Conectar
To identify strategies and mechanisms of interventions between caregivers and people with dementia that contribute to reducing refusals of care and determine how they work, in which contexts, why and for whom.
Realist synthesis.
There were three stages: (1) initial programme theory development and prioritisation through assessing video-recorded personal care interactions and interview transcripts; scoping the literature and team discussions, (2) literature search, review and synthesis and (3) realist interviews with stakeholders and refinement of evidence-based programme theories.
Searches were conducted in MEDLINE, EMBASE, PsycINFO, CINAHL Ultimate, Cochrane CENTRAL Register of Controlled Trials and Web of Science; date range: 2000–2024.
A total of 71 sources were included in the synthesis, and interviews with 15 stakeholders. Eight programme theories were generated, evidenced and refined, each incorporating multiple caregiver strategies. The overarching mechanism which made people with dementia more likely to accept assistance with personal care was trusting the caregiver and feeling safe. Seven mechanisms fed into this: a sense of control, positive connection, care feeling manageable, working together, engaging with the care activity (or something non-care related), comfort and needs being known and addressed.
Refusals of care from people with dementia can be reduced by multiple caregiver strategies related to communication, approach, the type of care offered and the care interaction process. Mechanisms reflect relational aspects: the quality of the caregiver/person partnership and making the person with dementia feel safe.
Our findings provide programme theories and practical care strategies which could be helpful for those, such as nurses, working to improve personal care practices for people with dementia.
Public representatives advised the study throughout, providing advice on initial programme theories, evidence-based programme theories and synthesised stakeholder evidence.
This synthesis uses the publication standards for realist synthesis (RAMESES 1).
PROSPERO: 2024 CRD42024496072
Management of patients with psychiatric disorders by non-psychiatric nurses presents unique challenges, as they may lack specific mental health training.
This study explores the experiences of non-psychiatric nurses who face challenges in caring for patients with psychiatric disorders, with regard to violent incidents.
A meta-synthesis of qualitative studies was conducted. Five electronic databases were searched and additional searches were manually conducted. The analysis included nine articles, and the quality of data were assessed using the Critical Appraisal Skills Program checklist. Schutz's analytical method was applied to analyse and synthesise the data.
Three main themes were identified: ‘Safety concern,’ ‘Nurse's emotional and ethical challenges in managing patients with psychiatric disorders’ and ‘Improper environment and system for psychiatric patient.’
From a safety perspective, specialised training is essential to identify psychiatric-specific indicators of violence and enhance nurses' ability to manage violent situations involving patients with psychiatric disorders. Emotionally, confidence-building training, addressing stigma and providing support for ethical dilemmas and burnout related to restrictive interventions are crucial. From a systemic perspective, establishing clear guidelines and standardised protocols, and implementing a collaborative care model are essential for safe and effective management of violence.
Comprehensive mental health training and better support systems are essential for non-psychiatric nurses. Improving protocols, risk assessments and collaboration can enhance the quality of care and nurse safety.
To consolidate and synthesise the literature reporting perceptions of nurses and nursing students regarding evidence-based nursing.
Qualitative systematic review.
Seven electronic databases (Cumulative Index to Nursing and Allied Health Literature, Embase, ProQuest Dissertations & Theses Global, PsycInfo, PubMed, Scopus and Web of Science) were searched from their respective inception dates to January 2025.
The Preferred Reporting Items for Systematic reviews and Meta-Analysis guidelines guided this review. The quality of included studies was assessed using the Critical Appraisal Skills Programme tool, and data were synthesised thematically using Sandelowski and Barroso's two-step approach.
Thematic analysis of the 19 included studies, published from 2007 to 2025, identified three key themes: (1) Advancing nursing through evidence, (2) Personal, structural and systemic challenges and (3) Promoting a new evidence-based nursing culture.
Evidence-based nursing can elevate nursing care standards and enhance patient outcomes. Numerous factors that encourage and hinder the implementation of evidence-based nursing among nurses and nursing students were reported.
