Mothers’challenges and experiences of children with cerebral palsy:a qualitative meta-synthesis

Objective:To examine what challenges and experiences a mother faces in caring for children with cerebral palsy(CP).As the main caregiver of children with CP,mothers are under multiple pressures.Even though mothers’challenges and experiences of children with CP will affect their quality of life and the rehabilitation of the children,little is known about their challenges and experiences during the whole care.Methods:A qualitative meta-synthesis was conducted to extract and analyze qualitative research from the PubMed,CINAHL,PsycINFO,Web of Science,Ovid and MEDLINE databases.Thirteen articles were selected and analyzed using thematic syntheses.Results:From 2522 screened abstracts,84 texts were reviewed,and 13 studies met the inclusion criteria.Mothers’challenges and experiences of children with CP include 4 themes,both positive and negative.Conclusions:The mothers of children with CP suffer from physical burden,as well as psychological pressure,in the care experience;social and healthcare support are their main challenges.Interventions to help them face the difficulties and adapt to the role of caregivers as soon as possible should target multiple aspects in order to maximize effectiveness,to promote the healthy growth of children with CP.

Effectiveness of non-pyrimethamine-based regimens for toxoplasma encephalitis:A systematic and meta-synthesis study

Objective:To examine the differences in effectiveness and side effects between pyrimethamine-based and non-pyrimethamine-based regimens for toxoplasma encephalitis since the availability of pyrimethamine in Indonesia is currently limited due to its withdrawal from the market.Methods:A systematic review and meta-synthesis study that was carried out by following a protocol guided by the Preffered Reporting Items for Systematic Review and Meta-analysis(PRISMA).Effectiveness measures included clinical improvement,mortality,and radiological improvement.We evaluated selected articles narratively because of the limitations of homogeneity.The risk of bias in RCTs was assessed using the Cochrane Risk of Bias tool for RCT(ROB 2.0)and cohort studies were assessed using the Risk of Bias In Non-Randomized Studies of Interventions(ROBINS-1)tool.Research quality was assessed using the GradePro software.Results:We included two retrospective cohort studies and one RCT.Narrative outcome assessment in these three studies did not show significant difference in effectiveness between pyrimethamine-based and non-pyrimethamine-based regimens for toxoplasma encephalitis treatment.However,drug side effects were consistently higher in the pyrimethamine-based regimen.Conclusions:This study has a high risk of bias.The quality of the research also has a low recommendation value.However,the results may be considered for application if a standard regimen is not available.

Nursing students’ experiences of caring for dying patients and their families: a systematic review and meta-synthesis

Objective: Nurses play important roles in caring for dying patients and their families. Difficulties students confronted when facing dying patients challenge the quality of nursing education. A better understanding of students' experiences would enhance teachers' ability in helping students. This study aims to describe available evidence about nursing students' experiences when caring for dying patients and their families.Methods: A review of qualitative studies published between 2005 and 2017 was undertaken using the following databases: MEDLINE, CINAHL, ProQuest Central, ScienceDirect, and CNKI. The keywords included were nursing students, experience, care, end-of-life, and dying. Qualitative Assessment and Review Instrument was used to assess the quality of the studies by two independent reviewers. The data from the studies were analyzed by meta-synthesis.Results: Eighteen English and two Chinese studies were selected in this review. Four themes were emerged:(1) Students with dying patients: students did not have enough ability in symptoms control, comfort supply, and therapeutic communication for dying patients.(2) Students with the patients' families: students advocated more caring for patients' families.(3) Students with the surroundings: professional medical staffs, especially the nursing preceptors, were key roles in constructing a supporting system for students.(4) Students with themselves: nursing students underwent various negative feelings and adopted both negative and positive strategies to cope with such feelings;students experienced professional and personal development during the caring for dying patients.Conclusions: Nursing students' abilities in terminal symptom control, comfort supply, and therapeutic communication should be improved by more theoretic learning and simulation practice. The nursing preceptors were key roles in constructing a supporting system for students and helping them to control the negative emotions when facing dying patients.

