Meta‐synthesis of qualitative research can be an important way to consolidate and grow nursing knowledge and theory. However, from recent readings of such works in the nursing literature, one can observe that there is increasing use of meta‐synthesis being used as a way to simply aggregate qualitative research findings in a manner claimed to be similar to quantitative meta‐research while also remaining compatible with the qualitative research tradition. The aim of this paper is to discuss (...) whether this meta‐aggregation form of research has a sound epistemological foundation and should be considered a viable form of meta‐synthesis. The conclusion drawn is that meta‐aggregation falls short of being a sound method and is not compatible with the qualitative research philosophy. It is also concluded that meta‐aggregation should not be seen as a form of qualitative meta‐synthesis. Meta‐synthesis is best understood as a way to re‐interpret, compare and translate disparate qualitative studies using different conceptual apparatus into a consolidated knowledge of fundamental importance to nursing care practitioners. To conclude, aggregating qualitative research tends to turn rich descriptions into thin abstractions that are of little use to nursing practice knowledge and does not advance nursing science. (shrink)

BackgroundThe past 10 years have witnessed a significant growth in sharing of health data for secondary uses. Alongside this there has been growing interest in the public acceptability of data sharing and data linkage practices. Public acceptance is recognised as crucial for ensuring the legitimacy of current practices and systems of governance. Given the growing international interest in this area this systematic review and thematic synthesis represents a timely review of current evidence. It highlights the key factors influencing public (...) responses as well as important areas for further research.MethodsThis paper reports a systematic review and thematic synthesis of qualitative studies examining public attitudes towards the sharing or linkage of health data for research purposes. Twenty-five studies were included in the review. The included studies were conducted primarily in the UK and North America, with one study set in Japan, another in Sweden and one in multiple countries. The included studies were conducted between 1999 and 2013. The qualitative methods represented in the studies included focus groups, interviews, deliberative events, dialogue workshops and asynchronous online interviews.ResultsKey themes identified across the corpus of studies related to the conditions necessary for public support/acceptability, areas of public concern and implications for future research. The results identify a growing body of evidence pointing towards widespread general—though conditional—support for data linkage and data sharing for research purposes. Whilst a variety of concerns were raised in cases where participants perceived there to be actual or potential public benefits from research and had trust in the individuals or organisations conducting and/or overseeing data linkage/sharing, they were generally supportive. The studies also find current low levels of awareness about existing practices and uses of data.ConclusionsWhilst the results indicate widespread public support for data sharing and linkage for research purposes, a range of concerns exist. In order to ensure public support for future research uses of data greater awareness raising combined with opportunities for public engagement and deliberation are needed. This will be essential for ensuring the legitimacy of future health informatics research and avoiding further public controversy. (shrink)

Xiong was the originator and founder of Modern Confucianism (xin ruxue ) as well as one of the first Chinese philosophers, who developed his own system of thought, which was based upon classical Confucian concepts and, at the same time, adjusted to the conditions of the New Era. His contribution to the development of modern Chinese philosophy can also be demonstrated in a much broader, general sense. Xiong Shili, namely, also represents one of the first theoretically qualified intellectuals of his (...) age, who didn’t advocate the conservative elitist nationalism, but at the same time opposed the prevailing trends of iconoclastic negation of tradition. Even later on, during the predomination of the so-called communist ideologies, Xiong rather consequently persisted in his—for that time completely unacceptable— standpoints.Thus Xiong Shili, remaining a real Confucian scholar at a time, when Confucianism was everything else but the prevailing state doctrine, doubtless represents a real traditional sage. For him, Confucianism was not solely the predominating system of thought, to which he should formally conform in order to achieve the realization of some privileges and private interests. He was a Confucian scholar by following his own inner conviction, or, with other words, he was a Confucian “inner sage.” Hereby,we encounter an extremely rare kind of Confucian scholars, namely of those, who did not remain limited to a paper-wrapped reproduction of idealistic principles of Confucian thought, but who also tried to perform them in their own life. Xiong’s personal moral was the ethics of a Confucian scholar, who can be a gentle, subtle thinker and a steadfast, consequent rebel at the same time. (shrink)

Background: Legislative changes are resulting in assisted death as an option for people at the end of life. Although nurses’ experiences and perspectives are underrepresented within broader ethical discourses about assisted death, there is a small but significant body of literature examining nurses’ experiences of caring for people who request this option. Aim: To synthesize what has been learned about nurses’ experiences of caring for patients who request assisted death and to highlight what is morally at stake for nurses who (...) undertake this type of care. Design: Qualitative meta-synthesis. Methods: Six databases were searched: CINAHL, Medline, EMBASE, Joanna Briggs Institute, PsycINFO, and Web of Science. The search was completed on 22 October 2014 and updated in February 2016. Of 879 articles identified from the database searches, 16 articles were deemed relevant based on inclusion criteria. Following quality appraisal, 14 studies were retained for analysis and synthesis. Results: The moral experience of the nurse is defined by a profound sense of responsibility, shaped by contextual forces that nurses navigate in everyday end-of-life care practice, and sustained by intra-team moral and emotional support. Discussion: The findings of this synthesis support the view that nurses are moral agents who are deeply invested in the moral integrity of end-of-life care involving assisted death. The findings further demonstrate that to fully appreciate the ethics of assisted death from a nursing standpoint, it is necessary to understand the broader constraints on nurses’ moral agency that operate in everyday end-of-life care. Ethical considerations: Research ethics board approval was not required for this synthesis of previously published literature. Conclusion: In order to understand how to enact ethical practice in the area of assisted death, the moral experiences of nurses should be investigated and foregrounded. (shrink)