This review suggests the need to incentivise nurses to champion evidence-based nursing initiatives, provide nurses and nursing students with continuing education, and develop updated evidence-based nursing guidelines. These strategies could help in cultivating a supportive evidence-based nursing workplace culture and improving the implementation of evidence-based nursing.
Valuable insights into the facilitators and barriers associated with the implementation of evidence-based nursing were reported by nurses and nursing students—the key personnel responsible for practising evidence-based nursing. Future research could be undertaken to explore the perceptions of nurses and nursing students across varied cultural settings and in underrepresented regions.
The Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines.
This study did not include patient or public involvement in its design, conduct, or reporting.
To systematically synthesise nurses' perspectives on dignified death, providing a culturally informed and comprehensive understanding.
Meta-ethnography.
This study was conducted using Noblit and Hare's approach, which included reciprocal translation, refutational synthesis, and line-of-argument synthesis. Methodological rigour and credibility were evaluated using the Critical Appraisal Skills Program (CASP) checklist. The review included peer-reviewed qualitative studies published in English or Korean that focused on nurses' or nursing students' views on dignified death in end-of-life care.
A systematic search was conducted in MEDLINE, EMBASE, CINAHL, and the Web of Science in August 2023, with an updated search in August 2024. Seventeen qualitative studies published between 2010 and 2024 met the inclusion criteria.
Four interconnected themes emerged: A death that embraces humanity, a death that preserves personal identity, a death that facilitates connection and reconciliation, and a death that affirms acceptance and spiritual serenity. These themes, including eight sub-themes, highlight cultural influences shaping nurses' approaches to dignified death.
The findings emphasise the influence of cultural context in shaping end-of-life care and support the development of culturally sensitive nursing education and guidelines to enhance care quality.
This research provides culturally grounded strategies to improve end-of-life care and strengthen nurses' competencies in delivering holistic support.
This study highlights cultural variations in nurses' approaches to balancing autonomy, family expectations, and spiritual needs, offering practical insights for holistic, patient-centred, and culturally sensitive care.
This review complies with the Equator and improving reporting of meta-ethnography (eMERGe) guidelines.
No patient or public contribution.
The effect of prehabilitation on reducing the level of postoperative stress and facilitating recovery has been proven to be controversial in previous studies involving patients with cancer. This review contributes to the improvement of an intervention programme by qualitatively integrating the prehabilitation experiences of patients with cancer.
This review aimed to integrate the individual experiences of patients with cancer who had received prehabilitation interventions to identify the barriers and facilitators to implementation, which can be used to understand patients' adherence behaviours.
This was a qualitative evidence synthesis review.
Articles were systematically searched from inception to February 18, 2025, using four English databases and three Chinese databases. Keywords and Medical Subject Headings were used to identify potential studies written in both Chinese and English. This study was performed using the Joanna Briggs Institute qualitative systematic review methodology.
Twenty-five articles were included in this review. Guided by the Theoretical Domains Framework (TDF), eight synthesised findings were extracted, focusing on the representation of factors influencing the adherence of patients with cancer to prehabilitation, including the domains of knowledge (two facilitators), reinforcement (two facilitators), beliefs about consequences (two facilitators), beliefs about capabilities (two barriers), environmental context and resources (two barriers, one intervention preference factor), social influence (one facilitator, one intervention preference factor), emotion (one barrier, one facilitator) and behavioural regulation (one facilitators, two intervention preference factors).
Our findings indicate that the adherence to prehabilitation among patients with cancer is shaped by a dynamic interplay of determinants. Structured assessments, self-monitoring, tailored interventions and tele-prehabilitation can improve patients' self-efficacy, perceived benefits and access to resources, which in turn can facilitate their completion of prehabilitation.
This study deepens our understanding of behaviours related to adherence to prehabilitation among patients with cancer and provides valuable guidance for the formulation and optimisation of subsequent prehabilitation intervention programmes.
ENTREQ.
No patient or public contributions.
