The purpose of this study is to gain a holistic understanding of the Asian gang phenomenon through the application of a meta-synthesis, which is seldom utilized within the criminal justice and criminology discipline. Noblit and Hare’s (1988) seven step guidelines for synthesizing qualitative research informed this methodology. Through this process, 15 studies were selected for synthesis. The synthesis of these studies not only identified prevalent themes across the sample, but also provided the basis for creating overarching metaphors that captured the collective experience of Asian gang members. Through the interpretive ordering of these metaphors, a line of synthesis argument was developed in which three major inferences about the Asian gang experience were made. First, regardless of ethnic and geographic differences, the experiences of Asian gangs and their members are similar. Second, although extant literature has applied different theories to explain gang membership for individual ethnic gangs (e.g. Chinese, Vietnamese), this synthesis revealed that the dominant theory for explaining the onset and persistence of Asian gangs is Vigil’s (1988) multiple marginality theory. Finally, in comparison to the broader literature, Asian gangs are more similar than they are different to non-Asian gangs because of their overlap in values.

Thesis advisor: Dorothy A. Jones / A metasynthesis of 90 published qualitative studies was conducted on the nurses’, students’, and patients’ perception of nurse caring. A mid-range theory of Nurse Caring emerged from the data, including three attributes: Presence, Concern for the Other, Knowledgeable, Competent Care, and Respect for the Person. The Nurse Caring Patient Scale (NCPS) was developed from patient descriptors within the metasynthesis. NCPS was tested to establish the psychometric properties of the instrument with 341 adult acute in-patients of a northeastern United States metropolitan teaching medical center. Initial reliability for total NCPS was .92. Factor analysis using principal components analysis with varimax rotation resulted in a parsimonious three factor solution that accounted for 50.49 % of the total variance. The final NCPS was 23 items with an alpha of .91. Component 1 (Presence, Concern for the Other) was comprised of 11 items with an alpha of .89. Component 2 (Knowledgeable, Competent Care) contained five items with an alpha of .77. Component 3 (Respect for the Person) had seven items and an alpha of .73. Participants were asked to write about an experience with a nurse. Components of caring and uncaring experiences described by participants did not add to the body of data from the metasynthesis or to the items of the NCPS. This study was limited by sample population, and the items of NCPS may be applicable only to those included in the synthesized qualitative studies. The metasynthesis of qualitative studies and mid-range theory of Nurse Caring add to the theoretical concept of caring by including the patients’ perceptions of the nurse-patient encounter. Components of Nurse Caring add competency, and respect to presence with the patient for a comprehensive definition of caring. NCPS offers nurses and administrators a valid reliable measure for patient perceptions of quality of care and satisfaction that were until now unseen and unmeasured. The theory of Nurse Caring provides nurse educators with a framework for nursing curricula, since the theory incorporates all aspects of nursing practice within its definition. / Thesis (PhD) — Boston College, 2008. / Submitted to: Boston College. Connell School of Nursing. / Discipline: Nursing.

There is no consensus of the concept sexual health in the context of being HIV-positive women. Research in the area tends to focus in different measurable parts of sexual health for HIV-positive women. A meta-synthesis on that research issue can develop a deeper understanding and knowledge of how HIV-positive women in qualitative studies describe and experience sexual health. The purpose with this study is to analyze and synthesize the results about how HIV-positive women describe and experience sexual health. The meta-synthesis follows Noblit and Hare´s method of meta-ethnography and additional use of Walsh and Downe´s checklist to appraise qualitative articles. The result shows that HIV involves changes in the body, sexuality and sexual activity and relationships. The changes lead to feelings of responsibility, fear and hopelessness. Combinations of these feelings lead to actions of avoidance of risks that result in feelings of loss. As a nurse you are expected to promote sexual health as a part of holistic care and with this new knowledge health care workers can help these women to better health and feeling of well-being. / Program: Fristående kurs

