First-person narratives around sexuality in residential healthcare settings: a meta-ethnographic synthesis

The aim of this review is to identify, critically appraise, and synthesise the existing literature exploring adults’ narratives around sexuality within residential healthcare settings from a first-person perspective. A systematic literature review was undertaken. Six databases were searched. A meta-ethnographic approach was used to synthesise studies’ findings. Thirteen studies using qualitative methodology that met the inclusion criteria were identified. The synthesis revealed six key themes: how service users define sexuality, sexuality as something not to be discussed (“privates are private”), sexuality as a separate aspect of the self (“sectionality”), hopes and fears for the future, the impact of the environment (“physicality of being physical”), and adapted sexuality. The studies included were of varying quality. Sexuality remains an important aspect for many residents, yet is rarely noted or discussed with them by healthcare staff. The residential healthcare environment presents implicit and explicit barriers to sexuality expression, causing residents to adapt how they experience their sexuality. Findings from this review highlight the importance of considering service users’ perspectives, and the need for open communication between residents and practitioners to facilitate care provision that acknowledges the barriers of the environment on sexuality and considers the person beyond the presenting illness

The views and experiences of suicidal children and young people of mental health support services: A meta-ethnography.

Background: Suicide is amongst the leading causes of death in young people globally and a health priority worldwide. For children and young people (CYP) attempting or considering suicide there is no agreed treatment model. Development of treatment models should be informed by the views and experiences of CYP using services. Methods: Meta-ethnography was used to systematically identify and synthesise studies reporting the views of CYP who used mental health services following suicidal behaviour. Relevant studies were quality appraised. First order (participants) and second order (original author) data were translated to identify common and disconfirming themes and concepts. Translated findings were synthesised and led to a new hypothesis supported by additional ‘linguistic analysis’ of texts to construct a novel third order line-of-argument. Results: Four studies conducted since 2006 in three countries involving 44 young people aged 11-24 years were synthesised. Translation revealed that suicidal CYP do not know where or how to access help, they cannot access help directly and when seen by mental health practitioners they do not feel listened to. Line-of-argument synthesis identified a silence around suicidality within the conversations CYP have with mental health practitioners and within academic research reporting. Use of the term ‘self-harm’ to encompass suicidal behaviours potentially contributes to this silence by avoiding the word ‘suicide’. Conclusions: CYP who are suicidal need to have easy access to mental health services. When using services, they want to feel listened to and have suicidal feelings acknowledged. This involves professionals referring explicitly to suicide not just self-harm

Connectivity, contest and the ties of self‐management support for type 2 diabetes: a meta‐synthesis of qualitative literature

This paper presents a meta-synthesis of the literature on community-based self-management to support experiences of people diagnosed with type 2 diabetes. The aim was to synthesise findings on both formal and informal self-management support with particular reference to the relevance and influence of the social context operating at different levels. The review forms part of EU-WISE, a project financed through EU's 7th Framework Programme. The review was performed by systematically searching MEDLINE, PubMed, EMBASE, CINAHL, PsycINFO and Web of Science for English language publications between 2005 and 2014 presenting research conducted in Europe on the experiences and perspectives of self-management concerns of patients diagnosed with type 2 diabetes. The search yielded 587 abstracts, which were reduced through search strategy refinement and eligibility and quality criteria to 29 papers that were included in the review. This review highlights the relevance of contextual factors operating at micro- and macro-levels. The synthesis yielded six second-order thematic constructs relating to self-management: sense of agency and identity, the significance and meaning of social networks, minimal disruption of everyday life, economic hardship, the problem of assigning patients' responsibility and structural influences of primary care. Using a line of argument synthesis, these themes were revisited, and a third-order construct, connectivity emerged which refers to how links in daily life are interwoven with peoples' social networks, local communities, economic and ideological conditions in society in a way which support self-management activities. This meta-synthesis indicates a need to heed the notion of connectivity as a means of mobilising and supporting the self-management strategies of people with type 2 diabetes in everyday life

A systematic review of the literature on counselling and psychotherapy for the prevention of suicide 2 : Qualitative studies

Scope of review: The paper reports a meta-synthesis of 13 qualitative studies of counselling and psychotherapy with people at risk of suicide. Publication time span: The studies considered were reported between 1997 and 2006. Publication origin: Seven studies were conducted in the UK, four in the USA, one in Canada, and one in Sweden. Findings: Themes in clients' and therapists' accounts of the process of counselling or psychotherapy were therapist qualities; therapy components; theoretical framework; and therapy techniques. Themes in their accounts of the effectiveness of counselling and psychotherapy were decrease in self-destructive behaviour, and quality of life. Themes in clients' views of barriers to effective counselling or psychotherapy were therapist characteristics; therapy components; secrecy; and transferring to the real-life situation. Secrecy was also identified as a barrier by therapists, as were responsibilities of the profession; training; and the nature of suicide and self-harm. Facilitators of successful counselling and psychotherapy as identified by clients were responsibility; support; and teaching therapy skills to family members, the latter also being identified by therapistsPeer reviewe