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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Advances in health care mean that we can now treat diseases that once cut lives short. However, the increase in life expectancy has not been matched by improvements in quality of life. The World Health Organization warns us that all countries should prepare to meet the challenges of an aging population and this is integral to the United Nations 2030 Agenda for Sustainable Development. This may require a shift in attitude toward aging. We aimed to use meta-ethnography to explore the experience of adults living beyond the age of 80. Our conceptual model illuminates the phenomenon of connection in older age and reflects on the paradox of time : ephemeral, yet interminable. Our findings encourage us to reflect on the influence of enlightenment philosophies that underpin the desire for autonomy at all costs. Our study challenges the stereotypes of old age and has the potential to influence people's perspectives toward aging. [ABSTRACT FROM AUTHOR]

The purpose of this article is to systematically identify, appraise and synthesise qualitative research concerning UK parents' experiences of their child receiving a diagnosis of autism spectrum disorder. In total, 11 articles were located through a systematic search of five databases, reference lists, citations and grey literature. These were critically appraised and their results synthesised using meta-ethnography. The quality scores given to included studies were variable, so suggestions are made to improve reporting of future research. Three third-order constructs were developed: (1) emotional needs, (2) informational needs and (3) relational needs. Each relates to parents' needs as they navigate the process of making sense of their child by seeking and adjusting to a diagnosis of autism spectrum disorder. Parents' experiences of assessment and diagnosis of their children varied, but these needs were evident across the course of the process. Fathers seemed to find it more difficult than mothers to reconcile having a child with autism spectrum disorder, which may have been grounded in a sense of exclusion from the assessment process. The findings should be considered by professionals working with children, particularly those directly involved in diagnosing autism spectrum disorder. Clinical implications emphasise the need for consideration of parents' emotional needs, provision of information to aid understanding, and strong relationships with professionals. Future clinical research, which should be informed by quality standards, might develop and evaluate standards of assessment and diagnosis, including post-diagnostic support. [ABSTRACT FROM AUTHOR]

Background: To enhance the acute care delivery system, a comprehensive understanding of the patient's perspectives for seeking care in the emergency department (ED) versus primary care (PC) is necessary.Methods: We conducted a qualitative metasynthesis on reasons patients seek care in the ED instead of PC. A comprehensive literature search in PubMed, CINAHL, Psych Info, and Web of Science was completed to identify qualitative studies relevant to the research question. Articles were critically appraised using the McMaster University Critical Review Form for Qualitative Studies. We excluded pediatric articles and nonqualitative and mixed-methods studies. The metasynthesis was completed with an interpretive approach using reciprocal translation analyses.Results: Nine articles met criteria for inclusion. Eleven themes under four domains were identified. The first domain was acuity of condition that led to the ED visit. In this domain, themes included pain: "it's urgent because it hurts," and concern for severe illness. The second domain was barriers associated with PC, which included difficulty accessing PC when ill: "my doctor said he was booked up and he instructed me to go to the ED." The third domain was related to multiple advantages associated with ED care: "my doctor cannot do X-rays and laboratory tests, while the ED has all the technical support." In this domain, patients also identified 24/7 accessibility of the ED and no need for an immediate copay at the ED as advantageous. The fourth domain included fulfillment of medical needs. Themes in this domain included the alleviation of pain and the perceived expertise of the ED healthcare providers.Conclusions: In this qualitative metasynthesis, reasons patients visit the ED over primary care included (1) urgency of the medical condition, (2) barriers to accessing primary care, (3) advantages of the ED, and (4) fulfillment of medical needs and quality of care in the ED. [ABSTRACT FROM AUTHOR]

Aim: To describe and explain the process of transition from cure‐focused to comfort‐focused health care as perceived and reported by patients, family members, and healthcare providers. Background: Moving into the last phase of life due to advanced illness constitutes a developmental transition with increased vulnerability for patients and family. Design: Qualitative metasynthesis. Data sources: Medline, CINAHL, and PsycInfo databases searched from inception through March 2016. Primary research reports published from 1990 to 2015, using qualitative designs to report transition experiences of patients, family members, and/or healthcare providers were included. Review methods: Key elements were extracted and organized into matrices. Findings from each report were analysed using qualitative coding. Results: The sample was 56 unique reports from 50 primary studies. Patients and families emphasized the importance of receiving understandable information, emotional support, respect for personhood and control. The critical juncture of 'realizing terminality' preceded a transition to comfort‐focused care. Subsequently, a shift in goals of care emphasizing comfort and quality of life could occur. Continued provision of information, effective support, respect and control promoted 'reframing perceptions' and capacity to embrace a changed identity. Reframing allowed patient and family to find meaning and value in this last phase of life and to embrace the opportunity to prepare for death, nurture relationships, and focus on quality of living. Conclusion: Understanding the developmental process that can be engaged by patients and families at the end of life provides a theoretical basis that can inform choice and timing of interventions to reduce suffering and enhance positive outcomes. [ABSTRACT FROM AUTHOR]

