Nurses' experiences of ethical preparedness for public health emergencies and healthcare disasters: a systematic review of qualitative evidence

Little is known about nurses' direct experiences of ethical preparedness for dealing with catastrophic public health emergencies and healthcare disasters or the ethical quandaries that may arise during such events. A systematic literature review was undertaken to explore and synthesize qualitative research literature reporting nurses' direct experiences of being prepared for and managing the ethical challenges posed by catastrophic public health emergencies and healthcare disasters. Twenty-six research studies were retrieved for detailed examination and assessed by two independent reviewers for methodological validity prior to inclusion in the review. Of these, 12 studies published between 1973 and 2011 were deemed to meet the inclusion criteria and were critically appraised. The review confirmed there is a significant gap in the literature on nurses' experiences of ethical preparedness for managing public health emergencies and healthcare disasters, and the ethical quandaries they encounter during such events. This finding highlights the need for ethical considerations in emergency planning, preparedness, and response by nurses to be given more focused attention in the interests of better informing the ethical basis of emergency disaster management.

The indelible ink of the special stamp: an insider’s research essay on imprints and erasures

The medical profession ascribes otherness to people with disabilities through diagnosis and expertism, which sets in motion discursive powers that oversee their exclusion through schooling and beyond. In this paper, I present a narrative pieced together from personal experiences of ducking and weaving the deficit discourse in ‘inclusive’ education, when seeking employment and in day-to-day family interaction as a person with severely impaired vision. This work builds on previous qualitative research I conducted in Queensland, Australia with a group of young people with impaired vision who attended an inclusive secondary school. I frame this discussion using Foucault’s conception of normalising judgement against the hegemony of normalcy, and consider that inclusion for people with disabilities is reminiscent of a haunting. Through this analysis, I demonstrate how my ideology is formed, and how it in turn shapes a research agenda geared toward seeking greater inclusion for young people with disabilities in schools.

Meta-analysis and research synthesis in education

This bibliography begins with this introduction followed by a general overview of meta-analysis and research synthesis methods in education. The third section cites references to illustrate how the concept of statistical integration of research findings dates back to early 20th century. Citations in the fourth section highlight early calls from educational researchers to recognize the process of synthesizing research as a scholarly endeavor in its own right. As evident from the citations in the fifth section, it was in the 1980s when monographs exclusively devoted to research synthesis methods started to be published. Since then, a number of books have been published on research synthesis methods. The sixth section cites some of the most comprehensive books on research synthesis methods and includes contributions from key players of meta-analysis current at the time. The citations in the seventh section illustrate how meta-analysis has become very popular over time. Several large organizations have been set up and software developed to support systematic reviews of research. These are cited in the eighth section. Citations in the ninth section illustrate critiques of systematic reviews. As qualitative research is becoming popular in education, sophisticated discussions of issues associated with synthesizing qualitative research have also been published, some of which are cited in the tenth section. The eleventh section presents a methodologically inclusive account of current developments in research synthesis methods. The final section cites examples of journals exclusively devoted to publishing research reviews and exemplary research synthesis with different methodologies. Individual methods of research synthesis are discussed chronologically as they became popular in educational research. Accordingly, this bibliography starts with a discussion of statistical methods of integrating research that parallels the dominance of quantitative research in education until the 1970s. As the popularity and diversity of qualitative research methods have been increasing in educational research, more methodologically inclusive discussions of research synthesis methods are becoming popular as described in the later sections of this bibliography.

Advancements in research synthesis methods: From a methodologically inclusive perspective

The dominant literature on research synthesis methods has positivist and neo-positivist origins. In recent years, the landscape of research synthesis methods has changed rapidly to become inclusive. This article highlights methodologically inclusive advancements in research synthesis methods. Attention is drawn to insights from interpretive, critical, and participatory traditions for enhancing trustworthiness, utility, and/or emancipatory potential for research syntheses. Also noted is a paucity of the literature that builds connections between methodologically diverse segments of the literature on research synthesis methods. Salient features of a methodologically inclusive research synthesis (MIRS) framework are described. The MIRS framework has been conceptualized by distilling and synthesizing ideas, theories, and strategies from the extensive literatures on research synthesis methods and primary research methods. Rather than prescribe how a research synthesis should be conducted or evaluated, this article attempts to open spaces, raise questions, explore possibilities, and contest taken-for-granted practices.

Epistemological pluralism in research synthesis methods

The purpose of research synthesis is to produce new knowledge by making explicit connections and tensions between individual study reports that were not visible before. Every effort of synthesizing research is inevitably premised on certain epistemological assumptions. It is crucial that research synthesists reflect critically on how their epistemological positioning enables them to pursue certain purposes while preventing them from pursuing other purposes. The literature on research synthesis methods is dominated by publications premised on positivist assumptions. The rhetoric of systematic reviews, best-evidence synthesis and What Works Clearinghouse privileges syntheses with positivist orientations. Contesting the hegemony of positivist research syntheses, this paper makes a case for research syntheses that are informed by diverse epistemological orientations. It illuminates how research syntheses with distinct epistemological orientations can serve complementary, equally worthwhile, purposes.

