Reading, writing and systematic review

This paper offers a discussion of the reading and writing practices that define systematic review

Tenerlos en la casa: the material world and craft of family caregiving for relatives with dementia

The environment has been found to be critical to the well-being of patients with dementia. The purpose of this study was to describe strategies Colombian caregivers used in the home to manage the care of relatives with dementia. Grounded theory techniques were used. Interviews were conducted in Medellín, Colombia, with 18 primary caregivers and 2 health care professionals. Participant observations were conducted in caregivers’ support groups and homes. Family caregivers rebuilt the environment as the disease progressed to accommodate caregiving and preserve family life. Caring for a relative with dementia is a craft that transforms the material world in which patient and caregiver live. The findings show the value of place-sensitive approaches to the study and practice of caregiving

Living the Golden Rule: Reciprocal Exchanges among African Americans with Cancer

Giving is receiving, and receiving is giving. This is the key finding from interviews conducted with 28 African American women and men with cancer who were active participants in dynamic relationships characterized by both giving and receiving. These participants engaged in reciprocal relationships varying in the number of persons involved, types of resources exchanged, and timing of exchange. Findings suggest the need to reconceptualize social support as caregiving and caregiving as social support. This study also points to the need to redesign intervention studies to be more inclusive of components that allow the elderly in illness-related situations to maintain their status as givers in their social networks

“It's a touchy subject”: Latino adolescent sexual risk behaviors in the school context

Adverse sexual health outcomes remain disproportionately high for Latino adolescents. To examine sexual risk behaviors in Latino adolescents, we conducted in-depth interviews with 18 Latino parents and 13 school staff members and carried out one year of fieldwork in the school and community. “It’s a touchy subject [sex] here” exemplified the reluctance of addressing sexual risk behaviors. Community and systems-level strategies are recommended

Delimiting Family in Syntheses of Research on Childhood Chronic Conditions and Family Life

Synthesis of family research presents unique challenges to investigators who must delimit what will be included as a family study in the proposed review. In this paper, the authors discuss the conceptual and pragmatic challenges of conducting systematic reviews of the literature on the intersection between family life and childhood chronic conditions. A proposed framework for delimiting the family domain of interest is presented. The framework addresses both topical salience and level of relevance and provides direction to future researchers, with the goal of supporting the overall quality of family research synthesis efforts. For users of synthesis studies, knowledge of how investigators conceptualize the boundaries of family research is important contextual information for understanding the limits and applicability of the results

Comparability work and the management of difference in research synthesis studies

The new imperative to be more methodologically inclusive has generated a burgeoning interest in synthesizing the findings of qualitative and quantitative studies, or mixed research synthesis. Yet, the very diversity seen to define the mixed research synthesis enterprise is also considered to defy it as it intensifies the problem of comparing the seemingly incomparable to enable the combination of the seemingly uncombinable. We propose here that the research synthesis enterprise, in general, and the mixed research synthesis enterprise, in particular, entail comparability work whereby reviewers impose similarity and difference on the studies to be reviewed. The very study diversity requiring management does not exist a priori but rather is itself an outcome of comparability work already done whereby judgments have been made about what constitutes methodological and topical diversity and uniformity. Conceiving the research synthesis process as defined by comparability work moves the backstage interpretive work of systematic review to center stage and, thereby, sets a new stage for addressing the methodological issues involved. These issues are explored by reference to the synthesis of empirical studies of antiretroviral adherence in HIV-positive women in the US

Research results have expiration dates: ensuring timely systematic reviews

Time and timeliness are key issues in appraising and ensuring the clinical relevance of systematic reviews. Time considerations entering the systematic review process include the history of the clinical problem, disease, or treatment that is the target of the review, and the history of the research conducted to address it. These considerations guide: (i) formulation of the research problems and questions; (ii) setting of parameters for the search and retrieval of studies; (iii) determination of inclusion and exclusion criteria; (iv) appraisal of the clinical relevance of findings; (v) selection of the findings that will be synthesized; and (vi) interpretation of the results of that synthesis

On Quantitizing

Quantitizing, commonly understood to refer to the numerical translation, transformation, or conversion of qualitative data, has become a staple of mixed methods research. Typically glossed are the foundational assumptions, judgments, and compromises involved in converting disparate data sets into each other and whether such conversions advance inquiry. Among these assumptions are that qualitative and quantitative data constitute two kinds of data, that quantitizing constitutes a unidirectional process essentially different from qualitizing, and that counting is an unambiguous process. Among the judgments are deciding what and how to count. Among the compromises are balancing numerical precision with narrative complexity. The standpoints of “conditional complementarity,” “critical remediation,” and “analytic alternation” clarify the added value of converting qualitative data into quantitative form

Using qualitative metasummary to synthesize qualitative and quantitative descriptive findings

The new imperative in the health disciplines to be more methodologically inclusive has generated a growing interest in mixed research synthesis, or the integration of qualitative and quantitative research findings. Qualitative metasummary is a quantitatively oriented aggregation of qualitative findings originally developed to accommodate the distinctive features of qualitative surveys. Yet these findings are similar in form and mode of production to the descriptive findings researchers often present in addition to the results of bivariate and multivariable analyses. Qualitative metasummary, which includes the extraction, grouping, and formatting of findings, and the calculation of frequency and intensity effect sizes, can be used to produce mixed research syntheses and to conduct a posteriori analyses of the relationship between reports and findings

The Nurse’s Medication Day

The medication administration stage of the medication-use process is especially vulnerable to error because errors are least likely to be caught before reaching the patient. Medication administration, however, remains poorly understood. In this article we describe medication administration as observed in an ethnographic study conducted on one medical and one surgical unit. A central finding was that medication administration entailed a complex mixture of varied and often competing demands that temporally structured the nurses' entire workday. Articulation work was evident in time management strategies nurses used to handle demands from institutional policies, technical devices, patients, the physical environment, and the medications themselves. The average number of doses of medication per patient was more than double the number policy groups have indicated. Medication administration is neither simply the giving of drugs nor does it have clearly defined temporal boundaries. Because of its inseparability from other nurses' work, medication administration inherently entails interruption, thereby calling into question the current emphasis on reducing interruptions as a tactic to decrease medication errors