The essence of healing from sexual violence: A qualitative metasynthesis

A qualitative metasynthesis was conducted to identify the essence of healing from sexual violence, as described by adults who experienced it as children or as adults. Based on the findings of 51 reports, four domains of healing were identified: (a) managing memories, (b) relating to important others, (c) seeking safety, and (c) reevaluating self. The ways of healing within each domain reflected opposing responses. The dialectical process identified for each of the four domains include, respectively: (a) calling forth memories, (b) regulating relationships with others, (c) constructing an “as‐safe‐as‐possible” lifeworld, and (d) restoring a sense of self. These complex processes resulted in a new reality for the participants that was based on a greater sense of agency and provided a more satisfying life course. © 2009 Wiley Periodicals, Inc. Res Nurs Health 32: 366–378, 2009     

The social trajectory of brain tumor: a qualitative metasynthesis

Purpose: Research indicates that strong social ties can buffer the adverse effects of chronic illness on psychological well-being. Brain tumor typically leads to serious functional impairments that affect relationships and reduce social participation. This metasynthesis aimed to identify, appraise and integrate the findings of qualitative studies that reveal the impact of brain tumor on social networks.

Methods: Four major databases (PubMed, CINAHL, Cochrane Library and PsycINFO) were systematically searched from inception to September 2016 for qualitative studies that reported findings on the impact of primary brain tumor on social networks during adulthood. Twenty-one eligible studies were identified and appraised according to the Consolidated Criteria for Reporting Qualitative Research. Key findings of these studies were integrated to form superordinate themes.

Results: The metasynthesis revealed the core themes of: 1) Life disrupted; 2) Navigating the new reality of life; and 3) Social survivorship versus separation.

Conclusions: Multiple changes typically occur across the social trajectory of brain tumor, including a loss of pre-illness networks and the emergence of new ones. Understanding the barriers and facilitators for maintaining social connection may guide interventions for strengthening social networks and enhancing well-being in the context of brain tumor.

• Implications for rehabilitation

• Social networks and roles are disrupted throughout the entire trajectory of living with brain tumor

• Physical, cognitive and psychological factors represent barriers to social integration

• Barriers to social integration may be addressed by supportive care interventions

• Compensatory strategies, adjusting goals and expectations, educating friends and family and accepting support from others facilitate social reintegration throughout the trajectory of living with brain tumor

     

Toward a metasynthesis of qualitative findings on motherhood in HIV-positive women

A qualitative metasynthesis of qualitative findings ought to be more than a mere summary of those findings. Yet the processes by which the interpretive innovation expected of qualitative metasynthesis projects can be achieved remain opaque. Several analytic devices for the metasynthesis of findings were clarified in the course of an ongoing methodological project involving 45 reports of qualitative studies of HIV-positive women. These devices include the creation of a taxonomy of findings, the explicit use of sustained comparisons, the translation of in vivo concepts, and the use of imported concepts. Any qualitative metasynthesis of findings constitutes an interpretation at least three times removed from the lives represented in them. Clarifying the analytic devices used to create such metasyntheses is essential to demonstrating that despite being far away from participants' lives, these interpretations remain close to them.     

Qualitative metasynthesis: Issues and techniques

There has been an accumulation of qualitative studies in recent years, but little cumulation of the understandings gained from them. Qualitative research appears endangered both by efforts to synthesize studies and by the failure to do so. Techniques used have included reciprocal translations of key metaphors and concepts and qualitative and quantitative comparative analyses to produce narrative and theoretical integrations. The major problem yet to be resolved is developing usable and communicable systematic approaches to conducting metasynthesis projects that maintain the integrity of individual studies. © 1997 John Wiley & Sons, Inc. Res Nurs Health 20: 365–371, 1997     

Bodily change following faecal stoma formation: qualitative interpretive synthesis

Title. Bodily change following faecal stoma formation: qualitative interpretive synthesis. Aim. This paper is a report of a literature review conducted to answer the question ‘How has the experience of bodily change following stoma formation been explored and interpreted through existing qualitative research?’. Background. A faecal stoma alters the function, appearance and sensation of the body. Quantitative research highlights the importance of bodily change following stoma formation but is limited in being able to explore what this experience means to ostomists. Qualitative research can identify ways in which ostomists experience their changed body but a conceptual framework of their experience drawn from qualitative findings which can inform patient‐centred care has not yet been identified. Method. The Amed, ASSIA, CINAHL, Embase, Medline and Psycinfo databases were searched from inception to April 2009 using predefined inclusion criteria. Of 144 papers identified, 11 were selected for review. An interpretive review methodology for qualitative research synthesis was employed. Findings. Three broad themes of bodily experience following stoma formation were identified: loss of embodied wholeness, awareness of a disrupted lived body and disrupted bodily confidence. These highlight the impact of the experience of living with a stoma on the embodied self and the ostomist’s embodiment within their lifeworld. Conclusion. A loss of embodied wholeness which underpins the experience of stoma formation can be represented through awareness of the disrupted lived body and impact on the lifeworld. Findings suggest the need for further research to identify a comprehensive conceptualization of bodily change, which can more closely match healthcare service to individual patient need.     

