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The funders had no role in considering the study design or in the collection, analysis, interpretation of data, writing of the report, or decision to submit the article for publication. Competing interests: I have read the journal’s policy and the authors of this manuscript have the following competing interests: EL is head of research for the BMJ; MJP is an editorial board member for PLOS Medicine; ACT is an associate editor and MJP, TL, EMW, and DM are editorial board members for the Journal of Clinical Epidemiology; DM and LAS were editors in chief, LS, JMT, and ACT are associate editors, and JG is an editorial board member for Systematic Reviews. [...]technological advances have enabled the use of natural language processing and machine learning to identify relevant evidence,[22–24] methods have been proposed to synthesise and present findings when meta-analysis is not possible or appropriate,[25–27] and new methods have been developed to assess the risk of bias in results of included studies. Summary points * To ensure a systematic review is valuable to users, authors should prepare a transparent, complete, and accurate account of why the review was done, what they did, and what they found * The PRISMA 2020 statement provides updated reporting guidance for systematic reviews that reflects advances in methods to identify, select, appraise, and synthesise studies * The PRISMA 2020 statement consists of a 27-item checklist, an expanded checklist that details reporting recommendations for each item, the PRISMA 2020 abstract checklist, and revised flow diagrams for original and updated reviews * We anticipate that the PRISMA 2020 statement will benefit authors, editors, and peer reviewers of systematic reviews, and different users of reviews, including guideline developers, policy makers, healthcare providers, patients, and other stakeholders Development of PRISMA 2020 A complete description of the methods used to develop PRISMA 2020 is available elsewhere.

Aim Nurses play roles in hospitals, families, society and other aspects and often face stress sources, such as heavy workload, doctor–patient conflict and medical accidents. Resilience can help the nurses to avoid or reduce various adverse consequences caused by stress sources; however, this phenomenon remains ill‐defined and under‐researched. The aim of this review was to summarize the experiences of development of nurses' resilience and explore the reasons for the formation of resilience by examining the findings of the existing qualitative studies. Design The review is a systematic review and meta‐synthesis of qualitative studies. Data Sources PubMed, Cochrane Library, CINAHL, Web of Science, Embase, and Ovid and Chinese databases include the following: Chinese National Knowledge Infrastructure (CNKI), Wanfang Database (CECDB), VIP Database and China Biomedical Database (CBM). Review Methods Relevant publications were identified by systematic searches across 11 databases in June 2021. All qualitative and mixed‐method studies in English and Chinese that explored the experiences of development of nurses' resilience were included. The qualitative meta‐synthesis followed the Preferred Reporting Items for Systematic Reviews and Meta‐Analyses (PRISMA) recommendations. Two independent reviewers selected the studies and assessed the quality of each study. Meta‐synthesis was performed to integrate the results. Results A total of nine studies revealed 10 sub‐themes and three descriptive themes: being psychologically strong, physical positive coping and adoption of external support. Conclusion Several factors contributed to the development of nurses' resilience, and various supporting strategies in the nursing management and education are helpful to their adaption ability. However, it is necessary to focus on the cultivation of nurses' resilience to improve the quality of clinical nursing. Leaders or organizations are required to establish and sustain multifaceted strategies to improve nurse’ resilience through scientific resilience training programmes and improved organizational support.

The term Metaverse has received much attention in various industries, in society, and, increasingly, in scientific communities. This creates demand for a comprehensive and broadly accepted definition of the subject, which is well grounded in research. At the same time, the Metaverse is rather a vision under evolution than an examinable phenomenon. Therefore, this study applied an adapted version of the meta-synthesis method to analyze the existing literature and distill a proposal for a Metaverse definition. The adapted method takes the nature of the subject into account by weighing younger publications with many citations over older, less influential documents. Initially, 47 publications were fed into the process, of which 24 were left after the primary analysis. As a result of the analysis, the following definition is proposed: “The Metaverse is an interconnected web of ubiquitous virtual worlds partly overlapping with and enhancing the physical world. These virtual worlds enable users represented by avatars to connect and interact with each other, to experience and consume user-generated content in an immersive, scalable, synchronous and persistent environment. An economic system provides incentives for contributing to the Metaverse.” The meta-synthesis method ensures a systematic and reproducible approach while at the same time preserving the original voice and notion of the analyzed literature in order to create new knowledge based on the existing literature; thus the proposed Metaverse definition might serve as a helpful foundation for future research.

