LGBTQ+ Persons’ Experiences of Parenthood in the Context of Maternal and Child Health Care: A Meta-ethnography
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ABSTRACT:
SUBMITTER: Haugland C
PROVIDER: S-EPMC10286167 | biostudies-literature | 2023 Jan
REPOSITORIES: biostudies-literature
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Project description:This study aimed to explore and describe the experiences of LGBTQ student-athletes to identify ways in which athletic staff, coaches, and others can support LGBTQ youth's safe participation in sports. Guided by the preferred reporting items for systematic reviews (PRISMA) and eMERGe reporting guidance. We conducted a meta-ethnography to synthesize qualitative research focused on student-athletes’ experiences. Fourteen studies were included in the meta-ethnography published between 1973 and 2022. Four themes were identified: (1) experiences of discrimination and violence; (2) perceived stigma; (3) internalized prejudice; and (4) coping and team support, and they were used to generate a line of argument model, which explains the stress process of LGBTQ student-athletes in the sports. LGBTQ student-athletes experience persistent discrimination in college sports, which poses a significant risk to their mental health. Meanwhile, this study identified that qualitative research on LGBTQ youth sports participation is lacking in many regions of the world and lacks knowledge of the sports participation experience of bisexual, gay, and transgender students. These findings revealed a way for research on LGBTQ-related issues and future policy and practice on LGBTQ youth-related issues in sports.
| S-EPMC10275786 | biostudies-literature
Project description:AimsTo synthesize evidence and knowledge from published research about nurses' experiences of nurse-patient relationships with adult patients in general, acute inpatient hospital settings.BackgroundWhile primary research on nurses' experiences has been reported, it has not been previously synthesized.DesignMeta-ethnography.Data sourcesPublished literature from Australia, Europe, and North America, written in English between January 1999-October 2009 was identified from databases: CINAHL, Medline, British Nursing Index and PsycINFO.Review methodsQualitative studies describing nurses' experiences of the nurse-patient relationship in acute hospital settings were reviewed and synthesized using the meta-ethnographic method.ResultsSixteen primary studies (18 papers) were appraised as high quality and met the inclusion criteria. The findings show that while nurses aspire to develop therapeutic relationships with patients, the organizational setting at a unit level is strongly associated with nurses' capacity to build and sustain these relationships. The organizational conditions of critical care settings appear best suited to forming therapeutic relationships, while nurses working on general wards are more likely to report moral distress resulting from delivering unsatisfactory care. General ward nurses can then withdraw from attempting to emotionally engage with patients.ConclusionThe findings of this meta-ethnography draw together the evidence from several qualitative studies and articulate how the organizational setting at a unit level can strongly influence nurses' capacity to build and sustain therapeutic relationships with patients. Service improvements need to focus on how to optimize the organizational conditions that support nurses in their relational work with patients.
| S-EPMC3617468 | biostudies-literature
Project description:Literature describing effective population interventions related to the pregnancy, birth, and post-birth care of international migrants, as defined by them, is scant. Hence, we sought to determine: 1) what processes are used by migrant women to respond to maternal-child health and psychosocial concerns during the early months and years after birth; 2) which of these enhance or impede their resiliency; and 3) which population interventions they suggest best respond to these concerns.Sixteen international migrant women living in Montreal or Toronto who had been identified in a previous study as having a high psychosocial-risk profile and subsequently classified as vulnerable or resilient based on indicators of mental health were recruited. Focused ethnography including in-depth interviews and participant observations were conducted. Data were analyzed thematically and as an integrated whole.Migrant women drew on a wide range of coping strategies and resources to respond to maternal-child health and psychosocial concerns. Resilient and vulnerable mothers differed in their use of certain coping strategies. Social inclusion was identified as an overarching factor for enhancing resiliency by all study participants. Social processes and corresponding facilitators relating to social inclusion were identified by participants, with more social processes identified by the vulnerable group. Several interventions related to services were described which varied in type and quality; these were generally found to be effective. Participants identified several categories of interventions which they had used or would have liked to use and recommended improvements for and creation of some programs. The social determinants of health categories within which their suggestions fell included: income and social status, social support network, education, personal health practices and coping skills, healthy child development, and health services. Within each of these, the most common suggestions were related to creating supportive environments and building healthy public policy.A wealth of data was provided by participants on factors and processes related to the maternal-child health care of international migrants and associated population interventions. Our results offer a challenge to key stakeholders to improve existing interventions and create new ones based on the experiences and views of international migrant women themselves.
| S-EPMC3733625 | biostudies-other
Project description:Prostate cancer affects one in nine men, so understanding patients' and their partners experiences is crucial for developing effective treatments. The purpose of this review was to synthesis and report the experiences and views of persons with prostate cancer and their partners.MethodsA qualitative evidence synthesis (QES) was conducted following the eMERGe reporting guideline. Six databases were searched for the relevant literature, and the Critical Appraisal Skills Program (CASP) tool was used for quality appraisal.ResultsA total of 1372 papers were identified, and 36 met the inclusion criteria. Four themes emerged: quality of life, relationships and dynamics, treatment journey and survivorship and aftercare.ConclusionsProstate cancer's impact on patients and partners is significant, requiring comprehensive support, holistic care, tailored assistance, and research into therapies to minimize adverse effects and address emotional distress and relationship strain. Prostate cancer treatment causes physical changes, triggering feelings of loss and grief, and affects coping mechanisms. Drawing on emotional support and education is vital for boosting confidence and resilience, as many patients and partners face fears of recurrence and lifestyle changes, highlighting the need for tailored information and presurgery support.