Body image of children and adolescents with cancer: A metasynthesis on qualitative research findings

Children and adolescents with cancer are confronted with many challenges. This review considered studies that used qualitative methods to examine the body image experience of children and adolescents with cancer. A systematic literature search of English and Chinese databases was undertaken, covering the period between 1960 and October 2010. Qualitative research findings were extracted and pooled using the Joanna Briggs Institute Qualitative Assessment and Review Instrument. Eight papers met the inclusion criteria. The derived four metasyntheses included being distanced from the body, loss of self-identity, self-protective strategies and support, and getting rid of the shackles of the body. In conclusion, children and adolescents with cancer also experience various problems associated with changes in their body image. Repeated courses of treatment lead to loss of a normal, orderly life, and might even result in changes in interpersonal interactions. In response to body image change, individuals with cancer develop self-protective, coping strategies. Children and adolescents who experience life-threatening cancer come to face body image change positively, and might hold a confident attitude toward their future.     

Living with a stoma: a review of the literature

Aims and objectives. This systematic review looks at the psychological and social impact of stoma surgery on peoples’ lives. Background. The formation of a stoma can have a negative effect on a person's quality of life and affect lifestyle in a number of ways. Methods. The review examines nursing literature from 1990 to date and focuses on how stoma patients’ lives are affected by the presence of a stoma. It informs nursing practice so nurses are better able to help individuals improve, maintain or recover their health following ostomy surgery. Results. The findings of the review indicate that stoma surgery can impact on individuals’ lives in many different ways. Relevance to clinical practice. Knowledge of the problems stoma patients can experience can help nurses plan care in an individualized way. Recommendations for nursing practice and future research are made.     

Adjustment to colostomy: stoma acceptance, stoma care self-efficacy and interpersonal relationships

AIM: This paper is a report of a study to examine adjustment and its relationship with stoma acceptance and social interaction, and the link between stoma care self-efficacy and adjustment in the presence of acceptance and social interactions. BACKGROUND: There have been significant advances in stoma appliances and an increase in nurses specialising in stoma care. Despite this, a large proportion of patients continue to experience adjustment problems, which suggests that improvements in the management of the stoma are by themselves not enough to enhance psychosocial functioning. Illness acceptance and interpersonal relationships are widely reported as correlates of adjustment to chronic illness, but these have not been specifically examined in patients with a colostomy. Evidence of their association could offer stoma therapists alternative ways of aiding adjustment. METHOD: Between 2000 and 2002, 51 patients with colostomies provided demographic and clinical data and completed validated questionnaires to measure acceptance of the stoma, relationship with others and stoma care self-efficacy 6 months after surgery. FINDINGS: Multiple regression analysis showed that stoma care self-efficacy, stoma acceptance, interpersonal relationship and location of the stoma were strongly associated with adjustment. The model explained 77% of the variance. Stoma-care self-efficacy accounted for 57.5%, the psychosocial variables 13% and location of the stoma 4.6%. The addition of gender, which was not statistically significant (P > 0.05), explained a further 1.9% of the variance. CONCLUSION: Addressing psychosocial concerns should become part of the care routinely given to stoma patients. We recommend more emphasis on dispelling negative thoughts and encouraging social interactions.     

Navigating in an unpredictable daily life: a metasynthesis on children's experiences living with a parent with severe mental illness

A large group of individuals suffering from mental illness are parents living with their children. These children are invisible in the health care even though at risk for illhealth. The aim of this metasynthesis was to advance knowledge of how children of parents with mental illness experience their lives, thus contributing to the evidence of this phenomenon. The metasynthesis is following Sandelowski and Barroso's guidelines. Literature searches covering the years 2000 to 2013 resulted in 22 reports which were synthesised into the theme ‘navigating in an unpredictable everyday life’ and the metaphor compass. Children of parents with mental illness irrespective of age are responsible, loving and worrying children who want to do everything to help and support. Children feel shame when the parent behaves differently, and they conceal their family life being afraid of stigmatisation and bullying. When their parent becomes ill, they distance to protect themselves. The children cope through information, knowledge, frankness and trustful relationships. These children need support from healthcare services because they subjugate own needs in favour of the parental needs, they should be encouraged to talk about their family situation, and especially, young children should to be child‐like, playing and seeing friends.     

男性不育症患者情感体验的质性研究

目的探讨男性不育症患者情感体验,为指导护士实施心理疏导提供依据。方法采用深度访谈法收集8例不育症男性患者资料,采用现象学分析法进行分析描述,了解男性不育症患者真实情感体验。结果不育症患者情感体验主要有5个主题:否认与焦虑,痛苦与接受,羞愧与孤立,哀伤与无价值感,性功能紊乱。结论不育症患者内心深处情感体验复杂,医护人员应主动了解不育症患者的负性情感,给予有效的正向情感引导,并尽可能提供完善的社会支持,使其尽快摆脱不育的阴霾。