PROSPERO CRD: 42024553972
Many systematic reviews (SRs) and meta-analyses (MAs) have reported the potential advantages and risks of ICU diary psychotherapy in patients and relatives, but the results remain uncertain and their quality has not yet been adequately assessed. We summarise existing SRs/MAs and assess their quality and level of evidence.
This overview of SRs was conducted in accordance with the preferred reporting items for overviews of reviews statement.
We conducted a detailed and comprehensive search of eight Chinese and English electronic databases from inception until March 2025. The Assessment of Multiple Systematic Reviews 2 (AMSTAR 2), the Preferred Reporting Items for Systematic Reviews and Meta-Analyses 2020 (PRISMA 2020), and the Grading of Recommendations Assessment, Development and Evaluation (GRADE) were used to assess methodological quality, reporting quality and evidence quality for inclusion in SRs/MAs, respectively.
Fifteen published SRs/MAs met the inclusion criteria and were included in the study. The results of the AMSTAR 2 assessment showed that the methodological quality of the included studies was critically low. In the PRISMA 2020 assessment, the response rate of “Yes” for items 7, 14, 15, 16, 21, 22, 24, 25 and 27 was less than 50%. The GRADE assessment showed that no results were high-quality evidence, 2 results were moderate-quality evidence, 26 results were low-quality evidence and 45 results were very low-quality evidence.
ICU diaries can improve patients' psychological outcomes and quality of life, and whether there are advantages for their relatives needs to be further explored. However, the methodological quality of the studies was low and the risk of migration was high, reducing its reliability. Therefore, these conclusions should be treated with caution. High-quality studies with large sample sizes are needed to provide stronger and more scientific evidence.
Our paper presents an overview of systematic reviews, and therefore, such specific details may not be relevant to our study.
PROSPERO: CRD42023448359
Patients with limited proficiency in the primary language who do not receive a healthcare interpreter have poorer health outcomes. Clinician preference is an important factor in determining whether a healthcare interpreter will be used; yet little is known about their experiences and preferences for working with healthcare interpreters.
To review and synthesise the evidence examining nurses' experiences of working with healthcare interpreters when caring for patients with limited proficiency in the primary language.
This review follows the reporting items contained within the ENTREQ statement. A systematic search of the literature was undertaken from inception to August 2024 in the databases CINAHL, Embase, Medline, PsychInfo, PubMed, Scopus, and ProQuest Dissertations and Theses Global. Included studies were assessed using the Critical Appraisal Skills Programme tool for qualitative studies. Thematic synthesis was undertaken on studies meeting the inclusion criteria, including studies undertaken in acute settings. Articles were limited to English-language papers and peer-reviewed.
Eighteen studies representing the experiences of 416 nurses from eight countries were included in the review. Four themes were identified: (1) working with Interpreters, (2) tensions and challenges, (3) making connections, and (4) workarounds.
Nurses' experiences of working with healthcare interpreters were overwhelmingly positive; however, concerns about interpretation accuracy, unreliable technology, additional time required when working with a healthcare interpreter, and being sidelined were evident. Nurses commonly resorted to using bilingual nurse colleagues and family members when healthcare interpreters were unavailable.
This review highlights the need for nurses to be allocated additional time in their patient loads when caring for patients with limited proficiency in the primary language. Healthcare policy that accommodates the use of bilingual healthcare professionals as well as the need for nurses to receive formal training on working collaboratively with healthcare interpreters is needed.
Not applicable due to systematic review.
To synthesise evidence on critical care nurses supporting bereaved families in intensive care units (ICUs).
Noblit and Hare's meta-ethnography approach.
We followed Noblit and Hare's 7-phase procedure, using reciprocal translation for data analysis and line-of-argument synthesis. We included studies on registered nurses in adult ICUs with experience supporting bereaved families, using qualitative or mixed-methods studies in English and published in peer-reviewed sources.
Five databases were searched without date restrictions, concluding in January 2024.