Understanding the relationships between the physical environment and physical activity in older adults: a systematic review of qualitative studies.

While physical activity (PA) provides many physical, social, and mental health benefits for older adults, they are the least physically active age group. Ecological models highlight the importance of the physical environment in promoting PA. However, results of previous quantitative research revealed inconsistencies in environmental correlates of older adults' PA that may be explained by methodological issues. Qualitative studies can inform and complement quantitative research on environment-PA relationships by providing insight into how and why the environment influences participants' PA behaviors. The current study aimed to provide a systematic review of qualitative studies exploring the potential impact of the physical environment on older adults' PA behaviors.

'I'm not a druggie, I'm just a diabetic': a qualitative study of stigma from the perspective of adults with type 1 diabetes

While health-related stigma has been the subject of considerable research in other conditions (eg, HIV/AIDS, obesity), it has not received substantial attention in diabetes. Our aim was to explore perceptions and experiences of diabetes-related stigma from the perspective of adults with type 1 diabetes mellitus (T1DM).

Discovering meanings in research with children

Drawing on a qualitative research study this paper explores the aspect of ascribing meanings in research. It presents an example of research with young children which illustrates a 'meaning-seeking' experience. Ascribing meaning is an external realisation of an inner thought, with the emphasis on the uniqueness of children's own voices and the researcher's commitment to seeking information from children's sociocultural contexts. A strong rationale for the importance of meaning in human experiences can be located in phenomenology. The idea of meaning as having its basis in social interactions has been manifested in the sociocultural paradigm. It is argued here that the phenomenological and sociocultural emphasis on 'meaning' as the core of life experiences constitutes a useful conceptual perspective which can guide research with children. This emphasis encourages researchers to explore research issues from research participants' perspectives, grasp their interpretive frame, and understand the meanings that participants bring to them. This in turn provides a means for reaching a profound understanding of human actions, experiences and existence.

Barriers to primary care clinician adherence to clinical guidelines for the management of low back pain: protocol of a systematic review and meta-synthesis of qualitative studies.

INTRODUCTION: Low back pain is the highest ranked condition contributing to years lived with disability, and is a significant economic and societal burden. Evidence-based clinical practice guidelines are designed to improve quality of care and reduce practice variation by providing graded recommendations based on the best available evidence. Studies of low back pain guideline implementation have shown no or modest effects at changing clinical practice. OBJECTIVES: To identify enablers and barriers to adherence to clinical practice guidelines for the management of low back pain. METHODS AND ANALYSIS: A systematic review and meta-synthesis of qualitative studies that will be conducted and reported using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) Statement guidelines. Eight databases will be searched using a priori inclusion/exclusion criteria. Two independent reviewers will conduct a structured review and meta-synthesis, and a third reviewer will arbitrate where there is disagreement. This protocol has been registered on PROSPERO 2014. ETHICS AND DISSEMINATION: Ethical approval is not required. The systematic review will be published in a peer-reviewed journal. The review will also be disseminated electronically, in print and at conferences. Updates of the review will be conducted to inform and guide healthcare translation into practice. TRIAL REGISTRATION NUMBER: PROSPERO 2014:CRD42014012961. Available from http://www.crd.york.ac.uk/PROSPERO/display_record.asp?ID=CRD42014012961.

Psychosocial factors impacting on life transitions among young adults with type 2 diabetes : an Australian - Danish qualitative study

BACKGROUND: Type 2 diabetes (T2DM) prevalence is increasing rapidly worldwide with a significant increase in young adults. There is limited information about psychosocial and service needs of this group. AIM: To explore similarities and differences in how psychosocial factors impact on Australian and Danish young adults with T2DM and to identify unmet support needs during life transitions. METHOD: A qualitative approach was adopted using thematic content analysis of 26 in-depth semi-structured interviews. An inductive descriptive content analysis was undertaken using a comparative coding system. FINDINGS: Eligible participants were from Australia (12) and Denmark (14), aged 19-42 years who had T2DM for more than 10 months. In general, they reported diabetes management was difficult during transitions and diabetes self-care routines had to change to accommodate life changes. The underpinning sense of 'uncertainty' initiated by life transitions caused guilt that often resulted in low self-worth, anxiety and depression, which in turn had a negative impact on social and professional relationships. The participants emphasised the importance of connectedness to social networks, particularly with T2DM peers, and the need for flexible access to health professionals, age-specific tailored support and lower costs for Australians. Australian participants were more concerned than Danish participants about the cost associated with diabetes care and their ability to stay employed; hence, they were reluctant to disclose diabetes at work. CONCLUSION: T2DM had a similar impact on life transitions of Australian and Danish young adults with T2DM, suggesting health care needs to encompass managing life transitions. Participants had to cope with uncertainty and the impact of people's responses to diabetes, particularly at work and in relationships. Health professionals are urged to integrate these factors in care plans and education, which must be individualised and focus on the psychosocial aspects that operate during life transitions.