Trauma-focused cognitive behavioural therapy (TF-CBT) is an effective intervention for post-traumatic stress disorder, yet implementation may be hindered by practitioners' concerns about how treatment is experienced by users. This metasynthesis systematically reviews qualitative evidence on youth and caregivers' experiences of TF-CBT to better understand user perspectives on process and outcomes of treatment. A systematic review and metasynthesis were undertaken for qualitative studies of treatment experience related to TF-CBT. Data were extracted according to Evidence for Policy and Practice Information and Coordinating Centre guidelines, and studies were critically appraised using Critical Appraisal Skills Programme checklists. Findings from included studies were coded and synthesized using thematic synthesis methodology. Eight studies were selected after a full-text review of 39 papers. Findings were organised around nine sub-themes, under three broad thematic categories: 'engagement in TF-CBT'; 'experience of treatment components'; and 'therapeutic outcomes'. Youth were often unclear about what to expect from treatment and concerned about (in)compatibility with their therapist. Youth reports indicated how such misgivings can be addressed through early psychoeducation and efforts to strengthen the therapeutic alliance. Once underway, treatment was viewed as a place of refuge and validation, aided by therapist competence and confidentiality. Youth and caregivers felt that constructing a trauma narrative was instrumental for recovery. Cognitive-behavioural coping techniques were useful during treatment and in the long-term. While participants in TF-CBT may begin treatment with unclear expectancies, careful attention to early engagement and other process issues can optimise process and outcomes. Implications for clinical practice and further research are discussed. [ABSTRACT FROM AUTHOR]

The aim of this metasynthesis review of published qualitative research was to investigate the lived experience and meaning ascribed to speech-generating devices (SGDs) by people with complex communication needs and their familiar communication partners. Bibliographic databases were searched up to June 2016, and selected articles were assessed for their relevance to the research aim. The metasynthesis included 21 original articles and resulted in the identification of six main themes, each of which was comprised of two or more sub-themes that related to the experience of using SGD: It's an Inefficient Voice, It's Not a Natural Voice, Making the Most of This Voice, It's My Voice, It's More Than a Voice, and Having a Voice: Being Heard. The findings depict how use of an SGD is a complex process of understanding the limitations of the device, acknowledging expectations of society, using strategies to optimize communication, being aware of what an SGD represents, and using the SGD to enable social participation and a sense of empowerment. [ABSTRACT FROM AUTHOR]

The number of refugees and asylum seekers throughout the world continues to increase, leading to increasing challenges in meeting healthcare needs of these individuals. Women's antenatal health is of particular concern due to their vulnerability to sexual violence and the substantial proportion of refugees consisting of women and girls of or nearing reproductive age. The purpose of this qualitative metasynthesis was to integrate and interpret findings from previously published research reports in which authors explored aspects of pregnancy among resettled refugee women. Following a systematic search process, we used Dedoose qualitative data analysis software to manage the process of extracting and condensing data from primary sources. We developed themes including: comparing pregnancy care in resettlement with care at home; navigating unfamiliar language and cultural practices; making meaning through pregnancy and associated healthcare experiences. Our analysis revealed authors used thematic analysis regardless of research design, limiting the range of reported findings. Prior research focused on identifying challenges to pregnancy in resettlement; our findings expand this by considering how women navigate and make meaning from challenges. Service providers might encourage mentally healthy resettlement by guiding refugees to consider differences in an open-minded rather than judgmental attitude that respects old and new cultures. [ABSTRACT FROM AUTHOR]

Evidence that interpersonal interactions and self-appraisal in social context are crucial in developing self-understanding raises concerns about how pupils with autism spectrum disorder make sense of themselves in school settings where many experience social marginalisation. Metasynthesis was used to systematically extract and integrate findings from qualitative studies examining the mainstream school experiences of these students. Synthesised findings identified three, intermeshing, aspects of experience which contribute to many pupils with autism spectrum disorder making sense of themselves as 'different' to typical peers in a negative way: difficulties linked to autism spectrum disorder; interpersonal relationships, particularly with peers; and accessibility of the school environment. Typical pupils' attitudes and responses towards peers with autism spectrum disorder, unusual sensory reactions to the physical school environment and individual sense-making about the self are highlighted as key areas requiring further research and intervention to improve the experiences, self-esteem and well-being of pupils with autism spectrum disorder in inclusive settings and to inform educational policy and practice. [ABSTRACT FROM AUTHOR]