The final sample included 24 studies published between 1995 and 2023. The metaphor “Candlelight guides the way through winter's chill” symbolised the crucial role of critical care nurses in supporting bereaved families in ICUs. The synthesis encapsulated two themes: (1) challenges in providing bereavement support, with subthemes of emotional intricacies in bereavement support, and ICU setting limitations; and (2) optimising families' bereavement experiences, with subthemes support systems and emotional commitment, professional nursing behaviours and care practices, and curating personalised and meaningful farewell experiences.
Bereavement support in ICUs poses significant challenges, highlighting the need for greater support for critical care nurses. Nonetheless, these nurses draw on support systems and emotional dedication to overcome obstacles, striving to optimise families' bereavement experiences.
Our findings highlight the importance of structured training programmes (peer support and emotional management) and systemic improvements (optimised workflows and adequate staffing) to enhance quality bereavement care.
This study interprets critical care nurses' experiences supporting bereaved families in intensive care, highlighting the emotional demands. The findings offer insights into improving end-of-life and bereavement care practices and policies, benefiting nurses and families.
This review followed the ENTREQ guidelines for reporting meta-ethnography.
There was no patient or public contribution, as the data were drawn from previously published studies.
CRD42024506847 [PROSPERO]
To describe and synthesise qualitative studies exploring sexual and gender minority migrants' experiences of health service access and utilisation.
Systematic meta-synthesis of qualitative studies.
Systematic searches in four databases and citation screening were conducted in 2023 and 2024. English-language empirical qualitative studies published in scientific journals within 10 years were included. Of 1109 screened, 21 reports were included.
Included reports were appraised using CASP and JBI checklists. Extracted results were analysed with inductive content analysis in a collaborative process.
All reports had acceptable quality, including 365 participants from 72 countries. A range of external and internal barriers to accessing health services were reported, including financial constraints and fears. Although migrants expressed an appreciation of health services, they also experienced non-affirming behaviours and discrimination related to their intersecting identities. Several essential components in health services necessary to cater to the needs of migrants were addressed, including the personality and manner of health professionals as well as adherence to confidentiality.
Barriers to health services, intersectional discrimination and non-affirming behaviours when interacting with health services are pressing issues that need further attention.
Ensuring safety through affirming support is key to achieving high-quality and accessible health services for sexual and gender minority migrants. Nurses and other health professionals need to carefully consider intersectional layers related to sensitivity and safety when supporting sexual and gender minority migrants. Open, friendly, validating, respectful and encouraging communication is essential in clinical settings.
This review addressed experiences of health services amongst a marginalised population. The findings highlight the importance of affirming care and are relevant for health professionals, stakeholders and decision-makers.
ENTREQ.
Two persons with lived experience were involved in the meta-synthesis.
To collate the common caregiving experience of Young Onset Dementia informal caregivers.
Qualitative systematic review.
Qualitative grey literature and peer-reviewed journals published between 2013 and 2023 that addressed Young Onset Dementia informal caregivers' experiences were included without context limitation. Only English language publications were included because of limitations in translation. Study selection was conducted with two independent reviewers. Critical appraisal using Joanna Brigg Institutes Qualitative Appraisal Instrument, data extraction of participant's quote verbatim and data synthesis through categorisation of extracted verbatim were conducted without an independent reviewer.
PubMed on 16 October 2023, Cochrane and MEDLINE on 17 October 2023, EMBASE, CINAHL, PsycINFO, ProQuest, Scopus, Web of Science and Google Scholar on 18 October 2023.
A total of 37 studies included in this review represented the experiences of 566 informal caregivers. A total of 354 extracted findings were synthesised into 25 categories and four themes through meta-aggregation which addressed informal caregivers' diagnosis challenges, challenges with complex care, experience with various support services and coping strategies.
Young Onset Dementia informal caregivers experience unique caregiving challenges. These informal caregivers required age-appropriate support services to meet their unique needs.
Gaps in available appropriate support services for Young Onset Dementia informal caregivers existed. Therefore, these informal caregivers experienced unique challenges such as loss of employment that informal caregivers of other diseases do not experience.
