personally in various ways and give meaning to the loss conditioned by personal and professional determinants. They unravel the grief of loss by looking for the meaning, expressing their grief, focusing and moving away from the loss. [ABSTRACT FROM AUTHOR]

Background Transmasculine people assigned female sex at birth but who do not identify with this classification have traditionally received little consideration in the voice literature. Some voice researchers and clinicians suggest that transmasculine people do not need attention because testosterone treatment leads to a satisfactory masculinization of their voice organs and voices. Others, however, argue that transmasculine people are a heterogeneous group whose members might not share the same body type, gender identity or desire for medical approaches to gender transitioning. Therefore, testosterone-induced voice changes may not necessarily meet the needs and expectations of all transmasculine people. Aims To evaluate the gender-related discursive and empirical data about transmasculine people's vocal situations to identify gaps in the current state of knowledge and to make suggestions for future voice research and clinical practice. Methods & Procedures A comprehensive review of peer-reviewed academic and clinical literature was conducted. Publications were identified by searching seven electronic databases and bibliographies of relevant articles. Thirty-one publications met inclusion criteria. Discourses and empirical data were analysed thematically. Potential problem areas that transmasculine people may experience were identified and the quality of evidence appraised. Main Contribution The extent and quality of voice research conducted with transmasculine people so far was found to be limited. There was mixed evidence to suggest that transmasculine people's vocal situations could be regarded as problematic. The diversity that characterizes the transmasculine population received little attention and the complexity of the factors that contribute to a successful or unsuccessful vocal communication of gender in this group appeared to be under-researched. While most transmasculine people treated with testosterone can expect a lowering of their pitch, it remains unclear whether the extent of the pitch change is enough to result in a voice that is recognized by others as male. Conclusions & Implications More research into the different factors affecting transmasculine people's vocal situations that takes account of the diversity within the population is needed. [ABSTRACT FROM AUTHOR]

Problem: One in seven children, aged 3–17, have a mental health diagnosis with suicide being the second leading cause of death in the United States in persons aged 10–24. Adolescents are at high risk for mental health disorders, substance use, and risky behaviors, yet most adolescents never receive treatment. Research is needed to answer the question, "What are adolescents' perceived barriers and facilitators to engaging in mental health treatment?" Methods: A four‐step qualitative meta‐synthesis design included: A structured research question and search strategy, data immersion through quality appraisal, thematic synthesis of primary research studies, and reciprocal translation of derived themes. Findings: Eight studies met inclusion criteria. Autonomy was the primary theme that emerged. Meta‐synthesis produced five subthemes: (a) choice as integral to engagement, (b) stigma as barrier to engagement, (c) quality of the therapeutic relationship as integral to engagement, (d) systemic influences as both barrier and facilitator to engagement, and (e) mental health literacy as crucial factor in decision to engage. Conclusion: Adolescents require autonomy to engage in mental health treatment. Improving treatment engagement in adolescents requires interventions that address their ability to be autonomous. [ABSTRACT FROM AUTHOR]

Primary care mental health services play a crucial role in public mental health by providing local and accessible psychological interventions that meet individuals' needs. Despite growing research investigating service users' perspectives of psychological interventions, a qualitative systematic review in this context is not available. The present meta‐synthesis collates the existing articles and gives a thematic synthesis of qualitative studies on service users' experience of psychological interventions in primary care. Multiple databases (CINAHL, EMBASE, PsychINFO, MEDLINE, and Cochrane Library) were searched for published qualitative studies of service users' experiences of psychological interventions delivered in primary care. Articles were included if they met inclusion criteria. Study quality was assessed using the Critical Appraisal Skills Programme tool. All types of psychological interventions were considered across model and delivery format (e.g., face‐to‐face, computerised programmes, and group). NVIVO was used to code the dataset and themes were extracted following thematic synthesis. Twenty‐two studies were included. Four analytical themes and 10 subthemes emerged. The identified themes were as follows: (1) 'Access and Acceptability: facilitators and barriers', (2) 'Structural aspects'; (3) 'Therapeutic process' and (4) 'Outcomes'. A model of interrelationships between themes is proposed. Findings suggest several 'essential ingredients' across psychological interventions and modalities. The crucial role of relational factors, the importance of assessing service users' perceptions of treatment features (e.g., remote delivery) and of tailoring the intervention to their needs were emphasised. Results also suggest involving service users more in discussions and decisions about psychological interventions offered might enhance access, acceptability, and engagement. Recommendations for practice and research are provided. [ABSTRACT FROM AUTHOR]