Det livslånga lärandet har stor betydelse för framtidens sjukvård. Dessvärre reagerar sjukvården alltför långsamt på denna förändring. Möjligen kan en kombination av grupphandledning och vårdvetenskap vara rätt medicin. Grupphandledning fungerar som en förändringsprocess med syfte att tillvarata och utveckla gruppens samlade kompetens med den lärande är i fokus där vårdvetenskapen mycket väl skulle passa in. Vårdvetenskapen i sin tur är en humanistisk vetenskap som karakteriseras av en holistisk människosyn som stöttar människans grundbehov och tar hänsyn till dennes personliga värderingar och erfarenheter. Syftet med studien är att klargöra om det finns något gemensamt mellan vårdvetenskapen och innehållet i yrkesmässig grupphandledning för vårdpersonal. Studien är en kvalitativ metasyntes där resultatet redovisar fyra grundteman; lära i gemenskap, stärkas som person, ta in den andre och samhörighet vilket tillsammans beskriver vilken påverkan grupphandledningen har för professionalismen. Dock finns det inget gemensamt mellan vårdvetenskapen och innehållet i grupphandledningen, vårdarna utför vården i en vårdvetenskaplig anda utan att vara medvetna om det. Det gemensamma mellan vårdvetenskapen och innehållet i grupphandledningen liknas därför vid ett isberg vilket också är studiens centrala metafor. I syfte att skapa en bättre vård bör grupphandledningen förankras i vårdvetenskapen och då kanske hejda den cynism, nonchalans och arrogans som dessvärre går att hitta i dagens sjukvård och ersätta dem med vårdvetenskapliga begrepp som tillit, förtroende och trygghet. / Program: Specialistsjuksköterskeutbildning med inriktning mot ambulanssjukvård

The literature review produced for this thesis systematically analysed qualitative studies of cognitive therapy using a methodology checklist and a meta-synthesis technique. Ten papers which used qualitative analysis to look at clients’ experiences of Cognitive Behavioural Therapy (CBT) met the selection criteria. Seven themes emerged. Three were linked to a therapeutic relationships theme; the trusted listener, power and authority and others like me. Four were linked to the impact of cognitive therapy theme; empowering information, analysing the problem, thinking differently and doing things differently. It was concluded that future research should focus on the components of cognitive therapy and that differences in technique between CBT and Rational Emotive Behaviour Therapy (REBT) should be explored via a qualitative study of clients’ experiences of REBT. A qualitative approach was taken to look at clients’ experiences of REBT. Seven participants were interviewed using a semi-structured interview guide and the resulting transcripts were analysed using interpretive phenomenological analysis. Three themes emerged: one which looked at what it was like to have mental health problems; a second, which looked at clients’ expectations and experiences of the more technical aspects of therapy, and a third which examined the therapeutic relationship. All of the participants appeared to value therapy. However, the extent to which they knew about and used the theory and philosophy of REBT varied greatly. These results suggest that further research needs to be carried out which looks at how people benefit from therapy as clients views may differ from those of therapists. A critical appraisal of the research process was written using the REBT model to reflect the experience of producing the thesis.

Effective communication in the doctor-patient relationship is an essential component to proper diagnosis and treatment (Gordon & Gerber, 2010). While a greater focus on improving doctor-patient communication needs to be addressed, nowhere is it more important than in interactions between geriatric patients and general practitioners. This study analyzes and synthesizes the findings of 16 selected socio-medical journal articles that report on the views of geriatric patients’ needs and desires when interacting with general practitioners. The findings of this study contribute a geriatric perspective to the current debate regarding patient-centred care and also identify communication barriers and facilitators that can be avoided or used by physicians when interacting with geriatric patients. By bringing together multiple socio-medical qualitative studies that look at geriatric patients’ perspectives, this research seeks to create an evidence base that is valued by both medical practitioners and policy-makers. / Thesis (Master, Cultural Studies) -- Queen's University, 2013-09-27 14:34:32.474

This thesis explores communication with children affected by sickle cell disease about their condition from the perspectives of both children and parents. It includes three papers: A literature review, an empirical paper and a critical appraisal. Papers one and two have been prepared for submission to Social Science and Medicine and Qualitative Health Research, respectively. Paper one is a meta-synthesis of qualitative literature investigating experiences of communication from the perspective of children with sickle cell disease. A systematic literature search revealed nine relevant papers, which were synthesised by extracting findings related to communication about sickle cell disease. Children were found to receive inconsistent messages about their condition from different personal and professional groups. Communication about the prognosis of sickle cell disease and the social acceptability of the condition differed across the groups. The implications for children's understandings of their condition and their adjustment are discussed. Paper two presents an empirical study of parental communication experiences with children affected by sickle cell disease. Twelve interviews were conducted and subject to inductive thematic analysis which was applied within a contextualist epistemological framework. Parents described skills in 'coaching' their child to negotiate the various challenges associated with managing sickle cell disease. They also described ways in which they avoided challenging topics of communication such as inheritance, the risk of comorbid disease and the life-long nature of the condition. The findings suggest a need for healthcare professionals to support parents in overcoming barriers to talking about difficult topics. This may facilitate more consistent communication between parents and professionals, which has implications for improving child wellbeing and adjustment. Paper three is a reflective piece and is not intended for publication. It critically evaluates papers one and two and discusses the joint implications of the findings for research and clinical practice. Reflections on the experience of conducting a meta-synthesis and an empirical qualitative study are offered in the context of personal and professional development.

