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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]

This article reviews and discusses empirical literature on the micro-mechanisms of Burt’s concept of brokerage for inter-firm business networks from a governance perspective. Using a combination of a literature review and a qualitative metasynthesis, research gaps are first identified in the literature about these micro-mechanisms and then filled with interpretations, stemming from a qualitative metasynthesis of 13 in-depth case studies on brokerage for business network environments. The paper discusses three related elements and their inter-relationship in the brokerage process: the enabling factors for brokerage in business networks; the brokerage activities, particularly the combination of “bonding”, “bridging”, exclusion, and moderation/negotiation in different network configurations; and the outcomes of brokerage for business networks. We argue that network managers should take care of these elements when using brokerage to govern business networks. For example, the positional factors of agents in the network who take over brokerage functions need to be monitored and a balance of their embeddedness in the network and independence of focal firms should be safeguarded. Moreover, activities associated with brokerage should be steered and controlled in order to generate network benefits such as a higher collaborative stance of the partaking firms or learning processes amongst them. [ABSTRACT FROM AUTHOR]

BackgroundMetasynthesis—the systematic review and integration of findings from qualitative studies—is an emerging technique in medical research that can use many different methods. Nevertheless, the method must be appropriate to the specific scientific field in which it is used. The objective is to describe the steps of a metasynthesis method adapted from Thematic Synthesis and phenomenology to fit the particularities of psychiatric research.MethodWe detail each step of the method used in a metasynthesis published in 2015 on adolescent and young adults suicidal behaviors. We provide clarifications in several methodological points using the latest literature on metasyntheses. The method is described in six steps: define the research question and the inclusion criteria, select the studies, assess their quality, extract and present the formal data, analyze the data, and express the synthesis.ConclusionMetasyntheses offer an appropriate balance between an objective framework, a rigorously scientific approach to data analysis and the necessary contribution of the researcher’s subjectivity in the construction of the final work. They propose a third level of comprehension and interpretation that brings original insights, improve the global understanding in psychiatry, and propose immediate therapeutic implications. They should be included in the psychiatric common research toolkit to become better recognized by clinicians and mental health professionals.

Aims and objectives: To synthesise and interpret previous findings with the aim of developing a theoretical framework for patient autonomy in a high‐tech care context. Background: Putting the somewhat abstract concept of patient autonomy into practice can prove difficult as when it is highlighted in healthcare literature, the patient perspective is often invisible. Autonomy presumes that a person has experience, education, self‐discipline and decision‐making capacity. Reference to autonomy in relation to patients in high‐tech care environments could therefore be considered paradoxical, as in most cases, these persons are vulnerable, with impaired physical and/or metacognitive capacity, thus making extended knowledge of patient autonomy for these persons even more important. Design: Theory development. Methods: The basic approaches in theory development by Walker and Avant were used to create a theoretical framework through an amalgamation of the results from three qualitative studies conducted previously by the same research group. Results: A theoretical framework—the control‐partnership‐transition framework—was delineated disclosing different parts cocreating the prerequisites for patient autonomy in high‐tech care environments. Assumptions and propositional statements that guide theory development were also outlined, as were guiding principles for use in day‐to‐day nursing care. Four strategies used by patients were revealed as follows: the strategy of control, the strategy of partnership, the strategy of trust and the strategy of transition. Conclusions: An extended knowledge base, founded on theoretical reasoning about patient autonomy, could facilitate nursing care that would allow people to remain/become autonomous in the role of patient in high‐tech care environments. Relevance to clinical practice: The control‐partnership‐transition framework would be of help in supporting and defending patient autonomy when caring for individual patients, as it provides an understanding of the strategies employed by patients to achieve autonomy in high‐tech care contexts. The guiding principles for patient autonomy presented could be used in nursing guidelines. [ABSTRACT FROM AUTHOR]

Background: The family often takes care of an elderly person who suddenly becomes dependent. This greatly affects different aspects of the caregivers' lives. The aim of this study is to explore the initial experiences, during the first year of care, of persons who suddenly become caregivers for elderly dependent relatives.Methods: A search in CINAHL, PsycINFO, WOS, Medline, and Scopus and a metasynthesis of qualitative research were conducted including 19 articles.Results: Three categories were developed to explain the process of becoming a caregiver 'taking on the role' (life changes, uncertainty and confusion, and acceptance or resistance); 'beginning to realise' (new needs, impact, and appraisal); and 'implementing strategies' (seeking help and self-learning, reordering family and social relationships, solving problems, and devising strategies to decrease negative emotions and stress).Conclusions: The synthesis provides a comprehensive understanding of the experience of becoming a caregiver in order to help health-care professionals to adapt care plans to this situation. [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]