Psychological experience of infected individuals during the pandemic: A qualitative meta-synthesis

The purpose of this review is to integrate the psychological experience of infected individuals during the pandemic.The spread of the pandemic has led to psychological and emotional impacts on patients.A qualitative synthesis is needed to identify,appraise,and integrate the available qualitative findings to provide an evidence for the development of interventions.A meta-aggregation approach was used to analyze studies published in English from January 2020 to August 2021.The JBI Qualitative Assessment and Review Instrument was used to assess the methodological quality of included studies.The ConQual system was used to establish the dependability and credibility in the synthesized findings.Six phenomenological studies and one narrative inquiry with an overall quality score of 70%-100% were included.The research findings from 87 participants in eligible studies were aggregated into three categories based on similarity of meaning.Two synthesized findings were generated and rated as moderate based on the ConQual score.The synthesized findings suggested that participants had psychological distress such as fear,anxiety,loneliness,and uncertainty,but they accepted the fact of being infected and tried to adjust themselves using some self-coping strategies,such as diverting attention from disease,seeking help from professional counselors,relying on religious beliefs,and participating in religious activities.They would like to learn more about infections and diseases and needed more informational support from health-care professionals.They were looking forward to recovery from the disease.

Symptom experience in patients with cancer-related fatigue:A systematic review and meta-synthesis

To understand the real experiences of patients with cancer-related fatigue and to promote quality of life,the researchers used computer searches of PubMed,EMbase,CINAHL,PsycINFO,Web of Science,and China National Knowledge Infrastructure,China Biology Medicine disc,Wanfang Data,China Science and Technology Journal Database for relevant qualitative studies from the inception to November 1,2021.The results showed that a total of 16 papers were included,and 57 outcomes were distilled into 9 categories,which were pooled into four integrated outcomes,such as somatic,psychological and social support and so on.It is concluded that patients with cancer-related fatigue are not only in the midst of multidimensional,unspeakable somatic experiences,and complex psychological experiences,they are also hindered in coping with fatigue symptom and social life.Therefore,healthcare professionals should provide health interventions and psychological support to those patients whenever possible.

Women’s Perception Concerning Health Care in the Post-Partum Period: A Meta-Synthesis

This meta-synthesis presents the results of qualitative studies on puerperal perception concerning woman’s care in the post-partum period. Four databases were researched using keywords such as “postnatal care” (or) “postpartum period”, (and) “care”, “women”, “perception”, “qualitative research”, “women’s health services”, “community health services”, “allied health personnel”, “primary health care”, resulting in 9 articles for analysis. Six themes were identified: interpersonal relationship, information, communication, attending the necessities, service organization and other supports. Results report mainly on the unsatisfactory professional care for women, appreciating the form of dealing with promptness and the timing to be attended;trust;content, coherence and the way to inform;clarification of doubts;friendly conversation and clinical assistance. The professional workload was restricted on postpartum period care quality. There were gaps found in clinical practice and in dialogical communication and information on women’s health necessities.

A Meta-Synthesis Study of MOOC Literature on Students' Learning

This research is a meta-synthesis study of Massive online open course(MOOC) literature on students' learning.It aims to investigate key components for the design of a MOOC as well as the benefits and challenged engaged in MOOCs' learning.It is found that in MOOC's all stages,discussion forum,video features and instructor's teaching are well connected to each other.

The impact of biophilic design in Maggie’s Centres:A meta-synthesis analysis

This paper presents a meta-synthesis conducted to identify,compare and synthesize published qualitative data related to the Maggie’s Centres,as a paradigmatic architectural example in the provision of non-institutional cancer support.These centres are internationally renowned for their unique architecture,where the careful design of indoors and outdoors spaces plays a critical role in their agenda for supporting care.Previous research has thoroughly analysed this approach to therapeutic environments,not only confirming the importance of designed space as originally conceived in Maggie’s philosophy but also identifying precise supporting effects associated with specific elements within their design.This paper aims to provide a new reading of Maggie’s contribution to cancer support by offering an examination of all these data through the lens of biophilia,which clarifies the impact of design decisions connected to nature on cancer patients’lives.The analytic process included a systematic search strategy,extraction and classification of salient concepts using an opencoding approach,and lastly an interpretive evaluation.The systematically selected data helped to identify and rank the biophilic design parameters that appear the most critical for promoting and supporting human health and wellbeing in non-clinical therapeutic environments,from the user’s perspective.It also provided a compilation of distinctive design interventions related to biophilic parameters,which provides benchmark information for future research and design guidance in these environments.

