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Chandy P, Kanthi E, Pradeep P, Sathianathan P, Jebakamal S, Narchaithi M, Anbarasi S. Lived experience of health-care providers during COVID-19: A meta-synthesis. Indian J Psychiatry 2022; 64:120-129. [PMID: 35494325 PMCID: PMC9045354 DOI: 10.4103/indianjpsychiatry.indianjpsychiatry_1403_20] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/18/2020] [Revised: 11/07/2021] [Accepted: 01/27/2022] [Indexed: 11/05/2022] Open
Abstract
AIM OF THE STUDY There is currently no meta-synthesis focused on the lived experiences of health-care providers during COVID-19. This meta-synthesis adds to evidence-based literature with an in-depth exploration of how health-care providers responded to the COVID-19 crisis. MATERIALS AND METHODS The meta-synthesis approach was used for the extraction and synthesis of data. RESULTS Fifteen qualitative research articles were identified and analyzed; the majority of which were done in China 7 (48%) and Iran 6 (40%). The total sample size was 383, and the majority of the samples were nurses 282 (74%). Three overarching themes identified were "It is my duty," "I am exhausted and about to fall," and "I have overcome it." The subthemes were professional responsibility, challenges faced, the unexpected burden at work, self-coping and reflection, hospital support, government support, and social support. CONCLUSION The recommendations for the policy-makers, put forward by the current study are; designing and engineering effective personal protective equipment (lightweight protective suit with long-lasting durable diapers and face masks with a portal for drinking juice or water), rostering minimal working hours, live-in care facilities, exclusion of pregnant and sick health care providers during an epidemic assignment and frequent outbreak training sessions for all department staff.
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Affiliation(s)
- Ponnambily Chandy
- Department of Community Health Nursing, Chettinad College of Nursing, Chettinad Academy of Research and Education, Kanchipuram, India
| | - Esther Kanthi
- Department of Paediatric Nursing, College of Nursing, Christian Medical College, Vellore, India
| | - Preetha Pradeep
- Acute Care Ward, Royal Hospital for Women, New South Wales 2031, Australia
| | | | - S Jebakamal
- Department of Nursing Service, ESI Hospital, Vellore, India
| | - Meetpin Narchaithi
- Department of Medical and Surgical Nursing, Scudder College of Nursing, Ranipet, Tamil Nadu, India
| | - S Anbarasi
- Department of Paediatric Nursing, College of Nursing, Christian Medical College Vellore Chittoor Campus, Chittoor, Andhra Pradesh, India
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Hortal-Mas R, Moreno-Poyato AR, Granel-Giménez N, Roviralta-Vilella M, Watson-Badia C, Gómez-Ibáñez R, Aguayo-González MP, Giménez-Díez D, Bernabeu-Tamayo MD, Leyva-Moral JM. Sexuality in people living with a serious mental illness: A meta-synthesis of qualitative evidence. J Psychiatr Ment Health Nurs 2022; 29:130-146. [PMID: 33047434 DOI: 10.1111/jpm.12700] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/04/2020] [Revised: 08/17/2020] [Accepted: 09/03/2020] [Indexed: 01/31/2023]
Abstract
WHAT IS KNOWN ON THE SUBJECT A serious mental illness influences sexual life and people affected have worries about their sexual health. People living with a serious mental illness can and want to participate in interventions related to sexual health. WHAT THE PAPER ADDS TO EXISTING KNOWLEDGE People who suffer a serious mental illness are interested in maintaining an active sex life. People who suffer a serious mental illness experience rejection when they open up and they lose intimate relationships or possibilities of meeting other people because of ignorance and prejudices surrounding mental health. WHAT ARE THE IMPLICATIONS FOR PRACTICE Mental health services must respond to this need, that is including sexual needs assessment among routine standard practices or training nurses on sexual education to allow them to advise patients and their families and friends. Health systems should promote awareness programmes and reduce the stigma surrounding mental health and sexuality. ABSTRACT INTRODUCTION: Sexuality-related nursing care is scarce and mainly focuses on biological issues. There is also a lack of knowledge about how serious mental illnesses affect sexuality. AIM To explain how people with a serious mental illness perceive and experience their sexuality. METHOD A meta-synthesis was conducted to integrate qualitative studies. Four databases were used to perform the search, focused in the last ten years. Nine articles were included, and their results analysed thematically. RESULTS Four categories were identified: "Pathologized sexuality," which explains how the disorder and treatment affect sexuality; "Not my sexuality anymore," which describes feelings emerging from the perceived limitations and the role of self-acceptance; "Learning to manage intimate relationships," which explains the desire to establish intimate personal relationships and define their meaning; and "Reconstructing my sexuality," which elucidates the influence of the environment on sexuality. DISCUSSION Sexuality is influenced by several factors, the main ones being: the clinical complications, the side effects of drug treatment, the social support, the relationship with the health sector and stigma. IMPLICATIONS FOR PRACTICE Having a serious mental illness affects sexuality and can provoke suffering and social isolation. Mental health services should address this issue and carry out community interventions to reduce stigma.
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Affiliation(s)
- Roger Hortal-Mas
- Psychiatric Rehabilitation Area, Hermanas Hospitalarias - Hospital Sagrat Cor, Martorell, Catalonia, Spain
| | - Antonio Rafael Moreno-Poyato
- Department of Public Health, Mental Health and Perinatal Nursing, Universitat de Barcelona, Barcelona, Catalonia, Spain.,Hospital del Mar Institute for Medical Research (IMIM), Barcelona, Catalonia, Spain
| | - Nina Granel-Giménez
- Department of Nursing, Grupo de Investigación Enfermera en Vulnerabilidad y Salud (GRIVIS), Universitat Autònoma de Barcelona, Barcelona, Catalonia, Spain
| | - Maria Roviralta-Vilella
- Institut de Neuropisquiatria i Addiccions, Parc de Salut Mar de Barcelona, Barcelona, Catalonia, Spain
| | - Carolina Watson-Badia
- Department of Nursing, Grupo de Investigación Enfermera en Vulnerabilidad y Salud (GRIVIS), Universitat Autònoma de Barcelona, Barcelona, Catalonia, Spain.,Knowledge Management Department, Hospital Universitari Vall d'Hebron, Barcelona, Catalonia, Spain
| | - Rebeca Gómez-Ibáñez
- Department of Nursing, Grupo de Investigación Enfermera en Vulnerabilidad y Salud (GRIVIS), Universitat Autònoma de Barcelona, Barcelona, Catalonia, Spain
| | - Mariela Patricia Aguayo-González
- Department of Nursing, Grupo de Investigación Enfermera en Vulnerabilidad y Salud (GRIVIS), Universitat Autònoma de Barcelona, Barcelona, Catalonia, Spain
| | - David Giménez-Díez
- Department of Nursing, Grupo de Investigación Enfermera en Vulnerabilidad y Salud (GRIVIS), Universitat Autònoma de Barcelona, Barcelona, Catalonia, Spain.,Partial Home Care Unit, CPB Serveis de Salut Mental, Barcelona, Catalonia, Spain
| | - Maria Dolores Bernabeu-Tamayo
- Department of Nursing, Grupo de Investigación Enfermera en Vulnerabilidad y Salud (GRIVIS), Universitat Autònoma de Barcelona, Barcelona, Catalonia, Spain
| | - Juan Manuel Leyva-Moral
- Department of Nursing, Grupo de Investigación Enfermera en Vulnerabilidad y Salud (GRIVIS), Universitat Autònoma de Barcelona, Barcelona, Catalonia, Spain.,Centre for Health Sciences Research, Universidad María Auxiliadora, Lima, Peru.,Evidence-Based Health Care South America: A Joanna Briggs Institute Affiliated Group, Universidad Norbert Wiener, Lima, Peru
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3
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Ismail R, Voss JG, Yona S, Nurachmah E, Boutain D, Lowe C, John-Stewart G, Woods NF. Classifying stigma experience of women living with HIV in Indonesia through the social ecological model. Health Care Women Int 2021; 43:345-366. [PMID: 34379051 DOI: 10.1080/07399332.2021.1929989] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
Little is known how stigma theories apply to women living with HIV (WLWH). To apply stigma theories to WLWH, and locate within the dimensions of the Social-Ecological Model (SEM). Using a literature review and a theoretical subtraction to apply stigma forms to the SEM dimensions. WLWH begin to self-stigmatize, receive stigma based on fear from the family and community. Healthcare providers and society stigmatize WLWH by ascribing character flaws to them. The SEM allowed us to locate the dimensions of stigma and identify areas for future interventions for WLWH in Indonesia and other countries.