Background Although pornography use is widespread, motivations for use may differ depending on certain identity categories. Analysis This article presents the motivations related to pornography use identified following a metasynthesis as a methodological framework. Using theoretical notions of intrinsic and extrinsic motivations, the metasynthesis allowed us to combine results derived from thirteen qualitative studies that examined motivations for pornography use among various audiences. Conclusions and implications The motivations identified are: entertainment, sexual satisfaction, fantasy and identity exploration, creation and strengthening of social or emotional ties, learning and information, transgression, and protection. Our results demonstrate that pornography use can be motivated by both social and personal considerations, and suggest that future research should consider the importance of gender and sexual orientation. [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]

Understanding the challenges of professionals in addressing child adversity is key to improving the detection, protection, and care of exposed children. We aimed to synthesize findings from qualitative studies of professionals’ lived experience of addressing child adversity. Through a systematic search, we identified eight qualitative studies and synthesized them using metaethnography. We generated three themes, “feeling inadequate,” “fear of making it worse,” and “facing evil,” and one overarching metaphor, “walking children through a minefield.” The professionals felt that they lacked the means necessary to explore child adversity, that they were apprehensive of worsening the child’s situation, and that their work with child adversity induced emotional discomfort. This metasynthesis indicated that the professionals’ efficiency in exploring abuse relied upon their ability to manage emotional and moral distress and complexity. To support children at risk, we propose developing professionals’ ability to build relationships, skills in emotion regulation, and proficiency in reflective practice. [ABSTRACT FROM AUTHOR]

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]

AimThe aim of this metasynthesis was to develop an understanding of the existing theoretical perspectives around nurse prescribing and to identify any gaps in knowledge, which would support further research into the lived experience of the nurse prescriber in the primary care setting.BackgroundNurse prescribing has been the focus of many research studies since its introduction, with many benefits to the patient, the prescriber and service identified; however, there remains variation in the utilisation of the prescribing qualification, particularly in primary care settings. Although a range of quantitative and qualitative studies have been undertaken, which aimed to explore the influences on prescribing, few have used a research methodology that supports the in-depth exploration of the nurse prescriber’s experience.MethodsAn extensive literature search was undertaken in April 2015 (20–24), which included UK and non-UK studies since 1999. Inclusion and exclusion criteria were applied to search for studies in which participants included nurse prescribers who practiced in primary or community care settings. Studies that only used a quantitative methodology and those not available in English were excluded. The literature search yielded 124 papers, with 50 papers remaining after the initial screen of full papers against the inclusion/exclusion criteria. The papers were reviewed and graded for their quality, with a further 13 papers excluded.A three-step qualitative analysis technique of metasynthesis was applied to the remaining 37 papers. Identification of similarities and differences enabled first-order interpretations to be identified, which were grouped into broader themes (second-order interpretations) by identifying concepts that applied to two or more studies. Further interpretation through synthesis of translation enabled third-order interpretations to emerge.FindingsFrom the metasynthesis of the 37 papers, nine themes emerged: patient-centred care; benefits to the service; the need for knowledge; professional accountability and boundary setting; safety consciousness; barriers to effective prescribing; role preservation; power-shifts and inter-professional relationships; and culture of prescribing. [ABSTRACT FROM PUBLISHER]

