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Experiencing and responding to chronic cancer-related fatigue: A meta-ethnography of qualitative research.

ABSTRACT: OBJECTIVE:One of the most prevalent and disrupting symptoms experienced by cancer patients is chronic cancer-related fatigue (CCRF). A better understanding of the chronic nature of CCRF can provide valuable insights for theory and practice. The purpose of this meta-ethnography was to derive an overarching interpretative narrative on patients' experiences and responses to CCRF. METHODS:We conducted a comprehensive systematic literature search in five databases (05-03-2018). In addition, papers from reference lists were retrieved. Two researchers independently screened the papers for eligibility and appraised quality (CASP-criteria). We followed the seven phases of meta-ethnography to extract, translate, and synthesise first-order constructs (ie, patients' views) and second-order constructs (ie, authors' views) from the selected studies into third-order constructs (ie, new interpretations). RESULTS:Of the 1178 collected articles, 16 articles were included. Through synthesis, a new figure of six interrelated third-order constructs was developed: (1) embodied experience entails the dominating presence of the body; (2) (mis)recognition includes lack of recognition of CCRF by patients, relatives, and health providers; (3) small horizon describes a resultant narrowed world; (4) role change encompasses adopting other life roles; (5) loss of self refers to the impact on one's identity; and (6) regaining one's footing describes the struggle against CCRF, adaptation to CCRF and finally acceptance of a "new normal with CCRF." CONCLUSION:A new embodiment figure of CCRF with social (eg, (mis)recognition), spatial (eg, small horizon) and temporal dimensions (eg, regaining one's footing) was developed. This figure can help professionals to recognise CCRF, inform patients, and personalise treatment.

SUBMITTER: Bootsma TI

PROVIDER: S-EPMC7027742 | biostudies-literature | 2020 Feb

REPOSITORIES: biostudies-literature

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Experiencing and responding to chronic cancer-related fatigue: A meta-ethnography of qualitative research.

Bootsma Tom I TI Schellekens Melanie P J MPJ van Woezik Rosalie A M RAM van der Lee Marije L ML Slatman Jenny J

Psycho-oncology 20190910 2

<h4>Objective</h4>One of the most prevalent and disrupting symptoms experienced by cancer patients is chronic cancer-related fatigue (CCRF). A better understanding of the chronic nature of CCRF can provide valuable insights for theory and practice. The purpose of this meta-ethnography was to derive an overarching interpretative narrative on patients' experiences and responses to CCRF.<h4>Methods</h4>We conducted a comprehensive systematic literature search in five databases (05-03-2018). In addi ...[more]

PMID: 31442340

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Project description:Play in nature-based environments in childhood education has positive benefits for child development. Although previous reviews showed the benefits of play in nature-based environments for child development they did not attempt to understand how and why nature-based environments contribute to play quality. This review aims to explore the value of play in nature-based environments compared to non-nature-based environments for developmental outcomes of young children (2-8 year). We searched for studies that investigated the relation between play and nature-based environments on the databases PsycINFO, ERIC, and Web of Science. Inclusion/exclusion criteria were: (1) the study focused on play in/on a nature based environment, (2) the study included participants between the age of 2-8 years, (3) it was an empirical study, (4) the study was conducted in the context of early childhood education (ECE), and (5) the study included participants without special needs or disabilities. Using these criteria we selected 28 qualitative studies with an overall sample size of N = 998 children aged 2-8 years. The studies were synthesized using an adaptation of Noblit and Hare's meta-ethnographic approach. Three overarching themes were found: (1) the aspects of play quality that are related to nature-based environments, (2) the aspects of nature-based environments that support play, and (3) the aspects of teacher-child interactions that contribute to nature play quality. The meta themes resonate with play theories and theories of the restorative value of nature. We draw on the qualitative data to refine and extend these theories, and to come up with a definition of the concept "nature play." This systematic review also sets a base for future research on play interventions in nature-based environments. We argue that (1) research will benefit from thoroughly conceptualizing the role of play in the development of young children, (2) using the affordances theory research will benefit from moving beyond the individual play actions as a unit of analysis, and (3) from an educational perspective it is important to shift the focus of nature play to its benefits for children's cognitive development.