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Affiliation(s)
- Rita Ismail
- Ministry of Health Republic of Indonesia, Jakarta, Indonesia
| | - Joachim G Voss
- Frances Payne Bolton School of Nursing, Case Western Reserve University, Cleveland, Ohio, USA
| | - Sri Yona
- Department of Medical Surgical Nursing, Faculty of Nursing, Universitas Indonesia, Depok, Indonesia
| | - Elly Nurachmah
- Department of Medical Surgical Nursing, Faculty of Nursing, Universitas Indonesia, Depok, Indonesia
| | - Doris Boutain
- Psychosocial and Community Health, School of Nursing, University of Washington, Seattle, Washington, USA
| | - Celia Lowe
- Department of Anthropology, University of Washington, Seattle, Washington, USA
| | - Grace John-Stewart
- Department of Global Health, University of Washington, Seattle, Washington, USA
| | - Nancy Fugate Woods
- Biobehavioral Nursing and Health Systems, School of Nursing, University of Washington, Seattle, Washington, USA
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Mlambo M, Silén C, McGrath C. Lifelong learning and nurses' continuing professional development, a metasynthesis of the literature. BMC Nurs 2021; 20:62. [PMID: 33853599 PMCID: PMC8045269 DOI: 10.1186/s12912-021-00579-2] [Citation(s) in RCA: 96] [Impact Index Per Article: 32.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2020] [Accepted: 03/31/2021] [Indexed: 11/30/2022] Open
Abstract
Background Continuing professional development (CPD) is central to nurses’ lifelong learning and constitutes a vital aspect for keeping nurses’ knowledge and skills up-to-date. While we know about the need for nurses’ continuing professional development, less is known about how nurses experience and perceive continuing professional development. A metasynthesis of how nurses experience and view continuing professional development may provide a basis for planning future continuing professional development interventions more effectively and take advantage of examples from different contexts. The aim of this paper is to conduct such a metasynthesis, investigating the qualitative research on nurses’ experiences of continuing professional development. Methods A metasynthesis of the qualitative literature was conducted. A total of 25 articles fulfilled the inclusion criteria and were reviewed. Results We determined five overarching themes, Organisational culture shapes the conditions, Supportive environment as a prerequisite, Attitudes and motivation reflect nurse’s professional values, Nurses’ perceptions of barriers and Perceived impact on practice as a core value. This metasynthesis highlights that nurses value continuing professional development and believe that it is fundamental to professionalism and lifelong learning. Moreover CPD is identified as important in improving patient care standards. Conclusions Based on the metasynthesis, we argue that access to continuing professional development could be made more attainable, realistic and relevant. Expediently, organizations should adequately fund and make continuing professional development accessible. In turn, nurses should continue to actively engage in continuing professional development to maintain high standards of nursing care through competent practice. This paper highlights the perceived benefits and challenges of continuing professional development that nurses face and offers advice and understanding in relation to continuing professional development. We believe that this metasynthesis contributes with insights and suggestions that would be valuable for nurses and policy makers and others who are involved in nurse education and continuing professional development.
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Affiliation(s)
- Mandlenkosi Mlambo
- Jersey General Hospital, St Helier, Jersey.,Department of LIME, Karolinska Institutet, Stockholm, Sweden
| | - Charlotte Silén
- Department of LIME, Karolinska Institutet, Stockholm, Sweden
| | - Cormac McGrath
- Department of LIME, Karolinska Institutet, Stockholm, Sweden. .,Department of Education, Stockholm University, Stockholm, Sweden.
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5
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Freeman R, Gwadz M, Wilton L, Collins LM, Dorsen C, Hawkins RL, Silverman E, Martinez BY, Leonard NR, Applegate A, Cluesman S. Understanding long-term HIV survivorship among African American/Black and Latinx persons living with HIV in the United States: a qualitative exploration through the lens of symbolic violence. Int J Equity Health 2020; 19:146. [PMID: 32859191 PMCID: PMC7453370 DOI: 10.1186/s12939-020-01253-w] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2020] [Accepted: 08/05/2020] [Indexed: 01/10/2023] Open
Abstract
BACKGROUND Persons living with HIV (PLWH) are living longer, although racial/ethnic and socioeconomic status (SES) disparities persist. Yet, little is known about the experience of living with and managing HIV over decades. The present study took a qualitative approach and used the lens of symbolic violence, a type of internalized, non-physical violence manifested in the power differential between social groups. We focused on adult African American/Black and Latinx (AABL) PLWH from low-SES backgrounds. METHODS Data were drawn from two studies with AABL PLWH in New York City (N = 59). After providing signed informed consent, participants engaged in in-depth semi-structured interviews on aspects of HIV management. Interviews were audio-recorded and professionally transcribed verbatim, and data were analyzed using directed qualitative content analysis. RESULTS Participants in the two studies were comparable on sociodemographic and background characteristics. They had lived with HIV for 20 years, on average (range 3-33 years). All were from low-SES backgrounds and most were African American/Black and men. Participants experienced a convergence of multiple social exclusions, harms, and stigmas, consistent with symbolic violence, which contributed to disengagement from HIV care and discontinuation of HIV medications. We organized results into five sub-themes: (1) participants were "ground down" over time by material, social, and emotional challenges and this diminished self-worth and, at times, the will to live; (2) social isolation and self-isolation, based in part on feeling devalued and dehumanized, served as stigma-avoidance strategies and mechanisms of social exclusion; (3) stigmatizing aspects of patient-provider interactions, both experienced and anticipated, along with (4) restricted autonomy in HIV care and other settings (e.g., parole) reduced engagement; and (5) poor HIV management was internalized as a personal failure. Importantly, resilience was evident throughout the five sub-themes. CONCLUSIONS Symbolic violence is a useful framework for understanding long-term HIV management and survivorship among AABL PLWH from low-SES backgrounds. Indeed, forms of symbolic violence are internalized over time (e.g., experiencing devaluation, dehumanization, loss of self-worth, and anticipated stigma), thereby impeding successful HIV management, in part because avoiding HIV care and discontinuing HIV medications are primary coping strategies. Results have implications for interventions in community and health care settings.
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Affiliation(s)
- Robert Freeman
- Independent Consultant, 205 Clinton Avenue, Brooklyn, NY, 11205, USA
| | - Marya Gwadz
- Silver School of Social Work, New York University, 1 Washington Square North, New York, NY, 10003, USA.
| | - Leo Wilton
- Department of Human Development, State University of New York at Binghamton, 4400 Vestal Parkway East, Binghamton, NY, 13902, USA
- Faculty of Humanities, University of Johannesburg, PO Box 524, Auckland Park, Johannesburg, 2006, South Africa
| | - Linda M Collins
- Department of Human Development and Family Studies, The Methodology Center, The Pennsylvania State University, 435 Health and Human Development Building, University Park, PA, 16802, USA
| | - Caroline Dorsen
- Center for Drug Use and HIV Research, NYU School of Global Public Health, 665 Broadway, 11th Floor, New York, NY, 10012, USA
- Rory Meyers College of Nursing, New York University, 433 1st Avenue, New York, NY, 10010, USA
| | - Robert L Hawkins
- Silver School of Social Work, New York University, 1 Washington Square North, New York, NY, 10003, USA
| | - Elizabeth Silverman
- Silver School of Social Work, New York University, 1 Washington Square North, New York, NY, 10003, USA
| | - Belkis Y Martinez
- Silver School of Social Work, New York University, 1 Washington Square North, New York, NY, 10003, USA
| | - Noelle R Leonard
- Silver School of Social Work, New York University, 1 Washington Square North, New York, NY, 10003, USA
- Center for Drug Use and HIV Research, NYU School of Global Public Health, 665 Broadway, 11th Floor, New York, NY, 10012, USA
| | - Amanda Applegate
- Edna Bennett Pierce Prevention Research Center, The Pennsylvania State University, 314 Biobehavioral Health Building, University Park, PA, 16802, USA
| | - Sabrina Cluesman
- Silver School of Social Work, New York University, 1 Washington Square North, New York, NY, 10003, USA
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Barsaei M, Feizollahzadeh H, Jabbarzadeh F, Hasankhani H, Shabanloei R. The Meaning of Life Related to Heart Disease and Its Relationship to Quality of Life After Repeat Coronary Artery Angioplasty. Creat Nurs 2020; 26:48-55. [PMID: 32024739 DOI: 10.1891/1078-4535.26.1.48] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
PURPOSE Following angioplasty for coronary artery disease, patients may search for a new meaning of life. The purpose of this study was to determine patients' meaning of life related to heart disease and its relationship to quality of life after repeat coronary artery angioplasty. METHODS The current descriptive-correlation study recruited 144 patients with coronary artery disease admitted to hospitals in Karaj, Iran. Data were collected using a demographics questionnaire, the Meaning in Heart Disease (MHD) instrument, and the Iranian version of the Short Form Health Survey (SF-12), and were analyzed with descriptive statistics and the Pearson correlation. FINDINGS There was a significant relationship between the meaning of life related to heart disease (creating illusions, changing goals, reattribution, and meaning congruence) and quality of life scores (p <.05). CONCLUSION The majority of the patients undergoing repeat angioplasty used the creation of illusions to support a positive attitude toward their heart disease. Nursing interventions based on the individual patient's meaning of life can promote health and life quality.
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Experiences and Attitudes of People with HIV/AIDS: A Systematic Review of Qualitative Studies. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17020639. [PMID: 31963822 PMCID: PMC7014086 DOI: 10.3390/ijerph17020639] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/02/2019] [Revised: 01/10/2020] [Accepted: 01/12/2020] [Indexed: 11/16/2022]
Abstract
The aim of this article was to explore the experiences and attitudes of people with HIV/AIDS. A systematic review of qualitative studies was carried out. Twenty-seven articles were included, with sample sizes ranging from 3 to 78. Articles from North America, South America, Central America, Europe, and Africa were included. Five topics emerged from the synthesis: feelings about the diagnosis of HIV/AIDS; stigma and HIV/AIDS; changes in sexual behavior after becoming infected; living with the virus; and pregnancy and motherhood in seropositive women. The moment of diagnosis is of vital importance for these people due to feelings such as disappointment, sadness, fear, despair, lack of awareness, and pain. Social support is highly valued among these people and is linked to an improvement in these peoples’ quality of life. Different kinds of stigma accompany people with HIV/AIDS throughout their life, like social stigma, self-stigma, and health professionals’ stigma. Seropositive women who decide to become mothers can feel frustration because they cannot breastfeed. Spirituality helps some people to deal with the fact of being a virus or disease carrier.