Background Scoping reviews are a relatively new approach to evidence synthesis and currently there exists little guidance regarding the decision to choose between a systematic review or scoping review approach when synthesising evidence. The purpose of this article is to clearly describe the differences in indications between scoping reviews and systematic reviews and to provide guidance for when a scoping review is (and is not) appropriate. Results Researchers may conduct scoping reviews instead of systematic reviews where the purpose of the review is to identify knowledge gaps, scope a body of literature, clarify concepts or to investigate research conduct. While useful in their own right, scoping reviews may also be helpful precursors to systematic reviews and can be used to confirm the relevance of inclusion criteria and potential questions. Conclusions Scoping reviews are a useful tool in the ever increasing arsenal of evidence synthesis approaches. Although conducted for different purposes compared to systematic reviews, scoping reviews still require rigorous and transparent methods in their conduct to ensure that the results are trustworthy. Our hope is that with clear guidance available regarding whether to conduct a scoping review or a systematic review, there will be less scoping reviews being performed for inappropriate indications better served by a systematic review, and vice-versa.

Background Healthcare workers across the world have risen to the demands of treating COVID-19 patients, potentially at significant cost to their own health and wellbeing. There has been increasing recognition of the potential mental health impact of COVID-19 on frontline workers and calls to provide psychosocial support for them. However, little attention has so far been paid to understanding the impact of working on a pandemic from healthcare workers’ own perspectives or what their views are about support. Methods We searched key healthcare databases (Medline, PsychINFO and PubMed) from inception to September 28, 2020. We also reviewed relevant grey literature, screened pre-print servers and hand searched reference lists of key texts for all published accounts of healthcare workers’ experiences of working on the frontline and views about support during COVID-19 and previous pandemics/epidemics. We conducted a meta-synthesis of all qualitative results to synthesise findings and develop an overarching set of themes and sub-themes which captured the experiences and views of frontline healthcare workers across the studies. Results This review identified 46 qualitative studies which explored healthcare workers’ experiences and views from pandemics or epidemics including and prior to COVID-19. Meta-synthesis derived eight key themes which largely transcended temporal and geographical boundaries. Participants across all the studies were deeply concerned about their own and/or others’ physical safety. This was greatest in the early phases of pandemics and exacerbated by inadequate Personal Protective Equipment (PPE), insufficient resources, and inconsistent information. Workers struggled with high workloads and long shifts and desired adequate rest and recovery. Many experienced stigma. Healthcare workers’ relationships with families, colleagues, organisations, media and the wider public were complicated and could be experienced concomitantly as sources of support but also sources of stress. Conclusions The experiences of healthcare workers during the COVID-19 pandemic are not unprecedented; the themes that arose from previous pandemics and epidemics were remarkably resonant with what we are hearing about the impact of COVID-19 globally today. We have an opportunity to learn from the lessons of previous crises, mitigate the negative mental health impact of COVID-19 and support the longer-term wellbeing of the healthcare workforce worldwide.

Background Qualitative synthesis approaches are increasingly used in healthcare research. One of the most commonly utilised approaches is meta-ethnography. This is a systematic approach which synthesises data from multiple studies to enable new insights into patients’ and healthcare professionals’ experiences and perspectives. Meta-ethnographies can provide important theoretical and conceptual contributions and generate evidence for healthcare practice and policy. However, there is currently a lack of clarity and guidance surrounding the data synthesis stages and process. Method This paper aimed to outline a step-by-step method for conducting a meta-ethnography with illustrative examples. Results A practical step-by-step guide for conducting meta-ethnography based on the original seven steps as developed by Noblit & Hare (Meta-ethnography: Synthesizing qualitative studies.,1998) is presented. The stages include getting started, deciding what is relevant to the initial interest, reading the studies, determining how the studies are related, translating the studies into one another, synthesising the translations and expressing the synthesis. We have incorporated adaptations and developments from recent publications. Annotations based on a previous meta-ethnography are provided. These are particularly detailed for stages 4–6, as these are often described as being the most challenging to conduct, but with the most limited amount of guidance available. Conclusion Meta-ethnographic synthesis is an important and increasingly used tool in healthcare research, which can be used to inform policy and practice. The guide presented clarifies how the stages and processes involved in conducting a meta-synthesis can be operationalised.

Aim To systematically review and synthesize the findings of qualitative research on the unmet rehabilitation needs of colorectal cancer survivors (CRC) after surgery. Design A qualitative meta‐synthesis registered with PROSPERO (CRD42022368837). Methods CNKI, Wanfang Data, PubMed, Scopus, Embase, Cochrane, Medline, PsychINFO and CINAHL were systematically searched for qualitative studies on the rehabilitation needs of CRC survivors after surgery from the inception of each database to September 2022. Results A total of 917 relevant reports were initially collected and 14 studies were finally included. A total of 49 needs were extracted and divided into 15 categories in 6 integrated findings: (1) the need to adopt healthy eating habits; (2) the need for exercise motivation and exercise guidance; (3) the conflicting needs to return to work; (4) unaddressed physiological needs; (5) spiritual needs; (6) the need for multi‐dimensional social support. Patient or Public Contribution Not applicable.