Purpose: From its beginnings in China in December of 2019, the novel coronavirus COVID‐19 spread and quickly became the center of nursing care and conversation across the globe (WHO, 2020). This meta‐ethnographic study was conducted in order to provide the profession of nursing interpretative explanations of a common experience during the care of patients with COVID‐19. Design and method: A literature review focused on the experience of the nurse during the COVID‐19 pandemic revealed a total of 13 qualitative studies conducted in China, Spain, Turkey, Iran, Brazil, and the United States. A meta‐ethnographic review of these qualitative works, using the method of Noblit and Hare, was then conducted which revealed the experience of the nurse across the globe during the COVID‐19 pandemic. Findings: The review revealed strong similarities between the experiences of the nurse across the 13 studies. Given this reciprocal relationship, translations were constructed and synthesized until four new themes emerged outlining the global experience of the nurse during the COVID‐19 pandemic. Conclusions: Despite the differences between the structures of healthcare and government of the six countries represented in this meta‐ethnography, the experience of the nurse emerged into a narrative shared by those represented in this study. As the profession of nursing continues to work through ongoing waves of COVID‐19, these results will help guide the resources and training provided to nurses on the frontline of care. Clinical relevance: Despite great personal risk, nurses across the globe stepped up to the challenge of upholding and improving the health of the world's people during the COVID‐19 pandemic. As health policy, education, and system leaders, we must listen to the common experience revealed in this meta‐synthesis and respond by providing the resources needed to improve nursing practice and care. [ABSTRACT FROM AUTHOR]

Background: Registered Nurses are expected to have acquired knowledge about the fundamental concepts within nursing science throughout their training and clinical work. However, the terminology and the concept of caring are debated; therefore, there is a need for a continuous critical investigation of scientific concepts within the area of nursing. Objectives: To illuminate nurses' perception about the meaning of the scientific concept of caring. Design: A qualitative systematic literature search was performed that subsequently underwent a descriptive meta‐synthesis in line with Deborah Finfgeld's descriptive meta‐synthesis methodology. Data sources/review method: Scientific articles published between 1 January 2003 and 25 January 2018 were identified and retrieved from CINAHL and PubMed. Each included study was assessed and critically appraised. Data were extracted, analysed and coded into categories resulting in four different themes in accordance with descriptive meta‐synthesis. Results: Four themes emerged in the analysis: 'To be', 'To want', 'To be able to' and 'To do'. These comprise different aspects within physical and metaphysical dimensions where simultaneously interact and influence each other. Conclusion: There are central elements to the practice of caring that are separated in their simplicity but at the same time coherent, where no part can exist without the others in the practice of caring. There are shortcomings concerning current nursing theories, nursing philosophies and organisational documents related to varied aspects based on what is included in the practice of caring. [ABSTRACT FROM AUTHOR]

Parents who give birth to an unexpected preterm infant not only suffer a psychological impact, but, in addition, their roles as parent are full of uncertainty. As part of family‐centered care, kangaroo care is an important way to support premature infants and their family. This review synthesizes qualitative studies on the experiences of parents who have used kangaroo care for preterm infants in neonatal intensive care units. English and Chinese databases were searched for relevant studies from 1970 to July 2018. The findings of qualitative studies were extracted and pooled using the Joanna Briggs Institute Qualitative Assessment and Review Instrument. A total of 731 studies were screened, and 9 were included. Five synthesized findings were identified: sense of emptiness of the parent's role, barriers in the translation of parental roles in kangaroo care, preparation enhances parental role expectations, kangaroo care enhances parental competency, and encouragement and support from family and friends. Through the implementation of kangaroo care, nurses are able to help prepare and guide parents, fit parents' needs, and help improve their ability and self‐confidence in their parental roles. [ABSTRACT FROM AUTHOR]