As the body of available qualitatively derived knowledge expands, there is increasing temptation to capitalize on it to generate knowledge synthesis products. Concurrently, in the wake of an ever-expanding enthusiasm for evidence-based practice knowledge in health care, scholars are facing pressure to forgo the more narrative or interpretive form of literature review in favor of reviews that are positioned as explicitly systematic. This has created a context in which both new and seasoned scholars are, in increasing numbers, working with extant bodies of qualitative literature in ways that counter the very motivations that drove health researchers into qualitative methods in the first place. In this commentary, I trace the evolution of this trend, illustrating how a reasonable original intent has taken a misguided turn in the context of competing understandings and priorities in health care knowledge development. On this basis, I propose a strategic direction for this journal as a leader in what constitutes the meaningful application of qualitative research methodological approaches, including that which purports to represent synthesis of available knowledge, for the purposes of addressing the inherently complex challenges of the health field. [ABSTRACT FROM AUTHOR]

The goal of this metasynthesis study was to employ qualitative research studies to explore the experiences of interpreters working in hospitals or mental healthcare facilities. Using Noblit and Hare's meta-ethnographic strategy, findings from six qualitative articles were reduced to seven main themes: (1) technicalities of interpreting, (2) balancing objectivity versus supporting and identifying with the patient, (3) emotionally charged stories, (4) workplace stress, (5) interpreters' recommendations, (6) coping strategies, and (7) integrating the past with existential growth. Practice recommendations include examining the workplace culture for attitudes that devalue interpreters. To reduce secondary trauma, it is recommended that interpreters become integrated team members with access to supervision and stress management, in order to build coping strategies. Interpreters suggested implementing preparation time and debriefing time, as well as ongoing training and professional development. However, these suggestions raise complicated administrative issues surrounding fee-for-service reimbursement. [ABSTRACT FROM AUTHOR]

Purpose: To identify, appraise, and synthesize findings from qualitative studies of individuals diagnosed with borderline personality disorder who have experienced dialectical behaviour therapy, to gain further understanding of their perceptions of the process and impact of therapy. Methods: We conducted a comprehensive systematic search of the literature from several online databases, and appraised them using an adapted version of the Critical Appraisal Skills Programme tool. A meta‐ethnographic approach was used to synthesize the data. Results: Seven studies met the criteria to be included and their quality subsequently appraised. Four main themes were identified through the synthesis process: life before DBT; the relationships that support change; developing self‐efficacy; and a shift in perspectives. Conclusions: The findings of the synthesis highlight the importance of a number of key factors in the process of DBT, and the impact that the therapy has both on day‐to‐day life and on individuals' identity. Practitioner points: Existing outcome measures may not capture the complexity and magnitude of impact of DBT on individuals with BPD. Exploring first‐hand accounts of individuals undertaking DBT can offer unique insight into the processes of therapy. [ABSTRACT FROM AUTHOR]

Purpose: Research indicates that strong social ties can buffer the adverse effects of chronic illness on psychological well-being. Brain tumor typically leads to serious functional impairments that affect relationships and reduce social participation. This metasynthesis aimed to identify, appraise and integrate the findings of qualitative studies that reveal the impact of brain tumor on social networks. Methods: Four major databases (PubMed, CINAHL, Cochrane Library and PsycINFO) were systematically searched from inception to September 2016 for qualitative studies that reported findings on the impact of primary brain tumor on social networks during adulthood. Twenty-one eligible studies were identified and appraised according to the Consolidated Criteria for Reporting Qualitative Research. Key findings of these studies were integrated to form superordinate themes. Results: The metasynthesis revealed the core themes of: 1) Life disrupted; 2) Navigating the new reality of life; and 3) Social survivorship versus separation. Conclusions: Multiple changes typically occur across the social trajectory of brain tumor, including a loss of pre-illness networks and the emergence of new ones. Understanding the barriers and facilitators for maintaining social connection may guide interventions for strengthening social networks and enhancing well-being in the context of brain tumor. Implications for rehabilitation: Social networks and roles are disrupted throughout the entire trajectory of living with brain tumor Physical, cognitive and psychological factors represent barriers to social integration Barriers to social integration may be addressed by supportive care interventions Compensatory strategies, adjusting goals and expectations, educating friends and family and accepting support from others facilitate social reintegration throughout the trajectory of living with brain tumor [ABSTRACT FROM AUTHOR]