Information on the factors influencing parents’ decision-making process following a lethal, life-limiting or severely debilitating prenatal diagnosis remains deficient. A comprehensive systematic review and meta-synthesis was conducted to explore the influencing factors for parents considering termination or continuation of pregnancy following identification of lethal, life-limiting or severely debilitating fetal abnormalities. Electronic searches of 13 databases were conducted. These searches were supplemented by hand-searching Google Scholar and bibliographies and citation tracing. Thomas and Harden’s thematic synthesis method was used to (...) synthesise data from identified studies. Twenty-four papers were identified and reviewed, but two papers were removed following quality assessment. Three main themes were identified through systematic synthesis. Theme 1, entitled ‘all life is precious’, described parents’ perception of the importance of the fetus’ life, a fatalistic view of their situation alongside moral implications as well as the implications decisions would have on their own life, in consideration of previous life experiences. Theme 2 contained two sub-themes which considered the parent’s own imagined future and the influence of other people’s experiences. Finally, Theme 3 presented three sub-themes which may influence their parental decision-making: These described parental consideration of the quality of life for their unborn child, the possibility of waiting to try for another pregnancy, and their own responsibilities and commitments. The first review to fully explore parental decision-making process following lethal, life-limiting, or severely debilitating prenatal diagnosis provided novel findings and insight into which factors influenced parents’ decision-making process. This comprehensive and systematic review provides greater understanding of the factors influential on decision-making, such as hope, morality and potential implications on their own and other’s quality of life, will enable professionals to facilitate supported decision-making, including greater knowledge of the variables likely to influence parental choices. (shrink)

Autistic children with sensory processing differences successfully navigate and engage in meaningful family daily occupations within home and community environments through the support of their family. To date however, much of the research on autistic children with sensory processing differences, has primarily been deficit focused, while much of the caregiver research has focused on issues of distress, burden, effort, and emotional trauma in coping with their child's diagnosis. This study aimed to conduct a qualitative evidence synthesis, using a (...) meta-ethnographic approach to explore the gap identified in understanding successful occupational experiences of family participation and daily family routines when supporting an autistic child with sensory processing differences and to offer an alternative strengths-based perspective. Inclusion criteria were studies which were peer-reviewed qualitative design, published from 2000 to 2021, and that concerned parents/caregivers' perspectives of family occupations of children diagnosed with autism spectrum disorder. Studies were electronically searched in eight databases from October to December 2021 and 23 studies were identified which met the inclusion criteria. Noblit and Hare's seven step approach for conducting analysis in meta-ethnography was used, and three themes identified: sensory processing differences in daily life, what is hard about hard, and orchestrating family life. Results identified the centrality of sensory experiences in understanding family life. Living with unpredictability while orchestrating certainty through routines was core to successful participation. This review provides insights into how parents negotiate the complexities of constructing family life when living with an autistic child. The results can inform the design of future interventions that specifically address the relationship between meaningful participation in family occupations and daily routines and sensory processing in autistic children.Systematic review registrationhttps://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42022298938, identifier: CRD42022298938. (shrink)

Aim To synthesize qualitative research on perspectives and understandings of Intensive Care Unit (ICU) patients, family members, and staff regarding respect and dignity in ICU, in order to explore the connotations and meanings of respect and dignity in ICU. Design A qualitative meta-synthesis. Methods The Chinese and English databases were systematically searched, including PubMed, Web of Science, CINAHL, Embase, Cochrane Library, CNKI, Wangfang Data, VIP, and CBM from each database’s inception to July 22, 2023. Studies were critically (...) appraised using the Joanna Briggs Institute (JBI) Critical Appraisal Checklist for Qualitative Research. Qualitative data were extracted, summarized, and meta-synthesized. (PROSPERO: CRD42023447218). Results A total of 9 studies from 6 countries were included in the meta-synthesis. Thirty-six main themes and 67 sub-themes were extracted, which were eventually integrated into 9 categories and 4 themes: (1) integrity of humanity; (2) autonomy; (3) equality; (4) environmental support. Conclusion To maintain patient dignity, it is necessary to create an environment of respect within the ICU where healthcare professionals uphold the concept of preserving human integrity and respect patients' autonomy and equality. Healthcare professionals need to value the dignity of ICU patients and treat them as unique individuals during treatment and care. Hospital managers should also strive to create a respectful environment to provide environmental support for dignity care implementation. (shrink)

Heideggerian philosophy is frequently chosen as a philosophical framing, and/or a hermeneutic analytical structure in qualitative nursing research. As Heideggerian philosophy is dense, there is merit in the development of scholarly resources that help to explain discrete Heideggerian concepts and to uncover their relevance to contemporary human experience. This paper uses a meta-synthesis methodology to pool and synthesise findings from 29 phenomenological research reports on Being-with in the nurse–patient relationship. We firstly considered and secured the most relevant Heideggerian (...) elements to nurse–patient Being-with. Under these deductive codes, we then inductively developed sub-themes that seemed to explain the multifaceted nature of Being-with, through a secondary analysis and synthesis of published data from 417 patient, carer and nurse participants. Dasein-with was enhanced when nurses had first-hand experience with a phenomenon. Nurses moved between the inauthentic they-mode, and the authentic self-mode. Through circumspection, technology and people were encountered environmentally feeding into nursing attention, assessment and communication. Nursing as a social arrangement was expressed through either leaping-in care or leaping-ahead care. There was a place for both inauthentic and authentic discourse that nurses wove through the ontic everydayness of nursing tasks. (shrink)

A large proportion of nursing home residents in developed countries come from ethnic minority groups. Unmet care needs and poor quality of care for this resident population have been widely reported. This systematic review aimed to explore social conditions affecting ethnic minority residents' ability to exercise their autonomy in communication and care while in nursing homes. In total, 19 studies were included in the review. Findings revealed that ethno‐specific nursing homes create the ideal social condition for residents to express their (...) care needs and preferences in a language of choice. In nonethno‐specific nursing homes, staff cultural competence and nursing home commitment to culturally safe care are crucial social conditions that enable this group of residents to fulfil their autonomy in communicating and in participating in their care. In contrast, social conditions that undermine residents' ability to express their care needs and preferences include low levels of staff cultural awareness and cultural desire, negative attitudes towards residents and limited organisational support for staff to improve culturally responsive and culturally safe care. In conclusion, it is important to optimise the social conditions to support ethnic minority residents to communicate their care needs and preferences. (shrink)

