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Joseph G. The role of sovereignty in Indigenous community-based health interventions: A qualitative metasynthesis. Am J Community Psychol 2024; 73:216-233. [PMID: 37058286 DOI: 10.1002/ajcp.12670] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/01/2021] [Revised: 06/01/2022] [Accepted: 01/10/2023] [Indexed: 06/19/2023]
Abstract
Indigenous peoples around the world suffer from health disparities attributed to a plethora of risk factors and social determinants of health stemming from colonialism and systemic oppression. Community-based health interventions have been identified as a means for addressing and reducing Indigenous health disparities by allowing for Indigenous sovereignty to be respected and centered. However, sovereignty relating to Indigenous health and well-being is underresearched. The present article explores the role of sovereignty in Indigenous community-based health interventions. A qualitative metasynthesis was conducted among 14 primary research studies co-authored by Indigenous people describing and evaluating Indigenous community-based health interventions. Five conceptual themes emerged as aspects of sovereignty which benefit Indigenous health and well-being outcomes: integration of culture; relocation of knowledge; connectedness; self-actualization; and stewardship. Implications are discussed, with the goal of creating a decolonial framework rooted in Indigenous epistemologies and perspectives for how sovereignty impacts Indigenous health, as well as strengthening a clear need for further research on and praxis of sovereignty in Indigenous healthcare.
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Affiliation(s)
- Gillian Joseph
- Center for World Indigenous Studies, Olympia, Washington, USA
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Girard M, Fernet M, Godbout N. "Like A Mouse Pursued By the Snake": A Qualitative Metasynthesis on the Experiences of Revictimization Among Women Survivors of Childhood Sexual Abuse and Partner Violence. Trauma Violence Abuse 2023:15248380231214783. [PMID: 38049952 DOI: 10.1177/15248380231214783] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/06/2023]
Abstract
A metasynthesis was performed on 15 qualitative studies to document the experience of revictimization by an intimate partner among women, based on survivors' perspectives on their sustained childhood sexual abuse and intimate partner violence victimization. Results identified two main conceptual categories: (a) Barriers to action: A belief system reflecting learned helplessness that hinders women's abilities to protect themselves and prevent further abuses, and (b) Broken internal compass: Cognitive elements blurring women's risk evaluation capacities and reference points limiting their ability to break the cycle of revictimization. These findings support the need to examine cognitive distortions and false beliefs in intervention practices and suggest valuable guidelines for practitioners. As the responsibility for violence always lies with the perpetrator, this study should not be interpreted as blaming women for their victimization, but instead, as a way to give women a voice about their experiences and give them a sense of power in the prevention of violence.
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Techau A, Gamm E, Roberts M, Garcia L. The Lived Experience of Medication for Opioid Use Disorder: Qualitative Metasynthesis. J Addict Nurs 2023; 34:E119-E134. [PMID: 37669351 PMCID: PMC10510791 DOI: 10.1097/jan.0000000000000475] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
PURPOSE OF THE STUDY Buprenorphine and methadone, when used as maintenance therapy in opioid use disorder (OUD), can significantly reduce the risk of death after an opioid overdose. Despite the many benefits, medication for OUD (MOUD) remains controversial and underutilized. The aim of this study was to (a) identify studies that explicate the lived experience of MOUD, (b) conduct a methodologically sound critical quality assessment, (c) conduct a metasynthesis of identified qualitative studies, and (d) analyze the results through the lenses of critical social justice, feminist standpoint, and social theories to inform a more culturally responsive, effective, and holistic approach to treatment to increase the utilization of and receptivity to MOUD in the treatment of OUDs. DESIGN AND METHODS Metasynthesis is the deliberate process of synthesizing data from multiple qualitative studies to create a new interpretation of previously published research. Our metasynthesis focused on forming a new interpretation of the lived experience of MOUD. Of the 292 studies identified, eight met inclusion criteria. The overall quality of the studies was variable. The study population included adults aged ≥ 18 years with OUD or dependency. RESULTS Metasynthesis produced three overarching themes: (a) The duplexity of MOUD creates ambivalence in how a person experiences MOUD; (b) the structure of treatment and systemic influences matter, and (c) MOUD as a stepping-stone with multiple meanings in recovery. IMPLICATIONS Understanding experiential dualities allows professionals to see from other perspectives and can inform interventions and treatment structures as well as serve as a backdrop for social change. The synthesized new meaning of MOUD was an ambivalent experience influenced by intersectionality.