Purpose To conduct a metasynthesis of qualitative research exploring parents' psychosocial experiences during complex and traumatic life transitions related to caring for a child with a life-limiting (LLI) or life-threatening illness (LTI). Background Parents' experiences of caring for a child impacted by an LLI or LTI are not clearly understood, and holistic, comprehensive pediatric nursing care for parents who have children with LLI and LTIs continues to be developed as treatment improves and survival is extended. Review Methods Predetermined inclusion and exclusion criteria were used to review qualitative studies. Those included were appraised, classified, and synthesized using systematic procedures guided by Sandelowski and Barroso (2006). Data Sources A systematic search of qualitative research was conducted by an experienced librarian to identify and retrieve studies from 10 databases. Results Of the 3515 studies screened, 23 were included. A synthesis of the findings demonstrated that parents experience profound and pervasive uncertainty, leading to their own illness experience being described as a dual reality in which fighting for survival and recognizing the threat of their child's death were daily challenges. Three key processes emerged: the devastation of living with uncertainty, the emergence of hope, and moving forward. Conclusion The integration of findings adds to the current body of knowledge by highlighting the very complex experiences that parents undergo. These findings can support a more comprehensive pediatric nursing plan of care that accounts for the intricacies of the parental experience and the importance of hope. [ABSTRACT FROM AUTHOR]

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

The adoption of social media in e-learning signals the end of distance education as we know it in higher education. However, it appears to have very little impact on the way in which open and distance learning (ODL) institutions are functioning. Earlier research suggests that a significant part of the explanation for the slow uptake of social media in e-learning lies outside of conventional factors attributed to distance learning reforms. This research used the conceptual framework for online collaborative learning (OCL) in higher education. Social media such as blogs, wikis, Skype or Google Hangout, Facebook; and even mobile apps, such as WhatsApp; could facilitate deep learning and the creation of knowledge in e-learning at higher educational institutions. This metasynthesis is an interpretative integration of peer-reviewed qualitative research findings on social media in e-learning. It includes a synthesis of data, research methods, and theories used to investigate social media in e-learning. Seven themes emerged from the data which have been recrafted into a framework for social media in e-learning as the final product. The proposed framework could be useful to instructional designers and academics who are interested in using modern learning theories and want to adopt social media in e-learning in higher education as a deep learning strategy.

Building Information Modelling (BIM) has been gaining widespread adoption in the Architecture, Engineering, and Construction (AEC) industry across the globe. Consequently, several research studies have attempted to construct a holistic review of the increasing BIM publications to identify the development trend using manual review, scientometric review, bibliometric review, or latent semantic review. These extant studies have often adopted a global view of the development despite the adoption of BIM varying across firms, countries, and continents. This approach is often regarded as not representative of the BIM development in countries and continents at the infancy stage. As BIM is still at the germinating stage of development in Africa and previous reviews are unrepresentative of BIM development in the AEC industry of Africa. This paper aims to present a scientometric review and metasynthesis of BIM development in the African AEC industry to explore the intellectual evolution of BIM, the status quo of BIM across the regions, and any potential barriers hindering BIM proliferation. The review findings revealed a varying level of BIM growth, with North Africa, West Africa, and Southern Africa leading the research development, whilst East Africa and Central Africa are slightly lagging behind. Additionally, the major challenges facing BIM adoption was found as people/process-related barriers. This study has provided valuable insights into BIM development and application in the growing African AEC industry.

Results from a metasynthesis of the relationships between 14 different types of preservice teacher preparation practices and teaching quality, preschool to university student performance, and university student and beginning teacher belief appraisals are reported. Each type of preservice practice (e.g., course-based student learning) included different kinds of instructional methods (e.g., problem-based learning, inquiry-based learning, and project-based learning). The metasynthesis included 118 meta-analyses and 12 surveys of more than three million study participants. Findings clearly indicated that active university student and beginning teacher involvement in mastering the use of instructional practices and both knowledge and skill acquisition by far stood out as the most important preservice teacher preparation practices. These included extended student teaching experiences, simulated instructional practices and microteaching, faculty coaching and mentoring, clinical supervision, different types of cooperative learning practices, and course-based active student learning methods. The pattern of results helped identify high leverage and high impact teacher preparation practices. Implications for future research and improving teacher preparation are described.