SOME DEVELOPMENTS IN THE STUDIES OF META-SYNTHESIS SYSTEM APPROACH

In the early 1990s, Professor Qian Xuesen (Tsien HsueShen) and his colleagues proposed the Metasynthesis system approach for solving the open complex giant system problems. The method emphasizes the synthesis of collected information and knowledge of various kinds of experts, and combining quantitative methods with qualitative knowledge. Later it is evolved into Hall of Workshop for Meta-Synthetic Engineering (HWMSE) which emphasizes to make use of breaking advances in information technologies. Then continuous endeavors have been taken to put those ideas into practice. With tremendous advances in networking and distributed computing technologies, past difficulties in implementation are disappearing together with farther understandings of HWMSE and fruitful results achieved in similar or relevant research fields in recent years in China. In this paper some of those development are introduced, together with some parallel research work abroad.

META-SYNTHESIS APPROACH TO EXPLORING CONSTRUCTING COMPREHENSIVE TRANSPORTATION SYSTEM IN CHINA

In this paper, meta-synthesis system approach （MSA） is applied to a consulting project on exploring constructing comprehensive transportation system in China. Firstly, brief introduction about the concept of comprehensive transportation is given to indicate that comprehensive transportation is an open complex giant system, which thus MSA is applied to exploring its constructing in China. A group argumentation environment （GAE） is applied to facilitate group divergent thinking process about what the concerned topics are in the project and acquire qualitative hypotheses for meta-synthetic system modeling. A multi-agent system model is constructed to analyze competitive relations of passenger transport between railway and highway as a demonstration of modeling by rule, one of 6 strategies of meta-synthetic system modeling. An evaluation support system is developed to integrate a variety of indicators and their related measure methods by a framework of input-output-outcome of comprehensive transportation to facilitate consultants to monitor current state of operation and management of transport system and generate alternatives of a set of indicators to evaluate efficiency or effectiveness of the whole system or its elements on demand.

Research on the Giant and Complex Financial Information System Engineering Management from the Perspective of Meta-synthesis Methodology——with the Bank Card Information Exchange System Engineering as a Sample

The paper empirically studies the engineering practices of the national currency circulation information system-China Union Pay's Bankcard Information Exchange System.By integrating the meta-synthesis methodology and the financial information system engineering,the paper proposes basic principles and processes of the giant and complex financial information system engineering management,and further explores its paradigm and toolkit.

Research and Practice of Meta-synthesis Management for the Government-led Urban Complex Construction Project

This paper researches the overall construction target of government-led urban complex construction projects based on the perspective of sustainable urban development. In order to achieve benefit maximization, the meta-synthesis management for the government-led urban complex construction project is studied. In order to combine theory and practice, several typical government-led urban complex construction project cases, such as Guangzhou Higher Education Mega Center and Guangzhou International Financial City etc. are examined. These examples point to the feasibility of government-led meta-synthesis management and demonstrate the benefits that can be achieved through this model.

Meta-synthesis management framework of a complex project： A case study of the deck pavement project of the Hong Kong-Zhuhai-Macao Bridge