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Stephen S, Bell L, Khan M, Love R, Macintosh H, Martin M, Moran R, Price E, Whitehead B, Elliott R. Comparing helpful and hindering processes in good and poor outcome cases: A qualitative metasynthesis of eight Hermeneutic Single Case Efficacy Design studies. Psychother Res 2021; 32:389-403. [PMID: 34088254 DOI: 10.1080/10503307.2021.1934746] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
Abstract
Objective: We tested qualitative metasynthesis of a series of Hermeneutic Single Case Efficacy Design (HSCED) studies as a method for comparing within-session processes that may explain good and poor therapeutic outcome. Method: We selected eight HSCED studies according to change in clients' scores on the Strathclyde Inventory (SI), a brief self-report instrument used to measure outcome in person-centered psychotherapy. Four of the case studies investigated the experience of clients whose pre-post change in SI scores showed improvement by the end of therapy, and the other four focused on clients whose change in SI scores indicated deterioration. We conducted a qualitative metasynthesis, adopting a generic descriptive-interpretive approach to analyze and compare the data generated by the HSCED studies. Results: In contrast to improvers, deteriorators appeared to be less ready to engage in therapeutic work at the beginning of therapy, and found the process more difficult; their therapists were less able to respond to these difficulties in a responsive, empathic manner; deteriorators were less able to cope successfully with changes of therapist and, eventually, gave up on therapy. Conclusion: We found that our qualitative metasynthesis of a series of HSCED studies produced a plausible explanation for the contrasting outcomes that occurred.
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Affiliation(s)
- Susan Stephen
- School of Psychological Sciences & Health, University of Strathclyde, Glasgow, UK
| | - Laura Bell
- School of Psychological Sciences & Health, University of Strathclyde, Glasgow, UK
| | - Maha Khan
- School of Psychological Sciences & Health, University of Strathclyde, Glasgow, UK
| | - Ruth Love
- School of Psychological Sciences & Health, University of Strathclyde, Glasgow, UK
| | - Hannah Macintosh
- School of Psychological Sciences & Health, University of Strathclyde, Glasgow, UK
| | - Melanie Martin
- School of Psychological Sciences & Health, University of Strathclyde, Glasgow, UK
| | - Rebecca Moran
- School of Psychological Sciences & Health, University of Strathclyde, Glasgow, UK
| | - Emily Price
- School of Psychological Sciences & Health, University of Strathclyde, Glasgow, UK
| | - Brigid Whitehead
- School of Psychological Sciences & Health, University of Strathclyde, Glasgow, UK
| | - Robert Elliott
- School of Psychological Sciences & Health, University of Strathclyde, Glasgow, UK
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Shannon AK, Melendez-Torres GJ, Hennegan J. How do women and girls experience menstrual health interventions in low- and middle-income countries? Insights from a systematic review and qualitative metasynthesis. Cult Health Sex 2021; 23:624-643. [PMID: 32116149 DOI: 10.1080/13691058.2020.1718758] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/18/2019] [Accepted: 01/16/2020] [Indexed: 06/10/2023]
Abstract
Increasing recognition of the difficulties women and adolescent girls face during menstruation has the prompted rapid implementation of menstrual health programmes and policies. Yet, there remains limited understanding of the influence of these interventions on individuals' menstrual experiences. We systematically reviewed and synthesised qualitative studies of participant experiences of menstrual health interventions. Included studies were undertaken in 6 countries (India, Uganda, Kenya, Ethiopia, Zimbabwe, South Africa) and involved over 900 participants. Interventions focused on menstrual product or education provision. Only 6 of the 12 included studies were rated as high or medium trustworthiness. Exposure to new menstrual products led to changes in women's and girls' expectations of what a menstrual material should offer, with recipients highly valuing reduced fears of leakage and improved freedom of movement. After learning how to use new products or receiving educational materials, women and girls reported feeling more empowered and aware of the physiological process of menstruation, and in some cases wanted to share this knowledge with others in their communities. For each intervention, the process of introduction, trial and error, and acceptance of the new technologies or information was influenced by the sociocultural environment including parents, peers and teachers.