Nursing policy and healthcare reform are focusing on two, interconnected areas: person‐centred care and fundamental care. Each initiative emphasises a positive nurse–patient relationship. For these initiatives to work, nurses require guidance for how they can best develop and maintain relationships with their patients in practice. Although empirical evidence on the nurse–patient relationship is increasing, findings derived from this research are not readily or easily transferable to the complexities and diversities of nursing practice. This study describes a novel methodological approach, called (...) holistic interpretive synthesis (HIS), for interpreting empirical research findings to create practice‐relevant recommendations for nurses. Using HIS, umbrella review findings on the nurse–patient relationship are interpreted through the lens of the Fundamentals of Care Framework. The recommendations for the nurse–patient relationship created through this approach can be used by nurses to establish, maintain and evaluate therapeutic relationships with patients to deliver person‐centred fundamental care. Future research should evaluate the validity and impact of these recommendations and test the feasibility of using HIS for other areas of nursing practice and further refine the approach. (shrink)

The arts provide openings for symbolic expression by engaging the sensory experience in the body they become a source of insight through embodied cognition and emotion, enabling meaning-making, and acting as a catalyst for change. This synthesis of sensation and enactive, embodied expression through movement and the arts is capitalized on in The BodyMind Approach®. It is integral to this biopsychosocial, innovative, unique intervention for people suffering medically unexplained symptoms applied in primary healthcare. The relevance of embodiment and arts (...) practices in TBMA are discussed in relation to the views of participants in the pursuit of self-management. If widely employed TBMA could have an enormous impact, reach, and significance for patients and global health services. This original pre-clinical trial of qualitative research reports on the perceptions of participant patients with generic MUS, a world-wide issue usually treated by either psychological therapy or physiotherapy. TBMA is not a therapy but a health education program founded upon the concept of an integration of psychological elements with physiological, bodily, and sensory experiences. Thematic analysis of qualitative data sets from open-ended questions in semi-structured interviews and a written questionnaire post intervention is presented. Five aspects which appear to be key to learning self-management were derived from analyzing the data: body with mind connections; importance of facilitation; potential benefits; preparedness for change; self-acceptance/compassion. This article advances the discourse on the nature of self-management for MUS through changing the mind-set and the relationship participants have with their bodily symptom/s through employing embodied methods and arts practices, challenging current, and solely verbal, psychological conceptual frameworks. Rigor lies in the method of data analysis using cross verification of credibility between reported findings and scrutiny by stakeholders. We conclude that facilitated TBMA groups employing embodied methods and arts practices can act as a method for developing the self-management of MUS and improving wellbeing. (shrink)

The aim of this article is to describe the synthesis of the concept of moral stress and to attempt to identify its preconditions. Qualitative data from two independent studies on professional issues in nursing were analysed from a hypothetical-deductive approach. The findings indicate that moral stress is independent of context-given specific preconditions: (1) nurses are morally sensitive to the patient’s vulnerability; (2) nurses experience external factors preventing them from doing what is best for the patient; and (3) nurses (...) feel that they have no control over the specific situation. The findings from this analysis are supported by recent research on stress in the workplace but differ in that the imperatives directing work are moral in nature. Stress researchers have found that persons who experience that they have no control over their work situation and at the same time experience high demands may be prone to cardiovascular diseases. An important question raised by this study is whether moral stress should be recognized as a health risk in nursing. Further research is required in order to generate intervention models to prevent or deal with moral stress. (shrink)

Background Informed consent is an integral component of good medical practice. Many researchers have investigated measures to improve the quality of informed consent, but it is not clear which techniques work best and why. To address this problem, we propose developing a core outcome set to evaluate interventions designed to improve the consent process for surgery in adult patients with capacity. Part of this process involves reviewing existing research that has reported what is important to patients and doctors in the (...) informed consent process. Methods This qualitative synthesis comprises four phases: identification of published papers and determining their relevance; appraisal of the quality of the papers; identification and summary of the key findings from each paper while determining the definitiveness of each finding against the primary data; comparison of key themes between papers such that findings are linked across studies. Results Searches of bibliographic databases returned 11,073 titles. Of these, 16 studies met the inclusion criteria. Studies were published between 1996 and 2016 and included a total of 367 patients and 74 health care providers. Thirteen studies collected data using in-depth interviews and constant comparison was the most common means of qualitative analysis. A total of 94 findings were extracted from the primary papers and divided into 17 categories and ultimately 6 synthesised findings related to: patient characteristics, knowledge, communication, the model patient, trust and decision making. Conclusions This qualitative meta-aggregation is the first to examine the issue of informed consent for surgery. It has revealed several outcomes deemed important to capture by patients and clinicians when evaluating the quality of a consent process. Some of these outcomes have not been examined previously in research comparing methods for informed consent. This review is an important step in the development of a COS to evaluate interventions designed to improve the consent process for surgery. Registration The study protocol was registered on the international prospective register for systematic reviews. (shrink)

The article shows that three antirealistic theories of classical analysis and synthesis are logically possible: presentationistic, solipsistic and Kantian, but only the latter is actually being developed. Revealed its specific features and features shared with other, logically possible antirealistic theories. The correlation of the Kantian theory of analysis and synthesis of knowledge with his theory of analysis and synthesis of subjects of knowledge is analyzed. Gnoseological problems that forced Kant to assert that new knowledge is provided only (...) by the synthesis of knowledge, and analysis only clarifies the results of synthesis, are characterized. The Kantian solution to these problems is correlated with their realistic solution. The role that the Kantian "Copernican revolution in philosophy" plays in his interpretation of the analysis and synthesis of subjects of knowledge is investigated. The Kantian theory of analytical and synthetic judgments is considered. It is shown that the Kantian question "how are synthetic judgments a priori possible?" is essentially a question about the nature of theoretical knowledge, which was historically formed in ancient geometry precisely as the unity of analysis and synthesis. A qualitative difference is shown between classical and geometric (by origin) analysis and synthesis. Three historical stages of their formation are described. The assertion of I. Newton that the natural science experiment arose as a result of the extension of the method of geometric analysis and synthesis to the natural sciences is investigated. (shrink)

