scholarly journals Interventions targeted at health professionals to reduce unnecessary caesarean sections: a qualitative evidence synthesis

BMJ Open ◽  
2018 ◽  
Vol 8 (12) ◽  
pp. e025073 ◽  
Author(s):  
Carol Kingdon ◽  
Soo Downe ◽  
Ana Pilar Betran
Keyword(s):  
Low Income ◽  
Health Professionals ◽  
Cultural Context ◽  
Resistance To Change ◽  
Evidence Synthesis ◽  
High Income ◽  
Primary Data ◽  
Qualitative Evidence Synthesis ◽  
Middle Income ◽  
Qualitative Evidence

ObjectiveTo establish the views and experiences of healthcare professionals in relation to interventions targeted at them to reduce unnecessary caesareans.DesignQualitative evidence synthesis.SettingStudies undertaken in high-income, middle-income and low-income settings.Data sourcesSeven databases (CINAHL, MEDLINE, PsychINFO, Embase, Global Index Medicus, POPLINE and African Journals Online). Studies published between 1985 and June 2017, with no language or geographical restrictions. We hand-searched reference lists and key citations using Google Scholar.Study selectionQualitative or mixed-method studies reporting health professionals’ views.Data extraction and synthesisTwo authors independently assessed study quality prior to extraction of primary data and authors’ interpretations. The data were compared and contrasted, then grouped into summary of findings (SoFs) statements, themes and a line of argument synthesis. All SoFs were Confidence in the Evidence from Reviews of Qualitative research (GRADE-CERQual) assessed.Results17 papers were included, involving 483 health professionals from 17 countries (nine high-income, six middle-income and two low-income). Fourteen SoFs were identified, resulting in three core themes: philosophy of birth(four SoFs); (2)social and cultural context(five SoFs); and (3)negotiation within system(five SoFs). The resulting line of argument suggests three key mechanisms of effect for change or resistance to change: prior beliefs about birth; willingness or not to engage with change, especially where this entailed potential loss of income or status (including medicolegal barriers); and capacity or not to influence local community and healthcare service norms and values relating to caesarean provision.ConclusionFor maternity care health professionals, there is a synergistic relationship between their underpinning philosophy of birth, the social and cultural context they are working within and the extent to which they were prepared to negotiate within health system resources to reduce caesarean rates. These findings identify potential mechanisms of effect that could improve the design and efficacy of change programmes to reduce unnecessary caesareans.PROSPERO registration numberCRD42017059455.

scholarly journals It’s crunch time: Exploring the sensibility of food textural acoustics for individuals with dysphagia

2021 ◽  
Vol 68 (1) ◽  
Author(s):  
Tasneem F. Karani ◽  
Mershen Pillay
Keyword(s):  
Scoping Review ◽  
Evidence Synthesis ◽  
Acoustic Properties ◽  
Qualitative Evidence Synthesis ◽  
Group Discussions ◽  
Middle Income ◽  
Review Analysis ◽  
Fields Of Study ◽  
Qualitative Evidence ◽  
Complex Process

Background: Various fields of study have alluded to food textural, and its associated acoustic, properties (i.e. food textural acoustics). However, because of the challenging nature of the inclusion of acoustic properties in diet textural modifications in dysphagia (swallowing disorders), this construct has not been sufficiently considered in the field.Objective: To investigate the sensibility of food textural acoustics as a construct to understand eating for individuals with dysphagia.Method: The study design was based on qualitative evidence synthesis methodologies. This involved revised scoping review methods (peer-reviewed published articles from 1980 to 2020 over seven databases), with an adapted consultation phase through online focus group discussions with six world experts. The data was analysed using frequency and thematic analysis, and ideology critique.Results: A total of 11 articles were included in the revised scoping review analysis (seven research studies and four review articles). The analysis of these articles revealed a lack of diversity in geography, discipline and perspective exploring the construct of food textural acoustics. A total of three themes with three associated core arguments emerged from the revised scoping review and the consultation phase. These arguments highlighted (1) the need to study food textural acoustics because of its salience and pleasure responses, (2) possible methodological dilemmas in studying food textural acoustics due to the complexity of eating, and (3) considerations with regard to the approach and positioning adopted when studying the construct.Conclusion: Food textural acoustics may be a sensible construct to understand eating for individuals with dysphagia. As eating is a complex process, there is a need to challenge the methods we use when studying this construct of food textural acoustics. We hope that this article inspires researchers and practitioners to think differently by using textural, and its associated acoustic, properties as a way to reimagine dysphagia practice, especially for those from low- to middle-income contexts such as South Africa and Brazil.

scholarly journals Public engagement and crowdfunding for health research: A global qualitative evidence synthesis and TDR pilot

2021 ◽  
Author(s):  
Eneyi E Kpokiri ◽  
Clarisse Sri-Pathmanathan ◽  
Priyanka Shrestha ◽  
Sana Navaid ◽  
Teerawat Wiwatpanit ◽  
...  
Keyword(s):  
Public Engagement ◽  
Health Research ◽  
Mixed Methods Research ◽  
Evidence Synthesis ◽  
Mitigation Strategies ◽  
Qualitative Evidence Synthesis ◽  
Middle Income ◽  
Pilot Programme ◽  
The Public ◽  
Qualitative Evidence

