Effectiveness of cognitive rehabilitation for people with multiple sclerosis: a meta-synthesis of patient perspectives

While previous randomised controlled trials and meta-analyses offer only limited evidence for the effectiveness of cognitive rehabilitation, qualitative studies examining patient perspectives report more positive outcomes. This meta-synthesis of qualitative studies examined patient perspectives of cognitive rehabilitation for memory, attention, and executive function problems in people with multiple sclerosis. Using set eligibility criteria, we screened electronic databases, reference lists, and academic networks for relevant papers. Seven papers (195 participants) were selected. Two independent researchers conducted quality appraisals of papers. Data analysis, guided by the thematic synthesis approach, yielded six main themes. These suggested that patients benefitted from the group environment in rehabilitation. Cognitive rehabilitation facilitated the participants’ reflection and awareness of their cognitive deficits, and was associated with increased knowledge and understanding of their illness. Increased strategy use was reported and associated with improvements in cognitive functioning and greater confidence and perseverance. Participants reported emotional and social improvements, and felt more optimistic. Overall, these changes had a positive impact on participants’ quality of life. This synthesis of qualitative studies indicates that people with multiple sclerosis who experience cognitive deficits benefit from cognitive rehabilitation programmes. This finding must, however, be viewed in light of the limitations of this meta-synthesis. The meta-synthesis was registered in the PROSPERO database under CRD42017040148

The Lived Experience of Bipolar Disorder: A Systematic Review and Meta-Synthesis

The purpose of this meta-synthesis was to review the available qualitative research on the lived experience of persons with bipolar disorder in order to find common themes that may enhance practitioner understanding. In this meta-synthesis, limited to studies conducted in the United States, 12 studies involving 234 participants met the authors’ inclusion criteria, and the following four major crosscutting themes, with subthemes, were identified: the process of acceptance of the diagnosis; its negative impact on relationships; internal coping strategies; and reliance on social support. Implications of these findings for direct practice are explored

A meta-synthesis of qualitative research on perceptions of people with long-term neurological conditions about group-based memory rehabilitation

The effectiveness of memory rehabilitation based on randomised controlled trials and meta-analyses has been inconclusive, but patient reports based on qualitative studies have been largely positive. We conducted a meta-synthesis of qualitative studies of group-based memory rehabilitation programmes for people with neurological conditions. Based on systematic searches of electronic databases and reference lists, five papers (87 participants) were selected. Quality appraisal of papers was conducted by two independent reviewers using the Critical Appraisal Skills Programme tool. Data synthesis was guided by the meta-ethnography approach. Fiver higher order themes were elicited. These suggested that memory rehabilitation was associated with insight and acceptance of participants’ neurological condition and resultant cognitive deficits. The therapeutic effects of the groups, with social support and leisure activities, helped with participants’ confidence. There were improvements in memory related to better self-awareness and learning to use new skills and strategies to compensate for memory deficits. These improvements also related to other psychological effects, in terms of positively affected mood, confidence and fatigue. Ultimately, these changes had a positive impact on daily life, with changes seen in the personal, inter-personal and professional spheres. Therefore, this synthesis of qualitative studies suggests that memory rehabilitation offers positive outcomes for people with long-term neurological conditions

Meta-Synthesis of Qualitative Case Studies: An Approach to Theory Building

The purpose of this article is to provide the research design of a meta-synthesis of qualitative case studies. The meta-synthesis aims at building theory out of primary qualitative case studies that have not been planned as part of a unified multisite effect. By drawing on an understanding of research synthesis as the interpretation of qualitative evidence from a postpositivistic perspective, this article proposes eight steps of synthesizing existing qualitative case study findings to build theory. An illustration of the application of this method in the field of dynamic capabilities is provided. After enumerating the options available to meta-synthesis researchers, the potential challenges as well as the prospects of this research design are discussed. © The Author(s) 2013

Coping Skills for Students with ADHD

Students diagnosed with Attention Deficit/Hyperactivity Disorder (ADHD) are often seen as problem students with little hope for academic success. It is common for these students to be medicated with a daily dosage of stimulants to help them function more appropriately in the classroom. This meta-synthesis identifies multiple ways to work with students with ADHD; effective interventions can help students with ADHD cope with their disorder and become more successful students