Aims and objectives: To aggregate, synthesise and interpret qualitative research studies of parents’ experiences of caring for a child with special health‐care needs at home. Background: Advances in the field of medical and nursing science have ensured better survival rates for children with chronic illnesses. Many of these children have significant special health‐care needs. Today parents assume a caregiver role, undertaking tasks previously provided by nurses in hospitals. As the complexity of care delivered by parents continues to develop, synthesised knowledge can provide an evidence base that will support and guide nurses when caring for these families. Design: Metasynthesis. Methods: Based upon a systematic search protocol, a structured literature search, covering the years 2003–2016, was conducted in five electronic databases. Ten studies were included and appraised using the Critical Appraisal Skills Program assessment tool. A metasummary and a metasynthesis were undertaken guided by the metasynthesis methodology as described by Sandelowski and Barroso (Handbook for synthesizing qualitative research. New York, NY: Springer, 2007). Results: The results were interpreted and integrated under the overarching theme “unsung heroes, flying blind,” supported by eight elucidating categories that illustrate aspects of the parents’ life world. Conclusions: The enormous burden of care can weaken the parents’ will to carry on and result in a decreased ability to provide care. This can have an impact on the parents’ health, family functioning and the sick child's potential health outcomes. Nurses are in a unique position to help these families and should be better prepared for the role. Relevance to clinical practice: Knowledge of how parents of children with special health‐care needs experience their daily lives can promote trust in nurses and guide them in their efforts to support families with children living with chronic illness. [ABSTRACT FROM AUTHOR]

The aims of this review were to systematically identify, critically appraise and synthesize the results of existing qualitative literature exploring the views and experiences of intimate relationships amongst people with intellectual disabilities. Fourteen peer-reviewed articles were identified through a systematic search of eight databases, reference lists, citations, and relevant journals. The identified articles were appraised for quality, then synthesized using a metaethnography approach. No study met all quality criteria and references to ethical approval were often lacking. Interpretation of the findings suggested three key themes: the meaning of intimate relationships, external constraints and facilitators, and managing external constraints. Though many people with intellectual disabilities desire and benefit from intimate relationships, they experience restrictions that others do not, which can lead to isolation and loneliness. Intimate relationships are not always necessarily linked with sexual behavior; therefore, intimate relationships warrant their own focus in future research, as well as in education and training for people with intellectual disabilities and their caregivers. Within this, a commitment to transparency over research processes is needed, in particular with reference to how ethical approval was obtained, since this has been a shortcoming of research with this focus to date. [ABSTRACT FROM AUTHOR]

Objective:This review aimed to synthesize qualitative research exploring clients’ perspectives of forming a therapeutic relationship with their therapist or counsellor.Method:Noblit and Hare’s meta-ethnographic approach was used to guide the synthesis of 13 studies meeting inclusion criteria. The quality of each study was rated using the Critical Appraisal Skills Programme quality rating checklist.Results:Findings demonstrated that clients create a hierarchy of desired therapist characteristics to assess how well the therapy can meet their needs (theme 1: assessing client-therapist match). The formation of the therapeutic relationship is facilitated by an openness from both the therapist and client (theme 2: facilitating openness) and helps to develop a connection through which the client can be fundamentally understood (theme 3: connecting on a deeper level). Displays of disrespectful or disempowering behaviour generate barriers in the formation of a therapeutic relationship (theme 4: empowerment through respect).Conclusions:The meta-ethnographic approach extended the findings from each individual study to highlight some significant discoveries, including that clients across different settings created a hierarchy of therapist characteristics which were of varying importance to them depending on their perceived needs. Additionally, clients reported that they preferred their therapists to disclose information in order to facilitate the therapeutic relationship. [ABSTRACT FROM PUBLISHER]

Phenomenography is a qualitative research method based on the assumption that almost any phenomenon will be understood by a group of people in a limited number of ways. Our aim in this article was to identify the different ways work can be understood by healthcare professionals. In a world where the delivery of healthcare is continually changing, a metasynthesis of phenomenographic articles on healthcare professionals’ understandings can provide knowledge about the focus and meaning of work for these individuals today. Our metaethnographic synthesis of 14 selected phenomenographic articles identified five different ways of understanding work, ranging from a limited to an all the more comprehensive view on patients and their needs. This range of understandings reveals problem areas and challenges facing healthcare professionals today. The possibility exists as well that limited understandings of work may be negative consequences of current demands for efficiency and all the more limited healthcare resources. [ABSTRACT FROM AUTHOR]

Abstract: Objectives: Perinatal mental health difficulties are prevalent among women and can adversely affect their partners too. There is also increasing recognition that a woman's partner can play a vital role in relation to her perinatal mental health and should be supported and involved in decisions about her care. Yet it is unclear how services are experienced by the partners of women with perinatal mental health difficulties. This study aimed to synthesize qualitative evidence of partners' views of perinatal mental health care. Methods: A systematic search of 5 electronic databases identified 20 studies that met the inclusion criteria. The findings of these studies were synthesized using an approach based on meta‐ethnography. Results: Six themes were identified, namely, the marginalization and neglect of women's partners, an unmet need for information, partners' ambivalence about involvement and support, practical barriers to involvement, views about support for women's partners, and the impact on partners of the care women received. Conclusions: Given the importance of women's partners in relation to perinatal mental health as well as to women's engagement with support and treatment outcomes, greater consideration should be given to their needs to ensure they feel well informed and involved in perinatal mental health care, rather than marginalized. However, professionals also need to challenge the barriers to involvement and support that women's partners face and consider the ways in which services may reinforce these barriers. [ABSTRACT FROM AUTHOR]