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8
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Polkowska D. New dimensions of precarious work among migrants: A qualitative meta-analysis of current research. ASIAN AND PACIFIC MIGRATION JOURNAL 2019. [DOI: 10.1177/0117196819890502] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
This qualitative meta-analysis examines the ways in which issues of precarious work among migrants are investigated with a view to: (a) determine which dimensions of precarity are analyzed, and (b) identify new dimensions of precarious work which emerged from an analysis of a sample of 20 qualitative studies. The study identified five new dimensions which were not included in previously proposed conceptualizations of precarious work, namely, precarity as a conceptual tool to analyze other issues, strategies dealing with precarity, individual experience of dealing with precarious conditions, reasons why precarity occurs, and political dimension.
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Callister C, Jones J, Schroeder S, Breathett K, Dollar B, Sanghvi UJ, Harnke B, Lum HD, Jones CD. Caregiver Experiences of Care Coordination for Recently Discharged Patients: A Qualitative Metasynthesis. West J Nurs Res 2019; 42:649-659. [PMID: 31585516 DOI: 10.1177/0193945919880183] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Caregivers of patients often provide key support for patients after hospitalization. This qualitative metasynthesis describes caregiver perspectives about care coordination for patients discharged from the hospital. A literature search of Ovid Medline and CINAHL completed on May 23, 2018, identified 1,546 studies. Twelve articles were included in the final metasynthesis. Caregiver perspectives about care coordination were compiled into overall themes. A subanalysis of studies in which patients were discharged with home health services was completed. Five main themes emerged related to caregiver perspectives on care coordination after hospitalization: (a) Suboptimal access to clinicians after discharge, (b) Feeling disregarded by clinicians, (c) Need for information and training at discharge, (d) Overwhelming responsibilities to manage appointments and medications, and (e) Need for emotional support.Findings from this metasynthesis suggest the need for clinicians to engage with caregivers to provide support, training, and communication after hospital discharge.
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Affiliation(s)
- Catherine Callister
- Division of Hospital Medicine, Department of Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - Jacqueline Jones
- College of Nursing, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - Shara Schroeder
- College of Liberal Arts and Sciences, Department of Sociology, University of Colorado, Denver, CO, USA
| | - Khadijah Breathett
- Division of Cardiovascular Medicine, University of Arizona, Sarver Heart Center, Tucson, AZ, USA
| | - Blythe Dollar
- Division of Geriatric Medicine, Department of Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - Urvi Jhaveri Sanghvi
- College of Nursing, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - Ben Harnke
- Health Sciences Library University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - Hillary D Lum
- Division of Geriatric Medicine, Department of Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO, USA.,VA Eastern Colorado Geriatric Research Education and Clinical Center, Aurora, CO, USA
| | - Christine D Jones
- Division of Hospital Medicine, Department of Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO, USA.,Veterans Affairs Medical Center, Aurora, Colorado, USA
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Hill M, Huff A, Chumbler N. "I'm Gonna Get Busy Living": Examining the Trajectories of Affect, Behavioral Health, and Psychological Resilience Among Persons Living With HIV in a Southeastern U.S. Health District. Glob Qual Nurs Res 2019; 6:2333393619834937. [PMID: 31069249 PMCID: PMC6492360 DOI: 10.1177/2333393619834937] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2018] [Revised: 02/02/2019] [Accepted: 02/04/2019] [Indexed: 11/16/2022] Open
Abstract
Internal psychological states and coping processes are significant determinants
of resilience. The primary aim of this qualitative work is to provide further
insight into how core affect influences the adaptability of persons living with
HIV (PLWH) after diagnosis. In-depth interviews were conducted with a diverse
group of PLWH in a health district located in the Southeastern United States. A
deductive-inductive approach was taken while coding and analyzing,
N = 18 participant narratives concerning the psychological
and coping processes surrounding diagnosis and engagement in care. Active
behavioral and cognitive coping after diagnosis was exhibited by PLWH expressing
salient attributes of positive affect, whereas the salience of negative affect
among PLWH was associated with avoidant coping and heightened distress. Our
findings illuminate the beneficial role of positive affect and active coping on
the health and well-being of PLWH. The study implications extend to the
development and enhancement of programs designed to fortify psychological
resilience.
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Affiliation(s)
| | - Amber Huff
- University of Sussex, Brighton, United Kingdom
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11
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Górska S, Forsyth K, Maciver D. Living With Dementia: A Meta-synthesis of Qualitative Research on the Lived Experience. THE GERONTOLOGIST 2019; 58:e180-e196. [PMID: 28069886 PMCID: PMC5946830 DOI: 10.1093/geront/gnw195] [Citation(s) in RCA: 30] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2016] [Accepted: 11/21/2016] [Indexed: 11/14/2022] Open
Abstract
Purpose of the Study To identify and examine the published qualitative research evidence relative to the experience of living with dementia. Design and Methods Metasynthesis was used as the methodological framework to guide data collection and analysis. Results Three themes were identified. The first theme considered the main condition-related changes experienced by people with dementia (PWD) and showed how these are interlinked and impact upon various areas of people’s lives. The second theme indicated that amidst these changes, PWD strive to maintain continuity in their lives by employing various resources and coping strategies. The third theme underlined the role of contextual factors. The reviewed evidence indicates that, the emerging experience of PWD and their potential to adjust to the continuous changes is influenced by access to and quality of both personal and contextual resources which remain in a constant, transactional relationship to each other. Implications The findings were interpreted and discussed in the context of relevant theoretical frameworks and research evidence. It was considered that current evidence and findings presented in this review can be further explored and expanded upon in a more systematic way through research conducted within the theoretical framework of dynamic systems theory. Further research would be also beneficial to explore the subjective experience of dementia from a participatory perspective. Exploring the application of these theoretical standpoints would contribute to the current state of knowledge and offer both PWD and carers fresh perspective on the nature of change and potential for adaptability in dementia.
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Affiliation(s)
- Sylwia Górska
- School of Health Sciences, Queen Margaret University, Edinburgh, Scotland
| | - Kirsty Forsyth
- School of Health Sciences, Queen Margaret University, Edinburgh, Scotland
| | - Donald Maciver
- School of Health Sciences, Queen Margaret University, Edinburgh, Scotland
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12
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Sankofa J, Cox A, Fader JJ, Inderbitzin M, Abrams LS, Nurse AM. Juvenile Corrections in the Era of Reform: A Meta-Synthesis of Qualitative Studies. INTERNATIONAL JOURNAL OF OFFENDER THERAPY AND COMPARATIVE CRIMINOLOGY 2018; 62:1763-1786. [PMID: 28831820 DOI: 10.1177/0306624x17727075] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
In this article, the authors synthesize knowledge from select qualitative studies examining rehabilitation-oriented juvenile residential corrections and aftercare programs. Using meta-synthesis methodology, the authors extracted and coded content from 10 research studies conducted by five authors across criminology, sociology, and social welfare disciplines. The total number of published works based on those studies analyzed was 18. Collectively, these studies offer insight into three major components of the juvenile correctional experience: therapeutic treatment and evidence-based practices, the shaping of identities and masculinities, and preparation for reentry. This analysis is particularly important as the United States is currently in an era of reform during which policymakers are increasingly espousing the benefits of rehabilitation for youth offenders over punishment. These studies took place before, during, and after this era of reform, and yet, the findings are surprisingly consistent over time, raising key questions about the effectiveness of the reform strategies.
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Kerrigan K, Green G. "Ghosts From the Past": The Re-Emergence of Internalized Religious Stigma Following Diagnosis of HIV Among Northern Irish Gay Men. JOURNAL OF HOMOSEXUALITY 2018; 66:635-652. [PMID: 29336695 DOI: 10.1080/00918369.2017.1423219] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
This article explores how previous exposure to religious homonegativity features in the sense-making process following HIV diagnosis in a homogenous sample of six gay men living in Northern Ireland. Interpretive phenomenological analysis was used to identify two key overarching themes: Negotiating authenticity in unsafe space, which relates to the experience of negotiating same-sex attraction within religious environments, and Re-emergence of religious shame in diagnosis, which relates to the way in which the men made sense of diagnosis from the position of having been exposed to religious homonegativity earlier in their lives. Findings demonstrate how the men negotiated their sexual orientation within religious contexts and how a reconstruction of God was necessary to preserve an authentic sense of self. Despite reaching reconciliation, HIV was initially appraised within a retributive religious framework that served to temporarily reinforce previously learned shame-based models of understanding this aspect of the self.
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Affiliation(s)
- Keith Kerrigan
- a RAID Liaison Mental Health Team , Antrim Area Hospital , Antrim , Northern Ireland
| | - Gill Green
- b School of Health and Social Care , University of Essex , Colchester , England
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Chambers LA, Jackson R, Worthington C, Wilson CL, Tharao W, Greenspan NR, Masching R, Pierre-Pierre V, Mbulaheni T, Amirault M, Brownlee P. Decolonizing Scoping Review Methodologies for Literature With, for, and by Indigenous Peoples and the African Diaspora: Dialoguing With the Tensions. QUALITATIVE HEALTH RESEARCH 2018; 28:175-188. [PMID: 29182046 DOI: 10.1177/1049732317743237] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/11/2023]
Abstract
This article summarizes our deepened understanding of decolonizing research with, for, and by Indigenous peoples and peoples of African descent that emerged from conducting a scoping review of the methodological literature and reflecting on our review process. Although our review identified decolonizing methodologies as a promising approach, we questioned if our scoping review process engaged in decolonizing knowing. To unpack the epistemological tensions between decolonizing knowing and Western ways of doing scoping reviews, we engaged in individual and collective reflective processes- dialoguing with the tensions-moving from individual immersion in the literature to transformative dialogues among the team. In reflecting upon our tensions with the scoping review process, themes that emerged included (a) ontological/epistemological disjunctures, (b) tensions with concepts and language, and (c) relationships with the literature and beyond. This reflexive process provides valuable insight into ways in which review methods might be made a decolonizing research experience.