Innovative technology and deep uncertainty during the design and construction process of complex projects introduce great challenges to their organization and management.The traditional methods,represented in the project management body of knowledge(PMBOK)guide,can solve systematic problems;however,they cannot solve complex problems.Based on the management practice implemented in the deck pavement project of the Hong Kong-Zhuhai-Macao Bridge(HZMB),in this work,we propose a meta-synthesis management framework for a complex project from the perspective of the science of complexity.The method deems that the complexity of the project has the characteristic of being multi-scale both in the design phase and the construction phase.These problems can be classified into different categories,each of which requires a different strategy.As a result,it is first necessary to adopt the"exploration"strategy to reduce project complexity and to transform the deep uncertainty problems into systematic problems.Then,the"exploitation"strategy should be used to apply the PMBOK and other traditional methods to achieve the design and construction goals of the project and to improve its efficiency.More specifically,in the design phase of a complex project,the"innovative integration"process is used for the exploration of the new engineering technology and knowledge;then,the"functional integration"process is employed to define the system architecture,the interface relationship,the technical index,and other functions.In the construction phase,the"adaptive integration"process is used for the construction of the engineering organization system;next,the"efficient integration"process is employed to improve the actual construction performance.The meta-synthesis management framework proposed in this work reveals the multi-scale principle of solving complex problems in the management practice of a complex project,and develops the methodology of metasynthesis.

Meta-synthesis of big data impacts on information systems development

Nowadays,it is common to think about big data and its consequences,especially in information systems(IS)room.This study investigated the effects of big data on the design and development of IS,and 167 articles were examined using meta-synthesis and the articles were selected for data extraction.Critical Appraisal Skills Program(CASP)was used to evaluate the quailty of the selected articles.The findings indicate that volume affects the layer of software engineering tools,but variety and velocity affect the layer of software engineering methods.Therefore,for the development of IS,it is essential to develop systems with specific capabilities.

Call for Papers The 9th International Workshop on Meta-synthesis and Complex Systems

Chengdu/Jiuzhaigou,China June 21-26,2009 http://msks.iss.ac.cn:8080/mcs2009/ http://www.mcdm2OO9.cn/default.html Co-sponsors Institute of Systems Science,Academy of Mathematics and Systems Science,Chinese Academy of Sciences Japan Advanced Institute of Science and Technology International Society for Knowledge and Systems Science Shanghai Academy of Systems Science

The Psychological Processes of Adaptation and Hope in Patients with Multiple Sclerosis: A Thematic Synthesis

Purpose: The purpose of the current research was to review the lived experiences of patients with multiple sclerosis (MS) in order to extrapolate the psychological process of adaptation. Methods: A thematic synthesis was undertaken within 3 phases: systematic search for literature, critical appraisal of included studies and synthesis of research. Results: A total of 47 studies were included in this review, this included 1146 (812 females, 265 males, and 69 unknown) unique patients with MS (aggregated mean age: 49.3 years [30/47 studies], aggregated time with illness: 12.3 years [28/47 studies]). The critical appraisal of research illustrated that the design of the studies and the reference to reflexivity in studies were not well considered. The synthesis was able to identify a primary response of psychological adaptation as well as distinct coping strategies. A model of emotion, hope, and adjustment was identified. Conclusion: Simple processes of adaptation for people with MS can be considered by clinicians and utilised to promote mental well-being in patients. Clinicians and researchers also need to be aware of the important psychological needs of patients during interactions. Discussion and clinical implications are provided.

Parenting the NICU infant: A meta-ethnographic synthesis

Parenting the infant in the neonatal intensive care unit(NICU)comes with a multitude of unique challenges,and NICU parents are often unprepared and ill equipped for the challenges.Moreover,a gap in the literature still exists concerning a full understanding of the breadth of the process parents of NICU infants undergo from the time of admission to discharge.This study utilized Noblit and Hare's meta-ethnography synthesis method for literature extraction and data analysis to illuminate the NICU parenting process by metaphorically comparing the process to Patricia Benner's novice to expert theory.Fourteen studies including 12 published qualitative research articles and 2 dissertations from the nursing discipline were included in the analysis.Findings illuminated the process of becoming a NICU parent more fully and revealed the most salient and effective facilitators of the process from being a novice and advanced beginner to becoming a competent,proficient,even expert NICU parent.In addition,this paper discusses four influencing factors in a NICU parent's progression:contact with and proximity to their infant,relationship with the nurse,having information,and social support.Nurses must engage with NICU parents in such a way as to maximize the likelihood that these parents will reach at minimum the proficient and at maximum the expert parenting stage by discharge.