Policymakers and healthcare professionals need to understand the unique experience of these informal caregivers to provide appropriate support services that could improve their caregiving experience.
PRISMA 2020 Statement.
No Patient or Public Contribution.
This review highlighted the various unique challenges encountered by informal caregivers.
PROSPERO Database (CRD42023467541). https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42023467541
To consolidate and appraise available evidence on the experiences and perceptions of male nurses and male midwives facing discrimination.
Qualitative systematic review. This review was informed by the Preferred Reporting Items for Systematic Review and Meta-Analyses (PRISMA).
The Critical Appraisal Skills Program checklist was used to appraise included articles, and extracted data were meta-summarised and meta-synthesised using Sandelowski and Barroso's two-step approach.
PubMed, EMBASE, CINAHL, Scopus, Web of Science, PsycINFO, Cochrane Library, ProQuest (Dissertations and Theses Global) and ClinicalTrials.gov were sourced from the inception to December 2022.
A total of 21 studies were included, involving 283 male nurses and 11 male midwives. Four themes were identified during the meta-synthesis: (1) It's a ‘women's world’, (2) discrimination within and beyond the workplace, (3) stereotypes and labels and (4) the silver lining.
This review offered male nurses' and male midwives' perspectives on discrimination faced in nursing. There is a need to ensure gender equality in the nursing profession by reinforcing the importance and value of employing men in this profession.
Future research should focus on examining the experiences of male nursing students and other healthcare stakeholders to understand discrimination faced by men in nursing from varied geographical and cultural backgrounds. The findings may provide helpful insights for planning supportive interventions, institutional adjustments, legislative changes, educational initiatives and research that benefit male nurses and male midwives.
This qualitative systematic review consolidated and meta-synthesised the available evidence on male nurses' and male midwives' experiences of discrimination. These findings contribute to the understanding of male nurses and male midwives as a gender minority and the need for greater gender equality.
PRISMA.
No patient or public contribution.
To review the qualitative literature regarding how people with fibromyalgia experience and are impacted by stigma.
A systematic review and metasynthesis of qualitative studies was conducted following the Thomas and Harden method.
The electronic databases PubMed, CINAHL, PsycInfo, Embase and Scopus were queried (September 2023). No publication year limit was set. Twelve studies were included in the final analysis. The findings were reported according to the Enhancing Transparency in Reporting the Synthesis of Qualitative Research (ENTREQ) statement.
Three main themes with 11 sub-themes were identified: manifestations and roots of stigma, avoidance and coping strategies, and consequences of stigma. Stigma arises from disbelief due to the invisibility of symptoms, protracted time to diagnosis and gender stereotyping, especially against women. Various strategies to avoid or cope with prejudice may involve social isolation, hiding the disease, controlling information, getting closer to or further away from other patients, acknowledging and understanding the disease. Stigmatisation can diminish a person's integrity and dignity, undermine trust in health care professionals and worsen suffering.
The metasynthesis findings align with previous research highlighting the pervasive stigma associated with chronic pain conditions. Greater awareness of the impact of disease-related stigma on individuals with fibromyalgia is crucial, not only among health care professionals but also within broader societal and institutional contexts.
Understanding the stigma experienced by individuals with fibromyalgia can guide health care professionals in adopting more empathtic approaches, potentially improving the diagnostic process and the overall management of the condition.
This study highlights the profound impact of stigma on individuals with fibromyalgia, emphasising the need for greater awareness and targeted interventions to address stigma in clinical practice and societal contexts.
No patient or public contribution.
Stroke represents the second leading cause of death worldwide after cardiovascular disease and the first cause of disability in adults. Only 25% of stroke survivors fully recover, 75% survive with some form of disability, and half of them lose self-sufficiency, negatively impacting their quality of life. This study aims to understand the experiences of stroke survivors and caregivers of training needs and support during the transitional care phase from hospital to home; it also investigates the experience of health care professionals (HCPs) of providing support and training to the dyad during this phase.