Purpose This review aimed to synthesize qualitative literature exploring inpatient hospital staff experiences of their relationships with people who self-harm. Methods Nine studies were identified from a systematic search of five research databases. Papers included the experiences of physical health and mental health staff working in inpatient settings. The studies employed various qualitative research methods and were appraised using an adapted quality assessment tool (Tong, Sainsbury, & Craig, 2007). A meta-synthesis was conducted using traditional qualitative analysis methods including coding and categorizing data into themes. Results Three main themes derived from the data. 'The impact of the system' influenced the extent to which staff were 'Fearing the harm from self-harm', or were 'Working alongside the whole person'. A fear-based relationship occurred across mental health and physical health settings despite differences in training; however, 'Working alongside the whole person' primarily emerged from mental health staff experiences. Systemic factors provided either an inhibitory or facilitative influence on the relational process. Conclusions Staff experiences of their relationship with people who self-harm were highlighted to have an important impact on the delivery and outcome of care. Increasing support for staff with a focus on distress tolerance, managing relational issues, and developing self-awareness within the relationship may lead to a more mutually beneficial experience of care. Equally, structure, clarity, and support within inpatient systems may empower staff to feel more confident in utilizing their existing skills. Practitioner points Working with people who self-harm can be emotionally challenging and how staff cope with this can significantly impact on the engagement of staff and patients., Increasing the skills of staff in managing relational issues and tolerating distress, as well as providing support and reflective practice groups may be useful in managing emotional responses to working with people who self-harm., Refining the supportive, procedural, and environmental structures surrounding the caregiving relationship may help enable better integration of physical and mental health care. [ABSTRACT FROM AUTHOR]

We continue the conversation initiated by Sally Thorne’s observations about “metasynthetic madness.” We note that the variety of labels used to describe qualitative syntheses often reflect authors’ disciplines and geographical locations. The purpose of systematic literature searching is to redress authors’ lack of citation of relevant earlier work and to reassure policy makers that qualitative syntheses are systematic and transparent. There is clearly a need to develop other methods of searching to supplement electronic searches. If searches produce large numbers of articles, sampling strategies may be needed to choose which articles to synthesize. The quality of any synthesis is dependent on the quality of the primary articles; both primary research and qualitative synthesis need to move beyond description and toward theory and explanation. Synthesizers need to pay attention to those articles which do not seem to fit their emerging analysis if they are to avoid stifling new ideas. [ABSTRACT FROM AUTHOR]

Objective The objective of this study was to explore Indigenous people’s experiences and perceptions of hospitalisation and acute care. Methods Systematic procedures were used for the literature search covering the period from 2000 to 2016. Final search was conducted in early September 2016. Quality of the selected studies was assessed using the Critical Appraisal Skills Program. Data extraction was conducted using the data extraction tool from the Joanna Briggs Institute. A thematic approach to synthesis was taken. Statements were assembled to produce aggregated data of the findings, which were then categorised based on similarity of meaning, and the categories were used to produce comprehensive synthesised findings. Data sources The literature search was conducted in the following databases: Cumulative Index to Nursing and Allied Health Literature, Google scholar, Medline, Psychology and Behavioural Sciences, and PsycINFO. Manual searches of the International Journal of Indigenous Health, Menzies website and references of reviewed papers were also conducted. Inclusion criteria were qualitative articles, published in English from across the world, in peer-reviewed journals, that investigated acute health care experiences of Indigenous people. Review methods A metasynthesis of qualitative research studies was conducted following Joanna Briggs Institute guidelines. Findings A total of 21 primary studies met the inclusion criteria. Three themes emerged from the metasynthesis: Strangers in a strange land ; Encountering dysfunctional interactions ; and Suffering stereotyping and assumptions . These themes emphasised the importance of meaningful relationships for Indigenous people and highlighted their cultural marginalisation in hospital settings. Conclusion The findings indicate that healthcare experiences of Indigenous patients and their relatives in acute settings can fall well short of their expectations and needs. It behoves healthcare professionals to firstly be aware of such discrepancies, and secondly to implement strategies that enable inclusive and individualised care. [ABSTRACT FROM AUTHOR]