Background and purpose The impact of subthalamic nucleus deep brain stimulation (STN‐DBS) on caregivers' burden is understudied. We perform a systematic review and meta‐synthesis aggregating qualitative studies involving partners of people with Parkinson disease (PwP) to explore their experiences and unmet needs. Methods A systematic review for retrieving qualitative studies included six databases: MEDLINE, Embase, CINAHL, Cochrane, PsycInfo, and Scopus. Inclusion criteria were as follows: (i) studies on the experience of caregivers of PwP in the context of STN‐DBS, (ii) English peer‐reviewed articles, and (iii) qualitative or mixed methods studies reporting caregivers' quotations. After the appraisal of included studies, we performed meta‐synthesis of qualitative findings. Descriptive themes and conceptual elements related to PwP partners' experiences and unmet needs were generated. Results A total of 1108 articles were screened, and nine articles were included. Three categories were identified: (i) dealing with Parkinson disease (PD) every day (the starting situation characterized by the impact of PD on ordinary life; the limitations to partners' socialization; partners' efforts in stepping aside for love and care activities), (ii) facing life changes with STN‐DBS (the feeling of being unprepared for changes; the fear and concern due to loved ones' behavioral changes; struggling to find an explanation for those changes), and (iii) rebuilding the role of caregiver and partner after STN‐DBS. Conclusions This meta‐synthesis elucidates concerns, challenges, and unmet needs of partners of PwP who underwent STN‐DBS. It is important to provide them with information, education, and adequate support to face these challenges. Professionals need to involve partners in the care and decision process, because STN‐DBS‐related outcomes do not depend solely on the well‐being of PwP but also on the well‐being of individuals surrounding them.

Background Young people have a higher prevalence of loneliness than other age groups, and they are also at risk of depression. Quantitative studies describe a bidirectional association between loneliness and depression, but there is limited understanding of how these influence each other. Little is known about the experience of loneliness among young people with depression. Qualitative approaches may help understand the relationship between loneliness and depression among young people, and how to intervene to improve outcomes. We aimed to conduct a meta-synthesis to understand the complex inter-relationship between loneliness and depression among young depressed people by synthesising evidence from a systematic review of qualitative studies. Methods We conducted a meta-synthesis of qualitative studies capturing experiences of loneliness among young people with depression. We systematically searched six electronic databases for selected search terms, critically appraised eligible studies, and analysed the data from included studies using the approach of thematic synthesis. We used feedback from an inter-disciplinary research workshop to improve reflexivity. Results Our inclusion criteria identified fourteen studies. Our analysis identified four themes: (1) social withdrawal due to poor mental health, (2) non-disclosure of depression contributing to social distance, (3) the desire to connect, and (4) paradoxes of loneliness and depression. These themes illustrated a range of pathways between depression and loneliness, and a sense of how these might be mutually reinforcing. Our findings suggest that where depressed individuals engage in certain behaviours (withdrawing; not confiding) for a range of reasons, this can lead to feelings of loneliness, an awareness of which worsens their mood, thus perpetuating their depression. Conclusions Young people with depression experience loneliness as an insurmountable distance between themselves and others. Our findings identified non-disclosure of depression, and the debilitating nature of the depressive symptomatology, as factors perpetuating a vicious cycle of loneliness and depression. They suggest that approaches to tackling the problem might include helping young people communicate about their depression to trusted friends and educating their social networks in how to support them. The wider research literature suggests that cognitive interventions may have a role in shifting maladaptive cognitions about their social world.

Purpose Given the global trajectory toward an aging population, renewed interest in the phenomena of self‐neglect is needed if relevant stakeholders are to be adequately prepared for an expected increase in the number of elder self‐neglect cases. This current study is designed to systematically review and synthesize the qualitative literature on the perspectives and experiences of older adults living with self‐neglect. Design A narrative meta‐synthesis was used. Methods Six English databases (PubMed, Web of Science, CINAHL Plus, Scopus, Embase, and PsycINFO) were comprehensively searched from inception to May 2022. The thematic synthesis method was applied to analyze and synthesize the findings of the included studies. The Critical Appraisal Skills Programme qualitative checklist was applied to evaluate the quality of the included studies. Findings A total of six qualitative studies were finally included with four studies conducted in the United States, one in Israel, and one in Ireland. Through meta‐synthesis, five analytical themes were identified: attributes of self‐neglect, life shaped by misery, insufficient social networks and resources, self‐protection and preservation, and anchoring beliefs and practices. Conclusions This qualitative synthesis provides profound insights into the self‐neglect phenomenon from the standpoint of older adults with self‐neglect and can provide guidance to relevant stakeholders on how to address elder self‐neglect cases with respect to its assessment, reporting and management. Future research across geographical locations on the experiences of older adults with self‐neglect are needed to provide a more global understanding of this significant and emerging public health issue. Clinical relevance The development of future self‐neglect management practices based on medical and sociocultural models of care can focus on supporting self‐neglecters with positive coping mechanisms and supporting service providers with spiritual care competencies to ensure interventions achieve ethical principles of autonomy, beneficence, and nonmaleficence.