UNASSIGNED: Qualitative studies have examined the experiences of subjective cognitive dysfunction in specific populations or specific disease stages, but there has not yet been a systematic synthesis and evaluation of findings related to perceptions of subjective cognitive dysfunction in nondementia-related chronic illnesses.
UNASSIGNED: The aim of this study was 2-fold: (1) to undertake a systematic review of experiences of subjective cognitive dysfunction in people with nondementia-related chronic disease and (2) to develop an explanatory framework to describe the experiences of living with subjective cognitive dysfunction.
UNASSIGNED: Four databases were systematically searched for studies on subjective cognitive dysfunction up to June 2023. Qualitative synthesis was conducted on the final sample (N = 25) using Sandelowski\'s adaptation of Nobilt and Hare\'s reciprocal transactional analysis method. Critical appraisal was completed using the Critical Appraisal Skills Programme checklist.
UNASSIGNED: Through constant comparison of key concepts, findings were organized within 4 interrelated themes that informed a conceptual explanatory model of adapting to living with subjective cognitive dysfunction: (1) symptoms, (2) health care, (3) perceptions of self, and (4) relationships. Participants highlighted how subjective cognitive dysfunction affected interactions in health care settings and involved other symptoms that in turn complicated meaning, self-enhancement, and mastery.
UNASSIGNED: Our model of the process of adapting provides a new way to conceptualize cognitive dysfunction in chronic illness and suggests opportunities for health care professionals to support patients and their families. The results highlight the need for more research to better understand the role of subjective cognitive dysfunction in nondementia-related chronic illnesses.The review protocol was registered in PROSPERO (CRD42021231410).

BACKGROUND: CAR-T therapy has emerged as a potentially effective treatment for individuals diagnosed with hematologic malignancies. Understanding patients\' unique experiences with this therapeutic approach is essential. This knowledge will enable the development of tailored nursing interventions that align with the increasing importance of patient-centered care.
OBJECTIVE: To examine and synthesize qualitative data on patients and their family caregivers\' experiences during the treatment journey.
METHODS: We conducted a systematic review and qualitative meta-synthesis. Eligible studies contained adult patient or family caregiver quotes about experiences of CAR-T therapy, published in English or Chinese in a peer-reviewed journal since 2015. Data sources included MEDLINE, CINAHL, Embase, PsycINFO, Web of Science, Scopus, Cochrane Library, CNKI, and WanFang.
METHODS: Systematic search yielded 6373 identified articles. Of these, 12 reports were included in the analysis, which covered 11 separate studies. Two reviewers independently extracted data into NVIVO 12.0. Qualitative meta-synthesis was performed through line-by-line coding of full text, organization of codes into descriptive themes, and development themes.
RESULTS: The qualitative meta-synthesis yielded eight primary themes. Noteworthy revelations from patients and their family caregivers regarding the CAR-T therapy journey encompassed various aspects. Prior to CAR-T therapy, patients experienced a lack of actual choice, struggled with expectations for treatment outcomes, and encountered intricate emotional experiences. During or immediately after CAR-T therapy, patients reported both comfortable and uncomfortable experiences. Additionally, patients emphasized that concerns regarding treatment efficacy and adverse reactions intensified treatment-related distress. After CAR-T therapy, significant changes were observed, and the burden of home-based rehabilitation. Additionally, we found factors contributed to the high CAR-T therapy cost.
CONCLUSIONS: To ensure the safety and sustainability of CAR-T therapy, it is crucial to address the physical and psychological aspects of the patient\'s experience. Effective communication and comprehensive management are highly valued by patients and their caregivers. Further research should investigate ways to reduce burdens and develop self-management education programs for patients and their families.