Project description:INTRODUCTION:Living with an altered facial appearance as a result of treatment for cancer requires considerable psychological adjustment. As such it is essential that health care professionals understand the lived experience of people affected. This systematic review provides a meta-ethnography of studies that have explored the experience of changed facial appearance as a result of cancer. METHODS:A search of four databases (Web of Science, CINAHL, PsycInfo, and Scopus) took place using terms relating to qualitative research, cancer, and changed facial appearance. Thirteen studies were identified, appraised, and included in the synthesis. The findings and interpretations within the studies were subject to meta-ethnography procedures so as to elicit novel cross-cutting themes. FINDINGS:The experience of changed facial appearance after cancer was clustered into three contexts. In the context of the disease, subthemes were the primacy of survival, the changing relationship with the disease, and the impact of the care team on the experience of changed appearance. In the context of the social world, subthemes were positive reactions, negative reactions, and coping strategies. In the context of the self, subthemes were the self under attack, self-to-self relating, the self in the world, and rebuilding the self. CONCLUSIONS:The findings indicate that health care professionals must conduct holistic assessments, so as to fully recognize and where necessary address the impact upon self. The meta-ethnography shows that the experience of facial appearance change following cancer is complex and requires awareness of a number of theoretical areas including identity construction, social support, stigmatization, and the specific literature on visible difference. Statement of contribution What is already known on this subject? Changed facial appearance after cancer can cause significant social difficulties and impact on the sense of self. The experience of managing the specific dual challenges of cancer and altered facial appearance is not clearly understood. Recent studies that have focused specifically on the experience of changes in appearance after cancer have been limited in scope and transferability. What does this study add? To our knowledge, this is the first meta-ethnography to bring together the literature on the impact of altered facial appearance following cancer. Patients may feel unable to talk about appearance with health care professionals because it is seen as a frivolous issue. Clinicians should facilitate open, person-centred opportunities for patients to discuss the impact of changed appearance and where necessary facilitate access to support.

Project description:BACKGROUND:The interest for qualitative research methodology has expanded beyond theoretical academic research on medical education, gathering interest from all healthcare professionals. Qualitative research has potentials in exploring the social, emotional, psychological aspects of care and in broadening professionals' scientific competencies. Nonetheless, qualitative research has still not been embraced within formal and academic curricula for future professionals, preventing newer generations from appreciating the value of its epistemological and methodological aspects and from using it in the development and implementation of clinical research. The purpose of this study was to comprehend the attitudes of health professionals learning and conducting qualitative studies within a practical training program developed in their workplace. METHODS:The present work consisted of a focused ethnography, including 14 professionals during their one-year attendance training on qualitative research methodology. Strategies used for collecting data included participant observations, field notes, semi-structured interviews, and a focus group. All the data were analyzed consistently with ethnographic indications. RESULTS:Analyses allowed us to evidence the educational, motivational, group-related and organizational factors influencing the attitudes and skill acquisition of healthcare professionals learning and conducting qualitative research within a practical training program developed in their workplace. Prior educational background was perceived as a sort of barrier. Nonetheless, the training boosted a change in attitude both in terms of appreciation of the research approach and trainees' emotional involvement with research participants. Doing a qualitative study in a multidisciplinary team raised in-group dynamics that hindered bringing the studies to conclusion. Trainees repeatedly lamented the difficulty in managing time to devote to research-related activities and questioned the feasibility of adopting this methodology for conducting research in their workplace. CONCLUSIONS:Continual education training on the methodological aspects and practical implications of qualitative research may foster a renewed attitude towards one's professional education, while making inter-professional relationship issues emerge. Nonetheless, broadening the perspectives of professionals on their clinical practice by means of learning qualitative methodology may have an evident quality improvement return. Strategies for future qualitative research methodology hands-on training addressed to health professionals in continuing education are proposed.

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Experiencing and responding to chronic cancer-related fatigue: A meta-ethnography of qualitative research.

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Experiencing and responding to chronic cancer-related fatigue: A meta-ethnography of qualitative research.

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