| S-EPMC11311449 | biostudies-literature
Project description:BackgroundAlthough the number of children living with complex care needs (CCN) is increasing worldwide, there is limited data on the experience of fathers caring for children with CCN. This paper reports on findings specific to fathers' experiences of caring for their child with CCN and highlights recommendations provided for parents of children with CCN, service providers, and policymakers. The findings emerged from a larger study designed to examine how Canadian families of children with CCN participate in society.MethodsWe used the qualitative research approach of ethnography and arts-based methodologies (ecomaps and photovoice) as well as purposive and snowball sampling techniques. Four parents were engaged as advisors and twenty-nine fathers participated in interviews (all were married or in a relationship; age range of 28 to 55 years). In line with an ethnographic approach, data analysis involved several iterative steps including comparing data from the first, second, and third set of interviews and refining themes.ResultsOne overarching theme, striving to be there for the child with CCN, was identified. Five supporting themes further exemplified how fathers strived to be there for their child: 1) contributing to the parental team through various roles; 2) building accessibility through adaptation; 3) engaging in activities with the child; 4) expressing admiration and pride in their children; and 5) meaning making. Recommendations for parents included making and nurturing connections and asking for help while recommendations for healthcare and social service providers included communicating authentically with families and listening to parents. Fathers also indicated that leadership and funding for programs of families of children with CCN should be priorities for policymakers.ConclusionsIn addition to documenting fathers' active involvement in their child's care and development, our findings provide new insights into how fathers make participation in everyday life accessible and inclusive for their children. Study findings also point to 1) priority areas for policymakers (e.g., accessible physical environments); 2) factors that are critical for fostering collaborative care teams with fathers; and 3) the need for complex care teams in the adult health care system. Implications for those providing psychosocial support for these families are noted as well as knowledge gaps worthy of future exploration such as the role of diversity or intersectionality in fathering children with CCN.
| S-EPMC10835869 | biostudies-literature
Project description:AimTo explore and synthesise findings from qualitative studies on adult patients' experiences of day surgery and the processes of recovery.BackgroundThere has been a shift in the practice of elective surgery, from inpatient to ambulatory treatment. Accordingly, more patients are undergoing day surgery and expected to care for themselves at home. To our knowledge, an updated metasynthesis on patients' experiences of day surgery across diverse contexts and continents is lacking.DesignMeta-ethnography.MethodsMEDLINE, EMBASE and CINAHL were systematically searched for qualitative research in English published between 2006 and 2023. Noblit and Hare's meta-ethnographic approach guided the synthesis of findings from 12 qualitative studies, and the eMERGe Reporting Guidance was used in the writing of this article.ResultsFour themes were revealed: (1) requests for tailored information, (2) challenges of recognising and understanding postoperative symptoms, (3) being dependent on continuous professional and personal support and (4) calling for individual adaptation.ConclusionOur meta-ethnography indicates there is a need to improve information provision to better prepare patients for the processes of day surgery and recovery and promote their self-care abilities. Our findings highlight the importance of ensuring adequate levels of individualised care and support throughout the treatment process.Relevance to clinical practiceTo improve quality of care in day surgery practice, implementation of interventions to enhance information provision and promote self-care during recovery at home may be considered. Pre-admission appointments that incorporate provision of tailored information and assessment of the patients' individual needs of care and support, home conditions and access to assistance from family/friends can be recommended.
| S-EPMC10701296 | biostudies-literature
Project description:ObjectiveMenopause and the changes it brings to a woman's life necessitate a comprehensive approach to face and experience the transition. This paper aims at synthesizing results from qualitative studies of menopausal experiences among Chinese and other women of similar ethnicity and culture.Design and methodA comprehensive search strategy of multiple databases along with bibliographic hand searches was employed to identify qualitative studies published in English peer-reviewed journals between 2008 and 2022 focused on the menopausal experiences (peri and post-menopause) of Chinese and other women of similar ethnic backgrounds. Twelve studies met the inclusion criteria. The final sample consisted of 238 women aged between 40 to 60 years who had experienced menopausal symptoms. This qualitative systematic literature review adopted Noblit and Hare's seven-stage theoretical meta-ethnographic approach to construct an inductive and interpretive form of synthesis and subsequent analysis.Syntheses of findingsThe synthesis of primary data identified four key concepts that entitle women's menopausal experiences: being menopausal, ramifications on well-being, family and social support around menopause, and healthcare throughout menopause. The subsequent second-order interpretation revealed that women accepted the inevitability of the natural aging process in the decline of sexual drive, reinvented relationships with partners, and expressed the significance of a supportive environment in order to successfully navigate the transition. Third-order interpretations sought to establish a link between physiological complications, loss of femininity, patriarchal-dominated societal norms, and a support system that spans the entire menopause experience. Healthcare's contribution has also been deemed to be insufficient due to a lack of information and empathy from health experts. Negligence or reluctance to seek healthcare and skepticism toward hormone replacement therapy (HRT) had also been a source of concern, as they have had the potential to exacerbate medical difficulties and emotional turmoil.Conclusions and implications for practiceA comprehensive approach that considers women's physiological and psychological well-being and major attempts to change cultural beliefs and norms about women's sexual health may be effective in aiding menopausal women during their transition. Additionally, appropriate guidelines and management should be in place to enable women to address menopause difficulties effectively with the assistance of healthcare experts and the support of their families and community.