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Affiliation(s)
- Alexandra K Shannon
- Department of Population, Family and Reproductive Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - G J Melendez-Torres
- Peninsula Technology Assessment Group, College of Medicine and Health, University of Exeter, Exeter, UK
| | - Julie Hennegan
- Department of Environmental Health and Engineering, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
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Parenti G, Tomaino SCM, Cipolletta S. The experience of living with rheumatoid arthritis: A qualitative metasynthesis. J Clin Nurs 2020; 29:3922-3936. [PMID: 32702139 DOI: 10.1111/jocn.15428] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2020] [Revised: 06/30/2020] [Accepted: 07/10/2020] [Indexed: 12/12/2022]
Abstract
AIMS AND OBJECTIVES To develop a model of understanding of how rheumatoid arthritis (RA) affects daily life based on a third-order interpretation of qualitative findings. BACKGROUND Rheumatoid arthritis is a chronic condition subject to a progressive deterioration of joints, limiting the ability to move and causing severe impairment in patients' lives. DESIGN A qualitative metasynthesis. METHODS CINHAL, ProQuest, PsycINFO, PubMed, SCOPUS and Web of Science databases were searched for relevant studies applying appropriate criteria. Screening and selection of studies were performed following the PRISMA guidelines and the PRISMA checklist was completed. Thirty-eight qualitative articles were retrieved: in total, 17 were excluded for failing to meet inclusion criteria, and 21 were considered for synthesis. Data analysis followed a third-order interpretation of data for synthesising qualitative research. RESULTS Findings led to the creation of a model consisting of two overarching categories: "rheumatoid arthritis impact on life domains" and "Confronting the illness," and two cross-sectional codes: "Health" and "Independence and normality." CONCLUSION This meta-study provides a model that is both inclusive of participants' own viewpoint and solidly grounded in a health psychology model. RELEVANCE TO CLINICAL PRACTICE The model can be highly informative for both practitioners and researchers in developing tailored interventions of support and prevention.
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Affiliation(s)
- Giulia Parenti
- Department of General Psychology, University of Padua, Padova, Italy
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Jepsen SL, Haahr A, Eg M, Jørgensen LB. Coping with the unfamiliar: How do children cope with hospitalization in relation to acute and/or critical illness? A qualitative metasynthesis. J Child Health Care 2019; 23:534-550. [PMID: 30453743 DOI: 10.1177/1367493518804097] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
The aim of this study was to identify and describe how young children cope with hospitalization in relation to acute and/or critical illness. The study is a qualitative metasynthesis inspired by the approach described by Sandelowski and Barroso. Based on an exhaustive literature search, six studies were included. Data were analyzed through a taxonomic analysis. The findings revealed that the hospitalized children face a variety of challenges during admission to the hospital due to acute and/or critical illness. The main challenge was that hospitalized children strive to cope with different aspects of 'the unfamiliar' that emerge in their illness treatment and hospital stay. The unfamiliar refers to unknown experiences on a physical, emotional, and relational level. Subsequently, children cope with the unfamiliar by striving to convert the hospital stay into something more similar to everyday life, using strategies to secure basic needs and constructing familiarity in the hospital stay. The consequences of the children's coping behavior are discussed and how children strive to keep their integrity intact during illness and hospitalization are revealed.
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Affiliation(s)
| | - Anita Haahr
- VIA Health Promotion & Rehabilitation, Centre for Research and Development, VIA University College, Denmark
| | - Marianne Eg
- Department of Paediatrics, Regional Hospital Viborg, Viborg, Denmark.,The Centre for Nursing Research, Viborg, Denmark
| | - Lene Bastrup Jørgensen
- Department of Clinical Medicine, Aarhus University, Aarhus, Denmark.,Cairos A/S, Copenhagen, Denmark
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Abstract
Qualitative metasynthesis, developed as an interpretative and inductive methodology, is increasingly influenced by standards from evidence-based medicine, established as a strategy to support policy decisions and guidelines. Currently, principles and procedures from the format developed for systematic reviews are often applied for review and synthesis of all kinds of evidence, including results from qualitative studies. In this article, I substantiate these claims, discussing benefits to be harvested and warnings to be given when qualitative metasynthesis approaches the evidence-based medicine methodology. Situating my exploration in the context of clinical practice, I contrast missions and values of these methodologies regarding review and synthesis of research literature, highlighting potential mismatches between ontology and epistemology, emphasizing challenges regarding sample, analysis, and transferability. Approving systematic and transparent strategies as generic for such purposes, I warn against the idea that methodology developed for evidence-based medicine is a universal gold standard for synthesis of research evidence.
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Affiliation(s)
- Kirsti Malterud
- 1 Uni Research Health, Bergen, Norway
- 2 University of Bergen, Norway
- 3 University of Copenhagen, Denmark
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Griffiths R, Mansell W, Edge D, Tai S. Sources of Distress in First-Episode Psychosis: A Systematic Review and Qualitative Metasynthesis. Qual Health Res 2019; 29:107-123. [PMID: 30066602 DOI: 10.1177/1049732318790544] [Citation(s) in RCA: 30] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
In this study, we aim to increase our understanding of the self-reported sources of distress among people who have experienced first-episode psychosis. Following a systematic literature search, 33 relevant studies containing first-person accounts of first-episode psychosis were identified, which were synthesized using thematic analysis. Two interrelated superordinate themes were identified: intrapersonal distress and interpersonal distress. Participants reported multiple, diverse, and multifaceted sources of distress across both themes. These were substantially different from those routinely recognized and targeted in clinical practice. This review suggests that practitioners who maintain a stance of genuine curiosity about the potential sources of distress for this population will be perceived as more helpful. The findings also highlight the importance of being service user-led when planning and delivering mental health care. Additional clinical and research implications are discussed.