OBJECTIVE: During the COVID-19 pandemic, midwives faced emotional and physical risks while on the frontlines providing care.
BACKGROUND: To maintain a healthy midwifery workforce, it is necessary to understand midwives\' pandemic challenges and successes, including how they personally and professionally faced changes to care provision.
OBJECTIVE: The aim of this meta-synthesis was to understand the experiences of midwives working during the COVID-19 pandemic.
METHODS: Noblit and Hare\'s (1988) approach to synthesising qualitative research studies was followed. Fifteen qualitative research reports were identified using PRISMA guidelines, producing a sample of 588 midwives from 12 countries.
RESULTS: The synthesis revealed three overarching themes: (1) Turmoil and confusion: a spectrum of emotions due to ever-changing protocols, (2) COVID-19 stripped the \"being with\" out of midwifery care, and (3) Finding our way: midwifery resilience and growth. Analysed together, these three themes contribute to understanding the experiences of midwives working during the COVID-19 pandemic.
CONCLUSIONS: Midwives experienced fear, stress, and anxiety. They felt they couldn\'t physically be with women during the pandemic. They were frustrated by being left out of institutional decision-making regarding COVID-19 protocols that impacted the women they served. Professional growth as a midwife, and personal resilience were ultimately realised.
CONCLUSIONS: The COVID-19 pandemic disrupted the routine ways in which midwives provide care in all settings. Understanding the complete experience of midwives during the pandemic allows for midwifery organizations to be aware of their members\' needs, as well as for institutions to ensure supports are in place for midwives in the event of future pandemics.

Social capital provides young people with a web of supportive relationships that can be leveraged in pursuit of education, career, and life goals. Organized activities, an umbrella term for extracurricular activities, after-school programs, and youth development programs, are important developmental contexts for building social capital. The purpose of this study was to illuminate the developmental pathway through which social capital development occurs in organized activities. A qualitative meta-synthesis was conducted using 33 articles that met inclusion criteria across five databases (e.g., ERIC, PsycINFO) between June 2022 and May 2023. Thematic analysis was used to identify malleable organized activity features that act as levers for social capital promotion. Seven thematically aligned features were identified, including (1) organizational partnerships, (2) organizational supporting structures, (3) relationally strong climate, (4) staff mindsets and skills, (5) youth mindsets and skills, (6) increased social capital opportunities, and (7) increased social capital activation. These seven themes were used to construct an empirically-grounded model that posits a process through which organized activities support youth social capital development. Implications for intentionally strengthening organized activities\' capacity to support youth social capital are discussed.

BACKGROUND: Adverse perinatal health outcomes are notably high among African-born women living in Australia. This problem is partly attributed to their lower engagement in maternity care services as compared to Australian-born women. Various barriers might limit African-born women\'s access to and use of services; however, these barriers are not well documented. Therefore, this review aimed to synthesise current qualitative evidence on barriers and facilitators of access to maternity care for African-born women living in Australia.
METHODS: The search was conducted in MEDLINE, CINAHL, Embase, PsychInfo, and Maternity and Infant Care databases on 16 April 2023. All articles retrieved were meticulously screened for eligibility by two independent reviewers with any disagreements resolved through discussion. The quality of the included articles was evaluated using the Mixed Methods Appraisal Tool. Studies were screened in Covidence and analysed in NVivo. The findings were organised and presented using Levesque\'s framework of healthcare access.
RESULTS: Out of 558 identified papers, 11 studies comprising a total of 472 participants met the eligibility criteria. The review highlighted provider-side barriers such as shortage of information, unmet cultural needs, long waiting times, low engagement of women in care, discrimination, and lack of continuity of care. User-side barriers identified include communication issues, difficulty navigating the health system, and lack of trustful relationships with healthcare providers. In contrast, the review pinpointed provider-side facilitators including positive staff attitudes, service availability, and the proximity of facilities to residential homes, while user-side facilitators such as cultural assimilation and feeling valued by healthcare providers were noted.
CONCLUSIONS: This review identified barriers and facilitators of access to maternity care for African-born women living in Australia. Empirical evidence that would inform potential changes to policy and practice to address African-born women\'s unique health needs was highlighted. Designing and implementing a culturally safe service delivery model could remove the identified access barriers and improve African-born women\'s engagement in maternity care. Moreover, reinforcing factors associated with positive healthcare experiences is essential for improving maternity care access for this priority population.
BACKGROUND: PROSPERO CRD42023405458.