Dignity is a value inherent to all human beings, guaranteed to every individual from birth, and influenced by culture and society. It is protected by various laws and declarations, and represents one of the fundamental human rights. Preserving human dignity is an essential aspect of nursing practice and a central element of care. Dignity is a highly subjective and personal concept; there may be variations in the way that patients perceive it and in the ways that nurses can guarantee it. (...) A systematic review of the qualitative literature was conducted to obtain a comprehensive understanding of adult patients’ perceptions of dignity in a hospital setting. This review adhered to the PRISMA Statement for reporting systematic reviews, and the results were reported in accordance with the Enhancing Transparency in Reporting the Synthesis of Qualitative Research (ENTREQ) guidelines. Major databases (PubMed, CINAHL, Scopus, and PsycINFO) were consulted and resulted in the inclusion of 21 studies. Methodological quality was assessed using the Critical Appraisal Skills Program (CASP) Checklist for Qualitative Studies. Six main themes emerged from the data analysis: (1) The concept of dignity and its various dimensions; (2) The significance of maintaining one’s own privacy and confidentiality; (3) The hospital environment’s influence on patients’ dignity; (4) Healthcare professionals’ characteristics and behaviours that affect dignity; (5) The role of communication and the relationship with healthcare providers; and (6) The patient’s ability to make choices and be involved actively in their care. These findings underscore the importance of understanding caregivers’ perspectives on dignity to ensure that they provide respectful and dignified care and treatment that prioritizes the patient’s mental and physical needs. (shrink)

The problem of ‘collective unity’ in the transcendental philosophies of Kant and Husserl is investigated on the basis of number’s exemplary ‘collective unity’. To this end, the investigation reconstructs the historical context of the conceptuality of the mathematics that informs Kant’s and Husserl’s accounts of manifold, intuition, and synthesis. On the basis of this reconstruction, the argument is advanced that the unity of number – not the unity of the ‘concept’ of number – is presupposed by each transcendental philosopher (...) in their accounts of the transcendental foundation of manifold, intuition, and synthesis. This presupposition is ultimately traced to Kant’s and Husserl’s responses to Hume’s philosophy of human understanding and the critical limits of what Kant calls the ‘qualitative’ unity of transcendental consciousness. These critical limits are exposed in both philosophers’ attempts to account for that ‘qualitative’ unity on the basis of the ‘quantitative’ unity of number. (shrink)

This paper aims to perform a qualitative synthesis of literature concerning the representation of information in displaced archives. Methodologically, this communication is configured in a metasynthesis oriented to theory building, constituting a non-reactive, documentary-based and exploratory type of study, focused on articles and books chapters published in English between 1954 and 2019. The collection of texts is supported by the SPICE strategy, applied to the search in databases (WoS and EBSCO). We adopted content analysis according to the assumptions (...) of Charmaz and Finfgeld-Connett. Of the 443 records, 155 texts that responded to the research purposes were included. Three themes emerged from the content analysis around the aforementioned theme with a view to theory building: “anarchivism as (non-) representation”, “archive of the archive”, and “archival canon”. Finally, displaced archives constitute an emerging theme in several domains, so it is important to explore the complex nature of this phenomenon from the point of view of representation and knowledge organization. (shrink)

The similarities between William James’ Stream of Consciousness and Henri Bergson’s La durée réelle have often been noted. Both emphasize the fundamentally temporal nature of our conscious experience and its constant flow. However, in this article, I argue that despite surface similarities between the OP theories, they are fundamentally different. The ultimate reason for the differences between the theories is that James believed that we should reject psychological explanations that depend on synthesis within the mental sphere. This is because (...) such explanations are incompatible with empiricism. Instead, we should look to the physiological mechanisms underpinning mental states. In contrast, Bergson was an adamant defender of a form of mental processing which he called qualitative synthesis. Duration itself, for Bergson, is a form of qualitative synthesis. However, in 1906, less than five years before James died, Bergson convinced him to change his mind. This results in a huge shift in James’ thought. Unless we understand how far apart James and Bergson were prior to this shift, we will not have a proper picture of the full influence of Bergson on James’ thought, nor of the major changes to James’ philosophy that occurred near the end of his life. (shrink)

BackgroundIn our globalizing world, caregivers are increasingly being confronted with the challenges of providing intercultural healthcare, trying to find a dignified answer to the vulnerable situation of ethnic minority patients. Until now, international literature lacks insight in the intercultural care process as experienced by the ethnic minority patients themselves. We aim to fill this gap by analysing qualitative literature on the intercultural care encounter in the hospital setting, as experienced by ethnic minority patients.MethodsA systematic search was conducted for papers (...) published between 2000 and 2015. Analysis and synthesis were guided by the critical interpretive synthesis approach.ResultsFifty one articles were included. Four dimensions emerged, describing the intercultural care encounter as a meeting of two different cultural contexts of care, in a dynamic and circular process of balancing between the two cultural contexts, which is influenced by mediators as concepts of being human, communication, family members and the hospital’s organizational culture.ConclusionsThis review provides in-depth insight in the dynamic process of establishing intercultural care relationships in the hospital. We call for a broader perspective towards cultural sensitive care in which patients are cared for in a holistic and dignity-enhancing way. (shrink)

