Understanding the barriers and facilitators of commercial sexual exploitation can inform the development of interventions that address the needs of CSEY and youth at risk for exploitation. The results of this review highlight the social and economic influences as well as the role of positive and negative reinforcements involved in sex work entry, its continuation, and exit. Needs for services, research, and advocacy are also discussed.
Introduction: The human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS) is a major public health problem that has claimed the lives of more than 34 million people worldwide. The health of people living with HIV (PLWH) is optimized by ongoing engagement in HIV care, yet many people living with HIV either do not enter or fall out of care. Access to care and ongoing engagement in care for antiretroviral (ARV) medication adherence and psychoeducational support are critical to achieving the desired outcomes of reducing the risk of further HIV transmission and HIV related morbidity and mortality, and managing other commonly co-occurring health, social and behavioral conditions, thereby maximizing wellness. Objective: The objective of the review was to identify, evaluate and synthesize existing qualitative evidence on the experiences of HIV-infected adults with healthcare systems/practices/processes, and the experiences of healthcare providers with healthcare systems/practices/processes that impact engagement in primary healthcare settings in the United States (US). Inclusion criteria: The review included studies reporting on the qualitative experiences of HIV-infected adults, aged 18–65 years, with healthcare systems, practices and processes and their healthcare providers (physicians, nurses and others providing care to these patients in the primary care healthcare setting). Qualitative studies including but not limited to designs such as phenomenology, ethnography, grounded theory, action research and qualitative descriptive were included. Studies published in languages other than English and conducted outside of the US were excluded. Methods: Using a three-step search strategy, databases of published and unpublished articles were searched from 1997 to 2017. All included studies were assessed by two independent reviewers for methodological quality, and data was extracted and pooled using the Joanna Briggs Institute System for the Unified Management, Assessment and Review of Information (JBI SUMARI). Findings were rated according to their level of credibility, categorized based on similarity in meaning and subjected to a meta-synthesis. Results: A total of 1038 qualitative articles were identified of which 41 were included after critical appraisal. Meta-synthesis generated four synthesized findings: i) What I want from my provider: to be a respectful, empathetic and holistic partner in my care; ii) I cannot do it alone: the critical importance of actively guiding and assisting patients during transitions and securing the needed resources; iii) Help me to understand my illness and care needs; iv) One-stop care that is de-stigmatizing and welcoming to diverse cultures keeps clients in care. These synthesized findings were derived from 243 study findings that were subsequently aggregated into 19 categories. Of the 243 study findings, 240 were rated unequivocal and three were rated credible. The overall ConQual for each of the four synthesized findings was moderate due to common dependability issues across the included studies. A total of 1597 participants were included. Only two studies were included from 1997 to 2000. The majority of included studies were published from 2005 to 2017. Conclusions: The synthesized findings illustrate clear quality indicators for primary care practice, emphasizing the patient-provider-care team partnership and shared decision making that is holistic, takes into account a patient's whole life, responsibilities and stressors, and reframes HIV associated misperceptions/myths. The review also highlights the importance of helping patients navigate and interact with the healthcare system by offering one-stop services that assist with multiple medical care needs and “wraparound” services that provide the needed care coordination to assist with critical quality of life needs such as food, housing, transportation, and assistance with applying for health insurance and medication.
Objective: The objective of this review is to assess the association between workplace bullying and nurse burnout. Introduction: Internationally, workplace bullying has been linked to nurse burnout. Burnout is of significant concern due to its association with nurses’ intent to quit, job dissatisfaction, reduced empathy and patient satisfaction. While there have been systematic reviews conducted on workplace bullying, none have explored its association with nurse burnout. Inclusion criteria: This review will consider studies that include licensed nurses in any clinical setting in any country. Only studies in which the Negative Acts Questionnaire-Revised was used to measure licensed nurses’ exposure to workplace bullying and in which the Maslach Burnout Inventory was used to measure burnout (i.e. the outcome of interest) will be considered. Prospective and retrospective cohort studies, case-control studies and analytical cross-sectional studies will be considered for inclusion. Methods: Key information sources to be searched for studies in English from 1990 to the present include CINAHL, Embase, PsycINFO, PubMed and Scopus. Two independent reviewers will screen titles, abstracts and full texts of selected citations against the inclusion criteria and appraise for methodological quality. Two reviewers will independently use the standardized data extraction tool to extract data from studies used in the review. Studies will, where possible, be pooled in a statistical meta-analysis. Where statistical pooling is not possible, the findings will be presented in narrative form including tables and figures to aid in data presentation, where appropriate. Systematic review registration number: PROSPERO CRD42019128798
The aim of this qualitative systematic review is to explicate the experiences of stigma among family members of persons living with schizophrenia in any setting where they receive care. More specifically, the review will: (i) describe the experiences of stigma among family members of persons living with schizophrenia, (ii) describe the factors that influence the experiences of stigma, and (iii) describe the strategies and approaches used to cope with the stigma.
The objective is to synthesize existing qualitative literature examining the experiences of transgender individuals when accessing health care.
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