Ritual power : illuminating the blind spot of births, deaths and marriages in news media research

This article conceptualises the role and place of the newspaper births, deaths and marriages column in Western societies and its relationship to news media. It identifies the births, deaths and marriages notices as a ‘blind spot’ within journalism and media research generated by powerful cultural norms and conventions shaping the field. This is exemplified by the ‘mythical’ divide between political economy and culturalist approaches to media studies that has created a gap where people’s everyday practices or the social value of ‘commercial’ content tends to be overlooked in discussions about news media. Drawing more deeply from cultural studies and scholarship around media power and rituals, the births, deaths and marriages column provides a compelling unique illustration of the ways newspapers – especially at the local level – continue to be perceived as central to the social in this changing media world. A qualitative research project into the future of small commercial newspapers in Australia provides rich data for exploring these key ideas.

Views of women and health professionals on mHealth lifestyle interventions in pregnancy: a qualitative investigation

BACKGROUND: Evidence suggests that women are failing to meet guidelines for nutrition, physical activity, and weight gain during pregnancy. Interventions to promote a healthy lifestyle in pregnancy demonstrate mixed results and many are time and resource intensive. mHealth-delivered interventions offer an opportunity to provide trusted source information in a timely and cost-effective manner. Studies regarding women's and health professionals' views of mHealth in antenatal care are limited.

OBJECTIVE: This study aimed to explore women's and health professionals' views regarding mHealth information sources and interventions to assist women to eat well, be physically active, and gain healthy amounts of weight in pregnancy.

METHODS: A descriptive qualitative research approach employed focus groups and in-depth interviews with 15 pregnant or postpartum women and 12 in-depth interviews with health professionals including two from each category: obstetricians, general practitioners, midwives, dietitians, physiotherapists, and community pharmacists. All interviews were transcribed verbatim and thematically analyzed.

RESULTS: Women uniformly embraced the concept of mHealth information sources and interventions in antenatal care and saw them as central to information acquisition and ideally incorporated into future antenatal care processes. Health professionals exhibited varied views perceiving mHealth as an inevitable, often parallel, service rather than one integrated into the care model. Four key themes emerged: engagement, risk perception, responsibility, and functionality. Women saw their ability to access mHealth elements as a way to self-manage or control information acquisition that was unavailable in traditional care models and information sources. The emergence of technology was perceived by some health professionals to have shifted control of information from trusted sources, such as health professionals and health organizations, to nontrusted sources. Some health professionals were concerned about the medicolegal risks of mHealth (incorrect or harmful information and privacy concerns), while others acknowledged that mHealth was feasible if inherent risks were addressed. Across both groups, there was uncertainty as to who should be responsible for ensuring high-quality mHealth. The absence of a key pregnancy or women's advocacy group, lack of health funds for technologies, and the perceived inability of maternity hospitals to embrace technology were seen to be key barriers to provision. Women consistently identified the functionality of mHealth as adding value to antenatal care models. For some health professionals, lack of familiarity with and fear of mHealth limited their engagement with and comprehension of the capacity of new technologies to support antenatal care.

CONCLUSIONS: Women exhibited positive views regarding mHealth for the promotion of a healthy lifestyle in antenatal care. Conversely, health professionals expressed a much wider variation in attitudes and were more able to identify potential risks and barriers to development and implementation. This study contributes to the understanding of the opportunities and challenges in developing mHealth lifestyle interventions in antenatal care.

Attitudes towards and beliefs about genetic testing in the haemophilia community: a qualitative study

Widespread genetic testing for haemophilia has recently been introduced in Victoria, Australia. While attitudes towards predictive testing have been studied in other conditions, such as cancer, there is limited knowledge about the attitudes of members of the haemophilia community towards predictive testing. This study aimed at exploring attitudes towards, and beliefs about, genetic testing amongst members of the haemophilia community in Victoria prior to the widespread introduction of testing. The study was qualitative and descriptive. In-depth face to face interviews were held with a sample of 39 individuals, including men with haemophilia, female carriers and family members. Data were analysed thematically using cross-case analysis techniques. There was considerable knowledge about the proposed introduction of widespread genetic testing. However, not everyone thought that testing was accessible or user friendly, and there was confusion about who needed to be tested. Most thought that testing was necessary for adolescent girls to determine carrier status to help prepare families for a child with haemophilia, rather than leading them to choose to terminate a pregnancy or not to have children. A minority of women stated that if there was a history of inhibitors in a family then a termination might be considered. The study revealed strong religious beliefs among those studied, which may have influenced attitudes and approaches towards testing. Further investigation is needed into how people with a possible haemophilia genotype negotiate decisions about their further identification, and how this knowledge is placed within cultural, religious and family contexts.