OBJECTIVE: Worldwide, 16 million girls give birth during adolescence each year, which has negative health, social, and economic consequences for adolescent women\'s future.
BACKGROUND: Childbirths occurring between the ages of 13-19, before teenage girls have reached the age of maturity to handle the parenting role, are often unplanned.
OBJECTIVE: The aim of this study was to gain a comprehensive understanding of lived childbirth experiences, identify the challenges of early motherhood, and explore the coping strategies employed by teenage mothers to overcome these challenges during the transition to motherhood.
METHODS: Six commonly cited databases were used to retrieve articles using the SPIDER framework. We utilized the Walsh and Downe quality appraisal tool, which is considered the most appropriate fit for the current qualitative meta-synthesis. The thematic analysis approach was used to draw conclusions and generate hypotheses.
RESULTS: This meta-synthesis showed that teenage mothers often encounter negative reactions from their partners, families, and communities due to their early childbirth. They face numerous challenges, including parenting incompetency, school dropout, conflict between adolescent interests and maternal responsibilities, emotional disturbance, and financial problems. Social support and self-efficacy are the main coping strategies to navigate these challenges and attain maternal competencies.
CONCLUSIONS: Families, peers, and midwives play a crucial role in providing parenting lessons for teenage mothers. Encouraging teenage mothers to believe in their capacities is an important coping strategy to facilitate a smoother motherhood transition. Further studies are needed to test the effectiveness of self-efficacy and social support interventions on teenage mothers\' parenthood role attainment and in preventing mental health problems following childbirth.

OBJECTIVE: To systematically review the illness experience of adolescent patients with type 1 diabetes mellitus (T1DM).
METHODS: This study used the JBI qualitative systematic review method. A meta-aggregate analysis of 14 qualitative studies was performed. Qualitative studies on the disease experience of adolescent patients with T1DM were obtained from Cochrane, PubMed, Web of Science, CINAHL, Embase, Wanfang, CNKI and VIP, and the search period was from 1995 to 2024. The qualitative research quality evaluation tool of JBI the Evidence-based Health Care Center in Australia was used to evaluate the analysis results.
RESULTS: Thirty-one results were distilled and categorized into 7 themes and then synthesized into 3 overarching findings: (1) experiencing psychological distress and developing coping mechanisms following adjustment; (2)acknowledging self-management shortcomings and actively seeking support; and (3)overcoming challenges and growing through experiences.
CONCLUSIONS: Adolescents with T1DM often experience negative physical and emotional challenges during their illness. Transitioning from dependency to independence poses numerous obstacles that can be overcome by improving both internal and external support, cultivating self-management skills, strengthening coping mechanisms, and achieving control over the disease while fostering personal growth.

UNASSIGNED: Cardiovascular implantable electronic devices (CIED) are more and more widely used in the clinical treatment of cardiovascular diseases. However, CIED implantation may also result in a variety of physical, psychological, and social problems among patients. To help patients adapt to life after CIED implantation, it is important to know patients\' needs from their perspectives. Explore the needs of CIED patients from their perspectives to guide healthcare providers to improve their quality of life.
UNASSIGNED: PubMed, Web of Science, Embase, the Cochrane Library, CNKI, the VIP database, the Wanfang database, and the China Biomedical Literature database were searched for qualitative studies on the experience of patients with CIED dating from January 2000 to August 2022. The quality of each article was evaluated according to the 2016 edition of the Joanna Briggs Institute Evidence-Based Health Care Center Qualitative Research Quality Evaluation Criteria and an integrative meta-synthesis was undertaken.
UNASSIGNED: A total of 18 documents were included, and 111 categories were extracted. Analysis of the data resulted in the identification of 3 themes and 12 subthemes. The first theme, Equipment Symbiosis, included \"Mixed feelings about the device as part of the body\", \"Mixed feelings about the patient\'s role\", and \"Mixed feelings about an electrical stimulus\". The second theme, External Support, included \"Husband and wife relationship damaged\", \"Eager to participate, unwilling to be overprotected\", \"Want to return to work but are forced to leave\", and \"Information supply and demand mismatch\". The third theme, Self-coping, included \"How to face a doctor\", \"How to deal with activity restrictions\", \"How to face yourself\", \"How to face the future\", and \"How to face death\".
UNASSIGNED: Healthcare providers need to accelerate technological innovation and clinical adoption of CIED. Additionally, healthcare providers need to establish a diverse support system led by medical staff, with family members, peers, and society working together, and improve CIEDs remote monitoring to help patients improve their quality of life.