Meta-synthesis was conducted following a critical-interpretative approach. The SPIDER method was used for sample selection, and the PRISMA research question was adopted for article selection. The search for studies on CINAHL, Pubmed, Scopus, ERIC, PsycInfo and OVID was conducted until August 2024.
Of the 1123 articles found, 32 met the inclusion criteria and were included in the meta-synthesis. Text analysis revealed two main thematic areas: (1) the training need is a new awareness in the transition of care from hospital to home and (2) moulding oneself to new life. The first theme had six subthemes: need for information and training, uncertainty, involvement, evaluation of training needs, individual discharge planning and physical-psychological problems. The second theme included three subthemes: different role perception, support after discharge and adaptation to change.
Knowing the training and support needs in the stroke survivor caregiver dyad guides HCPs to structure tailored discharge plans. Multi-method and multidisciplinary training and support interventions such as health coaching, weekend passes and early supported discharge are satisfactory outcomes for the triad involved in the transition of care, as continuous feedback on the needs of the new reality at home fortifies the relationship between the dyad and HCPs. A transitional care pathway based on the dynamic needs of the triad can improve the quality of care in the community.
To identify and synthesise the qualitative evidence that is available regarding reducing the turnover of hospital nurses from their own perspectives.
A qualitative systematic review using the meta-aggregation design.
Qualitative studies either in English or in Chinese, dating from 2018 to 2023, were obtained from eight databases, including CINAHL, PubMed, Web of Science, Embase, Ovid, and Chinese National Knowledge Infrastructure (CNKI), Wanfang Database and the China Biomedical Database.
Studies were screened using pre-determined inclusion and exclusion criteria. Quality assessment was done using the Joanna Briggs Institute Critical Appraisal Checklist for Qualitative Research. The study was reported according to the Enhancing Transparency in Reporting the Synthesis of Qualitative Research (ENTREQ) guidelines.
Sixteen papers were included that explored nurses' perspectives on enhancing their retention or reducing staff turnover. We developed three synthesised findings and 12 categories from 64 identified findings, including (1) individual adjustment strategy: professional pride, self-growth and psychological adjustment; (2) social support strategy: constructive workplace relationships, balancing work life and recognition of nursing and (3) organisational change strategy: embracing management and leadership, promote nursing professionalisation, workload management and support, flexible work patterns and opportunities, supporting personal career development and competitive salary.
This review provides an in-depth and meaningful understanding of nurses' own perceptions and suggestions for enhancing nursing turnover, which will call for a wide range of measures targeting the individual, social and organisational levels.
This study contributes important knowledge to help improve hospital nurse's turnover, which can provide evidence to support nurse managers, other stakeholders and policymakers in correspondingly developing effective measures to address nurse turnover.
There was no direct contribution from patient or caregiver to this study because the data of this study originated from published papers.
To synthesise evidence from qualitative studies on community-dwelling older adults' experiences of social interactions in group interaction programmes.
A systematic review and meta-synthesis based on the Preferred Reporting Items for Systematic Reviews and Meta-analysis guidelines.
Two independent researchers screened the titles and abstracts of all retrieved studies based on eligibility criteria. Quality appraisal was conducted based on the comprehensive Critical Appraisal Skills Programme checklist. Data were extracted through an adapted Data Extraction Tool from the Joanna Briggs Institute Qualitative Assessment and Instrument. Findings were synthesised through the JBI meta-aggregation approach.
A literature search for peer-reviewed studies was conducted across seven databases from inception to September 2023.
Our review included the experiences of 395 community-dwelling older adults across 25 studies, yielding the overarching theme of ‘Navigating relationships and facilitating growth in a supportive community’. Five themes were identified: feeling safe in a familiar environment, bringing people together, establishing meaningful relationships, improving personal well-being and facing socialising challenges.
Our findings provided not just theoretical insights but also practical implications. They can serve as a solid foundation for formulating or enhancing similar programmes, directly addressing the pervasive issues of loneliness and social isolation among the ageing population worldwide.