Background: Bedside shift reports have been recently recommended to ensure handovers. However, no evidence summarising studies designed to determine the qualitative approaches capable of better understanding patient experience have been published to date. Aim: The aim of this study was to acquire a deeper understanding of the experiences of patients regarding bedside shift reports. Data sources and review methods: A systematic review of qualitative studies followed by a meta‐synthesis method based upon Sandelowski's and Barroso's guidelines was performed. Four databases were systematically explored (PubMed, CINAHL, Scopus and PsycINFO) without any limitation in time and up to the 31 August 2018. A total of 10 studies were included and evaluated in their methodological quality; then, a thematic synthesis was developed to synthetize the findings. Results: Three major themes reflect patients' experience regarding the bedside shift reports: (i) 'Being involved'; (ii) 'Being the centre of nursing care processes'; and (iii) 'Experiencing critical issues'. Patients are supportive of bedside shift reports as a right, as an opportunity to be involved, and of being in the centre of the nursing care process. By designing and implementing bedside shift reports, nurses also have an opportunity to increase patient safety and to provide concrete proof of the advancements achieved by the nursing profession in recent years. Conclusions: The bedside shift reports experience has been little studied to date from the perspective of patients. According to the findings, implementation of the bedside shift reports should include providing education to nurses with regard to the preferences and expectations of patients, as well as the critical issues that they can experience during the bedside shift reports. Presenting the bedside shift reports method, asking patient consent, discussing potential critical issues and the degree of involvement preferred at hospital admission, is strongly recommended. [ABSTRACT FROM AUTHOR]

Background: Being diagnosed with cancer is an existential challenge and involves difficult treatment decisions, including treatment in clinical trials. Therapy for advanced cancer is potentially life‐prolonging and only rarely cures advanced cancer, which often renders these patients in a special situation where dealing with end of life, hope and meaning, become an important part of life. Many existing reviews include both patients with advanced cancer and patients undergoing adjuvant cancer treatment, and there is a lack of reviews with consistent study designs and methods. Aim: To systematically review and thematically synthesise the experiences of patients and relatives when they have to decide whether or not to participate in a clinical oncology trial and to provide knowledge about the decision‐making process. Method: A qualitative systematic literature review was conducted based on methods for thematic synthesis by Thomas and Hardens. Results: Eleven full‐text articles were included in this study. Six descriptive themes appeared and were grouped under two analytical themes: Individualised decisions and Hope and existential matters, which, through discussion, developed into the synthesis of What matters in treatment‐related decisions close to the end of life? This review has shown that existential matters are important in the decision‐making and that addressing these might be of great importance in medical decision‐making, whether it concerns the existential matters of the patients, of their relatives or of the health care professionals. Conclusion: This review points to existential issues as important contributors in making decisions about treatment. It can be beneficial if health care professionals address the role of existential matters in patients' decision‐making in terms of clinical trial participation and involve the relatives more directly to increase individualised decisions. Future research should include the health care professionals' experiences when going in depth with decision‐making, with a focus on the existential matters and uncertainties of the health care professionals. [ABSTRACT FROM AUTHOR]

Background: Dietetics students are a widely researched group. As emerging dietitians, they can provide valuable insights to inform how dietetics education programmes may be enhanced to meet contemporary healthcare needs. This review aimed to systematically synthesise dietetics students' experiences of dietetics workforce preparation. Methods: MEDLINE, CINAHL, Embase, PsycINFO, ERIC, Informit and ProQuest Dissertations and Theses Global were searched to identify research published until June 2017. Studies investigating dietetics students' experiences of dietetics workforce preparation, and employing qualitative data collection and analysis methods were included. Data analysis was guided by thematic synthesis, where themes were constructed through an iterative and inductive process. Study quality was appraised using the RATS Qualitative Research Review Guidelines. Results: From the 3301 records identified, five studies met the inclusion criteria and the views of 120 dietetics students from two countries over a 9‐year period were synthesised. The overarching theme of 'navigating through the ups and downs' was underpinned by four main themes: enduring hurdles; reconciling expectations; transforming self; and making and breaking connections. Quality appraisal results rated selection bias as being inadequate/inappropriate across all studies. Conclusions: Dietetics students undertake a transformational journey through dietetics education. They are inspired by seeing what is possible through meaningful encounters with practitioners in diverse settings. However, they are challenged by competitive environments and perceived ideals that are embedded in the profession. Strategies that focus on exposing dietetics students to inspirational practitioners, increasing and celebrating diversity in academic/placement settings, and incentivising collaboration across dietetics education, could act as catalysts to enhance the experience of future dietetics students and the nutrition‐related health of those they will serve. [ABSTRACT FROM AUTHOR]