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Affiliation(s)
| | | | | | | | - Wangari Tharao
- 4 Women's Health in Women's Hands, Toronto, Ontario, Canada
| | | | - Renee Masching
- 6 Canadian Aboriginal AIDS Network, Dartmouth, Nova Scotia, Canada
| | | | - Tola Mbulaheni
- 7 African and Caribbean Council on HIV/AIDS in Ontario, Toronto, Ontario, Canada
| | - Marni Amirault
- 6 Canadian Aboriginal AIDS Network, Dartmouth, Nova Scotia, Canada
| | - Patrick Brownlee
- 6 Canadian Aboriginal AIDS Network, Dartmouth, Nova Scotia, Canada
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de Vos JA, LaMarre A, Radstaak M, Bijkerk CA, Bohlmeijer ET, Westerhof GJ. Identifying fundamental criteria for eating disorder recovery: a systematic review and qualitative meta-analysis. J Eat Disord 2017; 5:34. [PMID: 29118983 PMCID: PMC5664841 DOI: 10.1186/s40337-017-0164-0] [Citation(s) in RCA: 89] [Impact Index Per Article: 12.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/06/2017] [Accepted: 06/29/2017] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND Outcome studies for eating disorders regularly measure pathology change or remission as the only outcome. Researchers, patients and recovered individuals highlight the importance of using additional criteria for measuring eating disorder recovery. There is no clear consensus on which additional criteria are most fundamental. Studies focusing on the perspectives of recovered patients show criteria which are closely related to dimensions of positive functioning as conceptualized in the complete mental health model. The aim of this study was to identify fundamental criteria for eating disorder recovery according to recovered individuals. METHODS A systematic review and a qualitative meta-analytic approach were used. Eighteen studies with recovered individuals and meeting various quality criteria were included. The result sections of the included papers were searched for themes that were stated as criteria for recovery or 'being recovered'. All themes were analyzed using a meta-summary technique. Themes were labeled into criteria for recovery and the frequency of the found criteria was examined. RESULTS In addition to the remission of eating disorder pathology, dimensions of psychological well-being and self-adaptability/resilience were found to be fundamental criteria for eating disorder recovery. The most frequently mentioned criteria were: self-acceptance, positive relationships, personal growth, decrease in eating disorder behavior/cognitions, self-adaptability/resilience and autonomy. CONCLUSIONS People who have recovered rate psychological well-being as a central criterion for ED recovery in addition to the remission of eating disorder symptoms. Supplementary criteria, besides symptom remission, are needed to measure recovery. We recommend including measurements of psychological well-being and self-adaptability/resilience in future research, such as outcome studies and in routine outcome measurement.
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Affiliation(s)
- Jan Alexander de Vos
- Centre for eHealth and Well-being Research, University of Twente, Psychology, Health, & Technology, Enschede, The Netherlands
- Human Concern Foundation, center for Eating Disorders, Amsterdam, The Netherlands
| | - Andrea LaMarre
- University of Guelph, Department of Family Relations and Applied Nutrition, Ontario, Canada
| | - Mirjam Radstaak
- Centre for eHealth and Well-being Research, University of Twente, Psychology, Health, & Technology, Enschede, The Netherlands
| | | | - Ernst T. Bohlmeijer
- Centre for eHealth and Well-being Research, University of Twente, Psychology, Health, & Technology, Enschede, The Netherlands
- Optentia Research Focus Area, North-West University (VTC), Vanderbijlpark, South Africa
| | - Gerben J. Westerhof
- Centre for eHealth and Well-being Research, University of Twente, Psychology, Health, & Technology, Enschede, The Netherlands
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Lever Taylor B, Billings J, Morant N, Johnson S. How do women's partners view perinatal mental health services? A qualitative meta-synthesis. Clin Psychol Psychother 2017; 25:112-129. [PMID: 28857366 DOI: 10.1002/cpp.2133] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2017] [Revised: 07/21/2017] [Accepted: 07/28/2017] [Indexed: 11/10/2022]
Abstract
OBJECTIVES Perinatal mental health difficulties are prevalent among women and can adversely affect their partners too. There is also increasing recognition that a woman's partner can play a vital role in relation to her perinatal mental health and should be supported and involved in decisions about her care. Yet it is unclear how services are experienced by the partners of women with perinatal mental health difficulties. This study aimed to synthesize qualitative evidence of partners' views of perinatal mental health care. METHODS A systematic search of 5 electronic databases identified 20 studies that met the inclusion criteria. The findings of these studies were synthesized using an approach based on meta-ethnography. RESULTS Six themes were identified, namely, the marginalization and neglect of women's partners, an unmet need for information, partners' ambivalence about involvement and support, practical barriers to involvement, views about support for women's partners, and the impact on partners of the care women received. CONCLUSIONS Given the importance of women's partners in relation to perinatal mental health as well as to women's engagement with support and treatment outcomes, greater consideration should be given to their needs to ensure they feel well informed and involved in perinatal mental health care, rather than marginalized. However, professionals also need to challenge the barriers to involvement and support that women's partners face and consider the ways in which services may reinforce these barriers.
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Affiliation(s)
| | - Jo Billings
- Division of Psychiatry, University College London, London, UK
| | - Nicola Morant
- Division of Psychiatry, University College London, London, UK
| | - Sonia Johnson
- Division of Psychiatry, University College London, London, UK
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17
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The Experience of Pregnancy in Women Living With HIV: A Meta-Synthesis of Qualitative Evidence. J Assoc Nurses AIDS Care 2017; 28:587-602. [PMID: 28479291 DOI: 10.1016/j.jana.2017.04.002] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2016] [Accepted: 04/04/2017] [Indexed: 11/24/2022]
Abstract
The lived experience of pregnancy from the perspectives of women living with HIV (WLWH) is not well understood. We aimed to understand the meaning of pregnancy for WLWH. A meta-synthesis was conducted to review and integrate qualitative studies about the phenomena; 12 databases were used to perform the search in English, Spanish, and Portuguese. Articles using qualitative methods published in peer-reviewed journals were included. Data were analyzed using the meta-synthesis method. We found that, for pregnant WLWH, pregnancy evolved as a mediated experience of commitment and dedication. The vital life experience of pregnancy was defined as an interplay of emotions, coping strategies, and feelings of satisfaction. Pregnancy in WLWH was experienced and impacted by societal beliefs, as the women focused all their efforts to take care of themselves and their babies.
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Seaman AT, Stone AM. Little White Lies: Interrogating the (Un)acceptability of Deception in the Context of Dementia. QUALITATIVE HEALTH RESEARCH 2017; 27:60-73. [PMID: 26613971 DOI: 10.1177/1049732315618370] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
This metasynthesis surveyed extant literature on deception in the context of dementia and, based on specific inclusion criteria, included 14 articles from 12 research studies. By doing so, the authors accomplished three goals: (a) provided a systematic examination of the literature-to-date on deception in the context of dementia, (b) elucidated the assumptions that have guided this line of inquiry and articulated the way those shape the research findings, and (c) determined directions for future research. In particular, synthesizing across studies allowed the authors to develop a dynamic model comprised of three temporally linear elements-(a) motives, (b) modes, and (c) outcomes that describe how deception emerges communicatively through interaction in the context of dementia.
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Affiliation(s)
- Aaron T Seaman
- Department of Comparative Human Development, University of Chicago, Chicago, IL, USA
| | - Anne M Stone
- Department of Communication, Rollins College, Winter Park, FL, USA
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19
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What patients say about living with psychogenic nonepileptic seizures: A systematic synthesis of qualitative studies. Seizure 2016; 41:100-11. [DOI: 10.1016/j.seizure.2016.07.014] [Citation(s) in RCA: 56] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2016] [Revised: 07/12/2016] [Accepted: 07/15/2016] [Indexed: 11/23/2022] Open
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[„Kids’ Skills” by Ben Furman – Description and Research Review]. Prax Kinderpsychol Kinderpsychiatr 2016; 65:200-15. [PMID: 26947531 DOI: 10.13109/prkk.2016.65.3.200] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
The article describes the programme „Kids’ Skills“ by the Finnish psychiatrist Ben Furman. „Kids’ Skills“ was developed to address behavioural issues in children. It is based on the assumption that children’s behavioural problems should not be pathologized, but can instead be corrected by learning a corresponding skill. The programme is characterised by its focus on strengths and its humorous and playful approach. The 15 steps of “Kids’ Skills” are intended to identify the specific skill, help generate a learning process and continue motivating the child. The authors describe the steps of the programme using a case study. They also address the limited number of existing studies, which have included a telephone and an online survey of practitioners using the programme, as well as case studies. The results of these studies are discussed with regard to their basis in evidence and practical relevance. Continuing research is recommended and possible implementations are suggested.