Prostate cancer ( PCa) can negatively impact on men's sexual, urinary and emotional functioning, affecting quality of life. Most men with PCa are older (≥65 years), married and heterosexual and little is known about the impact on men who are younger, unpartnered or gay. We aimed to synthesise existing qualitative research on these three groups of men. A systematic metasynthesis was undertaken that included data on the unique impacts of PCa on younger (<65 years) ( n = 7 papers), unpartnered ( n = 17 papers) or gay or bisexual men ( n = 11 papers) using a modified meta-ethnographic approach. The three overarching constructs illustrated the magnified disruption to men's biographies, that included: marginalisation, isolation and stigma-relating to men's sense of being 'out of sync'; the burden of emotional and embodied vulnerabilities and the assault on identity-illustrating the multiple threats to men's work, sexual and social identities; shifting into different communities of practice-such as the shift from being part of a sexually active community to celibacy. These findings suggest that PCa can have a particular impact on the quality of life of younger, unpartnered and gay men. This has implications for the provision of tailored support and information to these potentially marginalised groups. [ABSTRACT FROM AUTHOR]

Employing metasynthesis as a method, this study examined 52 empirical articles on culturally relevant and responsive science education in K-12 settings to determine the nature and scope of complementarity between culturally responsive and inquiry-based science practices (i.e., science and engineering practices identified in the National Research Council's Framework for K-12 Science Education). The findings from this study indicate several areas of complementarity. Most often, the inquiry-based practices Obtaining, Evaluating, and Communicating Information, Constructing Explanations and Designing Solutions, and Developing and Using Models were used to advance culturally responsive instruction and assessment. The use and development of models, in particular, allowed students to explore scientific concepts through families' funds of knowledge and explain content from Western science and Indigenous Knowledge perspectives. Moreover, students frequently Analyzed and Interpreted Data when interrogating science content in sociopolitical consciousness-raising experiences, such as identifying pollution and asthma incidences in an urban area according to neighborhood location. Specific inquiry-based practices were underutilized when advancing culturally responsive science instruction, though. For example, Using Mathematics and Computational Thinking and Engaging in Argument from Evidence were infrequently encountered. However, culturally responsive engineering-related practices were most often connected with these, and thus, represent potential areas for future complementarity, particularly as the United States embraces the Next Generation Science Standards. In considering innovative directions for advancing equitable science education, several possibilities are discussed in light of the findings of this study.© 2017 Wiley Periodicals, Inc. J Res Sci Teach 54:1143-1173, 2017 [ABSTRACT FROM AUTHOR]

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Protective isolation is aimed at preventing infection in neutropenic patients, but it is implemented inconsistently across centres and is supported by recommendations with poor evidence. This review and metasynthesis explored the experiences and the psychological implications of protective isolation in patients with haematological malignancies undergoing bone marrow ( BMT) or haematopoietic stem cell transplantation ( HSCT). A systematic search of multiple databases for qualitative studies exploring BMT or HSCT patients' experiences of protective isolation was completed. The metasynthesis followed the meta-aggregative method from the Joanna Briggs Institute, with four procedural steps: (1) comprehensive search, (2) quality appraisal, (3) extraction of relevant findings and (4) synthesis of the identified findings. Twenty-six findings were extracted from 11 articles included in the review. The synthesising process yielded seven categories, aggregated into three synthesised findings: (1) isolation is a source of suffering, (2) isolation can lead to relating with oneself and (3) the person does not close the door to the outside world. This metasynthesis sheds light on patients' suffering from being isolated, and the possibility of overcoming this suffering thanks to relationships that patients have with themselves and with the external world. Healthcare providers should reconsider this practise in order to avoid unnecessary patient suffering. [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]

Purpose Preventive health care services provide an important opportunity to assist adolescents to establish and maintain a healthy lifestyle and assume an increasing independent role in their health care. National guidelines emphasize the importance of an annual wellness visit to identify and address risk-behaviors that contribute significantly to the morbidity and mortality in this population. Despite these recommendations, adolescents utilize preventive health care at declining rates throughout adolescence. The purpose of this study was to capture a more holistic view of what adolescents, as consumers of health care services, expect from their primary health care providers (HCPs). Method A metasynthesis of 12 qualitative research studies was conducted using Noblit and Hare's (1988) meta-ethnographic approach. Results Five overarching metaphors, Talk with Me- Not at Me, Accept Me, Respect My Privacy and Confidentiality, Show Me You Are a Professional, and A Trusted Relationship described adolescents' expectations of their HCPs. Conclusions This study provides a more holistic view of adolescents' expectations of their HCPs. Clinical strategies are suggested to assist HCPs to meet adolescents' expectations. [ABSTRACT FROM AUTHOR]