Background Patient-centred care ( PCC) is associated with significant improvements in patients' health outcomes and healthcare systems. There is an opportunity to better understand PCC in dietetics. Thus, the present integrative review aims to critically synthesise literature relating to PCC in dietetics. Methods A systematic literature search was conducted between February and March 2016. Studies were included if they (i) involved dietitians and/or patients who had participated in an individual dietetic consultation; (ii) related to one or more components of PCC; and (iii) were empirical full-text studies in English, involving adult participants, published between 1997 and 2016. Following title and abstract screening, full texts were retrieved and independently assessed for inclusion by two of the investigators. Two independent investigators conducted data extraction and quality assessment using the Mixed Methods Appraisal Tool. Study findings were analysed thematically using meta-synthesis. Twenty-seven studies met the inclusion criteria. Results Six themes were discovered inductively: (i) establishing a positive dietitian-patient relationship; (ii) displaying humanistic behaviours; (iii) using effective communication skills; (iv) individualising and adapting care; (v) redistributing power to the patient; and (vi) lacking time for PCC practices. The first three themes were closely related. Studies used a broad range of methodological designs. Limitations of the studies included a lack of reflexivity and a lack of representativeness of the study population. Conclusions It is apparent that dietitians require good communication skills and humanistic qualities to build positive relationships with patients. Patients strongly desire individualised nutrition care and greater involvement in care. Ensuring dietitians are able to incorporate patient-centred practises during care requires further research. [ABSTRACT FROM AUTHOR]

Aims To explore the everyday experiences of children (aged ≤ 12 years) with Type 1 diabetes to identify factors that help or hinder diabetes self-management practices. Methods Eight databases (Embase, Medline, CINAHL, Web of Science, PsychInfo, ASSIA, ERIC and ProQuest Dissertations) were searched in 2016 to identify qualitative studies exploring children's views about self-managing diabetes. Data were extracted, coded and analysed using thematic synthesis. Results Eighteen studies from five countries were included in the review. Synthesis of studies' findings resulted in the identification of three overarching analytical themes. The first theme, 'Understandings of diabetes and involvement in self-management', outlines ways in which children understand diabetes and develop self-management responsibilities. The second theme, 'Disruption to life and getting on with it', reports children's frustrations at disruptions to everyday life when managing diabetes, and how attempts to appear normal to family and friends affect self-management practices. The third theme, 'Friends' support', describes how friends' reactions and responses to diabetes affect children's ability to appear normal and willingness to disclose information about diabetes, and support provided by 'informed friends', or peers with diabetes. Conclusions Although the synthesis has identified how children's everyday life experiences inform ways in which they undertake diabetes self-management, it was not possible to determine new ways to provide support. To help children optimise their glycaemic control, further work should be undertaken to identify their need for support and which takes into account the potential ways in which parents, friends and peers can offer assistance. [ABSTRACT FROM AUTHOR]

Purpose Studies show that co-bedding is a common cause of death in babies. The purpose of this study is to identify teaching strategies that can be used to increase safe sleep practices. Design and Methods A rigorous systematic literature search identified articles that expressed ways in which to provide co-bedding teaching or provided recommended approaches to educating mothers and families about co-bedding risks. NOTARI software, from OVID Tools, was used to appraise articles, extract data, and thematically organize the findings, resulting in meta-aggregation. Results Two major findings were synthesized from four categories. First, co-bedding occurred despite knowing risks and having received teaching. Second, families should receive co-bedding messages tailored to their specific circumstances and risks. Practice Implications Findings showed that the lack of dialogue in co-bedding teaching often deters caregivers and families from seeking further education or consultation. Nurses need to ensure that safe sleep practices are taught and that the material provided pertains to the caregiver's specific cultural and familial situation. [ABSTRACT FROM AUTHOR]