Background: According to the concept of "male depression," depression among men might be underdiagnosed and undertreated because of gender differences in symptoms and coping. There is evidence that men experience atypical depressive symptoms including irritability, aggression, substance abuse and increased risk behavior. To date, a substantial number of qualitative studies on men's views on depression has been conducted in the last few decades. Methods: Based on a systematic review and metasynthesis of qualitative studies on men's subjective perspectives on depression, we aim at a comprehensive understanding of men's subjective views on depression with a specific focus on masculinity constructions. Results: Based on 34 studies assessed as appropriate for the study, 2 overarching subthemes could be identified: normative expectations regarding masculinity ideals and men's subjective perspectives of depression as "weakness." Men's strategies include denial of"weakness" and "closing up." Further themes include suicide, masculinity ideals as a healthy resource and alternativemasculinities. Discussion/Conclusions: Traditional masculinity values might serve as barriers but also as facilitators to adaptive coping strategies in depressed men. More research is needed to study the dimensions and role of alternative masculinities in the context of depression. [ABSTRACT FROM AUTHOR]

Background Anorexia nervosa in adolescence has been increasingly documented in numerous quantitative and qualitative studies. Qualitative research, which focuses on subjective experience, is a well-established method to deepen our understanding and provide new insights about specific diseases. Objective We conducted a metasynthesis of qualitative studies to explore how anorexia nervosa is experienced by adolescents, their families, and the health professionals who provide care for them and to compare their perspectives. Review methods Five databases (Medline, PsycINFO, CINHAL, EMBASE, SSCI; 1990–2015) were systematically searched for qualitative studies reporting participants’ views about anorexia nervosa. Article quality was assessed with the Critical Appraisal Skills Program (CASP). We used thematic synthesis to examine and summarize the topics found in the articles selected and develop their central themes. Results We included 30 articles from seven different countries. Two domains of experience were inductively developed from the analysis: (1) constructs and beliefs about etiological theories of anorexia nervosa, and (2) the experience of the disease from the points of view of adolescents, parents, and healthcare providers. Conclusions We found important disparities between the three stakeholders. The adolescents underlined the psychological and emotional aspects of their experience, while the visible state of these patients’ bodies impeded the work of the professionals. These difficulties shed new light on the stakes of treatment of anorexia nervosa in adolescence, which must integrate both its psychological and physical components. [ABSTRACT FROM AUTHOR]

Most studies on casual sexual relationships and experiences (CSREs) are quantitative and focus on characteristics of individuals who experience them. There has been an increase in qualitative research on CSREs that have revealed new insights into how they are experienced among young adults. To synthesize qualitative knowledge on how CSREs are experienced, a qualitative metasynthesis was carried out using 13 studies published up to June, 2015, yielding seven conceptual categories. Opportunities and choices regarding CSREs were organized according to biographical context, socioenvironmental context, and peer norms. Expectations of CSREs related to lack of communication, emotional, and sexual commitment or accountability. Implicit rules allowed maintaining boundaries between sex and emotion. Thus, CSREs can satisfy various needs related to sex and intimacy. Sex in CSREs was reported as pleasure-centred, accessible, and improved when experienced in association with intimacy. However, intimacy and gender roles interfered with condom use. The sexual double standard and gender roles limited women's agency and enjoyment of sex. Expectations for the lack of intimacy and communication conflicted with developing unrequited feelings, resulting in self-blame and attempts to suppress emotions. While partners may have a hard time defining their relationship over time, some CSREs involved developing friendships or romance, and ruining friendships. The results indicate a clash between expectations, rules, and experiences of CSREs. The lack of symbolic markers for the meaning or status of CSREs as they develop can be seen as a consequence of the complexity of these relationships. [ABSTRACT FROM AUTHOR]

Objectives To report the findings of a metasynthesis review of qualitative studies on patient and provider experiences and perspectives on linkage and retention in HIV care. Design The review is an extraction, aggregation, interpretation and synthesis of qualitative findings based on the Sandelowski and Barroso method. Data sources A search of the literature was conducted in the databases Cumulative Index to Nursing and Allied Health, PubMed and PsycInfo for articles published from 2008 to 2013. Inclusion criteria were qualitative research articles published in English from across the world and in peer-reviewed journals. Literature reviews, conference abstracts and grey literature were excluded from this metasynthesis. Review methods The review consisted of a) comprehensive search, b) study classification, c) abstraction of findings, d) synthesis. Of the 4640 citations screened, 69 articles were included for this metasynthesis. Results 69 unique articles from 44 countries were included. This metasynthesis takes into account the perspectives of at least 2263 HIV-positive participants (740 men, 1008 women, 78 transgender individuals and 437 unspecified sex) and 994 healthcare providers, family members and community members. The most salient barriers and facilitators to HIV linkage and retention in HIV care affirm ecological factors that are mostly beyond individual patients’ control. Triadic streams of influence concurrently affect care engagement that include a person’s psychological state upon diagnosis and their informational challenges (intrapersonal stream); one-on-one interactions with providers and their immediate community (social stream); and life demands, overall quality of care experiences and other structural barriers (cultural-attitudinal stream). Each stream’s influence on HIV care engagement varies at any given point to reflect an individual’s evolving and unique experiences with HIV infection throughout the illness trajectory. Conclusion There is sufficient evidence that detail how to best link and retain patients in HIV care. Themes identified indicate going beyond individual-level factors and towards shifting attention and resources to systems that patients navigate. Forceful structural-level actions are needed to correct these long-identified barriers and enhance care engagement facilitators. [ABSTRACT FROM AUTHOR]