The adoption of social media in e-learning signals the end of distance education as we know it in higher education. However, it appears to have very little impact on the way in which open and distance learning (ODL) institutions are functioning. Earlier research suggests that a significant part of the explanation for the slow uptake of social media in e-learning lies outside of conventional factors attributed to distance learning reforms. This research used the conceptual framework for online collaborative learning (OCL) in higher education. Social media such as blogs, wikis, Skype or Google Hangout, Facebook; and even mobile apps, such as WhatsApp; could facilitate deep learning and the creation of knowledge in e-learning at higher educational institutions. This metasynthesis is an interpretative integration of peer-reviewed qualitative research findings on social media in e-learning. It includes a synthesis of data, research methods, and theories used to investigate social media in e-learning. Seven themes emerged from the data which have been recrafted into a framework for social media in e-learning as the final product. The proposed framework could be useful to instructional designers and academics who are interested in using modern learning theories and want to adopt social media in e-learning in higher education as a deep learning strategy. [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]

Background: Family caregivers (broadly defined as family and friends) experience multiple concurrent transitions when caring for a person with advanced cancer. Aims: To (a) explore the transition experience of family caregivers caring for persons with advanced cancer living in the community, (b) describe potential triggers for transitions, (c) identify what influences this experience, and (d) develop a conceptual framework of their transition experience. Design: Sandelowski and Barroso’s methodology for synthesizing qualitative research included (a) a comprehensive search of empirical literature, (b) quality appraisal of qualitative studies, (c) classification of studies, and (d) synthesis of the findings. Data sources: Literature was sourced from six electronic data bases. Inclusion criteria were as follows: (a) published qualitative studies (and mixed-method designs) of the caregiving experience of family caregivers of community-living persons with advanced cancer at the end of life, (b) participants (caregivers and care recipients) of 18 years of age and above, (c) studies published in English in any country, and (d) studies published between 2004 and 2014. Results: A total of 72 studies were included in the metasynthesis. Family caregivers experience a “life transition” whereby their lives are permanently altered. The participants described the process of redefining normal which consisted of coming to terms with their situation and connecting with others. Outcomes of these processes were as follows: (a) maintaining a sense of personhood, (b) reframing hope, (c) maintaining self-efficacy, (d) finding meaning, and (e) preparing for the death of their care recipient. Conclusion: The findings provide a framework to guide the development of supportive programs and future research. [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]

Few findings from qualitative studies about family presence in intensive care units (ICU) and emergency departments (ED) have been synthesized, despite a renewed appreciation and interest in incorporating qualitative studies in systematic reviews of evidence-based practice. We synthesized findings from 17 qualitative studies on family presence and the experiences of patients, families, and nurses. The essential themes of emotional support, feelings of safety and comfort, knowing, understanding, being informed, and being engaged emerged from the review synthesis. An overarching theme of family coping during stressful times, such as hospitalization, is described as system support and noted in the literature as a component of family resilience. We recommend that further studies be conducted to relate supportive behaviors of critical care nurses to family functioning and provide empirical evidence for further development of the theory of family resilience. [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]

This metasynthesis explores how non-heterosexual women experience informal social support. A systematic literature search was conducted to identify papers for inclusion, following which Noblit and Hare's (1988) meta-ethnographic approach was adopted to synthesize the findings of 16 papers. Four themes were derived: (a) disconnection from family life, (b) the benefits of cross-sexual orientation friendships, (c) negotiating (internalized) homophobia and seeking a space for authenticity, and (d) the intimacy of friendships between women. The impact of heterosexism on the women's experiences of social support is discussed, implications for health and social care are explored, and future research avenues are proposed. [ABSTRACT FROM AUTHOR]

From its origins in the 1990s, the qualitative health research metasynthesis project represented a methodological maneuver to capitalize on a growing investment in qualitatively derived study reports to create an interactive dialogue among them that would surface expanded insights about complex human phenomena. However, newer forms positioning themselves as qualitative metasynthesis but representing a much more technical and theoretically superficial form of scholarly enterprise have begun to appear in the health research literature. It seems imperative that we think through the implications of this trend and determine whether it is to be afforded the credibility of being a form of qualitative scholarship and, if so, what kind of scholarship it represents. As the standardization trend in synthesis research marches forward, we will need clarity and a strong sense of purpose if we are to preserve the essence of what the qualitative metasynthesis project was intended to be all about. [ABSTRACT FROM AUTHOR]