OBJECTIVE: To synthesise young person and family member perspectives on processes of change in family therapy for anorexia nervosa (AN), including systemic family therapy and manualised family-based treatments, to obtain an understanding of what helps and hinders positive change.
METHODS: A systematic search of the literature was conducted to identify qualitative studies focussing on experiences of therapeutic change within family therapies for AN from the perspectives of young people and their families. Fifteen studies met inclusion criteria and underwent quality appraisal following which they were synthesised using a meta-synthesis approach.
RESULTS: Six overarching themes were generated: \"A holistic focus on the young person\'s overall development\"; \"The therapeutic relationship as a vehicle for change\"; \"The therapist\'s confinement to a script and its impact on emotional attunement\"; \"A disempowering therapeutic context\"; \"Externalisation of the eating disorder (ED)\"; and \"The importance of family involvement\". Positive change was helped by understanding and support given to the young person\'s overall development including their psychological, emotional, social and physical wellbeing, positive therapeutic relationships, relational containment within the family system and externalising conversations in which young people felt seen and heard. Positive change was hindered by inflexibility in the treatment approach, counter-effects of externalisation, negative experiences of the therapist, a narrow focus on food-intake and weight, as well as the neglect of family difficulties, emotional experiences, and psychological factors.
CONCLUSIONS: Positive change regarding the young person\'s eating-related difficulties ensued in the context of positive relational changes between the young person, their family members, the therapist and treatment team, highlighting the significance of secure and trusting relationships. The findings of this review can be utilised by ED services to consider how they may adapt to the needs of young people and their families in order to improve treatment satisfaction, treatment outcomes, and in turn reduce risk for chronicity in AN.
This review synthesises the views of young people and their family members regarding their perspectives of therapeutic change within family therapies for Anorexia Nervosa (AN), including both manualised eating disorder-focussed family therapy models (family-based treatment; FBT and AN-focussed family therapy; FT-AN), as well as systemic family therapy (SyFT), to understand which aspects of these treatment approaches are helpful versus hindering to recovery from an eating disorder (ED). Parental involvement was crucial in facilitating the restoration of physical health through the process of parents taking temporary responsibility for the young person’s eating behaviours until they can feed themselves again. However, treatment often failed to acknowledge and address the psychological and emotional difficulties that made the young person vulnerable to developing AN, as well as the psychological distress caused by increasing food-intake and weight. A positive therapeutic relationship in which families felt well supported by their therapist was important in providing containment during a time of familial strain and instability, yet there was a need for greater flexibility and individualisation within manualised ED-focussed family therapy approaches, particularly FBT. The findings highlight the importance of eliciting the young person’s voice to enhance their personal agency in treatment and the value of therapeutic space to improve family functioning and enhance family unity. Lastly, they illuminate the need for manualised ED-focussed family therapy models to allow space for the therapist to emotionally attune to young people and families in order to contain their experience of distress.

BACKGROUND: The experiences and challenges associated with breastfeeding multiple births can be considerably more complex than those of singletons. Multiple births refer to the delivery of more than one offspring in a single birth event. Emphasizing the needs and experiences of mothers with multiple births during breastfeeding can enable healthcare providers to design targeted interventions that enhance breastfeeding rates. However, existing breastfeeding and health education resources and practices do not fully meet the needs of women who breastfeed multiples. This review aimed to review and synthesize qualitative studies on the breastfeeding experiences of women with multiple births.
METHODS: A systematic search was conducted in 10 electronic databases for papers published from the inception of the database to March 2024. The Joanna Briggs Institute Critical Appraisal Checklist for Qualitative Research was utilized to evaluate the methodological quality of the studies included. The thematic synthesis method of Thomas and Harden was employed to integrate and analyze the included literature to derive new categories and conclusions.
RESULTS: Eight studies met the inclusion criteria and quality assessment criteria for this study. Through the integration of their results, four themes were identified: the choice and willingness to breastfeed multiple births; the challenges of breastfeeding multiple births; stage management and individualised adaptation of breastfeeding; and the experience of support.
CONCLUSIONS: Throughout the feeding process from pregnancy to the postpartum period, mothers with multiple births often have predominantly negative experiences with breastfeeding. Consequently, hospitals should create a multidisciplinary follow-up team comprising obstetrics, neonatology, psychology, and community services to offer specialized and personalized support to these women at various stages.
BACKGROUND: [ https://www.crd.york.ac.uk/PROSPERO/ ], identifier [PROSPERO 2024 CRD42024520348].