Background: Many exceptional researchers, especially in low-and middle-income countries (LMICs) face structural disadvantages in applying for research grants. Public engagement and crowdfunding make it possible for researchers to directly seek support from the public, by engaging large groups of people who make small contributions to support a project. This manuscript synthesizes global qualitative evidence and describes a WHO-TDR public engagement and crowdfunding pilot programme. Methods: We searched six databases for primary qualitative and mixed-methods research. We used a thematic synthesis approach and assessed our findings using the GRADE-CERQual approach. A crowdfunding approach to finance research studies was tested through a pilot programme, with a focus on infectious diseases of poverty. TDR Global mentors provided support for five finalists to engage the public and develop crowdfunding campaigns. Results: Nine studies were included in the qualitative evidence synthesis. Themes were developed into seven key findings, including the need for extensive public engagement, the potential for crowdfunding to open a communication channel between researchers and the public, key correlates of crowdfunding success and the risks of crowdfunding health research with associated mitigation strategies. The TDR pilot programme received 121 entries from 37 countries. Five LMIC-based researchers received training and joined a working group. Three researchers launched their crowdfunding campaigns, met their goals and received substantial monetary and non-monetary contributions. Conclusion: Public engagement provides a foundation for effective crowdfunding for health research. Our evidence synthesis and pilot data provide practical strategies for LMIC researchers to engage the public and conduct crowdfunding campaigns.

scholarly journals Meta-ethnography to understand healthcare professionals’ experience of treating adults with chronic non-malignant pain

BMJ Open ◽  
2017 ◽  
Vol 7 (12) ◽  
pp. e018411 ◽  
Author(s):  
Francine Toye ◽  
Kate Seers ◽  
Karen L Barker
Keyword(s):  
Chronic Pain ◽  
Health Professionals ◽  
Biopsychosocial Model ◽  
Healthcare Professionals ◽  
Evidence Synthesis ◽  
Bibliographic Databases ◽  
Qualitative Evidence Synthesis ◽  
Qualitative Evidence ◽  
Patient Groups ◽  
Provision Of Care

ObjectivesWe aimed to explore healthcare professionals’ experience of treating chronic non-malignant pain by conducting a qualitative evidence synthesis. Understanding this experience from the perspective of healthcare professionals will contribute to improvements in the provision of care.DesignQualitative evidence synthesis using meta-ethnography. We searched five electronic bibliographic databases from inception to November 2016. We included studies that explore healthcare professionals’ experience of treating adults with chronic non-malignant pain. We used the GRADE-CERQual framework to rate confidence in review findings.ResultsWe screened the 954 abstracts and 184 full texts and included 77 published studies reporting the experiences of over 1551 international healthcare professionals including doctors, nurses and other health professionals. We abstracted six themes: (1) a sceptical cultural lens, (2) navigating juxtaposed models of medicine, (3) navigating the geography between patient and clinician, (4) challenge of dual advocacy, (5) personal costs and (6) the craft of pain management. We rated confidence in review findings as moderate to high.ConclusionsThis is the first qualitative evidence synthesis of healthcare professionals’ experiences of treating people with chronic non-malignant pain. We have presented a model that we developed to help healthcare professionals to understand, think about and modify their experiences of treating patients with chronic pain. Our findings highlight scepticism about chronic pain that might explain why patients feel they are not believed. Findings also indicate a dualism in the biopsychosocial model and the complexity of navigating therapeutic relationships. Our model may be transferable to other patient groups or situations.

scholarly journals Parental perceptions of the food environment and their influence on food decisions among low-income families: a rapid review of qualitative evidence

2022 ◽  
Vol 22 (1) ◽  
Author(s):  
Divya Ravikumar ◽  
Eleni Spyreli ◽  
Jayne Woodside ◽  
Michelle McKinley ◽  
Colette Kelly
Keyword(s):  
Low Income ◽  
Food Environment ◽  
Dietary Habits ◽  
Evidence Synthesis ◽  
Healthy Food ◽  
Rapid Review ◽  
Qualitative Evidence Synthesis ◽  
Qualitative Evidence ◽  
Food Decisions ◽  
Disadvantaged Families

Abstract Background The food environment within and surrounding homes influences family dietary habits with socio-economic areas at a nutritional disadvantage. Families’ perception of the food environment and how it influences their food decisions is less clear. This rapid review aimed to synthesise qualitative evidence of parental perspectives of the food environment and their influence on food decisions among disadvantaged families. Method Qualitative and mixed-methods peer-reviewed journal articles published after 2000, that explored the perspectives of low-income parents in relation to their food environment and how this impacted food decisions for families with children aged 2-17 years, were included in this review. Embase, Scopus and PsycINFO were the databases chosen for this review. Search strategies included seven concepts related to family, food, perceptions, influences, environment, socio-economic status and study type. Two independent reviewers screened sixty-four studies. Thematic synthesis was employed. Results Two thousand one hundred and forty five results were identified through database searching and 1,650 were screened. Fourteen articles that originated from the US, Australia and the UK were included in this review. No articles were excluded following quality appraisal. Child preferences, financial and time constraints, and location and access to food outlets were barriers to accessing healthy food. Parental nutrition education and feeding approaches varied but positive outcomes from interventions to address these behaviours will be short-lived if inequities in health caused by poverty and access to affordable and healthy food are not addressed. The reliance on social support from families or government sources played an important role for families but are likely to be short-term solutions to health and nutritional inequities. Conclusions This qualitative evidence synthesis provides an insight into the perceptions of low-income parents on the factors influencing food decisions. Findings have implications for public health and the development of effective strategies to improve the dietary habits of children of disadvantaged families. Sustainable changes to dietary habits for families on low-income requires policy responses to low income, food access and to the high cost of healthy foods.

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