A qualitative meta-synthesis: public health nurses role in the identification and management of perinatal mental health problems

Aim: To report findings of a systematic review and meta-synthesis of qualitative studies exploring public health nurses’ perceptions and experiences of identifying and managing women with perinatal mental health (PMH) problems. Background: Public health nurses play a key role in supporting women who experience PMH problems and several qualitative studies have explored their role. Design: Systematic review and meta-synthesis. Data sources: A comprehensive search was developed and multiple databases were searched from 2000–2015. Review methods: Studies that employed qualitative methods to explore experiences of public health nurses in identifying and managing women with PMH problems were included. Two reviewers independently assessed the methodological quality of studies. Themes, concepts and interpretations were extracted and synthesized using the process of thematic analysis. Results: Fifteen papers including 14 unique qualitative studies were included. Two overarching themes were identified: ‘conceptualization and detection of PMH problems’ and ‘barriers and facilitators to management’. The former of these comprised several subthemes including the use of formal screening tools vs. clinical intuition and challenges encountered in detection. The latter theme, barriers to management included availability of referral pathways and time. In terms of facilitators, training, public health nursing interventions, support groups and referral pathways were identified as factors that optimize management. Conclusions: Public health nurses use a variety of methods to identify women with PMH problems. However, several support structures are needed to optimize management including access to appropriate referral pathways, support groups and relationship continuity

A qualitative meta-synthesis of young peoples' experiences of ‘sexting’

Objective: To conduct a meta-synthesis of the qualitative research to explore young people's experiences and use of smart phones to send and receive sexually focused messages and images. Design: A qualitative meta-synthesis was conducted on the retrieved papers following a systematic search of PUBMED, Cumulative Index to Nursing and Allied Health Literature (CINAHL), COCHRANE, Embase, Medline and Psycinfo. The sample included five qualitative studies with a total sample size of 480 participants. Results: The meta-synthesis of the papers resulted in the development of four central themes: gender inequity, popularity with peers, relationship context, and costs and benefits. Conclusions: Drawing the qualitative work together highlights the manner in which ‘sexting’ is more nuanced than traditional ‘cyber-bullying’. The consensual sending of intimate images is a highly gendered activity. The gender issues require work with female students to explore the issue of ‘sexting’ and how it can be harmful. Work with male students around the issues of respect and gender harassment in relation to ‘sexting’ is also required and should contribute to sex and relationships education. The results indicate that school nurses working with young people need to build discussions about the use of technology within relationships into their work with young people

Teaching Language to Students with Autism

This meta-synthesis of the literature on methods of instruction to students with ASD examines the various methods of teaching language to students with ASD. While each student learns language at his or her own pace, the author has found that certain methods yield results quicker, and these methods need to be examined critically for any literature on their reliability, efficacy, and scientific research. If a student with autism can be taught language quickly, therefore mitigating any further delays in academic development relative to peers, then this methodology should be made accessible to all teachers of such students

THE INFLUENCE OF TEACHERS WITH DISABILITIES

This meta-synthesis of the literature on K-8 teachers with disabilities examines the profound influence that teachers with disabilities can have in our classrooms. Teachers with disabilities act as valuable and realistic role models for all students and bring unique qualities to the classroom, including a passion for inclusive education and creative methods of instruction. However, prejudicial barriers to success often restrict these exceptional teachers from access to our classrooms, undermining the inclusion movement present in most special education programs and schools today. When these teachers are denied employment, students with disabilities suffer in and out of the classroom from a lack of identity construction, reduced self-esteem, and nonexistent advocacy skills

Asperger's and the Effective Learning Environment

This meta-synthesis of the literature on developing an effective learning environment for children with Asperger Syndrome examines four critical areas that help support academic and social growth and self-advocacy. Early intervention and social skills instruction, while considering the specific needs of the child are foremost and provide the foundation from which all future learning will evolve. Effective learning not only encompasses approaches that are person-centered but also requires adaptations that support transition. For the Asperger child, as he moves into adulthood, transitioning can be especially challenging. As an adult, with ongoing support and interventions, transitions can be opportunities for self-awareness and growth