This metasynthesis surveyed extant literature on deception in the context of dementia and, based on specific inclusion criteria, included 14 articles from 12 research studies. By doing so, the authors accomplished three goals: (a) provided a systematic examination of the literature-to-date on deception in the context of dementia, (b) elucidated the assumptions that have guided this line of inquiry and articulated the way those shape the research findings, and (c) determined directions for future research. In particular, synthesizing across studies allowed the authors to develop a dynamic model comprised of three temporally linear elements—(a) motives, (b) modes, and (c) outcomes that describe how deception emerges communicatively through interaction in the context of dementia. [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]

This metasynthesis critically surveyed and evaluated the learning impacts on counselor and psychology trainees' multicultural development and intercultural competence through participating in cultural immersion (CI), based on published qualitative research evidence. Accordingly, this metasynthesis identified and assessed the characteristics, the methodological strengths and qualities, and the thematic findings of 33 qualitative and mixed-methods CI studies resulting from exhaustive database searches. Using a directed content analysis technique, a six-domain analytical framework was applied to code and analyze the themes reported in these studies. The results point to CI intervention as a multifaceted and versatile instructional apparatus that impacted and contributed to trainees' multicultural development and intercultural learning multidimensionally, across cognitive, perceptual-attitudinal, affective, and skills-behavioral domains. These learning outcomes include trainees' increased cultural awareness and knowledge (cognitive), enhanced reflexivity on their worldview, positionality, and attitude (perceptual-attitudinal), heightened emotion and growth in cultural empathy (affective), adaptation and display of new behaviors and relational skills and increased multicultural competence (skills-behavioral). Therefore, CI embodies many favorable characteristics of experientially-based learning as stipulated in the existing multicultural counseling and intercultural training literature. These findings lend nuanced empirical support for the application of CI to facilitate counselor trainees' multicultural orientation, development, and skills, and offer insights into structural facilitators for enhancing immersion training. However, a lack of structural and methodological consistency and theoretical depth among the existing CI studies were observed as major limitations. Implications and recommendations for advancing future CI and multicultural training practice and research are discussed. [ABSTRACT FROM AUTHOR]

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

Children, adolescents, and young adults living with sickle cell disease (SCD) often experience an unpredictable and complex disease course. Although there is a growing literature on the lived experience of patients with SCD, qualitative syntheses are lacking. Therefore, a qualitative metasynthesis was conducted to inform care and potential interventions. Noblit and Hare's phases of metaethnographic research were used to guide the synthesis of qualitative data. Data extracted from the identified studies were directly compared through reciprocal translation. The 12 studies that met inclusion criteria for the meta-synthesis included 177 participants ranging in age from 6 to 35 years old from six different countries. The authors identified three key metaphors: Ubiquitous Intrusion, Coping to Learn: Learning to Cope, and Part of the Whole. The metaphors were elucidated by three essential concepts that underlie the experience of children, adolescents, and young adults living with SCD: (1) recognition of SCD implications, (2) identifying ways to balance responsibilities, and (3) positioning oneself to thrive with SCD. The metaphors and essential concepts support the global theme of "Growing Beyond SCD." The metasynthesis revealed the shared complexity of living with SCD among children, adolescents, and young adults from diverse cultures in which the yearning for a normal life drove learning to adapt and manage SCD with their support network. The key metaphors may be used to guide development of nursing interventions designed to promote self-acceptance, coping, and adaptation skills among children, adolescents, and young adults that will help them to flourish while managing SCD as a chronic condition., (© 2023 Wiley Periodicals LLC.)

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]

The high epidemiological, social, economic and cultural impact of chronic non-communicable diseases affects what quality of life means to those who suffer from such illnesses and their family caregivers. Objective: Describe how the quality of life of those who care for the chronically ill is constructed. Method: Sandelowski and Barroso's proposal for qualitative metasynthesis was used to develop the study. Results: There are three moments in the process: 1) it is affected (programmed cell destruction), 2) transformed (self-control of development and growth) and 3) redefined (condensation). Construction of the meaning of quality of life for the caregiver is conditioned by four factors: social support, spirituality, ability to care and time. Conclusions: Quality of life is affected and reconstructed by virtue of the meaning the caregiver assigns to it. [ABSTRACT FROM AUTHOR]