Objectives: The objectives of this thesis were to: (i) understand the experiences of parents/caregivers of children with inherited metabolic diseases (IMDs), including perceptions of the health care system; and (ii) identify important patient/family-centred outcomes for measurement in future studies. Methods: A qualitative study used semi-structured interviews to gain in-depth insight into caregivers’ experiences. In an adapted meta-synthesis study, the qualitative findings were integrated with the results of related research to identify priority outcomes. Results: Twenty-one caregivers were interviewed. Participants described adjusting to the management of their child’s illness through specific coping strategies but reported stress related to social development. While generally satisfied with disease-specific care, participants described negative experiences with non IMD-specific health services. Health-related quality of life, parental coping, and specific experiences with health care emerged as high-priority outcomes. Conclusions: This project contributes to the limited published literature on caregiver experiences with pediatric IMD and informs future patient-centred research.

Bakgrund: Det är sen tidigare känt hur återhämtning från psykisk ohälsa yttrar sig. Återhämtning och vägen dit anses vara högst individuell, om än med vissa gemensamma faktorer. Mindre omskrivet är återhämtning från psykossjukdom. Det är av värde att ytterligare litteraturstudier görs för att förtydliga och stärka eller identifiera nya gemensamma drag inom återhämtning vid psykossjukdom. Syfte: Sammanställa individers upplevelse av återhämtning vid psykossjukdom. Metod: En systematisk litteraturstudie bestående av 11 studier med kvalitativ ansats. Analysförfarandet genom metasyntes i enlighet med Howell Major och Savin-Baden. Resultat: Metasyntesen resulterade i tre tredje nivåns tema: Att individen förändras och utvecklas under återhämtningen, Att omgivningen bidrar till återhämtning och Att återhämtningsprocessen har hinder. Diskussion: Jämförelser med tidigare reviewstudiers resultat görs. Vissa skillnader återfinns, främst att återhämtning innebär att vara symtomfri. Likheter som framkommer är att återhämtning är en subjektivt upplevd process. Slutsats: Vetenskapligt stöd för litteraturstudiens resultat finns. Stark indikation för klinisk implikation då studiens resultat kan vara användbart för sjuksköterskor i motivationsarbete med patient. / Background: It is previously known what recovery from mental illness is. The recovery journey is a subjective process, even if some factors are recurrent. Less known is recovery from psychotic disorders. It is of great value that further systematic reviews cover the topic to clarify or strengthening already known results, or to find unknown facts about recovery from psychotic disorders. Aim: To compile the experiences of individuals recovering from psychotic disorders. Method: A systematic review including 11 studies with a qualitative approach, analyzed through meta-synthesis as described by Howell Major and Savin-Baden. Findings: The meta-synthesis resulted in three third-level themes: The individual changes and evolves during the recovery, The environment contributes to reco-very and The recovery process has obstacles. Discussion: Comparison with pre-vious reviews are made. Some differences are found, mainly that recovery means being symptom free. Similarities that emerge are that recovery is a subjectively experienced process. Conclusion: Scientific support for the systematic review is presented. Strong indication for clinical implication as the study's results may be useful for nurses in motivational work with a patient.

Although adolescents experience psychological difficulty at a rate higher than any other age group, most do not get the support they need. The purpose of this study was to explore perceptions about barriers, facilitating factors, and help-seeking preferences for psychological support among adolescents. This study involved Best, Gil-Rodriguez, Manktelow, and Taylor’s conceptual framework pathways to online help-seeking to help explain adolescents’ perceptions of factors that influence them seeking support as well as identify pathways for support. A qualitative meta-synthesis design was used to synthesize findings of individual qualitative studies into themes around the central phenomenon of adolescent help-seeking. Data were collected by conducting an exhaustive literature review that initially identified 634 potential records, 16 of which met the specific inclusion criteria. The findings of this study indicate that adolescents identify 2 distinct pathways for support: formal and informal sources. Adolescents in the studies identified preferred informal sources of support as family (most often mothers), and school personnel (most often teachers), and most did not see formal sources as a viable option. Trust emerged as a primary factor in who, if anyone, adolescents chose to seek emotional support from. Other indicators of help-seeking included self-reliance, mental health literacy, stigma, and helper characteristics. Social change implications of this study include encouraging opportunities for schools to promote help-seeking by increasing mental health literacy for both students and staff and collaborating with families and professionals to promote transition to formal services.