Background: Many women from socially disadvantaged groups discontinue breastfeeding in the early postnatal period before lactation is fully established. This suggests that existing health service practices do not adequately meet the breastfeeding support needs of this population. The aim of this meta-synthesis is to review the literature exploring how women from socioeconomically deprived backgrounds experience breastfeeding establishment and to identify factors associated with supportive practice. Methods: The meta-synthesis includes qualitative studies exploring the perception of women from disadvantaged groups of in-hospital and professionally led interventions to support the establishment of breastfeeding. Searches were conducted for studies published between 1992 and 2013; after critical appraisal, eight studies were retained. Results: Three overarching themes of the influences on maternal perception of the efficacy of breastfeeding support were identified. These included practical skill and knowledge of the breastfeeding process, the influence of psychological factors on perceived breastfeeding ability, and the provision of a person-centered approach to infant feeding support. Conclusions: The findings illustrate that the factors associated with supportive breastfeeding practice are extensive, complex, and interrelated. Strategies which enable mothers to gain confidence in their ability to successfully breastfeed by acquiring technical expertise, which offer positive encouragement, and which are culturally specific are more likely to be perceived as supportive by women from socially disadvantaged groups. (BIRTH 42:4 December 2015) [ABSTRACT FROM AUTHOR]

The article presents a study which aims to distinguish whether or not their is proof to support multidisciplinary team (MDT) working in rheumatology. The report deals a primary research questionnaire on the role of a single profession and if the primary subject material did not reference rheumatology healthcare. The benefit of MDT working was lessened in the conditions managed pharmacologically, which include gout, and increased with allied health professional support including fibromyalgia.

The aim of this study was to explore the obstacles to and the opportunities for achieving optimal interprofessional team collaboration with the introduction of the nurse practitioner ( NP). A team approach can contribute importantly to sustainable and safe patient care, and NPs have been added to the healthcare team in many countries. Following the international trend towards the development of the acute care NP, the role has recently been initiated in surgical care in Sweden. The introduction of an advanced nursing role into existing organisations raises questions about how the role will be developed and what its effects will be on collaboration between the different professions. We conducted a systematic review of qualitative studies using the meta-ethnographic approach developed by Noblit and Hare. Literature in the field of nursing was searched on PubMed and CINAHL, and empirical qualitative studies from outpatient and inpatient care in seven countries were included. The studies were appraised according to national guidelines and templates and were analysed and synthesised according to the meta-ethnographic approach. A total of 26 studies were included in the synthesis. The analysis revealed four themes: (i) a threat to professional boundaries, (ii) a resource for the team, (iii) the quest for autonomy and control, and (iv) necessary properties of a developing interprofessional collaboration. Based on these themes, the synthesis was created and presented as a metaphorical journey. The implementation of a new nursing role in a traditional healthcare team is a complex process influenced by many factors and can be described as 'a tortuous journey towards a partially unknown destination'. The synthesised obstacles and opportunities drawn from international studies may help healthcare organisations and new NPs prepare for, and optimise, the implementation of a new nursing role. [ABSTRACT FROM AUTHOR]

Background Health-care professionals worldwide have started to appreciate patients' perspectives on the use of complementary and alternative medicine ( CAM) particularly given its popularity. However, cultural perspectives may vary and it may not be possible to apply research findings on the use of CAM from the west to the east. Objective This systematic review aims to synthesize usage patterns of traditional Chinese medicine ( TCM) amongst Chinese populations in different parts of the world and explore potential geographical variations. Search strategy Six international and four Chinese databases were searched, and manual searches of relevant monographs and government publications were carried out. Inclusion criteria Quantitative, qualitative or mixed-method research that aimed to investigate Chinese patients' perception of, and perspectives on, TCM was included. Data extraction and synthesis For each study included, texts under the headings of 'results' or 'findings' were extracted and subjected to analysis. A thematic synthesis approach was adopted for synthesizing qualitative and quantitative studies. Main results Amongst the 28 studies included, twenty were quantitative surveys, six were qualitative studies and two were mixed-method studies. The overall methodological quality was mediocre. Data synthesis suggested that patients from all regions share a common cultural affinity to TCM and consider it to be an effective complement to western medicine (WM) for treating chronic or serious diseases. However, heterogeneous views on (i) disclosing TCM use to WM doctors and (ii) the potential harm of herbs emerged across different study locations. Discussion and conclusions Future research should explore how variation in health systems may influence patients' perception of CAM in different countries. [ABSTRACT FROM AUTHOR]