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Affiliation(s)
- Robert Griffiths
- 1 Greater Manchester Mental Health NHS Foundation Trust, Manchester, United Kingdom
| | - Warren Mansell
- 2 The University of Manchester, Manchester, United Kingdom
| | - Dawn Edge
- 2 The University of Manchester, Manchester, United Kingdom
| | - Sara Tai
- 2 The University of Manchester, Manchester, United Kingdom
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Rivas C, Matheson L, Nayoan J, Glaser A, Gavin A, Wright P, Wagland R, Watson E. Ethnicity and the prostate cancer experience: a qualitative metasynthesis. Psychooncology 2016; 25:1147-1156. [PMID: 27416079 PMCID: PMC5096040 DOI: 10.1002/pon.4222] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2016] [Revised: 07/10/2016] [Accepted: 07/11/2016] [Indexed: 12/29/2022]
Abstract
Objectives To summarize black and minority ethnic (BME) patients' and partners experiences of prostate cancer by examining the findings of existing qualitative studies. Methods We undertook a systematic metasynthesis of qualitative studies using a modified version of Noblit and Hare's “meta‐ethnography” approach, with a 2000‐2015 search of 7 databases. Results Thirteen studies of men from US and UK BME groups were included. We explored constructs with BME‐specific features. Health care provider relationships, formation of a spiritual alliance with God (which enhanced the participants' feeling of empowerment and ability to cope with the cancer), and living on for others (generally to increase cancer awareness), often connected to spiritual regrowth, were the 3 constructs most commonly reported. A magnified effect from erectile dysfunction was also common. Initially, this affected men's disclosure to others about their cancer and their sexual problems, but eventually men responded by shifting their conceptualizations of masculinity to sustain self and social identities. There was also evidence of inequality resulting from financial constraints and adversity that necessitated resilience in coping. Conclusions The prostate cancer experience of BME men and their partners is affected by a complex intersection of ethnicity with other factors. Health care services should acknowledge this. If providers recognize the men's felt masculinities, social identities, and spiritual beliefs and their shifting nature, services could be improved, with community as well as individual benefits. More studies are needed in diverse ethnic groups.
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Affiliation(s)
- Carol Rivas
- Faculty of Health Sciences, University of Southampton, Southampton, UK.
| | - Lauren Matheson
- Faculty of Health and Life Sciences, Oxford Brookes University, Oxford, UK
| | - Johana Nayoan
- Faculty of Health Sciences, University of Southampton, Southampton, UK
| | - Adam Glaser
- Leeds Institute of Cancer and Pathology, Faculty of Medicine and Health, University of Leeds, Leeds, UK
| | - Anna Gavin
- School of Medicine, Dentistry and Biomedical Sciences, Centre for Public Health, Queen's University Belfast, Belfast, UK
| | - Penny Wright
- Leeds Institute of Cancer and Pathology, Faculty of Medicine and Health, University of Leeds, Leeds, UK
| | - Richard Wagland
- Faculty of Health Sciences, University of Southampton, Southampton, UK
| | - Eila Watson
- Faculty of Health and Life Sciences, Oxford Brookes University, Oxford, UK
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Abstract
BACKGROUND Inpatient psychiatric nurses are a large workforce, but their work is poorly articulated and thus poorly understood outside of the professional inpatient community. OBJECTIVE To learn how inpatient psychiatric nurses depict their work, define important aspects of their role, and view the impact of the unit environment on their clinical practice. DESIGN Metasynthesis of research that has focused on the ideas and perceptions of inpatient psychiatric nurses around their role and practice on inpatient psychiatric units. RESULTS Three themes emerged from the analysis; the first was an umbrella for three important aspects of nursing work: the nurses' efforts to forge engagement with patients; their activities which maintained the safety of the unit and interventions nurses viewed as educating/empowering patients. The second theme captures the conditions that enabled nurses to do this work such as a cohesive nursing team and their sense of self-direction in their role. The final theme centers on difficulties nurses encountered in enacting their role which included multiple responsibilities for patient care and management of the milieu; intense work often with low visibility and scant support within the organization. CONCLUSIONS Nurses need to articulate their practice so they can assert for the staffing and resources needed to keep units safe and promote patients' well-being, strive toward quality, and promote the development of the specialty.
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Affiliation(s)
- Kathleen R Delaney
- Kathleen R. Delaney, PhD, PMH-NP, FAAN, Professor, Rush College of Nursing, Chicago, IL, USA
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