Understanding Health Care Professional-Patient Interactions in Multiple Sclerosis: A Systematic Review and Thematic Synthesis

Aim: To examine the experiences of health care professional (HCP)-patient interactions in Multiple Sclerosis (MS), identifying factors that can influence these interactions. Methods: A three-stage systematic review and thematic synthesis of qualitative and quantitative research was undertaken. Stage 1: the systematic literature search;Stage 2: methodological appraisal of the qualitative papers;Stage 3: thematic synthesis of all qualitative papers and the integration of quantitative findings into the synthesis. Results: Forty-nine qualitative studies were identified. This included 1014 individuals with MS (244 male, 755 female and 15 unknown) and 106 carers and 86 HCPs. Seventeen quantitative studies were identified which included 7680 (2008 male, 5812 females, and 40 unknown) participants as well as 224 carers. Two themes are discussed: 1) The expectations, experiences and perceptions of interactions with HCPs, and 2) The factors that influenced interactions and relationships. Discussion: There is need for improvement in the content and provision of information to patients with MS from HCPs. Specific strategies are suggested and implications for patients and health care providers are considered.

The perceptions and experiences of advanced cancer patients and their families in advance care planning:a systematic review and synthesis of qualitative studies

Background:The goal of this study was to conduct a meta-synthesis of advanced cancer patients’and their relatives’experiences with advanced care planning(ACP)and to provide evidence-based guidance for the development and implementation of ACP in advanced cancer patients.Methods:We searched databases including China Knowledge Network,Wanfang database,VIP database,China Biomedical Literature Database,PubMed,Web of Science,Embase,Cochrane Library,and Cinahl from inception to April 2022 to collect qualitative studies on advanced cancer patients and families'experience about ACP.We use Joanna Briggs Institute Critical Appraisal Checklist for Qualitative Research to evaluate the quality of literature.After quality assessment,meta-synthesis was used to summarize and explain the results.Results:Eleven qualitative studies were included involving 29 results and ten categories.Three integrated themes were extracted:facilitators and barriers to the implementation of advanced medical care programs as perceived by patients and families with advanced cancer;attitudes of patients with advanced cancer and their families towards pre-existing medical care programs;suggestions from patients with advanced cancer and their families on the implementation elements of the pre-existing medical care program.Conclusion:ACP is a complex social process and influenced by many factors.It requires joint efforts of different stakeholders to achieve high-quality and successful ACP.

Four development stages of collective intelligence

The new generation of artificial intelligence(AI)research initiated by Chinese scholars conforms to the needs of a new information environment changes,and strives to advance traditional artificial intelligence(AI 1.0)to a new stage of AI 2.0.As one of the important components of AI,collective intelligence(CI 1.0),i.e.,swarm intelligence,is developing to the stage of CI 2.0(crowd intelligence).Through in-depth analysis and informative argumentation,it is found that an incompatibility exists between CI 1.0 and CI 2.0.Therefore,CI 1.5 is introduced to build a bridge between the above two stages,which is based on biocollaborative behavioral mimicry.CI 1.5 is the transition from CI 1.0 to CI 2.0,which contributes to the compatibility of the two stages.Then,a new interpretation of the meta-synthesis of wisdom proposed by Qian Xuesen is given.The meta-synthesis of wisdom,as an improvement of crowd intelligence,is an advanced stage of bionic intelligence,i.e.,CI 3.0.It is pointed out that the dual-wheel drive of large language models and big data with deep uncertainty is an evolutionary path from CI 2.0 to CI 3.0,and some elaboration is made.As a result,we propose four development stages(CI 1.0,CI 1.5,CI 2.0,and CI 3.0),which form a complete framework for the development of CI.These different stages are progressively improved and have good compatibility.Due to the dominant role of cooperation in the development stages of CI,three types of cooperation in CI are discussed:indirect regulatory cooperation in lower organisms,direct communicative cooperation in higher organisms,and shared intention based collaboration in humans.Labor division is the main form of achieving cooperation and,for this reason,this paper investigates the relationship between the complexity of behavior and types of labor division.Finally,based on the overall understanding of the four development stages of CI,the future development direction and research issues of CI are explored.