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Chambers LA, Rueda S, Baker DN, Wilson MG, Deutsch R, Raeifar E, Rourke SB. Stigma, HIV and health: a qualitative synthesis. BMC Public Health 2015; 15:848. [PMID: 26334626 PMCID: PMC4557823 DOI: 10.1186/s12889-015-2197-0] [Citation(s) in RCA: 201] [Impact Index Per Article: 22.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2015] [Accepted: 08/27/2015] [Indexed: 11/10/2022] Open
Abstract
Background HIV-related stigma continues to negatively impact the health and well-being of people living with HIV, with deleterious effects on their care, treatment and quality of life. A growing body of qualitative research has documented the relationship between HIV-related stigma and health. This review aims to synthesize qualitative evidence that explored the intersections of stigma and health for people with HIV. Methods A thematic summary was conducted that was guided by the qualitative metasummary technique developed by Sandelowski and Barraso. Literature searches yielded 8,622 references of which 55 qualitative studies were identified that illustrated HIV-related stigma in the context of health. Results The metasummary classified qualitative findings into three overarching categories: conceptualizing stigma which identified key dimensions of HIV-related stigma; experiencing stigma which highlighted experiences of stigma in the health context, and managing stigma which described ways in which stigma is avoided or addressed. To better illustrate these connections, the qualitative literature was summarized into the following themes: stigma within health care settings, the role of stigma in caring for one’s health, and strategies to address HIV-related stigma in the health context. A number of health care practices were identified – some rooted in institutional practices, others shaped by personal perceptions held by practitioners – that could be stigmatizing or discriminatory towards people with HIV. There existed interconnections between enacted stigma and felt stigma that influenced health care utilization, treatment adherence, and overall health and well-being of people with HIV. Intersectional stigma also emerged as instrumental in the stigma experiences of people living with HIV. A number of strategies to address stigma were identified including social support, education, self-efficacy, resilience activities, and advocacy. Conclusion This review of the qualitative evidence indicates that HIV-related stigma within health contexts is a broad social phenomenon that manifests within multiple social spheres, including health care environments. Findings from this review indicate that future stigma research should consider the social structures and societal practices – within and outside of health care environments – that perpetuate and reinforce stigma and discrimination towards people with HIV. Electronic supplementary material The online version of this article (doi:10.1186/s12889-015-2197-0) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Lori A Chambers
- School of Social Work, McMaster University, Kenneth Taylor Hall, KTH-319, 1280 Main St. West, Hamilton, ON, L8S 4M4, Canada.
| | - Sergio Rueda
- Social and Epidemiological Research Department, Centre for Addiction and Mental Health, c/o Research Services Office, 33 Russell St., T100, Toronto, ON, M5S 2S1, Canada. .,Department of Psychiatry, University of Toronto, 250 College St., 8th floor, Toronto, ON, M5T 1R8, Canada. .,Institute for Work & Health, 481 University Ave., Suite 800, Toronto, ON, M5G 2E9, Canada.
| | - D Nico Baker
- Ontario HIV Treatment Network, 1300 Yonge St., Suite 600, Toronto, ON, M4T 1X3, Canada.
| | - Michael G Wilson
- Ontario HIV Treatment Network, 1300 Yonge St., Suite 600, Toronto, ON, M4T 1X3, Canada. .,Department of Clinical Epidemiology and Biostatistics, McMaster University, Communications Research Laboratory, CRL-209, 1280 Main St. West, Hamilton, ON, L8S 4M4, Canada. .,Centre for Health Economics and Policy Analysis, McMaster University, 1280 Main St. West, Hamilton, ON, L8S 4M4, Canada. .,McMaster Health Forum, McMaster University, Mills Memorial Library, MML-417, 1280 Main St. West, Hamilton, ON, L8S 4M4, Canada.
| | - Rachel Deutsch
- Ontario HIV Treatment Network, 1300 Yonge St., Suite 600, Toronto, ON, M4T 1X3, Canada.
| | - Elmira Raeifar
- Department of Psychiatry, Weill Cornell Medical College, 21 Bloomingdale Rd., White Plains, NY, 10605, USA.
| | - Sean B Rourke
- Department of Psychiatry, University of Toronto, 250 College St., 8th floor, Toronto, ON, M5T 1R8, Canada. .,Ontario HIV Treatment Network, 1300 Yonge St., Suite 600, Toronto, ON, M4T 1X3, Canada. .,Centre for Research on Inner City Health, The Keenan Research Centre, Li Ka Shing Knowledge Institute, St. Michael's Hospital, 209 Victoria St, Toronto, ON, M5B 1 T8, Canada.
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- Ontario HIV Treatment Network, 1300 Yonge St., Suite 600, Toronto, ON, M4T 1X3, Canada
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Leyva-Moral JM, de Dios Sánchez R, Lluva-Castaño A, Mestres-Camps L. Living with constant suffering: a different life following the diagnosis of HIV. J Assoc Nurses AIDS Care 2015; 26:613-24. [PMID: 25998265 DOI: 10.1016/j.jana.2015.04.006] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2014] [Accepted: 04/18/2015] [Indexed: 11/18/2022]
Abstract
We used grounded theory in semi-structured interviews with 32 persons living with HIV (PLWH) in Barcelona, Spain, and found that PLWH live with constant suffering, a core category combining four realities: I need help; My life is constantly controlled; I have a new imposed life; and I have an uncertain reality. Participants described being constantly controlled by health policies and medications. They thought their lives were in the hands of others and that a new life, characterized by the constant fear of stigma, had been imposed on them. They felt they were losing freedom and vitality, as many questions remained unanswered, causing uncertainty related to health and public life. Emotional help was obtained mainly from peers and social networks. Our emergent theory shows a disruptive experience, with serious consequences to individual and social development. Health care has to focus on the real needs of PLWH to reduce suffering and uncertainty.
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Engel N, Pant Pai N. Qualitative research on point-of-care testing strategies and programs for HIV. Expert Rev Mol Diagn 2014; 15:71-5. [PMID: 25267607 DOI: 10.1586/14737159.2015.960518] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Point-of-care (POC) testing in communities, home settings and primary healthcare centers plays an important role in cutting delays in HIV diagnosis and in the uptake of voluntary testing and counseling. Qualitative research methods have important potential to overcome the current challenges in expanding HIV POC testing programs and strategies, by examining the diagnostic processes, complex inter-relationships and patterns involved in making POC diagnostics work in real-world settings. This article reviews existing qualitative studies on POC testing strategies and programs for HIV. Qualitative research on POC diagnostics around the uptake of POC tests, the actual diagnostic and testing processes involved, the influence of POC tests on clinical decision-making, communication of decisions and decisions exercised by patients are limited. Equally limited are studies that explore adaptation of POC programs to various socio-cultural contexts. More qualitative research is needed to inform test developers, funders and policymakers.
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Affiliation(s)
- Nora Engel
- Department of Health, Ethics and Society, Faculty of Health, Medicine and Life Sciences, Maastricht University, PO Box 616 NL - 6200 MD Maastricht, The Netherlands
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Chilemba W, van Wyk N, Leech R. Experiences of emotional abuse among women living with HIV and AIDS in Malawi. Health Care Women Int 2014; 35:743-57. [PMID: 24911313 DOI: 10.1080/07399332.2014.926901] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Our aim for this study was to describe emotional abuse as it is experienced by women living with HIV and AIDS in Malawi. The study was conducted in the Lilongwe district in Malawi and used a descriptive phenomenological approach. Twelve women from two public health care clinics under the Lilongwe District Health Office were interviewed. Violating experiences that scarred the personhood and inherent value of being human were found to be the essence of their emotional abuse. Their husbands, family, and community members were responsible for the humiliation, abandonment, and blaming that caused them to feel hopeless.
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Affiliation(s)
- Winnie Chilemba
- a Department of Nursing Science , University of Pretoria , Pretoria , South Africa
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Trevillion K, Hughes B, Feder G, Borschmann R, Oram S, Howard LM. Disclosure of domestic violence in mental health settings: a qualitative meta-synthesis. Int Rev Psychiatry 2014; 26:430-44. [PMID: 25137109 PMCID: PMC4162653 DOI: 10.3109/09540261.2014.924095] [Citation(s) in RCA: 41] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/02/2022]
Abstract
Little is known about how psychiatric services respond to service users' experiences of domestic violence. This qualitative meta-synthesis examined the healthcare experiences and expectations of mental health service users experiencing domestic violence. Twenty-two biomedical, social science, grey literature databases and websites were searched, supplemented by citation tracking and expert recommendations. Qualitative studies which included mental health service users (aged ≥ 16 years) with experiences of domestic violence were eligible for inclusion. Two reviewers independently extracted data from included papers and assessed quality. Findings from primary studies were combined using meta-synthesis techniques. Twelve studies provided data on 140 female and four male mental health service users. Themes were generally consistent across studies. Overarching theoretical constructs included the role of professionals in identifying domestic violence and facilitating disclosures, implementing personalized care and referring appropriately. Mental health services often failed to identify and facilitate disclosures of domestic violence, and to develop responses that prioritized service users' safety. Mental health services were reported to give little consideration to the role of domestic violence in precipitating or exacerbating mental illness and the dominance of the biomedical model and stigma of mental illness were found to inhibit effective responses. Mental health services often fail to adequately address the violence experienced by mental health service users. This meta-synthesis highlights the need for mental health services to establish appropriate strategies and responses to domestic violence to ensure optimal care of this vulnerable population.