The aim of this editorial is to reflect on the concept of "metasynthesis". Although there is some heterogeneity when referring to metasynthesis, there is some consensus in talking about Metasynthesis. The most essential interpretation is the one that describes it as a secondary research procedure, whose purpose is to review and synthesize rigorously and with a critical approach the knowledge coming from original research developed with qualitative methodology. [ABSTRACT FROM AUTHOR]

A large group of individuals suffering from mental illness are parents living with their children. These children are invisible in the health care even though at risk for illhealth. The aim of this metasynthesis was to advance knowledge of how children of parents with mental illness experience their lives, thus contributing to the evidence of this phenomenon. The metasynthesis is following Sandelowski and Barroso's guidelines. Literature searches covering the years 2000 to 2013 resulted in 22 reports which were synthesised into the theme 'navigating in an unpredictable everyday life' and the metaphor compass. Children of parents with mental illness irrespective of age are responsible, loving and worrying children who want to do everything to help and support. Children feel shame when the parent behaves differently, and they conceal their family life being afraid of stigmatisation and bullying. When their parent becomes ill, they distance to protect themselves. The children cope through information, knowledge, frankness and trustful relationships. These children need support from healthcare services because they subjugate own needs in favour of the parental needs, they should be encouraged to talk about their family situation, and especially, young children should to be child-like, playing and seeing friends. [ABSTRACT FROM AUTHOR]

Health technology assessment (HTA) agencies increasingly use reviews of qualitative research as evidence for evaluating social, experiential, and ethical aspects of health technologies. We systematically searched three bibliographic databases (MEDLINE, CINAHL, and Social Science Citation Index [SSCI]) using published search filters or “hedges” and our hybrid filter to identify qualitative research studies pertaining to chronic obstructive pulmonary disease and early breast cancer. The search filters were compared in terms of sensitivity, specificity, and precision. Our screening by title and abstract revealed that qualitative research constituted only slightly more than 1% of all published research on each health topic. The performance of the published search filters varied greatly across topics and databases. Compared with existing search filters, our hybrid filter demonstrated a consistently high sensitivity across databases and topics, and minimized the resource-intensive process of sifting through false positives. We identify opportunities for qualitative health researchers to improve the uptake of qualitative research into evidence-informed policy making. [ABSTRACT FROM AUTHOR]

Introduction Reciprocal translation, the understanding of one study's findings in terms of another's, is the foundation of most qualitative metasynthetic methods. In light of the proliferation of metasynthesis methods, the current review sought to create a taxonomy of operations of reciprocal translation using recently published qualitative metasyntheses. Methods On 19 August 2013, MEDLINE, Embase and PsycINFO were searched. Included articles were full reports of metasyntheses of qualitative studies published in 2012 in English-language peer-reviewed journals. Two reviewers, working independently, screened records, assessed full texts for inclusion and extracted data on methods from each included metasynthesis. Systematic review methods used were summarised, and metasynthetic methods were inductively analysed to develop the taxonomy. Results Of 61 included metasyntheses, 21 (34%) reported fully replicable search strategies and 51 (84%) critically appraised included studies. Based on methods in these metasyntheses, we developed a taxonomy of reciprocal translation with four overlapping categories: visual representation; key paper integration; data reduction and thematic extraction; and line-by-line coding. Discussion This systematic review presents an update on methods and reporting currently used in qualitative metasynthesis. It also goes beyond the proliferation of approaches to offer a parsimonious approach to understanding how reciprocal translations are accomplished across metasynthetis methods. Copyright © 2015 John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]

Transference in perversion is characterized by specific problems such as a defiant and polemic attitude, erotic transference, projections, and aggression. Such transference poses particular problems in the treatment of perversion and might render analytical work with these patients impossible. The authors propose that Lacan's L-schema can contribute to separating productive from counterproductive aspects of transference as it distinguishes between an Imaginary and a Symbolic dimension in transference. In this meta-synthesis of 11 published case studies on sexual perversion, patterns of transference are analysed. On the Imaginary dimension, the authors found that patients with perversion tend to (un)consciously engage the analyst in a relationship characterized by identification, fusion and rivalry. On the Symbolic dimension, they found that perverse patients are able to question their motives, lapses, symptoms, and subjective identity. The thematic analysis revealed the importance of the position of the analyst in this work, which is described within the L-schema as being the representative of the otherness in the Other. Implications for clinical practice and recommendations for further research are outlined. [ABSTRACT FROM AUTHOR]