Background Respectful maternity care (RMC) emphasizes the social and relational elements of maternity care and is a crucial part of initiatives to improve service accessibility and quality. Women's perceptions have influenced much of what we know about RMC and contempt in the labor ward. In order to understand midwives' perspectives of RMC, this meta-synthesis focused on them. Method For this inquiry, the databases PubMed/Medline, Embase, Web of Science, and Scopus were searched to find studies on midwives' perceptions of RMC (...) written between 2011 and April 20th 2023. The included articles were to English language restriction. The results of the included research were examined using thematic analysis. Using the inclusion criteria, 84 potentially relevant articles were carefully reviewed, and only 22 were ultimately selected for synthesis. The quality of the qualitative study was assessed using the CASP, a tool for quality evaluation and PRISMA guidelines were followed. Using the MAXQDA program, the cited quotes and the original authors' interpretations were combined. Result There were 22 studies total, thematic synthesis was determined to be appropriate for a total of 22 research studies. Following are the topics which we summarized our analysis: in six major themes: Midwives’ conceptualizations of RMC, Midwives commitment to woman’s rights, The value and impact of RMC to midwives, Midwife’s perception of disrespectful care, Challenges in providing respectful maternity care, and Midwives’ recommendations for optimal RMC practice. Conclusion In addition to specific focus on promoting cooperation, policies to enhance health systems and strategic consideration of the midwifery profession's future are required. (shrink)

Feelings are conscious mental events that represent body states as they undergo homeostatic regulation. Feelings depend on the interoceptive nervous system (INS), a collection of peripheral and central pathways, nuclei and cortical regions which continuously sense chemical and anatomical changes in the organism. How such humoral and neural signals come to generate conscious mental states has been a major scientific question. The answer proposed here invokes (1) several distinctive and poorly known physiological features of the INS; and (2) a unique (...) interaction between the body (the ‘object’ of interoception) and the central nervous system (which generates the 'subject' of interoception). The atypical traits of the INS and the direct interactions between neural and non‐neural physiological compartments of the organism, neither of which is present in exteroceptive systems, plausibly explain the qualitative and subjective aspects of feelings, thus accounting for their conscious nature. (shrink)

Nursing staff plays a key role in the public health response to the COVID-19 pandemic, being in the front line of care. This study sought to synthesise the qualitative literature on care experiences of frontline nurses during the COVID-19 pandemic. A search was conducted on five databases in January 2021. Fifteen qualitative studies met the inclusion criteria and were included in the research, being submitted to interpretive meta-synthesis according to the eMERGe guide. The final synthesis included (...) a line of argument that shows the experiences of frontline nurses during the COVID-19 pandemic, divided into three major themes: ‘Instability on the edge of a cliff: unpredictable and unknown context,’ ‘The price of walking the tightrope: the uncertainty surrounding care,’ and ‘Finding the balance to reach the other side: dealing with the emotional demands of care.’ Although essential in the health response to the COVID-19 pandemic, nurses experienced an emotional impact arising from the hampered care provision. Our results point to need for strengthening the training of nurses and future nurses, creating and promoting measures that contribute to their psycho-emotional well-being, ensuring a safe environment for their clinical practice, and promoting their participation in decision-making processes. (shrink)

While the richness of Heideggerian philosophy is attractive as a healthcare research framework, its density means authors rarely utilise its fullest possibilities as an hermeneutic analytic structure. This article aims to clarify Heideggerian hermeneutic analysis by taking one discrete element of Heideggerian philosophy (Being-towards-death), and using it’s clearly defined structure to conduct a meta-synthesis of Heideggerian phenomenological studies on the experience of living with a potentially life-limiting illness. The findings richly illustrate Heidegger’s philosophy that there is either an inauthentic (...) positioning towards death, or an authentic positioning towards death with a proposition that (1) death is certain; (2) death is indefinite; (3) death is non-relational; and (4) death is not-to-be-outstripped. None of the 29 included studies on the experience of a confrontation with death fully utilised this framework, despite claiming a grounding in Heideggerian thought. This demonstrates the value in modelling how Heideggerian existential structures can be used proactively as analytical ‘hooks’ for data in research claiming a basis in this philosophy and/or method. By modelling the potential application of an important Heideggerian philosophical construct to published qualitative data, this meta-synthesis has revealed new domains and more nuanced understandings of the temporal structure of Being-towards-death. Such an approach helps to more fully unveil the existential concerns of people at the core of interpretative phenomenological enquiry and may provide a blueprint to map either primary or synthesised data to other key ontological existentials. (shrink)

Background Relational autonomy is an alternative concept of autonomy in which an individual is recognized as embedded into society and influenced by relational factors. Social context, including social location, political structure, and social forces, significantly influence an agent to develop and exercise autonomy skills. The relational approach has been applied in clinical practice to identify relational factors impacting patient autonomy and decision-making, yet there is a knowledge gap in how these factors influence the demonstration of relational autonomy in the context (...) of medical decisions of adults. Objective The present study targeted the existing knowledge of what and how relational factors impact individuals making medical decisions using the theoretical framework of relational autonomy. Methods A meta-synthesis study was utilized. Four electronic databases, including Embase, OVID Medline, CINAHL, and PubMed, were searched, along with gray literature and reference lists, to identify relevant studies. Results 23 studies reporting 21 qualitative and two mixed-method studies were reviewed. Four themes emerged from the qualitative findings: (1) supportive relationships facilitate an individual’s relational autonomy; (2) obtaining comprehensive information from broader sources helps individuals exercise relational autonomy; (3) undue family pressure impedes the exercising of patient relational autonomy; and (4) healthcare providers’ dominant voice hampers the demonstration of relational autonomy. Conclusions Applying relational autonomy to assist adults in making well-considered decisions is essential. The meta-synthesis suggests establishing a supportive relationship between individuals, healthcare providers, and family. A supportive relationship will allow healthcare providers to make judgments in line with an individual’s values and wishes with the aim of promoting relational autonomy. Advance care planning was proposed as the effective solution to obtain a consensus between individuals and their families while respecting an individual’s values and preferences. Furthermore, it is considered crucial for healthcare providers to appreciate an individual's values and incorporate their preferences into recommendations. (shrink)