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Affiliation(s)
- Kylee Trevillion
- Section of Women’s Mental Health, Health Service and Population Research Department, Institute of Psychiatry, King’s College London
| | - Bryony Hughes
- Brighton & Sussex Medical School, University of Sussex, Brighton, East Sussex
| | - Gene Feder
- Centre for Academic Primary Care, School of Social and Community Medicine, University of Bristol, UK
| | - Rohan Borschmann
- Section of Women’s Mental Health, Health Service and Population Research Department, Institute of Psychiatry, King’s College London
| | - Siân Oram
- Section of Women’s Mental Health, Health Service and Population Research Department, Institute of Psychiatry, King’s College London
| | - Louise M. Howard
- Section of Women’s Mental Health, Health Service and Population Research Department, Institute of Psychiatry, King’s College London
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Hammell KRW. Belonging, occupation, and human well-being: An exploration. The Canadian Journal of Occupational Therapy 2014; 81:39-50. [DOI: 10.1177/0008417413520489] [Citation(s) in RCA: 85] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Farrell G, Comiskey C. Dualities of Living With HIV/HCV Co-Infection: Patients' Perspectives From Those who are Ineligible for or Nonresponsive to Treatment. J Assoc Nurses AIDS Care 2014; 25:9-22. [DOI: 10.1016/j.jana.2012.10.005] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2012] [Accepted: 10/16/2012] [Indexed: 01/08/2023]
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Adherence to antiretroviral therapy in Jinja, Uganda: a six-year follow-up study. PLoS One 2013; 8:e78243. [PMID: 24147126 PMCID: PMC3795690 DOI: 10.1371/journal.pone.0078243] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2013] [Accepted: 09/17/2013] [Indexed: 11/26/2022] Open
Abstract
Introduction We report on the adherence experience of a group of people living with HIV on ART over six years in Uganda. Methods Between 2005 and 2009, we followed up 41 participants who were also part of a clinical trial comparing home and facility based delivery of ART in Jinja, eastern Uganda. We conducted qualitative in-depth interviews at enrolment, 3, 6, 18 and 30 months to capture experiences with adherence over time. In 2011 we returned to these participants to find out how they were fairing with long term adherence. We managed to retrace 24 participants and interviewed them about their experience. We thematically analysed the data and compared findings over time. Results Initially there were few barriers to adherence and many followed the adherence guidance closely. By year six, relaxation of these rules was noticeable although self-reported adherence continued to be high. Alcohol consumption was more common than before. Some relatives of the participants who had died claimed that some deaths were a result of alcohol. While participants reported that ART had allowed them to reclaim independence and return to work the changes in work and social routines created new challenges for adherence. Side effects like lipodystrophy were not only causing some stigma but for some tested their faith in the drugs. Many participants reported resumption of sexual lives but apart from those who selected same status partners, disclosure to new partners was minimal. Conclusion Good adherence practice to ART wanes over the long-term, and people who may have disclosed at initiation find it difficult to do so to new partners once they are healthy. Further adherence interventions and support with disclosure over the course of therapy may need to be considered. (Words: 283)
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Rethinking the Experience of HIV-Positive Refugee Women in the Context of Pregnancy: Using an Intersectional Approach in Nursing. Res Theory Nurs Pract 2013; 27:240-56. [DOI: 10.1891/1541-6577.27.4.240] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
When providing care to HIV-positive refugee women in the context of pregnancy, nurses must be able to move beyond the individual experiences of health and illness and acquire a more meaningful understanding of the historical, social, cultural, political, and structural influences that shape women’s health and women’s lives. Intersectionality is a framework that focuses on various dimensions of a refugee woman’s social identity such as race, class, gender, as well as education, citizenships, and geographic location and how these dimensions intersect to influence the experiences of health and illness. In this article, we present a brief overview of the origins and evolution of intersectionality. From there we describe three distinct levels of analysis: (a) micro-level analysis to examine the influences that impact the social identity and social location of women; (b) meso-level analysis to explore informal and formal support systems; and (c) macro-level analysis to interrogate historical, social, cultural, political, and structural influences that shape health outcomes. Finally, we will examine how this framework may be useful for nursing practice, research, and knowledge development. We hope to illustrate how intersectionality is a useful framework to understand the experiences of HIV-positive refugee women in the context of pregnancy.
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McInnes E, Wimpenny P. Using Qualitative Assessment and Review Instrument software to synthesise studies on older people's views and experiences of falls prevention. INT J EVID-BASED HEA 2012; 6:337-44. [PMID: 21631830 DOI: 10.1111/j.1744-1609.2008.00104.x] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
Aim To report on the experiences of using software (Qualitative Assessment and Review Instrument (QARI)) specifically designed to synthesise qualitative research studies. Background The synthesis of qualitative research using a systematic review process is somewhat contentious and at present a variety of approaches exists. One approach is the QARI tool from the Joanna Briggs Institute (JBI) which provides a structured process to qualitative synthesis for appraising, extracting and synthesizing qualitative research that is considered more aggregative than interpretative. The process shares similarities with the methods of quantitative systematic review although the analysis stage is grounded in qualitative methodology. QARI provides a means for accumulating and synthesizing qualitative-based knowledge on the view and experiences of healthcare users and staff that can be used alongside systematic reviews of effectiveness to supply information on barriers and facilitators to adopting an intervention. The synthesis of qualitative research on older people's experiences of falls is used as the focus in this paper. Conclusions In common with other qualitative synthesis methodologies, there remain important areas for debate. These relate to the process and outcomes of: quality assessment, extracting findings from primary studies, the creation of categories (themes, metaphors), the expression of the synthesis and the credibility of an iterative review process.
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Affiliation(s)
- Elizabeth McInnes
- University of Manchester, Manchester, and Joanna Briggs Collaborating Centre for Evidence-based Multi-professional Practice, Faculty of Health and Social Care, The Robert Gordon University, Garthdee Campus, Aberdeen, AB10 7QG Scotland
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Ribeiro Nobre N, Kylmä J, Kirsi T. "I Live Quite a Good Balanced Life": A Pilot Study on the Life Experiences of Ageing Individuals Living with HIV. Nurs Res Pract 2012; 2012:128108. [PMID: 22761996 PMCID: PMC3385662 DOI: 10.1155/2012/128108] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2011] [Accepted: 03/08/2012] [Indexed: 11/17/2022] Open
Abstract
An ageing population is accompanied by an increased number of older adults living with HIV. So far, our knowledge regarding the life experiences of older adults living with HIV is still poor and under researched. The purpose of this study is to present new knowledge by interviewing nine Finnish HIV-positive individuals of 50 years of age and older. The data were analysed by inductive content analysis. Living with HIV is shaped by unique personal life experiences. These experiences played an important role on how the interviewees assessed their lives and their future as HIV positive individuals. Most of the participants reacted negatively to their HIV-positive diagnosis. However, throughout time they had found meaning in their lives and had developed a degree of positive attitude towards life and future which was articulated in terms of a good overall balanced life. Since caring is the tenor of the nursing profession, nurses should be able to identify and implement methods for assessing how successfully older adults living with HIV age and intervene in an informed way whenever needed.
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Affiliation(s)
- Nuno Ribeiro Nobre
- School of Health Sciences, Public Health, University of Tampere, 33014 Tampere, Finland
| | - Jari Kylmä
- School of Health Sciences, Public Health, University of Tampere, 33014 Tampere, Finland
| | - Tapio Kirsi
- School of Health Sciences, Public Health, University of Tampere, 33014 Tampere, Finland
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Seeley J, Mbonye M, Ogunde N, Kalanzi I, Wolff B, Coutinho A. HIV and identity: the experience of AIDS support group members who unexpectedly tested HIV negative in Uganda. SOCIOLOGY OF HEALTH & ILLNESS 2012; 34:330-344. [PMID: 21707665 DOI: 10.1111/j.1467-9566.2011.01384.x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
Living with HIV, for many of those infected, has meant adjusting to life with a stigmatised condition and, until recently, the threat of looming death. We explore the adjustment of a group of long-term former clients of The AIDS Support Organisation (TASO) in Uganda who, when tested for HIV during the rollout of antiretroviral therapy in 2004, were found to be HIV negative. In-depth semi-structured interviews with 34 former TASO clients were conducted between 2005 and 2007. Their narratives reveal a great deal about the biographical disruption they have faced, and the biographical work that they have undertaken in both the personal and the social dimensions of their lives in order to manage their new-found HIV-uninfected status. After the negative test result, as they were no longer HIV-infected, they had to leave TASO and that support was sorely missed, as was the friendship of TASO members to whom they often felt reluctant to disclose their new status. The identity 'reversal' or change was often handled privately. Compared with their transition to an HIV-positive identity, they now lacked a social dimension to their identity transformation as they managed their new identity in the face of self- and public doubt.
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Affiliation(s)
- Janet Seeley
- School of International Development, University of East Anglia, Norwich.
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Hannes K, Harden A. Multi-context versus context-specific qualitative evidence syntheses: combining the best of both. Res Synth Methods 2012; 2:271-8. [PMID: 26061890 DOI: 10.1002/jrsm.55] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2011] [Revised: 01/02/2012] [Accepted: 01/17/2012] [Indexed: 11/08/2022]
Abstract
There is an increasing interest in the conduct of qualitative evidence syntheses (QES), particularly in the field of health care. Approaches to QES vary in the way they conduct a search, a critical appraisal or the data-analysis. To date, the use of multi-context versus context-specific QES has not yet been fully considered. In a multi-context, QES exhaustive searches are used that retrieve studies from a broad variety of geographical, socio-cultural, political, historical, economical, health care, linguistic, or other context relevant to the review. Authors of a context-specific QES would generally have a particular end user in mind, therefore, using a selective search strategy with a focus on one particular context in order to provide lines of actions or theories that are sensitive to a local setting. We used the insights from a recently conducted, context-specific QES to map out potential strengths and weaknesses of these two approaches and make recommendations regarding the future conduct of QES. We propose two ways of combining the best of both: the production of umbrella reviews of context-specific syntheses and/or the trans-cultural modification and trans-contextual adaptation of findings from multi-context syntheses. Copyright © 2012 John Wiley & Sons, Ltd.