Résumé Objectifs Il s’agit d’une méta-synthèse des études qualitatives explorant la question de l’obésité de l’enfant et de l’adolescent. L’objectif est d’obtenir une vision globale synthétique et originale de la question, afin de proposer des pistes d’adaptation des soins. Méthode Quarante-cinq études qualitatives ont été inclues à l’issue d’une recherche systématique sur les principaux moteurs de recherche en médecine. Ils intègrent les différents points de vue que sont ceux des enfants et des adolescents souffrant d’obésité, ceux de leurs parents, ainsi que ceux des professionnels de santé impliqués dans les soins. L’analyse est thématique. Résultats Les résultats s’organisent autour de trois axes d’expérience communs aux trois groupes : voir et se voir, qui réunit les questions de la représentation de soi et de l’autre obèse, de la prise de conscience et du diagnostic ; comprendre et se comprendre, où l’objectif est de tenter de donner du sens au trouble ; et enfin traiter et se traiter, où l’enjeu est double, celui de l’appréhension globale de la démarche de soin d’une part, et celui de l’évaluation subjective de chaque thérapeutique spécifique d’autre part. Conclusion Les mots sont un enjeu thérapeutique important dans l’obésité de l’enfant et de l’adolescent : la relation médecin-enfant-parent doit être le lieu de la nécessaire circulation des représentations du trouble. Les difficultés d’échange de représentations de l’obésité entre médecin, parents et patient déstabilisent la relation thérapeutique. Summary Aims This metasynthesis of qualitative research deals with the issue of childhood and adolescence obesity. It aims to obtain coherent and original views of this question, in order to suggest therapeutic propositions. Method Forty-five qualitative studies – elicited by web searching on principal medicine databases – were investigated, focusing on clinical and personal experiences of child and adolescent suffering from obesity, their parents, and their carers. The analysis was thematic. Results Themes fall under three main axes: seeing others and oneself, understanding others and oneself, and treating others and oneself. Conclusion Parents-doctor-child relationship in obesity context is impacted by a lack of shared understandings. Each protagonist may exchange his/her viewpoints. Health professionals may take into account the personal experiences of obese children in order to adapt treatment plans. [ABSTRACT FROM AUTHOR]

Background: As far as we are aware, no previous systematic review and synthesis of the qualitative/descriptive literature on polypharmacy in anabolic-androgenic steroid(s) (AAS) users has been published. Method: We systematically reviewed and synthesized qualitative/descriptive literature gathered from searches in electronic databases and by inspecting reference lists of relevant literature to investigate AAS users' polypharmacy. We adhered to the recommendations of the UK Economic and Social Research Council's qualitative research synthesis manual and the PRISMA guidelines. Results: A total of 50 studies published between 1985 and 2014 were included in the analysis. Studies originated from 10 countries although most originated from United States (n=22), followed by Sweden (n = 7), England only (n = 5), and the United Kingdom (n = 4). It was evident that prior to their debut, AAS users often used other licit and illicit substances. The main ancillary/supplementary substances used were alcohol, and cannabis/cannabinoids followed by cocaine, growth hormone, and human chorionic gonadotropin (hCG), amphetamine/meth, clenbuterol, ephedra/ephedrine, insulin, and thyroxine. Other popular substance classes were analgesics/opioids, dietary/nutritional supplements, and diuretics. Our classification of the various substances used by AAS users resulted in 13 main groups. These non-AAS substances were used mainly to enhance the effects of AAS, combat the side effects of AAS, and for recreational or relaxation purposes, as well as sexual enhancement. Conclusions: Our findings corroborate previous suggestions of associations between AAS use and the use of other licit and illicit substances. Efforts must be intensified to combat the debilitating effects of AAS-associated polypharmacy. [ABSTRACT FROM AUTHOR]

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

Purpose -- The purpose of this paper is to systematically identify, appraise and synthesise qualitative research into how working as a peer support worker (PSW) affects personal recovery. Design/methodology/approach -- Ten articles were identified through a systematic search of seven databases, grey literature, reference lists, citations and contact with authors in the field. Identified articles were critically appraised and their results synthesised using metaethnography. Findings -- There is potential to significantly improve the quality of the research in this field. Four categories were constructed to synthesise the findings of the reviewed studies, which demonstrated that being a PSW has the potential to be both facilitative of and detrimental to personal recovery. Research limitations/implications -- The quality of existing studies varies widely. Further, high-quality research is required to specifically investigate the effects of employment as a PSW on personal recovery. Practical implications -- The findings are tentative in light of the quality of the studies, but should be considered in the employment, training and ongoing support of PSWs and the services they join. Originality/value -- Through its systematic methodology and appraisal of the quality of the studies reviewed, this review adds value to the literature about the effect of working as a PSW on personal recovery. It offers an original synthesis and criteria for measuring the quality of research in this field. [ABSTRACT FROM AUTHOR]