Background: The right of children to have their voice heard has been accepted by researchers, and there are increasing numbers of qualitative health studies involving children. The ethical and methodological issues of including children in research have caused worldwide concerns, and many researchers have published articles sharing their own experiences. Objectives: To systematically review and synthesise experts’ opinions and experiences about ethical and methodological issues of including children in research, as well as related solution strategies. Research design: The research (...) design was a systematic review of opinion-based evidence, based on the guidelines by Joanna Briggs Institute. Methods: A search of five computerised databases has been conducted in April 2014 and 2271 articles were found. After screening the titles, abstracts, full texts and appraising the quality, 30 articles were finally included in the review. A meta-aggregative approach was applied in the data analysis and synthesis process. Ethical considerations: Ethical approval is not needed as it is a systematic review of published literature. Results: Six themes were identified, including evaluating potential risks and benefits, gaining access, obtaining informed consent/assent, protecting confidentiality and privacy, building rapport and collecting rich data. The similarities and differences between research involving children and that involving adults were indicated. Conclusion: All potential incentives should be justified when designing the study. Further studies need to research how to evaluate individual capacity of children and how to balance protecting children’s right to participate and their interests in the research. Cultural differences related to researching children in different regions should also be studied. (shrink)

Objective Recent legislation mandating the inclusion of children in clinical trials has resulted in an increase in the number of children participating in research. We reviewed the literature regarding the reasons parents chose to accept or decline an invitation to enrol their children in clinical research. Methods We searched for qualitative studies, written in the English language that considered the experiences of parents who had been invited to enrol their children in research. SCOPUS and Web of Knowledge electronic databases (...) and reference lists of retrieved articles and review papers were searched. Retrieved articles were synthesised using the narrative synthesis method. Results 16 qualitative studies exploring the experiences of parents living in five countries whose children had a range of health conditions of varying severity were included. The health status of the child appeared to influence parents' reasons for participation. Parents whose children had life threatening conditions often considered they had no choice but to participate and many welcomed the innovation offered through research participation. Such parents also viewed the risks of research less negatively than those whose children were healthy or in the stable stage of a chronic condition. This raises questions regarding the voluntariness of informed consent by such parents. Conclusions A tailored approach is needed when discussing research participation with parents of eligible children. While parents of healthy children may be more open to discussions of altruism, those whose children have life threatening illnesses should be given adequate information about the alternatives to, and risks of, research participation. (shrink)

Globally, healthcare has become dominated by women nurses. Gender is also known to impact the way people are cared for in various healthcare systems. Considering gender from the perspective of how lived bodies are positioned through the structural relations of institutions and processes, this systematic review aims to explore the meaning of gender in the caring relationship between the nurse and the older person through a synthesis of available empirical data published from 1993 to 2022. CINAHL, PUBMED, EMBASE and (...) Web of Science were searched from the beginning of each database's temporal range, and PRISMA guidelines were used for the screening, reviewing and selection processes of available records. A thematic synthesis of the available data resulted in three analytical themes: (i) vulnerability of the gendered body, (ii) norms and values related to gender and sexuality and (iii) balancing closeness and distance in the nurse‐patient relationship. These themes are intertwined and represent different aspects of gender meaning in the nurse–patient relationship. This research shows that gender, through its influence on the gendered body, its relationship with power dynamics in the caring process, and its intersection with dimensions of identity, has a significant meaning for the experienced vulnerability in the nurse–patient relationship. This has implications for the well‐being and sense of dignity of the older person as well as the nurse. (shrink)

One challenge for those reading methodological debates in low consensus fields is determining the outcome when participants do not share standards. When parties to a debate do not agree on the standards to be used in assessing their arguments (i.e., quality), it may be useful to ask first if parties’ contributions meet their own expectations (i.e., integrity). Most protocols for review of qualitative research specify some form of quality assessment. These protocols normally require some test of internal coherence. Coherence (...) is also relevant when describing the match between a rebuttal and the argument it answers. In 2019,Nursing Inquirypublished a critique and rebuttal of the methods used by the Joanna Briggs Institute. In this essay, we attempted to use the Joanna Briggs Institute's own quality assessment standards to assess their rebuttal of this fundamental critique. We found it possible to use the Joanna Briggs Institute's own quality assessment standards to assess this rebuttal, and we found that JBI's rebuttal did not meet their own standards. (shrink)

Background: People with a personality disorder suffer from enduring inflexible patterns in cognitions and emotions, leading to significant subjective distress, affecting both self and interpersonal functioning. In clinical practice, Dance Movement Therapy is provided to clients with a PD, and although research continuously confirms the value of DMT for many populations, to date, there is very limited information available on DMT and PD. For this study, a systematic literature review on DMT and PD was conducted to identify the content of (...) the described DMT interventions and the main treatment themes to focus upon in DMT for PD.Methods: A systematic search was conducted across the following databases: EMBASE, MEDLINE, PubMed, WEB OF SCIENCE, PsycINFO/OVID, and SCOPUS following the PRISMA guidelines. The Critical Appraisal Skills Programme for qualitative studies was used to rank the quality of the articles. The Oxford Center for Evidence-based Medicine standards were applied to determine the hierarchical level of best evidence. Quantitative content analysis was used to identify the intervention components: intended therapeutic goals, therapeutic activities leading to these goals, and suggested therapeutic effects following from these activities. A thematic synthesis approach was applied to analyze and formulate overarching themes.Results: Among 421 extracted articles, four expert opinions met the inclusion criteria. Six overarching themes were found for DMT interventions for PD: self-regulation, interpersonal relationships, integration of self, processing experiences, cognition, and expression and symbolization in movement/dance. No systematic descriptions of DMT interventions for PD were identified. A full series of intervention components could be synthesized for the themes of self-regulation, interpersonal relationships, and cognition. The use of body-oriented approaches and cognitive strategies was in favor of dance-informed approaches.Conclusions: Dance movement therapists working with PD clients focus in their interventions on body-related experiences, non-verbal interpersonal relationships, and to a lesser extent, cognitive functioning. A methodological line for all intervention components was synthesized for the themes of self-regulation, interpersonal relationships, and cognition, of importance for developing systematic intervention descriptions. Future research could focus on practitioners' expertise in applying DMT interventions for PD to develop systematic intervention descriptions and explore the suitability of the identified themes for clinical application. Clients' experiences could offer essential insights on how DMT interventions could address PD pathology and specific PD categories. (shrink)