This review improves our understanding of the social, emotional and personal benefits for older adults upon engaging in group interaction programmes. The insights into the elements of successful group interaction programmes for older adults, include providing a safe and familiar setting and bringing people together for socialisation. Future interventions should incorporate these elements to promote social interactions and community engagement more effectively to mitigate loneliness among older adults. Finally, the diverse range of programmes explored in this review demonstrates that future programmes can be flexibly formulated to suit different interests.
The authors have nothing to report.
The review protocol has been registered on PROSPERO.
To integrate experiences and perceptions about stroke survivors during the transition from hospital-to-home care.
Seven databases, including PubMed, Embase, Cochrane Library, Ovid, Web of Science, EBSCO and MEDLINE, were searched comprehensively from inception to March 2024, including qualitative studies published in English.
A qualitative systematic review.
The search followed the Preferred Reporting Items report for Systematic Reviews and Meta-analysis (PRISMA 2020). The included research quality was assessed according to the Critical Appraisal Skills Programme (CASP). Meta-aggregation was used to develop analytical themes. Confidence in the Evidence from the Reviews of Qualitative Research (GRADE-CERQual) framework was applied to the findings.
Fifteen qualitative studies were included, from which 54 findings were extracted. Similar findings were summarised into eight categories, resulting in four synthesised findings: Joy and sadness intertwined, Destruction of sense of self and life, External support and internal motivation, and Emotional longings and practical needs.
Stroke can lead to devastating changes in survivors' sense of self and physically. Through external support from family members and healthcare professionals, as well as internal motivation to cope positively, stroke survivors positively accept and adapt to life. Meanwhile they still have high expectations for personal independence and reintegration into society.
The review findings can guide health professionals, survivors and families in optimising care during the hospital-to-home transition.
PROSPERO [CRD42024522555].
ENTREQ.
No Patient or Public Contribution.
To systematically review and integrate qualitative-research results pertaining to psychological distress in patients with breast cancer and to clarify its causes and drivers.
Patients with breast cancer experience psychological distress in the stages of diagnosis, treatment, and rehabilitation, which seriously affects their quality of life. Through comprehensive qualitative research, the study comprehensively describes the experiences of patients with breast cancer to guide medical personnel in taking better care of them.
A systematic review and synthesis of qualitative studies.
Qualitative studies were included if they were related to the psychological-distress experiences of patients with breast cancer. The Joanna Briggs Institute Qualitative Assessment and Review Instrument was used to appraise study quality. Data were synthesised using the Thomas and Harden method of thematic and content analysis.
Nine electronic databases (PubMed, Embase, Cochrane Library, CINAL [via EBSCO], and PsycINFO, China Knowledge Resource Integrated Database, Wanfang, Chinese Biomedical, and Weipu) were searched from inception until February 2024.
Thirteen studies were included in the meta-synthesis. Four analytical themes were identified: diagnostic and therapeutic, individual, environmental, and interpersonal factors.
Psychological distress is a subjective feeling influenced by interactions among individual, therapeutic, environmental, and interpersonal factors, and it is commonly encountered among patients with breast cancer. Therefore, to optimise the management of psychological distress, the characteristics and external environment of patients with breast cancer should be carefully considered when delivering routine nursing care.
Patients experience psychological distress at different stages of breast cancer; however, the causes of psychological distress at different stages differ. Medical staff should implement targeted psychological-distress intervention measures based on factors relevant to different stages.
The Enhancing Transparency in Reporting the Synthesis of Qualitative Research statement.
The protocol of this study has been registered in the database PROSPERO (registration ID: CRD42023417364).
During the transfer of intensive care unit (ICU) patients to general wards, patients often experience transfer anxiety due to changes in the healthcare environment, staff and unfamiliarity with the new ward. However, the experiences of ICU patients during this transition period have received less attention.
A systematic review and synthesis of the experiences of patients transitioning from the ICU to the ward.
Thematic synthesis of qualitative studies.