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Smith M, Aguirre RTP. Reproductive attitudes and behaviors in people with sickle cell disease or sickle cell trait: a qualitative interpretive meta-synthesis. SOCIAL WORK IN HEALTH CARE 2012; 51:757-779. [PMID: 23078010 DOI: 10.1080/00981389.2012.693580] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
Sickle cell disease (SCD) is a serious and life threatening disorder. The literature on informed reproductive decisions among people with SCD is limited, suggesting that there is a lack of awareness about SCD and Sickle cell trait status (SCT) among high-risk populations. The purpose of this qualitative interpretive meta-synthesis (QIMS) is to examine the reproductive attitudes and behaviors in people with SCD or SCT to create effective genetic counseling programs to inform reproductive decision making. Three studies were included in the QIMS for a total sample of 79 participants. The majority of the sample was African American, ages 16 to 63. Other demographic characteristics of the study populations and data collection methods used in these studies varied. Seven themes on reproductive attitudes and behaviors among people with SCD or SCT emerged: lack of awareness or education about SCD and SCT; men who deny having SCT; attitudes toward learning one's SCT status; rationales for learning a partner's SCT status prior to commencing a relationship; valuing relationships over SCD risk; learning one's own and partner's SCT status; and the consequences of not asking about partners' SCT status. Implications for prevention programming involving improved education and awareness about the disease and reproduction are discussed.
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Affiliation(s)
- Marcella Smith
- School of Social Work, The University of Texas at Arlington, Arlington, Texas 76019, USA
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35
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Rodkjaer L, Sodemann M, Ostergaard L, Lomborg K. Disclosure decisions: HIV-positive persons coping with disease-related stressors. QUALITATIVE HEALTH RESEARCH 2011; 21:1249-1259. [PMID: 21483024 DOI: 10.1177/1049732311405803] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
The purpose of this grounded theory study was to investigate how Danish HIV-positive persons live with their disease, focusing on HIV-related stressors. Using the Glaserian method, we analyzed textual data from in-depth interviews with 16 HIV-positive persons. Decisions about disclosure appeared to be a major concern and a determining factor for HIV-related stress. Consequently, we developed a substantive theory about disclosure decisions in which three different strategies could be identified: (a) disclosing to everyone (being open); (b) restricting disclosure (being partly open); and (c) disclosing to no one (being closed). Disclosure was a continuum; none of the three strategies automatically relieved HIV-related stress. The theory describes the main determinants and consequences of each strategy. Our study demonstrates the importance of recurrent individual considerations about disclosure choices and plans, and offers a theoretical basis for interventions designed to assist persons living with HIV to make the best possible individual decisions regarding disclosure, and thereby reduce HIV-related stress.
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Affiliation(s)
- Lotte Rodkjaer
- Department of Infectious Diseases, Aarhus University Hospital, Aarhus, Denmark.
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Gomersall T, Madill A, Summers LKM. A metasynthesis of the self-management of type 2 diabetes. QUALITATIVE HEALTH RESEARCH 2011; 21:853-871. [PMID: 21429946 DOI: 10.1177/1049732311402096] [Citation(s) in RCA: 58] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
Type 2 diabetes is a metabolic disorder characterized by chronically elevated blood glucose and high risk of comorbidities. In this article we report a metasynthesis of the 21st-Century qualitative research concerning the self-management of type 2 diabetes. We identified 38 relevant articles (sample size range 6 to 175), which were synthesized through a process of iterative reading and theory development. In this literature, authors argued and assumed that diabetes management is influenced by multiple, complex, competing factors, including interpersonal relations, gender, and sociocultural context. Conversely, self-management was sometimes construed as a facet of individual agency and was accepted uncritically, placing accountability for health with patients themselves. We conclude that a satisfactory account of diabetes care would pay attention to the "inner" world, while acknowledging the social and political conditions in which diabetes-related experiences unfold.
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Merten S, Kenter E, McKenzie O, Musheke M, Ntalasha H, Martin-Hilber A. Patient-reported barriers and drivers of adherence to antiretrovirals in sub-Saharan Africa: a meta-ethnography. Trop Med Int Health 2011; 15 Suppl 1:16-33. [PMID: 20586957 DOI: 10.1111/j.1365-3156.2010.02510.x] [Citation(s) in RCA: 125] [Impact Index Per Article: 9.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
This meta-ethnography aims at providing a synthesis and an interpretation of the findings of recent social science research on the questions of retention in antiretroviral therapy (ART) programmes in sub-Saharan Africa (SSA). The literature reviewed comprises ethnographic studies of the barriers to adherence to ART in various cultural settings. The results show that the quality of services, treatment-related costs, as well as the need to maintain social support networks - which can be negatively affected by HIV-related stigma - are important barriers to adherence. In addition, they show how African concepts of personhood are incompatible with the way services are conceived and delivered, targeting the individual. In SSA, individuals must balance physical health with social integrity, which is sometimes achieved by referring to traditional medicine. The ability of local concepts of illness to address social relations in addition to health, together with a historically grounded distrust in Western medicine, explains why traditional medicine is still widely used as an alternative to ART.
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Affiliation(s)
- Sonja Merten
- Swiss Institute of Tropical and Public Health, Basel, Switzerland.
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McDonald K, Slavin S. My body, my life, my choice: practices and meanings of complementary and alternative medicine among a sample of Australian people living with HIV/AIDS and their practitioners. AIDS Care 2011; 22:1229-35. [PMID: 20640948 DOI: 10.1080/09540121003668094] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
In this study we examine the sociocultural meaning and use of complementary and alternative medicine (CAM) by nine people living with HIV/AIDS (PLWHA) and four CAM practitioners. Analysis revealed five themes: focus on health not illness; resistance to antiretroviral therapy and adherence; allopathic medicine as narrow; difficulty disclosing to doctors; and a continuum of CAM that sometimes included conventional medicine and sometimes excluded it entirely. Literature on PLWHA in the West commonly describes them as sophisticated health consumers. We explore the concepts of individual responsibility in relation to health, holism, control and well-being in the context of CAM. We also consider the meaning and significance of CAM and western medicine to comment on the contemporary experience of HIV, including the possible impact of stigma and the perceived limits of allopathic medicine among some PLWHA. Understanding this will enable better insight into the treatment choices of PLWHA, particularly those who may be described as sceptical of conventional medical science.
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Affiliation(s)
- Karalyn McDonald
- Australian Research Centre in Sex, Health and Society, La Trobe University, Melbourne, Australia.
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Kim J, Shin G, Park YM, Lim EJ, Nam HA. Experience of People Living with HIV Working as Caregivers for AIDS Patients. ACTA ACUST UNITED AC 2011. [DOI: 10.12934/jkpmhn.2011.20.4.334] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Affiliation(s)
- Jiyoung Kim
- Assistant Professor, Red Cross College of Nursing, Chung-Ang University, Korea
| | - Gisoo Shin
- Professor, Red Cross College of Nursing, Chung-Ang University, Korea
| | - Young Mi Park
- Assistant Professor, Red Cross College of Nursing, Chung-Ang University, Korea
| | - Eun Ju Lim
- Assistant Professor, Red Cross College of Nursing, Chung-Ang University, Korea
| | - Hyun A Nam
- Assistant Professor, Red Cross College of Nursing, Chung-Ang University, Korea
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Tyer-Viola LA, Duffy ME. The Pregnant Women with HIV Attitude Scale: development and initial psychometric evaluation. J Adv Nurs 2010; 66:1852-63. [PMID: 20557397 DOI: 10.1111/j.1365-2648.2009.05234.x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
AIM This paper is a report of the development and initial psychometric evaluation of the Pregnant Women with HIV Attitude Scale. BACKGROUND Previous research has identified that attitudes toward persons with HIV/AIDS have been judgmental and could affect clinical care and outcomes. Stigma towards persons with HIV has persisted as a barrier to nursing care globally. Women are more vulnerable during pregnancy. An instrument to specifically measure obstetric care provider's attitudes toward this population is needed to target identified gaps in providing respectful care. METHODS Existing literature and instruments were analysed and two existing measures, the Attitudes about People with HIV Scale and the Attitudes toward Women with HIV Scale, were combined to create an initial item pool to address attitudes toward HIV-positive pregnant women. The data were collected in 2003 with obstetric nurses attending a national conference in the United States of America (N = 210). Content validity was used for item pool development and principal component analysis and analysis of variance were used to determine construct validity. Reliability was analysed using Cronbach's Alpha. RESULTS The new measure demonstrated high internal consistency (alpha estimates = 0.89). Principal component analysis yielded a two-component structure that accounted for 45% of the total variance: Mothering-Choice (alpha estimates = 0.89) and Sympathy-Rights (alpha estimates = 0.72). CONCLUSION These data provided initial evidence of the psychometric properties of the Pregnant Women with HIV Attitude Scale. Further analysis is required of the validity of the constructs of this scale and its reliability with various obstetric care providers.
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Affiliation(s)
- Lynda A Tyer-Viola
- Massachusetts General Hospital Institute of Health Professions, Boston, MA, USA.
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Timulak L. Meta-analysis of qualitative studies: a tool for reviewing qualitative research findings in psychotherapy. Psychother Res 2010; 19:591-600. [PMID: 19034804 DOI: 10.1080/10503300802477989] [Citation(s) in RCA: 111] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
Abstract
This article focuses on the presentation of qualitative meta-analysis as a method for reviewing qualitative studies. Qualitative meta-analysis is an attempt to conduct a rigorous secondary qualitative analysis of primary qualitative findings. Its purpose*to provide a more comprehensive description of a phenomenon and an assessment of the influence of the method of investigation on findings*is discussed. The distinctive features of conducting meta-analysis approaches are presented. Several considerations important for conducting qualitative meta-analysis are also discussed. The author uses examples of the first experiences attempted with qualitative meta-analysis in the field of psychotherapy research.