| S-EPMC10499211 | biostudies-literature
Project description:ObjectiveTransgender and non-binary individuals frequently engage with healthcare services to obtain gender-affirming care. Little data exist on the experiences of young people accessing gender care. This systematic review and meta-ethnography aimed to identify and synthesise data on youths' experiences accessing gender-affirming healthcare.MethodA systematic review and meta-ethnography focusing on qualitative research on the experiences of transgender and non-binary youth accessing gender care was completed between April-December 2020. The following databases were used: PsychINFO, MEDLINE, EMBASE, and CINAHL. The protocol was registered on PROSPERO, international prospective register of Systematic Reviews (CRD42020139908).ResultsTen studies were included in the final review. The sample included participants with diverse gender identities and included the perspective of parents/caregivers. Five dimensions (third-order constructs) were identified and contextualized into the following themes: 1.) Disclosure of gender identity. 2.) The pursuit of care. 3.) The cost of care. 4.) Complex family/caregiver dynamics. 5.) Patient-provider relationships. Each dimension details a complicated set of factors that can impact healthcare navigation and are explained through a new conceptual model titled "The Rainbow Brick Road".ConclusionThis synthesis expands understanding into the experience of transgender and non-binary youth accessing gender-affirming healthcare. Ryvicker's behavioural-ecological model of healthcare navigation is discussed in relation to the findings and compared to the authors' conceptual model. This detailed analysis reveals unique insights on healthcare navigation challenges and the traits, resources, and infrastructure needed to overcome these. Importantly, this paper reveals the critical need for more research with non-binary youth and research which includes the population in the design.
| S-EPMC8432766 | biostudies-literature
Project description:ObjectiveOur aim was to explore how the care managers put the complex care manager task into practice and how they perceived their task, which was to facilitate effective, person-centred treatment for stress-related disorder concordant with evidence-based guidelines in primary care.DesignThis was a qualitative study using examination reports from the course for care managers. Systematic text condensation according to Malterud was used for the analysis.SettingPrimary health care centres.SubjectTwenty-eight newly educated care managers in primary health care participated in the study. The median age was 50 (31-68) years. Twenty-seven were women and one was a man. Twenty-one were employed as nurses and seven as counsellors.ResultsThe informants perceived the role as care manager as meaningful but at times complicated. To participate in teams and to work closely with the general practitioner was experienced as important. The co-ordinating function was emphasised as especially important, as well as the increased continuity in care. The dual role as care manager and counsellor was sometimes experienced as problematic.ConclusionThe informants took advantage of the knowledge they had attained during the course. They perceived themselves as being a bridge between patients and other professionals. The result of having dual roles at the primary health care centre unexpectedly revealed difficulties for some professionals. The nurses seemed more familiar with the new way of working.
| S-EPMC6850534 | biostudies-literature
Project description:IntroductionBeing notified that the fetus has died in utero is an extremely challenging situation for parents, involving emotional chaos, shock, and despair. Healthcare professionals also find it challenging to cope with these situations. The purpose of this study was to explore parents' experiences of fetal death and the care they received between diagnosis and birth induction.MethodsWe conducted a meta-ethnography in accordance with Noblit and Hare's seven phases and the eMERGe reporting guidance. Literature searches were conducted in CINAHL, MEDLINE, PubMed and PsycInfo in October and November 2022 and updated in August 2024. A PRISMA flowchart was used to illustrate the search process and quality assessment was performed according to CASP.ResultsSeven studies were included in the meta-ethnography. 'Realizing the unreal by taking control of the uncontrollable' emerged as an overarching metaphor through a reciprocal translation of the data. The metaphor illustrated four main themes: 1) Falling into the unknown, 2) Needing care during vulnerable times, 3) Communicating the meaningless, and 4) Navigating the terrain. Receiving the diagnosis resulted in feelings of chaos. However, healthcare providers possessing empathetic communication skills helped them to cope with the situation and prepare for birth.ConclusionsOptimal care performance, where communication is central, is a useful strategy for healthcare professionals in their encounters with parents who experience fetal death. Training is vital in order to provide good care and support for parents throughout the process.
| S-EPMC11917500 | biostudies-literature