We searched the PubMed, Embase, CINAHL and Web of Science databases for qualitative research on the transition-to-ward experience of patients in ICUs for the year 2023 February.
The quality of the literature was evaluated according to the qualitative research quality assessment criteria of the Joanna Briggs Institute, as outlined by the Australian Centre for Evidence-Based Healthcare. The data were then extracted from the studies, analysed and synthesised using a thematic synthesis approach.
A total of 12 papers were included and the 32 findings were distilled and consolidated into three themes: emotional reactions; imperfections in the transition process; differences between wards and ICUs; and eight sub-themes: optimism; pessimism; emotionlessness; inadequate information; inadequate communication; physical condition; differences in care; differences in environment.
The transfer from an ICU to a general ward is a major change of environment for the patient and can trigger upset and anxiety. Planning for turn-out, meeting patients' information needs and easing patients' emotions are critical in this process.
Home parenteral nutrition (HPN) can improve the nutritional status of patients with gastrointestinal dysfunction. However, some patients face a series of challenges during its implementation, which significantly affect their quality of life.
To explore the experience and needs of living with home parenteral nutrition in adult patients.
A systematic review and meta-synthesis.
A search was conducted across multiple databases, including PubMed, Embase, Cochrane Library, Web of Science, Chinese Biomedical Literature Service System, China National Knowledge Infrastructure, Wanfang Database and Wipu Database, to explore the real-life experiences and needs of adult patients receiving HPN. The search covered the period up to March 2024. Qualitative research quality was evaluated using the Joanna Briggs Institute's Australian Centre for Evidence-Based Health Care Quality Assessment Criteria for Qualitative Research. Data synthesis was performed using Thomas and Harden's method of thematic and content analysis.
Twelve studies, each offering qualitative data, were analysed, resulting in the identification of four themes: positive experiences of HPN; the interplay of dynamic changes across physical, mental and social levels; self-adjustment to the new normal; and multidimensional needs of patients receiving HPN.
Patients receiving HPN face multiple challenges physically, psychologically and socially. This paper also reveals the supportive needs of patients in adapting to a new lifestyle with HPN. This indicates that healthcare professionals should provide comprehensive, continuous and dynamic supportive medical services to facilitate patients' reintegration and return to normal social life.
As this study constitutes a meta-synthesis, patient or public contribution is not applicable.
Adhering to the Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) reporting guidelines, this meta-synthesis was conducted.
To synthesise stakeholders' experiences and perceptions of animal-assisted intervention (AAI) for people with dementia in community care settings.
Qualitative evidence synthesis.
We systematically searched Medline, CINAHL, Embase, Scopus, Web of Science, PsycINFO and AgeLine for potentially eligible studies. Thematic synthesis was used to analyse the data from included studies. We assessed the methodological limitations of included studies using an adaptation of the Critical Appraisal Skills Programme checklist and used Confidence in the Evidence from Reviews of Qualitative Research (GRADE-CERQual) tool to assess confidence in review findings. This review is reported using the ENTREQ checklist.
We included 14 reports from 11 studies and developed three analytical themes incorporating a gardening analogy: planting–connecting with animals, growing–engaging in AAI and nurturing–making AAI work; and six subthemes: willingness to connect, building relationships, a rich experience, the benefits of AAI, individualised and holistic approach and training and support, with 15 key findings.
This review describes people's experiences and perceptions of AAI for people with dementia, and provides recommendations on the development and implementation of AAI, with moderate to high confidence. Nurses need to consider the factors that influence the implementation of AAI identified in this review, to facilitate engagement and long-term impacts while adopting AAI in community care settings.
This review may enhance healthcare professionals' understanding of AAI for people with dementia in community care settings. AAI is a complex intervention that can be delivered in varied manner. A multicomponent, flexible and individualised AAI is important. Additional training and education for staff are needed.
A man with dementia and his wife who share a love of dogs, advised at each step of the review, providing insights and perspectives and contributing as co-authors.
FreshRSS 