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Affiliation(s)
- Ladislav Timulak
- School of Psychology, Trinity College Dublin, Dublin 2, Ireland.
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Ironson G, Kremer H. Spiritual transformation, psychological well-being, health, and survival in people with HIV. Int J Psychiatry Med 2010; 39:263-81. [PMID: 19967899 DOI: 10.2190/pm.39.3.d] [Citation(s) in RCA: 52] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
OBJECTIVES Although Spiritual Transformation (ST) occurs in a sizable proportion of people with HIV (about 39%), there is little research on the potential benefits of ST with respect to psychological well-being, health, and survival in this population. Our study attempts to fill this gap. METHOD Using a mixed method approach, we related interviews of 147 people with HIV (identifying the presence/absence of ST) to questionnaires measuring demographics, medical history, treatment adherence, physical symptoms, and psychological well-being (i.e., stress, coping, life attitude, and spirituality), and assessments of CD4-counts and viral load and survival 3 to 5 years later. RESULTS At comparable times since HIV-diagnosis and antiretroviral medications prescribed, the presence of ST was significantly associated with better treatment success (undetectable viral loads, higher CD4 counts), better medication adherence, fewer symptoms, less distress, more positive coping, different life attitudes (i.e., existential transcendence, meaning/purpose in life, optimism, death acceptance), more spiritual practices, and increased spirituality. ST was also associated with substance-use recovery and with being African American. Survival up to 5 years was 5.35 times more likely among participants with ST (p(f) = .044). According to a Cox-regression adjusted for baseline CD4-counts, age, race-ethnicity, gender, education, years since HIV-diagnosis, and a history of substance-use problems, ST still reduced the risk of death (HR = 0.07, 95% CI = 0.01-0.53, p = .010). CONCLUSIONS ST has associated benefits for psychological well-being, health, and survival.
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Affiliation(s)
- Gail Ironson
- Department of Psychology, University of Miami, Coral Gables, Florida 33124, USA.
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Kremer H, Ironson G, Kaplan L. The fork in the road: HIV as a potential positive turning point and the role of spirituality. AIDS Care 2009; 21:368-77. [DOI: 10.1080/09540120802183479] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Affiliation(s)
- H. Kremer
- a Department of Psychology , University of Miami , Coral Gables , FL , USA
| | - G. Ironson
- a Department of Psychology , University of Miami , Coral Gables , FL , USA
| | - L. Kaplan
- a Department of Psychology , University of Miami , Coral Gables , FL , USA
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Bondas T, Hall EO. A decade of metasynthesis research in health sciences: A meta-method study. Int J Qual Stud Health Well-being 2009. [DOI: 10.1080/17482620701251684] [Citation(s) in RCA: 40] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
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Chartier M, Araneta A, Duca L, McGlynn LM, Gore-Felton C, Goldblum P, Koopman C. Personal values and meaning in the use of methamphetamine among HIV-positive men who have sex with men. QUALITATIVE HEALTH RESEARCH 2009; 19:504-518. [PMID: 19299756 DOI: 10.1177/1049732309333018] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
Our aim with this qualitative study was to understand the role of personal values, meaning, and impact of drug use among HIV-positive men who have sex with men (MSM) who struggle with methamphetamine use. Participants were 22 MSM recruited from an ethnically diverse county in the San Francisco Bay area of California. Grounded theory was used to analyze the data collected in individual interviews. Emergent constructs of context, meaning, and perceived impact were identified and are described in a theoretical narrative format. The importance of broadening our understanding of HIV and methamphetamine addiction and their interaction is highlighted. This study contributes to the understanding of the complexity of methamphetamine use within the specific population of MSM living with HIV/ AIDS, and suggests possible directions for addressing important maintaining factors like adaptive use and enhancing factors that could contribute to an individual's ability to make better choices based on meaning and personal values.
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Affiliation(s)
- Maggie Chartier
- Pacific Graduate School of Psychology-Stanford Psy.D. Consortium, Palo Alto, California, USA
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46
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Using Qualitative Assessment and Review Instrument software to synthesise studies on older peopleʼs views and experiences of falls prevention. INT J EVID-BASED HEA 2008. [DOI: 10.1097/01258363-200809000-00006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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47
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Greeff M, Phetlhu R, Makoae LN, Dlamini PS, Holzemer WL, Naidoo JR, Kohi TW, Uys LR, Chirwa ML. Disclosure of HIV status: experiences and perceptions of persons living with HIV/AIDS and nurses involved in their care in Africa. QUALITATIVE HEALTH RESEARCH 2008; 18:311-324. [PMID: 18235155 DOI: 10.1177/1049732307311118] [Citation(s) in RCA: 117] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/25/2023]
Abstract
Most people with HIV have disclosed their status to someone, often with mixed results. Most health literature seems to favor disclosure by persons living with acquired immunodeficiency syndrome (AIDS), but it could be that to disclose is not always a good thing. We used a descriptive, qualitative research design to explore the experience of human immunodeficiency virus (HIV) and AIDS stigma of people living with HIV or AIDS and nurses involved in their care in Africa. Focus group discussions were held with respondents. We asked them to relate incidents that they themselves observed, and those that they themselves experienced in the community and in families. Thirty-nine focus groups were conducted in five countries in both urban and rural settings. This article is limited to a discussion of data related to the theme of disclosure only. The sub-themes of disclosure were experiences before the disclosure, the process of disclosure, and responses during and after disclosure.
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Affiliation(s)
- Minrie Greeff
- School of Nursing Science, North-West University, Potchefstroom Campus, Potchefstroom, South Africa.
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48
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Bogart LM, Cowgill BO, Kennedy D, Ryan G, Murphy DA, Elijah J, Schuster MA. HIV-related stigma among people with HIV and their families: a qualitative analysis. AIDS Behav 2008; 12:244-54. [PMID: 17458691 DOI: 10.1007/s10461-007-9231-x] [Citation(s) in RCA: 127] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2006] [Accepted: 03/15/2007] [Indexed: 12/17/2022]
Abstract
We examined the interconnectedness of stigma experiences in families living with HIV, from the perspective of multiple family members. Semi-structured interviews were conducted with 33 families (33 parents with HIV, 27 children under age 18, 19 adult children, and 15 caregivers). Parents were drawn from the HIV Cost and Services Utilization Study, a representative sample of people in care for HIV in US. All of the families recounted experiences with stigma, including 100% of mothers, 88% of fathers, 52% of children, 79% of adult children, and 60% of caregivers. About 97% of families described discrimination fears, 79% of families experienced actual discrimination, and 10% of uninfected family members experienced stigma from association with the parent with HIV. Interpersonal discrimination seemed to stem from fears of contagion. Findings indicate a need for interventions to reduce HIV stigma in the general public and to help families cope with stigma.
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Affiliation(s)
- Laura M Bogart
- RAND Corporation, 1776 Main Street, PO Box 2138, Santa Monica, CA 90407-2138, USA.
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Rajabiun S, Mallinson RK, McCoy K, Coleman S, Drainoni ML, Rebholz C, Holbert T. "Getting me back on track": the role of outreach interventions in engaging and retaining people living with HIV/AIDS in medical care. AIDS Patient Care STDS 2007; 21 Suppl 1:S20-9. [PMID: 17563286 DOI: 10.1089/apc.2007.9990] [Citation(s) in RCA: 83] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
This qualitative study investigated the process of engagement in HIV medical care from the perspective of people living with HIV/AIDS (PLWHA). In-depth interviews were conducted with 76 participants in six cities. All participants were considered underserved because of histories of substance use, mental illness, incarceration, homelessness, or cultural barriers to the traditional health care system. A semistructured interview guide elicited narratives related to health care and the role of program interventions in facilitating access to care. Data analysis revealed that participants cycled in and out of care, a process that was influenced by (1) their level of acceptance of being diagnosed with HIV, (2) their ability to cope with substance use, mental illness, and stigma, (3) their health care provider relationships, (4) the presence of external support systems, and (5) their ability to overcome practical barriers to care. Outreach interventions played a role in connecting participants to care by dispelling myths and improving knowledge about HIV, facilitating access to HIV care and treatment, providing support, and reducing the barriers to care. The findings suggest that outreach programs can interrupt this cyclical process and foster sustained, regular HIV care for underserved PLWHA by conducting client-centered risk assessments to identify and reduce sources of instability and improve the quality of provider relationships; implementing strategies that promote healthy practices; creating a network of support services in the community; and supporting adherence through frequent follow-ups for medication and appointment keeping.
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Affiliation(s)
- Serena Rajabiun
- Health and Disability Working Group, Boston University School of Public Health, Boston, Massachusetts 02210, USA.
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50
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Baumgartner LM. The incorporation of the HIV/AIDS identity into the self over time. QUALITATIVE HEALTH RESEARCH 2007; 17:919-31. [PMID: 17724104 DOI: 10.1177/1049732307305881] [Citation(s) in RCA: 60] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/16/2023]
Abstract
In the mid-1990s HIV/AIDS transitioned from a terminal illness to a chronic disease because of medical advances. In this qualitative study the author examines how people incorporate the HIV/AIDS identity into their selves at three points in time. Findings demonstrate a five-component process, including diagnosis, postdiagnosis turning point, immersion, post-immersion turning point, and integration. In addition, the disclosure process corresponds to a particular component of incorporation. The author makes comparisons with the incorporation process of other chronic illness. Findings augment the literature on HIV/AIDS, chronic illness, and identity and have practical implications for HIV/AIDS educators.
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