Moral distress (MD) is well-documented within the nursing literature and occurs when constraints prevent a correct course of action from being implemented. The measured frequency of MD has increased among nurses over recent years, especially since the COVID-19 Pandemic. MD is less understood among nurse leaders than other populations of nurses. A qualitative systematic review was conducted with the aim to synthesize the experiences of MD among nurse leaders. This review involved a search of three databases (Medline, CINAHL, and (...) APA PsychINFO) which resulted in the retrieval of 303 articles. PRISMA review criteria guided authors during the article review and selection process. Following the review, six articles were identified meeting review criteria and quality was assessed using the Critical Appraisal Skills Programme (CASP) Checklist for qualitative studies. No ethical review was required for this systematic review. The six studies included in this review originated from the United States, Brazil, Turkey, and Iran. Leadership roles ranged from unit-based leadership to executive leadership. Assigned quality scores based upon CASP criteria ranged from 6 to 9 (moderate to high quality). Three analytical themes emerged from the synthesis: (1) moral distress is consuming; (2) constrained by the system; and (3) adapt to overcome. The unique contributors of MD among nurse leaders include the leadership role itself and challenges navigating moral situations as they arise. The nurse leader perspective should be considered in the development of future MD interventions. (shrink)

The underdevelopment of a pedagogical culture for research methods education and the lack of a body of knowledge with the potential to influence practice have been highlighted by previous studies. This systematic review explores the pedagogic approaches and strategies evident in recent literature (2014–2020) on teaching social science research methods in higher education. It synthesises 55 papers offering a detailed rationale for the approach and strategies employed in doctoral/post-doctoral education. While dispersed across journals, there is a plethora of case studies (...) and reflective accounts about teaching approach, strategy, tactics and tasks in research methods education. Most studies reviewed report on teaching qualitative methods and represent authors’ own teaching practices. Consistent with previous studies, experiential, active learning and student-centred approaches are predominantly discussed, often overlapping or combined with other approaches. This paper illustrates a growing pedagogic culture, represented by an increased volume of papers and theoretical discussion of practices, rationale and reflection on how research methods are taught and learnt. It is concluded that clear intention to engage in dialogue and contribute to evidence-based practice and knowledge in research methods education is evident, and that the ‘how to’ element is richly articulated and justified. (shrink)

The beanbag genetics controversy can be traced from the dispute between Fisher and Wright, through Mayr''s influential promotion of the issue, to the contemporary units of selection debate. It centers on the claim that genic models of natural selection break down in the face of epistatic interactions among genes during phenotypic development. This claim is explored from both a conceptual and a quantitative point of view, and is shown to be defective on both counts.Firstly, an analysis of the controversy''s theoretical (...) origins demonstrates that this claim derives from a misinterpretation of the conceptual foundations of Fisher''s genetical theory of natural selection, and confounds his fundamentally different concepts of the average excess and average effect of a gene. Secondly, an extension of the genic approach is proposed which models the dynamics of selection among epistatically interacting complexes of many genes. Paradoxically, this preliminary, but fundamentally genic model provides quantitative support for some controversial qualitative claims regarding the evolutionary consequences of strong gene interactions made by opponents of genic selectionism, including Mayr''s theory of peripartric speciation. These findings foster hope that the proposed approach may eventually nudge the beanbag controversy out of its conceptual trenches into a more empirically oriented dialogue. (shrink)

BackgroundThe areas of Research Ethics (RE) and Research Integrity (RI) are rapidly evolving. Cases of research misconduct, other transgressions related to RE and RI, and forms of ethically questionable behaviors have been frequently published. The objective of this scoping review was to collect RE and RI cases, analyze their main characteristics, and discuss how these cases are represented in the scientific literature.MethodsThe search included cases involving a violation of, or misbehavior, poor judgment, or detrimental research practice in relation to a (...) normative framework. A search was conducted in PubMed, Web of Science, SCOPUS, JSTOR, Ovid, and Science Direct in March 2018, without language or date restriction. Data relating to the articles and the cases were extracted from case descriptions.ResultsA total of 14,719 records were identified, and 388 items were included in the qualitative synthesis. The papers contained 500 case descriptions. After applying the eligibility criteria, 238 cases were included in the analysis. In the case analysis, fabrication and falsification were the most frequently tagged violations (44.9%). The non-adherence to pertinent laws and regulations, such as lack of informed consent and REC approval, was the second most frequently tagged violation (15.7%), followed by patient safety issues (11.1%) and plagiarism (6.9%). 80.8% of cases were from the Medical and Health Sciences, 11.5% from the Natural Sciences, 4.3% from Social Sciences, 2.1% from Engineering and Technology, and 1.3% from Humanities. Paper retraction was the most prevalent sanction (45.4%), followed by exclusion from funding applications (35.5%).ConclusionsCase descriptions found in academic journals are dominated by discussions regarding prominent cases and are mainly published in the news section of journals. Our results show that there is an overrepresentation of biomedical research cases over other scientific fields compared to its proportion in scientific publications. The cases mostly involve fabrication, falsification, and patient safety issues. This finding could have a significant impact on the academic representation of misbehaviors. The predominance of fabrication and falsification cases might diverge the attention of the academic community from relevant but less visible violations, and from recently emerging forms of misbehaviors. (shrink)

IntroductionIncorporating technology in cognitive interventions represents an innovation, making them more accessible, flexible, and cost-effective. This will not be feasible without adequate user-technology fit. Bearing in mind the importance of developing cognitive interventions whose technology is appropriate for elderly people with cognitive impairment, the objective of this systematic review was to find evidence about usability and user experience measurements and features of stimulation, training, and cognitive rehabilitation technologies for older adults with mild cognitive impairment or dementia.MethodThe Medline, PubMed, Scopus, ScienceDirect, (...) and PsycINFO databases were searched for literature published in the last 10 years, and three researchers independently reviewed potentially eligible studies, following specific inclusion criteria. A systematic review of the studies was conducted, presenting a qualitative synthesis of usability and UX measures with their outcomes, study characteristics and features of the cognitive intervention technologies.ResultsTen studies were selected: five were cognitive stimulation and five were cognitive training. Most of them were computer-based programs with a serious game format. Efficiency and effectiveness were the most frequent measurements used for collecting objective usability data, showing that elderly people with cognitive impairment require more time and help but can complete tasks. Regarding UX or subjective usability data, questionnaires and scales were the most used methods, reporting positive experience despite certain difficulties with the interface in five studies.ConclusionMeasuring usability and UX in cognitive intervention technologies for older adults with MCI or dementia provides an integrated view that can contribute to their development according to the needs and characteristics of the target population. More research is required to include this population group in usability and UX studies, as well as standardized tools and consensus on the relationship of these terms to guarantee the future effectiveness of cognitive intervention technologies.Review registrationThis review was registered in the PROSPERO International Register of Systematic Review Protocols. (shrink)

IntroductionMentalizing is a key aspect of social cognition. Several researchers assume that mentalization has two systems, an explicit one and an implicit one. In schizophrenia, several studies have confirmed the deficit of explicit mentalizing, but little data are available on non-explicit mentalizing. However, increasing research activity can be detected recently in implicit mentalizing. The aim of this systematic review and meta-analysis is to summarize the existing results of implicit mentalizing in schizophreniaMethodsA systematic search was performed in four major databases: MEDLINE, (...) EMBASE, Cochrane Central Register of Controlled Trials, Web of Science. Eleven publications were selected. Five studies were found to be eligible for quantitative synthesis, and 9 studies were included in qualitative synthesis.ResultsThe meta-analysis revealed significantly lower accuracy, slower reaction time during implicit mentalizing in patients with schizophrenia. The systematic review found different brain activation pattern, further alterations in visual scanning, cue fixation, face looking time, and difficulties in perspective taking.DiscussionOverall, in addition to the deficit of explicit mentalization, implicit mentalization performance is also affected in schizophrenia, if not to the same extent. It seems likely that some elements of implicit mentalization might be relatively unaffected, but the effectiveness is limited by certain neurocognitive deficits. These alterations in implicit mentalizing can also have potential therapeutic consequences.Systematic Review Registration:https://www.crd.york.ac.uk/prospero/, identifier: CRD42021231312. (shrink)

While cancer survivors commonly experience fear and anxiety, a substantial minority experience an enduring and debilitating fear that their cancer will return; a condition commonly referred to as fear of cancer recurrence. Despite recent advances in this area, little is known about FCR among people from Indigenous or other ethnic and racial minority populations. Given the high prevalence and poor outcomes of cancer among people from these populations, a robust understanding of FCR among people from these groups is critical. The (...) current review identified and aggregated existing literature on FCR amongst adult cancer survivors from Indigenous and minority populations. The protocol of this review was registered with PROSPERO in July 2020. A systematic search of bibliographic databases was conducted for relevant articles published from 1997 to November 2019. Data from eligible articles were extracted and appraised for quality by two independent reviewers. Nineteen articles from four countries met the inclusion criteria, including 14 quantitative, 4 qualitative and 1 mixed-methods study. Only one article reported on an Indigenous population. Few studies reported on FCR prevalence or severity. While the variation in tools used to measure FCR hindered a robust estimate of severity, results suggested some differences in FCR severity between minority and dominant populations, although these may have been due to study metholodological differences. Few factors were reported as being associated with FCR in minorities across multiple studies. The qualitative synthesis found five themes associated with the lived experience of FCR: variations in the lived experience of FCR; spirituality and worldview impacting on FCR; the importance of staying positive; complexities around support; and increasing cancer knowledge. The findings of this review highlight differences in FCR across cultures and contexts, which reinforces the need for culturally-specific approaches to this condition. The dearth of research in this area is of concern given the significant burden of cancer in these populations. A deeper understanding of this condition among Indigenous and minority populations is critical to developing and delivering appropriate and effective psychosocial care for cancer survivors from these groups. Systematic Review Registration: identifier [CRD42020161655]. (shrink)

Purpose The purpose of this paper is to present a quantitative and qualitative synthesis of the diverse academic proposals and initiatives for preventing and eliminating hate speech on the internet. Design/methodology/approach The foundation for this study is a systematic review of papers devoted to the analysis of hate speech. It has been conducted using the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) protocol and applied to an initial corpus of 436 academic texts. Having implemented the suitability, (...) screening and inclusion criteria, this corpus was refined to a sample of 74 articles. Findings The main subject categories studied in this corpus of academic research are legal issues and social media. In the majority of the articles, the use of hate speech via social media is associated with five typologies: religion, cyber racism, political slurs, misogyny and attacks on the LGTBI community. The absence of ethical reflection is one of the major shortcomings of IT-focused research and analysis devoted to online hate speech. Practical implications To date various systematic reviews have been presented, and they focus on detecting or describing hate speech. These have used either the search appraisal synthesis analysis framework or the Cochrane network. The PRISMA protocol was applied for this study, and both Scopus and texts in German were included. To date no major, rigorous systematic review has been undertaken of proposals to combat hate speech. Originality/value The link between hate speech and poverty has not been studied in depth within the academic sphere. Tolerance and ethical compassion are not granted the attention they merit when it comes to analysing the phenomenon of hate speech. (shrink)